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Neuro > NeuroOnc > Flashcards

NeuroOnc Flashcards

0
Q

primary brain tumor

A

tumor that develops from normal tissues of the brain

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1
Q

Metastasis

A

spreading of malignant tumor to a remote part of body

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2
Q

meningioma

A

usually benign; tumor that develops from covering of the brain

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3
Q

glioma

A

tumor that develops from glial cells

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4
Q

astrocytoma

A

glial tumor that develops from astrocytes

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5
Q

anaplastic astrocytoma

A

high grade glial tumor that develops from astrocytes

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6
Q

glioblastoma multiforme

A

maligant glial tumor that develops from astrocytes

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7
Q

medulloblastoma

A

tumor that develops from primative neuroectodermal cells (usualyl in children)

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8
Q

ependymoma

A

glial tumor that develops from ependymal cells

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9
Q

drop metastasis

A

metastasis, usually from glioblastomas or ependymomas that occurs through cerebrospinal system
–typically occurs around lumbar nerve roots or lower spinal cord

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10
Q

sensory level

A

line on the trunk below which sensation is lost

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11
Q

myelopathy

A

damage to the spinal cord

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12
Q

radiculopathy

A

damage to nerve root

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13
Q

non-metastatic complications

A

those of cancer that dont result from direct invlvement of tumor

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14
Q

paraneoplastic syndrome

A

syndrome usually from development of an autoimmune reaction, where there is damage to neural structures

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15
Q

intracranial tumors/neoplasm classified by

A

cell of origin

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16
Q

where do childhood tumors go?

A

posterior cranial fossa

spinal cord

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17
Q

where do adult tumors commonly found

A

adults

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18
Q

lung cancer and CNS mets

A

found in about 1/4th

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19
Q

most common primary intracranial tumors

A

gliomas

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20
Q

most aggressive tumor

A

atrocytoma (glioblastoma multiforme

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21
Q

slow growing tumors- little dysfunction until very late in course

A

meningiomas

neurilemmomas

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22
Q

rapidly enlaring neoplasm

A

metastatic tumors/glioblastomas

progressive loss of fx over short time interval

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23
Q

edema mostly around

A

metastatic tumors

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24
Q

edema leads to

A

rapid apperance signs and symptoms

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25
Q

glioblastoma dysfunction

A

appears rapidly, but the tumor looks like it should cause more damage because the tumor infiltrates nerve tissue and leaves many neurons functional

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26
Q

surgical removal of glioblastoma

A

may increase patients neurological impairment, but it is usally necessary

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27
Q

intracranial space

A

closed chamber with ONE outlet (foramen magnum) and stiff dural membranes (falx verebri and tentorium) that divides into compartments

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28
Q

As herniation progresses

A

rostral-caudal deterioriation of neural functions

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29
Q

papilledema

A

swelling of optic nerve–>increased intracranial pressure
swelling of optic nerve head (associated with loss of retinal venous pulsations and nelargement of blind spot on visual field testing)

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30
Q

non-localizing manifestations of tumors are usually due to

A

expanding supratentorial masses

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31
Q

what are the non-localizing manifestations?

A

unilateral/bilateral sixth nerve palsies via rostral-cudal displacement of brainstem

third nerve dysfunction from compression of herniating temporal lobe (where the nerve passes forward at the edge of the tenortium)

compression of contralateral cerebral peduncle –>ipsuilateral to mass hemiparesis

posterior cerebral artery compression

hydrocephalus-occlusion of fourth ventricle

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32
Q

where are large meningiomas often found?

A

inferior to frontal lobe in olfactory groove

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33
Q

if meningiomas are producing symptoms, most are

A

surgically resectable

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34
Q

gliomas come from

A

supportive cells of NS- oligodendrogia, astroglia, ependyma cells

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35
Q

astrocytoma vs oligodendroglioma

A

astrocytoma more common

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36
Q

astrocytomas and removal

A

difficult to removal completely

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37
Q

most malignant and more common glioma

A

glioblastoma multiforme

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38
Q

what is special about glioblastoma multiforme

A

this tumor can met– usually by spreading through CSF

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39
Q

aggressiveness of oligodendroglioma

A

somewhat less aggressive than the other two

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40
Q

what do oligodendrogliomas present with

A

seizures rather than mass effect

can calcify!

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41
Q

prognosis of oligodendrocytes

A

better with chemo and radiation–but not completely curable

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42
Q

neurolemoma

A

dervied from coverings of nerves

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43
Q

most common neurolemoma

A

acoustic neuroma from vestibular nerve (but impinges on acoustic nerve, so gradual hearing loss)
MAY affect facial nerve–>facial weakness

44
Q

why does acoustic neuroma cause vertigo?

A

slow growth so compensation

45
Q

surgery on neurolemoma?

