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Paediatrics > Oncology > Flashcards

Oncology Flashcards

1
Q

where are 50% of brain tumours found in children?

A

50% in posterior fossa

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2
Q

What type of brain tumour are 50% of them?

A

Gliomas

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3
Q

name 2 types of gliomas?

A

astrocytoma and ependymoma

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4
Q

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

A

pilocytic, benign

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5
Q

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

A

low grade astrocytoma, diffuse

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6
Q

What is the name of stage 3 astrocytoma?

A

anaplastic, low cure rate

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7
Q

What is the name of stage 4 astrocytoma?

A

glioblastoma multiforme

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8
Q

Where do ependymomas arise? prognosis?

A

4th ventricle, same prognosis whether well differentiated or not

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9
Q

2 subtypes of primitive neuroectodermal tumours (PNET)?

A

Medulloblastomas and pineoblastomas

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10
Q

List some different types of brain tumours in children?

A

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

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11
Q

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

A

Glioma - Astrocytoma, ependymoma

PNET

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12
Q

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

A

Astrocytoma - very poor prognosis even low grade

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13
Q

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

A

PNET, astrocytoma, NGGCT, teratoma dysgerminoma

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14
Q

5 inherited conditions relating to brain tumours in children?

A 
Neurofibromatosis 1
Von hippel lindau
Tuberous sclerosis
Li Fraumeni Syndrome
Turcot syndrome
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15
Q

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

A

Optic nerve

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16
Q

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

A

Sub ependymal giant cell astrocytoma

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17
Q

What pathway drives tumour development in tuberous sclerosis?

A

MTOR pathway

18
Q

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

A

Cerebellar haemangioblastomas

19
Q

An environmental compound that can cause brain tumours in children?

A

Polycyclic hydrocarbons

20
Q

Symptoms of brain tumour presentation?

A

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

21
Q

Campaign aiming to increase public and professional awareness?

A

HeadSmart Campaign

22
Q

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

A

20% from primitive neuroepithelial cells

Metastasise to the subarachnoid space or CSF dissemination

23
Q

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

A

80%

24
Q

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

A 
Less than full resection
Leptomeningeal spread
Aggressive histology - anaplastic, large cell
Metastasise
40%
25
Q

Treatment for medulloblastoma? 3 parts

A

surgery
post surgery radiotherapy
post radiotherapy chemotherapy

26
Q

Survival rate of ependymoma? treatment?

A

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

27
Q

5 main areas effected by glial tumours?

A

Optic nerve, cerebellar, hypothalamic, thalamic, brain stem

28
Q

Management of pilocytic glial tumour?

A

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

29
Q

Management of glioblastoma multiforme tumour?

A

Usually just palliative, chemo not proven to work

30
Q

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

A 
Pituitary and present with growth issues, thyroid problems and puberty issues
Cognitive - learning difficulties
Hearing
Cardiac
2nd malignant neoplasms
31
Q

Which tumour type often leaves a complication in hearing issues?

A

Medulloblastoma

32
Q

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

A

Cancer, meningitis (severe infections), organ failure

33
Q

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

A

CF, DMD, HIV

34
Q

Progressive disorders that need palliative care?

A

Neurodegenerative

35
Q

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

A

Cerebral palsy

36
Q

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

A

Prognosis not diagnosis

37
Q

TsFL framework breaks down prognosis into what 5 categories?

A 
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
38
Q

Most common points of symptom relief that are needed?

A 
Pain
Nausea/vomiting
constipation
drooling
seizures
Respiratory - tracheostomy, infections
Gastrostomy - when they cant eat
Psyhological 
Skin care
39
Q

Site of vomiting centre?

A

medulla oblongata

40
Q

Where is movement controlled?

A

Cerebellum in vestibular centre

41
Q

What is consequentialism in ethics?

A

When the outcome defines the means

42
Q

What is deontology in ethics?

A

Right action based on set of rules or moral code

Paediatrics (20 decks)

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