Pediatric Oncology

Question 1

what are 7 common presenting signs and symptoms of cancer

Answer 1

1. wt loss
2. ftt
3. anorexia
4. malaise
5. fever
6. LAD
7. pallor

Question 2

what is the most common form of pediatric ca

Answer 2

ALL (Acute Lymphocytic Leukemia)

Question 3

when you see LAD, HSM, and fever, think

Answer 3

ALL

Question 4

what type of cancer is characterized by lymphoblasts overproduced in the bone marrow

Answer 4

ALL

Question 5

what are 3 useful tests in ALL dx

Answer 5

CBC w. differential

peripheral smear

bone marrow aspiration

Question 6

when you see anemia, thrombocytopenia, and blasts on peripheral smear, think

Answer 6

ALL

Question 7

what is the definitive dx for ALL

Answer 7

bone marrow aspiration

Question 8

what is the treatment of choice for ALL

Answer 8

chemo (determined by phenotyping)

Question 9

what is the 2nd most common form of pediatric ca

Answer 9

CNS tumors

Question 10

what is the most common symptom of CNS tumors

Answer 10

HA

Question 11

what are 3 other common symptoms of CNS tumors besides HA

Answer 11

AM vomiting

macrocephaly

papilledema

sz

Question 12

what is the preferred diagnostic test for CNS tumors

Answer 12

MRI followed by bx

Question 13

what is the initial tx for CNS tumors

Answer 13

open surgical procedure:

obtain tissue for dx

remove tumor

Question 14

in what pt population should XRT be avoided

Answer 14

<3 yo

Question 15

what is leukocoria

Answer 15

absent red reflex

Question 16

__% of retinoblastomas are heritable

Answer 16

50

Question 17

heritable retinoblastomas have __ presentation

and __ risk for recurrence

Answer 17

earlier

higher

Question 18

retinoblastomas are __ if not treated

Answer 18

deadly

Question 19

what is the first step in tx of retinoblastomas

Answer 19

optho referral

Question 20

what are some possible tx for retinoblastomas

Answer 20

cryotherapy

chemo

radiation

Question 21

__ is recommended for all retinoblastoma pt’s

Answer 21

molecular genetic testing

Question 22

what is the most common malignancy of bone in peds and adolescents

Answer 22

osteosarcoma

Question 23

when you see, localized bone pain lasting months, think

Answer 23

osteosarcoma

Question 24

what causes the soft tissue mass common in osteosarcoma

Answer 24

tumor grows faster than periosteum can expand

Question 25

what are 2 characteristics of the soft tissue mass commonly seen in osteosarcoma

Answer 25

large ttp

Question 26

what is the most common site of metastasis in osteosarcoma

Answer 26

lung

Question 27

what is the most common cancer post XRT

Answer 27

osteosarcoma

Question 28

what are the most common sites for osteosarcoma to develop

Answer 28

distal femur proximal tibia proximal humerus middle/proximal femur

Question 29

when you see Pageant's Dz and previous radiation, think

Answer 29

osteosarcoma

Question 30

when you see Codman triangle and spiculated sunburst appearance on Xray, think

Answer 30

osteosarcoma

Question 31

what is the 2 diagnostic tests of choice for osteosarcoma (in order)

Answer 31

1. xray 2. followed by bx

Question 32

what is the order of treatment for osteosarcoma

Answer 32

1. preop chemo 2. surgery 3. postop chemo

Question 33

osteosarcoma is resistant to

Answer 33

XRT

Question 34

what are 3 common symptoms of Ewing Sarcoma

Answer 34

1. localized bony pain and swelling x a few months 2. limp 3. fx

Question 35

what are the two most common locations for Ewing Sarcoma

Answer 35

1. long bones 2. pelvis

Question 36

when you see small, round, blue cell tumor, think

Answer 36

Ewing Sarcoma

Question 37

what is sarcoma

Answer 37

a group of cancers that begin in bone and soft tissue

Question 38

what is the diagnostic process for Ewing Sarcoma (4 steps)

Answer 38

1. plain radiograph 2. bx to confirm dx 3. CT/MRI to show area of involvement 4. metastatic work up

Question 39

when you see “onion peel,” “moth eaten/permeative," on radiograph, think

Answer 39

Ewing Sarcoma

Question 40

what are the 3 tx modalities for Ewing Sarcoma

Answer 40

1. chemo (almost all) 2. surgical resection (local control) 3. XRT (local control)

Question 41

what causes the “onion peel” appearance on xray in Ewing Sarcoma

Answer 41

disruption of outer layer of periosteum

Question 42

Wilms Tumor is also called

Answer 42

Nephroblastoma

Question 43

what is the most common renal malignancy in kids

Answer 43

Wilms Tumor (Nephroblastoma)

Question 44

when you see firm, smooth, unilateral, nontender abdominal mass, think

Answer 44

Wilms Tumor (Nephroblastoma)

Question 45

besides abdominal mass, what are some other symptoms of Wilms Tumor (Nephroblastoma)

Answer 45

hematuria fever HTN

Question 46

when you see WAGR syndrome, Denys-Drash syndrome, and Wiedemann syndrome, think

Answer 46

Wilms Tumor (Nephroblastoma)

Question 47

what are the 2 diagnostic modalities of choice for Wilms Tumor (Nephroblastoma)

Answer 47

1. abdominal US -\> also used for screening 2. bx

Question 48

what is the screening modality of choice for Wilms Tumor (Nephroblastoma)

Answer 48

abdominal US

Question 49

all Wilms Tumor (Nephroblastoma) patients receive what 2 treatments

Answer 49

1. surgical resection 2. chemo

Question 50

leukocytes include

Answer 50

basophils eosinophils neutrophils T and B lymphocytes natural killer cells

Question 51

blood stem cells differentiate into \_\_ or \_\_

Answer 51

myeloid stem cells lymphoid stem cells

Question 52

lymphoid stem cells differentiate into

Answer 52

lymphocytes natural killer cells

Question 53

myeloid stem cells differentiate into

Answer 53

RBC granulocytes (BEN) platelets