new_n_lost
Politically InCorrect
Topics: 653
Posts: 6,086
|
But with a logical answer..... So think and also PLEASE explain your answers.
A 3-year-old boy is brought to the emergency department after the acute onset of headache, vomiting, nuchal rigidity, and impaired mental status. MRI reveals a posterior fossa tumor that fills the 4th ventricle. Surgery is immediately started, and intraoperative consultation leads to a "frozen section" diagnosis of medulloblastoma.
Which of the following pathologic mechanisms most likely accounts for this child's clinical presentation?
A. Acute hemorrhage into the 4th ventricle
B. Alteration of medullary function
C. Increased intracranial pressure
D. Infiltration of the cerebellar vermis by the neoplasm
E. Spread of tumor to the subarachnoid space
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| doc179
Forum Guru
Topics: 67
Posts: 1,217
|
C
|
| hope4dabest
Forum Elite
Topics: 16
Posts: 433
|
C..Medulloblastoma's compress 4th ventricle and can cause hydrocephalus
|
| doc179
Forum Guru
Topics: 67
Posts: 1,217
|
Oh ! sorry...I just realised that I was supposed to explain my answer.
The symptoms presented are associated with any disease that might increase the intracranial pressure and this tumor which fills the 4 th ventricle is definitely blocking the flow and drainage of CSF and hence increasing the intracranial pressure.
|
| keepgoing
Forum Guru
Topics: 63
Posts: 1,682
|
yes C explanation as above  ,let us know if differ!
|
| silver
Forum Guru
Topics: 21
Posts: 774
|
i don't like neuro  
___________________
Every disaster hides an opportunity.
|
| Ujk
Forum Guru
Topics: 42
Posts: 446
|
Could it be A? Since it is a tricky question with acute findings!
___________________
“When a person really desires something, all the universe conspires to help that person to realize his dream.”
|
| jean robert
Forum Guru
Topics: 162
Posts: 669
|
C
Medulloblastoma in the fourth ventricle.... block CSF circulation...... Increased intracranial pressure .........symptom of meningeal irritation.
___________________
Great works are performed not by strength, but by perseverance.
|
| new_n_lost
Politically InCorrect
Topics: 653
Posts: 6,086
|
doc179 wrote:
Oh ! sorry...I just realised that I was supposed to explain my answer.
The symptoms presented are associated with any disease that might increase the intracranial pressure and this tumor which fills the 4 th ventricle is definitely blocking the flow and drainage of CSF and hence increasing the intracranial pressure.
Good to see you back in the forum 
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| new_n_lost
Politically InCorrect
Topics: 653
Posts: 6,086
|
The correct answer is C.
Any tumor "filling the 4th ventricle" blocks the circulation of cerebrospinal fluid (CSF). This blockage leads to increased intracranial pressure, which manifests with nausea, vomiting, headache, nuchal rigidity, and mental status changes. If surgery is not performed promptly, cerebellar tonsillar herniation and rapid death will ensue. In children, medulloblastoma and ependymoma are the most frequent neoplasms presenting in this manner.
There is no evidence in this case suggesting that acute hemorrhage into the 4th ventricular cavity (choice A) has occurred, nor is medulloblastoma typically associated with this complication. CNS tumors that frequently bleed are metastases from melanoma, renal cell carcinoma, and choriocarcinoma.
Alterations in medullary function (choice B) lead to cardiorespiratory instability and may be caused by direct tumor compression or infiltration of the medulla, neither of which is supported by MRI findings in this case.
Infiltration of the cerebellar vermis (choice D) is certainly seen in many cases of medulloblastoma, a tumor that arises from this midline cerebellar structure. However, this would lead to truncal ataxia and gait instability, not symptoms of increased intracranial pressure.
Medulloblastoma characteristically spreads to the subarachnoid space (choice E), from which the neoplasm may metastasize to distant sites such as spinal cord. Plaques of medulloblastoma are often found on the cerebellar surface, creating a characteristic sugar coating, but this would not cause any significant blockage of CSF circulation.
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| doc179
Forum Guru
Topics: 67
Posts: 1,217
|
Thanx NNL its very encouraging to be here. Its always been a pleasure studying with you. Good luck
|
|
| |
| | | | | | | | | | | |
