Onc

Question 1

Malignant spinal cord compression

Answer 1

Prostate, lung, breast, renal, myeloma
Back pain, weakness, sensory, ?CES
Urgent MRI spine, bladder scan, bone profile, clotting, G&S
Dexamethosone 16mg OD. Thromboprophylaxis. Surgery, radiotherapy, palliative care.

Question 2

Tumour lysis syndrome

Answer 2

Onc emergency - rapid cell breakdown
Lymphoma, leukaemia, fast growing
12-72 hours after chemo
High urate, phosphate and potassium but low calcium
N&V, confusion, cramps, lethargy, low urine, syncope, palps, diarrhoea
ECG, urine dip, bloods
Prevent with IV fluids, allop/rasburi