CNS Quiz For Pathology
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A baby with pupillar dilation, visual disturbances, difficulty breathing, and enlarged head is diagnosed with Dandy-Walker syndrome. What is underlying possible mechanism of his disease?
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Problem with arachnoid granulations
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Tumor
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Alzheimers
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Hemorrhage/inflammations
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B and D
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About This Quiz
This CNS pathology quiz focuses on diagnosing and understanding mechanisms behind various brain conditions, including Dandy-Walker syndrome, intracerebral hemorrhage, and aneurysms.
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- 2.
A pain is initially clear but later presents with headache, vomiting and seizures, later he has hypertension and bradycardia. He received a blow to the side of his head. What kind of vessel was involved?
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Bridging veins
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Middle meningeal artery
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Anterior communicating artery
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Posterior communicating artery
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Middle cerebral artery
Correct Answer
A. Middle meningeal arteryExplanation
The middle meningeal artery is involved in this scenario. The symptoms described, such as headache, vomiting, seizures, hypertension, and bradycardia, are consistent with a condition called an epidural hematoma. This occurs when there is bleeding between the skull and the outermost layer of the brain, known as the dura mater. The middle meningeal artery runs in this space and can be damaged by a blow to the side of the head, leading to bleeding and the subsequent symptoms.Rate this question:
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- 3.
Subdural hematomas involve _ veins.
Correct Answer
-bridging -communicating -vena cavasExplanation
Subdural hematomas involve bridging veins, which are small veins that connect the surface of the brain to larger veins within the skull. These veins are susceptible to injury and can rupture, leading to the accumulation of blood between the brain and its outer covering, the dura mater. Communicating veins also play a role in subdural hematomas by allowing blood to flow between different regions of the brain. Vena cavas, on the other hand, are large veins that carry deoxygenated blood from the body to the heart and are not directly involved in subdural hematomas.Rate this question:
- 4.
A patient with headache, contralateral weakness and seizers and eventally congnitive impairment is diagnosed to have Alzheimers. The type of condition most closely resembling his state would be?
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Hematoma
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Tumor
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Respiratory illness
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Sexually tansmitted disease
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Liver cirrhosis
Correct Answer
A. HematomaExplanation
The correct answer is hematoma. A hematoma is a collection of blood outside the blood vessels, usually caused by trauma or injury. In this case, the patient's symptoms of headache, contralateral weakness, seizures, and cognitive impairment are consistent with the effects of a hematoma on the brain. These symptoms are not typically associated with conditions such as tumor, respiratory illness, sexually transmitted disease, or liver cirrhosis.Rate this question:
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- 5.
The most common cause of intracerebral hemorrhage is associated with
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Tumors
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Cerebral amyloid angiopathy
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Liver failure
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High cholesterol
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B and D
Correct Answer
A. B and DExplanation
The most common cause of intracerebral hemorrhage is associated with cerebral amyloid angiopathy and high cholesterol. Cerebral amyloid angiopathy is a condition where amyloid protein deposits in the blood vessels of the brain, weakening them and making them prone to rupture. High cholesterol can lead to the formation of fatty plaques in the blood vessels, increasing the risk of rupture and bleeding. Both these factors contribute to the development of intracerebral hemorrhage. Tumors and liver failure can also cause bleeding in the brain, but they are not the most common causes.Rate this question:
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- 6.
A patient comes in with a sudden excruciating headache, or the worst headache of his life. His syndrome worsens while doing activities that increase intracranial pressure like straining while passing stool or having sex. The most common etiology of his condition is?
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Aneurysm
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Hypertension
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Necrosis
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Pnemonia
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Transtentorial herniation
Correct Answer
A. AneurysmExplanation
The correct answer is aneurysm. An aneurysm is a bulge or ballooning in a blood vessel, usually caused by a weak spot in the vessel wall. When an aneurysm ruptures, it can cause a sudden and severe headache, often described as the worst headache of one's life. The headache may worsen with activities that increase intracranial pressure, such as straining while passing stool or having sex. This is because increased pressure can further stress the weakened vessel wall, leading to rupture and bleeding. Hypertension (high blood pressure) can also contribute to the development and rupture of an aneurysm, but it is not the most common etiology in this scenario.Rate this question:
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- 7.
