Oncology 🐻 Flashcards
What will you see on x ray of osteosarcoma?
Destruction of normal trabecular pattern and irregular margins
What is tumor lysis syndrome?
Massive tumor cell lysis causing:
HYPERkalemia
Hyperuricemia
Hyperphosphatemia
Acute renal failure
How do you diagnose Hodgkin lymphoma?
Tissue biopsy showing Reed-Sternberg cells
What marker is often elevated when someone has a hepatic tumor and will decrease when treatment is working?
Serum α-fetoprotein
Do retinoblastomas metastasize?
Not often, but when they do you die within one year
True or false:
Most liver masses found in childhood are malignant
True
Which is more common in ALL: B cell or T cell precursor lineage
B cell precursor lineage (85%)********
What’s the big deal if you have too many WBCs?
Hyperleukocytosis (>75,000) is an emergency because it can cause life threatening complications
How do you diagnose retinoblastoma?
A detailed ophthalmologic exam under anesthesia.
If you find a chalky, white retinal mass with soft friable consistency, you’ve diagnosed it
What are some of the predisposing factors for AML?
Down syndrome
Neurofibromatosis
Environmental exposures: radiation, benzene, previous chemo
What is the most common abdominal tumor?
Neuroblastoma
Is rhabdomyosarcoma a common cancer?
No
Your Hodgkin lymphoma patient starts having dyspnea, cough, orthopnea, and facial and arm edema. What do you suspect?
Superior vena cava syndrome
That mediastinal mass is smooshing the SVC
What are the clinical findings of nephroblastoma (Wilms tumor)
Asymptomatic abdominal mass that is smooth, firm, well demarcated, and RARELY crosses midline**
Fever, hematuria, HTN (kidney tumor duh)
What causes ALL?
Uncontrolled proliferation of immature lymphocytes
Which two leukemias are associated with Down syndrome?
ALL
AML
**
What are the 2 types of brain tumors?
Glial tumors
Nonglial tumors
What is the most common soft tissue sarcoma in childhood?
Rhabdomyosarcoma
Who does better with NON-Hodgkin lymphoma: children or adults?
Adults
In children, Non Hodgkin lymphomas are rapidly proliferating, high grade malignancies
What is the clinical presentation of ALL?
BONE PAIN- esp in pelvis, vertebrae, legs (may refuse to walk)
Bleeding- petechiae, pallor
Intermittent fever, fatigue
Hepatosplenomegaly
Lymphadenopathy
What will you see on a peripheral smear AND bone marrow biopsy of ALL?
Lymphoblasts
Who is most likely to get Ewing sarcoma?
White teenage boys
Is retinoblastoma ever Bilateral?
Yes 20-30% of the time.
May cause blindness
What is the usual presenting symptom of hepatic tumors?
Enlarging abdomen
10% of them are found on routine exam
Which bones are most often affected by Ewing sarcoma?
Shafts of long bones
Usually in extremities and pelvis
ALL vs AML. Which one has circulating lymphoblasts vs circulating myeloblasts
ALL= circulating lymphoblasts
AML= circulating myeloblasts (w auer rods too)
What will you see in a peripheral smear of CML?
Myeloid cells in all stages of maturation
Increased basophils and blast cells
Blast cells >20% in a blast crisis
What are Reed-Sternberg cells?
Germinal center B cells that have undergone a malignant transformation
(Hodgkin lymphoma)
Which type of leukemia has the Philadelphia chromosome?
CML
Philadelphia chromosome is a translocation between chromosomes 9 and 22
Who is most likely to get osteosarcoma?
13-16 year old boys
What will you see in the urine of 90% of kids with neuroblastoma?
Catecholamines will be elevated (dopamine, norepinephrine, epinephrine…..the most common primary site is the ADRENAL gland!!)
You work at family practice and you think your pediatric patient has cancer. Can you refer them to just any old oncologist?
NO, must send them to a ~pediatric~ oncologist
Idk she made this weird distinction
What is the most common sign of retinoblastoma?
