1) Oncologic emergencies include conditions like hypercalcemia, tumor lysis syndrome, SIADH, hyperviscosity states, and increased intracranial pressure that require immediate medical intervention.
2) Tumor lysis syndrome occurs when cancer cells die off rapidly, releasing electrolytes and metabolites that can overwhelm the kidneys, potentially causing renal failure, arrhythmias or seizures. It is treated by managing individual electrolyte abnormalities and renal failure.
3) Increased intracranial pressure in cancer patients can be caused by vasogenic edema, hemorrhage, or obstruction of cerebrospinal fluid flow. Symptoms include headache, vomiting and altered mental status. Treatment involves steroids
The document discusses symptom management of side effects from chemotherapy, immunotherapy, and targeted therapy, including mucositis, hair loss, infusion reactions, myelosuppression, peripheral neuropathy, and effects on sex and reproduction. It also covers common toxicities associated with immune checkpoint inhibitors such as pneumonitis, colitis, nephritis, hepatitis, hypothyroidism, and hyperthyroidism. Treatment options are provided for managing many of these side effects.
Pharmacology II Malignant Hematology Therapeuticsflasco_org
Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, depleting reduced folates and inhibiting DNA synthesis. It is primarily renally excreted so dose reduction is needed in renal insufficiency. High-dose methotrexate is used to treat CNS lymphomas after draining pleural effusions due to its slow exit from third spaces. Cytarabine is a mainstay of AML treatment and causes severe myelosuppression when given at high doses. Fludarabine and cladribine inhibit DNA synthesis and can cause immunosuppression requiring prophylaxis against opportunistic infections. Rituximab targets CD20 antigen on B cells and
This document discusses tumor lysis syndrome (TLS), a metabolic oncologic emergency caused by the breakdown of malignant cells following chemotherapy or radiation therapy. TLS results in the release of potassium, phosphorus, uric acid and other intracellular components into the bloodstream, potentially causing hyperkalemia, hyperphosphatemia, hyperuricemia and other electrolyte imbalances. The document outlines risk factors for TLS, signs and symptoms of specific electrolyte abnormalities, treatment approaches, and importance of monitoring patients at risk.
Oncologic emergencies are vital for many healthcare practitioners to note even if they do not take care of cancer patients alone. This slide deck covers malignant spinal cord compression, hypercalcemia of malignancy, and tumor lysis syndrome.
1. The patient presented with hypercalcemia due to metastatic lung cancer. Symptoms included confusion, dehydration, and signs of renal impairment.
2. Initial management involved IV rehydration with normal saline to improve kidney function and increase calcium excretion. Bisphosphonate therapy was given to reduce calcium levels.
3. Further imaging found a mass in the right hilum and new liver metastasis, consistent with progression of the original lung cancer.
Management of oncology emergencies, Mohh'd sharshirMoh'd sharshir
This document summarizes the management of oncologic emergencies, focusing on tumor lysis syndrome (TLS). TLS is caused by massive lysis of tumor cells, releasing potassium, phosphate and uric acid. It is classified based on laboratory and clinical criteria. Risk is highest in Burkitt lymphoma, ALL and other high-grade lymphomas. Prevention focuses on IV hydration and hypouricemic agents like rasburicase or allopurinol. Electrolyte abnormalities are managed based on their severity. High-risk patients receive aggressive prevention while intermediate-risk patients generally receive allopurinol prevention.
The document discusses symptom management of side effects from chemotherapy, immunotherapy, and targeted therapy, including mucositis, hair loss, infusion reactions, myelosuppression, peripheral neuropathy, and effects on sex and reproduction. It also covers common toxicities associated with immune checkpoint inhibitors such as pneumonitis, colitis, nephritis, hepatitis, hypothyroidism, and hyperthyroidism. Treatment options are provided for managing many of these side effects.
Pharmacology II Malignant Hematology Therapeuticsflasco_org
Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, depleting reduced folates and inhibiting DNA synthesis. It is primarily renally excreted so dose reduction is needed in renal insufficiency. High-dose methotrexate is used to treat CNS lymphomas after draining pleural effusions due to its slow exit from third spaces. Cytarabine is a mainstay of AML treatment and causes severe myelosuppression when given at high doses. Fludarabine and cladribine inhibit DNA synthesis and can cause immunosuppression requiring prophylaxis against opportunistic infections. Rituximab targets CD20 antigen on B cells and
This document discusses tumor lysis syndrome (TLS), a metabolic oncologic emergency caused by the breakdown of malignant cells following chemotherapy or radiation therapy. TLS results in the release of potassium, phosphorus, uric acid and other intracellular components into the bloodstream, potentially causing hyperkalemia, hyperphosphatemia, hyperuricemia and other electrolyte imbalances. The document outlines risk factors for TLS, signs and symptoms of specific electrolyte abnormalities, treatment approaches, and importance of monitoring patients at risk.
Oncologic emergencies are vital for many healthcare practitioners to note even if they do not take care of cancer patients alone. This slide deck covers malignant spinal cord compression, hypercalcemia of malignancy, and tumor lysis syndrome.
1. The patient presented with hypercalcemia due to metastatic lung cancer. Symptoms included confusion, dehydration, and signs of renal impairment.
