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PRM Board Exam > Cancer > Flashcards

Cancer Flashcards

1
Q

What percentage of pediatric cancer do leukemias represent?

A

30%

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2
Q

What is the second most common type of childhood cancer after leukemia?

A

brain tumors

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3
Q

Where do most pediatric brain tumors arise?

A

the posterior fossa

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4
Q

What is the most common type of malignant CNS tumor in children?

A

medulloblastoma

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5
Q

How do supratentorial tumors present?

A

with seizures and signs of increased ICP

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6
Q

What is the most common presentation of Hodgkin’s disease in children?

A

painless cervical adenopathy

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7
Q

What is the most common malignant bone tumor in children?

A

osteosarcoma

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8
Q

In what age group are malignant pediatric bone tumors more common?

A

over 10 years old

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9
Q

In what part of the bone does a osteosarcoma typically arise?

A

metaphysis

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10
Q

In what part and what type of bones does Ewing’s sarcoma typically arise?

A

the diaphysis of long and flat bones (pelvis)

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11
Q

What is the most common site for osteosarcomas?

A

distal femur

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12
Q

Most common type of leukemia in children?

A

Acute lymphoblastic leukemia - ALL (80%)

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13
Q

In what age range is the highest incidence of leukemias?

A

2-5 years old

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14
Q

In what age group are childhood cancers the highest?

A

15-19

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15
Q

What is the most common cancer in adolescents?

A

Hodgkin lymphoma

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16
Q

How are leukemias staged?

A

TMN system

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17
Q

For osteosarcoma and Ewing sarcoma, what is the goal of the initial surgical procedure?

A

To obtain a definitive diagnosis

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18
Q

What is the goal of the initial procedure with CNS tumors?

A

gross total resection

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19
Q

What tissues are most affected by chemotherapy?

A

those with actively dividing cells: intestine, bone marrow, skin

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20
Q

What are two major side effects of methotrexate?

A

demyelinating encephalopathy, osteopathy

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21
Q

What type of neuropathy does vincristine cause?

A

length-dependent axonal sensorimotor polyneuropathy

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22
Q

What is the major side effect of cisplatin and carboplatin?

A

hearing loss

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23
Q

What chemotherapeutic agents causes small fiber neuropathy?

A

taxanes (paclitaxel)

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24
Q

How do peripheral neuropathies due to platinum drugs present?

A

in a patchy distribution

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25
Q

What is “coasting” in terms of peripheral neuropathy?

A

symptoms may progress for months after stopping therapy

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26
Q

What should be suspected in a cancer patient with progressive weakness?

A

myopathy

27
Q

How does steroid-induced myopathy present?

A

painless symmetrical proximal muscle weakness

28
Q

What steroid more commonly causes steroid myopathy?

A

dexamethasone

29
Q

What are 3 major skeletal complications related to treatment for ALL?

A

osteoporosis, AVN, spinal deformities

30
Q

When should DXA be done for ALL patients?

A

during entry to long-term follow-up, typically at 2 years after completion of therapy

31
Q

When is AVN typical diagnosed in pediatric cancer patients?

A

about 1-2 years after starting steroid treatment

32
Q

Which steroid has more bone toxicity?

A

dexamethasone is more toxic to bone than prenisone

33
Q

What chemotherapeutic agent causes pulmonary fibrosis?

A

bleomycin

34
Q

What age group is more prone to cardiac toxicity from anthracycline agents?

A

younger than 5 years old

35
Q

What two cancer treatments put a child a greatest risk for neurocognitive deficits?

A

cranial radiation, intrathecal chemotherapy

36
Q

Which children are at higher risk for ototoxicity from platinum based chemotherapy agents?

A

Those who get therapy at a younger age (less than 5)

37
Q

Children under what age are at highest risk for neurocognitive impairment from radiation?

A

4 and under. We try to avoid radiation in those under 3.

38
Q

What presents with headache, nausea/vomiting, and focal neurologic deficits 6 or more months after CNS radiation therapy?

A

radiation necrosis

39
Q

Beside radiation necrosis and cognitive deficit, what are three other potential consequences of radiation that patients should be monitored for?

A

AVN, scoliosis, stroke due to focal narrowing of vessels

40
Q

When does acute GVHD develop?

A

2 - 5 weeks post transplant

41
Q

What is the treatment for GVHD?

A

glucocorticoids

42
Q

What are the four phases of cancer rehabilitation?

A

preventative, restorative, supportive, and palliative

43
Q

Below what level Hbg should one consider activity restriction and blood transfusion?

A

8 g/ml

44
Q

What is the goal of restorative rehabilitation?

A

to return patients to previous level of functioning

45
Q

What is the goal of supportive rehabilitation?

A

To teach patients to accommodate to their disabilities

46
Q

Below what platelet level is it recommended to avoid resistance exercises?

A

50,000

47
Q

Below platelet level is it recommended to minimize all exercise?

A

20,000

48
Q

Children with what genetic syndrome are 15 times more likely to develop ALL?

A

Down syndrome

49
Q

Why is dexamethasone the preferred glucocorticoid?

A

It has superior CNS penetration

50
Q

What are the three phases of cancer treatment?

A

Induction, intensification, and maintenance

51
Q

In what age range are infratentorial tumors most common?

A

2-10

52
Q

What is the most common glioma?

A

pilocystic astrocytoma

53
Q

What is usually the treatment for a pilocyctic astrocytoma?

A

surgical resection alone

54
Q

What is the 2 year survival rate for diffusely infiltrated gliomas?

A

Less than 20%

55
Q

What is the most common malignant tumor of childhood?

A

medulloblastoma

56
Q

What percentage of posterior fossa tumor resections are associated with posterior fossa syndrome?

A

25%

57
Q

In posterior fossa syndrome, within what time frame does mutism typically resolve?

A

6 months

58
Q

What is the most common spinal cord tumor?

A

astrocytoma

59
Q

How does a osteosarcoma present on X-ray?

A

with periosteal reaction or sunburst pattern

60
Q

What is the average age of diagnosis for Ewing sarcoma?

A

15

61
Q

Why are Ewing sarcoma’s mistaken for growing pains?

A

They occur in otherwise healthy and active children

62
Q

What is seen on X-ray of a Ewing sarcoma?

A

periosteal reaction or onion skin pattern

63
Q

What is the more common surgery type for bone tumors, amputation or limb-sparing?

A

limb-sparing

64
Q
A

PRM Board Exam (17 decks)

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