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Palliative Care Flashcards

1
Q

Tumour marker: Ca15-3

A

breast

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2
Q

Tumour marker: Ca125

A

ovarian

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3
Q

Tumour marker: CEA

A

colorectal (and breast, lung)

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4
Q

Tumour marker: Ca19-9

A

pancreatic

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5
Q

Tumour marker: beta-hCG

A

testicular, gestational trophoblastic (molar pregnancy)

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6
Q

Tumour marker: LDH

A

leukaemia, myeloma, lymphoma, testicular and female germ cell tumours, melanoma

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7
Q

Tumour marker: AFP

A

testicular and female germ cell tumours, hepatocellular carcinoma

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8
Q

Abx for Neutropenic sepsis

A

Tazocin (piperacillin/tazobactam)

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9
Q

When does neutropenic sepsis present?

A

within 6wks of chemotherapy, classically 7-10 days after chemo

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10
Q

Mx of spinal cord compression

A
  • 16mg dexamethasone STAT (and continue regular dex) + PPI cover
  • MRI whole spine within 24h
  • analgesia
  • urgent Mx with radiotherapy or surgery within 24h of MRI
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11
Q

Mx of SVC obstruction

A
  • prop up
  • give oxygen if hypoxic
  • 16mg dexamethasone stat (+ tapering regular dose)
  • chemotherapy or radiotherapy
  • rapid Sx relief: balloon venoplasty and SVC stentint
  • anticoagulation
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12
Q

Mx of hypercalcaemia

A
  • IV rehydration

- IV bisphosphonates (e.g. pamidronate, zolendronic acid)

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13
Q

Mx of brain mets

A
  • urgent CT/MRI if needed
  • 16mg dexamethasone to reduce cerebral oedema
  • radiotherapy
  • discuss with neurosurgery
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14
Q

What is tumour lysis syndrome?

A

occurs with chemotherapy for rapidly proliferative tumours (e.g. leukaemia, lymphoma, myeloma) when a large number of cells die, causing:

high urate, potassium and phosphate, and low calcium

risk of arrythmia and renal failure

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15
Q

Mx of tumour lysis syndrome

A

prevent with hydration and uricolytics e.g. rasburicase, allopurinol

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16
Q

Relative potency of PO vs SC morphine

A

morphine PO = 1

morphine SC = 2

17
Q

Relative potency of PO morphine vs SC diamorphine

A

morphine PO = 1

diamorphine SC = 3

18
Q

Relative potency of PO morphine vs PO codeine

A

morphine PO = 1

codeine PO = 0.1

19
Q

Relative potency of PO morphine vs PO tramadol

A

morphine PO = 1

tramadol PO = 0.1

20
Q

Tumour markers/bloods in teratomas (non seminomatous germ cell tumours)

A
  • AFP (90%)
  • bhCG (90%)
  • LDH
21
Q

Tumour markers/bloods in seminomas

A
  • bhCG (20%)
  • LDH
  • GGT in some
22
Q

Which laxatives should be used in opiate-induced constipation?

A

osmotic laxative (or docusate sodium) plus stimulant

osmotic e.g. lactulose, macrogol

stimulant e.g. senna

Finals (5 decks)

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