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Neurology 1 > Neurosurgery - Brain Tumours > Flashcards

Neurosurgery - Brain Tumours Flashcards

1
Q

symptoms of a brain tumour

A

focal generalised

raised intracranial pressure - headache, papilledema, vomiting

mental disturbances eg drowsiness, coma, personality changes

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2
Q

headache, papilledema, and voimiting is the classic triad of what

a.brain tumours
b.migraine
c.raised intracranial pressure
d.subarachnoid haemorrhage

A

c.raised intracranial pressure

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3
Q

which of these best describes a headache due to raised intracranial pressure

a. on waking gone within 1-2 hrs, disapears for days- weeks, throbbing and aggravated by coughing/sneezing, relived by aspirin and going to bed

b.on sleeping, lasting days, stabbing pain, relieved by coughing, made worse by resting

A

a. on waking gone within 1-2 hrs, disapears for days- weeks, throbbing and aggravated by coughing/sneezing, relived by aspirin and going to bed

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4
Q

an occipital headache radiating down the neck can indicate a tumour where

a.temporal lobe
b.occipital lobe
c.frontal lobe
d.brain stem
e.cp angle

A

e.cp angle

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5
Q

when does vomiting in raised intracranial pressure usually occur

a.at night
b.early morning

A

b.early morning

accompanying the headache

projectile and without warning no nausea

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6
Q

who is more likely to vomit in raised intracranial pressure states

a.children
b.adults
c.elderly

A

a.children

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7
Q

patients with which tumour type are more likely to vomit

a. post fossa
b.supraentorial

A

a. post fossa

supraentorial - ventricles and cerebrum

post fossa- brain stem and cerebellum

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8
Q

visual symptoms of raised ICP

A

asymptomatic

eventually vision affected and numerous tumours found

enlarged blind spot

intermittent more common than detiriorating
eg few mins amaurosis fugal

attacks precipitated by getting up from sitting or lying ie morning

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9
Q

intracranial tumours are classified based on what

a.cell of origin
b.location
c.size
d.symptoms

A

a.cell of origin

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10
Q

where do gliomas arise

a.glial cells
b.arachnoid cap cells
c.pituitary cells
d.schwann cells

A

a.glial cells

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11
Q

where do meningiomas arise

a.glial cells
b.arachnoid cap cells
c.pituitary cells
d.schwann cells

A

b.arachnoid cap cells

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12
Q

where do pituitary adenomas originate

a.glial cells
b.arachnoid cap cells
c.pituitary cells
d.schwann cells

A

c.pituitary cells

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13
Q

where do pituitary schwanomas originate

a.glial cells
b.arachnoid cap cells
c.pituitary cells
d.schwann cells

A

d.schwann cells

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14
Q

which cancers most commonly metastatsise to the brain

a.lung and liver
b.breast and lung
c.lung and pancreas
d.breast and cervical

A

b.breast and lung

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15
Q
A

a.benign

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16
Q

the majority of malignant tumours are..

a.gliomas
b.schwanomas
c.pituitary adenomas
d.meningiomas

A

a.gliomas

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17
Q

what type of tumour is a astrocytoma

a.gliomas
b.schwanomas
c.pituitary adenomas
d.meningiomas

A

a.gliomas

-astrocytes

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18
Q

what type of tumour is a oligodendroglioma

a.gliomas
b.schwanomas
c.pituitary adenomas
d.meningiomas

A

a.gliomas

  • oligodendrocytes
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19
Q

what type of tumour is a ependymomas

a.gliomas
b.schwanomas
c.pituitary adenomas
d.meningiomas

A

a.gliomas

  • ependymal cells
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20
Q

what grade is a slow growing astrocytoma that is likely to eventually become malignant with a survival of 5-7 yrs

a.1
b.2
c.3
d.4

A

b.2

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21
Q

which of these describes a glioblastoma

a.grade 2 slow growing and eventual progress to malignant grade
b. grade 3 , higher proliferation rate (more mitotically active)
c.grade 4 characterised by elevated tumour cell proliferation , endothelial proliferation , necrosis

A

b. grade 3 , higher proliferation rate (more mitotically active)

