Pediatric Cancers: Etiology, Clinical Presentation, and Management

Question 1

In discussions with parents of children with pediatric cancer, which ethical principle should be prioritized when addressing treatment options and prognoses?

Accepted Answer

Communicating honestly and sensitively while fostering hope and emotional well-being

Answer

Disclosing all information, regardless of its emotional impact

Answer

Avoiding negative or pessimistic language

Answer

Consulting an ethics committee before every discussion

Question 2

Which type of leukemia is most common in children?

Accepted Answer

Acute lymphoblastic leukemia

Answer

Acute myeloid leukemia

Answer

Chronic lymphocytic leukemia

Answer

Chronic myeloid leukemia

Question 3

According to NCCN (National Comprehensive Cancer Network) guidelines, how frequently are MRI scans recommended for surveillance after medulloblastoma treatment?

Accepted Answer

Yearly MRI scans for 5 years

Answer

Monthly MRI scans for 2 years

Answer

Quarterly MRI scans for 3 years

Answer

Yearly MRI scans for 10 years

Question 4

What is the primary objective of palliative care in pediatric cancer patients?

Accepted Answer

Managing symptoms

Answer

Curing the disease

Answer

Extending life expectancy

Answer

Providing emotional support

Question 5

In neuroblastoma, which genetic alteration is linked to a positive prognosis and reduced risk of recurrence?

Accepted Answer

Deletion of chromosome 1p

Answer

MYCN amplification

Answer

ALK gene mutation

Question 6

Which intervention is most effective in providing comprehensive psychosocial support to young cancer patients and their families throughout their cancer journey?

Accepted Answer

Establish a multidisciplinary team of social workers, psychologists, and child life specialists.

Answer

Refer families to support groups and online resources.

Answer

Provide education and resources to help families understand the cancer and its treatment.

Answer

Coordinate with community organizations to provide financial assistance.

Question 7

For localized Wilms' tumor, which treatment approach is typically prioritized?

Accepted Answer

Surgery

Answer

Chemotherapy

Answer

Radiation therapy

Answer

Immunotherapy

Question 8

How does risk stratification inform treatment decisions for childhood leukemia?

Accepted Answer

It determines treatment intensity, balancing efficacy and toxicity.

Answer

It solely predicts treatment response without influencing selection.

Answer

All children receive the same treatment, regardless of risk.

Answer

It applies only to specific leukemia subtypes, like acute lymphoblastic leukemia.

Question 9

Which limitation is associated with the use of advanced imaging techniques in the diagnosis and surgical planning of pediatric brain tumors?

Accepted Answer

Increased risk of radiation exposure

Answer

Improved tumor localization

Answer

Earlier detection of tumor recurrence

Answer

Assessment of tumor response to therapy

Question 10

Which of the following is the most frequent type of pediatric brain tumor?

Accepted Answer

Medulloblastoma

Answer

Ependymoma

Answer

Glioma

Answer

Astrocytoma

Question 11

A child presents with persistent fever, fatigue, pallor, hepatosplenomegaly, and lymphadenopathy. What is the most likely diagnosis?

Accepted Answer

Acute lymphoblastic leukemia

Answer

Wilms' tumor

Answer

Lymphoma

Answer

Neuroblastoma

Question 12

Which of the following symptoms is a characteristic clinical manifestation of neuroblastoma?

Accepted Answer

Horner's syndrome

Answer

Papilledema

Answer

Anisocoria

Answer

Strabismus

Question 13

What is the initial treatment of choice for unilateral localized Wilms' tumor?

Accepted Answer

Nephrectomy

Answer

Chemotherapy

Answer

Immunotherapy

Answer

Radiation therapy

Question 14

Which of the following is the most common type of brain tumor in children?

Accepted Answer

Medulloblastoma

Answer

Astrocytoma

Answer

Ependymoma

Answer

Glioma

Question 15

Which type of leukemia is characterized by the presence of a large number of immature lymphoid cells in the blood and bone marrow?

