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paediatrics cabinetchip > paediatric oncology > Flashcards

paediatric oncology Flashcards

1
Q

most common paediatric malignancies 5

A

leukaemia/lymphoma

brain tumours

neuroblastoma

Wilms tumour

bone tumour

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2
Q

presenation of brain tumours 5

A

raised ICP

focal seizures

neurological signs

endocrine distrubances

raised OFC - developmental delay/regression

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3
Q

features of raised ICP in brain tumours 4

A

early morning headaches become more severe

vomitting

papilloedema (LATE)

in extremis:
-hypertension
-bradycardia
-abnormal respirations
-reduced GCS

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4
Q

investigations for brain tumours 5

A

if suspected- CNS imagins MANDATORY
-often CT but brain/spinal MRI is investgiation of choice

tumour biopsy

consider tumour markers

endocrine screen

CSF- cytology and tumour markers

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5
Q

what type of brain tumour can have an endocrine impact and what is that impact

A

craniopharyngioma

-may cause hypopituitarism

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6
Q

managment of brain tumours 5

A

resus if necessary

neurosurg referral

consider dexamethasone to reduce peritumour oedema

consider chemo

consider radio

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7
Q

most common malignant bone tumour in kids 2

A

osteosarcoma

Ewings sarcoma

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8
Q

presenation of bone tumours 5

A

persistent pain (nocturnal)

swelling

deformity

pathological fractures

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9
Q

other symptoms associated with Ewings sarcoma 3

A

fever

anorexia

weight loss

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10
Q

paliative care in oncology with children

A

holistic individualised and active(not simply withdrawing treatment )

involves caring for child and their family and includes symptomatic management

Anticipation of and provision of end of life care in a location decided by carers.
Majority die at home other locations include hospital or hospice.

Bereavement services are provided where necessary

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11
Q

examination of an abdominal mass in a child 8

A

evaluate mass

organomegaly

bowel/bladder obstruction

BP

lymphadenopahty

skin nodules

skin rash

neuro assessment -EXCLUDE SPINAL CORD COMPRESSION

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12
Q

when are blueberry muffin nodules found

A

neuroblastomas

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13
Q

investigations in an abdo mass in a child:
when is urinalysis important

A

WIlms tumour (nephroblastoma)
-haematuria

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14
Q

investigations in an abdo mass in a child:
urinary catecholamines

A

neuroblastomas

-examples, VMAs and HVAs

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15
Q

investigations in an abdo mass in a child:
ophthalmosocpy

A

leucocoria - retinoblastoma

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16
Q

investigations in an abdo mass in a child:
-visual feilds

A

bitemporal hemianopia
-craniopharyngioma

17
Q

define wilms tumour

A

wilms nephroblastoma
-kidney tumour

0typically presents under 5

18
Q

associations to wilms tumour 3

A

beckwith-wiedemann

WAGR syndrome

1/3 cases associated w loss of function in WT1 gene on chromosome 11

19
Q

features of wilms tumours

A

abdo mass -unilateral (95% cases)

painless haematuria

flank pain

anorexia/fever

20
Q

management of wilms tumpur 3

A

nephrectomy

chemo

radiotherapy if advanced

21
Q

define neuroblastoma

A

accounts for 7-8% of childhood malignancies

-arises form neural crest tissues of the adrenal medulla and sympatethic nervous system

22
Q

features of neuroblastoma 8

A

BLUEBERRY MUFFIN NODULES

abdo mass

pallor/weight loss

bone pain/limp

hepatmegaly

paraplegia

proptosis

23
Q

investgations for neuroblastoma 3

A

raised urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels

calcfication may be seen on abdo XR

biopsy

24
Q

major complication of paeds oncology when receivieng chemo

A

if receiivng thorgh a central line are at an increased risk of neutropenic sepsis

-medical emergency w IV ABx ASAP

25
Q

what causes tumour lysis syndrome

A

breakdown of malginant cells

26
Q

what are the biochemical distrubances in tumour lysis syndrome 4

A

hyperuricaemia

hyperkalaemia

hyperphosphataemia

hypocalcaemia

27
Q

what complications can arise as a result of tumour lysis syndrome 3

A

AKI

seizures

cardiac arythmias

death

28
Q

when is tumour lysis syndrome most likely to occur

A

during induction of chemotherapy

29
Q

management of tumour lysis syndrome 8

A

regular obs

cardiac monitor

accurate fluid balance

fequent U&Es and bone profile

IV fluids

Xanthine oxidase inhibitor- allopurinol

management of hyperkalaemia (calcium gluconate)

renal dialysis

30
Q

early effects of chemo 5

A

 Marrow suppression
 Temporary hair loss
 Nausea and vomiting
 Hearing loss
 Renal impairment

31
Q

late effects of chemo 3

A

 Cardiac toxicity
 Infertility
 Risk of secondary malignancies

31
Q

late effects of chemo 3

A

 Cardiac toxicity
 Infertility
 Risk of secondary malignancies

paediatrics cabinetchip (80 decks)

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