CNS 2 Patho PDF

What organism is primarily responsible for chronic meningitis? A) Escherichia coli B) Mycobacterium tuberculosis C) Streptococcus pneumoniae D) Neisseria meningitidis E) Listeria monocytogenes; B) Mycobacterium tuberculosis Explanation: Mycobacterium tuberculosis is the primary organism respon...

What organism is primarily responsible for chronic meningitis? A) Escherichia coli B) Mycobacterium tuberculosis C) Streptococcus pneumoniae D) Neisseria meningitidis E) Listeria monocytogenes; B) Mycobacterium tuberculosis Explanation: Mycobacterium tuberculosis is the primary organism responsible for chronic meningitis, distinguishing it from other bacterial causes of meningitis. What is a key morphological feature of chronic meningitis? A) Fluid-filled cysts B) Mucosal edema C) Acute inflammatory cells D) Fibrinous exudate in subarachnoid space E) Granulomas; D) Fibrinous exudate in subarachnoid space Explanation: A key morphological feature of chronic meningitis is the presence of fibrinous exudate in the subarachnoid space, which is indicative of the chronic inflammatory process. What is characterized by obliterans in chronic meningitis? A) Subarachnoid hemorrhage B) Endarteritis C) Cerebral edema D) Ependymitis E) Meningeal fibrosis; B) Endarteritis Explanation: Endarteritis is characterized by obliterans in chronic meningitis, which refers to the inflammation of the arterial walls leading to narrowing or blockage. What type of cells are primarily present in the CSF during chronic meningitis? A) Lymphocytes with occasional neutrophils B) Eosinophils C) Plasma cells D) Basophils E) Monocytes; A) Lymphocytes with occasional neutrophils Explanation: The CSF in chronic meningitis typically shows a predominance of lymphocytes with occasional neutrophils, reflecting the chronic nature of the infection. Which of the following is a complication of chronic meningitis? A) Cerebral swelling B) Meningeal hemorrhage C) Acute ischemic stroke D) Hydrocephalus E) Brain abscess; D) Hydrocephalus Explanation: Hydrocephalus is a known complication of chronic meningitis, resulting from the obstruction of cerebrospinal fluid pathways due to inflammation. What describes the microscopic findings in viral encephalitis? A) Granulomatous lesions B) Perivascular and parenchymal cell infiltrates C) Coagulative necrosis D) Vascular thrombi E) Fibrinous exudate; B) Perivascular and parenchymal cell infiltrates Explanation: Microscopic findings in viral encephalitis typically include perivascular and parenchymal cell infiltrates, indicating the immune response to viral infection. How is poliomyelitis primarily transmitted? A) Fecal-oral route B) Airborne droplets C) Contaminated water D) Direct skin contact E) Blood transfusion; A) Fecal-oral route Explanation: Poliomyelitis is primarily transmitted through the fecal-oral route, which involves the ingestion of the virus from contaminated food or water, making it a significant public health concern. What effect does poliomyelitis have on motor neurons? A) Loss of anterior horn cells B) Enlargement of brainstem nuclei C) Activation of oligodendrocytes D) Hyperplasia of glial cells E) Degeneration of sensory neurons; A) Loss of anterior horn cells Explanation: Poliomyelitis leads to the loss of anterior horn cells in the spinal cord, which are crucial for motor function, resulting in muscle weakness and paralysis. Which symptom can result from poliomyelitis? A) Flaccid paralysis B) Spastic paralysis C) Sensory neuron degeneration D) Cognitive impairment E) Seizures; A) Flaccid paralysis Explanation: One of the hallmark symptoms of poliomyelitis is flaccid paralysis, which occurs due to the destruction of motor neurons, leading to weakness and loss of muscle tone. What is a key transmission method for rabies? A) Airborne transmission B) Vector-borne through fleas C) Found in the saliva of a rabid animal D) Water contamination E) Blood transfusion; C) Found in the saliva of a rabid animal Explanation: Rabies is primarily transmitted through the saliva of infected animals, often via bites, making it crucial to avoid contact with potentially rabid animals. What is a characteristic finding in rabies infection? A) Negri bodies in neurons B) Amyloid plaques C) Lipofuscin granules D) Neurofibrillary tangles E) Lewy bodies; A) Negri bodies in neurons Explanation: Negri bodies are characteristic cytoplasmic inclusions found in neurons of individuals infected with rabies, serving as a diagnostic marker for the disease. What major brain areas does rabies affect? A) Cerebellum and brainstem B) Thalamus and hippocampus C) Medulla and pons D) Cerebral cortex and basal ganglia E) Occipital lobe and temporal lobe; D) Cerebral cortex and basal ganglia Explanation: Rabies primarily affects the cerebral cortex and basal ganglia, leading to neurological symptoms and behavioral changes associated with the disease. What can rabies lead to as a fatal outcome? A) Severe headache B) Respiratory paralysis C) Cerebral edema D) Multiple seizures E) Nausea; B) Respiratory paralysis Explanation: Rabies can lead to respiratory paralysis, which is a critical and often fatal outcome of the disease, affecting the respiratory muscles and leading to respiratory failure. What is a major cause of increased intracranial tension? A) Decreased blood flow to the brain B) Low levels of oxygen in the blood C) Excess cerebrospinal fluid (CSF) accumulation D) Infection in the spinal cord E) High blood pressure; C) Excess cerebrospinal fluid (CSF) accumulation Explanation: Excess accumulation of cerebrospinal fluid (CSF) is a primary cause of increased intracranial tension, leading to pressure on brain structures. Which factor contributes to cerebral edema? A) Dehydration of brain cells B) Decrease in cerebrospinal fluid C) Increased blood viscosity D) Swelling of brain tissue E) Low blood pressure; D) Swelling of brain tissue Explanation: Swelling of brain tissue is a key factor that contributes to cerebral edema, resulting in increased pressure within the skull. What is a common space-occupying lesion causing increased intracranial pressure? A) Tumors displacing brain tissue B) Cysts causing fluid loss C) Thrombus blocking blood vessels D) Scarring from previous infections E) Hemorrhage; A) Tumors displacing brain tissue Explanation: Tumors that displace brain tissue are common space-occupying lesions that can lead to increased intracranial pressure, affecting brain function. What effect can increased intracranial tension have on the brain? A) Expansion of brain cells B) Increase in cognitive function C) Decreased blood supply D) Compression of brain structures E) Enhanced neural activity; D) Compression of brain structures Explanation: Increased intracranial tension can lead to compression of brain structures, which can impair brain function and lead to serious neurological consequences. What defines a stroke? A) Gradual decline in cognitive abilities B) Sudden disturbance of central nervous system function C) Insidious onset of headaches D) Recurrent seizures without warning E) Temporary loss of vision; B) Sudden disturbance of central nervous system function Explanation: A stroke is defined as a sudden disturbance of central nervous system function, which can result from various causes, including blood flow obstruction or hemorrhage. What is the primary risk factor for stroke associated with increased blood vessel obstacles? A) Excessive hydration B) Atherosclerosis leading to reduced blood flow C) Low cholesterol diet D) Frequent exercise E) High fiber intake; B) Atherosclerosis leading to reduced blood flow Explanation: Atherosclerosis is a condition where arteries become narrowed due to plaque buildup, which significantly reduces blood flow and increases the risk of stroke. How does thrombosis contribute to stroke risk? A) By enhancing oxygen delivery B) By dilating blood vessels C) By reducing blood viscosity D) By obstructing blood flow in vessels E) By increasing heart rate; D) By obstructing blood flow in vessels Explanation: Thrombosis involves the formation of a blood clot that obstructs blood flow in vessels, which can lead to a stroke by preventing adequate blood supply to the brain. What condition frequently leads to infarction during a stroke? A) Overactive neurotransmitter release B) Increased cranial