Oncologic Emergency

Question 1

3 causes of oncologic emergency?

Answer 1

tumor lysis syndrome
leukostasis
hypercalcemia of malignancy

Question 2

plasma uric acid > __ mg/dL is risk factor for TLS

Answer 2

7.5

Question 3

Cairo Bishop:

TLS is __ or more lab changes within __ days

Answer 3

2, 3

uric acid > 8mg/dL
potassium > 6mEq/L
phosphorous > 4.5 mg/dL
calcium < 7 mg/dL

Question 4

CTLS monitored every __ to __ hours

Answer 4

4, 6

Question 5

High risk of TLS monitored every __ to __ hours

Answer 5

6, 8

Question 6

intermediate risk of TLS monitored every __ to __ hours

Answer 6

8, 12

Question 7

Low risk of TLS monitored how often?

Answer 7

daily

Question 8

All TLS pts should receive IV fluids

a. true
b. false

Answer 8

a. true

Question 9

Avoid potassium, phosphate, and calcium supplementation if medium-high risk for TLS unless symptomatic

a. true
b. false

Answer 9

a. true

Question 10

What is preferred to treat urgent TLS?

Answer 10

rasburicase

can be used for prevention and treatment

Question 11

hyperleukocytosis is WBC > __

Answer 11

50 or 100 (x 10^9/L)

Question 12

What Tx is used for asymptomatic hyperkeukocytosis?

Answer 12

hydroxyurea

can be considered bridging strategy while waiting for results of diagnostic tests

Question 13

mild corrected calcium hypercalcemia levels?

Answer 13

10-5-11.9

Question 14

moderate corrected calcium hypercalcemia level?

Answer 14

12-13.9

Question 15

severe corrected calcium hypercalcemia level?

Answer 15

> = 14

Question 16

What is the mainstay of hypercalcemia treatment?

Answer 16

bisphosphonates

Question 17

bisphophonate onset of action?

Answer 17

24-48 hours

Question 18

bisphosphonate duration of action?

Answer 18

2-4 weeks

Question 19

Use bisphosphonates for Tx with what corrected calcium level?

Answer 19

> = 12

Question 20

Evaluate calcium at 48 hours and redose bisphosphonate when if calcium remains high?

Answer 20

day 7