EXAM #3: CHILDHOOD CANCER II Flashcards

1
Q

What is Acute Lymphoblastic Leukemia?

A

Hyperproliferation of lymphoid progenitor

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2
Q

What gender is ALL more common in?

A

Males

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3
Q

What are the signs and symptoms of Luekemia?

A

Constellation of symptoms associated with:

1) Anemia
2) Thrombocytopenia
3) Neutropenia

AND bone pain that causes a limp/decreased walking

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4
Q

What luekemia is gingival hypertrophy associated with?

A

Monoblastic leukemia

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5
Q

What are the CBC findings that are diagnostic for Leukemia?

A

1) Increased WBC
2) Lymphoblasts on PBS
3) 2+ cytopenias

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6
Q

What should be included in the differential for Leukemia?

A
  • EBV (Mono)
  • Acute anemia
  • Parvovirus B19
  • ITP
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7
Q

Kids with what genetic abnormality are at an increased risk for ALL?

A

Down’s Syndrome

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8
Q

What are the nongenetic risk factors for ALL?

A

X-rays/ radiation

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9
Q

What is the most common type of ALL?

A

B-ALL

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10
Q

What is the most common involvement of B-ALL?

A

Extramedullary

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11
Q

What group of children is T ALL more common in?

A

Male adolescents

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12
Q

What is the presentation of T-ALL?

A
  • Mediastinal mass
  • High WBC mass
  • LAD that resembles Mumps
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13
Q

What is the greatest risk factor in B-ALL?

A

Response to induction therapy in the first 28 days

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14
Q

What is the most common solid tumor of childhood?

A

Brain tumors

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15
Q

What is the most common brain tumor of childhood?

A

Astrocytomas

Note that this is specifically a low grade JPA

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16
Q

Where is the most common location for an astrocytoma?

A

Posterior fossa

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17
Q

What is the standard of care for an astrocytoma?

A

Total resection i.e. neurosurgery

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18
Q

What are the signs and symptoms of a brain tumor?

A
  • Neuro/ increased ICP signs/sx

- Regression of milestones

19
Q

Why is chemotherapy relatively ineffective in treating astrocytomas?

A
  • Low grade means less proliferation

- Slow growing tumors are hard to target with chemotherapy

20
Q

Radiation has a potential for use in all tumors but which one?

A

Choroid plexus tumors

21
Q

What are the long-term effects of radiation therapy in children for brain tumors?

A

1) Neuro-cognitive impairment
2) Hearing changes
3) Secondary cancer
4) Endocrine abnormalities
5) Skeletal growth abnormalities

22
Q

What disease are astrocytomas most commonly associated with? What is second?

A

1) NF-1

2) Li-Fraumeni Syndrome

23
Q

What is a Wilm’s tumor?

A

Renal tumor that is the 2nd most common type of abdominal malignancy in children

24
Q

What gene is mutated in Wilm’s tumors?

A

WT1 tumor suppressor mutation

25
Q

What race are Wilm’s tumors more common in?

A

African Americans

26
Q

What are the symptoms associated with Wilm’s Tumor?

A
  • HTN
  • Hematuria
  • Fever
27
Q

Describe the etiology of Retinoblastoma.

A

Loss of both Rb alleles

  • 60% are spontaneous
  • 40% are hereditary
28
Q

Where are neuroblastomas located? Where are the common metastases of neruoblastomas located at diagnosis?

A

Any neural crest tissue for primary tumor i.e.

  • Adrenal tissue
  • Parasympathetic tissue (cerivical, thoracic, pelvic)

Mets: bone, lymph nodes, skin, liver

29
Q

What are the signs and symptoms of a neuroblastoma?

A
  • Proptosis
  • Bone lesions
  • Periorbital ecchymoses i.e. “Racoon eyes”
30
Q

How do neuroblastomas commonly present?

A

1) Large abdominal mass that crosses the midline
2) LE weakness
3) Cervical or high thoracic mass causing Horner’s Syndrome

31
Q

What is the average age of onset for a neuroblastoma?

A

18 months

32
Q

What is the most common extracranial solid tumor in children?

A

Neuroblastoma

33
Q

What is the most common type of soft tissue sarcoma?

A

Rhabdomyosarcoma

34
Q

What are the signs and symptoms of a Rhabdomyosarcoma involving the head and neck?

A

Proptosis

Periorbital swelling

35
Q

What are the signs and symptoms of a parameningeal rhabdomyosarcoma?

A

1) CN palsy
2) Hearing loss
3) Chronic aural or sinus drainage

36
Q

What are the signs and symptoms of a male GU rhabdomyosarcoma?

A
  • Hematuria

- Urinary obstruction

37
Q

What are the signs and symptoms of a paratesticular rhabdomyosarcoma?

A

Pain testicular mass

38
Q

What are the signs and symptoms of a vaginal/uteral rhabdomyosarcoma?

A

1) Abdominal mass
2) Vaginal mass
3) Vaginal bleeding or discharge

39
Q

What is a Rhabdomyosarcoma?

A

Undifferentiated mesenchymal cells that differentiate into muscle

40
Q

At what age do Ewing’s Sarcomas peak?

A

11-15 years old

41
Q

How do Ewing’s Sarcomas present?

A

Limb pain and swelling, frequently after a sports related injury

More common in boys*

42
Q

Where do osteosarcomas typically present?

A

Long bones metaphyses (wide part near growth plate):

  • Distal femur
  • Proximal tibia
  • Proximal humerus
  • Pelvis
43
Q

Where do Ewing Sarcoma’s typically present?

A

Long bone diaphyses (narrow part)

Flat bones