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Oncological Emergencies

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Tumor Lysis Syndrome

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Clinical Features: Hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and renal failure. Management: Aggressive hydration, allopurinol or rasburicase, and dialysis if necessary.

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Cardiac Tamponade

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Clinical Features: Dyspnea, tachycardia, and Beck's triad (hypotension, distended neck veins, muffled heart sounds). Management: Urgent pericardiocentesis and treatment of underlying malignancy.

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Disseminated Intravascular Coagulation (DIC)

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Clinical Features: Bleeding from multiple sites, thrombosis, and organ dysfunction. Management: Treat underlying cause, supportive care, and replacement of coagulation factors if necessary.

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Febrile Neutropenia

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Clinical Features: Fever and evidence of neutropenia. Management: Broad-spectrum antibiotics and hematopoietic growth factors.

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Malignant Hyperthermia

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Clinical Features: Rapid increase in body temperature, muscle rigidity, and hypercarbia following exposure to certain anesthetic agents. Management: Immediate administration of dantrolene, cooling measures, and supportive care.

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Septic Shock

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Clinical Features: Severe sepsis with hypotension and organ dysfunction. Management: Intravenous fluids, vasopressors, and antimicrobial therapy.

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Leukostasis

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Clinical Features: Respiratory distress, altered mental status, and hypoxia. Management: Leukapheresis and chemotherapy to reduce leukocyte count.

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Malignant Pleural Effusion

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Clinical Features: Dyspnea, chest pain, and cough. Management: Thoracentesis for symptom relief and chemotherapy or pleurodesis to prevent re-accumulation.

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Malignant Bowel Obstruction

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Clinical Features: Abdominal pain, vomiting, constipation, and abdominal distension. Management: Nasogastric decompression, IV fluids, antiemetics, analgesia, and surgery or stenting if appropriate.

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Neutropenic Enterocolitis (Typhlitis)

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Clinical Features: Fever, abdominal pain, and possible signs of sepsis. Management: Broad-spectrum antibiotics, bowel rest, and possible surgical intervention.

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Hyperviscosity Syndrome

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Clinical Features: Blurred vision, headache, vertigo, and nystagmus. Management: Plasmapheresis, chemotherapy for underlying malignancy.

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Superior Vena Cava Syndrome

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Clinical Features: Facial and upper extremity swelling, dyspnea, and jugular venous distension. Management: Radiation therapy to shrink tumor and steroids to reduce inflammation.

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Carcinomatous Meningitis

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Clinical Features: Headache, neurologic deficits, and cranial nerve palsies. Management: Intrathecal chemotherapy and radiation therapy tailored to the part of the central nervous system involved.

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Spinal Cord Compression

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Clinical Features: Back pain, motor weakness, sensory loss, and autonomic dysfunction. Management: High-dose corticosteroids, surgery or radiotherapy to relieve pressure on the spinal cord.

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Hypercalcemia of Malignancy

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Clinical Features: Polyuria, polydipsia, dehydration, and altered mental status. Management: Hydration with IV fluids, bisphosphonates, and calcitonin.

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