Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Hematologic and Oncologic Disorders--->Oncological Syndromes
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Question 1# Print Question

A 19-year-old man with acute lymphoblastic leukemia is found to be lethargic and complains of nausea and muscle cramps after receiving cytotoxic therapy. A basic metabolic panel is notable for:

  • potassium level of 6.9 mEq/L
  • plasma phosphate of 5.5 mg/dL
  • uric acid level is 17 mg/dL

An ECG is notable for peaked T waves and frequent premature ventricular complexes.

Which one of the following treatment options is MOST appropriate at this time?

A. Rasburicase
B. Allopurinol
C. Hemodialysis
D. IV fluid therapy

Question 2# Print Question

A 65-year-old man with a diagnosis of small-cell lung cancer presents to the emergency with complaints of hoarseness, shortness of breath, and swelling of his face and right arm. His vital signs are:

  • T 36.4°C
  • RR 42 breaths/min
  • HR of 122 beats/min
  • BP 100/67 mm Hg
  • SpO2 87% on 4L nasal cannula

On examination, he is stridorous and unable to speak in full sentences. ECG is notable for sinus tachycardia and a chest x-ray reveals widened mediastinum.

What is the most appropriate next step in management?

A. Endotracheal intubation
B. Catheter-based venography
C. CT venography
D. Radiation therapy

Question 3# Print Question

A 54-year-old woman with breast cancer is brought to the emergency room with progressive confusion, anorexia, constipation, weight loss, and weakness. Vital signs are:
temperature 36.7°C

BP 94/57 mm Hg

HR 87 beats/min

SaO2 96% on RA

On examination, she is drowsy but easily arousable and oriented to person. Her neurologic examination is otherwise unremarkable. Lab studies are notable for:

  • creatinine level of 1.78 mg/dL (baseline 0.8 mg/dL)
  • serum calcium of 13.7 mg/dL

What is the most appropriate initial treatment? 

A. 0.9% normal saline infusion with furosemide
B. 0.9% normal saline infusion
C. Bisphosphonate therapy
D. Calcitonin

Question 4# Print Question

A 57-year-old woman with a history of breast cancer treated with mastectomy and radiation therapy is admitted with a 4-week history of progressive low back pain. She reports decreased sensation over her buttocks, perineal region, and posterior superior thighs and occasional difficulty with voiding. Her physical examination is noticeable for decreased anal sphincter tone.

What is the most appropriate next step in management?

A. Emergent decompressive surgery
B. CT scan of the spine with and without contrast
C. MRI of full spine
D. Intravenous dexamethasone

Question 5# Print Question

A 63-year-old man is admitted to the ICU with epistaxis, blurred vision, and altered mental status. His medical history includes hypertension, diabetes mellitus, and Waldenstrom macroglobulinemia. Vital signs are:

  • T 37.3°C
  • HR 102 beats/min
  • RR 44 breaths/min
  • BP 112/57 mm Hg
  • SaO2 80% on 100% nonrebreathing mask

His physical examination is notable for bloody nostrils, and he is somnolent but responsive to verbal stimuli. Laboratory studies are notable for:

  • Hgb of 9.8 mg/dL
  • platelet count of 87,000
  • a large monoclonal spike on serum protein electrophoresis

Which one of the following interventions is not indicated at this time?

A. Red blood cell (RBC) transfusion
B. Plasma exchange
C. Endotracheal intubation
D. IV fluid therapy

Category: Critical Care Medicine-Hematologic and Oncologic Disorders--->Oncological Syndromes
Page: 1 of 1