Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Tumours of the Nervous System > Flashcards

Tumours of the Nervous System Flashcards

1
Q

presentation of brain tumour?

A 
PROGRESSIVE neurological deficit
usually motor weakness
headache
seizures
(from most to least common)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

features of raised ICP?

A

headache
vomiting
mental changes
seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

causes of raised ICP?

A

mass
oedema
CSF flow blockage (hydrocephalus)
haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

uncal herniation causes what symptoms?

A

blown pupil (compresses CN III)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

tonsillar herniation causes what symptoms?

A

cushings response?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

can brain cope well with raised ICP?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

headache die to raised ICP?

A 
worse in the morning
wakes you up
worse with coughing/leaning forward
associated with and worsened by vomiting
basically similar to migrane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what do you do if suspected ICP headache?

A

fundoscopy

look for papilloedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

causes of tumour heacache?

A 
raised ICP
invasion/compression of dura, BVs, periosteum
2ndary to diplopia
2ndary to trying to focus eyes
extreme hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

DANISH?

A

//

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

suspected brain tumour investigations?

A 
imaging
lesion biopsy
EEG
evoked potential
angiograms
radionucleotide studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most common cause of brain tumour?

A

metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what cells can cause primary brai tumours?

A 
astrocytes (60%)
oligodendroglial cells
ependymal cells
neuronal cells
..
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

grading of brain tumours?

A 
molecular classification now
was graded 1-4
- 1 = pilocytic, pleomorphic xanthanoastrocytoma subependymal giant cell
- 2 = low grade astrocytoma
- 3 = anaplastic
- 4 = glioblastoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

grade 1 astrocytoma?

A 
truly benign
slow growing
children/young adults
optic nerve, cerebellum generally
take up contrast very well
treatment = surgery (curative)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

grade 2 astrocytoma?

A

fibrillary, gemistocytic, protoplasmic
hypercellularity
don’t take up contrast (unlike grade 1)
tend to present with seizures
ultimately not benign (turn malignant and higher grade over time)
treatment = surgery if safe +/- chemo/radiotherapy

17
Q

poor prognostic factors for grade 2 astrocytoma?

A 
age >50
focal deficit
short duration of symptoms
raised ICP
altered conscious
enhancement on contrast studies
18
Q

grade 3 astrocytoma?

A

malignant
anaplastic
can arise de novo
median survival = 2 years

19
Q

grade 4?

A

glioblastoma multiforme
most common primary tumour
median survival = <1 year
spread along white matter, tracking CSF pathways

20
Q

management of grade 3-4?

A

surgery not curative but can help symptoms
post op radiotherapy
combination of surgery + radiotherapy + chemo = survival increased to 14 months but often not done as 2 months doesn’t really make a difference

21
Q

how is tumour identified during surgery?

A

patient given drink of 5-ALA which causes tumour cells to appear pink under blue light

22
Q

who must be informed after a patient has had any brain surgery?

A

DVLA

patient cannot drive after any brain surgery (seizure risk)

23
Q

what chemo is used?

A

temozolomide
PCV
carmustine wafers

24
Q

use of radiotherapy in brain tumours?

A

clear role in post op malignant tumours

………

25
Q

oligodendroglial tumour?

A 
20% of glial tumours
….
present with seizures
generally in frontal lobe
…
difficult to distinguish
……….
treatment = surgery + chemotherapy (PCV)
26
Q

danger signs of brain tumour in children?

A

tiptoeing, ataxia, vomiting with headache

27
Q

meningioma?

A 
arachnoid cap cells
extra-axial
20% of intracranial neoplasms
most are asymptomatic
most common in women
can spread from breast cancer?
presentation = cranial nerve palsy, headache
slow growing
28
Q

aggressive meningiomas?

A 
clear cell
choroid
rhabdoid
papillary
radiation induced meningiomas (after childhood leukaemia, typically in midline)
29
Q

investigation of meningioma?

A

CT - homogenous, dense enhancing, oedema
MRI - …….
angiography +/- embolization - ………..

30
Q

management of meningioma?

A 
expectant if small (leave alone)
pre-op embolization
surgery
radiotherapy
recurrence
90% 5 year survival
31
Q

types of nerve sheath tumours?

A

schwannomas (AKA neuromas)
neurofibromas
malignant peripheral nerve sheath tumours

32
Q

commonest nerve sheath tumour?

A

acoustic neuroma/schwannoma (vestibular)
- hearing loss, tinnitus, disequilibrium, can cause hydrocephalus
5th/7th/8th CNs

33
Q

management of acoustic schwannoma?

A

expectant (25%)
surgery
radiation
manage hydrocephalus

34
Q

how do pineal tumours present?

A

para…. syndrome
nystagmus?
…..
all extra-ocular muscles are compromised?

35
Q

pineal tumour?

A 
//
can be germ cell?
36
Q

tumour makers on bloods?

A 
AFP
HCG
LDH
- perform for any midline brain tumour in a child
- perform a biopsy if negative
37
Q

how is hydrocephalus managed?

A

VP shunt

38
Q

features of pituitary tumour?

A

bitemporal hemianopia
headache
endocrine abnormality

39
Q

tests for pituitary tumour?

A 
prolactin measure (prolactinoma can generally be managed with cabergoline)
early morning cortisol
GH/IGF-1
thyroid function tests
FSH/LH
visual fields

Neurology (53 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions