Oncologic Emergencies Practice Test

These questions are part of the practice quiz. Start practicing

• In high-risk TLS, what prophylactic measures are recommended?
• After stabilization, which step best represents initial diagnostic workup in a suspected oncologic emergency?
• What are typical indications for thoracentesis and pleurodesis in malignant pleural effusion?
• How does SIADH differ from hypovolemic hyponatremia in cancer patients clinically and in management?
• What is typhlitis (neutropenic enterocolitis) and how is it managed?
• Which statement best describes the role of antifungal therapy in febrile neutropenia?
• What is the primary sign of airway compromise due to tumoral obstruction that warrants immediate action?
• Rasburicase should not be used in patients with which deficiency, and why?
• Before definitive surgery for suspected spinal cord compression, which steps are pivotal?
• When is empiric vancomycin recommended in febrile neutropenia?
• In patients with an anterior mediastinal mass, which anesthesia strategy helps minimize airway complications?
• In TLS, which electrolyte is typically decreased?
• In cancer patients with suspected DIC, what is a primary management step?
• Regarding malignant pleural effusion with recurrence, which option best describes management?
• Why must hyponatremia correction be gradual in SIADH-related cancer hyponatremia?
• Which statement best defines an oncologic emergency?
• Pleural fluid classification that is typically associated with cancer is which of the following?
• Which patients should receive TLS prophylaxis at the start of cytotoxic therapy?
• When should antifungal therapy be added in febrile neutropenia?
• MSCC is caused by compression of which anatomical structures?
• What lab pattern is typical of DIC?
• What does TLS stand for, and what is its defining mechanism?
• Which procedure is described as decompressing the spinal canal by removing bone and tumor mass?
• How is DIC managed in cancer patients?
• Which features help distinguish epidural spinal cord compression from other back pain etiologies in cancer patients?
• Which statement correctly describes the timing of corticosteroid use in suspected malignant spinal cord compression?
• In TLS-related hyperkalemia with high-risk features or EKG changes, what is the first step in management?
• In suspected oncologic emergencies, which item should be obtained promptly to guide management?
• In tumor lysis syndrome, which electrolyte abnormality is typically observed?
• What is the characteristic electrocardiographic finding in severe hypercalcemia and its clinical consequence?
• What defines leukostasis and how is it treated urgently?
• Which finding supports the diagnosis of TLS in the urine?
• What symptoms and diagnostic finding are commonly associated with malignant pleural effusion?
• When is renal replacement therapy indicated in tumor lysis syndrome?
• What is a key consideration before adding antifungal therapy in febrile neutropenia?
• When is pleurodesis indicated in malignant pleural effusion?
• Which MSCC procedure is not typically used according to the source?
• TLS-associated acute renal failure presents within which time frame after therapy, and which symptoms are commonly observed?
• Which of the following is NOT a TLS electrolyte abnormality?
• Which considerations are important for brain metastases patients undergoing radiotherapy regarding anticonvulsants and antiemetics?
• Which of the following is NOT a risk factor for TLS?
• Which of the following is listed as other therapies for SVC syndrome?
• What are the classic clinical features of superior vena cava syndrome?
• Why are calcium administration and phosphate removal strategies nuanced in TLS, and when is calcium administration appropriate?
• Which statement accurately describes the use of hypertonic saline in severe symptomatic hyponatremia due to SIADH?
• To prevent TLS, when should allopurinol be started relative to chemotherapy?
• Which description correctly expresses the goal of pleurodesis?
• When would denosumab be preferred over bisphosphonates in hypercalcemia of malignancy?
• Which sign is NOT a classic manifestation of superior vena cava syndrome?
• Surgery for MSCC where a balloon is inserted and inflated to expand the compressed vertebra to its normal height before filling the space with bone cement
• Which potassium level defines severe hyperkalemia according to the material?
• Which statement is true regarding corticosteroids in suspected spinal cord compression due to malignancy?
• Which strategy best describes the management goal in cancer-associated DIC?
• What is a major advantage of allopurinol over rasburicase in TLS management?
• In suspected spinal cord compression from cancer, corticosteroids are used to achieve what immediate benefit?
• Which anticonvulsant is preferred for seizures in patients with brain metastases to minimize interactions with cancer therapy?
• What is the best primary goal of corticosteroids in suspected spinal cord compression caused by malignancy?
• During TLS treatment, which laboratory monitoring is essential to avoid renal injury?
• In suspected spinal cord compression, what imaging step is pivotal to identify the level of compression before definitive treatment?
• Which procedure activates the inflammatory cascade to promote adhesion of pleural layers and prevent fluid re-accumulation?
