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Neoplasm > Neoplasm > Flashcards

Neoplasm Flashcards

1
Q

This is histological findings of Opsoclonus-Myoclonus-Ataxia-Syndrome

A

Mild loss of purkinje and inferior olives and brainstem

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2
Q

Recurrence rate of PCNSL

A

90%

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3
Q

What is the main feature of optic glioma

A

Ocular proptosis

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4
Q

What is the most common glioma of Spinal cord

A

ependymoma

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5
Q

Antineuronal antibody is associated with what paraneoplastic syndrome

A

Indistinguishible to ALS

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6
Q

The following are diagnostic of Angioblastic intravascular lymphoma

A

(+) C-ANCA
CSF: high CHON and negative cells
Elevated LDH and ESR

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7
Q

What predicts longer survival in patients with oligodendroglioma

A

Loss of 19q

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8
Q

What associated virus is implicated to castleman disease

A

EBV and HHV 8 and 6

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9
Q

This condition is presents as subacute onset and steady progression over weeks characterized by symmetrical ataxia of gait dysarthria and nystagmus

A

Paraneoplastic cerebellar degeneration

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10
Q

Female to male ratio of meningioma

A

2:1

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11
Q

3 pattern of intracranial metastasis

A

Skull/Dura
Brain
Craniospinal Meninges

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12
Q

Cytotoxic edema is observed in the following setting

A

hypoxic-ischemic injury

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13
Q

What causes Acromegaly?

A

Overproduction of GH after puberty

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14
Q

Increase in protein in patient with neoplasm can be explained by

A

Extension of tumor in meningeal surface or ventricular wall

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15
Q

What distinguishes metastatic tumor from primary ones

A

multiple nodular deposits of tumor on imaging

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16
Q

Associated antibody in Paraneoplastic cerebellar degeneration

A

anti-Yo

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17
Q

Treatment of colloid cyst

A

Surgery
VP shunting
Aspiration of cyst

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18
Q

MRI findings of Limbic encephalitis

A

T2 hyperintensity and edema with focal necrosis

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19
Q

This disease is characterized by infiltration of glial cells on one or both hemisphere

A

Gliomatosis Cerebri

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20
Q

Irradiation in metastatic brain tumor is given in

A

2 weeks period

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21
Q

What is the 5 year survival after surgery in lowgrade astrocytoma

A

90%

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22
Q

Most common cause of ischemic necrosis of the pituitary

A

Sheehan’s syndrome

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23
Q

Anti-Hu antibody is associated with this paraneoplastic syndrome

A

Sensory Neuropathy

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24
Q

MRI findings of Angioblastic Intravascvular lymphoma

A

Multiple nodular and variegated abnormality on T2 weighted image (contrast enhancing)

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25
Q

What are the associated diseases of Carotid body tumor

A

NF-1

VHL

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26
Q

MRI findings of Anti-NKDA encephalitis

A

T2 hyperintensity on the medial temporal lobe

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27
Q

Tumors that arise in Pons or in 4th ventricle that may manifest as CPA

A

Ependymoma
Astrocytoma
Papilloma
Medulloblastoma

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28
Q

How many patients with astrocytoma/low-grade where seizure is the most common presentation

A

2/3

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29
Q

Most common solid tumor of childhood

A

Neuroblastoma

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30
Q

Why is Pineal Gland not included in WHO classification

A

Classified as Germ Cell Tumor

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31
Q

This is characterized by astrocytes that tends to infiltrate tracts and nuclei, symptoms depends on the location

A

Brainstem glioma

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32
Q

The following is suggestive of poor outcome in neuroblastoma

A

Mutation of chr. 1 and 11

MYCN amplification or overexpression

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33
Q

How many percent of GBM located in hemisphere

A

80%

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34
Q

What elements is used in brachytherapy

A

Iodine 125

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35
Q

How is temozolamide given

A

7-5m/m tapering dose in 4 weeks then 5 days every 28 days for 6 years

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36
Q

Associated cancer of Opsoclonus-Myoclonus-Ataxia-Syndrome

A

Breast cancer

Small cell lung carconmoma

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37
Q

What is the common feature of oliogodendroglioma and low grade gliomas

A

fine granules of calcium

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38
Q

What is the diagnostic marker for biopsy in astrocytoma

A

GFAP

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39
Q

Treatment of optic glioma may differ from location

A

pre chiasmastic - surgical extirpatiom

chiasmatic - partial resection then RT

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40
Q

What differentiate Cushing Disease and Cushing syndrome

A

Cushing Disease - excess secretion of pituitary ACTH

Cushing Syndrome - Excess cortisol

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41
Q

Risk factors for Pituitary apoplexy

A 
anticoagulation
RADIATION
pituitary function tests
bromocriptine treatment
Head trauma
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42
Q

This tumor originates from non-chromaffin paranglioma cells found in the adventitia of jugular bulb

A

Glomus Jugulare Tumor

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43
Q

This disorder are low-grade malignant composed of glial cells astrocytes and neurons with various degrees of differentiation

A

Gangliomas

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44
Q

Imaging findings of Cytotoxic Edema

A

Decreased attenuation in CT
Hyperintensity in T2
Increased anisotropy on DWI

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45
Q

This tumor is characterized by ataxia of gait with signs of increased ICP with associated hepatic and pancreatic cyst

A

Hemangioblastoma of Cerebellum

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46
Q

Enlargement of tumor size can be explained by:

A

extensive demyelination and loss of oligodendrocytes with degree of necrosis

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47
Q

Infratentorial ependymoma accounts for how many percent

A

40%

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48
Q

What is the cut-off age 2nd surgery in recurrent GBM

A

40 years old and less

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49
Q

What leukemia has high predilection to infiltrate nervous system

A

AML > CML

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50
Q

Histologic findings of Germinoma

A

Large epithelial cells separated by network of reticular connective network tissue and contains lymphocytes

