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Pediatrics 2 > Hematology/Oncology > Flashcards

Hematology/Oncology Flashcards

(104 cards)

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1
Q

Which malignancy is associated with Bence-Jones proteins in 75% of patients, an M-spike and bone pain?

A

multiple myeloma

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2
Q

Which malignancy is associated with enlarged nodes 90% of the time and the unique presence of Reed-Sternberg cells?

A

Hodgkin’s lymphoma

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3
Q

Which malignancy is associated with B-symptoms and follicular and diffuse large B cell subtypes?

A

Non-Hodgkin’s lymphoma

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4
Q

Which malignancy has a 13q deletion, 90% of patients are over age 50 years old and a hallmark is the clonal expansion of cells expressing CD5+ B cells?

A

Chronic lymphocytic leukemia

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5
Q

Which malignancy has patients with the Philadelphia chromosome in 85-95% of the time?

A

Chronic Myelogenous Leukemia (Cheesesteaks Me Likey)

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6
Q

Which malignancy features > 30% peripheral blasts (5% is normal) that stain myeloperoxidase + and the median age of onset is 68 years of age?

A

Acute Myelogenous (Myeloid) Leukemia

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7
Q

What are some common findings with anemia?

A

pallor, jaundice, petechiae, and purpura

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8
Q

What will MCV look like in iron-deficiency anemia or Thalassemia?

A

Hypochromic, microcytic

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9
Q

What will MCV look like in anemia of chronic disease?

A

Normocytic, normochromic

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10
Q

What will MCV look like in Vitamin B12 or folate deficiency?

A

Macrocytic anemia

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11
Q

What should a be the ddx for fatigue?

A

anemia, CA

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12
Q

How does congenital aplastic anemia (Fanconi’s Anemia) appear in blood work?

A

First as thrombocytopenia OR neutropenia THEN progresses to pancytopenia

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13
Q

What are some physical signs of congenital aplastic anemia?

A

short stature, Cafe au lait spots, mental retardation

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14
Q

Are most anemias acquired or congenital?

A

Acquired

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15
Q

What is the ddx for congenital aplastic anemia?

A

Idiopathic thrombocytopenic purpura

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16
Q

What is the treatment for congenital aplastic anemia?

A

Bone marrow transplant

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17
Q

How does acquired aplastic anemia appear in blood work?

A

Peripheral pancytopenia with hypocellular bone marrow

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18
Q

What are the primary causes of acquired aplastic anemia?

A

50% idiopathic, some drugs, others viral (mostly hepatitis)

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19
Q

What will labs show in AAA?

A

Low reticulocyte (bone marrow isn’t producing new cells)

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20
Q

What is acquired aplastic anemia often seen to be comorbid with?

A

complications of overwhelming infection (low WBC) and severe hemorrhage (decreased platelets)

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21
Q

What is the treatment for acquired aplastic anemia?

A

Treatment of underlying cause (abx), blood transfusion, and bone marrow trans

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22
Q

What is the most common cause of anemia in children?

A

Iron deficiency anemia

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23
Q

What is the clinical presentation of iron deficiency anemia?

A

glossitis, angular stomatitis, fatigue

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24
Q

What will labs show in IDA?

