Term
| what is the most likey cancer in kids, when is it diagnosed |
|
Definition
|
|
Term
| what are the most common cancers in kids <5 yo (3) |
|
Definition
leukemia
germ cell tumors: neuroblastoma, wilms tumor, retinal blastoma |
|
|
Term
| what are the most common cancers in kids 5-10 yo (3) |
|
Definition
leukemia
brain cell tumor
lymphoma |
|
|
Term
| what are the most common cancers in kids 10-14 yo (3) |
|
Definition
lymphoma
brain cell tumor
leukemia |
|
|
Term
| what are red flags for malignancy that are mistaken for mono (2) |
|
Definition
weight loss
lymphadenopathy (enlarged node) |
|
|
Term
| why is anemia a red flag for malignancy, what are two symptoms |
|
Definition
caused by leukemia or neuroblastoma due to marrow infiltration
fatigue, lethargy |
|
|
Term
| why is petechiae a red flag for cancer, what is it |
|
Definition
purple spots
due to thrombocytopenia (low platelets) due tomarrow infirltration |
|
|
Term
| what are 13 red flags for cancer |
|
Definition
weight loss
lymphadenopathy
anemia - fatigue, lethargy
pallpw, fever, headache, poor growth, anorexia, vomiting, bone pain, limpness, hepatosplenomeagly, abdominal mass, testucylomeagly, infection petechiae |
|
|
Term
| what type of cancer presents with testiculomeagly |
|
Definition
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|
Term
| what is a hereditary condition that increases cancer risk |
|
Definition
|
|
Term
| what is a neurocutaneoous syndrome that increases risk for cancer |
|
Definition
|
|
Term
| what are 2 chromosomal abnormalities that increase risk for cancer |
|
Definition
| down syndrome, bloom syndrome |
|
|
Term
| what is a acquired immune deficiency that increases risk for cancer |
|
Definition
|
|
Term
| what are 2 congenital malformations that increase risk of cancer |
|
Definition
| hemihypertrophy, beckkeith-wedemann syndroome |
|
|
Term
| what are two intrauterine or postnatal agents that increase risk for cancer |
|
Definition
| chemotherapy, diethylstilbesterol |
|
|
Term
| what is a metabolic disease that incrases risk for cancer |
|
Definition
| a-1-antitrypsin deficiency |
|
|
Term
| what are 5 general things that increase risk for cancer |
|
Definition
| autoimmune diseases, sigling with cancer, history of cancer, drugs, radiation |
|
|
Term
| what is the molecular basis for malignancy, why do we care |
|
Definition
| oncogenes, that is where therapy is directed |
|
|
Term
| what can anemia be caused by (2) |
|
Definition
Fe deficency
marrow infiltration in cancer |
|
|
Term
| what can fever, low WBC be caused by (4) |
|
Definition
strep, viral pharyngenitis
leukrmia, neuroblastoma |
|
|
Term
| what can bone pain or arthralgia be caused by (6) |
|
Definition
trauma, RA, ostomyeloitis,
sarcoma, leukemia, neuroblastoma |
|
|
Term
|
Definition
|
|
Term
| what could an abdominal mass be caused by (6) |
|
Definition
organomedaly, hydronephrosis, constipation
neuroblastoma, wilms, cytoblastoma |
|
|
Term
| what could hypertension be caused by (3) |
|
Definition
| idiopathic, renovascular, sympathetic nervous system tumor |
|
|
Term
| what could chronic diarrha be caused by (3) |
|
Definition
| IBS, neuroblastoma, neuroma |
|
|
Term
| what can cause a white pupil (2) |
|
Definition
| congenital cataract, retinal blastoma |
|
|
Term
| what can cause periorbital echtimosis (2) |
|
Definition
|
|
Term
| what can cause thoracic mass (5) |
|
Definition
| pneumonia, sarcoidosis, pyloma, T cell lymphoma, neuroblastoma in posterior mediastinum |
|
|
Term
| what is the most common childhood cancer |
|
Definition
|
|
Term
| what are the three types of leukemia, when do they appear |
|
Definition
ALL: more common. peaks in 4 years
AML: peak in 1-10 years (during adolesence)
chronic myeloid (CLL): rare |
|
|
Term
| what is leukemia claim for fame |
|
Definition
| first disseminated cancer that is curable with chemotherapy and radiation |
|
|
Term
|
Definition
| enivornmental or infectious trigger |
|
|
Term
|
Definition
| seen in lots of immune deficiency patients |
|
|
Term
| how do we subclass leukemias |
|
Definition
| morphology of blast cells on marrow biopsy peripherial smear |
|
|
Term
| what are the three classifications of leukemia |
|
Definition
FAB L1: blast with small scanty cytoplasm
FAB L2: large blast with more cytoplasm, irregular nuclear membranes, prominent nucleoli
