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Phase 3a conditions list flashcards LOZZA > Paediatrics - Oncology > Flashcards

Paediatrics - Oncology Flashcards

(70 cards)

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1
Q

What are the most common childhood malignancies (7)?

A
  • Leukaemias = MC
  • Brain + CNS tumours
  • Bone tumours
  • Lymphoma
  • Wilms tumours
  • Hepatoblastoma
  • Retinoblastoma
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2
Q

What are the most common forms of leukaemia in children?

A
  • ALL (80%)
  • AML (15%)
    others e.g. CML
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3
Q

What age do ALL and AML most frequently occur?

A
  • ALL = 2-5/10 years
  • AML < 2 years
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4
Q

What are some risk factors for leukaemia (2)?

A
  • Radiation exposure e.g. x-ray during pregnancy
  • Genetic conditions - downs, kleinfelters, noonans
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5
Q

What effect does leukaemia have on cells in the blood?

A

Pancytopenia

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6
Q

What is pancytopenia?

A
  • Anaemia
  • Leukopenia
  • Thrombocytopenia
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7
Q

How does leukaemia lead to pancytopenia?

A

Mutation in a precursor cell in the bone marrow leads to an excessive production of single type of abnormal WBC. This excessive production of cells in the bone marrow deprives the blood of the normal production of other blood cells –> pancytopenia

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8
Q

What are the signs/ symptoms of leukaemia in children (11)?

A
  • Fatigue
  • Fever
  • Failure to thrive
  • Weight loss
  • Night sweats
  • Recurrent infections
  • Pallor
  • Petechiae/ bruising
  • Bleeding
  • Lymphadenopathy
  • Hepatomegaly
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9
Q

How soon should an FBC be done within when leukaemia is suspected?

A

48 hours

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10
Q

How should leukaemia be investigated (3)?

A
  • FBC
  • Blood film
  • Bone marrow biopsy = diagnostic
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11
Q

What would be present on a blood film of those with leukaemia?

A

Blast cells

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12
Q

What further tests are often used to investigate leukaemia (4)?

A
  • Chest X-ray
  • CT scan
  • Lumbar puncture
  • Genetic analysis
    imaging + lumbar used for staging
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13
Q

How is leukaemia treated (3)?

A
  • Chemo = mainstay
  • Radiotherapy
  • Bone marrow transplant
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14
Q

What medical emergency is common in patients with leukaemia and other malignancies?

A

Febrile neutropenia
chemo can cause low neutrophils as well

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15
Q

What are some complications of chemo in children (5)?

A
  • Neurotoxicity
  • Immunodeficiency
  • Infertility
  • Stunted growth/ development
  • Tumour lysis syndrome
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16
Q

What is the prognosis for childhood leukaemia?

A
  • ALL = 80% cured
  • AML = less positive
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17
Q

Are primary or secondary brain tumours more common in children?

A

Almost always primary in children

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18
Q

What are the 5 main types of brain tumours in children?

A
  • Astrocytoma = MC
  • Medulloblastoma
  • Ependymoma
  • Brainstem glioma
  • Craniopharyngioma
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19
Q

What type of tumour are astrocytomas and ependyomas?

A

Gliomas
astrocytes and ependyma (lining of ventricles) are glial cells

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20
Q

What is a highly malignant form of astrocytoma?

A

Glioblastoma multiforme

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21
Q

Where is a medulloblastoma?

A

Midline of the posterior fossa

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22
Q

What is a craniopharyngioma?

A

Developmental tumour arising from an embryological remnant near the pituitary gland

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23
Q

Which brain tumours have a worse prognosis (2)?

A
  • Glioblastoma multiforme
  • Brainstem glioma
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24
Q

What are the signs/ symptoms of brain tumours (7)?

