Who

Question 1

Pediatric brain tumor MCC age

Answer 1

15-19 followed by 0-4

Question 2

Common pediatric tumor < 20 yes

Answer 2

Glioma and glioneural tumors (45%)
Embryonal tumor ( medulloblastoma) 12 %
Pituitary tumor
Nerve shear tumor
Craniopharyngioma

Question 3

Incidence decrease of which tumors with younger < 20

Answer 3

pilocytic astrocytoma, malignant glioma, ependymal tumors, choroid plexus tumors, and embryonal tumors

Question 4

MCC infratentorial tumor affecting age

Answer 4

12-24 months > 70%
6-12 months > 53%

Question 5

MCC supratentorial tumors in pediatrics as in adulthood.

Answer 5

Astrocytomas

Question 6

MCC infratentorial tumors

Answer 6

Question 7

MCC Intracranial neoplasms during the first year of life ( neonate)

Answer 7

Tertoma

Question 8

MCC supratentorial tumors in neonate

Answer 8

astrocytoma, choroid plexus tumors, ependymomas, and craniopharyngiomas.

Question 9

MCC posterior fossa tumor in neonate

Answer 9

medulloblastoma and cerebellar astrocytoma

Question 10

The 6 histological groups that have a younger median age of diagnosis than other types are

Answer 10

Pilocytic Astro median age 11
Choroid plexus e20
Neuro glial tumor 26
Pineal 32
Embryonal 8 yes
GCT 15 y

Question 11

Invasion to which structure will cause headach ( pain sensitive structure )

Answer 11

Dura
Blood vessels
Periosteum’s
Cranial nerves

Question 12

In posterior fossa tumor EVD set for how long

Answer 12

Set in low pressure 10 for max 72 hr

Question 13

High suspicion fro Mets

Answer 13

Multiple brain lesion
Solitary ring enhancing lesion gray-white matter junction
Postioeor fossa
Wet loss

Question 14

CPA tumor mri protocol

Answer 14

FIESTA MRI and audiology screening

Question 15

Prophylactic antiseizure medications with brain tumors

Answer 15

Shouldn’t use routinely in patient dx with brain tumors w/o seizure
If undergoing craniotomy, prophylactic ASMs may be used, and if there has been no seizure, it is appropriate to taper off ASMs starting 1 week post-op

Question 16

F/u mri for newly dx brain tumors

Answer 16

3 months to r/o stability
If stable then annually

Question 17

Excellent chemotherapy passing BBB

Answer 17

Nitrosoureas

Question 18

Temozolomide MOA

Answer 18

1-at physiologic pH to the active metabolite monomethyl triazenoimidazole carboxamide (MTIC)
2- ). The mutagenic/cytotoxic effect of MTIC is associated with alkylation Add methyl group&raquo_space; the O6 and N7 positions on guanine
3-Cells can repair this damage via O6methylguanine-DNA methyltransferase (p.673) (MGMT), a protein which may be deficient to some degree in various tumors (especially astrocytomas, IDH-mutant (p.658)) which renders them more susceptible to temozolomide.

Question 19

Factor disturb BBB for chemotherapy

Answer 19

Malignant Glioma

lipophilic agents (e.g., nitrosoureas
Intra-arterial > increase penetration BBB

iatrogenically disrupted by mannitol
Intrathecal

Question 20

differentiating low grade gliomas from normal or reactive brain

Answer 20

limited perineuronal satellitosis is&raquo_space; normal

Question 21

astrocytoma vs. oligodendroglioma:

Answer 21

perineuronal satellitosis may in some cases be more pronounced in oligodendrogliomas. + fried egg apearnce > oligo

Question 22

radionecrosis vs. recurrent tumor (higher grade astroctymoa or glioblastoma)

Answer 22

Radiation necrosis > white matter

sclerosis/hyalinization of vessels or fibrinoid necrosis of vessel walls, perivascular lymphocytes, calcifications, and the presence of macrophages

Question 23

Classical histology features of menningioma

Answer 23

whorls, psammoma bodies, intranuclear pseudoinclusions) may be absent, and freeze artifact can create areas that resemble Antoni B fibers. 32

Question 24

Immunohistochemical stains

Answer 24

Question 25

GFAP stain postive

Answer 25

Oligo
Epndymoma
CPP

Question 26

S-100 protein +ve Glioma

Answer 26

Epndymoma
Chordoma
Craniophrangioma
Mets melanoma
Schwann o a and NF

Question 27

Cytokeratins

Answer 27

Stain epithiulime
+ve Mets carcinoma
CPP

Question 28

Epithelial membrane antigen (EMA)

Answer 28

+ve RCC
-ve hemangioblstoma

Question 29

Neuroendocrine stains

Answer 29

1-chromogranin
2-synaptophysin > +ve central neurocytoma
3-CD 56

4-neuron specific enolase (NSE)

Question 30

Mets postive stain of CD 56

Answer 30

Small cell carcinoma of the lung
Phechromocytoma
Merkel cell tumor

Question 31

B-hcg high in

Answer 31

Tertoma
Choricacrcinoma
Embryonal cell carcinoma of pineal

Question 32

Alpha-fetoprotein > 500 BG/ml

Answer 32

Colon ca,lung, pancreases,stomach,ovary,hepatitis and NTD ,GCT

Question 33

Carcinoembryonic antigen (CEA) > 1ng/ml

Answer 33

Colo ca, lung ca,breast ca,bladder and melanoma

Question 34

S -100 high

Answer 34

Head Truma

Creutzfeldt-Jakob disease

Question 35

leading cause of brain tumor-related death in children.

Answer 35

DIPG diffuse infiltration pontine Glioma

Question 36

DIPG triad

Answer 36

Short course of CN palsy , long tract , ataxia

Question 37

MCC glioma in pediatric

Answer 37

PCA

Question 38

violating Collins’ law

Answer 38

considered cured if it does not recur within a time 🟰 age at diagnosis ➕ 9 months

Question 39

40 % of p fossa tumor are

Answer 39

PCA of cerebellum🟰 cystic cerebella’s Astrocytomas

Question 40

diencephalic syndrome

Answer 40

infiltrating glioma of the anterior hypothalamus

🔺cachexia, hyper active and euophric

Question 41

3 rd most common brain tumors in pediatrics—

Answer 41

Brain stem Glioma

Question 42

Smallest intracranial tumors can cause death 💀

Answer 42

Tectal Glioma

Question 43

MCC brain Mets

Answer 43

Breast , lung , kidny , melanoma , colon ca