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Phase 2 PEDs > Oncology > Flashcards

Oncology Flashcards

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1
Q

Top three PEDs cancers?

A
  1. Leukemia
  2. CNS tumors
  3. Lymphoma
    4th is neuroblastoma
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2
Q

Standout S/S of cancer?

A

FOU
Petechiae/bleeding
Pallor

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3
Q

Tumor lysis syndrome is?

A

Common to leukemia/lymphoma TXT

- rapid cellular lysis = K+, PO4, Uric acid released

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4
Q

Tumor lysis syndrome can cause?

A

Cardiac arrest or arrhythmias
Gout/uric acid
Nephropathy

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5
Q

MC childhood cancer?

A

Leukemia

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6
Q

Subtypes of leukemia?

A

Acute lymphocytic leukemia (ALL)
Acute myelogenous leukemia (AML)
Chronic myelogenous leukemia (CML)

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7
Q

MC subtypes of leukemia?

A

ALL (75%)

AML (15-20%)

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8
Q

ALL is most common in what gender?

A

Males

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9
Q

What ages is ALL MC in?

A

2-5yo

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10
Q

What leukemia subtype is MC in neonates and late adolescence?

A

AML

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11
Q

Leukemia standout S/S present?

A

LAD

Hepatosplenomegaly

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12
Q

LAB findings of leukemia?

A

Immature blasts, Anemia, Decreased PLTs
CBC - L, NL, H sometimes >50k WBC
BM = blasts
Cytogenicshg6ytj8ikmnb

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13
Q

Important lab to perform w/ leukemia is?

A

LP to eval if CNS is affected

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14
Q

Definitive Dx of leukemia is?

A

Flow cytometry and Cytochemical staining

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15
Q

MC mutation of ALL?

A

t(12:21) translocation - best prognosis

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16
Q

Poorest prognosis mutation of ALL?

A

t(9:22) translocation

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17
Q

Poorest prognostic indicators of leukemia?

A 
<1yo or >9yo
>50k WBC
CNS or testicular Dz
Genetic mutations t(4;11) or t(9;22) translocations
No remission after 4wks of therapy
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18
Q

Lymphoma is?

A

Lymphoid tissie malignancy

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19
Q

3rd MC childhood cancer?

A

Lymphoma

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20
Q

What pathogen is ass/w lymphoma?

A

Epstein-Barr virus EBV

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21
Q

Major subtypes of lymphoma?

A

Hodgkin disease

Non-Hodgkin lymphoma

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22
Q

MC type of lymphoma?

A

Hodgkin’s lymphoma

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23
Q

MC population of hodgkins lymphoma?

A

Adolescents/young adult AND >50

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24
Q

MC population of NHL?