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51
Q

Symptoms of Adamantinoma

A

Children: blindness, DI, and adiposity
Adult: Weakness of legs, headache, waninglibido

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52
Q

Treatment of Anaplastic Ependymoma

A

RT and antineoplastic agents

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53
Q

What is the most frequent acquired genetic defect in Meningioma

A

NF2 gene(merlin) found in chr 22q

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54
Q

This accounts for poor neoplastic transformation of cerebellar stem cell at various stage

A

deletion of Chr 17 distal to p53

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55
Q

Other tumors of CPA

A 
Neurinoma 
Meningioma
Cholesteoma
Gliomus Jugularae Tumor
Neoplastic meningitis
Arachnoid Cyst
Epidural Plasmacytoma of petrous bone
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56
Q

Brainstem metastasis most often originate from what malignancy

A

lung cancer

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57
Q

MRI findings of pituitary ademoma

A

enhancing and only visualized if more than 3mm

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58
Q

What is the diagnostic marker for Pineal germinoma

A

B-HCG

AFP

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59
Q

What is the cell of origin of PCNSL

A

reticulum cells a histiocyte component of germinal center of the LN (B-Lymphocytes)

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60
Q

Neurological manifestation of Glomus Jugulare Tumors

A

Partial Deafness
Facial Palsy
Dysphagia
Unilateral Atrophy of tongue

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61
Q

This disease is characterized by loss of SC interneurons

A

stiffman syndrome

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62
Q

Associated antibody in LEMS

A

CRMP-5

Anti-Hu

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63
Q

Lhermitte Ducos Disease is associated with mutation of this gene

A

PTEN gene

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64
Q

This is characterized by rapid progression of degeneration of the spinal cord ascending sensorimotor deficit

A

Carcinomatous Myelopathy

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65
Q

What is the most common extracranial malignant tumor of infancy

A

Retinoblastoma

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66
Q

Manifestation of sphenoid wing meningioma

A 
anosmia
occulomotor palsies 
painful ophthalmoplegia
Foster Kennedy Syndrome
Uncinate Fits
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67
Q

Survival rate of PCNLS in immunocompetent individual

A

3 years

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68
Q

GH and TSH are secreted by this pituitary cells

A

Chromophobe

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69
Q

All tumors in sellar regions are classified as grade___

A

I

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70
Q

4 Histologic types of pineal tumors

A
  1. Germinoma
  2. Non-Germinoma
  3. Pinealoma
  4. Glioma
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71
Q

The presence of bridges between tumor cells is highly suggestive of this tumor

A

Adamantinoma

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72
Q

Adverse effect of Temozolamide

A

Thrombocytopenia
Leukopenia
Pneumocystis Carinii

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73
Q

treatment for Paraneoplastic cerebellar degeneration

A

Plasma exchange
IVIG
Removal of Primary tumor

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74
Q

What oral drug used in GBM

A

Temazolamide

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75
Q

What distinguishes GBM from anaplastic glioma

A

Variegated appearance

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76
Q

Vestibular schwanomma is associated with what disease

A

Von Recklinghausen disease

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77
Q

This neoplasm is characterized by soft jelly gray arise from primitive notochord

A

chordoma

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78
Q

How can hyperventilation alleviate increase ICP

A

reduced brain volume by producing respiratory alkaalosis

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79
Q

How many percent of pituitary tumors are prolactinoma

A

70%

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80
Q

Associated antibody with Opsoclonus-Myoclonus-Ataxia-Syndrome

A

Anti Ri

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81
Q

Treatment of Carotid body tumor

A

Surgical excision with or without embolization

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82
Q

Typical posture of patients with medulloblastoma

A

Head tilt the occiput is tilted back and away from the side of tumor

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83
Q

What is the imaging findings of vasogenic edema

A

Hyperintense T1
Decrease attenuation on CT
Decrease anisotropy on MRI

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84
Q

Characteristic feature of suprasellar arachnoid cyst where excision may result to resolution

A

Bobble head doll syndrome

Seesaw and pendular nystagmus

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85
Q

Median survival rate of patients with carcinomatous meningitis

A

6 months

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86
Q

Pathological findings in Paraneoplastic cerebellar degeneration

A

diffuse degenerative changes in cerebellar cortex as well as deep nuclei and tracts (posterior column and spinocerebellar tract)

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87
Q

Carcinomatous Myelopathy is associated. with what malignancy

A

Bronchogenic

Hodgkin

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88
Q

Presence of this histologic feature in medulloblastoma is suggestive of better prognosis

A

Desmoplastic

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89
Q

This tumor occur sporadically involving CN VIII

A

Vestibular schwanomma

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90
Q

What malignancy is associated with Stiffman syndrome

A

Breast cancer

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91
Q

location of limbic encepahalitis

A

Medial temporal lobe

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92
Q

PCNSL accounts for how many percent of all brain tumor

A

3%

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93
Q

This is an intracranial neoplasm that is derived from connective tissue elements

A

Sarcoma of the brain

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94
Q

Manner of mechanism of spread of PCNSL

A

systemic lymphoma with propensity to metastasis to NS

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95
Q

Initial symptoms of gliomatosis cerebri

A

frontal lobe syndrome
Depression
Subacute dementia
Pseudotumor cerebri

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96
Q

Common location of chordoma

A

a. clivus

b. sacrococcygeal regions

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97
Q

This tumor arise from the mucus membrane or nasopharynx near the eustachian tube

A

NPCa

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98
Q

Histology of Glomus Jugulare Tumor

A

Large epithelial cells arranged in alveolar pattern

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99
Q

The imaging of this tumor density depends on the hydration status of the patient

A

Colloid cyst

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100
Q

3 syndrome of Radiation Damage

A
  1. Acute
  2. Early Delayed
  3. Late Delayed
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101
Q

