Brain Tumours (Clinical) Flashcards

1
Q

What are the cancers which most commonly spread to the brain?

A
Renal
Lung
Breast
Melanoma
GI
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2
Q

What are the most common primary brain tumours?

A

GIioma
Meningioma
Adenoma

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3
Q

What is the most common cause of cancer in the brain?

A

Secondary metastasis

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4
Q

What is the most common grade of glioma? Describe this stage

A

Grade 4
Most aggressive, glioblastoma multiform spread by tracking through the white matter and CSF pathway, very rarely spread systemically

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5
Q

What cells do gliomas affect?

A

Astrocytes

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6
Q

What are the characteristics of meningioma?

A

Slowing growing extra-axial tumours that are usually benign. They arise form the arachnoid mater and frequently occur along the falx or sphenoid bone
If complete resection successful the patient is usually cured

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7
Q

What is the most common form of pituitary tumour?

A

Adenoma

Only 1% malignant

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8
Q

What are some of the effects of a ‘benign’ pituitary adenoma?

A

Visual disturbance caused by compression of the optic chiasm but he tumour, can cause hormone imbalance by the functioning hormone-secreting forms of at the adenoma

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9
Q

What are some basic presenting features of brain tumours?

A

Raised ICP
Focal neurological deficit
Epileptic fits
CSF obstruction

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10
Q

Give some symptoms of raised ICP

A
Headache - typically morning 
Nausea/vomiting
Visual disturbance
Somnolence
Cognitive impairment
Altered consciousness
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11
Q

What are some clinical signs of raised ICP?

A
Papilloedema
6th nerve palsy
Cognitive impairment 
Altered consciousness 
3rd nerve palsy
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12
Q

What is the average production of CSF in an adult?

A

400-500 cc per day

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13
Q

What can cause hydrocephalus and whom does this most commonly affect?

A

Tumours in or close to the css pathways, especially in the posterior fossa
Children

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14
Q

Give some focal neurological deficits

A
Hemiparesis
Dysphagia
Hemianopia
Cognitive impairment
Cranial nerve palsy
Endocrine disorders
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15
Q

What are the two general forms of epilepsy?

A

Focal epilepsy

Generalised epilepsy

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16
Q

What positional feature of tumours dictates whether they have the potential to cause epileptic fits?

A

This inly occurs in lesions above the tentorium

17
Q

What are the cerebral imaging options for brain tumours?

A

CT
MRI
PET
(Angiography)

18
Q

What are the management goals in brain tumours?

A

Accurate tissue diagnosis
Improve quality of life
Aid affect of adjuvant therapy
Prolong life expectancy

19
Q

What are the management options for Glioblastoma multiforme?

A

Complete surgical excision possible - biopsy or debunk possible
Medical - steroids, anticonvulsants
Radiotherapy
Chemotherapy

20
Q

What are the management options for metastasis to the brain?

A

DIAGNOSE PRIMARY SITE
Medical - steroids, anticonvulsants
Radiotherapy - whole brain, stereotatic
Surgery

21
Q

What is the general prognosis for meningioma?

A

Commonly cured by surgery, may require anticonvulsants

22
Q

What is the general prognosis for low grade astrocytoma?

A

Long life expectancy

23
Q

What is the general prognosis for high grade astrocytoma/GBM?

A

Average 1 year survival