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Peds Exam 3 - Oncology/Neuro

Total questions: 70

Worksheet time: 40mins

Name
Class
Date
1.

most common malignancy of childhood

a)

ALL

b)

AML

c)

CML

2.

Peripheral blood smears show abnormalities in RBCs, such as teardrops ***

a)

ALL

b)

AML

c)

CML

3.

Associated with congenital conditions, chromosomal and molecular genetic abnormalities ***

a)

ALL

b)

AML

c)

CML

4.

Dx includes Cytogenetic studies of Chromosomes 9 and 22 (Philadelphia chromosome) ***

a)

ALL

b)

AML

c)

CML

5.

Children aged 2-10 years; peak at age 4

– 10-20x more common in Downs Syndrome children

a)

ALL

b)

AML

c)

CML

6.

More common in males and in those over 16 years old (in the pediatric population)

a)

Hodgkin's Lymphoma

b)

Non-Hodgkin's Lymphoma

7.

Clinical Findings – painless cervical LAD – firm and rubbery ***

a)

Hodgkin's Lymphoma

b)

Non-Hodgkin's Lymphoma

8.

5%–10% of malignancies in children younger than 15 years.

a)

Hodgkin's Lymphoma

b)

Non-Hodgkin's Lymphoma

9.

can arise in any site of lymphoid tissue, including the lymph nodes, thymus, liver, and spleen. ***

a)

Hodgkin's Lymphoma

b)

Non-Hodgkin's Lymphoma

10.

Dx for Hodgkin's Lymphoma _________ MUST be present ***

a)

Reed-Stenberg cell

b)

Philadelphia chromosome

c)

Teardrop cells (dacrocytes)

11.

Most common brain tumor in children

a)

Astrocytomas

b)

Medulloblastomas

c)

Ependymomas

12.

Invasive and rapidly growing childhood CNS tumors

a)

Astrocytomas

b)

Medulloblastomas

c)

Ependymomas

13.

It has a bimodal peak at age 3 to 4 yr and at age 8 to 10 yr but can occur throughout childhood

a)

Astrocytomas

b)

Medulloblastomas

c)

Ependymomas

14.

Resection is very important, when possible. Complete resection is desirable.

Survival rate depends on age and on how much of the tumor can be removed.

a)

Astrocytomas

b)

Medulloblastomas

c)

Ependymomas

15.

most common cancer among infants

a)

Neuroblastoma

b)

Wilm's Tumor

c)

Ewing's Sarcoma

d)

Osteosarcoma

e)

Rhabdomyosarcoma

16.

Neuroblastoma: arise in different locations but the majority do so in ________

a)

adrenal glands

b)

thorax

c)

neck

d)

pelvis

17.

most ________ produce catecholamines, which can be detected as elevated levels of urinary catecholamine breakdown products

a)

Neuroblastomas

b)

Wilm's Tumors

18.

Most common sx of Neuroblastomas ***

a)

Abdominal pain

b)

Fever

c)

Weight loss

d)

Leukocoria

19.

Embryonal tumor of the kidney

a)

Neuroblastoma

b)

Wilm's Tumor

c)

Ewing's Sarcoma

d)

Osteosarcoma

e)

Rhabdomyosarcoma

20.

S/Sx: painless, palpable abdominal mass

a)

Wilm's Tumor

b)

Ewing's Sarcoma

c)

Osteosarcoma

d)

Rhabdomyosarcoma

21.

considered a “small, round, blue cell” malignancy -- a group of malignant neoplasms that have a characteristic appearance under the microscop

a)

Ewing's Sarcoma

b)

Osteosarcoma

c)

Rhabdomyosarcoma

d)

Retinoblastoma

22.

S/Sx - Pain at the site of the primary tumor is the most common presenting sign, with or without swelling and erythema. Usually a high LDH

a)

Ewing's Sarcoma

b)

Osteosarcoma

c)

Rhabdomyosarcoma

d)

Retinoblastoma

23.

an aggressive form of cancer characterized by chromosomal instability

a)

Ewing's Sarcoma

b)

Osteosarcoma

c)

Rhabdomyosarcoma

d)

Retinoblastoma

24.

S/Sx – usually pain in a long bone

may present with, loss of function, mass, or limp

a)

Ewing's Sarcoma

b)

Osteosarcoma

c)

Rhabdomyosarcoma

d)

Retinoblastoma

25.

