COMMON PEDIATRIC CANCERS

Common Pediatric Cancers

Children can get cancer in the same parts of the body as adults do, but cancers don't always act like or get treated like adult cancer. Childhood cancers can occur suddenly; however, they have a high rate of cure.

Some types of cancer are more common in children. The most common form of childhood cancer is leukemia. Leukemia is cancer of the blood.

In addition to leukemia, these are other common cancers found in children:

Acute lymphoblastic leukemia Acute myeloid leukemia Brain tumors Childhood lymphomas Ewing's sarcomas Extracranial germ cell tumor Hodgkin's disease Hepatoblastomas Liver cancer

Neuroblastomas Non-Hodgkin's lymphoma Retinoblastoma Rhabdomyosarcomas Soft tissue sarcoma Wilms' tumor & other childhood kidney tumors

COMMON PEDIATRIC VACCINES AND THEIR ABBREVIATIONS

Age	Vaccine
2 months	PCV, HBV-Hib, DTaP, IPV
4 months	PCV, HBV-Hib, DTaP, IPV
6 months	PCV, DTaP
6 months to 2 years*	Flu
9 months	HBV, IPV
12 months	MMR, Varivax
15 months	PCV, DTaP-Hib
3 to 6 years	MMR
5 years	DTaP, IPV
11 years	Td (and HBV, MMR and Varivax if not previously given)
17 years	Meningococcal vaccine

*Children between the ages of 6 months and 2 years are among those most likely to be hospitalized for influenza. For this reason, otherwise healthy children in this age range should receive the influenza vaccine in November for the upcoming winter. For children with asthma or other cardiopulmonary or immunologic disorders, an annual flu shot is recommended even beyond age 2. The first year your child gets a flu shot, two doses are required — separated by 1 month. In subsequent years only one dose is needed.

Vaccine abbreviations
DTaP. Diphtheria, tetanus and acellular pertussis	MMR. Measles-mumps-rubella
DTaP-Hib. Diphtheria, tetanus and acellular pertussis-Haemophilus influenzae type b	PCV. Pneumococcal conjugate vaccine
HBV. Hepatitis B	Td. Tetanus-diphtheria toxoid, adult type (booster)
HBV-Hib. Hepatitis B-Haemophilus influenzae type b	Varivax. Chickenpox (varicella) virus vaccine live
IPV. Poliovirus vaccine inactivated (also called Salk)	-

CRANIAL NERVES II-XII

Ever wondered what is tested when they say "cranial nerves II-XII are intact"?

Nervous: Cranial Nerves Exam

1. Setup

2. I: Olfactory

3. II: Optic

4. III-IV-VI: extraoculars

5. V: Trigeminal

6. VII: Facial

7. VIII: Vestibulocochlear

8. IX-X: Glossopharyngeal, Vagus

9. XI: Accessory

10. XII: Hypoglossal

Setup

• Patient sitting over edge of bed.

CN I: Olfactory

• Usually not tested.
• Rash, deformity of nose.
• Test each nostril with essence bottles of coffee, vanilla, peppermint.

CN II: Optic

• With patient wearing glasses, test each eye separately on eye chart/ card using an eye cover.
• Examine visual fields by confrontation by wiggling fingers 1 foot from pt's ears, asking which they see move.
  • Keep examiner's head level with patient's head.
• If poor visual acuity, map fields using fingers and a quadrant-covering card.
• Look into fundi.
• For more detail, See Eye Exam.

CN III, IV, VI: Oculomotor, Trochlear, Abducens

• Look at pupils: shape, relative size, ptosis.
• Shine light in from the side to gauge pupil's light reaction.
  • Assess both direct and consensual responses.
  • Assess afferent pupillary defect by moving light in arc from pupil to pupil. unne). Optionally: as do arc test, have pt place a flat hand extending vertically from his face, between his eyes, to act as a blinder so light can only go into one eye at a time.
• "Follow finger with eyes without moving head": test the 6 cardinal points in an H pattern.
  • Look for failure of movement, nystagmus [pause to check it during upward/ lateral gaze].
• Convergence by moving finger towards bridge of pt's nose.
• Test accommodation by pt looking into distance, then a hat pin 30cm from nose.
• If MG suspected: pt. gazes upward at Dr's finger to show worsening ptosis.

