PART 1 of 5
This is Part 1 of the Pediatric Oncology
Fundamentals 9th Edition Comprehensive Test
Bank by Pizzo, Poplack, Adamson, Blaney, &
Helman.
TABLE OF CONTENTS — PART 1
Chapter 1: Leukemia and Lymphoma — Questions 1–20
Chapter 2: Central Nervous System Tumors — Questions 21–40
Chapter 3: Neuroblastoma — Questions 41–60
Chapter 4: Wilms Tumor and Renal Tumors — Questions 61–80
Chapter 5: Soft Tissue Sarcomas — Questions 81–100
Chapter 1: Leukemia and Lymphoma — Questions 1–20
Q1. Which of the following is the most common childhood malignancy?
A. Acute lymphoblastic leukemia
B. Acute myeloid leukemia
C. Neuroblastoma
D. Wilms tumor
Correct Answer: Acute lymphoblastic leukemia
Rationale: Acute lymphoblastic leukemia is the most common childhood malignancy,
accounting for approximately 25 percent of all childhood cancers and 75 percent of pediatric
leukemias. Acute myeloid leukemia is less common, accounting for about 20 percent of childhood
leukemias. Neuroblastoma is the most common extracranial solid tumor but is less common than
acute lymphoblastic leukemia overall. Wilms tumor is the most common renal tumor in children but
is also less common. Recognizing the most common childhood malignancy is essential for prioritizing
diagnostic evaluation and understanding pediatric cancer epidemiology.
Q2. Which of the following is the peak age of incidence for acute lymphoblastic leukemia?
,A. 2 to 5 years
B. 6 to 10 years
C. 11 to 15 years
D. 16 to 20 years
Correct Answer: 2 to 5 years
Rationale: The peak age of incidence for acute lymphoblastic leukemia is 2 to 5 years, with a
second smaller peak in adolescence. The 6 to 10 year, 11 to 15 year, and 16 to 20 year age groups
have lower incidence rates. The early childhood peak is thought to be related to immune system
development and exposure to infections. Recognizing the peak age is essential for clinical suspicion
and timely diagnosis.
Q3. Which of the following is a characteristic of acute lymphoblastic leukemia?
A. Lymphoblasts in the bone marrow
B. Myeloblasts in the bone marrow
C. Normal bone marrow
D. Absence of bone marrow
Correct Answer: Lymphoblasts in the bone marrow
Rationale: Acute lymphoblastic leukemia is characterized by the proliferation of lymphoblasts
in the bone marrow, which replace normal hematopoietic cells and cause pancytopenia. Myeloblasts
are seen in acute myeloid leukemia. Normal bone marrow is not seen. Absence of bone marrow is
not characteristic. Recognizing the characteristic finding is essential for diagnosis.
Q4. Which of the following is the most common central nervous system complication of acute
lymphoblastic leukemia?
A. Leptomeningeal disease
B. Intracranial hemorrhage
C. Cerebral edema
D. Brain abscess
Correct Answer: Leptomeningeal disease
Rationale: Leptomeningeal disease is the most common central nervous system complication
of acute lymphoblastic leukemia, occurring when leukemic cells infiltrate the meninges. Intracranial
hemorrhage can occur due to thrombocytopenia but is less common. Cerebral edema and brain
abscess are not typical complications. Recognizing the most common central nervous system
complication is essential for prophylaxis and treatment.
,Q5. Which of the following is the most common site of extramedullary involvement in acute
lymphoblastic leukemia?
A. Central nervous system
B. Testes
C. Liver
D. Spleen
Correct Answer: Central nervous system
Rationale: The central nervous system is the most common site of extramedullary involvement
in acute lymphoblastic leukemia, followed by the testes. The liver and spleen are commonly involved
but are not considered extramedullary sites in the same context. Recognizing the most common site
is essential for prophylaxis and monitoring.
Q6. Which of the following is a poor prognostic factor in acute lymphoblastic leukemia?
A. Age less than 1 year
B. Age 2 to 5 years
C. White blood cell count less than 50,000 per microliter
D. Favorable cytogenetics
Correct Answer: Age less than 1 year
Rationale: Age less than 1 year at diagnosis is a poor prognostic factor in acute lymphoblastic
leukemia, associated with a higher risk of treatment failure and relapse. Age 2 to 5 years is a
favorable prognostic factor. White blood cell count less than 50,000 per microliter is favorable.
