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Child Health > Cancer > Flashcards

Cancer Flashcards

1
Q

Are carcinomas seen in adults or children more?

A

In adults more

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2
Q

Are embryonal tumours seen more in adults or children?

A

Children

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3
Q

List 3 common embryonal tumours.

A

Wilms tumour
Neuroblastoma
Rhabdomyosarcoma

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4
Q

Adolescence and young adulthood sees a high incidence of which cancers?

A

Bone tumours

Lymphomas

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5
Q

What causes childhood cancers?

A

Often unknown

Small amount due to genetic abnormality, mutations

Down’s syndrome and immune-compromised children at higher risk

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6
Q

If a cancer has infiltrated the bone marrow, what symptoms will you see?

A
  1. Anaemia: pallor, SOB, poor feeding
  2. More infections, unresolving infections
  3. Thrombocytopenia: bleeding, bruising, petechiae
  4. Bone pain, grumpy, not doing much
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7
Q

What does it mean if a child has an abnormal red reflex?

Also, what is the red reflex?

A

They could have retinoblastoma

When an ophthalmoscope is shined into eyes about 30cm away, the eye should appear red.

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8
Q

What could proptosis in a child signify?

A

Proptosis is when the eye sticks out

Infection
Neuroblastoma
Rhabdomyosarcoma

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9
Q

You’re a GP and see a 5 year old child 6 times in one year for ear discharge. What should you be concerned about?

A

Recurrent ear discharge could be a sign of rhabdomyosarcoma

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10
Q

As a rule, what cases should you consider malignancy?

A

In any child whose condition does not resolve or respond to treatment normally.

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11
Q

Which type of leukaemia is most common in children?

A

ALL: acute lymphoblastic leukaemia

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12
Q

Clinical features of ALL?

A 
Fever
Fatigue
Frequent infections
Lymphadenopathy
Hepatomegaly, splenomegaly
Anaemia
Bruising, petechiae
Bone, joint pain
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13
Q

Investigations of ALL?

A 
Blood film
Serum chemistry
CXR
Bone marrow aspirate
LP
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14
Q

Treatment of ALL? When are they indicated?

A

Chemotherapy: 5 phases
First line

Haemopoietic stem cell transplant
In high risk patients in remission or if a patient has relapsed.

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15
Q

How do tumours of the CNS present?

A

Headache (worse when lying down)

Vomiting (in the morning)

Papilloedema
Squint
Nystagmus

Ataxia

Personality/behaviour change

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16
Q

When should you arrange a head scan of children presenting with headache?

A

If there’s papilloedema

If they have neuro signs

If headache recurrent, or is early morning

If there’s vomiting

If they have growth/developmental delay

If they’re younger than 3

17
Q

What’s the treatment for CNS tumours?

A

Surgery

Chemotherapy

Radiotherapy

18
Q

Differential diagnosis of lymphadenopathy?

A

Self-limiting infection
HIV
Auto-immune disorders
Malignancy

19
Q

When should you become concerned about lymphadenopathy?

What should you do to investigate?

A

No clear infective cause

Persistently enlarged

Unusual site (supraclavicular)

If there’s fever, weight loss, hepato + splenomegaly

If the CXR is abnormal

You’d do a biopsy of the node.

20
Q

Management of lymphoma in children?

A

Chemotherapy

Radiotherapy (only in Hodgkins)

Radiotherapy (for relapses)

21
Q

What’s the difference between Hodgkin’s and Non-Hodgkin’s lymphoma?

Which has the worse prognosis?

A

In Hodgkin’s lymphoma Reed-Sternberg cells are seen under the microscope.

Non-Hodgkin’s has the worse prognosis

22
Q

How do children with abdominal tumours present?

A

With an abdominal mass

With associated symptoms (dependent on the type of cancer) - weight loss, pain, haematuria, hypertension, constipation.

23
Q

How would you investigate a child with an abdominal mass?

A

USS
CT
Biopsy

24
Q

Differential diagnosis of child with abdominal mass?

A 
Hepatoblastoma
Wilm's tumour
Adrenal Neuroblastoma
Lymphoma / leukaemia
Constipation
Polycystic Kidneys
25
Q

Where in the body are neuroblastomas often found?

A

Adrenal gland
Spinal cord
Chest

26
Q

How can you differentiate between a Wilm’s tumour and an adrenal neuroblastoma on a CT image?

A

In adrenal neuroblastoma, the tumour crosses the midline and encases the aorta and IVC

A Wilm’s tumour usually stays in one hemisphere, and it appears that the kidney is ‘grabbing’ the tumour

27
Q

Treatment of Wilm’s tumour?

A

Chemotherapy

Surgery: nephrectomy (total or partial)

Radiotherapy

28
Q

What are the late effects of cancer treatment?

A

Endocrine (growth and developmental delay)

Intellectual difficulties

Cardiac and renal toxicity

Fertility problems

Psychological problems

29
Q

Where are osteosarcomas and Ewing’s sarcomas commonly found?

A

Ewing’s: lower body: pelvis, femur, tibia

Osteo: large bones of upper and lower limb so humerus and femur

Child Health (17 decks)

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