Pediatrics: Leukemia/Lymphoma

Question 1

what is the most common childhood cancer?

Answer 1

ALL

Question 2

A patient presents with:

Anemia Sxs
Petechiae, purpura
Bone Pain
Hepatosplenomegaly
LAD

What is this concerning for?

Answer 2

ALL

Question 3

the following labs are indicative of:

CBC:
-pancytopenia

Peripheral smear:
-lymphoblasts

Bone Marrow Biopsy:
-lymphoblasts

Answer 3

ALL

Question 4

This leukemia is treated with:

Multi-drug chemo x 2-3 yrs
HSCT

Answer 4

ALL

Question 5

A patient with ALL is presenting with:

Hyperkalemia
Hyperuricemia
Hyperphostphatemia

This is concerning for?

Answer 5

Tumor Lysis Syndrome

Question 6

A patient presents with:

Anemia S/S
HA
AMS
CN Palsy

This is concerning for what?

Answer 6

AML

Question 7

Aeur rods on peripheral smear indicate…

Answer 7

AML

Question 8

20% myeloblasts on bone marrow biopsy indicates…

Answer 8

AML

Question 9

Profound Leukocytosis (> 100k) is emergent in what condition?

Answer 9

AML

Question 10

What 2 therapies treat AML?

Answer 10

chemo

HCT

Question 11

A patient presents with:

Massive Splenomegaly
Hepatomegaly
Fever
Night Sweats
Fatigue

This is concerning for

Answer 11

Late stage CML

Question 12

A patient presents with the following lab findings:

CBC:

• Anemia
• thrombocytosis
• Profound Leukocytosis

Peripheral Smear:

• Myeloid cells in all stages of development
• 20% blasts

Answer 12

CML

Question 13

What test is diagnostic for CML?

Answer 13

Philadelphia Chromosome

Question 14

What does the treatment regimen for CML look like?

Answer 14

Control with Tyrosine Kinase Inhibitor

Cure with HCT

Question 15

The following presentation is concerning for what?

Hx of EBV

Painless Cervical/Supraclavicular LAD

B Sxs

Mediastinal Mass

Answer 15

Hodgkin lymphoma

Question 16

What should you expect to see on biopsy in hodgkin lymphoma?

Answer 16

Reed Sternberg Cells

Question 17

How is Hodgkin Lymphoma Treated?

Answer 17

Chemo/Radiation

Autologous HCT

Question 18

A patient presents with:

Rapid Onset of sxs
Non-tender, enlarging LAD
B-sxs
Hepatosplenomegaly

This is concerning for?

Answer 18

non-Hodgkin Lymphoma

Question 19

What is an ED precaution for non-hodgkin lymphoma?

Answer 19

tumor lysis syndrome

Question 20

What is the treatment regimen for non-hodgkin lymphoma?

Answer 20

chemo

Autologous or allogenic HCT if relapse

Question 21

A patient with the following presentation is concerning for…

Increased head circumference
AM Headache
vomiting
Papilledema

Answer 21

Brain tumor

Question 22

What is the preferred imaging modality for brain tumors, but what is often used instead with pediatric patients becasue it is faster?

Answer 22

MRI preferred

CT faster

Question 23

A brain tumor is definitively diagnosed with…

Answer 23

tissue biopsy

Question 24

Astrocytoma and ependymoma are what type of tumor?

Answer 24

glial

Question 25

What is the tx of choice for brain tumor?

Answer 25

surgical resection

Question 26

A patient presents with: Firm, Fixed abdominal mass that crosses midline Fever Weight Loss Irritibility

Answer 26

Neuroblastoma

Question 27

What is the MC non-CNS solid neoplasm?

Answer 27

neuroblastoma

Question 28

A patient with elevated urinary catecholamines should be concerning for...

Answer 28

neuroblastoma

Question 29

What is the treatment of choice for neuroblastoma?

Answer 29

surgical resection and chemo

Question 30

A patient presents with: Asymptomatic abdominal mass that doesn't cross midline Fever Hematuria HTN this presentation is concerning for...

Answer 30

nephroblastoma (Wilm's Tumor)

Question 31

What imaging modalities can be helpful for nephroblastoma (Wilm's Tumor)?

Answer 31

Abd. US Abd. CT Chest CT

Question 32

What is definitively diagnostic for nephroblastoma?

Answer 32

biopsy/excision

Question 33

What is the tx of choice for nephroblastoma (Wilm's Tumor)?

Answer 33

Surgical Exploration Chemo/Radiation

Question 34

What is the most common bone tumor, especially common in boys 13-16 yo?

Answer 34

Ostoesarcoma

Question 35

A patient presents with: Bone pain Soft tissue mass Antalgic Gait

Answer 35

Osteosarcoma

Question 36

Where is the common site of osteosarcoma?

Answer 36

metaphysis of long bones

Question 37

An x-ray shows the following: Irregular margins Trabecular pattern. This should be concerning for...

Answer 37

osteosarcoma

Question 38

A patient with the following presentation is concerning for what? ``` Pain in long-bones or pelvis Worsening, local pain Pain worse at night Fatigue Fever Weight Loss ```

Answer 38

Ewing Sarcoma

Question 39

What confirms ewing sarcoma?

Answer 39

biopsy

Question 40

A patient < 5 yo presents with: Leukocoria Inflamed eye

Answer 40

Retinoblastoma

Question 41

How is retinoblastoma diagnosed?

Answer 41

ophthalmalic exam under anesthesia

Question 42

Can you do biopsy in suspected retinoblastoma

Answer 42

no

Question 43

What tx is used for retinoblastoma?

Answer 43

external beam radiation

Question 44

A patient < 6yo with the following presentation should be concerning for... Painless enlarging mass proptosis/exopthalmos hematuria Urinary obstruction pelvic mass

Answer 44

Rhabdomyosarcoma

Question 45

A patient presents with: Enlarging Abdomen Elevated AFP This is concerning for...

Answer 45

Hepatic Tumor

Question 46

What is the essential treatment for surviving hepatic tumors?

Answer 46

complete resection of tumor