Favorable cytogenetics is also a good prognostic factor. Recognizing prognostic factors is essential for
risk stratification and treatment planning.
Q7. Which of the following is a favorable prognostic factor in acute lymphoblastic leukemia?
A. Hyperdiploidy
B. Hypodiploidy
C. Philadelphia chromosome
D. MLL rearrangement
Correct Answer: Hyperdiploidy
Rationale: Hyperdiploidy, defined as more than 50 chromosomes, is a favorable prognostic
factor in acute lymphoblastic leukemia, associated with a good response to chemotherapy.
, Hypodiploidy, Philadelphia chromosome, and MLL rearrangement are poor prognostic factors.
Recognizing prognostic factors is essential for risk stratification.
Q8. Which of the following is the most common type of acute myeloid leukemia in children?
A. Acute promyelocytic leukemia
B. Acute myelomonocytic leukemia
C. Acute monocytic leukemia
D. Acute megakaryoblastic leukemia
Correct Answer: Acute promyelocytic leukemia
Rationale: Acute promyelocytic leukemia is the most common type of acute myeloid leukemia
in children, characterized by the PML-RARA fusion gene and a risk of disseminated intravascular
coagulation. Acute myelomonocytic leukemia, acute monocytic leukemia, and acute
megakaryoblastic leukemia are less common. Recognizing the most common type is essential for
diagnosis and treatment.
Q9. Which of the following is a characteristic of acute promyelocytic leukemia?
A. PML-RARA fusion gene
B. Disseminated intravascular coagulation
C. Response to all-trans retinoic acid
D. All of the above
Correct Answer: PML-RARA fusion gene
Rationale: Acute promyelocytic leukemia is characterized by the PML-RARA fusion gene, which
results from a t(15;17) translocation. Disseminated intravascular coagulation is a common
complication. Response to all-trans retinoic acid is a hallmark of treatment. While all of the above are
true, the question asks for a characteristic, and PML-RARA is the defining genetic feature.
Recognizing the characteristic is essential for diagnosis and treatment.
Q10. Which of the following is the treatment of choice for acute promyelocytic leukemia?
A. All-trans retinoic acid and arsenic trioxide
B. Chemotherapy alone
C. Radiation therapy
D. Observation
Correct Answer: All-trans retinoic acid and arsenic trioxide
This is Part 1 of the Pediatric Oncology
Fundamentals 9th Edition Comprehensive Test
Bank by Pizzo, Poplack, Adamson, Blaney, &
Helman.
TABLE OF CONTENTS — PART 1
Chapter 1: Leukemia and Lymphoma — Questions 1–20
Chapter 2: Central Nervous System Tumors — Questions 21–40
Chapter 3: Neuroblastoma — Questions 41–60
Chapter 4: Wilms Tumor and Renal Tumors — Questions 61–80
Chapter 5: Soft Tissue Sarcomas — Questions 81–100
Chapter 1: Leukemia and Lymphoma — Questions 1–20
Q1. Which of the following is the most common childhood malignancy?
A. Acute lymphoblastic leukemia
B. Acute myeloid leukemia
C. Neuroblastoma
D. Wilms tumor
Correct Answer: Acute lymphoblastic leukemia
Rationale: Acute lymphoblastic leukemia is the most common childhood malignancy,
accounting for approximately 25 percent of all childhood cancers and 75 percent of pediatric
leukemias. Acute myeloid leukemia is less common, accounting for about 20 percent of childhood
leukemias. Neuroblastoma is the most common extracranial solid tumor but is less common than
acute lymphoblastic leukemia overall. Wilms tumor is the most common renal tumor in children but
is also less common. Recognizing the most common childhood malignancy is essential for prioritizing
diagnostic evaluation and understanding pediatric cancer epidemiology.
Q2. Which of the following is the peak age of incidence for acute lymphoblastic leukemia?
,A. 2 to 5 years
B. 6 to 10 years
C. 11 to 15 years
D. 16 to 20 years
Correct Answer: 2 to 5 years
Rationale: The peak age of incidence for acute lymphoblastic leukemia is 2 to 5 years, with a
second smaller peak in adolescence. The 6 to 10 year, 11 to 15 year, and 16 to 20 year age groups
have lower incidence rates. The early childhood peak is thought to be related to immune system
development and exposure to infections. Recognizing the peak age is essential for clinical suspicion
and timely diagnosis.
Q3. Which of the following is a characteristic of acute lymphoblastic leukemia?
