Neuro: Test 1 : 7. Cordingley : Tumors

Front 1

(o)

Back 1

Front 2

2. The student will be able to correlate brain tumors and their usual anatomic compartments.

3. The student will be able to provide examples of brain tumors that are more or less common in younger and older patients.

(o)

Back 2

Front 3

midline tumors and tumors of cerebellar lobes are more common in adults or kids?

Back 3

kids

Front 4

this is the Fastest-growing and most lethal brain tumor in astrocytoma series
Infiltrates and spreads widely within brain, so surgery cannot entirely remove
Surgery still warranted for biopsy, with or without de-bulking and insertion of Gliadel wafer
Radiation therapy usually applied

*

Back 4

Glioblastoma Multiforme

Front 5

this brain tumor is chiefly in adults 30-50, has Intermediate growth rates depending on grade, can sit dormant for years with no effect. Radiation therapy can be applied, but is usually reserved for when the tumor is perceived as growing because there is a lifetime limit to how much can be given.

Back 5

Cerebral Astrocytomas

Front 6

Usually the slowest growing brain tumors, but can eventually crowd the brain.
Often discovered as an incidental finding on a scan done for another reason
Are usually calcified and are therefore very recognizable on CT scans.

Back 6

Meningiomas

Front 7

please give an example that fits each of the following:
A fast-growing intracranial tumor displaces brain.

A slow-growing intracranial tumor replaces brain

Back 7

A fast-growing intracranial tumor displaces brain. (Examples: glioblastoma multiforme, metastases.)

A slow-growing intracranial tumor replaces brain. (Example: typical meningioma.)

Front 8

Most frequent incidence between ages of 30 and 50
Also calcify and usually show this on CT scans.
Intermediate growth rate, and is usually "managed" (surgery, RT) rather than cured
Glial cell in origin

Back 8

Oligodendrogliomas

Front 9

Can be hormonally active or disruptive
Can compress optic chiasm from below and produce visual field losses
Often removed surgically through the nose and sphenoid sinus

Back 9

Pituitary Adenomas

Front 10

Usually arise from the 8th cranial nerve as Schwannomas
Auditory symptoms (unilateral hearing loss and tinnitus) are prominent
Meningiomas and other tumors can also appear in this location

Back 10

Cerebellopontine Angle Tumors

Front 11

Comprise about 1/3 of childhood posterior fossa tumors
Predilection for cerebellar vermis
Though malignant, they are highly radio-sensitive

Back 11

Medulloblastomas

Front 12

posterior fossa tumor of childhood
Often encapsulated
Complete surgical extirpation often possible

Back 12

Cerebellar Astrocytoma

Front 13

2 of the most common primary cancers in existence are what? so what can this lead to?

(o)

Back 13

breast and Lung

can lead to brain (intermediate tenancy to go to the brain)

Front 14

The student will be able to describe more and less common sources of metastatic brain tumors.

aka what are the most and least likely to go to the brain***

(o)

Back 14

Prostate: DOES NOT go to brain

Melanoma: GOES TO BRAIN (very high propensity)

Front 15

The student will be able to describe treatments for tumors of the nervous system as well as their optimum applications and limitations. What are the options (4)

(o)

Back 15

High-dose corticosteroids
Surgery
Radiation therapy
Chemotherapy

Front 16

How do high dose corticosteroids help treat brain tumors?

(o)

Back 16

Buys time by shrinking the edema around the tumor deposit, rather than affecting the tumor itself.
Effective against extracellular edema, but not intracellular edema, such as that seen in ischemia.
A typical starting dose is dexamethasone 10 mg, followed by 4 mg q.i.d

Front 17

how does radiation therapy help treat CNS tumors?

(o)

Back 17

RT is usually palliative--to shrink but not eliminate tumor deposits
For brain metastases, RT is sufficiently effective that the patient usually dies of non-CNS complications before CNS complications.
The treatment itself can damage the CNS.

Front 18

When do you often see chemotherapy for CNS tumor treatment?

(o)

Back 18

Usually reserved for glioblastoma multiforme (Fastest-growing and most lethal brain tumor in astrocytoma series
Infiltrates and spreads widely within brain, so surgery cannot entirely remove)


IV administration is complicated by intact blood-brain barrier blocking entry into CNS.
BCNU (carmustine) given IV probably crosses BBB to some extent.
Gliadel® wafers (also carmustine) can be implanted within the tumor bed.