CN V: Trigeminal

• Corneal reflex: patient looks up and away.
  • Touch cotton wool to other side.
  • Look for blink in both eyes, ask if can sense it.
  • Repeat other side [tests V sensory, VII motor].
• Facial sensation: sterile sharp item on forehead, cheek, jaw.
  • Repeat with dull object. Ask to report sharp or dull.
  • If abnormal, then temperature [heated/ water-cooled tuning fork], light touch [cotton].
• Motor: pt opens mouth, clenches teeth (pterygoids).
  • Palpate temporal, masseter muscles as they clench.
• Test jaw jerk:
• Dr's finger on tip of jaw.
• Grip patellar hammer halfway up shaft and tap Dr's finger lightly.
• Usually nothing happens, or just a slight closure.
• If increased closure, think UMNL, esp pseudobulbar palsy.

CN VII: Facial

• Inspect facial droop or asymmetry.
• Facial expression muscles: pt looks up and wrinkles forehead.
  • Examine wrinkling loss.
  • Feel muscle strength by pushing down on each side [UMNL preserved because of bilateral innervation].
• Pt shuts eyes tightly: compare each side.
• Pt grins: compare nasolabial grooves.
• Also: frown, show teeth, puff out cheeks.
• Corneal reflex already done. See CN V.

CN VIII: Vestibulocochlear (Hearing, Vestibular rarely)

• Dr's hands arms length by each ear of pt.
  • Rub one hand's fingers with noise on one side, other hand noiselessly.
  • Ask pt. which ear they hear you rubbing.
  • Repeat with louder intensity, watching for abnormality.
• Weber's test: Lateralization
  • 512/ 1024 Hz [256 if deaf] vibrating fork on top of patients head/ forehead.
  • "Where do you hear sound coming from?"
  • Normal reply is midline.
• Rinne's test: Air vs. Bone Conduction
  • 512/ 1024 Hz [256 if deaf] vibrating fork on mastoid behind ear. Ask when stop hearing it.
  • When stop hearing it, move to the patients ear so can hear it.
  • Normal: air conduction [ear] better than bone conduction [mastoid].
• If indicated, look at external auditory canals, eardrums.

CN IX, X: Glossopharyngeal, Vagus

• Voice: hoarse or nasal.
• Pt. swallows, coughs (bovine cough: recurrent laryngeal).
• Examine palate for uvular displacement. (unilateral lesion: uvula drawn to normal side).
• Pt says "Ah": symmetrical soft palate movement.
• Gag reflex [sensory IX, motor X]:
  • Stimulate back of throat each side.
  • Normal to gag each time.

CN XI: Accessory

• From behind, examine for trapezius atrophy, asymmetry.
• Pt. shrugs shoulders (trapezius).
• Pt. turns head against resistance: watch, palpate SCM on opposite side.

CN XII: Hypoglossal

• Listen to articulation.
• Inspect tongue in mouth for wasting, fasciculations.
• Protrude tongue: unilateral deviates to affected side.

LICENSED VACCINES IN THE USA

Please note that the list of vaccines is not a complete the list of all manufacturers and trade names. Just because I only show one manufacturer for a particular vaccine does not mean that it's the only manufacturer.

Vaccines in red are part of the AAP/CDC/AAFP recommended childhood immunization schedule.

Vaccine	Type	Route	Notes	Manufacturer & Trade Name
Adenovirus	Live virus	Oral	Available only to US armed forces; no longer being manufactured.
Anthrax	Inactivated bacteria	SC		BioPort
BCG	Live bacteria	ID (preferred) or SC		Aventis Pasteur "Theracys"
Cholera	Inactivated bacteria	SC, IM, or ID		Wyeth
Diphtheria-Tetanus (DT, for children)	Toxoids	IM		Aventis Pasteur "DT"
Diphtheria-Tetanus (tD, for adults)	Toxoids	IM		Aventis Pasteur "Td"
DTP	Toxoids and inactivated bacteria	IM
DTaP	Toxoids and inactivated bacterial components	IM		Aventis Pasteur "Tripedia", SmithKline Beecham "Infanrix"
Hepatitis A	Inactivated viral antigen	IM	Recommended only in selected areas	Merck "VAQTA", SmithKline Beecham "Havrix"
Hepatitis B	Inactivated viral antigen	IM		Merck "Recombivax HB", SmithKline Beecham "Engerix-B"
Hepatitis B/Hib	Inactivated viral antigen, Polysaccharide-protein conjugate	IM		Merck "ComVax"
Hib	Polysaccharide-protein conjugate	IM		Lederle "HibTITER", Merck "PedvaxHIB", Connaught "ActHIB", SmithKline Beecham "OmniHIB", Pasteur MerieuxConnaught"ProHIBiT"
Influenza	Inactivated whole virus, viral components	IM		Aventis Pasteur "Fluzone"
Japanese Encephalitis	Inactivated virus	SC		Aventis Pasteur "JE-VAX"
Lyme disease	Inactivated protein	IM		SmithKline Beecham "LYMErix"
Measles	Live virus	SC	Still being manufactured?	Merck "Attenuvax"
Meningococcal	Polysaccharide	SC		Aventis Pasteur "Menomune"
MMR	Live viruses	SC		Merck "M-M-R II"
Measles-Rubella	Live viruses	SC	Still being manufactured?	Merck "M-R-Vax"
Mumps	Live virus	SC	Still being manufactured?	Merck "Mumpsvax"
Pertussis	Inactivated bacteria	IM	Not sure this is still being manufactured; may be available in Michigan only.	BioPort
Plague	Inactivated bacteria	IM
Pnemococcal	Polysaccharide	IM or SC		Merck "Pneumovax23", Wyeth-Lederle "Prevnar"
Polio (IPV)	Inactivated virus	SC		Aventis Pasteur "IPOL"
Polio (OPV)	Live virus	Oral
Rabies	Inactivated virus	IM or ID		BioPort, Aventis Pasteur "Imovax"
Rubella	Live virus	SC	Still being manufactured?	Merck "Meruvax"
Tetanus	Toxoid	IM		Aventis Pasteur "Tet Tox"
Typhoid	Inactivated bacteria	SC
Typhoid	Polysaccharide	SC (boosters may be ID)		Aventis Pasteur "TYPHIM Vi"
Varicella	Live virus	SC		Merck "VARIVAX"
Yellow Fever	Live virus	SC		Aventis Pasteur "YF-VAX"