Arising from embryonal mesenchymal cells that have potential to differentiate into skeletal muscle cells. It can arise from almost any type of muscle tissue in any location, resulting in highly variable clinical manifestations.

a)

Ewing's Sarcoma

b)

Osteosarcoma

c)

Rhabdomyosarcoma

d)

Retinoblastoma

26.

Tx: -Surgical excision (limb salvage) or amputation is indicated based on the extent of the tumor.

-Plus chemotherapy

a)

Ewing's Sarcoma

b)

Osteosarcoma

c)

Rhabdomyosarcoma

d)

Retinoblastoma

27.

most common primary intraocular malignancy of childhood

a)

Ewing's Sarcoma

b)

Osteosarcoma

c)

Rhabdomyosarcoma

d)

Retinoblastoma

28.

Most common presenting sign in a child with previously undiagnosed retinoblastoma is

a)

Abdominal pain

b)

Fever

c)

Weight loss

d)

Leukocoria

29.

Microcytic hypochromic anemia

a)

Iron Deficiency Anemia

b)

Sickle Cell

30.

A history of pica is common

a)

Iron Deficiency Anemia

b)

Sickle Cell

31.

Neonatal screening test on all infants

a)

Iron Deficiency Anemia

b)

Sickle Cell

32.

Dactylitis is the most common initial symptom

a)

Iron Deficiency Anemia

b)

Sickle Cell

33.

have a mild to moderately severe microcytic hemolytic anemia (hemoglobin level of 7–10 g/dL), which may be accompanied by hepatosplenomegaly and some bony abnormalities

a)

one α-globin gene (three-gene deletion)

b)

deletion of all four α-globin genes

c)

α-thalassemia trait

34.

causes severe intrauterine anemia and results in hydrops fetalis and fetal demise or neonatal death shortly after delivery. Extreme pallor and massive hepatosplenomegaly are present.

a)

one α-globin gene (three-gene deletion)

b)

deletion of all four α-globin genes

c)

α-thalassemia trait

35.

require no treatment

a)

one α-globin gene (three-gene deletion)

b)

deletion of all four α-globin genes

c)

α-thalassemia trait

36.

Mild microcytic, hypochromic anemia

a)

β-Thalassemia minor

b)

β-Thalassemia intermediate

c)

β-Thalassemia major

37.

Microcytic, hypochromic anemia that usually becomes symptomatic after the first few years of life with hepatosplenomegaly.

a)

β-Thalassemia minor

b)

β-Thalassemia intermediate

c)

β-Thalassemia major

38.

Severe microcytic, hypochromic anemia with marked hepatosplenomegaly.

– Skeletal changes cause characteristic facial deformities (prominent forehead and maxilla) and predispose the child to pathologic fractures.

a)

β-Thalassemia minor

b)

β-Thalassemia intermediate

c)

β-Thalassemia major

39.

requires no specific therapy

a)

β-Thalassemia minor

b)

β-Thalassemia major

40.

β-thalassemia major, two treatments are available:

a)

chronic transfusion with iron chelation

b)

stem cell transplant

c)

Hemoglobin of 10–11 mg/

d)

iron supplementation

e)

chemotherapy

41.

Disorders of Hemostasis that result in Bleeding

a)

Hemophilia Von

b)

Willebrand disease

c)

Factor V Leiden

d)

Antithrombin III (ATIII) deficiency

e)

Protein C or protein S deficiency

42.

Disorders of Hemostasis that result in Clotting

a)

Factor V Leiden

b)

Antithrombin III (ATIII) deficiency

c)

Protein C or protein S deficiency

d)

Prothrombin (PT) gene mutation

e)

Antiphospholipid antibody syndrome

43.

Disorders of Hemostasis that resulting in Bleeding S/Sx:

a)

Blood in the urine or stool

b)

Bruising easily and excessively

c)

Extreme fatigue

d)

An injury that will not stop bleeding

e)

Recurrent pregnancy loss or stillbirth

44.

Disorders of Hemostasis that resulting in Bleeding S/Sx:

a)

Joint pain caused by internal bleeding

b)

Nosebleeds that seem to have no cause

c)

A painful headache that will not go away

d)

Prolonged bleeding from ordinary cuts or from surgery or dental work

e)

A heart attack or stroke at a young age

45.

Disorders of Hemostasis that resulting in Bleeding S/Sx:

a)

Sudden pain, swelling and warmth in joints or muscles

b)

Vision problems, such as double vision

c)

Vomiting repeatedly

d)

DVT

e)

PE

46.

