65 Questions
Which of the following headache symptoms is NOT concerning for the possibility of a brain tumor?
Chronic, mild headaches that have been present for years
What was the primary goal of the literature searches described in the text?
To determine when a headache should prompt evaluation for a brain tumor
Which of the following types of articles were included in the literature review?
Clinical trials, meta-analyses, systematic reviews, retrospective studies, and guidelines/consensus papers
What is the primary focus of the text?
When a headache should prompt evaluation for a brain tumor
Which of the following headache characteristics is NOT mentioned as concerning for the possibility of a brain tumor?
Chronic, dull headaches that have been present for several years
What was the primary method used to identify articles for the literature review described in the text?
A combination of searching PubMed, reviewing citations, and consulting the authors' knowledge
Which imaging feature is most characteristic of a glioblastoma?
Ring enhancement with central necrosis
What is the primary purpose of performing a cerebrospinal fluid (CSF) cytology following surgery for a brain tumor?
To assess for leptomeningeal dissemination
Which corticosteroid is preferred for the treatment of cerebral edema associated with brain tumors?
Dexamethasone
Which of the following imaging features is most characteristic of primary central nervous system (CNS) lymphoma?
Homogeneous enhancement
Which of the following brain tumors is associated with the presence of a 'dural tail' on imaging?
Malignant meningioma
What is the primary function of the T2-weighted/FLAIR sequence in the imaging of brain tumors?
To detect the presence of vasogenic edema
What is the most common presenting symptom of lower-grade gliomas?
Seizures
Which type of tumor is most likely to cause ocular palsies, hearing loss, or dysphagia?
Tumors with leptomeningeal dissemination
Which of the following is a common symptom of primary central nervous system lymphoma (PCNSL)?
Blurred vision or floaters
Which type of tumor is most likely to cause anosognosia, defined as the inability to recognize one's deficits?
Frontal lobe tumors
Which symptom is most likely to be associated with tumors in the dominant hemisphere?
Speech difficulty
What is a common symptom of increased intracranial pressure?
Transient loss of consciousness (plateau waves)
Which of the following symptoms is most commonly associated with tumors in the frontal lobe?
Contralateral motor deficits
A patient with a tumor in the temporal lobe is likely to experience which of the following symptoms?
Seizures
Which of the following symptoms is most commonly associated with tumors in the parietal lobe?
Contralateral sensory deficits
A patient with a tumor in the occipital lobe is likely to experience which of the following visual field defects?
Contralateral homonymous hemianopia
Which of the following symptoms is most commonly associated with tumors in the cerebellum?
Nausea and vomiting
A patient with a tumor in the brainstem is likely to experience which of the following symptoms?
Facial droop
What is the recommended dose of dexamethasone for severe symptoms of glioblastoma?
10 mg bolus, then 16 mg/d in divided doses
Which of the following is NOT a potential adverse effect of bevacizumab, a vascular endothelial growth factor inhibitor?
Hyperkalemia
What is the recommended prophylaxis for patients taking dexamethasone at a dose of 3 mg or higher for at least 1 month?
Pneumocystis pneumonia (PCP) prophylaxis
Which of the following statements about trimethoprim-sulfamethoxazole (TMP-SMX) is FALSE?
It should not be used in patients with sulfa allergy
What is the mechanism of action of dapsone, an alternative agent for Pneumocystis pneumonia prophylaxis?
Para-aminobenzoic acid antagonism
Which of the following is NOT listed as a potential adverse effect of dapsone?
Nephrotoxicity
What is a characteristic symptom reported by patients with steroid-induced myopathy?
Difficulty rising from a seated position
What is the primary target of Bevacizumab, a monoclonal antibody used for treating glioblastomas?
VEGF-A
How is IDH-wild-type glioblastoma diagnosed in patients aged 55 years and older?
Absence of immunoreactivity for IDH1 R132H
What does the 'not elsewhere classifiable' (NEC) designation indicate in diagnostic criteria?