• Which of the following best describes the rationale for early corticosteroid use in spinal cord compression due to cancer?
• Which statement best describes the initial clinical and laboratory findings that raise suspicion for tumor lysis syndrome in a patient starting chemotherapy?
• What anesthesia strategy minimizes airway collapse risk in patients with an anterior mediastinal mass?
• Should routine seizure prophylaxis be given in brain metastases with no prior seizures?
• What is a possible consequence of malignant spinal cord compression?
• What is initial management for brain metastases with edema and neurologic symptoms?
• Which chemotherapy agents have decreased clearance when co-administered with allopurinol?
• Which lab pattern helps distinguish hypercalcemia of malignancy from primary hyperparathyroidism?
• What is the threshold for platelet transfusion in DIC-related bleeding or risk?
• What best describes the pleural space?
• Hydration in TLS provides which benefits?
• Which mechanism best explains the benefit of corticosteroids in this condition?
• Which electrolyte disturbance is typical in tumor lysis syndrome?
• Which treatments for MSCC are considered to provide immediate relief?
• After a rasburicase dose, when should uric acid be monitored?
• What should be prioritized immediately after initial stabilization in a suspected oncologic emergency in the ED?
• What is the main purpose of administering corticosteroids in suspected spinal cord compression due to malignancy?
• Which emergency scenario requires urgent plasmapheresis in cancer patients?
• What is a key medication to reduce brain edema in brain metastases?
• What is a consequence of uric acid and xanthine accumulation in TLS?
• Which medication reduces vertebral fracture risk in vertebral metastases?
• What is the recommended management for recurrent malignant effusions after initial drainage?
• What is the recommended initial management for suspected malignant airway obstruction due to an intraluminal tumor?
• Why is aggressive hydration with isotonic saline used in TLS management?
• Define febrile neutropenia.
• Under Cairo-Bishop criteria, which best describes Laboratory TLS?
• Allopurinol is converted to an active metabolite that inhibits which enzyme?
• In suspected spinal cord compression, which immediate treatment should be started while awaiting imaging?
• Which of the following best encapsulates the reason corticosteroids are used in this setting?
• For palliation of spinal metastases in patients with short life expectancy, which radiotherapy approach is commonly used?
• What is the first-line therapy for suspected cancer-related spinal cord compression?
• Allopurinol is metabolized to which active compound that exerts its effect?
• TLS is defined by what percent changes from baseline in uric acid, potassium, phosphorus, and calcium?
• What is the key laboratory and imaging step in suspected oncologic emergencies?
• What strategies relieve airway compromise in SVCS due to tumor?
• When is surgical decompression favored in spinal cord compression?
• Which imaging is preferred to diagnose spinal cord compression?
• What are the two main mechanisms of hypercalcemia of malignancy?
• What procedure involves needle aspiration of pleural fluid for management of malignant pleural effusion?
• Which condition is caused by compression of the dural sac, spinal cord, or cauda equina by an extradural or intradural mass?
• How is malignant pericardial effusion with tamponade managed?
• What is the method of choice for diagnosing malignant spinal cord compression (MSCC)?
• What should be started immediately if MSCC is suspected?
• Which agent is NOT typically used as an initial empiric IV anti-pseudomonal beta-lactam in febrile neutropenia?
• TLS-associated acute kidney injury typically presents within which time frame after therapy?
• Which laboratory abnormalities constitute the hallmark pattern of tumor lysis syndrome?
• Which prophylaxis is used for high-risk TLS?
• Which statement best differentiates rasburicase from allopurinol in TLS management?
• Which action is least appropriate as the first step in a suspected oncologic emergency?
• In any suspected oncologic emergency presenting to the emergency department, what is the single most important initial step?
• When should hypocalcemia be treated according to the material?
• What is the active metabolite of allopurinol and which enzyme catalyzes this conversion?
• Which is an immediate therapy for severe hyperkalemia?
• Which sequence best reflects the initial management in a suspected oncologic emergency?
• What are classic signs of superior vena cava syndrome?
• Which statement about TLS hydration is true?
• The main therapeutic goal of corticosteroids in malignant spinal cord compression is to:
• Which device is described as being used for repeated drainage in malignant pleural effusion?
• Which therapy is used to acutely lower uric acid levels in TLS and has a rapid onset but is not useful for ongoing production?
• Which cancer is most characteristically associated with hyperviscosity syndrome due to an IgM monoclonal protein?
• Which statement about malignant pericardial effusion management is NOT recommended?
• Which of the following is a recognized risk factor for tumor lysis syndrome?
• In febrile neutropenia, which risk-stratification tool guides outpatient versus inpatient management?
• List three common symptoms of hypercalcemia in cancer.