A patient with a recent viral infection complains of fever, headache, nausea and vomiting. Upon taking a CSF sample, it is determined that there is no bacterial present and the protein levels are elevated. Which of the following occurs with glucose levels if the patient were infected with E.Coli?
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Increase
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Decrease
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Stay the same
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Glucose levels are irrelevant to the case
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B or C
Correct Answer
A. DecreaseExplanation
If the patient were infected with E.Coli, the glucose levels in the CSF would decrease. This is because E.Coli is a bacteria that consumes glucose as a source of energy. As a result, the bacteria would utilize the glucose in the CSF, leading to a decrease in its levels. This decrease in glucose levels, along with the elevated protein levels, is indicative of a bacterial infection rather than a viral one.Rate this question:
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- 8.
A patient presents with symptoms indicative of increased intracranial pressure. Tests on his brain indicates a lesion with a center that has undergone liquifactive necrosis with a surrounding fibrous capsule. These does not seem to be any spread into the ventricles. What is the most common etiological agent of his disease?
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Streptococci
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Bacteroides fragilli
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Mycobacterium tuberculi.
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None of the above
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All of the above are equally common
Correct Answer
A. StreptococciExplanation
The most likely etiological agent in this case is Streptococci. The presence of a lesion with a center that has undergone liquifactive necrosis and a surrounding fibrous capsule suggests a chronic infection. Streptococci are known to cause chronic infections, including brain abscesses, which can lead to increased intracranial pressure. Bacteroides fragilis is more commonly associated with intra-abdominal infections, and Mycobacterium tuberculosis typically causes granulomatous inflammation rather than liquifactive necrosis. Therefore, Streptococci is the most probable cause in this scenario.Rate this question:
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- 9.
A patient with mental slowing, difficulty remembering things (abnormal memory), abnormal moods, apathy and depression, also complains of ataxia, bladder incontinence and seizures. CSF shows no bacteria, with increased levels of proteins and normal levels of glucose. What is a common feature of his disease?
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Microglia
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Neurophagia
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Multinucleate giant cell involvement
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Cowdry Type A inclusion bodies
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All but choice D
Correct Answer
A. All but choice DExplanation
The correct answer is "All but choice D." This means that all of the options mentioned (microglia, neurophagia, multinucleate giant cell involvement) are common features of the patient's disease, except for Cowdry Type A inclusion bodies. These features suggest a neurodegenerative disorder, possibly a viral encephalitis or multiple sclerosis. The absence of bacteria in the CSF, along with increased protein levels and normal glucose levels, further supports a non-infectious inflammatory process.Rate this question:
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- 10.
A 25 year old man with Chronic Myelogenous Leukemia is seen have many lesions in the white matter of his ceberellum, destructive in nature. He reports to have recently undergone an immunosuppresive therapy for his cancer. What is the etiological agent and a key histological feature of his disease?
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JC polyomavirus; enlarged oligodentrocytes
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HIV virus; multinucleate giant cells
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HSV virus; hemosiderin laden macrophages
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Ebola virus; no prominent histological feature observed
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HPV; Cowdry Type A inclusion bodies
Correct Answer
A. JC polyomavirus; enlarged oligodentrocytesExplanation
The correct answer is JC polyomavirus; enlarged oligodendrocytes. Chronic Myelogenous Leukemia (CML) is a type of cancer that affects the white blood cells. The presence of many lesions in the white matter of the cerebellum, along with the destructive nature of these lesions, suggests an opportunistic infection in an immunosuppressed individual. JC polyomavirus is known to cause progressive multifocal leukoencephalopathy (PML), a condition characterized by demyelination in the central nervous system. Enlarged oligodendrocytes are a key histological feature observed in PML caused by JC polyomavirus.Rate this question:
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- 11.
