Paediatric Oncology Flashcards
1
Q
Whay is cancer?
A
Group of abnormal cells dividing in uncontrollable way:
- Usually occurs due to gene changes
- Stimulates own blood supply
- Can cause local invasion or metastatic spread via blood or lymphatic systems
2
Q
Cancer - aetiology
A
- Genes
- Down
- Fanconi
- BWS
- Li-Fraumeni familial cancer syndrome
- Neurofibromatosis
- Environment
- Radiation
- Infection
- Iatrogenic
- Chemotherapy
- Radiotherapy
3
Q
Cancer - epidemiology
A
- Very rare
- GP sees 1 in career
- Usually at younger age
- Between 0-4
4
Q
What are the most common cancers in children?
A
- Leukaemias
- CNS tumours
- Lymphomas
5
Q
How are cancers in children classified?
A
Classified by cell origin, not on primary site:
- International Classification of Childhood Cancer (ICCC)
- Based on tumour morphology (and primary site)
6
Q
Cancer - clinical features
A
- Unexplained petechiaea
- Hepatospenomegaly
- Neuro symptoms
- Abdominal mass
- Rest pain, back pain
- Unexplained lump
- Lymphadenopathy
- Unexplained vomiting
- Unexplained sweating or fever
7
Q
What are some oncological emergencies?
A
- Sepsis/febrile neutropenia
- Raised ICP
- Spinal cord compression
- Mediastinal mass
- Tumour lysis syndrome
8
Q
Sepsis/febrile neutropneia - risk factors
A
- ANC <0.5 x109
- Indwelling catheter
- Mucosal inflammation
- High dose chemo/SCT
9
Q
Sepsis/febrile neutropneia - presentation
A
- Fever (or low temperature)
- Rigors
- Drowsiness
- Shock
- Tachycardia, tachypnoea, hypotension, prolonged capillary refill time, reduced UO, metabolic acidosis
10
Q
What are signs of shock?
A
- Tachycardia, tachypnoea, hypotension, prolonged capillary refill time, reduced UO, metabolic acidosis
11
Q
Sepsis/febrile neutropenia - investigations
A
- Bloods
- Culture, FBC, coagulation, U&Es, LFT, CRP, lactate
- CXR
- Other
- Urine microscopy/culture
- Throat swab
- Sputum culture
- LP
- Viral PCRs
- CT/USS
12
Q
Sepsis/febrile neutropenia - management
A
- ABC
- Oxygen
- Fluids
- Broad spectrum antibiotics
- Inotropes
- PICU
13
Q
Raised ICP - presentation
A
- Early
- Early morning headache/vomiting
- Tense fontanelle
- Increasing head circumference
- Late
- Constant headache
- Papilloedema
- Diplopia (VI palsy)
- Loss of upgaze
- Neck stiffness
- Status epilepticus
- Reduced GCS
- Cushing triad (low HR, high BP)
14
Q
Raised ICP - investigations
A
- Imaging
- CT good for screening
- MRI best for accurate diagnosis
15
Q
Raised ICP - management
A
- Dexamethasone if due to tumour
- Reduce oedema dn increase CSF flow
- Neurosurgery
- Ventriculostomy
- EVD (temporary)
- VP shunt