This disorder is characterized by widespread dissemination of tumor cells throughout the meninges and ventricles

A

Carcinomatous meningitis

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102
Q

Common site of growth medulloblastoma

A

cerebellar vermis

roof of 4th ventricle

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103
Q

Dose of mannitol

A

0.5-1kg/bw

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104
Q

This antibody is the pathogenic of NMDA subunits

A

NR1

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105
Q

3 groups of paraneoplastic neoplastic syndromes of motor neurons

A
  1. Rapidly progressive amyotrophy and fasciculation with or without reflex
  2. Predominantly corticospinal tract
  3. Indistinguishible to ALS
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106
Q

This results from an infarction of adenoma that outgrown its blood supply

A

Pituitary apoplexy

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107
Q

What is the most initial presentation of oligodendroglioma

A

Seizure (50%)

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108
Q

What syndrome is associated with Hemangioblastoma

A

Von Hippel Lindau Disease (VHL)

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109
Q

How many percent of PCNSL are located in cortex

A

60%

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110
Q

Differential diagnosis of Chordoma

A

Wegeners granulomatosis
Erdheim-Chester disease
Sarcoidosis
Chondrosarcoma

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111
Q

Diagnosis of NPCa depends on the following

A

inspection
biopsy
lymph node involvement

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112
Q

Treatment for carcinomatous meningitis

A

Symptomatic therapy for symptomatic areas followed by IV MTX into lateral ventricles

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113
Q

This makes up 1/3 of metastatic malignancy of CNS

A

Lungs

then breast then MELANOMA

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114
Q

This is a multifocal neoplasm of large anaplastic monoclonal lymphocytes that infiltrate the wall of BV

A

Angioblastic Lymphoma

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115
Q

Temazolamide increases median survival if without RT

A

14.6 years

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116
Q

This occurs in children with neuroblastoma

A

Opsoclonus-Myoclonus-Ataxia-Syndrome

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117
Q

These antibodies are seen in patient with brainstem encephalitis

A

CRMPS
anti MA1
anti MA2

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118
Q

Associated antibody to rapidly progressive amyotrophy and fasciculation with or without reflex

A

anti-Hu

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119
Q

What is the characteristic behavior of PCNSL

A

Disappearance or complex resolutionin response to corticosteroids

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120
Q

What should be check to children with patient with hemangioblastoma

A

Renal cell carcinoma

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121
Q

Primary tumor accounts for how many percent of intracranial neoplasm

A

15/100,000

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122
Q

what is the central feature of limbic encephalitis

A

amnestic component

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123
Q

What causes empty sella syndrome

A

Defect of dural diaphragm due to stable of increased ICP

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124
Q

Sarcoma of brain is how many percent of all intracranial neoplasm

A

1-3%

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125
Q

Oligodendroglioma is how many percent of all intracranial neoplasm

A

5-7%

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126
Q

Clinical manifestation of colloid cyst

A

Drop attacks

headache modified by posture - ball valve obstruction

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127
Q

Ependymoma is how many percent of all intracranial glioblastoma

A

6%

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128
Q

Collection of neuroepithelial cells and clusters of oligodendrocytes with multinodular architecture with MUCINOUS cyst

A

Desmoplastic infantile ganglion Xanthpastrocytoma

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129
Q

IDH 1 and 2 is associated with what outcome and behavior of tumor

A

better outcome and slower progression

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130
Q

Breast cancer goes to CNS via what pathway

A

systemic spread via Batson Plexus

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131
Q

Onset of late delayed radiation injury

A

3 months to years

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132
Q

Age onset of Glioma of brainstem

A

80% before 20 years old

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133
Q

Most common location of ependymoma in childhood

A

4th ventricle

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134
Q

Cerebellar Foramen

A

Downward displacement of parts of cerebellar hemisphere

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135
Q

Pathological findings of papilloma of choroid plexus

A

Cuboidal epithelium of plexus closely related to ependymoma

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136
Q

What is the tumor antigen involve in Papilloma of choroid plexus

A

SV40 virus

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137
Q

Mutation of this oncogene is seen in younger patient

A

p53

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138
Q

What causes papilledema

A

Rise in intracranial and perioptic pressure leads to impair axonal transport to optic nerve serous drainage

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139
Q

What is the management of PCNSL in immunocomoetent individual

A

MTX and cytosine arabinose

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140
Q

What is the treatment of Gliomatosis Cerebri

A

Corticosterioids

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141
Q

MRI findings of Brainstem glioma

A

T1 hypointense

T2 heterogeneously increased

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142
Q

Histological feature is characterized by elongated bipolar cells

A

Pilocytic cell

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143
Q

Low-grade and intermediate glioma accounts to how many percent of all gliomas

A

25-30%

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144
Q

These are cells that are primitive looking

A

Blastoma

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145
Q

How many percent patients with neoplasm has seizure

A

25-50%

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146
Q

Meningioma is derived from

A

arachnoidal meningothelial cells specially those forming arachnoid villi

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147
Q

Age predilection of gangliomas

A

young

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148
Q

Differential diagnosis of pituitary tumors

A

Saccular aneurysm
Meningism tuberculous of sellae
MS
Empty Sella Syndrome

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149
Q

This tumor is derived from enpendymal cell of vertigial ventricular structure “paraphysis”

A

Colloid cyst

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150
Q

Recurrence of Adamantinoma usually occur?

