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Peds - Spring 2016 > Hematology/Oncology - Part 2 - Unit 4 > Flashcards

Hematology/Oncology - Part 2 - Unit 4 Flashcards

1
Q

What is the purpose of the immune system?

What are the primary lymphoid immune system organs? Secondary?

A

Differentiates self and non-self.

Primary - thymus, bone marrow, liver.
Secondary - lymph nodes, spleen, gut associated lymphoid tissue.

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2
Q

What is the difference between nonspecific and specific immune function?

A

Nonspecific - activated on exposure to any foreign substance, reacts the same regardless! Phagocytosis, neutrophils/monocytes.

Specific is humoral immunity and involves antibody production and complement - B lymphocyte. Differentiates!

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3
Q

What is cell mediated immunity?

A

Involves a variety of specific functions mediated by the T lymphocyte. Occurs within the cells! Includes cytotoxic t cells, helper T cells, and suppressor T cells. Protection against viral/fungal/protozoan infections and slow-growing infections such as TB. Rejection, etc.

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4
Q

HIV - primarily infections subset of ___ lymphocyte.

A

T lymphocyte.

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5
Q

What are some symptoms of HIV?

A

Diarrhea, growth delay (length and weight), lymphadenopathy, recurrent opportunistic infections, autoimmune disorders, and persistent oral candidiasis, neurological impairment.

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6
Q

When is testing done for HIV (think kids!)

A

Birth, 3/6/12/18 months.

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7
Q

What are therapy goals for HIV?

A

Slow the growth of HIV, promote/restore normal G&D, prevent complication infections and cancers, improve quality of life, prolong survival.

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8
Q

What are some ways to prevent transmission of HIV?

A

AZT therapy, avoiding breastfeeding, standard precautions, discourage high risk behaviors, minimize exposure to infections, nutritional support, psychological support, education, avoid live vaccines, etc.

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9
Q

What is SCID?

A

defect characterized by absence of both humoral and cell-mediated immunity. Unknown cause.

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10
Q

How do we treat SCID?

A

Histocompatible HSCT

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11
Q

what are some symptoms of cancer?

A

Pain, fever, bruising, headache/vomiting, vision changes

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12
Q

What are some treatment options for cancer?

A

Biopsy, removal, chemo, radiation, biologic response modifiers, bone marrow transplant

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13
Q

What are some complications of cancer therapy?

A

Tumor lysis syndrome, superior vena cava syndrome, spinal cord compression, DIC

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14
Q

What is tumor lysis syndrome? Treatment?

A

Electrolyte imbalances (hyperuricemia, hyperkalemia, hyperphophatemia, hypocalcemia) - might need fluids, etc. Treatment includes hydration, allopurinol, NaHCO3, dialysis.

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15
Q

What is superior vena cava syndrome? Symptoms? Treatment?

A

Swelling of face/arms/chest, cough, SOB, pain. Treatment = chemo, radiation, blood thinners for clots.

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16
Q

What are some side effects of cancer therapy?

A

Infection, hemorrhage, anemia, N/V, altered nutrition, neurologic problems, hemorrhagic cystitis, alopecia, steroid effects.

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17
Q

What is leukemia?

A

Non-functional blast cells, cannot fight infection, and they multiply continuously. This affects the bone marrow so they have anemia, thrombocytopenia, immunosuppression.

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18
Q

Acute leukemia - ALL - most common or least common?
Peak onset - __ to __ years.
Boys more than girls?

A

Most common.
2-5 years.
Boys.

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19
Q

What is AML?

A

Acute myelogenous leukemia. Similar between genders. Higher rates in less than 2 years. 40-50% cure rate.

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20
Q

How do we treat leukemia?

A

IV Chemo, divided into phases.

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21
Q

What are the 5 phases of leukemia treatment?

A 
Induction - getting blasted with chemo.
Intensification - different meds. 
Consolidation - less chemo.
Delayed intensification - another blasting!
Maintenance - some IV meds...
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22
Q

what does hodgkin’s lymphoma include?

A

Reid steinburg cells. Diagnosed by Ct/MRI, bone scan, etc.

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23
Q

How do we treat hodgkin’s lymphoma?

A

Chemo, radiation, etc.

24
Q

Do non-hodgkin’s lymphoma patients have the reid steinburg cells?

A

NO.

25
Q

Non-hodgkins lymphoma - also classified by what?

A

Cell - t-cell, b-cell, non-t, non-b, etc.

26
Q

Brain tumors - 60% are infratentorial - four types?

A

Brainstem glioma, infratentorial ependymoma, cerebellar astrocytoma, medulloblastoma, etc.

27
Q

Brain tumors - 40% supratentorial - four types?

