Oncological emergencies Flashcards
What are the investigations and treatments for SVC obstruction?
Investigations - Chest x ray and CT.
Treatment - Dexomethasone, PPI cover, oxygen and IV fluids. Definitive will be svc stent, chemo or radiotherapy
When should you be careful about using DOACs in a cancer patient?
Patients with GI malignancy as they are high risk of bleeding.
What is the definition of neutropenic sepsis and the treatment?
Neutrophil count < 0.5 in a patient with temp > 38 or signs of sepsis.
Treatment - Start sepsis 6 and Tazocin. Call oncology about Granulocyte colony stimulating factor (GCSF)
What are the investigations and management of suspected brain mets?
Investigations - Head CT with contrast then MRI head.
Treatment - Give dexamethasone and advise not to drive
What cancers often metastases to the brain?
Lung, renal, breast and melanoma
What is the investigations and management of spinal cord compression?
Investigations - whole spine MRI.
Treatment - Dexamethasone and spinal sergury.
What are the investigations and management of cancer bowel obstruction?
Investigations - Abdominal X ray and abdo CT.
Treat - Steroids, Analgesia, IV fluids, NG tube if vomiting. Can stop antihypertensives if dry
What are the investigations and treatment for immunotherapy mediated colitis
Investigations - 3x stool cultures, abdo x ray, flexible sigmoidoscopy.
Treatment - IV methylprednisolone
when and how do you wean steroids?
When - if patients are on steroids > 3 weeks.
How - Reduce dose by 25% each week
What are some side effects of steroids?
Acute - agitation, gastritis, hyperglycaemia.
Chronic - osteoporosis, cushingoid, proximal myopathy, adrenal suppression
What are is the presentation and treatment of tumour lysis syndrome?
Presentation - high potassium, uric acid, phosphate and low calcium.
Treatment - IV fluids, allopurinolor rasburicase
