Raven Neurology Review -9- Infectious Disease & Oncology

  1. Most common cause of bacterial meningitis in adults?
    Strep.Pneumo
  2. Common sequelae of bacterial meningitis?
    • Hydrocephalus
    • Epilepsy
    • Hearing loss
  3. Major cause on meningitis in neonates?
    Group B Strep
  4. MRI changes in congenital CMV infection?
    Periventricular calcification
  5. What does congenital CMV cause?
    • Sensorineural hearing loss
    • Hepatosplenomegaly
    • Petechiae
    • Microcephaly
  6. What does congenital Toxo cause?
    • Chorioretinitis,
    • hydrocephalus,
    • Scattered intracranial calcifications
  7. What does congenital rubella cause?
    • Deafness
    • Cataracts
    • Cardiac malformations
  8. Most common cause of spinal cord dysfunction in AIDS?
    HIV mediated vacuolar myelopathy
  9. Most common cause of mono neuritis multiplex in AIDS?
    CMV
  10. What is coccidiomycosis?
    • Common pulmonary fungal infection
    • Will cause confusion and ataxia secondary to hydrocephalus
    • TNF alpha MABs significantly increase your risk of it.
  11. Which fungal infection causes soap bubble cysts in the basal ganglia?
    Cryptococcus
  12. Which fungal infection causes haemorrhage strokes in post transplant patients?
    Aspergillosis
  13. Whats standard therapy for GBM?
    • Surgery
    • Radiotherapy
    • Temozolamide
  14. Presence of which genetic mutation confers a favourable response to alkylating agents?
    MGMT hypermethylation
  15. Histologic feature of GBM?
    Pseudopallisading necrosis
  16. Anti-Hu antibody?
    • From SCLC
    • Sensory neuronopathy
    • Cerebellar degen
    • Limbic encephalitis
  17. Anti-TR antibody?
    • Hodgkins lymphoma
    • Cerebellar degeneration
  18. Anti-Yo antibody?
    • Mostly ovarian and breast
    • Cerebellitis
  19. Anti-Ta antibody?
    • Testicular cancer
    • Limbic encephalitis
  20. Anti-Ma2 antibody?
    • Testicular and lung
    • Limbic and brainstem encephalitis
  21. What is foster-kennedy syndrome?
    • Olfactory groove tumors - lose sense of smell.
    • Cause ipsilateral optic nerve atrophy
    • Contralateral papilloedema
  22. What mutations are meningioma associated with?
    Mutations of the Merlin gene
  23. Which cell line do meningiomas arise from?
    Arachnoid
  24. Which is the most common primary brain tumour to haemorrhage?
    Oligodendroglioma
  25. Histology of ol-egg-odendrogliomas?
    • Chicken wire capillaries
    • Fried egg appearing cells
  26. Cytarabine side-effect?
    Acute cerebellar toxicity
  27. Pilocytic Astrocytomas?
    • Cystic cerebellar lesion with an enhancing mural nodule
    • Pilo means hair which represents the Rosenthal fibres on histology
    • Respond well to treatment
  28. Ataxia-Telangectasia
    • AR
    • Due to mutation in ATM gene responsible for DNA repair
    • Sensitive to radiotherapy
    • Have an Immunoglobulin deficiency so they get sinopulmonary infections
    • Increased risk of leukaemia and lymphoma
  29. Subependymal giant cell astrocytomas (SEGA) are typical for what?
    Tuberous sclerosis
  30. Most common location for a DNET?
    Temporal lobe
  31. Which variant of ependymomas arises from the filum terminale?
    Myxopapillary ependympoma
  32. Common haemorrhage mets?
    • Melanoma
    • Renal
    • Thyroid
    • Choriocarcinoma
  33. What cancer is Anti-ampiphysin assoc with?
    • Breast mainly
    • then lung
  34. Most common tumor associated with GABA-a?
    Thymoma
  35. 2 most common causes for leptomeningeal mets?
    • Breast
    • Lung
  36. Glial neoplasm with necrosis and pseudopallisading nuclei
    GBM
  37. "Fried egg" appearance
    Oligodendroglioma (fixation artefact)
  38. Perivascular pseudorosettes
    Ependymoma
  39. True Rosettes
    Ependymoma
  40. Homer-Wright Rosettes
    Medulloblastoma
  41. Ki-67
    Marker of nuclear proliferation
  42. GFAP
    Marker of glial intermediate filaments
  43. Cytokeratin
    Marker of epithelial intermediate filaments
  44. Rosenthal Fibres
    • Pilocytic astrocytomas
    • Pleomorphic xanthoastrocytoma
    • Alexander Disease
  45. Chromosome 1p and 19q deletion
    Good prognostic factor in ODG
  46. Where do Brain mets arise from?
    Lung>Breast>melanoma
  47. Tumors typically presenting with seizures?
    • ODG
    • Gangliomas
    • DNETs
  48. Anti-Ri?
    • Opsoclonus myoclonus
    • Breast, lung and ovarian
  49. Posterior fossa tutor with drop mets?
    Medulloblastoma
  50. Radiological features of gangliomas?
    Often in temporal lobes with cystic component.
  51. What differentiates a dermoid from an epidermoid?
    • Dermoids and teratomas have all sort fo tissue in them so they have a heterogenous internal sinal.
    • Epidermoid cysts are lined with squamous cells and are homogenous.
  52. What is a dandy walker malformation
    • A posterior fossa cyst that communicates with the 4th ventricle.
    • Severe atrophy of the vermis
  53. What differentiates GBM from lymphoma on MR?
    • Lymphoma  - Avid + homogenous enhancement NEAR CSF spaces
    • GBM - Heterogenous enhancement, situated peripherally.
  54. Commonest intracranial tumor?
    • Mets
    • Then Meningioma, GBM, pituitary microadenomas
  55. Whats the relevance on HHV 6?
    • Often comes out to play after bone marrow or solid organ transplant
    • Usually causes a limbic encephalitis
    • Can cause myelitis or leukoencephalopathy
  56. What percentage of patients with confirmed HSV have plum normal CSF?
    5%
  57. What is Lemierre's syndrome?
    • Primary oropharyngeal, tonsillar or peritonsillar inflammation
    • With later development of sepsis, internal jugular vein thrombosis and septic emboli.
    • This is typically caused by the bacterium Fusobacterium necrophorum.
  58. GabaA encephalitis
    • Often presents in status/NORSE
    • multifocal T2 lesions
  59. Which neoplasia is Morvan's most strongly associated with?
    Thymoma
  60. How long do you give dexamethasone for pneumococcal meningitis?
    4 days
  61. What is intracranial germinoma?
    • Homogenous, avidly enhancing, extra axial mass on or near the pineal.
    • Often presents in young male
    • Don't do surgery, you'll spread it everywhere - radiology works very well for it.
  62. How would you manage cryptococcal meningitis?
    • IV Amphoterocin
    • Oral flucytosine (better than fluconazole)
    • Daily LPs to drop ICP
    • Start antiretroviral 10-14 days after start of anti-fungal
Author
vb406
ID
350984
Card Set
Raven Neurology Review -9- Infectious Disease & Oncology
Description
neurology revision
Updated