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Phase 2 PEDs > Oncology > Flashcards

Oncology Flashcards

1
Q

Top three PEDs cancers?

A
  1. Leukemia
  2. CNS tumors
  3. Lymphoma
    4th is neuroblastoma
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2
Q

Standout S/S of cancer?

A

FOU
Petechiae/bleeding
Pallor

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3
Q

Tumor lysis syndrome is?

A

Common to leukemia/lymphoma TXT

- rapid cellular lysis = K+, PO4, Uric acid released

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4
Q

Tumor lysis syndrome can cause?

A

Cardiac arrest or arrhythmias
Gout/uric acid
Nephropathy

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5
Q

MC childhood cancer?

A

Leukemia

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6
Q

Subtypes of leukemia?

A

Acute lymphocytic leukemia (ALL)
Acute myelogenous leukemia (AML)
Chronic myelogenous leukemia (CML)

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7
Q

MC subtypes of leukemia?

A

ALL (75%)

AML (15-20%)

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8
Q

ALL is most common in what gender?

A

Males

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9
Q

What ages is ALL MC in?

A

2-5yo

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10
Q

What leukemia subtype is MC in neonates and late adolescence?

A

AML

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11
Q

Leukemia standout S/S present?

A

LAD

Hepatosplenomegaly

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12
Q

LAB findings of leukemia?

A

Immature blasts, Anemia, Decreased PLTs
CBC - L, NL, H sometimes >50k WBC
BM = blasts
Cytogenicshg6ytj8ikmnb

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13
Q

Important lab to perform w/ leukemia is?

A

LP to eval if CNS is affected

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14
Q

Definitive Dx of leukemia is?

A

Flow cytometry and Cytochemical staining

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15
Q

MC mutation of ALL?

A

t(12:21) translocation - best prognosis

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16
Q

Poorest prognosis mutation of ALL?

A

t(9:22) translocation

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17
Q

Poorest prognostic indicators of leukemia?

A 
<1yo or >9yo
>50k WBC
CNS or testicular Dz
Genetic mutations t(4;11) or t(9;22) translocations
No remission after 4wks of therapy
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18
Q

Lymphoma is?

A

Lymphoid tissie malignancy

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19
Q

3rd MC childhood cancer?

A

Lymphoma

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20
Q

What pathogen is ass/w lymphoma?

A

Epstein-Barr virus EBV

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21
Q

Major subtypes of lymphoma?

A

Hodgkin disease

Non-Hodgkin lymphoma

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22
Q

MC type of lymphoma?

A

Hodgkin’s lymphoma

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23
Q

MC population of hodgkins lymphoma?

A

Adolescents/young adult AND >50

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24
Q

MC population of NHL?

A

Whites > Blacks

Males > Females

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25
Q

Subtypes of NHL?

A

B-cell
T-cell
Large cell

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26
Q

B-cell NHL is AKA?

A

Burkitt lymphoma (sml noncleaved cell)

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27
Q

T-cell NHL is AKA?

A

Lymphoblastic

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28
Q

Two forms of Burkitt lymphoma?

A

Sporadic form - North America

Endemic form - Africa (EBV strongly ass/w)

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29
Q

Standout S/S of lymphoma?

A

Pruritis
B-Symptoms
SOB (Medialstinal LAD) / pleural effusion
Painless Cervical/supraclavicular LAD

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30
Q

B-symptoms are?

A

S/S ass/w lymphoma

  • Fever for 3 consecutive days
  • Night sweats
  • Unintentional wgt loss
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31
Q

What gives lymphoma a poorer prognosis?

A

Presence of B-Symptoms

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32
Q

Lymphoma labs only w/u?

A

CBC = NL
BM = disease staging (>25% blasts= Acute leuemia)
Tissue Bx pleural/peritoneal BF=Reed Sternberg cells

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33
Q

Reed Sternberg cells is ass/w?

A

Hodgkins lymphoma (Owl eyes)

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34
Q

Lymphoma imaging w/u?

A

CXR - +-medialstinal mass

CT - Dx staging

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35
Q

Difference between ALL and Lymphoma Bone marrow?

A

> 25% blasts in Bone marrow = ALL

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36
Q

MC solid tumors in PEDs are located where?

A

CNS tumors

37
Q

2nd MC childhood cancer?

A

CNS tumors

38
Q

Inherited syndromes ass/w

A

Neurofibromatosis
Li-Fraumeni syndrome
Tuberous sclerosis

39
Q

MC Location of CNS tumors in PEDS <2yo

A

MC - infratentorial (cerebellum/brainstem)

40
Q

MC Location of CNS tumors in PEDS >2yo

A

MC - Spinal or supratentorial

41
Q

S/S ass/w supratentorial lesion?

A

Visual S/S (field deficit)
Seizures
Foacl neuro
Personality changes

42
Q

S/S ass/w infratentorial lesion?

A

Hydrocephalus
Increased ICP(papilledema)
Cranial nerve palsies
Ataxia

43
Q

CNS tumor presents as?

A

Loss of developmental milestones
Poor school performance
Increased ICP - (HA, N/V, lethargy - 1st thing in AM)
— ICP increase > 6th nerve palsy
Cranial nerve deficits > brainstem involved

44
Q

Sign of increased ICP?

