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Peds II > Exam 1 - Oncology > Flashcards

Exam 1 - Oncology Flashcards

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1
Q

What is the most common malignancy in childhood?

A

Acute Lymphoblastic Leukemia (ALL)

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2
Q

What cancer is secondary to uncontrolled proliferation of immature lymphocytes?

A

ALL

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3
Q

The following clinical presentation is associated with what cancer?

  • Intermittent fever, fatigue, pallor
  • Bleeding
  • Bone pain (especially in the pelvis, vertebral bodies, legs)
  • Hepatosplenomegaly
  • Lymphadenopathy
A

ALL

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4
Q

The following laboratory findings are associated with what cancer?

  • Anemia and/or thrombocytopenia with normal or depressed WBC
  • Peripheral smear of bone marrow: Lymphoblasts
A

ALL

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5
Q

What is the treatment for ALL?

A
  • Chemotherapy (multidrug regimen)
  • Hematopoietic stem cell transplant

*may take 2-3 years to complete

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6
Q

What is the initial/first line therapy for ALL?

A

Chemotherapy

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7
Q

The following clinical findings are associated with what cancer?

  • Fatigue, pallor, bleeding, infection
  • Possible CNS involvement
A

Acute Myeloid Leukemia (AML)

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8
Q

The following laboratory findings are associated with what cancer?

  • Anemia, thrombocytopenia, and neutropenia
  • WBC > 100,000
  • Peripheral smear: showing at least 20% circulating myeloblasts and Auer Rods
A

AML

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9
Q

What is required for diagnosis of AML (2)?

A
  • Bone marrow biopsy showing 20% or more blasts

- Leukemic cells must be of myeloid origin

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10
Q

Lymphoblasts on peripheral smear are associated with what cancer?

A

ALL

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11
Q

Auer Rods on peripheral smear are associated with what cancer?

A

AML

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12
Q

What is the treatment for AML?

A
  • Chemotherapy (often two courses followed by consolidation chemo or HCT)
  • Allognic hematopoietic cell transplant (HCT)
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13
Q

What kind of cancer is a myeloproliferative disorder in which there is uncontrolled proliferation of mature and maturing granulocytes?

A

Chronic Myeloid Leukemia (CML)

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14
Q

Which cancer is associated with the Philadelphia Chromosome?

A

CML

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15
Q

The following laboratory studies are associated with what cancer?

  • Anemia, thrombocytosis, marked leukocytosis
  • Peripheral smear: Myeloid cells in all stages of maturation, increased basophils and blast cells
A

CML

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16
Q

What specific finding confirms the diagnosis of CML?

A

Philadelphia Chromosome

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17
Q

What is the treatment for CML?

A
  • Control via tyrosine kinase inhibitor

- Cure via allogenic hematopoietic cell transplant

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18
Q

Reed-Sternberg cells are diagnostic of what cancer?

A

Hodgkin Lymphoma

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19
Q

What are germinal-center B cells that have undergone malignant transformation?

A

Reed-Sternberg cells

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20
Q

The following clinical presentation is associated with what cancer?

  • Painless cervical or supraclavicular adenopathy
  • Mediastinal mass
  • Weight loss, fever, night sweats (B symptoms)
  • Splenomegaly
A

Hodgkin Lymphoma

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21
Q

What must you be cautious of with a mediastinal mass?

A

Superior Vena Cava Syndrome (dyspnea, cough, orthopnea, facial/upper extremity edema)

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22
Q

What can confirm the diagnosis of Hodgkin Lymphoma?

A

Reed-Sternberg cells in tissue biopsy

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23
Q

What is the staging for Hodgkin Lymphoma?

A

CXR, CT scan, bone marrow biopsy

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24
Q

What is the treatment for Hodgkin Lymphoma?

