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Peds > peds35 > Flashcards

peds35 Flashcards

1
Q

Reed-sternberg cell

A

hodgkins lymphoma; a large multinucleated cell with abundant cytoplasm

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2
Q

symptom onset for hodgkins vs nonhodgkins

A

hodgkins has a slow onset, whereas NH is rapid

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3
Q

common location of H and NH lymphoma

A

H is cervical and supraclavicular nodes; NHL is abdominal, mediastinal, and supraclavic nodes

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4
Q

systemic symptoms in H and NH lymphoma

A

H common, in NH uncommon

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5
Q

SVC syndrome

A

obstruction of the SVC by malignancies; dyspnea, headache, edema, other sx

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6
Q

SVC in H or NH lymphoma?

A

rare in hodgkins; common in nonhodgkins

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7
Q

staging system for hodgkins lymphoma

A

ann arbor system; subclassified into A or B (systemic sx); stage 1- single lymph node; stage 2- 2 or nodes on same side of diaphragm; stage 3- nodes on both sides of diaphragm; stage 4- dissem inovlvement of extralymph tissues

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8
Q

treatment for hodgkns

A

chemo and XRT; male sterility is common side effect of therapy

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9
Q

prognosis for hodgkins

A

stage 1 and 2 is excellent; more advanced disease less

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10
Q

non-hodgkins lymphoma

A

more aggressive and more common than hodgkins

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11
Q

non-hodgkins lymphoma gender pref?

A

male predominance; incr incidence after 5 years of age

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12
Q

three major categories of NHL

A

lymphoblastic lymphoma; burkitt’s lymphoma; large cell lymphoma

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13
Q

lymphoblastic lymphoma

A

type of NHL; T cell in origin; similar to the lymphoblast in ALL

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14
Q

Burkitt’s lymphoma

A

a type of small noncleaved cell lymphoma; most common lymphoma in childhood;b cell origin; type of NHL

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15
Q

large cell lympoma

A

b cell in origin; type of NHL

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16
Q

most common presenting sign in NHL

A

painless lymphadenopathy

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17
Q

lymphoblastic lymphoma- how doess it present?

A

anterior mediastinal mass; patient may develop SVC syndrome or airway obstruction as a result

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18
Q

Burkitt’s lymphoma clinicl features

A

intussusception (any kid older than 3 w intussus think BL); abdominal pain or mass

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19
Q

jaw mass

A

burkitt’s

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20
Q

large cell lymphoma prsents how?

A

enlargment of lymphoid tissue in the tonsils, adenoids, or peyer’s patches

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21
Q

adenoids

A

lymphatic tissue in the roof of the mouth

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22
Q

peyers patches

A

lymphoid nodules in the small intestine

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23
Q

treatment for NHL

A

must be rapid because it is aggressive; surgery, chemo, prophylaxis for CNS spread

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24
Q

prognosis for NHL

A

outlook good for localized lymphoma but poor for disseminated

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25
Q

second most common childhood cancer

A

brain tumors

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26
Q

most common solid tumors in kids

A

brain tumors

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27
Q

most common type of brain tumor

A

glial cell tumors

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28
Q

astrocyte

A

type of glial cell

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29
Q

glial cell

A

non-neuronal cells that make myelin and provide support

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30
Q

primitive neuroectodermal tumors quintessential example

A

medullablastomas arising from the cerebellum

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31
Q

ependymomas

A

tumor that arises from the epithelial-like lining of the ventricles

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32
Q

craniopharyngioma

A

tumor derived from the pituitary gland

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33
Q

infratentorial

A

cerebellum and below

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34
Q

infrantentorial tumors vs tentorial tumors

A

infratentorial are more common

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35
Q

most common infratentorial tumor

A

medullablastoma

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36
Q

most common supratentorial tumor

A

astrocytoma

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37
Q

ICP symptoms seen in brain tumors are worse when?

A

worse during sleep or on awakening; better during the day as venous return from the head improves with upright posture

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38
Q

sixth nerve palsy

A

sign of ICP; can’t contract LR to abduct the eye; so you get convergent strabismus

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39
Q

CT versus MRI for brain imaging

A

MRI generally better

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40
Q

principle treatment for brain tumor

A

surgery; radiation therapy reserved for kids over 5; chemo sometmes

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41
Q

astrocytoma prognosis

A

low grade fully-resectable have a good prognosis; high grade bad prognosis

42
Q

PNETs prognosis

A

worse in kids less than 4; good if tumor is fully resectable

43
Q

prognosis of brainstem gliomas

A

poorest prognosis; not possible to resect and chemo is ineffective

44
Q

neuroblastoma

A

malignant tumor of neural crest cells; can arise anywhere in the symp ganglion chain or adrenal medulla

45
Q

peak incidence for neuroblastomas

A

first 5 years of life; median age at dx is 2 yo

46
Q

most neuroblastomas occur where?

A

abdomen or pelvis; some can occur in posterior mediastinum and few in the neck

47
Q

diagnosis of neuroblastoma

A

urine excretion of excess catecholamines; definitive dx by bone marrow biopsy plus elevated urine catecholamines

48
Q

acute cerebellar atrophy

A

occurs in 2% of neuroblastoma; ataxis, random eye jerks, and myoclonus (“dancing eyes and dancing feet”)

49
Q

management of neuroblastoma

A

surgery for stages 1 and 2; chemo for metastatic disease; radiation therapy for advanced dz

50
Q

prognosis for neuroblastoma

A

good in stage 1 and 2; you can actually get spontaneous regression without tx in infants with stage IVS disease’ poor prognosis in stage III and IV;

51
Q

wilms tumor cell origing

A

nephroblastoma;

52
Q

most common childhood renal tumor

A

wilms tumor

53
Q

median age at dx for wilms tumor

A

3 years

54
Q

how does htn develop in wilms tumor kdis?