pressure C) Interruption of blood supply D) Excess cerebrospinal fluid retention E) High blood sugar levels; C) Interruption of blood supply Explanation: Infarction during a stroke is primarily caused by the interruption of blood supply to a part of the brain, leading to tissue damage and loss of function. What role does hypertension play in cerebrovascular disease? A) Enhancing blood flow efficiency B) Promoting tissue growth C) Damaging blood vessels and increasing stroke risk D) Reducing inflammation in the vessel walls E) Improving oxygen delivery; C) Damaging blood vessels and increasing stroke risk Explanation: Hypertension can cause damage to blood vessels, making them more susceptible to rupture or blockage, which significantly increases the risk of stroke. What can micro-aneurysms lead to if they rupture? A) Reduced cerebrospinal fluid pressure B) Enlarged brain tissue C) Cognitive deficits D) Bleeding within the brain E) Increased heart rate; D) Bleeding within the brain Explanation: If micro-aneurysms rupture, they can cause bleeding within the brain, which is a serious condition that can lead to stroke and other complications. Where can hemorrhage occur in the context of strokes? A) Exclusively inside the spinal cord B) Only within the skull base C) Intracerebrally or subarachnoid D) In the peripheral nervous system E) Only in the brainstem; C) Intracerebrally or subarachnoid Explanation: Hemorrhage in the context of strokes can occur either intracerebrally (within the brain) or in the subarachnoid space, both of which can have severe consequences. What is a common source of pyogenic bacterial infections for brain abscesses? A) Meningitis (bacterial) B) Encephalitis (viral) C) Tuberculosis (mycobacterial) D) Sinusitis (frontal) E) Viral infections; D) Sinusitis (frontal) Explanation: Sinusitis, particularly frontal sinusitis, is a common source of pyogenic bacterial infections that can lead to brain abscesses, highlighting its role in the pathogenesis of such infections. What type of brain tissue change is observed in brain abscess morphology? A) Atrophy of neurons B) Development of scar tissue C) Hyperplasia of glial cells D) Edematous surrounding tissue E) Necrosis of all brain tissue; D) Edematous surrounding tissue Explanation: In brain abscess morphology, edematous surrounding tissue is a characteristic change, indicating inflammation and swelling around the abscess. Which type of abscess wall is distinctly necrotic? A) Chronic abscess wall B) Acute abscess wall C) Normal brain wall D) Cystic abscess wall E) Fibrous abscess wall; B) Acute abscess wall Explanation: The acute abscess wall is distinctly necrotic, which is a key feature that differentiates it from other types of abscess walls. Which degenerative disease primarily affects the cerebral cortex? A) Multiple sclerosis B) Amyotrophic lateral sclerosis C) Alzheimer disease D) Cerebral palsy E) Huntington's disease; C) Alzheimer disease Explanation: Alzheimer disease primarily affects the cerebral cortex, leading to cognitive decline and memory loss, which are hallmark symptoms of this condition. Which degenerative disease affects the basal ganglia? A) Alzheimer disease B) Friedreich's ataxia C) Dementia pugilistica D) Parkinson disease E) Multiple sclerosis; D) Parkinson disease Explanation: Parkinson disease is known to primarily affect the basal ganglia, leading to motor symptoms such as tremors and rigidity. What characterizes the morphology of Alzheimer disease? A) Development of tumors in the cortex B) Thickening of the cerebral cortex C) Cortical atrophy with widened sulci D) Increased vascularization of the cortex E) Hyperplasia of neurons; C) Cortical atrophy with widened sulci Explanation: The morphology of Alzheimer disease is characterized by cortical atrophy with widened sulci, which reflects the loss of neurons and overall brain volume. What are neuritic plaques primarily composed of? A) Neurofilaments and lipids B) Calcium deposits and proteins C) Dopamine and nitrates D) AB amyloid surrounded by neurites E) Myelin and neurotransmitters; D) AB amyloid surrounded by neurites Explanation: Neuritic plaques are primarily composed of AB amyloid, which is surrounded by neurites, and are a hallmark of neurodegenerative diseases such as Alzheimer's. Where are neurofibrillary tangles typically found? A) In the extracellular matrix B) Within the myelin sheath C) In the blood-brain barrier D) Cytoplasm of neurons E) In the synaptic cleft; D) Cytoplasm of neurons Explanation: Neurofibrillary tangles are typically found in the cytoplasm of neurons and are associated with various neurodegenerative diseases, particularly Alzheimer's disease. Which disease is an example of spino-cerebellar degeneration? A) Amyotrophic lateral sclerosis B) Huntington disease C) Friedreich's ataxia D) Multiple sclerosis E) Parkinson's disease; C) Friedreich's ataxia Explanation: Friedreich's ataxia is a well-known example of spino-cerebellar degeneration, characterized by degeneration of the spinal cord and cerebellum. What potential complication do brain abscesses have? A) Formation of benign tumors B) Spread of infection C) Decreased blood flow to the area D) Complete recovery without treatment E) Increased intracranial pressure; B) Spread of infection Explanation: One of the significant complications of brain abscesses is the potential for the spread of infection, which can lead to more severe neurological issues. What is a common type of primary CNS tumor? A) Melanoma B) Meningioma C) Leukemia D) Astrocytoma E) Lymphoma; B) Meningioma Explanation: Meningioma is a common type of primary CNS tumor that arises from the meninges, the protective layers surrounding the brain and spinal cord. Which tumor is classified under glial tumors? A) Ganglioneuroma B) Neurofibroma C) Oligodendroglioma D) Hemangioma E) Meningioma; C) Oligodendroglioma Explanation: Oligodendroglioma is classified as a glial tumor, originating from oligodendrocytes, which are a type of glial cell in the CNS. What type of neuron-derived tumor is neuroblastoma? A) Neuronal tumor B) Vascular tumor C) Meningeal tumor D) Embryonic tumor E) Connective tissue tumor; A) Neuronal tumor Explanation: Neuroblastoma is classified as a neuronal tumor, originating from neural crest cells, which are precursors to neurons. What is a characteristic of nerve sheath tumors? A) They only appear in children. B) They include schwannoma and neurofibroma. C) They are always malignant. D) They are derived from blood vessels. E) They are exclusively benign.; B) They include schwannoma and neurofibroma. Explanation: Nerve sheath tumors encompass schwannomas and neurofibromas, which are derived from the cells that form the protective sheath around nerves. Which is NOT a type of choroid plexus tumor? A) Adenoma B) Carcinoma C) Melanoma D) Medulloblastoma E) Papilloma; C) Melanoma Explanation: Melanoma is not classified as a choroid plexus tumor; instead, choroid plexus tumors include adenomas, carcinomas, and papillomas. What grade does a benign tumor correspond to in WHO classification? A) Grade II B) Grade III C) Grade I D) Grade IV E) Grade V; C) Grade I Explanation: In the WHO classification, benign tumors are classified as Grade I, indicating a lower level of malignancy and a better prognosis. What defines the prognosis of CNS tumors? A) Age and gender B) Size, location, and grade C) Ethnicity and geography D) Patient's diet E) Family history; B) Size, location, and grade Explanation: The prognosis of CNS tumors is primarily determined by their size, location within the central nervous system, and histological grade, which reflects their aggressiveness. What is a typical feature of anaplastic malignant tumors? A) Well-defined borders B) Frequent abnormal mitoses C) Increased psammoma bodies D) Cystic lesions E) Low cellularity; B) Frequent abnormal mitoses Explanation: Anaplastic malignant tumors are characterized by frequent abnormal mitoses, indicating aggressive growth and a higher likelihood of malignancy. Which CNS tumors are more likely to cause compression effects? A) Benign tumors B) Melanoma C) Atypical tumors D) Anaplastic tumors E) Neurofibroma; A) Benign tumors Explanation: Benign tumors are more likely to cause compression effects due to their growth patterns, which can exert pressure on surrounding