Paediatric oncology Flashcards
What is the ICCC?
International Classification of Childhood Cancer
Based on tumour morphology and primary site
What is the most commonly diagnosed cancer in childhood in the UK?
Leukaemia
What are the main genetic cause of cancer?
Down Fanconi BWS Li-Fraumeni Familial Cancer syndrome Neurofibromatosis
What proportion of childhood cancers are cured?
85%
Name some symptoms which would warrant immediate referral.
Unexplained petechiae
Hepatosplenomegaly
Name some symptoms which would warrant urgent referral?
Repeat attendance with same problem and no clear diagnosis
New neuro symptoms
Abdominal mass
What are some common brain tumour symptoms in under 5s?
Persistent vomiting Abnormal balance/coordination Abnormal eye movements Behaviour change Fits/Seizures Abnormal head position
What are some common symptoms of brain tumours in children aged 5-11 years?
Persistent vomiting Persistent headache Abnormal balance/coordination Abnormal eye movements Blurred/double vision Behaviour changes Fits/seizures Abnormal head position
What are some symptoms which may be caused by brain tumours in children aged 12-18?
Persistent vomiting Persistent headache Abnormal eye movements Blurred or double vision Abnormal balance/coordination Behaviour change Fits or seizures Delayed or arrested puberty
What are some risk factors for sepsis/febrile neutropenia?
ANC <0.5x10^9
Indwellling catheter
Mucosal inflammation
High dose chemo
How would sepsis/febrile neutropenia present?
Fever
Rigors
Drowsiness
Shock
What is shock?
Tachycardia Tachypnoea Increased cap refill time Reduced urine output Metabolic acidosis
What are some early signs of raised ICP?
Early morning headache/vomiting
Tense fontanelle
Increased HC
What are some late signs of raised ICP?
Constant headache Papilloedema Diplopia (VI palsy) Loss of upgaze Neck stiffness Status epilepticus, Reduced GCS Cushings triad
What is Cushings triad?
Bradycardia
Irregular RR
Raised BP
Which imaging test is best for raised ICP screening?
CT
Which imaging technique is best for accurate diagnosis of raised ICP?
MRI
What does dexamethasone do to reduce >ICP caused by tumours?
Reduce oedema
Increase CSF flow
What is ventriculostomy?
Hole in membrane at base of 3rd ventricle with endoscope
For urgent CSF diversion to reduce ICP
What are the most common pathological processes causing spinal cord compression?
Invasion from paravertebral disease via intervertebral foramina
Vertebral body compression
CSF seeding
Direct invasion
What are the most common causes of Superior Vena Cava Syndrome (SVC syndrome)?
Lymphoma
Neuroblastoma
Germ cell tumour
Thrombosis
How does spinal cord compression present?
Weakness
Pain
Sensory disturbance
Sphincter disturbance
How is spinal cord compression managed?
Urgent MRI
Dexamethasone
Chemo if rapid response is expected
How does SVC syndrome present?
Oedema Cyanosis Distended veins Especially head and neck Reduced GCS
