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tas > Oncology > Flashcards

Oncology Flashcards

1
Q

What are the 2 Types of ALL

A

b-cell
T-cell

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2
Q

Whats the pathophysiology of ALL?

A

stem cell DNA mutations cause hyper proliferation of WBC - excessive production of immature blast cells

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3
Q

Environmental risk factors of developing cancer in children

A

Radiation
Infection
Parental smoking during pregnancy

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4
Q

Known genetic risk factors

A

Down’s syndrome- increase risk of leukaemia
Familial retinoblastoma

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5
Q

Which types of childhood cancers are caused by infections

A

Berkitts lymphoma
Hodgkin’s lymphoma
Nasopharyngeal carcinoma - EBV
Hepatocellular carcinoma - hep B
Kaposi sarcaom HHV8

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6
Q

What is a paraneoplastic phenomena

A

Symptoms that are not directly attributable to the tumour but arise as part of body’s response to disease

w.g. pain, lethargy, pallor

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7
Q

What is opsoclonus-myoclonus -ataxia syndrome?

A

Dancing eyes
Example of paraneoplastic phenomenon
Caused by neuroblastoma

Abnormal eye jerking

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8
Q

What is the treatment for opsoclonus-myoclonus-ataxia syndrome?

A

immunosuppression

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9
Q

Presentation of pancytopenia in children with malignancy

A

Pallor/ lethargy - low Hb
Recurrent fever/ infection - low WBC
Bruising or petechiae - low PLTS

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10
Q

Lymphadenopathy/ unexplained mass presentation

A

Lymph node with diameter greater than 2cm
Non-tener, ruberò, hard or fixed
Supraclavicular or axillary location
Systemic symptoms - fever/ weight loss/ night sweats

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11
Q

Respiratory symptoms

A

Orthopneoa
Reduced a/e - pleural effusion

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12
Q

Presentation if bone and joint pain

A

Persistent back pain
Night pain
Reluctance to weight-bear or new limp

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13
Q

Presentation if abdominal mass

A

General malaise - neuroblastoma
HTN - Wilms or neuroblastoma

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14
Q

Presentation if raised intracranial pressure

A

Heachache
Papilloedema
III and VI cn palsies

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15
Q

Neurological signs

A

cerebellar signs
Visual disturbances

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16
Q

What should you investigate if suspecting liver tumour or malignant germ cell tumour?

A

Alpha-fetoprotein AFP
b-human chorionic gonadotrophin B-HCG

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17
Q

What is AFP associated with

A

Epithelial liver tumours
Hepatiblastoma and hepatocellular carcinoma
Yolk sac tumours
Embryonaly carcinoma

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18
Q

What is G1 in the cell cycle

A

‘Gap phase’ - synthesis of the components required for DNA synthesis

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19
Q

What is S phase in cell cycle

A

DNA synthesis phase before second gap phase G2

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20
Q

What happens in G2

A

Cell prepares for mitosis

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21
Q

What happens in M phase of cell cycle

A

Final phase - actively replication cells is mitotic phase

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22
Q

What is G0 in cell cycle

A

Rest phase

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23
Q

How does vincristine work?

A

block the function of the spindle apparatus required for mitosis

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24
Q

How does etoposide work?

A

Causes DNA stand breaks or directly damage DNA by forming crosslinks

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25
Q

Where does antimetabolites work?

A

S phase - blocks synthesis of normal nucleic acids required for DNA synthesis

26
Q

Name antimetabolites

A

Methotrexate
Cytarabine
Mercaptopurine

27
Q

What cancers are at increase risk of Tumour lysis syndrome

A

High-count ALL and NHL (B cell)

28
Q

Cause of tumour lysis syndrome

A

Rapid lysis of malignant cells on initiating chemotherapy

29
Q

Features of tumour lysis syndrome

A

Hyperkalaemia
Hyperuricaemia
Hyperphosphataemia
Hypocalcmaeia

30
Q

What cancers are at risk of hyper viscosity syndrome?

A

High-count leukaemia

31
Q

Cause of hyper viscosity

A

Sludging of venous blood in small vessels
Large number of circulating blast cells -> poor perfusion -> stroke and death

Blood transfusion dangerous

32
Q

Raised intracranial pressures features

A

headaches
vomiting
ataxia
papilloedema

33
Q

Febrile neutropenia features

A

temp >38
neutrophil count <1

34
Q

Stage 1 Wilm’s Tumour

A

Tumour confined to kidney and is completely removed at time of surgery

35
Q

Stage 2 Wilms Tumour

A

Tumour has broken through the kidney lining but still removed by surgery

36
Q

Stage 3 will’s tumour

A

Some of the tumour if left behind at time of surgery- tumour breaks or complete surgical removal sis not possible

37
Q

Stage 4 Wilm’s tumour

A

Spread to other parts of body - lungs or lymph nodes

38
Q

Stage 5 Wilm’s tumour

A

Tumour in both kidneys

39
Q

Which Investigation differentiates B cell from T cell NHL

A

flow cytometry - identify presence of absence of protein markers on cell surface

40
Q

What genetic syndromes are Wilm;s Tumours ass. with?

A

Beckwith-Wiedemann syndrome
WAGR syndrome

microdeletions of short arm in chromosome 11 (11p)

41
Q

What would results show of biopsy of ?hogkins lymphoma

A

lymphocytic and histolytic cells

42
Q

Which lineage of cells does Hodgkin’s lymphoma come from?

A

clonal transformation of B- cells

43
Q

What are the four subtypes of Hodgkin’s lymphoma?

A

Nodular sclerosing - most common
Mixedixed cellularity
Lymphocyte rich
Lymphocyte depleted - rare in children

44
Q

Presentation of Hodgkin’s lymphoma

A

Painless enlargement of supraclavicular lymph nodes
B- symptoms
Splenomegly

45
Q

Lymph nodes biopsy in Hodgkin’s lymphoma

A

Reedsternberg cells

46
Q

Staging of Hodgkin’s lymphoma

A

Stage 1 - single lymph node or extranodal site
Stage 2 - 2 or more lymph nodes on same side of diaphragm
Stage 3 - Lymph-node involvement on both sides of diaphragm
Stage 4 - Disseminated or multiple involvement of extra nodal sites

47
Q

What percentage of lymphoblasts in bone marrow is needed for a definitive diagnosis of ALL

A

20% or more

48
Q

Prognosis is worse for…..

A

<1 year olds

49
Q

What Xray findings are in long bones with ALL

A

osteolytic medullary lesions

50
Q

What is a neuroblastoma?

A

Embryonal cancer of peripheral sympathetic nervous system

51
Q

What is a good prognostic indictator in neuroblastomas?

A

high levels of TRk gene give a favourable outcome

52
Q

Poor prognosis of ALL

A

Male
Age <2
WBC >50
T-cell phenotype
CNS disease

53
Q

Pathophysiology of hereditary spherocystosis

A

Abnormality of cytoskeleton of RBCS

54
Q

what does osmotic fragility test show

A

increase hamolysis
not specific to hereditary sphereocystosis

55
Q

What would you see on blood film in patients with hereditary spherocysotis

A

spheroidal cells

56
Q

What would you see in neuroblastoma

A

VMA or hva (URINE)

57
Q

What gene is related to retinoblastoma

A

RB1 on 13 q chromosome

58
Q

What is histological signs of ALL

A

blast cells
high nucleus to cytoplasm ratio

59
Q

What is burrkitt lymphoma

A

type of non-hodgkin lymphoma

60
Q

What gene is ass with bruit lymphoma

A

MYC gene

tas (18 decks)

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