Oncologic Emergencies Flashcards

Neutropenic fever in a cancer patient is defined as a single oral temperature ≥38.3°C (101°F) or ≥38°C (100.4°F) for 1 hour AND an ANC of:

Answer: < 500 cells/mm³

IDSA guidelines define neutropenic fever as fever with an ANC <500 cells/mm³, or <1000 cells/mm³ with expected decline to <500.

A neutropenic patient with fever should receive empiric broad-spectrum antibiotics within:

Answer: 1 hour of presentation

Current guidelines recommend initiating empiric IV antibiotics within 1 hour of presentation in febrile neutropenia to reduce morbidity and mortality.

Disseminated intravascular coagulation (DIC) in cancer is most commonly associated with which malignancy?

Answer: Acute promyelocytic leukemia (APL)

APL (AML-M3) is classically associated with DIC due to release of procoagulant granules from malignant promyelocytes.

A patient with known lung cancer develops distant heart sounds, jugular venous distension, and hypotension. The nurse suspects:

Answer: Cardiac tamponade

Beck's triad (muffled heart sounds, JVD, hypotension) is classic for cardiac tamponade, which can result from malignant pericardial effusion.

Which of the following best prevents tumor lysis syndrome in high-risk patients starting chemotherapy?

Answer: Allopurinol or rasburicase plus aggressive IV hydration

Allopurinol (or rasburicase for very high-risk cases) combined with aggressive IV hydration is the standard prophylaxis for TLS in high-risk patients.

Hyperviscosity syndrome is most commonly associated with which cancer?

Answer: Waldenström macroglobulinemia or multiple myeloma

Hyperviscosity syndrome results from excess paraproteins (IgM in Waldenström, or IgG/IgA in myeloma) thickening the blood and impairing flow.