oncology Flashcards
classification of leukemias
Lymphoblastic: lymphoid lineage
myeloid: grnulocyte, monocyte, erythrocyte, palatelet linage cell prolifertion.
tumor lysis syndrome
metabolic abnormalities that result from death of tumor cells and release of content into circulation. Cells release K+ (potassium), phosphate, and nucleic acids –> leads to hyperuricemia, hyperphosphatemia, hyperkalemia and hypocalcemia. usually seen with ALL and high grade lymphomas
risk factors for TLS
lager tumor burden, cancers that rapidly divide, Burkits > lymphoblastic lymphoma > T-cell ALL > B-cell ALL
what happens in TLS, consequenses of metabolic ambormalities
Hyperphosphatemia (+ hypocalcemia) –> tentani
hyperkalemia –> arrythmia
hyperuricemia –> ureate crystals –> oliguria and renal failure
clinical presentation of TLS
dec urine output, fatigue, muscle cramps, nausea, vomitin, diarrhea, resp distress, edema, hematuria, acute kidney injury, seizures, arrythmia, neurologic change
diagnosis and prevention of TLS
lab: kindey function, electrolytes, every 4-12 h depending on risk.
prevention: maintain urine output, iv fluids 24 h before starting chemo, lassix (k+)
most common cancer in children
Leukemia primary brain and spinal tumors (most common solid) lymphoma neuroblastoma soft tissue sarcoma wilms tumor bone tumor retinoblastoma
most common cancers in neonates
neuroblastoma, nephroblastoma, retinoblastoma
leukemia
MCC of cancer overall in childreb, mean age of diagnosis 2-5 yrs, can occur at any age . Begins in bone marrow, and produces a high number of abnormal leukemic cells (blasts)
ALL = MC, remianer AML, CML: rare
clinical presentation of leukemia
B symptoms (nightsweats, fvere, weight loss), bleeding, petechia, pallor, infections, DIC at diagnosis, BONE PAIN, lymphadenopathy, splenomegaly, mediastinal mass (esp T-cell ALL), leukostasis, renal failure.
diagnosis of leukemia
CBC: low hb/hct, thrombocytopenia, low wbc/ inc blasts (>20 %)
bone marrow exam: essential for diagnosis
x-ray: identify mediastinal mass
management leukemia
remission induction, eradication of blast and restoration of normal marrow: chemao. + intrathecal chemo because cytotoxic drugs prenetrate poorly into cns
Brain tumor epidemiology
2nd MCC of cancer i children
most common brain tumors??
ASTROCYTOMA: 50 % of all tumors, most commonly diagnosed between 5-9 yrs. can be benign and malignant. pilocytic astrocytoma, diffuse, anaplastic, glioblastoma multiforme
MEDULLOBLASTOMA: rapidly growing tumors that devellop in cerebellum. M>F, age 5-7
EPENDYMOMAS: slow growing tumors that develop in ventricles. usually
Clinical presentation of brain tumors
cause various symptoms depending on location, but usally cause signs of inc ICP. headache (worse when lyinh down) nause, vomiting, vison problems, loss of coordination and balance.
supratenorial: more likely present with seizure and focal signs
