Oncology

Question 1

Brain Tumors

Oncology

Answer 1

Common Symptoms: headache, N/V, abnormal gait, vision changes, fatigue

• most common type of cancer in children, next to leukemia
• Dx: MRI, CT, or PET scan
• Tx: surgery, radiation, chemotherapy (doesn’t pass the blood brain barrier)

Question 2

Signs & Symptoms of Brain Tumors

Oncology

Answer 2

• headache
• N/V
• Abnormal gait
• Vision changes
• Fatigue

Question 3

Wilms Tumor (Nephroblastoma)

Oncology

Answer 3

Rapidly developing malignant neoplasm of the kidney

• usually occurs in children younger than 5
• more likely to have bilateral
• high association with Beckwith-Wiedemann Syndrome
• tumors can double in size within a week or two

Dx: ultrasound, CT, CBC

Tx: surgery, chemotherapy, radiation

Question 4

Signs & Symptoms of Wilms Tumor (Nephroblastoma)

Oncology

Answer 4

• Usually asymptomatic & often found during a bath
• occational HTN secondary to renal damage
• hematuria (rarely)

Question 5

Osteosarcoma

Oncology

Answer 5

Malignant tumor of the bone; the bone never fully matures into compact bone

• Peak incidence occurs at 13 y/o for girls & 15-17 y/o for boys (at time of rapid growth)
• Tumor is most commonly located at the distal femur, proximal tibia, or proximal humerus
• Dx: CT & MRI, CBC
• Tx: limb salvage or amputation surgery & chemotherapy

Question 6

Signs & Symptoms of Osteosarcoma

Oncology

Answer 6

• Pain (deep bone pain & referred pain)
• Swelling
• A limp (in extremities)
• HIGH risk for lung metastasis (20%)

Question 7

Leukemia

Oncology

Answer 7

Proliferation of WBCs
* most common malignancy in children under 14
* 30% of all childhood cancers

Dx: bone marrow biopsy, aspiration, lumbar puncture

Tx: chemo & radiation

Types:
1.) Acute Lymphoblastic Leukemia (ALL) – B-Cell leukemia
2.) Acute Myelogenous (myeloid) Leukemia (AML) – T-Cell leukemia

Question 8

What are the 2 types of childhood leukemia?

Oncology

Answer 8

1.) Acute Lymphoblastic Leukemia (ALL)
* B-cell

2.) Acute Myelogenous (Myeloid) Leukemia (AML)
* T-cell

Question 9

Signs & Symptoms of Leukemia

Oncology

Answer 9

• Fever (61%)
• Bleeding (petechiae / purpura) (48%)
• Bone pain
• Pallor
• Splenomegaly (63%)
• Hepatomegaly (68%)
• Fatigue

Question 10

What are the 3 main types of oncologic emergencies?

Oncology

Answer 10

1.) Fever & Neutropenia
2.) Hyperleukocytosis
3.) Tumor Lysis Syndrome (TLS)

Question 11

Fever & Neutropenia (Oncologic Emergency)

Oncology

Answer 11

• Immediate evaluation required (for any patient receiving chemotherapy)

Need rapid assessment & treatment including:
* urinalysis (UA)
* Urine culture
* Chest x-ray (CXR)
* CBC & blood cultures
* immediate broad spectrum antibiotics

Question 12

Hyperleukocytosis (Oncologic Emergency)

Oncology

Answer 12

WBC > 100,000
* worse prognosis > 300,000

Question 13

Tumor Lysis Syndrome (TLS) (Oncologic Emergency)

Oncology

Answer 13

Rapid, spontaneous, or treatment-related tumor cell death

• Leads to ↑ K+, ↑ serum phosphate, & ↑ uric acid levels – as a result of cell lysis / death
• typically peaks 24-48 hours after start of treatment
• highest risk in patients with high tumor burden (big tumor = big risk)

Question 14

Lumbar Puncture

KNOW THIS!!!!!

Oncology

Answer 14

Examines Cerebrospinal Fluid

• presence of malignant cells indicates CNS involvement of cancer / cancer in the central nervous system