ATI RN
Burns Pediatric Primary Care Test Bank Questions
Question 1 of 5
Granulocytic sarcoma masses are commonly seen in which type of the following malignancies?
Correct Answer: D
Rationale: The correct answer is D) AML (acute myeloid leukemia) because granulocytic sarcoma, also known as chloroma, is a rare extramedullary tumor composed of immature granulocytic cells that can occur in patients with AML. This tumor can manifest as a mass in various sites, including soft tissues, bones, and lymph nodes. Option A) neuroblastoma is incorrect because neuroblastoma is a tumor of the sympathetic nervous system and does not typically present as granulocytic sarcoma masses. Option B) rhabdomyosarcoma is incorrect because it is a tumor of skeletal muscle origin and does not typically present with granulocytic sarcoma masses. Option C) soft tissue sarcoma is incorrect because it refers to a group of tumors arising from soft tissues and does not specifically involve granulocytic sarcoma masses. Educationally, understanding the association between granulocytic sarcoma and AML is crucial in pediatric oncology practice. Recognizing the clinical manifestations and diagnostic implications of granulocytic sarcoma can aid in early detection and appropriate management of pediatric patients with AML. It underscores the importance of considering extramedullary involvement in leukemia cases.
Question 2 of 5
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
Correct Answer: D
Rationale: In this question, the correct answer is D) embryonal carcinoma. The beta subunit of human chorionic gonadotropin (HCG) is characteristically elevated in embryonal carcinoma, a type of malignant germ cell tumor. Embryonal carcinoma is a highly malignant tumor that consists of undifferentiated, primitive cells resembling early embryonic tissue. These tumor cells can secrete HCG, which serves as a useful surface marker for diagnosing this specific type of GCT. Now, let's discuss why the other options are incorrect: A) Teratoma: Teratomas are typically composed of differentiated tissues from multiple germ cell layers and are not known to secrete HCG. B) Germinoma: Germinomas are tumors that arise from germ cells and are more commonly associated with elevated levels of alpha-fetoprotein (AFP) and/or beta-HCG, rather than solely beta-HCG. C) Endodermal sinus tumor: While endodermal sinus tumors can also secrete HCG, the characteristic elevation of the beta subunit of HCG is more commonly associated with embryonal carcinoma. Educational Context: Understanding the specific tumor markers associated with different types of germ cell tumors is essential in pediatric primary care and oncology. Knowledge of these markers aids in accurate diagnosis, treatment planning, and monitoring of patients with GCTs. By grasping the unique characteristics of each tumor type, healthcare providers can deliver targeted and effective care to pediatric patients with these malignancies.
Question 3 of 5
Which of the following malignancies is least likely to occur in a 10-month-old infant?
Correct Answer: D
Rationale: In a 10-month-old infant, the malignancy least likely to occur is hepatoblastoma (Option D). Hepatoblastoma is a rare liver tumor that typically occurs in young children, with peak incidence between 6 months to 3 years of age. While hepatoblastoma can occur in early childhood, it is less common than neuroblastoma (Option A), nephroblastoma (Option B), and retinoblastoma (Option C) in infants of this age. Neuroblastoma is a cancer that arises from immature nerve cells and is commonly seen in infants and young children. Nephroblastoma, also known as Wilms tumor, is a kidney cancer that primarily affects children under the age of 5. Retinoblastoma is a malignant tumor of the retina that often presents in early childhood. Educationally, understanding the typical age ranges and patterns of malignancies in pediatric patients is crucial for healthcare providers working in pediatric primary care. This knowledge helps in early detection, appropriate management, and referral of pediatric patients with suspected malignancies. By knowing the common types of cancers seen in specific age groups, healthcare providers can provide comprehensive and timely care to their young patients.
Question 4 of 5
You are discussing the risk of radiotherapy with the parents of a child with medulloblastoma; the mother has a concern about the late neurological complications post radiotherapy. The statement that should be included in the discussion that late neurological sequelae post radiotherapy is more severe with
Correct Answer: B
Rationale: In discussing the risk of radiotherapy with parents of a child with medulloblastoma, it is crucial to address the concern about late neurological complications. The correct answer, option B, stating that late neurological sequelae post radiotherapy is more severe in children less than 3 years old, is based on developmental vulnerabilities of the immature brain to radiation. Option A is incorrect because craniospinal irradiation involves a larger area and may result in more widespread side effects. Option C is incorrect because while concomitant chemo-radiotherapy can increase side effects, the age of the child is a more significant factor. Option D is incorrect as tumor grade does not directly correlate with the severity of late neurological complications. Educational Context: Understanding the age-related vulnerability to late neurological sequelae post radiotherapy is critical in pediatric oncology. Younger children have developing brains that are more sensitive to radiation, leading to potentially more severe long-term complications. Parents need to be informed about these risks to make informed decisions about their child's treatment.
Question 5 of 5
Alveolar type of rhabdomyosarcoma accounts for approximately 1/3 of all cases of pediatric RMS and carries the poorest prognosis. Of the following, the MOST common site of involvement by alveolar type RMS is
Correct Answer: C
Rationale: In this question, the correct answer is C) extremities. Alveolar type rhabdomyosarcoma (RMS) is a highly aggressive subtype accounting for about one-third of pediatric RMS cases. The extremities, particularly the muscles of the arms and legs, are the most common sites of involvement for alveolar type RMS. This is due to the nature of this subtype which tends to arise in the soft tissues of the body. Option A) orbit is less common for alveolar type RMS, as orbital RMS typically presents as embryonal subtype. Option B) middle ear is associated with embryonal type RMS, not alveolar type. Option D) bladder involvement is more commonly seen in genitourinary RMS, which can be of both embryonal and alveolar subtypes. In an educational context, understanding the different subtypes of RMS and their characteristic sites of involvement is crucial for healthcare providers caring for pediatric patients. Recognizing these patterns can aid in early detection, appropriate treatment planning, and prognostic discussions with patients and families. This knowledge is essential for pediatric primary care providers to ensure timely referrals and multidisciplinary management for better outcomes in pediatric oncology cases.