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Oncology AM > Oncological emergencies > Flashcards

Oncological emergencies Flashcards

1
Q

What are some oncological emergencies?

A 
Hypercalcaemia
Neutropenic fever
Tumour lysis syndrome
Malignant spinal cord compression
Leucostasis
Raised ICP
Superior vena cava syndrome
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2
Q

How common is hypercalcaemia?

A

Affects up to 1/3 cancer patients

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3
Q

What malignancies are associated with hypercalcaemia?

A 
Lung cancer
Breat cancer
Renal cancer
Mutliple myeloma
T cell lymphoma
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4
Q

What are the features of hypercalcaemia?

A 
Non specific
N&V, anorexia
Thirst
Bone pain, abdominal pain
Confusion, weakness
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5
Q

What is the management of hypercalcaemia?

A

IV fluids

IV bisphosphonates

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6
Q

What causes neutropenic fever?

A

Cytpotoxic therapies

Usually ~7 days after last dose

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7
Q

What are the features of neutropenic fever?

A

Fever >38.5

Neutrophils <1x10^9

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8
Q

What is the management of neutropenic fever?

A

Infection screen
Empirical antibiotics
Antifungals if unresponsive

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9
Q

What causes tumour lysis syndrome?

A

Abrupt release of large quantities of cellular components into blood

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10
Q

What are the characteristics pf tumour lysis syndrome?

A

Hyperuricaemia
Hyperkalaemia
Hyperphosphataemia
Hypocalcaemia

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11
Q

What malignancies is tumour lysis syndrome esp associated with?

A

ALL

Burkitt’s lymphoma

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12
Q

What is the presentation of tumour lysis syndrome?

A

Seizures
AKI
Arrythmias

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13
Q

What is the prevention of tumour lysis syndrome?

A

Allopurinol

Hydration

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14
Q

What is the management of tumour lysis syndrome?

A

Rehydration +/- loop diuretic
Phosphate binder
Dialysis if necessary

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15
Q

What is leucostasis?

A

Very high WCC –> decreased tissue perfusion

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16
Q

What cancers is leucostasis associated with?

A

ALL

AML

17
Q

What is the presentation of leucostasis?

A

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

18
Q

How many cancer patients does spinal cord compression affect?

A

up to 5%

19
Q

What are the common cancers that cause spinal cord compression?

A

Lung
Breast
Prostate

20
Q

What ar the features of spinal cord compression?

A

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

21
Q

What is the management of spinal cord compression?

A

High dose dexamethasone

Urgent assessment for radio/surgery

22
Q

What are the common causes of increased ICP?

A

Mets

HAematoma

23
Q

What cancers commonly cause brain mets?

A

Lung
Breast
Melanoma

24
Q

What is the presentation of increased ICP?

A

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

25
Q

What investigations are done for increased ICP?

A

CT/MRI

26
Q

What is the management of increased ICP?

A

Dexamethasone

Manage cause

27
Q

What is SIADH associated with?

A

Small cell lung cancer

28
Q

What is the presentation of SIADH?

A 
Hyponatraemia
Lethary 
Muscle cramps 
Seizures 
Neuro signs, deceased level of consciousness
29
Q

What is SVC syndrome?

A

Mediastinal tumour compression of SVC

30
Q

What are the common cases of SVC syndrome?

A

Lymphoma= most common
Lung
Mets

31
Q

What is the presentation of SVC syndrome?

A 
Oedema
Cyanosis
Distended veins 
Ill, anxious 
Decreased GCS
32
Q

What is the management of SVC syndrome?

A

Keep upright and urgent referral

33
Q

What is superior mediastinal syndrome?

A

Mediastinal tumour compression of trachea

34
Q

What is the common cause of superior mediastinal syndrome?

A

Lymphoma

35
Q

What is the presentation of superior mediastinal syndrome?

A

Dyspnoea, tachypnoea

Wheeze, cough

36
Q

What is the management of superior mediastinal syndrome?

A

Keep upright and calm

Urgent referral

Oncology AM (6 decks)

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