SC = subcutaneous, ID = intradermal; IM = intramuscular.

DEVELOPMENTAL TESTS

Test Name, Acronym, Year Published, Number of Copies

A

Adolescent Language Screening Test, ALST, 1984 (1)

Ammons & Ammons Quick Test, 1969 (1) (469 A/3^rd Floor)

Aphasia Diagnostics Profiles, 1992 (1)

Aphasia Language Performances Scale, ALPS, 1975 (5)

Apraxia of Speech Stimulus Library, 1993 (1)

Arizona Articulation Proficiency Scale 2^nd Edition, 1994 (1)

Arizona Articulation Proficiency Scale 3^rd Edition, 2002 (1)

Arizona Battery for Communicative Disorders of Dementia, ABCD, 1990 (5)

Assessment of Children’s Language Comprehension, ACLC, 1973 (1)

Assessment of Intelligibility of Dysarthric Speech, 1984 (1)

Assessment of Phonological Processes-Revised, APP-R, 1986 (3)

Auditory Discrimination Test, 1973 (1) (469 A/3^rd Floor)

Auditory Memory Span Test, 1973 (1)

B

Bankson Berthal Test of Phonology, BBTOP, 1990 (1)

Bedside Evaluation & Screening Test, 1987 (1)

Bersil Spanish Test Secondary, 1977 (1)

Bicultural Test of Nonverbal Reasoning, 1977 (1), (469 A/3^rd Floor)

Boehm Test of Basic Concepts Spanish and English, 1972 (2)

Boston Diagnostic Aphasia Examination 3^rd Edition, BDAE, 2001 (1)

Boston Naming Test, 1983 (6)

Bracken Basic Concepts Scale, 1984 (1)

C

Carolina Picture Vocabulary Test, CPVT, 1985 (1)

Carrow Screening Test for Auditory Comprehension of Language, 1973 (2)

Clinical Assessment of Articulation and Phonology, CAAP, 2002 (3)

Clinical Evaluation of Dysphagia (in protocol file)

Clinical Evaluation of Language Fundamentals – Preschool, CELP-P, 1992 (2)

Clinical Evaluation of Language Fundamentals 4^th Edition, Screening Test, CELF-4

Screening Test, 2004 (1)

Clinical Evaluation of Language Fundamentals 3rd Edition, CELF-3, 1995 (1) (469 A/3^rd

Floor)

Clinical Evaluation of Language Fundamentals 4^th Edition, CELF-4, 2003 (2)

Communication Sequences: Language, 1972 (1)

Communication Activities of Daily Living, CADL, 1999 (1)

Comprehensive Apraxia Test, 1989 (1), 469A only

Comprehensive Receptive & Expressive Vocabulary Test, CREVT, 1994 (2)

Compton Phonological Assessment of Children, 1986 (2)

Compton Phonological Assessment of Foreign Accent, 1983 (1)

Contextual Test of Articulation, 2000 (1)

D

Deep Test of Articulation, 1968 (1) (469 A/3^rd Floor)

Del Rio Language Screening Test Spanish/English, 1975 (1)

Detroit Test of Learning Aptitude – 4, DLTA-4, 1998 (1)

