Oncology Comp exam

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1
Acute Graft v. Host Disease (AGVHD) is a serious complication of _________ which typically occurs _______ after transplant and is characterized by ________. it is primarily _______ mediated
- allogeneic hematopoietic stem cell transplant
- in the first 100 days
- inflammation of the skin, liver, and gastrointestinal systems
- T cell
2
Chronic GVHD presents after ___ days and is accompanied by ________. Usually involves the ______, _____, ____, and _____
- 100
- Severe immunologic dysfunction
- MSK, mucous membranes, skin, and respiratory syndrome
3
Clinical manifestations of AGVHD include
generalized erythematous maculopapular rash which can progress to bullae formation and desquamation, hyperbilirubinemia, transaminitis, vomiting, diarrhea, abdominal pain, anorexia, mucosal sloughing, bloody stools, and ileus.
4
Graft v. Host Disease cutaneous initially presents as erythematous __________ on the _____, _____, or ________; and then generalizes into a morbilliform or ________ type rash, _____, _____, ______
- Blanchable macules
- Ears, palms, or soles
- Measels like
- Hyperkeratotic, bullae, sloughing
5
Graft v. Host Disease Cutaneous treatment includes _______, _______, ________ for chronic, ________, and oral care
- Systemic steroids, topical steroids, UV light therapy (chronic), cyclosporine,
6
Graft v. Host Disease GI presentation includes _______, _______, _______, & increased _______
- Diarrhea, sloughing, hematochezia, increased bilirubin
7
Graft v. Host Disease GI treatment includes _____, _______, & _______
- Steroids
- Mycophenolate (immunosuppressant)
- Cyclosporine
8
Typhlitis aka _________ triad symptoms....
- Neutropenic Enterocolitis
- Neutropenia, abdominal pain, fever
9
Typhlitis aka Neutropenic Enterocolitis is a potentially life-threatening infection d/t ________ damage from ______
- GI mucosal
- Cytotoxic therapy
10
Oral open lesions can be associated with ______ and can also be a port for systemic infection
typhlitis
11
What medications should you avoid in patients with Typhitis?
- Anticholinergics, antidiarrheals, narcotics
12
Veno-Occlusive Disease (VOD) is blockage of the venous system of the _____ leading to _____
- Liver
- Vasculitis
13
Risk Factors of Veno-Occlusive Disease (VOD) include ______ & ______
- Actinomycin-D chemo
- Liver radiation
14
Superior Vena Cava Syndrome is _____ of the SVC by _____, _____, or _____ leading to _______ --> ______
- Compression
- Tumor, lymphadenopathy, or thrombus
- Increased venous pressure -> decreased cardiac output
15
Hyperleukocytosis is a dangerously high WBC count > _____; risk for ____
- 100,000
- Leukostasis
16
Hyperleukocytosis is most commonly seen in ____
- AML
17
Most common complication of Hyperleukocytosis is _______
- Stroke
18
In a pt with Hyperleukocytosis you should avoid _____ & _____ to prevent further_______; Goal Hgb is _____
- Diuretics & PRBC
- Increase in blood viscosity
- < 10
19
Elevated ______, _______, & ______ levels are indicative of tumor lysis syndrome, a side effect of chemotherapy when tumor cells are broken down. Elevated ______ with low _____ can indicate renal failure which occurs as a result of tumor lysis syndrome.
- potassium, phosphorous, and uric acid
- BUN and creatinine
- calcium
20
Tumor Lysis Syndrome (TLS) is associated with _______; especially with ____, ____, or _____
- Initiation of chemo
- Leukemia/lymphoma/fast growing tumors
21
Tumor Lysis Syndrome (TLS) impacts the _____, ____, _____, & _____ function
- Neurologic, pulmonary, cardiac, and renal
22
Risk Factors for Tumor Lysis Syndrome (TLS) include ______, ______, _____, _____, & ______
- High initial uric acid, high tumor burden, NHL, T-cell leukemia, hyperleukocytosis
23
Bone Marrow Aspirate (BMA) w/ _____% blasts = leukemia
>25%
24
Leukemia is the abnormal _______ & ______ of immature _________ in blood/ bone marrow causing _________; & in other organs including ______, ____, _____, _____, _____, & _______
- Proliferation and accumulation
- WBC
- Bone marrow suppression
- Lymph nodes, testes, liver, spleen, CNS, & skin
25
Most common childhood cancer is ________
ALL
26
CAR-T Cell therapy Modifies autologous T cells to express a receptor which targets _____ on the surface of ____
- Antigens
- Lymphoblasts
27
CAR-T cell therapy has risks for serious and potentially fatal complications, including ______, _______, & _______
- TLS, cytokine release syndrome, and neurotoxicity
28
Prophylaxis for every leukemia patient is _______
IT methotrexate
29
CNS treatment for high risk leukemia patients include ______, _____, _____, _____, _____ & _______
IT methotrexate, cytarabine, steroids, plus IV methotrexate, asparaginase, radiation
30
Lymphoma is malignancy of the _____ arising in the ______; It is the _____ most common pediatric cancer
- Lymphocytes
- Lymph tissue/node
- 3rd
31
Hodgkins lymphoma is more common in ______ & ________; Ages _____ to _____ y.o
- Adolescents and young adults
- 15-35
32
Hodgkins lymphoma spreads in a contiguous (contact) manner to _______ but rarely involves ____ sites; Spreads ____ than NHL
