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Pediatrics > Oncology > Flashcards

Oncology Flashcards

1
Q

[Diagnose]

acute onset < 4 weeks
Anorexia, irritability, lethargy

anemia, bleeding, purpura, petechiae, low grade fever

Bone pain, LAD, splenomegaly

A

ALL

SSX due to leukemic expansion and crowding out of the normal bone marrow

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2
Q

What is the most common childhood malignany

A

ALL

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3
Q

What are the most important predictive factors in ALL?

A
  1. Age of the patient at the time of diagnosis
  2. Initial leukocyte count
  3. Speed of response to treatment
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4
Q

Where are the site of relapse in ALL?

A
  1. Bone marrow
  2. CNS
  3. testis
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5
Q

Where does ALL preferentially spread

A
  1. Liver
  2. Spleen
  3. lymph nodes
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6
Q

What are the poor prognostic factors of ALL

A
  1. <2 years or >10 years old
  2. Male
  3. WBC > 100,000 u/L on presentation
  4. Presence of CNS leukemia
  5. Presence of a mediastinal mass
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7
Q

What is the 2nd most common malignant abdominal tumor

A

wilms tumor

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8
Q

Wilms tumor is associated with what syndromes

A
  1. Neurofibromatosis
  2. Beckwith-Wiedemann syndrome
  3. WAGR syndrome
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9
Q

What are the components of Beckwith-Wiedemann syndrome?

A
  1. Hemihypertrophy
  2. Visceromegaly
  3. Macroglossia
  4. Wilms tumor
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10
Q

What are the components of WAGR syndrome

A
  1. Wilms tumor
  2. Aniridia
  3. Genitourinary
  4. Mental retardation
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11
Q

[Diagnosis]

flank mass that does not cross the midline
hematuria
hypertension

A

Qilms tumor

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12
Q

Worst prognosis in wilms tumor has the following features

A
  1. > 500 grams
  2. Stage III and IV
  3. Unfavorable histologuc type
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13
Q

What is the cure rate of Stage I to III Wilms Tumor

A

> 90%

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14
Q

What are the tumors that present with small, round blue cell?

A
  1. Wilms
  2. Acute leukemia
  3. Rhabdomyosarcoma
  4. Mesothelioma/ Medulloblatoma
  5. Ewing
  6. Retinoblastoma
  7. Primitive neuroectodermal tumor
  8. Neuroblastoma
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15
Q

Neuroblastoma is associated with what conditions?

A
  1. Tuberous sclerosis - N-myc oncogene
  2. Neurofibromatosis - pheochromocytoma
  3. Hirschsprung disease
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16
Q

[Diagnosis]

non-tender abdominal mass which may cross the midline

Horner syndrome

cord compression

raccoon eyes, dancing eyes, dancing feet (opsoclonus/myoclonus)

A

Neuroblastima

17
Q

What is parameter in the urine can be used to diagnose neuroblastoma

A
  1. 24 hour VMA and HVA
18
Q

What are the prognostic factors of neuroblastoma?

A
  1. Age at diagnosis
  2. Stage at diagnosis
  3. Shimada histology
19
Q

[Neuroblastoma Staging]

confined to the organ or structure of origin

A

Stage 1

20
Q

[Neuroblastoma Staging]

tumor extend beyond the structure of origin but not across the midline

A

Stage 2

2A - without ipsilateral LN involvement

2B - with ipsilateral LN involvement

21
Q

[Neuroblastoma Staging]

extend beyond the midline with or without bilateral LN involvement

A

Stage 3

22
Q

[Neuroblastoma Staging]

Disseminated to distant site

Bone, BM, lover, distant LN

A

Stage 4

23
Q

[Neuroblastoma Staging]

< 1 year old disseminated to liver, skin, BM without bone involvement with primary tumor

A

Stage 4S

24
Q

What is the cure rate pf stage 2 neuroblastima?

A

> 90%

25
Q

[Neuroblastoma vs Wilms tumor]

seen in the kidney
does not cross the midline
HPN, Hematuria
Can metastasize to the lungs

A

Wilms tumor

26
Q

[Neuroblastoma vs Wilms tumor]

Seen anywhere along the neuroaxis,
cross the midline
Many HPN, hematuria, opsoclonus, cord compression, racoon eye

mets to bones

A

Neuroblastoma

CT scan = calcifications

27
Q

[Diagnose]

Painless, non-tender, firm rubbery cervical or supravercical lymphadenopathy

Weight loss >10% over 3 months, unexplained high-fever, drenching nigh sweats

Regional adenopathy

No hepatosplenomegaly

A

Hodgkin lymphoma

Contigous LN spread

28
Q

[Diagnose]

Painless, non-tender, firm rubbery cervical or supravercical lymphadenopathy

Weight loss >10% over 3 months, unexplained high-fever, drenching nigh sweats

systemic adenopathy
more extranodal involvement
hepatosplenomegaly

A

Non-hodgkin lymphoma

29
Q

What is the chemo protocol for HL?

A

COPAD or COMP

Cyclophosphamide
Vincristine
Prednisone
Doxorubicin

Cyclophosphamide
Vincristine
Methotrexate
Prednisone
6-mercaptopurine
30
Q

What are the risk factors for HL

A

EBV, CMV, HHV

Age 20-30 years old

31
Q

Pathognomonic histologic finding of HL

A

Reed-Sternberg cells arising from the germinal center of B cells

32
Q

EBV is associated with what type of NHL?

A

Burkitt lymphoma

33
Q

[Diagnosis]

Pancytopenia
hypocellular bone marrow

A

Aplastic anemia

34
Q

[Pancytopenia]

Aplastic anemia
microcephaly
micropthalmia
hearing loss
absent radii and thumbs
A

Fanconi Anemia

Tx: Steroids, BMT

35
Q

What are the treatment options for Aplastic Anemia?

A
  1. RBC and platelet transfusion
  2. Allogenic BM transplant
  3. Granulocyte colony-stimulating factor
  4. Granulocyte macrophage colony-stimulating factor
  5. Withdrawal of any toxic causative agent
36
Q

Most common solid tumor

A

Brain tumors

37
Q

Most common solid tumor outside CNS

A

Neuroblastoma

38
Q

Most common soft tissue tumor

A

Rhabdomyosacoma

39
Q

Malignancy with highest mortality

A

Brain (PNET)

Pediatrics (15 decks)

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