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ONCOLOGY Flashcards

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1
Q

Commonest pediatric malignancy

A

Leukemia

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2
Q

2nd most common & 3rd most common malignancy.

A

CNS tumor
Embryonal and sarcomas

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3
Q

What are the 2 peaks of childhood malignancies

A

Early childhood
Adolescence

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4
Q

There’s an increased risk of cancers with?

A

Neurofibromatosis type 1 & 2
Down syndrome
Beckwith - wiedemann syndrome
Tuberous sclerosis
Ataxia telangiectasia
Klinefelter’s syndrome

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5
Q

The types of cancers associated with
1. Down syndrome
2. Beckwith-wiedemann syndrome
3. Tuberous sclerosis
4. Ataxia telangiectasia
5. Klinefelter’S syndrome.

A
  1. Leukemia
  2. Kidney, liver cancers
  3. Kidney cancer
  4. Skin cancers
  5. Testicular cancers
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6
Q

Infections and their associated pediatric malignancies.

A

Hepatitis B&c- HCC
HPV - cervical cancer
HIV - kaposi sarcoma

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7
Q

Peak age of onset of acute lymphoblastic leukemia

A

Between 2-6 years

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8
Q

Most pediatric malignancies are common among males or females?

A

Males.

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9
Q

Possible etiological factors for acute lymphoblastic leukemia

A

Down syndrome
Ionizing radiation
advanced maternal age. (>35 years)

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10
Q

Predominant cell type in acute lymphoblastic leukemia

A

Pre b-cells

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11
Q

Bad prognostic factors of acute lymphoblastic leukemia

A

Male
<1 year and >10 years
T cells
Mediastinal mass
WBC> 25x109/L
CNS involvement
t(9:22)
t(4:11)
Hypodiploidy
Longer time to respond to treatment

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12
Q

Two chromosomal dislocations that are bad prognostic features of ALL

A

t(9:22)
t(4:11)

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13
Q

Ix of ALL

A

Blood picture
Bone marrow aspiration
CBC

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14
Q

Blood picture findings of ALL

A

Thrombocytopenia
blast cells might not be seen

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15
Q

CBC findings of ALL

A

WBC high
Platelet, Hb reduced

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16
Q

Rx of ALL

A

Chemotherapy (vincristine)
Steroid (Dexa, prednisone)

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17
Q

CNS therapy of ALL route

A

Intrathecal - directly to spine

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18
Q

CNS therapy of ALL given on

A

At the start of treatment
once more during induction

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19
Q

Maintenance phase of ALL lasts

A

2-3 years

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20
Q

Survival of ALL

A

> 90%AT five years

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21
Q

Second most common malignancy in paeds

A

Brain tumors

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22
Q

T/F
1.Brain tumors are mostly primary.
2.Brain tumors are mostly malignant

A

1.T
2.T

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23
Q

Commonly seen age group for brain tumors in children

A

<= 7 years

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24
Q

Infratentorial and midline brain tumors clinical features

A

Features of increased ICP
Disorders of the equilibrium, gait, coordination
Blurry vision
Diplopia
Nystagmus