Detroit Test of Learning Aptitude – Adult, DLTA-A, 1991 (1)

Development of Observation Checklist Systems, DOCS, 1994 (2)

Developmental Sequence Scoring, DSS, 1971 (1) (469 A/3^rd Floor)

Developmental Test of Visual-Motor Integration, DMVI, 1967 (3)

Discourse Comprehension Test, 1993 (1)

E

Early Language Milestone Scale, 1983 (1)

Edinburgh Functional Communication profile, EFCP, 1984 (1)

Environmental Language Inventory, ELI, 1978 (2)

Environmental Pre-language Battery, 1978 (1)

Examining for Aphasia, 1954 (2)

Expressive One Work Picture Vocabulary Test, EOWPVT, upper extension, 1983 (1)

Expressive One Work Picture Vocabulary Test-Revised, EOWPVT-R, 1990 (1)

Expressive One Work Picture Vocabulary Test 3^rd Edition, 2000 (2 English/1 Spanish)

Expressive Vocabulary Test, EVT, 1997 (2)

F

Fisher-Logemann Test of Articulation Competence, 1971 (3)

Full Range Picture Vocabulary Test, 1948 (1) (469 A/3^rd Floor)

Functional Assessment of Communication Skills for Adults, 1995 (1)

Functional Linguistic Communication Inventory, 1994 (1)

Functional Communication Profile – Revised, 1995 (1)

Fundamental Speech Skills Test, FSST, 1990 (1)

G

Gessell Infant and Preschool Assessment, 1979 (1)

Gillian Autism Rating Scale, GARS, 1995 (1)

Goldman-Fristoe Test of Articulation, 2000 (4)

Goldman-Fristoe-Woodcock Test of Auditory Discrimination, 1970 (2)

Goodglass & Kaplan Assessment of Aphasia and Related Disorders, 1983 (1)

Grandfather Passage

Gray Oral Reading Test Revised, GORT-R, 1986 (2)

H

Hodson Assessment of Phonological Patterns, HAAP-3 (1)

I

Illinois Test of Psycholinguistic Abilities 3^rd Edition, ITPA-3, 2001 (1)

K

Khan-Lewis Phonological Analysis, 2002 (3 + front desk copy)

L

Language Modalities Test for Aphasia, 1961 (2)

Language Rehabilitation: Auditory Comprehension, 1981 (1)

Language Rehabilitation: Reading, 1981 (1)

Language Rehabilitation: Verbal Expression, 1981 (1)

Learning Accomplishment Profile - Revised, 1977 (1)

Learning Efficiency Test – Revised, LET-R, 1992 (1)

Lindamood Auditory Conceptualization Test, LACT, 1971 (2)

Ling (in protocol file)

Los Ninos Spanish/English Screening Test, 1978 (2) (469 A/3^rd Floor)

M

MacAuthur Communicative Development Inventories, 1993 (1)

Memory for Design Test, 1968 (1) (469 A/3^rd Floor)

Mini Inventory of Right Brain Injury, MIRBI, 1965 (1)

Minnesota Test for Differential Diagnosis of Aphasia, 1989 (2)

Motor-Free Visual Perception Test, MVPT, 1972 (1)

N

Neurosensory CTR Comprehensive Exam for Aphasia, 1973 (2)

Northwestern Syntax Screening Test, 1971 (2)

O

Oral and Written Language Scales, OWLS, 1995 (1)

Oral Speech Mechanism Screening Examination – Revised, OSMSE-R, 1978 (1)

Oral Speech Mechanism Screening Examination 3^rd Edition, OSMSE-3, 2000 (1)

P

Parent Diagnostic Questionaire, 1978 (protocol only)

Peabody Picture Vocabulary Test-III Form A, 1997 (3)

Peabody Picture Vocabulary Test-III Form B, 1997 (5)

Peabody Picture Vocabulary Test Technical Reference Book for Form A and B (4)

Phonological Awareness Test, 1997 (1)

Photo Articulation Test, PAT, 1969 (2)

Porch Index of Communicative Ability in Children, PICAC, 1967 (2)

Pre-reading Screening Procedures, 1977 (1)

Preschool Language Scale – 3, PLS-3, 1992 (3)

Preschool Language Scale – 4, PLS-4, 2002 (4 + Manipulative box)

Psycholinguistic Assessments of Language Processing in Aphasia, PALPA, 1974 (1)

R

Rating Scale of Communication in Cognitive Decline, 1990 (1)

Raven’s Colored Progress Matrices, 1962 (1)

Reading Comprehension Battery for Aphasia 2^nd Edition, RCBA, 1998 (1)

