L18: Ontological Complications

Question 1

What is a metastatic spinal cord compression

Answer 1

When cancer spreads via blood to the bone and this leads to collapse or compression of the vertebral bodies

Question 2

What are the symptoms of metastasic spinal cord compression

Answer 2

Backpain
Increase in cough/streaining
Neurological symptoms: limb weakness, difficulty walking
Sensory loss
Bladder and bowel dysfunction

Question 3

How do we investigate for metastasic spinal cord compression

Answer 3

MRI

Question 4

What does the immediate management of mscc involve

Answer 4

Steroids e.g dexamethasone with ppi to reduce the risk of upper gi bleed
Analgesia - strong opiates
Stabilise the spine

Question 5

What is the definitive management of mscc

Answer 5

Radiotherapy
Surgery
Chemotherapy
Rehabilitation

Question 6

To prevent mscc what can we give to the patients

Answer 6

Bisphonates

Denosumab

Question 7

What are the signs of superior vena cava obstruction

Answer 7

Dilated veins

Red face

Question 8

Which cancer is most likely to present with superior vena cava obstruction

Answer 8

Lung cancer

Question 9

What are the symptoms of superior vena cava obstruction

Answer 9

Shortness of breath
Cough
Fascial swelling
Arm swelling
Prominent veins

Question 10

How to we investigate for svco

Answer 10

CT scan with contrast

Question 11

What is the management of superior vena cava obstruction

Answer 11

Streoids- to decrease swelling of obstruction
Anticoagulation
Stenting the obstruction
Radiotherapy

Question 12

What are the diagnostic criteria for neutropenic sepsis

Answer 12

Neutrophils less than 0.5x10^9
Patient is having a anti cancer treatment
Temperature above 38
Other signs of sepsis

Question 13

What is the treatment for neutropenic sepsis

Answer 13

Treat as you are treating sepsis- sepsis 6

Antibiotics: gentamicin and tazocin

Question 14

What are the symptoms of hypercalcaemia

Answer 14

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

Question 15

What are the causes of hypercalcaemia

Answer 15

Malignancy due to:

• osteolytic bone tumour often bone metastases
• myeloma
• parathyroid hormone secreated by squamous cell lung cancer or breast cancer

Question 16

What is the treatment fo hypercalcaemia

Answer 16

Iv fluid
Bisphosonates
Pamidtroanate
Treatmetn of underlying malignnacy

Question 17

What does an adrenal carcinoma cause

Answer 17

Acth independent cushings syndrome

Question 18

What does small cell lung cancer and adrenal cancer cause

Answer 18

Acth dependent cushings syndrome

Question 19

What are the symptoms of cushing syndrome

Answer 19

weight gain
Mood change
Weakness
Acne
Hirtusim
Irregular periods
Erectile dysfunction

Question 20

What are the signs of cushings syndrome

Answer 20

Moon face
Striae
Bruises
Hypertension
Hyperglycaemia

Question 21

What is lambert eaton syndrome

Answer 21

an autoimmune condition associated with small cell lung cancer

Question 22

Why does lambert earton syndrome occur

Answer 22

Due to formation of antibodies against the pre-synaptic voltage gated calcium channels

Question 23

What are the symptoms of lambert eaton syndrome

Answer 23

Difficulty walking
Double vision
Autonomic symptoms: dry mouth, constipation and impotence

Question 24

What is the treatment of lambert eaton syndrome

Answer 24

Diaminopyridine
Iv immunoglobulin
Treating the underyling cancer