structures without invading them. Which type of metastatic tumor is an example? A) Melanoma B) Neurofibroma C) Choroid plexus carcinoma D) Medulloblastoma E) Meningioma; A) Melanoma Explanation: Melanoma is a type of metastatic tumor that can spread to the central nervous system, making it a relevant example in the context of CNS tumors. Where are meningiomas more commonly found? A) In the spinal cord B) Within the ventricles C) Base of the brain D) In the cerebellum E) In the brainstem; C) Base of the brain Explanation: Meningiomas are more commonly found at the base of the brain, where they can affect surrounding structures due to their location. What is a characteristic appearance of CNS tumors? A) Irregular and dispersed B) Rounded and well-defined C) Flat and colorless D) Rough and hollow E) Sharp and jagged; B) Rounded and well-defined Explanation: CNS tumors typically have a rounded and well-defined appearance, which helps in their identification during imaging studies. Which type of pathology shows a whorled pattern? A) Anaplastic tumors (Grade III) B) Atypical tumors (Grade II) C) Benign tumors (WHO Grade I) D) Embryonic tumors E) Glioblastoma; C) Benign tumors (WHO Grade I) Explanation: Benign tumors (WHO Grade I) are characterized by a whorled pattern, which is a distinctive histological feature. What distinguishes atypical tumors (WHO Grade II)? A) Absence of mitoses B) Presence of psammoma bodies C) Frequent abnormal mitoses D) Well-defined borders E) Low cellularity; C) Frequent abnormal mitoses Explanation: Atypical tumors (WHO Grade II) are distinguished by the presence of frequent abnormal mitoses, indicating a higher level of cellular activity and potential for malignancy. Which is an example of a complication from atypical tumors? A) Compression effects B) Infiltrative characteristics C) Cyst formation D) Well-contoured edges E) Benign growths; B) Infiltrative characteristics Explanation: Atypical tumors often exhibit infiltrative characteristics, which can complicate treatment and prognosis due to their tendency to invade surrounding tissues. What is cerebral edema? A) Excessive blood flow to the brain B) Accumulation of fluid within the brain C) Fluid in the spinal column D) Absence of fluid in brain ventricles E) Increased intracranial pressure; B) Accumulation of fluid within the brain Explanation: Cerebral edema refers to the accumulation of fluid within the brain, which can lead to increased intracranial pressure and various neurological symptoms. What characterizes vasogenic edema? A) Cell injury leading to fluid retention B) Increased vascular permeability causing fluid accumulation C) Excess fluid in the spinal cord D) Tissue necrosis in the brain E) Decreased blood flow to the brain; B) Increased vascular permeability causing fluid accumulation Explanation: Vasogenic edema is characterized by increased vascular permeability, which allows fluid to escape from blood vessels into the surrounding brain tissue. What is caused by increased intracellular fluid due to cell injury? A) Vasogenic edema B) Hypotonic edema C) Cytotoxic edema D) Dehydration edema E) Interstitial edema; C) Cytotoxic edema Explanation: Cytotoxic edema occurs when there is an increase in intracellular fluid due to cell injury, leading to swelling of the affected cells. Which morphological change occurs in cerebral edema? A) Large brain size with narrowed sulci B) Small brain with wide gyri C) Thickening of brain tissue D) Increased ventricular size without changes E) Normal brain size with no changes; A) Large brain size with narrowed sulci Explanation: In cerebral edema, the brain may appear larger due to swelling, and the sulci (the grooves on the brain's surface) become narrowed as a result of increased fluid accumulation. What defines hydrocephalus? A) Fluid accumulation in brain cells B) Fluid absence around the brain C) Excessive cerebrospinal fluid in the ventricular system D) Increased blood volume in the brain E) Decreased cerebrospinal fluid production; C) Excessive cerebrospinal fluid in the ventricular system Explanation: Hydrocephalus is defined by the excessive accumulation of cerebrospinal fluid in the ventricular system, which can lead to increased intracranial pressure and other complications. What causes non-communicating hydrocephalus? A) Excess production of CSF B) Increased drainage of CSF C) Obstruction of CSF flow D) Dehydration in the brain E) None of the above; C) Obstruction of CSF flow Explanation: Non-communicating hydrocephalus is primarily caused by an obstruction in the flow of cerebrospinal fluid (CSF), preventing it from circulating properly within the ventricles. Which of the following can result in communicating hydrocephalus? A) Obstruction due to tumors B) Excess CSF production from choroid tumors C) Ischemia in the brain D) Inflammation of brain tissue E) None of the above; B) Excess CSF production from choroid tumors Explanation: Communicating hydrocephalus can occur due to excess production of CSF, particularly from choroid tumors, which leads to an accumulation of fluid in the ventricles. What morphological feature is associated with hydrocephalus? A) Absence of ventricular enlargement B) Thinning of brain tissue C) Dilatation of the ventricles D) Compression of blood vessels E) None of the above; C) Dilatation of the ventricles Explanation: Hydrocephalus is characterized by the dilatation of the ventricles, which occurs due to the accumulation of cerebrospinal fluid. What is a common complication of hydrocephalus in infants? A) Reduced head size B) Enlargement of the head C) Increased mental acuity D) Development of muscle tone E) None of the above; B) Enlargement of the head Explanation: In infants, hydrocephalus often leads to an enlargement of the head due to the accumulation of cerebrospinal fluid. What complication is observed in children and adults with hydrocephalus? A) Improved cognitive function B) Increased intracranial pressure leading to brain atrophy C) Decreased brain activity D) Increased blood pressure only E) None of the above; B) Increased intracranial pressure leading to brain atrophy Explanation: In children and adults, hydrocephalus can result in increased intracranial pressure, which may lead to brain atrophy over time. What is cerebral infarction characterized by? A) Formation of new neural connections B) Increase in brain tissue size C) Liquefactive necrosis of the brain D) Thickening of grey matter E) None of the above; C) Liquefactive necrosis of the brain Explanation: Cerebral infarction is characterized by liquefactive necrosis, which is the death of brain tissue due to a lack of blood supply. Where can cerebral infarction occur? A) Only in the frontal lobe B) Exclusively in the cerebellum C) Limited to the brainstem D) In any site of the brain E) Only in the occipital lobe; D) In any site of the brain Explanation: Cerebral infarction can occur in any part of the brain, making it a widespread concern in neurological health. Where is cerebral infarction more extensive? A) In the occipital lobe B) In the medulla oblongata C) In the basal ganglia and thalamus D) In the temporal lobe E) In the frontal lobe; C) In the basal ganglia and thalamus Explanation: Cerebral infarction is often more extensive in the basal ganglia and thalamus, which are critical areas for motor control and sensory information. What is the most common type of cerebral infarction? A) Thrombotic infarction B) Hypoxic infarction C) Hemorrhagic infarction D) Embolic infarction E) Lacunar infarction; D) Embolic infarction Explanation: Embolic infarction is the most common type of cerebral infarction, often resulting from blood clots that travel from other parts of the body. Which of the following is a cardiac cause for embolic infarction? A) Carotid artery stenosis B) Cerebral venous thrombosis C) Atrial fibrillation D) Transient ischemic attack E) Hypertension; C) Atrial fibrillation Explanation: Atrial fibrillation is a significant cardiac cause of embolic infarction, as it can lead to the formation of blood clots that may travel to the brain. What leads to paradoxical embolism? A) Blood clot formation from trauma B) Severe arterial plaque buildup C) Normal heart valve function D) Deep Vein Thrombosis bypassing the lung E) Atrial fibrillation; D) Deep Vein Thrombosis bypassing