FAB L3: blasts that are basophyllic with vacoulization |
|
|
Term
| what is an alternative way to class or type leukemia |
|
Definition
| using antigens on blast cells to immunotype to determine if it came from T, B, pre B cells etc |
|
|
Term
| what are the 3 most common clinical signs, the CC of someone with leukemia |
|
Definition
| fever, viral upper respiratory infection, rash |
|
|
Term
| what are the thee signs of lekemia that are due to marrow supression, what caused them |
|
Definition
decreased neutrophils causes infection (viral UTI) and fever
decreased platelets causes thrombocytopenia (bleeding and petechiae)
decreased RBC causes anemia (malaise) |
|
|
Term
| what are the symptoms of leukemia that are not the CC or caused by marrow infiltration (10) |
|
Definition
| irritability, exanthems, occasional lymphadenopathy, increased ICP, splenomeagly, bone pain, arthalgia, mediastinal mass, anorexia, plae |
|
|
Term
| why do people with leukemia get increased ICP |
|
Definition
| blast cells infiltrate the meningies |
|
|
Term
| why does anemia come after thrombocytopenia |
|
Definition
| because RBC have life span of 120d and platelets 8d. so it takes more time to show anemia than thrombocytopenia even though their precursors both pooped at the same time |
|
|
Term
| what are the three most important parts of diagnosis for leukemia |
|
Definition
FAB morphology P1<1000,000
blast cells on peripherial smear
marrow aspiration (confirming test) |
|
|
Term
| what tests do you want to do if you suspect leukemia (not nessesciarly for diagnosis) (6) |
|
Definition
WBC > 50,000
platelets < 10,000 (thrombocytopenia)
chest x-ray to show mediastinal mass
bone x-ray to show cortical defects
serum uric acid
spinal tap: to see leukemia cells in CSF |
|
|
Term
| why do we test for serum uric acid in leukemia |
|
Definition
| treatment causes lysis of blast cells releasing uric acid so you need to see if it is high before treatment |
|
|
Term
| what three ddx will there be in leukemia |
|
Definition
infectious mononucleosis
aplastic anemia
pediatric tumor: neuroblastoma causing marrow infiltration |
|
|
Term
|
Definition
complete supression of bone marroq
supression of all precursors in marrow aspartate |
|
|
Term
| what are the 4 steps in leukemia treatment |
|
Definition
remission induction (4-6 weeks)
intrathecal treatment - if penetrated CNS
systemic continuation treatment
reinforcement |
|
|
Term
| what do you do if leukemia treatment dosent work, what values indicate this step |
|
Definition
marrow transplant
WBC < 100,000
age 1-10 yo
no mediastinal mass
B-cell immunophenotyping needed |
|
|
Term
| what are the three most common areas of leukemia relapse |
|
Definition
|
|
Term
| what are 4 signs that are good if you have leukemia |
|
Definition
age < 10 yo
WBC < 100,000
no CNS signs
no mediastinal node enlargement |
|
|
Term
| what 3 medicines do you use to induce remission in leukemia |
|
Definition
| vincristine, prednisone, asparginase |
|
|
Term
| where does lymphoma tank in common cancers |
|
Definition
|
|
Term
| what is the cardinal histological feature of a lymphoma |
|
Definition
|
|
Term
| what are the types of lymphoma |
|
Definition
|
|
Term
| what are the 4 different cell combinations in lymphoma |
|
Definition
nodular sclerosing (adolsecents) broad bands of collagendivide lymphoma
midex cellularity
lymphocyte predomnance
lymphocyte depletion - not good, seen in HIV |
|
|
Term
| where does lymphoma usually spread |
|
Definition
| adjacent node usually but can go to lung marrow and liver |
|
|
Term
| describe the node in a lymphoma, where could it be |
|
Definition
painless, firm, enlarged
cervical, axially, inguinal, mediastinal, supraclavicular |
|
|
Term
| what is the most common cause of an axillary node nelargement |
|
Definition
|
|
Term
| what is the complications of a mediastinal lymphoma, how do you check for it |
|
Definition
| can cause tracheal compression (cough, SOB), push on trachea |
|
|
Term
| what is the most common reason for large nodes |
|
Definition
|
|
Term
| what are signs for lymphoma other than large nodes (6) |
|
Definition
| fatigue, puritis, urticarial, node pain that worsens with alcohol, pulmonary infiltrates, biliary obstructions (due to nodes near bile duct) |
|
|
Term
| what are the 4 stages of lymphoma, what classifies |
|
Definition
1. one node region extralymphatic organ or site
