Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Palliative Care > Emergent conditions > Flashcards

Emergent conditions Flashcards

1
Q

Treatment options for airway obstruction

A

endoscopic options: microdebriedment, radiotherapy ablation, high dose endobronchial radiotherapy, brachytherapy
Trach
Bronchial stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Medications to treat airway obstruction

A

Morphine 20mg/ml solution
lorazepam 2mg solution
SQ midaz
SQ phenobarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

signs and sx of cardiac tamponade

A

Dyspnea
cough
orthopnea
dizziness
hypotension, elevated JVD, pulsus paradoxus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

treatment of cardiac tamponade

A

pericardiocentesis (if not recurrent ie malignant)
For recurrent:
- indwelling catheter
- pericardiostomy
- PERICARDIAL WINDOW
- med intrapericardial with sclerosing agent or antineoplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of massive hemorrhage

A
  • invasion of tumor into vessels
  • Coagulopathy
    – liver disease
    – cancer in bone marrow
    – medications
    – DIC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Interventions for bleeding from surface wound

A

hemostatic dressing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

treatment for bleeding from thrombocytopenia

A

aminocaproic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment for bleeding from hemoptysis

A

bleeding lung down
IV vasopressin or aerosolized vasopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

General approach to treatment for massive hemoptysis

A

stop AC
avoid steroids
endoscopic: banding, sclerotherapy, embolization, radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Adjustment for low albumin when looking at Ca

A

1g alb below 4 add 0.8mg Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of hypercalcemia

A

non-small cell lung cancer, breast, head and neck, RCC, multiple myeloma, t-cell lymphoma
(usually because rPTH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms of hypercalcemia

A

Groans – constipation
moans – fatigue, nausea
bones – bone pain
stones – kidney
psych overtones – depression, confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for hypercalcemia

A

-hydration
- loop diuretics
- bisphosphonate tx
- decrease external Ca
- Denosumab (prostate cancer and breast)
(calcitonin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bisphosphonates for hypercalcemia

A

pamidronate 60-90mg IV
Zolendronate 4mg IV

takes 2-4 days for effect
redose after 1-3 weeks

SE: Osteonecrosis (need dental check before start)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risks for pathologic fractures

A

osteoporosis, bone primary, mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for pathologic fractures

A

Bisphosphonates (osteoporosis and smaller diffuse mets)
Denosumab (met prostate and breast)
ortho (internal stabilization, replacement arthroplasty)
Vertebroplasty (Not really effective)

17
Q

When to avoid surgery in pts with pathologic fractures

A

prognosis <2-4 wks
high risk of failure to stabilize due to bone destruction
infected

18
Q

Common causes of spinal cord compression

A

breast, prostate and lung cancers

19
Q

Symptoms of spinal cord compression

A

pain, paraparesis, paralysis, incontinence
radicular pain wrapping around ribs or down legs
progressive polyneuropathy

20
Q

Physiology of spinal cord compression

A
  1. compression -> edema, venous congestion, demyelination (reversible)
  2. prolonged compression –> infarction (irreversible)
21
Q

Treatment for spinal cord compression

A

Steroids (dex 10mg then 16mg daily with 10-14d taper)
radiotherapy
surgery
Neuropathic adjuvants
IV bisphosphonates
radioisotope (prognosis months with widespread mets)

22
Q

When to recommend surgery for spinal cord compression

A
  • progressive neuro deficits
  • vertebral column instability
  • radio-resistant tumor (lung, colon, RCC)
  • intractable pain not relieved by XRT
23
Q

Causes of seizures

A

cerebral or leptomeningeal malignancy
(metabolic, infection, drugs, withdrawal, intracranial hemorrhage)

24
Q

treatment for nonconvulsive status epilepticus

A
  1. benzos + phenytoin
  2. benzos + valproic acid or barb
  3. levetiracetam or lidocaine
25
Q

Causes of SVC syndrome

A

Tumor in upper mediastinum
Lung Ca or lymphoma

26
Q

Sx of SVC

A

Early: facial plethora, facial and upper extremity edema, distended arm veins
Later: cough, hoarseness, headache, dyspnea, HD compromise

27
Q

SVC treatment

A

Steroids
thrombolytics
chemo
endovascular stenting
raise head of bed

28
Q

Common causes of urinary retention

A

Medications (anticholinergics, alpha adrenergic, opioids)
urethral stricture
lower abdominal tumor
fecal impaction

29
Q

Symptoms of urinary retention

A

oliguria or anuria
restlessness
delirium
diaphoresis
abdominal pain

30
Q

Treatment for urinary retention

A

Catheterization (intraurethral, suprapubic)
+/-indwelling stents, percutaneous nephrostomy
Watch for postobstructive diuresis

31
Q

Cancers that cause pericardial mets

A
  1. Lung cancer
  2. breast ca
  3. lymphoma

(myocardial mets from melanoma)

32
Q

When are steroids helpful for SVC syndrome

A
  1. emergency with severe airway obstruction and cant get stenting
  2. steroid response malignancies (lymphoma or thymoma)

otherwise conservative measures (O2, raising the head of the bed)

Palliative Care (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions