Febrile Neutropenia Flashcards Preview

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Flashcards in Febrile Neutropenia Deck (22)
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1
Q

What is febrile neutropenia

A
  1. Temperature recorded as above 38 degrees with absolute neutrophil count <1.0 x 10^9
2
Q

Why is not diagnosing febrile neutropenia on time a problem

A

Patients can easily die

3
Q

What patients are at risk

A
  1. Chemotherapy less than a week ago
  2. Those who had stem cell transplant or high dose chemotherapy within the last year
  3. Any haematological conditions resulting in neutropenia
4
Q

What haematological conditions can cause neutropenia

A
  1. Aplastic anaemia
  2. Autoimmune
  3. Leukaemia
5
Q

What drugs can cause neutropenia

A

METHOTREXATE
CARBIMAZOLE
CLOZAPINE

6
Q

Clinical presentation of neutropenia

A
  1. Pyrexia > 38 degrees
  2. Malaise
  3. Swetas
  4. Coughs/diarrhoae, abode pain
  5. Tachycardia, hypotension + raised respiratory rate
  6. May not always have temp/rigors due to inability to amount immune response
7
Q

How is neutropenia managed

A
  1. Start broad spectrum IV anrtibiiotcis WITHOUT waiting for results (1 hour into admission)
  2. DO NOT CATHETORISE
8
Q

Why do we not catheterise

A

Increased risk of infection

9
Q

What is Malignant spinal cord compression caused by

A
  1. Bone metastasis, vertebral collapse
  2. Local tumour extension
  3. Deposition of malignant cells within cord
10
Q

What conditions are commonly seen with spinal cord compression

A
  1. Myeloma

2. Lymphoma

11
Q

Clinical presentation of Malignant spinal cord compression

A
  1. Back Pain
  2. Weakness/numbness in legs
  3. Inability to control bladder/bowel
  4. Saddle paresthesia
  5. Uni/bilateral leg weakness
  6. Decreased anal tone
  7. Decreased perineal sensation
  8. In acute cord compression, tone, reflexes will be reduced
12
Q

How is Malignant spinal cord compression managed

A

BED REST

  1. High dose steroid (DEXAMETHASONE)
  2. ANALGESIA
  3. MRI of whole spine
13
Q

What is tumour lysis syndrome

A

Life threatening metabolic derangement that occurs when malignant cells BREAKDOWN:

HIGH uric acid
HYPERkalaemia
HYPERphosphataemia
HYPOcalcaemia

14
Q

What patients are at risk of tumour lysis syndrome

A
  1. High tumour burden
  2. High grade disease
  3. Pre-existing renal impairment
  4. Increasing age
15
Q

How is Tumour lysis Syndrome treated

A
  1. HYDRATION
  2. ALLOPURIONOL (Xanthine oxidase inhibitor) or RASBURICASE (recombinant rate oxidase)

Monitor electrolytes

Refere for dialysis

16
Q

What is hyper viscosity syndrome

A
  1. Increase in blood viscosity due to HIGH levels of igG
17
Q

How is hypercalcaemia treated

A

IV hydration - 3L a day

BISPHOSPHONATES (ZOLENDRONATE -r educed ca production)

18
Q

What is ONDANSETRON

A
  1. Anti-emetic drug

2. 5HT3 antagonist

19
Q

How is heparin treated

A

APTT - Activated Partial Thromboplastin Time)

20
Q

How does clopidogrel reduce platelet aggregation

A

Inhibits ADP induced

21
Q

When dow e stop aspirin before a surgery

A

5 days before

22
Q

What do NOACs act on

A

Factor II or X

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