Accepted Answer

Acute lymphoblastic leukemia (ALL)

Answer

Acute myeloid leukemia (AML)

Answer

Chronic myeloid leukemia (CML)

Answer

Chronic lymphocytic leukemia (CLL)

Question 16

Which of the following treatment approaches is typically recommended for children with localized, low-grade brain tumors?

Accepted Answer

Surgery followed by radiation therapy

Answer

Stem cell transplant

Answer

Immunotherapy

Answer

Chemotherapy alone

Question 17

Which of the following is a common presenting symptom of acute lymphoblastic leukemia in children?

Accepted Answer

Fatigue and pallor

Answer

Skin rash and itching

Answer

Joint pain and swelling

Answer

Abdominal pain and constipation

Question 18

Which of the following is a crucial role of nurses in providing care to children with cancer?

Accepted Answer

Offering emotional support and guidance to patients and their families

Answer

Administering chemotherapy

Answer

Performing diagnostic procedures

Question 19

Which of the following is the most prevalent type of brain tumor diagnosed in children?

Accepted Answer

Medulloblastoma

Answer

Astrocytoma

Answer

Ependymoma

Answer

Glioma

Question 20

Leukemia is defined as a type of cancer that originates in which type of blood cells?

Accepted Answer

White blood cells

Answer

Red blood cells

Answer

Platelets

Answer

All blood cells

Question 21

Neuroblastoma is characterized by the presence of which specific type of cells?

Accepted Answer

Neuroblasts

Answer

Eosinophils

Answer

Myeloblasts

Answer

Lymphoblasts

Question 22

The primary responsibility of a pediatric oncologist is to:

Accepted Answer

Diagnose and provide treatment for children with cancer

Answer

Perform surgical procedures on children

Answer

Offer counseling and support to families

Question 23

A 3-year-old child presents with ataxia, headache, and vomiting. Imaging reveals a cerebellar tumor. Which of the following is the most likely diagnosis?

Accepted Answer

Medulloblastoma

Answer

Glioma

Answer

Astrocytoma

Answer

Ependymoma

Question 24

A 5-year-old boy has persistent fever, fatigue, and easy bruising. Blood work reveals a high white blood cell count with blasts. Which of the following is the most likely diagnosis?

Accepted Answer

Acute lymphoblastic leukemia (ALL)

Answer

Hodgkin lymphoma

Answer

Non-Hodgkin lymphoma

Answer

Acute myeloid leukemia (AML)

Question 25

A 2-year-old girl has an abdominal mass, hypertension, and weight loss. Which of the following is the most likely diagnosis?

Accepted Answer

Neuroblastoma

Answer

Rhabdomyosarcoma

Answer

Hepatoblastoma

Answer

Wilms tumor

Question 26

A 4-year-old boy is found to have a painless, palpable abdominal mass. Which of the following is the most likely diagnosis?

Accepted Answer

Wilms tumor

Answer

Rhabdomyosarcoma

Answer

Neuroblastoma

Answer

Hepatoblastoma

Question 27

Which of the following is a significant risk factor for retinoblastoma?

Accepted Answer

Family history of retinoblastoma

Answer

Exposure to ultraviolet radiation

Answer

Preterm birth

Answer

Down syndrome

Question 28

Which of the following chemotherapeutic agents is commonly used in the treatment of acute lymphoblastic leukemia (ALL)?

Accepted Answer

Vincristine

Answer

Cisplatin

Answer

Cyclophosphamide

Answer

Doxorubicin

Question 29

A 6-year-old girl is diagnosed with a high-risk neuroblastoma. Which of the following therapeutic approaches would be most appropriate?

Accepted Answer

Multi-agent chemotherapy, surgery, and radiation therapy

Answer

Surgery alone

Answer

Radiation therapy alone

Answer

Observation only

Question 30

A 10-year-old boy with a history of treated leukemia is at increased risk for developing which of the following?

Accepted Answer

Secondary malignancies

Answer

Diabetes mellitus

Answer

Obesity

Answer

Cardiovascular disease

Question 31

Which of the following is an important component of psychosocial support for children with cancer?

Accepted Answer

Involving the family in decision-making

Answer

Focusing solely on the child's physical well-being

Answer

Administering chemotherapy without delay

Question 32

A 3-year-old child presents with ataxia, persistent headaches, and vomiting. An MRI reveals a cerebellar tumor. Which of the following is the most likely diagnosis?

Accepted Answer

Medulloblastoma

Answer

Ependymoma

Answer

Neuroblastoma

Answer

Wilms tumor

Question 33

A 5-year-old boy with a history of recurrent fevers, bone pain, and fatigue is found to have anemia, thrombocytopenia, and blasts on peripheral blood smear. Which of the following is the most likely diagnosis?

Accepted Answer

Acute lymphoblastic leukemia

Answer

Non-Hodgkin lymphoma

Answer

Hodgkin lymphoma

Answer

Multiple myeloma

Question 34

A 2-year-old girl presents with an abdominal mass, intermittent fevers, and recent weight loss. Imaging reveals an adrenal mass. Which of the following is the most likely diagnosis?

Accepted Answer

Neuroblastoma

Answer

Wilms tumor

Answer

Rhabdomyosarcoma

Answer

Hepatoblastoma

Question 35

A 4-year-old boy with a history of abdominal distension, hematuria, and polyuria is found to have a large renal mass on ultrasound. Which of the following is the most likely diagnosis?

Accepted Answer

Wilms tumor

Answer

Hepatoblastoma

Answer

Neuroblastoma

Answer

Rhabdomyosarcoma

Question 36

Which of the following is a major risk factor for developing retinoblastoma?

Accepted Answer

Family history of retinoblastoma

Answer

Obesity

Answer

Smoking

Answer

Exposure to UV radiation

Question 37

Which of the following is a common treatment modality for pediatric cancers?

Accepted Answer

Chemotherapy

Answer

Antihistamines

Answer

Antibiotics

Answer

Antivirals

Question 38

A 6-year-old boy with leukemia is undergoing chemotherapy. Which of the following is the most important consideration in managing his care?

Accepted Answer

Preventing infection

Answer

Providing emotional support

Answer

Maintaining nutritional status

Answer

Managing pain

Question 39

Which of the following is a significant long-term complication of childhood cancer treatment?

Accepted Answer

Secondary malignancies

Answer

Diabetes mellitus

Answer

Asthma

Answer

Congenital heart defects

Question 40

Which of the following is a common symptom of brain tumors in children?

Accepted Answer

Headache

Answer

Cough

Answer

Diarrhea

Answer

Fever

Question 41

A 3-year-old boy presents to the ED with a history of headaches, vomiting, and gait instability. MRI reveals a large, midline cerebellar tumor. What is the most likely diagnosis?

Accepted Answer

Medulloblastoma

Answer

Neuroblastoma

Answer

Ependymoma

Question 42

A 5-year-old girl presents with fatigue, paleness, and recurrent infections. Blood tests reveal a low red blood cell count and a high white blood cell count with a predominance of blasts. What is the most likely diagnosis?

Accepted Answer

Acute lymphoblastic leukemia (ALL)

Answer

Hodgkin lymphoma

Answer

Non-Hodgkin lymphoma

Answer

Acute myeloid leukemia (AML)

Question 43

A 10-year-old girl presents with a painless mass in her neck. A biopsy confirms a malignant lymphoma. Which of the following is the most likely subtype?

Accepted Answer

Hodgkin lymphoma

Answer

Follicular lymphoma

Answer

Diffuse large B-cell lymphoma

Answer

Burkitt lymphoma

Question 44

A 4-year-old boy presents with a large, painless abdominal mass. Ultrasound reveals a solid mass in the left kidney. What is the most likely diagnosis?

Accepted Answer

Wilms tumor

Answer

Neuroblastoma

Answer

Rhabdomyosarcoma

Answer

Hepatoblastoma

Question 45

Which of the following is a recognized risk factor for the development of childhood leukemia?

