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Flashcards in Emergencies Deck (63)
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1

Neurological Emergencies

Cord Compression
CNS metastases
Vascular events: Hyperviscosity/ leukostasis

2

Cardiopulmonary Emergencies

Cardiac tamponade
SVC syndrome

3

Metabolic Emergencies

Tumor lysis
Hypercalcemia
SIADH

4

Hematological Emergencies

Neutropenic fever
Severe thrombocytopenia
Overanticoagulation

5

Emergencies That Need to be Approached Immediately

Neutropenic fever
Tamponade
Cord compression
CNS metastases with symptoms

6

Emergencies That Need to be Approached Today

Coagulopathies
Tumor lysis
Leukostasis
Hyperviscosity
Severe thrombocytopenia (

7

Emergencies That Need to be Approached Today or Tomorrow

SVC Syndrome
Most hypercalcemia
Most CNS mets without edema
INR 5-9

8

Neurological: Cord Compression

Inflammation
Paresthesia
Autonomic dysfunction
Usually with vertebral mets
Rapid deterioration = worse outcome

9

How does cord compression occur?

Thecal sac becomes compressed
Spread through venous plexus & blood stream

10

Examination of Cord Compression

MRI/CT of whole spine
Decadron
Neurosurgery
XRT: radiation if multiple levels

11

How do steroids help with cord compression?

Decreased risk of paralysis due to reduction in inflammation

12

What is the most common brain tumor?

Brain mets

13

CNS Metastases with Symptoms

Headaches
Altered mental status
Vision changes
Ataxia
CN problems
Seizures
Personality changes
Confusion
Sensory changes

14

Which cancers like to go to the brain?

Lung
Breast
Colorectal
Melanoma
Kidney
Germ cell
Neuroblastoma
Sarcoma
Prostate

15

Presentation of Brain Metastases

Headache
Seizures
Altered mental status
Focal deficits

16

What improves survival of isolated brain mets?

Surgery + radiation

17

Necessary Steps to Treat Brain Metastases with Symptoms

Decadron: edema, focal symptoms
Dilantin: seizures
MRI imaging
Neurosurgery

18

Symptoms of Leukostasis

Altered mental status
Coma
Other organs involved: brain, respiratory
Hypoxia
Renal insufficiency

19

Leukostasis Mostly In

AML: WBC > 100,00

20

Relatively Nonspecific Symptoms Hyperviscosity

Somnolence
Headache
Blurry vision
Dizziness

21

What condition is hyperviscosity most common with?

Waldenstrom's

22

Less Common Conditions with Hyperviscosity

Multiple myeloma
Polycythemia vera
Essential thrombocytosis

23

Polycythemia Vera Hemoglobin Levels

>19 or 20

24

Essential Thrombocytosis Platelet Level

>10^6

25

Necessary Steps to Treat Hyperviscosity

Hydrated
Apheresis for IgM + chemotherapy
Phlebotomy for polycythemia vera
Hydroxyurea & aspirin for essential thrombocytosis

26

Necessary Steps to Treat Leukostasis

Hydrated
Quentin access (renal)
Chemotherapy
LP for cytology rule in/out CNS leukemia
Steroids

27

Most Common Primaries with Cardiac Tamponade

Lung
Breast

28

What does an EKG show with cardiac tamponade

Electrical alternans
Low voltage
ST elevation in all leads

29

Presentation of Cardiac Tamponade

Left or right sided failure
Pulsus paradoxus
Big heart on CXR

30

3 Main Reasons for Tamponade

Malignancy
Idiopathic
Autoimmune