Oncological emergencies Flashcards by Anna McCallum

What are some oncological emergencies?

Hypercalcaemia
Neutropenic fever
Tumour lysis syndrome
Malignant spinal cord compression
Leucostasis
Raised ICP
Superior vena cava syndrome

How well did you know this?

Not at all

Perfectly

How common is hypercalcaemia?

Affects up to 1/3 cancer patients

How well did you know this?

Not at all

Perfectly

What malignancies are associated with hypercalcaemia?

Lung cancer
Breat cancer
Renal cancer
Mutliple myeloma
T cell lymphoma

How well did you know this?

Not at all

Perfectly

What are the features of hypercalcaemia?

Non specific
N&amp;V, anorexia
Thirst
Bone pain, abdominal pain
Confusion, weakness

How well did you know this?

Not at all

Perfectly

What is the management of hypercalcaemia?

IV fluids

IV bisphosphonates

How well did you know this?

Not at all

Perfectly

What causes neutropenic fever?

Cytpotoxic therapies

Usually ~7 days after last dose

How well did you know this?

Not at all

Perfectly

What are the features of neutropenic fever?

Fever >38.5

Neutrophils <1x10^9

How well did you know this?

Not at all

Perfectly

What is the management of neutropenic fever?

Infection screen
Empirical antibiotics
Antifungals if unresponsive

How well did you know this?

Not at all

Perfectly

What causes tumour lysis syndrome?

Abrupt release of large quantities of cellular components into blood

How well did you know this?

Not at all

Perfectly

What are the characteristics pf tumour lysis syndrome?

Hyperuricaemia
Hyperkalaemia
Hyperphosphataemia
Hypocalcaemia

How well did you know this?

Not at all

Perfectly

What malignancies is tumour lysis syndrome esp associated with?

ALL

Burkitt’s lymphoma

How well did you know this?

Not at all

Perfectly

What is the presentation of tumour lysis syndrome?

Seizures
AKI
Arrythmias

How well did you know this?

Not at all

Perfectly

What is the prevention of tumour lysis syndrome?

Allopurinol

Hydration

How well did you know this?

Not at all

Perfectly

What is the management of tumour lysis syndrome?

Rehydration +/- loop diuretic
Phosphate binder
Dialysis if necessary

How well did you know this?

Not at all

Perfectly

What is leucostasis?

Very high WCC –> decreased tissue perfusion

How well did you know this?

Not at all

Perfectly

What cancers is leucostasis associated with?

ALL

AML

What is the presentation of leucostasis?

High fever
MI, limb ischaemic, DIC, stroke
Resp failure
Intracranial haemorrhage

How many cancer patients does spinal cord compression affect?

up to 5%

What are the common cancers that cause spinal cord compression?

Lung
Breast
Prostate

What ar the features of spinal cord compression?

Back pain- earliest and most common
Lower limb weakness
Sensory changes

What is the management of spinal cord compression?

High dose dexamethasone

Urgent assessment for radio/surgery

What are the common causes of increased ICP?

Mets

HAematoma

What cancers commonly cause brain mets?

Lung
Breast
Melanoma

What is the presentation of increased ICP?

Headache, N&V
Seizures, decreased level of conciousness
Focal neuro deficit

What investigations are done for increased ICP?

CT/MRI

What is the management of increased ICP?

Dexamethasone | Manage cause

What is SIADH associated with?

Small cell lung cancer

What is the presentation of SIADH?

``` Hyponatraemia Lethary Muscle cramps Seizures Neuro signs, deceased level of consciousness ```

What is SVC syndrome?

Mediastinal tumour compression of SVC

What are the common cases of SVC syndrome?

Lymphoma= most common Lung Mets

What is the presentation of SVC syndrome?

``` Oedema Cyanosis Distended veins Ill, anxious Decreased GCS ```

What is the management of SVC syndrome?

Keep upright and urgent referral

What is superior mediastinal syndrome?

Mediastinal tumour compression of trachea

What is the common cause of superior mediastinal syndrome?

Lymphoma

What is the presentation of superior mediastinal syndrome?

Dyspnoea, tachypnoea | Wheeze, cough

What is the management of superior mediastinal syndrome?

Keep upright and calm | Urgent referral