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BRAIN BATTACK > CH30: Intracranial Neoplasms > Flashcards

CH30: Intracranial Neoplasms Flashcards

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1
Q

In how many percent of cancer, the brain or its coverings are involved by neoplasm at some time in the course of illness? (p. 661)

A

25%

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2
Q

tumor- like formation that has its basis in maldevelopment and undergoes little change during the life of the host (p. 663)

A

hamartoma

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3
Q

viruses implicated tumors of the nervous system (p. 665)

A

HPV, HepB, EBV, HTLV

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4
Q

Edema wherein there is increased permeability of the capillary endothelial cells so that plasma proteins exude into the extracellular spaces (p. 666)

A

Vasogenic edema

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5
Q

All the cellular elements swell with fluid and there is a corresponding reduction in the extracellular fluid space (p. 667)

A

Cytotoxic edema

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6
Q

Type of vomiting wherein the patient vomit unexpectedly and forcibly without preceding nausea (p. 669)

A

Projectile vomiting

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7
Q

Gross pathology GBM (p. 670)

A

mottled gray, red, orange or brown

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8
Q

Natural history of GBM (p. 670)

A

Fewer than 20% survive for 1 year; only 10% live beyond 2 years

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9
Q

gene implicated in GBM (p. 671)

A

tumor suppression gene on Chromosome 17p

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10
Q

Stupp protocol (p. 672)

A

75mg/m2 concurrently with radiotherapy after a hiatus of 4 weeks, give for 5 days every 28 days for 6 cycles

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11
Q

How many percent of GBM will develop additional lesiosn at distant locations (p. 673)

A

10%

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12
Q

Tumor cells of low to intermediate- grade astrocytoma which is a useful diagnostic marker in biopsy specimen. (p. 673)

A

GFAP

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13
Q

Natural history of low- grade glioma (p. 674)

A

grow slowly and eventually undergo malignant transformation

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14
Q

Tumor that is pink-gray color and multilobar in form. It is relatively avascular and firm and has a tendency to encapsualte and form calcium and small cysts. (p. 677)

A

Oligodendroglioma

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15
Q

genes implicated in oligodendroglioma (p. 675)

A

Chromosome 1p: high degree of responsiveness; Chromosome 19q: longer survival

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16
Q

Chemotherapeutic treatment of oligodendroglioma (p. 676)

A

PCV

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17
Q

Most common glioma of the spinal cord (p. 676)

A

Ependymoma

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18
Q

Tumor described being found in 4th ventricle, graying pink, form, cauliflower growths (p. 676)

A

Ependymoma

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19
Q

Gene implicated with ependymoma (p. 676)

A

RELA gene (becoming fused to an open reading frame of Ch11)

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20
Q

Round or elongated nuclei, visible cytoplasmic membrane, and a characteristic tendency to encircle n another forming whorls and laminated calcific concretions (p. 677)

A

Meningioma

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21
Q

Most common type of meningioma (p. 677)

A

Meningothelial

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22
Q

How many percent of patients with ocular lymphoma will have cerebral involvement within the year? (p. 679)

A

2/3

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23
Q

Pinkish gray, soft, ill- defined infiltrative mass in the brain difficult to distinguish from astrocytoma (p. 679)

A

Lymphoma

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24
Q

Meningeal and cranial nerve lymphoma with similar characteristics to primary CNS lymphoma as complications of chronic lymphatic leukemia (p. 679)

A

Ritcher transformation

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25
Q

Tumor appears as a complication of an obscure medical condition such as salivary and lacrimal gland enlargement (p. 680)

A

Mikulicz syndrome

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26
Q

Predominant treatment in lymphoma patient with AIDS. (p. 681)

A

Cranial irradiation

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27
Q

Top 3 malignancies which is most prone to metastasize to the brain (p. 681)

A

Melanoma, Testicular tumors, small cell tumors

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28
Q

Almost half of intracranial metastatic cancer mets via hematogenous spread. (p. 681)

A

Breast

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29
Q

Hemorrhagic mets (p. 682)

A

Melanoma, chorioepthelioma

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30
Q

dose of radiation for malignant meningitis (p. 684)