A patient presents with rapidly progressive dementia and myclonus. He reports to have had a corneal transplantation recently. Upon taking a sample of the brain tissue, the pathologist would most likely see:
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PrPs plaques and spongiform degeneration
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Hemosiderin and increased neutrophilic infiltration
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Liquifactive necrosis and abscesses
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One of the above
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A and C
Correct Answer
A. PrPs plaques and spongiform degenerationExplanation
The patient's symptoms of rapidly progressive dementia and myoclonus, along with the recent corneal transplantation, suggest a possible diagnosis of Creutzfeldt-Jakob disease (CJD). CJD is a rare, degenerative neurological disorder caused by abnormal proteins called prions (PrPs). The presence of PrPs plaques and spongiform degeneration in the brain tissue is characteristic of CJD. Therefore, the pathologist would most likely see PrPs plaques and spongiform degeneration in the brain tissue sample.Rate this question:
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- 12.
A 70 year old male is diagnosed with a brain tumor arising in the white matter. The tumor appears to be rapidly expanding, gray, and poorly defined. Microscopic examination of his brain revealed an increased number of glial cells appearing in a palisading manner. It is determined that the patient will only survive for a few months. A gross feature of this tumor would be:
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Butterfly appearance
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Spongiform appearance
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Liquifactive necrosis
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Increased gliosis
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Lymphocytic infiltration and lipid laden macrophages
Correct Answer
A. Butterfly appearanceExplanation
The correct answer is "butterfly appearance." A butterfly appearance refers to the shape of the tumor, which typically spans across the midline of the brain, resembling the wings of a butterfly. This is a characteristic feature of glioblastoma multiforme, a highly aggressive type of brain tumor that arises from the glial cells in the white matter. The rapid expansion, gray color, and poor definition mentioned in the question are consistent with the aggressive nature of glioblastoma multiforme. The increased number of glial cells arranged in a palisading manner is another characteristic histological feature of this tumor.Rate this question:
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- 13.
Spindle shaped astrocytes and prominent Rosenthial fibers are seen in _
Correct Answer
Juvenile Pilocytic Astrocytoma
Multiforme Glioblastoma
Fibrillary AstrocytomaExplanation
Spindle shaped astrocytes and prominent Rosenthal fibers are characteristic histopathological features seen in all three types of astrocytomas mentioned in the options. Juvenile Pilocytic Astrocytoma is a low-grade tumor commonly seen in children and young adults, Multiforme Glioblastoma is a high-grade malignant tumor with aggressive behavior, and Fibrillary Astrocytoma is an intermediate-grade tumor. These features help in distinguishing astrocytomas from other types of brain tumors.Rate this question:
- 14.
A 6 year old child is diagnosed with a tumor near the medulla region. There appears to be metastasis to the ventricles from the spinal cord. What is key microscopic feature of his tumor?
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Pseudorosettes
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True rosettes
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Lipid laden macrophages
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Glial cell proliferation
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Increased size of astrocytes
Correct Answer
A. PseudorosettesExplanation
Pseudorosettes refer to a histological pattern seen in certain tumors, where tumor cells surround a central structure, resembling a rosette-like arrangement. This pattern is commonly observed in tumors such as ependymomas, which can occur in the medulla region and spread to the ventricles. Therefore, the presence of pseudorosettes in the tumor suggests a diagnosis of ependymoma, which is consistent with the given clinical scenario.Rate this question:
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- 15.
A patient presents with focal neurological deficits with increased intracranial pressure, headaches and hyperostosis of overlying bone. The tumor has arised from meningothelial cells of the arachnoid matter. What are common features of the disease?
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Neurofibromatosis type 2 and psamomma bodies
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Neurofibromatosis type 1 and nuclear inclusions
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Owl's eye inclusions and cowdry type A inclusions
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Multinucleated giant cells and extensive fibrosis
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None of the above
Correct Answer
A. Neurofibromatosis type 2 and psamomma bodiesExplanation
The correct answer is Neurofibromatosis type 2 and psammoma bodies. This is because the patient is presenting with focal neurological deficits, increased intracranial pressure, headaches, and hyperostosis of overlying bone, which are common features of Neurofibromatosis type 2. Psammoma bodies are also commonly seen in tumors arising from meningothelial cells of the arachnoid matter.Rate this question:
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- 16.
