Heme Onc

Question 1

Ewing sarcoma

Answer 1

Soft tissue

Question 2

Osteogenic sarcoma

Answer 2

More common in blacks
Teenager with growth spurt
Proximal, distal long bones (femur, humerus)

Question 3

Osteoid osteoma

Answer 3

Tibia, femur pain
Relieved with NSAIDs
Worse at night
Central radiolucent, surrounded by sclerotic

Question 4

Hodgkins lymphoma

Answer 4

Teenager
Nontender cervical nodes
Weight loss, fever, night sweats
Reed Sternberg cells
High WBCs, low lymphocytes

Question 5

Non Hodgkins lymphoma

Answer 5

Small chiild

Had/neck, abdominal mass

Question 6

Langerhans cell histiocytosis

Answer 6

Seborrheic rash
Ear discharge
Lytic skull lesions
Diabetes insipidus
Excessive urination

Dx: skin Bx, electron microscope

Question 7

Neuroblastoma

Answer 7

MC solid tumor
Survival rate 95% if < 12 mos

Nontender abdominal mass
Weight loss, anorexia
Racoon eyes
Horner syndrome
Irritability, hypertension, diarrhea

Dx: urine VMA, HMA

Question 8

Wilms tumor

Answer 8

Toddler
Asymptomatic abdominal mass
Hematuria
Hemihypertrophy
Beckwith Wiedeman syndrome

Question 9

Cyclophosphamide

Answer 9

Hemorrhagic cystitis

Question 10

Bleomycin

Answer 10

Pulmonary fibrosis

Question 11

Anthracycline
Doxorubicin
Daunorubicin

Answer 11

Cardiac toxicity

Question 12

Vincristine/Vinblastine

Answer 12

Neurotoxicity

SIADH

Question 13

Asparaginase

Answer 13

Pancreatitis

Question 14

Procarbazine

Answer 14

CNS problems

Question 15

Methotrexate

Answer 15

Oral, GI ulcers

Question 16

Ifosphamide

Answer 16

Nephrotoxicity

Question 17

Physiologic anemia

Answer 17

2nd/3rd mo (8-10 wks)
Low erythropoietin production
Normal MCV 70-90

Question 18

Beta Thalassemia

Answer 18

Mediterranean
Hepatosplenomegaly
Increased Hb A2, F
Hair on end appearance on skull XR

Cx: cholelithiasis, hemosiderosis

Question 19

Macrocytic anemia

Answer 19

B12 deficiency
Folate deficiency
Fanconi anemia
Blackfan anemia

Question 20

B12 deficincy

Answer 20

Bacterial overgrowth
Bowel resection
B12 deficiency
HLA B27 (Crohns)

Dx: Schilling test

Question 21

B12 deficiency

Answer 21

Weakness
Paresthesia
Sore tongue

Question 22

Folate deficiency

Answer 22

Erythrocyte folic acid concentration

R/ B12 deficiency

Question 23

G6PD deficincy

Answer 23

Heinz bodies
Dark urine, jaundice, anemia
Mothballs, antimalarials, nitrofurantoin

A: African Americans
B: Mediterranean

Question 24

Hereditary spherocytosis

Answer 24

Autosomal dominant

Increased MCHC
Spectrin deficiency
Hemolytic anemia

Tx: folic acid

Question 25

Pyruvate kinase deficiency

Answer 25

Autosomal recessive Normal osmotic fragility Hemolytic anemia

Question 26

Fanconi anemia

Answer 26

``` Short stature Cafe au lait Absent thumb, radius Cardiac defects Pancytopenia Leukemia, malignancy risk Chromosomal breakage ```

Question 27

Transient Erythroblastopenia of Childhood

Answer 27

Toddler Normal MCV, reticulocytopenia Spontaneous recovery

Question 28

Mediastinal mass

Answer 28

Anterior: lymphoma Posterior: neuroblastoma, Ewings