A

Craniopharyngioma, optic nerve glioma, cerebral astrocytoma, ependymoma, s/s related to their anatomic location/size.

28
Q

what are the functions of the cerebrum?

A

Composed of the right/left hemispheres. Initiation of movement, coordination of movement, temperature, touch, vision, hearing, judgment, reasoning, problem solving and learning.

29
Q

what are the functions of the brainstem?

A

sensory, movement of eyes, body temp, cardiac function, consciousness, involuntary muscle movement, etc.

30
Q

What are the functions of the cerebellum?

A

Located at the back of the head - infratentorial), coordinate voluntary muscle movements, maintains posture, etc.

31
Q

neuroblastoma - most common extra cranial solid tumor. T/F?

A

TRUE

32
Q

Neuroblastoma - primary site within ____ - other sites include what?

A

Primary = abdomen.

Other sites = head, neck, chest, pelvis, etc.

33
Q

Neuroblastoma - abdomen will feel like what?

A

Firm, nontender, irregular mass in the abdomen.

34
Q

Neuroblastoma - compression of kidney, ureter, or bladder may cause urinary frequency or retention. T/F?

A

TRUE

35
Q

what are some signs and symptoms of neuroblastoma?

A

Supraorbital ecchymosis, periorbital edema, proptosis (protrusion of the eyeball) lymphadenopathy, hepatomegaly, skeletal pain, pallor, weakness, irritability, anorexia, weight loss - just depends on the location.

36
Q

how do we diagnose neurblastoma?

A

CT scan, bone scan, bone marrow aspiration, urine catacholamines

37
Q

Neuroblastoma - it’s okay to palpate the abdomen. T/F?

A

FALSE - do not.

38
Q

How do we treat neuroblastoma?

A

Surgery, chemotherapy, irradiation, stem cell transplantation

39
Q

osteogenic sarcoma - common? When does it commonly grow? Sites?

A

Common…most commonly occurs in teens during growth spurt. Diametaphyseal region of long bones. Half in femur, half in humerus.

40
Q

how do we treat osteogenic sarcoma?

A

Surgery, biopsy, limb salvage, chemo, etc.

41
Q

Ewing’s Sarcoma (Primitive Neuroectodermal Tumor of the bone) - arises in where? Treatment?

A

Arises in bone marrow spaces. Originates in the shaft of the long and trunk bones. Treated with radiation and chemotherapy.

42
Q

what is van ness rotationplasty?

A

The heel becomes the patient’s knee!

43
Q

what is wilm’s tumor? Diagnosed by?

A

Nephroblastoma - most common kidney tumor. Associated with several congenital malformation syndromes. Diagnosed by ultrasound, CT/MRI

44
Q

How long is treatment for wilm’s tumor? what is the treatment?

A

6 months - chemo/surgery.

45
Q

what is rhabdomyosarcoma?

A

Most common soft tissue sarcoma in children - 4th most common type of solid tumor in children. Found almost anywhere in the body.

46
Q

What are the 3 classifications of rhabdomyosarcoma?

A

Embryonal, alveolar, pleomorphic

47
Q

How do we diagnose rhabdomyosarcoma? how is it staged?

A

Ct/MRI, LP, Metastatic evaluation, bone scan

staged upon resection of tumor and residual disease.

48
Q

how do we treat rhabdomyosarcoma?

A

Chemo, surgical resection, radiation.

49
Q

Rhabdomyosarcoma - prognosis is good the first time (if not metastatic) but bad if it’s a relapse. T/F?

A

TRUE

50
Q

Retinoblastoma - what is the cat’s eye reflex?

A

It looks like a red-eye without the red.

51
Q

How do we diagnose retinoblastoma?

A

indirect opthalmoscopy, ultrasound, CT

52
Q

How is a retinoblastoma treated?

A

Chemoterhapy, irradiation, brachyterhapy, photocoagulation, cryotherapy, radiation, enucleation for advanced disease with optic nerve invasion, intrathecal chemo, eye removal.

53
Q

what are germ cell tumors?

A

Like ovarian/testicular cancer. Yolk sak tumor/sacrococcygeal teratoma.

54
Q

Liver tumor - most common subtype is what?

A

Hepatoblastoma, treated with surgery/chemo

55
Q

what are some late effects of cancer?

A

Emotional, CNS (seizures, lower IQ scores, lower academic performance, etc), language/math issues, cardiovascular problems, eye issues, small teeth, missing teeth, teeth sensitivity, gum disease, short stature, skeletal issues, hearing (ringing), need for hearing aids, respiratory issues, urianry issues, etc.

Peds - Spring 2016 (29 decks)

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