the lung Explanation: Paradoxical embolism occurs when a blood clot from the venous system bypasses the lungs and enters the arterial system, often due to a right-to-left shunt. Where does embolic infarction typically occur? A) In the posterior cerebral artery B) In the anterior communicating artery C) In the middle cerebral artery D) In the vertebral artery E) In the basilar artery; C) In the middle cerebral artery Explanation: Embolic infarction most commonly occurs in the middle cerebral artery, which supplies a large portion of the lateral aspect of the cerebral hemisphere. Thrombotic infarction occurs due to thrombosis on top of what condition? A) Hemorrhage B) Atherosclerosis C) Cerebral atrophy D) Neuroinflammation E) Hypertension; B) Atherosclerosis Explanation: Thrombotic infarction is primarily associated with thrombosis that develops on top of atherosclerosis, a condition characterized by the buildup of plaques in the arteries, which can lead to blockages. What gross characteristic describes brain infarcts? A) They are hard and brittle. B) They are swollen and soft. C) They are grey and dry. D) They are compact and firm. E) They are rough and jagged.; B) They are swollen and soft. Explanation: Brain infarcts are characterized by their swollen and soft texture, which is a result of the loss of blood supply and subsequent tissue damage. What color could infarcted brain tissue appear? A) Bright red. B) Dark brown. C) Pure white. D) Yellow or hemorrhagic. E) Greenish.; D) Yellow or hemorrhagic. Explanation: Infarcted brain tissue can appear yellow or hemorrhagic, indicating the presence of necrosis and possible bleeding within the affected area. How is the grey and white matter defined in cerebral infarction? A) Clear distinction observed. B) Grey matter thickens significantly. C) Loss of definition between both. D) White matter becomes opaque. E) Both become indistinguishable.; C) Loss of definition between both. Explanation: In cerebral infarction, there is a loss of definition between grey and white matter, which can complicate the assessment of the extent of the damage. What percentage of adult primary tumors does astrocytoma represent? A) 60% B) 80% C) 50% D) 90% E) 70%; B) 80% Explanation: Astrocytoma represents approximately 80% of adult primary brain tumors, making it a significant type of tumor in this demographic. What type is classified as Grade I astrocytoma? A) Fibrillary B) Anaplastic C) Glioblastoma D) Pilocytic E) Oligodendroglioma; D) Pilocytic Explanation: Pilocytic astrocytoma is classified as a Grade I tumor, indicating it is typically slow-growing and has a better prognosis compared to higher-grade tumors. In which region is astrocytoma commonly found in children? A) Frontal B) Temporal C) Occipital D) Cerebellar E) Parietal; D) Cerebellar Explanation: Astrocytoma is commonly found in the cerebellar region in children, which is significant for understanding the typical locations of these tumors in pediatric patients. Which grade of astrocytoma is classified as malignant? A) Grade I B) Grade II C) Only Grade III D) Grade III and IV E) Grade V; D) Grade III and IV Explanation: Astrocytomas classified as Grade III and IV are considered malignant, indicating a higher degree of aggressiveness and poor prognosis compared to lower-grade tumors. What features are associated with astrocytoma tumors? A) Cohesive solid mass B) Well-defined borders C) Uniform color D) Ill-defined grayish-white areas E) Smooth surface; D) Ill-defined grayish-white areas Explanation: Astrocytoma tumors are characterized by ill-defined grayish-white areas, which can complicate surgical resection and diagnosis. Which cellular feature is NOT present in astrocytoma? A) Rodenthal fibers B) Granular bodies C) Bipolar cells without processes D) Nuclear atypia E) Pleomorphic cells; C) Bipolar cells without processes Explanation: Bipolar cells without processes are not a feature of astrocytoma, distinguishing them from other cellular characteristics that may be present. What distinguishes Oligodendroglioma from astrocytoma? A) Higher malignancy rates B) Thicker appearance C) More vascular proliferation D) Presence of calcification E) Larger cell size; D) Presence of calcification Explanation: The presence of calcification is a distinguishing feature of oligodendroglioma compared to astrocytoma, which aids in differential diagnosis. What is the prognosis for oligodendroglioma compared to astrocytoma? A) Generally better B) Generally worse C) Similar D) Depends on location E) Always worse; A) Generally better Explanation: Oligodendroglioma generally has a better prognosis compared to astrocytoma, which is important for treatment planning and patient counseling. From which cells does ependymoma originate? A) Ependymal cells B) Astrocytes C) Oligodendrocytes D) Neurons E) Microglia; A) Ependymal cells Explanation: Ependymoma originates from ependymal cells, which line the ventricles of the brain and the central canal of the spinal cord. What characteristic arrangement is seen in ependymoma cells? A) Roses or perivascular pseudorosettes B) Nodular clusters C) Spindle arrangements D) Random scattering E) Circular formations; A) Roses or perivascular pseudorosettes Explanation: Ependymoma cells are characterized by the presence of roses or perivascular pseudorosettes, which are distinctive arrangements that help in identifying this tumor type. Which symptom can ependymoma lead to in children? A) Seizures B) Cognitive decline C) Hydrocephalus D) Vision loss E) Hearing impairment; C) Hydrocephalus Explanation: Ependymoma can lead to hydrocephalus in children due to obstruction of cerebrospinal fluid pathways, which is a common complication associated with this type of tumor. What grades are assigned to ependymoma by WHO classification? A) Grade I and II B) Grade III and IV C) Grade II and III D) Grade I and III E) Grade IV only; C) Grade II and III Explanation: The World Health Organization classifies ependymoma into Grade II and III, indicating its varying degrees of malignancy and potential for aggressive behavior. What percentage of brain tumors in children does Medulloblastoma represent? A) 10% B) 20% C) 30% D) 50% E) 40%; B) 20% Explanation: Medulloblastoma accounts for approximately 20% of brain tumors in children, making it one of the most common pediatric brain tumors. Where does Medulloblastoma primarily originate? A) Frontal lobe B) Medulla C) Cerebellum D) Hippocampus E) Thalamus; C) Cerebellum Explanation: Medulloblastoma primarily originates in the cerebellum, which is the part of the brain responsible for coordination and balance. At what age group is Medulloblastoma most prevalent? A) Children under 6 years B) Teenagers 13–19 years C) Adults 25–40 years D) Elderly over 65 years E) Infants under 1 year; A) Children under 6 years Explanation: Medulloblastoma is most commonly found in children, particularly those under the age of 6, making this age group the most prevalent for this type of brain tumor. What is the characteristic appearance of Medulloblastoma? A) Well-defined cystic lesion B) Homogeneous white mass C) Irregular, ill-defined mass with necrosis D) Clear fluid-filled sac E) Solid black mass; C) Irregular, ill-defined mass with necrosis Explanation: Medulloblastoma typically presents as an irregular, ill-defined mass that may show areas of necrosis, which is a key characteristic in its diagnosis. Medulloblastoma is classified as what type of malignancy? A) Highly malignant (Grade IV) B) Low malignant (Grade I) C) Moderately malignant (Grade II) D) Benign E) Non-malignant; A) Highly malignant (Grade IV) Explanation: Medulloblastoma is classified as a highly malignant tumor, specifically Grade IV, indicating its aggressive nature and potential for rapid growth and spread. Which nerve is primarily affected by Schwannoma? A) Cranial Nerve V B) Cranial Nerve VII C) Cranial Nerve X D) Cranial Nerve VIII E) Cranial Nerve IX; D) Cranial Nerve VIII Explanation: Schwannoma primarily affects Cranial Nerve VIII, which is responsible for hearing and balance, leading to symptoms related to these functions. What is the main distinguishing feature of Neurofibromas? A) Subcutaneous nodules B) Vesicular lesions C) Tumors in the brain D) Skin ulcerations E) Hair loss; A) Subcutaneous nodules Explanation: Neurofibromas are