2. two or more node regions on the same side of the diaphragm or extralymphatic involve of an organ or nodes on the same side of the diaphragm
3. involvement of node or regions on both sides of the diaphragm. can have local involvement of extralymphatic organ or splenic involvement
4. disseminated involvement of extralymphatic organs without node involvement |
|
|
Term
| what are the three most important parts to lymphoma diagnosis |
|
Definition
persistant unexplained lymphadenopathy
large nodes that don't regress after infectous mono
node biopsy |
|
|
Term
| what are 4 less important diagnosis methods for lymphoma, |
|
Definition
chest x-ray
acute phase reactions
marrow aspiration
CT, MRI, marrow, bone scan (for staging) |
|
|
Term
| what do you see on a marrow aspiration for lymphoma |
|
Definition
| shows lymphatic predominance or deplation and mixed cellularity |
|
|
Term
| what will be seen on a node biopsy for lymphoma |
|
Definition
| lymphatic predominance or deplation and mexe cellularity |
|
|
Term
| when do you see a reed sternberg cell, decribe two things about it |
|
Definition
has two nuclei with nucleolus and membrane
has lot of cytoplasm
seen in all lymphoma but can be in other diseases too |
|
|
Term
| what is seen around reed-sternberg cells (3) |
|
Definition
| lymphocytes, plasma cells, tissue mononuclear cells |
|
|
Term
| what is the treatment for stage 1 or 2 lymphoma |
|
Definition
| radiation or chemotherapy (MOPP/ABVS) |
|
|
Term
| what is the treatment for advanced lymphoma |
|
Definition
| combinations or alterations of chemotherapy and radiation |
|
|
Term
| what is the prognosis of each of the stages of lymphoma |
|
Definition
1 and 2 100%
3 is 75-90%
4 60-75% |
|
|
Term
| what is the claim to fame of a neuroblastoma, when is it diagnosed |
|
Definition
most common extracranual solid tumor of childhood
median age 2, usually diagnosed before age 5 |
|
|
Term
| neuroblastoma cause and spread |
|
Definition
| comes from the neural crest cells of the sympathetic nervous system, invades locally, agressivly spreads to the blood, marrow, lymphatics, and liver |
|
|
Term
| what are the three areas of primarys for neuroblastoma, what is the chance it came from each |
|
Definition
70% abdomen
50% adrenal
20% thorax |
|
|
Term
| what are the symptoms of neuroblastoma |
|
Definition
neck or abdominal mass
hypertensive chrisis
incidental nodule on chest x-ray
ecchymosis or propotosis (metastasis or orbits)
bluish subcutaneous nodules
abdominal swelliing
hepatosplenomeagly |
|
|
Term
| what causes hypertensive chrisis in neuroblastoma |
|
Definition
| neural chest cells secrete catecholamines which can be seen in VMA in urine |
|
|
Term
| what is ecchymosis or proptosis,when is it seen, what causes it |
|
Definition
retroorbital infiltrates cause blue or bruised eye
metastasis to orbit
metastasis to orbits |
|
|
Term
| what is the two key thing to look for in neuroblastoma diagnosis, how does it look, where is it found |
|
Definition
pseudorosette cells on bopsy
cells that metastasized to the marrow
clusters of cells
and VMA in the urine |
|
|
Term
| how is neuroblastoma diagnosed, staged, and classified (6) |
|
Definition
VMA inurine, pseudorosette cells
CT or MRI show size and location
meta-isobenzyl guanidine scan shows metastasis
tissue and marrow biopsy |
|
|
Term
| how is a neuroblastoma treated (2) |
|
Definition
localized tumor: surgical resection can be curative
advanced disease: chemotherapy |
|
|
Term
| wim's tumor claim to fame, when is it diagnosed |
|
Definition
most common childhood renal tumor
diagnosis age 3 |
|
|
Term
| what ocnditions is wilms tumor associated with (3) |
|
Definition
GIU
aniritia (iris)
hemihypertrophy: hypertrophy of muscles on one side of the body |
|
|
Term
| what are the signs of a wilms tumor (4) |
|
Definition
asymptomatic abdominal or flank mass
hypertension, hematuria, paraneoplastic syndrome |
|
|
Term
| what is paraneoplastic syndrome (2) |
|
Definition
polycythemial: kidney cells make erythropoetin causing it
hypercalcemia |
|
|
Term
| how is wilms tumor diagnosed (2) |
|
Definition
|
|
Term
| what is the ddx of wimls tumor |
|
Definition
|
|
Term
| what is the treatment for wilms tumor (2) |
|
Definition
nephrectomy for unilateral tumors
post operative radiation and chemotherapy |
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