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Ultimate Neurosurgery > Neuro-oncology > Flashcards

Neuro-oncology Flashcards

1
Q

Most common primary brain tumor

A

Astrocytoma, of which grade IV (GBM) is the most malignant type

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2
Q

Location of ependymomas

A

Occur anywhere throughout the ventricular system or spinal canal, but is particularly common in the 4th ventricle and cauda equina

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3
Q

Uncommon cause of hydrocephalus due to excessive CSF production

A

Choroid plexus papilloma

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4
Q

Common location of PNETs

A

Commonly infrantentorially in children, where they are called medulloblastomas and found in the cerebellar vermis

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5
Q

Two common histopathological characteristics of meningiomas

A

Whorls of meningothelial and spindle cells, calcified psammoma bodies

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6
Q

Common locations of hemangioblastomas

A

Cerebellar parenchyma or spinal cord

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7
Q

Von Hippel-Lindau syndrome

A

Cerebellar or spinal cord hemangioblastomas with similar tumors in the retina and cystic lesions in the pancreas and kidney

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8
Q

Common location of primary CNS lymphoma

A

Forms around periventricular parenchymal blood vessels

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9
Q

Tumor marker for metastatic carcinoma

A

Cytokeratin

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10
Q

Tumor marker for neuronal tumors

A

Synaptophysin

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11
Q

Extrinsic tumors found in the posterior fossa

A

Schwannoma (VIII, V), meningioma, epidermoid/dermoid cyst, arachnoid cyst, mets

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12
Q

Intrinsic tumors found in the posterior fossa

A

Mets, hemangioblastoma, medulloblastoma, astrocytoma

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13
Q

Most common primary cerebellar tumor in adults

A

Hemangioblastoma

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14
Q

Imaging characteristics of hemangioblastomas

A

Strongly enhancing solid tumor in the cerebellum or a tumor nodule lying in the wall of a well defined cystic lesion

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15
Q

Most common location of medulloblastoma

A

Arise in the cerebellar vermis and usually extend into the 4th ventricle

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16
Q

Imaging characteristics of medulloblastoma

A

Isodense midline lesion in the cerebellar vermis, compressing and displacing the 4th ventricle and enhancing strongly with contrast

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17
Q

Most common location of cerebellar astrocytoma

A

Usually lie in the cerebellar hemisphere or vermis but occasionally extend through a peduncle into the brain stem

Many have cystic components

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18
Q

Imaging characteristics of cerebellar astrocytoma

A

Often a low density cystic area abuts or encircles the tumor mass

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19
Q

Most common location of epidermoid/dermoid cysts

A

Commonly found in the posterior fossa

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20
Q

Imaging characteristics of meningiomas

A

On T1 MRI - isointense with brain and diffusely enhance

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21
Q

Most common primary tumors with hemorrhage

A

GMB, oligodendroglioma, pituitary adenoma

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22
Q

Most common metastatic tumors with hemorrhage

A

Lung, melanoma, thyroid, renal, choriocarcinoma

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23
Q

Pneumonic for hemorrhagic tumors

A

CT MRB

Choriocarcinoma, thyroid, melanoma, renal, breast/bronchogenic

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24
Q

Pneumonic for ring-enhancing lesions

A

Magic Dr. L

Mets, abscess, GBM, infarct, cyst, demyelinating, radiation, lymphoma

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25
Q

Most common malignant brain tumor in children

A

Medulloblastoma

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26
Q

Medulloblastoma characteristics on CT scan

A

Hyperdense

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27
Q

Syndromes associated with medulloblastoma

A

Gorlin syndrome, Turcot syndrome, ataxia telangiectasia, and Li-Fraumeni syndrome

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28
Q

Gorlin syndrome

A

Autosomal dominant condition characterized by basal cell carcinoma, skeletal abnormalities, and microcephaly

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29
Q

Turcot syndrome

A

Increased risk of colorectal cancers and medulloblastoma

30
Q

Ataxia telangiectasia

A

Autosomal recessive disorder

Patients are at a higher risk for hematologic and breast cancer in addition to medulloblastoma

31
Q

Li-Fraumeni syndrome

A

Autosomal dominant disorder

Patients are at a higher risk for cancers of the breast, bone, soft tissue, brain, blood and adrenal cortex

32
Q

Common imaging characteristics of juvenile pilocytic astrocytoma (JPA)

A

Discrete cystic lesions with an enhancing mural nodule that tend to occur in the cerebellar hemisphere, optic nerve, hypothalamus, and brainstem

