BRS- Onc Flashcards Preview

Pediatrics > BRS- Onc > Flashcards

Flashcards in BRS- Onc Deck (85):
1

Leading cause of death from disease in childhood?
Most common childhood cancer?
Most common solid childhood cancer?

Cancer= leading cause of death from disease
Childhood cancer = ALL
Solid childhood cancer= brain tumors

2

Two immunodeficiencies that predispose kiddos to cancer

-Wiskott Aldrich: lymphomas & leukemias
-X linked lymphoproliferative disease: EBV --> lymphoma

3

EBV assc cancer?
HIV assc cancer?

EBV --> Burkitts
HIV --> Kaposci's

4

Downs syndrome assc cancers

ALL, AML

5

Syndrome assc with GI cancers

Blooms syndrome

6

NF II assc cancer

acoustic neuroma

7

Two abdominal mass types

Wilms Tumor
Neuroblastoma (crosses midline)

8

Soft mass on extremities

rhabdomyosarcoma

9

Early morning H/A + vomiting cause

brain mass

10

Tumor causing leukocoria

Retinoblastoma

11

Tumors causing HTN

Neuroblastoma
Wilms tumor
Pheochromocytoma

12

Peak incidence/ prototype patient with ALL

-white male age 2-6 years

13

Two classification types for ALL

-cell morphology
-immunophenotype (+/- CALA)

14

Describe cell morphology types + which is most common in ALL?

L1: small with little cytoplasm
L2: between
L3: large lymphoblasts

*L1 more common

15

Describe immunophenotypes in ALL + which is most common?

T/B/PreB cell +/- CALLA
Most common Pre B cell + CALLA

16

What does CALA stand for?

common acute lymphocytic leukemia antigen

17

Most common ALL symptoms?

fever and bone pain

18

CBC Findings in ALL

low platelets
anemia
variable WBC count
**CBC does not rule out leukemia
**Must confirm with marrow evaluation

19

Staging for ALL

no staging system

20

Favorable age, sex, race for ALL prognosis

-2-9
-female
-Caucasian

21

Favorable immunophenotype/genetic makeup for ALL:

+CALLA
-t(9,22)

22

Three stages of ALL management

-induction
-consolidation
-maintenance

23

What drug is given to all ALL patients in the induction stage of treatment?

intrathecal MTX

24

What is the consolidation phase of ALL treatment and what is its purpose?

How long is maintenance phase of ALL tx?

intrathecal MTX
cranial irradiation, high risk 5+
**prevents CNS involvement**

-maintenance up to 3 years

25

Lab findings assc with tumor lysis syndrome

-^^uric acid, ^^potassium, ^^phospohate (=low Ca)

26

Three sequelae of tumor lysis syndrome

-tetany
-renal disease
-cardiac disease

27

Overall ALL survival rate

85%

28

Four syndromes assc with AML

-Fanconi
-Downs
-Kostmann
-Neurofibromatosis

29

What are the 7 types of AML

M1: acute myeloblastic, immature
M2: acute myeloblastic, mature
M3: acute promyelocytic
M4: acute myelomonocytic
M5: acute monocytic
M6: erythroleukemia
M7: acute megakaryotic

30

What are the 4 more common types of AML

M1,2,4,5

31

Which type of AML is assc with Auer Rods?
assc with Down Syndrome?

Acute promyelocytic (M3)= auer rods
Acute megakaryocytic (M7) = Downs

32

Organ systemic more commonly involved in AML than ALL? Common oral finding in AML?

CNS involvement + gingival hyperplasia common in AML

33

Which type of AML is most successfully cured?

AML assc with Downs= most responsive

50% cured with chemo; 70% cured with marrow transplant (in general cases)

34

Least common type of leukemia in kiddos is _____.
Two types are ____ & ______.

CML
Adult type
Juvenile CML

35

Chromosomal abnormality assc with adult type and juvenile type CML?

adult type: 9,22 BCR ABL
juvenile type: chromosome 7,8 involvement

36

Age groups assc with adult type and juvenile type CML?
Which is more fatal

adult: older kiddos/teens
juvenile: younger than two, worst prognosis (often fatal, half relapse)

37

WBC count and sign suggestive of adult CML? Juvenile?

Adult: massive splenomegaly; extremely high WBC
Juvenile: facial rash, moderate leukocytosis

38

Hodgkins vs Non-Hodgkins lymphoma:
-which is more common?
-which grows more rapidly/is more aggressive?
-which is commonly assc with systemic symptoms?

-common: non
-rapid: non
-systemic: hodgkins

39

Emergent sequelae assc with nonhodgkins lymphoma:

-SVC syndrome
-airway compression

40

Describe the staging assc with Hogdkins lymphoma

Ann Arbor System:
I: single node
II: two+ nodes, same side of diaphragm
III: nodes on both sides of diaphragm
IV: diffuse

A: lack of symptoms
B: symptoms present

41

What predisposes kiddos to Hodgkins Lymphoma?

