Leukemia and CNS Infiltration Overview

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Questions and Answers

What is the primary goal of the induction stage in leukemia treatment?

To prevent Central Nervous System involvement during treatment.

To kill any cells that may have escaped the prior treatment.

To maintain the child in remission with less intense chemotherapy.

To induce remission so that the bone marrow is clear of disease. (correct)

What distinguishes acute myeloid leukemia (AML) from acute lymphocytic leukemia (ALL)?

AML primarily affects lymphocytes, while ALL affects myeloid cells.

AML can occur at any age, but ALL typically peaks between ages 2-5. (correct)

AML is usually treated with less intense chemotherapy than ALL.

AML has a survival rate of approximately 80%, whereas ALL has about 50%.

During which stage of leukemia treatment is intrathecal chemotherapy most commonly administered?

Maintenance stage.

Consolidation stage. (correct)

Re-induction stage.

Induction stage.

In chronic leukemia, what characteristic distinguishes it from acute leukemia?

Chronic leukemia generally has a higher white blood cell count than acute leukemia. Signup and view all the answers

What is a common consequence of the hypermetabolism associated with certain diseases?

Fatigue and muscle atrophy. Signup and view all the answers

What is a primary objective of ongoing chemotherapeutic agent administration?

To determine the optimal combination of drugs and treatment duration Signup and view all the answers

What is the purpose of intrathecal chemotherapy?

To treat infiltration of the central nervous system via spinal fluid Signup and view all the answers

How can radiation therapy affect brain development when combined with intrathecal chemotherapy?

It poses a risk to healthy brain development. Signup and view all the answers

When is hematopoietic stem cell transplantation (HSCT) considered in the treatment of AML?

Only after first remission or if chemotherapy fails Signup and view all the answers

What percentage of tumors in patients are sarcomas?

Up to 15% Signup and view all the answers

What types of tissue do sarcomas typically develop from?

Bone, connective, or muscle tissues Signup and view all the answers

At what age does osteosarcoma typically peak in children?

13-14 years Signup and view all the answers

Which of the following treatments is considered the initial approach for osteosarcoma?

Chemotherapy Signup and view all the answers

What is a common symptom of congenital toxoplasmosis in neonates?

Cerebral calcifications Signup and view all the answers

Which of the following is a primary means of transmission for Giardia lamblia?

Fecal-oral route Signup and view all the answers

Which characteristic is not commonly associated with osteosarcoma diagnosis?

Urinalysis Signup and view all the answers

What is the major risk factor associated with the metastasis of osteosarcoma?

Size of tumor at diagnosis Signup and view all the answers

What medication is initially given to prevent mother-infant transmission in cases of toxoplasmosis?

Spiramycin Signup and view all the answers

What is the most appropriate treatment for a child diagnosed with roundworms?

Albendazole 400mg orally in a single dose Signup and view all the answers

Which factor is NOT a risk factor associated with roundworm infections?

Good sanitation practices Signup and view all the answers

Which symptom is common to both roundworm and pinworm infections?

Malnutrition Signup and view all the answers

In the treatment of pinworms, which medication is also used to treat roundworms?

Albendazole Signup and view all the answers

What is a primary symptom of scalp ringworm (tinea capitis)?

Fine scaling and hair loss Signup and view all the answers

Which is an appropriate treatment for tinea corporis?

Topical antifungal medication for 4 weeks Signup and view all the answers

Which of the following statements about hookworms is incorrect?

They are typically fatal in all cases. Signup and view all the answers

What treatment is recommended for hookworm infections?

Albendazole Signup and view all the answers

What is a common symptom associated with both pinworm and roundworm infections?

Abdominal discomfort Signup and view all the answers

What is a common consequence of severe hookworm infection in children?

Hypochromic, microcytic anemia Signup and view all the answers

Which treatment options are appropriate for Tinea Capitis?

Griseofulvin orally Signup and view all the answers

How are hookworm larvae typically transmitted?

Penetrating the skin Signup and view all the answers

What is a key diagnostic method for hookworm infections?

Serial stool specimens Signup and view all the answers

What symptom is not associated with hookworm infection?

Hair loss Signup and view all the answers

Which of the following is a characteristic symptom of Tinea Corporis?

Erythematous circular patches Signup and view all the answers

What is the maximum dose of Pyrantel pamoate for hookworm treatment?

11 mg/kg to 1 g Signup and view all the answers

What is a primary treatment option for Tinea Corporis?

Topical antifungal medications Signup and view all the answers

Which of the following is an indication of a severe hookworm infection in infants?

Cardiomegaly and arrhythmias Signup and view all the answers

What is a critical step to take after treating hookworm infection?

Recheck stools one week after treatment Signup and view all the answers

What are the common areas affected by Tinea Cruris in individuals?

Under breasts and abdominal folds Signup and view all the answers

Which of the following is NOT a symptom of Tinea Pedis?

Fever and chills Signup and view all the answers

What is the primary mechanism of transmission for Pediculosis?

