Neuro: CNS Neoplasms

Question 1

Glioma bengin or malignant ?

Answer 1

malignant

Question 2

Glioma Pathophysiology: Arises from ______________ that preferentially_______________ down one of the cellular lineages

Answer 2

progenitor cell

differentiates

Question 3

Glioma types ?

Answer 3

Astrocytomas

Oligodendrogliomas

Ependymomas

Question 4

Astrocytomas location ?

Answer 4

frontal

may occur anywher) -

Stage IV– Glioblastoma

Question 5

Oligodendrogliomas location ?

Answer 5

cerebral hemispheres

Question 6

Ependymomas location ?

Answer 6

ventricles, 4th most common

Question 7

Glioma H and P ?

Answer 7

Seizure

Headache

Impaired cognition

Hemiparesis

Question 8

Glioma Tx ?

Answer 8

Surgical resection / VP shunts

Anticonvulsants

Radiation / chemo

Question 9

Medulloblastoma is what type of tumor ?

Answer 9

Malignant embryonic tumor

Question 10

Medulloblastoma pathophysiology ?

Answer 10

granule cell progenitors or from multipotent progenitors from the ventricular zone

Question 11

Medulloblastoma patho: often a genetic mutation of what pathway ?

Answer 11

sonic hedgehog

• *basal cell carcinoma - sonic hedge hog
• *

Question 12

Medulloblastoma location ?

Answer 12

midline at the cerebellum

Question 13

Medulloblastoma demographic ?

Answer 13

Primarily children

Most common malignant brain tumor of childhood

Question 14

Medulloblastoma H and P ?

Answer 14

Headache

Ataxia

signs of brainstem involvement ( breathing dysfunction )

kids with HA

Question 15

Medulloblastoma Treatment ?

Answer 15

Surgical resection

Radiation

Chemotherapy

Question 16

Meningioma benign or malignant ?

Answer 16

Benign tumor

Question 17

Meningioma pathophysiology ?

Answer 17

arise from the stromal arachnoid cells of the choroid plexus

Question 18

Meningioma demographic ?

Answer 18

Mostly adults

Question 19

Meningioma RF ?

Answer 19

Prior radiation

Question 20

Meningioma H and P ?

Answer 20

Headache

Hemiparesis

Impaired cognition

Question 21

Meningioma Treatment ?

Answer 21

Monitor

Consider
Surgical resection if symptomatic

Question 22

Meningioma location ?

Answer 22

Often attach to dura

Question 23

Schwannoma malignant or benign ?

Answer 23

Benign tumor

Question 24

Schwannoma Pathophysiology ?

Answer 24

well-circumscribed, encapsulated masses

abut the associated nerve without invading it

Question 25

Schwannoma is most commonly a _______________ ?

Answer 25

acoustic neuroma cerebellopontine angle, where they are attached to the vestibular branch of the eighth nerve

Question 26

Schwannoma demographic ?

Answer 26

40-60

Question 27

Schwannoma RF ?

Answer 27

Neurofibromatosis Type II

Question 28

Schwannoma H and P ?

Answer 28

Hearing loss– sensorineural Vertigo– more continuous

Question 29

Schwannoma Treatment ?

Answer 29

Patient Education -Consider patient population before treating May choose not to treat Options - Surgical excision - Focused radiation

Question 30

Schwannoma H and P as it gets larger ?

Answer 30

Midface numbness Absent corneal reflex - compression CN5 but that actually action is 7

Question 31

Schwannoma H and P: Hearing loss - sensorineural ?

Answer 31

Gradual more common in Rt ear and did a weber test - it will go t the left side the good side Rinne test in right ear - AC > BC - NL but auditory function will be a little less **BC > AC - cerumen impaction, rupture TM, middle ear and external ear, inner ear and back is sensonueral , most common cause of sensinueral hearing loss - Presbycusis **

Question 32

Paraneoplastic neurologic syndromes types ?

Answer 32

Lambert-Eaton myasthenic Subacute cerebellar Sensory motor peripheral neuropathy Stiff person syndrome

Question 33

Lambert-Eaton myasthenic syndrome pathophysiology ?

Answer 33

Antibody against presynaptic calcium channels at neuromuscular junction

Question 34

Lambert-Eaton myasthenic syndrome presentation ?

Answer 34

Weak muscles Difficulty keeping eyes open Trouble speaking Trouble breathing - Diaphragm

Question 35

Lambert-Eaton myasthenic | big association ?

Answer 35

SC lung ``` Non small cell lung Breast GI Lymphoma Ovarian ```

Question 36

Subacute cerebellar syndrome pathophysiology ?

Answer 36

Autoimmune reaction toward Purkinje cells of the cerebellum

Question 37

Subacute cerebellar syndrome presentation ?

Answer 37

``` Dysarthria Ataxia Vertigo Diplopia Nystagmus ```

Question 38

Subacute cerebellar syndrome association ?

Answer 38

Small cell carcinoma Breast GI Lymphoma Ovarian

Question 39

Sensory motor peripheral neuropathy pathophysiology ?

Answer 39

Anti-hu antibody attacking dorsal root ganglion (primary afferent pathway, anterior root is motor function which it is not attacking)

Question 40

Sensory motor peripheral neuropathy | presentation ?

Answer 40

Progressive sensory loss | Ataxia (intact strength)

Question 41

Sensory motor peripheral neuropathy association ?

Answer 41

Small cell lung

Question 42

Stiff person syndrome presentation ?

Answer 42

Severe muscle stiffness -Back and legs primarily May cause painful spasms

Question 43

Stiff person syndrome association ?

Answer 43

Breast

Question 44

Normal pressure hydrocephalus pathophysiology ?

Answer 44

Hydrocephalus with a patent aqueduct of Sylvius ( 4th ventricle - oligiodentrocytomas) Presumed stretching and distortion of subfrontal white matter tracts may lead to clinical symptoms

Question 45

Normal pressure hydrocephalus diagnostic studies ?

Answer 45

CT no contrast or MRI Lumbar puncture

Question 46

Normal pressure hydrocephalus diagnostic studies results: CT no contrast or MRI ?

Answer 46

Enlarged lateral ventricles

Question 47

Normal pressure hydrocephalus diagnostic studies results: LP ?

Answer 47

Pressure: normal (high normal) Protein: normal Glucose: normal Cells: normal

Question 48

Normal pressure hydrocephalus complication ?

Answer 48

Improvement may be short lasting despite treatment Often comorbid Alzheimer’s

Question 49

Normal pressure hydrocephalus Treatment ?

Answer 49

Ventriculoperitoneal shunt (VP shunt)