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Neurology > Tumors and Paraneoplastic Syndromes > Flashcards

Tumors and Paraneoplastic Syndromes Flashcards

1
Q

The 61-year-old businessman underwent surgery last year for carcinoma of the lung.
He has been suffering from headaches for about 3 weeks, which intensify with
coughing, flatulence and bending over. Analgesics do not help. He has discrete leftsided haemiparesis. It is probably:
a. brain metastases
b. carcinoma mening
c. sinusitis
d. meningitis (stiff neck, vomiting)

A

a. brain metastases

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2
Q

The incidence of brain tumours (primary and metastases) is approximately:
a. 1/100.000
b. 10/100.000
c. 30/100.000
d. 100/100.000

A

c. 30/100.000

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3
Q

The most common manifestation of low-grade pleomorphic xanthoastrocytoma is:
a. epilepsy
b. hemiparesis
c. cerebellar ataxia
d. hemianopsia

A

a. epilepsy

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4
Q

The most common localisation of pilocytic astrocytoma in children is:
a. Brainstem
b. Little Brains
c. optic nerve
d. thalamus

A

b. Little Brains

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5
Q

Which drug should be prescribed for a patient with a malignant oedematous tumour?
a. mannitol
b. sumatriptan
c. dexamethasone
d. oxygen mask

A

c. dexamethasone

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6
Q

Where are tumours most commonly found in children?
a. infratentorial
b. supratentorial
c. on the meninges
d. in the spinal cord

A

a. infratentorial

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7
Q

Where are brain metastases most commonly found?
a. on the surface of the crust
b. at the boundary between white and grey matter
c. on the meninges
d. in the liquor rooms

A

b. at the boundary between white and grey matter

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8
Q

The edema around a tumour growing in the brain is?
a. vasogenic
b. cytotoxic

A

a. vasogenic

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9
Q

Calcifications are characteristic of:
a. pilocytic astrocytoma
b. glioblastoma
c. to the seamstress
d. oligodendroglioma

A

d. oligodendroglioma

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10
Q

Which is the most common glioma?
a. pilocytic astrocytoma
b. meningeom
c. oligodendroglioma
d. glioblastoma
e. ependymom

A

d. glioblastoma

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11
Q

Which tumour is malignant?
a. nevrinom
b. neurofibrom
c. ependymom
d. meningeom

A

c. ependymom

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12
Q

Where will ependymoma occur in an adult?
a. conus medullaris and filum terminale
b. Little Brains
c. cerebral hemispheres
d. thoracic spinal cord

A

a. conus medullaris and filum terminale

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13
Q

Which tumour does not metastasise to the brain?
a. carcinoma of the lung
b. prostate cancer
c. breast carcinoma
d. malignant melanoma

A

b. prostate cancer

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14
Q

Which medicine will not be used to treat prolactinoma:
a. ropinirole
b. Pramipexola
c. propranolol
d. bromocriptine

A

c. propranolol

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15
Q

Spinal meningiomas are most commonly seen in:
a. younger women
b. older women
c. younger men
d. older men

A

b. older women

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16
Q

Neurinoma will most commonly affect:
a. CN VI
b. CN VII
c. CN VIII
d. CN IX

A

c. CN VIII

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17
Q

Pituitary adenoma is most commonly secreted by:
a. prolactin
b. ACTH
c. TSH
d. FSH/LH
e. GH

A

a. prolactin

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18
Q

How does a tumour in the left brainstem appear?
a. affected sensation of temperature and pain on the ipsilateral side
of the face and contralateral side of the body
b. affected sensation of temperature and pain on the contralateral side of the
face and contralateral side of the body
c. ipsilateral impaired sense of touch in the ring around the corner of the mouth
d. contralateral affected sense of touch in the ring around the corner of the mouth

A

a. affected sensation of temperature and pain on the ipsilateral side
of the face and contralateral side of the body

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19
Q

Which tumour is most characteristic of neurofibromatosis type 2?
a. gangliogliom
b. glioblastoma
c. bilateral VIIIth cranial nerve schwannoma
d. neuroblastoma
e. pilocytic astrocytoma

