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Paediatrics > Oncology and haematology > Flashcards

Oncology and haematology Flashcards

1
Q

In what ethnicity is iron deficiency anaemia in children most common?

A

Those from the Indian subcontinent

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2
Q

What is the daily iron requirement for children and toddlers?

A

High - 1mg/kg/day

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3
Q

How is iron deficiency anaemia diagnosed in children?

A

Hypochromic microcytic anaemia + low serum ferritin

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4
Q

How is iron deficiency anaemia managed in children?

A

Dietary advice + oral iron replacement therapy for 3/12

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5
Q

What are the broad causes of anaemia?

A
  1. Decreased/difficulty in red cell production
  2. Increased red cell destruction
  3. Combination of causes, e.g. anaemia of prematuirty
  4. Blood loss (uncommon)
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6
Q

What are the causes of decreased red cell production?

A
  1. Iron deficiency anaemia

2. Red cell aplasia

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7
Q

What are the different causes of red cell aplasia?

A
  1. Congenital red cell aplasia
  2. Transient erythroblastopenia of childhood (TEC)
  3. Parvovirus B19 infection
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8
Q

What are the causes of increased red cell destruction?

A
  1. Hereditary spherocytosis
  2. Thalassaemia
  3. Isoimmune
  4. Immune haemolytic anaemia
  5. G6PD
  6. Sickle cell disease
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9
Q

How is sickle cell disease inherited?

A

Autosomal dominant

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10
Q

What are the complications of sickle cell disease?

A
  1. Bacterial infection
  2. Acute chest syndrome
  3. Priapism
  4. Strokes
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11
Q

How is G6PD inherited?

A

X-linked, therefore usually affects males, but can affect females

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12
Q

What are the precipitants of haemolysis in G6PD?

A
  1. Infection
  2. Certain drugs
  3. Fava beans (broad beans)
  4. Naphthalene in mothballs
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13
Q

How is hereditary haemolysis treated?

A

Folic acid + splenectomy if symptomatic

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14
Q

How is hereditary haemolysis diagnosed?

A

Blood film

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15
Q

How is hereditary haemolysis inherited?

A

Autosomal dominant, but in 25% of cases there is no FHx

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16
Q

What are children with B-thalassaemia unable to produce?

A

HbA due to a mutation of the B-globulin gene

17
Q

How is B-thalassaemia treated?

A

Regular blood transfusion + prevention of iron-overload, with iron-chelation therapy with desferrioxamine or iron chelation

18
Q

What proportion of unilateral retinoblastomas are hereditary?

A

20%

19
Q

On what chromosome is the gene that predisposes a child to retinoblastoma?

A

Chromosome 13

20
Q

How do retinoblastoma present?

A
  1. White reflex

2. Squint

21
Q

How is retinoblastoma managed?

A

Chemotherapy (for shrinkage) + laser treatment to the retina

Advanced cases = enucleation or radiotherapy

22
Q

What is another name for nephroblastoma?

A

Wilm’s tumour

23
Q

From where do Wilm’s tumours originate?

A

Embryonal renal tumour

24
Q

What is the typical presentation of a Wilm’s tumour?

A

Large abdominal mass in an otherwise well child

25
Q

How is a Wilm’s tumour investigated?

A

USS or CT/MRU KUB

26
Q

How is a Wilm’s tumour treated?

A

Initial chemotherapy + delayed nephrectomy

Radiotherapy in advanced disease

27
Q

From where do neuroblastomas arise?

A

From neural crest tissue in adrenal medulla and sympathetic nervous system - most commonly children present with an abdominal mass, but they can occur anywhere along the sympathetic chain from neck to pelvis

28
Q

What is the most common leukaemia in children?

A

Acute Lymphoblastic Leukaemia - 80% of cases

29
Q

How is ALL Dx?

A

FBC + bone marrow examination

30
Q

What are the causes of bruising when the platelet count is REDUCED?

A
  1. Increased platelet destruction

2. Impaired platelet production

31
Q

What are the causes of bruising when the platelet count is NORMAL?

A
  1. Platelet dysfunction

2. Vascular disorders

32
Q

What are the causes of platelet dysfunctions that can cause bruising?

A

CONGENITAL - rare disorders, e.g. Glanzmann thromboasthenia

ACQUIRED - uraemia; cardiopulmonary bypass

33
Q

What are the vascular disorders that can cause bruising?

A

CONGENITAL - Ehlers Danlos; Marfan’s; HHT

ACQUIRED - Meningococcal infection; HSP; SLE; scurvy

34
Q

What are the causes of increased platelet destruction?

A

IMMUNE - ITP; SLE; alloimmune neonatal thrombocytopenia

NON-IMMUNE - haemolytic uraemic syndrome; TTP; CID; congenital heart disease; giant haemangiomas; hypersplenism

35
Q

What are the causes of impaired platelet production?

A

CONGENITAL - Fanconi anaemia; Wiskott-Aldrich syndrome; Bernard-Soulier syndrome
ACQUIRED - Aplastic anaemia; marrow infiltration; drug-induced

36
Q

What is the commonest cause of thrombocytopenia in children?

A

ITP

37
Q

What are the atypical features one should be aware of when considering a Dx of ITP, as they may point to aplastic anaemia or acute leukaemia?

A
  1. Anaemia
  2. Neutropenia
  3. Hepatosplenomegaly
  4. Marked lymphadenopathy

Paediatrics (27 decks)

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