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22
Q

what is the mean survival for a grade 2 diffusely infiltrating astrocytoma

a.5-7 years
b.2-3 years
c. 12 -18 months

A

a.5-7 years

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23
Q

what is the mean survival for a grade 4 glioblastoma characterised histologically by elevated tumour cell proliferation , endothelial proliferation and necrosis

a.5-7 years
b.2-3 years
c. 12 -18 months

A

c. 12 -18 months

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24
Q

what is the more definitive diagnosis method for gliomas

a.histology
b.ct brain
c. mri
d.x ray

A

a.histology

tumour debulking of focal tumours to relieve mass or pressure effect

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25
what eventually happen in the majority of glioma patients a.haemorrhage b.seizures c.wound infection
b.seizures
26
surgical treatment in cortical and subcortical low density presenting with seizures and progressive headache is limited to what a. diagnostic biopsy b.debulking of tumours
a. diagnostic biopsy
27
which of these surgical techniques helps to visualise malignant gliomas a.image guidance with pre op scans b.real time intra operative imaging c. tumour fluorescens eg gliolan d.awake surgery
c. tumour fluorescens eg gliolan
27
which of these surgical techniques helps to visualise malignant gliomas a.image guidance with pre op scans b.real time intra operative imaging c. tumour fluorescens eg gliolan d.awake surgery
c. tumour fluorescens eg gliolan
28
what is given in combination with temozolomide for glioblastomas which may extend survival by a few months especially if there is methylation of the MGMT promoter site a.radiotherapy b.chemotherapy c.tumour debulking
a.radiotherapy
29
temozolomide and radiotherapy ma extend survival in malignant glioma by a few months especially if there is ......................... of the MGMT promoter site a. acetylation b.methylation c.oxidation d.reduction e.desreuction
b.methylation down regulation of DNA damage repair gene so higher liklehood of tumour cell death
30
what is given for anaplastic oligodendrogliomas to extend life for a few years a.radiotherapy and temozolomide b.radiotherapy + PCV chemotherapy
b.radiotherapy + PCV chemotherapy procarbazine, lomustine, vincristine co deletion of 1p and 19q
31
how does radiotherapy and pcv chemotherapy given for anaplastic oligodendrogliomas extend life for a few years a.methylation of MGMT promoter regions b.co deletion of 1p and 19q
b.co deletion of 1p and 19q
32
what is done post operatively for glioblastoma a.chemotherapy p,c,v b.radiotherapy and temozolamide c.fractionated radiotherapy
c.fractionated radiotherapy
33
low grade gliomas are more likely in... a.children b.young adults c.elderly
b.young adults
34
what do low grade gliomas typically present with a.headaches b.seizures c.focal neuropathy d.visual disturbance e.motor and sensory defects
b.seizures
35
what is the life expectancy for an grade 1 astrocytoma (pilocytic astrocytoma) a.normal b.5-10 years c.2-3 years d.12-15 months
a.normal
36
what is the life expectancy for an grade 2 astrocytoma (low grade astrocytoma) a.normal b.5-10 years c.2-3 years d.12-15 months
b.5-10 years
37
what is the life expectancy for an grade 3 astrocytoma (anaplastic astrocytoma) a.normal b.5-10 years c.2-3 years d.12-15 months
c.2-3 years
38
what is the life expectancy for an grade 4 astrocytoma ( glioblastoma ) a.normal b.5-10 years c.2-3 years d.12-15 months
d.12-15 months
39
what is the life expectancy for an grade 2 oligodendrocytoma ) a.normal b.5-10 years c.2-3 years d.12-15 months e.10-15 years f.3-6 years
e.10-15 years
40
what is the life expectancy for an grade 3 oligodendrocytoma (anaplastic oligodendrocytoma) a.normal b.5-10 years c.2-3 years d.12-15 months e.10-15 years f.3-6 years
f.3-6 years
41
type 1 meningioma is .. a.benign b.atypical c.malignant
a.benign
42
type 2 meningioma is .. a.benign b.atypical c.malignant
b.atypical
43
type 3 meningioma is .. a.benign b.atypical c.malignant
c.malignant
44
majority of meningiomas are .......... a.benign b.malignant
a.benign
45
meningiomas arise from the .............. cap cells of the meninges a.dura b.pia c.subarachnoid d.arachnoid
d.arachnoid
46
which grade of meningiomas have a higher propensity to recur locally requiring a closer follow up with regular scans a.benign meningiomas b.atypical meningiomas c.malignant meningiomas
b.atypical meningiomas
