Headache Evaluation for Brain Tumor Quiz
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Questions and Answers

Which of the following headache symptoms is NOT concerning for the possibility of a brain tumor?

  • Headaches that are positional or worsen with exertion
  • Chronic, mild headaches that have been present for years (correct)
  • New headaches in older adults or children
  • Headaches associated with any new neurologic symptoms

What was the primary goal of the literature searches described in the text?

  • To evaluate the effectiveness of different treatment approaches for brain tumors
  • To determine when a headache should prompt evaluation for a brain tumor (correct)
  • To assess the prevalence of brain tumors in the general population
  • To identify causes of brain tumors

Which of the following types of articles were included in the literature review?

  • All types of articles, including case reports and editorials
  • Only clinical trials
  • Only meta-analyses and systematic reviews
  • Clinical trials, meta-analyses, systematic reviews, retrospective studies, and guidelines/consensus papers (correct)

What is the primary focus of the text?

<p>When a headache should prompt evaluation for a brain tumor (C)</p> Signup and view all the answers

Which of the following headache characteristics is NOT mentioned as concerning for the possibility of a brain tumor?

<p>Chronic, dull headaches that have been present for several years (B)</p> Signup and view all the answers

What was the primary method used to identify articles for the literature review described in the text?

<p>A combination of searching PubMed, reviewing citations, and consulting the authors' knowledge (C)</p> Signup and view all the answers

Which imaging feature is most characteristic of a glioblastoma?

<p>Ring enhancement with central necrosis (D)</p> Signup and view all the answers

What is the primary purpose of performing a cerebrospinal fluid (CSF) cytology following surgery for a brain tumor?

<p>To assess for leptomeningeal dissemination (D)</p> Signup and view all the answers

Which corticosteroid is preferred for the treatment of cerebral edema associated with brain tumors?

<p>Dexamethasone (A)</p> Signup and view all the answers

Which of the following imaging features is most characteristic of primary central nervous system (CNS) lymphoma?

<p>Homogeneous enhancement (D)</p> Signup and view all the answers

Which of the following brain tumors is associated with the presence of a 'dural tail' on imaging?

<p>Malignant meningioma (A)</p> Signup and view all the answers

What is the primary function of the T2-weighted/FLAIR sequence in the imaging of brain tumors?

<p>To detect the presence of vasogenic edema (D)</p> Signup and view all the answers

What is the most common presenting symptom of lower-grade gliomas?

<p>Seizures (C)</p> Signup and view all the answers

Which type of tumor is most likely to cause ocular palsies, hearing loss, or dysphagia?

<p>Tumors with leptomeningeal dissemination (A)</p> Signup and view all the answers

Which of the following is a common symptom of primary central nervous system lymphoma (PCNSL)?

<p>Blurred vision or floaters (A)</p> Signup and view all the answers

Which type of tumor is most likely to cause anosognosia, defined as the inability to recognize one's deficits?

<p>Frontal lobe tumors (B)</p> Signup and view all the answers

Which symptom is most likely to be associated with tumors in the dominant hemisphere?

<p>Speech difficulty (A)</p> Signup and view all the answers

What is a common symptom of increased intracranial pressure?

<p>Transient loss of consciousness (plateau waves) (B)</p> Signup and view all the answers

Which of the following symptoms is most commonly associated with tumors in the frontal lobe?

<p>Contralateral motor deficits (A)</p> Signup and view all the answers

A patient with a tumor in the temporal lobe is likely to experience which of the following symptoms?

<p>Seizures (A)</p> Signup and view all the answers

Which of the following symptoms is most commonly associated with tumors in the parietal lobe?

<p>Contralateral sensory deficits (B)</p> Signup and view all the answers

A patient with a tumor in the occipital lobe is likely to experience which of the following visual field defects?

<p>Contralateral homonymous hemianopia (D)</p> Signup and view all the answers

Which of the following symptoms is most commonly associated with tumors in the cerebellum?

<p>Nausea and vomiting (D)</p> Signup and view all the answers

A patient with a tumor in the brainstem is likely to experience which of the following symptoms?

<p>Facial droop (B)</p> Signup and view all the answers

What is the recommended dose of dexamethasone for severe symptoms of glioblastoma?

<p>10 mg bolus, then 16 mg/d in divided doses (D)</p> Signup and view all the answers

Which of the following is NOT a potential adverse effect of bevacizumab, a vascular endothelial growth factor inhibitor?

<p>Hyperkalemia (D)</p> Signup and view all the answers

What is the recommended prophylaxis for patients taking dexamethasone at a dose of 3 mg or higher for at least 1 month?

<p>Pneumocystis pneumonia (PCP) prophylaxis (A)</p> Signup and view all the answers

Which of the following statements about trimethoprim-sulfamethoxazole (TMP-SMX) is FALSE?

<p>It should not be used in patients with sulfa allergy (D)</p> Signup and view all the answers

What is the mechanism of action of dapsone, an alternative agent for Pneumocystis pneumonia prophylaxis?

<p>Para-aminobenzoic acid antagonism (B)</p> Signup and view all the answers

Which of the following is NOT listed as a potential adverse effect of dapsone?

<p>Nephrotoxicity (B)</p> Signup and view all the answers

What is a characteristic symptom reported by patients with steroid-induced myopathy?

<p>Difficulty rising from a seated position (D)</p> Signup and view all the answers

What is the primary target of Bevacizumab, a monoclonal antibody used for treating glioblastomas?