• Which laboratory parameters are monitored for tumor lysis syndrome before and after chemotherapy?
• What symptom relief is typically observed after plasmapheresis in hyperviscosity syndrome?
• What measures help prevent uric acid nephropathy in tumor lysis syndrome?
• For any suspected oncologic emergency, which action is unquestionably first?
• How does tumor lysis syndrome cause uric acid nephropathy?
• Which signs are most indicative of cauda equina syndrome and require urgent imaging and decompression?
• Which scenario warrants considering pleurodesis?
• In suspected malignant spinal cord compression, corticosteroids primarily aim to do which of the following first?
• A limitation of rasburicase when measuring uric acid is that it can cause which reading in blood samples?
• What is the usual intravenous dose of rasburicase?
• Which scenario is considered for surgical decompression in spinal metastases?
• Which agent is commonly used for pleurodesis?
• Which patients are at greatest risk for tumor lysis syndrome?
• Surgery for MSCC where the vertebral body and tumor mass are removed
• How is neutropenic sepsis managed?
• Rasburicase is contraindicated in which group of patients?
• Which statements correctly describe common agents used for hypercalcemia and their mechanisms?
• Humans lack which enzyme that metabolizes uric acid into allantoin?
• What is the initial management for suspected airway compromise from tumor causing stridor?
• Electrolyte monitoring in TLS management is typically performed how often?
• Corticosteroids in suspected spinal cord compression are used to preserve neurologic function while arranging what?
• What is the target urine output during TLS hydration?
• Pleural fluid classifications used to guide treatment and commonly associated with cancer are?
• Which of the following are patient-specific risk factors for TLS?
• Rasburicase administration can cause severe hemolysis in patients with deficiency of which enzyme?
• In suspected spinal cord compression, which practice is NOT recommended as part of initial management?
• In SIADH, what is the initial management step?
• Denosumab is considered in which situation?
• How soon after therapy initiation does hyperkalemia typically present?
• Which finding helps differentiate SIADH from hypovolemia in hyponatremia?
• Should be offered to patients with vertebral involvement to reduce the risk of vertebral fracture
• In cancer-associated DIC, what transfusion support is commonly used?
• Which option is NOT typically used when treating brain metastases with radiotherapy?
• What is the preferred initial anticoagulation for cancer-associated thrombosis?
• Primary goal of SVC syndrome management
• SVC presentation
• Which action should be prioritized immediately after stabilization in a suspected oncologic emergency?
• Which step should be performed immediately if a cancer patient presents with airway compromise?
• Which symptom is a hallmark of SVC syndrome related to venous drainage obstruction?
• What is the recommended administration approach for IV calcium gluconate when treating hypocalcemia?
• Which statement best captures the initial priority in an ED presenting with potential oncologic emergency?
• How should malignant pericardial effusion presenting with tamponade be managed?
• Rasburicase is a recombinant enzyme that catalyzes uric acid into which metabolite?
• Which cancer therapies are most commonly associated with TLS risk and necessitate prophylaxis?
• Which therapy is listed as a treatment option to stabilize the heart in severe hyperkalemia?
• What is the typical management approach for cancer-associated disseminated intravascular coagulation (DIC)?
• Which action should you perform first in the ED when a suspected oncologic emergency is suspected, after basic stabilization?
• The use of corticosteroids in suspected spinal cord compression is intended to:
• In patients with brain metastases, what is the role of corticosteroids?
• What is the most common first symptom of MSCC, and what are the other symptoms?
• How is malignant pericardial effusion monitored and managed?
• Which laboratory pattern is typical of cancer-associated DIC?
• In the context of spinal cord compression, which outcome is most directly supported by corticosteroid administration?
• What is the recommended approach to hyperphosphatemia management?
• How is hyperviscosity syndrome diagnostically confirmed?
• What white blood cell count range is associated with intermediate TLS risk?
• Which cancer is most commonly associated with causing malignant spinal cord compression?
• What is the drainage limit typically recommended for thoracentesis?
• What is the primary clinical objective when starting corticosteroids for suspected spinal cord compression due to cancer?
• In cancer patients with hyponatremia due to SIADH, what is the recommended management?
• Which statement correctly describes TLS prophylaxis by risk level?
• In febrile neutropenia, which statement best reflects the role of routine G-CSF according to guidelines?
• Airway obstruction from tumor emergency management: what is an appropriate initial step?
• TLS prophylaxis aims to maintain a urine output above how many mL per m2 per day?
• Which malignancy is associated with intermediate-risk tumor lysis syndrome?
• Hyperviscosity syndrome is most commonly associated with which cancers?
• What is the mainstay of hydration in hypercalcemia of malignancy, and which agents provide rapid and sustained calcium reduction?
