L18: Ontological Complications Flashcards
What is a metastatic spinal cord compression
When cancer spreads via blood to the bone and this leads to collapse or compression of the vertebral bodies
What are the symptoms of metastasic spinal cord compression
Backpain Increase in cough/streaining Neurological symptoms: limb weakness, difficulty walking Sensory loss Bladder and bowel dysfunction
How do we investigate for metastasic spinal cord compression
MRI
What does the immediate management of mscc involve
Steroids e.g dexamethasone with ppi to reduce the risk of upper gi bleed
Analgesia - strong opiates
Stabilise the spine
What is the definitive management of mscc
Radiotherapy
Surgery
Chemotherapy
Rehabilitation
To prevent mscc what can we give to the patients
Bisphonates
Denosumab
What are the signs of superior vena cava obstruction
Dilated veins
Red face
Which cancer is most likely to present with superior vena cava obstruction
Lung cancer
What are the symptoms of superior vena cava obstruction
Shortness of breath Cough Fascial swelling Arm swelling Prominent veins
How to we investigate for svco
CT scan with contrast
What is the management of superior vena cava obstruction
Streoids- to decrease swelling of obstruction
Anticoagulation
Stenting the obstruction
Radiotherapy
What are the diagnostic criteria for neutropenic sepsis
Neutrophils less than 0.5x10^9
Patient is having a anti cancer treatment
Temperature above 38
Other signs of sepsis
What is the treatment for neutropenic sepsis
Treat as you are treating sepsis- sepsis 6
Antibiotics: gentamicin and tazocin
What are the symptoms of hypercalcaemia
Bones, stones, groans and moans:
- calcium released by bones
- renal stones- renal colic pain
- groans: abdominal pain, vomiting, constipation and weight loss
- moans: depression, tiredness and confusion
What are the causes of hypercalcaemia
Malignancy due to:
- osteolytic bone tumour often bone metastases
- myeloma
- parathyroid hormone secreated by squamous cell lung cancer or breast cancer
What is the treatment fo hypercalcaemia
Iv fluid
Bisphosonates
Pamidtroanate
Treatmetn of underlying malignnacy
What does an adrenal carcinoma cause
Acth independent cushings syndrome
What does small cell lung cancer and adrenal cancer cause
Acth dependent cushings syndrome
What are the symptoms of cushing syndrome
weight gain Mood change Weakness Acne Hirtusim Irregular periods Erectile dysfunction
What are the signs of cushings syndrome
Moon face Striae Bruises Hypertension Hyperglycaemia
What is lambert eaton syndrome
an autoimmune condition associated with small cell lung cancer
Why does lambert earton syndrome occur
Due to formation of antibodies against the pre-synaptic voltage gated calcium channels
What are the symptoms of lambert eaton syndrome
Difficulty walking
Double vision
Autonomic symptoms: dry mouth, constipation and impotence
What is the treatment of lambert eaton syndrome
Diaminopyridine
Iv immunoglobulin
Treating the underyling cancer
