Pediatric Oncology Flashcards

Question

Signs of Bone Tumors

Answer 1

``` Pain Tenderness Limp Soft tissue mass Night pain "Growing pains" History of minor trauma Pathologic fracture ```

Answer 2

Precursor B cell (B-ALL) Burkitts (mature B-ALL) T cell (T ALL)

Answer 3

Marrow with 20+% blasts, prior therapy, Down syndrome, MDS, cytogenetics

Answer 4

``` Li Fraumeni Ataxia Telangectasia Neurofibromatosis Bloom Syndrome Klinefelter's Ataxia telangectasia Wiskott aldrich syndrome Chronic immunosuppression AIDS ```

Answer 5

``` Bone pain Adenopathy Hepatosplenomegaly Thymic expansion CNS symptoms Testicular involvement ```

Answer 6

Expansion of marrow cavity | May stop walking or favor the painful site

Answer 7

Headache Neck pain CN palsy Seizure

Answer 8

Painless Enlarged Usually rock hard Confirm with biopsy

Answer 9

``` WBC- high, normal, low Decreased neutrophil # Risk of tumor lysis syndrome Hyperleukocytosis Decreased platelets Decreased RBCs ```

Answer 10

``` Leukemia Aplastic anemia Metastatic solid tumor Myelodysplastic syndrome hemophagocytic lymphohistiocytosis Infection, post infectious Lupus Hypersplenism B12 or Folate deficiency ```

Answer 11

``` Leukemia (AML, ALL) Hepatitis associated aplastic anemia Metastatic solid tumor MDS HLH SLE ```

Answer 12

``` Infection ALL Thyrotoxicosis Neutropenias Addison's Disease ```

Answer 13

``` Infection Metastatic disease Leukemia Lymphoma Autoimmune disease ```

Answer 14

``` CBC with diff Peripheral smear Bone marrow aspirate LP Flow cytometry Morphology Cytogenetics Sanctuary Sites Testicular exam ```

Answer 15

``` 4 weeks- 3 drugs 4 week- oral with IT 8 week interim maintenance 8 week delayed intensifications 2nd interim maintenance Maintenance (2+ years) ```

Answer 16

``` 4 weeks- 4 drugs 8 weeks- IV consolidation 8 week interim maintenance 8 week delayed intensification 2nd interim maintenance Maintenance (2+ years) ```

Answer 17

Site of relapse important Time to relapse important Age at initial diagnosis Genetic features

Answer 18

``` Fever Bone pain LAD HSM Extra medullary disease Chloromas Sepsis Hyperleukocytosis Anemia Thrombocytopenia Hemorrhage DIC ```

Answer 19

Based on cytogenetics | Down syndrome

Answer 20

Remission induction- 2 courses intense chemo Post remission consolidation- transplant high risk; 2 courses intense chemo CNS prophylaxis- weekly IT chemo until cleared No maintenance No irradiation

Answer 21

Painless lymphadenopathy, mediastinal mass, and/or constitutional symptoms

Answer 22

Weight loss Drenching night sweats Unexplained fevers for 3+ days

Answer 23

``` Fatigue Anorexia Mild weight loss Pain following ETOH ingestion Pruritis ```

Answer 24

Elevated inflammatory markers Anemia of chronic inflammation Possible immune dysregulation

Answer 25

``` Normal thymus INfection Lymphoproliferative disorder Progressive transformation of germinal centers NHL Germ cell tumor Soft tissue sarcoma Metastasis ```

Answer 26

Multimodal- chemoradiation | Risk adapted

Answer 27

White male children

Answer 28

EBV Immunodeficiency Immunosuppression Pesticides

Answer 29

``` Compression of airway Pulmonary effusions SVC syndrome Tamponade Arrhythmia Paraspinal/epidural mass Electrolyte abnormalities Organ failure GI obstruction Intussusception Bleeding Perforation Jaundice Pancreatitis Cytopenias ```

Answer 30

