Brain Tumours

Question 1

What are the 2 general types of brain tumour?

Answer 1

Primary

Secondary metastatic

Question 2

In primary tumors, what are the different type?

Answer 2

Glioblastoma
Meninges
Pituitary

Question 3

What are the commonest tumours which spread to the brain?

Answer 3

Renal cell
Breast
Lung 
Malignant melanoma
GI tract

Question 4

What is the most common type of brain tumour?

Answer 4

Metastatic brain tumours

Question 5

What cells are gliomas derived from?

Answer 5

Astrocytes

Question 6

What stage is a GBM?

Answer 6

Stage IV

Question 7

What are classed as primary malignant tumours?

Answer 7

Gliomas

Question 8

In which meningeal layer do meningiomas usually present

Answer 8

Arachnoid

Question 9

Where fo meningiomas usually present in the brain?

Answer 9

Along falx, convexity or sphenoid bone

Question 10

Are meningiomas curable?

Answer 10

Yes by surgical excision

Question 11

What is the common signs of pituitary adenoma?

Answer 11

Optic field defect - bitemporal hemianopia

hormone imbalance

Question 12

What are the clinical presentations of a brain tumour?

Answer 12

Raised intracranial pressure
Focal neurological signs
Epileptic fit
CSF obstruction

Question 13

What are the main symptoms of raised ICP?

Answer 13

Headache 
Nausea/ vomiting 
Diploia or blurred vision 
Drowsiness
Cognitive impairment
Alter consciousness

Question 14

What are the signs of raised ICP?

Answer 14

Papilloedema
3rd nerve palsy
6th nerve palsy
Altered consciousness

Question 15

What is a RED FLAG sign of raised intracranial pressure?

Answer 15

Headache - worse in morning

Question 16

What investigations would you do if suspected brain tumour?

Answer 16

CT scan (brain)
MRI
PET

CXR
Biopsy - skin or lymph
Mammography

Question 17

What are some focal neurological deficits which may be observed?

Answer 17

Dysphagia 
Hemiparesis 
Hemianopia
Cognitive impairment 
Cranial nerve palsy 
Endocrine disorders

Question 18

Patient presents with ataxia & incoordination, where is the lesion?

Answer 18

Cerebellum

Question 19

Right handed patient presents with acalculia, agraphia, finger agnosia, left/ right confusion, where is the lesion?

Answer 19

Left parietal lobe

Question 20

If patient presents with bitemporal hemianopia, where is the lesion?

Answer 20

Pituitary

Question 21

If right handed patient presents with difficulty reading, difficulty expressed self, short term memory loss, where is the lesion?

Answer 21

Left temper-parietal area

Question 22

What are the main management goals?

Answer 22

Reduce size of tumour (debunk)

Improve focal neurological signs

Question 23

What type of management is available?

Answer 23

Steroids
Anticonvulsants
SuRgery
Radiotherapy

Question 24

Are GBM operable?

Answer 24

Yes but not curative only debulk or biopsy

Question 25

What treatment would be administered in someone with metastatic brain tumours?

Answer 25

Surgery | Radiotherpay

Question 26

What is the prognosis for GBM?

Answer 26

1 YRS

Question 27

What is the prognosis for meningioma?

Answer 27

Commonly cured with surgery

Question 28

What is the prognosis for metastatic disease?

Answer 28

Medium term remission

Question 29

Why do you NOT perform lumbar puncture in someone with brain tumour?

Answer 29

Risk of herniation syndrome and patient death

Question 30

What tumours are classed as primary benign?

Answer 30

Pituitary adenoma | Meningioma

Question 31

What are the presenting signs of brain tumour?

Answer 31

Raised ICP - nausea, headache, drowsiness Focal neurological signs Cognitive impairment

Question 32

What are the names of the dural sheets which divide the brain?

Answer 32

Falx cerebri | Tentorium cerebelli

Question 33

What are the localised lesion causes of increased intracranial pressure?

Answer 33

Haemtoma (haemorrhage) Tumour Abscess

Question 34

What are some of the generalised causes of increased ICP?

Answer 34

Oedema post trauma

Question 35

What are localised lesions also referred to as?

Answer 35

Space Occupying Lesions (SOL)

Question 36

What types of herniation can occur what increased ICP?

Answer 36

Uncal herniation Subfalcine (midline shift) Coning - cerebellotonsillar herniation

Question 37

Why is it called a subfalcine shift?

Answer 37

Falcine means falx therefore below falx cerebri

Question 38

In an uncle herniation what happens?

Answer 38

Brain herniates inferiorly below tentorium

Question 39

Cerebellar tonsil herniation causes what?

Answer 39

Brain stem death

Question 40

What are some of the initial signs & symptoms of Increased ICP?

Answer 40

Morning headache & nausea | Papilloedema

Question 41

What are some of the progressive signs of increased ICP?

Answer 41

Pupillary dilation Falling GCS score Brainstem death

Question 42

What are the different types of gliomas?

Answer 42

Glioblastoma Astrocytoma Oligodendroctoma Ependymoma

Question 43

What is the cell type found in medulloblastomas?

Answer 43

Embryonic neural cells

Question 44

What are meningiomas formed from?

Answer 44

Arachnoid cell

Question 45

What tumours occur from nerve sheath cell?

Answer 45

Neurofibroma | Schwannoma

Question 46

What tumour arises from blood vessels?

Answer 46

Haemangioblastoma

Question 47

Which tumour type is a malignant childhood tumour?

Answer 47

Medulloblastoma

Question 48

Where do the majority of brain tumours occur in adults/children?

Answer 48

Above tentorium | Below tentorium

Question 49

Which cells do gliomas descend from?

Answer 49

Glial cells

Question 50

Are gliomas malignant or benign?

Answer 50

Malignant

Question 51

Which cells are glioblastomas formed from?

Answer 51

Astrocytes

Question 52

What shape do astrocytes look like?

Answer 52

Star shaped

Question 53

Where are medulloblastomas usually found?

Answer 53

In posterior fossa, in children

Question 54

Are meningiomas benign or malignant?

Answer 54

Malignant

Question 55

Where are schwannomas found?

Answer 55

Peripheral nerve sheaths

Question 56

What is an acoustic neuroma?

Answer 56

Schwannoma of the 8th cranial nerve

Question 57

What is the main sign of an acoustic neuroma?

Answer 57

Unilateral hearing loss

Question 58

What is a pituitary adenoma?

Answer 58

Benign tumour of the pituitary gland