The Curbsiders Internal Medicine Podcast #358 Oncologic Emergencies with Dr. Aditi Singh
6 snips
Oct 3, 2022 AI Snips
Chapters
Transcript
Episode notes
Establish Diagnosis Before Definitive SVC Therapy
- Differentiate urgency vs emergency in SVC syndrome by checking for airway compromise, cerebral edema, or cardiac compression.
- If histology is unknown and patient is stable, obtain tissue before definitive therapy.
CT And Decompress For Malignant Bowel Obstruction
- For suspected malignant bowel obstruction, obtain a CT abdomen to find the transition point and assess for ischemia.
- Start NG decompression, aggressive IV fluids, analgesia, and antiemetics while consulting surgery and oncology.
Prioritize Symptom Relief And Goals For Obstruction
- Use octreotide and antiemetics for symptom control if surgery isn't immediate, but avoid metoclopramide in complete obstruction.
- Discuss venting G-tube and TPN with surgery and oncology based on prognosis; avoid TPN in patients with limited life expectancy.