Neurological & Oncological Disorders – Exam Review

120 vocabulary flashcards covering pathophysiology, clinical features, diagnostics, and treatments of cerebral palsy, multiple sclerosis, hydrocephalus, Parkinson’s disease, lung cancer, colon cancer, brain cancer, leukemia, lymphoma, and general oncology concepts.

Cerebral Palsy (CP)

A group of permanent motor-function disorders caused by non-progressive injury to the developing fetal or infant brain.

CP Pathophysiology

Prenatal, perinatal, or postnatal brain insult leads to abnormal brain development or injury to motor control centers, resulting in impaired movement and posture.

Spastic Cerebral Palsy

Most common CP type; characterized by hypertonia, hyperreflexia, and stiff, jerky movements due to upper motor-neuron injury.

Ataxic Cerebral Palsy

CP type with impaired balance and depth perception, wide-based gait, intention tremor, and difficulty with fine motor tasks.

CP Characteristic Gait

Scissor-like, toe-walking, or crouched gait produced by spasticity of hip adductors and gastrocnemius muscles.

CP Spasticity Medications

Drug classes (e.g., centrally acting muscle relaxants, antispasmodics, botulinum toxin) used to diminish excessive muscle tone.

Baclofen

GABA-B agonist used orally or intrathecally to reduce spasticity in cerebral palsy.

Diazepam (for CP)

A benzodiazepine prescribed short-term to relieve muscle spasms and anxiety in CP patients.

CP Prevalence by Gender

Slightly higher incidence in males than females worldwide.

CP Early Signs

Poor head control, delayed milestones, persistent primitive reflexes, and stiff or floppy extremities in infancy.

Multiple Sclerosis (MS)

Autoimmune demyelinating disease of the central nervous system leading to episodic neurologic deficits.

MS Pathophysiology

Immune-mediated destruction of oligodendrocytes causes myelin loss and axonal damage in brain and spinal cord.

Demyelination

Loss of the myelin sheath surrounding neurons, leading to slowed or blocked nerve conduction.

MS Plaques on MRI

T2-weighted hyperintense lesions (sclerotic plaques) typically seen in periventricular white matter.

Relapsing-Remitting MS

Most common MS form; episodes of neurologic dysfunction followed by partial or complete recovery.

Clinically Isolated Syndrome (CIS)

First isolated neurologic episode suggestive of MS, lasting ≥24 h, not yet fulfilling full diagnostic criteria.

Secondary Progressive MS

Initial relapsing course followed by steady neurologic decline with or without occasional relapses.

Primary Progressive MS

Steady functional decline from onset without distinct relapses or remissions.

Early MS Symptoms

Optic neuritis, sensory disturbances (paresthesias), Lhermitte sign, and fatigue.

Late MS Symptoms

Spasticity, ataxia, bowel/bladder dysfunction, cognitive impairment, and immobility.

Disease-Modifying Therapy (DMT)

Medications aimed at reducing MS relapse rate and slowing disability progression.

DMT Common Suffix “-mab”

Many monoclonal antibody DMTs (e.g., natalizumab, ocrelizumab) share the suffix “-mab.”

Interferon Beta

First-line DMT that modulates immune response to decrease MS relapse frequency.

Glatiramer Acetate

Synthetic polypeptide that mimics myelin basic protein, shifting immune response toward anti-inflammatory TH2 cells.

MS Exacerbation Trigger

Infections, heat, stress, or postpartum period can precipitate an MS relapse.

Hydrocephalus

Abnormal accumulation of cerebrospinal fluid (CSF) in cerebral ventricles causing ventricular dilation and raised ICP.

Hydrocephalus Pathophysiology

Imbalance between CSF production and absorption or obstruction to flow leads to ventricular enlargement.

Non-communicating Hydrocephalus Cause

Obstruction of CSF flow within ventricular system (e.g., aqueductal stenosis, tumor).

Communicating Hydrocephalus Cause

Impaired CSF reabsorption at arachnoid villi, often from meningitis or subarachnoid hemorrhage.

Infant Head Circumference Assessment

Serial measurements detect rapid head growth, a key sign of hydrocephalus in infants.

Bulging Fontanel

Tense anterior fontanel indicating increased intracranial pressure in infants with hydrocephalus.