2. Initial management involved IV rehydration with normal saline to improve kidney function and increase calcium excretion. Bisphosphonate therapy was given to reduce calcium levels.
3. Further imaging found a mass in the right hilum and new liver metastasis, consistent with progression of the original lung cancer.
Management of oncology emergencies, Mohh'd sharshirMoh'd sharshir
This document summarizes the management of oncologic emergencies, focusing on tumor lysis syndrome (TLS). TLS is caused by massive lysis of tumor cells, releasing potassium, phosphate and uric acid. It is classified based on laboratory and clinical criteria. Risk is highest in Burkitt lymphoma, ALL and other high-grade lymphomas. Prevention focuses on IV hydration and hypouricemic agents like rasburicase or allopurinol. Electrolyte abnormalities are managed based on their severity. High-risk patients receive aggressive prevention while intermediate-risk patients generally receive allopurinol prevention.
Reviews some of the emergencies in Oncology. For nursing students. Covers common oncologic emergencies including brain metastasis, spinal cord compression, SVC syndrome / SVC obstruction, Pain, Hypercalcemia, Hyperleukocytosis and Febrile Neutropenia.
The document discusses various oncologic emergencies including metabolic emergencies like tumor lysis syndrome, haematologic emergencies like hyperleukocytosis and coagulopathy, infections like febrile neutropenia and typhlitis, and neurological emergencies like spinal cord compression and increased intracranial pressure. It provides details on the pathophysiology, clinical features, investigations and management of these conditions.
This document discusses several oncological emergencies including spinal cord compression, bone marrow suppression/neutropenic sepsis, superior vena cava obstruction, raised intracranial pressure/brain metastases, stridor, acute blood loss, obstruction, biochemical crisis of hypercalcemia, and pulmonary embolism. It provides details on symptoms, signs, investigations, and management for each emergency. Spinal cord compression is discussed in depth including symptoms of back pain, sensory and motor deficits, and management with steroids, radiation, or surgery.
The document discusses several oncological emergencies including tumor lysis syndrome, leucoestasis, hypercalcemia, superior vena cava syndrome, spinal cord compression, and hyperviscosity syndrome. It provides details on the pathogenesis, risk factors, signs and symptoms, diagnostic evaluation and treatment recommendations for each condition. The treatment sections emphasize hydration, uric acid lowering agents, corticosteroids, radiation therapy, surgery, chemotherapy and other supportive measures depending on the specific emergency.
Oncological Emergencies are the group of conditions that occur as a direct or indirect results of cancer or its treatment that are potentially life-threatening.
after definition it consist of classification and descriptive explanation of each disease and in the end NURSES ROLE
1) Oncologic emergencies can involve several body systems and include conditions like pericardial tamponade, superior vena cava syndrome, increased intracranial pressure, spinal cord compression, tumor lysis syndrome, sepsis, and symptomatic complications from the cancer or its treatment.
2) The case documents presented examples of patients presenting with pericardial tamponade, superior vena cava syndrome, increased intracranial pressure from brain metastases, and spinal cord compression from a plasmacytoma.
3) For each emergency, the document discussed diagnostic tests, treatment approaches like steroids, surgery, radiation, chemotherapy, and emphasized the importance of rapid diagnosis and management
Interactive talk on common hematological and oncological emergencies - which if not noticed early can lead to irreversible complications and death .
Intended to be used for educational purposes for the fertile minds in medicine .
This document discusses various oncologic emergencies that can arise as complications of malignancy. It covers emergencies such as upper airway obstruction, malignant pericardial tamponade, superior vena cava syndrome, acute spinal cord compression, hypercalcemia, hyperviscosity syndrome, and others. For each emergency, it describes the typical causative tumors, symptoms, diagnosis, and treatment approaches. The goal is to highlight life-threatening complications of cancer and how emergency physicians can recognize and initially manage these conditions.
Tumor lysis syndrome describes the clinical and laboratory abnormalities that result from the rapid release of intracellular contents from dying tumor cells. It is a common oncologic emergency seen by nephrologists. The rapid release of ions and metabolites causes hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Prevention focuses on identifying at-risk patients and aggressive hydration and urate-lowering agents. Treatment involves fluid management, management of electrolyte abnormalities with agents like rasburicase, and potentially renal replacement therapy for severe cases.
This document discusses various oncologic emergencies organized by system. It covers cardiovascular emergencies like pericardial tamponade and superior vena cava syndrome. Neurological emergencies discussed include increased intracranial pressure and spinal cord compression. Other sections cover gastrointestinal, hematologic, infectious, metabolic and other emergencies cancer patients may experience. It provides details on mechanisms, symptoms, diagnosis and treatment of several example conditions like hypercalcemia, tumor lysis syndrome and mucositis. The document concludes by mentioning some new targeted cancer drugs and related complications.
This document summarizes several oncologic emergencies including:
1) Superior vena cava syndrome caused by obstruction of the superior vena cava which can be caused by lung cancer and treated with stents or chemotherapy and radiation.
2) Malignant spinal cord compression which occurs in 5-10% of cancer patients and presents with back pain and neurological deficits treated with dexamethasone and radiation.
