13 - Peds Oncology

Question 1

What is the MCC childhood CA?

Answer 1

Leukemia

Then CNS tumors
Then lymphoma

Question 2

What is Tumor Lysis Syndrome?

Answer 2

Common adverse effect of leukemia and lymphoma txt

Rapid cellular lysis -> potassium, phosphate, and uric acid release into circulation

Arrhythmias, cardiac arrest, gout, neuropathy

Question 3

ALL translocations:

Answer 3

12: 21 - more common, better prognosis
9: 22 - less common, poor prognosis

Question 4

What virus may play a causal role in lymphoma?

Answer 4

EBV

Question 5

What a “B” sxs?

Answer 5

Shitty prognostic indicators in lymphoma

Fever > 38 for three consecutive days
Drenching night sweats
Weight loss >10% c/in 6 mos dx

Question 6

Reed-Sternberg (Owl cells) think:

Answer 6

Hodgkin’s Lymphoma

Question 7

MC type of brain tumor?

Answer 7

Astrocytoma

Usually found in posterior fossa

Question 8

What is the MC childhood solid organ neoplasm outside the CNS?

Answer 8

Neuroblastoma

Question 9

What type of tumor is Wilm’s tumor?

Answer 9

Nephroblastoma

Question 10

Onion skin, moth eaten

Answer 10

Ewing

Question 11

Sunburst

Answer 11

Osteosarcoma

Question 12

Smal, round, blue cell tumors under microscopy, think:

Answer 12

Ewing sarcoma

Question 13

Age and sex for ALL

Answer 13

2-5 yo male

Question 14

Age and sex for AML

Answer 14

Neonates then late adolescence

Any sex

Question 15

poor prognostic indicators for leukemia:

Answer 15

<1yo or >10yo
>50K WBC (RR:4k-11k)
CNS or testicular dz
9:22 translocation
No remission after 4wks therapy

Question 16

If you’re working up what you think is a lymphoma patient and they’ve got >25% blasts on the bone marrow biopsy:

Answer 16

They’ve got acute leukemia

Question 17

CNS tumor clinical presentation <2yo:

Answer 17

Acute (rapidly growing): vomiting, lethargy, irritability, ataxia

Chronic (slower-growing): macrocephaly, hyperreflexia, cranial nerve palsies, weight loss

Question 18

CNS tumors clinical presentation >2yo

Answer 18

Supratentorial: visual field deficits, seizures, personality changes

Infratentorial: papilledema, cranial nerve palsies, ataxia

Question 19

Inability to abduct the eye (6th CN palsy) suggests:

Answer 19

Increased ICP

Question 20

MC type of brain tumor:

Answer 20

Astrocytoma

Usually found in posterior fossa

Often low grade, good prognosis

Question 21

Most common childhood solid neoplasm outside the CNS?

Answer 21

Neuroblastoma

Can occur anywhere sympathetic nervous tissue is found

Question 22

Most common infant malignancy?

Answer 22

Neuroblastoma

Median age at dx = 20mos

Question 23

MC presentation of neuroblastoma?

Answer 23

Abdominal mass/pain
Fever
Weight loss
Bone pain (mets)
Horner’s syndrome

Question 24

Paraneoplastic syndromes of neuroblastoma?

Answer 24

Profuse sweating
Secretory diarrhea
Opsomyoclonus

Question 25

Common locations of neuroblastomas?

Answer 25

Adrenal gland (MC) Retroperitoneal sympathetic ganglia Paravertebral ganglia

Question 26

Urine catecholamines in neuoblastoma?

Answer 26

Vanillylmandelic acid | Homovanillic acid

Question 27

What is the MC malignant renal tumor of childhood?

Answer 27

Wilms Tumor (nephroblastoma)

Question 28

Other anomalies associated with nephroblastoma?

Answer 28

WAGR (Wilms tumor, Aniridia, Genitourinary malformation, Retardation)

Question 29

Mean age of nephroblastoma dx?

Answer 29

3 1/2 yrs

Question 30

What is rhabdomyosarcoma?

Answer 30

Most common soft tissue sacroma in children Skeletal muscle Small, round, blue cell tumor (under microscopy)

Question 31

Ewing sarcoma is often misdiagnosed as:

Answer 31

Osteomyelitis