Neuroblastoma

[size=6]A 3-year-old boy has a 6 cm left posterior chest mass at the costovertebral angle that extends from T8 to T12. In planning resection, it would be important to obtain a a MRI of the spine b Cardiac ultrasound c CT angiogram d Chest CT[/size]

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[size=20px]A 9-month-old child undergoes removal of a central abdominal neuroblastoma. Postoperatively, she develops accumulation of fluid in her abdomen. The fluid has 90% lymphocytes and high chylomicron levels. She undergoes abdominal drain placement due to respiratory compromise. She receives octreotide infusion and TPN administration. Six weeks later, the patient continues to have 40-50 ml/kg/day of chylous ascites, persistent lymphopenia, and hypoalbuminemia. The best option to manage persistent chylous ascites is A abdominal exploration with direct ligation of lymphatic vessels B percutaneous lymphatic duct embolization C percutaneous retroperitoneal injec…

. A schematic illustration of the IDRF evaluation. Regarding the arteries, in cases where a vessel is completely surrounded by the tumor (total encasement), or more than half of the circumference of the vessel is surrounded by the tumor (contact ≧ 50 %), the vessel is considered to be “encased,” and the patient is considered to be IDRF positive. Vessel “contact” is defined by the surrounding of less than half of the artery circumference by the tumor; such cases are considered to be IDRF negative. In the case of veins, “encased” means the complete compression of the vessel with no visible lumen. “Contact” means that the lumen is visible and that case is IDRF negative

A 13-year-old boy with a history of high-risk neuroblastoma is seen for progressive abdominal pain. On exam he is mildly distended with tenderness to palpation in both upper quadrants. He is currently febrile and slightly tachycardic. There is no free air on plain radiographs. Subsequent cross-sectional imaging is concerning for pneumogastria (see below). The most likely causative agent for this disease process is [center][/center] [size=20px]A Entamoeba histolytica B Clostridium difficile C Helicobacter pylori D Escherichia coli E Streptococcus pneumoniae[/size]

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[size=20px]An otherwise healthy two-year old girl is undergoing induction chemotherapy for high grade neuroblastoma. She develops fever, tachycardia and irritability. Absolute neutrophil count (ANC) is 0 and is not expected to increase for the next 10 days. Her blood pressure is normal. CXR shows a new right lower lobe infiltrate. Cultures are sent. Initial antibiotic therapy for this patient with febrile neutropenia should be A piperacillin-tazobactam and caspofungin B ampicillin, gentamicin, and metronidazole C piperacillin-tazobactam and vancomycin D piperacillin-tazobactam E vancomycin, gentamicin, metronidazole, and caspofungin​[/size]

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[size=20px]A 15-month old presents with abdominal distension, pain and lower extremity weakness. On physical examination she has a large palpable abdominal mass that extends into the pelvis. She has decreased tone of the right lower extremity and refuses to bear weight. An abdominal/pelvic computerized tomography scan reveals a large pelvic mass that crosses the midline and extends into the right L5 neural foramina with spinal cord compression. What is the most critical step in management of neuroblastoma with spinal cord compression? A immediate pelvic primary tumor resection to relieve symptoms B immediate laminectomy and cord decompression C initiation of chem…

First one with correct answer with justification win. [size=20px]The mode of metastatic spread in neuroblastoma is A hematogenous B lymphatic C cerebral spinal fluid D a and b E a, b, and c[/size]