EBV mononucleosis

42

Cell assc with Hodgkins Lymphoma?

Binucleated reed Sternberg cell

43

Complications of Hodgkins Lymphoma therapy:

1) hypothyroidism
2) secondary malignancies
3) male sterility
4) growth retardation

44

Non-Hodgkins Lymphoma:
-age group/sex
-predisposing factor

-5+
-male
immunodeficiency predisposes

45

Three major categories of Non-Hodgkins lymphoms

1) lymphoblastic lymphoma (T cell)
2) small non-cleaved (B cell)
3) large cell (B cell)

46

Of the three non-hodgkins lymphomas, what type includes burkitts?

small non cleaved B cell

47

Most common presenting feature of non-hodgkins lymphoma

painless lymphadenopathy

48

Common presentation lymphoblastic lymphoma

anterior mediastinal mass w/ airway or SVC obstruction

49

Endemic Burkitts:
-location in the world
-location in the body

-Africa
-Jaw

50

Intussusception in a kiddo older than 3 requires workup for?

lymphoma (especially small cell)

51

Common location of large

-tonsils
-adenoids
-peyers patch

52

Three diseases assc with brain tumors

-VHL
-TS
-NF

53

Most and second most common peds brain tumors

-glial #1
-PNETs #2
ependymomas & craniopharygiomas also common

54

High grade brain tumor common location?
Low grade?

High= supratentorial
Low= infratentorial

55

Most common PNET tumor?

-medulloblastoma in the cerebellum

56

MC infratentorial tumor? supra?

supra= astrocytoma
infra= medulloblastoma

57

Ataxia is assc with what brain tumors?
Seizures?

ataxia= infratentorial (cerebellum)
seizures= supratentorial

58

Principal treatment of brain tumors?

-resection or debulking

59

Peds brain tumor with worst prognosis

brainstem glioma

60

Neuroblastoma:
-most common location
-most common age
-diagnosis

-75% in abdomen or pelvis, can be anywhere on the sympathetic ganglia chain
-first 5 years of life
-marrow biopsy + urine HVA/VMA

61

Neuro complication assc with 2% of neuroblastomas

-acute cerebellar atrophy
"dancing feet and eyes"
=ataxia, opsoclonus, myoclonus

62

Staging of neuroblastoma:

-I: localized
-II: spread but not crossing midline
-III: crosses midline
-IV: crosses midline + mets
-IVS: stage I-II + mets

63

What type of neuroblastoma may spontaneously regress?

-Stage IVs in a baby

64

What marker is significant for poor prognosis in neuroblastoma?

n-myc

65

Most common childhood renal tumor

Wilms, usually kiddos under 5

66

Describe Beckwith Wiedemann syndrome

-hemihypertrophy
-macroglossia
-visceromegaly

67

Describe WAGR syndrome + assc chromosome

chromosome 11
-wilms tumor
-aniridia
-genitourinary abnormalities
-retardation

68

Two symptoms assc with Wilms tumor

Hematuria
HTN (pressure on renal artery)

69

Staging Wilms tumor

-I: limited to kidney
-II: local spread, completely excised
-III: residual tumor after resection
-IV: distant mets
-V: bilateral renal involvement

70

Prognosis Wilms Timor:

90% survival

71

Condition predisposing to Rhabdo

neurofibromatosis

72

Most common sites for rhabdo

head and neck including the orbit

73

Most common and second most common bone tumors in kiddos? Prognosis of each?

-osteosarcoma (#1), 60% survive
-ewings sarcoma, 80% survive

74

Osteosarcoma:
-peak incidence
-common location
-radiographic findings
-presentation

-adolescent males during growth spurt
-metaphysis of long bones, esp common at knee
-sunburst pattern
-poor systemic involvement

75

Ewings Sarcoma:
-most common location
-symptoms
-radiographic findings

-diaphysis of long bones
-fever, weight loss, leukocytosis, ^ESR
-onion skin pattern

76

Ewings Sarcoma chromosomal abnormalities

t(11,21)

77

Most common type of liver tumor?
Most common age group?
Assc syndrome?

hepatoblastoma
under 3
Beckwith Wiedemann syndrome

78

Hepatocellular carcinoma:
most common assc disease

chronic hepatitis B

79

Prognosis for hepatoblastoma/ hepatocellular carcinoma

-both= poor, hepatocellular carcinoma worst

80

Six germ cell tumors seen in kiddos

-teratoma**
-seminoma (Male)
-dysgerminoma (Female)
-Yolk Sac
-Embryonal
-Choriocarcinoma

81

Most common germ cell tumor seen in kiddos

sacrococcygeal teratoma, 95% benign

82

Elevation of what protein is assc with yolk sac tumors?

AFP

83

How commonly are ovarian tumors malignant?

1/3rd younger the child= more malignant

84

Most common site for Langerhans Cell Histiocytosis

skull
(painful bony lesions +/- pathologic fractures)

85

Skin finding in LCH

mimics cradle cap