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Paediatrics > Paediatric oncology > Flashcards

Paediatric oncology Flashcards

1
Q

What is the ICCC?

A

International Classification of Childhood Cancer

Based on tumour morphology and primary site

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2
Q

What is the most commonly diagnosed cancer in childhood in the UK?

A

Leukaemia

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3
Q

What are the main genetic cause of cancer?

A 
Down
Fanconi
BWS
Li-Fraumeni Familial Cancer syndrome
Neurofibromatosis
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4
Q

What proportion of childhood cancers are cured?

A

85%

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5
Q

Name some symptoms which would warrant immediate referral.

A

Unexplained petechiae

Hepatosplenomegaly

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6
Q

Name some symptoms which would warrant urgent referral?

A

Repeat attendance with same problem and no clear diagnosis
New neuro symptoms
Abdominal mass

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7
Q

What are some common brain tumour symptoms in under 5s?

A 
Persistent vomiting
Abnormal balance/coordination
Abnormal eye movements
Behaviour change
Fits/Seizures
Abnormal head position
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8
Q

What are some common symptoms of brain tumours in children aged 5-11 years?

A 
Persistent vomiting
Persistent headache
Abnormal balance/coordination
Abnormal eye movements
Blurred/double vision
Behaviour changes
Fits/seizures
Abnormal head position
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9
Q

What are some symptoms which may be caused by brain tumours in children aged 12-18?

A 
Persistent vomiting
Persistent headache
Abnormal eye movements 
Blurred or double vision
Abnormal balance/coordination
Behaviour change
Fits or seizures 
Delayed or arrested puberty
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10
Q

What are some risk factors for sepsis/febrile neutropenia?

A

ANC <0.5x10^9
Indwellling catheter
Mucosal inflammation
High dose chemo

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11
Q

How would sepsis/febrile neutropenia present?

A

Fever
Rigors
Drowsiness
Shock

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12
Q

What is shock?

A 
Tachycardia
Tachypnoea
Increased cap refill time
Reduced urine output
Metabolic acidosis
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13
Q

What are some early signs of raised ICP?

A

Early morning headache/vomiting
Tense fontanelle
Increased HC

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14
Q

What are some late signs of raised ICP?

A 
Constant headache 
Papilloedema 
Diplopia (VI palsy) 
Loss of upgaze
Neck stiffness
Status epilepticus, 
Reduced GCS 
Cushings triad
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15
Q

What is Cushings triad?

A

Bradycardia
Irregular RR
Raised BP

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16
Q

Which imaging test is best for raised ICP screening?

A

CT

17
Q

Which imaging technique is best for accurate diagnosis of raised ICP?

A

MRI

18
Q

What does dexamethasone do to reduce >ICP caused by tumours?

A

Reduce oedema

Increase CSF flow

19
Q

What is ventriculostomy?

A

Hole in membrane at base of 3rd ventricle with endoscope

For urgent CSF diversion to reduce ICP

20
Q

What are the most common pathological processes causing spinal cord compression?

A

Invasion from paravertebral disease via intervertebral foramina
Vertebral body compression
CSF seeding
Direct invasion

21
Q

What are the most common causes of Superior Vena Cava Syndrome (SVC syndrome)?

A

Lymphoma
Neuroblastoma
Germ cell tumour
Thrombosis

22
Q

How does spinal cord compression present?

A

Weakness
Pain
Sensory disturbance
Sphincter disturbance

23
Q

How is spinal cord compression managed?

A

Urgent MRI
Dexamethasone
Chemo if rapid response is expected

24
Q

How does SVC syndrome present?

A 
Oedema
Cyanosis
Distended veins
Especially head and neck
Reduced GCS
25
Q

What is SVC syndrome?

A

Block of blood/oxygen flow from head/neck to thorax due to SVC/mediastinal compression

26
Q

How do we manage SVC syndrome?

A

Keep upright and calm
Biopsy, FBC, pleural aspirate, GCT, BM
Definitive treatment

27
Q

What are some options for definitive treatment of SVC syndrome?

A

Chemo
Steroids
Radiotherapy
Thrombolysis if there is thrombosis

28
Q

What is tumour lysis syndrome?

A

Metabolic derangement
Rapid death of Tumour Cells
Release of intracellular contents
Secondary to treatment

29
Q

What are some blood results in tumour lysis syndrome?

A

Raised potassium, urate and phosphate

Reduce calcium

30
Q

How does acute renal failure show up in tumour lysis syndrome?

A

Urate load

CaPO4 deposition in renal tubules

31
Q

How is uric acid reduced in tumour lysis syndrome?

A

Rasburicase

Allopurinol

32
Q

How is hyperkalaemia treated in tumour lysis syndrome?

A

Ca Resonium
Salbutamol
insulin

33
Q

What are some acute risks of chemotherapy?

A 
Hair loss
Nausea & vomiting
Mucositis
Diarrhoea / constipation
Bone marrow suppression
34
Q

What are some consequences of bone marrow suppression in chemotherapy?

A

Anaemia
Bleeding
Infection

35
Q

What are some chronic consequences of chemotherapy?

A

Organ impairment
Reduced fertility
Second cancer

36
Q

What are some acute consequences of radiotherapy?

A

Lethargy
Skin irritation
Swelling
Organ inflammation

37
Q

What are some chronic consequences of radiotherapy?

A

Fibrosis
Scarring
Second cancer
Reduced fertility

Paediatrics (25 decks)

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