3) Pericardial effusions and tamponade found in 5-10% of cancer patients which can be drained with pericardiocentesis and increased intracranial pressure from brain metastases treated with steroids and surgery or radiation.
1. Oncological emergencies refer to urgent clinical situations in cancer patients caused by cancer or its treatment.
2. Some examples discussed are hypercalcemia, tumor lysis syndrome, lactic acidosis, hypoglycemia, syndrome of inappropriate antidiuretic hormone secretion, superior vena cava syndrome, spinal cord compression, severe cystitis, bladder hemorrhage, disseminated intravascular coagulation, and cardiac tamponade.
3. The document provides details on symptoms, signs, and treatment approaches for each of these conditions.
This document provides an overview of various oncologic emergencies including hypercalcemia, tumor lysis syndrome, SIADH, hyperviscosity states, increased intracranial pressure, spinal cord compression, superior vena cava syndrome, neutropenic fever, and other urgencies. For each condition, it discusses causes, clinical manifestations, diagnosis, and treatment approaches. The goal is to educate medical professionals about emergency presentations that may occur in cancer patients and how to appropriately manage these critical situations.
Coronary artery disease occurs when plaque builds up in the coronary arteries, narrowing the arteries and reducing blood flow to the heart. This document outlines the definition, risk factors, pathophysiology, signs and symptoms, diagnosis, and treatment of coronary artery disease. The modifiable risk factors include hyperlipidemia, smoking, hypertension, diabetes, obesity, and physical inactivity. The pathophysiology involves injury to endothelial cells, inflammation, lipid accumulation in artery walls, and formation of thrombus. Diagnosis involves history, physical exam, ECG, and lab tests. Treatment focuses on lifestyle changes, medications like statins, and procedures like angioplasty, stents, or bypass surgery.
Paraneoplastic syndromes are diseases or symptoms caused by cancer but not by direct local effects of tumors. They are mediated through cross-reacting antibodies, physiologically active factors, or metabolic pathway interference. Syndromes are classified as endocrine, neurological, mucocutaneous, hematological, or other. Common endocrine syndromes include Cushing's syndrome, SIADH, hypoglycemia, and hypercalcemia. Neurological syndromes are often antibody-mediated and include Lambert-Eaton myasthenic syndrome and paraneoplastic cerebellar degeneration. Dermatological manifestations incorporate lesions like acanthosis nigricans. Treatment focuses on managing symptoms and removing the underlying tumor.
1) Neutropenic sepsis or fever is a life-threatening complication of chemotherapy that requires urgent assessment and antibiotic therapy reflecting local sensitivities.
2) Spinal cord compression is an oncological emergency that requires immediate diagnosis and treatment with steroids and radiotherapy to limit neurological damage.
3) Cardiac tamponade presents with breathlessness and collapse, and requires urgent echocardiogram-guided drainage of pericardial fluid.
This document summarizes several hematological disorders and their drug-induced causes. It begins with an introduction to anemia, describing it as a deficiency of red blood cells or hemoglobin. Deep vein thrombosis is defined as a blood clot forming in a deep vein, most commonly in the legs. Various drug-induced hematological disorders are then outlined affecting red blood cells, white blood cells, and platelets. Causes, symptoms, diagnoses, and treatments are discussed for disorders like anemia, deep vein thrombosis, aplastic anemia, hemolytic anemia, neutropenia, and thrombocytopenia.
Oncological emergencies are well explained. It is classified properly and important ones are explained clearly.
For video explanation follow me on YouTube
Nurse DE
https://youtu.be/GUQzSF7_UPc
onco emergencies.pptx adult health nursing II, semester B.SC Nursing batch M.Josephin Dayana
The document discusses various oncological emergencies including metabolic emergencies like tumor lysis syndrome, sepsis, disseminated intravascular coagulation, hypercalcemia, and syndrome of inappropriate antidiuretic hormone secretion. It also discusses structural emergencies such as spinal cord compression, superior vena cava syndrome, and cardiac tamponade. It provides details on the causes, risk factors, clinical manifestations, diagnosis, and treatment of these various oncological emergencies.
The document discusses tumor lysis syndrome (TLS), a potentially fatal metabolic complication that can result from spontaneous or treatment-related tumor cell death. TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. It defines TLS and outlines its frequency, etiology, risk factors, pathophysiology, prevention, diagnosis, and management, emphasizing the importance of identifying high-risk patients and initiating preventive treatment to avoid complications like acute renal failure.
Reviews some of the emergencies in Oncology. For nursing students. Covers common oncologic emergencies including brain metastasis, spinal cord compression, SVC syndrome / SVC obstruction, Pain, Hypercalcemia, Hyperleukocytosis and Febrile Neutropenia.
The document discusses various oncologic emergencies including metabolic emergencies like tumor lysis syndrome, haematologic emergencies like hyperleukocytosis and coagulopathy, infections like febrile neutropenia and typhlitis, and neurological emergencies like spinal cord compression and increased intracranial pressure. It provides details on the pathophysiology, clinical features, investigations and management of these conditions.
