CNS Cancer: Glioblastoma Quiz

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Created by Chris Galbraith and Connor Bohlken
Edited by Dr. Paris Ingledew

A glioblastoma is classified as what type of tumor?

1 point

Astrocytic Tumor

Oligodendroglial Tumor

Ependymal Tumor

Pineal Cell Tumor

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You are a 4th year medical student on your neurology rotation. You are seeing a patient with a newly diagnosed brain tumor. The note from the referring physician states the following: “64 year old female, insidious progression of: drowsiness, decreased attention, and altered judgement, has had two seizures within the last 6 months, previously none”. Based on this information alone, where do you suspect the tumor is within the brain?

1 point

Temporal Lobe

Frontal Lobe

Parietal Lobe

Cerebellum

Brainstem

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You are working with the esteemed neurosurgeon Dr. Encpecialist, who is famous for tossing out questions during surgery. Today, midway through a rather hairy resection, Dr. Encpecialist casually asks you what percentage of primary CNS tumours are of glial cell origin. You answer:

1 point

75%

50%

25%

20%

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You have impressed Dr. Encpecialist. Of course, it is never enough to get one question correct, so she is quick to fire off another one. In particular she would like to know if you can correctly rank the order of astrocytomas from least aggressive to most aggressive. You answer:

1 point

Glioblastoma, Pilocytic, Diffuse, Anaplastic

Anaplastic, Glioblastoma, Pilocytic, Diffuse

Diffuse, Anaplastic, Glioblastoma, Pilocytic

Pilocytic, Diffuse, Anaplastic, Glioblastoma

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Which of the following is NOT a risk factor for Primary CNS Tumors?

1 point

Li-Fraumeni Syndrome

Neurofibromatosis Type 2

Exposure to industrial rubber

Male Sex

Down Syndrome

Lynch Syndrome

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A 58 year old male comes to your clinic with a known history of glioblastoma, for which he underwent surgical resection 6 months ago, which sadly did not fully achieve clear margins. They are coming today for an unrelated issue, but you are vigilant and want to make sure that you are not noting any disease progression. Of the following what is NOT a potential sign or symptom you would expect to see?

1 point

Headache

Seizures

Hyporeflexia

Personality Changes

Memory Loss

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You are a 4th year medical student just starting an elective in rural family medicine. Your preceptor, Dr. Ketchum, is a huge proponent of the early identification of cancer, which he believes can be achieved in part through conscious effort during your history, physical, and a solid differential diagnosis. He gives you the following 5 hypothetical patients, and asks, which of the following patients would you consider for for further workup for suspected Primary CNS cancer:

1 point

25 year old female, tried a new yoga pose but fell and hit her head, presenting to the emergency room with the worst headache of her life, maximal at onset.

32 year old male, describes seeing “colorful fuzzy zig-zag lines” then developing a terrible headache that lasted 2 days for which all he could do was lock himself in a dark room.

45 year old female, describes a new headache that is worse in severity than headaches she typically gets and seems to be aggravated by laying flat, with exertion, and when she sneezes.

52 year old male, describes a headache that feels like a “band across my head”.

64 year old male, describes a recurrent severe headaches, pain is focused in the right orbital. There is associated eye tearing and swelling, headaches last about 30 mins, has been going on for 6 days.

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You are working a shift in the emergency department and your next patient slated to see is Mr. Scwann. He is a 52 year old male, who is presenting with headaches and new onset seizures. His wife is with him and says she has noticed some personality changes. On history you further elicit that he worked in petroleum refining. On physical exam you notice several cafe au lait spots, and can appreciate papilledema on fundoscopy. You are concerned about a CNS neoplasm. What is the gold standard imaging modality?

1 point

Ultrasound

Xray

MRI

Nuclear Imaging

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A patient with a known primary CNS tumor presents with sensorineural hearing loss in their left ear. Which cranial nerve has been affected by the tumor?

1 point

Left cranial nerve VIII

Right cranial nerve VIII

Left cranial nerve IV

Right cranial nerve IV

Left cranial nerve XI

Right cranial nerve XI

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You are a fourth year medical student doing an elective in neurosurgery. You get to be second assist on Mr. Scwann who was found to have a frontal lobe glioblastoma. The plan is to aim for maximal surgical resection, followed by adjuvant radiation and adjuvant chemotherapy. After you have scrubbed in, your attending asks you if you know what the current standard for adjuvant chemotherapy is. You answer:

1 point

Temozolomide

Methotrexate

Cisplatin

Vincristine

Bleomycin

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