CPHON flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ANC formula

Absolute neutrophil count equals the WBC count multiplied by the sum of the percentages of neutrophils and bands, divided by 100; severe neutropenia is an ANC below 500 per microliter.

Peak age of ALL

Acute lymphoblastic leukemia is the most common childhood cancer, peaking between ages 2 and 5 years and accounting for roughly one quarter of childhood malignancies.

Reed-Sternberg cells

Large binucleate cells with prominent nucleoli seen on lymph node biopsy in Hodgkin lymphoma; they typically express CD15 and CD30 and are the diagnostic hallmark.

Hydroxyurea in sickle cell

Increases fetal hemoglobin, reduces sickling and vaso-occlusive crises, and lowers rates of acute chest syndrome and hospitalization in children with sickle cell disease.

Platelet transfusion threshold

Most pediatric oncology protocols transfuse when platelets fall below 10,000 per microliter, or below 20,000 per microliter with fever, bleeding, or a planned invasive procedure.

Acute chest syndrome

A leading cause of death in sickle cell disease, with fever, chest pain, hypoxemia, and a new pulmonary infiltrate; treated with oxygen, antibiotics, bronchodilators, and transfusion.

Vincristine route of administration

Vincristine is a vesicant given only by the intravenous route; intrathecal administration is uniformly fatal, so the route must be independently verified before starting the infusion.

Leucovorin rescue

Given after high-dose methotrexate to bypass folate blockade and rescue normal tissues; dosing continues, guided by serum methotrexate levels, until levels fall to a safe range.

Mesna

A sulfhydryl compound that binds acrolein, the urotoxic metabolite of cyclophosphamide and ifosfamide, preventing hemorrhagic cystitis; it is given with vigorous hydration and frequent voiding.

Anthracycline cardiotoxicity

Doxorubicin and daunorubicin cause cumulative, dose-related myocardial injury; baseline and serial echocardiograms monitor ejection fraction and shortening fraction before each dose escalation.

Asparaginase toxicity

Pegaspargase can cause hypersensitivity reactions, pancreatitis, hyperglycemia, and coagulopathy with low fibrinogen and antithrombin; monitor glucose, amylase, and clotting studies.

Graft-versus-host disease

Donor T lymphocytes attack recipient skin, liver, and gut after allogeneic transplant, causing rash, jaundice, and diarrhea; prophylaxis combines a calcineurin inhibitor with methotrexate.

Cytokine release syndrome

A systemic inflammatory response after CAR-T or bispecific antibody therapy with fever, hypotension, hypoxia, and organ dysfunction; treated with tocilizumab and corticosteroids.

Febrile neutropenia

A single oral temperature of 38.3 degrees Celsius, or 38.0 degrees sustained for one hour, in a patient with an ANC below 500 per microliter or expected to fall below that level.

Empiric antibiotic timing

In febrile neutropenia, broad-spectrum intravenous antibiotics are started within 60 minutes of presentation, after blood cultures from all lumens are obtained.

Irradiated blood components

Cellular blood products are irradiated to inactivate donor T lymphocytes, preventing transfusion-associated graft-versus-host disease in heavily immunosuppressed children receiving chemotherapy or transplant.

Mucositis mouth care

Rinsing with saline or sodium bicarbonate several times daily and brushing with a soft toothbrush limit mucosal injury; alcohol- and hydrogen peroxide-based rinses are avoided.

Filgrastim adverse effect

Granulocyte colony-stimulating factor commonly produces bone pain in the sternum, spine, and long bones; it is usually managed with acetaminophen or other non-opioid analgesics.

Opioid-induced constipation

Tolerance to constipation does not develop, so a stimulant laxative with a stool softener is started when opioids begin and continued for the duration of therapy.

Tumor lysis syndrome

Two or more of hyperuricemia, hyperkalemia, hyperphosphatemia, or hypocalcemia occurring within three days before to seven days after chemotherapy, often with rising creatinine.

Rasburicase and G6PD

Rasburicase is contraindicated in glucose-6-phosphate dehydrogenase deficiency because it causes severe hemolysis; it rapidly lowers uric acid and samples must be kept on ice.

Hyperleukocytosis

A white blood cell count above 100,000 per microliter, seen in AML and infant ALL, that causes leukostasis with pulmonary and neurologic compromise; managed with cytoreduction and cautious hydration.

Spinal cord compression

Back pain with weakness, sensory loss, or bladder dysfunction from epidural tumor; treat emergently with dexamethasone and imaging, followed by radiation or surgery.

Anthracycline extravasation

Dexrazoxane is the antidote and is given intravenously within six hours of extravasation of doxorubicin or daunorubicin; cold compresses are applied to the site.

Neutropenic enterocolitis

Also called typhlitis, it presents with fever and right lower quadrant pain in a neutropenic child; treat with bowel rest, broad-spectrum antibiotics, and surgical consultation.

Hypercalcemia of malignancy

Corrected calcium above 10.5 mg/dL causing confusion, constipation, polyuria, and dehydration; treated with intravenous isotonic fluids and a bisphosphonate such as zoledronic acid.

Erikson school-age stage

Children aged 6 to 12 work on industry versus inferiority, so they benefit from concrete explanations, active participation in care, and continued schoolwork during treatment.

Preschool concept of death

Children under about five see death as temporary and reversible with magical thinking; use clear, literal language, avoid euphemisms, and reassure them they did not cause the illness.

Palliative care

Care that relieves suffering and improves quality of life for children with serious illness at any stage; it can be provided alongside curative-directed therapy from diagnosis.

FLACC behavioral pain scale

Scores Face, Legs, Activity, Cry, and Consolability from 0 to 2 each, for children aged 2 months to 7 years or those who cannot self-report pain.

Fertility preservation

Counseling offered before gonadotoxic therapy such as alkylating agents or pelvic radiation; options include sperm banking, oocyte or embryo cryopreservation, and gonadal shielding.

Sibling support needs

Brothers and sisters of children with cancer have increased anxiety, school difficulties, and feelings of neglect; they need accurate information, inclusion, and dedicated caregiver attention.