Childhood Cancers

Question 1

Types of brain tumour

Answer 1

Astrocytoma Medulloblastoma Ependymoma Brainstem glioma Craniopharyngioma

Question 2

S+S brain tumours

Answer 2

Increased ICP signs Headaches due to space occupying lesions. Worse when lying down + morning vomiting Diplopia, squint or facial nerve palsy Abnormal gait, nystagmus, seizures

Question 3

Leukaemia RF

Answer 3

More common in boys Age 2-5

Question 4

Leukaemia pathology

Answer 4

Malignant proliferation of abnormal white cells within bone marrow

Question 5

Types of leukaemia

Answer 5

Acute lymphoblastic (ALL) most common Acute myeloid/ acute non-lymphocytic

Question 6

S+S of leukaemia

Answer 6

Thrombocytopenia = bruising Anaemia Leucopenia = infection Bone pain Fever Lymphadenopathy Hepatosplenomegaly

Question 7

Investigations for leukaemia

Answer 7

Low Hb Circulating leukaemic blast cells

Question 8

Management of AML + ALL

Answer 8

Chemo

Question 9

Hodgkin lymphoma cells present

Answer 9

Reed sternberg

Question 10

S+S of Hodgkin’s lymphoma

Answer 10

Painless lymphadenopathy Larger + firmer than benign nodes Night sweats, weight loss + fever

Question 11

Management + monitoring of Hodgkins lymphoma, which are more likely in whichage group

Answer 11

Chemo +- RT

PET scanning for monitoring

NHL = childhood

HL = teens

Question 12

S+S NHL

Answer 12

Mediastinal mass - can cause SVC obstruction

Lymphadenopathy

Pain from intestinal obstruction or intussusception

Question 13

Pathology of neuroblastoma

Answer 13

Arise from neural crest tissue in adrenal medulla Most common before 5

Question 14

S+S neuroblastoma

Answer 14

Abdominal mass Pallor, weight loss, hepatomegaly, bone pain + limp

Question 15

Investigations for neuroblastoma

Answer 15

Raised urinary catecholamine degradation products (VMA, HMMA) Biopsy

Question 16

Wilms tumour pathology

Answer 16

Originates from embryonal renal tissue

Question 17

S+S Wilms tumour

Answer 17

Large abdo mass - solid + cystic Otherwise well child

Question 18

Diagnosis of Wilms tumour

Answer 18

USS/ CT/ MRI

Question 19

Management of Wilms tumour

Answer 19

Chemo + nephrectomy

Question 20

What is the treatment of leukaemia?

Answer 20

4 weeks chemo to gain remission, then block of intensive chemo to consolidate remission

Continuing chemo for up to 3 years.

Co-trimoxazole given prophylactically to prevent pneumocystitis carinii

Question 21

What do you do for a leukaemia relapse?

Answer 21

High dose chemo + total body irradiation + bone marrow transplant

Question 22

What blood results indicate CLL?

Answer 22

Anaemia + neutropenia + thrombocytopenia