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Medicine, oncology > Oncological emergencies > Flashcards

Oncological emergencies Flashcards

1
Q

What is SVCS?

A

Manifestation of blood flow- obstruction in SVC

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2
Q

Symptoms of SVCS?

A 
Facial and arm edema
Distended neck veins
Dyspnea
Hoarseness
Increased ICP
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3
Q

How to diagnose SVCS?

A

CLINICAL! CT, MRI

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4
Q

How can we divide SVCS ?

A

High dynamic and low dynamic

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5
Q

Characteristics of high dynamic SVCS?

A

Life threatening
NO collaterals
Very cyanotic

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6
Q

CHaracteristics of low dynamic SVCS?

A

NOT-life threatening
Collaterals
Less cyanotic

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7
Q

Tx of SVCS?

A

1) VASCULAR INTERVENTION!!!

2) Radio- and chemotx

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8
Q

When is SVCS usually seen?

A

LUNG cancer

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9
Q

Which lung cancer is SVCS?

A

SCLC

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10
Q

MC locaization of MSCC?

A

THoracic spine

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11
Q

MC causes of MSCC?

A

Breast ca
Lung ca
Prostate cs

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12
Q

Diagnostic tool for MSCC?

A

MRI

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13
Q

Symptoms of MSCC?

A 
Pain (back pain
Motor dysfunction (weakness, hyperreflexia)
Sensory dysfunction
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14
Q

Management of MSCC?

A

DETECT ANT TREAT ASAP!

  • decrompression of spine
  • steroids
  • opioids
  • radio, chemotx
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15
Q

Why is it so important to prevent permanent neurological damage in MSCC?

A

Loss of possibility to give chemo and radiotx

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16
Q

Which drug to treat neuropathic pain?

A

Neurontin (gabapentin)

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17
Q

Median survival if MSCC pt?

A

6 months :(

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18
Q

At which day will you see refeeding syndrome?

A

4TH DAY after refeeding

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19
Q

What is seen in labs in refeeding syndrome?

A

Hypophosphatemia

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20
Q

Most important tx of refeeding syndrome?

A

PREVENTION!

  • low calory nutrition dose
  • monitor electrolytes, creatinine
  • cooperate with other teams
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21
Q

What does SIADH cause?

A

Hyponatremia

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22
Q

What is SIADH caused by?

A

Paraneoplastic s from SCLC (ectopic production)

23
Q

Symptoms of SIADH?

A

Confusion, lethargy
Weakness
Decreased relfex
Seixures, coma

24
Q

Tx of SIADH?

A

Fluid restriction
Demeclocycline/Vaptans
Treat cause

25
Q

What should you think about if hypophosphatemia?

A

refeeding syndrome

26
Q

What should you think about if hyponatremia? Which ca?

A

SIADH, SCLC

27
Q

What should you think about if hypercalcemia? Which ca?

A

Paraneoplastic syndrome produces PTH, MYELOMA

28
Q

MC cause of ICP?

A

MEtastasis: LUNG CA, Renal ca

29
Q

Diagnostic in ICP?

A

MRI! Most sensitive

30
Q

Symptoms of ICP?

A

Morning headache
Blurry vision
Altered consciousness

CUSHINGS TRIAD

31
Q

What is Cushing’s triad?

A

Hypertension
Irregular RR
Bradycardia

32
Q

Tx of ICP?

A

Elevate head
IV mannitol
Hyperventilation
Dexamethasone

33
Q

In which disease is Beck’s triad seen?

A

Pericardial tamponade

34
Q

In which disease is Cushing’s triad seen?

A

Increased ICP

35
Q

In which disease is Virchow’s triad seen?

A

VTE

36
Q

Symptoms in Virchow’s triad?

A

Endothelial injury, Abnormal blood flow, hypercoagulability

37
Q

Symptoms in Beck’s triad?

A

Jugular vein distention
Muffled heart sounds
Decreased blood pressure

38
Q

What is carcinoid syndrome?

A

Well-differentiated neuroendocrine tumor

39
Q

What does carcinoid tumor release?

A

serotonin, bradykinin, histamine, chromogranin a

40
Q

Symptoms of carcinoid syndrome?

A

Flushing
Diarrhea
Dyspnea
Heart palp

41
Q

FIRST diagnostic test in carcinoid syndrome?

A

24 H urine test –> 5 HIAA

42
Q

Tx of carcinoid syndrome?

A

Octreotide (serotonin analogue)

43
Q

Which dangerous complication of carcinoid syndrome?

A

Valvular disease

44
Q

MC cause of pericardial tamponade?

A

Lung ca with metastatic tumors

45
Q

Symptoms of pericardial tamponade?

A

Becks triad
Pulsus paradoxus
Pericardial friction rub

46
Q

Tx of pericardial tamponade?

A

Pericardocentesis
prolonged drainage
decompression
intrapericardial chemotx

47
Q

Cause of tumor lysis syndrome (TLS)?

A

Massive tumor lysis –> release of K+, phosphate, nucleic acids

48
Q

WHen does TLS occur?

A

72 hours after chemo start

49
Q

What labs can confirm diagnosis?

A

25 increase in uric acid, potassium, phosphorus

25% decrease in calcium

50
Q

RF for TLS?

A

Rapidly growing tumors
Very chemosensitive tumor
Parient characteristics

51
Q

Most important tx of TLS?

A

PREVENTION!

  • IV hydration
  • Allopurinol
  • Rascubirase
52
Q

When is Rascubirase contraindicated?

A

In G6PD deficiency

53
Q

How many of cancer patients get VTE?

A

10%

54
Q

Tx of VTE?

A

LMWH

Medicine, oncology (15 decks)

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