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ABPP > Brain tumors > Flashcards

Brain tumors Flashcards

1
Q

Peak incidence of brain tumors in adults

A

74-84 yrs of age; avg age of onset is 54

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2
Q

Localizing symptoms of supratentorial tumors

A

Unilateral or migraine-type HAs, endocrine abnormalities, focal & generalized seizures, focal neurologic findings

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3
Q

Benign tumors

A

Do not invade nearby cells, tend to be circumscribed & well-differentiated, resemble cell of origin Can undergo malignant transformation & given their location, can become lethal

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4
Q

Anaplastic astrocytoma is most common in the

A

Cerebral cortex (adults), brainstem & cerebellum (children)

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4
Q

Effects of brain tumor chemotherapy treatment on CNS

A

WM particularly vulnerable Onset of changes may be delayed by months Evidence that chemo for non-cerebral tumors can impact functioning as well

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5
Q

Meningiomas are most common where?

A

Along the superior sagittal sinus, sphenoid ridge, & near optic chiasm

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6
Q

Most common sources for metastatic brain tumors

A

Lung (35-50%), breast (13-20%), melanoma (9-10%)

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8
Q

Most common brain tumors in adults

A

Glioblastoma & brain metastases; meningioma, schwannoma

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8
Q

Angioma

A

Congenital vascular malformation involving blood vessel proliferation that resembles a tumor

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9
Q

Short-term effects of chemotherapy for pediatric brain tumors

A

Drops in fine motor speed/coordination, performance on drawing/copying tasks

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9
Q

Radiation necrosis

A

Cerebral infarction from occlusion of small cerebral vessels that are damaged during high-dose radiation therapy for brain tumors; does not typically appear until approx. 6-18 mos after radiation therapy is complete

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10
Q

What types of cancers are most frequently associated with paraneoplastic syndromes?

A

Small cell lung, breast, testicular, ovarian

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11
Q

What type of chemotherapy is most common associated with neurocognitive effects in children?

A

High-dose IV cytarabine or methotrexate or intrathecal methotrexate

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11
Q

Olfactory groove meningioma

A

Tumor that originates in arachnoidal cells along the cribiform plate; may involve ipsilateral or bilateral anosmia & mental changes, including abulia, confusion, forgetfullness, & inappropriate jocularity

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12
Q

Effects of brain tumor radiation treatment on the CNS

A

Causes apoptosis in tumor cells & in non-tumor cells Dose-limited neurtoxicity is assoc. w/ spongiosis of the WM & vacular damage Can have both acute & delayed effects Impairements of memory & processing speed common

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13
Q

Predictors of poorer psychological outcome following pediatric brain tumors

A

Low child IQ, single parent family, low SES, higher family stress, mod-sev disfigurement, certain tumor locations, severe fx impairment

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14
Q

Paraneoplastic syndrome

A

Rare neurologic disorder caused by remote effects of cancer in the body leading to autoimmune response

16
Q

CNS lymphoma is more common where?

A

Around ventricles

17
Q

Risk factors for developmental stagnation after cranial irradiation

A

Younger age at time of treatment, higher dose of radiation, use of adjuvant therapies, higher baseline functioning = greater decline in overall IQ

18
Q

Anaplasia

A

Loss of cell differentiation that is characteristic of most malignant tumors

19
Q

What do declines in cognitive status with increasing time since radiotherapy treatment in children actually represent?

A

Stagnation in development rather than regression

21
Q

Grade IV tumor

A

High-grade malignant tumor, rapid growth, high infiltration potential, not encapsulated, identified in multiple areas of brain, high recurrence potential

21
Q

Academic outcome following pediatric brain tumor

A

57% have specific academic deficits, mostly arithmetic Those w/ hydrocephalus are particularly at risk Tx involving IT methotrexate & cranial RT either alone or in combo sig. increases likelihood for need of SPED services

23
Q

Nonspecific signs of pediatric brain tumors

A

Developmental delays or regression, signs of increased ICP, increased fatigue, irritability, papilledema

24
Q

Emotional distress following pediatric brain tumor

A

Mild withdrawal & social deficits in subset Significant parental distress & poor family functioning PTS symptoms are present in family members of survivors & less consistently in survivors themselves

26
Q

GBMs are most common in the

A

Cerebral cortex

26
Q

Radiation-associated encephalopathy

A

From radiation tx of tumors; associated with demyelination & necrosis; appears as subcortical dementia

27
Q

Schwannomas are most common on

A

CN VIII

28
Q

What is the most common type of paraneoplastic syndrome?

A

Limbic encephalitis w/ personality changes, memory loss Associated with non-systemic cancer, long/oat cell carcinoma, ovarian

29
Q

Prognosis for metastatic brain tumors is better with the following factors

A

Better for age

30
Q

Lambert-Eaton syndrome

A

Impaired presynaptic Ach release; paraneoplastic syndrome

32
Q

Radiotherapy in children is associated with what NP effects?

A

Visual motor integration, verbal fluency, visual memory, exec fx (no single profile); relatively intact verbal memory & language skills

33
Q

Malignant tumors

A

Anaplastic (cannot be clearly demarcated), usually proliferate rapidly, invade & destroy nearby cells

34
Q

Ependymoma

A

CNS neoplasm made up of relatively undifferentiated ependymal cells (usu. from central canal of spinal cord)

35
Q

Grade II tumor

A

Low grade malignant tumor, slowly growing, low infiltration potential, encapsulated but w/ poorly defined borders, greater potential for recurrence than I

36
Q

Oligodendrogliomas are most common in the

A

frontal lobes

37
Q

Common types of brain tumors in children

A

Low-grade astrocytomas, primitive neuroectodermal tumors (medulloblastoma most common), high-grade gliomas (more common in adults)

38
Q

Grade I tumor

A

Low grade, slowly growing, low infiltration potential, encapsulated with clearly defined borders, tend not to recur

39
Q

Treatment for brain tumors depends on what 3 factors?

A

Histological type, location, size

40
Q

Grade III tumor

A

High-grade malignant tumor, rapid growing, high infiltration potential, poorly encapsulated, tend to recur

41
Q

Localizing symptoms of infratentorial tumors

A

HA, nausea, persistent vomiting, balance problems & gait disturbances, signs of CN dysfx

ABPP (34 decks)

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