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Pediatrics-MJ > T3-Blueprint: Cancers > Flashcards

T3-Blueprint: Cancers Flashcards

1
Q

What are the s/s of brain tumors in children?

A
  • Vomiting
  • Seizures
  • Weakness of face, trunk, arms, or legs
  • Slurred speech
  • Difficult to stand or walk
  • Poor coordination
  • Headache

*In babies, a rapidly enlarging head

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2
Q

Nephroblasoma-What cancer?

A

Wilm’s tumor

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3
Q

S/s of the most common kidney tumor of childhood (Wilms aka nephroblasoma)

A
  • Hematuria
  • Abdominal swelling or mass (firm, nontender)
  • HTN
  • Anorexia (fatigue, malaise, weight loss)
  • Fever
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4
Q

What is treatment for Wilms Tumor?

A

Surgical removal or tumor or kidney

Chemo

Post op radiation

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5
Q

What are the chemo drugs for Wilms?

A

Dactinomycin or vincristine

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6
Q

Cancer that arises from the retina and is the most common intraocular malignancy in childhood

A

Retinoblastoma

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7
Q

S/S of retinoblastoma?

A

Leukocoria
Strabismus
Blindness (late sign)

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8
Q

Retinoblastoma: What is leukocoria?

A

Whitish glow in pupil (cats eye reflex)

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9
Q

Retinoblatoma: Why would enucleation be used?

A

To treat advanced disease with optic nerve invasion in which there is NO HOPE for saving vision

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10
Q

Retinoblastoma: Why would we use chemo?

A

To reduce tumor size to allow for other therapies

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11
Q

Retinoblastoma: Sometimes chemo is used to reduce the tumor size to allow for treatment of other therapies. What are those 3 therapies?

A
  • Plaque brachytherapy
  • Photocoagulation
  • Cryotherapy
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12
Q

Retinoblastoma: What is plaque brachytherapy?

A

Surgical implantation of iodine-125 applicator on sclera until max radiation dose has been delivered

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13
Q

Retinoblastoma: What is photocoagulation?

A

Use of laser beam to destroy retinal blood vessels that supply the tumor

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14
Q

Retinoblastoma: What is cryotherapy?

A

Freezing tumor to destroy microcirculation that feeds it

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15
Q

Retinoblastoma: Does chemo work in advanced diseases to increase survival rate?

A

NO

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16
Q

Malignancy that occurs in the adrenal gland, sympathetic chain of the retroperatitoneal area, head, neck, pelvis, or chest

A

Neuroblastoma

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17
Q

What are s/s of neuroblastoma?

A

Depend on location and stage of disease

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18
Q

T/F: Half of children who have neuroblastoma have lots of symptoms

A

FALSE–half of children who have neuroblastoma have FEW symptoms

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19
Q

What are s/s of metasis of neuroblastoma?

A
  • Ill appearance
  • Periorbital ecchymoses
  • Proptosis
  • Bone pain
  • Irrirability
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20
Q

What is treatment for neuroblastoma?

A

Surgical removal of tumor

Chemo and/or radiation used for metastasis and residual disease

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21
Q

Originates in skeletal muscle in any part of body (mostly in head and neck, with orbit of eye frequently affected)

A

Rhabdomyosaracoma

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22
Q

What are s/s of rhabdomyosarcoma?

A

Local pain due to compression by tumor

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23
Q

Rhabdomyosarcoma

T/F: Some places will not have pain until the tumor presses against the organs

A

True

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24
Q

S/S of rhabdomyosarcoma for CNS?

A

Headaches
Diplopia
Vomiting

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25
Q

S/S of rhabdomyosarcoma for orbit?

A

Unilateral proptosis
Ecchymosis of conductive
Strabismus

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26
Q

S/S of rhabdomyosarcoma of nasopharynx?

A

Stuff nose, pain, nasal obstruction, epistaxis, palpable neck nodes

*visible mass= late sign

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27
Q

What is treatment for rhabdomyosarcoma?

A

Surgical biopsy, local radiation therapy, and chemo rather than surgical procedures

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28
Q

Most common type of bone tumor in peds. More in boys or girls?

A

Osteosaracoma; boys

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29
Q

Common sites of osteosarcoma?

A

Ends of long bones

  • distal femur
  • proximal tibia
  • proximal humerus
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30
Q

S/s of osteosarcoma?

A
  • Pain and swelling at the site of disease
  • Palpable lymph nodes near site of timor
  • Limpness, inability to hold a heavy object
  • Weakness, decreased movement of extremitiy
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31
Q

S/s of osteosarcoma. One of the signs is pain and swelling at the site of disease What can be done to provide temporary relief?

A

Flex extremity

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32
Q

Treatment for osteosarcoma?