This document discusses several oncological emergencies including spinal cord compression, bone marrow suppression/neutropenic sepsis, superior vena cava obstruction, raised intracranial pressure/brain metastases, stridor, acute blood loss, obstruction, biochemical crisis of hypercalcemia, and pulmonary embolism. It provides details on symptoms, signs, investigations, and management for each emergency. Spinal cord compression is discussed in depth including symptoms of back pain, sensory and motor deficits, and management with steroids, radiation, or surgery.
The document discusses several oncological emergencies including tumor lysis syndrome, leucoestasis, hypercalcemia, superior vena cava syndrome, spinal cord compression, and hyperviscosity syndrome. It provides details on the pathogenesis, risk factors, signs and symptoms, diagnostic evaluation and treatment recommendations for each condition. The treatment sections emphasize hydration, uric acid lowering agents, corticosteroids, radiation therapy, surgery, chemotherapy and other supportive measures depending on the specific emergency.
Oncological Emergencies are the group of conditions that occur as a direct or indirect results of cancer or its treatment that are potentially life-threatening.
after definition it consist of classification and descriptive explanation of each disease and in the end NURSES ROLE
1) Oncologic emergencies can involve several body systems and include conditions like pericardial tamponade, superior vena cava syndrome, increased intracranial pressure, spinal cord compression, tumor lysis syndrome, sepsis, and symptomatic complications from the cancer or its treatment.
2) The case documents presented examples of patients presenting with pericardial tamponade, superior vena cava syndrome, increased intracranial pressure from brain metastases, and spinal cord compression from a plasmacytoma.
3) For each emergency, the document discussed diagnostic tests, treatment approaches like steroids, surgery, radiation, chemotherapy, and emphasized the importance of rapid diagnosis and management
Interactive talk on common hematological and oncological emergencies - which if not noticed early can lead to irreversible complications and death .
Intended to be used for educational purposes for the fertile minds in medicine .
This document discusses various oncologic emergencies that can arise as complications of malignancy. It covers emergencies such as upper airway obstruction, malignant pericardial tamponade, superior vena cava syndrome, acute spinal cord compression, hypercalcemia, hyperviscosity syndrome, and others. For each emergency, it describes the typical causative tumors, symptoms, diagnosis, and treatment approaches. The goal is to highlight life-threatening complications of cancer and how emergency physicians can recognize and initially manage these conditions.
Tumor lysis syndrome describes the clinical and laboratory abnormalities that result from the rapid release of intracellular contents from dying tumor cells. It is a common oncologic emergency seen by nephrologists. The rapid release of ions and metabolites causes hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Prevention focuses on identifying at-risk patients and aggressive hydration and urate-lowering agents. Treatment involves fluid management, management of electrolyte abnormalities with agents like rasburicase, and potentially renal replacement therapy for severe cases.
This document discusses various oncologic emergencies organized by system. It covers cardiovascular emergencies like pericardial tamponade and superior vena cava syndrome. Neurological emergencies discussed include increased intracranial pressure and spinal cord compression. Other sections cover gastrointestinal, hematologic, infectious, metabolic and other emergencies cancer patients may experience. It provides details on mechanisms, symptoms, diagnosis and treatment of several example conditions like hypercalcemia, tumor lysis syndrome and mucositis. The document concludes by mentioning some new targeted cancer drugs and related complications.
This document summarizes several oncologic emergencies including:
1) Superior vena cava syndrome caused by obstruction of the superior vena cava which can be caused by lung cancer and treated with stents or chemotherapy and radiation.
2) Malignant spinal cord compression which occurs in 5-10% of cancer patients and presents with back pain and neurological deficits treated with dexamethasone and radiation.
3) Pericardial effusions and tamponade found in 5-10% of cancer patients which can be drained with pericardiocentesis and increased intracranial pressure from brain metastases treated with steroids and surgery or radiation.
1. Oncological emergencies refer to urgent clinical situations in cancer patients caused by cancer or its treatment.
2. Some examples discussed are hypercalcemia, tumor lysis syndrome, lactic acidosis, hypoglycemia, syndrome of inappropriate antidiuretic hormone secretion, superior vena cava syndrome, spinal cord compression, severe cystitis, bladder hemorrhage, disseminated intravascular coagulation, and cardiac tamponade.
3. The document provides details on symptoms, signs, and treatment approaches for each of these conditions.
This document provides an overview of various oncologic emergencies including hypercalcemia, tumor lysis syndrome, SIADH, hyperviscosity states, increased intracranial pressure, spinal cord compression, superior vena cava syndrome, neutropenic fever, and other urgencies. For each condition, it discusses causes, clinical manifestations, diagnosis, and treatment approaches. The goal is to educate medical professionals about emergency presentations that may occur in cancer patients and how to appropriately manage these critical situations.
Coronary artery disease occurs when plaque builds up in the coronary arteries, narrowing the arteries and reducing blood flow to the heart. This document outlines the definition, risk factors, pathophysiology, signs and symptoms, diagnosis, and treatment of coronary artery disease. The modifiable risk factors include hyperlipidemia, smoking, hypertension, diabetes, obesity, and physical inactivity. The pathophysiology involves injury to endothelial cells, inflammation, lipid accumulation in artery walls, and formation of thrombus. Diagnosis involves history, physical exam, ECG, and lab tests. Treatment focuses on lifestyle changes, medications like statins, and procedures like angioplasty, stents, or bypass surgery.
