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Pediatrics > Malignant diseases > Flashcards

Malignant diseases Flashcards

1
Q

Most common malignancy

A

Leukemia - ALL

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2
Q

Second most common malignancy

A

Brain tumors

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3
Q

Cancers associated with EBV

A
  • Burkitt lymphoma
  • Hodgkin lymphoma
  • Nasopharyngeal carcinoma
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4
Q

Definition of allogeneic transplantation

A

Transplantation from a compatible donor

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5
Q

Definition of autologous transplantation

A

Transplantation for the patient him/herself, harvested beforehand, while the marrow is uninvolved or in remission

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6
Q

Infections associated with children under cancer therapy

A
  1. Pneumocystis jiroveci/carinii pneumonia
  2. Disseminated fungal infection (e.g. aspergillosis, candidiasis)
  3. Coagulase-negative staphylococcal infections of CV catheters
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7
Q

Age group acquiring ALL

A

Peaks at 2-5 years of age

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8
Q

Symptoms of ALL

A
  • General:
  • Malaise, anorexia
  • Bone marrow infiltration:
  • Anemia –> pallor, lethargy
  • Neutropenia –> infection
  • Thrombocytopenia –> bruising, petechiae, nose bleeds
  • Bone pain
  • Reticluo-endothelial infilatration:
  • Hepatosplenomegaly
  • Lymphadenopathy
  • Other organ infiltration (more common at relapse):
  • CNS –> headaches, vomiting, nerve palsies
  • Testes –> testicular enlargement
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9
Q

How does the CBC look like in ALL?

A
  • Low Hb
  • Low platelets - thrombocytopenia
  • Circulating leukemic blast cells
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10
Q

In ALL, a mediastinal mass is characteristic for?

A

T-cell disease

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11
Q

Most common subtype of ALL

A

Precursor B-cell –> B-lymphoblasts

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12
Q

Factors contributing to prognosis in ALL

A
  1. Patient age
  2. WBC count at presentation
  3. Cytogenetics of the leukemic cell
  4. Response to treatment
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13
Q

Poor prognosis in ALL, indicated when

A
  1. Age <1 or >10 years of age
  2. WBC >100.000/mm3
  3. Slow response to initial treatment
  4. Chromosomal abnormalities
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14
Q

What drug is given to protect real function in tumor lysis?

A

Allopurinol

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15
Q

What does remission mean?

A

Eradication of the leukemic blasts and restoration of normal marrow function

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16
Q

For how long is continuing therapy for ALL given?

A

Up to 3 years from diagnosis

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17
Q

Most common location of brain tumors

A

Infratentorial (located below the tentorium cerebelli)

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18
Q

Most common solid tumor in children

A

Brain tumor

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19
Q

Most common brain tumor in children

A

Astrocytoma

* Juvenile pilocytic astrocytoma (most often localized in cerebellum)

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20
Q

Clinical features in spinal tumors

A
  • Back pain
  • Peripheral weakness of arm or legs
  • Bladder/bowel dysfunction
  • -> depending on level of lesion
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21
Q

Clinical presentation of brain tumor

A
  • Persistent or recurrent vomiting
  • Problems with balance, coordination or walking
  • Behavioral change
  • Abnormal eye movement
  • Seizures
  • Abnormal head position - wry neck, head tilt, persistent stiff neck
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22
Q

First treatment of brain tumors

A

Surgery, if anatomically possible

23
Q

Clinical features in Hodgkin lymphoma

A
  • Classically presents with painless lymphadenopathy, most frequently in the neck. Large and firm nodes.
  • Long clinical history
  • System symptoms (‘B’ symptoms) - uncommon
24
Q

Prognosis of Hodgkin lymphoma

A

80%

With disseminated disease - 60%

25
Q

Clinical features of a mediastinal mass causing SVC obstruction

A
  • Dyspnea
  • Facial swelling and flushing
  • Venous distention in the neck
  • Distended veins in the upper chest and arms
26
Q

