brain and haematological tumors Flashcards
What in braintumors determines the kind of tumor (and how it behaves + treatment)?
The location and celtype
What 5 different anatomy stations are there in braintumors? and what kind of symptoms can they give?
- Supratentorieel: very broad symptomrange
- Achterste schedelgroeve: Coördination, balance, cognictive processes.
- Hersenstam: Breathing, vital functions
- Spinale kanaal: fall out of functions beneath. Motorical and vital are on the same side, gnostic on opposite side.
- Midline: diabetes insipidus, abnormal eye movement.
How many cases of braintumors each year?
120
What explains the difference in behaviour of tumor in the same anatomical area?
Molecular subgroups
What are acute symptoms/ situations in brain tumors?
Elevated intracranial pressure, epileptic insult, impending spinal cord injury and endocrine (diabetes insipidus, renal gland insufficience)
What are overall symptoms of braintumors?
Very aspecific symptoms, such as headache, nausea, vomiting, vision problems, confusion.
Also focal failure symptoms.
What are pitfalls in diagnosing braintumors?
The symptoms look like that of other diseases (1), the symptoms can vary over time (2), normal neurological research does not mean there is no braintumor (3)
What is seen in the acute situation of a hydrocephalus?
Trias of cushing, headache, decreased awareness, visus complaints, divergent pupilreaction, nausea and vomiting, changed mental state.
What is the trias of cushing?
Bradycardia, hypertension and irregular breathing.
How can a hydrocephalus be treated?
Dexamethason, mannitol, hypertoon zout ter overbrugging
But, the neurosurgian is needed to make space.
When is sunset phenomena seen often?
Central DTH
What can cause the acute situation of epileptic insult?
it is a disease of the neurons, so of the cortex. Things that can provoke the insult: tumor, OK, bleeding, elektrolyt disturbance, infection.
What causes headache, vomiting, coördination disturbance and seeing dubble?
Increased intracranial pressure.
What causes an increased skull size?
in children <1.5 it is caused by increased intracranial pressure.
What causes decreased consciousness?
Increased intracranial pressure
What causes failure of bladder or stool problems
Pressure on spinal cord (tumor spinal canal)
Loss of strength or sensory disorder is caused by
PRessure on spinal cord (tumor spinal canal)
What therapies can be given for braintumors?
Surgical resection is most important, next to that you can give radiotherapy, chemotherapy or immunetherapy.
What are late effects of brain tumor and treatment?
Decreased IQ, emotional and social functioning, quality of life. Gives hormonal problems (higher risk CVA) and second tumors (skin, thyroid, bone).
What did Alexander Fleming, the bombardment of Bari and Sidney Faber lead to/ find out?
Fleming: penicilline
Bombardement of Bari: Mosterdgas –> leukopenie –> alkylerende cytostatica
Faber: Foliumzuur
How do alkylating cytostatica, antimetabolics, antimitotic vinca-alkaloids, cytostatic AB and topo-isomerase work?
Alkylating cytostatica: add an alkyl group, which causes it being impossible to read.
Antimetabolics: Look like metabolics, get build in instead of metabolics and brake the workingsmechanism.
Antimitotical vinca-alkaloiden: build in beta-tubuline which causes polymerisation to stop –> apoptosis.
Cytostatic antibiotics: break celdevision
anti topo-isomerase: By breaking this protein, DNA can’t be read.
Of ALL, AML, hodgkin, non-hodgkin; which one is most prevalent?
ALL
… of all malignancies in children is haematological
1/3
How can cells in haematological oncologies be differentiated?
With morphology: how do de cells look? Auerse staven are typical for AML
CD markers: every celtype has a specific marker–> immunofenotypying.
- Stamcellen: CD34 positive
