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CH30: Intracranial Neoplasms Flashcards

1
Q

In how many percent of cancer, the brain or its coverings are involved by neoplasm at some time in the course of illness? (p. 661)

A

25%

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2
Q

tumor- like formation that has its basis in maldevelopment and undergoes little change during the life of the host (p. 663)

A

hamartoma

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3
Q

viruses implicated tumors of the nervous system (p. 665)

A

HPV, HepB, EBV, HTLV

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4
Q

Edema wherein there is increased permeability of the capillary endothelial cells so that plasma proteins exude into the extracellular spaces (p. 666)

A

Vasogenic edema

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5
Q

All the cellular elements swell with fluid and there is a corresponding reduction in the extracellular fluid space (p. 667)

A

Cytotoxic edema

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6
Q

Type of vomiting wherein the patient vomit unexpectedly and forcibly without preceding nausea (p. 669)

A

Projectile vomiting

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7
Q

Gross pathology GBM (p. 670)

A

mottled gray, red, orange or brown

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8
Q

Natural history of GBM (p. 670)

A

Fewer than 20% survive for 1 year; only 10% live beyond 2 years

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9
Q

gene implicated in GBM (p. 671)

A

tumor suppression gene on Chromosome 17p

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10
Q

Stupp protocol (p. 672)

A

75mg/m2 concurrently with radiotherapy after a hiatus of 4 weeks, give for 5 days every 28 days for 6 cycles

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11
Q

How many percent of GBM will develop additional lesiosn at distant locations (p. 673)

A

10%

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12
Q

Tumor cells of low to intermediate- grade astrocytoma which is a useful diagnostic marker in biopsy specimen. (p. 673)

A

GFAP

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13
Q

Natural history of low- grade glioma (p. 674)

A

grow slowly and eventually undergo malignant transformation

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14
Q

Tumor that is pink-gray color and multilobar in form. It is relatively avascular and firm and has a tendency to encapsualte and form calcium and small cysts. (p. 677)

A

Oligodendroglioma

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15
Q

genes implicated in oligodendroglioma (p. 675)

A

Chromosome 1p: high degree of responsiveness; Chromosome 19q: longer survival

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16
Q

Chemotherapeutic treatment of oligodendroglioma (p. 676)

A

PCV

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17
Q

Most common glioma of the spinal cord (p. 676)

A

Ependymoma

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18
Q

Tumor described being found in 4th ventricle, graying pink, form, cauliflower growths (p. 676)

A

Ependymoma

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19
Q

Gene implicated with ependymoma (p. 676)

A

RELA gene (becoming fused to an open reading frame of Ch11)

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20
Q

Round or elongated nuclei, visible cytoplasmic membrane, and a characteristic tendency to encircle n another forming whorls and laminated calcific concretions (p. 677)

A

Meningioma

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21
Q

Most common type of meningioma (p. 677)

A

Meningothelial

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22
Q

How many percent of patients with ocular lymphoma will have cerebral involvement within the year? (p. 679)

A

2/3

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23
Q

Pinkish gray, soft, ill- defined infiltrative mass in the brain difficult to distinguish from astrocytoma (p. 679)

A

Lymphoma

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24
Q

Meningeal and cranial nerve lymphoma with similar characteristics to primary CNS lymphoma as complications of chronic lymphatic leukemia (p. 679)

