Oncology Flashcards
Immunodeficiencies that predisposed to cancer?
Wiskott-Aldrich syndrome – lymphoma and leukemia
X linked lymphoproliferative disease – lymphoma
Most common causes of cancer in pediatrics?
Leukemia >brain tumors >lymphoma >neuroblastoma >tissue sarcoma > Wilms tumor >bone tumor
Cancer related to:
- Down syndrome
- Turner’s
- Trisomy 13
- Trisomy 18
- Kleinfelter (3)
- Leukemia (ALL/AML)
- Chondroblastoma
- Leukemia, teratoma
- Wilms tumor, neurogenic tumor
- Leukemia, germs cell tumors, breast cancer
Cancer related to:
- Fanconi anemia
- Xeroderma pigmentosa
- Ataxia telangiectasias
- Bloom syndrome
- Leukemia
- Basal/squamous cell carcinoma, melanoma
- Hodgkins, non-Hodgkin’s, leukemia, sarcomas
- Leukemia, lymphoma, solid tumors, GR malignancy
Cancer associated with:
- Beckwith-Weidemann syndrome
- Neurofibromatosis I
- Neurofibromatosis II
- Wilms tumor, hepatoblastoma, rhabdomyosarcoma, and adrenocortical carcinoma
- Brain tumors, lymphoma, leukemia, schwannoma
- Acoustic aroma
Abdominal mass – two cancers?
Truncal/extremity masses – two cancers?
Wilms tumor, neuroblastoma
Rhabdomyosarcoma, bone tumor
Most common childhood cancer? The most common phenotype? Marker? Clinical features? Diagnosis?
ALL; pre-B-cell phenotype; common acute lymphocytic leukemia and teaching (CALLA)
- Fever bone/joint pain
- Pallor, bruising, hepatosplenomegaly, lymphadenopathy
- Testicular pain, epistaxis may also be present
Marrow replacement with blasts; no staging system
Favorable prognostic outcome with ALL if?
White female 1-9 years with WBC <50,000, no organ involvement, CALLA positive
Stages of ALL treatment?
- Induction – destroy cancer cells (methotrexate, vincristine, L-asparaginase, corticosteroids)
- Consolidation – prevent CNS involvement (methotrexate, cranial irradiation if over 5)
- Maintenance – three years of chemotherapy
- Bone marrow transplant for high-risk children/relapse
Tumor lysis syndrome – Electrolyte abnormalities (and complications)?
- Hyperuricemia (Renal insufficiency)
- hyperkalemia (Cardiac dysrhythmias)
- hyperphosphatemia (Hypocalcemia with tetany)
Treatment side effect that causes:
- Pancreatitis?
- Cardiomyopathy?
- Cystitis?
- Hormonal problems?
- L-asparaginase
- Doxorubicin
- Cyclophosphamide
- Irradiation
Childhood AML – associated with (4)? clinical features? Diagnosis? Management?
Down syndrome, Fanconi anemia, Kostmann syndrome, neurofibromatosis
Similar to ALL but with more CNS involvement (fever hepatosplenomegaly, gingival hypertrophy, bleeding, bone pain)
Blood smear and bone marrow biopsy
Intensive myeloablative therapy and bone marrow transplant
Juvenile CML – chromosomes affected? Chromosome abnormality not present? Clinical features? Treatment? Prognosis?
7, 8; Philadelphia chromosome not effected
Fever, chronic eczematous rash, lymphadenopathy, petechia, anemia, moderate leukocytosis
BM transplant; Usually Fatal
Hodgkin’s lymphoma – associated with? Clinical features? Diagnosis? Management? Prognosis?
EBV
Painless cervical/supraclavicular lymphadenopathy
Redd-Sternberg cell
Chemotherapy/radiation therapy
Excellent
Hodgkin’s disease versus non-Hodgkin’s lymphoma:
- Symptoms onset
- Common location
- Systemic symptoms
- Abdominal findings
- Painless lymphadenopathy
- SVC syndrome
- Airway compression
- Slow versus rapid
- “Cervical/supraclavicular versus the abdominal, mediastinal, supraclavicular
- Common versus rare
- Rare versus common
- Common in both
- Rare versus common
- Rare versus common
Late complications of chemotherapy/radiation therapy?
- Growth retardation
- Hypothyroidism
- Male sterility
- Secondary malignancy (Breast cancer, AML, non-Hodgkin’s)
Non-Hodgkin’s lymphoma – associated with? Basic classifications? Most common presenting feature?
Immune deficiency states (HIV, Wiskott-Aldrich, ataxia telangiectasias, EBV)
- Lymphoblastic lymphoma
- Small, non-cleaved cell lymphoma (Burkitt’s lymphoma)
- Large cell lymphoma
Painless lymphadenopathy
Clinical features of lymphoblastic lymphoma?
Anterior mediastinal mass leading to:
- Superior vena cava syndrome
- airway obstruction
Clinical features of small, non-cleaved cell lymphoma?
- Intussusception with lymphoma and lead point
2. Jaw mass (Burkitt’s lymphoma)
Clinical features of a large cell lymphoma?
Enlargement of lymphoid tissue in tonsils, adenoids, Pyers patches
Langerhans cell histiocytosis? Cause? Diagnosis? Management?
Group of disorders characterized by uncontrolled growth of Langerhans cells
Unknown cause – not true malignancy but severe immune dysregulation
Skin/bone biopsy
Corticosteroids/radiation if one organ; multiagent chemo if multiple organs
Langerhans cell histiocytosis – clinical features?
Complications?
- Skeletal involvement – skull antibodies, bony lesions, pathologic fractures
- Skin involvement – seborrhic dermatitis
- Pituitary/hypothalamic involvement – growth retardation, diabetes insipidus, panhypopituitary reason
- Lymphadenopathy
- Hepatosplenomegaly
- Pulmonary Infiltrates
- Anemia
- Exophthalmos
Growth Impairment, learning problems, hearing loss, orthopedic deformities, chronic lung disease
