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pediatrics II > peds oncology > Flashcards

peds oncology Flashcards

1
Q

What is the most common pediatric CA

A
  • acute lymphoblastic leukemia
  • occurs more in kids (80%), adults (20%)
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2
Q

uncontrolled proliferation of malignant lymphoid precursor clone causes what type of CA

A
  • acute lymphoblastic leukemia
  • *lymphoid precursor clone -> unable to mature
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3
Q

acute lymphoblastic leukemia is stained with

A

TdT

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4
Q

What is the median age of people affected with acute myeloid leukemia

A
  • more common in adults, median age 65
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5
Q

uncontrolled proliferation of malignant myeloid precursor clone causes which type of CA

A

acute myeloid leukemia

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6
Q

acute myeloid leukemia is stained with

A

myeloperoxidase

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7
Q

presence of Auer rods is pathognomonic for what condition

A

acute myeloid leukemia

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8
Q

Name causes of leukemia

  • exposure
  • acquired disorders
  • genetics
  • infection
A
  • exposure: radiation, chemo
  • acquired disorders: MDS, myeloma
  • genetics: down’s syndrome, Neurofibromatosis, Klinefelter syndrome
  • infection: human T cells leukemia virus
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9
Q

acute leukemias will have what similar hallmark presentation on labs

A
  • pancytopenia with circulating blasts (immature cells)
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10
Q

what symptom can help differentiate between acute leukemia and aplastic anemia since both present with pancytopenia

A
  • bone pain
    • acute leukemias will have expansion of bone into bone marrow due to the presence of growing number of immature cells that will cause pain -> hyperplastic
    • aplastic anemia does not have blasts
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11
Q

Why can ALL present with thymic mass

A

T lymphocytes mature in the thymus

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12
Q

CNS involvement is more typical of which acute leukemia

A

ALL

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13
Q

what are the typical signs and symptoms of acute leukemia

A
  • anemia - pallor, tachycardia, SOB
  • thrombocytopenia - ecchymosis
  • neutropenia - fever and infection
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14
Q

What is leukostasis? treatment?

A
  • aka symptomatic hyperleukocytosis
    • WBC > 100,000/μL which causes hyperviscosity symptoms
      • dyspnea, HA, confsion
      • It is most often seen in leukemia patients
  • treatment: hydration and leukapharesis
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15
Q

how is acute leukemia diagnosed

A
  • bone marrow biopsy showing > 20% blasts
  • **Presence of t(8,21), inversion (16), t (16,16), and t (15,17) have AML regardless of blast percentage
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16
Q

why is it important to check a uric acid level

A
  • disease processes that cause a high proliferation of cells will cause uric acid dump which can destroy the kidneys
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17
Q

What can be given to patients with acute leukemia to reduce risk of tumor lysis syndrome: which is characterized by rapid development of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and acute renal failure.

A
  • Allopurinol and Rasburicase will lower uric acid
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18
Q

what is tumor lysis syndrome

A
  • constellation of metabolic disturbances that may follow the initiation of cancer treatment
    • hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia
    • -> acute renal failure
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19
Q

myeloproliferative neoplasm caused by dysregulation and unregulated proliferation of mature granulocytes

A

chronic myeloid leukemia

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20
Q

median age of people affected with chronic myeloid leukemia

A
  • 45-55
    • 15-50% of all leukemias in adults
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21
Q

striking feature of chronic myeloid leukemia in CBC

A

WBC found to be strikingly elevated

  • pt may be asymptomatic
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22
Q

cause of chronic myeloid leukemia

A
  • translocation of chromosome 9 (ABL) and 22 (BCR)
    • creates an oncogene that leads to the proliferation of granulocytes (neutrophils, eosinophils, basophils, and commonly platelets)
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23
Q

how is CML diagnosed

A
  • bone marrow biopsy
  • peripheral blood work for BCR/ABL via FISh or PCR
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24
Q

treatment of CML

A
  • Gleevec
  • Hydrea- given initially to bring down WBC if too high
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25
Q

diverse group of malignant lymphoproliferative neoplasms of lymphoid tissue derived from B-cell progenitor clone

A

non-hodgkins lymphoma

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26
Q

what is the 5th most common pediatric CA in children

A

non-hodgkins lymphoma

  • affects children < 15yo
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27
Q

clonal lymphoproliferative disorder with presence of reed sternberg cells

A

Hodgkin’s lymphoma

28
Q

Hodgkin’s lymphoma has bi-modal distribution and usually affects people ages 20-30s and 50s. If it does affect children, what age group is normally affected?

