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Semester 5 PMNM Exam 7 > CNS Tumors > Flashcards

CNS Tumors Flashcards

1
Q

CNS tumors - 5 year survival rate

A

34.2%

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2
Q

CNS tumors - ___ leading cause of cancer death in children

A

2nd (first is lymphomas or leukemia)

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3
Q

2/3 of CNS tumors in adults tend to be where

A

in the cerebral hemispheres

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4
Q

2/3 of CNS tumors in children tend to be where

A

in the cerebellum and brainstem

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5
Q

Medulloblastoma - most common at what age

A

0 to 9

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6
Q

Glioblastoma - most common at what age

A

Incidence increases with age

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7
Q

Classfication of CNS tumors - most common

A

Most common classification is WHO

Based on neuro-embryonal origin (cell of origin) and the Behavior (grade 1-4, 4 being most aggressive)

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8
Q

Classification - Anatomic location may be clue as to the type - Cerebral hemispheres

A

Gliomas (malignant)

Meningiomas (benign)

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9
Q

Classification - Anatomic location may be clue as to the type - Midline

A

Pituitary adenomas - benign but often have benign malignancy

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10
Q

Classification - Anatomic location may be clue as to the type - Spinal cord - extramedullary

A

Meningioma

Schwannomas

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11
Q

Classification - Anatomic location may be clue as to the type - spinal cord - intramedullary

A

Astrocytomas

Ependymomas

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12
Q

What does it mean for something to have benign malignancy

A

They are benign in nature but have functional malignancy where they can produce or lead to other symptoms that may be fatal

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13
Q

Clinical manifestations - depends on what

A 
Location
Type - aggressive or not
Level of structural displacement 
Edema due to vasogenic effects
CSF blockage
Inflammatory mediators
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14
Q

Clinical manifestations - early effects are usually

A

due to mechanical issues

mass occupying lesion that displaces or compresses structures and causes disruption to CSF or vascular structures

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15
Q

Clinical manifestations - later effects are usually from what

A

necrosis that is occurring from the inflammatory mediators - tumors take more blood supply so robs surrounding tissue

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16
Q

Clinical manifestations - s/s can include what

A 
Inc ICP
HA
Visual impairment
Papilledema
Mental status changes
N/V
Seizures
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17
Q

Gliomas - how common

A

most common, particularly in adults

45%

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18
Q

Glial cells are what

A

support structures of the neurons

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19
Q

Gliomas - grades

A

Range from grade 1 astrocytoma to a glioblastoma multiforme (GBM) which is a grade 4 astrocytoma

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20
Q

Gliomas - other types of gliomas include

A

Oligodendrogliomas (myelin)

Ependymomas (CSF)

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21
Q

Grade 1 and 2 Astrocytomas - how common

A

12% primary tumor in adults

25% in children

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22
Q

Grade 1 and 2 astrocytomas - ages

A

Bimodal - 5 to 15, 30 to 40

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23
Q

Grade 1 and 2 astrocytomas - description

A

Well differentiated

Slow growing

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24
Q

Grade 1 and 2 astrocytomas - tx

A

surgical resection is the tx of choice

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25
Q

Grade 1 and 2 astrocytomas - survival rates

A

10 yr with complete resection 100%

10 yr with partial resection 30%

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26
Q

Grade 3 and 4 astrocytoma - how common

A

30% of all brain tumors (mainly adults)

27
Q

Grade 3 and 4 asatrocytoma - age

A

40 to 60

M more than F

28
Q

Grade 3 and 4 astrocytoma - description

A 
Highly aggressive (usually multiple sites throughout hemispheres)
Frontal and temporal are most common initial site
29
Q