A

c. bilateral VIIIth cranial nerve schwannoma

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20
Q

What is not caused by a tumour growing in the parietal nondominant hemisphere?
a. finger agnosias
b. anosognosia
c. geographical agnosia
d. apraxia of dress

A

a. finger agnosias

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21
Q

Which tumour most commonly occludes nerves in the sphenoid sinus?
a. meningeom
b. pituitary

A

a. meningeom

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22
Q

A 76-year-old man’s cerebellum tumour is most likely:
a. metastasis
b. medulloblastoma
c. ependymom
d. meningeom

A

a. metastasis

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23
Q

A woman has grown a tumour that is causing her hearing problems. It is most likely to have
arisen from:
a. astrocita
b. Schwann cells
c. oligodendrocyte
d. ependymal cells

A

b. Schwann cells

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24
Q

A patient with a brain tumour has daily complex partial seizures. The oncologist
will then treat him with vincristine. Which antiepileptic is best:
a. carbamazepine
b. oxcarbazepine
c. primidone
d. valproate
e. levetiracetam

A

e. levetiracetam

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25
Q

What is not a microscopic feature of glioblastoma:
a. necrosis
b. Guest
c. glomeruloid vascular structures
d. multinucleated giant cell tumours
e. Rosenthal fibres

A

e. Rosenthal fibres

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26
Q

It has the most favourable forecast:
a. medulloblastoma
b. pilocytic astrocytoma
c. anaplastic astrocytoma
d. glioblastoma

A

b. pilocytic astrocytoma

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27
Q

It has the least favourable prognosis:
a. diffuse astrocytoma
b. pleomorphic xanthoastrocytoma
c. meningeom
d. to the seamstress

A

b. pleomorphic xanthoastrocytoma

28
Q

Bitemporal quadrantopsy of the upper quadrants causes:
a. pituitary adenoma
b. craniofaringeom
c. PNET
d. pinealoblastoma
e. medulloblastoma

A

a. pituitary adenoma

29
Q

What is not a risk factor for cerebellar neoplasia?
a. head irradiation
b. heavy metals
c. neurofibromatosis
d. HIV infection
e. tuberous sclerosis

A

b. heavy metals

30
Q

When will a surgeon not go in to operate on a tumour?
a. when close to the surface of the skull
b. when it is solitary
c. when the patient’s condition is good
d. when lesions change on MRI after 3 months

A

d. when lesions change on MRI after 3 months

31
Q

In a 35-year-old patient complaining of dizziness and tinnitus in the left ear, on
examination you find an extinct corneal reflex on the left side, hypoesthesia and
hypalgesia in the left trigeminal area, a wide left eye slit and a lowered left angle of
the mouth. Most likely diagnosis:
a. ischaemic stroke in the right brainstem
b. tumour in the left pons
c. tumour in the left pontocerebellar angle
d. polyneuropathy left
e. onset of ophthalmic herpes - acute left

A

c. tumour in the left pontocerebellar angle

32
Q

A large tumour with hyperostosis is most likely
a. glioblastoma
b. meningeom
c. to the seamstress
d. oligodendroglioma

A

b. meningeom

33
Q

Which tumour is treated with
radiotherapy and temozolomide?
a. glioblastoma
b. oligodendroglioma
c. priman lymphoma OŽ
d. meningeom

A

a. glioblastoma

34
Q

Which tumour would you expect to find in the cerebellum of a 35-year-old man?
a. pilocytic astrocytoma
b. haemangioblastoma
c. medulloblastoma
d. ependymom

A

b. haemangioblastoma

35
Q

The most common brainstem tumour?
a. glioma

A

a. glioma

36
Q

False claim for tumours:
a. medulloblastoma does not take root.

A

a. medulloblastoma does not take root.

