Term
| do you have to have had chemo to present wiht tumor lysis sybndrome? |
|
Definition
| no, but majority have had it |
|
|
Term
| TLS risk factors that deal with tumor-3 |
|
Definition
high prolifereraiton
sensitive to chemo/cytotixci therapy
large mass (10-15 cm) |
|
|
Term
| TLS risk factors that don't deal with tumor-4 |
|
Definition
leukocytosis
high LDH
pre-exisitng renal insuff
hematologic malignancies |
|
|
Term
| good what fucniton cna prevent TLS? |
|
Definition
|
|
Term
| what is a indirect indicator of high tumor burden/ more risk for TLS |
|
Definition
|
|
Term
| *any lymphoma has higher chance of TLS |
|
Definition
|
|
Term
high risk for TLS means if dont treat will die within how long
is low? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| cancers with highest risk for TLS-4 |
|
Definition
| AML, T cell ALL, Burkitt;s, lymphoblast leukemia |
|
|
Term
| Cancers with lowest risk for TLS-3 |
|
Definition
| GI ardenocarcinoma, medulloblastoma, low grade lymphoma |
|
|
Term
| pathophys of TLs invovles 3 things- |
|
Definition
rpaid lysis of tumor cells
releas eof intracell content
exceed normal compensaotry mechanisms |
|
|
Term
What 4 electorlyte findings can show TLS
which cna cause secondary HypoC? |
|
Definition
Hyperuricemia
hyperK
Hyperphosphatemia
HyopC
hyperphos |
|
|
Term
| too muhc uric acid in TLS is due to?-2 |
|
Definition
DNA breask down
bad kdiney funct->accumulation |
|
|
Term
| *TLs can rsult in acute renal failure and eventually death |
|
Definition
|
|
Term
| consequnce of HyperK in TLS-2 |
|
Definition
|
|
Term
| HyperPhos consequnces of TLS-2 |
|
Definition
|
|
Term
| HypoC consequences of TLS-3 |
|
Definition
| cardiac arrythmia, hypotension, muscular cramps |
|
|
Term
|
Definition
IV hydraiton
Alkainize urine
allopurinol
Rasburicase
close montiroing |
|
|
Term
when do you initaite IV hydration for TLS?
how long do you cont it for? |
|
Definition
24-48 hrs prior to therapy
48 hrs after |
|
|
Term
| important to have equal fluid intake and outake for hydraiton, so what pt would you slow infusion rate? |
|
Definition
|
|
Term
| why is alkanizaiton of urine not normally reccomedned in pts? |
|
Definition
| would shrink cells, can increase kindey damage thru Phos-Ca binding |
|
|
Term
| goal of alkanization is pH of? |
|
Definition
|
|
Term
| allppurinol does what to current uric acid formed |
|
Definition
| nothing, jus prevent more synthesis |
|
|
Term
|
Definition
| xanthine oxidase inhibitor |
|
|
Term
ADE of allopurinol?
when do you adjust dosing |
|
Definition
|
|
Term
| allopurinol interacts with what med |
|
Definition
|
|
Term
|
Definition
| increase uric acid to allantoin-> faster clearence |
|
|
Term
| if taking draw of uric acid for lab, what special things need to be done-3 |
|
Definition
| prechilled syringe, then keep on ice bucket-> eval w/i 4 hrs |
|
|
Term
| rasburicase is contraindicated for what deficinecy? |
|
Definition
|
|
Term
| Bow warnings for rasburicase-3 |
|
Definition
anaphylaxis
hemolysis
methoglobinemia |
|
|
Term
| *** do not give allopurinol and rasburicase together!!!!! it's one or the other |
|
Definition
|
|
Term
|
Definition
| CBC, electrolyes, renal, urine, fluid |
|
|
Term
| *use rasburicas rather than allppurinol for TREATMENT; prevention for TLS depedns on risk of chemo agent and TLS |
|
Definition
|
|
Term
| blood goes form SVC to the heart, so in Superior Vena cava syndomre there is SVC obstruction*** |
|
Definition
|
|
Term
|
Definition
increased VP
airway obstruction
cerebral edeam
decreased cardiac |
|
|
Term
|
Definition
| cough, chest pain, dysphagia, cyanosis, swelling of face, neck, veins on chest |
|
|
Term
| diagnosis tools for SVC-4 |
|
Definition
chest x ray
CT scan
venography
biopsy |
|
|
Term
|
Definition
chemo
radiation
surgery
anticoag/thombolytics
(relieve symtpoms/complications |
|
|
Term
| supportive measures for SVC-4 |
|
Definition
bed rest
O2
diuretics
low salt |
|
|
Term
| majority of spinal cord compresiosn is due to ? |
|
Definition
|
|
Term
| types of cancers associated with spinal cord compression-2 |
|
Definition
|
|
Term
the major symtpom of vertebral compression ?
other- |
|
Definition
pain (weeks to months befroe)
neurologic (moto, paraplegia) |
|
|
Term
| diagnosis of vertrbal compression-3 |
|
Definition
X ray of spine first
then MRI or CT |
|
|
Term
| treatment for verterbal spine compression |
|
Definition
|
|
Term
| dose for dexmethazone for spinal compresison |
|
Definition
| 10 mg IV bolus, then put on maint 4 mg PO q6 |
|
|
