Cerebral Infections & Tumours

Question 1

Name the three most common organisms causing bacterial meningitis in the first 3 months of life

Answer 1

Group B streptococcus, Escherichia coli, Listeria monocytogenes

Question 2

Name the three most common organisms causing bacterial meningitis in the first 1 month to 6 years of life

Answer 2

Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type B

Question 3

Between which ages is TB meningitis most common?

Answer 3

6 months to 6 years

Question 4

Name the most common causes of viral meningitis

Answer 4

Enteroviruses, cytomegalovirus (CMV), arbovirus

Question 5

State at least 3 immune factors increasing susceptibility to meningitis

Answer 5

Young age, HIV, complement system defects, asplenia

Question 6

Describe the appearance of the CSF in bacterial meningitis

Answer 6

Turbid, predominantly containing polymorphs (neutrophils), cell count 90-1000+, low glucose (<40), raised protein (often >250)

Question 7

Describe the appearance of the CSF in TB meningitis

Answer 7

Fibrin web, predominantly mononuclear (lymphocytes), cell count 10-1000, low glucose (<40), normal or slightly raised protein (50-500)

Question 8

Describe the appearance of the CSF in viral meningitis

Answer 8

Clear, predominantly mononuclear (lymphocytes), cell count 50-1000, normal glucose (>40), normal or slightly raised protein (<100)

Question 9

State at least 5 causes of viral encephalitis

Answer 9

Enteroviruses, Herpes Simplex Virus 1 &2, Varicella zoster virus, adenoviruses, arboviruses, HIV, mumps, rubella, rabies

Question 10

State the cause of subacute sclerosing pan-encephalitis (SSPE)

Answer 10

Past measles infection

Question 11

Describe the clinical features of encephalitis

Answer 11

Drowsiness, seizures, behavioural changes, headache, fever

Question 12

State the three most common sources of brain metastases

Answer 12

Lung cancer, breast cancer, malignant melanoma

Question 13

Describe the appearance of brain metastases

Answer 13

Well demarcated solitary or multiple tumours with surrounding oedema

Question 14

Which CNS tumour is associated with neurofibromatosis type II?

Answer 14

Meningioma

Question 15

Name at least 3 ventricular tumours

Answer 15

Choroid plexus papilloma, ependymoma, germinoma, teratoma, meningioma

Question 16

Name at least 3 skull base tumours

Answer 16

Chordoma, glomus jugulare, osteoma, chondrosarcoma

Question 17

Name at least 2 sellar or suprasellar tumours

Answer 17

Pituitary adenoma, craniopharyngioma, optic nerve glioma, spindle cell oncocytoma

Question 18

Name 2 posterior fossa tumours

Answer 18

Schwannoma, meningioma, metastases

Question 19

Name at least 3 intra-axial supratentorial tumours

Answer 19

Astrocytoma, glioblastoma, oligodendroglioma, ganglioma, lymphoma, metastases

Question 20

Name at least 5 neuroepithelial tumours

Answer 20

Astrocytoma, oligodendroglioma, glioblastoma, oligoastrocytoma, ganglion cell tumours, cerebral neuroblastoma, medulloblastoma, ependymoma, primitive neuroectodermal tumours (PNETs), pineal tumours

Question 21

Name at least 2 meningeal tumours

Answer 21

Meningioma, mesenchymal tumour, haemangioblastoma

Question 22

Name at least 2 germ cell tumours

Answer 22

Germinoma, teratoma, choriocarcinoma

Question 23

Describe Von Hippel Lindau syndrome

Answer 23

Haemangiomas of the cerebellum, brainstem, spinal cord, and retina, with renal cysts and phaeochromocytomas. Caused by mutations in the VHL gene (one can be inherited but the other must mutate during life to create the condition; cannot be inherited homozygously)

Question 24

Describe the cortical features of tuberous sclerosis

Answer 24

Giant cell astrocytoma, cortical tuber, subependymal nodules, calcifications on CT

Question 25

Describe the cortical features of neurofibromatosis type 1

Answer 25

Optic glioma, neurofibroma, astrocytoma

Question 26

Describe the cortical features of neurofibromatosis type 2

Answer 26

Vestibular schwannoma, meningioma, ependymoma, astrocytoma

Question 27

Which tumours does Li Fraumeni syndrome predispose to?

Answer 27

Astrocytoma, primitive neuroectodermal tumours (PNETs), sarcomas, breast cancer, leukaemia

Question 28

Which tumours does Turcot syndrome predispose to?

Answer 28

Glioblastoma multiforme, medulloblastoma, pineoblastoma