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NMF: Neurology > NEUROONCOLOGY > Flashcards

NEUROONCOLOGY Flashcards

1
Q

Damage to which area causes expressive dysphasia (the patient can still comprehend words but produces faulty sentences and phonemic errors )?

A

Broca’s area (inferior frontal gyrus)

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2
Q

Damage to which area causes nominal aphasia (problems recalling names, words and numbers)?

A

inferior parietal lobule containing angular gyrus

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3
Q

Damage to which area causes receptive aphasia (impaired comprehension and produces jargon “word salad”, however, their speech is fluent) ?

A

Wernicke’s area (dominant hemisphere superior temporal gyrus)

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4
Q

Where is the primary motor area?

A

the precentral gyrus of the frontal lobe

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5
Q

Where is the primary somatosensory area?

A

the postcentral gyrus of the parietal lobe

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6
Q

Where is the visual cortex?

A

the occipital lobe

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7
Q

What does the limbic system do?

A

serves for higher emotional functions and contains a major component of the memory system.

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8
Q

Name 2 important structures that make up the limbic system

A

the cingulate gyrus

hippocampus

amygdala

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9
Q

Pneumonic for cerebellar dysfunction

A

DANISH - Dysdiadochokinesia: impairment of rapid alternating movements. Ask the patient to perform quick, alternating pronation and supination of the hand. - Ataxia: patients may suffer from a ‘broad-based’ gait. Nystagmus: carry out the H-test for extraocular muscle function and notice if there is any nystagmus. Intention tremor: ask the patient to do the finger-nose test Scanning dysarthria: patient speaks slowly with poor articulation of speech. Hypotonia: reduced tone.

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10
Q

What are the 3 components of the cerebellum?

A

vestibulocerebellum, spinocerebellum and cerebrocerebellum

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11
Q

What does the vestibulocerebellum do?

A

receives input from the vestibular organs for the maintenance of balance and coordinating vestibule-ocular reflexes.

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12
Q

What does the spinocerebellum do?

A

maintains muscle tone and participates in posture and gait.

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13
Q

What does the cerebrocerebellum do?

A

coordination of voluntary motor activity and correct any error in the movements to ensure they are smoothly executed.

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14
Q

Which of the thalamus and hypothalamus is more superior?

A

thalamus

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15
Q

What can an infarction to the thalamus cause?

A

hemiparesis, spontaneous pain, hemichorea and even severe impairment of consciousness.

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16
Q

What systems does the hypothalamus influence?

A

the autonomic NS, the endocrine system and the limbic system

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17
Q

What does a lesion of the subthalamus cause?

A

contralateral hemiballism (a type of chorea)

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18
Q

What systems does the hypothalamus influence?

A

the autonomic NS, the endocrine system and the limbic system

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19
Q

What does a lesion of the subthalamus cause?

A

contralateral hemiballism (a type of chorea)

20
Q

What is contained within the basal ganglia?

A

the caudate nucleus, putamen and globus pallidus

21
Q

What characterises Parkinson’s disease histologically?

A

neuronal loss and the presence of alpha-synuclein containing inclusions known as Lewy bodies in specific areas of the brain in particular the substantia nigra pars compacta (dopaminergic neurons).

22
Q

What characterises Parkinson’s disease clinically/

A

Akinesia: slowness or difficulty initiation of movement. Rigidity: may feel like bending a lead pipe. Resting tremor: this is in the form of a 4–6 Hz rest tremor which, in the hand, is ‘pill‐rolling’ with flexion of the thumb.

23
Q

Name two basal ganglia disorders

A

Parkinson’s and Huntington’s

24
Q

What causes Huntington’s disease?

A

AD genetic expansion of CAG trinucleotides CAG repeat increase from generation to generation, this is called genetic anticipation, which describes increasing severity and earlier onset of an inherited disease during transmission over the generations.

25
Q

How is Huntington’s characterised clinically ?

A

short-lasting involuntary movements that affect multiple muscle groups called chorea.

26
Q

Which basal ganglia disorder is a) hypokinetic b) hyperkinetic?

A

a) Parkinson’s b) Huntington’s

27
Q

What are the 4 general symptoms of CNS tumour

A
  1. Progressive, focal neurological deficit 2. Headaches (worse on lying down, N+V) 3. Seizures 4. Gradual cognitive slowing
28
Q

What is the most common type of primary brain tumour?

A

high-grade glioma

29
Q

How does a parietal lobe tumour present?

A
  • contralateral weakness and sensory loss - contralateral inferior quadrantopia - Gerstmann syndrome (dyscalculia, dysgraphia, finger agnosia, LR disorientation) - neglect
30
Q

What is the most common type of primary brain tumour?

A

high-grade glioma (eg glioblastoma multiforme)

31
Q

Give types of high grade glioma (III or IV)

A
  • anaplastic astrocytoma - glioblastoma multiforme (GBM)
32
Q

Describe GBM

A

older people cerebral hemisphere tumour MRI - heterogenously enhaced with necrosis, butterfly appearance MGMT

33
Q

Standard treatment of glioblastoma

A

surgery + radiotherapy + chemotherapy

34
Q

Give examples of low grade gliomas

A

pilocytic astrocytoma, diffuse astrocytoma and oligodendrogliomas

35
Q

Which low grade glioma carries the best prognosis?

A

oligodendrogliomas

36
Q

Are meningiomas malignant or benign?

A

benign - grow slowly, well demarcated, usually do not infiltrate brain

37
Q

What causes multiple meningiomas?

A

neurofibromatosis type 2 childhood radiation

38
Q

What is Foster-Kennedy syndrome?

A

meningioma in olfactory grrove causing optic atrophy ipsilaterally and papilloedema contralaterally

39
Q

Where do acoustic neuromas most commonly arise?

A

the cerebellopontine angle

40
Q

What should you suspect if there are bilateral vestibular schawannomas?

A

neurofibromatosis type 2

41
Q

Symptoms of vestibular schwannoma

A
  • unilateral sensorineural hearing loss, tinnitus and vertigo - facial pain or numbness
42
Q

What is a haemangioblastoma?

A

a benign, cystic highly vascular tumour in the posterior fossa cause cerebellar dysfunction and raised ICP

43
Q

What syndrome is associated with haemangioblastomas?

A

von Hippel-Landau

44
Q

What lobe is affected if someone presents with progressive headache, wide based ataxia and difficulty speaking?

A

Cerebellum

45
Q

What lobe is affected when the patient has difficulty with writing, numbers and left-right disorientation?

A

Their non-dominant parietal lobe

46
Q

What lobe is affected if someone presents with seizures, headaches, bumping into things and has a L superior quadrantopia.

A

Right temporal lobe

NMF: Neurology (9 decks)

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