Leukocoria
Strabismus, nystagmus, and red inflamed eye are others
What is the most common primary site of a neuroblastoma?
Adrenal gland
What is the MOST COMMON malignancy of childhood?
Acute lymphoblastic leukemia (ALL)
What will you see on the peripheral smell of acute myeloid leukemia AML?
Circulating myeloblasts 20% or more
Auer rods
******
What causes Superior vena cava syndrome?
A ~mediastinal mass~ like the one in HODGKIN LYMPHOMA smushing against the superior vena cava
What specific kind of cells are associated with Hodgkin lymphoma?
Reed-Sternberg cells**
What the most common primary bone malignancy in pediatrics?
Osteosarcoma
Is there an association between Down syndrome and ALL?
Yes
What will you see on the CBC of someone with AML?
SHITLOADS of WBCs
20% of patients have WBC>100,000 at diagnosis
How do you diagnose AML?
Bone marrow biopsy with 20% or more blasts that are of myeloid origin
Is CML common in childhood?
No
What is the difference between the abdominal tumors in neuroblastoma vs nephroblastoma?
Neuroblastoma: firm, fixed, irregular shape that usually extends beyond midline
Nephroblastoma: smooth, firm, well demarcated and rarely crosses midline
Which parts of the body are most commonly affected by rhabdomyosarcoma?
Head and neck
What is leukocoria?
White pupillary reflex under age 2
A 15 year old boy comes in with pain above his knee and he says it’s keeping him from skateboarding. What should you suspect?
Osteosarcoma
***most common in distal femur
What is the clinical presentation of rhabdomyosarcoma?
Painless progressively enlarging mass*****
Orbital rhabdo- eyes bulging out***
Bladder rhabdo- distended bladder**, hematuria, pelvic mass
What are the cardinal signs of a bone tumor?
Bone pain over involved area
Mass formation +/- soft tissue involvement
Fracture through area
Antalgic gait (limping)
Who does better with brain tumors: children or adults?
Children
In children with nephroblastoma (Wilms Tumor), does it usually affect one or both kidneys
One
Is tumor lysis syndrome an emergency ?
YES
What is the second most common abdominal tumor in children?
Nephroblastoma (Wilms tumor)
Can you inherit retinoblastoma from your parent?
Yes
What kind of cancer has bone pain at NIGHT
Ewing sarcoma
What are the clinical manifestations of neuroblastoma?
Abdominal mass that is firm, fixed, irregularly shaped, and usually extends beyond midline***
Bone pain
Fever, weight loss, irritability, abdominal pain
What kind of disorder is CML?
A myeloproliferative disorder.
Uncontrolled proliferation of mature and immature granulocytes
How do you treat CML?
Tyrosine kinase inhibitor
Hematopoietic stem cell transplant (only consistently curative intervention)
Who does better with Hodgkin lymphoma: children or adults?
CHILDREN**
What is the most common intraocular tumor in pediatrics?
Retinoblastoma
Does leukocoria ALWAYS mean it is retinoblastoma?
NO!!! There are several causes, don’t freak out the parents.
What is the most common solid neoplasm outside the CNS?
Neuroblastoma
When i say Painless cervical or supraclavicular lymphadenopathy, you say:
Hodgkin lymphoma
What should you think if your patient has bone pain that is worse at night?
Ewing sarcoma
When should you be most anticipating tumor lysis syndrome?
When you first start a cancer patient on chemo
What is the brain tumor TRIAD of presenting symptoms?
Morning headache
Vomiting
Papilledma (optic disc swelling due to high ICP)
What is the second most common primary bone tumor in pediatrics?
Ewing sarcoma
What should you do if you see leukocoria in a childd
Refer to ophtho
What is the best diagnostic study for brain tumors?
MRI (takes 30 min)
What kinds of bones are affected by osteosarcoma?
LONG bones (metaphysis)****
Usually the distal femur
What is the most common SOLID tumor of childhood?
Brain tumors