37
Q

Best treatment prognosis for oligodendroglioma?
a. with 1p/19q codelation
b. with the absence of the 1p/19q deletion

A

a. with 1p/19q codelation

38
Q

A gentleman had surgery for lung carcinoma 6 months ago. For the last two
months he has been experiencing proximal weakness in his legs. What is the
likely diagnosis?
a. progressive multifocal leukoencephalopathy
b. dermatomyositis
c. multiple sclerosis
d. myasthenia gravis syndrome
e. myasthenia gravis

A

d. myasthenia gravis syndrome

39
Q

Description and picture, cystic tumour in the cerebellum of a child. It is probably:
a. metastasis
b. pilocytic astrocytoma
c. oligodendroglioma
d. medulloblastoma

A

b. pilocytic astrocytoma

40
Q
  1. A 29-year-old right-wing administrator has been experiencing vision problems for the
    past 3 weeks. She has limited upward vision, poor pupillary reactions, convergence
    nystagmus at rest. It is:
    a. Weber syndrome
    b. Benedict’s syndrome
    c. Parinaud syndrome
    d. Wallenberg syndrome
    MRI of the head in the previous patient shows an expansive process in:
    e. ponsu
    f. meduli oblongati
    g. of the mesencephalon
    h. epiphyses
A

c. Parinaud syndrome
h. epiphyses

41
Q

How to reduce a tumour that is too big for surgery:
a. methotrexate
b. PCV scheme
c. PCV scheme with other medicines

A

b. PCV scheme

42
Q

When will a surgeon always opt for a complete resection of the tumour?
a. A 12-year-old boy with a tumour in his brain stem
b. 90 years old…
c. 50-year-old man with a 5x6 cm frontal tumour
d. 40-year-old woman after surgery and radiation treatment for glioblastoma
e. 60-year-old woman with diffuse capsular tumour internal

A

c. 50-year-old man with a 5x6 cm frontal tumour

43
Q

For brain tumours, the most common treatments for epilepsy are:
a. ethosuximide and levetiracetam
b. carbamazepine and levetiracetam
c. lamotrigine and gabapentin
d. topiramate and valproate

A

b. carbamazepine and levetiracetam

44
Q

The edema around a tumour growing in the brain is?
a. vasogenic
b. cytotoxic

A

a. vasogenic

45
Q

What is the case with glioblastoma?
a. may look like an abscess on CT scan
b. stains well with contrast on CT
c. stains on MRI after contrast is added
d. no staining on MRI after contrast addition
e. MR spectroscopy is a useless method

A

c. stains on MRI after contrast is added

46
Q

Which tumour most commonly invades the brain?
a. Hodgkin’s lymphoma
b. lung carcinoma
c. Seminars
d. adenocarcinoma of the colon

A

b. lung carcinoma

47
Q

Kennedy-Foster syndrome, what do we find?
a. ipsilateral optic atrophy and anosmia, contralateral papilloedema
b. ipsilateral optic atrophy, contralateral anosmia and papilloedema
c. ipsilateral papilloedema, contralateral optic atrophy and anosmia
d. ipsilateral anosmia, contralateral optic atrophy and papilloedema

A

a. ipsilateral optic atrophy and anosmia, contralateral papilloedema

48
Q

A patient with metastasis of a lung tumour who is to be irradiated and has
epilepsy, which antiepileptic drug would you treat him with?
a. lamotrigine
b. carbamazepine
c. valproate
d. diazepam
e. with any of the above

A

b. carbamazepine

49
Q

What is an arachnoid cyst?
a. has the same signal as the liquid on all sequences
b. In contrast-enhanced MRI, there is intense staining around the margins

A

a. has the same signal as the liquid on all sequences

50
Q

Symptomatic treatment of CNS tumours includes:
a. antiepileptics, amtiemetics, analgesics, laxatives
b. medical cannabis

A

a. antiepileptics, amtiemetics, analgesics, laxatives

51
Q
  1. What is the average expected survival in oligodendroglioma with 1p/19q
    deletion?
    a. a few months
    b. 1 year
    c. 5 years
    d. 10 years
A

d. 10 years

52
Q

A 41-year-old man admitted for 2 weeks of amnestic syndrome and complex partial
seizures. Antibodies to Ma-1 protein were found. What are the problems
associated with?
a. Seminoma of the testis

