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Unit 1 Peds II > L3 Peds Oncology > Flashcards

L3 Peds Oncology Flashcards

1
Q

most common malignancy of childhood

A

Acute Lymphblastic Leukemia

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2
Q

ALL is

A

Uncontrolled proliferation of immature lymphocytes, usually B cell precursors

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3
Q

more likely to get ALL

A

Down syndrome
Viral infections
radiation

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4
Q

peak ages of ALL

A

2-5 years

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5
Q

fever, fatigue, pallor, bleeding→ petechiae, purpura, bone pain (pelvis, vertebrae, legs), hepatosplenomegaly, lymphadenopathy

A

ALL

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6
Q

ALL labs

A 
Anemia
Thrombocytopenia
Neutropenia
Peripheral smear, bone marrow biopsy: lymphoblasts
WBC could be normal, depressed, elevated
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7
Q

how long does treatment take for ALL

prognosis?

A

2-3 years

85% survival rate

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8
Q

ALL, AML treatment

A

Chemotherapy 1st

Hematopoietic stem cell transplant (HSCT) best if from matched sibling

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9
Q

Hyperkalemia
Hyperuricemia
Hyperphosphatemia
Acute renal failure

A

tumor lysis syndrome

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10
Q

AML is

A

proliferation of precursor cells, myeloblasts, commited to the myeloid line of cellular development–> reduced capacity to differentiate into mature cells

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11
Q

risk of AML

A

Down syndrome, neurofibromatosis, radiation, benzene (smoking), previous chemo

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12
Q

myeloblasts give rise to

A

granulocytes: basophils, neutrophils, eosinophils, monocytes

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13
Q

cancer that +/- CNS (10%): HA, lethargy, mental status changes, cranial nerve palsies

A

AML

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14
Q

WBC>100,000 (20%) → hyperleukocytosis (>75,000) is a life threatening medical emergency

A

AML

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15
Q

AML peripheral smear findings

A

Auer Rods: granular structures in the cytoplasm seen on peripheral smear
circulating myeloblasts, >20% diagnostic

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16
Q

2 things needed to diagnose AML

A
  1. bone marrow biopsy shows 20%+ blasts

2. blasts are of myeloid origin

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17
Q

AML prognosis

A

65-75%

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18
Q

philadelphia chromosome

A

CML

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19
Q

massive splenomegaly

A

CML

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20
Q

Chronic phase → accelerated phase → blast phase

A

CML

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21
Q

Peripheral smear: myeloid cells in all stages of maturation, increased basophils and blast cells
Blast cells > 20% during blast crisis

A

CML

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22
Q

CML tx

A

tyrosine kinase inhibitor

hematopoietic stem cell transplant

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23
Q

50% of all childhood lymphomas

A

Hodgkin Lymphoma

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24
Q

risk for hodgkin lymphoma

A

familial

EBV

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25
diagnosis of Hodgkin lymphoma
Reed-sternberg cells: germinal center B cells that have undergone malignant transformation
26
B symtpoms
fever night sweats weight loss
27
physical exam findings of Hodgkin lymphoma
painless cervical/supraclavicular adenopathy | mediastinal mass
28
superior vena cava syndrome
``` dyspnea cough othropnea facial/upper extremity edema Can be caused by mediastinal mass in Hodgkin lymphoma ```
29
hodgkin lymphoma survival rate
90%
30
Hodgkin lymphoma arises from | Non-Hodgkin lymphoma arises from
lymph nodes and spreads | any site of lymphoid tissue
31
patient has a history of EBV, which cancer do they have
either lymphoma
32
patients is HIV+, which cancer do they have
Non-Hodgkin lymphoma
33
Non-hodgkin lymphoma in peds is (but not in adults)
rapidly proliferating, high-grade, diffuse malignancies
34
when is heptamegaly/splenomegaly seen in non-hodgkin lymphoma
advanced stage | unlike others where it may be seen on initial presentation
35
fast, enlarging, non-tender lymphadenopathy
Non-hodgkin lymphoma
36
evaluating for brain tumor
measure head circumference, observe gait
37
Most common solid tumor of childhood
brain tumor
38
morning headache, vomiting, papilledema
brain tumor triad
39
brain tumor in young kids
Vomiting, unsteadiness, lethargy, irritability, macrocephaly, FFT, delayed development
40
brain tumor in older kids
HA, visual symptoms, seizure, focal neurological deficits, school failure, personality changes
41
preferred diagnostic study of brain tumor
MRI
42
Most common abdominal tumor, most common solid neoplasm outside CNS
neuroblastoma
43
most common primary site of neuroblastoma
adrenal gland
44
presentation of neuroblastoma
firm, fixed, irregular abdominal mass that **extends beyond midline**
45
neuroblastoma labs
anemia | urinary catecholamines: DA, epi, NE
46
neuroblastoma survival rate
<40%
47
Wilm's tumor
nephroblastoma
48
nephroblastoma presentation
asymptomatic abdominal mass/swelling, smooth, firm, well demarcated, **rarely crosses midline**. can extend into pelvis
49
hematuria, hypertension
wilm's tumor
50
who's most likely to get osteosarcoma
Males, 13-16 years old
51
where osteosarcoma happen
long bones metaphysis: femor
52
cardinal signs of bone tumor
bone pain at site mass formation fracture through the area of cortical destruction
53
who gets ewing sarcoma, and where
White males, 2nd decade, long bone diaphysis
54
osteosarcoma vs ewing sarcoma in long bones
osteosarcoma: metaphysis, often femur | ewing sarcoma: diaphysis
55
osteosarcoma vs ewing sarcoma soft tissue involvement
osteosarcoma: maybe, evaluate using MRI | ewing sarcoma: rare
56
presentation of retinoblastoma
leukocoria, strabismus, nystagmus, red inflamed eye
57
leukocoria
white pupillary light reflex
58
diagnostic of retinoblastoma
chalky, off white retinal mass with soft, friable consistency
59
when to use chemo for retinoblastoma
Retinoblastoma that is confined to the globe
60
retinoblastoma tx
External beam radiation
61
proptosis/exophthalmos
Orbital Rhabdomyosarcoma
62
hematuria, urinary obstruction, pelvic mass
Bladder Rhabdomyosarcoma
63
Presentation: painless, progressively enlarging mass Can resemble fat, fibrous tissue, muscle, at any part of the body Head & neck more common
Rhabdomyosarcoma
64
Serum alpha-fetoprotein
Hepatic tumors: Elevated at diagnosis Excellent marker of response to treatment
65
hepatic tumor survival rates
1/3 survive with complete resection

Unit 1 Peds II (3 decks)

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