A patient presents with unilateral vision loss, motor and sensory abnormalities, spasticity, improper conjugate eye movements. Upon examination of the brain, it is detected that there are gray plaques around the ventricles. Which of the following would most likely be elevated in his disease?
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Y globulins
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A globulins
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Neutrophils
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Calcium levels
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None of the above
Correct Answer
A. Y globulinsExplanation
The presence of gray plaques around the ventricles suggests that the patient may have multiple sclerosis (MS). MS is characterized by the destruction of myelin, the protective covering of nerve fibers in the central nervous system. Y globulins, also known as immunoglobulin G (IgG), are typically elevated in MS due to the immune response against myelin. Therefore, Y globulins would most likely be elevated in this patient's disease.Rate this question:
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- 17.
A patient was recently placed on a therapy that overcorrected his hyponatremia. Which of the followings diseases has a pathology most similar to his condition?
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Multiple sclerosis
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Leukodystrophies
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Pneumonia
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Astrocytoma
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Meningioma
Correct Answer
A. Multiple sclerosisExplanation
Multiple sclerosis is a chronic autoimmune disease that affects the central nervous system, specifically the brain and spinal cord. It is characterized by the destruction of the protective covering of nerve fibers, called myelin, leading to communication problems between the brain and the rest of the body. In the case of the patient with overcorrected hyponatremia, there may be damage to the nerves or disruption in the communication between the brain and other parts of the body, similar to the pathology seen in multiple sclerosis.Rate this question:
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- 18.
A 68 year old male presents with loss of memory, cognitive impairment and demential. It is discovered that there is an APP gene mutation associated with his condition. Which of the following is not a key feature of his disease?
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Ab deposition
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Tau proteins
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Senile plaques
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Hirano bodies
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None of the above
Correct Answer
A. None of the aboveExplanation
The given correct answer is "None of the above". This means that all of the options listed (Ab deposition, Tau proteins, Senile plaques, and Hirano bodies) are key features of the disease associated with the APP gene mutation. This suggests that all of these features are present in the patient's condition, indicating a likely diagnosis of Alzheimer's disease.Rate this question:
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- 19.
A patient presents with slowness of movement and muscular rigidity, coarse tremor of the distal extremities even at rest, expressionless face, reduced rate of swallowing, stooped posture, and dementia. Which of the following is not a feature of his disease?
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Loss of pigmentations
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Lewy bodies
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Viral encephalopathy as an etiological factor
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Oxidative stress induction
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Neurofibrillary tangles
Correct Answer
A. Neurofibrillary tanglesExplanation
The patient's symptoms, including slowness of movement, muscular rigidity, tremor, expressionless face, reduced swallowing, stooped posture, and dementia, are consistent with Parkinson's disease. Parkinson's disease is characterized by the presence of Lewy bodies, which are abnormal protein aggregates found in the brain. Loss of pigmentation, viral encephalopathy, and oxidative stress induction are all associated with Parkinson's disease. However, neurofibrillary tangles are not a feature of Parkinson's disease. Neurofibrillary tangles are typically associated with Alzheimer's disease, not Parkinson's disease.Rate this question:
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- 20.
A 40 year old male presents with involuntary movement of all parts of the body , cognitive function impairment, and severe emotional disturbance. Which parts of the brain are atrophied?
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Frontal
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Caudate
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Putamen
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Amygdala
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Three of the above
Correct Answer
A. Three of the aboveExplanation
The correct answer is three of the above (frontal, caudate, and putamen). The symptoms described in the question, including involuntary movement, cognitive function impairment, and severe emotional disturbance, are characteristic of Huntington's disease. This neurodegenerative disorder primarily affects the basal ganglia, which includes the caudate and putamen. Additionally, the frontal cortex is also commonly affected in Huntington's disease. The amygdala, although involved in emotional processing, is not specifically mentioned in the symptoms and may not be directly related to the atrophy seen in this condition.Rate this question:
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- 21.
