Crawford, Byron E.

CNS Tumors

1). Differentiation of a low grade astrocytoma from a glioblastoma multiforme is based on:

1. absence of necrosis in a glioblastoma multiforme
2. presence of necrosis in a glioblastoma multiforme
3. presence of necrosis in a well differentiated astrocytoma
4. presence of vascular proliferation in a well differentiated astrocytoma
5. absence of vascular proliferation in a glioblastoma multiforme

Correct Answer: B

2). The most common brain tumor in adults is:

1. low grade astrocytoma
2. meningioma
3. metastatic carcinoma
4. glioblastoma multiforme
5. oligodendroglioma

Correct Answer: C

3). The following tumors retain cellular features of undifferentiated primitive neuroectodermal cells:

1. medulloblastoma
2. oligodendroglioma
3. ganglioneuroma
4. pilocytic astrocytoma
5. pleomorphic xanthoastrocytoma

Correct Answer: A

4). The following tumor occurs commonly in the ventricles and in the filum terminale of the spinal cord:

1. pilocytic astrocytoma
2. hemangioblastoma
3. oligodendroglioma
4. medulloblastoma
5. ependymoma

Correct Answer: E

5). The following is the most common CNS neoplasm in immunocompromised patients:

1. Kaposi’s sarcoma
2. meningeal carcinomatosis
3. primary CNS lymphoma
4. medulloblastoma
5. pleomorphic xanthoastrocytoma

Correct Answer: C

6). A brain tumor which sometimes contains psammoma bodies and progesterone receptors is:

1. hemangioblastoma
2. meningioma
3. germ cell tumor
4. primary brain lymphoma
5. pineoblastoma

Correct Answer: B

7). The following CNS tumor is commonly cystic, histologically contains Rosenthal fibers and typically occurs in children and young adults:

1. hemangioblastoma
2. medulloblastoma
3. pleomorphic xanthoastrocytoma
4. pilocytic astrocytoma
5. germ cell tumor

Correct Answer: D

8). The following list of primary malignancies accounts for the majority of metastatic brain tumors in adults:

1. lung, breast, melanoma
2. testis, ovary, melanoma
3. lung, prostate, uterus
4. pancreas, melanoma, ovary
5. salivary gland, ovary, testis

Correct Answer: A

9). CNS tumors which commonly present clinically with tinnitus and hearing loss include:

1. meningioma
2. metastatic carcinoma
3. ganglioneuroma
4. schwannoma
5. ependymoma

Correct Answer: D

(10-13) Match the following neoplastic processes of the central and peripheral nervous system with the following neurocutaneous syndromes.

1. hemangioblastoma
2. pilocytic astrocytoma
3. meningioma
4. cortical hamartoma
5. plexiform neurofibromas

10). Neurofibromatosis, Type I __E___

11). Neurofibromatosis, Type II __C___

12). Tuberous sclerosis __D___

13). von Hippel-Lindau disease __A___

Abnormalities of the following chromosomes are associated with these disease processes. Answers may be used more than once.

1. 22
2. 17
3. 3
4. 9

14). von Hippel-Lindau disease __C__

15). Meningioma __A__

16). Tuberous sclerosis __D___

17). Neurofibromatosis, Type I __B___

18). Neurofibromatosis, Type II __A___

19). Medulloblastoma __B___

20. The following is the most common primary intracranial tumor in adults:

1. meningioma
2. ependymoma
3. pineoblastoma
4. astrocytoma
5. glioblastoma multiforme

Correct Answer: E

1. pineoblastoma
2. pleomorphic xanthoastrocytoma
3. medulloblastoma
4. gemistocytic astrocytoma
5. meningioma

22). The following tumor causes seizures secondary to compression and tends to erode bone:

1. astrocytoma
2. meningioma
3. ependymoma
4. medulloblastoma
5. oligodendroglioma

23). The following statement(s) is/are true regarding Schwannomas:

1. Usually are circumscribed.
2. Can arise from small and large nerves.
3. A component of neurofibromatosis, Type II.
4. May be multiple or single.
5. All of the above.

24). The following statement(s) is/are true regarding neurofibromas:

1. Are not well circumscribed and tend to merge with surrounding tissue.
2. Plexiforme type is a component of neurofibromatosis Type I.
3. May be multiple or single.
4. May undergo malignant degeneration in a patient with neurofibromatosis, Type I.
5. All of the above.

Correct Answer: E

25). The following CNS tumor contains tumor cell rosettes as a typical histologic feature:

1. pilocytic astrocytoma
2. ependymoma
3. glioblastoma multiforme
4. meningioma
5. oligodendroglioma

Correct Answer: B

26). The following statement(s) is/are true regarding oligodendroglioma:

1. Account for less than 15% of gliomas.
2. Usually a slow growing tumor, clinically produces seizures, and has a better prognosis than astrocytomas.
3. May be circumscribed and usually contains calcifications.
4. Has a predilection for white matter and histologically tumor cells have a "fried-egg" appearance due to nuclei surrounded by a clear cytoplasmic halo.
5. All of the above.

27). The following tumor contains perivascular pseudorosettes:

1. ependymoma
2. oligodendroglioma
3. glioblastoma multiforme
4. meningioma
5. pilocytic astrocytoma

Correct Answer: A

28).This lesion may produce positional headaches, and can cause non-communicating hydrocephalus secondary to obstruction of the foramina of Monro:

1. acoustic neuroma
2. pilocytic astrocytoma
3. colloid cyst
4. hamartoma of tuberous sclerosis
5. meningioma, papillary variant

Correct Answer: C

Match the following cells of origin with the list of tumors below:

1. neural crest
2. astrocytes
3. primitive undifferentiated neuroectodermal cells
4. unknown cell of origin
5. meningothelial cells
6. Rathke pouch remnants

29). Glioblastoma multiforme ______

Correct Answer: B

30). Meningioma, secretory variant ______

Correct Answer: E

31). Schwannoma ______

Correct Answer: A

32). Craniopharyngioma ______

Correct Answer: F

33). Hemangioblastoma ______

Correct Answer: D

34). Medulloblastoma ______

Correct Answer: C