brain tumours and head injury

Question 1

symptoms of brain tumour?

Answer 1

headaches
vomiting
mental changes
seizures

Question 2

headache that wakes someone up

Answer 2

red flag

Question 3

Invstigations for brain tumour

Answer 3

CT 
MRI
LP 
PET 
Lesion biopsy 
EEG

Question 4

which type of cancer commonly metastasises to the brain/

Answer 4

lung

Question 5

how are they graded?

Answer 5

WHO grading system

Question 6

grade 1 astrocytoma - malignant?

Answer 6

benign

Question 7

how to low grade astrocytomas present?

Answer 7

seizures

Question 8

low grade astrocytomas, are they dangerous?

Answer 8

they are not benign

Question 9

grade 2 astrocytoma treatment?

Answer 9

radio and chemo

Question 10

what do grade 2 astrocytomas become?

Answer 10

glioblastoma (G2G)

Question 11

most common primary brain tumour?

Answer 11

glioblastoma

Question 12

In head trauma you get release of?

Answer 12

excitatory amino acids (glutamate and aspartate)

Question 13

which receptors do glutamate and aspartate bind to?

Answer 13

NMDA

Question 14

get release of intracellular ___ after head trauma?

Answer 14

calcium. Release of intracellular calcium, activation of phospholipases, breakdown of cell membrane, cell swelling, activation of apoptosis.

Question 15

aim for cerebral perfusion pressure of what after head injury?

Answer 15

60mmHg

Question 16

In base of skull fracture, you get what signs in anterior cranial fossa fracture?

Answer 16

panda/racoon eyes

Question 17

middle cranial fossa fracture?

Answer 17

battle sign over mastoid

Question 18

Eyes pneumonic for Glasgow Coma Scale

Answer 18

1. (E)yes Closed
2. (Y) shaped sharp pricking object (responds to pain)
3. (E)ar piercing noise (responds to voice)
4. (S)pontaneous (opens eyes spontaneously)

Question 19

Voice pneumonic for glasgow coma scale

Answer 19

Voiceless - 1 
OOOh -- obscure incoherent sounds - 2
Inappropriate words - 3
Confused and Disorientated - 4
Elegant speech and orientated - 5

Question 20

Pain - glasgow coma scale neumonic?

Answer 20

old ben

6. obeys commands
7. localises to pain
8. draw away
9. bend/flexion (decorticate posture by pain)
10. extension (decerebrate posture by pain)
11. no motor response (motionless)

Question 21

minimum score you can get on GCS?

Answer 21

3

Question 22

a coma equates to a GCS score of ?

Answer 22

8 or less

Question 23

what can’t a patient do in a coma ?

Answer 23

does not open eyes, does not obey commands, does not speak

Question 24

when should you request a CT scan?

Answer 24

any patient with a skull fracture
or not orientated
focal neurological signs
taking anti coagulants

Question 25

why sedate in head injury?

Answer 25

reduces metabolic rate reduces cerebral blood flow reduces ICP

Question 26

what does mannitol do?

Answer 26

improves Microperfusion

Question 27

what are the late effects of head injury?

Answer 27

epilepsy, CSF leak and cognitive problems