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Own peds boards > Oncology > Flashcards

Oncology Flashcards

1
Q

Pattern: 4yr with fever, pallor, lymphadenopathy, bruising, anemia, thrombocytopenia, bone pain in long bones

A

ALL

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2
Q

What criteria define standard risk?

A

1-10yrs
WBC <50K
No prior steroids
No CNS or testicular involvement

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3
Q

What defines very high risk?

A

hypodiploid <44 chromosomes, MLLrearrangement 4:11, involves 11q23; induction failure

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4
Q

Define purpose of each phase of chemo: induction, consolidation, maintenance

A

Induction - max log to kill to induce remission
Consolidation - CNS sanctuary
Maintenance - additional cytoreduction or cure

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5
Q

Pattern: boys, WBC>100K, rapid growth rate, highest risk of testicular relapse, mediastinal mass, massive lymphadenopathy

A

T-cel leukemia/lymphomas

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6
Q

What is order of product buildup in tumor lysis?

A

1) K 12-24hr, 2) P 34-48hrs, 3) uric acid 48-72hrs

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7
Q

What happens to calcium in tumor lysis?

A

goes down

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8
Q

Describe treatment for tumor lysis

A

1) neutralize urine - alkaline prevents uric acid crystals, acid prevents calcium phosphate crystals

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9
Q

When does Ca/PO4 precipitate out

A

when product is >60

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10
Q

Spontaneous tumor lysis happens in which two cancers the most often?

A

Burkitt’s and T-cell leukemia/lymphoma

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11
Q

Describe EKG with K at 6, 7, 8

A

6 - peaked t waves 7 - prolonged PR 8 - absent pwaves/widened

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12
Q

Pattern: chloromas, leukemia cuts, gum hypertrophy, CNS disease, nucleated RBC, never involves the testicle

A

AML

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13
Q

What causes nucleated RBC in AML

A

ineffective erythropoiesis, functional asplenia, marrow replacement

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14
Q

What is typically seen in leukoerythroblastic reaction

A

primitive WBC, nucleated RBC, teardrop RBC

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15
Q

Pattern: HA, blurred vision, resp distress in AML

A

leukoerythroblastic reaction

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16
Q

High risk criteria for AML

A

Monosomy 7, monosomy 5/5q, FLT3internal trandem duplication

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17
Q

What is characteristic of AML of histolgy

A

Auer rods

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18
Q

Which genetics has good prognosis?

A

Trisomy 8 t(8:21)
Inv (16) or t(16:16)
Trisomy 21

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19
Q

What 7 genetic disorders are associated with leukemia

A

Down, Klinefelter, Blooms, NF, Kostmann’s neutropenia, Schwachman’s, Fanconi

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20
Q

Association: mediastinal mass

A

T cell ALL

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21
Q

DIC

A

M3

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22
Q

Extra-medullary

A

M4-5

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23
Q

Pancytopenia

A

megakaryoblastic

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24
Q

Pattern: adolescent, persistent neutrophila without infection, absolute basophila, thrombocytosis, increased B12

A

CML

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25
Q

What is the usual pattern of CML development

A

chronic –> accelerated –> blast (anemia, lymphadenopathy, thrombocytosis)

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26
Q

What are problems with Gleevec

A

resistance and CHF

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27
Q

What are criteria for poor prognosis of CML

A

massive HSM,
WBC >100K
Blasts, nucleated rbc
Platelet count <150K or >500K

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28
Q

Pattern: ab pain, RLQ mass, adenopathy below diaphragm

A

Burkitt’s

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29
Q

Pattern: jaw involvement n young children

A

African Burkitts

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30
Q

Criteria for high risk Burkitts

A

CNS, bone marrow, LDH >1000

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31
Q

Starry sky

A

Burkitt’s

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32
Q

EBV associated

A

Burkitts

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33
Q

Pattern: intra-thoracic, pleural effusion, SVC syndrome, lymphadenopathy above diaphragm

A

lymphoblastic lymphoma T-cell disease

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34
Q

Which cancer has associated cyclic fever

A

lymphoblastic lymphoma

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35
Q

Pattern: painless cervical/supraclavicular nodes, 2/3 mediastinal involvement, not below, chronic more so than lymphoblastic lymphoma

A

Hodgkin’s

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36
Q

Reed sternberg cells

A

Hodgkin’s disease

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37
Q

What are constitutional B symptoms in Hodgkin’s

A

unexplained fever >38
unexplained weight loss of 10% within 6 months
Drenching night sweats

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38
Q

Pattern: organomegaly, pruritus, ESR, serum Cu

A

Hodgkin’s

39
Q

Pattern: Pallor, periorbital ecchymoses, leg and hip pain, <4yr, liver/spleen, bone, bone marrow invovelement

A

Neuroblastoma

40
Q

What are favorable criteria for neuroblastoma

A

<18months, localized, hyperdiploid

41
Q

What are poor prognostic values for neuroblastoma

A

N-myc, 1p-deletion, diploid or pseudo-diploid

42
Q

What lab findings in neuroblastoma?

A

increased VMA, HVA, DA, epi, norepi

43
Q

What diseases can develop into neuroblastoma?

