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Phase 3a medicine > Paediatric - Oncology > Flashcards

Paediatric - Oncology Flashcards

1
Q

How might Acute Leukaemia present in a child and name 2 investigations other than blood tests

A

a. ) Fever/Fatigue/Anaemia/Bruising/Bone pain/Infections

b. ) Chest x-ray; Bone marrow aspirate; Lumbar puncture

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2
Q

Detection of which cell indicates a Hodgkin’s lymphoma?

A

Reed-Sternberg cell

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3
Q

A 4-year-old male presents to the emergency department after his mother brings him in with anaemia, neutropenia, thrombocytopenia, easy bruising, pale, lethargic. What is the most likely diagnosis?

A

ALL

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4
Q

Where does a Wilms’ tumour affect?

A

Kidney

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5
Q

Wilms’ tumour is most common in children of what age?

A

Under 5 years

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6
Q

Name some features of a patient with Wilm’s tumour

A
  • Abdominal mass
  • Abdominal pain
  • Haematuria
  • Lethargy
  • Fever
  • Hypertension
  • Weight loss
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7
Q

What is the initial investigation of a Wilms’ Tumour?

What else to stage the tumour and identify histology?

A 
Renal ultrasound
(A CT or MRI scan can be used to stage the tumour) (Biopsy to identify the histology is required to make a definitive diagnosis)
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8
Q

What is first treatment of Wilm’s Tumour and what is the adjuvant therapy given?

A

Surgical excision of the tumour along with the affected kidney (nephrectomy).

The main options for adjuvant treatment are:

  • Adjuvant chemotherapy
  • Adjuvant radiotherapy
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9
Q

Neuroblastoma is a solid tumour that affects what?

A

The sympathetic nervous system

most commonly in the adrenal or paraspinal sites

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10
Q

What is the most established genetic marker of risk in neuroblastoma?

A

oncogene MYCN

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11
Q

What are some features of a patient with a Neuroblastoma?

A
  • Loss of appetite.
  • Occasionally watery diarrhoea due to vaso-active intestinal polypeptide (VIP) secretion.
  • Vomiting.
  • Weight loss.
  • Fatigue.
  • Bruising due to pancytopenia as a result of marrow infiltration.
  • Periorbital bruising - ‘racoon eyes’ (due to metastatic disease in the orbits).
  • Weakness, limping, paralysis and bladder and bowel dysfunction due to spinal cord compression from paraspinal sympathetic tumours.
  • Bone pain (due to bone metastases).
  • Permanent cognitive deficits - rare.
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12
Q

Name a complication of Neuroblastoma at presentation, during chemotherapy and a surgical complication

A

At presentation

  • Cord compression from paraspinal tumour.
  • Severe hypertension.
  • Renal insufficiency.

During or after chemotherapy

  • Myelosuppression and immunosuppression.
  • Impaired renal function.
  • Hearing loss.
  • Tumour lysis syndrome - hyperkalaemia, hyperuricaemia, hyperphosphataemia.

Surgical complications

  • Haemorrhage.
  • Intussusception.
  • Injury to major vessels or nerves.
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13
Q

Around 40% of retinoblastoma cases are caused by a hereditary mutation on which chromosome?

A

13 (retinoblastoma 1 (Rb1) gene)

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14
Q

Name some features in a patient with a retinoblastoma

A

The most common and obvious sign is abnormal appearance of the pupil, leukocoria.

Second most common sign is Strabismus

Other less common and less specific signs and symptoms are:

  • deterioration of vision
  • a red and irritated eye
  • faltering growth or delayed development.
  • Some children with retinoblastoma develop a squint.
  • Affected children are likely to be systemically well.
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15
Q

Name a treatment for Retinoblastoma

A
  • Photocoagulation
  • Cryotherapy
  • Transpupillary thermotherapy
  • Transpupillary thermotherapy
  • Chemotherapy
  • Enucleation
  • External beam radiotherapy
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16
Q

If an infant or child presents with a sign or indication of Rb, what test must be performed?

A

A red reflex test

17
Q

Name a feature of a patient with Hepatoblastoma

A

Hepatoblastoma usually presents as a lump in the tummy. Other symptoms include:

  • poor appetite
  • weight loss
  • lethargy
  • fever
  • vomiting
  • jaundice.
18
Q

Name a type of paediatric brain tumour

A 
Choroid plexus carcinoma
Craniopharyngioma
Embryonal tumors
Ependymoma
Glioma
Medulloblastoma
Pineoblastoma
19
Q

Name some features in a paediatric patient with a brain tumour

A

Some of the more common symptoms of a brain tumor in children include:

  • Headaches, which may become more frequent and more severe
  • Feeling of increased pressure in the head
  • Unexplained nausea or vomiting
  • Abrupt onset of vision problems, such double vision

Other possible signs and symptoms, depending on the tumor location, include:

  • A fuller soft spot (fontanel) on the skull in babies
  • Seizures, especially when there’s no history of seizures
  • Abnormal eye movement
  • Slurred speech
  • Trouble swallowing
  • Loss of appetite; or in babies, difficulty feeding
  • Difficulty with balance
  • Trouble walking
  • Weakness or loss of sensation in an arm or a leg
  • Weakness or drooping on one side on the face
  • Confusion, irritability
  • Memory problems
  • Personality or behavior changes
  • Hearing problems

Phase 3a medicine (24 decks)

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