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NEUROMUSCULAR > neuro- oncology > Flashcards

neuro- oncology Flashcards

1
Q

____ is benign or malignant expanding lesion whose constituent cells multiply without restraint and form a mass

A

neoplasm

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2
Q

what is the difference between primary anf secondary tumors

A

primary arise from the CNS cells and secondary metastatic from other primary sites

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3
Q

what are the most common cancer type in children

A

brain and CNS

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4
Q

t/f: most CNS tumors are metastases

A

true

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5
Q

Pilocytic astrocytoma, choroid plexus tumors, neuronal tumora, pineal region tumors, germ cell tumors… these tumors are common in who

A

children

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6
Q

Meningioma and Glioblastoma… these 2 tumors are common in who

A

adults

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7
Q

men have higher incidence for what kind of tumor ? what about women

A

brain tumor for mena and meningeal tumor for women

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8
Q

where is the localization of CNS tumors for children adn adults

A

children’s is 70% in posteior fossa
adults is 70% in cerebral hemisphere

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9
Q

symptoms of a tumor is produced by what 3 things and how do u categorizes symptoms

A

-tumor
-edema surrounding tumor
- injury to normla brian tissue

categorize them into focal or generalized

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10
Q

what are symptoms of a brain tumor

A

• Focal Neurologic Symptoms – based on location.
• Seizures
• Headaches
• Symptoms of elevated ICP

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11
Q

if a pateints has a brain tumor and presents with personality changes , nonfluent aphasia (dominant) , urinary frequency and urgency, seizures and hemiparesis where do u think the tumor is

A

frontal

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12
Q

if a patient has a brain tumor anf they presents with hemiparesis , hemisenosry loss and non fluent aphasia where is the tumor site

A

frontoparietal

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13
Q

if. a pateint has a brain tumor and presents with hemisneosry loss , nonfluent aphasia , hemineglect (non dominant) , anosognosia (non dom) , hemiparesis , and homonymous hemianopsia where do u think the tumor is

A

parietal

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14
Q

what are symptoms of increase ICP

A

• Headache – Dull
– Worse in the am
– Worse if bending over
– Seen in 50% of pts with brain tumors
• Nausea
• Papilledema (swelling of optic disc)

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15
Q

what is the herniation syndrome , monro kellie doctrine

A

-brian enclosed in hard skull
- sum of volume of CSF , blood and brain is constant

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16
Q

what is the thing that divides the intracranial comparemtns and play a key roll in hernimation syndromes

A

dural septa

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17
Q

• Expanding lesion presses cerebral hemisphere under falx to contralateral side
• Compression of branches of ACA that run along falx can cause infarction and further swelling

what herniation is this

A

subfalcine (cingulate) herniation

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18
Q

what is uncal herniation

A

hippocampus and uncus of the temporal lob herniate down

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19
Q

uncal herniation symptoms are due to pressure on ___ ____ and what are they

A

tentorial notch ( kernohans notch phenomenon)

• Ipsilateral fixed and dilated pupil (CN III)
• Impaired consciousness
• Hemiparesis
• PCA infarcts 16

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20
Q

what is tonsillar herniation

A

cerebellar tonsils push down foramen magnum
compress 4th ventricle and medulla

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21
Q

during th etonsillar herniation the Cerebellar tonsils pushed down foramen magnum and Compress 4th ventricle and medulla which leads to what

A

stiff neck progressing to decerebrate posturing and coma

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22
Q

what does an MRI w/o contract see for CNS tumor

A

little study for postieor fossa

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23
Q

what does a CT w/o contrast assessment for CNS tumors

A

assess cranial bones, vertebral column and hemorrhage

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24
Q

what imagining for a CNS tumor determines blood supply and embolize

A

angiography

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25
Q

what are the 2 brain locations for CNS tumors

A

• Supratentorial (above cerebellum)
• Infratentorial

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26
Q

what are the 3 spinal locations for CNS tumors

A

• intradural, intramedullary
• intradural, extramedullary
• extradural

27
Q

Ependymoma and astrocytoma are examples of what kind of spinal cord tumors

A

intramedullaruy -within the SC

28
Q

meningioma and neurofibroma are what kind of spinal cord tumors

A

extramedullary intradural - lying on surface of cord arising from roots or meninges

29
Q

metastases and lymphoma are what kind of SC tumors

A

extradural - in epidural space , bit able to compress upon SC

30
Q

____ resemble glial cells (astrocytes, oligodendrocytes, and ependymal cells)

A

gliomas

31
Q

Meningiomas arise from ___ cells

A

arachnoid

32
Q

Neuroblastomas, neurocytomas: derived from
____

A

neurons

33
Q

Medulloblastomas arise from ____ cells

A

primitive

34
Q

what grade on the historical glioma classification is a pilocytic astrocytoma and what is its characteristics

