Cancer

Question 1

Different from adults

Answer 1

1 >80% survive

And No screening

Question 2

Common childhood cancers

Answer 2

Leukemia 30%
brain tumors
Solid tumors

Question 3

Leukemia

Answer 3

ALL 80%
AML 20%
ALL 75% cured

Question 4

ALL

Answer 4

Present with anaemia, bruising, fever, bone pain, HMG,SMG lymphadenopathy

Question 5

Dd of ALL

Answer 5

ITP
Neutropenia 
Infectious mononucleosis 
Infection with lymphadenopathy 
Other tumors withBM involvment

Question 6

AML

Answer 6

20% of all the leukemia
More serious than ALL
Presentation similar to ALL
50% need BM transplantion

Question 7

Brain tumors

Answer 7

2nd most common cancer in childhood 
Most deaths in childhood
Post Fossa is the common site 
Younger children embryonic tumors 
Presentation fused /non fused sutures
Fused  headache, vomiting raised ICP seizures, diplopia 
Non fused
HC increased, FTT, irritable, change in gait or balance 
Can present  with head tilt

Question 8

Treatment of brain tumors

Answer 8

Radiation
Surgery excision shunt for hydrocephalus
Chemo

Question 9

Radiation of the brain has lots of side effect

Answer 9

1 neuro endocrine eg Growth hormone, puberty, thyroid
2 neuro cognition eg IQ and attention span reduced
3 hearing
4 carcinogenic 2ary brain tumors from the radiation

Question 10

Solid tumors

Answer 10

Neuroblastoma
Sick child ,adrenal tumor ( abdo mostly but can go thorax, pelvis)
Poor prognosis for most
MIGB scan

Wilms tumor 1-7years
Kidney tumor
Presentation abdo mass in a well child Haematuria / metastasis

Question 11

Dd a mass in the abdo of a child

Answer 11

1 wilms tumor kidney /haematuria
2 neuroblastoma urinary catecholamines
3 germ cell aFP levels

Question 12

Hodgkin lymphoma

Answer 12

Older child/teenagers
Neck mass/mediastinal mass
Fevers/ weight loss/night sweats
Good prognosis

Question 13

Bone sarcomas

Answer 13

1 Ewing’s sarcoma
Osteosarcoma
Adolescents and young adults
70% cure if non metastatic

Question 14

Immunosuppressive
What are the groups of kids who have it 3
How do you treat a fever
Other considerations

Answer 14

1 Current cancer treatment 
2Have a central line eg haemohillia 
3Stem cell transplant 
If get a fever >38C need bloods /blood culture 
And iv antibiotics 
If fever persists ? Fungal infection 

Other
Exposure to chicken pox school/family VIG <96hours
HSV oral acyclovir
Bactrim for all pneumocystis pneumonia
DONT give LIVE calcination to pt on chemotherpay
Need revaccination post treatment 6/12
Meningococcal B 12/12