Peds - Oncology - Intro, All, Brain Tumors

Front 1

• What is the primary treatment form for CA?
  
• What are other common treatments?
  

Back 1

• Chemotherapy
• Radiation, surgery

Front 2

Name and explain 5 classifications of chemotherapy

Back 2

• Adjuvant: chemo s/p sx to ↓ recurrence
  
• Neoadjuvant: chemo before sx to ↓ size
  
• Induction: To induce remission (usu. for leukemia)
  
• Consolidation: After remission in attempt to sustain remission
  
• Maintenance: low-dose to assist prolonging remission (usu. in leukemia)
  

Front 3

• Differences between first line, second line, and palliative chemo?
  
• What is nadir?

Back 3

• First Line: Known to have best probability of treating a given type of CA
  
• Second Line: If first line is unsuccessful
  
• Palliative: Symptom management w/o reducing the CA
  
• The low-point for blood counts (RBC, WBC, Platelets) after chemo, (usu. 3-4 weeks before returning to normal)

Front 4

• What childhood cancers are most common?
  
• What type of leukemia is most common?
  
• What are the most common solid tumors?

Back 4

• Leukemias (33%) and CNS cancers (~18%)
  
• Acute lymphoblastic leukemia
  
• Brain tumors (gliomas, medulloblastomas)

Front 5

• What is acute lymphoblastic leukemia?
  
• How does this affect the rest of the blood?
  
• Survival rate?

Back 5

• A malignant proliferation of immature WBCs infected in the blood and bone marrow
  
• Greater proportion of WBCs leads to relatively less RBCs (anemia), platelets (↑ bruising), and normal WBCs (↑ infection risk)
• 80%

Front 6

What are some potential warning signs of acute lymphoblastic leukemia?

Back 6

• Persistent fever, loss of appetite, weakness, malaise, paleness
  
• Unexplained bone/joint pain, pain or fullness below the ribs
• Easy bruising/bleeding
• Petechiae (flat, pinpoint, dark-red spots under the skin caused by bleeding)
• Painless lumps in neck, armpit, stomach, or groin

Front 7

• What drug is most commonly used to treat acute lymphoblastic leukemia? What is one SE of this drug?
  
• What other drug may be used? What are SEs?
• What are some other common complications of ALL/SEs of meds

Back 7

• Vincristine; foot drop & other neuropathies
  
• Methotrexate; Roid rage/mood difficulty, OP
• Pain, muscle cramps, muscle weakness, ↓ gross/fine motor development, paresthesia, AVN, reduced DTRs

Front 8

• What area ot fitness to children have difficulty with during and after acute lymphoblastic leukemia treatment?
  
• What proportion of children c/ ALL are obese?
  

Back 8

• Cardiopulm fitness, activity levels, strength, ROM, motor skills, balance
  
• 11-57%
  

Front 9

• What WBCs values are indicated/contra'ed for exercise?
  
• How does low level mobility fit into this?
• What values of HgB permit what types of exercise?

Back 9

• < 5000 mm with fever (no exercise); > 5000 mm (exercise OK)
  
• It differs from exercise, so ankle pumps/circles, quad sets/glute sets, arm circles, etc. are OK
  
• < 8 = no exercise, just ADLs; 8-10 = light aerobics, light weights; >10 = PREs

Front 10

• What HCT values permit what types of exercise?
  
• What PLT values permit what types of exercise?

Back 10

• <25% = no exercise, just ADLs; >25% = light exercise; >35% = PREs
• <20,000 = no exercise; 20,000-50,000 light exercise, but no PROM; >50,000 = resisted AROM

Front 11

• What are embryonal tumors?
  
• What are 3 types?

Back 11

• Biologically differing lesions that share a tendency to disseminate throughout the nervous system via CSF
• Medulloblastomas, CNS PNET (primitive neuroectodermal tumor), atypical teratoid/rhabdoid tumor

Front 12

What are warning signs of medulloblastomas in children?

Back 12

Generally related to CSF blockage/hydrocephalus

• Abrupt onset HAs (no HA is normal in peds)
• Vomiting
• Lethargy
• Nystagmus
• Papilledema

Front 13

What are warning signs of medulloblastomas in infants?

Back 13

• Nonspecific lethargy
  
• Psychomotor delays
  
• Loss of developmental milestones
  
• Feeding difficulties
• Bulging of anterior fontanelle

Front 14

• How are medulloblastomas typically treated?
  
• How do pts typically present s/p surgery?

Back 14

• Excised by surgery as much as possible, chemo and radiation may be included additionally
  
• With severe neuro deficits similar to TBI, potentially with cerebellar mutism syndrome (aka posterior fossa syndrome)

Front 15

What are S&S of cerebellar mutism syndrome?

Back 15

• Delayed onset of speech
  
• Suprabulbar palsies (feeding/swallowing/drooling/dysarthria)
  
• Ataxia
  
• Hypotonia
  
• Emotional lability
  

Front 16

How should the typical pt s/p brain tumor (including medulloblastoma) sx be examined?

Back 16

As if they had TBI

• Assess stage of recovery
• Assess alertness
• Assess cog functioning
• Assess neuro impairments