A
  • Combination therapy of chemotherapy and low dose radiation
  • Autologous HCT
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25
How is childhood Non-Hodgkin Lymphoma different from adult?
Childhood Non-Hodgkin lymphomas are rapidly proliferating, high-grade, diffuse malignancies
26
The following clinical findings are associated with what cancer? - Fast, usually 1-3 weeks - Enlarging, non-tender lymphadenopathy - Abdominal pain, fevers, cough, dyspnea, weight loss - Hepatomegaly/Splenomegaly (advanced stage)
NHL
27
What is the treatment for NHL?
- Chemotherapy | - Autologous or allogeneic HCT (for those who relapse)
28
What cancer has predisposing factors of Down syndrome and Neurofibromatosis?
AML
29
What is the most common solid tumor of childhood?
Brain tumor
30
What is the triad associated with brain tumors?
- AM headache - Vomiting - Papilledema
31
What is the preferred diagnostic study for brain tumors?
MRI
32
On a tissue biopsy for a brain tumor, what are the two categories of tumors and which is cancerous versus benign?
1. Glial tumors (usually benign) - Astrocytomas 2. Nonglial tumors (usually cancerous) - Medulloblastoma
33
What is the treatment for brain tumors?
- Initial approach: surgical removal | - Radiation and chemo when indicated (avoid in < 3 years of age)
34
What is the most common abdominal tumor in children?
Neuroblastoma
35
What is the most common solid neoplasm outside the CNS?
Neuroblastoma
36
The following clinical manifestations are associated with what childhood cancer? - Abdominal mass that often extends beyond midline - Bone pain from metastatic disease - Fever, weight loss, irritability, abdominal pain, anorexia
Neuroblastoma
37
The following laboratory findings are associated with what cancer? - Anemia - Urinary catecholamines are elevated
Neuroblastoma
38
How is neuroblastoma diagnosed?
- Histologic confirmation OR - Evidence of metastasis of bone marrow/concomitant urine catecholamines
39
What is the treatment for neuroblastoma?
- Surgical resection coupled with chemo - Surgery alone if low grade - Radiation sometimes necessary
40
What is the second most common abdominal tumor in children?
Nephroblastoma (Wilms Tumor)
41
What clinical finding helps to differentiate Neuroblastoma from Nephroblastoma?
The abdominal mass/swelling rarely crosses midline in Nephroblastoma
42
The following clinical findings are associated with what cancer? - Asymptomatic abdominal mass/swelling which is smooth and does not cross midline - Fever, hematuria, hypertension
Nephroblastoma
43
What imaging should be obtained to assess for Nephroblastoma?
- Ultrasound or CT of the abdomen | - CT of chest
44
What is the treatment for Nephroblastoma?
Surgical exploration, chemo, and radiation
45
What is the most common primary bone malignancy in pediatrics?
Osteosarcoma
46
In which bones does osteosarcoma occur in?
``` Long bones (metaphysis) - distal femur (40%) ```
47
What are the cardinal signs of a bone tumor? (3)
- Bone pain at the site - Mass formation - Fracture through the area of cortical destruction
48
Patient presents with the following symptoms: - Bone pain over certain area for the past few months - Soft tissue mass which is tender to palpation - Antalgic gait What should you be concerned for?
Osteosarcoma
49
What imaging studies should you consider when concerned for osteosarcoma?
- X-ray - MRI - Bone scan - CT of the chest
50
What is the treatment for osteosarcoma?
- Surgery | - Chemo
51
What is the second most common primary bone tumor in pediatrics? What population is primarily affected?
Ewing Sarcoma White males during their second decade of life
52
Patient presents with the following findings: - Worsening localized pain and swelling - Bone pain which is worse at night - Fatigue, fever, some weight loss What should you be concerned for?
Ewing Sarcoma
53
What is the treatment for Ewing Sarcoma?
- Chemo - Surgery - Radiation OR combo if needed
54
What is the staging associated with Ewing Sarcoma?
CT scan of chest, bone scan, bone marrow aspirates and biopsy
55
What contributes to 90% of tumors diagnosed before age 5 and is the most common intraocular tumor in pediatrics?
Retinoblastoma
56
The following symptoms should make you consider what disorder? - Leukocoria: white pupillary reflex - Strabismus, nystagmus, red inflamed eye
Retinoblastoma
57
What is the most common sign of Retinoblastoma?
Leukocoria
58
What is diagnostic for Retinoblastoma?
Chalky, off white retinal mass with soft, friable consistency
59
What kinds of diagnostic evaluations should be performed for Retinoblastoma?
- Detailed ophthalmologic exam under anesthesia - Ocular ultrasound - MRI of brain and orbits
60
What are the treatment options for Retinoblastoma?
- Many "vision-sparing" therapies - External beam irradiation - Chemo if confined to the globe
61
What is the most common soft tissue sarcoma in childhood?
Rhabdomyosarcoma
62
What are common symptoms associated with Rhabdomyosarcoma in general? What about orbital specifically? What about bladder specifically?
General: Painless, progressively enlarging mass Orbital: Proptosis/Exophthalmos Bladder: Hematuria, urinary obstruction, pelvic mass
63
What diagnostic testing should be performed when concerned for Rhabdomyosarcoma?
- Xray and CT or MRI of mass - Chest CT to r/o pulmonary mets - Skeletal survey to r/o bone mets
64
What is the treatment for Rhabdomyosarcoma?
Any combination of surgery, chemo, radiation
65
What is hyperleukocytosis?
WBC count of >100,000, medical emergency with life threatening complications
66
What is the most common primary hepatic malignancy in pediatrics?
Hepatoblastoma
67
What is often elevated in Hepatic tumors?
Serum alpha fetoprotein

Peds II (11 decks)

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