onc + pall

• How do muscarinic antagonists like hyoscine hydrobromide help in palliative care?

  They manage respiratory secretions to reduce gurgling sounds
• What is the steroid of choice for managing malignant spinal cord compression?

  Dexamethasone
• What causes spinal cord compression due to bony metastases?

  Cancer spreading to the vertebrae
• What symptoms indicate spinal cord compression from bony metastases?

  Pain, weakness, numbness, and paralysis
• How does hyoscine butylbromide help terminally ill patients?

  It reduces noisy respiratory secretions
• What long-term complication can arise from external beam radiotherapy for prostate cancer?

  Colorectal cancer
• What are the common symptoms of superior vena cava syndrome?

  Dyspnoea, stridor, and distended veins
• How should analgesia be managed in end-of-life palliative care patients?

  Titrate based on response and adjust doses
• What features are associated with hepatocellular carcinoma?

  Cirrhosis, jaundice, and raised serum AFP
• What conditions increase the risk of cholangiocarcinoma?

  Ulcerative colitis and primary sclerosing cholangitis
• How should end-of-life pain be managed in palliative care patients?

  Calculate total daily opioid requirement and prescribe
• What is the treatment for hypercalcaemia in multiple myeloma?

  Bisphosphonate therapy like pamidronate
• What systemic symptoms can liver metastases cause in carcinoid syndrome?

  Impaired hormonal metabolisation in portal circulation
• What is the initial treatment for suspected spinal cord compression?

  High-dose corticosteroids like dexamethasone
• What may indicate an epidural haematoma in patients with recent epidural anaesthesia?

  Acute back pain and leg weakness
• What mutations are associated with hereditary non-polyposis colorectal cancer?

  MHS2 mutations
• What should be done for established status epilepticus unresponsive to benzodiazepines?

  Administer intravenous levetiracetam or phenytoin
• How does hyoscine butylbromide help with small bowel obstruction?

  Reduces crampy abdominal pain and nausea
• What is multiple myeloma?

  A plasma cell malignancy causing hypercalcaemia
• What are common presentations of primary brain tumours like glioblastoma?

  Progressive neurological symptoms and raised ICP
• What is essential for managing tumour lysis syndrome after chemotherapy?

  Prompt fluid resuscitation and monitoring
• What is the initial management for suspected superior vena cava obstruction?

  Administer dexamethasone to reduce symptoms
• What should be done for a firm thyroid nodule found during examination?

  Investigate with ultrasound and fine needle aspiration
• What commonly causes superior vena cava obstruction?

  Extrinsic compression from a pulmonary tumour
• What does NICE recommend for patients over 45 with unexplained hoarseness?

  Refer under the suspected laryngeal cancer pathway
• What is Horner syndrome and its potential cause?

  Unilateral miosis, ptosis, and anhidrosis from Pancoast tumour
• What should be done for persistent thoracic spinal pain disturbing sleep?

  Urgent referral for potential spinal metastases
• What should patients receiving methotrexate for lymphoma be monitored for?

  Signs of pulmonary fibrosis
• How can dexamethasone help patients with secondary brain metastases?

  Relieves nausea and vomiting by reducing ICP
• What should be done for individuals with a history of smoking and red flag symptoms?

  Perform a chest X-ray as initial investigation
• What is the first-line medication for managing agitation in advanced dementia?

  Haloperidol
• What symptoms may indicate hypercalcaemia in cancer patients?

  Vomiting, abdominal pain, confusion, and constipation
• What does significant shortness of breath without cough or chest pain indicate in oncology patients?

  Possible symptomatic anaemia requiring transfusion
• What is the first-line antiemetic for managing nausea in patients with intracranial metastases?

  Cyclizine
• How does colorectal cancer typically metastasise?

  Through the portal circulation to the liver
• What is essential for managing suspected metastatic spinal cord compression?

  Prompt administration of dexamethasone
• What may indicate a Pancoast tumour in a patient?

  Horner's syndrome and brachial neuropathy
• How does dexamethasone help with brain metastases?

  Reduces inflammation and intracranial pressure
• What is nasopharyngeal carcinoma associated with?

  Epstein-Barr virus (EBV)
• What is a common side effect of vincristine treatment?

  Peripheral neuropathy with reduced sensation