Extraneural metastasis from primary brain tumors is MOST commonly likely to occur in which tumor?

Correct Answer: A

Rationale: In this question, the correct answer is A) medulloblastoma. Extraneural metastasis from primary brain tumors is most commonly seen in medulloblastoma. Medulloblastoma is a highly malignant brain tumor that tends to spread through cerebrospinal fluid to other parts of the body, leading to extraneural metastasis. Primitive neuroectodermal tumor (PNET) and ependymoma are less likely to metastasize outside the central nervous system compared to medulloblastoma. Malignant gliomas are more likely to invade surrounding brain tissue rather than metastasize outside the CNS. In an educational context, understanding the likelihood of extraneural metastasis from different types of brain tumors is crucial for healthcare providers caring for pediatric patients with brain tumors. This knowledge can guide treatment decisions, follow-up care, and discussions with patients and their families about prognosis and potential complications.

Correct Answer: C

Rationale: The correct answer is C) Wilms tumor. Aniridia, which is the absence of the iris, and hemihypertrophy, an asymmetrical overgrowth of one side of the body, are features of WAGR syndrome. WAGR syndrome includes Wilms tumor as one of its associated conditions. Wilms tumor is a common kidney cancer in children, and individuals with WAGR syndrome have a higher predisposition to develop this specific tumor. Option A) rhabdomyosarcoma is a soft tissue tumor that is not specifically associated with aniridia and hemihypertrophy. Option B) hepatoblastoma is a liver cancer that is not typically linked with aniridia and hemihypertrophy. Option D) medulloblastoma is a type of brain tumor that is not commonly seen in the context of aniridia and hemihypertrophy. Understanding these associations is crucial for healthcare providers caring for pediatric patients with specific syndromes. Recognizing the patterns of tumor predisposition in syndromes like WAGR can aid in early detection and appropriate management of these conditions. It highlights the importance of thorough assessment and surveillance in children with syndromes associated with an increased risk of certain tumors.

Correct Answer: B

Rationale: In the context of tumor lysis syndrome (TLS) in children, metabolic derangements occur due to the rapid release of intracellular contents into the bloodstream following cancer treatment. The correct answer, B) hypernatremia, is not typically associated with TLS. A) Hyperuricemia is a common finding in TLS due to the release of uric acid from the breakdown of nucleic acids. C) Hyperkalemia results from the release of intracellular potassium during tumor cell lysis. D) Hyperphosphatemia occurs due to the release of phosphate from the breakdown of nucleic acids. Educationally, understanding the metabolic consequences of TLS is crucial for nurses caring for pediatric patients undergoing cancer treatment. Recognizing and managing these electrolyte imbalances promptly can prevent serious complications such as renal failure and cardiac arrhythmias in these vulnerable patients.

Correct Answer: C

Rationale: In this question from the ATI Pediatric Practice Questions, the correct answer is C) anaplastic histology. The rationale for this is that anaplastic histology in Wilms tumor is associated with a poorer prognosis and higher risk of relapse compared to favorable histology. Therefore, relapse with anaplastic histology is not unexpected in these cases. Option A) low stage (I/II) at diagnosis is incorrect because the stage of the tumor at diagnosis does not impact the risk of relapse. Option B) no prior radiotherapy is incorrect because the absence of prior radiotherapy does not exclude the possibility of relapse. Option D) more than 12 months from nephrectomy is incorrect because the timeframe from nephrectomy does not determine the likelihood of relapse. Educationally, this question highlights the importance of understanding the prognostic factors and risk factors associated with Wilms tumor relapse. It emphasizes the significance of histology in predicting outcomes and underlines the need for comprehensive knowledge in pediatric oncology to provide optimal care for children with cancer.

Correct Answer: B

Rationale: In the context of pediatric melanoma risk factors, the correct answer is B) dark-skinned child because having darker skin tones actually provides some level of natural protection against melanoma due to increased melanin production. Melanin helps to absorb and dissipate harmful UV radiation from the sun, reducing the risk of developing melanoma. Positive family history of melanoma (option A), hairy nevus (option C), and dysplastic nevus (option D) are all recognized risk factors for the development of melanoma in children. A positive family history indicates a genetic predisposition to the disease. Hairy nevus and dysplastic nevus are types of moles that are known to be associated with an increased risk of melanoma due to their atypical features and potential for transformation into cancerous lesions. In an educational context, understanding these risk factors is crucial for healthcare professionals working with pediatric populations. By identifying and recognizing these risk factors, healthcare providers can implement preventive strategies such as regular skin examinations, sun protection measures, and early detection practices to reduce the incidence of melanoma in children. This knowledge is essential for promoting early detection and appropriate management of melanoma cases in pediatric patients.