Oncologic Emergencies Flashcards

A patient with multiple myeloma presents with severe back pain, lower extremity weakness, and urinary retention. Which oncologic emergency does this presentation suggest?

Answer: Spinal cord compression

Spinal cord compression presents with back pain, motor weakness, and autonomic dysfunction such as urinary retention or incontinence.

Which laboratory finding is NOT part of the classic tumor lysis syndrome (TLS) triad?

Answer: Hypernatremia

TLS is characterized by hyperkalemia, hyperphosphatemia, hyperuricemia, and secondary hypocalcemia — hypernatremia is not a feature.

A patient receiving high-dose methotrexate suddenly develops fever, rigors, and hypotension. Which oncologic emergency is most likely?

Answer: Septic shock

Febrile neutropenia with hemodynamic compromise meets criteria for septic shock and requires immediate broad-spectrum antibiotics and fluid resuscitation.

Which first-line intervention is indicated for hypercalcemia of malignancy with corrected serum calcium > 14 mg/dL?

Answer: Aggressive IV normal saline hydration followed by bisphosphonate

Aggressive IV normal saline rehydration is the immediate priority, followed by a bisphosphonate such as zoledronic acid to lower calcium.

A patient with lung cancer develops facial plethora, arm edema, and distended neck veins. Which imaging study is the priority?

Answer: CT chest with contrast

CT chest with contrast delineates the extent of superior vena cava (SVC) obstruction and identifies the underlying mass causing it.

Rasburicase is contraindicated in which patient population due to risk of hemolytic anemia?

Answer: Patients with G6PD deficiency

Rasburicase generates hydrogen peroxide as a byproduct, which causes oxidative hemolysis in patients with G6PD deficiency.