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Flashcards in haem/ oncology Deck (35):
1

what happens in ITP

immune. destruction circulating platelets by IgG

2

what happens in ITP

immune. destruction circulating platelets by IgG

3

features ITP

2-10y. onset after 1-2w after viral infection. usually short Hx days or weeks.

4

signs ITP

petechiae, purpura, superficial bruising, epistaxis, other mucosal bleeding. profuse bleeding is uncommon.

5

what are the platelet levels in ITP

often falls to below 10

6

diagnosis ITP

of exclusion. younger child- consider congenital eg Bernard soulier syndrome. do bone marrow to exclude acute leukaemia or aplastic anaemia if anaemia, neutropenia, hep splen meg

7

diagnosis ITP

of exclusion. younger child- consider congenital eg Bernard soulier syndrome. do bone marrow to exclude acute leukaemia or aplastic anaemia if anaemia, neutropenia, hep splen meg

8

features ITP

2-10y. onset after 1-2w after viral infection. usually short Hx days or weeks.

9

signs ITP

petechiae, purpura, superficial bruising, epistaxis, other mucosal bleeding. profuse bleeding is uncommon.

10

what are the platelet levels in ITP

11

what is a rare complication ITP

intracranial haemorrhage

12

treatment chronic ITP

supportive. drug treatment only if chronic persistent bleeding affecting daily life, QOL

13

if going to treat with steroids ITP what should you do

examine bone marrow as could mask ALL

14

what treatments are there for chronic ITP

ritixumab- antibody against B lymphocytes. thrombopoietic growth factors. splenectomy

15

when would you treat in ITP

major bleeding or persistent minor bleeding

16

treatments ITP

oral pred. IV anti D or IVIg. platelet transfusion if life threatening

17

what is chronic ITP

in 20%, platelet count remains low after 6 months diagnosis

18

diagnosis neuroblastoma

catecholamine degradation products- VMA, HMMA usually raised

19

treatment neuroblastoma

chemo with radio and surgery

20

what treatments are there for chronic ITP

ritixumab- antibody against B lymphocytes. thrombopoietic growth factors. splenectomy

21

what is a neuroblastoma

malignant tumour arising from sympathetic nervous tissue. derived from neural crest tissue which makes up sympathetic chain and adrenal medulla

22

where does neuroblastoma commonly develop

adrenal gland

23

presentation neuroblastoma

abdominal mass, mass can be present anywhere along sympathetic chain. large tumour. early mets to bone, liver, skin.

24

prognosis Wilms

90% long term survival

25

treatment neuroblastoma

chemo with radio and surgery

26

signs retinoblastoma

strabismus (squint) and leukocoria (white pupil). absent red reflex

27

presentation Wilms tumour

unilateral abdominal mass (95% unilat), often solid and cystic mass. fever, flank pain. haematuria not common.

28

diagnosis Wilms tumour

US- renal pelvis distortion. hydronephrosis. CT/MRI

29

management Wilms tumour

avoid biopsy. nephrectomy + vincristine and actinomycin for 4 weeks preop. 2 drugs for early tumour and no radio, 3 drugs for more advanced with radiotherapy

30

prognosis Wilms

90% long term survival

31

what is retinoblastoma

most common intraocular tumour in childhood.

32

signs retinoblastoma

strabismus (squint) and leukocoria (white pupil). absent red reflex

33

when would you think it is familial (RB)

bilateral. RB1 gene which is a tumour suppressor gene

34

treatment RB

chemo (good for bilat), enucleation, external beam radiotherapy. screen parents and siblings

35

what is RB associated with

sarcomas- rhabdosarcoma, osteosarcoma