A

a. Seminoma of the testis

53
Q

What is the immunophenotype of adenocarcinoma of the lung?
a. CK7+, CK20-, TTF1+, Napsn A+

A

a. CK7+, CK20-, TTF1+, Napsn A+

54
Q

A 70-year-old man. The patient has a CSF pressure of 220 mmH2 O, a protein
concentration of 1,5 g/L, a cell count of 150 mm3
, a glucose count of 0,9 mmol/L
(blood 5,0 mmol/L), and negative oligoclonal bands. What is wrong with him?
a. Carcinomatosis of the meninges

A

a. Carcinomatosis of the meninges

The reduction of glucose is due to cancer cells consumption,

55
Q

The neurosurgeon will opt for a biopsy of the lesion rather than a radical resection
if the results suggest:
a. Primary CNS lymphoma

A

a. Primary CNS lymphoma

56
Q

Not applicable to glioblastoma:
a. Incidence is highest between 30 and 40 years of age
b. It is the most common brain tumour
c. Survival after chemotherapy and radiation is 1 year
d. Originates in the basal ganglia
e. Sometimes it overgrows the corpus callosum

A

a. Incidence is highest between 30 and 40 years of age
d. Originates in the basal ganglia

57
Q

Cerebellar defects in antibodies according to the clinical picture.
a. anti-Yo
b. anti-Hu
c. anti-MAG
d. anti-Ri

A

a. anti-Yo

58
Q

A CNS tumour expresses the following markers: CK7+, CK20-, TTF-. What is
the origin of the metastasis?
a. carcinoma of the lung
b. breast carcinoma
c. colon carcinoma
d. malignant melanoma
e. prostate cancer

A

b. breast carcinoma

59
Q

What of the following would you not expect to find in a little brain?
a. abscess
b. metastases
c. haemangioblastoma
d. medulloblastoma
e. glioblastoma

A

e. glioblastoma

60
Q

What are peripheral nerve tumours?
a. to the seamstress
b. neurofibrom
c. fibrom
d. MPNST
e. ependymom

A

b. neurofibrom
d. MPNST

61
Q

Not applicable to paraneoplastic syndromes:
a. respond well to corticosteroids
b. occur in limited cancers
c. it is best to treat the underlying disease
d. subacute development of symptoms
e. severe disability

A

a. respond well to corticosteroids

62
Q

The radiotherapist has decided to give postoperative radiotherapy to the
astrocytoma. What dose will he use?
a. 5-10 Gy
b. 20-30 Gy
c. 50-60 Gy
d. 90-100 Gy
e. 120-130 Gy

A

c. 50-60 Gy

63
Q

Which tumour is not WHO grade I?
a. pilocytic astrocytoma
b. disembryoplastic neuroepithelial tumour
c. to the seamstress
d. meningeom
e. oligodendroglioma

A

e. oligodendroglioma

64
Q

An elderly patient has double images, hearing loss in the left ear, headache. Paresis
of the right abducens is also noted. What is it?
a. behind the seam of the pontocerebellar angle
b. for carcinosis of the meninges
c. for brainstem glioma
d. for pituitary adenoma
e. for meningioma of the posterior cranial fossa

A

b. for carcinosis of the meninges

Dissemination of the tumor

65
Q

Which is not a paraneoplastic antibody?
a. Lg1
b. anti-Hu
c. anti-Ri
d. anti-Yo
e. anti-ma1

A

a. Lg1

66
Q

A 38-year-old gentleman with progressive dysarthria, gait faltering and
intention tremor. He fails the finger-to-nose test. Most likely:
a. glioblastoma
b. haemangioblastoma
c. medulloblastoma
d. lymphoma
e. oligodendroglioma

A

b. haemangioblastoma

67
Q

A patient has a parasagittal meningioma - which symptom occurs acutely?
a. epilepsy
b. paraplegia due to rapid growth
c. symptoms of elevated ICT

A

a. epilepsy

Neurology (22 decks)

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