A

3 years

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151
Q

CSF picture of leukemia of NS

A

Lymphocytes predominance (similar to carcinomatous meningitis)

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152
Q

How does NS is affected by leukemia

A

infiltration of leptomeningeal and cranial spinal nerve roots

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153
Q

Associated cancer of Anti-NMDA encephalitis

A

teratoma
ovarian ca
small cell ca

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154
Q

Most common site of oligodendroglioma

A

Frontal and temporal

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155
Q

Solid tumor in children accounts for how many percent of intracranial neoplasm

A

22%

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156
Q

Mulicentricity of GBM occurs in how many percent of patient

A

3-6%

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157
Q

CSF picture of Anti-NMDA enccephalitis

A

(+) WBC

(+) oligoclonal bands

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158
Q

Mutation of NF-2 would usually occur during what age

A

before 21 years old

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159
Q

What syndrome is associated with anti NMDA

A

Ophelia syndrome

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160
Q

This ependymoma is characterized by high mitotic activity and nuclear atypia

A

Anaplastic ependymoma

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161
Q

Histologic features of Meningioma

A

round elongated nuclei with cytoplasmic membrane forming whorls “psammoma bodies”

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162
Q

Histological findings of limbic encephalitis

A

extensive loss of neuron with microglial proliferation and small patches of necrosis and perivascular cuffing

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163
Q

This syndrome is characterized by acral growrg, visceromegaly, HA andendocrine disorders (DM and hypermetabolism)

A

Acromegaly

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164
Q

What are clues of malignant meningioma

A

High mitotic activity
Nuclear atypia
Marked nuclear and cellular pleomorphism
Invasiveness of brain

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165
Q

In Ependymoma, RT would assist Surgery in

A

address the high rate of seeding in the ventricles

166
Q

What symptoms usually results to good survival in brainstem glioma

A

Patient who initially presents long tract signs has increase survival

167
Q

What tumor classification of medulloblastoma

A

PNET

168
Q

What is the disadvantage of gamma knife in management of pituitary adenoma

A

Effects after several months

169
Q

The duration of amenorrhea is directly proportional to:

A

Level of prolactin

170
Q

Where in the neuroaxis does systemic lymphoma woukd manifest

A

SC or cauda equina

171
Q

Why is white matter causes edema

A

Because of its loose structural organization which offers less resistance to fluid under pressure

172
Q

Mean age for anaplastic glioma

A

46 years old

173
Q

What is the most sensitive auditory evoked response in the presence of acoustic schwanomma

A

BAER

174
Q

Stain used in Pineal tumors

A

Silver carbonate

175
Q

This is a non-tumorous enlargement of sella

A

Empty sella syndrome

176
Q

How is PCNSL diagnose

A

stereotactic needle biopsy

177
Q

Age of onset of retinoblastoma

A

80% before 5 years old

178
Q

Treatment for Glomus Jugulare Tumor

A

Radical Mastoidectomy follows irradiation

Embolization prior to surgery

179
Q

Associated antibody to predominantly corticospinal tract

A

none

180
Q

Treatment of Medulloblastoma

A

Maximal resection of tumor

CT and RT of the entire neuroaxis

181
Q

Treatment for limbic encephalitis

A

Plasma Exchange

Anti VGKL

182
Q

CSF findings of Carcinomatous Myelopathy

A

Increased CHON

(+) oligoclonal bands

183
Q

4 Categories of Meningioma

A

Meningothelial or Syncitial
Fibroblastic
Angioplastic
Malignant Type

184
Q

What is the most common pareneoplastic neurlogic syndrome

A

Lambert Eaton Syndrome (LEMS)

185
Q

Vestibular schwannoma will occur during

A

5th-6th decade of life

186
Q

Differential diagnosis of BS glioma

A

Pontine MS
Vascular malformation of pons
Brainstem encephalitis

187
Q

Survival rate of PCNSL in AIDS

A

10-18months

188
Q

This astrocytoma is characterized by enlarged cell distended with hyaline and eosinophils

A

Gemistocytic

189
Q

What should not be given RT in oligodendroglioma

A

well-differentiated oligodendroglioma

190
Q

Craniopharyngioma originate from what cell elements

A

Cell nest at the junction of infindubulum and pituitary

Rathkes Pouch

191
Q

Diagnostic picture of Acromegaly

A 
Increased GH (>0.10ng/ml)
Failure of GH in respopnse to glucose and TRH
192
Q

Surgical extirpation in metastatic brain disease is indicated in the following settings:

A

Single Parenchymatous
Growth of primary tumor and metastasis are under good control
Accessible to surgery
Not located at motor and language area

193
Q

What medication causes SSS thrombosis

A

Phenytoin and radiation

194
Q

Early CT/MRI findings of Paraneoplastic cerebellar degeneration

A

none

late - atrophy of BS and cerebellum

195
Q

Pattern of inheritance of VHL

A

AD

196
Q

Characterized by focal motor symptoms secondary to enlargement of tumor size

A

Early radiation syndrome

197
Q

Pathophysiology of GBM

A

Hypercellularity with pleomorphism of cells and nuclear atypia
Giant cells and mitosis
Hyperplasia of endothelial cells
Necrosis & hemorrhage with thrombosis

198
Q

Meningioma originates in the following structures

A

Dura and Arachnoid

199
Q

Treatment for hemangioblastoma of cerebellum

A

Craniotomy and opening of cerebellar cyst and excision of hemangioblastomatpous nodule
Endovascular embolization

