Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Oncology > Flashcards

Oncology Flashcards

1
Q

Define generalised lymphadenopathy

A

Enlarged lymph nodes in 3 or more non-contiguous areas.
Almost always indicates presence of significant systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are palpable lymph notes normal in healthy children (3)

A

. Anterior cervical
. axillary
• inguinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How describe characteristics of lymph nodes (7)?

A
  • Site
  • consistency
  • Mobile vs fixed/matted
  • tender vs painless
  • clearly demarcated
  • size
  • duration and rate growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When worry about size of lymph node? (3)

A

1,5-2 cm in size
Epitrochlear notes > 0,5cm
Inguinal > 1,5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Right supraclavicular lymph node significance? (3)

A

• Cancer in mediastinum
• lungs
• esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Left supraclavicular lymph node significance? (7)

A

= Virchow’s node
• testes
• ovaries
• kidneys
• pancreas
• stomach
• gallbladder
• prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Paraumbilical lymph node significance? (2)

A

= sister Joseph’s
• abdominal neoplasm
• pelvic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does lymphadenopathy of >4 weeks indicate? (3)

A

• Chronic infection
• collagen vascular disease
• malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do hard lymph nodes indicate?

A

Cancer infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do rubbery lymph nodes indicate?

A

Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do matted lymph nodes indicate?

A

Tb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name 7 differences between benign and malignant lymphadenopathy

A
  • <2 cm (1) vs >2
  • soft vs hard, firm, rubbery
  • <2 weeks vs > 2 weeks
  • mobile vs fixed
  • surroundings not attached vs attached (invasion)
  • inguinal, submandibular vs supraclavicular epitrochlear or generalised
  • lender vs non lender
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name 4 causes localised lymphadenopathy

A
  • Local infection in draining area
    -Metastasis
  • lymphoma: Hodgkin’s disease
  • Scrofuloderma (TB skin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name 5 broad causes generalised lymphadenopathy with 2 specific examples

A

• Infections
→ viral: EBV, CMV, infectious mononucleosis , HIV
→ bac: tb, brucellosis,chancroid (usually localised)
→ parasite: toxoplasmosis, leishmaniasis, trypanosomiasis
→ fungal: histoplasmosis,coccidioidomycosis
→ chlamydia: lymphogranuloma venereum (usually localised),

• malignant
→ hematological: hodgkins disease, non-hodgkin’s lymphoma, acute and chronic leukaemias
→ metastatic

• connective tissue disorder: SLE,rheumatoid arthritis, mctd

• infiltrative: sarcoidosis , histiocytosis x

• other rare: drugs eg phenytoin, mucocutaneous LN disease (Kawasaki disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 4 indications for lymph node biopsy

A
  • Increase in size over baseline in 2 weeks
  • no decrease in size in 4-6 weeks
  • no regression to normal in 8-12 weeks
  • develop new signs and symptoms
  • preferred nodes: supraclavicular, cervical, axillary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Approach to acute ( <2 week) lymphadenopathy

A

• low clinical risk: clinical diagnosis
• high clinical risk: FNA
→ if no diagnosis, do excision biopsy

17
Q

Approach to chronic ( > 2 week) lymphadenopathy

A

• Low clinical risk: additional labs eg FBC, ESR, CXR, lactate dehydrogenase, uric acid, lft…
• high risk: FNA
→ if no diagnosis, do excision biopsy

18
Q

Name 11 red flags for childhood cancer <15

A

CHILD CANCER
- contusions/ bruising, bleeding, rash
- headaches, often with vomiting - early night / morning
- inflammation/ swelling or pain in bones, joints, back, legs
- lump/mass abdomen, neck, chest,pelvis, armpits
- decreasing weight: continuous, unexplained
- colour whitish behind pupil
- anemic: constant tired or pale
- nausea that persists, or vomiting without nausea ; neurological signs
- constant infections
- eye or vision changes that occur suddenly and persists eg squint, blind, bulge
- Recurrent fevers of unknown origin

19
Q

Name 2 causes febrile neutropenia and sepsis

A

• Disease eg leukemia, bone marrow infiltration
. Myelo suppression caused by chemo (most marked 5-10 days after admin)

20
Q

Name 5 important sites of infection in neutropenia

A

• oral mucosa and mouth
• pharynx, lower esophagus
• lungs,
• skin, esp vascular access sites
• perineum and anus

