T3 - Non-Hodgkins Lymphoma, Aplastic Anemia, Retinoblastoma

Question 1

Non-Hodgkins Lymphoma derives from which type of cells?

Answer 1

Mature B Cells

T Cellls

Cells of uncertain lineage

Question 2

What are the three most common malignancies in children?

Answer 2

Acute Leukemia

Brain Tumor

Non-Hodgkins Lymphoma

Question 3

What are the most common sites for NHL?

Answer 3

Abdomen

Mediastinum

Head/Neck

Question 4

What s/s of NHL in abdomen?

Answer 4

pain

distention

n/v

Question 5

S/S of NHL in Mediastinum?

Answer 5

pleural effusion

pain

dyspnea

dysphagia

SVC syndome (sweating of upper arm, face, and neck)

Question 6

S/S of NHL in Head/Neck

Answer 6

painless, non-tender mass

Question 7

Which treatment is used the most w/ NHL?

Answer 7

Chemo

• occasionally radiation if tumor interferes w/ vital structures
• occasionally surgery where debulking is beneficial

Question 8

What is the most important factor in determining prognosis of NHL?

Answer 8

extent of disease at Dx is determined by pretreatment staging

Question 9

Clinical manifestations of NHL

Answer 9

Lymph node involvement in limitation to 1 or 2 adjacent lymphatic regions

Extra nodal site, nasopharynx, oropharynx, or other isolated extra nodular sites with or without lymphadenopathy

GI involvement limited to mesentery

Question 10

— is a tumor of the eye.

Answer 10

Retinoblastoma

Question 11

80% of Retinoblastomas are diagnosed at what age?

Answer 11

before age 5

Question 12

What is noteworthy about the genetics of Retinoblastoma?

Answer 12

gene is present in all body cells in inherited from but only tumor cells in non-inherited form

Question 13

S/S of Retinoblastoma

Answer 13

FTT

Strabismus

Glaucoma

Orbital Cellulitis

Blood Shot Eyes

Nystagmus

Leucocoria (white discoloration of pupil)

Question 14

What does fundus examination reveal?

Answer 14

allows visualization of the entire retina in both eyes to determine extent of tumor

Question 15

What is the most important factor in the prognosis for visual acuity w/ Retinoblastoma?

Answer 15

early diagnosis

Question 16

Treatments for Retinoblastoma

Answer 16

Enucleation

Radiation

Cryotherapy

Photo-coagulation

Chemo

Question 17

What is the most common second malignancy w/ Retinoblastoma?

Answer 17

osteosarcoma

Question 18

How many types of Aplastic Anemia?

Answer 18

Two

• Congenital
• Acquired

Question 19

Fanconi’s Anemia is —

Answer 19

congenital

Question 20

What are the S/S of Congenital Aplastic Anemia

Answer 20

Pallor

Purpura (due to thrombocytopenia)

Infection (due to leukopenia)

Question 21

What are the S/S of Acquired Aplastic Anemia?

Answer 21

Pallor

Weakness

Loss of appetite

Question 22

Possible causes of Acquired Anemia

Answer 22

Drugs

Chemicals

Toxins

Irradiation

Infections (hepatitis, AIDS, Rocky Mountain SF)

Question 23

Lab values to identify Aplastic Anemia

Answer 23

decreased hematopoeietc cells w/ replacement by fatty tissue

anemia

thrombocytopenia

bone marrow

Question 24

Treatment for Congenital Aplastic Anemia

Answer 24

Supportive w/ packed cell transfusions of platelets and WBCs on occasion

Steroid/Androgen therapy

Bone marrow transplant

Question 25

Treatment for Acquired Aplastic Anemia

Answer 25

Remove exposure to hazardous drugs/toxins

Avoid bleeding into vital organ (platelet transfusions)

Oral contraceptives to suppress menses in females

Avoid aspirin

Avoid infections and treat promptly

Bone marrow transplant

Drugs

• prednisone
• oral androgens
• cyclosporine