Hepatitis C virus infection is a risk factor for which of the following malignancy?

Correct Answer: B

Rationale: The correct answer is B) splenic lymphoma. Hepatitis C virus infection is associated with an increased risk of developing non-Hodgkin lymphoma, particularly splenic lymphoma. This is due to the chronic inflammatory state caused by the virus, which can lead to the development of lymphoproliferative disorders. Option A) hepatoblastoma is a rare liver cancer that primarily affects children and is not directly linked to hepatitis C virus infection. Option C) Hodgkin lymphoma is a different type of lymphoma compared to non-Hodgkin lymphoma, which is the one associated with hepatitis C virus infection. Option D) nasopharyngeal carcinoma is not directly linked to hepatitis C virus infection. It is more commonly associated with other factors such as Epstein-Barr virus infection and environmental factors. In an educational context, understanding the relationship between viral infections like hepatitis C and their potential impact on malignancy is crucial for healthcare providers, especially in pediatrics. This knowledge can guide appropriate screening, management, and treatment strategies for patients with hepatitis C infection to prevent or detect associated malignancies early.

Correct Answer: D

Rationale: In pediatric rhabdomyosarcoma, the primary site of involvement plays a crucial role in determining the stage and prognosis of the disease. In this case, the correct answer is D) paranasal sinuses, as involvement of this site is considered unfavorable. Rhabdomyosarcoma arising in the paranasal sinuses is associated with a higher risk of local invasion, difficulty in complete surgical resection, and a propensity for metastasis. The proximity of this site to critical structures in the head and neck region also contributes to the challenging nature of managing tumors in this location. Regarding the other options: A) Vagina: Rhabdomyosarcoma in the vagina is categorized as an intermediate-risk site. B) Uterus: Uterine involvement is also considered an intermediate-risk site. C) Testis: Testicular rhabdomyosarcoma is classified as a favorable site with a relatively better prognosis compared to involvement of paranasal sinuses. Educationally, understanding the risk stratification based on primary site in pediatric rhabdomyosarcoma is essential for healthcare providers caring for pediatric patients. This knowledge guides treatment decisions, prognostication, and follow-up care, emphasizing the importance of accurate staging and risk assessment in managing this rare pediatric malignancy.

Correct Answer: D

Rationale: In this question, the correct answer is D) retinoblastoma. Retinoblastoma is least likely to occur in adults compared to children because it is a pediatric cancer that primarily affects the retina of the eye and is rare in adults. This occurs because retinoblastoma arises from immature cells in the retina, which are typically present in children. Option A) acute Lymphoblastic Leukemia (ALL) is a type of leukemia that can occur in both children and adults, but it is more common in children. Option B) osteosarcoma is a type of bone cancer that primarily affects children and young adults. Option C) medulloblastoma is a malignant brain tumor that mainly occurs in children. Understanding the age-specific prevalence of different malignant tumors is crucial for healthcare providers, especially those working in pediatric care. Recognizing the differences in tumor incidence across age groups can aid in early detection, appropriate management, and better outcomes for patients. It also highlights the importance of considering age-related factors in the diagnosis and treatment of pediatric cancers.

Correct Answer: D

Rationale: In this case, the correct answer is D) stage IIB. According to the Ann Arbor Classification system for staging Hodgkin lymphoma, stage IIB indicates involvement of two or more lymph node regions on the same side of the diaphragm. Option A) stage IA is incorrect because it represents involvement of a single lymph node region. Option B) stage IB is also incorrect as it denotes involvement of a single lymph node region and the adjacent or nearby tissue. Option C) stage IIA is not applicable in this scenario as it signifies involvement of two or more lymph node regions on the same side of the diaphragm without systemic symptoms. Educationally, understanding the staging of Hodgkin lymphoma is crucial for healthcare providers, especially for nurse practitioners working in pediatric oncology. It guides treatment decisions, prognosis, and follow-up care. This question reinforces the importance of knowing the Ann Arbor Classification system and applying it to determine the extent of disease in pediatric patients with Hodgkin lymphoma.

Correct Answer: D

Rationale: In the context of pediatric oncology, a biopsy is not usually performed for a child with suspicion of Wilms tumor if there is intratumoral calcification radiologically. This is because the presence of intratumoral calcification is a characteristic feature of Wilms tumor, and biopsies are typically not necessary in cases where the imaging findings are highly suggestive of this specific type of tumor. Option A, the age of 2-3 years, is not a reason to avoid biopsy as Wilms tumor commonly presents in this age group. Option B, signs of inflammation or infection, are not relevant to the decision-making process for performing a biopsy in the context of Wilms tumor suspicion. Option C, significant lymph node enlargement radiologically, may prompt further investigation but is not a definitive factor in deciding against a biopsy for Wilms tumor. From an educational standpoint, understanding the typical imaging findings and clinical presentation of Wilms tumor is crucial for healthcare providers working in pediatric oncology. This knowledge aids in making informed decisions about the need for biopsies and helps in the timely and accurate diagnosis of pediatric cancers. It also underscores the importance of interpreting radiological findings in the context of specific pediatric malignancies to guide appropriate management strategies.