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em@3am

EM@3AM: Immune-Related Adverse Event from Immune Checkpoint Inhibitors

A 43-year-old female with a history of breast cancer presents to the ED with diffuse abdominal pain and diarrhea for one week. She is experiencing over 12 episodes of non-bloody diarrhea daily. She is currently receiving Atezolizumab (Tecentriq) for breast cancer. Vital signs include BP 82/43, HR 121, T 98F oral, RR 22, SpO2 98% on RA. She appears tired, and her oral mucosa are dry. She displays diffuse abdominal tenderness to palpation, but there is no evidence of peritonitis. What is the patient’s diagnosis?

EM Cases

EM Cases: Oncologic Emergencies

In this episode on Oncologic Emergencies Dr. John Foote (University of Toronto’s CCFP(EM) residency program director) and Dr. Joel Yaphe (the director of the University of Toronto’s Annual Update in Emergency Medicine conference in Whistler), review 5 important presentations in the patient with cancer: fever, shortness of breath, altered mental status, back pain and acute renal failure; with specific attention to key cancer-related emergencies such as febrile neutropenia, hypercalcemia, superior vena cava syndrome, hyperviscosity syndrome and tumor lysis syndrome.