A

Hirschsprung’s, fetal hydantoin syndrome, von REcklinghausen’s disase

44
Q

What can neuroblastoma differentiate into?

A

ganglioneuroma

45
Q

Pattern: 2yo with painless abd mass and hematuria, black girl, HTN

A

Wilm’s tumor

46
Q

Pattern: hemihypertrophy, aniridia

A

WAGR’s 11p13

47
Q

Unfavorable Wilm’s

A

anaplastic, clear cell

48
Q

Pattern: macroglossia, hemi-hypertrophy, neonatal hypoglycemia, flame nevus of ace, hepatoblastoma, abdominal wall defects

A

Beckwith-Wiedemann Syndrome

49
Q

Pattern: gonadal dysgenesis, nephropathy, Wilm’s WTI mutation 11p, bilateral tumors

A

Denys-Drash syndrome

50
Q

13q

A

Rb

51
Q

11q

A

Denys-Drash

52
Q

Osteogenic sarcoma or Ewing’s

Firm mass at metaphysis

A

osteogenic sarcoma

53
Q

Osteogenic sarcoma or Ewing’s

Sunburst appearance, Codman’s triangle

A

osteogenic sarcoma

54
Q

Osteogenic sarcoma or Ewing’s

60% around knee joint

A

osteogenic sarcoma

55
Q

Osteogenic sarcoma or Ewing’s

mets to lungs

A

both

56
Q

Osteogenic sarcoma or Ewing’s

painless

A

osteogenic sarcoma

57
Q

Osteogenic sarcoma or Ewing’s

Sequelae of radiation therapy esp Rb because of tumor suppressor

A

osteogenic

58
Q

Osteogenic sarcoma or Ewing’s

Painful

A

Ewing’s sarcoma

59
Q

Osteogenic sarcoma or Ewing’s

teenager, mid-shaft of long bones, onion skin pattern on XR

A

Ewing’s sarcoma

60
Q

Osteogenic sarcoma or Ewing’s

Li-Farumenni association

A

Osteogenic sarcoma

61
Q

Osteogenic sarcoma or Ewing’s

Systemic symptoms

A

Ewing’s

62
Q

Pattern: benign bone cortical elsion, 10-30 yrs old, pain worse at night, sclerotic lesion around radiolucent

A

osteoid osteoma

63
Q

Tumors associated with VHL

A

cerebellar hemangioblastoma, pheochromocytoma, retinal angiomas

64
Q

Birbeck granules look like what

A

tennis rackets

65
Q

Pattern: lytic bone, exophalamus, DI, +birbeck granules

A

Hand schuller christine

66
Q

Pattern: seborrheic rash, draining ears, lymphadenopathy, HSM, FTT, organ dysfunction

A

Letterer Siwe

67
Q

What HLA association with LCH

A

HLA-B7

68
Q

Age of patient of Letterer Swie, Hand-Schuller Christian, Siwe granuloma

A

Infant, pre-school, older

69
Q

Poor prognosis criteria for LCH

A

younger, more disseminated, male gender

70
Q

Markers: ESR, copper

A

Hodgkins

71
Q

Markers: urine catechol, ferritin

A

neuroblastoma

72
Q

Markers; alpha-fetoprotein

A

hepatoblastoma, teratocarcinoma

73
Q

Markers: Beta HCG

A

embryonal carcinoma, choriocarcinoma, germinoma

74
Q

Pattern: 12yo male, pallor, new onset wheezing, cervical, supraclavicular adenopathy

A

leukemia lymphoma, lymphoblastic lymphoma

75
Q

Pattern: 14yo male massive splenomegaly

A

CML

76
Q

Pattern: 6yo boy, RLQ pain/mass

A

Burkitt’s

77
Q

Pattern: 16yo boy with painless cervical/supraclavicular adenopathy

A

Hodgkins

78
Q

Pattern: 3yo girl with pallor, periorbital ecchymosis, hip pain

A

neuroblastoma

79
Q

Pattern: 2yo girl with painless abdominal mass and hematuria

A

Wilm’s

80
Q

Pattern: 14yo boy with painful swelling of right femur

A

Ewing’s

81
Q

Translocation c-myc

A

Burkitt’s lymphoma

82
Q

DIC risk

A

M3 ALL

83
Q

t(4:11)

A

VHR-ALL

84
Q

9:22

A

CML

85
Q

t(8:14) with myc

A

Burkitt’s

86
Q

1p n-myc amplication, hyperdiploid (infants)

A

neuroblastoma 1p

87
Q

13q rb

A

Retinoblastoma

88
Q

SE cyclophosphamide

A

SIADH, hemorrhagic cystitis, cardiotoxicity

89
Q

SE vincristine, vinblastine

A

Peripheral neuropathy, extravasation causes tissue necrosis, SIADH

90
Q

SE L-asparaginase

A

Pancreatitis, coagulopathy

91
Q

SE actinomycin D

A

radioimmetic

92
Q

SE pulmonary fibrosis

A

busulfan

93
Q

SE cisplatin/carboplatin

A

sensory neural hearing loss, renal toxicity

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