Approach to childhood malignany

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Averil Tam
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Averil Tam
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1. 4yo boy with 2 weeks of fever. Lost 4kg in the last month. Large mass palpable on the right side of his abdomen - ballotable, does not move with respiration. Pale and irritable. Likely diagnosis? A. Wilms tumour B. Neuroblastoma C. Rhabdomyosarcoma D. All of the above D
TRUE/FALSE? 2. 3yo boy having maintenance chemotherapy for ALL. T 38.5C. He looks well, no obvious focus of infection on exam. FBC last week is suggestive of neutropenia. A. Take blood cultures, start empiric IV antibiotics for febrile neutropaenia and admit to hospital. Discuss with the oncologist at the treating children’s hospital. True
TRUE/FALSE? 2. 3yo boy having maintenance chemotherapy for ALL. T 38.5C. He looks well, no obvious focus of infection on exam. FBC last week is suggestive of neutropenia. B. As the child looks well, manage conservatively with an anti-pyretic agent. False
TRUE/FALSE? 2. 3yo boy having maintenance chemotherapy for ALL. T 38.5C. He looks well, no obvious focus of infection on exam. FBC last week is suggestive of neutropenia. C. Often a broad spectrum IV antibiotic regime is used. True
TRUE/FALSE? 2. 3yo boy having maintenance chemotherapy for ALL. T 38.5C. He looks well, no obvious focus of infection on exam. FBC last week is suggestive of neutropenia. D. Admit to hospital for observation because of the significant risk of overwhelming infection. False
3. 2yo on maintenance chemotherapy for ALL. Had contact with a child with active chickenpox this morning. What do you advise the parents? A. Varicella zoster immunoglobulin to be administered within 96 hours of contact. B. Admission to hospital for intravenous acyclovir C. No intervention needed if the child has had chicken pox in the past. A
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