A

microcytic, hypochromic RBCs, low serum iron, elevated TIBC

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25
What is the treatment for IDA?
Fe supplement
26
What is the ddx for IDA?
Thalassemia in African, Mediterranean, or Asian children
27
How do you diagnose thalassemia?
Hemoglobin electrophoresis
28
What are the primary causes of megaloblastic anemia?
Vitamin B12, folic acid deficiency (or both)
29
What will labs for megaloblastic anemia show?
elevated MCV and MCH
30
What is the treatment for megaloblastic anemia? What treatment should be done first? Why?
Vitamin B12 or folate replacement therapy; Vitamin B12 should be done first to prevent irreversible peripheral neuropathy
31
What is hereditary spherocytosis?
inherited hemolytic anemia
32
What are findings of hereditary spherocytosis?
post-hepatic jaundice and splenomegaly
33
What will labs show in hereditary spherocytosis?
increased reticulocyte count
34
what is the treatment of hereditary spherocytosis?
splenectomy to prevent RBC destruction
35
What will labs show in thalassemia?
Microcytic (MCV of 50) but Hb is just below normal range at 10 or 11 (out of proportion to the degree of the anemia)
36
What is the treatment for beta major thalassemia?
Bone marrow transplant
37
What is the treatment for beta minor and alpha thalassemia?
Blood transfusion
38
What is the most common red cell enzyme causing anemia?
G6PD
39
What will labs reveal in G6PD deficiency? infants?
low MCP and high reticulocyte and Heinz bodies; infants will show hyperbilirubinemia
40
Where do we see the highest incidence of sickle cell disease?
in people of Central African decent
41
What is the clinical presentation of sickle cell disease?
Some jaundice, mostly PAIN due to vasoocclusion
42
What are sickle cell patients at a much higher risk for?
Bacterial sepsis
43
What will labs of sickle cell anemia show?
low Hb, high reticulocyte, abnormal Hbg on electrophoresis
44
What is the treatment for sickle cell anemia?
Supportive, blood transfusion if it becomes acute, education
45
What will labs show if you suspect lead poisoning?
basophilic stripping on peripheral blood smear
46
What is the treatment for lead poisoning?
Chelation therapy with edetate calcium disodium
47
What is the primary cause of polycythemia?
secondary hypoxemic disorder
48
What is the clinical presentation for polycythemia?
HA due to increased blood viscosity
49
What is the treatment for primary polycythemia?
phlebotomy
50
What is the secondary cause of polycythemia? How do you treat it?
cyanotic congenital heart dz: Transposition of the great vessels or the tetrology of Fallot; surgical correction
51
What is the most common bleeding disorder in patients age 2-5?
Idiopathic thrombocytopenic purpura
52
What is the mechanism of action of idiopathic thrombocytopenic purpura? What does it usually follow
immune system attacks platelets; usually follows viral infection
53
What is the treatment for idiopathic thrombocytopenic purpura?
prednisone for bleeding
54
What are two common inherited bleeding disorders?
Factor VIII (hemophilia A) and Factor IX (hemophilia B)
55
What are three most commonly acquired bleeding disorders?
DIC, Vitamin K, liver dz
56
What is the cause of DIC? What happens?
Injury or hypoxia; causes microthrombi and a decrease in platelets as well as hemorrhaging
57
What are labs like in DIC?
increased PT, aPTT, FDP, d-dimer, decreased platelets
58
What will liver disease result in?
decreased clotting factors
59
What will labs look like in vitamin k deficiency?
decreased platelet count, increased bleeding time, increased INR/PT (VII-warfarin), increased aPTT (VIII-heparin)
60
What are three commonly inherited thrombotic disorders? FHX of clotting
Factor 5 leiden, antithrombin III, and Protein C and S
61
What is the CP of thrombotic disorders?
DVTs of lower extremities
62
What is the most common form of small vessel vasculitis in children ages 2-7? When do most cases occur?
Henoch-Schonlein purpura; 66% occurs following a URI
63
What is the most common malignancy of childhood?
Acute lymphoblastic leukemia
64
What is the CP of acute lymphoblastic leukemia?
intermittent fever, pelvic, vertebrae, and leg bone pain
65
What is are PE findings on someone with ALL?
hepatomegaly or splenomegaly, +/- lymphadenopathy
66
What do labs show in patient with ALL? Bone marrow?
WBC > 200,000, increased lactate dehydrogenase, bone marrow is shown with leukemic blasts
67
What is the treatment for ALL?
chemo, anticipate tumor lysis syndrome
68
What is tumor lysis syndrome?
Hyperkalemia, hyperuricemia, hypocalcemia, renal failure
69
What disorder has most diagnoses over age 60 but is still seen in children?
acute myeloid leukemia
70
What disease should you suspect if you see a cytogenic clonal abnormalitiy?
Acute myeloid leukemia
71
What will labs show in acute myeloid leukemia?
low Hb, low platelet, low neutrophils (leukocytosis in 25%)
72
What dangerous condition a/w acute myeloid leukemia can become more of a medical emergency than ALL?
leukocytosis
73
What is the treatment for acute myeloid leukemia?
chemo
74
Only 5% of leukemias are this, seen with what finding?
Chronic Myelogenous Leukemia; Philadelphia chromosome
75
How do you treat chronic myelogenous leukemia?
interferon alpha or bone marrow transplant
76
What is the most common solid tumor of childhood?
brain tumor
77
What is the CP of brain tumor? What will older children report?
vomiting, lethargy, irritable, gait, head asymmetry; older children report HA and visual changes
78
How do you dx a brain tumor?
MRI
79
an astrocytoma ependymoma is what type of brain tumor?
Glial
80
a meulloblastoma is what type of brain tumor?
Nonglial
81
How do you treat a brain tumor?
surgery, radiation, and chemo
82
What is the CP of Hodgkins dz?
anorexia, wt loss, fever, fatigue, night sweats (B cell symptoms), painless cervical/supraclavicular lymph nodes
83
How do you dx Hodgkins lymphoma?
CXR, CT, bone marrow bx, look for REED-STERNBERG cells (owl eyes)
84
What disease do you see Reed-Sternberg cells in (owl eyes)?
Hodkins Lymphoma
85
As far as response to chemo goes, Hodgkins lymphoma has a better prognosis in
kids
86
As far as response to chemo goes, Non-Hodgkins lymphoma has a better prognosis in
adults (rapidly proliferating, high-grade, diffuse malignancies in kids)
87
What is the CP of Non-Hodgkin in kids?
cough, dyspnea, orthopnea, lymphadenopathy, abd pain, vomiting, fevers
88
How do you dx Non hodgkin?
Biopsy
89
How do you treat Non Hodgkin lymphoma?
chemo
90
What cancer invades the sympathetic nervous system? 90% are diagnosed before 5 y.o.
neuroblastoma
91
What is the CP of neuroblastoma?
fever, weight loss, ABDOMINAL MASS
92
What is needed for staging of a neuroblastoma?
bone scan and skeletal survey
93
What is the treatment for neuroblastoma?
Chemo, radiation, surgery
94
What is the CP of nephroblastoma (Wilms Tumor)? What is the tx?
asymptomatic ABD mass, hematuria, HTN; surgical exploration of abd and chemo
95
What is the prognosis for a patient with osteosarcoma?
Poor
96
When is the peak incidence for osteosarcoma? Treatment?
adolescent growth spurt, found in long bones; surgery (70% metastasize to lungs w/o chemo) PLUS chemo
97
Ewing sarcoma is cancer of what areas?
Long bone and soft tissue
98
What is the CC of Ewing Sarcoma?
NIGHTTIME BONE PAIN in white males
99
How do you dx Ewing Sarcoma?
CT, MRI
100
How do you tx Ewing Sarcoma?
chemo, surgery
101
90% of diagnoses are made in kids under age 5 in what 2 diseases?
neuoblastoma and retinoblastoma
102
What is known as purely a "soft tissue tumor"? It is also the most common soft tissue tumor in childhood
Rhabdomyosarcoma (70% dx before age 10)
103
Where does rhabdomyosarcoma usually affect?
the head and neck
104
Upon palpation of the abdomen, you find a tumor that is malignant 57% of the time. What test are you going to run? How will you treat it?
AFP; surgery and chemo

Pediatrics 2 (3 decks)

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