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Adams 10th > Chapter 31 - Intracranial neoplasms > Flashcards

Chapter 31 - Intracranial neoplasms Flashcards

1
Q

What differentiates anaplastic astrocytoma from glioblastoma?*
A. hypercellularity with pleomorphism of cells
B. frequent mitosis
C. hyperplasia of endothelial cells of small vessels
D. necrosis and hemorrhage

A

D. necrosis and hemorrhage (p. 650)

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2
Q 
Glioblastomas typically recur within how many cm from their original site?*
A. 1 cm
B. 2 cm
C. 3 cm
D. 4 cm
A

B. 2 cm (p. 652)

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3
Q

What is the treatment for anaplastic astrocytoma?*
A. Surgery alone
B. Surgery + radiotherapy
C. Surgery + radiotherapy + concomitant temozolamide
D. Surgery + radiotherapy + concomitant and adjuvant temozolamide

A

D. Surgery + radiotherapy + concomitant and adjuvant temozolamide (p. 651)

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4
Q 
Most common type of low-grade astrocytoma:
A. Protoplasmic or fibrillary
B. Gemistocytic
C. Pilocytic
D. Mixed astrocytoma-oligodendroglioma
A

A. Protoplasmic or fibrillary (p. 652)

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5
Q

True regarding treatment of low-grade pure astrocytomas EXCEPT:
A. Resection of the tumor nodule is of singular importance in delaying or preventing a recurrence
B. In younger patients, radiation can be delayed and the course of the tumor evaluated by serial imaging
C. An increase in seizures or worsening neurologic signs presses one to turn to radiation or further surgery
D. Chemotherapy is mainstay in the treatment of such tumors

A

D. Chemotherapy is mainstay in the treatment of such tumors (p. 653)

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6
Q

True regarding treatment of low-grade pure astrocytomas EXCEPT:
A. Resection of the tumor nodule is of singular importance in delaying or preventing a recurrence
B. In younger patients, radiation can be delayed and the course of the tumor evaluated by serial imaging
C. An increase in seizures or worsening neurologic signs presses one to turn to radiation or further surgery
D. Chemotherapy is mainstay in the treatment of such tumors

A

D. Chemotherapy is mainstay in the treatment of such tumors (p. 653)

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7
Q

Most common cell type of the pituitary gland
A. Chromophobe
B. Acidophil
C. Basophil

A

A. Chromophobe (p. 676)

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8
Q

Adenomas of the pituitary are most commonly composed of what cell type?
A. Chromophobe
B. Acidophil
C. Basophil

A

A. Chromophobe (p. 676)

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9
Q

Which of the following does not cause empty sella syndrome?*
A. Pituitary microadenoma
B. Pseudotumor cerebri
C. Hydrocephalus
D. Post-surgical excision of pituitary meningioma

A

A. Pituitary microadenoma (p. 679)

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10
Q 
32-year-old male with 5-year history of focal seizures with MRI findings of a right frontal heterogenous mass which is hyperintense on T2 and is near the cortical surface with relatively well defined borders, some contrast enhancement, and with intratumoral calcification*
A. GBM
B. Anaplasric astrocytoma
C. Oligodendroglioma
D. Meningioma
A

C. Oligodendroglioma (p. 655)

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11
Q 
Most common glioma of the spinal cord:
A. GBM
B. Anaplastic astrocytoma
C. Oligodendroglioma
D. Ependymoma
A

D. Ependymoma (p. 656)

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12
Q 
Most common cerebral site of ependymomas:*
A. Lateral ventricles
B. Third ventricle
C. Fourth ventricle
D. Cerebral cortex
A

C. Fourth ventricle (p. 656)

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13
Q 
Most frequent acquired genetic defect of meningiomas involves inactivating mutations in which chromosome?
A. 1p
B. 6q
C. 9p
D. 22 q
A

D. 22 q (p. 656)

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14
Q 
Which is not part of the standard treatment for primary CNS lymphomas?*
A. Surgical resection
B. Intrathecal methotrexate
C. Cytarabine
D. Radiation
A

A. Surgical resection (p. 659)

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15
Q 
Cancers of which regions have a higher tendency to spread in the posterior fossa?
A. Pelvis and colon
B. Breast
C. Lung
D. Renal
A

A. Pelvis and colon (p. 660)

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16
Q 
These are metastatic tumors that are most likely to be single brain metastasis except:
A. Kidney
B. Breast
C. Thyroid
D. Melanoma
E. Lung adenocarcinoma
A

D. Melanoma (p. 660)

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17
Q 
Most common metastatic tumor to bleed
A. Melanoma
B. Lung
C. Thyroid
D. Kidney
A

B. Lung (p. 660)

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18
Q 
Brainstem metastases most often originate from where?
A. Melanoma
B. Lung
C. Thyroid
D. Kidney
A

