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Additional CSO Cards > Chapter 13: pediatric oncology > Flashcards

Chapter 13: pediatric oncology Flashcards

1
Q

Cancer is the #______ cause of death for children 0-14 in the US, but the 5 year survival is ______%

A

1st
84%

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2
Q

What are the 2 most common types of childhood cancer, each with 25% (broad)

A
  1. Brain/CNS
  2. Leukemia
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3
Q

What kind of cancer is Wilm’s tumor

A

Most common kidney malignancy in children, often presenting with a large abdominal mass and sometimes HTN

ESRD occurs with bilateral disease

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4
Q

T/F: Children are at greater risk for malnutrition during cancer treatment than adults

A

True, as their metabolic demands are higher as they’re need to gain weight/grow

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5
Q

These are 2 most common types of childhood cancers

A
  1. Acute Lymphoblastic Leukemia
    (think ALL children’s hospital)
  2. Acute Myeoloid Leukemia
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6
Q

These are 2 long-term side effects of ALL in children (maintenance and continuation phases)

A
  1. Obesity
  2. Reduced bone mineral density
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7
Q

This is considered “unhealthy weight” for children

A

< 5th percentile for BMI or > 85th percentile

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8
Q

T/F: Children with AML are especially prone to anorexia, weight loss, N/V, mucositis, and malnutrition d/t intensive chemotherapy regimens

A

True

(think M for malnourished & myopathy, L for large)

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9
Q

This is a late side effect of AML in children

A

Cardiomyopathy

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10
Q

_______ is a potential complication for children with posterior fossa, cerebellum, or brain stem tumors

A

Dysphagia

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11
Q

Long term complications of childhood CNS tumors

A

cognitive/motor deficits, weight gain, central adiposity, feeding difficulties

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12
Q

Radiotherapy to the brain may disrupt _______ & ______ cues, causing excessive energy intake

A

ghrelin & leptin cues

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13
Q

T/F: Significant weight loss may be a presenting symptom in hodgkins & non-hodgkins lymphomas

A

True

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14
Q

Medistinal radiation is often used for lymphomas and may cause abnormal function of the _____, ______, _______

A

Thyroid, heart, lung

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15
Q

Anthracycline chemotherapies of often used for childhood lymphoma and have ___________ risk

A

cardiovascular (cardiomyopathies)

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16
Q

T/F: Most childhood leukemias & lymphomas put survivors at risk for obesity, reduced strength, high fat/low muscle

A

True

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17
Q

________ is the most common solid tumor in children, often diagnosed (and less risky) in the first year of life

A

Neuroblastoma

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18
Q

Malnutrition at the time of dx of neuroblastoma is high, __________ (%)

A

20-50% though d/t the NIS, not hypermetabolic state

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19
Q

What are the 5 steps for ALL treatment in children?

A
  1. Remission induction
  2. Consolidation
  3. Interim Maintenance - sometimes this is the last phase
  4. Delayed intensification
  5. Maintenance/continuation

(Radiation Can Inhibit Daily Meals)

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20
Q

Describe Remission Induction phase

A

Lasts ~1 month, kills as many cancer cells as possible to bring WBC, RBC, Platelets to normal levels

Usually in the hospital

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21
Q

Explain Consolidation

A

Goal is to maintain remission and prevent relapse. This is more intense chemo than remission induction. It lasts several months.

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22
Q

Explain maintenance

A

This is lower chemo dose but goes on for longer periods of time

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23
Q

What is rhabdomyosarcoma

A

Soft tissue tumor that usually starts in the muscle and may occur in children, various parts throughout the body

Side effects depend on where treatment is given (often chemoradiation)

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24
Q

Which 2 common types of childhood cancer often benefits from MUAC?

A

Wilm’s tumor d/t large abdominal mass. This often causes anorexia/early satiety

Hepatoblastoma d/t abdominal tumor growth

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25
Q

These are the first & second most common BONE tumors in pediatric patients

A
  1. Osteosarcoma
  2. Ewing Sarcoma
26
Q

__________ is a bone tumor that typically occurs during periods of rapid growth, with pain being the most common presenting symptom

A

Osteosarcoma

27
Q

Ewing sarcoma is typically found in the ______ extremities, ______, & chest wall

A

Lower, pelvis, and chest wall

28
Q

_________ is the most common liver malignancy in children

A

Hepatoblastoma

29
Q

CAR T-cell therapy has been approved for pediatrics with relapsed or refractory __________

