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CMED 311 > WEEK 4: Neurooncology > Flashcards

WEEK 4: Neurooncology Flashcards

1
Q

Most common presentation of neuroonco?

A

progressive neurologic deficit
(68%), usually motor weakness (45%)
• Headache 54%
• Seizures 26%

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2
Q

Temporal profile of CNS tumors?

A

chronic and progressive

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3
Q

• Headache with focal neurologic deficit or seizure were

thought to differentiate tumors form other diagnoses. T or F?

A

T

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4
Q

• Occur with or without elevated ICP
• Present equally in patients with primary or metastatic tumor
(-50% of patients)
• Classically described as being worse in the morning (possibly
due to hypoventilation during sleep)

A

Headache c brain tumor

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5
Q

The brain itself is not pain

sensitive.

A

T

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6
Q

The brain being
enclosed in a closed vault has consistent volumes.
It is divided into three; brain parenchyma, blood,
and CSF. Any increase in any of the components
will cause increased ICP because it is
compartmentalized.

A

Monroe kellie doctrine

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7
Q

Landmarks of malignancy histology:

A

Vascular

proliferation, central necrosis.

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8
Q

Cushing’s Triad:

A

Hypertension, bradycardia and bradypnea.

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9
Q

Most Pediatric tumors are infratentorial, adult tumors are usually supratentorial.T or F?

A

T

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10
Q

The most common brain tumor is

A

metastatic

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11
Q

Most common primary brain tumor is

A

glioblastoma.

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12
Q

is the most aggressive type of brain tumor. It is WHO grade 4 along with anaplastic astrocytoma which may be grade 3 or grade 4. If you have these, usually you only have a prognosis of 4 months to 2 years if you have the money for chemotherapy and radiation

A

Glioblastoma multiforme

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13
Q

Oligodendroglioma and other low grade astrocytomas or gliomas you have a prognosis of around

A

5 - 10 years

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14
Q

Usually, high grade tumors ENHANCE T or F?

A

T

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15
Q

is characterized by anaplasia, vascular proliferation and areas of necrosis.

A

GBM

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16
Q

medulloblastoma vs ependymoma

A

Medulloblastoma – located in the roof of the 4th ventricle

 Ependymoma – located in the floor of the 4th ventricle

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17
Q

• Arise from ependymocytes
• Infratentorial
o More common in pediatric population
o Located in the floor of the 4th ventricle, spreads to the CSF outlets (Foramina of Magendie and Luschka)

A

infratentorial ependymoma

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18
Q

o More common in adults, but with poorer prognosis

o Located in the lateral or 3rd ventricle

A

supratentorial ependymoma

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19
Q

Posterior fossa symptoms:

A 
Posterior fossa symptoms:
o Headache
o Nausea
o Vomiting
o Ataxia
20
Q

Primitive neuroectodermal tumor of the posterior fossa
• Most common malignant pediatric brain tumor
• Usually midline, at the roof of the 4th ventricle
• Present with symptoms of increased ICP
• Histologic characteristics include densely packed small round cells with large nuclei and scant cytoplasm, unencapsulated, frequently disseminate within the CNS
• Generally, not encapsulated
• Frequently disseminate within the CNS

A

medulloblsatoma

21
Q

Poor prognosis if residual tumor is_____ cm, and the patient is _____ years old.

A

Poor prognosis if residual tumor is <1.5 cm, and the patient is <3 years old.

22
Q

• Benign epithelial tumors arising from the remnants of Rathke’s pouch in the suprasellar region

  • Encapsulated extra-axial lesions with interdigitating patterns of adhesions to adjacent structures including the optic apparatus, tuber cinereum of the pituitary stalk, hypothalamus, and Circle of Willis.
  • Cysts are high in lipid deposits referred to as machinery/crankcase oil.
A

Craniopharyngioma

23
Q

kind of shunt that has no exit in the peritoneum

A

Ommaya shunt

24
Q

Currently the most common primary brain tumor? genetic predisposition?

A

Meningioma; female

25
Q

The most common intracranial locations of meningioma are along the

A

falx, convexity and the sphenoid wing.

26
Q

Probable etiologies of meningioma

A

o Irradiation
 It will cause neoplastic changes.
o Trauma
o Infectious – Inoue-Melnick virus (IMV)

27
Q

Usually called cerebellopontine angle tumors because your vestibulocochlear nerve is in the vicinity of the pons
• Asymmetric sensorineural hearing loss, tinnitus, CN VII palsy
 Since cranial nerves VII and VIII are bundled, you would also notice that the patient has peripheral CN VII palsy.
• Grow at a rate of 2.4 mm/year

A

Acoustic schwannoma

28
Q

Two main histologic patterns of acoustic schwannoma

A

Two main histologic patterns:
o Antoni A (Dense)
o Antoni B (Loose) – cystic

29
Q

_______________ are pathognomonic for neurofibromatosis type 2 (NF2), a syndrome resulting from mutation of chromosome 22.

A

Bilateral acoustic neuromas are pathognomonic for neurofibromatosis type 2 (NF2), a syndrome resulting from mutation of chromosome 22.

30
Q

3 surgical management to acoustic schwannoma?

A

o Retrosigmoid
o Middle fossa
o Translabyrinthine

• May also be managed by stereotactic radiosurgery if <3cm in diameter, or focused high-dose radiation.

31
Q

Currently, the gold standard in stereotactic surgery is __________

A

Currently, the gold standard in stereotactic surgery is gamma knife.

32
Q

Arise from the anterior pituitary gland (adenohypophysis).

 If it arises from the posterior pituitary gland, it is usually metastatic.

A

Pituitary adenoma

33
Q

are often diagnosed when quite small due to endocrine dysfunction.

Secrete endocrinologically active compounds at pathologic levels
 The most common endocrine syndromes are Cushing’s disease, due to adrenocorticotropic hormone secretion, Forbes-Albright syndrome, due to prolactin secretion, and acromegaly, due to growth hormone secretion.

A

Functional tumors

34
Q

are typically diagnosed as larger lesions causing mass effects as visual field deficits due to compression of the optic chiasm or panhypopituitarism due to compression of the gland.

A

non functional tumor

35
Q

usually shrink with dopaminergic therapy alone, which inhibits production and secretion of prolactin.

A

prolactin secreting tumors

36
Q

dopaminergic therapy namely?

A

bromocriptine

37
Q

Most pituitary tumors are approached through the nose via the

A

transsphenoidal approach

38
Q

The most common manifestation of pituitary adenoma are

A

bitemporal hemianopsia and anosmia.

39
Q

Hemorrhage into a pituitary tumor causes abrupt symptoms of headache, visual disturbance, decreased mental status, and endocrine dysfunction. This is known as

A

pituitary apoplexy.

40
Q

CNS lymphoma may arise either primarily in the CNS or secondarily from systemic disease. T or F?

A

T

41
Q

(Dexamethasone is oncolytic) T or F?

A

T

42
Q

Surgical excision is not indicated in lypmhoma?

A

T

43
Q

in lymphoma, Stereotactic needle biopsy usually confirms the diagnosis?

A

T

44
Q

Most common intracranial tumors; Usually located at the gray white matter junction

A

metastasis

45
Q

most common source of brain metastasis?

A

Primary lung cancer

46
Q

Highest predilection for intracranial metastases

A

melanoma

CMED 311 (47 decks)

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