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Peds II > Exam 1 - Oncology > Flashcards

Exam 1 - Oncology Flashcards

1
Q

What is the most common malignancy in childhood?

A

Acute Lymphoblastic Leukemia (ALL)

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2
Q

What cancer is secondary to uncontrolled proliferation of immature lymphocytes?

A

ALL

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3
Q

The following clinical presentation is associated with what cancer?

  • Intermittent fever, fatigue, pallor
  • Bleeding
  • Bone pain (especially in the pelvis, vertebral bodies, legs)
  • Hepatosplenomegaly
  • Lymphadenopathy
A

ALL

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4
Q

The following laboratory findings are associated with what cancer?

  • Anemia and/or thrombocytopenia with normal or depressed WBC
  • Peripheral smear of bone marrow: Lymphoblasts
A

ALL

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5
Q

What is the treatment for ALL?

A
  • Chemotherapy (multidrug regimen)
  • Hematopoietic stem cell transplant

*may take 2-3 years to complete

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6
Q

What is the initial/first line therapy for ALL?

A

Chemotherapy

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7
Q

The following clinical findings are associated with what cancer?

  • Fatigue, pallor, bleeding, infection
  • Possible CNS involvement
A

Acute Myeloid Leukemia (AML)

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8
Q

The following laboratory findings are associated with what cancer?

  • Anemia, thrombocytopenia, and neutropenia
  • WBC > 100,000
  • Peripheral smear: showing at least 20% circulating myeloblasts and Auer Rods
A

AML

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9
Q

What is required for diagnosis of AML (2)?

A
  • Bone marrow biopsy showing 20% or more blasts

- Leukemic cells must be of myeloid origin

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10
Q

Lymphoblasts on peripheral smear are associated with what cancer?

A

ALL

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11
Q

Auer Rods on peripheral smear are associated with what cancer?

A

AML

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12
Q

What is the treatment for AML?

A
  • Chemotherapy (often two courses followed by consolidation chemo or HCT)
  • Allognic hematopoietic cell transplant (HCT)
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13
Q

What kind of cancer is a myeloproliferative disorder in which there is uncontrolled proliferation of mature and maturing granulocytes?

A

Chronic Myeloid Leukemia (CML)

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14
Q

Which cancer is associated with the Philadelphia Chromosome?

A

CML

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15
Q

The following laboratory studies are associated with what cancer?

  • Anemia, thrombocytosis, marked leukocytosis
  • Peripheral smear: Myeloid cells in all stages of maturation, increased basophils and blast cells
A

CML

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16
Q

What specific finding confirms the diagnosis of CML?

A

Philadelphia Chromosome

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17
Q

What is the treatment for CML?

A
  • Control via tyrosine kinase inhibitor

- Cure via allogenic hematopoietic cell transplant

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18
Q

Reed-Sternberg cells are diagnostic of what cancer?

A

Hodgkin Lymphoma

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19
Q

What are germinal-center B cells that have undergone malignant transformation?

A

Reed-Sternberg cells

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20
Q

The following clinical presentation is associated with what cancer?

  • Painless cervical or supraclavicular adenopathy
  • Mediastinal mass
  • Weight loss, fever, night sweats (B symptoms)
  • Splenomegaly
A

Hodgkin Lymphoma

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21
Q

What must you be cautious of with a mediastinal mass?

A

Superior Vena Cava Syndrome (dyspnea, cough, orthopnea, facial/upper extremity edema)

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22
Q

What can confirm the diagnosis of Hodgkin Lymphoma?

A

Reed-Sternberg cells in tissue biopsy

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23
Q

What is the staging for Hodgkin Lymphoma?

A

CXR, CT scan, bone marrow biopsy

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24
Q

What is the treatment for Hodgkin Lymphoma?

A
  • Combination therapy of chemotherapy and low dose radiation
  • Autologous HCT
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25
Q

How is childhood Non-Hodgkin Lymphoma different from adult?

A

Childhood Non-Hodgkin lymphomas are rapidly proliferating, high-grade, diffuse malignancies

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26
Q

The following clinical findings are associated with what cancer?

  • Fast, usually 1-3 weeks
  • Enlarging, non-tender lymphadenopathy
  • Abdominal pain, fevers, cough, dyspnea, weight loss
  • Hepatomegaly/Splenomegaly (advanced stage)
A

NHL

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27
Q

What is the treatment for NHL?

A
  • Chemotherapy

- Autologous or allogeneic HCT (for those who relapse)

28
Q

What cancer has predisposing factors of Down syndrome and Neurofibromatosis?

A

AML

29
Q

What is the most common solid tumor of childhood?

A

Brain tumor

30
Q

What is the triad associated with brain tumors?

A
  • AM headache
  • Vomiting
  • Papilledema
31
Q

What is the preferred diagnostic study for brain tumors?

A

MRI

32
Q

On a tissue biopsy for a brain tumor, what are the two categories of tumors and which is cancerous versus benign?

A
  1. Glial tumors (usually benign)
    - Astrocytomas
  2. Nonglial tumors (usually cancerous)
    - Medulloblastoma
33
Q

What is the treatment for brain tumors?

