OSCE Prep Flashcards Preview

Oncology > OSCE Prep > Flashcards

Flashcards in OSCE Prep Deck (14):
1

How do you recognise neutropenic sepsis?

Anyone with a neutrophil count of < 0.5x10^9 per litre.

Who also has a temperature of higher than 38*C, OR any signs/symptoms of sepsis.

Who has known immunodeficiency or has had chemo within 6 weeks.

2

Treatment for neutropenic sepsis:

ABX TREATMENT: TAZOCIN w/i 60 minutes

Sepsis 6:
15 L/min of O2 via non-rebreathe
Antibiotics: Tazocin
Fluids

Blood cultures
Urine output
Lactate

Contact acute oncology team!

3

Signs of (neutropenic) sepsis:

Fever / hypothermia
Reduced GCS
Tachypnea
Tachycardia
Poor perfusion (cyanosis, cold, clammy, mottled appearance)
Reduced urine output

4

What does a neutrophil count of less than 0.1 suggest?

Bacteraemia: bacterial infection of blood

5

How soon do you give antibiotics in suspected neutropenic sepsis?

Immediately AFTER blood cultures are taken

(Unless there is likely to be any delay in getting blood cultures)

Certainly no later than 1 hour after they present.

6

Further investigations after acute management of neutropenic sepsis

CT chest to check for fungal infection of lungs.

7

What is MSCC

Malignant spinal cord compression.

Spinal metastases pressing on the spinal cord.

8

What types of cancers are most likely to spread to bone?

Prostate, breast, lung.

9

Symptoms of MSCC

Back pain
Bladder or bowel dysfunction
Numbness / parasthesia
Weakness or paralysis
Loss of tone

Cauda equina syndrome:
- saddle anaesthesia
- bladder retention
- leg weakness

10

Investigations for MSCC

MRI Spine
CT-guided tumour biopsy and histopathology

11

What is the probability of cancer patients developing hypercalcaemia?

What does it mean for the patient if they develop hypercalcaemia?

10-20%
40% of patients with myeloma.

Poor prognostic sign: 75% mortality within 3 months.

12

What causes raised calcium in cancer patients?

Parathyroid hormone-related protein produced by the tumour.
Local osteolysis (in myeloma)

13

Symptoms of malignancy-associated hypercalcaemia

Confusion
Weakness
Seizure
Weight loss
Nausea
Polyuria
Polydipsia

14

Treatment for malignancy associated hypercalcaemia

Aggressive rehydration.
Calcitonin for immediate (short-term) normalisation of calcium.
Bisphosophonates for slower acting normalisation of calcium (2-3 days)