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Oncology > Oncological Emergencies > Flashcards

Oncological Emergencies Flashcards

1
Q

What percentage of cancer patients develop metastatic spinal cord compression (MSCC)?

A

5%

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2
Q

What percentage of cancer diagnoses are based off the first presentation being a MSCC?

A

20%

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3
Q

Which cancers commonly metastasise to bone and develop MSCC?

A

Breast
Lung
Prostate
Kidney

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4
Q

What percentage of MSCC occurs in the; Thoracic spine?

A

60%

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5
Q

What percentage of MSCC occurs in the; Lumbosacral spine?

A

30%

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6
Q

What percentage of MSCC occurs in the; Cervical spine?

A

10%

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7
Q

What are the red flag signs for back pain to be aware of?

A
  • Band-like pain around the back
  • Pain is poorly responsive to treatment
  • Heavy legs or altered sensations in the legs
  • Worse on lying flat
  • Agonising pain
  • Gait disturbance
  • Grossly disturbed sleep
  • History of Cancer
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8
Q

What would be the immediate management for MSCC?

A

16mg stat dose of DEX then 8mg Dexamthasone BD

Omeprazole for cover (or any PPI)

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9
Q

What investigation would you arrange for someone presenting with acute MSCC and in what time frame?

A

MRI whole spine in 24hours of presentation

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10
Q

What would you always consider in a known cancer patient presenting with an acute febrile illness who is receiving chemotherapy?

A

This MUST be considered to be neutropenic sepsis until proven otherwise!!!

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11
Q

What would be your immediate management of a patient with suspected neutropenic sepsis?

A
  1. A-E approach
  2. Inform senior
  3. Initiate the SEPSIS 6
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12
Q

What is the Sepsis 6?

A
  1. Give O2 (if necessary)
  2. Cannulate - take blood cultures
  3. Measure lactate
  4. Give broad spectrum IV Abx via cannula (e.g. Tazocin and meropenem)
  5. Give IV fluids
  6. Measure urine output
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13
Q

What other investigations might you want to perform in a patient presenting with suspected neutropenic sepsis?

A
  1. Samples for culture - urine, bloods, sputum (if indicated), CSF (if indicated)
  2. ABG - lactate and to check for acidosis or alkalosis
  3. CXR (if indicated)
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14
Q

How quickly should IV Abx be administered to a patient with suspected neutropenic sepsis?

A

Within 1 hour of presenting

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15
Q

If a known cancer patient presented with the following, what is your main diagnosis and what would your management be; Neck and face swelling. headache, blurred vision?

A

Superior vena cava obstruction (SVCO)

  1. A-E assessment
  2. Steroids
  3. Stent
  4. Chemotherapy or radiotherapy
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16
Q

What scan is required to confirm a SVCO?

A

CT scan with contrast

Oncology (7 decks)

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