- Nearby lymph nodes
- Extranodal
- slower
33
Children with _________ are at greater risk for Hodgkins lymphoma; also associated w/ _____
- Immunodeficiency
- EBV
34
Non-Hodgkins Lymphoma is more common in ______ children, ages ___ to ___
- School-age
- 5-15
35
Non-Hodgkins Lymphoma can spread _______ & involve extranoday sites including the ____, _____, & _____; Spreads more ______ & ____ than HL
- Non-Contiguously
- Skin, brain, & GI tract
36
Osteosarcoma & Ewing’s Sarcoma is proliferation of the ______ or _______ cell with peak incidence during ______
- Osteoblasts
- Mesenchymal stem
- Growth spurts
37
Osteosarcoma effects the _______ region; Up to 20% metastasize at dx to the ____ and _____
- Metaphyseal
- Lungs and Brain
38
Ewing Sarcoma effects the _____ regions or ______; 25% metastisize to _____, _____, or _____
- Diaphyseal
- Soft tissues around the bone
- Bone, bone marrow, or lungs
39
Codman triangle seen on xray in _____ or ______ is a _____ reaction seen when an aggressive bone lesion...... Only the periosteum at the very margin of the lesion has time to ossify creating a triangular lip of _______
- Osteosarcoma or Ewing's sarcoma
- Periosteal
- Grows faster than new periosteum can be ossified
- New bone
40
Rhabdomyosarcoma is a _______ tumor from _______ cells; 50% originate from ________ cells & has 3 main variants including ______, _____, & _______
- Soft tissue
- Mesenchymal
- Striated muscle progenitor
-Embryonal Form (most common)
- Botryoid
- Alveolar
41
Embryonal Form of Rhabdomyosarcoma occurs _________ but most often in the ______, _____, ______, and ______ and is more common in ___ to ___ y.o
- Anywhere on the body
- Head, neck, orbits, and GU
- 1-8
42
Botryoid Rhabdomyosarcoma is seen in the _____ or ______ and is more common in ______
- Bladder or vagina
- Infants
43
Alveolar Rhabdomyosarcoma occurs in the _____ or ______ and is more common in ____ & _____
- Extremities or bone marrow
- Adolescents and young adults
44
2/3rds of Rhabdomyosarcoma cases occur in pts <_____ y.o. It is slightly more common in _____ and ______; Associated with _____
- 10
- Males
- African descent
- RB gene mutation
45
Wilms Tumor or Nephroblastoma is a tumor from _______ precursor cells; Most common in kids b/t ___ to ___ y.o; 90% dx before _____
- Renal
- 2-3
- 5 y.o
46
Wilms Tumor or Nephroblastoma is associated with ____ syndromes, including _____ & ______
- Genetic
- Denys-Drash syndrome
- Beckwith-Wiedemann
47
Wilms Tumor or Nephroblastoma is usually found by ____ during _____ or during ________
- Caregiver
- Bathing
- Routine physical exam
48
Neuroblastoma is a neoplasm of the ________; It's the most common ______ solid tumor
- Sympathetic nervous system
- extracranial
49
Neuroblastoma is the most frequently diagnosed malignancy during _____ & is slightly more common in ______ descent
- Infancy
- Caucasian
50
Neuroblastoma is associated with ______, _____, and _______ aka _______
- Hirschsprung’s
- Neurofibromatosis
- Congenital hypoventilation aka neural crest disorders
51
Opsoclonus-myoclonus ataxia (OMA) is ______, ______, +/- ______. 50% of patients who present with OMA have ________
- Myoclonic jerking, random eye movements, +/- cerebellar ataxia
- Neuroblastoma
52
Infratentorial or _______ brain tumors occur in the _______ / _______
- Posterior Fossa
- Cerebellum/Brainstem
53
Supratentorial brain tumors occur in the _______, _____, ______, _____, & ______ or ______
- Cerebrum, basal ganglia, hypothalamus, optic chiasm, parasellar or pituitary
54
Retinoblastoma is a neoplasm of the retinal cells that can extend into the ______; It accounts for ____ to ___ % of childhood cancers. Commonly metastasizes to the ____, ____, & _____
- Vitreous humor
- 1 to 3%
- Orbit, brain, lymph
55
Retinoblastoma is associated with _____; 2/3rds of cases are kids ____ y.o; 95% diagnosed by _____ y.o
- RB1 gene
- < 2
- 5
56
Hepatoblastoma is the most common liver mass in children. An elevated _______ is present in 90% of children
- α-fetoprotein
57
Many chemotherapy agents are considered _______ , so a baseline _______ is indicated along with interval checks
- cardiotoxic
- EKG or echocardiography
58
Iron overload has been reported in patients following chemotherapy and hematopoietic stem cell transplant. A prolonged elevated ferritin level can lead to
liver dysfunction, endocrine disorders, and altered cardiac function.
59
Mucositis can be a severe complication of an immunocompromised state and in the preparation process for stem cell transplant, due to the increased doses of chemotherapy and radiation. The most important prevention method is
meticulous mouth care.
60
The most sensitive scan to detect a new soft tissue mass in a previously radiated site is _______.
- PET scan
61
A PET scan is a nuclear medicine imaging technique that uses tracers to indicate ________. It can identify _____
- tissue metabolic activity by regional glucose uptake
- very small lesions early in the course.
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