A

B-cell ALL

30
Q

_________ is an approach to treating extensive peritoneal disease and involves administering heated chemotherapy agents directly into the peritoneal cavity

A

HIPEC

Hyperthermic Intraperitoneal Chemotherapy

31
Q

T/F: HIPEC sometimes requires EN or PN

A

True, feeding tube is sometimes placed during the surgery

32
Q

Name 4 common nutrition considerations of brain tumors

A
  1. Decreased appetite
  2. Taste changes
  3. Dysphagia
  4. Weight gain
33
Q

Are pediatric patients with SOLID tumors at lower or higher risk for malnutrition at the time of diagnosis

A

Solid (but increases a lot w/ blood cancers during treatment)

34
Q

Define Z score

A

Looks at standard deviations from the mean and used in pediatrics to determine malnutrition when only 1 datapoint is available

-1-1.9 (mild malnutrition)
-2-2.9 (moderate malnutrition
-3-3.9 (severe malnutrition)

35
Q

T/F: Every child w/ cancer should be screened, assessed, and re-assessed by RD

A

True

36
Q

This is the 1 validated screening tool for identifying children at risk for malnutrition

A

SCAN
(Screening for Childhood Cancer)
** >/= 3 of 10 points puts at risk for malnutrition

37
Q

What are the criteria involved in the SCAN tool? (6)

A

Does this pt have a high risk cancer?

Is the child undergoing intensive treatment?

Does the pt have GI symptoms?

Has the pt had poor intake over the past week?

Has the patient had amy weight loss over the past month?

Does the patient show signs of undernutrition?I

38
Q

Children with _______ & ______ cancer may have amputations, thus weight, BMI, and IBW must be adjusted

A

Osteosarcoma & Ewing Sarcoma

39
Q

T/F: Predictive equations tend to overestimate energy needs in children

A

True

Thus use IC or adjust using clinical judgement

40
Q

The ________ equation for pediatric critically ill patients should be used

A

WHO equation for REE

41
Q

Explain growth charts, WHO versus CDC

A

WHO = 0-24 months
CDC = 2-20 years

42
Q

Z score of >/= _____ for height should be investigated in pediatric population

A

+2

43
Q

Z score of </= _____ for weight/BMI should be investiaged

A

1

44
Q

The ______ (lab) indicates the body’s ability to fight infection and often how the pt feels/eats

A

Absolute Neutrophil Count (ANC)

45
Q

This nutrient is often falsely ELEVATED d/t inflammation

A

Ferritin

46
Q

Children with ______ syndrome are at increased risk for developing leukemia

A

Down’s Syndrome

47
Q

Hepatosplenomegaly is common with ________

A

Leukemia

48
Q

3 large solid tumors in children include

A
  1. Hepatoblasoma
  2. Neuroblastoma
  3. Wilm’s Tumor
49
Q

Pediatric SGA has been validated for use in ________ pediatric patients

A

Hospitalized (not specifically oncology patients)

50
Q

D/t calcium/vitamin D deficiencies, _______ is common in pediatric cancer survivors

A

Osteoporosis

51
Q

Equation for adjusted body wt

A

Actual wt x 100 / (100% - % of ambutation)

*will be higher than the current wt

52
Q

T/F: Activity factors for peds are slightly higher for males than females

A

False

Remember sedentary, low sedentary, active, very active

53
Q

Energy equations may overestimate up to _______ kcal in pediatric cancer survivors

A

491 kcal/day

54
Q

Protein goals for children

A

Use RDA (0.8-1.5 g/kg depending on the age, may need up to 150-200% of the RDA for illness, stress, infection, diarrhea

*1 g/kg + resistance training may help to build lean mass

55
Q

T/F: Protein is metabolized if kcal intake is inadequate in the presence of stress

A

True

56
Q

The ______ equation should be use for predicting fluid needs in children

A

Holliday-Segar

57
Q

These 2 micronutrients are commonly deficient in pediatric cancer pts

A

Calcium & vitamin D

(thus high risk for osteoporosis)

58
Q

Low vitamin D has been associated with _______ & ______ infections

A

C. diff & staphyloccocous

59
Q

Vitamin D goal for pediatric cancer patients

A

> 30 ng/mL

60
Q

3 appetite stimulants for peds

A
  1. Megace
  2. Dronabinol
  3. Cyproheptadine

Additional CSO Cards (26 decks)

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