Oncology

Question 0

BONE PAIN
intermittent fever
fatigue, parlor
petechiae, purpura hepatomegaly
lymphadenopathy

Answer 0

Acute Lymphoblastic Leukemia

Question 1

Proliferation of IMMATURE LYMPHOCYTES
Down syndrome
viral infections

Answer 1

Acute Lymphoblastic Leukemia

Question 2

DX: anemia, thrombocytopenia (low platelets)
       WBC = normal or low
       neutropenia (low neutrophils?)
       peripheral smear : lymphoblasts
Dx: bone marrow biopsy

Answer 2

Acute Lymphoblastic Leukemia

Question 3

Acute Lymphoblastic Leukemia (ALL) Tx

Answer 3

Chemotherapy, HSCT

Anticipate tumor lysis syndrome: massive tumor lysis -> hyperkalemia, hyperurecemia, hyperphosphatemia, renal failure

Question 4

MOST COMMON MALIGNANCY OF CHILDHOOD

Answer 4

ALL

“ALL kids could get ALL”

Question 5

Unable to differentiate precursor myeloid cells into mature cells/elements

Answer 5

Acute Meyloid Leukemia (AML)

Question 6

fatigue, pallor
bleeding
infection (fever)

Answer 6

AML Acute Myeloid Leukemia

Question 7

Hyperleukocytosis!!! (WBC > 75,000) can be associated with LIFE THREATENING COMPLICATIONS = MEDICAL ER

WBC > 100,000 at Dx !!! in 25% OF PTS

Answer 7

Acute Meyloid Leukemia AML

Question 8

AUER RODS (granular structures in cytoplasm) in peripheral smear

Answer 8

Acute Myeloid Leukemia AML

Question 9

Tx for AML

Answer 9

Chemotherapy

HSCT (hematopoietic stem cell transplant)

Question 10

(Risk factors for AML)

Answer 10

often none
Down syndrome
exposure to radiation, benzene (smoking), chemotherapy drugs

Question 11

Philadelphia Chromosome

Answer 11

Chronic Myelogenous Leukemia (CML)

Question 12

Myeloproliferative dz

Chrom Philadelphia

Answer 12

CML

Question 13

DX of CML

Labs: anemia, thrombocytosis, leukocytosis (>100,000)

Answer 13

Philadelphia Chrom

Question 14

SOLID TUMOR
Younger: vomit, lethargy, irritable, macrocephaly
Older: HA, visual sx, sz, personality change, neuro deficits

Answer 14

Brain tumors

Question 15

Dx: measure head
observe gait
MRI

Answer 15

Brain tumor

Question 16

most common solid tumor of childhood

Answer 16

brain

Question 17

Tx brain tumor

Answer 17

surgery, chemo, radiation

Question 18

M>F
starts in lymph and spreads
germinal center B CELLS mutation

Answer 18

Hodgkin Dz

Question 19

PAINLESS CERVICAL OR SUPRACLAVICULAR ADENOPATHY,
MEDIASTINAL MASS
fever, sweats,
wgt loss, fatigue
spleno/hepatomegaly

Answer 19

Hodgkin Dz

Question 20

REED-STERNBERG cell in bone marrow biopsy

Answer 20

Hodgkin Dz

Question 21

Hodgkin dz tx:

Answer 21

chemo, radiation

Question 22

KIDS HAVE BETTER RESPONSE TO TX THAN ADULTS in which dz?

Answer 22

Hodgkin Dz

Question 23

FAST (1-3 WEEKS)
enlarging non-tender lymphadenopathy

B sx: cough, dyspnea, orthopea, abd pain, vomiting, fever

Answer 23

Non Hodgkin Lymphoma (NHL)

Question 24

Dx of Non Hodgkin Lymphoma

Answer 24

Biopsy

Question 25

Arise from any lymphoid tissue, B cell derived, risk with immunodeficiency syndromes and EBV

Answer 25

Non Hodgkin Lymphoma

Question 26

RAPIDLY PROLIFERATING, HIGH-GRADE, DIFFUSE MALIGNANCIES

Answer 26

NON Hodgkin Lymphoma (NHL)

Question 27

sympathetic nervous tissue - predominantly adrenal gland (no PNS innervation)

Answer 27

Neuroblastoma

Question 28

ABDOMINAL MASS bone pain faver, wgt loss, irritable

Answer 28

Neuroblastoma

Question 29

Labs: URINARY CATECHOLAMINES | skeletal survey, bone scan, biopsy

Answer 29

Neuroblastoma

Question 30

Neuroblastoma tx

Answer 30

surgery and chemo, sometimes radiation

Question 31

MOST COMMON ABDOMINAL TUMOR IN KIDS (OUTSIDE CNS) | 90% dx before age 5

Answer 31

Neuroblastoma

Question 32

Asymptomatic abdominal mass | fever, hematuir, HTN

Answer 32

Nephroblastoma

Question 33

U/S CT abd | CT chest

Answer 33

Nephroblastma

Question 34

SECOND MOST COMMON ABDOMINAL TUMOR IN KIDS

Answer 34

Nephroblastoma

Question 35

Tx nephroblastoma

Answer 35

surger, chemo, radiation

Question 36

occurs in LONG BONES | peaks in growth spurt/adolescence

Answer 36

Osteosarcoma

Question 37

bone pain with or w/o soft tissue swelling

Answer 37

osteosarcoma

Question 38

Tx: SURGERY AND CHEMO = CRITICAL TO PREVENT METASTASIS

Answer 38

in Osteosarcoma

Question 39

MOST COMMON PRIMARY MALIGNANCY OF BONE

Answer 39

Osteosarcoma

Question 40

Wilms Tumor

Answer 40

Nephroblastoma

Question 41

occurs in long bones or soft tissues NIGHT BONE PAIN fatigue, fever, wgt loss swelling/pain localized

Answer 41

Ewing Sarcoma

Question 42

Dx of osteosarcoma with

Answer 42

bone scan

Question 43

Tx Ewing sarcoma

Answer 43

chemo, surgery, radiation or combo of all 3

Question 44

SECOND MOST COMMON PRIMARY BONE TUMOR

Answer 44

Ewing Sarcoma

Question 45

WHITE PAPILLAR REFLEX

Answer 45

retinoblastoma

Question 46

``` 90% dx'd before 5 yo sporatic vs inherited detailed ophtthalm exam several vision sparing therapies MOST COMMON INTRAOCULAR TUMOR ```

Answer 46

retinoblastoma

Question 47

PAINLESS, ENLARGING MASS | any body part (usu head/neck)

Answer 47

Rhabdomyosarcoma

Question 48

soft tissue sarcoma

Answer 48

Rhabdomyasarcoma

Question 49

MOST COMMON SOFT TISSUE SARCOMA IN KIDS | 70% dx bf 10 yo

Answer 49

Rhabdomyosarcoma

Question 50

enlarging abd check serum Alpha Fetal Protein (AFP) Abd US, CT, MRI Surgery, chemo, radiation, liver transplant

Answer 50

Hepatic tumor