Oncological emergencies - writtens Flashcards
Mx of SVC obstruction
Dexamethasone
Consider stenting
Causes of SVC obstruction
Malignancy: lung cancer, LNs, thymus
SVC thrombosis: due to CVC
Facial plethora
Engorged neck veins
Orthopnea
SVC obstruction
Ix for ?SVCO
- Sputum cytology - LUNG CA
- CXR
- CT
- Venography
Peutz Jeghers
Visible features?
Risk?
Multiple telangiectasia on face, oral mucosa, palms
GI hamartamous polyps
- increased risk of CRC + other Ca
BRCA genes
BRCA 1 = breast + ovarian
BRCA2 = breast
HNPCC - what is it?
Increased risk of CRC (usually R sided)
What is FAP
what surgery do they often have
Autosomal dominant Chr5 mutation
Promotes b-catenin (an oncogene)
- need another mutation eg Kras or p53
Panproctocolectomy + end ileostomy
100% risk of CRC
Most common cancers - top 4
Skin
Breast/prostate
Lung
CRC
Commonest mortality from cancer
Lung
Breast/prostate
CRC
Febrile neutropenia - WCC?
Mx?
PMN <1x10^9
Isolation + barrier nursing
Broad spectrum IV ABx, antifungals, antivirals
COtrimoxazole
Spinal cord compression - presentation?
Ix?
Mx?
LMN @level
Radicular pain
UMN below level
Ix: MRI spine
Mx: Dexamethasone + neurosurgical referral
Specific sign in SVCO?
Pemberton’s sign
- Raise arms for >1 min –> facial plethora, wheeze, raised JVP
Causes of hypercalcemia in malignancy - give 2
PTHrP
Lytic bone mets
Symptoms of hypercalcemia
Confusion Lethargy Polyuria, polydipsia Abdominal pain Constipation Renal stones