'Appropriate diagnostic testing performed, but no alternative diagnosis found'
Which group of patients should have further molecular work-up to exclude specific genetic findings related to brain tumors?
Patients with pediatric-type diffuse gliomas
What symptom may resolve after discontinuing steroid use in patients with steroid-induced myopathy?
Difficulty climbing stairs
What type of headaches should prompt evaluation for a brain tumor?
Headaches that worsen with exertion
Which population group may new headaches raise concern for brain tumors?
Older adults or children
What types of studies were primarily included in the literature review mentioned in the text?
Retrospective studies
Which action was part of the methods for conducting literature searches in the text?
Excluding articles with the MeSH term 'pediatric'
What type of headaches may raise concern for brain tumor if they represent a change from prior headache patterns?
Acute, severe headaches
Which type of brain tumor was NOT specifically mentioned in the text's literature searches?
Astrocytoma
Which type of glioma typically affects patients younger than 50 years of age?
Oligodendroglioma
What is the peak incidence age range for glioblastoma, the most common malignant primary brain tumor in adults?
75-84 years
Which organization's classification of Tumors of the Central Nervous System is referred to as the international standard?
World Health Organization
Which of the following terms is used in the text to describe the group of brain tumors that includes glioblastoma?
Adulttype diffuse gliomas
What is the most common presenting symptom of lower-grade gliomas?
Seizures
What is the recommended dose of dexamethasone for mild to moderate symptoms of glioblastoma?
4 to 8 mg per day without a loading dose
How often is once- or twice-a-day dosing typically recommended for dexamethasone in managing neurologic symptoms?
Once or twice a day
What is the primary reason for the slow taper of corticosteroids in patients with glioblastoma?
To identify the minimal steroid dose required for symptom control
In patients with glioma, what percentage may experience seizures?
75%
Which group of drugs can affect the metabolism of concomitant medications due to their effect on hepatic cytochrome P450 enzymes?
Antiepileptic drugs
In patients receiving the equivalent of prednisone 20 mg daily for more than a month, approximately how much dexamethasone would they be taking daily?
$3 mg daily
Which brain region is most commonly affected by tumors causing anosognosia?
Frontal lobes
Which symptom is most likely to occur with leptomeningeal dissemination or increased intracranial pressure?
Cranial neuropathies
Which brain tumor type preferentially affects deep matter structures?
Primary central nervous system lymphoma (PCNSL)
What is the most common presenting symptom of lower-grade gliomas?
Seizures
Which brain region is most likely associated with speech difficulties when affected by a tumor?
Dominant hemisphere
Which symptom is most likely associated with tumors affecting the nondominant hemisphere?
Spatial distortion and constructional apraxia
Which of the following is a potential adverse effect of dexamethasone, a corticosteroid used to treat cerebral edema in brain tumors?
Hyperglycemia
What is the recommended prophylaxis for patients taking dexamethasone at a dose of 3 mg or higher for at least 1 month?
Trimethoprim-sulfamethoxazole (TMP-SMX)
What is the mechanism of action of bevacizumab, a monoclonal antibody used in the treatment of glioblastoma?
Vascular endothelial growth factor inhibition
Which of the following is NOT a potential adverse effect of trimethoprim-sulfamethoxazole (TMP-SMX), a drug used for Pneumocystis pneumonia prophylaxis?
Methemoglobinemia
Which of the following is a potential adverse effect of dapsone, an alternative agent for Pneumocystis pneumonia prophylaxis?
Methemoglobinemia
What is the recommended dosing of dexamethasone for severe symptoms of glioblastoma?
Bolus 10 mg, then 16 mg/day in divided doses
Learn about the signs and symptoms of headaches that may indicate a brain tumor and necessitate immediate evaluation. Understand when to seek medical attention based on the characteristics of the headache and associated symptoms.
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