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Paeds BPT Written Exam > Oncology > Flashcards

Oncology Flashcards

(48 cards)

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1
Q

Risk factors for ALL?

A
  • Prenatal radiation exposure
  • Postnatal exposure to high doses of radiation
  • Down syndrome
  • Ataxia- telangiectasia
  • Fanconi anaemia
  • Neurofibromatosis
  • Bloom syndrome
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2
Q

Top 4 most common childhood malignancies?

A

Leukaemias (25%)

CNS tumours (17%)

Neuroblastomas (7%)

NHL (6%) and Wilms (6%)

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3
Q

Key pathology finding in Hodgkins Lymphoma

A

Reed-Sternberg cells, large multinucleated cells that divide rapidly and live longer than normal cells

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4
Q

Histologic subtypes of Non-Hodgkin Lymphoma

A
  • Burkitt lymphoma
  • Lymphoblastic lymphoma
  • Diffuse large B cell
  • Anaplastic large cell
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5
Q

Common brain tumour associated with NF1?

A

OPTIC GLIOMAS
Meningiomas
Ependymomas

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6
Q

Common brain tumour associated with NF2?

A

BILATERAL VESTIBULAR SCHWANNOMA
regional glioma
meningioma
glioma
schwannomas (cranial and peripheral nerve)

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7
Q

Common brain tumour associated with tuberous sclerosis?

A

Subependymal giant cell tumours

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8
Q

What is rasburicase

A

Used in patients with TLS with high rate levels or those at high risk of TLS

It is an enzyme that degrades uric acid

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9
Q

AFP is a tumour marker for which cancers?

A

Hepatoblastoma and HCC
Yolk sac tumours
Immature teratomas
embryonal carcinomas

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10
Q

Beta hCG is a tumour marker for which tumours

A

Choriocarcinomas
Seminomas
Some dysgerminomas

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11
Q

Tumour markers for neuroblastoma

A

Urine catecholamines (VMA and HMA)
Neuron specific enolase (NSE)

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12
Q

Cancers associated with Beckwith-Wiedemann Syndrome?

A

Hepatoblastoma
Wilms Tumour

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13
Q

Cancers associated with Gorlin Syndrome

A
  • BCC
  • Medulloblastoma

PTCH gene mutation

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14
Q

Staging of Wilms Tumour

A
  • Stage 1: limited to 1 kidney
  • Stage 2: extends beyond the kidney but can be completely excised
  • Stage 3: confined to abdomen and local lymph nodes
  • Stage 4: haemogenous spread - commonly to lungs
    Stage 5: bilateral kidney involvement (5-10%)
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15
Q

Which cancers are associated with Li Fraumeni syndrome?

A

Sarcomas
Breast cancer
Adrenocortical cancer
Brain cancer
ALL
Lymphoma (esp HL)

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16
Q

PTEN hamartoma syndrome is associated with what clinical features and cancer predisposition?

A
  • Acral keratosis (papules on hands/feet)
  • Facial papules
  • Hamartomas tumours of the outer hair sheath follicle
    increased risk of THYROID, breast, endometrial, kidney, and colorectal cancers.
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17
Q

Cancers associated with ataxia-telangiectasia?

A
  • Leukaemia and lymphoma
  • Breast cancer
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18
Q

Cancers associated with HNPCC (Lynch Syndrome)

A
  • Colorectal
  • Endometrial and ovarian
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19
Q

Cancers associated with familial adenomatous polyposis? (APC gene mutation)

A
  • Colorectal
  • Hepatoblastoma
  • Thyroid
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20
Q

Cancer associated with Noonan Syndrome?

Study These Flashcards
A

Myeloproliferative disorder/ Juvenile Myelomonocytic Leukaemia (JMML) - A rare, agressive leukaemia

21
Q

Management of Philadelphia chromosome positive ALL?

Study These Flashcards
A

Need addition of tyrosine kinase inhibitor (eg imatinib)

22
Q

Poor prognostic indicators in ALL?

Study These Flashcards
A
  • Age <1 or >10 at diagnosis
  • Philadelphia chromosome t(9;22)
  • T cell leukaemia
  • Extramedullary disease (ie CNS or testicular disease)
  • Measurable residual disease at end of induction (>0.01% blasts)
  • Mature B cell leukaemia
  • WCC>50 at presentation

(Hyperdiploidy, rapid response to treatment, trisomies of chromosome 4 and 10 and T(12;21) translocation are GOOD prognostic factors)

23
Q

Chloromas (green-hued skin lesions), subcutaneous nodules (“blueberry muffin”) and infiltration of gingiva are distinguishing features of which cancer?

