Brain Tumours (clinical)

Question 1

What is three types of brain tumours

Answer 1

Metastases
Primary malignant
Primary benign

Question 2

What is the common metastases brain tumours

Answer 2

Renal 
Lung 
Malignant melanoma 
Breast 
GI tract

Question 3

What is a primary malignant brain tumour

Answer 3

Glioma (glioblastoma multiforme)

Question 4

What is examples of primary benign brain tumours

Answer 4

Meningioma

pituitary adenoma

Question 5

What do brain tumours present with

Answer 5

Signs of raised intracranial pressure
seizures
neurological deficits

Question 6

What is the aims of managing brain tumours

Answer 6

Appropriate investigations

ease symptoms

aid effect of adjuvant radiotherapy and chemotherapy

prolong life expectancy

Question 7

What is symptoms of raided intracranial pressure

Answer 7

Headaches (morning)
Nausea/vomiting 
visual disturbance 
somnolence 
cognitive impairment 
altered consciousness

Question 8

What is the signs of raised intracranial pressure

Answer 8

pailloedema 
6th nerve palsy 
cognitive impairment
altered consciousness 
3rd nerve palsy

Question 9

What is the signs of focal neurological deficit

Answer 9

Hemiparesis 
dysphasia
hemianopia
cognitive impairment 
cranial nerve plays 
endrocrine disorder

Question 10

What does seizures indicate about the location of tumour

Answer 10

Lesion located above tentorium

Question 11

How does CSF obstruction arrises and what does it cause

Answer 11

Tumours in or close to CSF pathway

results in hydrocephalus

Question 12

How do you diagnose brain tumours

Answer 12

History and examination 
MRI/CT
Biopsy 
PET 
Angiogram

Question 13

What investigation takes place if suspecting metastases

Answer 13

CXR

CT Chest/abdo/pelvis

Biopsy of skin lesions/lymph nodes

Question 14

What is the overall treatment for brain tumours

Answer 14

Surgery - exision of lesion

Radiotherapy

chemotherapy

coricosteriods

anticonvulsants (treat epilepsy)

anlagesics

endocrine replacement

counselling

Question 15

What is the costicosterod used to treat brain tumours

Answer 15

dexamethasone

Question 16

As complete surgical excision of glioblastoma multiform is impossible what is performed instead

Answer 16

debulking of lesions

Question 17

What is the chemotherapy dug used in treating GBM

Answer 17

temazolamide

Question 18

What doesn’t occurs in metastasis treatment

Answer 18

Chemotherapy

Question 19

How is meningioma commonly cured

Answer 19

By surgery

Question 20

What treatment might be needed in meningioma

Answer 20

anti convulsants

Question 21

What is the life expectancy of low grade astrocytoma vs high grade astrocytoma

Answer 21

Low grade - long life expectancy

High grade - average i year survival

Question 22

What is the prognosis of metastases

Answer 22

frequently good medium term remission

Question 23

Left handed, presents with ataxia and in-coordiantion, where would you suspect lesion to be

Answer 23

Cerebellum

Question 24

A 44 year old, right handed, woman presents with acalculia, agraphia,
finger agnosia and right/left confusion.
Where would you suspect
her lesion to be?

Answer 24

left (dominant) parietal lobe lesions

= gerstmans syndromme

Question 25

What is Gerstmanns syndrome

Answer 25

rare neurological disorder that can occur as the result of a brain injury or as a developmental disorder.

The syndrome is characterized by the loss or absence of four cognitive abilities- the agraphia,
dysgraphia,
acalculia,
finger agnosia,

Question 26

A 30 year old, right handed, man presents with a bi temporal hemianopia.
Where would you suspect
his lesion to be?

Answer 26

Pituitary

Question 27

50 year old right handed man

Presented to medical team with cognitive language dysfunction:
difficulty reading e mails
difficulty expressing what he wished to say
short-term memory impairment

where do you expect the lesion to be

Answer 27

Left temper-parietal

Question 28

What is the clinical presentation of glioblastoma multiforme

Answer 28

Decreased level of consciousness

• drowsiness
• headaches and nauseated