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Pediatrics > Pediatric Malignancies > Flashcards

Pediatric Malignancies Flashcards

1
Q

What type of cancers are more common in younger vs older children?

A
  • younger: embryonal (neuro, retino, hepato, medulllo, nephroblastoma)
  • older: epithelial (osteosarcoma)
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2
Q

Death in pediartic cancers usually occur in:

A
  • Infants <1 year

- Adolescents

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3
Q

What is the most common cancer in pediatrics?

A

Acute lymphoblastic leukemia

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4
Q

Which has a better prognosis

Acute myeloid or acute lymphoid??

A

Lympohoid with b-cell lineage

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5
Q

What is the peak age for acute lymphoblastic leukemia

A

2-5 yeats

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6
Q

First most common cancer in pediatrics:

A

Acute leukemia

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7
Q

2- Second most common group of cancers in children:

A

CNS malignancies

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8
Q

Usually short duration of symptoms, Constitutional symptoms, Related to the blasts infiltrating organs:

A

Acute leukemia

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9
Q

Acute leukemia emergencies:

A
  • Tumor Lysis Syndrome
  • Hyperleukocytosis / Leukostasis > More common in AML
  • Disseminated intravascular Coagulation (DIC) > Classic in a type of AML
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10
Q

Indicates increase risk of DIC:

A

Auer rods (mostly located in Acute promyelocytic leukemia M3)

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11
Q

Seen in Mature type of leukemia (Burkitt) & Indicates increase risk of tumor lysis syndrome:

A

Cytoplasmic vacuoles

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12
Q

Blasts should be ……. to be diagnosed as leukemia:

A

> 20%

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13
Q

Guide for prognosis and therapy of acute leukemia:

A

Cytogenetics / molecular

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14
Q

What is the standard risk for ALL?

A

WBC count < 50,000 AND Age between 1 and 10 in ALL:

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15
Q

What is the high risk for ALL?

A

WBC count > 50,000 OR Age < 1 or >10 in ALL:

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16
Q

What is a favorable prognosis of all?

A

Hyperdiploidy > 50 chromosomes:

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17
Q

Other factors that make patient high risk in ALL:

A

CNS disease / Testicular disease

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18
Q

Risk factors for AML (Certain syndromes):

A

Down syndrome / Fanconi anemia

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19
Q

Risk factors for AML (Acquired conditions):

A

Aplastic anemia / Myelodysplastic syndromes

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20
Q

Risk factors for AML (Environmental exposures):

A

Previous chemotherapy / Radiation / Benzene exposure

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21
Q

Translocation of acute promylocytic anemia

A

15:17

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22
Q

A type of vitamin A can induce differentiation and maturation of cells:

A

All trans-retionic acid (ATRA)

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23
Q

ALL is more common in general except in the first ….. of life - AML more common:

