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Flashcards in Oncology Deck (22):
0

Most common causes of cancer in pediatrics?

Leukemia >brain tumors >lymphoma >neuroblastoma >tissue sarcoma > Wilms tumor >bone tumor

1

Immunodeficiencies that predisposed to cancer?

Wiskott-Aldrich syndrome – lymphoma and leukemia

X linked lymphoproliferative disease – lymphoma

2

Cancer related to:
1. Down syndrome
2. Turner's
3. Trisomy 13
4. Trisomy 18
5. Kleinfelter (3)

1. Leukemia (ALL/AML)
2. Chondroblastoma
3. Leukemia, teratoma
4. Wilms tumor, neurogenic tumor
5. Leukemia, germs cell tumors, breast cancer

3

Cancer related to:
1. Fanconi anemia
2. Xeroderma pigmentosa
3. Ataxia telangiectasias
4. Bloom syndrome

1. Leukemia
2. Basal/squamous cell carcinoma, melanoma
3. Hodgkins, non-Hodgkin's, leukemia, sarcomas
4. Leukemia, lymphoma, solid tumors, GR malignancy

4

Cancer associated with:
1. Beckwith-Weidemann syndrome
2. Neurofibromatosis I
3. Neurofibromatosis II

1. Wilms tumor, hepatoblastoma, rhabdomyosarcoma, and adrenocortical carcinoma
2. Brain tumors, lymphoma, leukemia, schwannoma
3. Acoustic aroma

5

Abdominal mass – two cancers?

Truncal/extremity masses – two cancers?

Wilms tumor, neuroblastoma

Rhabdomyosarcoma, bone tumor

6

Most common childhood cancer? The most common phenotype? Marker? Clinical features? Diagnosis?

ALL; pre-B-cell phenotype; common acute lymphocytic leukemia and teaching (CALLA)

1. Fever bone/joint pain
2. Pallor, bruising, hepatosplenomegaly, lymphadenopathy
3. Testicular pain, epistaxis may also be present

Marrow replacement with blasts; no staging system

7

Favorable prognostic outcome with ALL if?

White female 1-9 years with WBC <50,000, no organ involvement, CALLA positive

8

Stages of ALL treatment?

1. Induction – destroy cancer cells (methotrexate, vincristine, L-asparaginase, corticosteroids)
2. Consolidation – prevent CNS involvement (methotrexate, cranial irradiation if over 5)
3. Maintenance – three years of chemotherapy
4. Bone marrow transplant for high-risk children/relapse

9

Tumor lysis syndrome – Electrolyte abnormalities (and complications)?

1. Hyperuricemia (Renal insufficiency)
2. hyperkalemia (Cardiac dysrhythmias)
3. hyperphosphatemia (Hypocalcemia with tetany)

10

Treatment side effect that causes:
1. Pancreatitis?
2. Cardiomyopathy?
3. Cystitis?
4. Hormonal problems?

1. L-asparaginase
2. Doxorubicin
3. Cyclophosphamide
4. Irradiation

11

Childhood AML – associated with (4)? clinical features? Diagnosis? Management?

Down syndrome, Fanconi anemia, Kostmann syndrome, neurofibromatosis

Similar to ALL but with more CNS involvement (fever hepatosplenomegaly, gingival hypertrophy, bleeding, bone pain)

Blood smear and bone marrow biopsy

Intensive myeloablative therapy and bone marrow transplant

12

Juvenile CML – chromosomes affected? Chromosome abnormality not present? Clinical features? Treatment? Prognosis?

7, 8; Philadelphia chromosome not effected

Fever, chronic eczematous rash, lymphadenopathy, petechia, anemia, moderate leukocytosis

BM transplant; Usually Fatal

13

Hodgkin's lymphoma – associated with? Clinical features? Diagnosis? Management? Prognosis?

EBV

Painless cervical/supraclavicular lymphadenopathy

Redd-Sternberg cell

Chemotherapy/radiation therapy

Excellent

14

Hodgkin's disease versus non-Hodgkin's lymphoma:
1. Symptoms onset
2. Common location
3. Systemic symptoms
4. Abdominal findings
5. Painless lymphadenopathy
6. SVC syndrome
7. Airway compression

1. Slow versus rapid
2. "Cervical/supraclavicular versus the abdominal, mediastinal, supraclavicular
3. Common versus rare
4. Rare versus common
5. Common in both
6. Rare versus common
7. Rare versus common

15

Late complications of chemotherapy/radiation therapy?

1. Growth retardation
2. Hypothyroidism
3. Male sterility
4. Secondary malignancy (Breast cancer, AML, non-Hodgkin's)

16

Non-Hodgkin's lymphoma – associated with? Basic classifications? Most common presenting feature?

Immune deficiency states (HIV, Wiskott-Aldrich, ataxia telangiectasias, EBV)

1. Lymphoblastic lymphoma
2. Small, non-cleaved cell lymphoma (Burkitt's lymphoma)
3. Large cell lymphoma

Painless lymphadenopathy

17

Clinical features of lymphoblastic lymphoma?

Anterior mediastinal mass leading to:
1. Superior vena cava syndrome
2. airway obstruction

18

Clinical features of small, non-cleaved cell lymphoma?

1. Intussusception with lymphoma and lead point
2. Jaw mass (Burkitt's lymphoma)

19

Clinical features of a large cell lymphoma?

Enlargement of lymphoid tissue in tonsils, adenoids, Pyers patches

20

Langerhans cell histiocytosis? Cause? Diagnosis? Management?

Group of disorders characterized by uncontrolled growth of Langerhans cells

Unknown cause – not true malignancy but severe immune dysregulation

Skin/bone biopsy

Corticosteroids/radiation if one organ; multiagent chemo if multiple organs

21

Langerhans cell histiocytosis – clinical features?

Complications?

1. Skeletal involvement – skull antibodies, bony lesions, pathologic fractures
2. Skin involvement – seborrhic dermatitis
3. Pituitary/hypothalamic involvement – growth retardation, diabetes insipidus, panhypopituitary reason
4. Lymphadenopathy
5. Hepatosplenomegaly
6. Pulmonary Infiltrates
7. Anemia
8. Exophthalmos

Growth Impairment, learning problems, hearing loss, orthopedic deformities, chronic lung disease