Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 14: Cancer in ChildrenMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. What congenital malformation is commonly linked to acute leukemia in children?a. Down syndromeb. Wilms tumorc. Retinoblastomad. NeuroblastomaANS: ATrisomy 21 (Down syndrome) is the most common genetic defect linked to the development of acute leukemia. Children with Down syndrome have a 10- to 20-fold increased risk of developing acute lymphoblastic and myelogenous leukemia and a higher risk for developing acute megakaryocytic leukemia. No current research supports a link between Wilms tumor, retinoblastoma, or neuroblastoma and acute leukemia.PTS: 1 DIF: Cognitive Level: Remembering 2. When are childhood cancers most often diagnosed?a. During infancyb. At peak times of physical growthc. After diagnosis of a chronic illnessd. After an acute illnessANS: BChildhood cancers are most often diagnosed during peak times of physical growth. No current research supports the association between frequency of diagnosis and infancy, chronic illness, or acute illness.PTS: 1 DIF: Cognitive Level: Remembering 3. Prenatal exposure to diethylstilbestrol (DES) can result in which type of cancer?a. Breast cancerb. Leukemiac. Vaginal cancerd. LymphomaANS: CDES has been identified as a transplacental chemical carcinogen; a small percentage of the daughters of women who took DES during pregnancy developed adenocarcinomas of the vagina. No current research supports a link between the drug and other cancers.PTS: 1 DIF: Cognitive Level: Remembering 4. Currently, what percentage of children with cancer can be cured?a. 40%b. 50%c. 60%d. 85%ANS: DCurrently, more than 85% of children diagnosed with cancer are cured.PTS: 1 DIF: Cognitive Level: Remembering 5. What do most childhood cancers arise from?a. Epitheliumb. Mesodermal germ layerc. Embryologic ectodermal layerd. VisceraANS: BMost childhood cancers originate from the mesodermal germ layer that gives rise to connective tissue, bone, cartilage, muscle, blood, blood vessels, gonads, kidney, and the lymphatic system. The epithelium, embryologic ectodermal layer, and the viscera are not common sites from which cancers originate.PTS: 1 DIF: Cognitive Level: Remembering 6. Which form of cancer is linked to congenital malformation syndromes?a. Wilms tumorb. Retinoblastomac. Osteosarcomad. RhabdomyosarcomaANS: AWilms tumors are linked with other genetically linked childhood cancers. It is the only form among the available options that is associated with congenital malformation syndromes.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 7. Research data support a carcinogenic relationship in children resulting from exposure to which virus?a. Herpes simplex virusb. Influenzac. Varicella-zoster virusd. Epstein-Barr virusANS: DThe strongest association between viruses and the development of cancer in children has been the Epstein-Barr virus (EBV), Burkitt lymphoma, nasopharyngeal carcinoma, and Hodgkin disease. No current research supports a link between the other viruses and childhood cancer.PTS: 1 DIF: Cognitive Level: Remembering 8. What does a child diagnosed with acquired immunodeficiency syndrome (AIDS) have an increased risk of developing?a. Non-Hodgkin lymphomab. Retinoblastomac. Epstein-Barrd. LeukemiaANS: AChildren with AIDS have an increased risk of developing non-Hodgkin lymphoma and Kaposi sarcoma. Leukemia is linked to retinoblastoma. Epstein-Barr has been linked to the development of some cancers, whereas no known link has been found between AIDS and the development of leukemia.PTS: 1 DIF: Cognitive Level: Remembering 9. Which intervention has the greatest effect on a child’s mortality rate when diagnosed with cancer?a. Age at the time of diagnosisb. Participation in clinical trialsc. Proximity to a major cancer treatment centerd. Parental involvement in the treatment planningANS: BMortality rates have significantly declined in the past 40 years largely as a result of advances in treatment and participation in clinical trials. Although important, age, proximity to treatment centers, and parental involvement are not believed to have an effect on the decline of the mortality rate of childhood cancer.PTS: 1 DIF: Cognitive Level: Remembering 10. Which statement is likely true regarding children being treated for cancer with radiation therapy?a. They will most likely have a successful remission of tumor growth.b. They seldom require follow-up maintenance treatments.c. They are prone to experience severe developmental delays.d. They are at increased risk for developing childhood cancers.ANS: DAlthough the need exists for long-term studies, research has shown a correlation between radiation-induced malignancies from radiotherapy (as in cancer treatment) or radiation exposure from diagnostic imaging; both have shown to increase the risk of developing cancer during childhood. The other options are not necessarily true regarding the outcomes of radiation therapy for childhood cancers.PTS: 1 DIF: Cognitive Level: Remembering 11. How should the healthcare professional reply when parents question why a computed tomographic (CT) scan of the head was not ordered for their 5-year-old child after a minor fall?a. Physicians are cautious about ordering CT scan on children younger than 10 years of age.b. CT scans are seldom conclusive when used to diagnosis head injuries in young children.c. The child’s symptoms will determine whether a CT scan is necessary and worth the expense.d. Research suggests that repeated CT scans can increase the risk of developing brain cancer.ANS: DFindings from a recent study of 176,587 children suggest that those who have two or three CT scans of the head before the age of 22 years are three times more likely to develop brain cancer as those in the general population, and the risk of developing leukemia is three times as great in those who received 5 to 10 CT scans. The other options do not represent the logic behind not ordering a CT scan in relationship to minor head trauma.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 3MULTIPLE RESPONSE 1. Childhood exposure to which risk factors is known to increase the susceptibility for developing cancers? (Select all that apply.)a. Low birth weightb. Chemotherapyc.
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