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Clin Med IV: Pediatrics > Pediatric Oncology > Flashcards

Pediatric Oncology Flashcards

1
Q

What is the most common pediatric cancer

A

Leukemia
(A.L.L.)

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2
Q

what is the second most common cancer in kids

A

Brain/CNS

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3
Q

What are signs and symptoms of pediatric cancers

A

non-specific
fever, malaise
headache
lymphadenopathy

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4
Q

What are red flags for pediatric cancer

A

unexplained weight loss
HTN
persistent adenopathy
HA with vomiting in AM
Abnormal neuro exam
afebrile seizure
dilated pupil, white spot in the pupil
sudden onset of excessive bruising/bleeding
persistent swelling/pain in a limb

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5
Q

where does a neuroblastoma arise

A

adrenal medulla or less often sympathetic nervous system (Abdomen, chest, neck)

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6
Q

what cancer is most common in infants under age of 1

A

neuroblastoma

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7
Q

how is diagnosis confirmed with neuroblastoma

A

biopsy

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8
Q

what is the treatment of neuroblastomas

A

surgical resection
chemo
raditation
high-dose chemo with stem cell transplant
cis-retinoic acid
immunotherapy

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9
Q

what is the median age of diagnosis of neuroblastomas

A

17 months

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10
Q

What is the presentation of neuroblastomas

A

abdominal pain
discomfort
sense of fullness due to abdominal mass
mets: bone pain, periorbital ecchymosis and proptosis, abd distention

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11
Q

Whatis opsoclonus-myoclonus

A

dancing eyes and dancing feet (paraneoplastic syndrome)

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12
Q

what other tests need to be completed when there is concern for Neuroblastomas

A

Urinary vanillylmandelic acid (VMA) or Homovanillic acid (HVA) or both: elevated in >90% of patients

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13
Q

What is Stage IVS Neuroblastoma

A

localized primary tumor with dissemination limited to skin, liver and/or bone marrow in infant younger than 1 year of age

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14
Q

What are good prognositc factors with neuroblastomas

A

limited stage
younger age
4S disease

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15
Q

what is wilms tumor

A

AKA nephroblastoma
embryonal cancer of kidney composed of blastemal, stromal and epithelial elements

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16
Q

how is wilms tumor diagnosed

A

US, ABD CT/MRI

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17
Q

what is the treatment of Wilms tumor

A

surgical resection
chemo
radiation

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18
Q

when is wilms tumors most common

ages

A

< 15 years old
usually manifests age < 5 years

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19
Q

What is the presentation of wilms tumor

A

painless, palpable, abdominal mass

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20
Q

What are risk factors for CNS malignancies

A

cranial irradiation
genetic/familial syndromes (neurofibromatosis, tuberous sclerosis., etc)

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21
Q

When is imaging considered for CNS malignancy

A

persistent headache (> 4weeks)
persistent vomiting upon waking
visual finding
motor findings

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22
Q

What is the imaging of choice for CNS malignancies

A

MRI (best - requires sedation, takes longer)
CT -initial

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23
Q

what is a cancer arising from immature retina

A

retinoblastoma

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24
Q

what are signs/symptoms of retinoblastomas

A

common leukocoria, stabismus; less often, inflammation, impaired vision

25
Q

What is leukocoria

A

white reflex in the pupil

25
Q
A
26
Q

How are retinoblastomas diagnosed

A

opthalmoscopic exam; US, CT or MRI

27
Q

what is the treatment of retinoblastomas

A

small CA, bilat: photocoagulation, cryotherapy, radiation
Advanced, larger CA: Enucleation and occasioanl chemotherapy

28
Q

when are retinoblastomas typically diagnosed

A

< 2 years of age

29
Q

What is Rhabdomyosarcoma

A

Childhood cancer that arises from embryonal mesenchymal cells that have potential to differentiate into skeletal muscle cells
can arise from almost any type of muscle tissues in any location. resulting in highly variable clinical manifestations

30
Q

how is rhabdomyosarcoma categorized

A

soft tissue sarcoma; most common cancer in this group

31
Q

what populations are rhabdomyosarcoma more common in

A

whites > blacks
Boys > girls

32
Q

Where is rhabdomyosarcoma found

A

can occur almost anywhere in the body:
Head and neck region, GU, Extremities, Trunk/Miscellaneous sites

33
Q

what is the presentation of rhabdomyosarcoma

A

firm, palpable mass OR with organ dysfunctiond ue to impingement on organ by cancer
orbital and nasopharyngeal: tearing, eye pain, proptosis
GU: abdominal pain, mass, difficulty urinating, heaturia

34
Q

How is rhabdomyosarcoma diagnosed

A

CT; head and neck lesions better defined by MRI
confirmed with biopsy or excision

35
Q

What is the treatment of rhabdomyosarcoma

A

surgery, chemo, sometimes radiation

36
Q

when do osteosarcomas peak

A

Adolescence-growth spurt (may also occur in older adults)

37
Q
A
38
Q

what are risk factors for osteosarcoma

A

prior cancer or cancer treatments

39
Q

What is the presentation of osteosarcomas

A

pain, limp swelling

40
Q

where are osteosarcomas located

A

metaphysis of long bones
distal femur
proximal tibia
proximal humerus

41
Q

what is the “sunburst pattern” on x-ray associated with

A

Osteosarcoma

42
Q

what is the treatment of osteosarcoma

A

surgery and chemo

43
Q

what is Ewing sarcoma

A

believed to be neural crest cells in origin
mostly occur in bone, but can be extra-osseous
peak in adolescent; dose not occur in older adults

44
Q

where are Ewing sarcomas likley located

A

Axial skeleton
pelvis
femur

45
Q

What is the presentation of Ewing sarcoma

A

pain and swelling
can have systemic complaints:
fatigue, weight loss, fever, anemia

46
Q

what is seen on x-ray with ewing sarcoma

A

“moth eaten”
“onion skinning”

47
Q

What is the treatment of ewing sarcoma

A

chemo, radiation, surgery

48
Q

what is the most common pediatric cancer

A

ALL
(acute lymphoblastic leukemia)

49
Q

What are symptoms of ALL

A

fatigue, pallor, infection, bone pain, CNS symptoms , easy brusing, and bleeding

50
Q

How is ALL diagnosed

A

Peripheral blood smear and bone marrow

51
Q

What are the risk facotrs in children for ALL

A

exposure to Ionizing radiation
genetic syndromes (DOwns, neuofibromatosis)

52
Q

What is the treatment of ALL

A

sysetmic chemo
prophylactic CNS chemo and sometimes CNS radiation
supportive care
maybe immunotherapy, targeted therapy, stem cells transplantation, and or radiation

53
Q

What are the phases of chemotherapy for ALL

A
  1. remission induction
  2. post-remission consolidation
  3. interim mainenance and intensification
  4. maintenance
54
Q

What is the goal of induction treatment for ALL

A

complete remission

55
Q

how long is the induction phase of chemotherapy for ALL

A

4 weeks

56
Q

how long is consolidation chemotherapy for ALL

A

4- 6 months

57
Q

How long is maintenance chemotherapy for ALL

A

24-36 months

Clin Med IV: Pediatrics (16 decks)

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