200
Q

Pineal Glioma is derived from what structures

A

astroglial cell of pineal body

201
Q

Age of onset of oligodendroglioma

A

3rd-4th decade of life

202
Q

treatment for arachnoid cyst

A

Asymptomatic - leave alone

Symptomatic - check for subdural hemorrhage

203
Q

Other name for lyphomatoid granulomatosis

A

Castleman disease

204
Q

What are the association metastatic malignancy in infratentorial area

A

Pelvic and colon

205
Q

How many cycles should PCV given

A

6 cycles

206
Q

What is the radiation dose for cranial nerves encephalopathy

A

Radiation at 3,000 cGy in 10 divided dose for 10 days

207
Q

Diagnostic for Cushing Disease

A

Excess plasma and urinary cortisol not suppressed by dexamethasone in small dose but can be suppressed by higher dose

208
Q

What is the management of Anti-NMDA encephalitis if there is no tumor

A

IVIG

209
Q

Subependymal giant cell astrocytoma are usually found in

A

Foramen of monroe

210
Q

Gangliocytomas may grow in the following sites:

A 
Adrenal gland
Thoracic sympathetic 
Internal auditory canal
SC
Cerebellum
211
Q

Cerebellar degeneration is associated with what malignancy

A

Ovarian ca

Hodgkin’s disease

212
Q

This tumor is characterized by clock paralysis and atropy weakness of hands and intercostals

A

Foramen magnum tumor

213
Q

Treatment for non-germcell pineal tumors

A

Radiation and Surgery

214
Q

Imaging findings of oligodendroglioma

A

T2 hyperintensity heterogenous mass with well-defined borders
Intratumoral calcification > 1/2
Enhance with contrast

215
Q

Imaging findings of GBM

A

Homogenous mass with center that is hypointense and non enhancing with irregular rim of enhancement surrounding the core lesion

216
Q

What is the function of Erlotinib and Gefinitinib

A

Tyrosine kinase inhibitors that is responsive to upregulated of EGFR

217
Q

What is the prognosis of GBM if with surgery and RT

A

12 months

218
Q

What type of lymphoma has a high tendency to cause meningeal dissemination

A

non Hodgkin lymphoma

219
Q

Imaging of Pilocytic astrocytoma

A 
Sharply demarcated and smooth borders 
T1 hypointensity
T2 hyperintensity
enhanced nodular distal portion
with cystic and calcium in cerebellar lesion
220
Q

Tumor brush is defined as

A

tendency to calcify as their prominent vascularity

221
Q

Imaging of Fibrillary Tumor

A

less stereotyped appearance
T1 hypointensity
T2 hyperintensity
no contrast enhancement

222
Q

Vomiting and Dizziness is seen mostly seen in patient with tumor in these regions

A

posterior fossa

223
Q

Types of Pinealoma (3)

A
  1. Pineacytoma
  2. atypical pineacytoma
  3. pineablastoma
224
Q

MRI findings of gliomatosis cerebri

A

one or more confluent area of signal changes

Contrast enhancing is scant

225
Q

Main syndrome of neuroblastoma

A

Polymyoclonus
Opsoclonus
Ataxia

226
Q

Early stage neuroblastoma management

A

Observe, most of them regress spontaneously

227
Q

Treatment (medulloblastoma)
Low Risk - _________
Intermediate- __________
High Risk - ____________

A

Treatment (medulloblastoma)
Low Risk - observe
Intermediate- CT
High Risk - Sx, RT and CT

228
Q

Differential diagnosis of Tumor of Foramen Magnum

A

Chiari malformation
MS
Syringomyelia
Bony abnormalities at craniocervical junction

229
Q

Meningioma is how many percent of all primary intracranial neoplasm

A

15%

230
Q

What is the management of ependymoma

A

Surgical excision
VP shunting
irradiation

231
Q

Gene that is involve in retinoblastoma

A

RB gene

232
Q

What predicts the responsiveness of recurrent gliomas to treatment

A

suppression of PTEN

233
Q

Imaging findings of PCNSL

A

dense homogenous enhancing infiltrating

non-necrotic , non-hemorrhagic periventricular masses

234
Q

What is the characteristic feature of chordoma

A

This is the only tumor that may manifest both intracranial and extracranial mass

235
Q

What is the etiology of Cushing Disease

A

Hyperplasia of pituitary basophilic cells or non basophilic micradenoma

236
Q

This disease is characterized by lesion in photoreceptor cells and manifest with scotoma and attenuation of retinal arterioles

A

Paraneoplastic retinopathy

237
Q

This tumor causes visual disturbances related to the borders of sella tursica

A

Pituitary adenoma

238
Q

What is the permanent cure for meningioma

A

Surgical Excision

239
Q

What virus is involved in Angioblastic intravascular lymphoma

A

EBV

240
Q

This tumor grows slowly forming a mass in the cerebellum composed of granule, purkinje and glial cells

A

Lhermitte Ducos

241
Q

How many percent of patient will have recurrence in one year in pituitary adenoma

A

15%

242
Q

What stain can the fried egg appearance is better visualized

A

Silver Carbomate

243
Q

When is craniotomy indicated in pituitary adenoma

A

extrasellar extensive of pituitary growth with transfrontal approach followed by RT

244
Q

This disease is characterized by acute to subacute psychiatric manifestation in combination with hallucination, panic disorder and memory disturbance

A

Anti-NMDA Encephalitis

245
Q

Imaging findings of Ependymoma

A

CT: well demarcated heterogenous hyperdense mass with uniform enhancement
MRI: HypoT1 HyperT2 with calcification

246
Q

What is the characteristic feature of arachnoid cyst in infants

A

Extensive transillumination and macrosomia

247
Q

This manifest during child bearing years where it is induced by OCP use when was stop cycle is not reestablish the cycle

A

Ammenorhea-Galactorrhea syndrome

248
Q

What makes the meningioma highly vascularized and prominent edema

A

VEGF

249
Q

(1) 2nd most frequency next to anti-Hu associated with what carcinoma (2)

A
  1. CRMS

2. lung carcinoma

250
Q

Treatment of disseminated lymphoma of NS

A

RT + chemotherapy

251
Q

Common location of brainstem glioma

A

Dorsal

252
Q

Where does anti-Yo binds that promotes cerebellar degeneration

A

C-MYC

253
Q

Diagnostic tool used in carcinomatosis meningitis

A

CSF analysis with cytology & flow cytometry techniques

254
Q

This tumor invaginate the 3rd ventricle and blocks the foramen monroe

A

suprasellar arachnoid cyst

255
Q

Median survival of RT alone in GBM

A

12.1

256
Q

In astrocytoma, if treated early, the survival rate is

A

5.3 years

257
Q

initial manifestation of sphenoid wing meningioma

A

Exophthalmos

258
Q

Supratentorial meningioma accounts of how many percent of all meningioma based on location

A

90%

259
Q

Extracranial metastatasis of medulloblastoma occurs where

A

Liver lung scalp and LN

260
Q

Treatment of retinoblastoma

A

early recognition
radiation
surgery

261
Q

Neurological symptoms of carcinomatous meningitis

A 
Headache
Backache 
Sciatica 
Cauda Equina
Multiple craniopathies
262
Q

Symptoms of ependymoma

A

Similar to medulloblastoma except protracted course and lacks cerebellar signs

263
Q

This disorder is characterized by continuous muscle fiber activity

A

Chorea Fibrillaire

264
Q

This tumor are found in 20% with tuberous sclerosis

A

Subependymal giant cell astrocytoma

265
Q

PCV regimen includes

A

Procarbazine Cyclophosphamide and Vincristine

266
Q

Treatment of Neuroblastoma

A

Depends on clinical staging

267
Q

Treatment for BS glioma(Diffuse infiltrative type)

A

RT and VP shunting

partial resection - long term survival

268
Q

This tumor manifests as painless mass at the side of neck below the angle of jaw

A

Carotid body tumor

269
Q

What are the markers in oligodendroglioma that confer benefit

A

Loss of 1p

IDH1 mutation

270
Q

5 years survival in medulloblastoma with treatment

A

80%

271
Q

Reticulum cell sarcoma

A

CNS Lymphoma

272
Q

What is a pleuripotent stem cells

A

this cells are capable of differentiating into neuronal or glial elements

273
Q

Rb gene is associated in what loss of chromosome

A

Chr 10

274
Q

What antiangiogenic agents can be given in patient with NF-2

A

Becacizumab

275
Q

What causes loosening of BBB by allowing passing of blood products

A

Protease

276
Q

Most common histological feature of astrocytoma

A

Fibrillary

277
Q

Analogue of somatostatin shown to reduced tumor size

A

Octreotide 200mg/d

278
Q

Outcome of GBM if no treatment

A

7-9 months

279
Q

This is a dopamine agonist used in adjunct galactorrhea syndrome where it reduces the tumor size and improvement of visual symptoms

A

Bromocriptine 0.5-1.25 OD

280
Q

This disorder is characterized failure of a slow bitemporal hemianopia without endocrine deficit

A

Meningioma of tuberculum sellae

281
Q

CT/MRI findings of optic glioma

A

tumor and enlargement of optic foramen >7mm

282
Q

The deletion of this gene is seen in 50% with astrocytoma

A

p53

283
Q

This tumor is characterized by its systemic malignant tumor that metastasize to base of skull specifically to anterior fossa

A

Esthesioneuroblastoma

284
Q

Antibody associated with Carcinomatous Myelopathy

A

Anti-Hu

285
Q

treatment for germ cell pineal tumor

A

Surgery

286
Q

Other neurological findings in paraneoplastic cerebellar degeneration

A 
Myoclonus
Opsoclonus
SNHL
Diplopia
Vertigo
287
Q

Malignant types ependymoma would present symptoms as

A

First symptoms to 4 weeks after diagnosis is suggestive of malignant type

288
Q

What are the possible causes if the onset is sudden in metastatic brain tumor

A

Tumoral bleed

Non bacterial thrombotic endocarditis with cerebral embolism

289
Q

PNET tumors are recognized as:

A

small cell glioma

undifferential embryonal origin

290
Q

Treatment of Papilloma of Choroid plexus

A

Surgical excision

VP shunting

291
Q

What is the most cellular elements affected in pituitary adenoma

A

Chromophobe > Acidophil > Basophil (CAB) 5:4:1

292
Q

(7) Grade IV WHO Classification of tumor

A 
GBM
Giant cell glioblastoma
Gliosarcoma
Medulloblastoma
PNET
Atypical Teratoma
MPNST
293
Q

Give 4 viruses that are associated with primary tumor

A

HPV
HBV
EBV
HTLV

294
Q

What condition predisposes to empty sella syndrome

A

Pseudotumor cerebri
Post-excision of pituitary adenoma
Hydrocephalus

295
Q

Biomarkers of carcinomatous meningitis

A

LDH
B-Glucoronidase
B-Globulin
CEA

296
Q

What drugs can be used in patients with interstitial edema

A

Furosemide and acetazolamide

297
Q

This herniation is associated with cingulate gyrus is pushed under the falx

A

Subfalcine

298
Q

Patient who had neurological signs and symptoms when treatment is initiated the median survival is

A

3.4 years

299
Q

What is the management of ocular lymphoma

A

irradiation ONLY!

300
Q

Give 4 tumors that occurs before age of 20

A

Medulloblastoma
Polar Spongioblastoma
Optic Nerve Glioma
Pinealoma

301
Q

Pattern of growth of pituitary adenoma

A

Pituitary > Optic chiasm > cavernous sinus > 3rd ventricle > posterior fossa

302
Q

Radiation dosage that is proven to increase survival of 5 years

A

6,000 cGY

303
Q

This accounts for 50% of pineal tumors

A

Germinoma

304
Q

Histological classification of astrocytoma

A

Fibrillary
Gemistocytic
Pilocytic
Mixed Type

305
Q

Rate of growth of tumor depends on the following

A

Nuclear atypia
Cellularity
Mitosis
Vascular Proliferation

306
Q

What chromosome does p53 is found

A

Chr. 17

307
Q

Pathologic findings of medulloblastoma

A

Closely packed hyperchromatic nuclei little cytoplasm and many nuclei (PSEUDOROSETTES)

308
Q

Radiographic findings of Desmoplastic infantile ganglion xanthoastrocytoma

A

Nodule or small cyst
hyperintense T2
Non-enhancing

309
Q

What are the common locations of papilloma of choroid plexus with percentage

A

Lateral Ventricle 50%
4th ventricle 40%
3rd ventricle 10%

310
Q

Treatment for chordoma

A

Surgical excision and focused radiation

311
Q

What is the adverse effect of IV MTX in treating leukemia of NS

A

Necrotizing leukoencephalopathy

312
Q

This tumor is associated with Lhermitte Ducos Disease

A

Gangliocytoma

313
Q

Associated disorder of Chorea fibrillaire

A

Isaac Syndrome

Lunch cancer

314
Q

Neurological symptoms of pineal tumors (6)

A 
Increased ICP
Parinauds syndrome
Limb ataxia 
Oculomotor signs
Precocious puberty
Sleep not affected
315
Q

Tumor in the foramen accounts how many percent of all intracranial tumor

A

1%

316
Q

Fate of the brainstem glioma

A
  1. malignant transformation

2. spread to meninges - meningeal gliomatosis

317
Q

This tumor is similar to medulloblastoma but occurs in supratentorial region

A

PNET

318
Q

What is highly characteristic in acromegaly

A

Facial and bodily appearance

319
Q

Age and sex predilection of medulloblastoma

A

4-8 years old

M>F 3:1

320
Q

GBM is how many percent of all intracranial tumor

A

20%

321
Q

How many patient with neoplasm presents with headache

A

25%

322
Q

This tumor is high in AIDS and immunosuppressed state

A

PCNSL

323
Q

Treatment for oligodendrocytes

A

Surgical excision with RT

324
Q

What drug should be use to target in recurrent GBM

A

VEGF

325
Q

Increase ICP, seizure and worsening of tumor

A

Acute

326
Q

Medulloblastoma is derived from what stem cells

A

Pleuripotent stem cells

327
Q

Presence of this gene is associated with poor prognosis in medulloblastoma

A

C-MYC

328
Q

Where is the lateral of papilloma of choroid plexus where it manifests like CP angle tumor

A

lateral recess

329
Q

Where does olfactory groove meningioma originates

A

arachnoidal cells along the cribriform plate

330
Q

Most common location of ependymoma

A

4th ventricle

331
Q

What is the hallmark genetic defect of vestibular schwanomma is the inheritance is AD

A

NF-2

332
Q

Treatment for Anti-NMDA encephalitis

A

Removal of ovarian containing teratoma or other inciting tumor

333
Q

How many years survival in “loss of 1p” in oligodendrocytes

A

10 years

334
Q

2 Types of Ependymoma

A
  1. Ependymoma

2. Ependymoblastoma

335
Q

Favored sites of recurrence

A 
Cerebrum
Cerebellum
Hypothalamus
Optic Nerve
Optic Chiasm
336
Q

treatment for early radiation syndrome

A

Steroids

337
Q

Histologic findings of retinoblastoma

A

small cells with neurofibrils like neurofibroblastoma and has a tendency to form rosette

338
Q

Distinct features of limbic encephalitis

A 
confusional attack
memory deficit
seizure
dementia
hallucination
339
Q

Survival rate of anaplastic tumor

A

3-5 years

340
Q

Mean age of GBM

A

60 years old

341
Q

Ependymoma is derived from

A

Ependymal cells that lines the ventricles of brain and central canal

342
Q

Wha is the imaging findings of necrotizing leukoencephathy

A

Large areas of hypodensity

T2 Hyperintensity

343
Q

What growth factor is increased meningioma

A

VEGFR

344
Q

What is the common location of PCNSL

A

periventricular area

345
Q

What chromosome is involve in medulloblastoma

A

Chr 17

346
Q

Laminated calcific concretion of calcium deposits

A

Psammoma Bodies

347
Q

What agents increase the prolactin level in normal individual

A

Chlorpromazine

TRH

348
Q

What is the defective gene in Subependymal giant cell astrocytoma

A

mTOR

349
Q

Paraneoplastic syndromes associated with lung cancer

A

Sensory neuropathy

Myasthenic syndrome

350
Q

Location distribution of metastatic brain carcinoma

A

80% supratentorial

20% infratentorial

351
Q

The imaging findings of Lhermitted Ducos Disease

A

Alternating lesion of dysmorphic cerebellar cells

“TIGER SKIN:

352
Q

Histological findings of Carcinomatous myelopathy

A

Symmetrical necrosis of both gray and white matter of most cord

353
Q

What is the most important prognostic factor in intracranial neoplasm

A

Age

354
Q

MRI findings of radiation injury of the brain (Late-delayed)

A

Contrast enhancing lesion and avascular mass

355
Q

This neoplasm is characterized by dimming of vision, constriction of fields and papilledema

