Oncologic Emergencies

An 82-year-old woman with a history of breast cancer presents to clinic with complaints of headache for the past 2 weeks. She describes daily retro-orbital headaches that are worse in the morning. In addition, she notes severe nausea and vomiting. MRI of the brain reveals multiple metastatic lesions.   Which of the following is the most appropriate initial management for this patient?

A 42-year-old man with a medical history significant for lung cancer is brought to an emergency room for altered mental status. His family reports altered mental status for 3 days. He has been lethargic and difficult to arouse. On examination, he has orthostatic blood pressure and dry mucous membranes. Laboratory evaluation reveals Ca 14.5 mg/dl and Cr 2.0 mg/dl.   Which of the following is the most appropriate initial management for this patient?

A 25-year-old man was recently diagnosed with leukemia. He is admitted to the hospital for further evaluation and chemotherapy initiation. He only complains of fatigue and malaise. Laboratory evaluation reveals pancytopenia, hyperkalemia (K 6.8), uric acid 13, hyperphosphatemia (12), and elevated lactate dehydrogenase (LDH).   What is the most likely cause of his electrolyte abnormalities?

A 75-year-old man with lung cancer was admitted to the hospital with worsening dyspnea. He complains of progressive dyspnea for 2 months. On physical examination, he has distended jugular veins, plethoric face, venous collaterals on his chest wall, and distant heart sounds.   What is the most likely diagnosis?

A 30-year-old woman with leukemia presents to the emergency room with fever for less than 24 hours. A week previously, she completed a course of chemotherapy through a Hickman catheter. She only complains of fever and fatigue. On examination, she is pale and febrile (101.5° F). Laboratory evaluation reveals a leukocyte count of 780 with 25% polymorphonuclear cells.   Which of the following is the most appropriate therapy?