Oncology Etiology Flashcards
Spinal Cord Compression
Cancers that cause spinal cord compression most commonly metastasize to the vertebral bodies, resulting in physical damage to the spinal cord from edema, hemorrhage, and pressure-induced ischemia to the vasculature of the spinal cord.
Persistent compression can result in irreversible changes to the myelin sheaths resulting in permanent neurologic impairment.
Neutropenic Fever
Infectious agents may be viral, fungal or bacterial
Viral – CMV, HSV, VZV (varicella)
Bacterial – Staph, Strep. Enterococcus, H. flu, E. coli, Klebsiella, Pseudomonas
Fungal – Candida or Aspergillosis
Sites of infection: include central venous access catheter, skin, mouth, sinuses, chest or lung, abdomen, perianal region, and CNS
Hypercalcemia mechanism
Hypercalcemia is caused by one of three mechanisms:
**Systemic effects of tumor-released proteins
Direct osteolysis of bone by tumor
Increased absorption of calcium due to increased active metabolite of Vitamin D**
MC cause is cancer secreting PTH
Patho- This activates the parathyroid hormone receptor, stimulating osteoclastic activity and promoting renal reabsorption of calcium
Hypercalcemia stats
- Cancer secreting PTH is usually a marker of advanced cancer, with median survival ranging from 1 to 3 months. remember there’s other mechanisms for high calcium
- Affects 20-30% of all cancer patients at some point
- MC myeloma, breast, NSCLC lung
LARP + Breasts - Hypercalcemia
Doesn’t include myeloma for some reason
Tumor Lysis Syndrome
: massive release of cellular material including nucleic acids, proteins, phosphorus, and potassium.
Effusions
-may be the initial finding in a patient with cancer
-Pleural, pericardial, or peritoneal space
-may also appear during the course of disease
-MC serous surface with tumor
-Pleural and pericardial effusions MC by lung and breast cancers
Malignant ascites associated with ovarian, colorectal, stomach, and pancreatic cancers.
For cardiac tamponade - The rate of accumulation and distensibility of the sac determine the degree of hemodynamic instability
SVC Syndrome
The result of direct obstruction of the superior vena cava by malignancies such as compression of the vessel wall by right upper lobe tumors or thymoma and/or mediastinal lymphadenopathy
The most common malignancy that causes SVCS is bronchogenic carcinoma
Thromboembolic Event
Several factors make patients with cancer more susceptible to thromboembolic events, including DVT and PE
Malignancy causes a hypercoagulable state
Neoplastic cells and chemotherapy can cause intimal injury
Obstructive tumors cause venous stasis