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Year 4 Oncology > Oncological complications and treatment > Flashcards

Oncological complications and treatment Flashcards

1
Q

What are the medical complications of N+V

A

Dehydration
Electrolyte disturbances
Risk of aspiration pneumonia

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2
Q

Define acute nausea and vomiting from chemo

A

Within 24 hours of receiving chemo

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3
Q

Define delayed nausea and vomiting with chemo

A

24 hours to 7 days post chemo

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4
Q

What is the most effective way of controlling post chemo nausea and vomiting?

A

NK1 antagonist
5Ht3 antagonist
Dexamethasone

Combination of all is best

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5
Q

Where in the brain is the chemo receptor trigger zone

A

Area postrema

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6
Q

What drug is most effective for acute vomiting

A

5HT3 antagonist (ondansetron or granisetron)

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7
Q

What is anticipatory n+v and how do you treat it

A

Conditioned response to sights and smells

Lorazepam good treatment

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8
Q

Which antiemetic constipate and what would you use instead

A

Ondansetron and cyclisine constipate so use metoclopramide instead

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9
Q

Which opioid would you use in renal impairment

A

Fentanyl

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10
Q

Codeine is what of morphine

A

1/10

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11
Q

Tramadol is what of morphine

A

1/10th to 1/5th

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12
Q

Oxycodone is what of morphine

A

Double the strength

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13
Q

Hydro morphone is how many times stronger than morphine

A

7.5

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14
Q

Methadone is how many times stronger than morphine

A

10

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15
Q

How can you treat myoclonus as a result of opioids

A

Benzos

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16
Q

What is good for bone pain

A

NSAIDS

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17
Q

What is good for pain relief which will stimulate appetite

A

Corticosteroids

18
Q

What is good for neuropathic pain?

A

TCAs/ amitriptylline

19
Q

What is the most common metabolic oncology emergency

A

Hypercalcaemia >2.5mmol/l

20
Q

How does hypercalcaemia present

A 
Dehydration 
Constipation 
Seizure
Weakness 
Myopathy 
Ecg changes 
Polyuria
21
Q

Treat hypercalcaemia

A

2.5-4 litres of saline in 24 hours

Bisphosphonates (IV panidronate)

22
Q

Why does SIADH occur in oncology

A

Chemo or small cell lung cancer

23
Q

What is the main sign on bloods of SIADH

A

<133 mol

24
Q

What’s the criteria for SIADH

A

Normovolaemia
Normal renal adrenal and thyroid function
Urine osmolalityb>100
Urine Na>30
No drugs causing hyponatraemia
Improvement of Na following water restriction

25
Q

Treat SIADH

A

Fluid restrict
Treat cancer
Demeclocycline

26
Q

Radicalar pain in oncology means

A

Cord compression

27
Q

What’s revthe urgent signs of cord compression

A

Loss of bowel or bladder control
Severe or increasing numbness
Severe pain and weakness that spreads into one or both legs making it hard to walk or get out of a chair

28
Q

What are the main symptoms of malignant pericardial effusion

A

Becks triad

29
Q

What are the symptoms of SVC obstruction

A 
Dyspnoea 
Headache 
Facial oedema 
Venous distension 
Light headed 
Cough
30
Q

What is the main aim of investigations in SVC obstruction

A

To distinguish whether the blockage from within (clot; foreign body like in dwelling catheter; tumour in vessel like renal cancer) or out with and compression from mass like lung cancer or lymphoma

31
Q

How do you treat SVC obstruction

A

Stenting or thrombolysiswif clot

32
Q

What is the definition of neutropenia sepsis

A

Sepsis and neutrophils <0.5 (or <1 if chemo given within last 21 days)

Check for neutropenia sepsis if had recently chemo and a fever >38

33
Q

What may mask a temp spike

A

Steroids

34
Q

67% of organisms causing neutropenia fever and gram what

A

Negative

35
Q

Peripheral lines may become infected by what organisms

A

Staph aureus

Coag neg staph

36
Q

Which abx in neutropenia sepsis

A

IV tazocin plus or minus gentamicin

37
Q

If neutropenia sepsis and pen allergy give

A

Teicoplanin and aztreonam

38
Q

What is pancoast syndrome?

A

Apical Lung ca and ipsilateral horners (miosis enophthalmos sunken eye ptosis and unilateral swelling

39
Q

What sort of lung cancer can be treated by radiotherapy

A

NSCLC

40
Q

What is the most common side effect of radiotherapy

A

Tiredness

Year 4 Oncology (23 decks)

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