A

Ritcher transformation

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25
Tumor appears as a complication of an obscure medical condition such as salivary and lacrimal gland enlargement (p. 680)
Mikulicz syndrome
26
Predominant treatment in lymphoma patient with AIDS. (p. 681)
Cranial irradiation
27
Top 3 malignancies which is most prone to metastasize to the brain (p. 681)
Melanoma, Testicular tumors, small cell tumors
28
Almost half of intracranial metastatic cancer mets via hematogenous spread. (p. 681)
Breast
29
Hemorrhagic mets (p. 682)
Melanoma, chorioepthelioma
30
dose of radiation for malignant meningitis (p. 684)
300cGy per day for 10days
31
Systemic disease with prominent nodular pulmonary lesions, dermal and lymph nodes changes and in approximately 30 percent of cases, involvement of CNS (p. 686)
lymphomatoid granulamotosis
32
Castleman disease is precipatated by which virus (p. 686)
HHV 8
33
chromosome implicated in Medulloblastoma (p. 687)
Ch17 distal to the p53region
34
Medulloblastoma + mutations in the gene encoding a patched, the receptor for sonic hedgehog ligand (p. 687)
Gorlin syndrome
35
Medulloblastoma, consequence of mutations in DNA repair genes (p. 687)
Turcot syndrome
36
Overexpression of this is associated with poorer prognosis in medulloblastoma (p. 687)
N-MYC
37
Virus also implicated with medulloblastoma (p. 688)
JC virus
38
Distinctive radiographic appearance of medulloblastoma (p. 688)
high T1 and T2, heterogenous enhancement, typical location adjacent to fourth vetricle
39
Treatment of medulloblastoma (p. 688)
surgery + resection + chemotherapy
40
Most common soild tumor of childhood (p. 689)
Neuroblastoma
41
Treatment of neuroblastoma (p. 689)
Depends on clinical staging
42
Most common areas of papilloma of choroid plexus (p. 690)
Lateral ventricle
43
Involved in tumor induction of papillomas of choroid plexus (p. 690)
oncogene T antigen of teh SV40 virus
44
Most common type of pineal tumor (p. 691)
germinoma
45
large spherical epithelial cells separated by a network of reticular connective tissue and containing many lymphocytes (p. 691)
Pineal germinoma
46
dysplastic gangliocytoma of the cerebellum (p. 692)
Lhermitte- Duclos disease
47
Gangliocytoma appearance in imaging (p. 693)
tiger striped
48
Syndrome of multiple skin hamartomas, cancers of gynecologic, breast, and thyroid (p. 693)
Cowden syndrome
49
The radiographic appearance of small cyst, a cluster of several adjacent small cystic lesions, generally not enhancing and hyperintense on T2 (p. 693)
DNET
50
seen in 20% of patients with tuberous sclerosis (p. 693)
subependymal giant cell astrocytoma
51
T/F cholesteatoma causes more severe facial weakness (p. 697)
TRUE
52
Chromophobe, acidophil, basophil ratio (p. 698)
5:4:1
53
Examples of acidophils or chromophobe (p. 699)
GH, TSH, prolactin
54
Examples of basophils (p. 699)
ACTH, LH, FSH, b lipotropin
55
How many percent of pituitary adenomas are prolactin- secreting (p. 699)
60-70%
56
How many percent of pituitary adenomas are GH- secreting (p. 699)
10%
57
Cut-off size for microadenomas (p. 699)
1cm
58
How many percent of adenomas extend to the cavernous sins (p. 699)
5-10%
59
bitemporal hemianopia with normal- size sella (p.699)
saccular aneurysm of circles of Willis
60
Excess prolactin value (p. 700)
100ng/mL
61
Excess GH value (p. 700)
0.10ng/mL
62
excessive secretion of pituitary ACTH (p. 700)
Cushing disease
63
excessive administration. of steroids, adenoma of adrenal cortex, ACTH- producing bronchial carcinoma (p. 700
Cushing syndrome
64
Dose of bromocriptine (p. 701)
0.5 to 1.25mg daily
65
Dose of octreotide (p. 701)
200mg/d
66
How many percent of GH- secreting tumors and prolactinomas will recur at 1 year? (p. 701)
15%
67
Can stereotactic radiosurgery be used in PitAd? (p. 701)
Yes, provided that the vision is not being threatened and there is no other urgent need for surger
68
Ischemic necrosis of the pituitary post-partum or partum (p. 702)
Sheehan syndrome
69
Inappropriate jocularity (p. 701)
witzelsucht
70
Soft, jelly- like, gray-pink growth that arises from remnants of the primitive notochord (p. 703)
Chordoma
71
Lesion: Superior orbital fissure (p. 705)
Rochon- Duvigneau
72
Lesion: Apex of the orbit (p. 705)
Jacod- Rollet
73
Lesion: Cavernous sinus (p. 705)
Foix- Jefferson
74
Lesion: Apex of the petrous temporal bone (p. 705)
Gradenigo- Lannois
75
Lesion: Sphenoid and petrosal bone (p. 705)
Jacod
76
Lesion: Jugular foramen (p. 705)
Vernet
77
Lesion: Anterior occcipital condyles (p. 705)
Collet- Sicard
78
Lesion: Retroparotid space (p. 705)
Villaret
79
Lesion: Half of the base of the skull (p. 705)
Garcin
80
Electric- like sensations down the spine and limbs upon flexing the neck (p. 706)
Lhermitte sign
81
Most common paraneoplastic manifestation (p. 706)
Sensory neuronopathy
82
Almost universal and central feature in most cases of paraneoplastic limbic encephalitis (p. 708)
Amnesia
83
Limbic encephalitis + faciobrachial dystonic seizures (p. 708)
LG1 antibodies
84
Limbic encephalitis + peripheral motor hyperexcitability
CASPR 2 antibodies and VGKC
85
Receptor of NMDA in anti-NMDAR encephalitis (p. 709)
NR1
86
Paraneoplastic sensory neuronopathy (p. 708)
Anti- Hu antibody
87
Most common underlying malignancy for paraneoplastic cerebellar degeneration (p. 709)
Lung
88
Can be found in half of the patients with paraneoplastic cerebellar degeneration w large majority related to breast or female genitala malignancy (p. 710)
Anti- Pukinje (Anti- Yo)
89
A child's malignancy causing opsoclonus- myoclonus-ataxia syndrome (p. 711)
Neuroblastoma
90
Unique feature of neuroblastoma and OMA syndrome (p. 711)
Response to corticosteroids and ACTH
91
subgroup of breast CA produce antineuronal antibody directed against a different RNA binding antigen from anti-Hu (p. 711)
Anti- Ri (antineuronal antibody type 2- ANNA 2)
92
Which antibody cross react with testicular antigens (p. 712)
Anti- Ma ( causing ataxic opsoclonic syndrome, limbic, brainstem or hypothalamic inflammation)
93
Optic neuropathy is most specific associated syndrome with this antibody (p. 712)
CRMP-5 antibody
94
Triad of paraneoplastic retinopathy (p. 712)
Photosensitivity, ring scotomas, attenuation of the retinal arterioles
95
continuous muscle fiber activity, insomnia, and hallucinosis (p. 712)
choree fibrillaire of Morvan
96
paraneoplastic myotonia (p. 712)
Isaac syndrome
97
basal ganglia paraneoplastic syndrome- esp chorea (p. 712)
anti-Hu and CRMP-5
98
Main clinical features of delayed radiation toxicity (p. 713)
progressive dementia, ataxia and urinary incontinence
99
Most reliable way of differentiating radiation necrosis and tumor or peritumor products (p. 714)
PET scan
100
GRADE 2 Meningioma
ACC Atypical Clear cell Choroid
101
GRADE 3 Meningioma
RAP Rhaboid Anaplastic Papillary

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