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Phase 3a conditions list flashcards > Paediatrics - Oncology > Flashcards

Paediatrics - Oncology Flashcards

1
Q

What are the most common childhood malignancies?

A
  • Leukaemias = MC
  • Brain + CNS tumours
  • Bone tumours
  • Lymphoma
  • Wilms tumours
  • Hepatoblastoma
  • Retinoblastoma
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2
Q

What are the most common forms of leukaemia in children?

A
  • ALL (80%)
  • AML (15%)
    others e.g. CML
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3
Q

What age do ALL and AML most frequently occur?

A
  • ALL = 2-5 years
  • AML < 2 years
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4
Q

What are some risk factors for leukaemia?

A
  • Radiation exposure e.g. x-ray during pregnancy
  • Genetic conditions - downs, kleinfelters, noonans
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5
Q

What effect does leukaemia have on cells in the blood?

A

Pancytopenia

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6
Q

What is pancytopenia?

A
  • Anaemia
  • Leukopenia
  • Thrombocytopenia
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7
Q

How does leukaemia lead to pancytopenia?

A

Mutation in a precursor cell in the bone marrow leads to an excessive production of single type of abnormal WBC. This excessive production of cells in the bone marrow deprives the blood of the normal production of other blood cells –> pancytopenia

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8
Q

What are the signs/ symptoms of leukaemia in children (10)?

A
  • Fatigue
  • Fever
  • Failure to thrive
  • Weight loss
  • Night sweats
  • Pallor
  • Petechiae/ bruising
  • Bleeding
  • Lymphadenopathy
  • Hepatomegaly
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9
Q

How soon should an FBC be done within when leukaemia is suspected?

A

48 hours

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10
Q

How should leukaemia be investigated (3)?

A
  • FBC
  • Blood film
  • Bone marrow biopsy = diagnostic
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11
Q

What would be present on a blood film of those with leukaemia?

A

Blast cells

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12
Q

What further tests are often used to investigate leukaemia (4)?

A
  • Chest X-ray
  • CT scan
  • Lumbar puncture
  • Genetic analysis
    imaging + lumbar used for staging
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13
Q

How is leukaemia treated (3)?

A
  • Chemo = mainstay
  • Radiotherapy
  • Bone marrow transplant
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14
Q

What medical emergency is common in patients with leukaemia and other malignancies?

A

Febrile neutropenia
chemo can cause low neutrophils as well

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15
Q

What are some complications of chemo in children (5)?

A
  • Neurotoxicity
  • Immunodeficiency
  • Infertility
  • Stunted growth/ development
  • Tumour lysis syndrome
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16
Q

What is the prognosis for childhood leukaemia?

A
  • ALL = 80% cured
  • AML = less positive
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17
Q

Are primary or secondary brain tumours more common in children?

A

Almost always primary in children

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18
Q

What are the 5 main types of brain tumours in children?

A
  • Astrocytoma = MC
  • Medulloblastoma
  • Ependymoma
  • Brainstem glioma
  • Craniopharyngioma
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19
Q

What type of tumour are astrocytomas and ependyomas?

A

Gliomas
astrocytes and ependyma (lining of ventricles) are glial cells

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20
Q

What is a highly malignant form of astrocytoma?

A

Glioblastoma multiforme

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21
Q

Where is a medulloblastoma?

A

Midline of the posterior fossa

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22
Q

What is a craniopharyngioma?

A

Developmental tumour arising from an embryological remnant

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23
Q

Which brain tumours have a worse prognosis (2)?

A
  • Glioblastoma multiforme
  • Brainstem glioma
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24
Q

What are the signs/ symptoms of brain tumours (6)?

A
  • Raised ICP headache
  • Papilloedema
  • N+V
  • Seizures
  • Growth failure
  • Visual field defects
  • Focal neurological signs
  • Back pain (spinal tumours)
  • Peripheral weakness
  • Bladder/ bowel dysfunction
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25
Q

What is characteristic of raised ICP headaches (2)?

A
  • Wake up with headache
  • Coughing/ straining/ bending forward worsen headache
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26
Q

What are the two types of lymphoma?

A
  • Hodgkin lymphoma
  • Non-hodgkin lymphoma
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27
Q

What cells are found in those with Hodgkin lymphoma?

A

Reed-Sternberg cells

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28
Q

What is a common type of non-hodgkin lymphoma in children?

A

Burkitts lymphoma

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29
Q

Which lymphocytes does burkitts lymphoma affect?

A

B-cells

30
Q

Where is burkitts lymphoma most common?

A

Africa

31
Q

What are some risk factors for lymphoma (3)?

