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Oncology Flashcards

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1
Q

Pattern: 4yr with fever, pallor, lymphadenopathy, bruising, anemia, thrombocytopenia, bone pain in long bones

A

ALL

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2
Q

What criteria define standard risk?

A

1-10yrs
WBC <50K
No prior steroids
No CNS or testicular involvement

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3
Q

What defines very high risk?

A

hypodiploid <44 chromosomes, MLLrearrangement 4:11, involves 11q23; induction failure

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4
Q

Define purpose of each phase of chemo: induction, consolidation, maintenance

A

Induction - max log to kill to induce remission
Consolidation - CNS sanctuary
Maintenance - additional cytoreduction or cure

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5
Q

Pattern: boys, WBC>100K, rapid growth rate, highest risk of testicular relapse, mediastinal mass, massive lymphadenopathy

A

T-cel leukemia/lymphomas

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6
Q

What is order of product buildup in tumor lysis?

A

1) K 12-24hr, 2) P 34-48hrs, 3) uric acid 48-72hrs

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7
Q

What happens to calcium in tumor lysis?

A

goes down

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8
Q

Describe treatment for tumor lysis

A

1) neutralize urine - alkaline prevents uric acid crystals, acid prevents calcium phosphate crystals

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9
Q

When does Ca/PO4 precipitate out

A

when product is >60

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10
Q

Spontaneous tumor lysis happens in which two cancers the most often?

A

Burkitt’s and T-cell leukemia/lymphoma

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11
Q

Describe EKG with K at 6, 7, 8

A

6 - peaked t waves 7 - prolonged PR 8 - absent pwaves/widened

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12
Q

Pattern: chloromas, leukemia cuts, gum hypertrophy, CNS disease, nucleated RBC, never involves the testicle

A

AML

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13
Q

What causes nucleated RBC in AML

A

ineffective erythropoiesis, functional asplenia, marrow replacement

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14
Q

What is typically seen in leukoerythroblastic reaction

A

primitive WBC, nucleated RBC, teardrop RBC

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15
Q

Pattern: HA, blurred vision, resp distress in AML

A

leukoerythroblastic reaction

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16
Q

High risk criteria for AML

A

Monosomy 7, monosomy 5/5q, FLT3internal trandem duplication

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17
Q

What is characteristic of AML of histolgy

A

Auer rods

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18
Q

Which genetics has good prognosis?

A

Trisomy 8 t(8:21)
Inv (16) or t(16:16)
Trisomy 21

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19
Q

What 7 genetic disorders are associated with leukemia

A

Down, Klinefelter, Blooms, NF, Kostmann’s neutropenia, Schwachman’s, Fanconi

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20
Q

Association: mediastinal mass

A

T cell ALL

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21
Q

DIC

A

M3

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22
Q

Extra-medullary

A

M4-5

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23
Q

Pancytopenia

A

megakaryoblastic

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24
Q

Pattern: adolescent, persistent neutrophila without infection, absolute basophila, thrombocytosis, increased B12

