Red flags for cancer in childhood Flashcards
Red flags for cancer in children
persistent tired/lethargic
pallor
unusual bruising/petechiae
prolonged bleeding
persistent, prolonged or recurrent infections (>12 viral/year or >1 proven bacterial)
generally unwell and parental concern
lymphadenopathy >2cm for >6w not reducing in size
supraclavicular lymph node enlargement
pain waking from sleep at night
persistent limp
abdominal mass +/- frank haematuria
daily drenching full body night sweats
unexpected weight loss
double vision, focal neurology including squint
facial nerve palsy
white eye reflex (leucocoria)
acute behavioural change
Cushing’s triad
hypertension
bradycardia
irregular respirations
(raised ICP signs)
Raised ICP in children management
mannitol or hypertonic saline
nurse at 45 degrees
CT head
emergency transfer to PICU + neurosurgery unit
contact anaesthetics
Brain and spinal cancer red flags in children
persistent or recurrent vomiting
balance, coordination or walking problems
abnormal eye movements or suspected loss of vision
behaviour change or lethargy
seizures
head circumference increasing crossing centiles
delayed or arrested puberty
new onset squint
Name some malignant brain tumours that occur in children
medulloblastoma
ependymoma
diffuse intrinsic pontine glioma (DIPG)
embryonal tumours
atypical teratoid rhabdoid tumour (ATRT)
high grade astrocytoma
intracranial germ cell tumours
Lymphoma features in children
lymphadenopathy and/or splenomegaly
abdominal distension/swelling
breathlessness (not explained by known resp disease history)
distended veins/venous congestion of upper chest, face head (SVCO)
night sweats, fever, pruritus and weight loss
spinal cord compression
Abdominal distension in child differentials
toddler belly
constipation
intestinal obstruction
nephrotic syndrome
hepatosplenomegaly
asymptomatic proteinuria
Wilm’s tumour
renal cell carcinoma
neuroblastoma
phaeochromocytoma
Abdominal mass in children differentials
Wilm’s tumour
neuroblastoma (adrenal glands)
ovarian tumours
Burkitts lymphoma
endocrine tumours
Red flags for haematological cancers in children
unexplained bruising, petechiae, pallor
night sweats
persistent (>6w) lymph nodes >2cm
wheeze + stridor - not responding to salbutamol
bone pain
back pain
unexplained weight loss
limp
Red flags for solid tumours in children
unexplained neurology/new squint
white reflex/proptosis
headaches:
- wake at night
- early morning
- associated vomiting/neurology
- coloured aura
- under 5y
