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Paediatrics > Oncology > Flashcards

Oncology Flashcards

1
Q

What additional factors have to be considered with childhood cancers?

A
  1. Potentially irreversible damage caused by chemotherapy and radiotherapy - stem cell transplant may be required
  2. Preservation of fertility is important
  3. Immunosuppression means patients are more prone to serious illness from measles and VZV
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2
Q

What are some residual effects of cancer treatment?

A
  • Hypopituitarism
  • Infertility
  • Asymmetric growth
  • Sexual dysfunction
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3
Q

Features of acute lymphoblastic leukaemia (ALL)…

A

BONE MARROW FAILURE:

  • Anaemia = lethargy, pallor
  • Neutropaenia = frequent infections
  • Thrombocytopenia = easy bruising, petechiae

OTHER FEATURES:

  • Bone pain
  • Splenomegaly
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4
Q

Diagnosis of ALL…

A

Bloods : low counts of most cells, increased WBC

Diagnostic= Bone marrow aspirate/ trephine: will show cytogenic charactersitics

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5
Q

Treatment of ALL…

A

Month 1 = Induction: high doses of vincristine, dexamethasone…
Month 1 -2 = consolidation and CNS protection
Month 2-4= Maintenance phase 1 (monthly vincristine and dexamethasone + weekly methotrexate)
Month 4-6 = delayed intensification (like induction)
Month 6 - 2 yrs in girls, 3 yrs in boys = Maintenance phase 2 (monthly vincristine and dexamethasone + weekly methotrexate)

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6
Q

Clinical features of neuroblastoma…

A
  • Normally present with abdominal mass (tumour arises from neural crest tissue in adrenal glands)
  • Pallor
  • Weight loss
  • Bone pain and limp
  • Paraplegia if spinal invasion
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7
Q

Investigation findings for neuroblastoma…

A
  • Raised urinary catecholamines (VMA and HVA)
  • CT for assessing and staging tumour
  • Adrenal biopsy = diagnostic
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8
Q

Management of neuroblastoma…

A

Localised primary tumour= surgery to remove

Extensive disease = high dose chemotherapy, radiotherapy and stem cell transplantation

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9
Q

Clinical features of nephroblastoma…

A

Most common presentation = abdominal mass in a well child

Other sx = flank pain, haematuria, anorexia, fever

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10
Q

Investigations used in nephroblastoma…

A
  • Blood tests and genetic studies
  • USS/ CT KUB to identify the tumour and then grade accordingly
  • Arrange paeds review within 48 hrs for unexplained abdominal mass
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11
Q

Management of nephroblastoma …

A
  • Nephrectomy + adjuvant chemotherapy
  • Neo-adjuvant chemotherapy used for large tumours
  • Radiotherapy is added for advanced disease
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12
Q

Clinical features of retinoblastoma…

A
  • Absence of red-reflex, replaced by white pupil (leukocoria)
  • Strabismus (squint)
  • Visual problems
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13
Q

Management of retinoblastoma…

A
  • preservation of vision is key
  • Focal treatment = external beam radiotherapy, photocoagulation
  • Advanced disease will require enucleation (removal of eye)
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Paediatrics (12 decks)

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