Oncologic Emergencies Flashcards

A patient develops sudden-onset dyspnea, muffled heart sounds, hypotension, and jugular venous distension. Which emergency is this?

Answer: Cardiac tamponade

Beck's triad of hypotension, muffled heart sounds, and jugular venous distension is the hallmark of cardiac tamponade requiring urgent pericardiocentesis.

Which cancer type is most commonly associated with disseminated intravascular coagulation (DIC) in adults?

Answer: Acute promyelocytic leukemia (APL)

APL releases tissue factor and procoagulant granules, causing the most severe DIC of any malignancy.

In febrile neutropenia, an absolute neutrophil count (ANC) below which threshold defines high-risk neutropenia?

Answer: < 500 cells/mm³

An ANC < 500 cells/mm³ (or < 1000 with predicted decline to < 500) defines high-risk neutropenia requiring prompt empiric antibiotics.

Which agent is used as first-line prophylaxis against tumor lysis syndrome in high-risk patients?

Answer: Allopurinol

Allopurinol inhibits xanthine oxidase and is the standard first-line prophylactic agent for intermediate- and high-risk TLS.

A patient with a known brain metastasis develops sudden-onset severe headache, vomiting, and altered consciousness. What is the priority intervention?

Answer: Dexamethasone IV and urgent CT head

Increased intracranial pressure from cerebral herniation requires immediate dexamethasone to reduce edema and urgent imaging to guide further management.

Which electrolyte abnormality most immediately threatens cardiac function in tumor lysis syndrome?

Answer: Hyperkalemia

Hyperkalemia causes fatal arrhythmias and is the most immediately life-threatening electrolyte disturbance in TLS.