9 / 99
T
reatment
of
medulloblastoma
in
children
and
adolescents
R
ev
A
ssoc
M
ed
B
ras
2016; 62(4):297
297
B
ernardo
WM
et
al
.
F
elipe
-S
ilva
A
ACCREDITATION
Treatment of medulloblastoma in children and adolescents
T
ratamento
do meduloblastoma
em
crianças
e
adolescentes
N
elci
Z
anon
C
ollange
1
, S
ilvana
de
A
zevedo
B
rito
1
, R
icardo
R
ezende
C
ampos
1
, E
gmond
A
lves
S
ilva
S
antos
1
,
R
icardo
V
ieira
B
otelho
1
1
Sociedade Brasileira de Neurocirurgia
http://dx.doi.org/10.1590/1806-9282.62.04.2971. Medulloblastoma in children should consider:
a.
Medulloblastoma can be cured if diagnosed early.
b.
Prognosis for medulloblastoma depends on the se-
verity of hydrocephalus, size of the tumor, and wheth-
er there is brain-stem invasion.
c.
The age of onset of medulloblastoma has no relation
to the prognosis.
d.
Medulloblastoma should be considered a serious ill-
ness in children.
2. Surgical resection:
a.
Does not change the prognosis.
b.
Can be performed for biopsy alone, since treatment
is chemotherapy.
c.
Complete resection should be attempted if possible
as it improves the prognosis.
d.
Resection of brain-stem tumor should be avoided.
3. On the effect of tumor resection for the resolu-
tion of hydrocephalus:
a.
All patients require ventricular shunt.
b.
All patients require external ventricular shunt during
resection.
c.
Most patients achieve resolution of hydrocephalus
after tumor removal.
d.
Hydrocephalus resolves after chemotherapy.
4. Radiotherapy associated with the treatment of me-
dulloblastoma:
a.
Should not be performed; only chemotherapy is in-
dicated.
b.
Should be avoided in children under 3 years old.
c.
Should be performed on the skull and spine.
d.
Should be performed only in the skull.
e.
Two of the above conditions are true.
5. On the disease-free interval after treatment:
a.
The approximate disease-free survival at 5 years is 50%.
b.
Tumor recurrence, if any, occurs after 15 years of
treatment.
c.
The presence of brain-stem invasion is related to the
prognosis.
d.
Patients with hydrocephalus have a shorter tumor-
free period following surgery.
A
nswers
to
clinical
scenario
: U
pdate
on
Z
ika
virus
infection
in
pregnancy
[
published
in
RAMB 2016; 62(2)]
1. Which factors may be related to the substantial
increase in the number of cases of microcephaly
in Brazil?
Increased active search for this congenital malforma-
tion, and change in diagnostic criteria. (Alternatives
A
and
C
)
2. What is the clinical and laboratory method indi-
cated (sensitivity and specificity) to confirm Zika
virus infection within a week of the onset of symp-
toms?
Real-time polymerase chain reaction (RT-PCR). (Al-
ternative
D
)
3. Regarding symptoms in pregnant women with
suspected Zika virus infection, we know that:
Most are asymptomatic but they can manifest fever,
rash and fatigue. (Alternatives
A
and
C
)
4. What treatments are recommended for people in-
fected with Zika virus?
Hydration, rest and non-salicylic analgesic drugs. (Al-
ternative
C
)
5. Regarding pregnant women diagnosed with Zika
virus infection, we know that:
Fetal ultrasounds must be done in series every 3 to 4
weeks, and the newborn should receive complete phys-
ical examination with ophthalmologic assessment.
(Alternative
B
)