characterized by the presence of subcutaneous nodules, which are benign tumors that can appear on the skin. Which condition is associated with café au lait skin patches? A) Schwannoma B) Medulloblastoma C) Neurofibromatosis D) Astrocytoma E) Meningioma; C) Neurofibromatosis Explanation: Café au lait skin patches are a hallmark feature of Neurofibromatosis, a genetic disorder that causes tumors to form on nerve tissue. What type of genetic disorder is Multiple Neurofibromatosis? A) Recessive disorder B) X-linked disorder C) Mitochondrial disorder D) Autosomal dominant disorder E) Chromosomal disorder; D) Autosomal dominant disorder Explanation: Multiple Neurofibromatosis is classified as an autosomal dominant disorder, meaning that only one copy of the mutated gene from an affected parent can cause the disorder in offspring. What are common complications of intracranial tumors? A) Infection and fever B) Compression and edema C) Loss of appetite D) Visible skin changes E) Nausea and vomiting; B) Compression and edema Explanation: Intracranial tumors often lead to complications such as compression of surrounding structures and edema, which can significantly affect brain function. Which symptom is commonly seen with intracranial tumors? A) Hydrocephalus B) Hypotension C) Rash D) Hearing loss E) Fever; A) Hydrocephalus Explanation: Hydrocephalus is a common symptom associated with intracranial tumors, as they can obstruct the normal flow of cerebrospinal fluid, leading to increased intracranial pressure. What is a key histological feature of Schwannomas? A) Pleomorphic cells B) High mitotic activity C) Palisading of nuclei D) Necrosis E) Inflammatory infiltrate; C) Palisading of nuclei Explanation: A key histological feature of Schwannomas is the palisading of nuclei, which is characteristic of these tumors and helps in their identification under a microscope. What type of stroma do larger cells in Antoni B areas of Schwannomas have? A) Dense fibrous stroma B) Adipose stroma C) Granulomatous stroma D) Myxoid stroma E) Loose connective stroma; D) Myxoid stroma Explanation: Larger cells in Antoni B areas of Schwannomas are typically surrounded by myxoid stroma, which contributes to the tumor's unique histological appearance. What do malignant nerve sheath tumors increase the incidence of in Multiple Neurofibromatosis? A) Cerebral aneurysms B) Benign lesions C) Meningiomas D) Malignant nerve sheath tumors E) Gliomas; D) Malignant nerve sheath tumors Explanation: In individuals with Multiple Neurofibromatosis, there is an increased incidence of malignant nerve sheath tumors, which are a serious complication of the disorder. What potential effect does cerebral edema have on the brain? A) Dilation B) Atrophy C) Herniation D) Hypertrophy E) Necrosis; C) Herniation Explanation: Cerebral edema can lead to increased intracranial pressure, which may result in herniation, where brain tissue is displaced due to swelling. What is Anencephaly characterized by? A) Protrusion of meningeal sac from skull B) Meninges and spinal cord involved C) Only partial brain development occurs D) Complete failure of brain development E) Normal brain structure; D) Complete failure of brain development Explanation: Anencephaly is a severe neural tube defect characterized by the complete failure of brain development, leading to the absence of a major portion of the brain. What is the defining feature of Meningocele? A) Complete brain malformation B) Protrusion of a meningeal sac from a skull defect C) Spinal column fails to close D) Brain tissue protrudes through the skull E) Normal spinal structure; B) Protrusion of a meningeal sac from a skull defect Explanation: Meningocele is characterized by the protrusion of a meningeal sac through a defect in the skull or spinal column, containing cerebrospinal fluid. How does Encephalocele differ from Meningocele? A) It involves protruded brain tissue B) It has no brain tissue involvement C) It's a type of Spina Bifida D) It occurs only in the spinal region E) It is a normal condition; A) It involves protruded brain tissue Explanation: Encephalocele is characterized by the protrusion of brain tissue through a defect in the skull, differentiating it from Meningocele, which involves only the meninges. What is Spina Bifida? A) A condition where the spinal column does not close completely B) Incomplete closure at the cranial end C) It only affects the brain D) Full closure of the spinal column E) A normal spinal condition; A) A condition where the spinal column does not close completely Explanation: Spina Bifida is a congenital condition resulting from the incomplete closure of the spinal column, which can lead to various neurological issues. In which area does Meningocele occur? A) Only in the cranial region B) In the brain tissue only C) It affects only the face D) In the spinal region E) In the abdominal region; D) In the spinal region Explanation: Meningocele typically occurs in the spinal region, where a meningeal sac protrudes through a defect in the spinal column. What is Meningomyelocele? A) A type of cranial meningocele B) A more severe form of Spina Bifida involving spinal cord C) Complete closure of the spinal region D) Only involves meningeal sac protrusion E) A benign spinal tumor; B) A more severe form of Spina Bifida involving spinal cord Explanation: Meningomyelocele is characterized as a more severe form of Spina Bifida, where the spinal cord is involved, leading to significant neurological implications. What characterizes an Epidural Hematoma? A) Develops in the subdural space B) Occurs in the extradural space C) Parenchymal bleeding occurs D) Does not involve the skull E) Only occurs in children; B) Occurs in the extradural space Explanation: An Epidural Hematoma is specifically characterized by its occurrence in the extradural space, which is the area between the skull and the outer layer of the meninges. What usually causes an Epidural Hematoma? A) Mild injury to veins B) Linear fracture damaging middle meningeal artery C) Chronic bleeding from hypertension D) Injury to brain tissue directly E) Severe head trauma without fracture; B) Linear fracture damaging middle meningeal artery Explanation: An Epidural Hematoma is typically caused by a linear fracture that damages the middle meningeal artery, leading to bleeding in the extradural space. How does Subdural Hematoma develop? A) From skull fracture B) From mild traumatic injury to veins C) Parenchymal bleeding in the brain D) From severe vascular disease E) From chronic alcohol use; B) From mild traumatic injury to veins Explanation: A Subdural Hematoma develops primarily from mild traumatic injuries to the veins, which can lead to bleeding in the subdural space. What causes Intracerebral Hemorrhage? A) Fracture of the skull B) Only occurs in cranial malformations C) Massive trauma, hypertension, or arterial vascular diseases D) Caused by mild traumatic injuries E) Result of surgical complications; C) Massive trauma, hypertension, or arterial vascular diseases Explanation: Intracerebral Hemorrhage is often caused by massive trauma, hypertension, or various arterial vascular diseases, leading to bleeding within the brain tissue. What is the symptom onset for Epidural Hematoma? A) Gradual onset B) Rapid onset C) Only occurs in chronic cases D) Intermittent onset over time E) Delayed onset after several days; B) Rapid onset Explanation: The symptom onset for an Epidural Hematoma is typically rapid, often occurring shortly after the injury due to the immediate accumulation of blood in the extradural space. What are some initial symptoms of Epidural Hematoma? A) Severe headache immediately. B) Mild symptoms that can progress to significant issues. C) Only loss of consciousness. D) No symptoms at all initially. E) Nausea and vomiting.; B) Mild symptoms that can progress to significant issues. Explanation: Initial symptoms of an epidural hematoma often start mild and can escalate to more severe complications, making early recognition crucial. How do Subdural Hematoma symptoms vary? A) Always present severe headaches. B) Consistent symptoms for all cases. C) No correlation with bleeding severity. D) Based on severity and speed of bleeding. E) Symptoms only appear after a week.; D) Based on severity and speed of bleeding. Explanation: The symptoms