Question

A diagnostic workup is being performed on a 1-year-old child with suspected neuroblastoma. The nurse reviews the results of the diagnostic tests and understands that which finding is most specifically related to this type of tumor?

1.Positive Babinski's sign
2.Presence of blast cells in the bone marrow
3.Projectile vomiting, usually in the morning
4.Elevated vanillylmandelic acid urinary levels

Answer 1

Elevated vanillylmandelic acid (VMA) urinary levels are most specifically related to neuroblastoma, as VMA is a breakdown product of catecholamines, which are often overproduced by neuroblastomas.

Step-by-step explanation:

A 1-year-old child with suspected neuroblastoma would most specifically have elevated levels of vanillylmandelic acid (VMA) in the urine. This metabolite is a breakdown product of catecholamines, which are often produced in excess by neuroblastomas. In contrast, a positive Babinski's sign would be more indicative of an upper motor neuron lesion rather than specifically to neuroblastoma. The presence of blast cells in the bone marrow could suggest a hematological malignancy rather than neuroblastoma. Projectile vomiting is a common sign of increased intracranial pressure, which may or may not be related to neuroblastoma. Therefore, elevated VMA is the finding most specifically associated with neuroblastoma.