33
Q

Associations of optic nerve JPAs and well-differentiated astrocytomas

A

NF type II

34
Q

Characteristics of pleomorphic xanthoastrocytomas

A

Astrocytic neoplasms found in young adults with a long history of seizures

Usually superficial in the cerebral cortex and may consist of a mural nodule associated with a cyst

35
Q

Characteristics of oligodendroglial tumors

A

Most present in young adult with onset of seizures

Calcifications are typical

36
Q

Common location and presentation of ependymal tumors

A

Floor of the 4th ventricle and presents with increased ICP (nausea, vomiting, headache, gait ataxia, diplopia, vertigo)

37
Q

Important workup for ependymymas

A

Neuro-axis imaging for drop mets

38
Q

Treatment of intramedullary spinal cord ependymomas

A

Surgery alone

39
Q

Common location for myxopapillary ependymomas

A

Conus or filum terminale of the spinal cord

40
Q

Common locations for choroid plexus tumors

A

In children less than 2, they are usually located in the lateral ventricles

In adults, the usually occur in the 4th ventricle, foramen of Luschka or CPA

41
Q

Characteristics of gangliocytoma

A

Primarily supratentorial with the most common location being the temporal lobe

Majority present in the first 2 decades of life

42
Q

Symptoms of Parinaud’s syndrome

A

Pupillary mydriasis, paralysis of upgaze, and convergence retractorius

43
Q

Characteristics of neuroblastoma

A

Arises in deep cerebral hemispheres of young children (

44
Q

Imaging characteristics of spinal neurofibromas

A

Dumbbell appearance when they extend across the neuroforamena

45
Q

Most common intradural, extramedullary tumors

A

Meningiomas, nerve sheath tumors, and filum terminale ependymomas

46
Q

Dumbbell appearance of intradural, extramedullary tumors

A

Schwannomas (69%) and neurofibromas (12%)

47
Q

DDx for benign, extradural tumors

A

Hemangioma, enchondroma/chondroma, osteochondroma, osteoma/osteoblastoma

48
Q

DDx for malignant, extradural tumors

A

Osteosarcoma, chondrosarcoma, chordoma, Ewing sarcoma, Giant cell, plasmacytoma, multiple myeloma

49
Q

DDx for intradural, extramedullary tumors

A

Meningioma, Schwannoma, neurofibroma, filum terminale ependymoma

50
Q

DDx for intradural, intramedullary tumors

A

Astrocytoma, ependymoma, hemangioblastoma

51
Q

Most common spinal cord tumor in the pediatric population

A

Astrocytomas

52
Q

Intramedullary tumors that may have an associated syringomyelia

A

Ependymomas, followed by hemangioblastomas and cavernomas

53
Q

Gene locus and gene affected in NF1.

A

17q11

NF1 gene

54
Q

Gene locus and gene affected in NF2.

A

22q12

NF2 gene

55
Q

Gene locus and gene affected in tuberous sclerosis.

A

9q34/16p13

TSC1 and TSC2 genes

56
Q

Gene locus and gene affected in von Hippel-Lindau.

A

3p25

VHL gene

57
Q

Gene locus and gene affected in Li-Fraumeni syndrome

A

17p13

TP53 gene

58
Q

Gene locus and gene affected in Gorlin syndrome

A

9q22

PTCH gene

59
Q

Gene locus and gene affected in Turcot syndrome

A

5q21

APC gene

60
Q

Gene locus and gene affected in Cowden disease.

A

10q23

PTEN gene

61
Q

Gene locus and gene affected in MEN1.

A

11q13

MEN1 gene

62
Q

Gene locus and gene affected in rhabdoid tumor predisposition syndrome.

A

22q11

SMARCB1 gene.

63
Q

CNS neoplasms seen in NF1.

A

Neurofibroma, malignant peripheral nerve sheath tumor, optic nerve glioma, meningioma.

64
Q

CNS neoplasms seen in NF2.

A

Scwhannoma, meningioma, ependymoma.

65
Q

CNS neoplasms seen in tuberous sclerosis.

A

Subependymal giant cell astrocytoma.

66
Q

CNS neoplasms seen in von Hippel-Lindau.

A

Hemangioblastoma.

67
Q

CNS neoplasms seen in Li-Fraumeni syndrome.

A

Glioma.

68
Q

CNS neoplasms seen in Gorlin syndrome.

A

Medulloblastoma.

69
Q

CNS neoplasms seen in Turcot syndrome.

A

Astrocytoma, glioblastoma, medulloblastoma.

70
Q

CNS neoplasms seen in Cowden disease.

A

Dysplastic gangliocytoma of cerebellum.

71
Q

CNS neoplasms seen in MEN1.

A

Pituitary adenoma.

Ultimate Neurosurgery (16 decks)

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