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CKPeds > Oncology > Flashcards

Oncology Flashcards

1
Q
  • 77% of all childhood leukemias

* Onset brief and nonspecific (poor prognosis age <1 or >10 years at diagnosis

A

ALL

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2
Q

MC SSx of ALL

A

− Common—bone and joint pain, especially lower extremities

− Then signs and symptoms of bone marrow failure

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3
Q

CBC of ALL

A

° Anemia
° Thrombocytopenia
° Leukemic cells not often seen early

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4
Q

Best Dxtic for ALL

A

− Best test is bone marrow aspirate → lymphoblasts

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5
Q

PP factors for ALL

A

− If chromosomal abnormalities, poor prognosis

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6
Q

1st phase of Tx ALL

Remission with induction meds

A

98% remission in 4–5 weeks

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7
Q

2nd phase of Tx ALL

A

Second phase = central nervous system (CNS) treatment

Intensive systemic plus intrathecal chemotherapy

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8
Q

% relapse after Tx

A

Majority is relapse (15–20%):

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9
Q

Location of ALL relapse

A

° Increased intracranial pressure (ICP) or isolated cranial nerve palsies
° Testicular relapse in 1–2% of boys

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10
Q

What Cx of ALL

result of initial chemotherapy (cell lysis): hyperuricemia, hyperkalemia, hypophosphatemia → hypocalcemia (tetany, arrhythmias, renal calcinosis

A

Tumor lysis syndrome

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11
Q

Tumor lysis syndrome Tx

A

° Treat with hydration and alkalinization of urine; prevent uric acid formation
(allopurinol)

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12
Q

Overall prognosis of ALL

A

Prognosis: >85% 5-year survival

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13
Q

Most in 15- to 19-year-olds

• Ebstein-Barr virus may play a role; immunodeficiencies may predispose

A

Hodgkin Lymphoma (HL)

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14
Q

HL Dxtic hallmark

A

Diagnostic hallmark—Reed-Sternberg cell (large cell with multiple or multilobulated
nuclei

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15
Q

HL subtypes

A

− Lymphocytic predominant
− Nodular sclerosing
− Mixed cellularity
− Lymphocyte depleted

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16
Q

now considered to be a high-grade non-Hodgkin lymphoma

A

Lymphocyte depleted

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17
Q

MC Sign in HL

A

− Painless, firm cervical or supraclavicular nodes (most common presenting sign

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18
Q

Dx of HL

A

− Excisional biopsy of node (preferred)

19
Q

Tx of HL determined by?

A

− Determined by disease stage, large masses, hilar nodes

20
Q

Prognosis of HL

A

Prognosis—overall cure of 90% with early stages and >70% with more advanced

21
Q

Malignant proliferation of lymphocytes of T-cell, B-cell, or intermediate-cell origin

A

NHL

22
Q

______major role in Burkitt lymphoma

A

Epstein-Barr virus—

23
Q

Sybtypes of NHL

A

− Lymphoblastic usually T cell, mostly mediastinal masses
− Small, noncleaved cell lymphoma—B cell
− Large cell—T cell, B cell, or indeterminate

24
Q

Tx of NHL

A

Surgical excision of abdominal tumors, chemotherapy, and monoclonal antibodies
± radiation

25
Q

• Second most common malignant abdominal tumor
− Usual age 2–5 years
− One or both kidneys (bilateral in 7

A

Nephroblastoma (Wilm’s tumor)

26
Q

Associations of Wilms

A

° Hemihypertrophy
° Aniridia
° Genitourinary anomalies
° WAGR

27
Q

SSx of Wilms

A

most are asymptomatic abdominal mass

28
Q

Why is there high BP in WIlms

A

↑ BP due to renal ischemia

29
Q

Dxtics for WIlms

A

− Best initial test–ultrasound

− Abdominal CT scan confirmatory test

30
Q

Tx for wilms

A

− Surgery
− Then chemotherapy and radiation
− Bilateral renal—unilateral nephrectomy and partial contralateral nephrectomy

31
Q

Prognosis of Wilms

A

Prognosis—54 to 97% have 4-year survival

32
Q

Other presentation of Neuroblastoma

Patients with neuroblastoma can present with _____ or _____ (“dancing eyes and dancing feet”). These patients may also have Horner
syndrome

A

ataxia or opsomyoclonus

33
Q

Neuroblastoma

Firm, palpable mass in flank or midline; painful; with______ and ____

A

calcification and hemorrhage

34
Q

Best Dxtics for NB

A

− Plain x-ray, CT scan, MRI (overall best)

35
Q

Other Dxtics for NB

A

Elevated urine homovanillic acid (HVA) and vanillylmandelic acid (VMA) in
95% of cases

36
Q

• Catecholamine-secreting tumor from chromaffin cells

A

Pheochromocytoma

37
Q

asscn of Pheochromocytoma

A

Autosomal dominant; associated with neurofibromatosis, MEN-2A and MEN2B,
tuberous sclerosis, Sturge-Weber syndrome, and ataxia-telangiectasia

38
Q

Dxtics of Pheochromocytoma

A

Can use I131 metaiodobenzylguanidine (MBIG) scan → taken up by chromaffin
tissue anywhere in body

39
Q

What to do prior to Sx with Pheochromocytoma

A

• Treatment—removal, but high-risk

− Preoperative alpha and beta blockade and fluid administration

40
Q

Location of rhabdomyosarcoma

A 
− Head and neck—40%
− Genitourinary tract—20%
− Extremities—20%
− Trunk—10%
− Retroperitoneal and other—10%
41
Q

rhabdomyosarcoma increased freq of what condition?

A

Increased frequency in neurofibromatosis

42
Q

Types of rhabdomyosarcoma

______—60%, Intermediate prognosis
______—vagina, uterus, bladder, nasopharynx, middle ear
−______—15%, ° Very poor prognosis, ° Trunk and extremities
− ______—adult form; very rare in children

A

− Embryonal

− Botryoid (projects; grapelike)

Alveolar

Pleomorphic

43
Q

Tx of rhabdomyosarc

A

Treatment—best prognosis with completely resected tumors (but most are not completely
resectable)
− Chemotherapy pre- and postoperatively; radiation

CKPeds (20 decks)

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