A

Inability to abduct eye (6th nerve palsy)

45
Q

6th nerve palsy affects what muscle?

A

Eye muscle - cant abduct (CN6)

46
Q

CNS tumors affect pituitary fx?

A

Prolactinoma > glactorrhea

GH secreting > excess growth/precocious puberty

47
Q

Cerebellar tumors S/S?

A

Ataxia, diminished coordination

48
Q

MC type of Brain tumor?

A

Astrocytoma

49
Q

2nd MC brain tumor?

A

Medulloblastomas

50
Q

Where are Astrocytomas found mostly?

A

Posterior fossa of brain

51
Q

Where are Medulloblastomas found mostly?

A

Cerebellar vermis

52
Q

MC solid tumor outside of CNS?

A

Neuroblastoma

53
Q

MC infant malignancy?

A

Neuroblastoma (20mo median age)

54
Q

Where are neuroblastomas derived from?

A

MC - Neural crest cells that form adrenal medulla/SNS

but can form anywhere along SNS

55
Q

MC presentation of Neuroblastoma?

A 
Abd Pain/Mass (flank, hard, smooth, non-TTP)
Fever, WGT loss
Bone pain
Horner syndrome
Paraneoplastic syndromes
56
Q

Horner syndrome is MC ass/w what malignancy?

A

Neuroblastoma

57
Q

Paraneoblastic syndrome S/S?

A

Profuse sweating
Secretory diarrhea
Opsomyoclonus (Dancing eyes/feet)

58
Q

W/U of neuroblastoma

A

Catecholamines (Urine- vanillylmandelic & homovanillic acid)
Tissue Bx
BM aspiration/Bx
CBC

59
Q

Vanillylmandelic and homovanillic acid is ass/w what malignancy?

A

Neuroblastoma

60
Q

Imaging ordered to w/u neuroblastoma?

A

XR - calcifications
CT
Bone scan

61
Q

Nephroblastoma is AKA?

A

Wilms tumor

62
Q

MC renal tumor of PEDs?

A

Nephroblastoma

63
Q

Anomalies ass/w nephroblastoma?

A 
WAGR syndrome
W- Wilms tumor
A- Aniridia
G- GU malformation
R- Retardation
64
Q

Mutation ass/w WAGR syndrome anomalies?

A

Chromo 11p deletion

65
Q

Avg Age of Nephroblastoma?

A

3-3.5y

66
Q

Syndromes ass/w Nephroblastoma?

A

WAGR syndrome

Beckwith-Wiedemann syndrome

67
Q

Beckwith-Wiedemann syndrome S/S?

A

Macroglossia
Umbilical Hernia
Omphalocele

68
Q

Nephroblastoma Standout S/S?

A

Fever
HTN
Hematuria

69
Q

Sarcoma is?

A

Tumors from bone or soft tissue

70
Q

MC soft tissue sarcoma?

A

Rhabdomyosarcoma (skeletal muscle)

71
Q

MC bone sarcoma(s)?

A

MC - Osteosarcoma

- Ewing sarcoma

72
Q

Syndromes ass/w increased risk of soft tissue sarcomas?

A

Li-Fraumeni

Neurofibromatosis

73
Q

Syndromes ass/w increased risk of Osteosarcoma?

A

Hereditary retinoblastoma

74
Q

What TXT increases risk of osteosarcoma?

A

Radiation or Chemo (alkylating)

75
Q

Microscopic characteristics of Rhabsomyosarcoma?

A

Small, Round, Blue cell tumors (Like Ewing)

76
Q

Microscopic characteristics of Osteosarcoma?

A

Osteoid substance present

77
Q

Osteosarcoma MC occurs where?

A

Epiphysis or metaphysis

  • Distal Femur
  • Proximal Tibia
  • Proximal humerus
78
Q

Osteosarcoma tends to follow what?

A

Trauma - (not dx due to S/S blamed on trauma)

79
Q

XR of Osteosarcoma will show?

A

Starburst pattern

80
Q

Standout S/S ass/w Ewing sarcoma?

A

Pain and fever

81
Q

Ewing sarcoma is often misdx as?

A

Osteomyelitis

82
Q

MC bone Ewing sarcoma occurs in?

A

MC - Femur or Pelvis

- but anywhere really

83
Q

Ewing sarcoma microscopic characteristics?

A

Small round blue cell tumors

84
Q

XR of Ewing sarcoma will show?

A

Onion-skin or Moth eaten characteristics

85
Q

Dx of sarcomas?

A

Microscopy
Histology
Cytogenics

86
Q

Microscopic findings that differentiae sarcomas?

A 
Rhabo/Ewing = Small round blue cell tumors
Osteosarcoma = Osteoid substance
87
Q

Mutation ass/w Ewing sarcoma?

A

t(11;22) (95% of tumors)

88
Q

Histologic variants of Rhabomyosarcoma?

A

Embryonal - Young PEDs w/ head, neck, GU tumors
vs
Alveolar - older w/ trunk or extremity tumors

89
Q

Mutations ass/w Rhabomyosarcoma Alveolar variant?

A

t(2;13) or t(1;13)

Phase 2 PEDs (23 decks)

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