Sharing personal items like clothing or bedding Signup and view all the answers

What is the preferred treatment for Scabies?

Permethrin 1% cream rinse Signup and view all the answers

Which statement about the characteristics of Head Lice is accurate?

Predominantly affects children Signup and view all the answers

Which of the following treatments is recommended specifically for Tinea Cruris?

Washing area with selenium sulfide shampoo Signup and view all the answers

What type of rash is typically associated with Tinea Cruris?

Erythematous and scaly with papules Signup and view all the answers

What unique symptom might indicate a scabies infestation?

Burrows under the skin Signup and view all the answers

Study Notes

Infiltration of the CNS

Increased intracranial pressure can lead to severe symptoms like headaches, vomiting, and coma.
Symptoms include papilledema and nuchal rigidity, potentially progressing to death.

Hypermetabolism

Causes cell nutrient deprivation, leading to anorexia, weight loss, muscle atrophy, and fatigue.

Leukemia vs. Leukocytosis

Leukemia involves proliferation of one type of WBC, originating from hematopoietic stem cells, categorized as lymphoid or myeloid.
Acute leukemia presents low WBC counts due to cells being halted at the blast stage and progresses rapidly.
Chronic leukemia features mature cells and progresses more slowly.

AML & ALL

Acute Myeloid Leukemia (AML) affects all ages, linked to genetic factors, with a 50% survival rate post-treatment.
Acute Lymphocytic Leukemia (ALL) is the most common childhood leukemia, peaking between ages 2-5, with an 80% survival rate with treatment.

Stages of Leukemia Treatment

Treatment protocols are tailored to leukemia types, employing multi-drug regimens for efficacy.

Induction

Focuses on achieving remission by clearing bone marrow of disease over 4-6 weeks.

Consolidation

Aims to eliminate residual cells over 4-8 months, sometimes using intrathecal chemotherapy for CNS prevention.

Maintenance

Continued treatment lasting 2-3 years with less intensive chemotherapy to maintain remission.

Relapse Treatments

Re-induction therapy using different drugs occurs if leukemia relapses after initial treatment stages.

Intrathecal Chemotherapy

Administers drugs directly into spinal fluid for CNS infiltration treatment.

Sarcomas

Rhabdomyosarcoma and Osteosarcoma are notable types affecting muscle or bone tissues in children.

Osteosarcoma

Most common skeletal tumor in children, typically occurs in brisk growth phases (ages 13-14).
Metaphysis of long bones is often affected; metastasis rates are high.
Symptoms include pain and localized swelling.

Osteosarcoma Treatment

Initial chemotherapy aims to reduce tumor size pre-surgery, followed by surgical intervention (amputation or limb-salvage).

Toxoplasma Gondii

Transmitted via cat feces or undercooked meat, posing risks during pregnancy.
Congenital toxoplasmosis can lead to severe neonatal symptoms, primarily if the mother is infected in the first trimester.

Giardia Lamblia

Common waterborne protozoan causing non-bacterial diarrhea, particularly in children through fecal-oral transmission.

Roundworms (Ascaris lumbricoides)

These worms can grow up to 13 inches, causing malnutrition and abdominal discomfort.
Diagnosis and treatment options include albendazole or mebendazole.

Pinworms (Enterobius vermicularis)

Tiny worms causing intense perianal itching, treated with similar antiparasitic medications as roundworms.

Hookworms (Necator americanus)

Can lead to severe gastrointestinal damage and malnutrition, especially in warm Southern US climates.
Initial symptoms include localized itching, followed by abdominal pain and anemia.

Tinea Capitis (Scalp Ringworm)

Affects children, causing hair loss and fine scaling. Treatment includes griseofulvin and selenium sulfide shampoo.

Tinea Corporis (Ringworm)

Fungal skin infection with circumscribed patches, treated with topical antifungals.

Tinea Cruris (Jock Itch)

Fungal infection in warm, moist skin areas, with treatment similar to other tinea infections.

Tinea Pedis (Athlete's Foot)

Fungal foot infection characterized by itching and scaling. Treatment includes antifungals and keeping the feet dry.

Pediculosis (Lice Infestation)

Transmitted through contact, leading to severe itching and skin irritation. Treatment typically involves permethrin.

Scabies

Contagious skin infection from mites requiring direct contact for transmission. Symptoms include intense itching and rash. Treatment often involves albendazole or mebendazole.

HIV/AIDS in Infants

Most commonly acquired perinatally; diagnosis requires HIV DNA or RNA assays due to maternal antibody interference.
Symptoms of AIDS include failure to thrive and recurrent infections.
Treatment involves combination antiviral therapy based on CD4 counts, tailored to age and disease severity.

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Description

Explore the critical aspects of CNS infiltration, hypermetabolism, and the distinctions between leukemia and leukocytosis. This quiz covers acute and chronic leukemia, including Acute Myeloid and Lymphocytic variants, along with treatment stages. Test your knowledge on symptoms, progression, and survival rates related to these conditions.