Oncology

Question 1

where are 50% of brain tumours found in children?

Answer 1

50% in posterior fossa

Question 2

What type of brain tumour are 50% of them?

Answer 2

Gliomas

Question 3

name 2 types of gliomas?

Answer 3

astrocytoma and ependymoma

Question 4

What is the name of stage 1 astrocytoma? benign or malignant?

Answer 4

pilocytic, benign

Question 5

What is the name of stage 2 astrocytoma? what is its appearance histologically?

Answer 5

low grade astrocytoma, diffuse

Question 6

What is the name of stage 3 astrocytoma?

Answer 6

anaplastic, low cure rate

Question 7

What is the name of stage 4 astrocytoma?

Answer 7

glioblastoma multiforme

Question 8

Where do ependymomas arise? prognosis?

Answer 8

4th ventricle, same prognosis whether well differentiated or not

Question 9

2 subtypes of primitive neuroectodermal tumours (PNET)?

Answer 9

Medulloblastomas and pineoblastomas

Question 10

List some different types of brain tumours in children?

Answer 10

Gliomas, neuroectodermal tumours (PNET), meningiomas, craniopharyngiomas, germ cell tumours, pituitary tumours, choroid plexus tumours.-

Question 11

If a brain tumour arises in the posterior fossa, what are the 3 most likely tumour types?

Answer 11

Glioma - Astrocytoma, ependymoma

PNET

Question 12

If a brain tumour arises in the brain stem what is the most liekly tumour type? prognosis?

Answer 12

Astrocytoma - very poor prognosis even low grade

Question 13

If the brain tumour is in the hypothalamic or pineal region what are the 4 most likely tumour types?

Answer 13

PNET, astrocytoma, NGGCT, teratoma dysgerminoma

Question 14

5 inherited conditions relating to brain tumours in children?

Answer 14

Neurofibromatosis 1
Von hippel lindau
Tuberous sclerosis
Li Fraumeni Syndrome
Turcot syndrome

Question 15

Which nerve do children with NF1 tend to develop low grade leiomas?

Answer 15

Optic nerve

Question 16

What type of tumours do children with tuberous sclerosis tend to develop?

Answer 16

Sub ependymal giant cell astrocytoma

Question 17

What pathway drives tumour development in tuberous sclerosis?

Answer 17

MTOR pathway

Question 18

What type of tumours tend to appear with Von Hippel Lindau disease?

Answer 18

Cerebellar haemangioblastomas

Question 19

An environmental compound that can cause brain tumours in children?

Answer 19

Polycyclic hydrocarbons

Question 20

Symptoms of brain tumour presentation?

Answer 20

Headache, early morning vomiting, personality changes, squint, reduced school performance, seizures, growth failure

Question 21

Campaign aiming to increase public and professional awareness?

Answer 21

HeadSmart Campaign

Question 22

% of CNS tumours are medulloblastomas? arise from what cells? where do they tend to metastasise (2)?

Answer 22

20% from primitive neuroepithelial cells

Metastasise to the subarachnoid space or CSF dissemination

Question 23

If a medulloblastoma is standard risk, what is the 5 year survival rate?

Answer 23

80%

Question 24

What factors make a medulloblastoma high risk? 5 year survival rate?

Answer 24

Less than full resection
Leptomeningeal spread
Aggressive histology - anaplastic, large cell
Metastasise
40%

Question 25

Treatment for medulloblastoma? 3 parts

Answer 25

surgery post surgery radiotherapy post radiotherapy chemotherapy

Question 26

Survival rate of ependymoma? treatment?

Answer 26

50% 5 year survival surgical disease radiotherapy and chemo little role unless under 3 years old

Question 27

5 main areas effected by glial tumours?

Answer 27

Optic nerve, cerebellar, hypothalamic, thalamic, brain stem

Question 28

Management of pilocytic glial tumour?

Answer 28

watch wait and see Radio/chemo if surgery not possible Surveillance MRI

Question 29

Management of glioblastoma multiforme tumour?

Answer 29

Usually just palliative, chemo not proven to work

Question 30

What are some of the late effects on the child functionning?

Answer 30

``` Pituitary and present with growth issues, thyroid problems and puberty issues Cognitive - learning difficulties Hearing Cardiac 2nd malignant neoplasms ```

Question 31

Which tumour type often leaves a complication in hearing issues?

Answer 31

Medulloblastoma

Question 32

3 examples of patients who need palliative care for failed treatment?

Answer 32

Cancer, meningitis (severe infections), organ failure

Question 33

3 examples of life limiting conditions that preempt early death and therefore need palliative care?

Answer 33

CF, DMD, HIV

Question 34

Progressive disorders that need palliative care?

Answer 34

Neurodegenerative

Question 35

Disorders that are likely to have severe complications and therefore need palliative care?

Answer 35

Cerebral palsy

Question 36

What factor is looked at for children in terms of palliative care needs?

Answer 36

Prognosis not diagnosis

Question 37

TsFL framework breaks down prognosis into what 5 categories?

Answer 37

``` Children who will live to 18 Children who might die before 18 Children who have to months to years Children who are critically ill Children who die ```

Question 38

Most common points of symptom relief that are needed?

Answer 38

``` Pain Nausea/vomiting constipation drooling seizures Respiratory - tracheostomy, infections Gastrostomy - when they cant eat Psyhological Skin care ```

Question 39

Site of vomiting centre?

Answer 39

medulla oblongata

Question 40

Where is movement controlled?

Answer 40

Cerebellum in vestibular centre

Question 41

What is consequentialism in ethics?

Answer 41

When the outcome defines the means

Question 42

What is deontology in ethics?

Answer 42

Right action based on set of rules or moral code