Oncology

Question 1

what is a neuroblastoma

Answer 1

Tumours arising from the neural crest tissue in the adrenal mudulla and sympatetic nervous system

Question 2

what is the name of a benign version of a neuroblastoma

Answer 2

Galnglioneuroma

Question 3

what is the presentation of a neuroblastoma

Answer 3

mass

• anywhere on sympathetic nervous system
• or on the adrenal glands (abdo mass)

bone pain

red flags

hepatomegaly

limp/paraplegia (spinal cord compression)

cervicle lymphadenopathy

perioorbital bruising

skin nodules

Question 4

how would you diagnose a neuroblastoma

Answer 4

CT/MRI

urinalysis (catecholamine)

Biopsy

Bone Marrow Samples

Question 5

what is the management of a neuroblastoma

Answer 5

surgery

chemo

radio

immunotherapy

+stem cell rescue

+long term retinoic acid

Question 6

what is a hepatoblastoma

Answer 6

uncommon liver cancer presenting in children over 3y

Question 7

what are the types of hepatoblastoma

Answer 7

epithelial

mesenchimal

Question 8

what is the presentation of a hepatoblastoma

Answer 8

painless abdo mass

+/-

jaundice, back pain, caput medusae, fever, N+V

Question 9

how do you diagnose a hepatoblastoma

Answer 9

bloods:increase in alpha fetoprotein

MRI

Biospy

Question 10

how do ou treat a hepatoblastoma

Answer 10

surgey

chemo

liver transplant

Question 11

at what age do bone tumours usually present

Answer 11

post puberty

before then malignant bone tumours are uncommon

Question 12

what are types of bone tumour

Answer 12

Ewing Sarcoma (children - uncommon)

Osteogenic sarcome (teens - common)

Question 13

what is the presentation of bone tumours

Answer 13

persistent localised bone pain

Question 14

how would you diagnose bone tumours

Answer 14

X RAY

MRI

PET/BONE SCAN

CHEST X RAY ?METS

BONE MARROW SAMPLING

Question 15

what XRAY findings would be present for bone tumpurs

Answer 15

destruction/boney lesions

variable periosteal bone formation

Question 16

how do you manage bone tumours

Answer 16

combination chemo

surgery

ewings sarcome = radiotherapy esp in pelvix and axial skeleton

Question 17

what are the subtypes of leukaemia

Answer 17

acute lymphoblastic

acute myeoloid

chronic lymphoblastic

chronci myeliod

Question 18

what are the cells involved in ALL

Answer 18

froliferation of blast cells (immature B and T cells)

Question 19

which leukemia commonly affects children

Answer 19

ALL

Question 20

how does childhood leukaemia usually present

Answer 20

insidious

lethargy

febrile

aches

easy bruising

Question 21

what investigations are required + what are the results

Answer 21

bloods: - Hb - Platelets + blast cells

bone marrow aspirate

C X ray: may show mediastinal mass of T cell disease

Question 22

what is the management of T cell leukaemia

Answer 22

fluids

allopurinol

blood transfusions

chemo with then profylactic chemo + co trioxazol for 3y

intrathecal chemo if CNS is involved

Question 23

give an overview of other leukaemias (not ALL)

Question 24

what is Hodkins lymphoma

Answer 24

malignancy of B + T lymphocytes

Question 25

at what age does Hodkins present

Answer 25

teens

Question 26

what is the presentation of Hodkins

Answer 26

Painless lymphadenopathy hard and V large lymph nodules (can cause airway obstruction) red flags may be present - but uncommon

Question 27

how do you diagnose Hodkins

Answer 27

ymph node biopsy radiologial assessment of all lymph node sites bone marrow biopsy for staging

Question 28

how do you treat Hodkins

Answer 28

chemo and radio

Question 29

how do you monitor progess of Hodkins

Answer 29

PET scans

Question 30

what is the prognosis of Hodkins

Answer 30

if simple = 80% recovery if disseminated = 60%

Question 31

what are the 5 types of chilhood brain tumour

Answer 31

astrocytoma medullablastoma ependymoma brainstem glioma Craniopharangioma

Question 32

what is an astrocytoma (brain tumour)

Answer 32

originates from a type of **glial cell** called **astrocytes**

Question 33

what is a medulla blastoma

Answer 33

originates from midline of posterior fossa can have spinal mes through CSF seeding(20%)

Question 34

what is an ependymoma

Answer 34

a tumour arising from CNS tissue

Question 35

what is a craniopharangioma

Answer 35

a developmental tumour originating from Rathkes Pouch remenant

Question 36

what is the presentation of a brian tumour

Answer 36

raised IC signs and Sx Persistent back pain periferal weakness of arms and legs Bladder and bowel dysfunction

Question 37

how do oyu diagnose a brain tumour

Answer 37

mri and magnetic resonance spectroscopy

Question 38

what is magnetic resonance spectroscopy

Answer 38

examine the biological activity of a tumour

Question 39

what is the management of a brain tumour

Answer 39

surgery + tissue sample + histology radio w or w/o chemo

Question 40

what is a retinoblastoma

Answer 40

malignant tumour of retinal cells

Question 41

what are the types of retinoblastoma

Answer 41

bilateral (usually hereditary) Unilateral

Question 42

what are future risks of retinoblastoma which is herediatary

Answer 42

increased risk of sarcoma

Question 43

what is the presentation of a retinoblastoma

Answer 43

white pupillary reflex squint

Question 44

at what age does retinoblastoma ususally present

Answer 44

think of that baby photo case on the news younger or around 3 y

Question 45

how would oyu diagnose a retinoblastoma

Answer 45

MRI OPthalmology under anasthesia NO BIOPYSY

Question 46

how do you manage a retinoblastoma

Answer 46

lazer therapy +/- chemo or radio enucleation of the eye

Question 47

what is a wilms tumour

Answer 47

a nephroblastoma originating from embryonal renal tissue is the commonest childhood tumour

Question 48

at what age do wilms tumour present

Answer 48

5y+

Question 49

what is the presentation of a wilms tumour

Answer 49

large abdominal mass in well child sometimes (rarely) can present with Anorexia Abdo pain Haematuria

Question 50

how would you diagnose a wilms tumour

Answer 50

US (CT/MRI) x ray chest - looking for lung mets check function of other kidney

Question 51

how would you manage a wilms tumour

Answer 51

chemo nephrectomy radio in advanced disease