Solid Tumor

Question 1

Which imaging is most important in diagnosing solid tumors

Answer 1

US

Question 2

What is the next step after US in soft tissue tumor

Answer 2

MRI

Question 3

What’s tough about MRI and how do you manage it with a child

Answer 3

He kids move so you give them sedation

Question 4

CT is used for what malignancy in pediatrics

Answer 4

Mestastasis in the lung. CT is ideal for pulmonary lesions

Question 5

How to treat brain tumor initially

Answer 5

Neurosurgeon first resects brain tumor initially (is it resectable or most of it)

Question 6

Other types of solid tumors that’s not in brain, how to diagnose and treat

Answer 6

You try to biopsy and try not to be aggressive. Then start neoadjuvant chemo. Add radiation if necessary

Question 7

When do we use bone marrow transplant

Answer 7

Autogenous used in solid tumors. Sample taking from patient and preserved. Then a bunch of chemo is given to the patient and then they are giving bone marrow transplant.

Question 8

Types of bone marrow transplant

Answer 8

Autogenous and allogenous

Question 9

What do you use for ALL in stem cells

Answer 9

Allogenous

Question 10

What are the most common childhood cancer types not brain tumor

Answer 10

• soft tissue (rhabdomyosarcoma)
• neuroblastoma (adrenal gland is most localized neuroblastoma)
• retinoblastoma (doesn’t get red eye effect and the chorio is not black)
• Wilms tumor (nephroblastoma from primitive kidney cells)
• hepatoblastoma

Question 11

The younger the patient the less

Answer 11

Malignant the tumor

Question 12

Late cases of retinoblastoma are handled by

Answer 12

Removing the eye

Question 13

Wilms effects how many kidneys and which age kid?

Answer 13

Usually 5 year olds or less and usually effects one kidney

Question 14

How is Wilms tumor treated

Answer 14

Chemotherapy

Question 15

How do we treat a neuroblastoma

Answer 15

If we can, we remove it. If we can’t the chemo, radio, immunotherapy, and autologous stem cell transplant

Question 16

What does hepatoblastoma cause? How is it treated?

Answer 16

Hepatomegaly. Requires chemo and resection.

Question 17

What to do if the liver cancer is so far along

Answer 17

Do a liver transplant

Question 18

Where are rhabdomysarcoma most located

Answer 18

Head and neck. But can be in abdomen or prostate.

Question 19

Two most common bone tumors in children

Answer 19

Osteosarcoma and Ewing sarcoma

Question 20

Where does osteosarcoma affects? Ewing sarcoma?

Answer 20

Long bones. Ewing sarcoma can be anywhere

Question 21

Do we do amputation for osteosarcoma

Answer 21

No, not done so often these days.

Question 22

Most common metastasis of osteosarcoma?

Answer 22

Metastasis to lung

Question 23

How are lung metastasis treated

Answer 23

Treated with chemo and will tend to disappear. If they don’t disappear then they will have thorax surgery to remove tumors.

Question 24

If a huge chunk of bone has a tumor what do you do

Answer 24

Intraoperative irradiation. You cut out the bone and give huge amount of radiation that would kill the patient and put back in the patient only the calcium and phosphate

Question 25

What are the most common side effects of chemo

Answer 25

Nausea, pancytopenia, hair loss

Question 26

Long term side effect of chemo

Answer 26

Secondary malignancy (melanoma, breast cancer, papillary thyroid cancer). Infertility. Kidney damage (cyclophosphamide).
Pulmonary fibrosis (bleomycin). Cardiac failure (doxorubicin). Growth failure.

Question 27

What is the most dangerous in short term consequences?

Answer 27

Infections are the most dangerous due to pancyopenia. Can develop sepsis or septic shock in a few hours.

Question 28

How would you administer abx in patient with pancytopenia

Answer 28

Broad spectrum IV abx

Question 29

More dangerous bacteria in pancytopenic patient

Answer 29

Gram negative since they can come from the bowel track. So infection can come from inside and cause sepsis. If they have a cut and get infection then more likely gram positive.

Question 30

Which abx are used

Answer 30

Pipercillin and tazobactam

Question 31

What other infections can afflict kids

Answer 31

HSV, CMV, or Chicken pox. Or it could be fungi.

Question 32

What can you do about cytopenia?

Answer 32

RBC and thrombocyte transfusion. GCF (colony stimulating factor) for WBCs