Peds Leukemia and Lymph

Question 1

Reassuring qualities of a lymph node

Answer 1

where expected, soft, normal, mobile, not warm, not red, non tender, pt feeling okay

Question 2

Concerning qualities of a lymph node

Answer 2

multiple locations of nodes, very large, matted and “stuck down”, fluctuant, tender, associated with enlarged liver or spleen

Question 3

Hemangioma

Answer 3

most common tumor-like lesions of infancy, can be cavernous or capillary

Question 4

Sturge Weber syndrome

Answer 4

facial port wine stain, leptomeningeal angiomas, developmental delay/intellectual disability

Question 5

Neuroblastoma

Answer 5

tumor of sympathetic ganglia and adrenal medulla, elevated VMA and HVA; blueberry muffin baby

Question 6

Wilms tumor

Answer 6

most common primary renal tumor of childhood, associated with Beckwith-Wiedmann, WAGR syndrome, Denys-Drash syndrome (gonadal dysgenesis)

Question 7

Most common malignancy in kids<10 years old

Answer 7

Leukemia

Question 8

Most common malignancy in adolescents 15-19 yo

Answer 8

Hodgkin lymphoma

Question 9

Retinoblastoma

Answer 9

most common primary ocular malignancy of childhood, begins in the retina

Question 10

Ewing sarcoma

Answer 10

bone or soft tissue around bone, causes chronic bone pain in area of tumor

Question 11

When does physiologic nadir for Hgb in infants occur?

Answer 11

two months

Question 12

What does a low or low-normal RTC count in an anemic patient indicate?

Answer 12

inadequate bone marrow response – bone marrow failure, ineffective erythropoiesis

Question 13

Diamond-Blackfan anemia

Answer 13

congenital pure red blood cell aplasia that presents in infancy

Question 14

Fanconi anemia

Answer 14

most common inherited form of aplastic anemia, macrocytic anemia, leukopenia, thrombocytopenia, increased apoptosis in bone marrow

Question 15

IDA

Answer 15

dietary deficiency in peds, microcytic, hypochromic anemia; pale child that drinks a lot of cow’s milk

Question 16

Mentzer index

Answer 16

MCV/RBC; >13 IDA, <13 thalassemia

Question 17

Absolute neutrophil ct

Answer 17

[(% neutrophils + %bands) x (WBC)] /100

Question 18

Kostmann syndrome

Answer 18

life threatening pyogenic infections early in life, impaired myeloid differentiation caused by maturational arrest of neutrophil precursors, autosomal recessive

Question 19

Cyclic neutropenia

Answer 19

cyclic fever, oral ulcers, gingivitis, peridontal disease, recurrent bacterial infections, stem cell regulatory defect resulting in defective maturation, autosomal dominant

Question 20

Schwachman-Diamond syndrome

Answer 20

neutropenia, exocrine pancreas insufficiency, and skeletal abnormalities; defects in neutrophil mobility, migration and chemotaxis in addition to neutropenia, autosomal recessive

Question 21

Leukocyte adhesion deficiency

Answer 21

delayed separation of umbilical cord stump, recurrent and severe bacterial and fungal infections without pus accumulation, poor wound healing; diminished adhesion to surfaces, autosomal recessive

Question 22

Hyper-Ig E syndrome

Answer 22

severe eczema, recurrent bacterial infections of skin, recurrent pulm infections; defect in chemotaxis of neutrophil, increased IgE, eosinophilia, autosomal dominant

Question 23

Chediak-Higashi syndrome

Answer 23

partial oculocutaneous albinism, neuropathies, recurrent pyogenic infections; defects in chemotaxis and degranulation, ineffective granulopoiesis, autosomal recessive

Question 24

Chronic granulomatous disease

Answer 24

recurrent purulent infections with fungal or bacterial catalase-positive organisms; defect in oxidative metabolism, absent generation of superoxide, X-linked recessive

Question 25

Fifth disease

Answer 25

viral illness associated with viral exanthem 1-2 weeks after infection; results in anemia, neutropenia/thrombocytopenia

Question 26

Number one cause of death due to illness in US

Answer 26

Brain cancer

Question 27

number one cause of death in children

Answer 27

unintentional injuries

Question 28

B-signs used in staging of HL

Answer 28

unexplained fever, wt loss >10% BW over 6 months, drenching night sweats

Question 29

Indications for chest x-ray in pt with LAD

Answer 29

persistent, unexplained LAD unassociated with obvious underlying inflammatory or infectious process, accompanying resp sxs

Question 30

Wiscott-Aldrich

Answer 30

X-linked recessive; recurrent sino-pulm and ear infections, severe atopic dermatitis, bleeding secondary to significant thrombocytopenia; predisposition to B cell lymphoma

Question 31

Plt clount of clinically significant bleed

Answer 31

<20k

Question 32

Plt count of life threatening hemorrhage

Answer 32

<10k

Question 33

Clinical findings consistent with thrombocytopenia

Answer 33

petechiae, purpura, gingival bleeding ,epistaxis, menorrhagia, GI bleed, hematuria, CNS hemorrhage, ecchymosis

Question 34

Immune thrombocytopenic purpura

Answer 34

anti-platelet antibodies, usually <20k, PT/PTT normal

Question 35

Kasabach-Merritt phenomenon

Answer 35

thrombocytopenia and hypo-fibrinogenemia associated with giant hemangioma, associated intravascular coagulation

Question 36

“Red flag” signs and sxs in pts with thrombocytopenia

Answer 36

pancytopenia, raised LDH, associated new renal impairment

Question 37

Hemolytic uremic syndrome

Answer 37

usually presents after gastroenteritis - microangiopathic hemolytic anemia, thrombocytopenia, acute renal damage