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peds rotation > Oncology 🐻 > Flashcards

Oncology 🐻 Flashcards

1
Q

What will you see on x ray of osteosarcoma?

A

Destruction of normal trabecular pattern and irregular margins

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2
Q

What is tumor lysis syndrome?

A

Massive tumor cell lysis causing:

HYPERkalemia

Hyperuricemia

Hyperphosphatemia

Acute renal failure

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3
Q

How do you diagnose Hodgkin lymphoma?

A

Tissue biopsy showing Reed-Sternberg cells

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4
Q

What marker is often elevated when someone has a hepatic tumor and will decrease when treatment is working?

A

Serum α-fetoprotein

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5
Q

Do retinoblastomas metastasize?

A

Not often, but when they do you die within one year

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6
Q

True or false:

Most liver masses found in childhood are malignant

A

True

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7
Q

Which is more common in ALL: B cell or T cell precursor lineage

A

B cell precursor lineage (85%)********

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8
Q

What’s the big deal if you have too many WBCs?

A

Hyperleukocytosis (>75,000) is an emergency because it can cause life threatening complications

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9
Q

How do you diagnose retinoblastoma?

A

A detailed ophthalmologic exam under anesthesia.

If you find a chalky, white retinal mass with soft friable consistency, you’ve diagnosed it

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10
Q

What are some of the predisposing factors for AML?

A

Down syndrome

Neurofibromatosis

Environmental exposures: radiation, benzene, previous chemo

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11
Q

What is the most common abdominal tumor?

A

Neuroblastoma

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12
Q

Is rhabdomyosarcoma a common cancer?

A

No

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13
Q

Your Hodgkin lymphoma patient starts having dyspnea, cough, orthopnea, and facial and arm edema. What do you suspect?

A

Superior vena cava syndrome

That mediastinal mass is smooshing the SVC

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14
Q

What are the clinical findings of nephroblastoma (Wilms tumor)

A

Asymptomatic abdominal mass that is smooth, firm, well demarcated, and RARELY crosses midline**

Fever, hematuria, HTN (kidney tumor duh)

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15
Q

What causes ALL?

A

Uncontrolled proliferation of immature lymphocytes

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16
Q

Which two leukemias are associated with Down syndrome?

A

ALL

AML
**

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17
Q

What are the 2 types of brain tumors?

A

Glial tumors

Nonglial tumors

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18
Q

What is the most common soft tissue sarcoma in childhood?

A

Rhabdomyosarcoma

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19
Q

Who does better with NON-Hodgkin lymphoma: children or adults?

A

Adults

In children, Non Hodgkin lymphomas are rapidly proliferating, high grade malignancies

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20
Q

What is the clinical presentation of ALL?

A

BONE PAIN- esp in pelvis, vertebrae, legs (may refuse to walk)

Bleeding- petechiae, pallor

Intermittent fever, fatigue

Hepatosplenomegaly

Lymphadenopathy

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21
Q

What will you see on a peripheral smear AND bone marrow biopsy of ALL?

A

Lymphoblasts

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22
Q

Who is most likely to get Ewing sarcoma?

A

White teenage boys

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23
Q

Is retinoblastoma ever Bilateral?

A

Yes 20-30% of the time.

May cause blindness

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24
Q

What is the usual presenting symptom of hepatic tumors?

A

Enlarging abdomen

10% of them are found on routine exam

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25
Q

Which bones are most often affected by Ewing sarcoma?

A

Shafts of long bones

Usually in extremities and pelvis

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26
Q

ALL vs AML. Which one has circulating lymphoblasts vs circulating myeloblasts

A

ALL= circulating lymphoblasts

AML= circulating myeloblasts (w auer rods too)

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27
Q

What will you see in a peripheral smear of CML?

A

Myeloid cells in all stages of maturation

Increased basophils and blast cells

Blast cells >20% in a blast crisis

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28
Q

What are Reed-Sternberg cells?

A

Germinal center B cells that have undergone a malignant transformation

(Hodgkin lymphoma)

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29
Q

Which type of leukemia has the Philadelphia chromosome?

A

CML

Philadelphia chromosome is a translocation between chromosomes 9 and 22

30
Q

Who is most likely to get osteosarcoma?

A

13-16 year old boys

31
Q

What will you see in the urine of 90% of kids with neuroblastoma?

A

Catecholamines will be elevated (dopamine, norepinephrine, epinephrine…..the most common primary site is the ADRENAL gland!!)

32
Q

You work at family practice and you think your pediatric patient has cancer. Can you refer them to just any old oncologist?

