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Neurology > Brain Tumours > Flashcards

Brain Tumours Flashcards

1
Q

What area of the brain may be affected if patient is demonstrating problems with balance and coordination?

A

Cerebellum

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2
Q

Where might the tumour be if the patient is showing behavioural changes, abnormal emotional responses, and problems with their hearing and vision?

A

Temporal Lobe

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3
Q

What lobe is implicated when the patient is showing problems with their thought, reasoning, behaviour, smell, memory and movement.?

A

Frontal lobe

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4
Q

What lobe is involved if patient demonstrates symptoms involving their hearing, sensation, reasoning, intellect, thought and memory?

A

Parietal Lobe

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5
Q

What area of the brain could be affected if patient is showing abnormal speech, motor and sensory functions along with vision problems?

A

Left occipital lobe

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6
Q

What area of the brain could be affected if patient is demonstrating abstract concept problems and vision problems?

A

Right occipital lobe

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7
Q

What cells are found in astrocytic tumours?

A

Glial cells

Oligodendrocytes

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8
Q

How are astrocytic tumours graded?

A

Using the WHO grading

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9
Q

What is a grade 1 astrocytoma?

A

Benign slow growing astrocytoma with 97% 5 year survival rate?

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10
Q

What category of patients are grade 1 astrocytoma’s commonest in?

A

Children and young adults

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11
Q

What is the treatment for a grade 1 astrocytoma?

A

Surgery = curative

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12
Q

Do grade 1 astrocytoma’s have malignant potential?

A

Yes
Slowly may progress into malignancy if left untreated
Progression accompanied by increased neurological symptoms

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13
Q

What are some negative prognostic factors in grade 1 astrocytoma’s?

A 
>50y/o
Focal deficits
Altered consciousness
Sudden onset/short duration of symptoms
Increased ICP
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14
Q

What is the main presenting symptom in low grade astrocytoma?

A

Seizures

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15
Q

What are the treatments for grade 2 astrocytoma?

A

Surgery +/-
Chemo and radiotherapy
Depends on morphology

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16
Q

What are some negative prognostic factors in grade 2 astrocytoma’s?

A 
>45 y/o
>6cm diameter
incomplete resection during surgery
Tumour crosses midline 
Low performance score
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17
Q

What re grade 3 astrocytoma’s referred to as?

A

Anaplastic Astrocytoma’s

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18
Q

What is the median survival rate for anaplastic astrocytoma’s?

A

2 years

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19
Q

Surgery is curative in anaplastic astrocytoma - True/False

A

False

Can provide symptomatic relief

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20
Q

What is the most common primary brain tumour?

A

glioblastoma multiforme

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21
Q

What is the median survival rate for a glioblastoma multiforme?

A

<1 year

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22
Q

In malignant astrocytoma’s, what type of tumour has a better prognosis?

A

MGMT methylated tumour

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23
Q

Where are oligodendroglia tumours mainly found?

A

Frontal lobe

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24
Q

What age group is most commonly affected by oligodendroglial tumours?

A

25-45 y/o

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25
Q

What is the main presentation of oligodendroglia tumours?

A

Seizures

26
Q

What is the appearance of an oligodendroglial tumour?

A

solid
Grey-pink in colour
Toothpaste consistency
Look for calcification and cysts

27
Q

What % of glial tumours are oligodendroglial tumours?

A

20%

28
Q

How do we treat oligodendroglial tumours?

A

Chemotherapy - procarbazine, vincristine Radiotherapy - decreases seizures
Surgery (only in lower grade)

29
Q

What is the median survival for (low grade) oligodendroglial tumours ?

A

10 years

30
Q

What are warning/red flag signs in children with potential brain tumours?

A

Tiptoeing
Ataxia
Vomiting with headache

31
Q

What is the most common type of extra-axial tumour?

A

Meningioma

32
Q

What do patients normally present with?

A

Most are asymptomatic
Headaches - at skull base
Regional anatomical disturbances

33
Q

Meningiomas are more common in Males/Females?

A

Females

34
Q

Meningioma’s are associated with what other type of cancer?

A

Breast cancer

35
Q

What chromosome s considered to be associated with meningiomas/breast cancer?

A

22q

36
Q

Meningioma’s are benign. True/false

A

True

In 90% of cases they are benign and slow growing

37
Q

List some types of aggressive meningiomas:

A

Clear cell
Choroid
Rhabdoid
Papillary

38
Q

What can occur in children who have previously suffered from leukaemia?

A

Radiation-induced meningiomas

Commonly found in the midline

39
Q

What treatment options are there for meningiomas?

A

Pre-op embolization
Surgery
Radiotherapy

40
Q

What is the median survival of meningiomas?

A

90% survival at 5 years

41
Q

What investigations are done for meningioma?

A

CT
MRI
Angiography - if planning embolization

42
Q

List a few examples of nerve sheath tumours:

A

Neurofibromas
Schwannomas
Malignant peripheral nerve sheath tumour (MPST)

43
Q

What condition is an acoustic neuroma associated with?

A

Neurofibromatosis II

44
Q

What are the symptoms of an acoustic neuroma?

A

Hearing loss
tinnitus
Disequilibrium

45
Q

What is an acoustic neuroma?

A

A schwannoma of the 8th cranial nerve

46
Q

Are acoustic neuroma’s benign?

A

Yes

Malignant transformation is extremely rare

47
Q

How are acoustic neuromas treated?

A

25% managed medically
50% surgically
Radiation, gamma knife etc

48
Q

What are some post op complications of acoustic neuroma surgery?

A

Facial palsy
Corneal reflex
Nystagmus
Abnormal eye movement

49
Q

What is a complication of gamma knife treatment in acoustic neuroma?

A

Gradual decline in hearing over the years

Vestibular function decreases in first months then stabilises

50
Q

What is the common group affected by germ cell tumours?

A

<20 years old
Peak age range 10-12
Males more than females

51
Q

What is the most common type of CNS germ cell tumour?

A

germinomas

52
Q

What is the survival rate of germinomas?

A

5 years 65-95% survival

53
Q

What therapy are germinoma’s particularly sensitive to?

A

Radiotherapy

54
Q

Where do roughly 11% of germinoma’s metastasize to?

A

Spine

55
Q

List some non-germinomatous germ cell tumours:

A

Teratoma
Yolk sac tumour
Choriocarcinoma
Embryonal carcinoma

56
Q

What tumour markers must you test for in a child with a midline brain tumour?

A

AFP
HCG
LDH
These detect different germ cell tumours

57
Q

What can be used to treat hydrocephalus?

A

A ventriculoperitoneal shunt

58
Q

How do you treat non-germinomatous germ cell tumours?

A

If benign operate
Radiotherapy 1st line (if >3y/o)
Chemotherapy 2nd line

59
Q

What is the survival rate for non-germinomatous germ cell tumours?

A

17-38% 5 year survival

60
Q

List the common presenting complaint in a person with a pituitary tumour?

A

Bitemporal hemianopia
Headache
Endocrine abnormalities e.g. galactorrhoea

61
Q

What condition would you suspect in a patient with pallor, yellowing skin, no axillary hair, puffy face and fine wrinkles but expressionless?

A

Panhypopituitarism

62
Q

What tests can be done to diagnose panhypopituitarism?

A

GH is the first hormone to decrease
Then LH and FSH
TSH, prolactin and ACTH will be the last hormones to decrease so test in that order

Neurology (15 decks)

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