Paraneoplastic syndromes are diseases or symptoms caused by cancer but not by direct local effects of tumors. They are mediated through cross-reacting antibodies, physiologically active factors, or metabolic pathway interference. Syndromes are classified as endocrine, neurological, mucocutaneous, hematological, or other. Common endocrine syndromes include Cushing's syndrome, SIADH, hypoglycemia, and hypercalcemia. Neurological syndromes are often antibody-mediated and include Lambert-Eaton myasthenic syndrome and paraneoplastic cerebellar degeneration. Dermatological manifestations incorporate lesions like acanthosis nigricans. Treatment focuses on managing symptoms and removing the underlying tumor.
1) Neutropenic sepsis or fever is a life-threatening complication of chemotherapy that requires urgent assessment and antibiotic therapy reflecting local sensitivities.
2) Spinal cord compression is an oncological emergency that requires immediate diagnosis and treatment with steroids and radiotherapy to limit neurological damage.
3) Cardiac tamponade presents with breathlessness and collapse, and requires urgent echocardiogram-guided drainage of pericardial fluid.
This document summarizes several hematological disorders and their drug-induced causes. It begins with an introduction to anemia, describing it as a deficiency of red blood cells or hemoglobin. Deep vein thrombosis is defined as a blood clot forming in a deep vein, most commonly in the legs. Various drug-induced hematological disorders are then outlined affecting red blood cells, white blood cells, and platelets. Causes, symptoms, diagnoses, and treatments are discussed for disorders like anemia, deep vein thrombosis, aplastic anemia, hemolytic anemia, neutropenia, and thrombocytopenia.
Oncological emergencies are well explained. It is classified properly and important ones are explained clearly.
For video explanation follow me on YouTube
Nurse DE
https://youtu.be/GUQzSF7_UPc
onco emergencies.pptx adult health nursing II, semester B.SC Nursing batch M.Josephin Dayana
The document discusses various oncological emergencies including metabolic emergencies like tumor lysis syndrome, sepsis, disseminated intravascular coagulation, hypercalcemia, and syndrome of inappropriate antidiuretic hormone secretion. It also discusses structural emergencies such as spinal cord compression, superior vena cava syndrome, and cardiac tamponade. It provides details on the causes, risk factors, clinical manifestations, diagnosis, and treatment of these various oncological emergencies.
The document discusses tumor lysis syndrome (TLS), a potentially fatal metabolic complication that can result from spontaneous or treatment-related tumor cell death. TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. It defines TLS and outlines its frequency, etiology, risk factors, pathophysiology, prevention, diagnosis, and management, emphasizing the importance of identifying high-risk patients and initiating preventive treatment to avoid complications like acute renal failure.
This document discusses hematological emergencies and tumor lysis syndrome. It provides classifications of hematological emergencies and describes tumor lysis syndrome, including its causes, risk factors, clinical manifestations, and treatments like hypouricemic drugs, hydration, and renal replacement therapy. It also covers superior vena cava syndrome, its causes, clinical features, grading of severity, diagnosis using imaging, and treatments including supportive care, stenting, and glucocorticoids.
C. Retinopathy, edema are common finding.
While primary aldosteronism can cause hypokalemia, metabolic alkalosis and high-normal sodium levels, retinopathy and edema are not common findings. The other answer choices are true statements about primary aldosteronism.
This document outlines several oncological emergencies including tumor lysis syndrome, hyperleukocytosis, disseminated intravascular coagulopathy, superior vena cava obstruction, febrile neutropenia, and infection. It provides details on the characteristics, risks factors, signs and symptoms, and management approaches for each emergency. Key aspects of management include hydration, monitoring of electrolytes and blood counts, use of allopurinol or steroids to prevent tumor lysis, platelet transfusions for coagulopathies, and early treatment of febrile neutropenia with antibiotics. The document emphasizes the need for prompt recognition and treatment of these potentially life-threatening oncological complications.
This document discusses oncologic emergencies in pediatrics. It begins with an introduction and overview of common pediatric malignancies. It then categorizes oncologic emergencies and discusses several examples in more depth, including metabolic emergencies like tumor lysis syndrome, hematologic emergencies such as hyperleukocytosis and bleeding disorders, and cardiothoracic emergencies like superior vena cava syndrome. For each emergency, it covers pathophysiology, risk factors, diagnostic criteria, evaluation and management strategies. The document provides a comprehensive review of potential life-threatening complications that may arise from pediatric cancers or their treatment and strategies for rapid recognition and management.
Tumor lysis syndrome occurs when cancer cells release their contents into the bloodstream, causing electrolyte imbalances like hyperkalemia, hyperuricemia, and hyperphosphatemia that can damage organs. It is diagnosed when a patient develops acute kidney injury, arrhythmias, or seizures from their electrolyte changes. Treatment involves rapid hydration, uric acid-lowering drugs like allopurinol or rasburicase, and dialysis for severe electrolyte abnormalities or kidney injury. With advances in prevention and management, the prognosis for tumor lysis syndrome has improved in recent years.