A

grade 1 and benign , slow growing

35
Q

what grade on the historical glioma classification is a glioblastoma and what is its characteristics

A

grad 4 (bas bas ) and vascular proliferation and necrosis

36
Q

for a Astrocytoma: IDH mutation & 1p/19q intact.. where is its usual locations and what does it commonly present with

grade 1

A

location cerebral hemisphere
present with seizures and HA

37
Q

what is the treatment and prognosis for astrocytoma

A
  • Treatment
    – Surgical resection
    – +/- radiation
    – +/- chemotherapy

good his prognosis

38
Q

what is a favorable prognosis for a Astrocytomas

A

– Younger age
– Seizure as only symptom – Smaller tumor size

39
Q
  • Incidence 3:100,000
  • Higher incidence in men
  • Median age at diagnosis is 59
  • Median survival 1.5years
    * Presenting symptom–focal signs,cognitive changes, increased ICP
    * Risk factors:
    – ionizing radiation
    – genetic cancer syndromes

what tumor do u think

A

glioblastoma

40
Q

what symptoms and risk factors foes a glioblastoma presents with

A

focal sings
cognitive changes
increase CP

RF: ionizing radiation , genetic cancer syndrome

41
Q

treatment from glioblastoma

A

-steroids
-sx
- radiation
-chemo
-CT/MRI monitor

42
Q

if you are > ___ then u have a poor prognosis for glioblastoma

A

70

43
Q

what helps the prognosis for a glioblastoma

A

higher level functioning

44
Q
  • 23% of tumors in children
  • Peak incidence age 6
  • Located in cerebellum
  • Tumor can cause CN deficits or obstruct 4th ventricle -> hydrocephalus
  • Drop metastases in CNS

what tumor do u think

A

medulloblastoma

45
Q

where is medulloblastoma located in and most common in

A

cerebellum and kid

46
Q

medulloblastoma tumor can causes ___ deficits or obtrstuc ___ ventricles leading to ____

A

CN ‘4th ‘hydrocephalus

47
Q

treatment for medulloblastoma

A

-sx
-mod dos rad
- chemo w ct or mri

48
Q

where is recurrence come in for medulloblastoma

A

postioer fossa

bc remeber most location of tumors for kids is in the postieor fossa and adults is cerebral hemisphers

49
Q

how is the prognosis for medulloblastoma

A

good ish with sx and rad but extra cranial metastases is worse

50
Q
  • Most common 1° brain tumor
  • Incidence increases with age
  • F>M
  • Arise from arachnoid cells
    * Benign, slow growing tumors
  • Calcification common

what thumor do u think

A

meningiomas

51
Q

what is the most common primary brai tumor

A

meningiomas

52
Q

what are the primary sites for metastases to CNS

A

• Lung (50%)
• Breast (15%)
• Melanoma (10%)
• GI, prostate, ovary (10%)

53
Q

what is seizures treated w for metastistc disease

A

antipeileptic drugs usually LEVTIRACATEM (keppra) or LACOSAMIDE (vimpat)

54
Q

which SC region is most likely to metastases

A

thoracic then lumbar then cervical

55
Q

what is the primary tumor site for SC metastases

A

lung , breast. , prostate , kidney , thyroid ,gut

56
Q

what are the symptoms for SC metastases

A

back pain
tenderness
paraparesis
incontinence

57
Q

what do u treat SC metastases with

A

high dose steroid , radiation

58
Q

what is the prognosis of spinal metastatic disease

A

if walking then will remain walking if not walking then 1 year to survive

59
Q

what is the common primary cancers from leptomeningeal metastases

A

– Breast
– Lung
– Melanoma

60
Q

what are the sites for-of invovlment for leptomeningela metastases and what does it show

A

– Basal cisterns
• Ataxia
• CN deficits

– Cauda equina
• polyradiculopathy

61
Q
  • Heterogeneous group of disorders associated with cancer
  • Mechanism thought related to autoimmunity
    – Antibodies to receptors/proteins on cell surface
    – Antibodies to intracellular tagets

what disorder is this

A

Paraneoplastic Disorders

62
Q

• Polyneuropathy
• Polymyositis or dermatomyositis
• Cerebellar degeneration
• Limbic and brainstem encephalitis
• Necrotizing myelopathy
• Lambert Eaton myasthenic syndrome

theses are examples of what disorder

A

Paraneoplastic Disorders

63
Q

– Neuropathy
– Delirium
– Dementia
– Seizures
– Headaches
– Visual Loss
– Cerebellar dysfunction’

these are complications for what treatment for tumors

A

chemo

64
Q

– Headache
– Worsening of neurologic symptoms
– Radiationnecrosis
• Leukoencephalopathy
• Corticalatrophy
– Cognitive impairment
– Neuropathy
– Myelopathy
– Vasculopathy
– Endocrinopathy

these are complications fot what treatment for brain tumors

A

rad

NEUROMUSCULAR (15 decks)

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