peds review Flashcards
A patient presents with short term memory loss and loss of sensation in his right hand. What area of the brain might be effected?
Occipital lobe
Parietal lobe
Frontal lobe
Temporal lobe
parietal
Symptoms: Decreased motor skills, unable to form speech. What area of the brain?
Occipital lobe
Parietal lobe
Frontal lobe
Temporal lobe
frontal
Astrocytomas arise from what type of glial cells?
Astrocytes
Ependymal cells
Oligodendrocytes
astrocytes
What is the most common tumour that occurs in the supratentorial region of the brain?
Medulloblastoma
Meningioma
Glioblastoma multiforme
Low grade astrocytoma
low grade astro
All of the following are radiographic characteristics of a high grade astrocytoma, except:
Indistinct borders
Cystic component
Edema
Areas of necrosis
cystic
What would be the WHO Grade designation for an anaplastic astrocytoma?
Grade I
Grade II
Grade III
Grade IV
grade 3
The most common location of extracranial metastasis via the blood is to the:
Lymph nodes
Lung
Cerebrospinal fluid
Spinal canal
lung
Blood – Lung
High grade tumours of brain and meninges spread by seeding into CSF
What would be the most appropriate treatment management option for a 4 year old with a Grade II astrocytoma?
- observation
- neurosurgery
- RT
- chemo
a - 1
b - 2 and 4
c - 2 and 3
d - 3 and 4
b
ages 3-5 neurosurgery primary treatment, in 3-5 yrs olds post-op chemo, delay RT until brain maturation
What is the most appropriate dose/fractionation to treat a low grade astrocytoma? 3600cGy/180cGy 4500cGy/180cGy 5040cGy/180cGy 5760cGy/180cGy
5040cGy/180cGy
Low grade 5000-5400cGy
High grade 5400-6000cGy
What is the most common location for a tumour of the brain stem to occur?
Cerebellum
Medulla oblongata
Midbrain
Pons
pons
50-70%
What is the peak age for this type of tumour to occur?
2 years old
5 years old
8 years old
12 years old
5
An MRI image of a medulloblastoma tumour would have all of the following features, except:
Central cerebrum mass
Hydrocephalus
Round in shape
Possible compression of 4th ventricle
central cerebrum mass
mass would be in the cerebellum
Medulloblastoma can develop distant mets to _______?
Lung
Liver
Bone
Brain
bone
Metastatic disease anywhere in CSF
Location outside of posterior fossa
All of the following would be considered part of the high risk tumour group, except:
2 year old child
M0 – Chang staging system
2.5 cm residual tumour post-operatively
Extension to Supratentorial region
(medullablastoma)
M0- chang
> 1.5 cm of residual tumour disease post-operatively
<3 years old
What is the most important prognostic factor?
Grade of disease
Location
Size of tumour
Disease extent
(medullablastoma)
disease extent
What area has the highest risk of recurrence?
Pons
Posterior fossa
Cerebral cortex
Midbrain
(medullablastoma)
post fossa
Chemotherapy is used as a treatment in all of the following, except:
High risk disease
Patients with recurrent disease
Sole modality treatment
3 year old child
(medullablastoma)
sole modality
Which of the following structures must be included in the cranial fields for CSI to decrease risk of subfrontal recurrence?
Optic nerve
Temporal fossa
C2
Cribriform plate
(medullablastoma)
cribriform plate
due to High risk of subfrontal recurrence
What is the typical CSI dose/fractionation schedule? 1500ccGy/150cGy 2340cGy/180cGy 3600cGy/180cGy 5580cGy/180cGy
(medullablastoma)
3600cGy/180cGy
All of the following structures would be included in the posterior fossa boost except:
Cerebellum
Medulla oblongata
Pons
C2
(medullablastoma)
C2
What is the most common age for children to present with a unilateral Wilms’ tumour?
8 months of age
24 months of age
26 months of age
39 months of age
39
26 for bilateral
What is the most common presentation?
Gross hematuria
Tender mass on one side of abdomen
Painless swelling in abdomen
Enlarged lymph nodes
gross hematuria
What is the most common presentation for wilms tumours?
Gross hematuria
Tender mass on one side of abdomen
Painless swelling in abdomen
Enlarged lymph nodes
gross hematuria
What is the most common metastatic site for wilms tumours?
Bone
Brain
Liver
Lungs
lung
What is the dose/fractionation for treatment a tumour of Stage II favourable histology wilms tumour?
1080 cGy/180cGy 1500cGy/150cGy 2100cGy/150cGy 2400cGy/180cGy None of the above
none of the above does not require RT
What is the dose/fractionation for treatment a tumour of Stage I unfavourable histology wilms tumour?
2100cGy/150cGy 1500cGy/150cGy 1080cGy/150cGy 2400cGy/150cGy None of the above
1080/180
Whole Abdominal RT for wilms tumours would be used for all of the following scenarios, except:
Post-surgical gross residual disease
Peritoneal seeding
Preoperative intraperitoneal rupture
Very favourable histology
very fave histology
Postoperative RT for wilms tumours would be used for all of the following scenarios, except?
Completely resected Stage I UFH
Stage II FH
Stage III UFH
Stage IV FH
stage 2 FH
What is the inferior treatment border for the whole abdomen radiation fields for wilms tumours?
2-3 margin around inferior extent of disease
L1
Top of iliac crests
Below the obturator foramen
below obturators
For treatment of the flank fields for wilms tumours, what dose should the remaining kidney be limited to?
<1000cGy
<1200cGy
<1500cGy
<2000cGy
Dose limited to second kidney to 1000 cGy
What is the peak age for medullablastomas
a. 2 years old
b. 5 years old
c. 8 years old
d. 12 years old
b
An MRI image of a medulloblastoma tumour would have all of the following features, except:
Central cerebrum mass
Hydrocephalus
Round in shape
Possible compression of 4th ventricle
a
Medulloblastoma can develop distant mets to _______?
Lung
Liver
Bone
Brain
c
All of the following would be considered part of the high risk tumour group, except:
2 year old child
M0 – Chang staging system
2.5 cm residual tumour post-operatively
Extension to Supratentorial region
b
What is the most important prognostic factor?
Grade of disease
Location
Size of tumour
Disease extent
d
Chemotherapy is used as a treatment in all of the following, except:
High risk disease
Patients with recurrent disease
Sole modality treatment
3 year old child
c
Which of the following structures must be included in the cranial fields for CSI to decrease risk of subfrontal recurrence?
Optic nerve
Temporal fossa
C2
Cribriform plate
d
What is the typical CSI dose/fractionation schedule?
1500ccGy/150cGy
2340cGy/180cGy
3600cGy/180cGy
5580cGy/180cGy
c
All of the following structures would be included in the posterior fossa boost except:
Cerebellum
Medulla oblongata
Pons
C2
d