of a subdural hematoma can vary significantly depending on how severe the bleeding is and how quickly it occurs, affecting the clinical presentation. What symptoms can occur with Intracerebral Hemorrhage? A) Only mild headache and dizziness. B) Severe headache, loss of consciousness, neurological deficits. C) No immediate symptoms. D) Only local symptoms at the site. E) Numbness in extremities.; B) Severe headache, loss of consciousness, neurological deficits. Explanation: Intracerebral hemorrhage is characterized by severe headaches, potential loss of consciousness, and various neurological deficits, indicating significant brain injury. What is a key characteristic of liquefactive necrosis? A) Presence of necrotic neuron cell bodies. B) Formation of scar tissue. C) Necrotic tissue infiltrated by macrophages with lipids. D) Accumulation of calcium deposits. E) Presence of fibrous tissue.; C) Necrotic tissue infiltrated by macrophages with lipids. Explanation: Liquefactive necrosis is characterized by the infiltration of necrotic tissue by macrophages, which often contain lipids, leading to the formation of a liquid mass. What surrounds the necrotic area in liquefactive necrosis? A) Only macrophages and lymphocytes. B) Fibrous scar tissue only. C) Reactive glial cells and proliferating capillaries. D) Blood vessels and neurons. E) Only connective tissue.; C) Reactive glial cells and proliferating capillaries. Explanation: In liquefactive necrosis, the necrotic area is typically surrounded by reactive glial cells and proliferating capillaries, which are part of the body's response to injury. After approximately how many weeks does liquefactive necrosis develop into a cyst? A) 1 week. B) 2 weeks. C) 4 weeks. D) About 3 weeks. E) 5 weeks.; D) About 3 weeks. Explanation: Liquefactive necrosis typically develops into a cyst approximately three weeks after the initial injury, marking a significant change in the tissue structure. Who is most commonly affected by intracerebral hemorrhage? A) Children under 10 years B) Young adults under 30 years C) Individuals over 60 years of age D) Middle-aged adults 40-50 years E) Infants and toddlers; C) Individuals over 60 years of age Explanation: Intracerebral hemorrhage predominantly affects individuals over 60 years of age, making them the most at-risk group for this condition. What is the leading cause of intracerebral hemorrhage? A) Trauma B) Aneurysm rupture C) Hypertension D) Blood disorders E) Stroke; C) Hypertension Explanation: Hypertension is identified as the leading cause of intracerebral hemorrhage, significantly increasing the risk of bleeding within the brain. Where does intracerebral hemorrhage predominantly occur? A) Cerebral cortex only B) Brain stem and cerebellum only C) Basal ganglia (80% of cases) D) Frontal lobe and temporal lobe E) Occipital lobe; C) Basal ganglia (80% of cases) Explanation: Intracerebral hemorrhage predominantly occurs in the basal ganglia, accounting for approximately 80% of cases, which is crucial for understanding its common locations. What morphological feature is observed in intracerebral hemorrhage? A) Calcified plaques B) Inflammatory cell infiltration C) Tissue necrosis without blood D) Presence of extravasated blood (hematoma) E) Fibrous tissue formation; D) Presence of extravasated blood (hematoma) Explanation: The presence of extravasated blood, or hematoma, is a key morphological feature observed in cases of intracerebral hemorrhage, indicating bleeding within the brain tissue. What is a possible outcome of intracerebral hemorrhage? A) Resolution and absorption leading to a cystic cavity B) Formation of a solid tumor C) Increased blood flow to the area D) Permanent nerve damage E) Complete recovery without any effects; A) Resolution and absorption leading to a cystic cavity Explanation: A possible outcome of intracerebral hemorrhage is the resolution and absorption of the hematoma, which can lead to the formation of a cystic cavity in the affected area. Who is most commonly affected by subarachnoid hemorrhage? A) Infants and toddlers B) Adults aged 70 and above C) Individuals aged 30-40 years D) Individuals under 50 years of age E) Teenagers; D) Individuals under 50 years of age Explanation: Subarachnoid hemorrhage most commonly affects individuals under 50 years of age, highlighting a different demographic risk compared to intracerebral hemorrhage. What often causes subarachnoid hemorrhage? A) Chronic hypertension B) Multiple sclerosis C) Viral infections D) Rupture of a berry aneurysm E) Chronic migraines; D) Rupture of a berry aneurysm Explanation: The rupture of a berry aneurysm is a well-known cause of subarachnoid hemorrhage, leading to bleeding in the subarachnoid space of the brain. What is a common clinical presentation of subarachnoid hemorrhage? A) Gradual onset of blurry vision B) Persistent migraine-like symptoms C) Sudden severe headache D) Altered consciousness over days E) Nausea and vomiting; C) Sudden severe headache Explanation: A sudden severe headache, often described as a 'thunderclap' headache, is a hallmark symptom of subarachnoid hemorrhage. What can result from subarachnoid hemorrhage post-rupture? A) Ischemia and infarction due to reflex spasm B) Immediate tissue regeneration C) Invading inflammatory cells only D) No significant aftereffects E) Increased blood flow to the brain; A) Ischemia and infarction due to reflex spasm Explanation: Following a rupture, subarachnoid hemorrhage can lead to ischemia and infarction as a result of reflex vasospasm in the cerebral arteries. What can the development of subarachnoid hemorrhage lead to? A) Improved cerebral perfusion B) Decreased intracranial pressure C) Hydrocephalus D) Blocking of blood flow to the spine E) Increased oxygenation of brain tissue; C) Hydrocephalus Explanation: The accumulation of blood in the subarachnoid space can obstruct the flow of cerebrospinal fluid, leading to hydrocephalus. What is the most common route of infection in CNS infections? A) Hematogenous Spread B) Direct Implantation C) Local Spread D) Axonal Spread E) Lymphatic Spread; A) Hematogenous Spread Explanation: Hematogenous spread, where pathogens enter the central nervous system through the bloodstream, is the most common route for CNS infections. What is a characteristic cause of septic meningitis? A) Meningococci B) Enteroviruses C) Measles D) Lymphocytes E) Streptococcus pneumoniae; A) Meningococci Explanation: Meningococci are a well-known bacterial cause of septic meningitis, leading to severe inflammation of the protective membranes covering the brain and spinal cord. Which type of meningitis shows a lymphocytic infiltrate? A) Septic (Pyogenic) Meningitis B) Tuberculous Meningitis C) Aseptic (Viral) Meningitis D) Fungal Meningitis E) Bacterial Meningitis; C) Aseptic (Viral) Meningitis Explanation: Aseptic (Viral) Meningitis is characterized by a lymphocytic infiltrate in the cerebrospinal fluid, distinguishing it from other types of meningitis. What morphological change is seen in septic meningitis? A) Lymphocytic infiltrate B) Normal appearance of meninges C) Thick, swollen meninges D) Thinning of the meninges E) Hyperplastic meninges; C) Thick, swollen meninges Explanation: In septic meningitis, the meninges typically appear thick and swollen due to inflammation and infection. Which CSF change is noted in septic meningitis? A) High levels of neutrophils B) Normal glucose levels C) Low protein levels D) High lymphocyte count E) High levels of eosinophils; A) High levels of neutrophils Explanation: Septic meningitis is characterized by high levels of neutrophils in the cerebrospinal fluid, indicating a bacterial infection. What can be a complication of acute meningitis? A) Hyperglycemia B) Liver failure C) Pneumothorax D) Hydrocephalus E) Renal failure; D) Hydrocephalus Explanation: Hydrocephalus can occur as a complication of acute meningitis due to the obstruction of cerebrospinal fluid pathways. Which symptom is particularly pronounced in septic meningitis? A) Absent neck stiffness B) Normal irritability C) Mild headache D) Fever E) Dizziness; D) Fever Explanation: Fever is a particularly pronounced symptom in septic meningitis, often indicating an underlying infection. What is the result of axonal spread of pathogens? A) Infection from traumatic injury B) Pathogens travel along peripheral nerves C) Local spread from air sinuses D) Inflammation in the cerebrospinal fluid E) Direct infection of the brain; B) Pathogens travel along peripheral nerves Explanation: Axonal spread of pathogens refers to the ability of pathogens to travel along peripheral nerves, which can lead to infections in the central nervous system. What does Waterhouse-Friderichsen syndrome refer to? A) Increased intracranial pressure B) Septicemia C) Adrenal necrosis D) Meningococcal rash E) Viral infection; C) Adrenal necrosis Explanation: Waterhouse-Friderichsen syndrome is characterized by adrenal necrosis, often associated with severe infections, particularly meningococcal septicemia. Which organism is commonly associated with meningitis in neonates? A) E. coli B) Meningococci C) Beta Streptococcus D) Measles virus E) Listeria monocytogenes; C) Beta Streptococcus Explanation: Beta Streptococcus is a common organism associated with meningitis in neonates, highlighting the importance of early identification and treatment. What is a defining characteristic of aseptic meningitis CSF? A) Elevated neutrophils B) Increased turbidity C) Reduced protein levels D) Normal glucose levels E) High white blood cell count; D) Normal glucose levels Explanation: Aseptic meningitis is characterized by normal glucose levels in the cerebrospinal fluid (CSF), which helps differentiate it from bacterial meningitis. Which symptom does NOT indicate meningeal irritation? A) Neck stiffness B) Photophobia C) Loss of appetite D) Headache E) Fever; C) Loss of appetite Explanation: While neck stiffness, photophobia, and headache are classic signs of meningeal irritation, loss of appetite is not a direct indicator. Which type of meningitis can resolve without extensive treatment? A) Bacterial meningitis B) Chronic meningitis C) Recurrent meningitis D) Self-Limiting cases E) Viral meningitis; D) Self-Limiting cases Explanation: Self-limiting cases of meningitis can resolve without extensive treatment, often seen in viral meningitis. What defines intracerebral hemorrhage? A) Acute massive hemorrhage from ruptured arteriosclerotic vessels B) Chronic bleeding from a single small vessel C) Localized swelling of brain tissue D) Formation of microaneurysms without hemorrhage E) Diffuse brain edema; A) Acute massive hemorrhage from ruptured arteriosclerotic vessels Explanation: Intracerebral hemorrhage is characterized by acute massive hemorrhage, often resulting from the rupture of arteriosclerotic vessels. Where are lacunar infarcts primarily located? A) Cortex and cerebellum areas B) Brainstem and spinal cord C) Near the frontal lobe's white matter D) In the deep grey matter, basal ganglia, and thalamus E) In the occipital lobe; D) In the deep grey matter, basal ganglia, and thalamus Explanation: Lacunar infarcts are primarily found in the deep grey matter, including the basal ganglia and thalamus, which are critical areas affected by small vessel disease. What is the primary cause of lacunar infarcts? A) Occlusion of a single penetrating branch of a large artery B) Rupture of a large cerebral artery C) Cholesterol buildup in brain vessels D) Increased intracranial pressure due to trauma E) Venous thrombosis; A) Occlusion of a single penetrating branch of a large artery Explanation: Lacunar infarcts are primarily caused by the occlusion of a single penetrating branch of a large artery, leading to localized ischemia in the brain. Which symptoms are associated with hypertensive encephalopathy? A) Nausea and dizziness only B) Confusion, headache, and convulsions C) Severe motor paralysis D) Gradual onset of dementia E) Visual disturbances; B) Confusion, headache, and convulsions Explanation: Hypertensive encephalopathy is characterized by symptoms such as confusion, headache, and convulsions, indicating severe neurological impairment due to high blood pressure. What diastolic blood pressure is linked to hypertensive encephalopathy? A) Below 90 mm Hg B) Between 100 and 120 mm Hg C) Above 150 mm Hg only D) Exceeding 130 mm Hg E) Exactly 140 mm Hg; D) Exceeding 130 mm Hg Explanation: Hypertensive encephalopathy is associated with a diastolic blood pressure exceeding 130 mm Hg, which indicates severe hypertension and potential damage to the brain. What post-mortem finding is associated with hypertensive encephalopathy? A) Cerebral edema B) Atrophy of the cerebral cortex C) Presence of amyloid plaques D) Ischemic changes in the brainstem E) Hemorrhagic lesions; A) Cerebral edema Explanation: Post-mortem findings in hypertensive encephalopathy often reveal cerebral edema, which is a result of increased intracranial pressure and vascular damage. What forms as a result of fibrinoid necrosis of arterioles? A) Increased blood flow to the brain B) Damage to the vessel walls C) Clot formation within the arterioles D) Regeneration of healthy vessel tissue E) Formation of new blood vessels; B) Damage to the vessel walls Explanation: Fibrinoid necrosis of arterioles leads to damage to the vessel walls, which can contribute to various cerebrovascular diseases, including lacunar infarcts. What characterizes intracerebral hemorrhage in hypertensive cerebrovascular disease? A) Gradual onset of mild bleeding B) Localized edema and inflammation C) Slow loss of brain function over time D) Acute massive hemorrhage due to ruptured vessels E) Chronic bleeding from small vessels; D) Acute massive hemorrhage due to ruptured vessels Explanation: Intracerebral hemorrhage in hypertensive cerebrovascular disease is characterized by acute massive hemorrhage resulting from the rupture of blood vessels, which is a critical and life-threatening condition. Where are lacunar infarcts typically located? A) Deep grey matter of basal ganglia and thalamus B) Cerebellum and brainstem areas C) Surface cortex near the ventricles D) Cortex adjacent to the occipital lobe E) Frontal lobe; A) Deep grey matter of basal ganglia and thalamus Explanation: Lacunar infarcts are typically found in the deep grey matter of the basal ganglia and thalamus, which are areas prone to small vessel disease. What blood pressure level is associated with hypertensive encephalopathy? A) Systolic blood pressure above 140 mm Hg B) Diastolic blood pressure greater than 130 mm Hg C) Diastolic blood pressure below 70 mm Hg D) Average blood pressure below 90 mm Hg E) Systolic blood pressure below 120 mm Hg; B) Diastolic blood pressure greater than 130 mm Hg Explanation: Hypertensive encephalopathy is associated with significantly elevated diastolic blood pressure, specifically greater than 130 mm Hg, indicating severe hypertension. Which finding is typical in post-mortem analysis of hypertensive encephalopathy? A) Cerebral edema and fibrinoid necrosis B) Necrosis of white matter only C) Increased myelin breakdown products D) Presence of multiple microbleeds E) Normal brain tissue appearance; A) Cerebral edema and fibrinoid necrosis Explanation: In post-mortem analysis of hypertensive encephalopathy, typical findings include cerebral edema and fibrinoid necrosis, which reflect the damage caused by severe hypertension. What is the most common route of entry for infections into the nervous system? A) Direct implantation from surgery B) Hematogenous spread C) Local spread from sinus infections D) Axonal spread via peripheral nerves E) Contamination from open wounds; B) Hematogenous spread Explanation: The most common route for infections to enter the nervous system is through hematogenous spread, where pathogens travel through the bloodstream to reach the brain and spinal cord. What type of meningitis is associated with a thick, swollen appearance of the meninges? A) Septic (pyogenic) meningitis B) Chronic meningitis C) Aseptic (viral) meningitis D) Tuberculous meningitis E) Fungal meningitis; A) Septic (pyogenic) meningitis Explanation: Septic (pyogenic) meningitis is characterized by a thick, swollen appearance of the meninges due to the inflammatory response to bacterial infection. Which organisms are common causes of septic meningitis? A) Staphylococci and streptococci B) Fungi and protozoa C) Meningococci, pneumococci, and E. coli D) Viruses like measles and mumps E) Mycobacteria; C) Meningococci, pneumococci, and E. coli Explanation: These organisms are well-known causes of septic meningitis, leading