A

15-19 yo

29
Q

exposure to what virus may increase risk of getting Hodgkin’s lymphoma

A

ebstein barr virus

30
Q

painful adenopathy after ETOH consumption is seen with which condition

A

Hodgkin’s lymphoma

31
Q

painless and persistent lymphadenopathy is seen in

A

lymphomas

32
Q

supraclavicular nodes are commonly affected in which type of lymphoma?

A

Hodgkin’s lymphoma

33
Q

what classifies as Stage 1 lymphoma

A
  • one area of nodes
34
Q

what classifies as Stage II lymphoma

A

two areas of nodes on ONE side of the diaphragm

35
Q

what classifies as Stage III lymphoma

A

nodal sites on BOTH sides of diaphram

36
Q

what classifies as Stage IV lymphoma

A

involvement to extranodal sites (bone marrow)

37
Q

Describe the A, B, E staging of lymphoma

A
  • A: no night sweats, weight loss, or bulky nodes
  • B: night sweats, weight loss, or bulky nodes
  • E: extranodal site contagious with nearby node
38
Q

steriod use can have what effect on presentation of lymphomas

A

will cause lymphadenopathy to go down for a period of time, but swelling will return

39
Q

diagnosis of lymphomas

A

excisional node biopsy

40
Q

workup if you suspect lymphoma

A
  • CBC
  • CMP
  • LDH: monitor cell turnover
  • uric acid
  • beta 2 microglobulin: measure of tumor burden
  • sed rate
  • excisional node biopsy
  • bone marrow biopsy: part of staging
41
Q

children with NHL usually have what grade

A

High grades

  • requires therapy right away
  • adults can vary from low to high grade
42
Q

if you relapse or you follow a low grade lymphoma, why should you always re-biopsy

A

lymphomas can morph!

43
Q

primary malignant tumor characterized by production of osteoid or immature bone by malignant cells

A

Osteosarcoma

44
Q

what is the most common primary bone malignancy in children and adolescents

A

Osteosarcoma

  • peak age range 13-16 (growth spurt)
45
Q

osteosarcoma has what typical clinical presentation

A
  • pain and swelling
  • commonly long bones: femur or tibia
  • fever, weight loss, malaise
46
Q

how is Osteosarcoma diagnosed

A
  • biopsy
  • also get CT for mets
47
Q

what is the 2nd most common primary bone malignancy? Most affected age range?

A
  • ewing’s sarcoma
  • 10-15 yo
48
Q

12% of patients with ewing’s sarcoma have

A

urogenital anomalies

49
Q

ewing’s sarcoma most commonly develops on which bones

A

flat or long bones

50
Q

is ewings sarcoma usually a metastatic disease?

A
  • approx 75% have localized disease
  • less likely will have nodal, meningeal, or CNS spread
51
Q

brain tumors can be seperated into what two types

A
  • glial: most common
  • nonglial
  • *glial cells: give nerve cells nourishment
52
Q

standarized testing to confirm brain tumors

A

MRI

53
Q

this brain tumor arises from primitive sympathetic ganglian cells in the CNS

A

Neuroblastoma

54
Q

What is the most common solid neoplasm in children

A

Neuroblastoma

55
Q

Neuroblastoma most commonly affect what part of the body

A
  • adrenal gland (40%)
  • abdomen (25%)
  • thoracic (15%)
56
Q

treatment for Neuroblastoma

A
  • low risk disease: watch and wait
  • higher risk: surgery
57
Q

What is the most common renal malignancy

A
  • Nephroblastoma (Wilms tumor)
58
Q

are one or both kidneys usually affected in younger children with nephroblastoma

A

bilateral

  • unilateral in older children
59
Q

what is the most common intraocular cancer of childhood

A

Retinoblastoma

60
Q

leukocoria is associated with

A

Retinoblastoma

  • leukocoria: abnormal white reflection from the retina of the eye
61
Q

bilat retinoblastoma is a result of

A

RB1 gene

62
Q

What is the most common soft tissue sarcoma of childhood

A

Rhabdomyosarcoma

63
Q

Rhabdomyosarcoma affects which gender more

A

boys

64
Q

common causes of hepatic tumors

A
  • majority are primary tumors
  • can be metastatic from
    • Wilms tumor
    • rhabodomyosarcoma
65
Q

Which type of hepatic tumors is seen in children < 5 yo and occurs in the right side of the liver

A

Hepatoblastoma

pediatrics II (4 decks)

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