Oncology Flashcards

Terms Definitions
What syndromes are associated with leukemia?
Down, Bloom, and Fanconi's
sites for Osteogenic sarcoma?
proximal and distal long bones
typical patient for osteogenic sarcoma?
teenager going through growth spurt with pain
What race is associated wtih ewing sarcoma? osteogenic sarcoma?
not african americans. african americans
Ewing or osteogenic sarcoma associated with soft tissue component?
treat OS or Ewing sarcoma.
chemo, radiation, and surgery
main site of OS mets?
Recurring persistent pain even in the face of trauma?
Osteogenic sarcoma
Describe osteoid osteoma.
Tibia or femur pain relieved by ibuprofen worse at night
Xray for osteoid osteoma?
Central radiolucent surrounded by sclerotic bone
Most common solid tumors?
Brain tumors
Presentation of brain tumor?
Headache worse in the morning better with standing and vomiting
Most common pediatric malignancy?
Poor prognosis for ALL?
Younger than 2, wbc >50, T cell
What ALL is ok?
Pre B cell
Presentation of ALL?
Bone pain, joint swelling, fevers, pancytopenia, WBC count may be normal, enlarged liver or spleen
Treatment of leukemia
Chemi to induce remission, intrathecal chemotherapy
Hodgkins presentation?
Teens, non tender enlarged cervical nodes, weight loss, night sweats
Hodgkins progression?
Cervical nodes first then mediastinal, abdominal, and pelvis
What cells associated with hodgkins?
Reed sternberg, high white cells with low lymphocytes
Differentiate between hodgkins and lupus.
Hodgkins has thrombocytopneia
Non hodgkins presentation?
Small child with head or neck mass or abdomen
Two types of non hodgkins?
Lymphoblastic (T cell), nonlymphoblastic (Bcell) like Burkitt
Differentiate non hodgkins from leukemia.
Leukemia has more than 25% blasts even if there is a mass, non hodgkins has less than 25% with mass
Main features of Langerhans Cell Histiocytosis?
seborrheic rash, ear discharge, lytic skull lesions, DI
diagnose Langerhans Cell histiocytosis?
skin biopsy with electron microscopy
remember Langerhans Cell Histiocytosis.
long hands hysterical X - long fingers with sharp Xs poking holes in head, hitting pituitary, popping ear drums and causing drainage that causes a rash, cut hands with biopsy
second most common solid tumor in children?
When is survival best with neuroblastoma?
less than 1 year old
features of neuroblastoma?
non-tender Ab mass, raccoon eyes (from mets), horner syndrome, symptoms of catecholamine excess
what is cause of HTN in neuroblastoma?
1. renal artery compression, 2. catecholamines
what is opsoclonus-myoclonus?
random jerky movements of eyes seen with neuroblastoma
diagnose neuroblastoma?
1. biospy, 2. high urine VMA and HMA with bone marrow tumor
lab findings with neuroblastoma?
pancytopenia, elevated ferritin, elevated LDH
what lab value predicts prognosis? what does high and low mean?
n-myc amplification - if there it is bad, if not it is good
What are the genetics of retinoblastoma if parent had in both or one eye?
both - kid has 50% chance, one - kid has 5% chance
what does retinoblastoma put you at risk for later in life?
what is the character of benign or malignant ovarian tumors by US?
benign - fluid filled, malignant - echodensities
Most common soft tissue tumor in kids?
Where is rhabdo located in 2-6 years? in teens?
head and neck. truncal or extremity
typical boards presentation of rhabdo and osteosarcoma?
trauma but pain is getting worse and is atypical
What is a grapelike mass protruding from the vagina?
Most common pediatric abdominal malignancy?
Wilms tumor
median age for Wilm's tumor?
3.5 years
other name for Wilm's tumor?
most common presentation of Wilm's tumor?
asymptomatic abdominal mass with hypertension and gross hematuria
treat Wilm's tumor.
nephrectomy then chemo and/or radiation
Features of Wilm's
aniridia, abdominal mass, and hemihypertrophy
What tumor is associated with aniridia?
Wilm's - wilma from flintstones had no iris
How would you distinguish Wilm's from neuroblastoma on CT?
Wilm's distorts renal parenchyma
Does Wilm's calcify?
What disorder is hemihypertrophy associated with ? What cancer are these patients at risk for?
Beckwith Weidemann - Wilm's
Classic tumor leading to tumor lysis syndrome?
Burkitt's lymphoma
symptoms of tumor lysis syndrome?
hyperphos, hyperK, hyperuricemia
treat tumor lysis
hydration, alkalinization, and allopurinol
treat tumor causing spinal cord compression
steroids and/or radiation
Airway management in anterior mediastinal mass?
NOT intubation because may not get below mass with tube
What are the causes of anterior mediastinal masses? How do you remember?
4Ts - thymoma, teratoma, thyroid, and terrible T cell lymphoma
Most common tumor to cause SVC syndrome?
Hodgkins or T cell lymphoma
What should be avoided in the management of anterior mediastinal masses?
anesthetizing - may lose control of airway
emeregently treat mediastinal mass?
steroids or radiation
Side effects: cyclophosphamide
hemorrhagic CYstitis
Side effects: bleomycin
pulmonary fibrosis
side effects: anthacycline (doxorubicin or daunorubicin)
cardiac tox
side effects: vincristine
neurotox and SIADH - guy named Vin with blasting headache replaced by crystal ball
side effects: Asparaginase
pancreatitis - pancrease looks like asparagus bunch
Side effects: procarbazine
CNS probs - Pro Car BAM scene (car crashes into a head)
side effects: methotrexate
oral and GU ulcers - Mouthotrexate
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