Paraneoplastic Syndromes Flashcards
The paraneoplastic syndrome may be the first sign of a malignancy
The paraneoplastic syndrome may be the first sign of a malignancy
Endocrine:
Ectopic ACTH - cause? effects?
How is it diagnosed?
Small Cell Lung Cancer - Smoking!!!!
Also found in pancreatic tumours
Cushing’s Syndrome - Hirsutism, DM, HTN, Hyperpigmentation (precursor is melanocyte-stimulating hormone), Adrenal hyperplasia
(1) 24 hr urinary cortisol
(2) High plasma ACTH/precursors
(3) High dose dexamethasone suppression test - not suppression as not coming from HPA axis
SIADH:
Common causes?
Lab findings? - 3
Rx?
CNS mainly - Infections, vasculitis, TUMOURS etc.
SCLC aswell
Low Na - due to hypervolaemia - even though you are taking in more sodium
Low serum osmolality - dilute
Urine osmolality > serum osmolality
Fluid restriction
Democlocycline
Gonadotrophins:
Type of tumours?
Main presentation in men?
Gestational trophoblastic tumours
Germ cell tumours
Gynaecomastia
Hypercalcaemia due to PTH-rP:
What does rP stand for?
This happens without bone mets
What type of cancer could cause this?
How will this present?
Diagnosis:
- Is phosphate high or low in the urine?
- PTH is not detected due to suppression - extra production coming from something else
Related peptide
NON-SCLC
SCC of oesophagus
Stones, bones, groans, and psychiatric moans
Polyuria\Polydipsia
Dehydration
Cardiac arrhythmias
HIgh urine phosphate
Encephalomyopathies:
What is it?
Diagnosis:
- CSF
- Serum
Treatment - anti-tumour therapy!
Can be any part of the brain so presents differently in every patient
Perivascular inflammation and selective neuronal degeneration
CSF - raised protein/IgG level
Serum - Anti-Hu antibody, MRI
Lambert Eaton Myasthenic Syndrome:
Describe?
SCLC MAJOR CAUSE!
Presentation?
Diagnosis?
Treatment?
Affects voltage-gated calcium channels - autoimmune
Like MG - proximal muscle weakness,
LEMS w/o bulbar involvement as that is mainly CNS
EMG - normal conduction velocity - low muscle activity - nerve conduction study normal
Cholinesterase inhibitors - stops the breakdown of acetylcholine - increased stimulation of NMJ
Dermatomyositis/Polymyositis:
Proximal myopathy
Skin changes
Other systemic features: cardiopulmonary conditions, arthralgias, retinopathy
Dermatomyositis/Polymyositis:
Proximal myopathy
Skin changes
Other systemic features: cardiopulmonary conditions, arthralgias, retinopathy
Haematological manifestations?
Polycythaemia - ectopic EPO
Anaemia - CC
Thrombocytosis (inflammatory involvement of cancer)
DIC and coagulopathies