A

compression of renal artery or increased renin secretion by tumor

55
Q

wilms tumor associated congenital anomalies

A

GU malformations, hemihypertrophy, sporadic aniridia

56
Q

aniridia

A

absence of the iris

57
Q

wilms tumor bilateral?

A

5% of cases

58
Q

management of wilms tumor

A

surgery for staging and debulking; chemo used for alll stages; radiation therapy for advanced disease

59
Q

prognosis for wilms tumor

A

outcome is excellent

60
Q

rhabdomyosarcoma

A

cancer cells arise from skeletal muscle precursors

61
Q

most common soft tissue sarcoma in childhood

A

rhabdomyosarcoma

62
Q

most common sites of involvement for soft tissue tumors

A

head and neck(orbital, nasopharyngeal, laryngeal)

63
Q

second most common site of soft tissue tumor

A

GU tract

64
Q

prognosis for soft tissue tumors

A

good for head, neck, and GU tumors; poor for other sites

65
Q

osteogenic sarcoma

A

malignant tumor that forms new bone

66
Q

most common malignant bone tumor

A

osteogenic sarcoma

67
Q

when does incidence of osteogenic sarcoma peak?

A

rapid growth spurt during adolescence

68
Q

clinical features of osteogenic sarcoma

A

about 50% occur near the knee; periosteal racton with “sunburst” appearance; occur at metaphysis; mets in 15%

69
Q

management of osteogenic sarcoma

A

surgery to remove the primary tumor; chemo improves survival; pulm mets removed surgically

70
Q

prognosis of osteogenic sarcoma

A

survival greater than 60%

71
Q

ewing’s sarcoma

A

sarcoma characterized by small, round, blue cell tumor

72
Q

ewing’s sarcoma what population?

A

most commonly during adolescence and more common in males; rare in asians and african americans

73
Q

ewing’s sarcoma genetic cause

A

translocation between chroms 11 and 21 (similar to PNET brain tumors)

74
Q

treatment of ewing’s tumor

A

multiagent chemo due to high risk of mets and also surgery

75
Q

prognosis for ewing’s sarcoma

A

good for local disease; poor if mets

76
Q

ewing’s sarcoma affects what part of the bone?

A

flat bones and diaphysis (as opposed to metaphysis in osteogenic); on radiograph see periosteal reaction with onion skin appearance;

77
Q

two types of liver tumors

A

hepatoblastoma and HCC

78
Q

most common type of liver tumor in kids

A

hepatoblastoma

79
Q

hepatoblastoma seen in what age kids? Associated with what syndrome

A

less than 3 yo; beckwith weidemann syndrome

80
Q

HCC seen in what age? Associated with what?

A

kids and adolescents; associated with chronic active Hep B

81
Q

jaundice in liver tumors?

A

not usually

82
Q

treatment of liver tumors

A

surgical resection and chemot

83
Q

prognosis for liver tumros?

A

very poor; most unresectable and will met to the lungs; HCC less curable than hepatoblastoma

84
Q

germ cell tumors

A

derived from cellular precursors of sperm and eggs

85
Q

most common teratoma during first years of life

A

sacrococcygeal teratoma

86
Q

sacrococcygeal tumor

A

75% females and most are benign; surgical resection of the tumor and the coccyx

87
Q

how do anterior mediastinal teratomas present?

A

airway obstruction; usually being

88
Q

ovarian teratomas

A

generally benign; most common ovarian tumor

89
Q

most common germinomas of the testicle

A

yolk sac tumor, followed by teratomas

90
Q

peak age for testicular cancer

A

5 yo

91
Q

testicular tumors in kids versus adults

A

in adults, testicular tumors are always malignant; in kids, one third are benign

92
Q

serum alpha fetoprotein is elevated in what type of testicular cancer?

A

yolk sac tumors; also in ovarian yolk sac tumors

93
Q

treatment of yolk sac tumors

A

radical orchiectomy and, if necessary, retroperitoneal lymph node dissection

94
Q

ovarian tumors- are they malignant?

A

1/3 are malignant and the younger the child, the more likely the tumor is malignant

95
Q

ovarian tumor freq in puberty

A

ovarian tumors incr in frequency in puberty

96
Q

Langerhans cell histiocytosis

A

uncontrolled growth of langerhans cell (activated dendritic cells and macrophages); not a true malignancy but immune dysregulation

97
Q

examples of langerhans cell histiocytosis

A

eosinophilic granuloma, hand-schuller-christian disease, and letterer-siwe disease

98
Q

clinical features of langerhans cell histiocytosis

A

skeletal involvemnt, skin involvement, pituitay or hypothal involvemtn, systemic features

99
Q

management of langerhans cell histiocytosis

A

if single lesion is involved, local curretage or low dose radiation; steroids or single agent chemo; if multiple sites, multiagent chemo is used

100
Q

anaphylaxis

A

IgE mediated; release of potent mediators that affect vascular tone and bronchial reactivity

101
Q

when do symptoms of anaphylaxis appear?

A

within 30 mins after exposure

Peds (99 decks)

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