Flashcards in Neoplasms and ALS Deck (57):
How does a brain tumor commonly present?
subacute progression of focal neurological deficit
nonfocal neurological deficit
Subacute progression of focal neurological deficit d/t?
the tumor pressing down on the white matter
disruption of neuronal circuits
Nonfocal neurological deficit - sx?
personality disorders (esp if in the frontal lobe)
gait disturbances (cerebellar)
HA types from nonfocal neurological deficit?
worse when resting
d/t displacement of pain-sensitive structure
Increased ICP HA?
happens many times a day
fast on, fast off
Brain tumor - tx?
glucocorticoids- decrease edema (Dexa)
What do watch out for Dexa?
What is a primary brain tumor?
What is glioma?
any brain tumor that arises from glial cell
What are the different types of glioma?
What is the most common brain tumor?
Astrocytoma - pathophysio?
damages the brain tissues first
Astrocytoma - prognosis?
not good - cannot excise entirely
Astrocytoma - histological grades?
Grade I - IV (low and high)
Astrocytoma - low grade?
grade I has good prognosis AFTER excision
grade II has 5-6 yr survival AFTER excision
Astoryctoma - high grade?
grade IV astrocytoma: survival <1yr
Subtype of astrocytoma?
if not able to surgically remove (like high grade) - symptomatic:
antiseizure - Keppra
Oligodendraglioma - prognosis?
a little benign- actually have a chance at surviving (longer life expectancy): excisable and respond well to chemo
Ependymomas - location?
spinal cord (filum terminale)
Ependymomas - tx?
excision; if able to? good prognosis - but usually deadly
Medullablastoma and primitive neuroectodermal tumors?
DEADLY AND AGGRESSIVE
Medullablastoma and primitive neuroectodermal tumors - location? population?
posterior fossa; neural precurosr cell
CNS lymphomas - types?
CNS lymphomas primary - population?
immunocompromised patients - HIV pts
CNS lymphomas secondary - population?
B cell lymphoma pts or B cell leukemia who have tumor of the bone, bone marrow, cranial sinus
CNS lymphomas primary and secondary - tx?
benign tumor that starts at the mesoderm (attached to dura) and make it's way into the brain
Meningioma - population?
Meningioma - areas?
dorsum of spinal cord
arises from schwan cells
Schwannoma - area?
8th CN - acoustic
aka vestibular schwannnoma
Schwannoma - sx?
unilateral hearing loss
+/- compress facial nerve (CN VII) - facial palsy
Schwannoma - tx?
hearing is lost
Type of pituitary tumor/adenoma?
arises from Rathke's pouch
Carniopharyngioma - sx?
visual field defect
What are secondary/metastatic brain tumors?
cancer starts from somewhere else but makes it's way up to the brain
Secondary/metastatic brain tumors - most common?
Secondary/metastatic brain tumors - tx?
What is neurofibromatosis?
benign peripheral nerve tumors
schwann cells + fibroblasts
Type I von recklinghausen disease?
type of neurofibromatosis
cafe au lait spots
freckles in NON EXPOSED spots
nothing until it cxs radiculopathy
cutaneous lesions on the skin
neuroma of plantar nerve (3rd and 4th metatarsal)
Morton neuroma - sx?
something stuck in shoe
Morton neuroma - tx?
What is ALS?
progressive weakness and paralysis of VOLUNTARY muscles
death of both UMN and LMN
What is the prognosis of ALS?
not good - pneumonia will kill them b/c they cannot cough up the phlegm
3-5 yrs of survival
ALS - population?
ALS - sx?
NO PAIN AND NO SENSORY LOSS
limb weakness first >>> painless difficulty turning keys/buttons (dexterity)
ALS - what is spared?
bladder, bowel, sexual fxn
ALS - PE?
LMN - weakness, atrophy, fasciculation
UMN - hyperreflexia, babinski sign spasticity
ALS - dx?
MRI may be used to r/o