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Paediatrics > Paediatric Oncology > Flashcards

Paediatric Oncology Flashcards

1
Q

3 Categories of causes of cancer

A

Genetic
Environment
Iatrogenic

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2
Q

Genetic causes of cancer and associations with genetic conditions

A 
Down's Syndrome
Fanconi
Beckwith Wiedemann Syndrome
Li-Fraumeni
Neurofibromatosis
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3
Q

Genetic mutation in Li-Fraumeni

A

p53

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4
Q

How is Fanconi monitored?

A

3 monthly Ultrasound until 7 years old

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5
Q

What is fanconi syndrome?

A

Disorder of proximal tubule. Excess glucose, potassium, bicarb, phosphates, sodium, uric acid excreted in urine

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6
Q

Environmental causes of cancer

A

Infection

Radiation

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7
Q

Iatrogenic causes of cancer

A

Chemotherapy

Radiotherapy

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8
Q

Signs and symptoms of cancer

A 
Unexplained petechiae
Hepatosplenomegaly
New neurological symptoms
Abdominal mass
Recurring symptoms
Pain at rest
Back pain
Unexplained lumps
Lymphadenopathy (no preceding viral illness)
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9
Q

What two signs and symptoms of cancer indicate an urgent referral

A

Unexplained petechiae

Hepatosplenomegaly

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10
Q

Investigations for cancer

A

Imaging
Biopsy
Tumour markers
Staging - scans, bone marrow

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11
Q

Which tumour markers are measured in suspected cancer?

A

B-HCG

Testicular

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12
Q

3 treatment options for cancer

A

Chemotherapy
Radiotherapy
Surgery

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13
Q

Side effects of chemotherapy

A 
Hair loss
Nausea and vomiting
Mucositis
Diarrhoea/constipation
Bone marrow suppression
Organ impairment
Reduced fertility
Secondary cancer
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14
Q

Symptoms of bone marrow suppression (as caused by chemotherapy)

A

Anaemia
Bleeding
Infection

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15
Q

Side effects of radiotherapy

A 
Lethargy
Skin irritation
Swelling
Organ inflammation
Fibrosis
Secondary cancer
Reduced fertility
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16
Q

Features of cancer treatment leading to sepsis - febrile neutropenia

A

Low neutrophils
Indwelling catheter
Mucosal inflammation
SCT/ high dose chemotherapy

17
Q

Symptoms of sepsis

A 
Fever
Rigors
Drowsiness
Shock - tachycardia, tachypnoea
Hypotension
Prolonged capillary refill
18
Q

Management of sepsis

A 
Iv access
Blood cultures
 Lactate
Urine output
IV fluids
IV antibiotics
High flow oxygen
19
Q

What blood tests should be completed if child might be septic?

A 
FBC
U&Es
CRP
LFTs
Lactate
Blood gas
20
Q

What other samples may be taken alongside blod if septic?

A

Urine and sputum cultures

Throat swabs

21
Q

Symptoms of raised intracranial pressure

A

Early morning headache
Vomiting
Tense fontanelle

22
Q

Late symptoms of raised intracranial pressure

A 
Headache can become constant
Papilloedema
Diplopia
Loss of upgaze
Neck stiffness
Status epilepticus
Reduced GCS
Cushing's traid - low HR, high BP
23
Q

What is cushing’s triad?

A

Low heart rate
High blood pressure
Decreased respiration

24
Q

Management of raised intracranial pressure

A

Imaging - CT, MRI
Dexamethasone
Neurosurgery - rapid CSF diversion

25
Q

Tumours that result in spinal cord compression

A

Ewing’s sarcoma
Medulloblastoma
Neuroblastoma
Germ Cell Tumour

26
Q

Symptoms of spinal cord compression

A

Weakness
Pain
Sensoey symptoms
Sphincter disturbance

27
Q

Management of spinal cord compression

A

Imaging - MRI
Dexamethasone
Surgery

28
Q

Presentation of Superior Vena Cava Syndrome

A 
Facial/neck/thoracic plethora
Oedema
Cyanosis
Disteneded veins
Very ill
Anxious
Reduced GCS
29
Q

What is Superior Mediastinal Syndrome?

A

Superior Vena Cava Syndrome in addition to obstruction of trachea

30
Q

Presentation of Superior Mediastinal Syndrome

A 
Dyspnoea
Wheeze
Cough
Stridor
Orthopnoea
31
Q

Investigation for Superior Mediastinal Syndrome

A

CXR

ECHO

32
Q

Sign of Superior Mediastinal Syndrome on X-ray

A

Complete whiteout with tracheal deviation

33
Q

Management of SVCS and SMS

A

Chemotherapy rapidly effective
Biopsy
Steroids
Keep child calm

34
Q

Why would radiotherapy be avoided in SMS/SVCS?

A

Increases respiratory distress

35
Q

What occurs in Tumour Lysis Syndrome?

A

Cell dies and releases intracellular contents

36
Q

Example of tumour in Tumour Lysis Syndrome

A

Burkitt’s lymphoma

Increased potassium, urate, phosphate

37
Q

Management of tumour lysis syndrome

A

Hyperhydrate- no potassium
ECG monitoring
Diuresis
Check electrolytes
Decrease uric acid - Urate oxidase, uricozyme, allopurinol
Hyperkalaemia - calcium resonium, insulin, salbutamol
Renal replacement therapy

Paediatrics (10 decks)

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