A

300cGy per day for 10days

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31
Q

Systemic disease with prominent nodular pulmonary lesions, dermal and lymph nodes changes and in approximately 30 percent of cases, involvement of CNS (p. 686)

A

lymphomatoid granulamotosis

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32
Q

Castleman disease is precipatated by which virus (p. 686)

A

HHV 8

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33
Q

chromosome implicated in Medulloblastoma (p. 687)

A

Ch17 distal to the p53region

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34
Q

Medulloblastoma + mutations in the gene encoding a patched, the receptor for sonic hedgehog ligand (p. 687)

A

Gorlin syndrome

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35
Q

Medulloblastoma, consequence of mutations in DNA repair genes (p. 687)

A

Turcot syndrome

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36
Q

Overexpression of this is associated with poorer prognosis in medulloblastoma (p. 687)

A

N-MYC

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37
Q

Virus also implicated with medulloblastoma (p. 688)

A

JC virus

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38
Q

Distinctive radiographic appearance of medulloblastoma (p. 688)

A

high T1 and T2, heterogenous enhancement, typical location adjacent to fourth vetricle

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39
Q

Treatment of medulloblastoma (p. 688)

A

surgery + resection + chemotherapy

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40
Q

Most common soild tumor of childhood (p. 689)

A

Neuroblastoma

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41
Q

Treatment of neuroblastoma (p. 689)

A

Depends on clinical staging

42
Q

Most common areas of papilloma of choroid plexus (p. 690)

A

Lateral ventricle

43
Q

Involved in tumor induction of papillomas of choroid plexus (p. 690)

A

oncogene T antigen of teh SV40 virus

44
Q

Most common type of pineal tumor (p. 691)

A

germinoma

45
Q

large spherical epithelial cells separated by a network of reticular connective tissue and containing many lymphocytes (p. 691)

A

Pineal germinoma

46
Q

dysplastic gangliocytoma of the cerebellum (p. 692)

A

Lhermitte- Duclos disease

47
Q

Gangliocytoma appearance in imaging (p. 693)

A

tiger striped

48
Q

Syndrome of multiple skin hamartomas, cancers of gynecologic, breast, and thyroid (p. 693)

A

Cowden syndrome

49
Q

The radiographic appearance of small cyst, a cluster of several adjacent small cystic lesions, generally not enhancing and hyperintense on T2 (p. 693)

A

DNET

50
Q

seen in 20% of patients with tuberous sclerosis (p. 693)

A

subependymal giant cell astrocytoma

51
Q

T/F cholesteatoma causes more severe facial weakness (p. 697)

A

TRUE

52
Q

Chromophobe, acidophil, basophil ratio (p. 698)

A

5:4:1

53
Q

Examples of acidophils or chromophobe (p. 699)

A

GH, TSH, prolactin

54
Q

Examples of basophils (p. 699)

A

ACTH, LH, FSH, b lipotropin

55
Q

How many percent of pituitary adenomas are prolactin- secreting (p. 699)

A

60-70%

56
Q

How many percent of pituitary adenomas are GH- secreting (p. 699)

A

10%

57
Q

Cut-off size for microadenomas (p. 699)

A

1cm

58
Q

How many percent of adenomas extend to the cavernous sins (p. 699)

A

5-10%

59
Q

bitemporal hemianopia with normal- size sella (p.699)

A

saccular aneurysm of circles of Willis

60
Q

Excess prolactin value (p. 700)

A

100ng/mL

61
Q

Excess GH value (p. 700)

A

0.10ng/mL

62
Q

excessive secretion of pituitary ACTH (p. 700)

A

Cushing disease

63
Q

excessive administration. of steroids, adenoma of adrenal cortex, ACTH- producing bronchial carcinoma (p. 700

A

Cushing syndrome

64
Q

Dose of bromocriptine (p. 701)

A

0.5 to 1.25mg daily

65
Q

Dose of octreotide (p. 701)

A

200mg/d

66
Q

How many percent of GH- secreting tumors and prolactinomas will recur at 1 year? (p. 701)