A

NO, must send them to a ~pediatric~ oncologist

Idk she made this weird distinction

33
Q

What is the most common sign of retinoblastoma?

A

Leukocoria

Strabismus, nystagmus, and red inflamed eye are others

34
Q

What is the most common primary site of a neuroblastoma?

A

Adrenal gland

35
Q

What is the MOST COMMON malignancy of childhood?

A

Acute lymphoblastic leukemia (ALL)

36
Q

What will you see on the peripheral smell of acute myeloid leukemia AML?

A

Circulating myeloblasts 20% or more

Auer rods
******

37
Q

What causes Superior vena cava syndrome?

A

A ~mediastinal mass~ like the one in HODGKIN LYMPHOMA smushing against the superior vena cava

38
Q

What specific kind of cells are associated with Hodgkin lymphoma?

A

Reed-Sternberg cells**

39
Q

What the most common primary bone malignancy in pediatrics?

A

Osteosarcoma

40
Q

Is there an association between Down syndrome and ALL?

A

Yes

41
Q

What will you see on the CBC of someone with AML?

A

SHITLOADS of WBCs

20% of patients have WBC>100,000 at diagnosis

42
Q

How do you diagnose AML?

A

Bone marrow biopsy with 20% or more blasts that are of myeloid origin

43
Q

Is CML common in childhood?

A

No

44
Q

What is the difference between the abdominal tumors in neuroblastoma vs nephroblastoma?

A

Neuroblastoma: firm, fixed, irregular shape that usually extends beyond midline

Nephroblastoma: smooth, firm, well demarcated and rarely crosses midline

45
Q

Which parts of the body are most commonly affected by rhabdomyosarcoma?

A

Head and neck

46
Q

What is leukocoria?

A

White pupillary reflex under age 2

47
Q

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?

A

Osteosarcoma

***most common in distal femur

48
Q

What is the clinical presentation of rhabdomyosarcoma?

A

Painless progressively enlarging mass*****

Orbital rhabdo- eyes bulging out***

Bladder rhabdo- distended bladder**, hematuria, pelvic mass

49
Q

What are the cardinal signs of a bone tumor?

A

Bone pain over involved area

Mass formation +/- soft tissue involvement

Fracture through area

Antalgic gait (limping)

50
Q

Who does better with brain tumors: children or adults?

A

Children

51
Q

In children with nephroblastoma (Wilms Tumor), does it usually affect one or both kidneys

A

One

52
Q

Is tumor lysis syndrome an emergency ?

A

YES

53
Q

What is the second most common abdominal tumor in children?

A

Nephroblastoma (Wilms tumor)

54
Q

Can you inherit retinoblastoma from your parent?

A

Yes

55
Q

What kind of cancer has bone pain at NIGHT

A

Ewing sarcoma

56
Q

What are the clinical manifestations of neuroblastoma?

A

Abdominal mass that is firm, fixed, irregularly shaped, and usually extends beyond midline***

Bone pain

Fever, weight loss, irritability, abdominal pain

57
Q

What kind of disorder is CML?

A

A myeloproliferative disorder.

Uncontrolled proliferation of mature and immature granulocytes

58
Q

How do you treat CML?

A

Tyrosine kinase inhibitor

Hematopoietic stem cell transplant (only consistently curative intervention)

59
Q

Who does better with Hodgkin lymphoma: children or adults?

A

CHILDREN**

60
Q

What is the most common intraocular tumor in pediatrics?

A

Retinoblastoma

61
Q

Does leukocoria ALWAYS mean it is retinoblastoma?

A

NO!!! There are several causes, don’t freak out the parents.

62
Q

What is the most common solid neoplasm outside the CNS?

A

Neuroblastoma

63
Q

When i say Painless cervical or supraclavicular lymphadenopathy, you say:

A

Hodgkin lymphoma

64
Q

What should you think if your patient has bone pain that is worse at night?

A

Ewing sarcoma

65
Q

When should you be most anticipating tumor lysis syndrome?

A

When you first start a cancer patient on chemo

66
Q

What is the brain tumor TRIAD of presenting symptoms?

A

Morning headache

Vomiting

Papilledma (optic disc swelling due to high ICP)

67
Q

What is the second most common primary bone tumor in pediatrics?

A

Ewing sarcoma

68
Q

What should you do if you see leukocoria in a childd

A

Refer to ophtho

69
Q

What is the best diagnostic study for brain tumors?

A

MRI (takes 30 min)

70
Q

What kinds of bones are affected by osteosarcoma?

A

LONG bones (metaphysis)****

Usually the distal femur

71
Q

What is the most common SOLID tumor of childhood?

A

Brain tumors

peds rotation (13 decks)

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