A
  • Initial approach: surgical removal

- Radiation and chemo when indicated (avoid in < 3 years of age)

34
Q

What is the most common abdominal tumor in children?

A

Neuroblastoma

35
Q

What is the most common solid neoplasm outside the CNS?

A

Neuroblastoma

36
Q

The following clinical manifestations are associated with what childhood cancer?

  • Abdominal mass that often extends beyond midline
  • Bone pain from metastatic disease
  • Fever, weight loss, irritability, abdominal pain, anorexia
A

Neuroblastoma

37
Q

The following laboratory findings are associated with what cancer?

  • Anemia
  • Urinary catecholamines are elevated
A

Neuroblastoma

38
Q

How is neuroblastoma diagnosed?

A
  • Histologic confirmation
    OR
  • Evidence of metastasis of bone marrow/concomitant urine catecholamines
39
Q

What is the treatment for neuroblastoma?

A
  • Surgical resection coupled with chemo
  • Surgery alone if low grade
  • Radiation sometimes necessary
40
Q

What is the second most common abdominal tumor in children?

A

Nephroblastoma (Wilms Tumor)

41
Q

What clinical finding helps to differentiate Neuroblastoma from Nephroblastoma?

A

The abdominal mass/swelling rarely crosses midline in Nephroblastoma

42
Q

The following clinical findings are associated with what cancer?

  • Asymptomatic abdominal mass/swelling which is smooth and does not cross midline
  • Fever, hematuria, hypertension
A

Nephroblastoma

43
Q

What imaging should be obtained to assess for Nephroblastoma?

A
  • Ultrasound or CT of the abdomen

- CT of chest

44
Q

What is the treatment for Nephroblastoma?

A

Surgical exploration, chemo, and radiation

45
Q

What is the most common primary bone malignancy in pediatrics?

A

Osteosarcoma

46
Q

In which bones does osteosarcoma occur in?

A 
Long bones (metaphysis)
- distal femur (40%)
47
Q

What are the cardinal signs of a bone tumor? (3)

A
  • Bone pain at the site
  • Mass formation
  • Fracture through the area of cortical destruction
48
Q

Patient presents with the following symptoms:

  • Bone pain over certain area for the past few months
  • Soft tissue mass which is tender to palpation
  • Antalgic gait

What should you be concerned for?

A

Osteosarcoma

49
Q

What imaging studies should you consider when concerned for osteosarcoma?

A
  • X-ray
  • MRI
  • Bone scan
  • CT of the chest
50
Q

What is the treatment for osteosarcoma?

A
  • Surgery

- Chemo

51
Q

What is the second most common primary bone tumor in pediatrics?

What population is primarily affected?

A

Ewing Sarcoma

White males during their second decade of life

52
Q

Patient presents with the following findings:

  • Worsening localized pain and swelling
  • Bone pain which is worse at night
  • Fatigue, fever, some weight loss

What should you be concerned for?

A

Ewing Sarcoma

53
Q

What is the treatment for Ewing Sarcoma?

A
  • Chemo
  • Surgery
  • Radiation
    OR combo if needed
54
Q

What is the staging associated with Ewing Sarcoma?

A

CT scan of chest, bone scan, bone marrow aspirates and biopsy

55
Q

What contributes to 90% of tumors diagnosed before age 5 and is the most common intraocular tumor in pediatrics?

A

Retinoblastoma

56
Q

The following symptoms should make you consider what disorder?

  • Leukocoria: white pupillary reflex
  • Strabismus, nystagmus, red inflamed eye
A

Retinoblastoma

57
Q

What is the most common sign of Retinoblastoma?

A

Leukocoria

58
Q

What is diagnostic for Retinoblastoma?

A

Chalky, off white retinal mass with soft, friable consistency

59
Q

What kinds of diagnostic evaluations should be performed for Retinoblastoma?

A
  • Detailed ophthalmologic exam under anesthesia
  • Ocular ultrasound
  • MRI of brain and orbits
60
Q

What are the treatment options for Retinoblastoma?

A
  • Many “vision-sparing” therapies
  • External beam irradiation
  • Chemo if confined to the globe
61
Q

What is the most common soft tissue sarcoma in childhood?

A

Rhabdomyosarcoma

62
Q

What are common symptoms associated with Rhabdomyosarcoma in general?

What about orbital specifically?

What about bladder specifically?

A

General: Painless, progressively enlarging mass

Orbital: Proptosis/Exophthalmos

Bladder: Hematuria, urinary obstruction, pelvic mass

63
Q

What diagnostic testing should be performed when concerned for Rhabdomyosarcoma?

A
  • Xray and CT or MRI of mass
  • Chest CT to r/o pulmonary mets
  • Skeletal survey to r/o bone mets
64
Q

What is the treatment for Rhabdomyosarcoma?

A

Any combination of surgery, chemo, radiation

65
Q

What is hyperleukocytosis?

A

WBC count of >100,000, medical emergency with life threatening complications

66
Q

What is the most common primary hepatic malignancy in pediatrics?

A

Hepatoblastoma

67
Q

What is often elevated in Hepatic tumors?

A

Serum alpha fetoprotein

Peds II (11 decks)

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