Oncology

Question 1

Doxorubicin side effects

Answer 1

Dilated cardiomyopathy

Question 2

Osteomyelitis x-ray

Answer 2

periosteal reaction

Question 3

Osteosarcoma x-ray

Answer 3

Sunburst
metaphysis or growth plate

Question 4

Ewing sarcoma

Answer 4

onion skinning
Mottled
diaphysis and axial

Question 5

Langerhans cell histiocytosis

Answer 5

1-Rash
2-neutropneia
3-Skull abnormalities
4-DI (polyuria and polydipsia)

Question 6

Neuroblastoma

Answer 6

Opsoclonus-myoclonus
Dx: urine VMA/HVA
or MIBG scintigraphy

Question 7

12-year-old female, with fatigue, diffuse lymphadenopathy, HSM, supraclavicular lymph node, normal Hb and WBC, and low normal platelets 150s. Viral studies (EBV) normal. What is the NEXT best step?

Answer 7

CXR

Question 8

WAGR

Answer 8

Wilams Tumor
Aniridia
GU abnormalities
retreated mentally

Question 9

5yo with LCH s/p chemotherapy with vinblastine and prednisone 1 year prior, currently in remission. Presenting with polyuria and polydipsia. What is the cause?

Answer 9

Central diabetes insipidus

Question 10

Kid with Burkitt’s and TLS. Urine pH 7.0. What’s next.

Answer 10

Rasburicase

Question 11

Features of Tumor lysis syndrome

Answer 11

Remember cells are bursting
1-high K
2-high phosphate
3-low ca
4-high ca in the urine
5-high LDH

Question 12

Tumor lysis management

Answer 12

Allopurinol: decreases production of urate
Rasbirucase: binds urate to excrete it

Question 13

A child with ALL finished chemo 1 month ago and is exposed to Varicella. How do you treat?

Answer 13

VZIG

Question 14

Examples of live vaccine

Answer 14

MMR, varicella, rotavirus
Nasal flu
BCG, Zoster

Question 15

Chemotherapy that causes low sodium and vomiting

Answer 15

Cyclophosphamide

Question 16

Vincristine side effect?

Answer 16

Peripheral neuropathy

Question 17

14 y.o boy w supraclavicular LN. What is your next step

Answer 17

CXR

Question 18

Child with head tilt, ataxia, nystagmus. Most likely diagnosis:

Answer 18

Cerebellar astrocytoma

Question 19

Teenager with generalized lymphadenopathy and right supraclavicular node. What to do next?
what is the next step in evaluation NOT what would give the dx?

Answer 19

a.CXR
b. BMA
c. CT abdo

Question 20

Which cancer will most likely have bone marrow infiltration

Answer 20

neuroblastoma

Question 21

What is a risk factor for child leukemia?
a. parent treated for leukemia
b. in utero radiation
c. maternal alcohol
d. NF type 1

Answer 21

in utero radiation

Question 22

16 y.o. boy undergoing treatment for non-Hodgkin’s lymphoma. Forty-eight hours after his last chemotherapy, he develops mild dysuria and hematuria. Platelet count was 90 pre-treatments. He is happy and well-looking. He is sexually active. What is the most likely because of his hematuria:

Answer 22

cyclophosphamide-induced hemorrhagic cystitis

Question 23

Child with aniridia, what investigation will this child need regularly?

Answer 23

Abdominal U/S