21
Q

Management febrile neutropenia and sepsis? (5)

A

• FBC, diff, platelets; UKE, CRP, blood culture, urine analysis
• CXR
• start empiric broad spectrum antibiotics immediately to cover g+ and esp G - (g- sepsis can be fatal within hours!)
-First line tazocin (piperacillin/tazobactam) 90 mg /kg / dose iv 6 hourly and amikacin 15 mg/kg / day iv daily.
-If evidence infection central line or no improve after 48 hours ,, add vancomycin 10 mg /kg / dose 6 hourly

22
Q

Define acute and delayed nausea and vomiting post chemo

A

• acute 6-12 hours after admin
• delayed 24 hours or more, especially cisplatin

23
Q

What nausea and vomiting prophylaxis should be given to all patients receiving ematogenic chemo and patients receiving total body, cranial and abdominal radiation?

A

Odansetron (zofran) 0,15 mg /kg / dose iv 8-12 hourly
Or
Granisetron (kytril) 1-3 mg iv daily before chemo

24
Q

Rescue treatment for breakthrough acute and delayed nausea and vomiting post chemo?
(4)

A

Add stepwise:
- odansetron or kytril as with prophylaxis
- dexamethasone 10mg once daily
-Lorazepam (Ativan) 0,025 mg / kg iv 6 hourly
- metoclopramide (maxolon)

25
Q

Management epistaxis in cancer children? (6)

A

Medical emergency!
- ABC
- insert bismuth iodoform paraffin paste (BIPP) pack
- cykclokapron 15-25 mg/kg 2-4 x/day (tranexamic acid)
-Platelet transfusion 15-20 ml/ kg over 30-60 min
-FFP transfusion as above
-Packed RBC 15-20 ml/ kg over 4h

25
Q

Management epistaxis in cancer children? (6)

A

Medical emergency!
- ABC
- insert bismuth iodoform paraffin paste (BIPP) pack
- cykclokapron 15-25 mg/kg 2-4 x/day
-Platelet transfusion 15-20 ml/ kg over 30-60 min
-FFP transfusion as above
-Packed RBC 15-20 ml/ kg over 4h

26
Q

Name 6 metabolic features tumour lysis syndrome

A

• HyperuricaeMia
• hyper K
• hyper p
. Hypo or hyper Ca
• renal failure , cardiac arrythmias, seizures, coma, DIC, death

27
Q

Management tumour lysis syndrome?(5)

A
  • Hydration: 3000 ml / m2/day of K free solution (grs )
  • maintain urine output 3-6 ml/kg/h , strict measure input and output, lasix to induce diuresis if needed
  • inotropes if indicated
  • alkalanize urine to keep ph 6,5 - 7,5
  • allopurinol 10 mg/kg 8 hourly
28
Q

Management hyper K? (6)

A

• Stop all K iv and po
• nahco3 1-2 mmol/kg iv to drive k intracellular
• insulin and glucose: dextrose 0,5 g/kg /h with insulin 0,1 u / kg /h
• Ca gluconate
• kayexelate
• dialysis if fail

29
Q

Management hypo k?

A

<3 MMOl/ L: replace iv total of 40 MMOl in 1000 ml

> 3: po

30
Q

When transfuse with packed cells? (3)

A

15-20 ml/kg over 4 hours
- Hb <6,5 g/L in asymptomatic
- hb <8 in symptomatic eg evidence CCf, oxygen dependent, sepsis
- hb <10 in certain situations eg major surgery, AML M3 with initiation therapy

31
Q

When transfuse with platelets? (2)

A
  • Platelets <10x10 ^ 9 / L in asymptomatic
  • <50 prior to procedure eg lp, tru-cut biopsy, minor surgery, active bleed (epistaxis), AML with start treatment
32
Q

When transfuse with FFP?

A

15-20 ml/kg over 30 -60 min of leucodepleted

DIC (elevated D dimer ) secondary to severe sepsis, acute leukemia esp AML M3

33
Q

What causes loss of the eye’s red reflex?

A

Neuroblastoma

34
Q

Which enlarged lymph nodes are most suggestive of malignancy?

A

Supra clavicular

35
Q

Name 3 warning signs intra-cranial tumour

A
  • Acute hemiparesis
  • Chronic headache
  • macrocephaly in infants
  • vomiting without nausea
36
Q

Which viral infection causes large tender cervical lymph nodes

A

EBV

Paediatrics (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions