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Neuro Block 2 > (31A) Tumors of CNS > Flashcards

(31A) Tumors of CNS Flashcards

1
Q

tumors that originate from astrocytes/glial cells

A

glioma, ependymoma, oligiodendroglioma

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2
Q

tumors that are classified as “nerve tumors”

A

schwannoma and neurofibroma

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3
Q

What are the common types of cancers that metastasize to the CNS

A

Giant Retards Love Brain Mets

GI 
Renal Cell Carcinoma
Lungs
Breast 
Melanoma
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4
Q

origin of meningioma

A

arachnoid cap cells

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5
Q

definitive risk factors for CNS tumors

A

ionizing radition, genetic syndromes, immunosuppression

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6
Q

need to know hereditaty syndromes that are assc with brain tumors

A

??

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7
Q

What effect does an increase in intracranial volume have on intracranial pressure

A

pressure stays constant until the compliance threshold has been reached. at this point small changes in volume will cause a large increase in pressure

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8
Q

What is the plateau wave phenomenon?

A

?? cant find on google

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9
Q

general signs of CNS tumor vs focal signs of CNS tumor

A

general: headache, vomitting, mental status change
focal: papilledema, seizures, focal neuro deficits

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10
Q

specifically what characteristics of a headache are red flags for CNS tumor

A

worse upon awakening and improvement within 1 hr

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11
Q

specifically what characteristics of a vomitting are red flags for CNS tumor

A

vomit immediately after onset of headache (suggesting inc ICP)

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12
Q

_____ herniation compresses the ACA

A

subfalcine

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13
Q

____ herniation causes ipsilateral occulomotor N palsy and contra or ipsilateral hemiparesis

A

uncal

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14
Q

_____ herniation causes horners syndrome + contralateral hemiparesis

A

upward through tentorium

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15
Q

_____ herniation causes only horners syndrome

A

diencephalic

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16
Q

____ herniation causes changes in BP, RR, and horner’s

A

tonsillar

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17
Q

CT or MRI to detect CNS tumors

A

MRI

*CT is good for calcifications which can tell you the pathology of the tumor

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18
Q

T1 vs T2 weighted MRI scans

A

T1 contrast only gets in tumors

T2 edema and tumor appears hyperintense (edema spares the cortex though so anything in the cortex is tumor!)

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19
Q

What is the most common primary CNS tumor

A

glioma

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20
Q

___ grade gliomas are more commonly seen in children.

A

low

high grade = adults

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21
Q

low or high grade tumors are well differentated

A

low

*de-differentation is bad and = high grade

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22
Q

necrotic centers is a feature of a high or low grade glioma

A

high

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23
Q

surrounding edema is a feature of a high or low grade glioma

A

high

24
Q

treatment that produces rapid but temporary improvement of glioma symptoms

A

STEROIDS–they reduce the swelling and restore BBB

25
Q

seizures from a glioma are treated with (enzyme inducing or non-enzyme inducing) anti-seizure drugs

A

non-enzyme inducing

26
Q

normal tissue and tumor recieve the same dose of radiiation

A

conventional/2D RT

27
Q

chemo that is the std of care for glioma

A

temozolomide

28
Q

genetic testing for ____ is needed before temozolomide

A

MGMT = need to have active MGMT to see response from temozolomide

29
Q

drug used to treat gliomas that reoccured

A

bevacizumab

30
Q

survival with a glioma is better if the pt has what genes?

A

MGMT active
isocitrate dehydrogenase mutation
1p and 19q deletion in oligiodendroglioma

31
Q

meningioma is derived from

A

arachnoid cap cells

32
Q

Who gets meningioma

A

45 yo; women

33
Q

meningioma is a slow growing or aggressive tumor

A

slow growing

34
Q

characteristic MRI finding for a meningioma

A

diffuse enhancement + dural tail

35
Q

meningiomas are axial or extra axial tumors

A

extra axial

36
Q

pituitary tumors are usually from the (ant or post) pit

A

anterior

37
Q

microademomas are usually (non-functional or functional)

A

functional (make hormones)

macro are non-functional

38
Q

signs/symp of pituitary tumors

A

headache, endocrine dysfunction, vidula defects (due to compression of optic chiasm)

39
Q

treatment for PRLomas

A

DA agonists

40
Q

origin of acoustic neuroma

A

schwann cells surrounding CN VIII > CN V > spinal radicles

41
Q

Where do acoustic neuromas arise?

A

internal auditory meatus or cerebelloponitine angle

42
Q

who gets acoustic neuromas

A

middle aged; M = F

43
Q

acoustic neuromas are (slow growing or aggressive tumors_)

A

slow growing

44
Q

how might an acustic neuroma present

A

hearing loss, tinnitus, headache, TN, ataxia

45
Q

where do primary CNS lymphomas arise

A

leptomeninges and deeper periventricular brain parenchyma

46
Q

how is primary CNY lymphoma different from the other adult primary CNS tumors?

A

multiple masses

47
Q

Other than a scan how can PCNSL be diagnosed

A

LP contains monoclonal B cells in CSF

48
Q

treatment for PCNSL

A

steroids but give AFTER biopsy otherwise you get a poor specimen for pathology (cells die quickly**

49
Q

PCNSL is highly sensitive to

A

chemo and radiation therefore you can get CR and cure in younger pts

50
Q

what is the treatment of choice for brain mets if there is progressive extracranial dz

A

whole brain radiation

51
Q

diff dz for ring enhancing lesions on MRI

A

mets, CVA, demylenation, high grade glioma, lymphoma

52
Q

signs and symptoms of a spinal cord tumor

A

pain, weakness, and parasthesis

53
Q

most common extradural tumors of spinal cord

A

mets

54
Q

most common intradural and extramedullary spinal cord tumors

A

schwannomas, neurofibromas, maningiomas

55
Q

most common intradural and intramedullary spinal cord tumors

A

astocytomas (ped), ependymoma (adults), hemangioblastoma

Neuro Block 2 (22 decks)

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