A

Whites > Blacks

Males > Females

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25
Subtypes of NHL?
B-cell T-cell Large cell
26
B-cell NHL is AKA?
Burkitt lymphoma (sml noncleaved cell)
27
T-cell NHL is AKA?
Lymphoblastic
28
Two forms of Burkitt lymphoma?
Sporadic form - North America | Endemic form - Africa (EBV strongly ass/w)
29
Standout S/S of lymphoma?
Pruritis B-Symptoms SOB (Medialstinal LAD) / pleural effusion Painless Cervical/supraclavicular LAD
30
B-symptoms are?
S/S ass/w lymphoma - Fever for 3 consecutive days - Night sweats - Unintentional wgt loss
31
What gives lymphoma a poorer prognosis?
Presence of B-Symptoms
32
Lymphoma labs only w/u?
CBC = NL BM = disease staging (>25% blasts= Acute leuemia) Tissue Bx pleural/peritoneal BF=Reed Sternberg cells
33
Reed Sternberg cells is ass/w?
Hodgkins lymphoma (Owl eyes)
34
Lymphoma imaging w/u?
CXR - +-medialstinal mass | CT - Dx staging
35
Difference between ALL and Lymphoma Bone marrow?
>25% blasts in Bone marrow = ALL
36
MC solid tumors in PEDs are located where?
CNS tumors
37
2nd MC childhood cancer?
CNS tumors
38
Inherited syndromes ass/w
Neurofibromatosis Li-Fraumeni syndrome Tuberous sclerosis
39
MC Location of CNS tumors in PEDS <2yo
MC - infratentorial (cerebellum/brainstem)
40
MC Location of CNS tumors in PEDS >2yo
MC - Spinal or supratentorial
41
S/S ass/w supratentorial lesion?
Visual S/S (field deficit) Seizures Foacl neuro Personality changes
42
S/S ass/w infratentorial lesion?
Hydrocephalus Increased ICP(papilledema) Cranial nerve palsies Ataxia
43
CNS tumor presents as?
Loss of developmental milestones Poor school performance Increased ICP - (HA, N/V, lethargy - 1st thing in AM) --- ICP increase > 6th nerve palsy Cranial nerve deficits > brainstem involved
44
Sign of increased ICP?
Inability to abduct eye (6th nerve palsy)
45
6th nerve palsy affects what muscle?
Eye muscle - cant abduct (CN6)
46
CNS tumors affect pituitary fx?
Prolactinoma > glactorrhea | GH secreting > excess growth/precocious puberty
47
Cerebellar tumors S/S?
Ataxia, diminished coordination
48
MC type of Brain tumor?
Astrocytoma
49
2nd MC brain tumor?
Medulloblastomas
50
Where are Astrocytomas found mostly?
Posterior fossa of brain
51
Where are Medulloblastomas found mostly?
Cerebellar vermis
52
MC solid tumor outside of CNS?
Neuroblastoma
53
MC infant malignancy?
Neuroblastoma (20mo median age)
54
Where are neuroblastomas derived from?
MC - Neural crest cells that form adrenal medulla/SNS | but can form anywhere along SNS
55
MC presentation of Neuroblastoma?
``` Abd Pain/Mass (flank, hard, smooth, non-TTP) Fever, WGT loss Bone pain Horner syndrome Paraneoplastic syndromes ```
56
Horner syndrome is MC ass/w what malignancy?
Neuroblastoma
57
Paraneoblastic syndrome S/S?
Profuse sweating Secretory diarrhea Opsomyoclonus (Dancing eyes/feet)
58
W/U of neuroblastoma
Catecholamines (Urine- vanillylmandelic & homovanillic acid) Tissue Bx BM aspiration/Bx CBC
59
Vanillylmandelic and homovanillic acid is ass/w what malignancy?
Neuroblastoma
60
Imaging ordered to w/u neuroblastoma?
XR - calcifications CT Bone scan
61
Nephroblastoma is AKA?
Wilms tumor
62
MC renal tumor of PEDs?
Nephroblastoma
63
Anomalies ass/w nephroblastoma?
``` WAGR syndrome W- Wilms tumor A- Aniridia G- GU malformation R- Retardation ```
64
Mutation ass/w WAGR syndrome anomalies?
Chromo 11p deletion
65
Avg Age of Nephroblastoma?
3-3.5y
66
Syndromes ass/w Nephroblastoma?
WAGR syndrome | Beckwith-Wiedemann syndrome
67
Beckwith-Wiedemann syndrome S/S?
Macroglossia Umbilical Hernia Omphalocele
68
Nephroblastoma Standout S/S?
Fever HTN Hematuria
69
Sarcoma is?
Tumors from bone or soft tissue
70
MC soft tissue sarcoma?
Rhabdomyosarcoma (skeletal muscle)
71
MC bone sarcoma(s)?
MC - Osteosarcoma | - Ewing sarcoma
72
Syndromes ass/w increased risk of soft tissue sarcomas?
Li-Fraumeni | Neurofibromatosis
73
Syndromes ass/w increased risk of Osteosarcoma?
Hereditary retinoblastoma
74
What TXT increases risk of osteosarcoma?
Radiation or Chemo (alkylating)
75
Microscopic characteristics of Rhabsomyosarcoma?
Small, Round, Blue cell tumors (Like Ewing)
76
Microscopic characteristics of Osteosarcoma?
Osteoid substance present
77
Osteosarcoma MC occurs where?
Epiphysis or metaphysis - Distal Femur - Proximal Tibia - Proximal humerus
78
Osteosarcoma tends to follow what?
Trauma - (not dx due to S/S blamed on trauma)
79
XR of Osteosarcoma will show?
Starburst pattern
80
Standout S/S ass/w Ewing sarcoma?
Pain and fever
81
Ewing sarcoma is often misdx as?
Osteomyelitis
82
MC bone Ewing sarcoma occurs in?
MC - Femur or Pelvis | - but anywhere really
83
Ewing sarcoma microscopic characteristics?
Small round blue cell tumors
84
XR of Ewing sarcoma will show?
Onion-skin or Moth eaten characteristics
85
Dx of sarcomas?
Microscopy Histology Cytogenics
86
Microscopic findings that differentiae sarcomas?
``` Rhabo/Ewing = Small round blue cell tumors Osteosarcoma = Osteoid substance ```
87
Mutation ass/w Ewing sarcoma?
t(11;22) (95% of tumors)
88
Histologic variants of Rhabomyosarcoma?
Embryonal - Young PEDs w/ head, neck, GU tumors vs Alveolar - older w/ trunk or extremity tumors
89
Mutations ass/w Rhabomyosarcoma Alveolar variant?
t(2;13) or t(1;13)

Phase 2 PEDs (23 decks)

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