Sunset Eyes

Inferior deviation of eyes from pressure on periaqueductal structures; classic hydrocephalus sign.

Ventriculoperitoneal (VP) Shunt

Surgical diversion of CSF from ventricles to peritoneal cavity to treat hydrocephalus.

Shunt Infection

Fever, irritability, and abdominal pain; most common serious VP shunt complication.

Shunt Malfunction (Obstruction)

Blockage of catheter causing return of hydrocephalus symptoms and increased ICP.

Parkinson’s Disease

Progressive neurodegenerative disorder characterized by bradykinesia, rigidity, tremor, and postural instability.

Parkinson’s Risk Factors

Advancing age, male sex, pesticide exposure, and family history increase disease likelihood.

Alpha-Synuclein

Misfolded neuronal protein forming Lewy bodies, a neuropathologic hallmark of Parkinson’s disease.

Dopamine Deficiency

Loss of dopaminergic neurons in substantia nigra reduces dopamine levels, impairing motor control.

Basal Ganglia Dysfunction

Imbalance of dopamine and acetylcholine disrupts basal ganglia circuits, producing Parkinsonian symptoms.

Resting Tremor

Rhythmic pill-rolling movement of hands that diminishes with voluntary activity in Parkinson’s disease.

Bradykinesia

Slowness of movement and reduced spontaneous activity, a core Parkinsonian feature.

Cogwheel Rigidity

Jerky resistance felt during passive limb movement due to rhythmic muscle contraction.

Postural Instability

Impaired reflexes leading to stooped posture and falls in Parkinson’s disease.

Festinating Gait

Short, shuffling steps with forward trunk lean seen in Parkinson’s patients.

Levodopa/Carbidopa

Dopamine precursor combined with decarboxylase inhibitor; gold-standard symptomatic therapy for Parkinson’s.

Levodopa Challenge Test

Improvement after a trial dose supports Parkinson’s diagnosis when imaging is inconclusive.

Lung Cancer

Malignant tumor originating in respiratory epithelium; leading cause of cancer death worldwide.

Non-Small Cell Lung Cancer (NSCLC)

Represents ~85% of lung cancers; includes squamous cell, adenocarcinoma, and large-cell carcinoma.

Small Cell Lung Cancer (SCLC)

Highly aggressive neuroendocrine carcinoma with early metastasis and frequent paraneoplastic syndromes.

NSCLC Subtype: Squamous Cell Carcinoma

Smoking-related tumor arising centrally in bronchial epithelium.

NSCLC Subtype: Adenocarcinoma

Most common lung cancer in nonsmokers; originates peripherally from glandular cells.

Squamous Cell Carcinoma Location

Typically found in proximal bronchi near hilum of lung.

Adenocarcinoma Location

Usually located in peripheral lung fields and bronchioles.

Environmental Risk: Radon Gas

Radioactive gas seeping from soil; second-leading environmental cause of lung cancer.

Environmental Risk: Asbestos Exposure

Inhalation of asbestos fibers increases risk for lung cancer and mesothelioma.

Non-Environmental Risk: Genetic Predisposition

Inherited polymorphisms in DNA repair genes elevate lung cancer risk independent of environment.

Early Lung Cancer Symptom: Persistent Cough

Chronic cough that does not resolve with usual treatment may indicate early lung malignancy.

Paraneoplastic Syndrome (SIADH in SCLC)

Ectopic hormone production (e.g., ADH) by tumor causing systemic effects like hyponatremia.

Colorectal (Colon) Cancer

Malignancy of large intestine mucosa, often arising from adenomatous polyps.

Colon Cancer Risk Factor: Low-Fiber Diet

Diets high in red meat and low in fiber increase carcinogen contact time with colonic mucosa.

Colon Cancer Risk Factor: Family History

First-degree relative with CRC doubles personal risk; linked to hereditary syndromes (FAP, HNPCC).

Precancerous Adenomatous Polyp

Benign glandular lesion that may undergo dysplasia and progress to carcinoma over years.

Occult Gastrointestinal Bleeding

Microscopic blood loss in stool; common initial finding in colorectal cancer.

Iron-Deficiency Anemia from GI Bleed

Chronic blood loss reduces iron stores, causing fatigue and pallor in CRC patients.

