Oncology

Question 1

Most common childhood cancers

Answer 1

leukemia or lymphoma

Question 2

Peak incidence of embryonal tumors (neuroblastomas and retinoblastomas)

Answer 2

first 2 years of life

Question 3

Peak incidence of ALL

Answer 3

2-5 yrs

Question 4

Common symptoms for T-cell ALL and Non-Hodgkin Lymphoma

Answer 4

lymphadenopathy and organomegaly

Question 5

General differences between malignant and infectious/inflammatory masses

Answer 5

malignant masses are firm, fixed, nontender. infectious/inflammory masses are softer, mobile, tender

Question 6

Common metabolic emergency often seen in treatment of leukemia and lymphoma where large amounts of phosphate, potassium, and uric acid are released from lysed cells

Answer 6

tumor lysis syndrome

Question 7

Define adjuvant therapy

Answer 7

chemotherapy administration after removal of the primary tumor

Question 8

Protein kinase inhibitor that targets the effects of the t(9;22) translocation of chronic myeloid leukemia and acute lymphoblastic leukemia

Answer 8

Imatinib mesylate

Question 9

Common extramedullary site for ALL

Answer 9

testes

Question 10

Clinical presentation includes: older males (8-10), high WBC count, mediastinal masses, cervical lymphadenopathy, hepatosplenomegaly, CNS involvement

Answer 10

T-cell ALL

Question 11

Characterized by immature blast cells, anemia, thrombocytopenia, and low/nml/high WBC count

Answer 11

acute leukemia

Question 12

Why is treatment of AML different than ALL?

Answer 12

nonmyelosuppressive drugs are not effective for AML

Question 13

Classification of low risk in ALL

Answer 13

1-9 yrs old, initial WBC count < 50,000, and favorable cytogenics t(12;21) translocation

Question 14

Overall cure rate for childhood ALL and AML

Answer 14

ALL-80%. AML-50%

Question 15

What do the following have in common: small noncleaved cell (Burkitt), lymphoblastic, and large cell?

Answer 15

histologic subtypes of NHL

Question 16

Type of lymphoma that is diffuse, highly malignant, and shows little differentiation

Answer 16

NHL

Question 17

Most common clinical presentation of Hodgkin disease

Answer 17

painless, firm lymphadenopathy confined to one or two lymph node areas (usually supraclavicular and cervical)

Question 18

Type of lymphoma characterized by high fever, drenching night sweats, unintentional weight loss

Answer 18

Burkitt’s (B cell)

Question 19

Primary sites for lymphoblastic NHL (T cell)

Answer 19

mediastinum and cervical nodes

Question 20

Pathologic hallmark of Hodgkin disease

Answer 20

Reed-Sternberg cells

Question 21

Prognosis for Hodgkin disease and NHL

Answer 21

hodgkin-90% 5 yr survival. NHL-70-90% 3 yr survival

Question 22

Difference between brain tumors in children and adults

Answer 22

Children- primary tumors that originate in CNS. Adults- high grade astrocytomas or secondary tumors that are metastases from other carcinomas

Question 23

Most common solid tumors in children

Answer 23

CNS tumors

Question 24

Symptoms of increased ICP

Answer 24

lethargy, HA, vomiting, inability to abduct the eye (CN VI palsy)

Question 25

Examination technique of choice for CNS tumor

Answer 25

MRI

Question 26

Administered immediately to reduce tumor associated edema

Answer 26

dexamethasone

Question 27

5 yr overall survival rate for CNS tumors

Answer 27

50% due to high curability of cerebellar astrocytomas and medulloblastomas. Poor prognoses for gliomas and glioblastomas

Question 28

Derived from the neural crest cells that form the adrenal medulla and the sympathetic nervous system

Answer 28

neuroblastoma

Question 29

Most common presentation for neuroblastoma

Answer 29

abdominal pain or mass

Question 30

Associated symptoms include: paraneoplastic syndromes-secretory diarrhea, profuse sweating, opsomyoclonus (dancing eyes and dancing feet), and periobital ecchymoses

Answer 30

neuroblastoma

Question 31

Percentage of neuroblastomas that produce catecholamines that can be detected in the urine

Answer 31

90%

Question 32

Prognosis for neuroblastomas

Answer 32

Patients under 1 yr have better prognosis than older patients

Question 33

Most common malignant renal tumor of childhood

Answer 33

Wilms Tumor

Question 34

Clinical presentation includes abdominal mass, abdominal pain, fever, HTN, hematuria

Answer 34

Wilms Tumor

Question 35

Tx for Wilms tumor

Answer 35

nephrectomy followed by adjuvant chemo

Question 36

Cure rate for patients with Wilms tumor

Answer 36

localized-85%. pulmonary metastases-70-80%