AOCNP Oncologic Emergencies

Question 1

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

Accepted Answer

Spinal cord compression

Answer

Superior vena cava syndrome

Answer

Tumor lysis syndrome

Answer

Hypercalcemia of malignancy

Question 2

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

Accepted Answer

Hypernatremia

Answer

Hypocalcemia

Answer

Hyperkalemia

Answer

Hyperphosphatemia

Question 3

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

Accepted Answer

Septic shock

Answer

Anaphylaxis

Answer

Cardiac tamponade

Answer

Disseminated intravascular coagulation

Question 4

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

Accepted Answer

Aggressive IV normal saline hydration followed by bisphosphonate

Answer

IV bisphosphonate alone

Answer

Oral calcitonin

Answer

Furosemide alone

Question 5

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

Accepted Answer

CT chest with contrast

Answer

MRI brain

Answer

Bone scan

Answer

Echocardiogram

Question 6

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

Accepted Answer

Patients with G6PD deficiency

Answer

Patients with renal impairment

Answer

Patients with hepatic failure

Answer

Patients receiving steroids