Oncology/Neurology Flashcards
Between what ages do Febrile Seizures occur?
6 months - 5 years
In order for a Febrile Seizure to be diagnosed, there cannot be history of epilepsy or an intracranial cause. What are the 2 types?
Simple
Complex
Describe a Simple Febrile Seizure
Duration < 15 minutes
Generalized tonic-clonic
1 within a 24 hour time period
What is the treatment for a Simple Febrile Seizure?
Acetaminophen/treat underlying cause
**Reassure and send home!
Describe a Complex Febrile Seizure
Duration > 15 minutes or
Focal seizure or
> 1 in a 24 hour time period or
Slow return to baseline
What should be done (3) if a child has a Complex Febrile Seizure?
Neurologic workup
EEG
MRI
What is Cerebral Palsy?
Non-hereditary and Non-progressive disorder of movement and posture
Cerebral Palsy is usually idiopathic but can be caused by?
Prenatal neurologic insult
What is the most common presenting sign of Cerebral Palsy?
Delayed motor development
Spastic paresis, ataxic gait and choreoathetoid/dystonic movements are likely seen with?
Cerebral Palsy
Are other deficits common besides motor with Cerebral Palsy?
Yes
What is the most common malignancy of childhood?
ALL
= Acute Lymphocytic Leukemia
What are some presenting symptoms of ALL?
Fever, fatigue, bone pain, hepatosplenomegaly, bruising, petechiae, etc.
What will be seen on peripheral smear and bone marrow aspirate/biopsy with ALL?
Lymphoblasts
What complication should you watch out for with the start of chemotherapy?
Tumor Lysis Syndrome
What pneumonic helps to remember the electrolyte changes with Tumor Lysis Syndrome?
PUKE Calcium
What electrolyte changes are present with Tumor Lysis Syndrome?
PUKE Calcium
- Phosphorus
- Uric acid
- K - potassium
= Elevated
- Calcium LOW
What electrolyte changes are present with Tumor Lysis Syndrome?
PUKE Calcium
- Phosphorus
- Uric acid
- K - potassium
= Elevated
- Calcium LOW
What is the treatment for Tumor Lysis Syndrome? (2)
Diuretics + Allopurinol
In what age group are Neuroblastomas the most common?
< 2 years old
What cells cause Neuroblastomas and thus, what will it look histologically?
NCC origin
- Small, round, blue cell tumor
Neuroblastomas can present many different ways. One common presentation is?
Abdominal mass that CROSSES midline
If a young child has ptosis, BM suppression, subcutaneous nodules and an abdominal mass, what should you suspect?
Neuroblastoma
Are Neuroblastomas metastatic at presentation?
Yes
What urinary change can help to diagnose a Neuroblastoma?
HIGH urinary catecholamines
= VMA and HVA
With what tumor will there be high urinary vanillymandelic acid and homovanillic acid?
Neuroblastoma
In what age group are Wilms Tumors common?
2-5 years old
What is the common presentation for a Wilms Tumor?
Abdominal mass that does NOT cross midline
- pain +/- hematuria
A Wilms tumor is associated with a few syndromes. List 2.
Beckwith-Wiedemann
WAGR
Beckwith-Wiedemann Syndrome
Wilms tumor
Macroglossia
Hemihypertrophy
Visceromegaly
WAGR
Wilms tumor
Aniridia
GU anomalies
Retardation
When do Osteosarcomas and Ewing Sarcomas present?
Teenagers
Symptoms of an Osteosarcoma?
Pain and swelling
Symptoms of a Ewing Sarcoma?
Pain, swelling and systemic symptoms (fever, weight loss, fatigue)
What will be present with Ewing Sarcoma that is often not present with Osteosarcoma?
Systemic signs – fatigue, fever, anorexia
Where do Osteosarcomas occur?
Metaphysis of long bones
= Distal femur/Proximal tibia/Proximal humerus
What will be seen on XR with Osteosarcoma?
Sunburst lytic lesion
Where do Osteosarcomas often spread?
Lungs
What translocation is often present with Ewing Sarcoma?
11;22
Where do Ewing Sarcomas occur?
Midshaft of long bones
What will be seen on XR with a Ewing Sarcoma?
Onion skinning periosteal reaction
What lab change can present with Osteosarcoma?
HIGH Alkaline phosphatase
What lab changes can present with Ewing Sarcoma?
HIGH ESR and WBC count
Abdominal mass that does not cross midline
Wilms (renal) tumor
Abdominal mass that does cross midline
Neuroblastoma