A 76-year-old male is admitted to the ICU for recovery after lung surgery. His BP is 168/96 mmHg without end-organ damage, so this represents a hypertensive urgency rather than emergency. Fundoscopic exam is not needed for this transient postoperative hypertension. Starting IV antihypertensives or consulting a hypertension specialist are not necessary actions at this time. The patient should be reassessed later since there is no end-organ damage currently.
A 76-year-old male is admitted to the ICU for recovery after lung surgery. His BP is 168/96 mmHg without end-organ damage, so this represents a hypertensive urgency rather than emergency. Fundoscopic exam is not needed for this transient postoperative hypertension. Starting IV antihypertensives or consulting a hypertension specialist are not necessary actions at this time. The patient should be reassessed later since there is no end-organ damage currently.
This patient has hypokalemia with metabolic alkalosis. The combination of hypokalemia and hypertension suggests hyperaldosteronism, likely primary hyperaldosteronism (Conn syndrome). Aldosterone causes increased sodium reabsorption and potassium secretion in the distal tubule of the kidney, resulting in hypokalemia and metabolic alkalosis. Further workup would include plasma aldosterone and renin levels.
This document summarizes hemoglobinopathies, specifically sickle cell disease. It discusses the genetics, pathophysiology, clinical features including acute complications like vaso-occlusive crises and stroke, and chronic complications affecting organs like the lungs, kidneys, liver, bones and CNS. Key aspects of management include treating acute pain, acute chest syndrome, priapism, stroke prevention through transfusions or hydroxyurea, and addressing end-organ damage.
This document provides information about tumor lysis syndrome (TLS), including its definition, risk factors, pathophysiology, and management. TLS is an oncometabolic emergency that can occur after tumor targeted therapy leads to rapid cell death and release of cellular contents like uric acid, potassium, and phosphorus. It can cause abnormalities in electrolytes and kidney injury. High risk groups include those with hematologic malignancies like lymphoma. Management involves prevention, monitoring, volume expansion, and in some cases urinary alkalinization or allopurinol.
This document discusses hypertension in pediatrics. It defines different types and stages of hypertension based on blood pressure percentiles. Secondary hypertension is most common in infants and children and is usually caused by an underlying condition. Accurate blood pressure measurements should be taken routinely starting at age 3. Treatment involves identifying and managing the underlying cause, lifestyle changes like salt restriction, and medications like ACE inhibitors, ARBs, calcium channel blockers, and diuretics. Hypertensive emergencies require promptly but gradually lowering blood pressure over hours to days to prevent end organ damage, while hypertensive urgencies can be treated orally by lowering blood pressure over 1-2 days.
This document summarizes the structure and functions of the adrenal cortex. It is divided into three zones: the zona glomerulosa secretes aldosterone and regulates sodium retention; the zona fasciculata secretes cortisol and regulates carbohydrate, fat, and protein metabolism; the zona reticularis secretes sex hormones like androgens. Conn's syndrome and Cushing's syndrome are also summarized, outlining their causes, clinical features, investigations, and treatments. Addison's disease, a condition of chronic adrenal failure, is briefly mentioned at the end.
The document provides information on deep vein thrombosis and pulmonary embolism. It discusses:
1. The coagulation process and how abnormalities in the vessel wall, blood flow, or blood components can lead to thrombosis according to Virchow's triad.
2. Risk factors for deep vein thrombosis and pulmonary embolism such as age, cancer, immobilization, and inherited conditions.
3. Diagnostic tests for pulmonary embolism including the Wells criteria for estimating probability, imaging tests like CT scans, and their limitations. Treatment involves anticoagulants like heparin or warfarin.
Tumor lysis syndrome is a potentially life-threatening condition caused by the rapid breakdown of tumor cells during cancer treatment, releasing electrolytes into the bloodstream. It can cause severe electrolyte abnormalities like hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia. These abnormalities are due to the release of intracellular contents from dying tumor cells and can lead to acute kidney injury. Tumor lysis syndrome is most common in patients with high-grade lymphomas and leukemias undergoing aggressive chemotherapy and requires careful monitoring and prevention with hydration and medications to reduce complications.
Tumor lysis syndrome is a potentially life-threatening condition caused by the rapid breakdown of tumor cells during cancer treatment, releasing electrolytes into the bloodstream. It can cause severe electrolyte abnormalities like hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia. These abnormalities are due to the release of intracellular contents from dying tumor cells and can lead to acute kidney injury. Tumor lysis syndrome is most common in patients with high-grade lymphomas and leukemias undergoing aggressive chemotherapy and requires careful monitoring and prevention with hydration and medications to avoid complications.
Acute Oncology Presentations Caused by DiseaseMsccMohamed
This document discusses several types of acute oncology presentations including those caused by the underlying disease, such as hypercalcemia, SIADH, superior vena cava obstruction, and pathological fractures. It also discusses seven patient case studies presenting with various acute oncology issues like hypercalcemia, SIADH, SVC obstruction, choroidal metastases, and lymphangitis carcinomatosa. For each case, it describes the patient's history and presentation, diagnostic steps, and treatment approach.
