DUMS neuro conditions

Question 1

what is pilocytic astrocytoma

Answer 1

benign slow growing
most common primary brain tumour in children
often seen around the cerebellum, brainstem

Question 2

what is low grade astrocytoma

Answer 2

vascular proliferative and nuclear atypia
predilection for temporal lobe or around central gyrus

Question 3

what is GBM

Answer 3

necrosis and neovascularisation
butterfly appearance
peripherally enhancing lesion and hypodense centre
spreads through white matter tracts

Question 4

what is an oligodendroglioma

Answer 4

glial tumours
frontal lobes often
calcification, cysts and peritumoural haemorrhage
greyish pink, subarachnoid accumulations give ‘toothpaste’ appearance

Question 5

what is meningioma

Answer 5

most common benign brain tumour
arise from arachnoid cap cells
extra-axial
often asymptomatic

Question 6

leptomeninges

Answer 6

inner 2 meninges (pia and arachnoid)
may see bulging fontanelles in infant

Question 7

kernig’s sign

Answer 7

pain and resistance on passive knee extension with hips fully flexed

Question 8

brudzinki’s sign

Answer 8

knees and hips flex on bending the head forward

Question 9

suspected meningitis Ix

Answer 9

LP- opening pressure normal or increased
CT
throat swab, rash swab
blood cultures: FBC, U&Es, coagulation
consider PCR

Question 10

contraindication for a LP in suspected meningitis

Answer 10

papilloedema
seizures
focal neurological signs
GCS <13
severe/rapidly developing illness

Question 11

LP:
normal/ elevated opening pressure
lymphocytes WBC elevated
gram stain -ve
bacterial antigen detection -ve
protein normal/slightly raised
glucose normal

Answer 11

viral meningitis

Question 12

LP:
opening pressure elevated
neutrophils WBC elevated
gram stain +ve
bacterial antigen +ve
protein high
<40% blood glucose

Answer 12

bacterial menigitis