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ONCOLOGY Flashcards

1
Q

Commonest pediatric malignancy

A

Leukemia

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2
Q

2nd most common & 3rd most common malignancy.

A

CNS tumor
Embryonal and sarcomas

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3
Q

What are the 2 peaks of childhood malignancies

A

Early childhood
Adolescence

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4
Q

There’s an increased risk of cancers with?

A

Neurofibromatosis type 1 & 2
Down syndrome
Beckwith - wiedemann syndrome
Tuberous sclerosis
Ataxia telangiectasia
Klinefelter’s syndrome

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5
Q

The types of cancers associated with
1. Down syndrome
2. Beckwith-wiedemann syndrome
3. Tuberous sclerosis
4. Ataxia telangiectasia
5. Klinefelter’S syndrome.

A
  1. Leukemia
  2. Kidney, liver cancers
  3. Kidney cancer
  4. Skin cancers
  5. Testicular cancers
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6
Q

Infections and their associated pediatric malignancies.

A

Hepatitis B&c- HCC
HPV - cervical cancer
HIV - kaposi sarcoma

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7
Q

Peak age of onset of acute lymphoblastic leukemia

A

Between 2-6 years

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8
Q

Most pediatric malignancies are common among males or females?

A

Males.

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9
Q

Possible etiological factors for acute lymphoblastic leukemia

A

Down syndrome
Ionizing radiation
advanced maternal age. (>35 years)

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10
Q

Predominant cell type in acute lymphoblastic leukemia

A

Pre b-cells

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11
Q

Bad prognostic factors of acute lymphoblastic leukemia

A

Male
<1 year and >10 years
T cells
Mediastinal mass
WBC> 25x109/L
CNS involvement
t(9:22)
t(4:11)
Hypodiploidy
Longer time to respond to treatment

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12
Q

Two chromosomal dislocations that are bad prognostic features of ALL

A

t(9:22)
t(4:11)

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13
Q

Ix of ALL

A

Blood picture
Bone marrow aspiration
CBC

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14
Q

Blood picture findings of ALL

A

Thrombocytopenia
blast cells might not be seen

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15
Q

CBC findings of ALL

A

WBC high
Platelet, Hb reduced

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16
Q

Rx of ALL

A

Chemotherapy (vincristine)
Steroid (Dexa, prednisone)

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17
Q

CNS therapy of ALL route

A

Intrathecal - directly to spine

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18
Q

CNS therapy of ALL given on

A

At the start of treatment
once more during induction

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19
Q

Maintenance phase of ALL lasts

A

2-3 years

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20
Q

Survival of ALL

A

> 90%AT five years

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21
Q

Second most common malignancy in paeds

A

Brain tumors

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22
Q

T/F
1.Brain tumors are mostly primary.
2.Brain tumors are mostly malignant

A

1.T
2.T

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23
Q

Commonly seen age group for brain tumors in children

A

<= 7 years

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24
Q

Infratentorial and midline brain tumors clinical features

A

Features of increased ICP
Disorders of the equilibrium, gait, coordination
Blurry vision
Diplopia
Nystagmus

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25
Q

Supratentorial brain tumors features

A

Changes in personality
mentation
motor weakness
sensory changes
speech disorders
seizures
reflex abnormalities
hand preference

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26
Q

Imaging standard of brain tumors

A

MRI

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27
Q

Medulloblastoma age of presentation

A

5-7 years

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28
Q

Bad prognostic factors of medulloblastoma

A

Young age

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29
Q

Clinical features of medulloblastoma

A

Increased ICP
cerebellar signs

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30
Q

Mx of medulloblastoma

A

Surgery
Chemo
Radiotherapy

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31
Q

location of craniopharyngioma

A

within the suprasellar region

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32
Q

MRI shows…. in craniopharyngioma

A

Calcification

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33
Q

Clinical features of craniopharyngioma

A

panhypopituitarism
growth failure
visual loss- bi-temporal hemianopia

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34
Q

Mx of craniopharyngioma

A

Surgery only.

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35
Q

Signs of tumors of the brainstem

A

Motor weakness
cranial nerve defects
cerebellar defects
increased ICP
Torticollis

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36
Q

Why is there a poor prognosis on tumors of the brain

A

Because it is difficult to operate

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37
Q

Mother says while giving a bath she noticed a lump on the babies abdomen. the child is always irritable and sweating. Once taken to the GP clinic it was found out the child has high BP. Dx?

A

neuroblastoma

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38
Q

Tumor/ lump crossing the midline+ calcifications

A

Neuroblastoma

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39
Q

Tumor/ lump not crossing the midline and no calcifications

A

Renal tumors

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40
Q

Neuroblastoma cell type

A

Sympathetic ganglia.

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41
Q

Most commonly diagnosed neoplasm in infants

A

Neuroblastoma

42
Q

Neuroblastoma age of presentation

43
Q

poor prognostic factors of Neuroblastoma

A

advanced stage
advanced age

44
Q

characteristics of a Neuroblastoma

A

firm nodular mass
cross the midline
calcifications on the X- Ray

45
Q

Signs of metastasis in Neuroblastoma

A

fever
irritability
failure to thrive
bone pain
bluish subcutaneous nodules
orbital proptosis
periorbital ecchymosis

46
Q

MC site of metastasis in Neuroblastoma

A

long bones bone marrow
skull bone marrow
liver
lymph nodes
Skin

47
Q

CNS signs of Neuroblastoma

A

Horner’s syndrome
Spinal cord compression
Opsomyoclonus (Rapid eye movements, jerky movements of arms and legs)

48
Q

Some Neuroblastoma tumors secrete…..

