Oncology

Question 1

What is the most likely diagnosis for pt presenting with morning headaches, emesis, progressive behavior changes, and bitemporal hemianopsia?

Answer 1

Craniopharyngioma

Question 2

what is the most common diagnosis for an infant presenting with a nontender abdominal mass, rapid chaotic eye movements, myoclonus, diarrhea and biopsy showing small round blue cells?

Answer 2

Neuroblastoma

(most common malignancy in infancy)

(arise from adrenal glands; secrete VIP)

Question 3

What is the most likely diagnosis for pt presenting with incidentally found asymptomatic mass and claw sign (splaying of the kidney) on CT?

Answer 3

Wilms Tumor (nephroblastoma)

Question 4

What is the most likely diagnosis for pt presenting with progressive double vision, facial and limb weakness, unsteady gait, difficulty swallowing, and vomiting with mass in the midbrain?

Answer 4

Diffuse intrinsic pontine glioma (<5% survival rate)

Question 5

What is the most likely diagnosis for pt presenting with hemihypetrophy, macroglossia, and Wilms tumor?

Answer 5

Beckwith-Wiedemann syndrome

should be screened for Wilm tumor until 8 years old

Question 6

What is a possible side effect of taking 6-MP if a patient is deficient of thiopurine methyltransferase (TPMT)?

Answer 6

severe neutropenia

Question 7

What is the most likely diagnosis of pt presenting with leg pain after trauma and found to have a painful mass near the growth plate with a sunburst (new bone formation) appearance on Xray?

Answer 7

Osteosarcoma

Question 8

What malignancy is most common to metastasize to the eye (proptosis and periorbital ecchymoses like raccoon eyes)?

Answer 8

Neuroblastoma

Question 9

What are the 3 B symptoms associated with Hodgkin lymphoma (medistinal mass on CXR)?

Answer 9

1. more than 10% weight loss in 6 months
2. fever
3. night sweats

Question 10

What long term complication can Hodgkin lymphoma survivors develop?

Answer 10

Breast cancer

Question 11

What is the long-term side effect of Doxorubicin?

Answer 11

Cardiomyopathy

Question 12

What is the long term side effect of etoposide?

Answer 12

leukemia (usually within 3 years)

Question 13

What is the most likely diagnosis of a Caucasian pt presenting with hip pain, fever, weight loss and found to have onion skin appearance with moth-eaten lucencies (diaphysis lytic lesion) on Xray?

Answer 13

Ewing sarcoma

(small round blue cell)

(more common bone tumor in children under 10 years old)

Question 14

What is the most likely diagnosis for athletic pt presenting with dull persistent pain that is worse at night and improves with NSAIDs, and Xray shows a radiolucent, sharp rounded lesion surrounded by sclerotic bone?

Answer 14

Osteoid osteoma

Question 15

What diagnosis is consistent with an Xray showing an eccentric stalk-like or broad based cortical out-growth (bony projection with cauliflower appearance) arising from the external surface of the bone and directed away from the joint?

Answer 15

Osteochondroma

(most common benign bone tumor in kids)

(painless mass that has local swelling and tenderness with physical activity)

Question 16

What is a cutaneous manifestation associated with neuroblastoma?

Answer 16

bluish-purple subcutaneous nodules

Question 17

What is the most likely diagnosis of pt presenting with persistent intussusception (despite reduction attempt), lead point found as large, rapidly growing mass in bowel well, elevated LDH, and elevated uric acid in the setting of prior EBV infection?

Answer 17

Burkitt Lymphoma

African presentation involves facial bone/ jaw tumor

Question 18

What is the peak age for leukemia?

Answer 18

2-5 years old

Question 19

what is the most likely diagnosis of pt presenting with fever, splenomegaly, cytopenias (anemia less than 9, neutrohilia less than 1000, thrombocytopenia less than 100,000), elevated Tg, low fibrinogen, bone marrow showing phagocytosis of RBCs and WBCs, elevated ferritin, elevated IL-2 receptor (CD25) and low/absent NK cell activity?

Answer 19

Hemophagocytic lymphohistiocytosis

Question 20

What disorder is associated with Juvenile xanthogranuloma (multiple firm, yellowish, dome shaped nonumbilicated nodular papules with dense dermal infiltrates of histiocytes)?

Answer 20

Juvenile myelomonocytic leukemia

Question 21

What is the most likely diagnosis of pt presenting with recurrent ear infections, chronically draining ears, mastoid bone lesion, seborrheic like lesions, signs of DI (decreased urine osmolarity), bony lesions of skull/ femur/ humerus/ vertebrae, Xray shows lytic punched out cirucular lesion, and biopsy showing tennis racket shaped Birbeck granules in ctyoplasm of cells?

Answer 21

Langerhans cell histiocytosis

Question 22

What is the side effect associated with the asparginase treatment?

Answer 22

pancreatitis

Question 23

What tumors are closely associated with neurofibromatosis type 2 (NF 2)?

Answer 23

bilateral acoustic neuromas

Question 24

What is the best initial step in management once a pt is diagnosed with a solid testicular mass?

Answer 24

measure serum beta HCG and alpha fetoprotein

Question 25

What is the most likely diagnosis for pt presenting with large firm abdominal mass, constipation and elevated AFP (alpha fetoprotein)?

Answer 25

Hepatoblastoma

associated with prematurity, beckwith-wiedermann, and hemihypertrophy

Question 26

What is the most likely diagnosis for pt presenting with irregular menses, lower abdominal pain, abdominal heaviness, and Xray showing calcification of the ovary?

Answer 26

mature cystic teratoma

Question 27

What is a side effect of vincristine therapy?

Answer 27

peripheral neuropathy (foot drop)

Question 28

Should an oncology patient with history of being on chemotherapy have their temperature taken rectal?

Answer 28

No