Oncology

Question 1

3 functional units of cerebellum

Answer 1

vestibulocerebellum
cerebrocerebellum
spinocerebellum

Question 2

function of vestibulocerebellum

Answer 2

input from vestiular organs

maintenance of balance and vestibulo-ocular reflex

Question 3

function of cerebrocerebellum

Answer 3

coordination of voluntary motor activity and correct movement error

Question 4

function of spinocerebellum

Answer 4

maintenance of muscle tone and posture and gait

Question 5

cerebellar dysfunction symptoms?

Answer 5

DANISH 
Disdiadochokinesia 
Ataxia 
Nystagmus 
Intention tremor 
Scanning dysarthria 
Hypotonia

Question 6

infarct/lesions in thalamus may cause?

Answer 6

hemiparesis
spontaneous pain
hemichorea
severe consciousness impairment

Question 7

infarct/lesions in subthalamus may cause

Answer 7

contralateral hemiballism

Question 8

lesions of hypothalamus may cause

Answer 8

confusion 
ataxia 
nystagmus 
korsakoffs 
anterograde amnesia 
confabulation

Question 9

general presentation of brain malignancy

Answer 9

headache - worse lying down 
N+V
Focal neuro 
Seizure
Cognitive slowing or personality decline 
Endocrine disturbance possibly

Question 10

parietal lobe specific malignancy symptoms

Answer 10

contralateral weakness/sensation loss
contralateral inferior quadrantopia
neglect, dressing apraxia
dyscalculia, dysgraphia, finger agnosia, left right disorientation (dominant lobe)

Question 11

temporal lobe specific malignancy symptoms

Answer 11

memory issues
receptive aphasia/dysphasia if wernickes involved
contralateral superior quadrantopia
seizure

Question 12

occipital lobe specific malignancy symptoms

Answer 12

visual hallucination

contralateral homonymous hemianopia

Question 13

frontal lobe specific malignancy symptoms

Answer 13

contralateral weakness due to motor dysfunction
personality change
disinhibition
cognitive slowing
urinary incontinence
expressive aphasia/dysphasia if left brocas
seizure

Question 14

types of gliomas and if they are high or low grade

Answer 14

high - glioblastoma multiforme, anaplastic astrocytoma

low - pilocytic astrocytoma, diffuse astrocytoma, oligodendrogliomas

Question 15

who does GBM present in and where is it more likely

Answer 15

older patients

temporal, frontal, parietal

Question 16

imaging for GBM and how may it appear

Answer 16

MRI - heterogenous enhancing SOL with necrosis and butterfly appearance

Question 17

true/false - histology is needed for GBM

Answer 17

true

Question 18

what is the stupp protocol and what is it used for

Answer 18

high grade glioma

chemotherapy, surgery and radiotherapy

Question 19

where do oligodendrogliomas affect and what are the common symptoms

Answer 19

frontal lobe, white matter and cortex

seizure and headache

Question 20

what is the risk with diffuse astrocytoma, where do they grow

Answer 20

can transform to grade III/IV tumours

cerebral hemispheres, frontal and temporal

Question 21

who is pilocytic astrocytoma seen in and what is the prognosis

Answer 21

children and young adults

high cure rate after surgery ± adjuvant

Question 22

where is pilocytic astrocytoma often seen

Answer 22

midline structures and cerebellum

Question 23

what is a meningioma

Answer 23

benign extra axial tumours of arachnoid cap cells

Question 24

who are meningiomas more common in

Answer 24

women

older patients

Question 25

what is foster kennedy syndrome

Answer 25

meningioma in olfactory groove leading to optic atrophy in ipsilateral eye and papilloedema in contralateral eye

Question 26

what is a haemangioblastoma and where are they found

Answer 26

benign and highly vascularised tumours in posterior fossa

Question 27

what are haemangioblastomas most commonly associated with

Answer 27

von hippel lindau syndrome

Question 28

what are acoustic neuromas

Answer 28

benign tumours of schwann cells in cerebellopontine angle and affecting vestibular part of VIII

Question 29

what to suspect if bilateral acoustic neuroma

Answer 29

NF2

Question 30

presentation of acoustic neuroma?

Answer 30

``` sensorineural hearing loss headache vertigo tinnitus facial pain or numbness in trigeminal involvement ```

Question 31

management of acoustic neuroma

Answer 31

observation and hearing aid stereotatic radiosurgery microsurgical excision

Question 32

pituitary microadenoma is __mm

Answer 32

<10

Question 33

pituitary macroadenoma is __mm

Answer 33

>10

Question 34

most comon functional pituitary adenoma

Answer 34

prolactinoma

Question 35

features of prolactinoma

Answer 35

``` galactorrhoea infertility amenorrhoea loss of libido erectile dysfunction ```

Question 36

tx of prolactinoma

Answer 36

cabergoline first line

Question 37

features of GH adenoma

Answer 37

pre puberty - gigantism post puberty - acromegaly colon cancer, headache, cardiac disease, arthralgia, sleep apnoea, hyperhidrosis, diabetes, large hands/feet, coarse facial features

Question 38

features of ACTH secreting tumours

Answer 38

central obesity, abdo striae, skin thinning, hirsutism, HTN, muscle wasting, puffy face, psych disturbance

Question 39

diagnosis of ACTH secreting tumours

Answer 39

low dose dexamethasone suppression testing

Question 40

typical visual presentation of pituitary tumours?

Answer 40

bitemporal hemianopia

Question 41

management of pituitary tumours

Answer 41

surgery radiotherapy medical - cabergoline in prolactinoma, pegvisomant or octreotide in GH tumour