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25
Supratentorial brain tumors features
Changes in personality mentation motor weakness sensory changes speech disorders seizures reflex abnormalities hand preference
26
Imaging standard of brain tumors
MRI
27
Medulloblastoma age of presentation
5-7 years
28
Bad prognostic factors of medulloblastoma
Young age
29
Clinical features of medulloblastoma
Increased ICP cerebellar signs
30
Mx of medulloblastoma
Surgery Chemo Radiotherapy
31
location of craniopharyngioma
within the suprasellar region
32
MRI shows.... in craniopharyngioma
Calcification
33
Clinical features of craniopharyngioma
panhypopituitarism growth failure visual loss- bi-temporal hemianopia
34
Mx of craniopharyngioma
Surgery only.
35
Signs of tumors of the brainstem
Motor weakness cranial nerve defects cerebellar defects increased ICP Torticollis
36
Why is there a poor prognosis on tumors of the brain
Because it is difficult to operate
37
Mother says while giving a bath she noticed a lump on the babies abdomen. the child is always irritable and sweating. Once taken to the GP clinic it was found out the child has high BP. Dx?
neuroblastoma
38
Tumor/ lump crossing the midline+ calcifications
Neuroblastoma
39
Tumor/ lump not crossing the midline and no calcifications
Renal tumors
40
Neuroblastoma cell type
Sympathetic ganglia.
41
Most commonly diagnosed neoplasm in infants
Neuroblastoma
42
Neuroblastoma age of presentation
<2 years
43
poor prognostic factors of Neuroblastoma
advanced stage advanced age
44
characteristics of a Neuroblastoma
firm nodular mass cross the midline calcifications on the X- Ray
45
Signs of metastasis in Neuroblastoma
fever irritability failure to thrive bone pain bluish subcutaneous nodules orbital proptosis periorbital ecchymosis
46
MC site of metastasis in Neuroblastoma
long bones bone marrow skull bone marrow liver lymph nodes Skin
47
CNS signs of Neuroblastoma
Horner's syndrome Spinal cord compression Opsomyoclonus (Rapid eye movements, jerky movements of arms and legs)
48
Some Neuroblastoma tumors secrete.....
Catecholamines
49
Clinical features of Neuroblastoma that secrete catecholamines
Increased sweating Hypertension secretory diarrhea
50
4S stage of neuroblastoma
subcutaneous tumor nodules Massive liver involvement
51
Subcutaneous tumor nodules of Neuroblastoma appearance is also known as
Blueberry muffin appearance
52
Ix of Neuroblastoma
breakdown products of adrenaline on urine - HVA, VMA CT Bone marrow USS Abd
53
Mx of Neuroblastoma
surgical resection +/- chemo +/- radiotherapy
54
Nephroblastoma is also known as
Wilm's tumor
55
Age of onset of Nephroblastoma
2-5 years
56
Wilm's tumor is associated with
Anirida WAGR syndrome Beckwith Wiedemann syndrome Neurofibromatosis 1
57
Wilm's tumor clinical features
abdominal mass often detected by doctors. no calcification Rarely crosses the midline HTN hematuria Anaemia Fever
58
Is hematuria common in Wilm's tumor
no
59
Is bilateral involvement of kidneys common in Wilm's tumor
Rare
60
Mx of wilm's
surgery and chemo
61
Possible X ray findings of wilm's
Chest and abdomen mets in the lungs
62
Are all cases of retinoblastoma bilateral
no. some are unilateral
63
Can retinoblastoma be misdiagnosed?
Yes. U/L can be misdiagnosed
64
Gene involved in Retinoblastoma
RB1 inactivated
65
Sx of retinoblastoma
Leukoria
66
Leukoria
White pupillary reflex (usually red when shining a light)
67
DDs of leukoria
Cataract Visceral larva migrans chorodial coloboma ROP(Retinopathy of prematurity) Retinoblastoma
68
Dx test contraindicated in retinoblastoma
Pupillary biopsy
69
Ix of retinoblastoma
Orbital USS CT MRI
70
Rx of retinoblastoma ( Primary and secondary goals)
Primary - cure Secondary- preserving vision
71
Mx modality for B/L involvement of retinoblastoma
Chemo - laser photocoagulation or cryotherapy
72
Situations where enucleation is performed in retinoblastoma
No potential for useful vision optic nerve involvement
73
Enculeation?
Removing the eye
74
Retinoblastoma has a good prognosis if it's associated with
Osteosarcoma
75
Hepatoblastoma age of presentation
<3 years
76
Hepatoblastoma is associated with
FAP Beckwith- wiedemann syndrome Hemihypertrophy
77
Sx of Hepatoblastoma
Large asymptomatic abdominal mass on the right side (R>L)
78
Ix of Hepatoblastoma
alpha feto protein levels high
79
Bilirubin and liver enzyme levels in Hepatoblastoma
Usually normal
80
Mx of Hepatoblastoma
Surgery/ Chemo
81
HCC is seen ..... (age group)
Adolescents
82
HCC is associated with
Hep B,C Galactosemia Glycogen storage disease alpha- 1 anti trypsin deficiency biliary cirrhosis chronic hereditary tyrosinemia
83
HCC presents as
Hepatic mass Abdominal distension Anorexia Weight loss Abdominal pain
84
AFP ( Alpha feto protein levels ) in HCC vs and Hepatoblastoma
Levels Hepatoblastoma> HCC
85
HCC prognosis is usually good or bad
Bad
86
Characteristic age of malignant tumors of bone
2nd decade
87
Two examples of malignant tumors of the bone
Osteosarcoma Ewing's tumor
88
T/F Malignant tumors of the bone is common in males than females
True
89
Etiology of osteosarcoma
Retinoblastoma Paget disease Radiotherapy Li- Fraumeni syndrome
90
Affected part of bones in osteosarcoma
Metaphysis of long bones
91
Affected part of bones in Ewing sarcoma
Diaphysis of long bones Flat bones
92
Sx of osteosarcoma
Local pain and swelling
93
Osteosarcoma has a Hx of
Injury
94
Sx of Ewing sarcoma
Local pain and swelling Fever
95
Radiographic findings of Osteosarcoma
Sclerotic destruction Sunburst appearance
96
Radiographic findings of Ewing sarcoma
Primarily lytic Onion skinning appearance
97
Onion skinning appearance in Ewing sarcoma is due to
Multilaminar periosteal reaction
98
Mets of both Osteosarcoma and Ewing sarcoma- sites
Lung Bones
99
Mx of osteosarcoma
Chemo > surgery
100
Mx of Ewing's sarcoma
Chemo Radiotherapy
101
Outcome of bone tumors with mets at presentation
<= 20% survival

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