Chapter 31 - Intracranial neoplasms Flashcards
What differentiates anaplastic astrocytoma from glioblastoma?*
A. hypercellularity with pleomorphism of cells
B. frequent mitosis
C. hyperplasia of endothelial cells of small vessels
D. necrosis and hemorrhage
D. necrosis and hemorrhage (p. 650)
Glioblastomas typically recur within how many cm from their original site?* A. 1 cm B. 2 cm C. 3 cm D. 4 cm
B. 2 cm (p. 652)
What is the treatment for anaplastic astrocytoma?*
A. Surgery alone
B. Surgery + radiotherapy
C. Surgery + radiotherapy + concomitant temozolamide
D. Surgery + radiotherapy + concomitant and adjuvant temozolamide
D. Surgery + radiotherapy + concomitant and adjuvant temozolamide (p. 651)
Most common type of low-grade astrocytoma: A. Protoplasmic or fibrillary B. Gemistocytic C. Pilocytic D. Mixed astrocytoma-oligodendroglioma
A. Protoplasmic or fibrillary (p. 652)
True regarding treatment of low-grade pure astrocytomas EXCEPT:
A. Resection of the tumor nodule is of singular importance in delaying or preventing a recurrence
B. In younger patients, radiation can be delayed and the course of the tumor evaluated by serial imaging
C. An increase in seizures or worsening neurologic signs presses one to turn to radiation or further surgery
D. Chemotherapy is mainstay in the treatment of such tumors
D. Chemotherapy is mainstay in the treatment of such tumors (p. 653)
True regarding treatment of low-grade pure astrocytomas EXCEPT:
A. Resection of the tumor nodule is of singular importance in delaying or preventing a recurrence
B. In younger patients, radiation can be delayed and the course of the tumor evaluated by serial imaging
C. An increase in seizures or worsening neurologic signs presses one to turn to radiation or further surgery
D. Chemotherapy is mainstay in the treatment of such tumors
D. Chemotherapy is mainstay in the treatment of such tumors (p. 653)
Most common cell type of the pituitary gland
A. Chromophobe
B. Acidophil
C. Basophil
A. Chromophobe (p. 676)
Adenomas of the pituitary are most commonly composed of what cell type?
A. Chromophobe
B. Acidophil
C. Basophil
A. Chromophobe (p. 676)
Which of the following does not cause empty sella syndrome?*
A. Pituitary microadenoma
B. Pseudotumor cerebri
C. Hydrocephalus
D. Post-surgical excision of pituitary meningioma
A. Pituitary microadenoma (p. 679)
32-year-old male with 5-year history of focal seizures with MRI findings of a right frontal heterogenous mass which is hyperintense on T2 and is near the cortical surface with relatively well defined borders, some contrast enhancement, and with intratumoral calcification* A. GBM B. Anaplasric astrocytoma C. Oligodendroglioma D. Meningioma
C. Oligodendroglioma (p. 655)
Most common glioma of the spinal cord: A. GBM B. Anaplastic astrocytoma C. Oligodendroglioma D. Ependymoma
D. Ependymoma (p. 656)
Most common cerebral site of ependymomas:* A. Lateral ventricles B. Third ventricle C. Fourth ventricle D. Cerebral cortex
C. Fourth ventricle (p. 656)
Most frequent acquired genetic defect of meningiomas involves inactivating mutations in which chromosome? A. 1p B. 6q C. 9p D. 22 q
D. 22 q (p. 656)
Which is not part of the standard treatment for primary CNS lymphomas?* A. Surgical resection B. Intrathecal methotrexate C. Cytarabine D. Radiation
A. Surgical resection (p. 659)
Cancers of which regions have a higher tendency to spread in the posterior fossa? A. Pelvis and colon B. Breast C. Lung D. Renal
A. Pelvis and colon (p. 660)
These are metastatic tumors that are most likely to be single brain metastasis except: A. Kidney B. Breast C. Thyroid D. Melanoma E. Lung adenocarcinoma
D. Melanoma (p. 660)
Most common metastatic tumor to bleed A. Melanoma B. Lung C. Thyroid D. Kidney
B. Lung (p. 660)
Brainstem metastases most often originate from where? A. Melanoma B. Lung C. Thyroid D. Kidney
B. Lung (p. 660)
Meningiomas usually elaborate this type of soluble protein:* A. EGFR B. VEGF C. PDGF D. BDGF
B. VEGF (p. 656)
These tumors are characterized microscopically by tumor cells with a small round nucleus and halo of unstained cytoplasm* A. Glioblastoma B. Oligodendroglioma C. Ependymoma D. Meningioma
B. Oligodendroglioma (p. 654)
Which of the following is incorrect about CNS leukemia?
A. Greater incidence in acute than chronic leukemia
B. Greater incidence in lymphocytic than myelocytic leukemia
C. More frequent in children than adults
D. None of the above
D. None of the above (p. 663)
Which of the following is incorrect regarding necrotizing leukoencephlopathy?
A. Occurs most frequently when cranial irradiation is combined with intrathecal and intravenous methotrexate
B. Lesions enhance on CT and MRI
C. Radiation is the most important factor
D. Most patients are children
B. Lesions enhance on CT and MRI (p. 663)
Leptomeningeal dissemination in high grade lymphomas have a predilection for which cranial nerve? A. VII B. VIII C. IX D. X
B. VIII (p. 663)
Most common neurologic complication of all types of lymphoma
A. Extradural compression of the spinal cord or cauda equina
B. Brain metastasis
C. Cerebral infarction
D. Intracerebral hemorrhage
A. Extradural compression of the spinal cord or cauda equina (p. 663)
Chromosomal studies of medulloblastomas reveal a deletion on which chromosome? A. 15 B. 16 C. 17 D. 18
C. 17 (p. 665)
Treatment for medulloblastomas:
A. Surgery alone
B. Surgery and radiotherapy only
C. Surgery, chemotherapy, and radiation of the posterior fossa
D. Surgery, chemotherapy, radiation of the entire neuraxis
D. Surgery, chemotherapy, radiation of the entire neuraxis (p. 666)
Most common location of choroid plexus papillomas: A. Lateral ventricle B. Third ventricle C. Fourth ventricle D. All are equally affected
A. Lateral ventricle (p. 667)
Which is associated with poorer prognosis in medulloblastomas?* A. Desmoplastic features B. N-MYC amplification C. Nodular histologic pattern D. Onset older than 3 years of age
B. N-MYC amplification (pp. 665)
Most common source of brain metastasis* A. Lung B. Breast C. Melanoma D. GIT
A. Lung (p. 660)