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Lifespan > Pediatric Oncology > Flashcards

Pediatric Oncology Flashcards

1
Q

Risk factors

A 
Largely unknown (ALL)
Genetic abnormalities
AIDS
Ionizing radiation exposure
Chemo and radiation
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2
Q

Leukemia

A

Most common cancer in children

Malignancy of WBCs

2-5 years

2 types - ALL, AML

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3
Q

Leukemia name

A

Based on cell type

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4
Q

Leukemia symptoms

A

Easy bruising
Pallor
Bone and/or joint pain
Lymphadenopathy

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5
Q

Leukemia dx

A

Bone marrow aspiration/biopsy

Lumbar puncture

Peripheral blood smear

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6
Q

Leukemia Prognosis

A

Based on…

WBC count
Age
Cytogenetics
Immunology
Response to initial treatment
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7
Q

Leukemia tx

A

Chemo - three phases
Radiation
SCT

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8
Q

Sanctuary sites

A

Where cancer can hang out dormant

CNS
Testicular involvement

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9
Q

Leukemia chemo phases

A

Induction
Consolidation
Delayed Intensification
Maintenance

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10
Q

Induction

A

Intense
Often admitted for induction
Pushes into remission

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11
Q

Brain tumors

A

2nd most common pediatric cancer

Astrocytoma
Medulloblastoma
Ependymoma

Peak incidence 5 years old

Leading cause of childhood cancer related death

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12
Q

Most common location of brain tumors

A

Posterior fossa

Cerebellum
4th ventricle

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13
Q

Tentorium

A

layer of connective tissue that defines cerebellum below cerebrum

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14
Q

Glioma/astrocytoma

A

Inoperable

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15
Q

Ependymoma

A

Surgery through the nose

We usually don’t see full resections

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16
Q

Brain tumor symptoms

A 
Headache
Double vision
NV
Irritability
Sleep difficulties
Changes in personality/behavior
Impaired concentration
Memory loss
Problems with reasoning
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17
Q

Cerebellum location specific

A

Clumsiness
Difficulty with coordination

Medulloblastoma

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18
Q

Ventricle location specific

A

Increased head size before 2 years

Ependymoma

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19
Q

Brainstem location specific

A

Facial droop
Difficulty swallowing
Slurred speech

Glioma
Astrocytoma

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20
Q

Brain tumor dx

A

Imaging

Biopsy

21
Q

Brain tumor prognosis

A

Overall 70%

Brainstem no good
Medulloblastoma easily operable
A/M varies

22
Q

Brain tumor treatment

A 
Chemo
Radiation
Surgery
Steroids
Anti-convulsants
23
Q

Anti-convulsants

A

Cause major swelling and steroid-induced myopathy

24
Q

Neuroblastoma

A

Most common solid, extracranial tumor in children

Children under 1 year

Comprises 15% all cancer related deaths

25
Q

Primary tumor location Neuroblastoma

A

Nerve root
SC

Anywhere in the sympathetic nervous system

  • Adrenal glands
  • Sympathetic ganglia

Widely disseminated disease

26
Q

Neuroblastoma symptoms

A

Reflect location of tumor

Lump in abdomen, chest, neck
Dark circles around eyes
Bone pain
Swollen stomach
Labored breathing in infants
Painless, bluish lumps under skin
Weakness, paralysis

Increased catecholamine release

Some may be asymptomatic

27
Q

Blueberry spots

A

You’ll see them on the palms of the hands and soles of the feet

28
Q

Diagnosis Neuroblastoma

A

MIBG scan

24-hour urine collection

29
Q

MIBG scan

A

Dx neuroblastomas

Marker that binds to tumor and makes it light up

30
Q

Neuroblastoma low risk tx

A

Observation vs surgery only

31
Q

Neuroblastoma moderate risk tx

A

Surgery

Moderate intensity chemo

32
Q

Neuroblastoma high risk tx

A 
Chemo
Surgery
High dose chemo
Hematopoietic Stem Cell Rescue
Radiation
Clinical trials
33
Q

Sarcoma

A

Unclear etiology

Rapid bone growth
-Adolescent growth spurt

Occurs at an earlier age in girls

34
Q

Sarcoma tumor location

A

Metaphyseal plate

35
Q

Osteosarcoma

A

Primary malignant bone tumor

Most common bone cancer in children and adolescents

13-16 years of age

36
Q

Primary tumor location Osteosarcoma

A

Long bones…

Distal femur
Proximal tibia
Proximal humerus

Less common sites…

Pelvis
Jaw
Fibula
Ribs

37
Q

Ewing’s sarcoma

A

Second most common primary bone tumor

Peak incidence 10-15

38
Q

Primary tumor location Ewing Sarcoma

A

Can occur in flat and long bones

Primary sites…

LE
Pelvis
Chest wall
UE
Spine
Skull
39
Q

Bone cancer symptoms

A

Localized pain…

Awakens at night
Increases with WB
Constant

Swelling

Palpable mass

Fracture

40
Q

Bone cancer diagnosis

A 
xray
MRI
CT scan
Biopsy
Bone marrow aspirate
41
Q

Bone cancer biopsy

A

CT guided core needle biopsy

Open biopsy - taking out whole thing while we’re in there

42
Q

Bone cancer prognosis

A

Based on…

Site and size of primary tumor
Presence of METs
Response to initial therapy
Age at dx

43
Q

Bone cancer tx

A

Chemo - before and after sx
Radiation
Surgery

44
Q

Neoadjuvant

A

Before surgery chemo in bone cancer

45
Q

Adjuvant

A

After surgery chemo in bone cancer

46
Q

Rotationplasty

A

Tumor resection
Spared neurovascular bundle
Use of ankle joint as knee joint with prosthesis

47
Q

Expandable Prosthesis

A

For kiddos in FIRST growth spurt

Under high-powered magnet, they can expand the prosthesis

Allows for continued limb growth

48
Q

Epiphysiodesis

A

Halting growth on the other side

For kiddos in their LATER growth spurt

49
Q

Incidence of Childhood Cancer

A

Leukemia

Lymphoma

Lifespan (18 decks)

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