A 27 year old male presents with headaches and vomiting. Physical exam reveals nystagmus, bilateral papilledema, and ataxic gait Laboratory studies reveal a hemoglobin of 19gm/l and hematocrit of 57%. An MRI is obtained of the head revealing a low density cystic midline cerebellar mass. A biopsy is obtained from the cerebellar mass, revealing the following:

 

1-The gene responsible for this disease is located on the following chromosome:

A-17p11.2

B-3p25-26

C-9q22

D-11p22

E-None of the above

 

2-The vascular lesions are typically located in :

A-Cerebellar lobes

B-Retina

C-Lung

D-A and B are true

E-A and C are true

 

3-These patients have a strong propensity for developing tumors of these organs:

A-Retina

B-Kidney

C-Cerebellum

D-Pancreas

E-All of the above

 

4-This syndrome is associated with:

A-Renal cell carcinoma

B-Cysts of liver, pancreas and kidney

C-Increased levels of erythropoietin

D-Hemangioblastomas

E-All of the above

 

5-The pattern of inheritance of this disease is:

A-X-linked

B-Autosomal recessive

C-Autosomal dominant

D-None of the above

 

6. Based on this presentation, the most likely diagnosis of this patient is:

  1. Tuberous sclerosis with subependymal astrocytoma
  2. Neurofibromatosis type 1, with malignant nerve sheath tumor
  3. von Hippel-Lindau disease with hemangioblastoma
  4. Neurofibromatosis type 2, with ependymoma