Pathology IV

Question 1

What is the treatment for cluster headaches?

Answer 1

Inhaled oxygen, sumatriptan (p.446)

Question 2

Describe the symptoms/ pain associated with tension headaches.

Answer 2

Steady pain without photophobia or phonophobia. No aura (p.446)

Question 3

Describe the symptoms/ pain associated with migraine headaches.

Answer 3

Pulsating pain with nausea, photophobia, or phonophobia. May be present with an aura. Caused by irritation of CN V, meninges, or blood vessels (release of substance P, CGRP, vasoactive peptides) (p.446)

Question 4

What is the treatment for migraine headaches?

Answer 4

Abortive therapies (triptans); prophylactic treatments (propanolol, topiramate) (p.446)

Question 5

Name five non traditional causes of headache.

Answer 5

SAH, meningitis, hydrocephalus, neoplasia, arteritis (p.446)

Question 6

How are cluster headaches differentiated from trigeminal neuralgia?

Answer 6

Based on duration- TN pain lasts for typically less than a minute; cluster headache pain lasts usually greater than 15 minutes (p.446)

Question 7

Describe the pain associated with trigeminal neuralgia.

Answer 7

Repetitive, shooting pain in the distribution of CN V that lasts typically for < 1 minute (p.446)

Question 8

What are the two types of vertigo?

Answer 8

Peripheral (more common) and central vertigo (p.446)

Question 9

What is the etiology of peripheral vertigo?

Answer 9

Inner ear etiology (e.g semicircular canal debris, vestibular nerve infection, Meniere’s disease) (p.446)

Question 10

What positional testing results indicate peripheral vertigo?

Answer 10

Positional testing. Positive test is delayed horizontal nystagmus (p.446)

Question 11

Where do meningiomas most commonly occur?

Answer 11

In the convexities of hemispheres near to the surfaces of the brain and in the parasagittal region. They are extra axial (external to the brain parenchyma) and may have a dural attachment (tail) (p.447)

Question 12

From where do meningiomas arise?

Answer 12

Arachnoid cells (p.447)

Question 13

What is the prognosis for a patient with a meningioma?

Answer 13

Tumors are usually benign and resectable (p.447)

Question 14

How does a patient with a meningioma most typically present?

Answer 14

Often asymptomatic or may present with seizures or focal signs (p.447)

Question 15

What characterizes histology of mengioma tumors?

Answer 15

Spindle cells concentrically arranges in a whorled pattern with psammoma bodies (laminated calcificaitons) (p.447)

Question 16

What is the third most common tupe of primary adult brain tumor?

Answer 16

Schwannomas (p.447)

Question 17

Where are schwannomas typically located and what is their cellular origin?

Answer 17

Often localized to CN VIII (acoustic neuromas) and found at the cerebellopontine angle; of Schwann cell origin (p.447)

Question 18

How are schwannomas usually treated?

Answer 18

Resection or sterotactic radiosurgery (p.447)

Question 19

What type of staining is characteristically positive in schwannomas?

Answer 19

S-100 (p.447)

Question 20

What type of schwannomas are often present in NF type II?

Answer 20

Bilateral acoustic schwannomas (p.447)

Question 21

What are oligodendrogliomas?

Answer 21

Relatively rare, slow growing tumors that are most often located in the frontal lobes (p.447)

Question 22

Describe the appearance of pattern of oligodendroglioma tumors.

Answer 22

Chicken-wire capillary pattern with ‘fried-egg’ cells (round nuclei with clear cytoplasm) that are often calcified (p.447)

Question 23

What symptoms are typically caused by pituitary adenomas?

Answer 23

Bitemporal hemianopia (due to pressure on the optic chiasm), hyper- or hypopituitarism (p.447)

Question 24

What is the most common form of pituitary adenoma?

Answer 24

Prolactinoma (p.447)

Question 25

Name the five types of primary childhood brain tumors.

Answer 25

Pilocytic (low-grade) astrocytoma, medulloblastoma, ependymoma, hemingioblastoma, craniopharyngioma (p.448)