Accepted Answer

Exposure to ionizing radiation

Answer

Cigarette smoke exposure

Answer

Family history of heart disease

Answer

Obesity

Question 46

A 6-year-old girl with acute lymphoblastic leukemia is receiving chemotherapy. She develops fever and neutropenia. What is the most appropriate initial step in management?

Accepted Answer

Start empiric broad-spectrum antibiotics

Answer

Perform a bone marrow biopsy

Answer

Administer granulocyte colony-stimulating factor (G-CSF)

Answer

Increase the dose of chemotherapy

Question 47

Which of the following is a potential long-term consequence of childhood cancer treatment that can significantly impact quality of life?

Accepted Answer

Cognitive impairment

Answer

Increased risk of obesity

Answer

Decreased risk of autoimmune disorders

Answer

Family history of heart disease

Question 48

A 7-year-old boy with a history of neuroblastoma is being monitored after completing treatment. Which of the following is the most appropriate tool for long-term surveillance to detect recurrence?

Accepted Answer

Serial urine catecholamine levels

Answer

Annual chest X-ray

Answer

Stool occult blood testing

Answer

Regular ophthalmological examinations

Question 49

A 3-year-old child presents with ataxia, headache, and vomiting, raising suspicion of a brain tumor. Which of the following is the most common type of brain tumor in this age group?

Accepted Answer

Medulloblastoma

Answer

Astrocytoma

Answer

Craniopharyngioma

Answer

Ependymoma

Question 50

A 5-year-old child with acute lymphoblastic leukemia (ALL) is undergoing chemotherapy. Which of the following is a common adverse effect of chemotherapy?

Accepted Answer

Neutropenia

Answer

Hypoglycemia

Answer

Hypothyroidism

Answer

Hypertension

Question 51

A 2-year-old child is diagnosed with neuroblastoma. Which of the following is a hallmark feature of this tumor?

Accepted Answer

Elevated urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels

Answer

Elevated serum calcium levels

Answer

Presence of Reed-Sternberg cells

Question 52

What is the most common treatment approach for osteosarcoma in a 10-year-old child with the disease affecting their femur?

Accepted Answer

Surgery and chemotherapy

Answer

Radiation therapy alone

Answer

Chemotherapy alone

Answer

Immunotherapy

Question 53

A 6-month-old infant presents with a large, firm abdominal mass and enlarged liver. Which of the following is the most likely diagnosis?

Accepted Answer

Hepatoblastoma

Answer

Rhabdomyosarcoma

Answer

Neuroblastoma

Answer

Wilms tumor

Question 54

A 7-year-old child with acute lymphoblastic leukemia (ALL) is in remission.  What factor is most crucial for determining the long-term outcome of their treatment?

Accepted Answer

The child's response to the initial chemotherapy regimen

Answer

The child's age at diagnosis

Answer

The child's gender

Answer

The child's family history of cancer

Question 55

A 4-year-old child with a Wilms tumor is undergoing surgery. What is the primary principle guiding surgical management in this case?

Accepted Answer

Complete removal of the tumor with clear margins

Answer

Partial surgical removal of the tumor

Answer

Radiation therapy before surgery

Question 56

A 12-year-old child with Hodgkin lymphoma is undergoing chemotherapy. Which of the following is a potential long-term complication associated with chemotherapy treatment?

Accepted Answer

Development of secondary malignancies

Answer

Diabetes mellitus

Answer

Hypothyroidism

Answer

Hypertension

Question 57

What is a characteristic feature of retinoblastoma in a 1-year-old child?

Accepted Answer

Leukocoria (a white reflex) in the affected eye

Answer

Decreased visual acuity

Answer

Painful, red eye

Answer

Strabismus

Question 58

A 9-year-old child is diagnosed with Ewing sarcoma. What is a common site for this type of tumor?

Accepted Answer

Bones, especially the long bones

Answer

Brain

Answer

Kidney

Answer

Liver