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Paediatrics > Malignant Disease > Flashcards

Malignant Disease Flashcards

1
Q

What is the most common form of leukaemia in children?

What accounts for the remainder?

What age does it peak?

A
  1. Acute Lymphoblastic Leukaemia (80%)
  2. Acute myeloid, acute non lymphocytic leukeaemia
  3. peaks ages 2-5
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2
Q

How does Acute Lymphoblastic Leukaemia present?

A
  • Malaise and Anorexia
  • Anaemia causing pallor and lethargy
  • Thrombocytopenia causing petechia, nose bleeds, bruising
  • Neutropenia causing infections
  • Bone marrow infiltration causing bone pain
  • hepatosplenomegaly and lymphadenopathy
  • CNS infiltration causing headaches, vomiting and nerve palsies
  • Testes infiltration causing testiculer enlargement
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3
Q

What investigations would you do for ALL?

A 
FBC: Low Hb, thrombocytpoenia, neutropenia, evidence of BLAST CELLS 
Bone marrow examination essential
Clotting screen for DIC
LP 
CXR
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4
Q

How would you manage ALL?

  1. intitially
  2. induction of remission
  3. CNS disease
A
  • blood transfusion for anaemia, treat infection
  • combination of chemotherapy and steroids
  • Additional treatment with intrathecal therapy for CNS infiltration
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5
Q

What are the clinical features of Hodgkin lymphoma?

A
  • painless lympadenopathy, usually in the neck (can cause airway obstruction)
  • systemic symptoms - sweating, pruritus, weight loss, fever = b symptoms (rare even in advanced disease)
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6
Q

What investigations would you do for Hodgkins lymphoma?

A
  • lymph node biopsy
  • radiological assesment
  • bone marrow biopsy
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7
Q

How would you manage Hodgkin Lymphoma?

A
  • combination chemotherapy +/- radiotherapy

- Monitor using PET scan

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8
Q

How can T cell malignancies present?

A

As Non-Hodgkin lymphoma or ALL

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9
Q

How do B cell malignancies present?

A

More commonly as Non Hodgkin Lymphoma

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10
Q

What characterises ALL and non-hodgkin lymphoma? What can this cause?

A
  • mediastinal mass
  • can cause SVC obstruction
  • may lead to dyspnoea, facial swelling, flushing, venous distension in neck and distended veins in upper chest and arms
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11
Q

What investigations would you do for Non-Hodgkins Lymphoma?

A
  • biopsy

- radiological assesment

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12
Q

What is the management for Non Hodgkins lymphoma?

A
  • multiagent chemo
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13
Q

What is Burkitt lymphoma associated with?

Where is it most common?

What parts of the body does it involve?

What is treatment?

A

EBV virus, HIV

malaria endemic regions

jaw and facial bones

treatment is multiagent chemotherapy

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14
Q

Where do Neuroblastomas originate and what makes them different?

Which age are they most common?

A
  • originate from neural crest cells in the adrenal gland and the sympathetic nervous system - can regress spontaneously in young infants
  • most common before the age of 5
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15
Q

How do Neuroblastomas present?

A
  • abdo mass
  • primary tumour anywhere in sympathetic chain from neck to pelvis
  • abdominal primary - adrenal orgin
  • bone marrow suppression leading to weight loss and malaise and bone pain
  • can infiltrate vertebra - cord compression - neuro symptoms - emergency decompression surgery needed
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16
Q

What investigations would you do for neuroblastoma?

when is prognosis worse?

A
  • urine analysis - raised urine catecholamine metabolite level (VMA,HVA)
  • confirmatory biopsy
  • X-ray - calcification
  • worse prognosis over the age of 1 and amplification of MYCN gene
17
Q

What is the management for neuroblastoma?

A
  • surgery if localised

- chemo if metastatic

18
Q

Where does Wilm’s tumour originate?

A
  • embryonal renal tissue
19
Q

What are the clinical features - common and less common?

A

common:

  • abdominal mass
  • haematuria

less common

  • abdo pain
  • anorexia
  • anaemia
  • htn
20
Q

What investigations would you do for Wilm’s tumour?

How would you manage?

A
  • USS
  • CT, MRI (shows intrinsic renal mass)
  • chemo
21
Q

Where do retinoblastoma originate?

which form are all hereditary?

Which chromosome is associated?

A
  • malignant tumour of retinal cells
  • all bilateral tumours are hereditary
  • chromosome 13
22
Q

What are the clinical features of retinoblastomas?

What investigations would you do?

How do you manage retinoblastomas?

A
  • characteristic red pupillary reflex replaced with white reflex
  • squint
  • MRI and examination under anaesthetics
  • chemo in bilateral disease followed by local laser tx to retina
  • radiotherapy in advanced
23
Q

What is Kaposi Sarcoma?

A

low grade cancer that arises from blood or lymph

24
Q

What triggers Kapsi sarcoma

Where is it most common?

A

Human herpes virus-8

common in subsahran africa

25
Q

What are the features of Kaposi sarcoma?

How do you diagnose?

How do you manage?

A
  • purple/brown skin rahs
  • lymphadenopathy
  • diagnose with biopsy
  • manage with chemotherpay and antiretroviral therapy

Paediatrics (9 decks)

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