Peds Oncology

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Author:
alyn217
ID:
186546
Filename:
Peds Oncology
Updated:
2012-12-02 11:10:19
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PT3
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Description:
Pediatric Oncology
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  1. SnSs of childlhood leukemia?
    • Pallor
    • Fatigue
    • Bruising/Bleeding
    • Recurrent
    • Infections
    • Adenopathy
    • Organomegaly
    • Bone Pain 
  2. Tx for leukemia?
    • Chemotherapy
    • Radiation Therapy
    • Allogeneic (stem cell) BMT
    • A.L.L.(>60-70% cured)
    • A.M.L.(30-40% cured) 
  3. What are the most important factors in determining outcomes for CNS tumors?
    • 1) success of resection
    • 2) ability to tx across blood/brain barrier.
    • (Radiation, although improved, is still devestating especially to children.) 
  4. SnSs for non-Hodgkin's Lymphoma
    • Adenopathy
    • Organomegaly
    • Hyperuricemia
    • Tumor Lysis Syndrome
    • Superior Vena-Cava Syndrome 
  5. Tx for non-Hodgkin's Lymphoma?
    • Prevention & Treatment of Hyperuricemia #1 Priority
    • Response often very rapid to induction chemotherapy 
  6. What is Hodgkin's Disease?
    • Tumor Lysis issues rare
    • Prognosis depends on stage/histology
    • Systemic chemotherapy replacing XRT
    • Follow-Up for Late Effects vital!
  7. T/F: Amputation is the gold standard Tx for Osteosarcoma and Ewing's Sarcoma.
    • False: Used to be true, but new procedures have made amputation the exception, not the rule, and limbs are salvaged whenever possible.
    • Both still require agressive chemo. 
  8. What is a neuroblastoma?
    • Tumor of sympathetic nervous tissue
    • Common sites include adrenal gland, mediastinum, liver
    • Bone involvement = poor outcome
    • Infants < 12 months often have spontaneous regression of tumor 
  9. SnSs for Neuroblastoma?
    • Pallor
    • Bone Pain
    • Secretory Diarrhea
    • Weight Loss
    • Abdominal Mass
    • Flushing/Skin Lesions
    • Orbital Ecchymoses 
  10. Tx for Neuroblastoma?
    • Chemotherapy
    • Radiation Therapy
    • HD Chemo with PBSC’s (Periferal Blood Stem Cells) 
    • Infants < 12 mos with Stage IV-S receive no therapy 
  11. What is Wilm's Tumor?
    • Primary tumor of the kidney
    • Patients often appear well except for palpable mass
    • Outcome generally good, even in metastatic cases unless unfavorable histology
    • Chemotherapy often curative without radiation 
  12. What is a rabdomyosarcoma?
    • Tumor involving muscle cell precursors
    • Multiplesites possible 
  13. Where do pts usually express Germ Cell Tumors?
    • – Testicular
    • – Ovarian
    • – Mediastinum
    • – CNS 
    • (usually accompanied by 
  14. What is included in a workup for a pt with cancer who is showing neutorpenia and fever?
    • CBC w/manual diff
    • Blood Cultures
    • Physical Exam
    • CXR
    • Broad-Spectrum Antibiotics X 48 hours minimum
  15. What is the greatest risk of toxicity for oncology pts?
    • • Greatest risk is for bacteria to get out of where they “belong” and enter the blood stream:
    •  – Staph (skin)
    • – Alpha Strep (Throat)
    • – Gram neg’s (GI) 
  16. When do you start thinking blood transfusion in an oncology pt?
    • Generally, Transfuse When Hgb < 8.0 (< 10 if Patient is Receiving Radiation Therapy)
    • Infuse slowly over 3-4 hrs. 
  17. When does thrombocytopenia get scary?
    • When platelet count <50k.
    • Infuse between 30-60 minutes as fast as pt can tolerate. 
  18. What is stomatitis?
    • Stomach's response to chemo/radiation toxicity, ie: 
    • Nausea/Vomiting
    • Constipation
    • Diarrhea
    • Decreased Appetite
    • Taste Distortion 
  19. Where does stomatitis occur?
    • Breakdown of mucosal lining of:
    • Oropharynx
    • Esophagus
    • Stomach/Lower GI
    • Vagina
    • Rectum
    • Tx with multiple Rx depending on symptoms/locations
  20. What is most commonly used to treat n/v related to chemo/radation?
    • zofran
    • kytril
    • (neither cases distonia, hallucinations, or sedation)
  21. What is most important to remember with a patient with constipation issues related to chemo/radiation?
    NOTHING PER RECTUM!
  22. What are some SnSs of renal toxicity in a pt undergoing chemo/radiation?
    • Hematuria
    • Cystitis
    • Frequency/Dysuria
    • Colored Urine When Drug Excreted
    • Electrolyte wasting
    • • Decreased GFR
    • • Decreased drug excretion 
  23. What do you do to Tx pancreatic toxicity in the patient undergoing chem/radation?
    • Chemical Pancreatitis
    • Treatment is Symptomatic & Supportive (“Pseudo-Diabetes”)
    • Monitor status by assessment of amylase/lipase 

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