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14 Onco > Pediatric Onco 1 > Flashcards

Pediatric Onco 1 Flashcards

1
Q

most common malignancy in pediatric age

A

hematologic malignancy (leukemia)

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2
Q

most common solid tumor in pedia

A

brain and spinal tumor

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3
Q

outcome of pedia tumors

A

more aggressive, rapid progression, but greater response to treatment

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4
Q

t/f 80% of pediatric cases are diagnosed with metastasis

A

true, s/sx caused by systemic involvement

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5
Q

s/sx of childhood cancer mimicking normal illness

A

table 2

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6
Q

red flag signs

A
  • lymphadenopathy >/= 2 cm
  • morning symptoms
  • rapid changes in vision +/- papilledema
  • painless swelling
  • fever associated with pallor +/- night sweats
  • abdominal, bone, soft tissue masses
  • scrotal masses that dont transilluminate
  • urinary retention
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7
Q

tumor location and ddx

A

table 3

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8
Q

incidence of brain and spine tumors is highest in __

A

infants and children <5

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9
Q

brain tumors accg to cell origin

A
  • neuroepithelium !!
  • cranial nerves
  • meninges and sella
  • hematopoietic cells
  • germ cells
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10
Q

brain tumors by age

A

1st year: supratentorial tumors (choroid plexus tumors and teratomas)

1-10 yo: infratentorial tumors (medulloblastoma and pilocytic astrocytoma)

> 10 yo: supratentorial tumors (diffuse astrocytoma!!)

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11
Q

most common malignant brain tumor of childhood, most common primary brain tumor age 0-4

A

medulloblastoma

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12
Q

most common location of brain tumors

A

infratentorial area

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13
Q

most common symptoms reported by children

A

headaches, but presence of headache alone should not be a red flag for diagnosis

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14
Q

red flag signs for headache

A

read

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15
Q

structures in the supratentorial region

A
  • optic pathway
  • pineal region
  • suprasellar region
  • third ventricular region
  • hypothalamic or pituitary
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16
Q

presentation of supratentorial involvement

A
  • focal motor weakness
  • focal sensory changes
  • language disorders
  • focal seizures
  • reflex asymmetry
  • infants: premature hand preference
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17
Q

presentation of vetricular system involvement

A

neuroendocrine deficits

  • galactorrhea
  • precocious puberty
  • hypothyroidism
  • subacute development of obesity
  • abnormal linear growth velocity
  • diabetes insipidus
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18
Q

diencephalic syndrome

A

failure to thrive, emaciation despite normal caloric intake, inappropriately normal or happy affect

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19
Q

parinaud syndrome

A
  • paresis of upward gaze
  • pupillary caliber reactive to accomodation but not to light
  • nystagmus to convergence
  • eyelid retraction
20
Q

classic symptoms of infratentorial tumor

A

headache, nausea, vomiting, papilledema

21
Q

most common pediatric brain tumor

A

astrocytoma

22
Q

pilocytic vs diffuse s pilomyxoid astrocytoma

A

read

23
Q

management of low grade astrocytoma

A

main is surgical, rad/chemo if needed or recurrence

good outcome

24
Q

types of high grade astrocytoma

A

anaplastic ang glioblastoma

25
Q

location of ependymoma

A

infratentorial

26
Q

subtypes of ependymoma

A

cellular !!
anaplastic
myxopapillary

27
Q

management of ependymoma

A

surgery!, radiation, chemo

younger = poorer outcomes
posterior fossa or infratentorial = poorer outcomes

28
Q

most common cns tumors in children <1 yo

A

choroid plexus tumors

29
Q

clinical course of choroid plexus tumors

A

increased icp, macrocephaly, focal neurologic defects

30
Q

subtypes of choroid plexus tumors

A

choroid plexus papilloma, atypical choroid plexus papilloma, choroid plexus carcinoma

31
Q

t/f all variants of embryonal tumors are grade 4

A

true

  • supratentorial pnet
  • ependymoma
  • medulloepithelioblastoma
  • atypical teratoid or rhabdoid tumor
32
Q

most common group of malignant cns tumors of childhood

A

embryonal tumors

33
Q

what is craniophayngioma

A

read

  • endocrinologic abnormalities
  • visual changes
34
Q

management of brainstem tumors

A

radiation therapy, chemo has no benefit

35
Q

most important prognostic factor in brainstem tumors

A
  • location of lesion
  • structures being compressed
  • infiltrates
  • survival is 12 mos
36
Q

subtypes of brainstem tumors

A
  • focal brainstem tumor
  • dorsal exophytic brainstem tumor
  • cervicomedullary tumor
  • diffuse intrinsic pontine glioma
37
Q

most common site of origin of germ cell tumors

A

pineal gland

38
Q

clinical course of germ cell tumors

A
  • insidious course

- headache, parinaud syndrome, di, precocious puberty, ataxia, hemiparesis

39
Q

subtypes of germ cell tumors

A
  • secreting germinoma

- nongerminomatous tumors (tumor markers!! afp and bhcg)

40
Q

subtypes of pineal parenchymal tumors

A
  • pineoblastoma
  • pineocytoma

multimodal approach

41
Q

most common intraocular tumor in children

A

retinoblastoma, average age is 2 yo

42
Q

histology in retinoblastoma

A

flexner winetsteiner rosettes, necrosis, calcification

43
Q

clinical manifestation of retinoblastoma

A
  • leukocoria
  • strabismus
  • dec visual acuity
  • orbital inflammation
  • hyphema
  • vitreous hemorrhage
  • pain
44
Q

diagnosis of retinoblastoma

A
  • directed opthalmoscopy
  • ct/mri/uts
  • clinical
    BIOPSY CONTRAINDICATED
  • lumbar puncture
  • bone scan
  • bone marrow biopsy
45
Q

t/f in retinoblastoma, primary goal is cure, secondary goal is preserving vision

A

true

14 Onco (27 decks)

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