Tumor lysis syndrome (TLS) describes metabolic derangements that occur from rapid tumor breakdown associated with cytotoxic therapy. It is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. TLS requires immediate intervention as it can overwhelm homeostatic mechanisms. It occurs primarily in hematologic malignancies with high proliferation rates that are sensitive to therapy. Prevention through hydration, hypouricemic agents, and monitoring of at risk patients is important to manage TLS.
This document provides an outline about hypertension in children. It defines hypertension and classifies it into different stages. It discusses hypertensive crisis, risk factors, pathophysiology, clinical presentations, diagnostic approach, and treatment. It notes that approximately 30% of children with a BMI over the 95th percentile have hypertension. It also outlines diagnostic testing, treatment considerations including medication options and goals, and provides algorithms for treating hypertensive urgency and emergencies. The treatment involves gradually lowering blood pressure over 24-48 hours while monitoring for side effects and end organ damage.
Similar to Oncologic Emergencies and Symptom Management (20)
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
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GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
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TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
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TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
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The South Beach Coffee Java Diet is a variation of the popular South Beach Diet, which was developed by cardiologist Dr. Arthur Agatston. The original South Beach Diet focuses on consuming lean proteins, healthy fats, and low-glycemic index carbohydrates. The South Beach Coffee Java Diet adds the element of coffee, specifically caffeine, to enhance weight loss and improve energy levels.
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MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
8. Treatment of Hypercalcemia
• MILD Hypercalcemia
– Avoid inactivity and ambulate
– Avoid dehydration
• Severe Hypercalcemia
– Rehydrate
– Increase renal calcium excretion
– Decrease Bone Resorption
9. Treatment of Hypercalcemia
• Rehydration: IVF NS at rate necessary to achieve
diuresis of 100 cc/hr or as limited by CV status
• Renal Calcium Excretion: Loop diuretics
(furosemide). Heart Failure, Renal Insufficiency
• Decrease Bone Resorption: Bisphosphonates
(zoledronate/pamidronate/etidronate, etc)
• Monitoring
– Check electrolytes q 8 to 12 hours
– 12-lead EKG and telemetry – Shortened QT interval
Calcitonin
- Antagonizes effects of PTH. Results seen in 12 – 48
hrs. Short term Effects.
10. Tumor Lysis Syndrome
• Syndrome of Metabolic Disorders – Sequelae
to spontaneous or treatment-induced cell death. The
resulting electrolytes and metabolites overcome the
kidney’s ability to maintain homeostasis.
• TLS has historically been associated with:
• poorly differentiated
• highly proliferative
• treatment-sensitive
• high tumor burden
• myelolymphoproliferative disorders (acute
• leukemias/lymphomas)
• Rare in pts with epithelial malignancies
11. Tumor Lysis Syndrome
• Etiology: Massive release of K, PO4, Uric Acid and
other breakdown products of dying tumor cells, 12 – 72
hrs post cytotoxic and/or radiation
• Clinical Presentation: Nausea/vomiting, diarrhea,
muscle cramps, paresthesia, seizures, tetany, syncope,
fluid overload, chest pain and palpitations.
• Labs: CBC, CMP, Mag, PO4, Uric Acid, LDH
12. Tumor Lysis Syndrome
• DX: Renal failure, Hyperuricemia,
Hyperphosphatemia, Hypocalcemia and
Hyperkalemia
• Hyperuricemia: Most common metabolic
abnormality - uremia, acute renal failure and an
elevated anion gap metabolic acidosis.
• Signs and symptoms: nausea/vomiting, mental
status changes, flank pain (urate nephrolithiasis),
chest pain (uremic pericarditis), seizures, edema,
oliguria/anuria, and non cardiogenic pulmonary
edema
13. Tumor Lysis Syndrome:
Hyperphosphatemia
Manifestations: Symptomatic hypocalcemia. ARF,
Arrhythmias
Hypocalcemia
• Manifestations: Muscle cramps, Paresthesias, Tetany,
Mental status changes, Seizures.
Hypotension and QT prolongation.
• Trousseau’s and Chvostek’s - dramatic when present but of
unknown sensitivity and specificity.
Hyperkalemia
Presentation: Muscle weakness, Ekg Changes
14. Tumor Lysis Syndrome
• Laboratory TLS: 2 or more of Uric acid
• Potassium
• Phosphate
• Calcium
• Clinical TLS Lab TLS plus renal failure,
cardiac arrhythmias, seizures, sudden death
15. Treatment of Tumor Lysis
Syndrome
The old adage “prevention is better than cure”
holds true for TLS.
Allopurinol prophylaxis with isotonic saline prior
to antitumor treatment has significantly reduced
the development of urate nephropathy, was as
high as 10% in treated acute lymphoblastic
leukemia.
• Treat individual electrolyte abnormalities
• Treat Renal failure or cardiac arrhythmias
16. Tumor Lysis Syndrome
Treatment
Hyperuricemia:
Hydration/Diuresis – NS IVF and Diuretics
(Lasix or Mannitol)
Decrease Uric Acid Production –
Allopurinol
Increase Uric Acid Destruction –
Rasburicase
Use of Allopurinol vs Rasburicase - Based on
WBC, LDH, Uric Acid and
Tumor Type and Extent
17. Tumor Lysis Syndrome
Treatment
Hyperkalemia
Mild (<6) : Avoid p.o. and IV potassium.
D/C offending medications
Moderate (6 – 7): Same as Mild. Also EKG
monitoring, Sodium
polystyrene sulfonate, NS IVF
Severe (>7): Symptomatic and EKG
changes. Moderate Txt plus
Calcium gluconate, insulin
and D50. Possible hemodialysis
20. HYPERVISCOSITY
SYNDROMES
• Due to elevated levels of compounds with high
molecular weights, such as proteins.
• Seen in polycythemias, leukemia, monoclonal
gammopathies (IgM) in Waldenstrom’s
macroglobulinemia, or IgA or IgG in multiple
myeloma, sickle cell anemia and sepsis.
24. Herniation Syndromes
• Mechanisms of increased intracranial pressure (ICP) in cancer
patients: Vasogenic edema, hemorrhage, Cerebrospinal (CSF) obstruction or
to associated conditions(infections, abscesses, thrombotic states and
coagulopathies).
Vasogenic Edema: Brain metastases from melanoma and lung cancer.
Cerebral hemorrhage: Melanoma, choriocarcinoma, renal cell carcinoma
and papillary thyroid cancer.
CSF Obstruction: Large mass lesions or tumor burdens, e.g. leukostasis
with acute leukemias or leptomeningeal carcinomatosis. CSF obstruction due
to large infectious burdens of Cryptococcus, Aspergillus, Candida,
Listeria and Herpes Simplex Virus.
• Cancer-induced hypercoagulopathy: Sinus venous thrombosis.
• At the other end of the spectrum, cancer patients on anticoagulation for venous
thromboembolism, thrombocytopenic after chemotherapy or inherently prone
to spontaneous bleeding e.g. promyelocytic leukemia, may have elevated
acute ICP because of coagulopathies.
25. Herniation Syndromes
• Central
– Decreased consciousness
– Headache/Focal neurological deficits
– Cheyne Stoke respirations/fixed pupil
• Uncal
– Rapid loss of consciousness
– Ipsilateral hemiparesis/Lateral pupil dilation
– Temporal lobe mass
• Tonsillar
– Occipital headache
– Hiccups/emesis/respiratory compromise
– Posterior fossa mass
26.
27. Increased Intracranial Pressure
• Symptoms:
– Headache most common SX (increased in the morning
after lying supine all night) and is relieved with emesis.
– Depressed level of consciousness, lethargy and coma.
• Signs:
– Ocular findings: Papilledema, when early, causes lack
of venous pulsations of the optic disc, while later, the
margin of the optic disc becomes blurred.
– Koscher-Cushing triad of hypopnea, hypertension and
bradycardia
– Abnormal Posturing
– Depressed Level of Consciousness
28.
29. Increased Intracranial Pressure
• Diagnosis:
– Gold standard: Measurement of the intracranial pressure
(ICP) --NL in an adult is <15 mm Hg, while >20 mm Hg is
considered pathologic.
– Role of CT scans; Less accurate than direct measurement. In a
prospective study of 753 patients whose initial CT scans
were negative for midline shifts or mass lesions, a 10-15%
chance of developing elevated ICP during their
hospitalization was found.
– MRI with gadolinium: Modality of choice as better able to
distinguish between infectious, neoplastic and ischemic
etiologies of increased ICP which would affect treatment
strategies.
30. Increased Intracranial Pressure:
Management
• IV dexamethasone 10 - 100 mg load; then 4 - 24 mg qd
(if from tumor induced vasogenic edema)
• Head elevation (facilitate gravity assisted cerebral
venous drainage)
• Isotonic fluids to maintain euvolemic iso/hyper-
osmolality (goal to keep the cerebral perfusion pressure
(CPP) 60-75 mmHg. CPP is mean arterial pressure
(MAP) – ICP*
• Intubation/hyperventilation (keep pCO2 25-30:
stimulates cerebral vasoconstriction)
31. Increased Intracranial Pressure:
Management
• IV Mannitol in unstable patients to promote
osmotic diuresis
– (dose of 20-25% @ 0.75-1.0 g/kg IV initially,
then 0.25-0.5g/kg every 3-6 h is recommended
by most experts. This is to be discontinued if
the serum osmolality exceeds 300)
• Neuro-surgical decompression (herniation)
• Supportive Care
44. Oncologic Urgencies
Bony Metastasis
Common Tumors – Prostate, Thyroid, Breast, Lung, Kidney
“P.T. Barnum Loves Kids.”
Treatment
– Bisphosphonates and Chemotherapy
– Surgery for femoral neck/shaft lesion or pathologic fx and consider with
other significant lesions in the weight bearing skeleton like the spine.
– XRT including radiopharmaceuticals 89SR
45. Oncologic Urgencies
• Neutropenic Fever
ANC< 500, Fever: single 101
One hr 100.4
Panculture, Empiric ABX
Avoid Sepsis Syndrome
• Typhlitis/Enteritis
• DVT/PE
• Extravasation of vesicants. Stop infusion and
plastic surgery consult.