24
Q

Pathognomonic blood film finding in AML?

Study These Flashcards
A

Auer rods (inside peripheral blood cell blasts)

25
Common condition seen in early infancy in T21?
Transient abnormal myelopoeisis (circulating blasts, often associated with hepatomegaly)- resolves spontaneously in most cases
26
Side effects of cyclophosphamide?
- Haemorrhagic cystitis (give Mesna) - Anaphylaxis - secondary malignancies - Myelosuppression - Infertility
27
Side effects of doxorubicin /anthracyclines?
Cardiomyopathy + arrhythmia Red urine Tissue necrosis with extravasation Myelosuppression
28
Which chemotherapy agent commonly causes ototoxicity?
Platinums (eg cisplatin, carboplatin)
29
Which chemo agent commonly causes constipation?
Vincristine
30
Which chemo agent commonly causes peripheral neuropathy?
Vincristine
31
Which chemo agent commonly causes diarrhoea?
Irinotecan
32
Which chemo agents cause pulmonary fibrosis?
Bleomycin Busulfan
33
Main side effects of methotrexate?
Myelosuppression Mucositis Hepatitis Stomatitis High dose - renal toxicity, neurocognitive effects Long term: osteopenia
34
Which chemo agents need genetic testing performed to ensure toxic dosing not given?
Mercaptopurine and azathioprine Thiopurine S- methyltransferase (TMPT) gene encodes one of the metabolising enzymes of thiopurines (azathioprine, mercaptopurine). Low levels of this enzyme -> accumulation -> severe myelosuppression
35
5 Features of veno-occlusive disease?
- Weight gain >5% above baseline - Tender hepatomegaly - Ascites - Rising bilirubin from baseline on 3 consecutive days - refractory thrombocytopenia Highest risk in first month post bone marrow transplant
36
Management of veno-occlusive disease?
Defibrotide (a single stranded polydeoxyribomucleotide which has local anti-thrombotic, anti-ischaemic, anti-inflammatory activity) Supportive care: diuretics, analgesia, electrolyte replacement
37
Mixed linear leukaemia is commonly seen in which type of leukaemia?
Infant ALL. Rare disorder with much poorer outcome
38
Acute promyelomyelocytic leukaemia
- May present with DIC - If survive induction, often very good prognosis - Manage with retinoid acid +/- arsenic
39
What are CAR-T cells?
Engineered autologous T cells - T cells taken out, reprogrammed using a viral vector to recognise cancer cells/ other cells expressing a particular antigen - infused after lymphodepleting chemotherapy Used in B cell malignancy (eg B cell lymphoma, CD19+ ALL)
40
Which type of HSCT has the highest rates of GVHD?
Peripheral blood stem cells > bone marrow > cord blood
41
Order of preference for Allogenic HSCT?
1. Matched sibling donor (Marrow >PBSCs) 2. Matched unrelated donor - BM 3. Matched unrelated donor - cord 4. Mismatched familial haploidentical donor- BM 5. Matched unrelated donor - PBSC 6. Miamatched unrelated donor - cord > marrow > PBSC
42
Acute GVHD affects which organs?
Skin Liver Intestines (diarrhoea)
43
Risk factors for Acute GVHD
HLA mismatch Unrelated donor Sex mismatch Total body irradiation High T cell numbers in donor Low concentration of recipient immunosuppressive meds
44
Management of acute GVHD
- Optimise immunosuppression - Increase ciclosporin - Steroids - Wet wraps
45
Poor prognostic factors in hyperleukocytosis (WCC >100)?
- WCC >200 - Age <1 or >10yrs - AML (due to size of blasts) Associated with neuromuscular and Resp complications, DIC and tumour lysis syndrome
46
Features of posterior reversible encephalopathy syndrome (PRES)?
Headache HTN (75%) Confusion Convulsions Vision loss MRI; bilateral hyperintense densities in parieto-occipital region on T2
47
Which chemotherapies are associated with increased risk of secondary AML/ myelodysplastic syndrome?
Etoposide Alkylating agents (eg cyclophosphamide)
48

Paeds BPT Written Exam (18 decks)

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