Receptive-Expressive Emergent Language Scale – 2, REEL-2, 1991 (1)

Receptive-Expressive Emergent Language Scale – 3, REEL-3, 2002 (1)

Receptive One-Word Picture Vocabulary Test, 2000 (3 English + 1 Spanish)

Recognition Memory Test, 1984 (1)

Revised Token Test, 1978 (1)

Right Hemisphere Language Battery, 1989 (1)

Riley Articulation and Language Test, 1966 (2) (incomplete)

Riley Articulation and Language Test Revised, 1971 (1) (incomplete)

Riley Motor Problems Inventory, 1976 (1) (incomplete)

Rivermead Behavioral Memory Test for Adults Ages 16-69+, 1991 (1)

Rivermead Behavioral Memory Test for Children Ages 5-10, 1991 (1)

Ross Information Processing Assessment, RIPA, 1986 (1)

Ross Information Processing Assessment 2^nd Edition, RIPA-2, 1996 (2)

Ross Information Processing Assessment – Geriatric, RIPA-G, 1996 (2)

Ross Test of Cognitive Process, 1979 (1)

Rosetti Infant Toddler Language Scale, 1990 (3)

S

SCAN-C: Test for Auditory Processing Disorders in Children-Revised, 2000 (1)

Severe Impairment Batter, SIM (1)

School-Aged Student Who Stutters, 2002 (1)

Screening Speech Articulation Test, 1970 (3)

Screening Test for Developmental Apraxia of Speech, STDAS, 1980 (1)

Screening Test of Spanish Grammar, 1973 (2)

Sequenced Inventory of Communicative Development – Revised, SICD-R, 1984 (1)

Sklar Aphasia Scale, 1973 (1)

Slingerland Screening Tests for Identifying Specific Language Impairment Form A,

Form B, and Form C, 1984 (1)

Slingerland Screening Tests for Identifying Specific Language Impairment Form D, 1974

(1)

Slingerland High School Level Screening Tests, 1993 (1)

Structured Photographic Expressive Language Test, SPELT-2, 1983 (1)

Structured Photographic Expressive Language Test, SPELT-3, 2003 (1)

Structured Photographic Expressive Language Test Preschool, SPELT-P, 1983 (1)

Stuttering Prediction Instrument for Young Children, 1982 (2)

Stuttering Severity Instrument for Children and Adults 3^rd Edition, SSI-3, 1994 (2)

Successful Stuttering Management Program (1)

Swrl /s/ Speech Articulation Kit, 1973 (1)

T

Templin Darley Test of Articulation 2^nd Edition, 1969 (4)

Test of Adolescent Language, TOAL, 1980 (1)

Test of Adolescent Language 3^rd Edition, TOAL-3, 1994 (1)

Test of Auditory Perceptual Skills – Revised, TAPS-R, 1996 (2)

Test of Auditory Comprehension of Language, TACL-3, 1999 (1)

Test of Early Language Development 2^nd Edition, TELD-2, 1991 (1)

Test of Early Language Development 3^rd Edition, TELD-3, 1996 (1)

Test of Early Reading Ability 2^nd Edition, TERA-2, 1989 (1)

Test of Examining Expressive Morphology, TEEM, 1983 (1)

Test of Language Competence – Expanded Edition, TLC, 1988 (1)

Test of Language Development – Intermediate 3^rd Edition, TOLD-I3, 1997 (2)

Test of Language Development – Primary 3^rd Edition, TOLD-P3, 1997 (3)

Test of Non-Verbal Intelligence 2^nd Edition, TONI-2, 1992 (1)

Test of Oral Structures and Functions, TOSF, 1986 (2)

Test of Reading Comprehension, TORC, 1978 (1)

Test of Relational Concepts, TRC, 1988 (1)

Test of Sensory Function in Infants, TSFI, 1993 (1)

Test of Syntactic Abilities, 1978 (1)

Test of Word Finding, TWF, 1986 (1)

Test of Written Language, TOWL, 1981 (1)

U

Utah Test of Language Development – Revised, 1978 (1)

W

Western Aphasia Battery, 1982 (1)

Wide Range Achievement Test, WRAT, 1965 (1)

Wiig Assessment of Basic Concepts, WABC, 2004 (1)

Wisconsin Card Sorting Test, 1993 (1)

Woodcock Language Proficiency Battery Revised, 1991 (1)

Word Test – Revised Elementary, 1990 (1)

Word Test 2 – Test of Expressive Vocabulary and Semantics: Elementary, 2004 (1)

Word Test 2 – Test of Expressive Vocabulary and Semantics: Adolescent, 2004 (1)