Brain Tumours

Question 1

a tumour is unlikely to bleed T or F

Answer 1

T

Question 2

children tend to get what kind of brain tumours?

Answer 2

infratentorial neoplasms

Question 3

what is a sign of an infratentorial neoplasm?

Answer 3

walking on tiptoes due to problematic cerebellar coordination
hydrocephalus

Question 4

brain tumours are more common in adults than children T or F

Answer 4

F, 2nd most common cancer in children

Question 5

general presentation of a brain tumour

Answer 5

progressive neuro deficit
motor weakness
headache
seizures
behaviour changes

Question 6

frontal lobe controls what functions?

Answer 6

personality
micturition
gait

Question 7

what eye problem will a left occipital lobe tumour give?

Answer 7

right homonomous hemianopia

Question 8

3 causes of increased pressure in the brain

Answer 8

blood eg haemorrhage
brain swelling
inc CSF

Question 9

increased IC pressure produces what symptoms?

Answer 9

headaches
vomiting
mental changes
seizures

Question 10

why can a swollen brain cause CN3 palsy

Answer 10

CN3 runs along the side of the brainstem as swollen CSF presses on the uncus

Question 11

what diuretic is used to relieve pressure in the brain?

Answer 11

mannitol

Question 12

what eye sign would make you think the brain is swollen

Answer 12

blown pupil

Question 13

how does the brain physiologically control its own pressure

Answer 13

constricts arterioles to prevent blood entry

Question 14

what kind of headache makes you think it could be a brain tumour

Answer 14

worse in the morning (WAKES THEM UP)
worse on cough/leaning forward
get nausea too
migraine/tension headache-like

Question 15

2nd eye doesn’t adduct, other eye has nystagmus is indicative of…

Answer 15

MS

Question 16

how does the brain try to physiologically respond to raised ICP? what is this process called?

Answer 16

increased BP
bradycardia
irregular resp
= cushings triad

Question 17

Ix for suspected brain tumour

Answer 17

1. CT for big things or blood
   MRI for tissue definition and chronic bleed
2. lesion biopsy to confirm tumour type

Question 18

main red flag screen for mets?

Answer 18

are they bleeding from anywhere??

Question 19

what cells in the brain do glial tumours arise from?

Answer 19

1. astrocytes

2. oligodendrocytes

Question 20

Tx for grade 1 astrocytoma

Answer 20

surgery (curative)

Question 21

grade 1 astrocytomas are benign T or F

Answer 21

T

Question 22

who gets grade 1 astrocytomas

Answer 22

children and young people

Question 23

low grade premalignant astrocytomas tend to present with…

Answer 23

seizures

Question 24

low grade pre maignant astrocytomas tend to present in the __ lobe

Answer 24

temporal

Question 25

what factors affect the prognosis of an astrocytoma

Answer 25

``` age >50 focal deficit short duration of symptoms raised ICP altered consciousness ```

Question 26

should you operate on a benign tumour

Answer 26

yes if it is growing as it is premalignant

Question 27

Tx of grade 2 astrocytoma

Answer 27

surgery +/- : radiation chemo combo of radio and chemo

Question 28

grade 2 astrocytomas can become what kind of tumour?

Answer 28

glioblastoma

Question 29

what brain tumour patients are not allowed to drive?

Answer 29

glioblastoma patients due to seizure risk patients who have had seizures in the past yr those with visual field defects

Question 30

who gets oligodendroglial tumours? where do they usually arise?

Answer 30

adults (25-45 yrs) | frontal lobe

Question 31

main presentation of oligodendroglial tumour?

Answer 31

seizures

Question 32

which glial tumour shows up with calcification?

Answer 32

oligodendroglial tumour

Question 33

Tx for ODG tumours?

Answer 33

surgery + chemo (very chemosensitive)

Question 34

a meningioma tends to arise from what cells

Answer 34

arachnoid cap cells

Question 35

meningioma symptoms?

Answer 35

headaches | cranial nerve neuropathies

Question 36

menigiomas are benign T or F

Answer 36

T

Question 37

name the4 types of malignant meningioma

Answer 37

``` CCRaP clear cell chordoid rhabdoid papillary ```

Question 38

which type of tumour presents with a "dural tail" on MRI

Answer 38

meningioma

Question 39

Tx of meningiomas?

Answer 39

pre-op embolisation (look at vasculature of tumour) surgery radiotherapy

Question 40

name the 3 types of nerve sheath tumour

Answer 40

schwannoma aka neuroma neurofibroma MPST (malignant peripheral nerve sheath tumour)

Question 41

most common schwannoma? what condition makes you likely to get it?

Answer 41

vestibular affecting CN8 | NF 2

Question 42

an acoustic neuroma makes you likely to get what complication in the brain?

Answer 42

hydrocephalus (blocks 4th ventricle)

Question 43

Tx of acoustic neuroma?

Answer 43

radiation surgery manage hydrocephalus

Question 44

complications of acoustic neuroma

Answer 44

CN7 palsy corneal reflex problems nystagmus

Question 45

who gets germ cell tumours?

Answer 45

children and teens (usually boys)

Question 46

Ix for germ cell tumours?

Answer 46

CT

Question 47

most common CNS germ cell tumour?

Answer 47

germinoma

Question 48

blood tests for a suspected midline tumour in a child?

Answer 48

ALP b-HCG LDH

Question 49

Tx for hydrocephalus?

Answer 49

VP shunt