Paediatric Flashcards
1
Q
How is treating a paediatric patient different from an adult?
A
- consider parents
- kids dont understand
- different dose limits and secondary malignancies
- tumour types different
- kids more at risk of late side effects
neurocognitive effects - muscle developement
2
Q
What are the symptoms of medulloblastoma? (8)
A
- headaches
- nausea and vomitting in the morning
- problems with motor skills (clumsiness or poor handwriting)
- tiredness
- tilting of head to one side
- walking difficulty and balance problems
- back pain
- inability to control bladder and bowel
3
Q
How do you diagnosis medulloblastoma?
A
- symptom history
- MRI with and without contrast
- lumbar puncture (to see if tumour has progressed down CNS)
- surgery/biopsy
- pathology report
4
Q
What is the classification of high risk Medulloblastoma?
A
- <3 yrs at diagnosis
- tumour remaining following surgery is more than 1.5cm^2
- M1-4
5
Q
What is M0-M4 classification of Medulloblastoma?
A
M0 - no evidence of mets M1 - tumour cells in the spinal fluid M2 - tumour spread within the brain M3 - tumour has spread to the spine M4 - tumour has spread away from brain or spine
6
Q
What are the survival rates of Medulloblastoma?
A
- M0- 70-80%
- if disease has spread to spinal cord, SR 60%
- children under 3 often lower SR due to more aggressive disease
7
Q
Who is involved in a paediatrics multi-disciplinary team?
A
- occupational therapists
- physiotherapists
- medical oncologists
- paediatric nurses
- GA team
- RT
- Dieticians
- Speech pathologists
- teacher
8
Q
What is play therapy?
A
- play-based procedural support and preparation refers to a specific child life intervention that aims to promote the child’s coping with new and unfamiliar medical experiences
9
Q
What does RT play therapy involve?
A
- delivery a social story by the OT
- practice making a mask and vacbag on toy or parent
- playing in the treatment room including using the controls
- watching parents on the monitor from outside the treatment room
- practice leaving the child in the room by themselves
10
Q
What type of child is likely to require GA?
A
- children under 3
- behavioural issues
- compliance issue due to condition (e.g. posterior fossa syndrome)
11
Q
What is posterior fossa syndrome?
A
- most commonly from surgery for posterior fossa tumours in paeds
- occurs in 8-24% cases
- absence of reduction in speech
- axial hypotonia and ataxia
- mild to completely disabling symptoms
12
Q
What is GA is not an option?
A
- get the child to be very hungry then feed and then will fall into a deep sleep and then set up with straps
13
Q
What was the old RT method of treating CNS?
A
- prone
- lateral skull fields
- single post spinal fields
- moving junction
14
Q
What is the CT set-up of a CNS?
A
- supine
- full shell (mask)
- vacbag from head to pelvis
- knee bolster
- footstocks
15
Q
What are some anatomical considerations when setting up a CNS?
A
- head tilt in neutral position with VBL = ITN to colmella
- spine straight and level
- arms are slighly anterior to spine
- shoulders should be level and relaxed inferil=oly
- no nappy as it effects pelvic tilt