A

3 year

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24
Q

What is Transient Myeloproliferative Disorder

A
  • 10% of Down syndrome,
  • high WBC, anemia, thrombocytopenia
  • blasts in peripheral smear
  • hepatosplenomegaly
  • spontaneous resolution
  • 20 to 30% will develop AML later
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25
Most common cancer in adolescents:
Hodgkin Lymphoma
26
What is Hodgkin Lymphoma characterised of
- progressive enlargement of lymph nodes | ‘slow, painless, non tender, firm lymph nodes’
27
B-symptoms are of prognostic value in which type of cancer
Hodgkin lymphoma:
28
Patients with immunodeficiencies are at increased risk of:
Non Hodgkin lymphoma
29
Microscopy of hodgkin lymohoma will show
Reed sternburg
30
More likely to have extra-nodal presentation, usually high grade and aggressive, has a unpredictable pattern of spread:
: Non Hodgkin lymphoma
31
Most common type of Non Hodgkin lymphoma in 0-14 years age group:
Burkitt Lymphoma
32
Most common type of Non Hodgkin lymphoma in 15-19 years age group:e
Diffuse Large B-cell Lymphoma
33
Type of lymphoma from mature cells (B-cell origin): from immature cells (T-cell more common than B-cell): from mature cells (T-cell origin):
- Burkitt Lymphoma & Diffuse Large B-cell - Lymphoblastic Lymphoma - Anaplastic Large Cell Lymphoma
34
Emergency of non-hodgkin lymphoma
Tumor Lysis syndrome, Superior mediastinal syndrome, Superior Vena Cava syndrome, Spinal Cord Compression
35
Define Superior mediastinal syndrome (Non Hodgkin lymphoma)
Enlarged lymph nodes in the anterior mediastinum & Respiratory symptoms:
36
Define Superior Vena Cava syndrome (Non Hodgkin lymphoma)
Compression of the superior vena cava, Swelling, plethora and cyanosis of the face, neck and upper extremities, Altered mental status:
37
Define Spinal Cord Compression (Non Hodgkin lymphoma)
Localized back pain, Bowel / bladder incontinence, Loss of strength and sensation:
38
Burkitt lymphoma translocation
t(8:14) c-myc:
39
Jaw mass vs abdominal mass in lymphoma
- endemic | - sporadic
40
Optic pathway glioma is associated with
Neurofibromatosis Type 1
41
Vestibular Schwannoma is associated with
Neurofibromatosis Type 2
42
Subependymal giant cell astrocytoma (SEGA) is associated with
Tuberous Sclerosis
43
Astrocytoma is associated with
Li-Fraumeni Syndrome
44
What are supra tentorial tumors
* Cerbral hemisphere: Low grade glioma (Pilocytic astrocytoma) &High grade glioma (glioblastoma multiform) * Sella - germ cell tumors * Chaism - optic pathway glioma
45
What are the Infratentorial Tumors:
* Posterior fossa - Medulloblastoma * Brain stem tumors - Low and high grade glioma (DIPG)
46
The most common CNS tumors in children:
Infratentorial tumors
47
Increased intracranial pressure symptoms
Headache, irritability, lethargy, vomiting, Papilledema, Bulging fontanelle are ...... in CNS malignancies:
48
Supratentorial masses symptoms
Lateralized deficits, Focal motor weakness, Language disorders, Focal seizures, Asymmetrical reflexes, In infants may present with premature hand preference, increasing size of head circumference
49
Infratentorial symptoms
Disorders of equilibrium, gait and coordination:
50
Brainstem malignancy symptoms
Multiple cranial nerve palsies:
51
Most common CNS malignancy in children:
Pilocytic astocytoma
52
How to treat pilocytic astrocytoma
Surgery only
53
What is the growth rate of pilocytic astrocytoma
Slow growing
54
What is the common site for pilocytic astrocytoma
cerebellum
55
Name, the radio sensitive tumors in the lecture
Diffuse Intrinsic Pontine Glioma (DIPG | And high-grade astrocytoma
56
Can you obtain biopsy from DIPG?
No, very critical site
57
Where is the location of the medulloblastoma
Cerbellum vermis
58
What is the risk that comes with medulloblastoma?
Leptomeningeal metastasis
59
What is Most common extra cranial solid tumor in children:
Neuroblastoma
60
What is the clinical presentation of neuroblastoma?
Abdomen mass (most common), Neck mass, Neurologic abnormalities (from sympathetic ganglia)
61
Neuroblastoma | High or low risk of metastasis?
High
62
Racoon eye is commonly seen in
Neuroblastoma
63
What will you see in the basic investigations of neuroblastoma?
Anemia + thrombocytopenia + increased serum catechloamine metabolites (Homovanillic acid (HVA), Vanillymandelic acid (VMA))
64
In neuroblastoma; Presence of ........ indicates more aggressive disease and less favorable prognosis:
n-myc amplification
65
Most common renal tumor in children:
Wilm's tumor
66
Wilms tumor is characterized by
Asymptomatic abdominal mass felt by parents while bathing or clothing patient, Hypertension, Hematuria:
67
Where is calcification more common | “Neuroblastoma or wilms tumor”
Neuroblastoma
68
What is the tumor of - metaphysis - diaphesis
- osteosarcoma | - Ewing sarcoma
69
What is the pattern of osteosarcoma in x-ray
Sunburst appearance
70
Ewing sarcoma occur in which type of bone
Flat
71
Which one is more common to have fever - ewing - osteosarcoma
Ewing
72
What is the x-ray finding of ewing sarcoma?
Moth eaten and onion peel

Pediatrics (41 decks)

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