Most common non-hodgkin lymphoma

A

Aggressive lymphoma –> large b-cell lymphoma

27
Q

Histology of Burkitt lymphoma

A

B-cell non-Hodgkin lymphoma

28
Q

The three variants of Burkitt lymphoma

A
  1. Endemic variant - in children living in malaria endemic regions. Malaria reduces resistance to EBV.
  2. Sporadic - can be associated with EBV
  3. Immunodeficiency-associated - associated with HIV
29
Q

Histologic subtypes of non-hodgkin lymphomas

A
  1. Lymphoblastic (usually T-cell)
  2. Small, non cleaved cell lymphoma (B-cell)
  3. Large cell (T cell, B cell or indeterminate)
30
Q

The histological hallmark of Hodgkin lymphoma

A

Reed-Sternberg cell

31
Q

What does neuroblastoma arise from?

A
  1. Neural crest tissue in the adrenal medulla

2. Sympathetic nervous system

32
Q

At which age is neuroblastoma most common?

A

Before the age of 5 years

33
Q

Clinical features of neuroblastoma

A

Initial presentation often as metastasis:

  • Abdominal mass (can lie anywhere along the sympathetic chain from the neck to the pelvis), classically from adrenal origin
  • Weight loss
  • Pallor
  • Hepatomegaly
  • Bone pain
  • Limp
34
Q

Elevation in urine of which catecholamine indicate neuroblastoma?

A

Homovanillic acid (HVA)

35
Q

Elevation of urine Vanillylmandelic acid (VMA) indicate which tumor?

A

Pheochromocytoma

36
Q

Neurologic signs in neuroblastoma

A
  • Ataxia
  • Myoclonus
  • ‘Dancing eyes’
  • ‘Dancing feet’
  • Horner syndrome
37
Q

Tumor lysis syndrome

A
  1. Hyperuricemia
  2. Electrolyte imbalance (hyperkalemia, hypophosphatemia, hypocalcemia)
  3. Renal failure
38
Q

Most common renal tumor of childhood

A

Wilms tumor

39
Q

Wilms tumor originates from

A

Embryonal renal tissue

40
Q

Most common age group of Wilms tumor

A

2-5 years of age

41
Q

Clinical features of Wilms tumor

A
  • Asymptomatic abdominal mass (found on routine examination/bathing)
  • Hematuria
42
Q

Wilms tumor association

A
  • Hemihypertrophy
  • Aniridia
  • Genitourinary anomalies
  • WAGR
43
Q

What are sarcomas?

A

Cancers of connective tissue, such as muscle or bone

44
Q

Most common soft tissue cancer

A

Rhabdomyosarcoma

45
Q

Rhabdomyosarcoma originate from

A

Primitive mesenchymal tissue

46
Q

Most common site of rhabdomyosarcoma

A

Head and neck (40%)

  • Proptosis
  • Nasal obstruction
  • Bloodstained nasal discharge
47
Q

Different presentations of rhabdomyosarcoma

A
  • Head and neck (40%)
  • Proptosis
  • Nasal obstruction
  • Bloodstained nasal discharge
  • Genitourinary tract (20%)
  • Dysuria, urinary obstruction
  • Scrotal mass
  • Bloodstained vaginal discharge
  • Extremities (20%)
  • Trunk (10%)
  • Metastatic (lung, liver, bone or bone marrow)
48
Q

Histological types of rhabdomyosarcoma

A
  1. Embryonal (60%)
    * Botryoid
  2. Alveolar (15%)
  3. Pleomorphic - adult form
49
Q

Most common bone tumor

A

Osteosarcoma

* Appear in 2nd decade (adolescence) - when rapid bone growth

50
Q

Symptoms of osteosarcoma

A
  • Persisten localized bone pain
51
Q

Genetics of retinoblastoma

A

Rb gene on chromosome 13. Autosomal dominant.

All bilateral tumors are hereditary, as ar about 20% of unilateral cases.

52
Q

Clinical features of retinoblastoma

A
  • White pupillary reflex

- Squint

53
Q

Kaposi sarcoma is associated with which virus?

A

Human herpes virus-8

Pediatrics (9 decks)

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