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Pediatrics > Oncology > Flashcards

Oncology Flashcards

1
Q

3 most common childhood cancers

A
  1. Leukemia
  2. Brain tumors
  3. Lymphoma
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2
Q

Down Syndrome cancers

A

ALL

Sometimes AML

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3
Q

Turner Syndrome cancers

A

Gonadoblastoma

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4
Q

Trisomy 13 Cancer

A

Leukemia

Teratoma

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5
Q

Trisomy 18 cancers

A

Wilm’s tumor

Neurogenic tumors

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6
Q

Klinefelter’s syndrome cancers

A

Leukemia

Germ cell tumors

Breast cancer

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7
Q

Fanconi anemia cancers

A

Leukemia

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8
Q

Xeroderma Pigmentosum cancers

A

Basal and squamous cell carcinoma

Melanoma

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9
Q

Ataxia Telangectasia cancers

A

Hodgkin’s and non-Hodgkin’s

Leukemia

Sarcomas

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10
Q

Bloom syndrome cancers

A

Leukemia

Lymphoma

GI malignancies

Solid tumors

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11
Q

Beckwith-Wiedemann syndrome cancers

A

Wilm’s tumor

Hepatoma stroma

Rhabdomyosarcoma

Adrenocortical carcinoma

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12
Q

NFT type I cancers

A

Brain tumors

Lymphoma

Leukemia

Malignant schwannoma

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13
Q

NFT type II Cancer

A

Acoustic neuroma

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14
Q

MC childhood cancer

A

ALL (L1 classification)

Also most commonly Pre-B cell phenotype with CALLA (+)

Usually occurs at 2-6 years of age

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15
Q

Favorable ALL prognostic factors

A

1-9 years of age

Female

White people

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16
Q

Diagnosis of leukemia

A

Requires bone marrow exam

Pts can have a normal CBC

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17
Q

ALL phases of treatment (3)

A
  1. Induction
    • intrathecal MTX is always used occasionally alongside corticosteroids, vincristine, and L-asparaginase
  2. Consolidation
    • continue intrathecal MTX, sometimes use intracranial radiation if absolutely necessary
  3. Maintenance
    • chemotherapy for up to 3 yrs
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18
Q

Tx. Of neutropenia associated infxn following chemotherapy

A

IV Broad spectrum antibiotics

-Should also consider opportunistic infxns like PCP, Aspergillus, and fungi

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19
Q

Tumor lysis syndrome complications

A

Hyperuricemia ➡️ renal insufficiency

Hyperkalemia ➡️ cardiac Dysrhythmia

Hyperphosphatemia ➡️ Hypocalcemia with tetany

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20
Q

Drugs causing medication induced pancreatitis

A

L-asparaginase

Corticosteroids

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21
Q

AML classifications

A

M1= acute myeloblastic leukemia (no maturation)

M2= acute myeloblastic leukemia (some maturation)

M3= acute promyelocytic leukemia (Auer rods common)

M4= acute myelomonocytic leukemia

M5= acute Monocytic leukemia

M6= erythroleukemia

M7= acute megakaryocytic leukemia (assoc. W/ Down’s)

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22
Q

AML differences in clinical signs from ALL

A

CNS involvement

Gingival hypertrophy

DIC

BM management after chemo is recommended

(Both have fever, hepatosplenomegaly, bruising, bleeding)

23
Q

Juvenile CML

A

Least common type of leukemia and is due to abnormalities on Cr. 7 and 8 (NOT the Philadelphia chromosome)

Signs/Symptoms: 
   Fever
   ***Eczemalike facial rash
   ***Suppurative lymphadenopathy
   Petechiae/Purpura 
   Moderate leukocytosis (
24
Q

Hodgkin’s Disease

A

Lymphoma assoc. w/ EBV infection! !

-Commonly presents w/ painless lymphadenopathy in the supraclavicular or cervical regions

Signs/Symptoms: (opposite of non-Hodgkins)

  • Slow, indolent onset
  • Cervical and supraclavicular nodes (+)
  • Presents w/ systemic signs of cancer (nausea, night sweats)
  • Rare abdominal findings
  • Painless adenopathy
25
Q

Staging of Hodgkin’s Lymphoma

A

I: Single node or extralymphatic site

II: Involvement of 2 or more nodes on same side of diaphragm or extension to extralymphatic site and one or more nodes on same side of diaphragm

III: involvement of nodes on both sides of diaphragm

IV: disseminated involvement of organs

**A=lack of systemic symptoms

 B=Systemic symptoms
26
Q

Complications of Hodgkin’s Tx.

A

Growth retardation (radiation)

Secondary malignancies (AML, non-Hodgkin’s)

***Male sterility

Hypothyroidism

27
Q

Lymphoblastic lymphoma

A

non-hodgkin’s assoc. w/ immunodeficiency states that is ***T-cell in origin

***Presents w/ an anterior mediastinal mass (SVC, Airway obstruction, Horner’s)

28
Q

Small, noncleaved cell lymphoma

A

B-cell origin lymphoma that presents as intussusception, abdominal pain, or mass

**CONSIDER THIS IN ANY KID OLDER THAN 3 YEARS WITH INTUSSUSCEPTION

29
Q

MC lymphoma in childhood

A

Burkitt’s Lymphoma

B-cell in origin; presents as a large jaw mass

30
Q

Large Cell lymphoma

A

B-cell in origin; presents as enlarged tonsils, adenoids, or Peyer’s patches

31
Q

Most common solid tumors in children (and their categories and sites)

