Oncology

Question 1

Mortality rate for pediatric cancer?

Answer 1

40%

Question 1

Children < 9 yo most likely have what cancer?

Answer 1

Leukemia

Question 2

Children 10-19 yo most likely have what cancer?

Answer 2

Lymphoma

Question 3

What is the most common childhood cancer?

Answer 3

Leukemia (33%)

Question 4

ALL incidence peaks at what age?

Answer 4

4 yo

Question 5

Dx of ALL?

Answer 5

• FAB morphology
• Plt count < 100,00
• Blast cells on peripheral smear
• Bone marrow aspirate for confirmation

Question 6

What is the Tx of ALL?

Answer 6

Radiation + Chemotherapy

Question 7

What are (2) PE signs of ALL?

Answer 7

• Splenomegaly
• Mediastinal mass

Question 8

20% of childhood cancers are what type of leukemia?

Answer 8

AML

Question 9

AML incidence is increased at what age?

Answer 9

1-10 yo

Question 10

AML incidence increases during what period of growth?

Answer 10

Adolescence

Question 11

What is the 3rd most common childhood cancer?

Answer 11

Lymphoma

Question 12

What is a cardinal histologic feature of lymphoma?

Answer 12

Reed-Sternberg Cells

Question 13

Reed-Sternberg cells are diagnostic for what type of lymphoma?

Answer 13

Hodgkin’s Lymphoma

Question 14

You should suspect lymphoma after mono (EBV) if what occurs?

Answer 14

Lymphadenopathy that does not resolve

Question 15

What lymph nodes are commonly enlarged in lymphoma?

Answer 15

Supraclavicular lymph nodes

Question 16

What is diagnostic procedure for lymphoma?

Answer 16

Biopsy

Question 17

What is Ann Arbor Stage I lymphoma?

Answer 17

Single node or single site (100% cure rate)

Radiation only

Question 18

What is Ann Arbor Stage II lymphoma?

Answer 18

≥2 lymph nodes or regions on the same side of the diaphragm

Radiation only

Question 19

What is Ann Arbor Stage III lymphoma?

Answer 19

Lymph node regions on both sides of diaphragm

Chemotherapy alone or with radiation

Question 20

What is Ann Arbor Stage IV lymphoma?

Answer 20

Disseminated disease: Lung, Bone, Bone Marrow, Liver

Chemotherapy alone or with radiation

Question 21

Neuroblastoma originates from which cells?

Answer 21

Neural crest cells

Question 22

What is the most common solid extra-cranial childhood tumor?

Answer 22

Neuroblastoma

Question 23

What is the median age of neuroblastoma development?

Answer 23

2 yo

Question 24

What are the S/Sx of **neuroblastoma**?

Answer 24

* **Pseudorosettes** on biopsy * Bluish tinged SQ nodules * Abdominal swelling | Blueberry Muffin

Question 25

**Excessive VMA** in **urinalysis** leads you to the suspicion of what childhood cancer?

Answer 25

Neuroblastoma

Question 26

What is the most common childhood **renal** tumor?

Answer 26

Wilms Tumor

Question 27

What are common features to **Wilms tumor** patients?

Answer 27

* HTN * Hematuria * Hemihypertrophy (1 side bigger than other) * Aniridia (absence of iris)

Question 28

**Myc** amplification is seen in what disease?

Answer 28

Neuroblastoma

Question 29

Translocation **15;17** is noted in which cancer?

Answer 29

AML; Acute promyelocytic

Question 30

What translocation is not for a poor prognosis in **ALL** is noted in what cancer?

Answer 30

4;11

Question 31

What is the translocation noted in **ALL/CML**?

Answer 31

Philadelphia Chromosome (9;22)

Question 32

**Leukemia** has an increased incidence in what pediatric population?

Answer 32

Down Syndrome patients

Question 33

What are common sites of **leukemia relapse**?

Answer 33

* Bone marrow (repeat chemo & possible BM transplant) * Testicles * CNS

Question 34

What are good prognostic features of bone marrow transplant for **leukemia**?

Answer 34

* 1-10 yo * WBC < 100,000 * Lack of Mediastinal mass or CNS involvement * B-cell immunophenotyped * 12;21 translocation

Question 35

**Reed-Sternberg cells** appear like what type of animal?

Answer 35

Owl

Question 36

What type of translocation means a poor prognosis for **neuroblastoma**?

Answer 36

myc translocation

Question 37

What type of scan is recommended to evaluate for metastasis of **neuroblastoma**?

Answer 37

MIBG scan

Question 38

What is the Tx of a **localized neuroblastoma**?

Answer 38

complete surgical resection (curative)

Question 39

What is the Tx of **advanced neuroblastoma**?

Answer 39

Chemo then surgery

Question 40

What do **pseudorosettes** mean for a **neuroblastoma** patient?

Answer 40

* Clumps of tumor cells in biopsy * Means metastasis to bone marrow (likely)

Question 41

What does **ecchymosis** of **proptosis** mean for **neuroblastoma** patients?

Answer 41

* Spread to orbits * Can look like abuse