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Flashcards in oncoped Deck (41):
1

most common childhood malignancy; increased incidence in Down syndrome; ataxia-telangiectasia; Fanconi syndrome; NF1; risk is >70% if the first twin is diagnosed during the 1st yr of life and they shared the same placenta; patients who have undergone intense Tx for a solid tumor

ALL

2

Diagnoses by a bone marrow evaluation that shows >25% of the BM cells as a homogenous population of lymphoblasts

ALL

3

most important prognostic factor in ALL

treatment

4

3 of the most important predictive factors in ALL

age at the time of diagnosis; intitial leukocyte count; speed of response to treatment

5

Treatment of ALL Remission induction

Vincristine; prednisone; L-asparaginase x4wks + CNS prophylactic irradiation or chemotherapy to eradicate leukemic cells from BM

6

Tx of ALL Maintenance phase

Mercaptopurine daily and Methothrexate weekly x2-3yrs

7

complication of therapy in ALL

tumor lysis syndrome

8

definition of remission in ALL

<5% blasts in the BM and a return of neutrophil and platelet count to near-normal levels after 4.5wks of tx

9

site of metastasis of ALL

liver; spleen; lymph nodes

10

poor prognostic factors in ALL

10 yrs; male; WBC>100k U/L on presentation; presence of CNS leukemia; presence of mediastinal mass

11

Ann Arbor staging of lymphomas

Stage 1-one LN group involved; Stage II-two LN groups involved on the same side of the diaphragm; Stage III-two LN groups involved on both sides of the diaphragm or extralymphatic involvement; Stage IV-diffuse extralymphatic site involvement (usually BM CNS or liver)

12

B symptoms in lymphoma

weight loss >10% of TBW over 3mos; unexplained high-grade fever; drenching night sweats)

13

Chemotherapeutic agenets for Hodgkin's lymphoma

COPAD Cyclophosphamide; Vincristine; prednisine; Doxorubicin) or COMP (Cylophosphamide; vincristine; methotrexate; prednisone; 6mercaptopurine)

14

treatment of hodgkin's in patients with refractory disease or relapse

myeloblative autologous stem cell transplant

15

3rd most common posterior fossa tumor of childhood infiltrates the pons and spreads throughout the brainstem

brain stem glioma

16

common supratentorial tumor in children with solid and cystic areas that tend to calcify; shor stature; hypothyroidism; DI; adrenal insufficiency

craniopharyngioma

17

most common malignant abdominal tumor

Wilm's tumor?

18

Wilm's tumor is associated with what dse entities

neurofibromatosis; Beckwith-Wiedemann syndrome; WAGR syndrome

19

hemihypertophy; visceromegaly; macroglossia

Becwith-Weidememann syndrome

20

WAGR syndrome

Wilm's tumor; aniridia; genito-urinary abnormalities; mental Retardation

21

painless abdominal mass with flank mass that DOES NOT cross the midline

Wilm's tumor

22

3rd most common pediatric cancer

neuroblastoma

23

pluripotent stem cells invaginate and migrate along the neuraxis where neural crest cells are present (sympathetic ganglia; adrenal glands)

neuroblastoma

24

most common extracranial tumors in infants

neuroblastoma

25

nontender abdominal mass which may cross the midline; Horner syndrome; HTN; cord compression(from a paraspinal tumor)

neuroblastoma

26

most common sites of metastasis in neuroblastoma

long bones; skull; bone marow; liver; lymph nodes; skin

27

Tx for St1(confined to structure of orgin) and St2(tumor beyond structure of origin but not cross the midline with 2B or without 2A LN involvement

surgery

28

a tumor of striated muscle; most common soft tissue sarcoma in children

rhabdomyosarcoma

29

histologic type of rhabdomyosarcoma with the worst prognosis

alveolar

30

most common histologic type of rhabdomyosarcoma

embryonal

31

vaginal grape-like mass type of rhabdomyosarcoma

sarcoma botyroides

32

highest risk period for developing osteosarcoma

adolescent growth spurt

33

risk factor in developing osteosarcoma

hereditary retinoblastoma

34

most common SSx in osteosarcoma

pain; limp; swelling

35

px with deep bone pain often nighttime awakening; palpable mass; xray demonstrating the lesion

osteosarcoma

36

Xray finding in osteosarcoma

sunburst pattern (due to mineralization and formation of periosteal spicules in the surrounding tissues

37

small; round cell undifferentiated tumor with small uniform nuclei and scant cytoplasm thought to be of neural crest origin; with systemic manifestations like fever and weight loss unlike osteosarcoma

Ewing's sarcoma

38

most likely chromosomal aberration in Ewing's sarcoma

t(11;22) translocation

39

Xray finding in Ewing's sarcoma

onion-skinning or moth-eaten appearance (lytic bone lesion with periosteal reaction)

40

what part of the bone is the most common location of osteosarcoma

metaphysis

41

what part of the bone is the most common location of Ewing's sarcoma

diaphysis