B. Lung (p. 660)

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19
Q 
Meningiomas usually elaborate this type of soluble protein:*
A. EGFR
B. VEGF
C. PDGF
D. BDGF
A

B. VEGF (p. 656)

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20
Q 
These tumors are characterized microscopically by tumor cells with a small round nucleus and halo of unstained cytoplasm*
A. Glioblastoma
B. Oligodendroglioma
C. Ependymoma
D. Meningioma
A

B. Oligodendroglioma (p. 654)

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21
Q

Which of the following is incorrect about CNS leukemia?
A. Greater incidence in acute than chronic leukemia
B. Greater incidence in lymphocytic than myelocytic leukemia
C. More frequent in children than adults
D. None of the above

A

D. None of the above (p. 663)

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22
Q

Which of the following is incorrect regarding necrotizing leukoencephlopathy?
A. Occurs most frequently when cranial irradiation is combined with intrathecal and intravenous methotrexate
B. Lesions enhance on CT and MRI
C. Radiation is the most important factor
D. Most patients are children

A

B. Lesions enhance on CT and MRI (p. 663)

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23
Q 
Leptomeningeal dissemination in high grade lymphomas have a predilection for which cranial nerve?
A. VII
B. VIII
C. IX
D. X
A

B. VIII (p. 663)

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24
Q

Most common neurologic complication of all types of lymphoma
A. Extradural compression of the spinal cord or cauda equina
B. Brain metastasis
C. Cerebral infarction
D. Intracerebral hemorrhage

A

A. Extradural compression of the spinal cord or cauda equina (p. 663)

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25
Q 
Chromosomal studies of medulloblastomas reveal a deletion on which chromosome?
A. 15
B. 16
C. 17
D. 18
A

C. 17 (p. 665)

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26
Q

Treatment for medulloblastomas:
A. Surgery alone
B. Surgery and radiotherapy only
C. Surgery, chemotherapy, and radiation of the posterior fossa
D. Surgery, chemotherapy, radiation of the entire neuraxis

A

D. Surgery, chemotherapy, radiation of the entire neuraxis (p. 666)

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27
Q 
Most common location of choroid plexus papillomas:
A. Lateral ventricle
B. Third ventricle
C. Fourth ventricle
D. All are equally affected
A

A. Lateral ventricle (p. 667)

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28
Q 
Which is associated with poorer prognosis in medulloblastomas?*
A. Desmoplastic features
B. N-MYC amplification 
C. Nodular histologic pattern
D. Onset older than 3 years of age
A

B. N-MYC amplification (pp. 665)

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29
Q 
Most common source of brain metastasis*
A. Lung
B. Breast
C. Melanoma
D. GIT
A

A. Lung (p. 660)

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30
Q 
3-year-old boy presents with inability to look upward and slightly dilated pupils that react on accommodation but not to light. What is the most likely diagnosis?*
A. Medulloblastoma
B. Neuroblastoma
C. Germinoma
D. Hemangioblastoma
A

C. Germinoma (p. 669)

31
Q 
Choriocarcinomas express this marker in blood and CSF:
A. B-HCG
B. AFP
C. Both
D. Neither
A

A. B-HCG (p. 669)

32
Q 
Endodermal sinus tumors express this marker in blood and CSF:
A. B-HCG
B. AFP
C. Both
D. Neither
A

B. AFP (p. 665)

33
Q 
Immature brain teratomas express this marker in blood and CSF:
A. B-HCG
B. AFP
C. Both
D. Neither
A

B. AFP (p. 669)

34
Q 
Germinomas express this marker in blood and CSF:
A. B-HCG
B. AFP
C. Both
D. Neither
A

C. Both (p. 670)

35
Q 
True of Lhermitte-Duclos disease except
A. Has a poor prognosis
B. Usually excised when symptomatic
C. Tiger stripe appearance on imaging
D. May be associated with cancers of gynecologic, breast, and thyroid glands
A

A. Has a poor prognosis (p. 670)

36
Q 
Neoplasm derived from cells that have failed to migrate from the germinal matrix which has known to cause intractable seizures in children*
A. Gangliocytoma
B. DNET
C. Subependymoma
D. Germinoma
A

B. DNET (p. 671)

37
Q 
Treatment for enlarging and symptomatic arachnoid cysts
A. Surgical excision
B. Radiotherapy
C. Close observation
D. Marsupialization
A

D. Marsupialization (p. 672)

38
Q 
50-year-old woman with partial deafness, facial palsy, dysphagia, and unilateral atrophy of the tongue with a palpable mass below and anterior to the mastoid eminence: what is the most likely diagnosis?
A. Vestibular schwannoma
B. Cholesteatoma
C. CP angle meningioma
D. Glomus jugulare tumor
A