47
which type of meningioma is likely to recur within aa shorter period and also carry a risk of extracranial metastases a.benign meningiomas b.atypical meningiomas c.malignant meningiomas
c.malignant meningiomas
48
what is the primary site for brain metastases a. lung b.breast c.skin d.thyroid
a. lung
49
what is used to treat brain metastases in the form of solid large tumours causing pressure effects a.surgical resection b.tumour debulking c.radioterapy and temozolomide d.radiotherapy and PCV chemotherapy
a.surgical resection
50
what is used to treat brain metastases in the form of small- medium sized tumours (up to 4 lesions) a.surgical resection b.tumour debulking c.radioterapy and temozolomide d.radiotherapy and PCV chemotherapy e.focused beams of radiation f.full brain radiotherapy
e.focused beams of radiation
51
what is used to treat brain metastases in a palliative care setting in cases of widespread disease a.surgical resection b.tumour debulking c.radioterapy and temozolomide d.radiotherapy and PCV chemotherapy e.focused beams of radiation f.full brain radiotherapy
f.full brain radiotherapy
52
what is the optimal primary treatment for childhood brain tumours in the infratentorial compartment a.surgical resection b.tumour debulking c.radioterapy and temozolomide d.radiotherapy and PCV chemotherapy e.focused beams of radiation f.full brain radiotherapy
a.surgical resection
53
complete resection of which childhood tumour may lead to a normal life expectancy a.pilocytic astrocytoma b.medulloblastoma c. ependyoma
a.pilocytic astrocytoma
54
where do childhood brain tumours usually develop a.cerebellum and fourth ventricle b.third and fourth ventricle c.cerebrum and cerebellum d.frontal lobe
a.cerebellum and fourth ventricle infratentorial compartment
55
which of these childhood brain tumours can metastatsize through csf pathways including the spine with patients usually requiring post surgical radiotherapy a.pilocytic astrocytoma b.medulloblastoma c.ependyoma
b.medulloblastoma
56
which childhood brain tumour is generally not as aggressive as medulloblastomas but have a tendency to recur and metastatsize a.pilocytic astrocytoma b.medulloblastoma c.ependyoma
c.ependyoma
57
csf seeding may occur in cases of which childhood brain tumour a.pilocytic astrocytoma b.medulloblastoma c.ependyoma
c.ependyoma
58
if possible radiotherapy is avoided under which age due to the effect of CNS toxicity on developing brain and spinal cord a.10 b.20 c.4 d.16
c.4
59
which tunours are slow growing benign sheath tumours arising on the vestibular nerve a.pilocytic astrocytoma b.medulloblastoma c.ependyoma d. vestibular shwannomas e.pituitary tumours
d. vestibular shwannomas
60
which nerve sheath do slow growing benign tumours arise on s.trigeminal b.occipital c.vestibular d.trochlear e.abducens
c.vestibular
61
hearing loss, tiniitus and balance problems are associated with which tumours? a. slow growing astrocytoma b.anaplastic astrocytoma c.pilocytic astrocytoma d.medulloblastoma e.ependyoma f.vestibular schwannomas
f.vestibular schwannomas
62
hearing loss, tiniitus and balance problems are associated with which tumours? a. slow growing astrocytoma b.anaplastic astrocytoma c.pilocytic astrocytoma d.medulloblastoma e.ependyoma f.vestibular schwannomas
f.vestibular schwannomas
63
what is vestibular schwannoma associated with a.fibromyalgia b.MS c.motor neurone disease d.Neurofibromatosis e.glioblastoma
d.Neurofibromatosis NF2
64
What is indicated for small volume lesions less than 3cm in diameter a.surgical resection b.tumour debulking c.radioterapy and temozolomide d.radiotherapy and PCV chemotherapy e.focused beams of radiation f.full brain radiotherapy g.stereotactic radiosurgery
g.stereotactic radiosurgery
65
what is the classical presentation for large pituitary adenomas a.unilateral hemianopia b.bitemporal hemianopia c.homonymous hemianopia d.homonymous hemianopia w macular sparing
b.bitemporal hemianopia compression of adjacent structures eg optic nerves
66
............ pituitary tumours may cause cushings or acromegaly a.small b.large
a.small
67
stereotactic radiosurgery is used for
benign brain tumours of small volume brain metastatses
68
what is given for peri tumoral oedema in palliative care a.dexamethosone b.prednisolone c.beclomethasone d.hydrocortisone
a.dexamethosone
69
angiogenesis
recruitment of blood supply to feed the tumour

Neurology 1 (44 decks)

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