Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

E CAN ext. > Spinal Cord Compression > Flashcards

Spinal Cord Compression Flashcards

1
Q

Is spinal cord compression a medical emergency?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is required with spinal cord emergency?

A

Swift diagnosis and treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is it important that spinal cord compression receives swift diagnosis and treatment?

A

To prevent long-term disability due to irreversible spinal cord injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is metastatic spinal cord compression?

A

Compression by direct pressure and/or induction of vertebral collapse or instability by metastatic spread or direct extension of malignancy that threatens to cause neurological disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What might cause malignant spinal cord compression?

A
  • Extradural spread from vertebral body metastasis
  • Direct metastasis
  • Vertebral crush fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What cancers most often metastasise to bone and cause spinal cord compression?

A
  • Breast
  • Kidney
  • Thyroid
  • Prostate
  • Lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When are most spinal metastases diagnosed?

A

Most are diagnosed following the diagnosis of the primary cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In what % of cases are spinal metastases the first manifestation of an unknown tumour?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can early detection of spinal cord compression be achieved?

A

You should inform patients at high risk of metastases of the symptoms of spinal cord compression, and advise them of what to do should they develop these symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What symptoms suggest possible spinal metastases?

A
  • Pain in thoracic or cervical spine
  • Severe unremitting or progressive lumbar spine pain
  • Spinal pain aggravated by straining
  • Noctural spinal pain preventing sleep
  • Localised spinal tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What symptoms suggest spinal cord compression?

A
  • Radicular pain
  • Limb weakness
  • Difficulty in walking
  • Sensory loss, or bladder and bowel dysfunction
  • Neurological signs of spinal cord or cauda equina compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What investigation is done in spinal cord compression?

A

MRI imaging of whole spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the purpose of MRI imaging of the whole spine in spinal cord compression?

A

So definitive treatment can be planned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How soon should MRI imaging of the whole spine be performed if clinical features suggest spinal metastasis?

A

Within 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How soon should MRI imaging of the whole spine be performed if clinical features suggest spinal cord compression?

A

Within 24 hours, or sooner (including out of hours) if emergency treatment is needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should management be started for spinal cord compression?

A

As soon as possible after diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the aim of starting treatment as soon as possible after diagnosis in spinal cord compression?

A
  • Minimising permanent damage to the spinal cord

- Reduce pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why might treatment for spinal cord compression reduce pain?

A

If the treatment shrinks the tumour and therefore relieves the pressure on the nerves and spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What factors will the treatment for spinal cord compression depend on?

A
  • Type of cancer
  • Area of spine affected
  • General fitness
20
Q

What are the treatment options for spinal cord compression?

A
  • Steroids
  • Radiotherapy
  • Chemotherapy
  • Surgery
  • Hormonal therapy
  • Drugs that strengthen bones
21
Q

How do steroids work in spinal cord compression?

A

They help reduce pressure and swelling around the spinal cord

22
Q

Who should be given steroids in spinal cord compression?

A

All patients with spinal cord compression unless contraindicated

23
Q

Give an example of a contraindication to steroids in spinal cord compression

A

Significant suspicion of lymphoma

24
Q

What steroid is given in spinal cord compression?

A

Dexamethasone

25
Q

What dose of dexamethasone should be given in spinal cord compression?

A

16mg loading dose, followed by short course of 16mg daily while treatment is being planned

26
Q

When should the loading dose of dexamethasone be given in spinal cord compression?

A

As soon as possible after assessment

27
Q

What should happen to the dose of steroids after surgery or the start of radiotherapy in spinal cord compression?

A

It should be gradually reduced over 5-7 days and stopped

28
Q

What should be done to the dose of steroids if the neurological function deteriorates at any time in spinal cord compression?

A

Reconsider the dose

29
Q

What is the most common treatment for spinal cord compression?

A

Radiotherapy

30
Q

Is radiotherapy used on its own or in conjunction with other treatments in spinal cord compression?

A

Can be used on its own, or alongside other treatments such as surgery

31
Q

What kind of radiotherapy is used for spinal cord compression?

A

External radiotherapy

32
Q

What course of radiotherapy is given in spinal cord compression?

A

Usually given as a short course of treatment, ranging from 1 single treatment to one treatment a day for 1-3 weeks, or longer for some types of cancer

33
Q

When should radiotherapy for spinal cord compression be started?

A

As soon as possible after diagnosis

34
Q

is surgery available for everyone with spinal cord compression?

A

No, it is only available for a small number of people

35
Q

What does the availability of surgery in spinal cord compression depend on?

A
  • Type of cancer
  • Area of spine affected
  • How stable the spine is
36
Q

What is the aim of surgery in spinal cord compression?

A

Remove as much of the tumour as possible, and relieve pressure on the spinal cord and nerves
May also involve removing several parts of the vertebrae

37
Q

What care needs to be taken with surgery for spinal cord compression?

A

Not to weaken the spine

38
Q

What types of surgery are used in the management of spinal cord compression?

A
  • Stabilisation and debulking of the tumour

- Decompression laminectomy

39
Q

What is a decompression laminectomy?

A

Where a section of bone is removed from one of the vertebrae

40
Q

How can the spine be further stabilised in spinal cord compression?

A

Using metal rods, screws, or bone grafts

41
Q

When might adjuvant radiotherapy be given in spinal cord compression?

A

If the tumour cannot be completely removed, or if there is recurrence

42
Q

When is chemotherapy used to treat spinal cord compression?

A

When it is caused by tumours that are very sensitive to chemotherapy, e.g. lymphoma, testicular cancer

43
Q

What is hormonal therapy often used in combination with in spinal cord compression?

A

Chemotherapy

44
Q

When is hormonal therapy used in spinal cord compression?

A

For certain cancers such as breast cancer and prostate cancer

45
Q

Give two examples of drugs that strengthen the bones

A
  • Bisphosphonates

- Denosumab

E CAN ext. (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions