This condition causes swelling of the face and neck, dyspnea, and JVD.
For extra points, please include the most dangerous complication of this disease
What is SVC syndrome
EC: tracheal obstruction
100
A disease defined by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia caused by destruction of rapidly proliferating neoplastic cells
What is Tumor Lysis Syndrome
100
The most common paraneoplastic syndrome
What is hypercalcemia
100
The most common complication of cancer treatment
What is neutropenia with infection
100
The patient is complaining of swollen face and neck fullness.
SVC syndrome will need treatment with radiation and/or chemotherapy for debulking, and possible SVC stenting
200
Name 5 sites of obstruction which are caused by masses
What are the SVC, cardiac outflow, intestines, urinary tract, biliary tract, spinal cord, intracerebral, airway
200
Indications for this therapy in tumor lysis syndrome include potassium >6, uric acid>10, creatinine>10, phosphate>10, or worsening symptomatic hypocalcemia
What is hemodialysis
200
Describe a workup of hyponatremia which would make you suspect SIADH as the root cause.
What is euvolemic hyponatremia with normal renal function, low uric acid level, and high urine sodium level.
200
A patient is being treated with cyclophosphamide and develops hemorrhagic cystitis. How could this have been prevented?
What is maintaining a high urine flow rate and treatment with mesna (2-mercaptoethanesulfonate) to detoxify the metabolites of chemotherapy
200
Spinal cord compression
What is decadron, radiation, anterior resection of vertebral body with spinal stabilization
300
You see multiple air fluid levels on X-ray of a patient complaining of abdominal pain, distention, and vomiting. Name two potential primary causative lesions
What are colorectal and ovarian tumors
May also be metastases from lung/breast/melanoma
300
Describe the mechanism of hypocalcemia in Tumor Lysis Syndrome and the complication it may lead to.
What is mobilization of phosphate from the lysed cells causing binding of calcium and formation of calcium phosphate. This may precipitate in the kidneys causing crystal deposition and renal failure
300
This is the most common organ involved in development of lactic acidosis
What is extensive liver involvement with the primary tumor
300
A common complication of infusion with antibody based therapy such as rituximab, trastuzumab the first time the patient is receiving therapy.
What is a human antibody infusion reaction consisting of fever, chills, nausea, and headache. This is caused by release of inflammatory mediators and may be prevented with tylenol and benadryl
300
Neoplastic meningitis
What is intrathecal chemotherapy
400
A patient complains of sudden onset of headache, nausea, vomiting, and focal neurologic defecit. Name the likely cause AND a primary tumor type
What is hemorrhagic brain metastasis caused by melanoma, germ cell tumor, or renal cell cancer
400
Renal failure is generally caused by ________ in tumor lysis syndrome, and treatment involves ___________.
What is hyperuricemia/uric acid deposition, treated using allopurinol/rasburicase and aggressive hydration. May also consider urinary alkalinization which may precipitate calcium phosphate stones.
400
A patient is treated with aggressive volume resuscitation and bisphosphonate therapy. What protein caused his condition
What is PTHrP
400
A patient being treated for AML presents complaining of watery diarrhea, fever, and abdominal pain. He is found to have pneumotosis on CT scan and is leukopenic. Name his condition and early treatment.
What is neutropenic enterocolitis (typhlitis), treated with rapid initiation of broad spectrum antibiotics and NG decompression of the bowel.
400
lactic acidosis of malignancy
What is attempt to reverse underlying malignant cause. Early bicarb administration for severe acidosis
500
Describe the management of the patient presenting with headache, worsening lethargy, and papilledema
What is urgent airway control with intubation, hyperventilation with goal PCO2 25-30, mannitol infusion, and steroids
500
Complete the quote: "You clearly don't know who you're talking to, so let me clue you in. I am not in danger, Skyler. I am the danger. A guy opens his door and gets shot, and you think that of me? No! ..."
What is "I am the one who knocks!"
500
A pt was treated for a metabolic condition caused by his primary lung tumor and developed quadriparesis, ataxia, and abnormal eye movements. Name the mechanism of his illness and the cause of his metabolic derangement.
What is central pontine myelinolysis caused by over-rapid correction of hyponatremia. In this clinical situation, it was likely caused by SIADH
500
A patient is found to have schistocytes on peripheral smear, renal failure, anemia, and thrombocytopenia. Name his condition and the time course of it's appearance
What is Hemolytic Uremic Syndrome approximately 4-8 weeks after the last dose of chemotherapy
500
Tumor lysis syndrome
What is prevention is the primary therapy with hydration and uric acid lowering agents. hold chemotherapy, cardioprotective calcium, potassium lowering therapy and dialysis if necessary. Allopurinol or rasburicase, aggressive fluids, consider urine alkalinization