Pediatric Cancer

Question 1

Warning signs of blood cell cancers.

Answer 1

s/s of anemia,
activity intolerance,
infections

Question 2

Warning signs of tumor cancers.

Answer 2

palpable mass,
discomfort/pain,
severe wt loss,
neurologic symptoms (paresthesia)

Question 3

Briefly describe a neuroblastoma.

Answer 3

a neuro-endocrine tumor in the adrenal gland or sympathetic ganglia

Question 4

Briefly describe how neuroblastoma presents.

Answer 4

Mass in abdomen or chest,
bone pain,
bruising around eyes

Question 5

Identify other s/s associated with neuroblastoma.

Answer 5

abdominal distention,
anorexia, wt loss,
GI & GU dysfunction,
hepatosplenomegaly

Question 6

Diagnostic imaging for neuroblastoma.

Answer 6

Ultrasound for abdomen OR X-ray for chest,
CT, MRI,
MIBG scan

Question 7

Briefly describe the MIBG scan.

Answer 7

specific scan for neuroendocrine tumors; tumors show as dark regions

Question 8

Identify lab testing for neuroblastomas.

Answer 8

24h urine collection to look for “vanilla” catecholamines

Question 9

Briefly identify complications of neuroblastomas.

Answer 9

metastasis to lymph nodes,
nerve compression leading to neurological deficits

Question 10

Briefly describe retinoblastoma.

Answer 10

A malignant tumor in the retina.

Question 11

Identify key sign of retinoblastoma.

Answer 11

Leukocoria
aka the “cat’s eye reflex”
(pupil shines white with light)

Question 12

Identify other s/s of retinoblastoma.

Answer 12

strabismus,
vision loss,
orbital inflammation,
proptosis

Question 13

Briefly define strabismus.

Answer 13

cross-eyed

Question 14

Briefly define proptosis.

Answer 14

Abnormal protrusion/bulge of the eye.

Question 15

Identify the chief goal of treatment for retinoblastoma.

Answer 15

preserve the eye and vision,
protect the remaining eye!

Question 16

Briefly define enucleation.

Answer 16

removal of the eye

Question 17

Briefly describe initial presentation of a Wilms tumor.

Answer 17

(aka nephroblastoma)

a unilateral firm abdominal mass (without any other symptoms yet)

Question 18

Identify key thing when assessing for a nephroblastoma.

Answer 18

(aka Wilms tumor)

DO NOT PALPATE THE ABDOMEN!

Question 19

Identify key complications of a Wilms tumor.

Answer 19

(aka nephroblastoma)

seeding - ruptures easily to metastasize to the lungs, brain, bones, and lymph nodes

Question 20

Identify key s/s of Wilms tumor.

Answer 20

(aka nephroblastoma)

asymmetry in abdomen,
abdominal discomfort,
s/s of kidney damage:
HTN due to renin production,
hematuria

Question 21

Most common medication for kidney-related symptom of a nephroblastoma.

Answer 21

(aka Wilms tumor)

ACE inhibitors for the hypertension

Question 22

Labs to monitor with Wilms tumor.

Answer 22

(aka nephroblastoma)

Kidney things:
BUN/creatinine,
K+ (hyperkalemia)

Question 23

Key pt teaching for nephroblastoma.

Answer 23

(aka Wilms tumor)

No contact sports (worried about seeding if tumor reoccurs).

Question 24

Briefly describe an osteosarcoma.

Answer 24

a large, tender soft tissue mass near the growth plate of a long bone

Question 25

Identify risk factors for an osteosarcoma

Answer 25

growth spurt around 13-16yo,
recent injury,
Hx of radiation/chemo,
female

Question 26

s/s of osteosarcoma

Answer 26

localized pain lasting months,
soft tissue swelling,
limping,
pathological fracture

Question 27

Identify some long-term concerns with osteosarcoma.

Answer 27

reoccurrence, metastasis,
poor body image,
halted limb growth

Question 28

Identify labs for osteosarcoma.

Answer 28

elevated alkaline phosphate (byproduct of bone formation),
elevated ESR (indicating inflammation)

Question 29

Identify imaging for osteosarcoma.

Answer 29

X-ray showing woven bone matrix “sun burst” pattern,
CT, MRI,
bone scan

Question 30

Identify key treatment options for osteosarcoma.

Answer 30

chemo to reduce tumor size and prevent metastasis,
limb-sparing removal,
amputation