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NPS Lectures > AP: CNS Neoplasms 1 & 2 > Flashcards

AP: CNS Neoplasms 1 & 2 Flashcards

1
Q

What are trasncalvarial herniations?

A

Brain herniating out through defect (skull defect, traumatic, surgical).

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2
Q

What are three causes of communicating hydrocephalus (obstruction of CSF pathway in subarachnoid space)?

A
  • Inflammation (meningitis)
  • Haemorrhage (subarachnoid haemorrhage)
  • Tumour within the subarachnoid space (meningeal carcinomatosis)
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3
Q

What are some causes of non-communicating hydrocephalus (obstruction to CSF pathways within ventricular system)?

A
  • Congenital malformations.
  • Inflammatory processes.
  • Tumours.
  • Haemorrhage.
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4
Q

What are common sites of obstruction in non-commouncating hydrocephalus?

A
  • Foramen of Monro (interventricular foramen)
  • Aqueduct of Sylvius (cerebral aqueduct)
  • Exit foramina of the fourth ventricle
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5
Q

How is cerebral oedema classified?

A
  1. Vasogenic
  2. Cytotoxic
  3. Interstitial/hydrocephalic
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6
Q

What is vasogenic cerebral oedema?

A

Most common type - results from increased permeability of endothelium of the cerebral vasculature, which forms the blood brain barrier.

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7
Q

What is cytotoxic cerebral oedema?

A
  • Excessive amounts of water entering one or more cellular populations (because of changes at cellular level).
  • Results from injury impairing cellular capacity to maintain ionic haemostasis.
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8
Q

What is interstitial cerebral oedema?

A
  • The accumulation of CSF in extracellular spaces and periventricular white matter.
  • CSF collects in obstructed ventricles.
  • Pressure increased, CSF forced across ependymal linings into extracellular glial tissue spaces.
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9
Q

How are CNS tumours classified?

A
  • Primary neoplasm.
  • Secondary or metastatic neoplasm.
  • Pseudoneoplastic lesion.
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10
Q

What are the two different growth patterns considered in primary neoplasms?:

  • _____ vs _____.
  • _____ vs _____.
A
  • Compression vs. infiltration.
  • Diffuse vs. circumscribed gliomas.
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11
Q

What are the clinical effects of CNS neoplasms?

A

Localised:

  • Loss of function/neurological deficits
  • Inappropriate excitation/seizures

Generalised:

  • Raised ICP
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12
Q

What is the function of oligodendrocytes?

A

Make and maintain myelin

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13
Q

What were the 4 grades under the WHO grading scale?

A

WHO Grade 1:

  • low proliferative potential
  • potential for cure with resection

WHO Grade 2:

  • tendency to progress with recurrence
  • survival >5 years

WHO Grade 3:

  • post operative adjuvant treatment
  • survival 2-3 years

WHO Grade 4:

  • malignant microscopy
  • rapid pre- and post- evolution, fatal
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14
Q

Where are gliomas normally found across the lifespan?

A

Kids: brainstem, cerebellum and midbrain

Adults: cortex, spinal cord

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15
Q

What is an astrocytoma?

A

Diffuse astrocytoma = morphological and biological continuum ranging from well differentiated to highly anaplastic lesion.

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16
Q

What are 2 possible signs of Grade IV Astrocytoma (Glioblastoma)?

A
  • Necrosis and/or
  • Endothelial proliferation (piling up of cells in vascular tube).
17
Q

What proportion of glioblastomas are primary/secondary, and what gene variations are they related to?

A
  • Primary 90-95%, Older
    • EGFR amp
    • PTEN deletion
  • Secondary 5-10%, Younger
    • p53 mutation
    • IDH mutation
18
Q

What is glioblastoma multiforme? (5 points)

A
  • White matter of hemispheres
  • Variegated
  • Haemorrhage
  • Necrosis
  • Thrombosed vessels
19
Q

What is an independent prognostic factor for anaplastic gliomas and glioblastomas?

A

IDH1 and IDH2

20
Q

MENINGIOMAS

  • Where are they most often derived from?
  • Desribe their growth pattern.
  • Circumscribed: Y/N?
A
  • Almost invariably derived from dura.
  • Grow locally and tend to be circumscribed.
  • Some will invade, but push the brain.
21
Q

What are stereotypic features of meningioma?

A

Behaviour is highly variable

  • Whorls
  • Syncytial arrangements
  • Nuclear pseudoinclusions
  • Psammoma bodies
  • Stromal calcification
22
Q

What is a schwannoma/neurilemmoma?

A

Benign peripheral nerve sheath tumour that classically involve the acoustic cranial nerve

23
Q

What proportion of CNS tumours do metastases make up? Where do they commonly come from?

A

20-25%

Lung, Breast, Melanoma, Renal, GIT

24
Q

What is a pituitary adenoma?

A
  • 10-15% intracranial neoplasms.
  • Have a mass effect.
  • Apoplexy, haemorrhage.
  • Peptide production (GH, ACTH, Prolactin, TSH etc).
  • Pituitary deficiencies.

NPS Lectures (36 decks)

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