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children > Oncological conditions > Flashcards

Oncological conditions Flashcards

1
Q

What is cancer?

A

Cancer refers to a group of diseases in which there is

out-of-control growth and spread of abnormal cell

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2
Q

What are the types of cancer?

A
  • Solid Tumors

* Hematological

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3
Q

What is the name of a cancer depend on its cell origin?

A

• Sarcoma – connective tissue, muscle, bone
• Carcinoma – epithelial tissue (glands, hollow
organs, outer layer of skin that lines the blood
vessels)

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4
Q

What are the most common childhood malignancy?

A
  1. Leukaemia ( most common )
  2. Solid tumours
  3. Lymphomas
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5
Q

Leukaemia

A
  • Acute Lymphochytic Leukemia

* Acute Myelogenous Leukemia

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6
Q

Solid tumours

A

• Brain Tumours

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7
Q

Lymphomas

A
  • Hodgkin’s Disease

* Non-Hodgkin’s Lymphoma

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8
Q

What are the common symptoms of leukemia?

A

Systemic

  • weight loss
  • fever
  • frequent infections

Lungs
- easy shortness of breath

Muscular
- weakness

Bones or joints
- Pain or tenderness

Psychological

  • Fatigue
  • Loss of appetite

Lymph nodes
- Swelling

Spleen and/or liver
- Enlargement

Skin

  • Night sweats
  • Easy bleeding and bruising
  • Purplish patches or spots
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9
Q

What are the other childhood malignancy?

A 
Neuroblastoma
• Nerual crest cells: brain, adrenal medulla, pelvis, mediastinum and sympathetic
ganglia
Sarcoma
• Soft tissue sarcoma – Mesenchymal cells in skeletal muscle, smooth muscle, fat
fibrous tissue, bone and cartilage
• Rhabdomyosarcoma
Wilm’s Tumor
• Nephroblastoma (Kidney)
Bone Tumor
• Osteosarcoma
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10
Q

What are the treatment modalities?

A
  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Hematopoietic stem cell transplantation
  • Biological response modifiers
  • A combination of these modalities is a frequently use
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11
Q

What are the surgery for cancer?

A
  • Remove all visible and microscopic malignant cell
  • Obtain biopsy for microscopical diagnosis
  • Tumor staging
  • Reconstructive surgery – correct defects
  • Insertion of venous access devices
  • Palliative: Relieve pain and obstruction
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12
Q

Chemotherapy for cancer

A

• Most frequently used treatment
• Effective for systemic cancers that cannot be managed by surgery or radiation
therapy

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13
Q

Chemotherapy drugs categories

A
  • Alkylating agents
  • Antimetabolites
  • Anti-tumor antibiotics
  • Plant alkaloids
  • Enzymes
  • Miscellaneous agents
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14
Q

What are the side effects of chemotherapy?

A
  • Hematopoietic: Myelosuppression, anemia, thrombocytopenia, neutropenia
  • Gastrointestinal: Mucositis
  • Hepatic: Liver toxicity
  • Renal: Renal Toxicity
  • Integumentary: Alopecia
  • Reproductive: Oligomenorrhea
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15
Q

What is radiation therapy?

A

• Deliver a dose of ionizing radiation to a tumor with minimal effects to the healthy
surrounding tissue
• External Beam
• Brachytherapy

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16
Q

What is acute lymphocytic ( lymphoblastic ) leukemia (all)

A

• ALL is responsible for 70-75% of childhood leukemias and involves lymphoblasts (immature
lymphocytes)
• Highest incidence of ALL in children is 2-6 years of age

17
Q

What is the most common type of cancer in children?

A

-Leukemia

18
Q

What is the clinical manifestation for leukemia?

A
  • Fatigue
  • Pallor
  • Low-grade fever
  • Bone and joint pain
  • Petechiae & bruising
  • Purpura
  • Lymph nodes may be enlarged
19
Q

What is the investigation for acute lymphocytic leukemia?

A 
• Bone marrow aspirate (abnormal
lymphoblasts)
• Biological markers (origin of leukemia,
B-cell precursor, mature B-cell
precursor, T-cell)
• WBC (<5000/mm3)
• Lumbar puncture (CSF for cytospin for
blast) - CNS involvement
• CXR (mediastinal mass)
• Laboratory Tests
20
Q

What is the treatment for acute lymphocytic leukemia?

A

• Induction Phase (4 weeks to remission)
• IV Vincristine, L-asparaginase, Prednisolone
• Consolidation
• High-dose chemo, IT/radiation therapy if CNS is involved
• Maintenance
• Chemo agents by oral, IV or IM route
Event free survival rate > 80% (Vrooman & Silverman, 2009)

21
Q

What is the management for acute lymphocytic leukemia?

A
  • Prevent infection
  • Prevent bleeding and injury
  • Reducing pain
  • Promoting energy conservation
  • Relieving anxiety
  • Promoting normal growth and development
22
Q

What is sepsis?

A

• Sepsis is a generalized bacterial infection that usually occur in the first month of life
• Neonates are highly susceptible because of their immature immune response
• Risk factors includes: prematurity, invasive procedure, steroid use for chronic
condition and nosocomial exposure to pathogens

23
Q

What is the clinical manifestation for Sepsis?

A

• For infants: Poor sucking and feeding lethargy, weak cry, irritability

24
Q

What is the subsequent sign and symptoms for Sepsis?

A

• Tachycardia, increased or irregular respiration, mottling, GI disturbances,
temperature instability, dehydration, hypotension

25
Q

What is meningitis?

A
  • Infection of the meninges – usually caused by bacterial invasion
  • Prognosis depends on the age, organism and child’s response to therapy
  • Most cases occur between 1month – 5 years
  • Infants < 12months most susceptible to bacterial meningitis
26
Q

What is organisms?

A

• E.coli and Group B Strep are the common organism causing meningitis in neonates
• Infant and children: Neisseria meningitidis, Strep. Pneumoniae and Group B Strep.
HiB vaccine has dramatically decreased the incident of Haemophis Influenzas
meningitis
• Viral meningitis due to coxsackievirus, mumps is self-limiting lasting 7-10days

27
Q

What is the pathophysiology?

A

• Bacteria enters the meninges through bloodstream and spread via CSF
• Infection can directly be spread through trauma or neurosurgery
• Pathogen acts as a toxin, creating meningeal inflammation response and results in
release of purulent exudates

28
Q

Assessment of clinical manifestation

Children < 2 years

A
  • Poor feeding, irritability and lethargy
  • High pitch cry, bulging fontanel
  • Fever or low temperature
  • Hyperextension of neck and spine
29
Q

Assessment of clinical manifestation

Older children

A

• Respiratory or GI problem (early stages)
• Stiff neck
• Headache
• Tripod posturing
• Kernig signs - pain and resistance to knee extension when on
supine position
• Brudzinski’s sign – flexion of knees and hips when neck is flexed
when on supine position

30
Q

Assessment of clinical manifestation

A

• Monitor vital signs - note clinical characteristic of condition change
• Monitor I/O, fluid and electrolyte balance:
- Maintain IV therapy, fluid restriction may be needed to prevent
cerebral oedema
- Overhydration is avoided to prevent the occurrence of
syndrome of inappropriate antidiuretic hormone (SIADH)
• Assess signs of raise ICP
• Administer prescribed medications - antibiotic, anticonvulsant or steroid to
relieve cerebral oedema
• Provide supportive intervention – quiet room to decrease environmental
stimuli

children (12 decks)

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