9: Case Studies Flashcards
Most common solid tumor of childhood.
Brain cancers
1 cause of death among all childhood cancers.
Brain cancers
What is the role of the FNP in brain cancers?
Awareness of s/sx. Manage multitude of potential late effects of therapy. Liaison between pediatric and adult care to help provide continuity of care.
Brain tumor classification is based on histological criteria by _____.
WHO
Most common are neuroepithelial-derived tumors. Among neuroepithelial brain tumors, _____ are the most common.
Gliomas
Low-grade (stages 1/2) or high-grade/malignant (stages 3/4) glioma?
Juvenile piloocytic astrocytoma
Low-grade
Low-grade (stages 1/2) or high-grade/malignant (stages 3/4) glioma?
Diffuse fibrillary astrocytoma
Low-grade
Low-grade (stages 1/2) or high-grade/malignant (stages 3/4) glioma?
Anaplastic astrocytoma
High-grade/malignant
Low-grade (stages 1/2) or high-grade/malignant (stages 3/4) glioma?
Glioblastoma multiforme
High-grade/malignant
In assessing a 4 yo with headaches x 1 month, where do you begin?
OLDCART for headache. PMH (seizures, migraines) Meds Family hx Social hx ROS
Would this tumor be located in the suprasellar/chiasmatic, pons, pineal/midbrain, cerebellum, basal ganglia/thalamus, cortex, or cervicomedullary junction?
Visual field deficit, precocious/delayed puberty, anorexia, diabetes insipidus.
Suprasellar/chiasmatic
Would this tumor be located in the suprasellar/chiasmatic, pons, pineal/midbrain, cerebellum, basal ganglia/thalamus, cortex, or cervicomedullary junction?
Diplopia, facial weakness, drooling, weakness, incoordination, dysconjugate gaze.
Pons
Would this tumor be located in the suprasellar/chiasmatic, pons, pineal/midbrain, cerebellum, basal ganglia/thalamus, cortex, or cervicomedullary junction?
Upgaze paralysis, vomiting, nystagmus, diplopia, tremor.
Pineal/midbrain
Would this tumor be located in the suprasellar/chiasmatic, pons, pineal/midbrain, cerebellum, basal ganglia/thalamus, cortex, or cervicomedullary junction?
Vomiting, ataxia, tremor, dysmetria, nystagmus, scanning speech.
Cerebellum
Would this tumor be located in the suprasellar/chiasmatic, pons, pineal/midbrain, cerebellum, basal ganglia/thalamus, cortex, or cervicomedullary junction?
Movement disorder, weakness, hemisensory deficit, visual deficit.
Basal ganglia/thalamus
Would this tumor be located in the suprasellar/chiasmatic, pons, pineal/midbrain, cerebellum, basal ganglia/thalamus, cortex, or cervicomedullary junction?
Seizures, weakness, disorder of language, encephalopathy, visual field deficit.
Cortex
Would this tumor be located in the suprasellar/chiasmatic, pons, pineal/midbrain, cerebellum, basal ganglia/thalamus, cortex, or cervicomedullary junction?
Head tilt, Horner syndrome, weakness, dysphagia, dysphonia, torticollis.
Cervicomedullary junction
Triad of headache, n/v, and gait imbalance is most common presentation of what?
Posterior Fossa Tumor. Posterior fossa is the midbrain, pons, cerebellum, 4th ventrical, medulla, and tentorium. Vomiting is often early morning vomiting. Early morning vomiting is related to nocturnal hypoventilation, hypercarbia, vasodilation of cerebral vessels, increased cerebral blood volume and increased CSF production. All while the child is lying down, sleeping. Head tilt or torticollis is present as well when there is invasion of the Luschka foramen.
T/F The majority of seizures are d/t brain tumors.
False. Mostly d/t other disorders.