What is the leading cause of death by disease in children younger than 15 yoa? Childhood Cancer
What is the survival rate for childhood cancer? Overall 5-year survival rate is close to 80%. Varies widely for different types of cancers Clinical manifestations depend on type of tissues involved and ...
NUR 370 Exam 3 Questions and 100%
Correct Answers
What is the leading cause of death by disease in children younger than 15 yoa?
✅Childhood Cancer
What is the survival rate for childhood cancer? ✅Overall 5-year survival rate is close to
80%. Varies widely for different types of cancers
Clinical manifestations depend on type of tissues involved and location of the abnormal
cell growth
What is chemotherapy? ✅Antineoplastic drugs kill cancer cells - some normal cells are
also killed in the process
Protocols consist of set combinations of specific drugs
Venous access devices
What are the side effects of chemotherapy? ✅Myelosuppression
GI effects
Hepatic effects
Renal effects
Integumentary effects
Reproductive effects
What is radiation therapy? ✅Use of unstable isotopes to disrupt the DNA molecule and
cause cell death
Side effects:
Fatigue
Skin changes
Hair loss
Sore mouth
GI effects: nausea vomiting, diarrhea, anorexia
Myelosuppression
What is stem cell transplantation? ✅Hematopoietic stem cells from umbilical cord
blood, peripheral stem cell collection, or bone marrow.
Bone marrow transplant is no longer the preferred method because bone marrow
collection is more painful and more invasive than collecting the stem cells peripherally,
although BMT is still used in some cases.
,Allows for administration of high doses of chemotherapy and radiation that would
otherwise be lethal - doses that kill the cancer but also will kill the bone marrow
Bone marrow function restored by giving stem cells that graft into the marrow
What is an autologous stem cell transplant? ✅collect the patient's own stem cells prior
to the massive chemo and radiation, store them and give back to the patient after the
chemo and radiation are completed
What is an allogeneic stem cell transplant? ✅stem cells from a donor
Whether a patient is a candidate for autologous or allogeneic transplant is determined
by the type of cancer
What is a neuroblastoma? ✅Adrenal medulla tumor in kids, dancing eyes/feet,
secretes catecholamines
Tumor originates in primitive neurocrest cells that form the adrenal medulla,
paraganglia, and sympathetic nervous system
Often a "silent" tumor, not diagnosed until after metastasis occurs
Commonly a smooth, hard, nontender mass
What are the clinical manifestations of neuroblastoma? ✅Clinical manifestations
determined by location of tumor:
Altered bowel and bladder function
Weight loss
Hepatomegaly
Abdominal distention
Fatigue
Fever
Dyspnea
Edema
Malaise
Pancytopenia
How do you treat neuroblastoma and what is the prognosis? ✅Therapeutic
management
Surgical excision
Radiation
Chemotherapy
Prognosis
Survival rate 75% for children <1 yoa
50% for children >1 yoa
Spontaneous regression may occur
,What are the different classifications of leukemia? ✅Classifications based on which
cell line is affected
ALL - acute lymphoid leukemia - aka acute lymphocytic leukemia
ANLL or AML - acute non-lymphoid leukemia - aka acute myelogenous leukemia
Can be classified further by cell-type using cytochemical markers, chromosome studies,
and cell-surface immunologic markers
What is leukemia? ✅cancer of white blood cells
Unrestrained proliferation of immature WBCs in the blood-forming tissues
Infiltration and replacement of any tissue of the body with nonfunctional leukemia cells
Proliferating cells depress the production of blood cells in the bone marrow
What are the main consequences of leukemia? ✅- Anemia due to decreased RBCs
- Infection secondary to neutropenia
- Bleeding and bruising secondary to decreased platelet production
Bone pain caused by bone marrow being "packed" with leukemia cells
Hepatosplenomegaly is common
Leukemic infiltration of CNS may cause increased intracranial pressure
How do you diagnosis and prognosis leukemia? ✅Prognosis - prognostic indicators
include initial WBC count, age at diagnosis, type of cell involved, sex of child, and
karyotype analysis
Diagnosis - bone marrow biopsy gives definitive diagnosis - diagnostic work-up includes
LP to determine CNS involvement
How do you treat leukemia? ✅- Chemotherapy with or without radiation therapy
- Stem cell transplant in some cases
What are the phases of chemotherapy treatment for leukemia? ✅1. Induction: goal is
to induce remission
2. CNS prophylactic therapy: 2nd phase - intrathecal chemotherapy to prevent leukemic
cells from invading CNS. Cranial radiation for highest risk patients
3. Consolidation (intensification): goal is to eradicate any residual leukemia cells
4. Maintenance phase: to maintain remission
5. Reinduction: if there is a relapse, start over with a different combination of drugs
, When is stem cell transplant used for leukemia? ✅Stem cell transplant only after
successful induction of remission
Not usually recommended for children in first remission of ALL because of probability of
excellent results with chemotherapy
AML has poorer prognosis, may consider transplant in first remission
Significant morbidity and mortality, including graft-vs-host disease, overwhelming
infection, and organ damage
What are lymphomas? ✅Neoplastic diseases arising from lymphoid and hematopoietic
systems
Two types
- Hodgkin
- Non-Hodgkin
Most common presentation is enlarged, nontender cervical or supraclavicular
lymphadenopathy
What is Hodgkin lymphoma? ✅Stages based on number of sites of lymph node
involvement, presence of extranodal disease, and history of symptoms
*Fevers, night sweats, and weight loss are referred to as "B symptoms" - stage is A if
they are not present, B if they are - prognosis is better if they are not present*
How do you diagnose hodgkin lymphoma? ✅Diagnostic work-up
- Lymph node biopsy - presence of Reed-Sternberg cells
- Bone marrow biopsy
What are the differences between non-hodgkin and hodgkin lymphoma? ✅Diffuse
rather than nodular
Cell type either undifferentiated or poorly differentiated
Dissemination occurs early, more often, and rapidly
Mediastinal involvement and invasion of meninges are common
How do you treat non-hodgkin lymphoma? ✅Therapeutic management: aggressive
treatment with radiation and chemotherapy
Classified based on histologic pattern and cell type
Diagnostic evaluation: surgical biopsy, bone marrow aspiration, x-rays, LP
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