Oncologic emergencies Flashcards
Spinal Cord Compression- Presentation
Back pain aggravated by lying down, weight bearing, sneezing, coughing. Lower extremity sensory loss, progressive weakness, bowel & bladder dysfunction.
Spinal Cord Compression- Eti
Metastatic solid tumor lymphoma or multiple myeloma. Severe neurologic deficits unreversible
Spinal Cord Compression- Treatment
Dexamethasone- immediately
1 area: Surgical decompression followed by radiation therapy
Multiple: Radiation therapy
Hypercalcemia of malignancy- Presentation
Early: Anorexia, N, polyuria, fatigue, constipation
Late: Musc. weakness, hyporeflexia, confusion, psychosis, tremor
Hypercalcemia of malignancy- Eti
20-30% of CA pts. Commonly due to myeloma, breast carcinoma, non-small cell lung CA.
Hypercalcemia of malignancy- Treatment
Bisphosphate or calcitonin. IV fluids to ensure hydration
Tumor lysis syndrome- Presentation
Acute kidney injury, hyperuricemia, hyperphosphatemia (N/V seizures), hyperkalemia
Tumor lysis syndrome- Treatment
Prevention: aggressive hydration to facilite excretion
Treatment: Allopurinol
PE/ DVT- Presentation
Dyspnea, tachypnea, chest pain with breathing. Leg pain.
PE/ DVT- Treatment
Anticoagulation- Heparin & warfarin
Superior vena cava syndrome- Presentation
Swelling of neck, face, extremities. HA, dizziness, stupor, syncope, visual disturbances, elevated venous press, brawny edema and cyanosis of face, neck and arms. Bending down accentuates symptoms
Superior vena cava syndrome- Treatment
Mediastinal irradiation, IV diuretics, chemotherapy, balloon angioplasty & stent.
Febrile Neutropenia- Presentation
Shaking chills, hypotension, +/- fever, breathing difficulties
Febrile neutropenia- Treatment
Antibiotics + anti fungal if persistently febrile