D. Glomus jugulare tumor (p. 675)

39
Q 
Most common location of chordomas
A. Clivus
B. Sacrococcygeal region
C. Both A and B
D. Neither A or B
A

C. Both A and B (p. 681)

40
Q 
Most common sources of systemic malignant tumors that metastasize to basal skull bones except
A. Prostate
B. Lung
C. Breast
D. Renal
A

D. Renal (p. 682)

41
Q 
Children with bobble-head doll syndrome most commonly have which type of tumor?
A. Esthesioneuroblastoma
B. Nasopharyngeal carcinoma
C. Chordoma
D. Suprasellar arachnoid cyst
A

D. Suprasellar arachnoid cyst (p. 682)

42
Q

Lesions of the third, fourth, sixth, and V1 with ophthalmoplegia, pain, and sensory disturbances in the area of V1; often with exophthalmos
A. Superior orbital fissure syndrome/Rochon-Duvigneau
B. Apex of the orbit syndrome/Jacod-Rollet
C. Apex of the petrous temporal bone syndrome/Gradenigo-Lannois
D. Jugular foramen syndrome/Vernet

A

A. Superior orbital fissure syndrome/Rochon-Duvigneau (p. 683)

43
Q

Visual disturbances, central scotoma, papilledema, optic nerve atrophy; occasional exophthalmos, chemosis
A. Superior orbital fissure syndrome/Rochon-Duvigneau
B. Apex of the orbit syndrome/Jacod-Rollet
C. Apex of the petrous temporal bone syndrome/Gradenigo-Lannois
D. Jugular foramen syndrome/Vernet

A

B. Apex of the orbit syndrome/Jacod-Rollet (p. 683)

44
Q 
Lesions of the apex of the petrous temporal bone/Gradenigo-Lannois syndrome involve which cranial nerves?*
A. 3, 4, 6
B. 5, 6
C. 7, 8
D. 9, 10
A

B. 5, 6 (p. 683)

45
Q 
Anti-Yo antibodies*
A. Cerebellar degeneration
B. Limbic encephalitis
C. Opsoclonus-myoclonus-ataxia
D. Retinal degeneration
A

A. Cerebellar degeneration (p. 685)

46
Q 
Jugular foramen/Vernet syndrome involves which cranial nerves?
A. 9 only
B. 9, 10
C. 9, 10, 11
D. 9, 10, 11, 12
A

C. 9, 10, 11 (p. 683)

47
Q 
Lesions of the anterior occipital condyles/Collet-Sicard (Vernet-Aargnon) involve which cranial nerves?
A. 9 only
B. 9, 10
C. 9, 10, 11
D. 9, 10, 11, 12
A

D. 9, 10, 11, 12 (p. 683)

48
Q 
Anti-Ri (ANNA 2) antibodies
A. Cerebellar degeneration
B. Limbic encephalitis
C. Opsoclonus-myoclonus-ataxia
D. Retinal degeneration
A

C. Opsoclonus-myoclonus-ataxia (p. 685)

49
Q

Retinal degeneration due to anti-recoverin mandate investigation for which tumors?
A. Ovary, fallopian tube, lung
B. Breast, fallopian tube, small cell lung
C. Small cell lung, thymoma, renal cell, melanoma
D. Small cell lung, Hodgkin

A

C. Small cell lung, thymoma, renal cell, melanoma (p. 685)

50
Q 
Antibodies associated with LEMS*
A. VG Ca channels
B. VG K channels
C. VG Na channels
D. Na/K/ATPase pump
A

A. VG Ca channels (p. 685)

51
Q 
Anti-NMDA encephalitis isost commonly associated with which tumor?*
A. Ovarian teratoma
B. Breast cancer
C. Hodgkin lymphoma
D. Thymoma
A

A. Ovarian teratoma (pp. 685-686)

52
Q 
Treatment of patients with opsoclonus-myoclonus-ataxia syndrome in the setting of neuroblastoma except
A. Corticosteroids
B. ACTH
C. Surgical removal
D. Plasma exchange
A

D. Plasma exchange (p. 689)

53
Q 
Ophelia syndrome is due to which antibody?
A. Anti-Yo
B. Anti-Hu
C. Anti-Ma
D. Anti-mGluR5
A

D. Anti-mGluR5 (p. 690)

54
Q 
Most specific associated syndrome with anti-CRMP5?
A. Limbic encephalitis 
B. Chorea
C. Subacute sensory neuropathy
D. Optic neuropathy
A

D. Optic neuropathy (p. 690)

55
Q 
Most reliable way of differentiating radiation necrosis from tumor progression
A. Contrast CT
B. Contrast MRI
C. PET
D. CT or MR perfusion
A

