Haematology

Question 1

Early warning signs of childhood cancer

Answer 1

Unusual swelling
Prolonged or unexplained fever
Unexplained weight loss
PAllor with or without fatigue
Abnormal bleeding (petechiae, epistaxis)
Unexplained prolonged pain eg headache
Acute neurological symptoms eg nausea and vomiting
white spot or squint in an eye

Question 2

common type of leukemia in children

Answer 2

Acute lymphoblastic leukemia

then Acute myeloid leukemia
(chronic lymphocytic doesnt occur at all in children)

Question 3

Clinical features of ALL

Answer 3

Pallor, FATIGUE, dizziness (from reduced red cells)
Bleeding/petechiae/epistaxis (from reduced platelets)
Recurrent infections (from reduced WCC)
Lymphadenopathy (blasts proliferation)
Fever
Hepatosplenomegaly
Thymic enlargement
Focal neurological signs
Bone pain

Question 4

What electrolytes abnormalities occur with tumor lysis syndrome

Answer 4

Hyperkalemia
hyperphosphatemia
hypocalcemia

(prevent/treat with allopurinol and hyperhydration. Ensuring urine output 2-4ml/kg/hour, renal function monitoring and electrolytes monitoring)

Question 5

which prophylaxis medication should all children getting chemotherapy receive

Answer 5

cotrimoxazole for pneumocystis jirovecii

Question 6

Outline the classification of St Jude staging system of lymphoma

Answer 6

STage 1: SIngle nodal or extra nodal site not in abdo or mediastinum
Stage 2: One or more extra nodal site + regional nodes, two extranodal on same side of diaphragm
Stage 3: Two or more on both sides of diaphragm. Includes abdo and intrathoracic
Stage 4: Bone marrow involvement, with or not with CNS

Question 7

WHat infection predisposes children to burkitts

Answer 7

EBV

Question 8

What is the most common finding/feature of a T lymphoblastic lymphoma

Answer 8

Mediastinal mass
Obstruction of superior vena cava with threatning airway obstruction necessating emergency tx

(remember ashwin from tut)

Question 9

Common feature of a B lymphocytic lymphoma

Answer 9

maxillary or mandibula mass
appearance of tooth initially

Question 10

What is the average age for hodgkins

Answer 10

Around 20s
peak before adolescence in low income
Another peak after 50 in high imcome

Question 11

What is the most common hodgkins lymphoma subtype

Answer 11

Nodular sclerosis

(the other subtypes are: Mixed cellularity, Lymphocyte-rich, Lymphocyte-depleted)

Question 12

Features of Hodgkins and common findings

Answer 12

Weighloss, night sweats, fever, pruritus

findings: mediastinal lymphadenopathy on CXR