PNCB Prep:
Hematologic/Immunology/Rheumatology/Oncology –
Q’s And A’s
Which embryologic germ layer tissue is responsible for the development of
most childhood cancers? Right Ans - Mesoderm (e.g. muscle, connective
tissue, bone, blood, testes)
Which disorders increase a child's risk for a Wilms' Tumor and ovarian
cancer? Right Ans - - Turner's syndrome
- WAGR
Which disorder increases a child's risk for breast cancer? Right Ans -
Klinefelter's syndrome
Which disorder has a strong association with acute lymphocytic leukemia or
lymphoma? Right Ans - Ataxia-telangiectasia
What are the most common intraabdominal tumors in children less than 1
year of age? Right Ans - - Neuroblastoma
- Wilms' tumor
What is the difference between a neuroblastoma and a Wilms' tumor?
Right Ans - A neuroblastoma crosses the midline; children present with
systemic illness (fever, malaise, anorexia)
A Wilms' tumor does NOT cross the midline; children present feeling well.
A 9-month-old is seen with a 1 week Hx of fever, malaise and decreased
appetite. Mother reports that she thinks his "tummy is much bigger" and that
diapers no longer fit around the child's waist. On PE an abdominal mass that
crosses the midline is palpated. What is the most suspected diagnosis?
Right Ans - Neuroblastoma
The role of the primary care provider in the diagnosis of a child with cancer
can best be described as: Right Ans - Recognition of signs and symptoms
and prompt referral to a pediatric cancer center.
, The role of the primary care provider in the care of the child undergoing
cancer treatment is best described as: Right Ans - Providing primary,
preventive health maintenance to the child throughout cancer treatment
A child is undergoing treatment for AML. he is currently receiving high-dose
chemotherapy that is aimed at removing the bulk of his leukemic cells. Which
treatment stage is the child currently in? Right Ans - Induction
An autologus bone marrow transplant uses stem cells from: Right Ans -
The patient's own bone marrow which is reinfused following treatment
What is the function of biologic response modifiers (e.g. monoclonal
antibodies) in the treatment of childhood cancer? Right Ans - Using the
innate immunologic defense mechanisms of the child to target cancer cells
An 8yo male is just completed treatment for ALL that included chemotherapy.
He is 5th percentile for height and 10th percentile for weight. Parents are
concerned because he used to be tall or as tall as other children his age. What
guidance should the PCP offer? Right Ans - The effects of chemotherapy on
growth are usually only temporary
The child will mostly go through a period of catch-up growth
Which mode of cancer treatment has the most damaging effect on physical
growth? Right Ans - Cranial radiation
- through damage to endocrine glands that are responsible for growth-related
hormone production
Patients who have had Hodgkin's lymphoma are particularly susceptible to
what vaccine preventable disease? Right Ans - Meningococcal disease
- Should be given Meningococcal vaccination 6 months after cancer treatment
What childhood cancer might be suspected for a child who presents with
leukocoria? Right Ans - Retinoblastoma
What test is most definitive to use in the diagnosis of sickle cell anemia?
Right Ans - Hemoglobin electrophoresis
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