Oncologic Emergencies Flashcards

A patient with small cell lung cancer presents with facial swelling, venous distension of the neck and chest, and dyspnea. This presentation is most consistent with:

Answer: Superior vena cava (SVC) syndrome

SVC syndrome is caused by obstruction of the SVC, commonly by mediastinal tumors, leading to facial edema, neck vein distension, and dyspnea.

Tumor lysis syndrome (TLS) is most likely to occur in which cancer type?

Answer: Highly proliferative tumors such as Burkitt lymphoma or ALL

TLS most commonly occurs with highly proliferative hematologic malignancies like Burkitt lymphoma or ALL due to rapid cell lysis releasing intracellular contents.

Which laboratory finding is NOT consistent with tumor lysis syndrome?

Answer: Hypercalcemia

TLS causes hypocalcemia (not hypercalcemia) because phosphate released from lysed cells binds calcium, lowering serum levels.

A patient with multiple myeloma presents with confusion, polyuria, and constipation. Serum calcium is 13.5 mg/dL. The priority nursing intervention is:

Answer: Initiate aggressive IV hydration with normal saline

Aggressive IV hydration with normal saline is the first-line treatment for hypercalcemia of malignancy to dilute calcium and promote renal excretion.

Spinal cord compression in oncology patients most commonly presents initially with:

Answer: Back pain

Back pain is the earliest and most common presenting symptom of malignant spinal cord compression, often preceding neurologic deficits.

Which treatment is the immediate priority for a patient with confirmed malignant spinal cord compression?

Answer: High-dose corticosteroids (dexamethasone)

High-dose dexamethasone is given immediately to reduce spinal cord edema while definitive treatment (radiation or surgery) is arranged.