Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neurology > Brain Tumours > Flashcards

Brain Tumours Flashcards

1
Q

why are brain tumours not classified according to TNM

A

they don’t spread beyond the CNS

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

what histological features are used for clasifcation

A

cellularity
pleomorphism
mitotic activity

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

grade 1 tumour

A

pilocytic astrocytoma

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

grade 2 tumour

A

diffuse astrocytoma (or grade 2 oligodendroglioma)

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

grade 3 tumour

A

anaplsatic astrocytoma (or grade 3 oligodendroglioma)

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

grade 4

A

glioblastoma

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

most common kind of brain tumour

A

astrocytoma

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

age group affected by primary glioblastoma

A

elderly - de novo

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

age group affected by secondary glioblastomas

A

younger - end point from low grade transformation

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

Genetic markers of brain tumours

A

IDH – astrocytoma and oligodendroglia, not primary glioblastoma
LoH1p/19q – oligodendrogliomas and anaplastic oligodendrogliomas
TP53 ATRX – astrocytoma

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

common clinical features

A 
progressive neurological deficit
motor weakness
headaches
seizures 
increased ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

features of headache caused by tumours

A

worse in the morning, exacerbated by coughing, straining or bending downwards

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

supratentorial tumours cause symptoms from which lobes

A

frontal, parietal, temporal, occipital, sellar region

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

infratentorial cause symptoms from

A

brain stema nd cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

low grade glioblastomas present in symptoms of which order

A

seizures»ICP»focal deficit

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

high grade glioblastomas present in symptoms of which order

A

ICP/focal deficit > seizure

shirt history

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

most common type of brain tumours

A

astrocytomas

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

how do astrocytomas cause regional effects

A

compression, invasion, destruction of brain parenchyma, arterial and venous hypoxia, competition for nutrients, release of metabolic end products and release and recruitment of cellular mediators

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

risk factors of astrocytic tumours

A

male, white, neurofibromatosis type 1, tuberous scelrosis, li-fraumeni syndrome, turcots cancer, ionising radiation

