Oncology Flashcards
Which type of spine tumors are most common?
Metastatic (95%), 50% are from breast, lung, or prostate cancers.
Thoracic spine is MC affected (70%)
While evaluating back pain, what would raise your concern of spinal cord compression due to tumors?
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
What subset of cord compression cases has diminished DTR’s, retention, constipation, lower limb flaccidity, and sensory loss of leg and perianal region?
Cauda equina syndrome
What type of imaging should be used for suspected spinal tumors?
MRI or CT
Lumbar puncture may be necessary
X-rays may reveal lytic changes, but may miss lesions.
What is the treatment for spinal cord compression tumors?
IV steroids and possibly radiation or surgery
For what condition might Gamma-knife radiosurgery be indicated?
Brain tumors
What is Superior Vena Cava Syndrome (SVCS) [obstruction] usually caused by?
Malignancies
What malignancy is the MC cause of SVCS?
Bronchogenic carcinoma
can also be caused by thrombosis around an indwelling catheter, or uncommonly a cerebral edema
What are the MC symptoms of SVCS?
SOB
Facial or arm swelling
Headache
Edema of the face
What is Trousseau’s sign of malignancy?
Episodes of vessel inflammation due to blood clot (thrombophlebitis) which are recurrent or appearing in different locations over time.
What sign is specific for SVCS?
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)
What are the items of Beck’s triad and what condition does it indicate?
Hypotension
JVD
Muffled heart sounds;
Indicates cardiac tamponade
What ECG finding is seen with cardiac tamponade?
Electrical alternans and low voltage of T waves
What is one of the MC complications related to cancer treatment, particularly chemotherapy?
Febrile neutropenia
What defines febrile neutropenia?
Temp 101F or higher
ANC less than 500 per mm3
Hypercalcemia caused by bone lysis and resorption is MC due to what?
Metastatic breast or prostate cancer
Hypercalcemia due to cytokine production is MC due to what?
Multiple Myeloma
What is the normal range of serum calcium?
9-10.5 mg/dL
What can be produced by a variety of different tumor cells and is MC associated with cancer of the lung, breast, and kidney?
Parathyroid hormone related protein (PTHrP)
What is the prognosis for hypercalcemia of malignancy?
Grave (1 to 2 months)
How do you treat hypercalcemia?
Saline for dehydration
IV Lasix for Ca excretion
Bisphosphonates
What MC causes SIADH?
Small cell carcinoma of the lung
What lab finding is a hallmark of SIADH?
Hyponatremia
Tx for SIADH?
Fluid intake restriction
Demeclocycline (ADH antagonist)
Tx cancer
