Tumor lysis syndrome, superior vena cava syndrome, spinal cord compression, febrile neutropenia, hypercalcemia of malignancy, antiemetics and growth factors.
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- What triggers tumor lysis syndrome?
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Massive, rapid breakdown of tumor cells releasing potassium, phosphate, and nucleic acids into the blood, usually after starting chemotherapy.- Name the four core metabolic abnormalities that define tumor lysis syndrome.
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Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia.- Why does hypocalcemia occur in tumor lysis syndrome?
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Released phosphate binds free calcium, forming calcium phosphate precipitates.- Which malignancies carry the highest risk of tumor lysis syndrome?
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Bulky, rapidly proliferating cancers such as Burkitt lymphoma and acute leukemias.- What is the main preventive measure before chemotherapy in a patient at risk for tumor lysis syndrome?
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Aggressive IV hydration.- Which drug is preferred over allopurinol for rapidly lowering uric acid in high-risk tumor lysis syndrome?
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Rasburicase.- What usually causes superior vena cava syndrome in cancer patients?
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Tumor compression or direct invasion of the superior vena cava, obstructing venous blood flow from the head, neck, and arms.- What is the most common malignant cause of superior vena cava syndrome?
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Lung cancer.- List the classic physical signs of superior vena cava syndrome.
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Facial and neck swelling, distended neck and chest wall veins, and dyspnea.- How do superior vena cava syndrome symptoms typically change with position?
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They worsen when bending forward or lying down.- What is the imaging study of choice to confirm superior vena cava syndrome and its cause?
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Contrast-enhanced CT of the chest.- What is the most common cause of malignant spinal cord compression?
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Metastasis to a vertebral body, most often from breast, lung, or prostate cancer.- What is the earliest and most common presenting symptom of malignant spinal cord compression?
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Back pain, often worse at night or when lying flat, preceding any neurologic deficit.- What is the first urgent medical treatment given for suspected malignant spinal cord compression?
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High-dose IV corticosteroids, such as dexamethasone.- What is the imaging study of choice for suspected spinal cord compression?
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MRI of the spine.
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