Paediatric Oncology Flashcards
What are the most common paediatric cancers?
Leukaemias CNS tumours Lymphomas Neuroblastoma Soft tissue sarcomas Retinoblastoma Bone tumours
What genetic factors can predispose to paediatric cancer?
Down syndrome Fanconi BWS Li-Fraumeni familial cancer syndrome Neurofibromatosis
What environmental factors can predispose to paediatric cancers?
Radiation Viral infections (EBV, HIV, HepB)
What iatrogenic factors can predispose to paediatric cancers?
Radiotherapy
Chemotherapy
When should a child be referred?
Rest pain
Back pain
Unexplained lump
When should a child be urgently referred?
Repeat attendance for same problem
No clear diagnosis
When should a child be immediately referred?
Unexplained petechiae
Hepatosplenomegaly
What are the clinical signs and symptoms of paediatric cancers?
Pallor Lump, mass or swelling Lymphadenopathy Abnormal movement Bruising Fatigue Bleeding Headache Visual symptoms Pain MSK symptoms
What is tumour lysis syndrome?
Metabolic derangement
Rapid death of tumour cells and release of intracellular contents
What are the clinical features of tumour lysis syndrome?
Increased potassium Increased urate Increased phosphate Decreased calcium Acute renal failure
What is the treatment for tumour lysis syndrome?
ECG monitoring
Hyperhydrate
Diuresis
Never give potassium
Treat hyperkalaemia (Ca Resonium, salbutamol, insulin)
Decrease uric acid (urate oxidase-uricoenxyme, allopurinol)
Renal replacement therapy
What is febrile neutropenia?
Neutrophils <0.5x10^9/L
Fever >38C
What are the investigations for febrile neutropenia?
Cultures
Swabs
Stool
Urine
What is the treatment for febrile neutropenia
Broad spectrum IV antibiotics
What are the features of spinal cord compression in children?
Weakness Spine tenderness Sphincter disturbance Sensory disturbance Gait disturbance Back pain
