Brainscape's Knowledge GenomeTM

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


See full index

Year 4 Oncology > Supportive care in haematological cancers > Flashcards

Supportive care in haematological cancers Flashcards

1
Q

1 unit of red blood cells

A

Increases Hb by 10g/L

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

1 unit of platelets

A

10^11 platelets

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

When are irradiated products used

A
  • In bone marrow or stem cell transplant patients
  • 7 days before stem cell harvest
  • Hodgkin’s disease
  • Congenital T cell immunodeficiency
  • HLA matched products
  • Intrauterine tranfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why are irradiated blood tranfusions given?

A

Decreased risk of transfusion-associated graft vs host disease

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

What is irradiated blood products

A

T cells removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is CMV negative blood used?

A

Neonates < 28 days old
Intra uterine tranfusion
Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Different types of IV access

A

Cannulas
Tunnelled central line
PICC line
Portacath

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

Portacath

A

Port under skin so less likely to be pulled out.

Used in children

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

Tunnelled central line

A

Line inserted under sedation of general anaesthetic
USS or Xray guided
2 incisions - jugular vein and chest wall

  • Long lasting
  • Rapid IV access
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tumour lysis syndrome pathophysiology

A

Chemotherapy can cause rapid tumour cell lysis which releases cellular components such as K+, this causes metabolic derangements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Classes of tumour lysis syndrome

A

Laboratory - asymptomatic but +ve bloods

Clinical - symptomatic such as AKI, arrhythmia, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cellular components released by tumour cell lysis

A

Uric acid increased - gout

Potassium increased - hyperkalaemia

Phosphorous increased - hyperphosphataemia

Calcium decreased - hypocalcaemia

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

Symptoms of tumour lysis syndrome

A

AKI - creatinine > 1.5

Cardiac arrhythmia/ sudden death

Seizures

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

Investigations for tumour lysis syndrome

A

Bloods and haematinics

U+Es

ECG

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

Treatment of tumour lysis syndrome

A

Risk adaptive approach:

  • Allopurinol - inhibits xanthine oxidase blocking uric acid production
  • Rasburicase - urate oxidase inhibitor

Not given together
Given with chemotherapy to prevent tumour lysis syndrome

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

How to prevent infections

A

Mouth care - chlorhexidine mouthwash qds

Prophylactic antifungals - fluconazole to prevent thrush

Prophylactic co - trimoxazole - prevents pneumocystis jiroveci

Prophylactic antiviral - aciclovir - prevents the reactivation of shingles

Prophylactic antibiotics - gram negative cover

17
Q

Contraception with chemotherapy

A
  • Avoid pregnancy whilst on chemotherapy for men and women
  • Requires a 3 month washout period
  • Norethisterone - patients with acute leukaemia, stops menstruation
  • Avoid COCP due to thrombotic risk
  • Barrier protection at all times
18
Q

Fertility with chemotherapy

A
  • risk of infertility
  • fertility preservation - egg collection or sperm storage
  • liaise with local assisted conception unit
19
Q

Neutropenic sepsis features

A

Fever > 38C or > 37.5 over 1 hour

Neutropenia < 0.5 or < 1 and falling

Caution - can have infection without fever

20
Q

Management of neutropenic sepsis

A

Hospital neutropenic sepsis protocol

  • Tazocin or meropenem if allergic
  • Aminoglycosides - if hypotension or septic shock
    (reduce gentamicin dose if low eGFR or elderly)
  • Vancomycin - gram +ve cover for line infections
  • G-CSF subcut injection- stimulates the production of white cells, reducing the severity and duration of neutropenia
21
Q

Side effects of G- CSF

A

Bone pain
Headaches
Fatigue
Nausea

22
Q

G-CSF and leukaemia

A

Wait until tested to be in remission for leukaemia before giving G-CSF as can skew results

23
Q

Treatment for bleeding

A

Tranexamic acid
Prothrombin complex concentrate - minimises effects of DOACs
Stop DOACs

24
Q

Which DOAC can be reversed

A

Dabigatran using idarucizumab (Praxbind)

25
Q

History for neutropenic sepsis

A

Date of last chemo and which agent

Infection symptoms

Ask about lines

Drugs and allergies

26
Q

Investigations for neutropenic sepsis

A

Bloods - FBC, U+E, LFT, CRP, glucose and lactate

Blood culture

CXR - if symptomatic

Discuss with senior

27
Q

Treatment for chemo-induced diarrhoea

A

Loperamide

28
Q

Acute N+V

A

Within 24 hours of having chemo

29
Q

Delayed N+V

A

More than 24 hours after chemo

30
Q

Treatment for mucositis

A

Good oral hygiene - chlorhexidine mouthwash
Oromorph if in pain
Tranexamic acid mouthwash if bleeding

Year 4 Oncology (21 decks)

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