Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Brain tumours > Flashcards

Brain tumours Flashcards

1
Q

What is a brain tumour?

A 
Growth of cells
Benign or malignant
Primary or secondary 
Supra or infratentorial 
Extrinsic or intrinsic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are common presentations for brain tumours?

A

Progressive neurological deficit
Motor weakness
Headache - raised ICP
Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can result in an increased ICP?

A

Contribution of mass within a rigid closed box
Tumour/ mass/ oedema mass effect
Hydrocephalus
Haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are symptoms of increased ICP?

A

Headaches
Vomiting
Mental changes
Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are different types of herniation?

A

Coning; tonsillar herniation
Uncal herniation
Subfalcine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is cushing’s reflex?

A

Hypertension
Bradycardia
Respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What occurs with an uncal herniation?

A

Ipsilateral blown pupil as the herniation presses on the 3rd CN (can also get down and out pupil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a bad sign with headaches?

A

If it wakes you up in the morning or worse in the morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What should be done immediately with a headache worse in the morning?

A

FUNDOSCOPY to look for papilloedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why will increased ICP result in vomiting?

A

Increased pressure on the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Will a headache associated with increased ICP get better or worse on coughing and leaning forward?

A

Worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should be given immediately if cushing’s triad is present?

A

Mannitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where should you look if there are metastases in the brain?

A

Testes
Breasts
Melanoma (moles, subungal)
Axillary freckling for NF1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are tumours of the neuroepithelial tissue?

A 
Astrocytes
Oligodendroglial cells
Ependymal cells/ choroid plexus
Neuronal 
Pineal 
Embryonic  - AFP, LDH, b-hcg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a grade 1 astrocytic tumour?

A

Pilocytic
Pleomorphic xanthoastroytoma
Subependymal glial cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a grade 2 astrocytoma?

A

Low grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a grade 3 astrocytoma?

A

Anaplastic astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a grade 4 astrocytoma?

A

Glioblastoma multiforme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe a grade 1 astrocytoma

A

Benign
Slow growing
Children and young adults
Cerebellum affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How are grade 1 astrocytomas treated?

A

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are poor prognostic factors associated with low grade astrocytomas?

A 
Age over 50 
Focal deficit
Short duration of symptoms
Raised ICP
Altered consciousness
Enhancement on contrast studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment of a grade 2 astrocytoma?

A

Surgery +/- radio and chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What will low grade astrocytomas commonly present with?

A

Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the median survival for an anaplastic astrocytoma?

A

2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the median survival for a glioblastoma multiforme?

A

14 months

26
Q

Where will a GBM spread?

A

White matter tracking through corpus callosum and corticospinal tracts

27
Q

What should you think about if there are multiple gliomas?

A

NF
Tuberous sclerosis
PML (Progressive multifocal leukoencephalopathy)

28
Q

What is the treatment for GBM?

A

Non curative surgery to reduce mass effect
Post-op radiotherapy
If MGMT promoter myelination; should get treatment with oral alkylating chemotherapy

29
Q

What will a GBM look like on MRI?

A

Heterogeneously enhancing SOL with areas of necrosis and a butterfly appearance

30
Q

What is the grading of gliomas based off?

A

Cellular and nuclear atypia
Mitotic activity
Vascular endothelial proliferation
Necrosis

31
Q

What do pilocytic astrocytomas look like pathologically?

A

Bipolar cells with long hair like projections

32
Q

What are common sites for pilocytic astrocytomas?

A

Cerebellum

Midline; thalamus or optic chiasm

33
Q

Where will oligodendrocytes grow?

A

Frontal lobe of cerebral hemisphere and can affect white matter and cortex

34
Q

From what cell type will meningiomas grow?

A

Arachnoid cap cells in the arachnoid membrane

35
Q

What is Foster Kennedy Syndrome?

A

Optic atrophy in ipsilateral eye and papilloedema int he contralateral eye

36
Q

What are the common presentations of meningiomas?

A

Headache

Increased ICP

37
Q

What are the clinical features of a prolactinoma?

A 
Amenorrhoea
Infertility
Galactorrhoea 
Loss of libido 
ED
38
Q

How are prolactinomas treated?