A

CML

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25
What is the usual pattern of CML development
chronic --> accelerated --> blast (anemia, lymphadenopathy, thrombocytosis)
26
What are problems with Gleevec
resistance and CHF
27
What are criteria for poor prognosis of CML
massive HSM, WBC >100K Blasts, nucleated rbc Platelet count <150K or >500K
28
Pattern: ab pain, RLQ mass, adenopathy below diaphragm
Burkitt's
29
Pattern: jaw involvement n young children
African Burkitts
30
Criteria for high risk Burkitts
CNS, bone marrow, LDH >1000
31
Starry sky
Burkitt's
32
EBV associated
Burkitts
33
Pattern: intra-thoracic, pleural effusion, SVC syndrome, lymphadenopathy above diaphragm
lymphoblastic lymphoma T-cell disease
34
Which cancer has associated cyclic fever
lymphoblastic lymphoma
35
Pattern: painless cervical/supraclavicular nodes, 2/3 mediastinal involvement, not below, chronic more so than lymphoblastic lymphoma
Hodgkin's
36
Reed sternberg cells
Hodgkin's disease
37
What are constitutional B symptoms in Hodgkin's
unexplained fever >38 unexplained weight loss of 10% within 6 months Drenching night sweats
38
Pattern: organomegaly, pruritus, ESR, serum Cu
Hodgkin's
39
Pattern: Pallor, periorbital ecchymoses, leg and hip pain, <4yr, liver/spleen, bone, bone marrow invovelement
Neuroblastoma
40
What are favorable criteria for neuroblastoma
<18months, localized, hyperdiploid
41
What are poor prognostic values for neuroblastoma
N-myc, 1p-deletion, diploid or pseudo-diploid
42
What lab findings in neuroblastoma?
increased VMA, HVA, DA, epi, norepi
43
What diseases can develop into neuroblastoma?
Hirschsprung's, fetal hydantoin syndrome, von REcklinghausen's disase
44
What can neuroblastoma differentiate into?
ganglioneuroma
45
Pattern: 2yo with painless abd mass and hematuria, black girl, HTN
Wilm's tumor
46
Pattern: hemihypertrophy, aniridia
WAGR's 11p13
47
Unfavorable Wilm's
anaplastic, clear cell
48
Pattern: macroglossia, hemi-hypertrophy, neonatal hypoglycemia, flame nevus of ace, hepatoblastoma, abdominal wall defects
Beckwith-Wiedemann Syndrome
49
Pattern: gonadal dysgenesis, nephropathy, Wilm's WTI mutation 11p, bilateral tumors
Denys-Drash syndrome
50
13q
Rb
51
11q
Denys-Drash
52
Osteogenic sarcoma or Ewing's | Firm mass at metaphysis
osteogenic sarcoma
53
Osteogenic sarcoma or Ewing's | Sunburst appearance, Codman's triangle
osteogenic sarcoma
54
Osteogenic sarcoma or Ewing's | 60% around knee joint
osteogenic sarcoma
55
Osteogenic sarcoma or Ewing's | mets to lungs
both
56
Osteogenic sarcoma or Ewing's | painless
osteogenic sarcoma
57
Osteogenic sarcoma or Ewing's | Sequelae of radiation therapy esp Rb because of tumor suppressor
osteogenic
58
Osteogenic sarcoma or Ewing's | Painful
Ewing's sarcoma
59
Osteogenic sarcoma or Ewing's | teenager, mid-shaft of long bones, onion skin pattern on XR
Ewing's sarcoma
60
Osteogenic sarcoma or Ewing's | Li-Farumenni association
Osteogenic sarcoma
61
Osteogenic sarcoma or Ewing's | Systemic symptoms
Ewing's
62
Pattern: benign bone cortical elsion, 10-30 yrs old, pain worse at night, sclerotic lesion around radiolucent
osteoid osteoma
63
Tumors associated with VHL
cerebellar hemangioblastoma, pheochromocytoma, retinal angiomas
64
Birbeck granules look like what
tennis rackets
65
Pattern: lytic bone, exophalamus, DI, +birbeck granules
Hand schuller christine
66
Pattern: seborrheic rash, draining ears, lymphadenopathy, HSM, FTT, organ dysfunction
Letterer Siwe
67
What HLA association with LCH
HLA-B7
68
Age of patient of Letterer Swie, Hand-Schuller Christian, Siwe granuloma
Infant, pre-school, older
69
Poor prognosis criteria for LCH
younger, more disseminated, male gender
70
Markers: ESR, copper
Hodgkins
71
Markers: urine catechol, ferritin
neuroblastoma
72
Markers; alpha-fetoprotein
hepatoblastoma, teratocarcinoma
73
Markers: Beta HCG
embryonal carcinoma, choriocarcinoma, germinoma
74
Pattern: 12yo male, pallor, new onset wheezing, cervical, supraclavicular adenopathy
leukemia lymphoma, lymphoblastic lymphoma
75
Pattern: 14yo male massive splenomegaly
CML
76
Pattern: 6yo boy, RLQ pain/mass
Burkitt's
77
Pattern: 16yo boy with painless cervical/supraclavicular adenopathy
Hodgkins
78
Pattern: 3yo girl with pallor, periorbital ecchymosis, hip pain
neuroblastoma
79
Pattern: 2yo girl with painless abdominal mass and hematuria
Wilm's
80
Pattern: 14yo boy with painful swelling of right femur
Ewing's
81
Translocation c-myc
Burkitt's lymphoma
82
DIC risk
M3 ALL
83
t(4:11)
VHR-ALL
84
9:22
CML
85
t(8:14) with myc
Burkitt's
86
1p n-myc amplication, hyperdiploid (infants)
neuroblastoma 1p
87
13q rb
Retinoblastoma
88
SE cyclophosphamide
SIADH, hemorrhagic cystitis, cardiotoxicity
89
SE vincristine, vinblastine
Peripheral neuropathy, extravasation causes tissue necrosis, SIADH
90
SE L-asparaginase
Pancreatitis, coagulopathy
91
SE actinomycin D
radioimmetic
92
SE pulmonary fibrosis
busulfan
93
SE cisplatin/carboplatin
sensory neural hearing loss, renal toxicity

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