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Neuromuscular > Oncology and Neuroinfections > Flashcards

Oncology and Neuroinfections Flashcards

1
Q

Neoplasm

A

-benign or malignant expanding lesion

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2
Q

CNS Tumors and Cancer

A

-2nd MC death in children: posterior fossa
-2nd MC cause of death in males 20-39y: cerebral hemipheres
-women: MC meningeal tumors

Clinical Presentation:
-s/s of tumor, edema, injury to surrounding tissue
-focal or generalized

S/s:
-seizures
-location dependent
-HA
-increased cranial pressure

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3
Q

Brain Tumor Sites

A

Frontal: personality, Brocas aphasia, urinary frquency, seizures, hemiparesis

Frontoparietal: Hemiparesis/sensory, wernickes aphasia

Parietal: Hemisensory, werenickes aphasia, neglect (non dom), homo hemianopsia

Occipital: homo hemianopsia, visual agnosas

Temporal: aphasia, memory, sup quadrantonopsia

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4
Q

Increased Intracranial Pressure

A

-hydrocephalus

S/s:
-headache
-worse in AM and bending over
-nausea
-increased ventricles (massive)

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5
Q

Classification of Tumors

A

-genetics determine prognosis

Brain:
-Supratentorial: cortex, frontal (MC), temporal
-Infratentorial: cerebellar and BS

Spinal:
-Intramedullar: within SC
-Extramedullary/intradural: on surface of cord
-Extradural: in epidural space, can compress

-Gliomas: resemble glial cells
-Meningiomas: arise from arachnoid cells (MC)
Neuroblastomas/neurocytomas: from neurons
-Medulloblastomas: from primitive cells medulloblasts

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6
Q

Glioma Classification

A
  1. Pilocytic Astrocytoma: benign, slow
  2. Low Grade Astrocytoma: non replicating, increased cellularity
  3. Anaplastic Astrocytoma: high replication, high cellularity
  4. Glioblastoma: high replication, high cellularity, vascular proliferation and necrosis
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7
Q

Astrocytoma

A

-25-45y
-usually in cerebral hemispheres
-1-3

S/s:
-seizures (good outcomes if only), HA

Outcome:
-9-17yrs
-80% at 5 yrs

Tx:
-surgery, radiation, chemo

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8
Q

Glioblastoma

A

-men, 59yrs
-4
-in cortex

S/s:
-focal signs, cognitive changes, increased ICP
-irregular cystic mass on MRI

Outcome:
-older=worse prognosis
-high level of function @ diagnosis=good

Tx:
-steroids
-surgery
-high dose radiation/chemo
-tumor treating field: targets mitosis of cancer cells

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9
Q

Medulloblastomas

A

-23% tumors and children
-peak age at 6
-in cerebellum
-more posterior

S/s:
-CN
-obstructs 4th ventricle
-ataxia
-high ICP
-spreads to SC

Outcome:
-33-60% 10 yrs
-recurremce in posterior
-extracranial metastases worse

Tx:
-resection
-med dose radiation/chemo

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10
Q

Meningiomas

A

-MC brain primary tumor
-F>M
-arise from arachnoid cells
-calcification common, asymptomatic

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11
Q

Metastasis to CNS

A

-30% of cancer pts develop CNS
-50% is symptomatic
-70% thoracic, 20% lumbar, 10% cervical

Primary Sites:
-lungs
-breast
-melanoma

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12
Q

Metastatic Disease

A

-multiple masses in brain at grey/white junction
-SC: prognosis of ambulation depends on state @ diagnosis

S/s:
-increased ICP
-Seizures
-Back pain/tenderness
-Paraparesis
-Incontinence

Tx:
-dependent on location and presentation
-steroids, radiation

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13
Q

Leptomeningeal Metastases

A

-coating of tumor along the meninges
-bad prognosis <6m

S/s:
-ataxia
-CN defects
-polyradiculopathy

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14
Q

Paraneoplastic Disorders

A

-heterogenous group of disorders ass with cancer
-autoimmuity reaction to cancer/antibodies