<p>VEGF-A (C)</p> Signup and view all the answers

How is IDH-wild-type glioblastoma diagnosed in patients aged 55 years and older?

<p>Absence of immunoreactivity for IDH1 R132H (A)</p> Signup and view all the answers

What does the 'not elsewhere classifiable' (NEC) designation indicate in diagnostic criteria?

<p>'Appropriate diagnostic testing performed, but no alternative diagnosis found' (A)</p> Signup and view all the answers

Which group of patients should have further molecular work-up to exclude specific genetic findings related to brain tumors?

<p>Patients with pediatric-type diffuse gliomas (C)</p> Signup and view all the answers

What symptom may resolve after discontinuing steroid use in patients with steroid-induced myopathy?

<p>Difficulty climbing stairs (B)</p> Signup and view all the answers

What type of headaches should prompt evaluation for a brain tumor?

<p>Headaches that worsen with exertion (C)</p> Signup and view all the answers

Which population group may new headaches raise concern for brain tumors?

<p>Older adults or children (C)</p> Signup and view all the answers

What types of studies were primarily included in the literature review mentioned in the text?

<p>Retrospective studies (D)</p> Signup and view all the answers

Which action was part of the methods for conducting literature searches in the text?

<p>Excluding articles with the MeSH term 'pediatric' (B)</p> Signup and view all the answers

What type of headaches may raise concern for brain tumor if they represent a change from prior headache patterns?

<p>Acute, severe headaches (B)</p> Signup and view all the answers

Which type of brain tumor was NOT specifically mentioned in the text's literature searches?

<p>Astrocytoma (D)</p> Signup and view all the answers

Which type of glioma typically affects patients younger than 50 years of age?

<p>Oligodendroglioma (B)</p> Signup and view all the answers

What is the peak incidence age range for glioblastoma, the most common malignant primary brain tumor in adults?

<p>75-84 years (A)</p> Signup and view all the answers

Which organization's classification of Tumors of the Central Nervous System is referred to as the international standard?

<p>World Health Organization (D)</p> Signup and view all the answers

Which of the following terms is used in the text to describe the group of brain tumors that includes glioblastoma?

<p>Adulttype diffuse gliomas (C)</p> Signup and view all the answers

What is the most common presenting symptom of lower-grade gliomas?

<p>Seizures (B)</p> Signup and view all the answers

What is the recommended dose of dexamethasone for mild to moderate symptoms of glioblastoma?

<p>4 to 8 mg per day without a loading dose (C)</p> Signup and view all the answers

How often is once- or twice-a-day dosing typically recommended for dexamethasone in managing neurologic symptoms?

<p>Once or twice a day (A)</p> Signup and view all the answers

What is the primary reason for the slow taper of corticosteroids in patients with glioblastoma?

<p>To identify the minimal steroid dose required for symptom control (C)</p> Signup and view all the answers

In patients with glioma, what percentage may experience seizures?

<p>75% (A)</p> Signup and view all the answers

Which group of drugs can affect the metabolism of concomitant medications due to their effect on hepatic cytochrome P450 enzymes?

<p>Antiepileptic drugs (D)</p> Signup and view all the answers

In patients receiving the equivalent of prednisone 20 mg daily for more than a month, approximately how much dexamethasone would they be taking daily?

<p>$3 mg daily (D)</p> Signup and view all the answers

Which brain region is most commonly affected by tumors causing anosognosia?

<p>Frontal lobes (A)</p> Signup and view all the answers

Which symptom is most likely to occur with leptomeningeal dissemination or increased intracranial pressure?

<p>Cranial neuropathies (A)</p> Signup and view all the answers

Which brain tumor type preferentially affects deep matter structures?

<p>Primary central nervous system lymphoma (PCNSL) (A)</p> Signup and view all the answers

What is the most common presenting symptom of lower-grade gliomas?

<p>Seizures (B)</p> Signup and view all the answers

Which brain region is most likely associated with speech difficulties when affected by a tumor?

<p>Dominant hemisphere (D)</p> Signup and view all the answers

Which symptom is most likely associated with tumors affecting the nondominant hemisphere?

<p>Spatial distortion and constructional apraxia (B)</p> Signup and view all the answers

Which of the following is a potential adverse effect of dexamethasone, a corticosteroid used to treat cerebral edema in brain tumors?

<p>Hyperglycemia (B)</p> Signup and view all the answers

What is the recommended prophylaxis for patients taking dexamethasone at a dose of 3 mg or higher for at least 1 month?

<p>Trimethoprim-sulfamethoxazole (TMP-SMX) (D)</p> Signup and view all the answers

What is the mechanism of action of bevacizumab, a monoclonal antibody used in the treatment of glioblastoma?

<p>Vascular endothelial growth factor inhibition (A)</p> Signup and view all the answers

Which of the following is NOT a potential adverse effect of trimethoprim-sulfamethoxazole (TMP-SMX), a drug used for Pneumocystis pneumonia prophylaxis?

<p>Methemoglobinemia (A)</p> Signup and view all the answers

Which of the following is a potential adverse effect of dapsone, an alternative agent for Pneumocystis pneumonia prophylaxis?

<p>Methemoglobinemia (A)</p> Signup and view all the answers

What is the recommended dosing of dexamethasone for severe symptoms of glioblastoma?

<p>Bolus 10 mg, then 16 mg/day in divided doses (B)</p> Signup and view all the answers

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