Tenesmus

Sensation of incomplete rectal evacuation despite empty bowel; symptom of distal colon cancer.

Change in Bowel Habits

Alternating constipation and diarrhea or narrowing of stools suggest luminal obstruction.

Metastatic Colon Cancer Symptom: Hepatomegaly

Enlarged, tender liver indicates spread via portal circulation to hepatic tissue.

Colonoscopy Screening

Endoscopic examination recommended every 10 years starting at age 45-50 for average risk.

Carcinoembryonic Antigen (CEA)

Tumor marker used to monitor treatment response and recurrence in colon cancer.

Right-Sided Colon Cancer Symptom: Melena

Black, tarry stools from occult bleeding typical of proximal colon tumors.

Primary Brain Tumor

Neoplasm originating from brain parenchyma, meninges, or glial cells.

Secondary (Metastatic) Brain Tumor

Intracranial lesion arising from systemic cancer spread (e.g., lung, breast, melanoma).

Most Common Primary Brain Cancer: Glioblastoma Multiforme

High-grade astrocytoma characterized by rapid growth, necrosis, and poor prognosis.

Early Brain Tumor Symptom: Headache

Worse in morning or with Valsalva due to raised intracranial pressure.

Seizures in Brain Tumor

Irritation of cortical neurons by mass lesion precipitates focal or generalized seizures.

Papilledema

Optic disc swelling from increased ICP, visible on fundoscopic exam in brain tumors.

Increased Intracranial Pressure (ICP)

Elevated pressure within skull causing nausea, vomiting, and altered consciousness.

Brain Tumor Focal Neurological Deficit

Localized weakness, aphasia, or visual field loss depending on lesion site.

Leukemia

Malignant proliferation of immature or mature white blood cells in bone marrow and blood.

Leukemia Pathophysiology

Genetic mutations lead to uncontrolled clonal expansion of leukocytes, impairing normal hematopoiesis.

Blast Cells

Immature precursor white cells that accumulate excessively in acute leukemias.

Bone Marrow Crowding

Overgrowth of malignant cells suppresses production of red cells, platelets, and functional leukocytes.

Acute Myeloid Leukemia (AML)

Rapid-progressing cancer of myeloid lineage common in adults; characterized by ≥20% myeloblasts.

Chronic Lymphocytic Leukemia (CLL)

Slow-growing proliferation of mature but dysfunctional B lymphocytes, typical in older adults.

Pancytopenia

Reduction of all blood cell lines causing anemia, infection risk, and bleeding tendency in leukemia.

Leukemia Symptom: Frequent Infections

Neutropenia and dysfunctional white cells predispose to recurrent bacterial or fungal infections.

Leukemia Symptom: Fatigue

Anemia from marrow failure produces weakness and decreased exercise tolerance.

Bone Pain in Leukemia

Expanding marrow cavity causes aching pain in long bones and sternum.

Diagnostic Test: Bone Marrow Biopsy

Aspiration and histologic examination confirm leukemia type and blast percentage.

Posterior Iliac Crest Biopsy Site

Preferred location for bone marrow aspiration due to easy access and safety.

Splenomegaly in Leukemia

Enlarged spleen caused by infiltration of malignant cells and increased hematopoietic activity.

Tumor Lysis Syndrome Risk

Rapid cell breakdown releases uric acid, potassium, and phosphate during leukemia treatment.

Philadelphia Chromosome

t(9;22) translocation creating BCR-ABL fusion gene associated with CML and some ALL cases.

Hyperleukocytosis

Very high WBC count (>100 × 10⁹/L) causing leukostasis and microvascular occlusion.

Lymphoma

Malignancy of lymphocytes within lymph nodes or extranodal tissues.

Hodgkin Lymphoma (HL)

B-cell neoplasm characterized by Reed-Sternberg cells and predictable nodal spread.

Non-Hodgkin Lymphoma (NHL)

Heterogeneous group of B- or T-cell malignancies with variable aggressiveness.

Reed-Sternberg Cell

Large binucleated cell with owl-eye nuclei pathognomonic for Hodgkin lymphoma.

B-Cell Origin

Most lymphomas, especially HL and many NHL subtypes, arise from B lymphocytes.