paediatric oncology Flashcards
most common paediatric malignancies 5
leukaemia/lymphoma
brain tumours
neuroblastoma
Wilms tumour
bone tumour
presenation of brain tumours 5
raised ICP
focal seizures
neurological signs
endocrine distrubances
raised OFC - developmental delay/regression
features of raised ICP in brain tumours 4
early morning headaches become more severe
vomitting
papilloedema (LATE)
in extremis:
-hypertension
-bradycardia
-abnormal respirations
-reduced GCS
investigations for brain tumours 5
if suspected- CNS imagins MANDATORY
-often CT but brain/spinal MRI is investgiation of choice
tumour biopsy
consider tumour markers
endocrine screen
CSF- cytology and tumour markers
what type of brain tumour can have an endocrine impact and what is that impact
craniopharyngioma
-may cause hypopituitarism
managment of brain tumours 5
resus if necessary
neurosurg referral
consider dexamethasone to reduce peritumour oedema
consider chemo
consider radio
most common malignant bone tumour in kids 2
osteosarcoma
Ewings sarcoma
presenation of bone tumours 5
persistent pain (nocturnal)
swelling
deformity
pathological fractures
other symptoms associated with Ewings sarcoma 3
fever
anorexia
weight loss
paliative care in oncology with children
holistic individualised and active(not simply withdrawing treatment )
involves caring for child and their family and includes symptomatic management
Anticipation of and provision of end of life care in a location decided by carers.
Majority die at home other locations include hospital or hospice.
Bereavement services are provided where necessary
examination of an abdominal mass in a child 8
evaluate mass
organomegaly
bowel/bladder obstruction
BP
lymphadenopahty
skin nodules
skin rash
neuro assessment -EXCLUDE SPINAL CORD COMPRESSION
when are blueberry muffin nodules found
neuroblastomas
investigations in an abdo mass in a child:
when is urinalysis important
WIlms tumour (nephroblastoma)
-haematuria
investigations in an abdo mass in a child:
urinary catecholamines
neuroblastomas
-examples, VMAs and HVAs
investigations in an abdo mass in a child:
ophthalmosocpy
leucocoria - retinoblastoma
investigations in an abdo mass in a child:
-visual feilds
bitemporal hemianopia
-craniopharyngioma
define wilms tumour
wilms nephroblastoma
-kidney tumour
0typically presents under 5
associations to wilms tumour 3
beckwith-wiedemann
WAGR syndrome
1/3 cases associated w loss of function in WT1 gene on chromosome 11
features of wilms tumours
abdo mass -unilateral (95% cases)
painless haematuria
flank pain
anorexia/fever
management of wilms tumpur 3
nephrectomy
chemo
radiotherapy if advanced
define neuroblastoma
accounts for 7-8% of childhood malignancies
-arises form neural crest tissues of the adrenal medulla and sympatethic nervous system
features of neuroblastoma 8
BLUEBERRY MUFFIN NODULES
abdo mass
pallor/weight loss
bone pain/limp
hepatmegaly
paraplegia
proptosis
investgations for neuroblastoma 3
raised urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels
calcfication may be seen on abdo XR
biopsy
major complication of paeds oncology when receivieng chemo
if receiivng thorgh a central line are at an increased risk of neutropenic sepsis
-medical emergency w IV ABx ASAP
what causes tumour lysis syndrome
breakdown of malginant cells
what are the biochemical distrubances in tumour lysis syndrome 4
hyperuricaemia
hyperkalaemia
hyperphosphataemia
hypocalcaemia
what complications can arise as a result of tumour lysis syndrome 3
AKI
seizures
cardiac arythmias
death
when is tumour lysis syndrome most likely to occur
during induction of chemotherapy
management of tumour lysis syndrome 8
regular obs
cardiac monitor
accurate fluid balance
fequent U&Es and bone profile
IV fluids
Xanthine oxidase inhibitor- allopurinol
management of hyperkalaemia (calcium gluconate)
renal dialysis
early effects of chemo 5
Marrow suppression
Temporary hair loss
Nausea and vomiting
Hearing loss
Renal impairment
late effects of chemo 3
Cardiac toxicity
Infertility
Risk of secondary malignancies
late effects of chemo 3
Cardiac toxicity
Infertility
Risk of secondary malignancies