• How soon after therapy initiation do hyperuricemia, hyperphosphatemia, and hypocalcemia typically present?
• Tumor lysis syndrome typically begins after starting cytotoxic therapy within which time frame?
• What is the suggested management for a cancer patient with symptomatic hyponatremia due to SIADH?
• Which anticonvulsant is preferred for brain metastases to minimize drug interactions during radiotherapy?
• Which binder is listed for short-term phosphate control in hyperphosphatemia?
• When is rasburicase preferred over allopurinol in TLS?
• What is the first-line pharmacologic uric acid–lowering agent used in tumor lysis syndrome and what precaution must be checked before use?
• Which antibiotic regimens are commonly used as initial empiric therapy for febrile neutropenia?
• Surgery for MSCC where bone cement is injected into a fractured bone
• In TLS prophylaxis, which drug is preferred when rapid uric acid reduction is needed?
• Which imaging modality is commonly used to assess malignant pleural effusion?
• What is the preferred imaging for brain metastases?
• Calcitonin is used in hypercalcemia for what reason?
• Which electrolyte imbalance is most likely to be worsened by acute kidney injury in TLS?
• Which event qualifies as Clinical TLS when Laboratory TLS is present?
• Which of the following is NOT a recommended consideration in airway obstruction from a tumor?
• Neutropenia is defined as an absolute neutrophil count (ANC) below what value?
• Direct oral anticoagulants in cancer-associated thrombosis are increasingly used with caution based on what factors?
• How is cancer-associated pulmonary embolism typically treated?
• Which statement about DIC management is true in cancer patients?
• What radiotherapy options are used for brain metastases?
• Denosumab is preferred for cancer-related hypercalcemia in which scenario?
• Which of the following represents the main electrolyte abnormalities seen in TLS?
• Which scenario indicates the need for dialysis in TLS?
• What is the standard initial approach to fever in a patient with neutropenia and how quickly should therapy be initiated?
• Malignant pleural effusion is most commonly associated with which condition?
• High TLS risk is defined by which criterion?
• In a patient with suspected malignant spinal cord compression, corticosteroids should be used with the aim to:
• What is the role of rapid intravenous hydration in TLS, and what hydration rate is typically recommended?
• What diagnostic test confirms malignant pleural effusion?
• What is the main treatment for hyperviscosity syndrome?
• What is the empiric antibiotic regimen for hemodynamically stable febrile neutropenia?
• Which malignancy is associated with high TLS risk?
• Which malignancies are most commonly associated with DIC?
• Which condition is characterized by mucosal bleeding, hyperviscosity symptoms, and responds best to plasmapheresis?
• What is the role of dexamethasone in brain metastases?
• In suspected airway compromise from tumor with stridor, what is the immediate priority?
• In the ED, for suspected oncologic emergency, which action should be performed first?
• Which list correctly identifies the four main TLS electrolyte abnormalities?
• What is the initial management of a symptomatic malignant pleural effusion?
• What is the initial management priority for suspected superior vena cava syndrome due to thoracic malignancy?
• What is the mechanism of action of allopurinol in preventing TLS?
• Which phrase best describes the indication for an indwelling pleural catheter?
• If malignant pericardial effusion with tamponade recurs after drainage, what additional intervention is commonly considered?
• What should be the first step in any suspected oncologic emergency?
• What are the main goals in management of malignant effusions causing respiratory compromise?
• Which enzyme catalyzes the purine catabolism steps leading to uric acid in TLS?
• How should seizures in a patient with brain metastases be managed to minimize interactions with cancer therapy?
• Major blood vessel for venous blood flow from head, neck, upper extremities to heart and lungs and what happens when it is compressed by tumors
• What is the initial management of moderate-severe cancer-related hypercalcemia?
• The product produced from uric acid by rasburicase is which compound?
• Which of the following best describes the commonly encountered pleural effusion associated with advanced malignancy?
• In hypercalcemia of malignancy, what systemic effect contributes to polyuria and dehydration?
• Which statement best describes the overall management goal for SVC syndrome?
• Which prophylaxis is recommended for intermediate-risk TLS?
• After stable patient, what is the next essential action in suspected oncologic emergencies?
• Rasburicase is administered via which route?
• Which of the following is NOT listed as a symptom of MSCC?
• What are typical symptoms of hyperviscosity syndrome?
• What supportive measure is essential alongside drainage for malignant pericardial effusion with tamponade?
• What is the primary event in TLS that leads to metabolic derangements?
• Which of the following best describes the emergent management for suspected spinal cord compression in a cancer patient with back pain and neurologic deficits?
• What cancers are most associated with DIC?