A

yes, usually resectable, but if large could still have deficit

46
Q

ependymoma

A

derive from lining tissue of the ventricles and the central canal of spinal cord

47
Q

who do we tend to see epndymoma in

A

younger individuals

48
Q

treatment of ependyomoma

A

many are completely resectable, but most require adjuvant therapy

49
Q

mets in ependymoma

A

can exceed the ventricular system and even subarachnoid space and so-called drop metastes are possible

50
Q

deficits are from what in ependymoma

A

pressur eand local invasion

or frm treatment

51
Q

primitive neuroectodermal tumors

A

midline tumors- posterior fossa (cerebellum, 4th ventricle area of tectum)–small blue tumors

52
Q

who are PNTs mostly seen in

A

children and young adults

53
Q

prognosis in PNTs

A

sensitive to chemo and radiation, but not completley curable in most cases–can spread to other areas of brain and spinal cord through spinal fluid

54
Q

particular types of priminitive neuroectoermal tumors

A

pineal tumors

medulloblastomas

55
Q

common cancers that met to brain and spine

A 
lung cancer
breast cancer
colon cancer
ovarian
melanoma
56
Q

less common

A

renal cancer

57
Q

rare places to get mets from

A

prostate

58
Q

radiation for mets is

A

usually only palliative

59
Q

lymphoma

A

form of cancer that can either develop in brain (primary) or spread to brain

  • -primary CNS lymphoma from patients with severe immunosuppression
  • -secondary spready of lymphoma to NS-involvement of nerve roots and meninges (carcinomatous meningitis)
60
Q

spinal tumors

A

most are metastatic, but some primary as well

61
Q

what do spinal tumors often result in?

A

expanding extradural masses–>can compress cord or nerve roots

62
Q

intradural, but extramedullary tumors

A

neurofibromas
meningiomas
schwanomas

63
Q

intramedullary spinal cord tumors

A

gliomas

ependymomas

64
Q

intramedullary tumors can

A

met in spinal gluid and result in extraaxial mass

65
Q

treatment for spinal tumors

A

steroids, surgery/radiation

66
Q

cerebellar tumors commonly found

A

children

67
Q

most common cerebellar tumor

A

cerebellar astrocytoma

68
Q

cerebellar astrocytoma prognosis

A

often surgically curable

69
Q

if cerebellar astrocytoma develops in pons

A

not curable because the surgical procedures can produce intolerable deficits

70
Q

medulloblastoma

A

severe and devastating form of cancer that develops in cerebellar region of children
–may occasionally respond to chemotherapy and radiation, but typically progresses fast and is fATAL

71
Q

pituitary tumors

A

neoplasms involving pit gland, hypothalamus, or both

72
Q

if pituitary tumor encroaches on____ you get ___

A

neighboring optic chiasm

visual field deficits (bitemporal hemianopia)

73
Q

cranipharyngioma

A

benign cystic tumor that derives from remnants of rathke’s pouch that encroaches on optic chiasm

74
Q

anterior pit tumors

A

positive humoral effects via increased secretion of pituitary hormones

  • -eosinophilic adenomas
  • -basophilic adenomas
75
Q

eosinophilic adenomas

A

secrete growth hormone

76
Q

basophilic adenomas

A

cushing’s hyperadrenal syndrome

77
Q

routine procedure for all people suspected of having intracranial tumor

A

CT or MRI

78
Q

MRI is more

A

sensitive! intracranial lesions that are the same radiographic density as brain can be missed with un enhanced CT scans

79
Q

intravascular contrast helps

A

because many tumors have blood vessels that do not have normal BBB; excluded from normal brain, but often enhances apperance of tumor

80
Q

MRI helps to

A

evaluation chemical constituents of mass; distinguish tumor frm other enhancing masses (abscesses)

81
Q

PET

A

metabolic activity

82
Q

CSF should be

A

negative

83
Q

if test shows increased iCP

A

no LP because can cause rostralcaudal deterioration

84
Q

LP only in prelim exam when

A 
CNS infection (maningitis) is suspected
pt has severe acute heache or other symptom or a history that suggests subarachnoid hemorrhage in teh absence of positve CT becaus eCT can miss small sub arac
85
Q

major finding

A

elevation of CSFs

86
Q

adults tend to get tumors

A

supratentorial

87
Q

children tend to get tumors

A

infratentorial

88
Q

cortical signs

A

aphasia, hemiparesis, homonymous, hemianopsia, sensory loss

89
Q

dysinhition is a

A

frontal lobe sihn

90
Q

incoordination is a

A

cerebellar sign

91
Q

unilateral loss of pin and temperature sense on face

A

lateral brainstem

92
Q

loss of upward gaze

A

dorsal brainstem

pineal region

93
Q

bilateral hemianopsia

A

pituitary region tumor

94
Q

paraplegia/sphnciter dysfunction

A

spinal cord

95
Q

cushing response

A

increase BP with decrease pulse

96
Q

symptoms and signs of increase ICP

A

awakened from sleep by headache
papilledema or loss of venous pulsations in fundus of eye
cushing response

97
Q

transtentorial sign of herniation

A

dilating pupil (usually ipsilateral)
oculomotor palsy-III nerve (usually ipsilateral)
hemipareis (usually contralateral)

98
Q

failure of upward gaze/parinaud’s syndrome

A

pineal/tectal region

99
Q

edema responds to

A

steroids

100
Q

glioblastoma multiforme is a grade 4 (worst)

A

astrocytoma

101
Q

childhood tumors and prognosis

A

cerebellar astrocytoma- good prognosis
pontine glioma- bad prognosis
medulloblastoma- bad prognosis

102
Q

most tumors of the spine are

A

metastatic

103
Q

good for spine tumors

A

steroids, radiation

major surgery

104
Q

rare tumors inside spinal cord

A

ependymoma

glioma

105
Q

bbb limits

A

type of chemo

106
Q

other approaches to treatment

A

black angiogenesis
small targeted molecules
immune targeting

107
Q

paraneoplastic

A

remote effect of cancer, probably autioimmune

clinical manigestations vary according to nervous system structure affected

Neuro (23 decks)

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