LAD In Kids

Question 1

How do we define LAD?

Answer 1

Lymph nodes that are abnormal in size, number and consistency

Question 2

What 4 regional lymph nodes to always check regardless?

Answer 2

Cervical, Supra clavicualr, axillary and inguinal

Question 3

5 things to consider when taking the history of a child with LAD?

Answer 3

Age, location of enlarged nodes, onset and duration, localized symptoms, generalized symptoms.

Question 4

What is the size that is considered enlarged and what location of nodes is not normal to have enlarged lymph nodes?

Answer 4

Greater than 2 cm

Supraclavicular

Question 5

3 indications to biopsy a LN?

Answer 5

1. If watchful waiting is the plan and they never get better
2. If plan was antibiotics and the meds didn’t do anything
3. Supraclavicular node is palpated along with findings of cancer

Question 6

What two viral infections can cause LAD in kids?

Answer 6

EBV and HIV

Question 7

5 bacterial infections that can cause LAD?

Answer 7

Strep pneumonia 
Staph aureus
Tularemia
Cat scratch disease (bartonella henselae)
Yersinia pestis

Question 8

Big time manifestation in the eye of cat scratch disease?

Answer 8

Neuroenteritis. Macular star

Question 9

What do we do with a patient with testicular mass and no history of trauma or injury?

Answer 9

Chest x ray because malignancy is likely

Question 10

What is the difference between heterotopic and hamartomas?

Answer 10

Heterotopic lesions are normal cells in the wrong place of the body
Hemartomas are overgrowth of cells and tissues in their native place.

Question 11

What is the most common tumor of infancy? Two types and where in the body do we most commonly find them?

Answer 11

Hemangioma
Cavernous and capillary
Skin of kids

Question 12

What are the two lymphatic tumors of kids?

Answer 12

Lymphangiomas and lymphangiestacis

Question 13

What are the two fibrous tumors?

Answer 13

Fibromatosis

Fibrosarcoma

Question 14

What are the most common teratomas?

Answer 14

Sacrococcygeal

Question 15

What are the 5 most common places in the body that childhood cancers arise from?

Answer 15

Hematopoietic system, nervous system, soft tissues, bone and kidney

Question 16

Top 4 cancers for kids 0-4?

Answer 16

Leukemia
Retinoblastoma
Neuroblastoma
Wilms tumor

Question 17

What is the most common extra-cranial solid tumor of childhood and what two places do we find it?

Answer 17

Neuroblastoma

Sympathetic ganglia and adrenal medulla

Question 18

In children less than 2 with a neuroblastoma what are 4 clinical symptoms/signs?

Answer 18

Fever, large abdominal mass, possible weight loss, and if they have disseminated disease, they can present with multiple cutaneous metastasis causing a blue color and we call them blueberry muffin babies

Question 19

What is a very important diagnostic feature of nueroblastomas?

Answer 19

Almost all of them produce catecholamines so elevated urine VMA and HVA

Question 20

What are the three conditions associated with increased risk of developing a wilms tumor?

Answer 20

WAGR syndrome
Denys crash syndrome
Beckwith wiedemann syndrome

Question 21

4 clinical signs of WAGR Syndrome and what is the chromosomal mutation?

Answer 21

Wilms tumor, no iris, genital anomalies, and mental retardation
Deletion of 11p13

Question 22

What is the percentage that patient will get a wilms tumor with Denys crash syndrome and what are 2 clinical signs and what is the genetic mutation?

Answer 22

90
Gonadal dysgenesis and progressive renal disease
WT1 protein on 11p13

Question 23

What is the overall clinical setting of Beckwith Wiedemann syndrome and what is the genetic mutation?

Answer 23

Macro, big. Everything big. Big tongue big organs.

WT2 protein on 11p15.5

Question 24

3 clinical presenting signs of wilms tumors?

Answer 24

Unilateral flank mass, hematuria and HTN