A

Dopamine agonist; cabergoline

Basically never operated on

39
Q

What are the clinical symptoms of a growth hormone secreting tumour?

A

Pre-puberty: gigantism

Post-puberty: acromegaly

40
Q

What tests should be run in the diagnosis of acromegaly?

A

Growth hormone levels
IGF-1 levels
OGTT

41
Q

What tests should be run to diagnose cushing’s disease?

A

Low dose dexamethasone test to confirm cortisol excess
High dose dexamethasone test to differentiate between adrenal or pituitary causes (high dose will suppress cortisol if the source is pituitary)

42
Q

How are pituitary tumours operated on?

A

Transsphenoidal hypophysectomy

43
Q

What is the medical management of a growth hormone secreting tumour?

A

Pegvisomant and a somatostatin analogue such as octreotide to shrink the tumour pre surgery

44
Q

What is the treatment of pituitary tumours if they are too large or are invading the cavernous sinus?

A

Radiotherapy

45
Q

What is a vestibular schwannoma?

A

Benign tumours of schwann cells at the cerebellopontine angle affect the vestibular portion of CN8

46
Q

What are the symptoms of a vestibular schwannoma?

A 
Unilateral: 
Tinnitus 
Vertigo 
\+/- headache
\+/- facial numbness
47
Q

What does a bilateral vestibular schwannoma indicate?

A

NF2

48
Q

What do vestibular schwannomas look like histologically?

A

Verocay bodies which are palisading nuclei against a fibrillary background

49
Q

What is a haemangioblastoma?

A

Benign, cystic, highly vascular tumour

50
Q

Where do haemangioblastomas originate?

A

Posterior fossa - resulting in cerebellar dysfunction and increased ICP

51
Q

What conditions are haemangioblastomas associated with?

A 
VHL: 
Haemangioblastoma 
Retinal angioma
Renal cell carcinoma 
Phaeo
52
Q

Describe an upper motor neurone lesion

A 
Hypertonia
Hyperreflexia
Spasticity 
\+ve babinski sign 
Clonus
53
Q

Describe a lower motor neurone lesion

A 
Hyporeflexia
Hypotonia 
Flaccid muscle weakness
Fasciculations 
Muscle atrophy
54
Q

How will children commonly present with brain tumours?

A

Tiptoeing
Ataxia
Vomiting with headache

55
Q

What occurring in childhood will increase the risk of developing a meningioma as an adult?

A

Radiotherapy e.g. child with leukaemia

Meningioma will typically present with midline shift in the frontal lobe

56
Q

What are the signs of a vestibular schwannoma?

A

Facial nerve palsy
Corneal reflex absent
Nystagmus
Hydrocephalus

57
Q

What should be performed in any child with a midline tumour?

A

AFP
Beta-hcg
LDH
But not in increased ICP (risk of herniation)

58
Q

What are symptoms of frontal lobe tumours/stroke/lesions?

A

Contralateral weakness due to deficit in primary motor cortex
Personality changes including disinhibition and cognitive slowing
Urinary incontinence due to disruption of micturition inhibition centre
Gaze abnormalities if involvement of frontal eye fields
Expressive dysphasia if brocas involved
Seizures

59
Q

What are the symptoms of a temporal lobe tumour/ stroke/ lesion?

A

Memory deficit
Receptive aphasia if wernickes
Contralateral superior quadrantanopia
Seizures

60
Q

What are the symptoms of a parietal lobe tumour/ stroke/ lesion?

A

Contralateral weakness and sensory loss
Contralateral inferior quadrantanopia
Dyscalculia - difficulty with maths
Dysgraphia- difficulty in ability to write
Finger agnosia - inability to distinguish fingers
Left-right disorientation- confusion between right and left limbs
If dominant lobe affected; gerstmann syndrome
If non-dominant lobe affected; neglect, dressing apraxia and constructional apraxia

61
Q

What are the symptoms of an occipital lobe tumour/ stroke/ lesion?

A

Contralateral homonymous hemianopia

Visual hallucinations

62
Q

What are the symptoms of a cerebellar tumour/ stroke/ lesion?

A 
Ipsilateral ataxia
N+V 
Dizziness and vertigo 
Slurred speech 
Intention tremor

Neurology (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions