10/21: CNS Part 2

Question 1

Where are most CNS tumors located?

Answer 1

Intracranial; spinal cord tumors are less frequent

Question 2

Where are CNS tumors located in adults and children?

Answer 2

Adults: supratentorial
Children: infratentorial

Question 3

What is the second most common malignancy in children?

Answer 3

CNS tumors

Question 4

What are two types of astrocytomas?

Answer 4

Glioblastoma - Diffuse
Pilocytic astrocytoma -Localized

Question 5

What is the most common adult primary tumor?

Answer 5

Glioblastoma (diffuse)

Question 6

Who is pilocytic astrocytoma primarily found in?

Answer 6

Children

Question 7

What WHO grade is pilocytic astrocytoma?

Answer 7

WHO 1 (favorable outcome)

Question 8

Who are oligodendrogliomas commonly found in?

Answer 8

Adults

Question 9

What genes are associated with oligodendroglioma?

Answer 9

1p19q co-deletion

Question 10

Oligodendroglioma has a better prognosis than _________

Answer 10

Astrocytoma

Question 11

What WHO grade is oligodendroglioma?

Answer 11

WHO grades II, III

Question 12

Who is ependymoma associated with?

Answer 12

Children/adults

Question 13

Where is ependymoma found in children and adults?

Answer 13

Children - intracranial
Asults - spinal cord

Question 14

What WHO grade is ependymoma?

Answer 14

WHO grade II, III , grade II most common

Question 15

What WHO grade is medulloblastoma?

Answer 15

grade IV
- Despite the WHO grade IV designation, this tumor
has a very favorable prognosis in many cases

Question 16

Where is medulloblastoma located?

Answer 16

In the cerebellum

Question 17

What is the second most common primary intracranial tumor in adults >30 years and female?

Answer 17

Meningioma

Question 18

What nerve is schwannoma associated with?

Answer 18

Cranial nerve VIII

Question 19

What is the most common metastases?

Answer 19

Lung
Breast

Question 20

What is often hemorrhagic metastases?

Answer 20

Kidney
Melanoma
Choriocarcinoma

Question 21

What are examples of meningitis infection?

Answer 21

Bacterial
Fungal
Viral
Other

Question 22

What are examples of encephalitis infection?

Answer 22

Bacterial
Viral: herpetic, rabies, polio, slow virus

Question 23

Definition of enecphalitis, meningitis, meningoencephalitis, meningoencephalomyelitis, and meningomyelitis

Answer 23

• Encephalitis: inflammation of the brain
• Meningitis: inflammation of the meninges
• Meningoencephalitis: inflammation of the brain and
  meninges
• Meningoencephalomyelitis: inflammation of the meninges,
  brain and spinal cord
• Meningomyelitis: inflammation of the spinal cord and its
  membranes

Question 24

What kind of spread of infection is most common?

Answer 24

Hematogenous

Question 25

Where do local infections spread from?

Answer 25

Paranasal sinuses, dental infections, skin (facial) infections

Question 26

Who has the peak incidence of meningitis?

Answer 26

Children (75% of cases)

Question 27

What are cerebral abscess?

Answer 27

Penetrating skull injury Spread of infection from other sources May be bacterial or fungal in origin

Question 28

What are toxoplasmosis?

Answer 28

Multilple necrotizing abscessess

Question 29

Where is herpes simplex encephalitis distributed?

Answer 29

In an assymetric fashion through the medial temporal and inferior frontal lobes

Question 30

What is CMV?

Answer 30

* Rare in adults, typically immunocompromised * Important in pregnancy and early postnatal period * One of the TORCH infections * Causes periventricular calcifications * Viral particles in brain and persist for decades after fetal infection

Question 31

What is PML?

Answer 31

Opportunistic demyelinating disease caused by the JC polyomavirus

Question 32

Who is PML most common in?

Answer 32

Immunocompromised patients

Question 33

What is the diagnostic hallmark for PML?

Answer 33

Presence of oligodendrocytes with enlarged nuclei

Question 34

What are prios?

Answer 34

abnormal forms of a cellular protein that causes transmissible neurodegenerative disorders

Question 35

What are demyelinating diseases?

Answer 35

Multiple sclerosis (MS)

Question 36

What are degenerative diseases?

Answer 36

Alzheimer Parkinson ALS

Question 37

What is MS characterized by?

Answer 37

more than one episode of neurologic deficits separated in time, attributable to CNS white matter lesions that are separated in space

Question 38

What is found on MRI for multiple sclerosis?

Answer 38

Multifocal lesions of various ages in white mater located adjacent to lateral ventricles

Question 39

What are pathologic landmarks of alzheimers disease?

Answer 39

Neuritic plaques and neurofibrillary tanles

Question 40

What is parkinson disease characterized by?

Answer 40

Presence of lewy bodies

Question 41

What is parkinson disease visible as?

Answer 41

Depigmentation of the substantia nigra in the midbrain