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Peds Exam (5900) #3 > Child with Malignancy > Flashcards

Child with Malignancy Flashcards

1
Q

Cells growing and spreading in a disorderly, chaotic fashion.

A

Malignancy

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2
Q

the leading cause of cancer-related death in children?

A

Brain tumors

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3
Q

Most prevalent cancer in children?

A

Leukemia

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4
Q

Term for malignant soft tissue or bone cancer

A

Sarcoma

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5
Q

Common Presenting Signs & Symptoms of malignancy?

A
  • Fever
  • Pain
  • Fatigue
  • Headaches
  • Lymphadenopathy (hard, rubber, immovable nodes)
  • Pallor
  • Purpura
  • Weight loss
  • Neurological changes
  • Mass or swelling
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6
Q

the distorted and uncontrolled proliferation of white blood cells.

A

Leukemia

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7
Q

Formation and development of the various blood cells (red blood cells, leukocytes, and platelets)

A

Hematopoiesis

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8
Q

red blood cells, leukocytes, and platelets develop from which type of stem cell?

A

undifferentiated, pluripotent stem cell

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9
Q

Myeloid cells differentiate into?

A

Red blood cells, monocytes, granulocytes, and platelets

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10
Q

Lymphoid cells differentiate into?

A

B cells and T cells

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11
Q

Two major classifications of leukemia?

A
  • Acute lymphcytic leukemia (ALL)

- Acute myelogenous leukemia (AML)

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12
Q

Most common classification of leukemia?

A

ALL

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13
Q

Peak age of onset for ALL?

A
  • 4 years old
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14
Q

Malignant cell line involved in ALL?

A

the immature lymphocyte, the lymphoblast.

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15
Q

Most common type of leukemia in adults?

A
  • AML

- frequency increase in late adolescence

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16
Q

Clinical Presentation of Leukemias?

A
  • Anemia: malaise, fatigue, pallor
  • Thrombocytopenia: gingival, cutaneous or nasal bleeding
  • Neutropenia: fever, recurrent infections
  • Hepatosplenomegaly, abdominal pain, nausea, vomiting
  • Bone pain (23%)
  • Lymphadenopathy
  • Anorexia, weight loss
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17
Q

S/S of Anemia?

A

malaise, fatigue, pallor

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18
Q

S/S of Thrombocytopenia?

A

gingival, cutaneous or nasal bleeding

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19
Q

S/S of Neutropenia?

A

fever, recurrent infections

20
Q

S/S of Hepatosplenomegaly?

A

abdominal pain, nausea, vomiting

21
Q

Clinical Presentation of AML

A
  • May present with life-threatening sepsis or hemorrhage
  • Gingival hypertrophy
  • Extramedullary infiltration
22
Q

Extramedullary infiltrations?

A
  • into the soft tissues and skin)
  • Chloromas (myeloid sarcoma)
  • Leukemia cutis (infiltration of leukemia cells under the skin approx 3%– colorless or slightly purple, “blueberry muffin” appearance
23
Q
  • infiltration of leukemia cells under the skin approx 3%

- colorless or slightly purple, “blueberry muffin” appearance

A
  • Leukemia cutis
24
Q

Gastrointestinal Potential Side Effects of CTX?

A

nausea, vomiting, diarrhea, constipation, impaired liver function, pancreatitis, anorexia, & electrolyte imbalances

25
Q

Skin/mucosal Potential Side Effects of CTX?

A

mucositis, stomatitis, rashes, discoloration, increased sensitivity to sunlight, alopecia

26
Q

Hematologic Potential Side Effects of CTX?

A

anemia, neutropenia, and thrombocytopenia

Immunosuppression

27
Q

Other Potential Side Effects of CTX?

A

pulmonary, renal, neurological, or cardiac damage, possible sterility

28
Q

Staff should wear appropriate protection to shield them from body & blood for how long after CTX has been completed?

A

48 hours

29
Q

Common classifications of brain tumors?

A
  • Astrocytomas
  • Low-grade astrocytomas
  • Anaplastic astrocytomas & glioblastoma multiforme
  • Brainstem glioma
  • Medulloblastoma
  • Ependymoma
    Craniopharyngioma
30
Q

Brain tumor clinical presentations caused by increased ICP?

A

Headache, vomiting, ataxia, nystagmus, & diplopia

31
Q

What symptoms are associated with brainstem involvement either from tumor or compression from tumor or hydrocephalus

A

Cranial nerve deficits

32
Q

Supratentorial symptoms caused by brain tumors?

A

hemiparesis, seizures, visual changes, and intellectual problems.

33
Q

Midline tumors in the hypothalamus/pituitary region present with?

A

visual changes, endocrine abnormalities, and increased ICP.

34
Q

Tx of brain tumors?

A
  • Primary treatment with maximal surgical resection being the goal.
  • Radiation
  • Chemotherapy
35
Q

Most common intraabdominal and kidney tumor of childhood?

A

Wilms Tumor

- Nephroblastoma,

36
Q

Most common presenting sign of Wilms tumor?

A
  • swelling or mass within the abdominal area

- Firm, nontender, confined to one side, deep within the flank

37
Q

Manifestations of Wilms Tumor?

A

swelling or mass within the abd, hematuria, anemia, hypertension, weight loss, fever

38
Q

Tx of Wilms Tumor?

A
  • surgical removal

- Children with localized tumors (Stage I and II) have 90% chance of cure with multimodal therapy

39
Q

Postop concerns for Wilms Tumor removal patient?

A
  • Monitor GI activity; bowel sounds, bowel movements, distention, and vomiting
  • Observe for s/s of infection, especially during chemotherapy
40
Q

Osteogenic Sarcoma

A
  • Primary malignant tumor of bone
  • Most common bone tumor & 6th most common malignancy in pediatrics
  • Peak incidence is in the 2nd decade of life due to the rapid bone growth occurring during this time.
  • Often occurs earlier in girls due to their earlier growth spurt
  • more common in boys due to their larger bone volume.
41
Q

Primary malignant tumor of bone?

A

Osteogenic Sarcoma

42
Q

Most common sites for Osteogenic Sarcoma?

A
  • long bones
  • Distal femur (35%)
  • Proximal tibia (17%)
  • Proximal humerus (10%)
43
Q

Clinical Presentation of OS

A
  • Pain that is dull, aching, and constant and is often worse at night
  • Average duration of pain is 3 months prior to diagnosis
  • Pain is often attributed to trauma
  • May or may not have soft tissue swelling
  • May have altered gait or function of extremity
44
Q

Most common metastatic site for OS?

A

Lungs

45
Q

Surgical Tx’s for OS?

A
  • Limb salvage procedure (implant or bone graft)
  • Arthrodesis (joint fusion)
  • Amputation
  • Rotationplasty (ankle used as knee joint)
46
Q

Risks of CTX in children?

A
  • infection
  • fluid volume deficit
  • weight loss
  • pain
  • altered oral mucus membranes (ulcers, mucicitis)
  • constipation

Peds Exam (5900) #3 (10 decks)

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