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Paediatrics > Malignancy > Flashcards

Malignancy Flashcards

1
Q

Common cancers before 6yrs old

A

Neuroblastoma

Wilm’s tumour

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2
Q

Common cancers in adolescence

A

Hodgkin lymphoma

Bone

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3
Q

Most common childhood cancer

A

Leukaemia

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4
Q

Side effects of chemotherapy

A 
Bone marrow suppression = anaemia
Immunosuppression = infections
Nausea and vomiting
Anorexia = malnutrition
Alopecia
Headache
Muscle atrophy
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5
Q

Most common childhood leukaemia

A

Acute lymphoblastic leukaemia

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6
Q

2 types of Acute lymphoblastic leukaemia

A

B and T lymphoblastic leukaemia

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7
Q

Clinical features of acute lymphoblastic leukaemia

A 
Pancytopenia = pallor, anaemia, bleeding, bruising, nose bleeds, infections.
Fatigue, malaise, anorexia
Bone pain
Painless lumps in neck, axilla and groin
Hepatosplenomegaly
Headaches
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8
Q

Investigations for acute lymphoblastic leukaemia

A

FBC = normocytic normochromic anaemia. Thrombocytopenia/Low platelets, can get low WWC.
High lactate dehydrogenase, high urate.
Bone marrow biopsy diagnostic, shows blast nucleated cells.
LP = CSF high protein, low glucose, pleocytosis (high lymphocytes)
CXR = mediastinal mass in T cell type.

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9
Q

Onset of symptoms of ALL and age

A

Within 4 weeks, 2-6yrs.

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10
Q

Complication of ALL

A

Febrile neutropenic sepsis
Metastasis to CNS
Poor growth

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11
Q

Management of ALL

A

Chemotherapy in 3 stages:
Induction treatment - aim to achieve remission, vincristine, dexamethasone + asparaginase.
Consolidation treatment - exterminate residual disease.
Maintenance treatment - extend remission, methotrexate and mercaptopurine.

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12
Q

2 main types of brain tumours in kids

A

Astrocytoma

Medulloblastoma

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13
Q

CFx of lymphoma

A

Painless lymphadenopathy (mostly neck)
Longer history of symptoms than leukaemia.
Cough

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14
Q

Febrile neutropenic sepsis

A

Septicaemia

Piptazobactam and gentamicin.

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15
Q

Risk factors for ALL

A

Down syndrome
Philedelphia chromosome
Radiation exposure

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16
Q

High risk ALL

A

Age less than 1yr or greater than 10yrs
WCC greater than 50,000
CNS or testicular involvement
Genetics such as philedelphia chromosome.

17
Q

Name 3 types of brain cancers

A

Astrocytoma from glial cells
Craniopharyngioma (cause bilateral homonymous hemianopia)
Medulloblastoma.

18
Q

Presentation of brain tumour

A 
Headache - worse on lying down
Early morning vomiting.
Squint, nystagmus, papilloedema
Ataxia
Personality and behaviour changes.
19
Q

Investigations for brain tumour

A

MRI

20
Q

Management of a brain tumour

A

Surgical resection if appropriate location (not brainstem!)

Radio +/- chemotherapy depending on age.

21
Q

Name of a neuroendocrine tumour

A

Neuroblastoma

22
Q

Origins of a neuroblastoma

A

adrenal medulla or sympathetic nervous system Rea e.g. sympathetic chain.

23
Q

Age of neuroblastoma

A

before 5

24
Q

Clinical features of a neuroblastoma

A 
Englarged abdomen
Abdominal mass
Weight loss
Hepatomegaly
Limp and bone pain
Symptoms of compression of local structure or spinal root.
25
Q

Investigations for neuroblastoma

A

CT and check for metastasis
High urine catecholamine
Biopsy

26
Q

Management of neuroblastoma

A

Surgery +/- chemotherapy

If severe stem cell transplant

27
Q

Name 2 types of bone tumours

A

Osteogenic sarcoma (most common, esp in older children). Ewing’s sarcoma (more common in younger)

28
Q

Age and gender of bone tumour

A

POST or during puberty! male

29
Q

Presentation of bone tumour

A

limp and bain

30
Q

Investigations and features of bone tumour

A

x-ray = nidus with central high density area, sclerosis or periosteal reaction, moth-eaten appearance.
MRI
Bone scan

31
Q

Management of bone tumour

A

Chemotherapy before surgery (endo-prosthetic resection)

32
Q

Name a kidney tumour

A

Nephroblastima/Wilm’s

33
Q

Clinical features of a kidney tumour

A

Painless, abdominal mass
Haematuria
Hypertension
Anorexia

34
Q

Investigations for a nephroblastoma

A

US/CT/MRI

Show distorted renal structure

35
Q

Management of a nephroblastoma

A

Chemo before and after nephrectomy or resection.

Radiotherapy if advanced/high-grade.

Paediatrics (16 decks)

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