Complications of Brain Tumor

Question 1

Which cancers are most common for metastases to the brain

Answer 1

Breast and Lung

Question 2

What is the only way to know someone hasa brain tumor

Answer 2

Biopsy

Question 3

What are the most common brain tumors

Answer 3

Meniginoma, Pituitary tumor, gioblastomas

Question 4

What are clinical symptoms of Brain Tumor

Answer 4

Worst headache, N/V, seizure, personality changes, sppech impairment, loss of balance, numbness

Question 5

What contrast is used for MRI, what is the caution of use

Answer 5

Galatium, can’t use in patient with bad kidney function

Question 6

What are the goals of treatment

Answer 6

Control signs and symptoms, preserve normal brain function, control tumor growth and its surrounding effects

Question 7

What are treatment options for brain tumors

Answer 7

Surgery, radiation, chemotherapy, rehabilitation

Question 8

What are medical complications of brain tumors

Answer 8

Intracranial hypertension ( cerebral edema, hydrocephalus, herniation), Intracranial hemorrhage, seizure, VTE

Question 9

How is the intractanial hypertension managed, what medications are used at what doses

Answer 9

Osmotic gradient moves water into the intravascular space/ Mannitol 20%: 1 gram/kg IVPB PRN, Hypertonic 23.4? saline: 30-60 ml IVPB PRN

Question 10

What should be monitored while giving mannitol, hypertonic saline

Answer 10

serum Na, osmolality, osmolar gap, urine output/ serum sodium

Question 11

How is cerebral edema managed, what medication is used and at what dose

Answer 11

Decrease mass effect, pressure, and vascular permeability, Dexemethasone 10 mg IV, then 4-6 mg by mouth every 6 hours

Question 12

What are the adverse effects of dexamthasone

Answer 12

Myopathy, hyperglycemia, psychosis, edema, weight gain

Question 13

How is hydrocephalus treated in brain tumors

Answer 13

External ventricular drain

Question 14

What are the three most common herniations associated with Brain tumors/ most dangerous

Answer 14

Subfaicine herniation, Transfentorial (uncal), Tonsillar (cerebellar) herniation/ Cerebellar

Question 15

What drugs are used for seizure due to brain tumor

Answer 15

Valproic acid, phenytoin, phenobarbital

Question 16

What drugs are used to treat VTE and at what doses, monitor

Answer 16

Heparin 5000 units sc every 8 to 12 hours, enoxaparin 30 mg sc every 12 hours OR daleparin 5000 units sc every 24 hours, signs and symptoms of bleeding, PTT, INR, platelet

Question 17

What is the most common type of pituitary adenoma

Answer 17

Prolactinoma

Question 18

For a patient with prolactinma what are the treatment options, what type of surgeries

Answer 18

Dopamine receptor 2 agonist (bromocriptine, peroglide, cabergoline)/ trans-sphenoidal adenomectomy

Question 19

What happens after surgery of the pituitary

Answer 19

Reduction of certain hormones

Question 20

What should be given for ADH deficiency

Answer 20

Desmopressin: 100 mcg tablet OR 10 mcg spray ONCE IN A NOSTRIL OR 1 mg sc/iv

Question 21

What should be given for ACTH deficiency, TSH deficiency, Hypogonadism, GH

Answer 21

hydrocortisone or cortisone acetate, L-thyroxine, estrogen/progestrin for women, testosterone for men, GH 3-4 mcg/kg/day in adults (6-26 mcg/kg/day in kids)

Question 22

What is a good way to tell if a patient has little activity at the adrenal glands

Answer 22

They are hypotensive