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Paeds AM > Oncology > Flashcards

Oncology Flashcards

1
Q

What is the most common type of childhood cancer?

A

Leukaemia

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2
Q

What is the most common leukaemia in children?

A

ALL

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3
Q

What is the peak age of ALL?

A

2-3yo

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4
Q

What is the 2nd most common leukaemia?

A

AML

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5
Q

What is the peal age of AML?

A

<2yo

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6
Q

What is the presentation of leukaemia?

A 
Fever
Weight loss
Night sweats
Bleeding and bruising
Lymphadenopathy
one/joint pain
HEepatosplenomegaly
Pancytopenia- anaemia, thrombocytopenia, leukopenia
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7
Q

What is an indication for investigation of leukaemia?

A

Any unexplained bruising/bleeding

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8
Q

What investigations are done for acute leukaemia?

A

FBC- pancytopenia, very high or low WCC
Blood film- blast cells
Bone marrow and lymph node biopsy

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9
Q

What is the management of acute leukaemia?

A

Chemotherapy

Bone marrow transplant

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10
Q

What is the prognosis for childhood leukaemia?

A 
ALL= 80% cure
AML= worse
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11
Q

What is the 2nd most common childhood cancer>

A

Brain tumours

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12
Q

What is the most common primary brain tumour in children>

A

Pilocytic astrocytoma

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13
Q

What is the presentation of pilocytic astrocytoma?

A

Dependent on size and location
Most common= increased ICP
Slow growing

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14
Q

What investigation and management if for pilocytic astrocytoma?

A

CT/MRI

Surgery

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15
Q

Who is osteosarcoma sen in?

A

10-20yo

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16
Q

What are the common sites of osteosarcoma?

A

Femur= most common

Tibia, humerus

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17
Q

What is the presentation of osteosarcoma?

A

Persistent bone pain, worse at night
Bone swelling
Palpable mass
Restricted joint movement

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18
Q

What is done for unexplained bone pain/swelling?

A

Urgent XR within 48 hours

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19
Q

What is seen on XR with osteosarcoma?

A

Destruction of norma bone and fluffy appearance

Sunburst appearance

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20
Q

What investigations are done for osteosarcoma?

A 
XR
Bloods- elevated ALP
Staging- CT/MRI
PET
Biopsy
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21
Q

What is the management of osteosarcoma?

A

Surgical resection, often with amptation

Adjuvant chemo

22
Q

What is a complication of osteosarcoma?

A

Pathological fracture

23
Q

Who gets Ewing sarcoma?

A

M>F

10-20yo

24
Q

What is the presentation of Ewing sarcoma?

A

Persistent bone pain0 worse at night
Bone swelling
Restricted joint movement

25
Q

What investigations are one for Ewing sarcoma?

A

XR- onion skin periosteal reaction, wide transition zone

MRI/CT= moth eaten destructive radiolucencies

26
Q

What is the management of Ewing sarcoma?

A

Chemo and surgery/radio

27
Q

Who is retinoblastoma seen in?

A

Almost exclusively young children

28
Q

What is the presentation of retinoblastoma?

A

Leukocoria- white appearance of retina
Detrioration of vision
Red irritated eye
Strabismus- squint

29
Q

What is the screening for retinoblastoma?

A

Red reflex
Hirschberg test
Eye exam

30
Q

What is the most common cancer in babies?

A

Neuroblastoma

31
Q

What s the median age of neuroblastoma?

A

20 months

32
Q

What is neuroblastoma?

A

Arises from neural crest tissue of adrenal medulla and sympathetic nervous system

33
Q

What is the presentation of neuroblastoma?

A

Abdo mass
Pallor
Weight loss
Hepatomegaly

34
Q

What is the investigation for neuroblastoma?

A

AXR

Biopsy

35
Q

What is nephroblastoma and when does it present?

A

Rare renal tumour of childhood

Presents usually in first 4 years

36
Q

What is the presentation of nephroblastoma?

A 
Loin pain
Haematuria
Lethrgy
Pyrexia
Early mets
37
Q

What investigations are done for nephroblstoma?

A

US
CT/MRI
Biopsy

38
Q

What is the management of nephroblastoma?

A

Nephrectomy

+/- adjuvant chemo or radio

39
Q

What are some oncological emergencies

A 
Febrile neutropenia
Raised ICP
Spinal cord compression
Superior vena cava syndrome
Superior mediastinal syndrome
Tumour lysis syndrome
40
Q

What is the management of raised ICP?

A

Emergency= dexamethasone and refer to neurosurgery

41
Q

What is the neurosurgical management of raised ICP?

A

Ventriculostomy
EVD= temporary
VP shunt

42
Q

What is the management of spinal cord compression?

A

Urgent MRI
Start dexamethasone
Refer for surgery/radiotherapy

43
Q

What causes superior vena cava syndrome?

A

Mediastinal tumur compression of SVC

Usually lymphoma

44
Q

What is the presentation of SVC syndrome?

A 
Oedema 
Cyanosis
Distended veins
Ill, anxious
Reduced GCS
45
Q

What is the management of SVC syndrome?

A

Keep upright and calm

Urgent referral

46
Q

What is superior mediastinal syndrome?

A

Mediastinal tumour compression of trachea

Usually lymphoma

47
Q

What is the presentation of superior mediastinal syndrome?

A

Dyspnoea
Tachypnoea
Wheeze, cough

48
Q

What is the management of superior mediastinal syndrome?

A

Keep upright and calm

Urgent referral

49
Q

What are the features of tumour lysis syndrome?

A

Hyperkalaemia, hyperuricaemia, hyperphosphataemia
Hypocalcaemia
AKI

50
Q

What is the management of tumour lysis syndrome?

A

NEVER give potassium
Dialysis
Manage K= IV calcium gluconate, insulin-dextrose, salbutamol

51
Q

What is the prevention of tumour lysis syndrome?

A

Allopurinol

52
Q

What cancers are particularly associated with tumour lysis syndrome?

A

High grade lymphoma

Acute leukaemia

Paeds AM (28 decks)

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