Oncology Flashcards
What is febrile neutropenia and when do you at antifungals?
Febrile neutropenia is an ANC <500
Absolute Neutrophil count includes PMNs and Bands
Add antifungals if no source within 4 days.
Oncological Causes of a spinal cord compression
Neuroblastoma
Leukemia
ewings Sarcoma
Germ cell tumor
Tumor Lysis Syndrome
Hyperphos, hyperK, Hyper Uricemia
Hypocalcemia
The biggest risk is within the first 7 days.
Treatment: Fluid, Allopurinol/Risbericase
Risk factors for Tumor Lysis Syndrome
Leukemia, Burkitts, NB and Germ Cell
Pemberton Sign
Superior Vena Cava syndrome - face becomes very red and flushed when you are arms are raised in the air.
Late effects of radiation
Leukemia
Cataracts
Pituitary Insufficiency
Neurocogntive impairment
Differentiating between supratentorial tumor presentation and infratentorial
Supra: Localizing signs with OUT evidence of ICP. Seizures, visual changes, hemiparesis.
Infra: Increased ICP, ataxia (cerebellum); if located in the brainstem (pons, medulla or midbrain) then you will also have addd on cranial nerve findings and long tract signs (hyper reflexia), swallowing difficulties.
Neuroblastoma
Diagnosis
HMA and VMA; bone marrow (for mets) MIBG scan
It is an embryonal cancer of the peripheral nervous system. The median age of diagnosis is about 22 months.
Most common features: Opsoclonus myoclonus, periorbital echymmoses and Horner syndrome and abdominal mass
What is Stage 4S neuroblastoma
This is common only in children less than 1 year of age, it is only on the skin (if liver invovlement then worse off) but can spontaneously regress.
What is langerhan Cell Histiocytosis?
It is a clonal proliferation of epidermal dendritic cells.
It is present in the BONES and SKIN
Poorer prognosis if young child, pancytopenia and hepatomegally
Treatment: mainly observe and treat locally.
What is HLH?
Hemophagocytic lymphohistocytosis; macrophage are eating everything.
MAS in rheum, and found in malignancie as well
Treatment: chemo, steroids or BMT
GVHD
Acute: <100 days and usually Skin Liver and Gut
Chronic: >100 days and can affect any organ
Osteopetrosis
An inherited bone disease that involves dense, sclerotisc bones prone to fracture
There is associated growth impairment, HSM, epilepsy
TX Bone marrow
What is the most important prognostic factor for leukemia?
Their response to 29 day induction treatment
Hodgkins and Non Hodgkins Lymphoma
HL: the most common malignancy in the 15-19 year old population. Reed sternberg cell is pathognomonic.
Firm, rubbery supraclavicular lymphnode.
NHL: 60% of all lymphomas (think about those related to immunodeficiencies) SCID, wiskott aldrich ataxia-telang
All of the tumors grow very rapidly (Burkitts, diffuse B cell, anaplastic and lymphoblastic).
