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Emergency Med > Oncology > Flashcards

Oncology Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Which type of spine tumors are most common?

A

Metastatic (95%), 50% are from breast, lung, or prostate cancers.
Thoracic spine is MC affected (70%)

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2
Q

While evaluating back pain, what would raise your concern of spinal cord compression due to tumors?

A

Pain worsens when the pt is lying down or w/ vertebral body percussion.
Incontinence and loss of sensory function with late neurologic deficits.
Positive Valsalva, Babinski
DTR’s increased

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3
Q

What subset of cord compression cases has diminished DTR’s, retention, constipation, lower limb flaccidity, and sensory loss of leg and perianal region?

A

Cauda equina syndrome

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4
Q

What type of imaging should be used for suspected spinal tumors?

A

MRI or CT
Lumbar puncture may be necessary
X-rays may reveal lytic changes, but may miss lesions.

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5
Q

What is the treatment for spinal cord compression tumors?

A

IV steroids and possibly radiation or surgery

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6
Q

For what condition might Gamma-knife radiosurgery be indicated?

A

Brain tumors

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7
Q

What is Superior Vena Cava Syndrome (SVCS) [obstruction] usually caused by?

A

Malignancies

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8
Q

What malignancy is the MC cause of SVCS?

A

Bronchogenic carcinoma

can also be caused by thrombosis around an indwelling catheter, or uncommonly a cerebral edema

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9
Q

What are the MC symptoms of SVCS?

A

SOB
Facial or arm swelling
Headache
Edema of the face

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10
Q

What is Trousseau’s sign of malignancy?

A

Episodes of vessel inflammation due to blood clot (thrombophlebitis) which are recurrent or appearing in different locations over time.

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11
Q

What sign is specific for SVCS?

A

Pemberton’s sign
(Development of facial flushing, distended neck and head superficial veins, inspiratory stridor and elevation of the jugular venous pressure (JVP) upon raising both of the patient’s arms above his/her head simultaneously)

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12
Q

What are the items of Beck’s triad and what condition does it indicate?

A

Hypotension
JVD
Muffled heart sounds;
Indicates cardiac tamponade

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13
Q

What ECG finding is seen with cardiac tamponade?

A

Electrical alternans and low voltage of T waves

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14
Q

What is one of the MC complications related to cancer treatment, particularly chemotherapy?

A

Febrile neutropenia

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15
Q

What defines febrile neutropenia?

A

Temp 101F or higher

ANC less than 500 per mm3

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16
Q

Hypercalcemia caused by bone lysis and resorption is MC due to what?

A

Metastatic breast or prostate cancer

17
Q

Hypercalcemia due to cytokine production is MC due to what?

A

Multiple Myeloma

18
Q

What is the normal range of serum calcium?

A

9-10.5 mg/dL

19
Q

What can be produced by a variety of different tumor cells and is MC associated with cancer of the lung, breast, and kidney?

A

Parathyroid hormone related protein (PTHrP)

20
Q

What is the prognosis for hypercalcemia of malignancy?

A

Grave (1 to 2 months)

21
Q

How do you treat hypercalcemia?

A

Saline for dehydration
IV Lasix for Ca excretion
Bisphosphonates

22
Q

What MC causes SIADH?

A

Small cell carcinoma of the lung

23
Q

What lab finding is a hallmark of SIADH?

A

Hyponatremia

24
Q

Tx for SIADH?

A

Fluid intake restriction
Demeclocycline (ADH antagonist)
Tx cancer

25
Q

What is a major risk factor for tumor lysis syndrome?

A

Pre-existing renal dysfunction

26
Q

Who might experience tumor lysis syndrome?

A

Cancer pts w/ large tumor burden that is very sensitive to chemotherapy

27
Q

What is Homan’s sign?

A

Discomfort in the calf or behind the knee on dorsiflexion of the foot

28
Q

What are the SSX of pulmonary embolism?

A

SOB
Chest pain - pleuritic
Apprehension
Tachypnea/tachycardia

29
Q

What are the SSX of hypercalcemia?

A 
Stones (renal or biliary), bones (bone pain), groans
(abdominal pain, nausea and vomiting),
thrones (constipation and polyuria) and
psychiatric overtones (depression 30-40%,
anxiety, cognitive dysfunction, coma).

Emergency Med (8 decks)

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