A

Catecholamines

49
Q

Clinical features of Neuroblastoma that secrete catecholamines

A

Increased sweating
Hypertension
secretory diarrhea

50
Q

4S stage of neuroblastoma

A

subcutaneous tumor nodules
Massive liver involvement

51
Q

Subcutaneous tumor nodules of Neuroblastoma appearance is also known as

A

Blueberry muffin appearance

52
Q

Ix of Neuroblastoma

A

breakdown products of adrenaline on urine - HVA, VMA
CT
Bone marrow
USS Abd

53
Q

Mx of Neuroblastoma

A

surgical resection +/- chemo +/- radiotherapy

54
Q

Nephroblastoma is also known as

A

Wilm’s tumor

55
Q

Age of onset of Nephroblastoma

56
Q

Wilm’s tumor is associated with

A

Anirida
WAGR syndrome
Beckwith Wiedemann syndrome
Neurofibromatosis 1

57
Q

Wilm’s tumor clinical features

A

abdominal mass often detected by doctors.
no calcification
Rarely crosses the midline
HTN
hematuria
Anaemia
Fever

58
Q

Is hematuria common in Wilm’s tumor

59
Q

Is bilateral involvement of kidneys common in Wilm’s tumor

60
Q

Mx of wilm’s

A

surgery and chemo

61
Q

Possible
X ray findings of wilm’s

A

Chest and abdomen mets in the lungs

62
Q

Are all cases of retinoblastoma bilateral

A

no. some are unilateral

63
Q

Can retinoblastoma be misdiagnosed?

A

Yes. U/L can be misdiagnosed

64
Q

Gene involved in Retinoblastoma

A

RB1 inactivated

65
Q

Sx of retinoblastoma

66
Q

Leukoria

A

White pupillary reflex (usually red when shining a light)

67
Q

DDs of leukoria

A

Cataract
Visceral larva migrans
chorodial coloboma
ROP(Retinopathy of prematurity)
Retinoblastoma

68
Q

Dx test contraindicated in retinoblastoma

A

Pupillary biopsy

69
Q

Ix of retinoblastoma

A

Orbital USS
CT
MRI

70
Q

Rx of retinoblastoma ( Primary and secondary goals)

A

Primary - cure
Secondary- preserving vision

71
Q

Mx modality for B/L involvement of retinoblastoma

A

Chemo - laser photocoagulation or cryotherapy

72
Q

Situations where enucleation is performed in retinoblastoma

A

No potential for useful vision
optic nerve involvement

73
Q

Enculeation?

A

Removing the eye

74
Q

Retinoblastoma has a good prognosis if it’s associated with

A

Osteosarcoma

75
Q

Hepatoblastoma age of presentation

76
Q

Hepatoblastoma is associated with

A

FAP
Beckwith- wiedemann syndrome
Hemihypertrophy

77
Q

Sx of Hepatoblastoma

A

Large asymptomatic abdominal mass on the right side (R>L)

78
Q

Ix of Hepatoblastoma

A

alpha feto protein levels high

79
Q

Bilirubin and liver enzyme levels in Hepatoblastoma

A

Usually normal

80
Q

Mx of Hepatoblastoma

A

Surgery/ Chemo

81
Q

HCC is seen ….. (age group)

A

Adolescents

82
Q

HCC is associated with

A

Hep B,C
Galactosemia
Glycogen storage disease
alpha- 1 anti trypsin deficiency
biliary cirrhosis
chronic hereditary tyrosinemia

83
Q

HCC presents as

A

Hepatic mass
Abdominal distension
Anorexia
Weight loss
Abdominal pain

84
Q

AFP ( Alpha feto protein levels ) in HCC vs and Hepatoblastoma

A

Levels Hepatoblastoma> HCC

85
Q

HCC prognosis is usually good or bad

86
Q

Characteristic age of malignant tumors of bone

A

2nd decade

87
Q

Two examples of malignant tumors of the bone

A

Osteosarcoma
Ewing’s tumor

88
Q

T/F
Malignant tumors of the bone is common in males than females

89
Q

Etiology of osteosarcoma

A

Retinoblastoma
Paget disease
Radiotherapy
Li- Fraumeni syndrome

90
Q

Affected part of bones in osteosarcoma

A

Metaphysis of long bones

91
Q

Affected part of bones in Ewing sarcoma

A

Diaphysis of long bones
Flat bones

92
Q

Sx of osteosarcoma

A

Local pain and swelling

93
Q

Osteosarcoma has a Hx of

94
Q

Sx of Ewing sarcoma

A

Local pain and swelling
Fever

95
Q

Radiographic findings of Osteosarcoma

A

Sclerotic destruction
Sunburst appearance

96
Q

Radiographic findings of Ewing sarcoma

A

Primarily lytic
Onion skinning appearance

97
Q

Onion skinning appearance in Ewing sarcoma is due to

A

Multilaminar periosteal reaction

98
Q

Mets of both Osteosarcoma and Ewing sarcoma- sites

99
Q

Mx of osteosarcoma

A

Chemo > surgery

100
Q

Mx of Ewing’s sarcoma

A

Chemo
Radiotherapy

101
Q

Outcome of bone tumors with mets at presentation

A

<= 20% survival

PAEDIATRICS (15 decks)

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