brain and haematological tumors

Question 1

What in braintumors determines the kind of tumor (and how it behaves + treatment)?

Answer 1

The location and celtype

Question 2

What 5 different anatomy stations are there in braintumors? and what kind of symptoms can they give?

Answer 2

1. Supratentorieel: very broad symptomrange
2. Achterste schedelgroeve: Coördination, balance, cognictive processes.
3. Hersenstam: Breathing, vital functions
4. Spinale kanaal: fall out of functions beneath. Motorical and vital are on the same side, gnostic on opposite side.
5. Midline: diabetes insipidus, abnormal eye movement.

Question 3

How many cases of braintumors each year?

Answer 3

120

Question 4

What explains the difference in behaviour of tumor in the same anatomical area?

Answer 4

Molecular subgroups

Question 5

What are acute symptoms/ situations in brain tumors?

Answer 5

Elevated intracranial pressure, epileptic insult, impending spinal cord injury and endocrine (diabetes insipidus, renal gland insufficience)

Question 6

What are overall symptoms of braintumors?

Answer 6

Very aspecific symptoms, such as headache, nausea, vomiting, vision problems, confusion.
Also focal failure symptoms.

Question 7

What are pitfalls in diagnosing braintumors?

Answer 7

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)

Question 8

What is seen in the acute situation of a hydrocephalus?

Answer 8

Trias of cushing, headache, decreased awareness, visus complaints, divergent pupilreaction, nausea and vomiting, changed mental state.

Question 9

What is the trias of cushing?

Answer 9

Bradycardia, hypertension and irregular breathing.

Question 10

How can a hydrocephalus be treated?

Answer 10

Dexamethason, mannitol, hypertoon zout ter overbrugging

But, the neurosurgian is needed to make space.

Question 11

When is sunset phenomena seen often?

Answer 11

Central DTH

Question 12

What can cause the acute situation of epileptic insult?

Answer 12

it is a disease of the neurons, so of the cortex. Things that can provoke the insult: tumor, OK, bleeding, elektrolyt disturbance, infection.

Question 13

What causes headache, vomiting, coördination disturbance and seeing dubble?

Answer 13

Increased intracranial pressure.

Question 14

What causes an increased skull size?

Answer 14

in children <1.5 it is caused by increased intracranial pressure.

Question 15

What causes decreased consciousness?

Answer 15

Increased intracranial pressure

Question 16

What causes failure of bladder or stool problems

Answer 16

Pressure on spinal cord (tumor spinal canal)

Question 17

Loss of strength or sensory disorder is caused by

Answer 17

PRessure on spinal cord (tumor spinal canal)

Question 18

What therapies can be given for braintumors?

Answer 18

Surgical resection is most important, next to that you can give radiotherapy, chemotherapy or immunetherapy.

Question 19

What are late effects of brain tumor and treatment?

Answer 19

Decreased IQ, emotional and social functioning, quality of life. Gives hormonal problems (higher risk CVA) and second tumors (skin, thyroid, bone).

Question 20

What did Alexander Fleming, the bombardment of Bari and Sidney Faber lead to/ find out?

Answer 20

Fleming: penicilline
Bombardement of Bari: Mosterdgas –> leukopenie –> alkylerende cytostatica
Faber: Foliumzuur

Question 21

How do alkylating cytostatica, antimetabolics, antimitotic vinca-alkaloids, cytostatic AB and topo-isomerase work?

Answer 21

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.

Question 22

Of ALL, AML, hodgkin, non-hodgkin; which one is most prevalent?

Answer 22

ALL

Question 23

… of all malignancies in children is haematological

Answer 23

1/3

Question 24

How can cells in haematological oncologies be differentiated?

Answer 24

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

Question 25

How does immunotherapy work?

Answer 25

Works on CD-markers. If you label a medicine to a CD-receptor, only that specific cell will be attacked.

Question 26

What is the “philedelphia chromosome” and how can you treat this?

Answer 26

Chromosome 22 and 9 are attached together. This forms BCR-ABL gene. Codes for a fusion protein –> BCR-ABL tyrosinokinase. It can be treated with a tyrosinokinase remmer, for example imatinib.

Question 27

What are side effects of corticosteroïd treatment (dexametason)?

Answer 27

Kinderen worden een draak, ook kan je depressief van worden. Next to that cortico’s can cause DM or botonkalking.

Question 28

Asparginase can have the following side effects:

Answer 28

Allergies, pancreatitis!

Question 29

Vincristine can have the following side effects:

Answer 29

Obstipation, neuropathy

Question 30

Antracyclines can have the following side effects:

Answer 30

Cardiomyopathie! Also aplasia that causes immunodefficiancy. Thats why you always give AB.

Question 31

What are specific complaints of lymfoma?

Answer 31

1. Shortness of breath: door stapeling van maligne lymfocyten in lymfeklieren in borstholte, thymus.
2. Decreased miction: Lymfekliermassa kan afvoer nieren verminderen
3. Invagination: opgezette lymfeklieren rondom darmpakket vormen leadingpoint voor invaginatie.

Question 32

T-cel lymfoma is mostly localized in…

Answer 32

Thorax, where the thymus is

Question 33

B-cell lymfoma is mostly localized in…

Answer 33

Belly, where you can find the Burkitt-syndrome.