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51 Cards in this Set
- Front
- Back
what are the signs of increased intracranial pressure?
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headache
nausea vomiting |
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How will edema present?
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widened gyri and narrowed sulci
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what is a midline shift?
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herniation of the cingulate gyrus to the opposite cerebral hemisphere due to increased intracranial pressure
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what is the most medial part of the temporal lobe called?
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uncus
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what will uncal herniation cause?
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necrosis of the uncus
compression on CN III Kernohan's notch |
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how will CN III compression present?
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fixed dilated pupils
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what causes Kernohan's notch? how will it present?
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uncle herniation compressing the cerebral peduncles
presents with ipsalateral hemiparesis (ipsalateral to the tumor) |
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what is the main concern with cerebellar tonsil herniation?
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compression of the medulla which causes depression of vital functions
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what is a duret hemorrhage?
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when the brain herniates downward into the foramen magnum due to increased intracranial pressure it can cause the tiny vessel of the pons to rupture. this is called a duret or pontine hemorrhage
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how will a midline shift or cingulate gryus herniation present?
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lower extremity weakness
urinary incontinence |
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how will a duret hemorrhage present clinically?
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stupor
coma |
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what are the 3 prognostic factors for CNS tumors? what is the best?
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age
location grade age is the best prognostic factor |
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what is the most common tumor type seen in the CNS?
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astrocytomas
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what is a PNET? what is the most common type?
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Primitive Neural Ectodermal Tumor - a tumor that develops from a primitive stem cell that has not differentiated yet
Medulloblastoma is the most common type |
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who is affected by glioblastomas?
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adults of old age
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who is affected by medulloblastoma?
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children
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what are the 3 grades of infiltrative astrocytomas?
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Diffuse astrocytoma - grade II
anaplastic astrocytoma - grade III glioblastoma - grade IV |
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what age group is affected by astrocytomas? where do they most commonly occur?
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30 - 50 y/o
cerebral cortex |
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what immunohistochemical marker is associated with astrocytomas?
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GFAP
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what tumor has a gross appearance that makes it called the "butterfly glioma"?
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glioblastoma
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glioblastoma
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pseudopalisading appearance and glomeruloid vasculature histologically
butterfly appearance grossly necrosis hemorrhagic vascular proliferation |
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brain stem glioma
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affects children and young adutls
found in the brain stem histologically looks like astrocytoma |
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Pilocytic astrocytoma
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children and young adults
most commonly in cerebellum astrocytes look like hair abundant rosenthal fibers |
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oligodendroglioma
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grade II
fried egg appearance chicken wire vessels affects 30-40 y/o with a long history of seizures |
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what is the genetic alteration associated with oligodendroglioma?
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loss of heterozygosity of chromosome 1p and 19q
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ependymoma
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10-15 y/o
usually found near 4th ventricle will find true rosettes grade III |
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what is a big concern with medulloblastoma?
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metastatic spread via the CSF
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myxopapillary ependymoma
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affect all ages but ave. is 36 y/o
more common in males clinically present with low back pain for a long duration arise from filum terminale |
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medulloblastoma
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most common brain tumor of children
most commonly found in cerebellum small blue cell tumor homer wright rosettes |
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primary CNS lymphoma
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seen in immunosuppressed (AIDS patients)
most commonly of B cell origin and associated with Ebstein-Barr virus infiltrates parencyma and clusters around blood vessels |
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what is meant by angiocentric pattern? in what pathology would you see it?
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the tendency to cluster around blood vessels
primary CNS lymphoma |
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choriod plexus papilloma
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first decade of life
most commonly lateral and 4th ventricles |
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meningioma
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adults
common in females more common in spine than cranium form as a lobulated firm mass attached to the dura whorls and psammoma bodies associated with NF 2 |
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which chromosome is associated with neurofibromatosis 2? which tumor is associated with NF 2?
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chromosome 22
meningioma bilateral schwannomas of CN VIII are diagnostic |
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what are the primary sites of CNS metastatic tumors?
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lung
breast melanoma kidney GI |
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what is meningeal carcinomatosis?
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diffuse infiltration by tumor cells in the meninges of the brain, spinal cord, and nerve roots
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which cancers are most likely to produce paraneoplastic syndromes that affect the CNS?
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lung
ovarian |
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what nerve is most commonly involved in schwannoma?
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CN VIII - vestibulocochlear
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what is a schwannoma?
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a beging solitary well circumscibed mass attached to a nerve
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what disease or disorder are schwannomas associated with?
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NF 2 (on chromosome 22)
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what is the major difference between a schwannoma and a neurofibroma?
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schwannomas do not infiltrate the nerve while neuroribromas do
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what disease or disorder are neurofibromas associated with?
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neurofibromatosis 1
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ganglioglioma
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grade I/II
usually benign 8.5 - 25 y/o usually in temporal lobe |
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what is the difference between a ganglioglioma and a gangliocytoma?
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gangliocytomas are composed of mature ganglion cells alone while gangliogliomas has neoplastic glial cells
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central neurocytoma
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located in lateral ventricle
small round clear cells with uniform nuclei calcifications |
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neurofibromatosis 1
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chromosome 17
autosomal dominant inheritance will cause neurofibromas all over the body characteristic cafe-au-lait spots and Lisch nodules in the iris |
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neurofibromatosis 2
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chromosome 22
autosomal dominant associated with schwannomas and multiple meningiomas |
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what does bilateral schwannoma tell you?
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the person has NF 2
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tuberous sclerosis
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chromosome 9 and 16
autosomal dominant seizures, mental retardation, behavior problems, increased ICP benign tumors, shagreen patches, hypopigmentation of the skin |
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subependymal giant cell astrocytoma
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associated with tuberous sclerosis
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von Hippel-Lindau disease
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chromosome 3
autosomal dominant associated with hemangioblastoma |