Disorders of Hemostasis that resulting in Bleeding Tx:

a)

Replacement therapy

b)

Desmopressin.

c)

Discontinuing aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)

d)

Blood transfusions

e)

Heparin or low molecular weight heparin

47.

Disorders of Hemostasis that resulting in Bleeding Tx:

a)

Preventive dental care

b)

Subcutaneous immunizations

c)

Joint strengthening

d)

Heparin or low molecular weight heparin.

e)

Warfarin.

48.

Disorders of Hemostasis that result in Clotting Tx:

a)

Preventive dental care

b)

Subcutaneous immunizations

c)

Joint strengthening

d)

Heparin or low molecular weight heparin.

e)

Warfarin.

49.

Disorders of Hemostasis that result in Clotting S/Sx:

a)

DVT

b)

PE

c)

A heart attack or stroke at a young age

d)

Recurrent pregnancy loss or stillbirth

e)

An injury that will not stop bleeding

50.

Criteria for febrile seizures

a)

age 3 months to 6 years (most occur between ages 6 and 36 months)

b)

fever of greater than 38.8°C (101.8ºF)

c)

non-CNS infection

d)

inflammation

51.

most common causes of febrile seizures

a)

upper respiratory infections

b)

otitis media

c)

gastroenteritis (most commonly caused by Shigella or Campylobacter)

d)

urinary tract infections

e)

Sometimes after vaccinations such as MMR

52.

Febrile Seizures diagnosis is

a)

Clinical after exclusion of other causes.

b)

CSF analysis

c)

Cranial MRI

53.

Bacterial Meningitis causes for newborns ***

a)

Group B strep

b)

Escherichia coli

c)

Listeria monocytogenes

d)

Streptococcus pneumoniae

e)

Neisseria meningitis

54.

Bacterial Meningitis causes for Infants and Children ***

a)

Escherichia coli

b)

Listeria monocytogenes

c)

Streptococcus pneumoniae

d)

Neisseria meningitis

e)

Haemophilus influenzae type B

55.

Bacterial Meningitis causes for Adolescents and Young Adults ***

a)

Escherichia coli

b)

Listeria monocytogenes

c)

Streptococcus pneumoniae

d)

Neisseria meningitis

e)

Haemophilus influenzae type B

56.

With the patient supine, passively flex the hip to 90 degrees while the knee is flexed at about 90 degrees With the hip kept in flexion, attempts to extend the knee produce pain in the hamstrings and resistance to further extension

a)

Kering Sign

b)

Brudzinski Sign

57.

With the patient supine and the limbs extended, passively flex the neck. Flexion of the hips is a positive sign

a)

Kering Sign

b)

Brudzinski Sign

58.

Viral Meningitis: most cases caused by

a)

HIV infection

b)

EBV

c)

Enterovirus

d)

mononucleosis

59.

What to order for Viral Meningitis ***

a)

CBC

b)

Culture of CSF

c)

PCR for enteroviruses

d)

Cranial MRI

60.

Viral Meningitis most useful diagnostic method and can give an answer within 24–48 hours

a)

CBC

b)

Culture of CSF

c)

PCR for enteroviruses

61.

CSF in Meningitis ***

Glucose: low

a)

Bacterial

b)

Viral

62.

CSF in Meningitis ***

Opening Pressure

a)

Bacterial - Elevated

b)

Bacterial - Slightly Elevated

c)

Viral - Slightly Elevated

d)

Bacterial - Elevated

63.

CSF in Meningitis ***

Protein: VERY high

a)

Bacterial

b)

Viral

64.

CSF in Meningitis ***

WBCs

a)

Bacterial > 200

b)

Bacterial < 200

c)

Viral < 200

d)

Viral > 200

65.

CSF in Meningitis ***

CBC Diff

a)

Bacterial - PMNs

b)

Bacterial - Monocytes

c)

Viral - Monocytes

d)

Viral - PMNs

66.

CSF in Meningitis ***

Appearance

a)

Bacterial - Turbid

b)

Bacterial - Clear

c)

Viral - Clear

d)

Viral - Turbid

67.

No definitive cause or cure for ADHD/ADD

a)

True

b)

False

68.

NO SPECIFIC physical examination or laboratory findings associated with ADHD

a)

True

b)

False

69.

______ Sensory Processing Disorder may result in tantrums as a way to express frustration ***

a)

Hyposensitive

b)

Hypersensitive

c)

Both

70.

Sensory Processing Disorders, who can help?

a)

ADHD medications

b)

Occupational therapists

c)

Ortho

d)

Oncologists

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