C. PET (p. 691)

56
Q 
First symptom in majority of patients with astrocytoma*
A. Headache
B. Seizure
C. Hemiplegia
D. Altered mental status
A

B. Seizure (p. 652)

57
Q 
Least prominently affected structure pathologically in ALS*
A. Alpha motor neurons
B. Motor nerves
C. Corticospinal tract
D. Motor cortex
A

D. Motor cortex (p. 1113)

58
Q 
Most common intracranial tumor in children*
A. Astrocytoma
B. Medulloblastoma
C. Ependymoma
E. Craniopharyngioma
A

A. Astrocytoma (Table 31-1, p. 640)

59
Q 
The following tests for hormones are helpful in identifying pituitary adenomas EXCEPT*
A. Serum growth hormone
B. Glucagon
C. Serum cortisol
D. Serum FSH, LH
E. Anti-Mullerian hormone
A

E. Anti-Mullerian hormone (Table 31-4, p. 676)

60
Q 
Mutation in glioblastoma that is predictive of response to chemotherapy*
A. MGMT
B. PTEN
C. EGFR
D. IDH1
A

A. MGMT (pp. 651-652)

61
Q 
Imaging findings of glioblastoma*
A. Homogenous rim of enhancement
B. Irregular rim of enhancement
C. Hypodense necrotic core with hypodense rim
D. Surrounding edema with mass effect
A

B. Irregular rim of enhancement (p. 650)

62
Q

Which of the following is NOT true of oligodendrogliomas?*
A. Constitutes 15% of all gliomas
B. More common in men
C. Most common sites are the frontal and temporal lobes
D. With one or more streaks of calcium but little or no surrounding edema

A

A. Constitutes 15% of all gliomas (p. 654)

63
Q 
IDH1 mutation is not seen in which of these tumors?*
A. Pilocytic astrocytoma
B. Glioblastoma
C. Diffuse astrocytoma
D. Oligodendroglioma
E. Anaplastic astrocytoma
A

A. Pilocytic astrocytoma (p. 655)

64
Q 
Perivascular pseudorosettes* 
A. Glioblastoma
B. Anaplastic astrocytoma
C. Oligodendroglioma
D. Ependymoma
E. Meningioma
A

D. Ependymoma (p. 656)

65
Q 
The most frequent acquired genetic defect of meningiomas involve which gene?*
A. NF-2 on chromosome 22
B. NF-1 on chromosome 17
C. Deletion on chromosome 1p
D. Deletion on chromosome 10q
A

A. NF-2 on chromosome 22 (p. 656)

66
Q 
Psamomma bodies are characteristic of*
A. Glioblastoma
B. Neuroblastoma
C. Medulloblastoma
D. Meningioma
E. Ependymoma
A

D. Meningioma (p. 657)

67
Q 
Most common type of primary CNS lymphoma*
A. Diffuse large B cell
B. Non-Hodgkin's
C. T-cell
D. None of the above
A

A. Diffuse large B cell (p. 658)

68
Q

True about medulloblastoma*
A. Seeding of the tumor may occur via CSF pathways
B. Tumor resection is not recommended due to location
C. Surgery, radiation, and chemotherapy permits 5-year survival in less than half of cases
D. None of the above

A

A. Seeding of the tumor may occur via CSF pathways (p. 666)

69
Q 
Polycythemia is usually associated with which tumor?*
A. Medulloblastoma
B. Neuroblastoma
C. Ependymoma
D. Hemangioblastoma
A

D. Hemangioblastoma (p. 668)

70
Q 
A child presents with the inability to look upward, near-light dissociation but with intact accomodation. What is the most likely diagnosis?*
A. Medulloblastoma
B. Germinoma
C. Ependymoma
D. Retinoblastoma
A

B. Germinoma (p. 669)

71
Q 
The only grade IV pineal tumor*
A. Pineocytoma
B. PPID
C. Pineoblastoma
D. Papillary tumor of the pineal region
A

C. Pineoblastoma (p. 642)

72
Q

What is the importance of measurement of CSF or serum melatonin in the management of pineal tumors?*
A. Detection of malignant cells
B. Detection of tumor recurrence after surgery
C. Identification of specific pineal tumor
D. None of the above

A

B. Detection of tumor recurrence after surgery (p. 669)

73
Q 
Slowly developing unilateral exophthalmos, slight bulging of the bone in the temporal region, and radiologic evidence of thickening or erosion of the lesser wing of the sphenoid bone*
A. Meningioma of the sphenoid ridge
B. Meningioma of the olfactory groove
C. Meningioma of the tuberculum sella
D. Parasagittal meningioma
A

A. Meningioma of the sphenoid ridge (p. 680)

Adams 10th (27 decks)

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