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Year 4 Paeds > Oncology Paeds > Flashcards

Oncology Paeds Flashcards

1
Q

most common solid tumour in children

A

brain tumour

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2
Q

top 2 most common cancers in children

A
  1. leukaemia
  2. brain tumour
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3
Q

common location of brain tumours

A

50% posterior fossa
50% glioma

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4
Q

3 main paeds CNS tumours

A

astrocytoma
ependymoma
medulloblastoma

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5
Q

2 main branches of CNS tumours

A

glial - astrocytoma and ependymoma
neuroectodermal

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6
Q

astrocytoma grading

A

1 - 4
1 = pilocytic (essentially benign)
4 = glioblastoma

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7
Q

definition: ependymoma

A

glial but originate from ependymal lining of vernticles (lateral or 4th)

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8
Q

defintion: medulloblastomas

A

primitive neuroectodermal tumour
found in medulla oblongata usually

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9
Q

most common brain tumour

A

medulloblastoma

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10
Q

type of tumour in cerebellum (3)

A

astrocytoma, ependymoma, PNET

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11
Q

type of tumour in brainstem (1)

A

astrocytoma

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12
Q

type of tumour in hypothalamus/pineal

A

astrocytoma, PNEY, NGGCT< teratoma, dysgerminoma

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13
Q

type of supratentorial tumour

A

astrocytoma, PNET, ependymoma

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14
Q

syndromes increasing risk of brain tumour

A

neurofiromatosis type 1
tuberous sclerosis
von-hippel lindau
Li Fraumeni syndrome
Turcot syndrome

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15
Q

tumour associated with neurofibromatosis type 1

A

optic nerve glioma

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16
Q

tumour associated with tuberous sclerosis

A

subependymal giant cell astrocytoma

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17
Q

associations with brain tumours

A

ionising radiation
HIV, ataxic telangectasia

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18
Q

clinical presentation of brain tumours (8)

A

vomiting
headache
changes in personality
squint
reduced school performance
growth failure
seizures
developmental delay

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19
Q

aetiology: PNT tumours

A

arise from primitive neuroepithelial cells

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20
Q

Metastasis PNT

A

invade locally
metastasise in subarachnoid space

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21
Q

PNT treatment (3)

A

surgery
post-op craniospinal radiothetrapy
post-radio chemotherapy

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22
Q

Radiotherapy side effects in <4y/o

A

severe hearing loss
visual problems
ambulatory problems

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23
Q

tx: ependymoma

A

surgery
radiotherapy
(no chemo if >3y/o)

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24
Q

grading of glial tumours

A

pilocytic (low)
low grade (low)
anaplastic (intermediate)
glioblastoma multiforme (high)