``` Jaw swelling Abdominal swelling Orbital swelling Paraspinal mass CNS/marrow involvement ```

Answer 31

``` Rapidly expanding abdominal mass Spontaneous tumor lysis Non-specific GI symptoms CNS involvement Marrow infiltration ```

Answer 32

Extranodal involvement- bowel, mesentery, retroperitoneum

Answer 33

``` Mediastinal mass Pleural/pericardial effusion Pain Dysphagia Dyspnea ```

Answer 34

Slowly progressive Systemic symptoms Organs & skin can be involved

Answer 35

Depends on type All receive chemo Most DO NOT receive radiation

Answer 36

Survival rate high

Answer 37

Neuroblastoma

Answer 38

``` Coincidental finding Neck mass GU symptoms Neurologic abnormalities Paraneoplastic syndromes Malaise Irritable Weight loss Anorexia Pain Abdominal distension Proptosis Raccoon eyes Fever Respiratory distress ```

Answer 39

``` CT spine MRI spine Bon marrow biopsy Radiolabelled MIBG Catecholamine metabolites Tumor biopsy ```

Answer 40

``` Age >18 months Advanced stage disease Myc-N amplification Poorly or undifferentiated tumor histology Diploid DNA content ```

Answer 41

Aniridia Hemi-hypertrophy GU malformation Malformation of any type Genetic predisposition: WAGR, Beckwith Wiederman, Denys-Drash Syndrome, Perlman syndrome, Sotos syndrome, Simpson-Golabi-Behmel

Answer 42

``` Asymptomatic upper abdominal mass Abdominal pain Fever Anemia Hematuria Hypertension Family hx Congenital defects ```

Answer 43

``` CBC UA BUN Cr Total bilirubin Alkaline phosphatase Albumin SGPT ```

Answer 44

Resection CT chest Abdominal ultrasound CT abdomen

Answer 45

Clear cell sarcoma of the kidney Rhabdoid tumor Renal cell carcinoma Congenital Mesoblastic nephroma

Answer 46

``` Stage 1: confined to kidney Stage 2: confined to renal fossa Stage 3: gross residual disease Stage 4: disseminated Stage 5: bilateral tumors ```

Answer 47

``` Stage Histology Gene expression profile Tumor size Age >2 is worse ```

Answer 48

Surgical resection Multiagent chemo Radiation for higher stages Higher stages get more intense therapy

Answer 49

``` Leukocoria Strabismus Nystagmus Buphthalos Glaucoma Periorbitalcellulitis Proptosis + LN Mets ```

Answer 50

``` Exam under anesthesia Ocular ultrasound MRI orbits & brain Bone scan, bone marrow & CSF for advanced disease Genetic counseling ```

Answer 51

``` Congenital cataracts Coats' disease Persistent fetal vasculature Retinitis Medulloepithelioma Astrocytic hamartoma Choroidal osteoma ```

Answer 52

Multiple staging systems | Treatment individualized

Answer 53

Cure Eye salvage Vision preservation

Answer 54

``` High risk histology Massive choroidal replacement Ciliary body or iris involvement Optic nerve extension Extra CNS disease CNS disease- dismal prognosis No CNS disease- survival good ```

Answer 55

``` Ependymoma High grade glioma Germ cell tumor Medulloblastoma Pilocytic astrocytoma ```

Answer 56

Epithelial tumor Arises from Rathke cleft Cystic appearance with solid component Treatment: surgery & radiation

Answer 57

``` Hypothyroid Obesity DI Amblyopia Temporal hemianopsia Blindness Optic atrophy Headache N/V Papilledema ```

Answer 58

Headache N/V Papilledema

Answer 59

``` Headache Ataxia Nystagmus Seizure Increased head circumference ```

Answer 60

Pilocytic Astrocytoma

Answer 61

Chronic back or neck pain Scoliosis Progressive weakness

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Pediatric Oncology Flashcards

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