A
  • EBV
  • Malaria
  • HIV/ immunodeficiency
32
Q

What are the signs/ symptoms of lymphoma (5)?

A
  • Lymphadenopathy
  • B symptoms (fever, night sweats, weight loss)
  • Fatigue
  • Recurrent infections
  • SOB
33
Q

What is a specific symptom of burkitts lymphoma?

A

Swollen jaw

34
Q

Where is a neuroblastoma?

A
  • Adrenal medulla
  • Sympathetic nervous chain
    tumour arises from neural crest tissue
35
Q

What is the prognosis of neuroblastomas?

A

Very good - 80% cured

36
Q

What age does neuroblastoma usually occur?

A

Under 5 years

37
Q

How do neuroblastomas present (6)?

A
  • Abdo lump
  • Pallor (anaemia due to marrow infiltration)
  • Weight loss
  • Bone pain
  • Hepatomegaly
  • Lymphadenopathy
38
Q

How are neuroblastomas investigated?

A
  • Raised urine catecholamines due to increased production of catecholamines ((nor)adrenaline/ dopamine)
  • Biopsy
  • Imaging
39
Q

What is the most common renal tumour in children?

A

Wilms tumour

40
Q

What age does wilms tumour usually present?

A

< 5 years (80% of cases)

41
Q

Where do wilms tumours come from?

A

Embryonal renal tissue

42
Q

What are the signs/ symptoms of Wilms tumours (6)?

A
  • Large abdo mass
  • Haematuria
  • Abdo pain
  • Anorexia
  • Hypertension
  • Anaemia
43
Q

How are Wilms tumours investigated?

A

CT/ MRI
biopsy can cause spread of cancer, so usually done post surgery

44
Q

How is Wilms tumour managed (2)?

A
  • Chemotherapy first
  • Nephrectomy
45
Q

What are cancers of connective tissue known as?

A

Sarcomas

46
Q

What is the most common type of sarcoma in children?

A

Rhabdomyosarcoma (skeletal muscle cancer)

47
Q

When do bone tumours most commonly occur in childhood?

A

After puberty

48
Q

What is the most common childhood bone cancer overall?

A

Osteosarcoma

49
Q

What childhood bone cancer is most common in younger children (before puberty)?

A

Ewing sarcoma

50
Q

What is the presentation of bone cancers in children?

A

Persistent localised bone pain even when resting
most patients are otherwise well

51
Q

Where are bone cancers most commonly found?

A

In the limbs

52
Q

How are bone cancers investigated in children (2)?

A
  • X-ray then MRI
  • CT for metastises
53
Q

What might an x-ray show in bone cancer (2)?

A
  • Bone destruction and variable periosteal bone formation
  • Ewing = soft tissue swelling/ mass
54
Q

How is bone cancer managed in children (3)?

A
  • Chemo first
  • Surgical resection
  • Radiotherapy if resection impossible
55
Q

What cell do retinoblastoma come from?

A

Retinal cells

56
Q

What percent of severe visual impairments in children are due to retinoblastomas?

A

5%

57
Q

What age do retinoblastomas usually present?

A

< 3 years

58
Q

What is the cause of bilateral retinoblastomas?

A

Hereditary genetic cause

59
Q

What is the inheritance of hereditary retinoblastoma and which chromosome is affected?

A

Auto dom affecting chromosome 13

60
Q

What is the presentation of retinoblastomas (2)?

A
  • Loss of red reflex –> replaced by white reflex
  • Squint
61
Q

How are retinoblastomas investigated (2)?

A
  • MRI
  • Examination under local anaesthetic
62
Q

How is retinoblastomas managed (2)?

A
  • Chemo
  • Laser therapy
63
Q

What are some complications of retinoblastomas (2)?

A
  • Visual impairments
  • Recurrence/ secondary tumour common
64
Q

What cancer often affects those with HIV?

A

Kaposi sarcoma
not a true sarcoma, comes from cells of blood/ lymph vessels

65
Q

How does Kaposi sarcoma present (2)?

A
  • Red/ purple lesions on skin/ GI tract
  • Lymphadenopathy
66
Q

What is the most common type of liver cancer in children/

A

Hepatoblastoma

67
Q

How does hepatoblastoma present (2)?

A
  • Abdo mass/ distension
  • Rarely pain/ jaundice
68
Q

What tumours sometimes form in the ovaries and testes amongst other places?

A

Germ cell tumours

69
Q

How are germ cell tumours treated?

A

Chemo
usually very responsive to chemo

70
Q
A

Phase 3a conditions list flashcards (25 decks)

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