A
  • Amputation
  • Tiknoff linbergy procedure
  • TCA antidepressents to treat phantom limb pain following an amputation
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33
Q

Osteosarcoma: If limb is amputated, how far above the site does the amputation begin?

A

5-6 cm

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34
Q

Osteosarcoma: What is the tiknoff-linberg procedure?

A

Procedure to spare the limb if the bone has stopped growing (older adolescents)

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35
Q

Most common cause of childhood cancer? Who is ti more common in? Peak onset?

A

Leukemia

More common in boys and caucasians

Peak onset: 2-5 years of age

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36
Q

Children with ____ have a greater risk for developing leukemia

A

Downs syndrome

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37
Q

What is leukemia?

A

Group of malignancies that affect the bone marrow and lymphatic system

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38
Q

How is leukemia classified?

A

Type of WBC that becomes neoplastic

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39
Q

Leukemia is classified by the type of WBC that becomes neoplastic. What are the two groups?

A
  1. Acute lymphoid leukemia (ALL)

2. Acute myelogenous or non lymphoid leukemia (AML/ANLL)

40
Q

Leukemia causes an increase in the production of _____, which leads to infiltration of organs and tissues

A

Immature WBC

41
Q

Leukemia: What results of deficient RBC?

A

Anemia

42
Q

Leukemia: What results of deficient WBC?

A

Neutropenia–bleeding and bruising

43
Q

Leukemia: What results of deficient platelets?

A

Trhombocytopenia–bleeding and bruising

44
Q

Symptoms of leukemia?

A
  • Pallor
  • Easy bruising
  • Lethargy
  • Malaise
  • Enlarged liver, lymph nodes and joints
  • Abdominal, leg, and joint pain
  • Constipation, headache, vomiting, anorexia, unsteady gait
45
Q

What are late signs of leukemia?

A
  • Pain
  • Hematuria
  • Ulcerations in mouth
  • Enlarged kidneys and testicles
  • Signs of ICP
46
Q

What is treatment for leukemia?

A

Chemo

Bone marrow transplant

47
Q

Malignancy that originates in the lymphoid system and primary involves the lymph nodes

A

Hodgkins

48
Q

Hodgkins primarily involves the lymph nodes..where does it metatasize?

A

Non-lymp sites, especially the spell, liver, bone marrow, lungs, and mediastinum

49
Q

Hodgkins stage 1?

A

Lesions in one lymph node area OR only one extralymphatic site

50
Q

Hodgkins stage 2?

A

2 or more node regions on same side of diaphragm OR 1 additional extralymphatic site or organ on same side as diaphragm

51
Q

Hodgkins stage 3?

A

lymph node regions on both sides of diaphragm OR one extra lymphatic site, spleen, or both are involved

52
Q

Hodgkins stage 4?

A

Cancer has metastisized diffusely thoughout body to one or more extralymphatic sites

53
Q

T/F: With Hodgkins, there is painless enlargement of lymph nodes

A

TRUE

54
Q

Hodgkins: Most common findings of lymph nodes?

A

Firm, nontender, enlarged, movable nodes in supraclavicular or cervical area

55
Q

What is treatment for Hodgkins?

A

Chemo and radiation

56
Q

Third most common cancer in meds–lymphatic cancer that derives from mature B Cells, T cells and cells of uncertain lineage

A

Non-hodgkins

57
Q

Non-hodgkin’s stage 1?

A

Single tumor at single site

58
Q

Non-hodgkin’s stage 2?

A

Single tumor with regional involvement on same side as diaphragm

59
Q

Non-hodgkin’s stage 3?

A

Tumor on both sides of abdomen; also all primary thoracic, intraabdominal, and paraspinal or epidural tumors

60
Q

Non-hodgkin’s stage 4?

A

Stages 1-3 + CNS or bone marrow involvement

61
Q

What are sites of non-hodgkin?

A

Abdomen
Mediastinum
Head and neck

62
Q

What are symptoms if non-hodgkins is in the abdomen?

A

Pain
Distention
N/V

63
Q

What are symptoms if non-hodgkins is in the mediastinum?

A
  • Pleural effusion
  • Dyspnea
  • Dysphagia
  • SVS Syndrome (swelling of upper arm, face, and neck)
64
Q

What are symptoms if non-hodgkin is in the head and neck?

A

Painless, non-tender mass

65
Q

What is treatment for non-hodgkin?

A

Aggressive approach using radiation and chemo

66
Q

When is bone marrow transplant used?

A

For children who have malignancies that are unlikely to be cured by any other means

67
Q

Bone marrow transplant allows for administration of _____ of chemo, often combined with radiotherapy, to rid body of all cancer cells

A

Lethal dose

68
Q

Bone marrow transplant: New transfused marrow or stem cells begin to produce ___________–recepient accepts a new blood-forming organ

A

Functioning, nonmalignant blood cells

69
Q

What is the primary form of treatment in cancer?

A

Chemo, or adjunct to radiotherapy

70
Q

What is the action of chemo?

A

Interfere with the function/production of DNA and RNA

71
Q

Chemo contain vesicants. What does this mean?

A

Can cause cellular damage if the drug infiltrates (special training is needed to administer these drugs)

72
Q

One side effect of chemo is mucosal alteration. Why is mouth care so important when a patient has chemo?

A
  • Mouth is one of the easiest places to get an infection due to immune system being diminished
  • Must do frequent oral care to inspect for ulceration and hemorrhage
  • Use soft-bristled tooth nurse, lube lips to avoid cracking; offer soft, bland foods
73
Q

What can we apply to reduce the pain in the mouth if a patient has chemo treatment?

A

Local anesthetics and antiseptic mouthwash

74
Q

Mouth care if pt. is having chemo:

What do we avoid? (4)

A
  1. Viscous lidocain: causes aspiration; depressed gag reflex
  2. Hydrogen peroxide: delays healing
  3. Milk of magnesia: dries mucous membranes
  4. Lemon glycerin swabs: causes tooth decay and erosion of tissue
75
Q

Skin breakdown is another effect of chemo. What do we do to help with this?

A
  • Inspect skin daily
  • Avoid rectal temps
  • Provide sitz bath as needed
  • Reposition frequently
76
Q

Neuropathy is an effect of chemo. What do we do to help with this?

A
  • Constipation is likely so encourage a diet high in fiber, administer stool softeners, encourage fluid
  • If jaw pain, give a soft diet
77
Q

Loss of appetite is an effect of chemo. What do we do to help with this?

A
  • Control n/v with antimetic
  • Small, frequent, well-balanced meals
  • Weigh child daily
  • Monitor electrloytes
  • Administer chemo early in day
78
Q

Hemorrhage cystitis is an effect of chemo. What do we do to help with this?

A

Encourage fluids and frequent voiding

Administer chem early and administer MESNA to protect the bladder

79
Q

Alopecia is an effect of chemo. What do we do to help with this?

A

PREPARE THEM FOR THIS!!!!!

Encourage use of cotton hat or scarf or wig if they are self-conscious

80
Q

How is intrathecal chemo delivered?

A

Through lumbar puncture (spinal tap) or device placed under the scalp

81
Q

Why is intrathecal chemo given?

A

To treat cancers that have reached CNS (including some types of leukemia and lymphoma)

82
Q

Intrathecal chemo delivers chemo drug directly into ____ surround the brain and spinal cord to target cancer cells that have spread there.

A

Cerebrospinal fluid

*typically chemo doesnt cross the BBB, so this method has to be used instead

83
Q

What is low blood counts?

A

Anemia

84
Q

What is low platelets?

A

Thrombocytopenia

85
Q

What is low neutrophils?

A

Neutropenia

86
Q

What is immature RBCs?

A

Leukemic blasts

87
Q

A deficiency of granulocytes in the blood, causing increase vulnerability to infection

A

Agranulocytosis

88
Q

Low plateltes in blood–causes bleeding into tissues, bruising, and slow blood clotting after injury

A

Thrombocytopenia

89
Q

An abnormally increase concentration of hemoglobin in blood, through either reduction of plasma volume or increase in red cell numbers. It may be a primary disease of unknown cause, or a secondary condition liked to respiratory or circulatory disorder or cancer

A

Polycythemia

90
Q

A red blood cell that is typical biconcave disc without a nucleus. They contain the pigment hemoglobin, which imparts the red color to blood, and transports oxygen and carbon dioxide to and from the tissues

A

Erythrocytes

91
Q

A colorless cell that circulates in the blood and body fluids and is involved in counteracting foreign substances and disease; there are several types, all amoeboid cells with a nucleus, including lymphocytes, granulocytes, monocytes, and amcrophages

A

Leukocytes

92
Q

Immature WBCs; fill bone marrow spill into the blood stream; production of normal blood cells is affected, causing anemia, bleeding problems, and infection

A

Leukemic blasts

93
Q

Normal platelet count?

A

150-450 billion

94
Q

Normal HCT in male? female?

A

Male: 38.8- 50%
Female: 34.9-44.5%

95
Q

Normal hgb in male? female?

A

Male: 13.5-17.5 g/dl
Female: 12-15.5 g/dl

*Above 11 g/dl is key

96
Q

Normal leukocyte count?

A

Aka WBC

4500-11000

Pediatrics-MJ (61 decks)

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