Heme Onc Emergencies

Question 1

Pathogens to cover with antibiotics in acute chest syndrome

Answer 1

S. pneumoniae

Atypicals

Question 2

Treatment of choice for acute chest syndrome

Answer 2

Exchange transfusion

Question 3

Drug that has no role in acute chest syndrome

Answer 3

Hydroxyurea

Question 4

Leukemia associated with gingival hyperplasia, rash, and lymphadenopathy

Answer 4

AML

Question 5

Leukemia associated with bleeding and thrombosis (DIC or hyperfibrinolysis)

Answer 5

APL

Question 6

Leukemia associated with lymphadenopathy, organomegaly, CNS, bone pain, and tumor lysis

Answer 6

ALL

Question 7

Leukemia associated with hypercalcemia and bone lesions

Answer 7

T cell leukemia

Question 8

Treatment for acute promyelocytic leukemia

Answer 8

all trans retinoic acid

Question 9

Condition associated with treatment of APL with all trans retinoic acid

Answer 9

APL differentiation syndrome

Question 10

Presentation of APL differentation syndrome

Answer 10

Fever, leukocytosis, pulmonary infiltrates, and effusions in patient with APL treated with all trans retinoic acid

Question 11

Treatment for APL differentiation syndrome

Answer 11

dexamethasone

Question 12

Common syndrome from CAR T therapy

Answer 12

Cytokine release syndrome

Question 13

Onset of cytokine release syndrome after infusion of CAR T therapy

Answer 13

1 week

Question 14

Treatment for cytokine release syndrome

Answer 14

supportive
Tocilizumab first line
Corticosteroids

Question 15

Treatment of hyperleukocytosis

Answer 15

Leukapheresis first line
Cytoreduction
Cranial irradiation

Question 16

Condition with AMS, dyspnea, and papilledema with retinal hemorrhages

Answer 16

Hyperleukocytosis

Question 17

2 false lab results on ABG in patients with hyperleukocytosis

Answer 17

Pseudohypoxemia

Pseudohyperkalemia

Question 18

Etiology of hyperviscosity syndrome in multiple myeloma

Answer 18

Increased amount of immunoglobulins

Question 19

Condition with sausage like engorgement of the retinal veins

Answer 19

Hyperviscosity syndrome

Question 20

3 classic symptoms of hyperviscosity syndrome

Answer 20

Mucosal bleeding
Neurologic symptoms
Visual symptoms

Question 21

Treatment for hyperviscosity syndrome

Answer 21

Plasmapheresis

Chemotherapy for underlying condition

Question 22

What is produced in lymphoma to cause elevated calcium levels?

Answer 22

Vitamin D (calcitriol)

Question 23

Protein in many cancers that causes increased levels of calcium?

Answer 23

PTH Releated Peptide (PTHRP)

Question 24

3 EKG changes associated with hypercalcemia

Answer 24

QT shortening, T wave flattening

PR and QRS prolongation

Repolarization abnormalities (BBB, brugada syndrome)

Question 25

Primary treatment of hypercalcemia

Answer 25

Fluids

Question 26

Medication for treatment of hypercalcemia

Answer 26

Zolendronic acid or pamidronate

Calcitonin for severe

Question 27

Treatment for hypercalcemia unique to Vitamin D related causes (i.e. malignancy)

Answer 27

Glucocorticoids

Question 28

Standard amount to increase pain medication in acute pain crisis for malignancies

Answer 28

25-50% of morphine equivalent

Question 29

Amount to reduce dose when switching between opioids in chronic use with tolerance

Answer 29

25-50%

Question 30

Medication given to reduce edema in spinal cord compression

Answer 30

corticosteroids

Question 31

Medication used in tumor lysis syndrome if renal failure has developed

Answer 31

Rasburicase

Question 32

Disease that must be tested for before starting rasburicase

Answer 32

G6PD deficiency

Question 33

Electrolytes abnormalities in tumor lysis syndrome

Answer 33

Elevated K, UA, and PO4

Reduced Ca

Question 34

Oncologic emergency characterized by dyspnea, facial swelling, and distended neck and arm veins

Answer 34

Superior vena cava syndrome

Question 35

Are prophylactic antiepileptics recommended in mets to the brain with or without edema?

Answer 35

No