Grade 3 and 4 astrocytomas - survival

A

10% 5 yr Grade 3

Rare 5 yr if Grade 4

30
Q

Grade 4 astrocytoma - median survival

A

12 months

Generally less than 3 months for 50-60% of patients with Grade 4

31
Q

Oligodendrogliomas - how common

A

5% of all tumors

32
Q

Oligodendrogliomas - age

A

most common 35-45 yo

33
Q

Oligodendrogliom - description

A

Slow growing
Frontal lobes common
Spontaneous bleed so might see stroke s/s
Seizures or HA are often initial presenting manifestation

34
Q

Oligodendroglioma - median surivial

A

17 years

35
Q

Oligodendroglioma - often contain

A

solid mineral deposits

usually Ca

36
Q

Ependymomas - how common

A

9% of all childhood tumors

37
Q

Ependymomas - description

A

Cells lining ventricles and spinal canal
4th ventricle and LS junction are common sites
Inc ICP s/s

38
Q

Ependymomas - prognosis

A

improving

5yr is 80%

39
Q

Medulloblastomas are predominantly

A

malignant

40
Q

Medulloblastoma - how common and ages

A

Children 2-10 is 20-30% (most common type in children)

Adults 45-55 yo is peak

41
Q

Medulloblastomas - description

A

Rapid growth

CSF blockage and cbm involvement are common- hydrocephalus

42
Q

Medulloblastoma - survivial rate

A

5 yr is 45-70%

43
Q

Pituitary adenoma - how common

A

3rd most common primary intracranial tumor in adults

44
Q

Pituitary adenoma - more common in who and what age

A

Females

Middle age and older adults

45
Q

Pituitary adenoma - description

A

70% or more are functional so they can start to release more of a given hormone
Highly treatable!

46
Q

Pituitary adenoma - s/s

A

endocrine in nature but can also impact CNS

47
Q

Meningiomas - how common

A

15-27% of intracranial tumors in adults - more F

25% of spinal tumrors

48
Q

Meningiomas - how old

A

20 to 60 yo with peak around 45

49
Q

Meningiomas - common areas

A

Base of skull, thoracic spine

50
Q

Meningiomas - presenting s/s

A

Compression - arm pain or pain btw scapulae and what we are doing as PTs is not getting them better - think of this as a possibility

51
Q

Meningiomas - survivial

A

10 yr of 90% with complete resection but by the time they are found there might already be residual impacts

52
Q

Metastatic tumors - how common

A

most common CNS tumor in adults! 8 times!

53
Q

Metastatic - what percent of primary cancer pts metastasis to brain

A

20%

54
Q

Metastatic - what percent of primary cancer metastasis to spinal cord

A

10%

55
Q

What are the most common cancers to metastasize to the CNS

A

Lung and breast

56
Q

What are the second most common cancers to metastasize to the CNS

A

Renal, malignant melanoma, GI

57
Q

Lymphomas and leukemias tend to metastasize to where

A

meninges

58
Q

Metastasis - treatment

A

Often to reduce size of metastatic tumor to decrease the effects rather than an actual cure

59
Q

S/S based on location - brainstem

A

Cranial neuropathies
UMN signs
Ataxia
Late development of inc ICP

60
Q

S/S based on location - Cerebral hemispheres

A 
Hemiparesis
Hemi sensory loss
Hemi visual loss
Cog changes
Seizures
61
Q

S/S based on location - midline

A

Visual impairment
Endocrinopathies
Changing personality
Non localizing signs of inc ICP (HA, nausea)

62
Q

S/S based on location - Cerebellar

A 
Trunal ataxia
Extremity ataxia
Scanning speech
Hypotonia
Nystagmus
Early development inc ICP
63
Q

S/S based on location - Supratentorial

A 
Focal deficits
HA
Seizures
Mental status change
Visual field impairment
Endocrinopathies
64
Q

S/S based on location - Infratentorial

A

Hypdrocephalus s/s like HA, n/v, papilledema, vertigo, diplopia
Mass effect of ataxia, dysmetria, CN impair, intention tremors

Semester 5 PMNM Exam 7 (7 decks)

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