A
  • Raised ICP headache
  • Papilloedema
  • N+V
  • Seizures
  • Mood/ personality change
  • Visual field defects
  • Focal neurological signs
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25
What is characteristic of raised ICP headaches (2)?
* Wake up with headache * Coughing/ straining/ bending forward worsen headache
26
What are the two types of lymphoma?
* Hodgkin lymphoma * Non-hodgkin lymphoma
27
What cells are found in those with Hodgkin lymphoma?
Reed-Sternberg cells
28
What is a common type of non-hodgkin lymphoma in children?
Burkitts lymphoma
29
Which lymphocytes does burkitts lymphoma affect?
B-cells
30
Where is burkitts lymphoma most common?
Africa
31
What are some risk factors for lymphoma (3)?
* EBV * Malaria * HIV/ immunodeficiency
32
What are the signs/ symptoms of lymphoma (5)?
* **Lymphadenopathy** * B symptoms (fever, night sweats, weight loss) * Fatigue * Recurrent infections * SOB
33
What is a specific symptom of burkitts lymphoma?
Swollen jaw
34
Where is a neuroblastoma?
* Adrenal medulla * Sympathetic nervous chain *tumour arises from neural crest tissue*
35
What is the prognosis of neuroblastomas?
Very good - 80% cured
36
What age does neuroblastoma usually occur?
Under 5 years
37
How do neuroblastomas present (6)?
* Abdo lump * Pallor (anaemia due to marrow infiltration) * Weight loss * Bone pain * Hepatomegaly * Lymphadenopathy
38
How are neuroblastomas investigated?
* Raised urine catecholamines due to increased production of catecholamines ((nor)adrenaline/ dopamine) * Biopsy * Imaging
39
What is the most common renal tumour in children?
Wilms tumour
40
What age does wilms tumour usually present?
< 5 years (80% of cases)
41
Where do wilms tumours come from?
Embryonal renal tissue
42
What are the signs/ symptoms of Wilms tumours (6)?
* **Large abdo mass** * **Haematuria** * Abdo pain * Anorexia * Hypertension * Anaemia
43
How are Wilms tumours investigated?
CT/ MRI *biopsy can cause spread of cancer, so usually done post surgery*
44
How is Wilms tumour managed (2)?
* Chemotherapy first * Nephrectomy
45
What are cancers of connective tissue known as?
Sarcomas
46
What is the most common type of sarcoma in children?
Rhabdomyosarcoma (skeletal muscle cancer)
47
When do bone tumours most commonly occur in childhood?
After puberty
48
What is the most common childhood bone cancer overall?
Osteosarcoma
49
What childhood bone cancer is most common in younger children (before puberty)?
Ewing sarcoma
50
What is the presentation of bone cancers in children?
Persistent localised bone pain even when resting *most patients are otherwise well*
51
Where are bone cancers most commonly found?
In the limbs
52
How are bone cancers investigated in children (2)?
* X-ray then MRI * CT for metastises
53
What might an x-ray show in bone cancer (2)?
* Bone destruction and variable periosteal bone formation * Ewing = soft tissue swelling/ mass
54
How is bone cancer managed in children (3)?
* Chemo first * Surgical resection * Radiotherapy if resection impossible
55
What cell do retinoblastoma come from?
Retinal cells
56
What percent of severe visual impairments in children are due to retinoblastomas?
5%
57
What age do retinoblastomas usually present?
< 3 years
58
What is the cause of bilateral retinoblastomas?
Hereditary genetic cause
59
What is the inheritance of hereditary retinoblastoma and which chromosome is affected?
Auto dom affecting chromosome 13
60
What is the presentation of retinoblastomas (2)?
* Loss of red reflex --> replaced by white reflex * Squint
61
How are retinoblastomas investigated (2)?
* MRI * Examination under local anaesthetic
62
How is retinoblastomas managed (2)?
* Chemo * Laser therapy
63
What are some complications of retinoblastomas (2)?
* Visual impairments * Recurrence/ secondary tumour common
64
What cancer often affects those with HIV?
Kaposi sarcoma *not a true sarcoma, comes from cells of blood/ lymph vessels*
65
How does Kaposi sarcoma present (2)?
* Red/ purple lesions on skin/ GI tract * Lymphadenopathy
66
What is the most common type of liver cancer in children/
Hepatoblastoma
67
How does hepatoblastoma present (2)?
* Abdo mass/ distension * Rarely pain/ jaundice
68
What tumours sometimes form in the ovaries and testes amongst other places?
Germ cell tumours
69
How are germ cell tumours treated?
Chemo *usually very responsive to chemo*
70

Phase 3a conditions list flashcards LOZZA (31 decks)

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