A

15%

67
Q

Can stereotactic radiosurgery be used in PitAd? (p. 701)

A

Yes, provided that the vision is not being threatened and there is no other urgent need for surger

68
Q

Ischemic necrosis of the pituitary post-partum or partum (p. 702)

A

Sheehan syndrome

69
Q

Inappropriate jocularity (p. 701)

A

witzelsucht

70
Q

Soft, jelly- like, gray-pink growth that arises from remnants of the primitive notochord (p. 703)

A

Chordoma

71
Q

Lesion: Superior orbital fissure (p. 705)

A

Rochon- Duvigneau

72
Q

Lesion: Apex of the orbit (p. 705)

A

Jacod- Rollet

73
Q

Lesion: Cavernous sinus (p. 705)

A

Foix- Jefferson

74
Q

Lesion: Apex of the petrous temporal bone (p. 705)

A

Gradenigo- Lannois

75
Q

Lesion: Sphenoid and petrosal bone (p. 705)

A

Jacod

76
Q

Lesion: Jugular foramen (p. 705)

A

Vernet

77
Q

Lesion: Anterior occcipital condyles (p. 705)

A

Collet- Sicard

78
Q

Lesion: Retroparotid space (p. 705)

A

Villaret

79
Q

Lesion: Half of the base of the skull (p. 705)

A

Garcin

80
Q

Electric- like sensations down the spine and limbs upon flexing the neck (p. 706)

A

Lhermitte sign

81
Q

Most common paraneoplastic manifestation (p. 706)

A

Sensory neuronopathy

82
Q

Almost universal and central feature in most cases of paraneoplastic limbic encephalitis (p. 708)

A

Amnesia

83
Q

Limbic encephalitis + faciobrachial dystonic seizures (p. 708)

A

LG1 antibodies

84
Q

Limbic encephalitis + peripheral motor hyperexcitability

A

CASPR 2 antibodies and VGKC

85
Q

Receptor of NMDA in anti-NMDAR encephalitis (p. 709)

A

NR1

86
Q

Paraneoplastic sensory neuronopathy (p. 708)

A

Anti- Hu antibody

87
Q

Most common underlying malignancy for paraneoplastic cerebellar degeneration (p. 709)

A

Lung

88
Q

Can be found in half of the patients with paraneoplastic cerebellar degeneration w large majority related to breast or female genitala malignancy (p. 710)

A

Anti- Pukinje (Anti- Yo)

89
Q

A child’s malignancy causing opsoclonus- myoclonus-ataxia syndrome (p. 711)

A

Neuroblastoma

90
Q

Unique feature of neuroblastoma and OMA syndrome (p. 711)

A

Response to corticosteroids and ACTH

91
Q

subgroup of breast CA produce antineuronal antibody directed against a different RNA binding antigen from anti-Hu (p. 711)

A

Anti- Ri (antineuronal antibody type 2- ANNA 2)

92
Q

Which antibody cross react with testicular antigens (p. 712)

A

Anti- Ma ( causing ataxic opsoclonic syndrome, limbic, brainstem or hypothalamic inflammation)

93
Q

Optic neuropathy is most specific associated syndrome with this antibody (p. 712)

A

CRMP-5 antibody

94
Q

Triad of paraneoplastic retinopathy (p. 712)

A

Photosensitivity, ring scotomas, attenuation of the retinal arterioles

95
Q

continuous muscle fiber activity, insomnia, and hallucinosis (p. 712)

A

choree fibrillaire of Morvan

96
Q

paraneoplastic myotonia (p. 712)

A

Isaac syndrome

97
Q

basal ganglia paraneoplastic syndrome- esp chorea (p. 712)

A

anti-Hu and CRMP-5

98
Q

Main clinical features of delayed radiation toxicity (p. 713)

A

progressive dementia, ataxia and urinary incontinence

99
Q

Most reliable way of differentiating radiation necrosis and tumor or peritumor products (p. 714)

A

PET scan

100
Q

GRADE 2 Meningioma

A

ACC

Atypical
Clear cell
Choroid

101
Q

GRADE 3 Meningioma

A

RAP

Rhaboid
Anaplastic
Papillary

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