CPHON Late Effects of Childhood Cancer Treatment 2

Question 1

Which late effect is associated with bleomycin chemotherapy used in treatment of Hodgkin lymphoma?

Accepted Answer

Pulmonary fibrosis

Answer

Bleomycin causes inflammation and progressive fibrosis of the pulmonary parenchyma. Pulmonary fibrosis is the major dose-limiting late toxicity, potentially resulting in chronic restrictive lung disease.

Question 2

A 10-year-old who received high-dose methotrexate during ALL treatment now has difficulty with math and reading comprehension. Which pathologic mechanism best explains this?

Accepted Answer

Leukoencephalopathy from methotrexate-induced white matter damage

Answer

High-dose methotrexate can cause leukoencephalopathy—demyelination and white matter injury—leading to cognitive deficits in attention, processing speed, and academic skills.

Question 3

Which late effect monitoring test is most important for a childhood cancer survivor who received high-dose cisplatin?

Accepted Answer

Audiogram for sensorineural hearing loss

Answer

Cisplatin is ototoxic, causing permanent sensorineural hearing loss—particularly in high frequencies. Regular audiologic monitoring is essential for survivors who received cisplatin.

Question 4

A male survivor of childhood cancer who received testicular radiation or alkylating agents should be counseled about which reproductive late effect?

Accepted Answer

Azoospermia and infertility

Answer

Testicular radiation and alkylating agents destroy spermatogonia, leading to azoospermia and potential permanent infertility. Testosterone production may or may not be affected depending on Leydig cell damage.

Question 5

Which late effect is associated with corticosteroid use during childhood cancer treatment?

Accepted Answer

Avascular necrosis of bone

Answer

Prolonged high-dose corticosteroid use impairs blood supply to bone, most commonly affecting the femoral head and causing avascular necrosis (osteonecrosis), which can lead to joint collapse and chronic pain.

CPHON Exam Practice Test

CPHON Exam Practice Test

CPHON Late Effects of Childhood Cancer Treatment 2