to severe inflammation and infection in the meninges. What changes occur in cerebrospinal fluid (CSF) during septic meningitis? A) Normal levels of neutrophils and glucose B) Increased lymphocytes and normal proteins C) Increased neutrophils and pus; reduced glucose D) Increased glucose and proteins, normal neutrophils E) Decreased proteins and normal glucose; C) Increased neutrophils and pus; reduced glucose Explanation: In septic meningitis, the CSF typically shows increased neutrophils and pus, along with reduced glucose levels, indicating a bacterial infection. What type of infiltrate is typically seen in aseptic (viral) meningitis? A) Neutrophilic infiltrate B) Granulomatous infiltrate C) Lymphocytic infiltrate D) Hemorrhagic infiltrate E) Eosinophilic infiltrate; C) Lymphocytic infiltrate Explanation: Aseptic meningitis is characterized by a lymphocytic infiltrate, which is indicative of a viral infection rather than a bacterial one. Which complication can arise from meningitis, specifically during severe cases? A) Chronic headache without fever B) Mild cognitive impairment only C) Encephalitis and cranial nerve compression D) Increased energy and alertness E) Peripheral neuropathy; C) Encephalitis and cranial nerve compression Explanation: Severe cases of meningitis can lead to complications such as encephalitis and cranial nerve compression, which can have serious neurological consequences. In the clinical picture of meningitis, what symptom is indicative of meningeal irritation? A) Memory loss B) Dizziness C) Neck stiffness D) Paresthesia of extremities E) Nausea; C) Neck stiffness Explanation: Neck stiffness is a classic sign of meningeal irritation, often assessed during a physical examination of a patient suspected of having meningitis. What infections can lead to a brain abscess? A) Viral infections from herpes simplex B) Bacterial infections from pneumonia C) Pyogenic bacterial infections from sinusitis, otitis media, pyemia D) Fungal infections from histoplasmosis E) Parasitic infections from toxoplasmosis; C) Pyogenic bacterial infections from sinusitis, otitis media, pyemia Explanation: Pyogenic bacterial infections, particularly from conditions like sinusitis and otitis media, are common precursors to the development of brain abscesses. Which lobe may show multiple abscesses in a brain abscess? A) Frontal lobe B) Temporal lobe C) Occipital lobe D) Parietal lobe E) Cerebellar lobe; D) Parietal lobe Explanation: The parietal lobe is noted for potentially showing multiple abscesses in cases of brain abscess, indicating its susceptibility to such infections. What gross morphological change occurs in a brain abscess? A) Cyst formation with surrounding fibrosis B) Solid tumor mass with necrosis C) Uniform swelling without cavitation D) Irregular cavitation and edematous surrounding brain E) Complete tissue regeneration; D) Irregular cavitation and edematous surrounding brain Explanation: A brain abscess typically presents with irregular cavitation and edema in the surrounding brain tissue, which is a significant morphological change associated with this condition. What is a key microscopic feature of an acute abscess? A) Necrotic wall B) Single layer of epithelial cells C) Inflammatory lymphocytic infiltrate D) Fibrotic capsule with no necrosis E) Normal cellular architecture; A) Necrotic wall Explanation: A key microscopic feature of an acute abscess is the presence of a necrotic wall, which indicates tissue death and the inflammatory response associated with the abscess. What complication can arise from a brain abscess? A) Spread of infection B) Formation of scar tissue C) Development of high blood pressure D) Increased cognitive function E) Improved memory retention; A) Spread of infection Explanation: One of the significant complications that can arise from a brain abscess is the spread of infection, which can lead to further neurological issues and systemic complications. What is the most common cause of dementia in the elderly? A) Alzheimer Disease B) Parkinson Disease C) Huntington Disease D) Friedreich's Ataxia E) Multiple Sclerosis; A) Alzheimer Disease Explanation: Alzheimer Disease is recognized as the most common cause of dementia in the elderly, highlighting its prevalence and impact on cognitive decline in this population. What morphology is observed in Alzheimer Disease? A) Thickened cortex with narrow sulci B) Cortical atrophy with widened sulci and ventricular dilation C) Uniform cortical thickness D) Smooth surface without dilation E) Hyperplastic cortical layers; B) Cortical atrophy with widened sulci and ventricular dilation Explanation: In Alzheimer Disease, the characteristic morphology includes cortical atrophy, which leads to widened sulci and dilation of the ventricles, indicating significant brain changes. What are neuritic plaques primarily composed of? A) Tau protein without neurites B) Neurotransmitters aggregated in neurons C) Amyloid beta surrounded by neurites D) Lipids producing cellular debris E) Neurofilaments in the cytoplasm; C) Amyloid beta surrounded by neurites Explanation: Neuritic plaques are primarily composed of amyloid beta peptides that aggregate and are surrounded by neuritic processes, which are indicative of neurodegenerative conditions like Alzheimer's disease. What is a characteristic of neurofibrillary tangles? A) Basophilic structures in cytoplasm of neurons B) Uniformly distributed throughout the cytoplasm C) Found exclusively extracellularly D) Accompanied by excessive collagen E) Composed of lipids; A) Basophilic structures in cytoplasm of neurons Explanation: Neurofibrillary tangles are characterized as basophilic structures found within the cytoplasm of neurons, primarily composed of hyperphosphorylated tau protein, and are associated with neurodegenerative diseases. What are common examples of primary CNS tumors? A) Breast carcinoma and lung adenocarcinoma B) Osteosarcoma and liposarcoma C) Meningioma and gliomas D) Melanoma and seminoma E) Lymphoma and leukemia; C) Meningioma and gliomas Explanation: Meningioma and gliomas are common examples of primary CNS tumors, which originate from the brain or spinal cord tissue, distinguishing them from secondary tumors that spread from other parts of the body. What type of tumor is astrocytoma classified as? A) A neuronal tumor B) A nerve sheath tumor C) A glioma D) A vascular tumor E) A mesenchymal tumor; C) A glioma Explanation: Astrocytoma is classified as a glioma, which is a type of tumor that arises from glial cells in the central nervous system, specifically astrocytes. What is a defining feature of benign tumors (WHO Grade I)? A) Poorly defined and irregular shape B) Whorled pattern with indistinct borders C) Highly aggressive with numerous mitoses D) Uniform cellular arrangement and structure E) Presence of necrosis; B) Whorled pattern with indistinct borders Explanation: Benign tumors, classified as WHO Grade I, often exhibit a whorled pattern with indistinct borders, indicating a less aggressive nature compared to higher-grade tumors. Which tumors are classified under embryonic tumors? A) Neuroblastoma and schwannoma B) Medulloblastoma C) Choroid plexus adenoma and meningioma D) Hemangioma and ganglioma E) Ependymoma and oligodendroglioma; B) Medulloblastoma Explanation: Medulloblastoma is classified as an embryonic tumor, originating from primitive neuroectodermal cells, and is most commonly found in children. What appearance do most CNS tumors have grossly? A) Irregular and infiltrative B) Flat and non-capsulated C) Highly vascularized and necrotic D) Rounded, well-defined, and capsulated E) Diffuse and poorly defined; D) Rounded, well-defined, and capsulated Explanation: Most CNS tumors typically present with a rounded, well-defined, and capsulated appearance, which helps in distinguishing them from other types of lesions. What characterizes the microscopic features of atypical tumors (WHO Grade II)? A) Absence of abnormal cell structures B) Lack of mitotic activity C) Frequent abnormal mitoses D) Minimal inflammation and necrosis E) Uniform cell structure; C) Frequent abnormal mitoses Explanation: Atypical tumors (WHO Grade II) are characterized by frequent abnormal mitoses, indicating a higher level of cellular activity and potential malignancy compared to lower-grade tumors.