Oncology Flashcards Preview

Paeds Exam > Oncology > Flashcards

Flashcards in Oncology Deck (35)
Loading flashcards...
1

Which medication is associated with hypertrichosis and gum hyperplasia?

A. Azathioprine.
B. Cyclosporin.
C. Methotrexate.
D. Mycophenolate.
E. Tacrolimus.

 

B. Cyclosporin. Causes hypertrichosis and gum hyperplasia in 5-19%

 

All other medications cause alopecia.

2

What is the single most common malignancy of childhood?

3

What is this a picture of?

Immature lymphocytes.

Note no granules in cytoplasm.

4

What is pathogenesis of ALL?

Aetiology is unclear but must have

Maturation arrest and

uncontrolled proliferation

5

What is peak age for ALL?

3 years then steadily decreases with another much smaller peak at approx 16 years.

6

What is second most common leukaemia of childhood?

AML

7

What is cure rate of AML?

60-65%

8

What is treatment of AML?

Cytarabine base chemo for 6-9 months

9

What are some presenting features of AML?

  • Fever
  • Malaise
  • Wt loss
  • Myalgia/arthralgia
  • Lymphadenopathy
  • Anemia, thrombocytopenia
  • Hepatosplenomegally
  • Leucopenia or leucocytosis
  • Bleeding
  • Masses
  • gum hypertrophy

10

What is this and what does diagnosis do you consider?

Auer Rod = AML (pathognomonic)

11

In the FAB classification of AML, M7 is megakaryoblastic leukaemia. What population of people are more likely to have this diagnosis?

Downs Syndrome

12

In the FAB classification of AML, M3 is APML (Acute Promyelocytic Leukaemia).

What do you need to be careful to look for on diagnosis of APML?

DIC.

Need full coag profile plus fibrinogen and then serial measurements.

13

What is treatment of APML?

Anthracycline & ATRC - Al Trans Retinoic Acid

14

Anthracycline and ATRA are used in treatment of APML. What does these drugs do, what is a significant side effect and what is survival?

Anthracycline helps mature blasts into healthier cells.

Beware ATRA syndrome - acute resp failure with pulmonary oedema.

Good outcomes if survive induction.

15

What are prognostic features of AML?

  • Age - worse with increasing age
  • Presentation WCC count - higher wcc = higher risk
  • CNS disease - poorer prognosis
  • Cytogenetics
    • favourable 8:21, 15:17
    • bad = monosomy 7, complex karyotype

16

When is Hodgkins Lymphoma more common?

2nd decade

17

What is usual presentation of Hodgkins Lymphoma?

Slowly progressing lymphadenopathy - often in teenage girl.

Mediastinal mass

"B" symptoms

Paraneoplastic syndromes ie itch.

18

Prognosis of Hodgkin Lymphoma?

Good. 80% at 5 years depending on B symptoms.

19

5 lines on Burkitts Lymphoma

  • most common NHL
  • Very aggressive
  • usually presents at high stage often with large abdominal mass
  • frequently bone marrow involvement
  • Cure in 85%
  • Treatment very intensive

20

Tumour Lysis Syndrome

  • Seen in malignancies with high tumour burden and high mitotic rate
  • might be present at diagnosis
  • usually commences after starting chemo

Lysis of tumour cells leads to release of intracellular electrolytes incl K+, Ca2+, phosphate and uric acid.

 

21

What usually causes fatality in tumour lysis syndrome?

Hyperkalaemia

22

Why does renal impairment/failure occur in tumour lysis syndrome?

Precipitation of calcium phosphate and uric acid in the tubules.

Calcium phosphate most likely to precipitate but most damage done by uric acid crystals.

23

What is management of tumour lysis syndrome?

  • Hyperhydration -NEVER with potassium
  • Allopurinol or rasburicase (uric oxidase) NOT both
  • Treat hyperkalaemia (sodibic)
  • Check electrolytes, phosphate and uric acid.

24

Why should you avoid giving Allopurinol and rasburicase together in treatment of tumour lysis sydrome?

Allopurinol - prevents formation of uric acid

Rasburicase - breaks down uric acid

 

allopurinol with decrease substrate for rasburicase so waste of medication.

25

Haemorrhagic cystitis

Acrolein produced from degradation of cyclophosphamide causing haemorrhagic cystitis.

Mercaptoethane sulphonate (MESNA) used to prevent.

26

Where should vincristine NEVER be given?

Intrathecal.

 

Should only be via central IV - causes tissue chemical burns peripherally.

27

Hemihypertrophy and hemihyperplasia are associated with what oncological condition?

Beckwith-Wiedeman Syndrome associated with

  • Wilms Tumour
  • Hepatoblastoma

28

What cells are depleted to minimise graft vs host disease?

T cells

29

This CT plus 2/12 progressive ataxia and headaches =?

Medulloblastoma

35-40% posterior fossa tumours

2-3 month hx of headache, vomiting and truncal ataxia

30

Describe veno-occlusive disease of the liver.

  • Occurs in first 3/52 after transplant
  • Fibrous obliteration of terminal hepatic venules and small lobular veins. Results in damage to surrounding hepatocytes and sinusoids.
  • Most common cause of hepatic vein obstructioin in children
  • Cause of VOD after bone marrow transplant not clear

Symptoms

  • Jaundice
  • painful hepatomegally
  • rapid weight gain
  • ascites