A. Lymphoblasts in the bone marrow
B. Myeloblasts in the bone marrow
C. Normal bone marrow
D. Absence of bone marrow
Correct Answer: Lymphoblasts in the bone marrow
Rationale: Acute lymphoblastic leukemia is characterized by the proliferation of lymphoblasts
in the bone marrow, which replace normal hematopoietic cells and cause pancytopenia. Myeloblasts
are seen in acute myeloid leukemia. Normal bone marrow is not seen. Absence of bone marrow is
not characteristic. Recognizing the characteristic finding is essential for diagnosis.
Q4. Which of the following is the most common central nervous system complication of acute
lymphoblastic leukemia?
A. Leptomeningeal disease
B. Intracranial hemorrhage
C. Cerebral edema
D. Brain abscess
Correct Answer: Leptomeningeal disease
Rationale: Leptomeningeal disease is the most common central nervous system complication
of acute lymphoblastic leukemia, occurring when leukemic cells infiltrate the meninges. Intracranial
hemorrhage can occur due to thrombocytopenia but is less common. Cerebral edema and brain
abscess are not typical complications. Recognizing the most common central nervous system
complication is essential for prophylaxis and treatment.
,Q5. Which of the following is the most common site of extramedullary involvement in acute
lymphoblastic leukemia?
A. Central nervous system
B. Testes
C. Liver
D. Spleen
Correct Answer: Central nervous system
Rationale: The central nervous system is the most common site of extramedullary involvement
in acute lymphoblastic leukemia, followed by the testes. The liver and spleen are commonly involved
but are not considered extramedullary sites in the same context. Recognizing the most common site
is essential for prophylaxis and monitoring.
Q6. Which of the following is a poor prognostic factor in acute lymphoblastic leukemia?
A. Age less than 1 year
B. Age 2 to 5 years
C. White blood cell count less than 50,000 per microliter
D. Favorable cytogenetics
Correct Answer: Age less than 1 year
Rationale: Age less than 1 year at diagnosis is a poor prognostic factor in acute lymphoblastic
leukemia, associated with a higher risk of treatment failure and relapse. Age 2 to 5 years is a
favorable prognostic factor. White blood cell count less than 50,000 per microliter is favorable.
Favorable cytogenetics is also a good prognostic factor. Recognizing prognostic factors is essential for
risk stratification and treatment planning.
Q7. Which of the following is a favorable prognostic factor in acute lymphoblastic leukemia?
A. Hyperdiploidy
B. Hypodiploidy
C. Philadelphia chromosome
D. MLL rearrangement
Correct Answer: Hyperdiploidy
Rationale: Hyperdiploidy, defined as more than 50 chromosomes, is a favorable prognostic
factor in acute lymphoblastic leukemia, associated with a good response to chemotherapy.
, Hypodiploidy, Philadelphia chromosome, and MLL rearrangement are poor prognostic factors.
Recognizing prognostic factors is essential for risk stratification.
Q8. Which of the following is the most common type of acute myeloid leukemia in children?
A. Acute promyelocytic leukemia
B. Acute myelomonocytic leukemia
C. Acute monocytic leukemia
D. Acute megakaryoblastic leukemia
Correct Answer: Acute promyelocytic leukemia
Rationale: Acute promyelocytic leukemia is the most common type of acute myeloid leukemia
in children, characterized by the PML-RARA fusion gene and a risk of disseminated intravascular
coagulation. Acute myelomonocytic leukemia, acute monocytic leukemia, and acute
megakaryoblastic leukemia are less common. Recognizing the most common type is essential for
diagnosis and treatment.
Q9. Which of the following is a characteristic of acute promyelocytic leukemia?
A. PML-RARA fusion gene
B. Disseminated intravascular coagulation
C. Response to all-trans retinoic acid
D. All of the above
Correct Answer: PML-RARA fusion gene
Rationale: Acute promyelocytic leukemia is characterized by the PML-RARA fusion gene, which
results from a t(15;17) translocation. Disseminated intravascular coagulation is a common
complication. Response to all-trans retinoic acid is a hallmark of treatment. While all of the above are
true, the question asks for a characteristic, and PML-RARA is the defining genetic feature.
Recognizing the characteristic is essential for diagnosis and treatment.
Q10. Which of the following is the treatment of choice for acute promyelocytic leukemia?
A. All-trans retinoic acid and arsenic trioxide
B. Chemotherapy alone
C. Radiation therapy
D. Observation
Correct Answer: All-trans retinoic acid and arsenic trioxide