A patient presents with truncal ataxia, unsteady gate and nystagmus. He has been a drinker for a while now. He distorted memory which he compensates for by confabulation. What histological feature is seen in his disorder?
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Degeneration of neurons in the medial dorsal nucleus of the thalamus
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Neurofibrillary tangles
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Excess accumulation of tau proteins
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Atrophy of the frontal caudate and putamen of the brain
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None of the above
Correct Answer
A. Degeneration of neurons in the medial dorsal nucleus of the thalamusExplanation
The correct answer is degeneration of neurons in the medial dorsal nucleus of the thalamus. Truncal ataxia, unsteady gait, and nystagmus are characteristic symptoms of Wernicke-Korsakoff syndrome, which is caused by thiamine deficiency due to chronic alcohol abuse. The degeneration of neurons in the medial dorsal nucleus of the thalamus is a key histological feature of this disorder. This degeneration disrupts the connections between the thalamus and other areas of the brain, leading to the symptoms observed in the patient.Rate this question:
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- 22.
A 6 year old child presents with a tumor that is gray and friable within the vermis of the medulla. Microscopically there appears to be small blue cells. His symptoms appear to be associated with cerebellar dysfunction. If untreated, what would be the most likely prognosis of his tumor?
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Poor
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Benign
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Undetermined
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Good because he is young
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None of the above
Correct Answer
A. PoorExplanation
Based on the given information, the child's tumor is located in the vermis of the medulla and is gray and friable. Microscopically, there are small blue cells present. Additionally, the child is experiencing symptoms associated with cerebellar dysfunction. These characteristics suggest that the tumor is likely malignant and aggressive, leading to a poor prognosis if left untreated.Rate this question:
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- 23.
A 50 year old male presents with hearing problems. The tumor appears to be slow growing with microcysts, myxoid material, and very few cells. Which of the following cells has a function similar to the cell of origin?
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Oligodendrocyte
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Osteclasts
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Osteoblasts
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Glial cells
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Macrophages
Correct Answer
A. OligodendrocyteExplanation
The correct answer is oligodendrocyte. Oligodendrocytes are a type of glial cell in the central nervous system that produce myelin, a substance that insulates and protects nerve fibers. The description of the tumor as slow growing with microcysts, myxoid material, and very few cells suggests a tumor of low cellularity, which is characteristic of oligodendrogliomas. Oligodendrogliomas are tumors that arise from oligodendrocytes and are typically slow growing with a similar appearance to the cells of origin. Therefore, the function of oligodendrocytes is similar to the cell of origin in this case.Rate this question:
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- 24.
An AIDs patient presents with increased intracranial pressure. He has difficulty seeing. Which cells are commonly seen in this tumor?
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B cells
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T cells
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Plasma cells
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Macrophages
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None of the above
Correct Answer
A. B cellsExplanation
In this case, the correct answer is B cells. B cells are commonly seen in lymphomas, which can occur in patients with AIDS. Increased intracranial pressure and difficulty seeing are symptoms commonly associated with lymphomas involving the central nervous system. B cells are a type of white blood cell that play a crucial role in the immune response, and their abnormal growth can lead to the development of tumors.Rate this question:
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- 25.
A patient presents with weakness and wasting of his muscles. He drops objects easily and also experiences spasticity and fasciculations.His lesion involves a loss of upper motor neurons. What is the most common of death in these patients?
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Pulmonary infections
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Fractures
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Dementia
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Visual impairment
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Wasting of the muscles
Correct Answer
A. Pulmonary infectionsExplanation
Patients with a loss of upper motor neurons often develop weakness and wasting of muscles, as well as other symptoms such as spasticity and fasciculations. These patients are at a higher risk of developing pulmonary infections due to impaired cough reflex and difficulty with clearing secretions. The weakness and wasting of respiratory muscles can lead to ineffective cough and impaired clearance of secretions, increasing the risk of pneumonia and other pulmonary infections. Therefore, pulmonary infections are the most common cause of death in these patients.Rate this question:
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Mar 22, 2023Quiz Edited by
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Jun 15, 2009Quiz Created by
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