Pediatric oncology II Flashcards Preview

Year 2 Hematology > Pediatric oncology II > Flashcards

Flashcards in Pediatric oncology II Deck (38)
1

what is the most common malignancy in childhood?

ALL

2

what is the pathogenesis of ALL?

1. lymphoid progenitor cell undergoes clonal expansion
2. altered expression of genes whose products contribute to normal development of B and T cells

3

what are the three main signs of leukemia?

1. bone marrow infiltration
2. extramedullary disease
3. fever of malignancy

4

what are the manifestations of bone marrow infiltration in leukemia?

1. anemia
2. low platelets
3. neutropenia
4. bone pain

5

what are the manifestations of extramedullary disease in leukemia?

1. lymphadenopathy
2. hepatosplenomegaly
3. orthopnea, cough
4. gingival hypertrophy

6

orthopnea could alert physican to what type of mass?

mediastinal

7

what is the most helpful test in the diagnosis of ALL?

CBC

8

what % of ALL cases will show elevated WBC?

50%

9

what % of ALL patients will have 2 or more cytopenias?

95%

10

what are the primary accepted nongenetic risk factors for ALL?

prenatal exposure to x rays and high dose radiation

11

what is the presentation for precursor B cell ALL?

1. bone marrow involvement
2. frequently also extramedullary - CNS, skin, gonads, lymph nodes, liver, spleen

12

what is the presentation for precursor T cell ALL?

1. mediastinal mass
2. high WBC
3. prominent lymphadenopathy

13

what are the main prognostic factors in B cell leukemia?

1. WBC count
2. age

14

what is the greatest predictor of outcome for ALL?

response of induction therapy in bone marrow within 28 days

15

what are the late effects of treatment for ALL?

1. osteonecrosis, osteopenia
2. neuropathies
3. neuropsychometric concerns
4. obesity

16

what are the prognostic indicators for AML?

1. age
2. race
3. cytogenetics

17

what is the most common brain tumor in children?

astrocytoma

18

what are the signs of posterior fossa tumors?

ataxia, tremors, dysarthria, stiff neck, papilledema

19

what are the signs of brainstem tumors?

1. extremity weakness
2. cranical nerve signs

20

what are the signs of hemispheric tumors?

1. hemiparesis
2. hemianopsia
3. aphasia
4. seizures

21

what is generally needed for brain tumor diagnosis?

surgery

22

what has the greatest impact on brain tumor outcome?

surgery

23

what is the treatment for a tumor that disseminates via CSF?

neuro-axis radiation prophylaxis

24

what role does chemotherapy have in childhood cancer cases?

adjunctive

25

astrocytomas are associated with what mutation in 50-80% of cases?

NF-1

26

what is the leading cause of morbidity and mortality among pediatric cancers?

brain tumors

27

what is the gene mutation associated with wilms tumor?

WT1

28

what are the anomalies and syndromes associated with wilms tumor?

1. hemihypertrophy
2. aniridia
3. denys-drash syndrome
4. beckwith-widemann syndrome

29

what are the main history symptoms associated with wilms tumor?

1. hypertension
2. gross hematuria

30

what tests are used to evaluate for wilms tumor?

1. CBC
2. CT abdomen
3. CT chest
4. CXR
5. abdominal US

31

what is the cause of retinoblastoma?

loss of both alleles of RB gene

32

where do neuroblastomas occur?

any neural crest tissue - adrenal, paraspinal sympathetic tissue

33

what is the clinical presentation for neuroblastoma?

1. large abdominal mass crossing midline
2. lower extremity weakness
3. cervical, high thoracic mass - horner's syndrome

34

what is the most common extracranial solid tumor in children?

neuroblastoma

35

what is the average age of diagnosis for neuroblastoma?

18 months

36

what are the poor prognositc indicators for neuroblastoma?

1. age over 18 months
2. myc-n amplification
3. unfavorable histology

37

what are the tests to evaluate for neuroblastoma?

1. urine catecholamines
2. imaging - CT, bone scan
3. BM biopsy
4. lymph node evaluation

38

what are the differences between osteogenic sarcomas and ewings sarcomas?

1. osteogenic - metaphysis of long bone
2. ewings - diaphysis of long bone, all other bones