(31A) Tumors of CNS Flashcards Preview

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Flashcards in (31A) Tumors of CNS Deck (55):
1

tumors that originate from astrocytes/glial cells

glioma, ependymoma, oligiodendroglioma

2

tumors that are classified as "nerve tumors"

schwannoma and neurofibroma

3

What are the common types of cancers that metastasize to the CNS

Giant Retards Love Brain Mets

GI
Renal Cell Carcinoma
Lungs
Breast
Melanoma

4

origin of meningioma

arachnoid cap cells

5

definitive risk factors for CNS tumors

ionizing radition, genetic syndromes, immunosuppression

6

need to know hereditaty syndromes that are assc with brain tumors

??

7

What effect does an increase in intracranial volume have on intracranial pressure

pressure stays constant until the compliance threshold has been reached. at this point small changes in volume will cause a large increase in pressure

8

What is the plateau wave phenomenon?

?? cant find on google

9

general signs of CNS tumor vs focal signs of CNS tumor

general: headache, vomitting, mental status change

focal: papilledema, seizures, focal neuro deficits

10

specifically what characteristics of a headache are red flags for CNS tumor

worse upon awakening and improvement within 1 hr

11

specifically what characteristics of a vomitting are red flags for CNS tumor

vomit immediately after onset of headache (suggesting inc ICP)

12

_____ herniation compresses the ACA

subfalcine

13

____ herniation causes ipsilateral occulomotor N palsy and contra or ipsilateral hemiparesis

uncal

14

_____ herniation causes horners syndrome + contralateral hemiparesis

upward through tentorium

15

_____ herniation causes only horners syndrome

diencephalic

16

____ herniation causes changes in BP, RR, and horner's

tonsillar

17

CT or MRI to detect CNS tumors

MRI

*CT is good for calcifications which can tell you the pathology of the tumor

18

T1 vs T2 weighted MRI scans

T1 contrast only gets in tumors

T2 edema and tumor appears hyperintense (edema spares the cortex though so anything in the cortex is tumor!)

19

What is the most common primary CNS tumor

glioma

20

___ grade gliomas are more commonly seen in children.

low

high grade = adults

21

low or high grade tumors are well differentated

low

*de-differentation is bad and = high grade

22

necrotic centers is a feature of a high or low grade glioma

high

23

surrounding edema is a feature of a high or low grade glioma

high

24

treatment that produces rapid but temporary improvement of glioma symptoms

STEROIDS--they reduce the swelling and restore BBB

25

seizures from a glioma are treated with (enzyme inducing or non-enzyme inducing) anti-seizure drugs

non-enzyme inducing

26

normal tissue and tumor recieve the same dose of radiiation

conventional/2D RT

27

chemo that is the std of care for glioma

temozolomide

28

genetic testing for ____ is needed before temozolomide

MGMT = need to have active MGMT to see response from temozolomide

29

drug used to treat gliomas that reoccured

bevacizumab

30

survival with a glioma is better if the pt has what genes?

MGMT active
isocitrate dehydrogenase mutation
1p and 19q deletion in oligiodendroglioma

31

meningioma is derived from

arachnoid cap cells

32

Who gets meningioma

45 yo; women

33

meningioma is a slow growing or aggressive tumor

slow growing

34

characteristic MRI finding for a meningioma

diffuse enhancement + dural tail

35

meningiomas are axial or extra axial tumors

extra axial

36

pituitary tumors are usually from the (ant or post) pit

anterior

37

microademomas are usually (non-functional or functional)

functional (make hormones)

macro are non-functional

38

signs/symp of pituitary tumors

headache, endocrine dysfunction, vidula defects (due to compression of optic chiasm)

39

treatment for PRLomas

DA agonists

40

origin of acoustic neuroma

schwann cells surrounding CN VIII > CN V > spinal radicles

41

Where do acoustic neuromas arise?

internal auditory meatus or cerebelloponitine angle

42

who gets acoustic neuromas

middle aged; M = F

43

acoustic neuromas are (slow growing or aggressive tumors_)

slow growing

44

how might an acustic neuroma present

hearing loss, tinnitus, headache, TN, ataxia

45

where do primary CNS lymphomas arise

leptomeninges and deeper periventricular brain parenchyma

46

how is primary CNY lymphoma different from the other adult primary CNS tumors?

multiple masses

47

Other than a scan how can PCNSL be diagnosed

LP contains monoclonal B cells in CSF

48

treatment for PCNSL

steroids **but give AFTER biopsy** otherwise you get a poor specimen for pathology (cells die quickly**

49

PCNSL is highly sensitive to

chemo and radiation therefore you can get CR and cure in younger pts

50

what is the treatment of choice for brain mets if there is progressive extracranial dz

whole brain radiation

51

diff dz for ring enhancing lesions on MRI

mets, CVA, demylenation, high grade glioma, lymphoma

52

signs and symptoms of a spinal cord tumor

pain, weakness, and parasthesis

53

most common extradural tumors of spinal cord

mets

54

most common intradural and extramedullary spinal cord tumors

schwannomas, neurofibromas, maningiomas

55

most common intradural and intramedullary spinal cord tumors

astocytomas (ped), ependymoma (adults), hemangioblastoma