Podcast 577: Immunotherapies
Emergency Medical Minute13 Juli 2020

Podcast 577: Immunotherapies

Contributor: Don Stader, MD

Educational Pearls:

  • Checkpoint inhibition normally helps our body detect abnormal cells and terminate it but cancerous cells often are able to avoid this countermeasure
  • Monoclonal antibodies that bind to checkpoint inhibitors can stop cancerous cells from turning off immunologic T cells and allows the immune system to continue to attack cancers.
  • These therapies carry risks of exacerbating autoimmune problems due to the ramped up immune response
  • Most often this autoimmune attack leads to skin and GI symptoms but can affect many other organ systems. In the emergency room this can present many different ways, but the mainstay of treatment is steroids to stop these exacerbations.
  • Chimeric Antigen Receptor (CAR) T-cell Therapy is another immunotherapy where antigens to a cancerous cell are re-introduced to spur a directed immune response
  • Cytokine release syndrome can occur in these patients and mimic other presentations such as septic shock, a result of tumor break down
  • This is treated with steroids and monoclonal antibodies that help thwart the cytokine release

References

Hay, KA. Cytokine release syndrome and neurotoxicity after CD19 chimeric antigen receptor-modified (CAR-) T cell therapy. Br J Haematol. 2018 Nov;183(3):364-374. doi: 10.1111/bjh.15644. Epub 2018 Nov 8.

Hryniewicki AT, Wang C, Shatsky RA, Coyne CJ. Management of Immune Checkpoint Inhibitor Toxicities: A Review and Clinical Guideline for Emergency Physicians. J Emerg Med. 2018;55(4):489-502. doi:10.1016/j.jemermed.2018.07.005

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Avsnitt(1145)

Emergency Medicine Cases with Dr. Barlock

Emergency Medicine Cases with Dr. Barlock

Contributors: Travis Barlock MD, Jeffrey Olson MS4 Feel free to use the cases below for your own practice. All of the scenarios are completely made up and designed to hit several teaching points. Case...

9 Sep 202553min

Episode 973: Meningitis Retention Syndrome

Episode 973: Meningitis Retention Syndrome

Contributor: Travis Barlock MD Educational Pearls: Meningitis retention syndrome is a relatively novel and rare clinical condition Aseptic meningitis + acute urinary retention One study reports an i...

8 Sep 20252min

Episode 972: Hepatic Encephalopathy

Episode 972: Hepatic Encephalopathy

Contributor: Alec Coston, MD Educational Pearls: Hepatic encephalopathy (HE) is defined as a disruption in brain function that results from impaired liver function or portosystemic shunting. Manifes...

3 Sep 20253min

Episode 971: Calcium Pretreatment for Diltiazem in AFib with RVR

Episode 971: Calcium Pretreatment for Diltiazem in AFib with RVR

Contributor: Taylor Lynch, MD Educational Pearls: What is atrial fibrillation with rapid ventricular response (AFib with RVR) and how does it differ from atrial fibrillation (AFib)? AFib is an abnorm...

25 Aug 20252min

Episode 970: Fever Management

Episode 970: Fever Management

Contributor: Aaron Lessen, MD Educational Pearls: Recorded March 2025 What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two? The journal Pediatrics aimed to answer...

22 Aug 20252min

Episode 969: Shoulder Reduction

Episode 969: Shoulder Reduction

Contributor: Aaron Lessen, MD Educational Pearls: There are many techniques for reducing a shoulder dislocation A recent study discussed a new variation of closed reduction technique: wrist-clamping ...

11 Aug 20252min

Episode 968: Heavy Metals

Episode 968: Heavy Metals

Contributor: Megan Hurley MD Educational Pearls: Acute toxicity of heavy metals: Gastrointestinal upset is the most common presentation Chronic toxicity of heavy metals: Symptoms depend on the meta...

4 Aug 20252min

Episode 967: Dilutional Hyponatremia

Episode 967: Dilutional Hyponatremia

Contributor: Taylor Lynch, MD Educational Pearls: Dilutional Hyponatremia: Occurs when there is an excess of free water relative to sodium in the body. Causes a falsely low sodium concentration witho...

28 Juli 20252min

Populärt inom Vetenskap

svd-nyhetsartiklar
p3-dystopia
dumma-manniskor
pojkmottagningen
allt-du-velat-veta
det-morka-psyket
kapitalet-en-podd-om-ekonomi
rss-experimentet
dumforklarat
rss-vetenskapsradion-2
halsorevolutionen
rss-ufo-bortom-rimligt-tvivel
medicinvetarna
rss-vetenskapsradion
paranormalt-med-caroline-giertz
bildningspodden
rss-spraket
sexet
vetenskapsradion
4health-med-anna-sparre