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25
sites of glial tumours
optic nerve hypothalamic thalamic cerebellar brain stem
26
tx: low grade glioma
watch adn wnd surgery watch and wait if not able to operate - ?chemo and radio
27
tx: high grade glioma
palliative temozolamide to reduce progression
28
effects of cancer therapy in children
endocrine - growth, puberty, thyroid, fertility cognitive - learning and psychosocial neurological hearing - radiotherpy and cisplatin 2ary melignant neoplasms cardiac
29
# leukaemia most common leukaemia in children
acute lymphoblastic leukaemia (ALL) ## Footnote leukaemia
30
other types of leukaemia common in children
AML - acute myeloid leukaemia ANLL - acute non-lymphocytic leukaemia
31
peak ages of leukaemia in children
ALL - peaks 2-5 y/o AML - <2 y/o
32
pathyphysiology of leukaemia
bone marrow cancer genetic mutation in one of precursor cells in bone marrow causes excessive production of single type of abnormal WBC excessive production of one causes suppression of other lines - PANCYTOPENIA (low RBC, WBS and platelets - anaemia, luekopenia and thrombocytopenia)
33
investigations: leukaemia
FBC bone marrow biopsy coagulation screen (DIC - disseminated intravascular coagulation) lumbar puncture (disease in CSF) CXR (mediastinal mass - characteristic of T-cell sdisease)
34
risk factors: leukaemia
radiation exposure (AXR in prepgnancy) Down's syndrome Kleinfelter's Noonan Fanconi's anaemia
35
Presentation: leukaemia (12)
persistent fatigue unexplained fever failure to thrive weight loss night sweates petechiae and abnormal brusing unexplained bleeding lymphadenopathy bone or joint pain (unexplained and persistent) hepatosplenomegaly abdominal pain pallor
36
diagnosis: leukaemia
immediate referral to specialist FBC within 48 hours blood film - can show blast cells bone marrow biopsy lymph node biopsy
37
staging investigations: leukaemia
CXR CT scan lumbar puncture genetics analysis and immunophenotypung
38
management: leukaemia
chemotherapy mainstay radio, bone marrow transplant or sugery are other options)
39
complications of chemotherapy
endocrine - failure to thrive, puberty, growth, fertility immunodeficiency secondary malignancy cadiotoxicity neurotoxicity infections and immunodeficiency
40
3 core symptoms ALL
recurrent inffections (neutropenia) anaemia (pallor and fatigue) thrombocytopena (purpuric/bruising)
41
supratentorial tumour
astrocytoma
42
midline brain tumour
cranipharygioma
43
cerebellar brain tumour
medulloblastoma, astrocytoma or ependymoma
44
brainstem brain tumour
brainstem glioms
45
spinal cord tumour
astrocytoma, ependymoma
46
clinical features with cupratentorial (cortex tumours) (3)
seizures hemiplegia focal neurological signs
47
clinical features of midline tumours
visual field loss (bitemporal hemianopia) pituitary failure (growth failure, diabetes insipud, weight gain)
48
clinical features with cerebellar and IVth ventricle tumour
truncal ataxia co-oordination difficulties abnormal eye movements
49
clinical features of brainstem tumours
cranial nerve defects pyramidal tract signs cerebellar signs (ataxia) no raised ICP
50
4 year old refusing to walk, unable to climb stairs, qsquint and facial asymmetry with drooling
brainstem glioma
51
10 y/o headaches, vomiting, poor groth, struggling to see board at school
craniopharygioma
52
3 year old vomiting in mornings, unsteady on feet and new onset convergent squint
medulloblastoma
53
14 y/o aggressive behavious, headaches, seizures
astrocytoma - glioblastoma multiforme
54
investigations for brain tumours
MRI scan
55
management of brain tumours
surgery usually 1st lune
56
aetiology: neuroblastoma
neural crest tissue in adrenal medulla and aympathetic nervous system
57
common age of neuroblastoma
<5y/o
58
clinical features: neuroblastoma
abdominal mass primary tumour usually in sympathetic chain between neck and pelvis tumour mass often large and croses midline - affecting major blood vessels and lymph nodes spinal cord compression
59
clinical features metatstatic neuroblastoma
bone pain bone morrow suppression weight loss malaise
60
symptoms of neuroblastoma
palloe weight loss abdominal mass hepatomegaly bone painlimp
61
investigations: neuroblastoma
raised urinary catecholamine metabolite levels confirmatory biopsy
62
oncogene predictive of neuroblastoma prognosis
MYCN
63
management: neuroblastoma
surgery alone if no mets chemotherapy if metastatic, stem cell, surgery and rasiotherapy
64
def: Wilm's tumour
nephroblastoma originates from embryonal renal tissue and is most common renal cancer of childhood
65
age of presentation with Wilm's
<5y/o (v rare after 10 y/o)
66
clinical feat: Wilm's tumour
large abdominal mass haematuria otherwise well
67
RF: nephroblastoma/Wilm's tumour
Beckwith-Wiedemann syndrome
68
investigations: Wilm's
USS and/or CT/MRI - intrinsic renal mass
69
management: wilm's tumour
chemotherapu and delayed nephrectomy
70
def: retinoblastoma
malignant tumour of retinal cells
71
aetiology of retinoblastoma
bilateral = all hereditary (chromosome 13) dominant pattern of inheritance but incomplete penetrance
72
common age of presentation retinoblastoma
<3 y/o
73
clinical features: retinoblastoma
white puilary reflex squint
74
investigations: retinoblastoma
MRI and examination under anaesthetic
75
treatment: retinoblastoma
chemotherapy (esp bilateral) to shrink tumour laser
76
2 main types of bone cancer
osteosarcoma Ewing sarcoma
77
clinical features: bone cancer
limbs most common site persistent localised bone pain mass on limbs mainly otherwise well
78
investigation: bonce cancer
plain X-ray - destruction and variable periosteal new bone formation MRI bone scan CT chest for lung mets bone marrow sampling
79
what is often seen on imaging of Ewing sarcoma
substantial soft tissue mass
80
management: bone tumour
chemotherapy before surgery radiotherapy in Eqing sarcoma

Year 4 Paeds (6 decks)

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