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

histological features of pilocytic (grade 1) astrocytomas

A

childhood, benign behavng, long hair like processes

pilocytic, pleomorphic xanthoastrocytoma, subependymal giant cell

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

histological features of grade 2

A

well differentiated

nuclear atypia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

histological features of grade 3

A

anaplastic
greater nuclear atypia
mitotic activity

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

histological features of secondary grade 4 glioblastomas

A

extreme nuclear atypia
mitotic activity
necrosis and/or neovascularisation

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

histological features of primary grade 4 glioblastomas

A

extreme nucelar atypia
mitotic activty
necrosis or neovascularisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
common presenting features of pilocytic grade 1
``` effects children progressive headache, wide based gait, difficulty speaking Persistent/recurrent headache Balance/co-ordination/walking problems Persistent/recurrent vomiting Abnormal eye movements Blurred or double vison/loss of vision Behaviour change Fits or seizures Abnormal head position Tailing of developmental milestones ```
26
treatment of grade 1
surgical removal
27
low grade symptomatic development
long presymptomatic phase, apparent latency stability (will have slow underlying malignant transformation)
28
management of low grade gliomas (2)
watch and wait | maximal resection +/- radiotherapy (only if incomplete removal and malignant degeneration) and chemotherapy
29
role of radiotherapy
early - after surgery | delayed - wait until progression
30
role of chemotherapy
if Ip19q consider sole therapy
31
management of high grade glioma
surgery - florescence guided resection radiotherapy after 4 weeks +/- temozolomide
32
management of recurrent GBM
only 10% re-do surgery 2nd line chemo response rate (<10%) New agents - anti-VEGF, immune checkpoint inhibitors, vaccine
33
causes of tumour headache
raised ICP invasion/compression of dura, BVs, periosteum 2ry to diplopia (III, IV, VI, INO) 2ry to difficulty focusing Extreme hypertension (cushings triad of increased ICP) Psychogenic (stress of loss of functional capacity) headaches not caused by tumour themselves, brain cells have no nerves
34
Investigtaions for brain tumours
MRI best CT contrast and non contrast if not available other - LP, PET, leison biopsy, EEG, evoked potentials, angiograms, radionucleotide studies
35
poor prognostic factors for grade 2 astrocytomas
``` Age > 50 Focal deficit Short duration of symptoms Altered consciousness Raised ICP Enhancement of contrast studies ```
36
poor surgical prognosis of grade 2 astrocytomas if
``` Age > 45 Low performance score Large tumours(dia>6cm) /crossing midline Incomplete resection Will be more aggressive in treatment ```
37
oligodendroglial tumours pathophysiology
chicken wire appearance - finely branching vasculature | perineuronal satellitosis - when invading grey matter oligodendrocytes cluster around neurons
38
histological appearance of oligodendroglial tumours
fried egg appearance - enlarged, round nuclei with dark, compact nuclei and small amount of eosinophilic cytoplasm
39
collision tumours
oligodendroglal cells coexist woth astrocytic cells in a neoplastic collision tumour, shared common precursor
40
oligodendroglial tumours grading histology
grade II fried egg | grade III chicken wire
41
how to differentiate oligodendroglial tumours from astrocytic tumours
Biopsy | features include calcification, cysts, peritumoral haemorrhage
42
malignant astrocytomas include
anaplastic astrocytomas | glioblastoma multiforme - divide so fast often necrosis in middle
43
management of oligodendrogliomas
surgery + chemotherapy (PLC) +/- radiotherapy
44
where do meningiomas arise from
arachnoid granulations often near dural sinuses are extraaxial - also parasagittal
45
epidemiology factors about meningomas
most common benign tumour more common in female (3:2) 15% or primary tumours
46
meningioma en plaque
meningioma may involve bone - produces hyperptosis and mass in regions often producing visible bony growth or proptosis
47
causes of meningiomas
previous radiotherapy (especially in childhood) family history hormones (prsence of receptors) link with breast cancer and NF11 (22Q gene?)
48
how are meningiomas classified?
by site in cranium - parasagittal, convexity, sphenoid, intraventricular Also - classic, angioblastic, atypical, malignant
49
aggressors in malignant meningiomas
clear cell, choroid, rhabdoid, papillary, radiation induced
50
histology of meningiomas
calcified psammoma bodies multinuclear syntcium of fused cells whorls of meningothelial and spindle cells
51
clinical features of meningiomas
as other tumours often asymptomatic due to small size compress rather than invade adjacent brain
52
preoperative evaluation of meningioma
CT – homogenous, densely enhancing, oedema, hyperostosis/skull blistering MRI – dural tail, patency of dural sinuses Angiography +/- embolization – external carotid artery feeders, occlusion of sagittal sinus
53
management of meningiomas
low grade - resection high grade - resection and radiotherapy recurrence - depends on grade and extent of resection
54
simpson grading for extent of resection
grade I - complete removal including underlying bone and associated dura grade II - complete removal and coagulation of dural attachment grade III - complete removal w/o resection of dura or coagulation grade IV - subtotal resection grade V - simple decompression with or without biopsy
55
medulloblastomas predominantly occur in what age group
children (2nd most common type of tumour)
56
where do medulloblastomas commonly occur
midline of the cerebellum, below tentorium cerebellum | forms near 4th ventricle
57
clinical features of medulloblastoma relate to
increased ICP
58
medulloblastomas are sensitive to
radiotherapy
59
types of nerve sheath tumours
schwannomas, neurofibromas, malignant peripheral nerve sheath tumours
60
acoustic neuromas are also known as
vestibular schwannomas
61
clinical features of acoustic neuromas relate to which cranial nerves
V, VI, VII, VIII
62
clinical features of acoustic neuromas
``` asymmetrical hearingloss facial numbness dizziness vertifo tinnitus absent corneal reflex dysequilibrium ```
63
investigationsof acoustic neuromas
audiologic/audopmetry gadolinium enhanced MRI CT head auditory brainstem reflexes
64
management of acoustic neuromas
if hearing okay - expectant management (hearing aids) | hydrocephalus management - surgeyr and radiation
65
complications of surgery on acoustic neuromas
facial nerve palsy corneal reflex nystagmus abnormal eye movement
66
STUPP Protocol
for treatment of glioblastoma | surgical resection, chemotherapy, radiation
67
what is MGMT promotor methylation
predicts response to alkylating chemotherapy whereby presence of methylation predicts better survival
68
what symptoms occur with brain tumours in frontal lobe?
– Personality dysfunction – Paraparesis – Paratonia – Grasp reflex – Frontal gait dysfunction (magnetic gait) – Cortical hand – Seizures – Incontinence – Visual field defects (anterior visual pathway incl optic chiasms are beneath frontal lobe) – Expressive dysphasia (Broca’s area is in the dominant frontal lobe) – Anosmia (olfactory pathway is beneath frontal lobes)
69
what symptoms occur with brain tumours in temporal lobe?
* Memory dysfunction especially episodic memory * Agnosia (visual and sensory modalities in particular) * Language disorders eceptive dysphasia (Wernicke, dominant hemisphere) * Visual field defects (congruous upper homonymous quadrantanopia) * Auditory dysfunction (Heschel’s gyrus, as hearing is represented bilaterally, deafness is not a cerebral feature) * Limbic dysfunction * Temporal lobe epilepsy
70
what symptoms occur with brain tumours in parietal lobe?
* Visual field defect (congruous lower homonymous quadrantanopia) * Sensory dysfunction (visual and sensory modalities in particular) * Gerstmann’s syndrome (disease of the dominant angular gyrus, part of the inferior parietal lobe): Dysgraphia, left-right disorientation, finger agnosia, acalculia * Dyspraxia * Inattention (non-dominant angular gyrus) * Denial

Neurology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions