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Clinical Medicine Lecture - Professor Kramer > Neuro: CNS Neoplasms > Flashcards

Neuro: CNS Neoplasms Flashcards

1
Q

Glioma bengin or malignant ?

A

malignant

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2
Q

Glioma Pathophysiology: Arises from ______________ that preferentially_______________ down one of the cellular lineages

A

progenitor cell

differentiates

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3
Q

Glioma types ?

A

Astrocytomas

Oligodendrogliomas

Ependymomas

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4
Q

Astrocytomas location ?

A

frontal

may occur anywher) -

Stage IV– Glioblastoma

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5
Q

Oligodendrogliomas location ?

A

cerebral hemispheres

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6
Q

Ependymomas location ?

A

ventricles, 4th most common

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7
Q

Glioma H and P ?

A

Seizure

Headache

Impaired cognition

Hemiparesis

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8
Q

Glioma Tx ?

A

Surgical resection / VP shunts

Anticonvulsants

Radiation / chemo

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9
Q

Medulloblastoma is what type of tumor ?

A

Malignant embryonic tumor

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10
Q

Medulloblastoma pathophysiology ?

A

granule cell progenitors or from multipotent progenitors from the ventricular zone

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11
Q

Medulloblastoma patho: often a genetic mutation of what pathway ?

A

sonic hedgehog

  • *basal cell carcinoma - sonic hedge hog
  • *
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12
Q

Medulloblastoma location ?

A

midline at the cerebellum

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13
Q

Medulloblastoma demographic ?

A

Primarily children

Most common malignant brain tumor of childhood

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14
Q

Medulloblastoma H and P ?

A

Headache

Ataxia

signs of brainstem involvement ( breathing dysfunction )

kids with HA

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15
Q

Medulloblastoma Treatment ?

A

Surgical resection

Radiation

Chemotherapy

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16
Q

Meningioma benign or malignant ?

A

Benign tumor

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17
Q

Meningioma pathophysiology ?

A

arise from the stromal arachnoid cells of the choroid plexus

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18
Q

Meningioma demographic ?

A

Mostly adults

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19
Q

Meningioma RF ?

A

Prior radiation

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20
Q

Meningioma H and P ?

A

Headache

Hemiparesis

Impaired cognition

21
Q

Meningioma Treatment ?

A

Monitor

Consider
Surgical resection if symptomatic

22
Q

Meningioma location ?

A

Often attach to dura

23
Q

Schwannoma malignant or benign ?

A

Benign tumor

24
Q

Schwannoma Pathophysiology ?

A

well-circumscribed, encapsulated masses

abut the associated nerve without invading it

25
Q

Schwannoma is most commonly a _______________ ?

A

acoustic neuroma

cerebellopontine angle, where they are attached to the vestibular branch of the eighth nerve

26
Q

Schwannoma demographic ?

27
Q

Schwannoma RF ?

A

Neurofibromatosis Type II

28
Q

Schwannoma H and P ?

A

Hearing loss– sensorineural

Vertigo– more continuous

29
Q

Schwannoma Treatment ?

A

Patient Education
-Consider patient population before treating
May choose not to treat

Options

  • Surgical excision
  • Focused radiation
30
Q

Schwannoma H and P as it gets larger ?

A

Midface numbness

Absent corneal reflex - compression CN5 but that actually action is 7

31
Q

Schwannoma H and P: Hearing loss - sensorineural ?

A

Gradual more common

in Rt ear and did a weber test - it will go t the left side the good side

Rinne test in right ear - AC > BC - NL
but auditory function will be a little less

**BC > AC - cerumen impaction, rupture TM, middle ear and external ear, inner ear and back is sensonueral , most common cause of sensinueral hearing loss - Presbycusis **

32
Q

Paraneoplastic neurologic syndromes types ?

A

Lambert-Eaton myasthenic

Subacute cerebellar

Sensory motor peripheral neuropathy

Stiff person syndrome

33
Q

Lambert-Eaton myasthenic syndrome pathophysiology ?

A

Antibody against presynaptic calcium channels at neuromuscular junction

34
Q

Lambert-Eaton myasthenic syndrome presentation ?

A

Weak muscles

Difficulty keeping eyes open

Trouble speaking

Trouble breathing - Diaphragm

35
Q

Lambert-Eaton myasthenic

big association ?

A

SC lung

Non small cell lung
Breast
GI
Lymphoma
Ovarian
36
Q

Subacute cerebellar syndrome pathophysiology ?

A

Autoimmune reaction toward Purkinje cells of the cerebellum

37
Q

Subacute cerebellar syndrome presentation ?

A 
Dysarthria
Ataxia
Vertigo
Diplopia
Nystagmus
38
Q

Subacute cerebellar syndrome association ?

A

Small cell carcinoma

Breast
GI
Lymphoma
Ovarian

39
Q

Sensory motor peripheral neuropathy pathophysiology ?

A

Anti-hu antibody attacking dorsal root ganglion (primary afferent pathway, anterior root is motor function which it is not attacking)

40
Q

Sensory motor peripheral neuropathy

presentation ?

A

Progressive sensory loss

Ataxia (intact strength)

41
Q

Sensory motor peripheral neuropathy association ?

A

Small cell lung

42
Q

Stiff person syndrome presentation ?

A

Severe muscle stiffness
-Back and legs primarily

May cause painful spasms

43
Q

Stiff person syndrome association ?

44
Q

Normal pressure hydrocephalus pathophysiology ?

A

Hydrocephalus with a patent aqueduct of Sylvius ( 4th ventricle - oligiodentrocytomas)

Presumed stretching and distortion of subfrontal white matter tracts may lead to clinical symptoms

45
Q

Normal pressure hydrocephalus diagnostic studies ?

A

CT no contrast or MRI

Lumbar puncture

46
Q

Normal pressure hydrocephalus diagnostic studies results: CT no contrast or MRI ?

A

Enlarged lateral ventricles

47
Q

Normal pressure hydrocephalus diagnostic studies results: LP ?

A

Pressure: normal (high normal)

Protein: normal

Glucose: normal

Cells: normal

48
Q

Normal pressure hydrocephalus complication ?

A

Improvement may be short
lasting despite treatment

Often comorbid Alzheimer’s

49
Q

Normal pressure hydrocephalus Treatment ?

A

Ventriculoperitoneal shunt (VP shunt)

Clinical Medicine Lecture - Professor Kramer (28 decks)

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