Which chromosomal abnormality is often characteristic of infantile ALL?

Correct Answer: A

Rationale: In pediatric nursing, understanding chromosomal abnormalities associated with diseases like infantile Acute Lymphoblastic Leukemia (ALL) is crucial for accurate diagnosis and management. The correct answer is A) t(4;11) for infantile ALL. This translocation involves a fusion of the MLL gene on chromosome 11, leading to a poor prognosis in pediatric ALL patients. Option B) t(12;21) is characteristic of pediatric ALL, but it is associated with a more favorable prognosis compared to t(4;11). Option C) t(9;22) is commonly seen in adult ALL (Philadelphia chromosome) and chronic myeloid leukemia, not infantile ALL. Option D) t(1;19) is associated with pre-B cell ALL, not infantile ALL. Educationally, this question helps students differentiate between various chromosomal abnormalities seen in pediatric leukemias, highlighting the importance of genetic factors in disease pathogenesis and prognosis. Understanding these molecular mechanisms is essential for providing evidence-based care to pediatric patients with leukemia.

Correct Answer: D

Rationale: The correct answer is D) liver. In infants with multiple cutaneous hemangiomas, the most common site of visceral involvement by hemangiomas is the liver. This is known as hepatic hemangiomas. These benign vascular tumors in the liver are often asymptomatic and can regress over time. Option A) brain is less common in cases of cutaneous hemangiomas. Brain involvement can occur but is not as frequent as liver involvement. Option B) heart involvement by hemangiomas is rare in comparison to liver involvement. Cardiac hemangiomas are uncommon and usually present differently from cutaneous hemangiomas. Option C) lung involvement by hemangiomas is also less common than liver involvement. Pulmonary hemangiomas are rare and may not typically be the first consideration in cases of cutaneous hemangiomas. Understanding the common sites of visceral involvement in hemangiomas is crucial in pediatric nursing to provide appropriate care and monitoring for these patients. Recognizing the liver as the most common site can help in early detection and management of hepatic hemangiomas in infants with cutaneous hemangiomas.

Correct Answer: A

Rationale: The correct answer is A) t(9;22) for the chromosomal abnormality of childhood ALL that carries the highest risk of relapse despite intensive chemotherapy. This abnormality is known as the Philadelphia chromosome, resulting from a translocation between chromosomes 9 and 22. This translocation leads to the formation of the BCR-ABL fusion gene, which is a hallmark of a more aggressive form of ALL. Option B) t(4;11) is associated with MLL rearrangements and has a relatively poor prognosis, but it is not as strongly linked to high relapse rates as the Philadelphia chromosome. Option C) hypodiploidy is a chromosomal abnormality associated with high-risk ALL due to the presence of fewer than 44 chromosomes. However, it does not carry as high a risk of relapse as the Philadelphia chromosome. Option D) t(1;19) is associated with the TCF3-PBX1 fusion gene and is considered a favorable risk factor in childhood ALL, with a lower risk of relapse compared to the Philadelphia chromosome. Understanding the prognostic significance of different chromosomal abnormalities in childhood ALL is crucial for pediatric nurses and healthcare professionals involved in the care of these patients. Recognizing high-risk factors like the Philadelphia chromosome can inform treatment decisions and monitoring strategies to improve patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) age less than 10 years. Extraneural metastasis in primary brain tumors is a rare occurrence, but it is more likely to happen in younger children, particularly those under the age of 10. This is due to the increased vascularity and rapid growth of brain tumors in this age group, which can facilitate the spread of cancer cells to other parts of the body. Option B) female gender and option D) supratentorial tumor are not considered risk factors for extraneural metastasis in primary brain tumors. Gender is not typically associated with an increased risk of metastasis in this context, and the location of the tumor (supratentorial) does not necessarily predict the likelihood of extraneural spread. Option C) ventriculoperitoneal (VP) shunt insertion is not directly related to an increased risk of extraneural metastasis. While VP shunt insertion is a common procedure in managing certain types of brain tumors, it is not a known risk factor for the spread of cancer cells outside the central nervous system. In an educational context, understanding the risk factors for extraneural metastasis in pediatric brain tumors is crucial for healthcare providers working with pediatric oncology patients. Recognizing the factors that can increase the likelihood of cancer spread allows for more targeted monitoring and treatment strategies to improve patient outcomes. It is important to stay informed about current research and evidence-based practices in pediatric oncology to provide the best care for these vulnerable patients.

Correct Answer: B

Rationale: In this scenario, the BEST confirmatory diagnostic evaluation for a suspected case of retinoblastoma in a 10-month-old infant is option B) examination under general anesthesia by an experienced ophthalmologist. This is the most appropriate choice because retinoblastoma is a malignant tumor of the retina that requires detailed evaluation under anesthesia to assess the extent of the tumor, its location, and the involvement of the optic nerve. Option A) indirect ophthalmoscopy with slit-lamp examination may not provide a comprehensive view of the entire retina, especially in infants who may not cooperate fully during the examination. Option C) orbital ultrasonography can be useful in certain cases, but it may not offer the detailed visualization needed to confirm a diagnosis of retinoblastoma definitively. Option D) brain MRI is not the first line of diagnostic evaluation for retinoblastoma, as the primary site of concern is the eye and not the brain. In an educational context, it is crucial for healthcare providers, especially pediatric nurses, to understand the importance of prompt and accurate diagnosis of conditions like retinoblastoma that can significantly impact a child's vision and overall health. By selecting the most appropriate diagnostic evaluation, healthcare professionals can ensure timely intervention and appropriate management of the condition, ultimately improving outcomes for the child.