A

Optic glioma

356
Q

Familial Schwanomma is associated with mutation of these chromosome and gene

A

Chromosome: Chr.22
Gene: SMARCB1 gene

357
Q

Growth rate of Carotid body tumor

A

2cm every 5 years

358
Q

AB of LEMS is directed against what channel

A

Calcium

359
Q

This marker is associated with limbic encephalitis

A

anti-Hu

360
Q

What is the most common type of Meningioma

A

Syncitial

361
Q

This is the most serious radiation injury where it is characterized by necrosis of white matter of the brain

A

Late-Delayed Process

362
Q

This is a neuroectodermal cells that contains aggregate of paranglioma seen in patients residing in high altitude

A

Carotid Body Tumor (paraganglioma)

363
Q

Imaging findings of medulloblastoma

A

High intensity in both T1 and T2 with heterogenous enhancement at 4th ventricle

364
Q

Amplification of this gene is associated with poor outcome in patient with neuroblastoma and medulloblastoma

A

MYCN

365
Q

p16 is associated with overexpression of

A

EGF

366
Q

Differential diagnosis of Paraneoplastic cerebellar degeneration

A

CJD

Post-infectious cerebellitis

367
Q

Age of onset of hemangioblastoma of cerebellum

A

15-50 years old

368
Q

Surgical technique of schwanomma

A

Microsurgical suboccipital transmeatal approach

369
Q

What are other receptors found in meningioma

A

Estrogen and Progesterone

370
Q

Paraneoplastic Optic neuropathy is associated with what antibody

A

CRMP-5

371
Q

What is the acceptable radiation dose

A

6,000 cGY

372
Q

This tumor if covered the cerebral hemisphere may result to external hydrocephalus

A

Arachnoid cyst

373
Q

Incidence of primary tumor

A

46/100,000

374
Q

Histologic findings of PCNSL

A

highly cellular and grows around the blood vessel in angiocentric pattern

375
Q

What tumor where contents may cause chemical meningitis

A

Cholesteoma

376
Q

What is wutzelueth

A

inappropriate jocularity due to compression of inferior frontal lobe

377
Q

Sex predilection of chordoma

A

M>F

378
Q

What is the management of meningioma if located in Skull base and small in size

A

Focused radiation

379
Q

Amplification of this gene is associated with tumor in older patients

A

EGFR

380
Q

What disease should be exclude in the presence of lack of ballooning of sella

A

pituitary adenoma

suprasellar tumor

381
Q

This tumor has a predilection to grow in juxtacortical at lateral or medial temporal lobe

A

Desmoplastic infantile ganglion Xanthpastrocytoma

382
Q

What gene is responsible for transformation of oligodendrocytes and astrocytoma to malignant form

A

IDH 1 and IDH 2

383
Q

Mixed oligodendroglioma and astrocytoma treatment

A

treated as astrocytoma

Give Temazolamide

384
Q

This pineal tumors are highly cellular of small undifferentiated cells resemble to medulloblast

A

Pineblastoma

385
Q

Factors decrease the survival in medulloblastoma

A

Brainstem Invasion
Spinal Subarachnoid invasion
Incomplete removal
Very Early Onset

386
Q

What carcinoma is associated with limbic encephalitis

A

Small cell carcinoma (lung)

Hodgkin Lymphoma

387
Q

What is the most vulnerable to injury in radiation

A

dividing cells

388
Q

Associated malignancy with cerebellar degeneration

A

Lung cancer
Hodgkin
Lymphoma
Ovarian Tumor

389
Q

What is the most common of hemangioblastoma in SC

A

posterior column

390
Q

Most reliable diagnostic tool in radiation associated brain injury

A

PET-SCAN

391
Q

All GBM recur within how many cm of their original site

A

2cm

392
Q

Basophilic cells in pituitary are responsible for synthesize of what hormones

A

ACTH
LH
FSH

393
Q

Most common types of tumor in the foramen magnum

A

Meningioma > schwanomma > neurofibroma and dermoid cyst

394
Q

How to treat PCNSL

A

Corticosteroids and RT

395
Q

What chromosomes appear to correlate with good survival in patient with oligodendroglioma

A

Deletion of 1p and 19q

396
Q

Responsiveness to PCV can be determined by the presence of the gene defect

A

Loss of allele of Chr 1p

397
Q

The form of treatment of chordoma offers survival rate of

A

5 years without recurrence in 80%

398
Q

This is a systemic lesion with prominent nodular pulmonary, dermal and lymphnode

A

Lymphomatoid Granulomatosis

399
Q

Other condition that has anti-Hu antibody

A

Sjogrens

Small Cell Ca

400
Q

What is the treatment for angioblastic intravascular lymphoma

A

corticosteroids

401
Q

Age of onset of optic glioma

A

before age of 15

Mean age 3.5 years

402
Q

Small round nucleus and halo of unstained neoplasm

A

Fried egg appearance

403
Q

loss of long arm of Chr.22 in meningioma is due to

A

Deletion of Merlin

404
Q

What channel is defective in chorea fibrillaire

A

K channel

405
Q

Pineal tumor that tends to form pineacytomatous rosettes

A

Pineacytoma

406
Q

What is the prognosis of gliomatosis cerebri

A

POOR

407
Q

Pathological feature of ependymoma

A

rosettes around the blood vessels (pseudorosettes)T

408
Q

This is a tumor like formation that has its basis in maldelevelopment

A

Hamartroma

409
Q

The direction of CSF flow in the presence of suprasellar area

A

upward

410
Q

What gene is associated with glioma and oligodendroglioma

A

IDH 1 & 2

Neoplasm (1 decks)

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