-polyneuropathy
-dermatomyositis (high prob of cancer)
-encephalitis
-lambert eaton

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15
Q

Complications of Treatment

A

Chemotherapy:
-neuropathy
-delirum
-dementia
-seizures
-HA

Radiation:
-HA
-neuro s/s worsening
-radiatio necrosis
-cognitive impairment

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16
Q

Types of CNS Infection

A

-Meningitis
-Encephalitis (in parenchyma)
-Abscess Brain and SC

-ring enhancing lesion

Entry:
-hematogenous spread
-infected cranial structures
-penetrating injuries
-surgical invasion

17
Q

Meningitis

A

-bacteria excite acute inflammatory reaction
-vessels may thrombose
-exudate may back up

S/s:
-infection signs
-HA
-neck pain and stiffness
-convulsions
-confusion
Infants: bulging fontanels
-cloudy lumbar puncture

Meningeal Signs:
-Kernig’s sign: flx hip and ext knee causes pain
-Brudzinski’s neck sign: flx neck causes flx of hips and knees

Tx:
-antibiottics
-10-21d

18
Q

Meningococcal Meningitis

A

-epidemics
-rapid over hours
-skin rash

Mortality:
-10% with tx
-50% w/o

19
Q

Viral (aseptic) Meningitis

A

-fever, HA, meningal irritation
-CSF with lymphocytic dominance

Causes:
-enterovirus, herpes (acyclovir only treatment and only for herpes), syphillus, lyme

20
Q

Acute Encephalitis

A

-fever, impairied consciousness, seizures, ataxia, CN palsies
-usually meningeal

21
Q

Herpes Simplex Encephalitis

A

-most serious of viral enxephalitides
-fever, confision, coma
-temporal and frontal

Tx:
-IV Acyclovir

22
Q

Tuberculous Meningitis

A

-organism reaches BBB
-basal meningities
-tubercles
-hydrocephalus and stroke
-CN palsies

23
Q

Subdural Empyema

A

-purulent infection of subdural space
-disease of sinuses in middle
-meningeal veins thrombose cause infarction

S/s:
-HA, fever, focal signs, hemiparesis
-Increased ICP
-pus

Tx:
-drainage

24
Q

Intracranial Thrombophlebitis

A

-infection leading to thrombosis of venus system
-increased ICP

Tx:
-surgery or antibiotics

25
Q

Brain Abcess

A

-necrosis of the brain with bacterial infection

Diseases Ass.:
-chronic pulmonary infections
-Congenital heart disease

S/s:
-HA, drowsiness, confusion, seizures

Tx:
-aspiration and antibiotics

26
Q

Neurosyphilis (meningitis)

A

-STD

Early Meningitis:
-6-12m after primary infection

Meningovascular Syphilis: 5-12y
-after primary

Late, tertiary syphilis: tabes dorsalis

27
Q

Lyme Disease

A

-Borrelia burgderi
-tics

S/s:
-meningitis, CN palsies, radiculopathy, neuropathy, cardiac disease, bell’s palsy

28
Q

Fungal Infections in CNS

A

-less common

Cryptococcosis:
-MC in us
-AIDS and subacute

Mucormycosis:
-a complication of diabetes

29
Q

COVID-19 Acute Neurologic Manifestation

A

-CNS manifestation 30%
-Anosmia 75%
-PNS symptoms 7%

30
Q

Prion Disease

A

-Creutzfeldt-jakob disease, rapidly progressive dementia, behavioral changes, ataxia, blindness
-abnormal, protein
-fatal in 1 year

31
Q

HIV and AIDS

A

-can affect NS at any level
-aseptic meningitis, neuritis, myelitis

32
Q

Neurocysticercosis

A

-a parasite in pork
-common for seizures

S/s:
-seizures, HA, arachnoiditis

Tx:
-antiparasitics
-steroids
-surgery

Neuromuscular (21 decks)

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