Oncological Emergencies

Question 1

In neutropenic fever, MASCC score >21 is indicative of a (LOW/ HIGH) risk patient that doesn’t require hospital admission and expected to last less ghan 7 days.

Answer 1

Low risk patient

Question 2

Ab used to treat gram - ve organism amd MRSA in neutropenic fever.

Answer 2

Carbapenem & cephalosporin

Question 3

Ab used to treat gram +ve organism in neutropenic fever

Answer 3

Vancomycin,
If resistant: linezolid

Question 4

A patient is suspected to have neutropenic fever due to catheter related infection, what is the differential time to positivity needed to confirm the diagnosis?
And what is the management?

Answer 4

DTTP > 2hrs
MANAGEMENT: vancomycin or teicoplanin

Question 5

A cancer patient taking Topoisomerase inhibitors has pneumonia due to neutopenic fever, the causative organism of which is Mycoplasma. What is the antibiotic recommended for this case?
What if the organism was pneumocystis?

Answer 5

For mycoplasma: Macrolide +beta lactam
For pneumocystis: cotrimoxazole (high dose)

Question 6

A cancer patient has neutropenic fever in form of cellulitis, the doctor prescribes him an antibiotic.
what is the recommended antibiotic to use?

Answer 6

Vancomycin

Question 7

What isbthe treatment of a vesicular lesion on top of neutopenic fever?

Answer 7

Acyclovir
Gancyclovir for CMV infection

Question 8

What is the 1st line treatment for candida infection on top of neutopenic fever?

Answer 8

Amphotericin B or caspofungin

Question 9

A patient comes with diarrhea for a few days, has is a known cancer patient.
What is the drug used for him?

Answer 9

Metronidazole,

Question 10

Treatment of bacterial meningitis with neutropenic fever?

Answer 10

Ceftazidime + ampicillin

Question 11

Treatment of viral encephalitis with neutropenic fever

Answer 11

Acyclovir

Question 12

Gold standard inveatigation in diagnosis of spinal cord compression due to cancer.

Answer 12

MRI

Question 13

1st line of treatment in spinal cors compression

Answer 13

Steorids

Question 14

A patient comes in the A&E with superior vena caval obstruction, the doctors want to confirm the diagnosis.
What is the gold standard investigation?

Answer 14

MRI

Question 15

A patient come to the hospital complaining of bone pains and history of kidney stone two days ago that has passed by itself. His corrected calcium is high.
What is the treatment of choice in such case.?

Answer 15

This is a case of hypercalcemia.
Tx is bisphosphonates (zolendronic acid)
With IV saline

Question 16

A cancer patient taking cyclophosphamide has chemotherapy induced cystitis.

What is the management?

Answer 16

Vigorous IV hydration.
Mercaptoethane sulfonate (MESNA) to detoxify Acrolein.