Cancer

Question 1

There is some evidence that tamoxifen can negatively impact ___ and ___ in breast cancer patients.

Answer 1

word list generation and verbal memory

Question 2

Children treated with chemotherapy for leukemia typically have IQs in the ___ range. Deficits in __, ___, ___, and ___ have been found

Answer 2

attention, verbal/visual memory, EF, processing speed

Question 3

Neurocognitive effects of chemo for non-CNS cancers in adults (5)

Answer 3

learning & memory, attention, working memory, processing speed, EF

Question 4

malignancies that commonly spread to the brain in adults are melanoma and cancer of the __, ___, and ___.

Answer 4

breast, colon, lung

Question 5

overall IQs of children treated for medulloblastoma with radiation tend to be in the ___ range, and scores often __ over time.

Answer 5

low average, decline.

Question 6

most common location of metastic brain tumors are _____.

Answer 6

gray and white matter junction

Question 7

For primary brain tumors in the CNS the most common tumor site is the ___

Answer 7

meninges

Question 8

Combined treatment with chemo and radiotherapy in kids may have a ___ and has been associated with higher risk of ___.

Answer 8

negative impact, cognitive impairment

Question 9

Presentation/signs of brain tumor include (6)

Answer 9

headaches, increased ICP (headaches, nausea, vomiting), progressive neurologic deficits, endocrinopathies, seizures, cognitive and behavioral changes.

Question 10

Children treated with craniospinal radiation for leukemia show deficits in ___, ___, ____, ____, ___.

Answer 10

attention, visuospatial skills, visual motor skills, working memory, processing speed

Question 11

which grade? poorly differentiated, brisk mitotic activity, inflitrative, typically require chemo/radiation, tend to progress to higher grade

Answer 11

III

Question 12

Late complications of radiation in children (12+ months) are (7):

Answer 12

neuropsychological deficits, neuroendocrine dysfunction, vascular complications, hearing loss, cataracts, impaired growth/development, secondary malignancy

Question 13

___ can show most tumors and can identify calcifications and hemorrhage but may not identify posterior fossa tumors or low-grade gliomas.

Answer 13

CT

Question 14

Radiation therapy is often deferred or contraindicated in patients under __ of age.

Answer 14

3 years

Question 15

____ deficits are the most common finding across studies of adults and children treated for cancer.

Answer 15

processing speed

Question 16

Given the critical structures in the brain and the confined space within the skull, “benign tumors” can have ___ morbidity.

Answer 16

high

Question 17

Late complications of radiation in adults (12+ months) are typically ___, can consist of local ___ or diffuse ___. mild to moderate problems with ___ and ___ are common. Motor problems include __ and ___ problems.

Answer 17

not reversible, radionecrosis, leukoencephalopathy, attention, short-term memory, incontinence, gait

Question 18

A complication of cerebellar tumor resection, associated with brainstem involvement of the tumor, location in the vermis. Mutism, emotional lability, cranial nerve deficits, ataxia. Resolves over days/weeks and sometimes months.

Answer 18

posterior fossa mutism syndrome.

Question 19

which grade? well differentiated, non-infiltrative, low proliferative potential, slow growing, good possibility of cure with surgery

Answer 19

I

Question 20

undifferentiated, widespread infiltration, propensity for craniospinal dissemination, high degree anaplasia, mitotically active, high degree necrosis, require multi-modality treatment, rapid recurrence

Answer 20

IV

Question 21

Which grade? moderately differentiated, somewhat infiltrative, low proliferative activity, can progress to higher grades

Answer 21

II

Question 22

Late effects of chemo in adults (12+ months) (6):

Answer 22

leukoencephalopathy, hearing loss, peripheral neuropathies, secondary cancers, fatigue, neuropsych deficits

Question 23

MRI shows diffuse ___, ventricular ___, and ___ abnormalities in adults with severe late encephalopathy associated with radiation.

Answer 23

atrophy, enlargement, white matter

Question 24

Primary brain tumors are (more or less) common in children than adults?

Answer 24

more

Question 25

In survivors of childhood brain tumors, a triad of cognitive processes appears particularly affected (3)

Answer 25

attention, WM, and info processing speed

Question 26

Chemotherapy agents target rapidly dividing cells by disrupting ___ and interferring with ___ and ___.

Answer 26

DNA, transcription, replication

Question 27

___ is the imaging modality of choice for diagnosing and monitoring brain tumors.

Answer 27

MRI with contrast

Question 28

A study of patients with prostate cancer treated with androgen deprivation therapy showed declines in ___

Answer 28

visuospatial skills

Question 29

late effects of chemo in children (12+ months) (10):

Answer 29

leukoencephalopathy, endocrine dysfunction, cardiovascular px, seizures, hearing loss, neuropathies, cerebellar syndromes, organ dysfunction, secondary cancers, neuropsychological deficits

Question 30

Risk factors for neurocognitive impairment in children treated for non-CNS cancers (3)

Answer 30

younger age at treatment, higher doses of radiation, female gender

Question 31

Decline in __ and ___ has been noted after bone marrow transplantation.

Answer 31

EF and memory