Peds heme-Onc

Question 1

Aplastic anemia

Answer 1

Eti: failed bone marrow, drug reactions, infections (EBV)
S/sx: Weakness and pallor, petechiae, purpura, and bleeding, frequent/severe infections.
Dx: CBC, bone marrow biopsy
Tx: supportive, abx if indicated, blood transfusion may be necessary

Question 2

Sickle cell

Answer 2

S/sx: first 3-4 months: asymptomatic, moderately severe hemolytic anemia by 1 yo,
- Dactylitis is most common initial symptom. Recurrent abdominal or MSK pain. Acute chest syndrome.
Dx: neonatal screening, CBC (showing normo or macrocytic anemia), blood smear (showing sickle cells and Howell-Jolly bodies)
Tx: daily prophylactic penicillin (2 mos - 5 years). Pneumococcal vaccine. All illness with fever need treated promptly with parenteral broad-spectrum abx.
- Acute episodes need hydration and transfusions.

Question 3

Hemophilia A

Answer 3

Factor 8

Question 4

Von willebrands Disease

Answer 4

Mucosal bleeding…

Tx: DDAVP

Question 5

Hemophilia B

Answer 5

Factor 9

Question 6

Protein C deficiency

Answer 6

sx: VTE, purpura fulminans, retinal thrombosis
Tx: lifelong anticoagulation

Question 7

Idiopathic throbocytopenic purpura

Answer 7

Spleen forms platelet cross-reactive antibodies
Sx: occurs in healthy child usually following infection. Acute onset with appearance of multipe petechiae and ecchmoses, epistaxis

Question 8

Factor V leiden

Answer 8

Sx: VTE, lots of clots

Question 9

Chronic myelogenous leukemia

CML

Answer 9

Epi<5% childhood lleukemia
Age onset >3
S/sx: bone pain, fever, night sweats, fatigue
Dx: CBC - marked leukocytoisis

Question 10

Neuroblastoma

Answer 10

Cancer that develops from immature nerve cells found in sveral areas of the body: adrenal glands and other areas.
s/sx: abd mass, hepatomegaly, fever, bone pain, limp,
Dx: ab ultrasound, CT chest/abd/pelvis

Question 11

Medulloblastoma

Answer 11

15% of brain tumors
HA, vomiting, papilledema, irritability, failure to thrive,
Dx: measure head circumference

Question 12

Acute lymphoblastic leukemia (ALL)

Answer 12

Most common malignancy of childhood

S/sx: intermittent fevers, bruising, pallor, bone pain, HSM petechiae

Question 13

Acute myelogenous leukemia (AML)

Answer 13

S/sx: anemia, pallor, fatigue, bruising, infections
Tx: CBC
Auer Rods

Question 14

Hodgkin lymphoma

Answer 14

S/sx: painless cervial adenopathy, supraclavicular, unilateral
Dx; lymph node biopsy, CT,
Dx: presence of the Reed-Sternberg cells

Question 15

Astrocytoma

Answer 15

MC brain tumor in kids
S/sx: HA, vomiting, papilledema, ataxia
Phys: measure head circumference and observe gait

Question 16

wilms tumor

Answer 16

MC type of kidney cancer in children
Asymptomatic adb mass
Rarely crosses midline

Question 17

Which is more common Wilms tumor or neuroblastoma?

Answer 17

Neuroblastoma is most common abdominal tumor in kids

Question 18

Retinoblastoma

Answer 18

MC intraoccular tumor in kids

S/sx: Leukocoria