A
  1. Glial cells (includes astrocytoma, most common supratentorial)
  2. Primitive neuroectodermal tumors (includes medulloblastoma, common infratentorial)
  3. Ependyomas
  4. Craniopharyngiomas
    * Infratentorial location more common
32
Q

Optic glioma

A

Cranial tumor assoc. w/ diminished vision, visual field defects, and strabismus

33
Q

Craniopharyngioma

A

Tumor assoc. w/ growth retardation, delayed puberty, bitemporal hemianopsia, diabetes insipidus

34
Q

Preferred imaging for brain tumors

A

MRI; better imaging of temporal lobes, cranial base, and brainstem

35
Q

Second most common solid tumors in children

A

Neuroblastoma; can arise anywhere along sympathetic ganglia and in the adrenal medulla

*Peak incidence is before 5 yrs; 75% reoccurrence rate

36
Q

Acute cerebellar atrophy

A

Symptoms of ataxia, opsoclonus (eye jerks), and myoclonus that occurs w/ neuroblastomas

37
Q

Neuroblastoma staging (which do you not have to treat?)

A

I: localized to structure of origin

II: extends beyond structure of origin but not beyond the midline

III: extends past the midline

IV: metastasizes to bone, lymph nodes, bone marrow, or soft tissue

IVS: local tumor at Stage I or II but with distant metastasis to any organ but bone (spontaneously regresses!)

*Poor prognostic factors include stages III or IV, presence of n-myc, diploidy

38
Q

Most common childhood renal tumor

A

Wilm’s tumor

Presents as an abdominal mass that doesn’t cross midline

Signs/Symptoms:

  • Hematuria
  • Abdominal pain
  • HTN
  • Fever, anorexia
  • GU malformations
  • Hemihypertrophy
  • Sporadic aniridia
39
Q

Beckwith-Wiedemann Syndrome

BMW

A

Big tongue

heMihypertrophy

Wilm’s tumor

-Also hepatoblastoma, visceromegaly

40
Q

WAGR syndrome

A

Wilm’s tumor

Aniridia

Genitourinary malformation

Retardation of the mental kind

41
Q

Wilm’s tumor staging

A

I: Limited to kidney and excised intact w/o rupture

II: extends locally but still resected w/o residual disease

III: residual tumor remains in abdomen or spills during resection

IV: distant metastasis to lung, liver, bone, brain

V: bilateral renal involvement

42
Q

MC site of metastasis for Wilm’s tumor

A

Lung

43
Q

Most common soft tissue sarcoma of childhood

A

Rhabdomyosarcoma; pts. w/ NFT 1 at increased risk

***MC sites= Head and neck (may present as proptosis, chemosis, epistaxis, airway obstruction, or hoarseness)

-Also occur at GU tract (hematoma, obstruction) or extremities (painless mass)

44
Q

Most common malignant bone tumor

A

Osteogenic sarcoma; peak incidence is during MALE GROWTH SPURT

-Assoc. w/ Rb, Paget’s, radiation therapy

Tx: Surgery; remove pulmonary metastases as well

45
Q

Osteogenic sarcoma findings (from table)

A

Site: Metaphysis of long bones
-Distal femur, proximal tibia, proximal humerus

Signs/Symptoms: Pain, swelling, soft tissue mass

*No systemic symptoms

Radiographic findings: Periosteal reaction w/ SUNBURST appearance
-Lytic lesions

Metastases: Lungs

46
Q

Ewing’s Sarcoma findings (from table)

A

Site: Flat bones and diaphysis of long bones
-Pelvis, humerus, femur

Signs/Symptoms: Pain, swelling, soft tissue mass

***Fever, malaise, weight loss, leukocytosis, increased ESR

Radiographic findings: Periosteal rxn w/ “ONION SKIN’

Metastases: Slightly more common, also goes to lung mostly but also bone marrow

47
Q

Second most common malignant bone tumor

A

Ewing’s Sarcoma; assoc. w/ 11;21 translocation

-Bone scan, chest CT, and bone marrow usually examined for metastasis

***Chemotherapy important due to risk of metastasis

48
Q

MC liver tumor in childhood

A

Hepatoblastoma; assoc. w/ Beckwith-Wiedemann syndrome

  • Presents as RUQ abdominal mass w/ anorexia, weight loss
  • NO JAUNDICE
  • Slightly better prognosis than hepatocellular carcinoma
49
Q

Hepatocellular carcinoma

A

Presents in kids w/ chronic HBV infxn as well as biliary atresia, a1-antitrypsin deficiency, hereditary tyrosinemia

  • RUQ abdominal mass, anorexia, weight loss
  • NO JAUNDICE
50
Q

Most common teratoma during first year of life

A

Sacrococcygeal teratoma; mostly in females

-Soft tissue mass arising from the coccyx that is mostly benign

51
Q

MC testicular tumor

A

Germinoma; yolk-sac type (will see increased AFP)

-Assoc. w/ cryptorchid testes

52
Q

Amount of malignant ovarian tumors

A

1/3; increase in frequency during puberty

53
Q

Eosinophilic granuloma

A

Sub-type of Langerhans Cell Histiocytosis assoc. w/ localized bony changes

***MC involves the SKULL

-May see pathologic fractures, chronic draining ears due to mastoid involvement, ***SEBORRHEIC DERMATITIS (skin involvement), nonspecific systemic signs

54
Q

Letterer-Siwe disease

A

Langerhan’s cell histiocytosis assoc. w/ DISSEMINATED DISEASE

Pediatrics (9 decks)

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