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CSO Exam 2025 > Nutritional Management of the Pediatric Oncology Patient > Flashcards

Nutritional Management of the Pediatric Oncology Patient Flashcards

1
Q

What is the most common childhood malignancy?

A

Acute lymphoblastic leukemia (ALL)

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2
Q

True or False: Patients with ALL are at risk for developing obesity during the maintenance and continuation phases of treatment.

A

True

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3
Q

What nutrition-related issues are patients with acute myeloid leukemia (AML) most prone to d/t the intensive chemo regimen?

A
  • Anorexia
  • Weight loss
  • N/V
  • Mucositis
  • Malnutrition
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4
Q

What are common nutrition-related side effects caused by medications used during the remission induction phase of ALL treatment?

A
  • Vincristine: constipation, jaw pain
  • Steroids: increased appetite, weight gain
  • Asparaginase, Daunorubicin, Cytarabine: hyperglycemia, pancreatitis, anorexia, N/V, mucositis
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5
Q

What are common nutrition-related side effects caused by medications used during the consolidation phase of ALL treatment?

A
  • Cyclophosphamide: anorexia
  • Cytarabine: N/V
  • Mercaptopurine: mouth sores
  • Vincristine: constipation, jaw pain
  • Pegasparaginase: pancreatitis
  • Methotrexate
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5
Q

What are common nutrition-related side effects caused by medications used during the delayed intensification phase of ALL treatment?

A
  • Vincristine: constipation, jaw pain
  • Steroids: increased appetite, weight gain
  • Doxorubicin: anorexia, mucositis
  • Methotrexate (IT): hyperglycemia
  • Pegasparaginase: pancreatitis
  • Cyclophosphamide: N/V
  • Cytarabine
  • Thioguanine
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5
Q

What are common nutrition-related side effects caused by medications used during the interim maintenance phase of ALL treatment?

A
  • Methotrexate (IV, high-dose): mucositis, mouth sores
  • Methotrexate (IT): decreased appetite
  • Vincristine: constipation, jaw pain
  • Mercaptopurine
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6
Q

What are common nutrition-related side effects caused by medications used during the maintenance and continuation phase of ALL treatment?

A
  • Steroids: increase appetite, weight gain
  • Mercaptopurine (low-dose, oral)
  • Methotrexate (low dose, oral or IT)
  • Vincristine
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7
Q

What is one nutritional consideration during astrocytoma treatment?

A
  • anorexia s/t chemo and radiation
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8
Q

What are nutritional considerations during brainstem glioma treatment?

A
  • difficulty chewing or swallowing
  • rapid weight gain with steroids
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9
Q

What are nutritional considerations during atypical teratoid/rhabdoid tumor (embryonal tumor) treatment?

A
  • taste changes
  • anorexia
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10
Q

What are nutritional considerations during atypical medulloblastoma (embryonal tumor) treatment?

A
  • dysphagia
  • anorexia
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11
Q

What are nutritional considerations during germ cell tumor treatment?

A
  • diabetes insipidus
  • anorexia
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12
Q

What are nutritional considerations during craniopharyngioma treatment?

A
  • growth abnormalities
  • hypothalamic obesity
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13
Q

What are nutritional considerations during ependymoma treatment?

A
  • dysphasia
  • anorexia
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14
Q

What are the four most common subtypes of non-Hodgkin lymphoma (NHL)?

A
  • precursor lymphoblastic lymphoma
  • Burkitt or Burkitt-like lymphoma
  • diffuse large B-cell lymphoma (DLBCL)
  • anaplastic large cell lymphoma
15
Q

What nutrition impact symptoms are associate with neuroblastoma treatment?

A
  • N/V
  • taste changes
  • anorexia
  • abdominal discomfort
16
Q

True or False: Wilms tumor is the most common kidney malignancy in children.

A

True

17
Q

What nutrition impact symptoms are associated with chemotherapy for osteosarcoma?

A
  • N/V
  • anorexia
  • hypomagnesemia
  • metallic taste changes
  • mucositis
18
Q

What nutrition impact symptoms are associated with chemotherapy for Ewing sarcoma?

A
  • N/V
  • anorexia
  • weight loss
19
Q

What nutrition impact symptoms are associated with chemotherapy for hepatoblastoma?

A
  • N/V/D
  • anorexia
  • mucositis
  • renal toxicity
  • electrolyte wasting
20
Q

What are the primary indicators of pediatric malnutrition when a single data point is available?

A

Mild: Weight-for-height, BMI-for-age, or MUAC z score −1 to −1.9
Moderate: Weight-for-height, BMI-for-age, or MUAC z score −2 to −2.9
Severe: Weight-for-height, BMI-for-age, MUAC, or Length/height-for-age z score −3 or below

21
Q

What are the primary indicators of pediatric malnutrition when 2+ data points are available?

A

Mild:
- weight gain velocity (<2 yr age) <75% of expected
- weight loss (2-20 yrs age) 5% of usual weight
- decline of 1 z score in weight for length or BMI
- 51-75% of estimated energy and protein needs

Moderate:
- weight gain velocity (<2 yr age) <50% of expected
- weight loss (2-20 yrs age) 7.5% of usual weight
- decline of 2 z score in weight for length or BMI
- 26-50% of estimated energy and protein needs

Severe:
- weight gain velocity (<2 yr age) <25% of expected
- weight loss (2-20 yrs age) 10% of usual weight
- decline of 3 z score in weight for length or BMI
- </=25% of estimated energy and protein needs

22
Q

What are the 6 questions in SCAN (nutrition screening tool for childhood cancer)?

A
  1. Does the patient have a high-risk cancer? (1 pt)
  2. Is the patient currently undergoing intensive treatment? (1 pt)
  3. Does the patient have any symptoms r/t the GI tract? (2 pts)
  4. Has the patient had poor intake over the past week? (2 pts)
  5. Has the patient had any weight loss over the past month? (2 pts)
  6. Does the patient show signs of undernutrition? (2 pts)

> /= 3 pts: at risk for malnutrition

23
Q

How much protein (g/kg) do pediatric patients need (based on RDA and stress (RDA x1.5-2))?

A

0-6 mo: 1.52; 2.3-3
7-12 mo: 1.2; 1.8-2.4
1-3 yr: 1.05; 1.6-2.1
4-13 yr: 0.95; 1.4-1.9
14-18 yr: 0.85; 1.3-1.7

24
Q

What are the estimated fluid needs for pediatric patients (based on Holliday-Segar)?

A

< 10 kg BW: 100 mL/kg
10-20 kg BW: 1,000 mL + 50 mL/kg for each kg over 10 kg
> 20 kg BW: 1,500 mL + 20 mL/kg for each kg over 20 kg

25
Q

What is the RDA for vitamin D for pediatrics?

A

0-12 mo: 400 IU
1-18 yr: 600 IU

26
Q

What is the sufficient vitamin D level for pediatric patients with cancer?

A

30-100 ng/mL

27
Q

What are 3 appetite stimulants commonly used in pediatric oncology?

A
  • Cyproheptadine (Periactin)
  • Dronabinol (Marinol)
  • Megestrol acetate (Megace)

CSO Exam 2025 (25 decks)

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