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CNS PATHOLOGY TEST

Total questions: 20

Worksheet time: 20mins

Name
Class
Date
1.

A 23-year-old woman presents with episodes of visual blurring and difficulty walking that improve but recur. MRI shows multiple periventricular plaques. What is the underlying mechanism?

a)

Autoimmune T-cell–mediated destruction of myelin

b)

Neuronal degeneration due to tau accumulation

c)

Viral infection of oligodendrocytes

d)

Ischemic infarction of deep white matter

e)

Autoantibodies against acetylcholine receptors

2.

A 19-year-old man has fever, headache, neck stiffness, and photophobia. CSF: ↑neutrophils, ↓glucose. What is the most likely organism?

a)

Neisseria meningitidis

b)

Listeria monocytogenes

c)

Streptococcus pneumoniae

d)

E. coli

e)

HSV-1

3.

A 45-year-old HIV-positive patient develops progressive focal neurological deficits. MRI: multifocal white matter lesions without mass effect. Which diagnosis is likely?

a)

Progressive multifocal leukoencephalopathy

b)

Multiple sclerosis

c)

Subacute sclerosing panencephalitis

d)

Bacterial meningitis

e)

Glioblastoma multiforme

4.

A 34-year-old woman presents with seizures. MRI shows an infiltrative frontal lobe tumor. Histology: fibrillary background with increased glial nuclei. Diagnosis?

a)

Diffuse astrocytoma

b)

Oligodendroglioma

c)

Medulloblastoma

d)

Pilocytic astrocytoma

e)

Meningioma

5.

A 55-year-old man with rapidly progressive dementia and myoclonus shows periodic sharp-wave complexes on EEG. Pathology reveals spongiform change. Mechanism?

a)

Accumulation of protease-resistant prion protein

b)

Autoimmune demyelination

c)

Viral inclusion bodies

d)

Dopaminergic neuron loss

e)

Amyloid deposition

6.

A 25-year-old woman develops confusion and seizures 2 weeks after measles infection. MRI: diffuse demyelination. Diagnosis?

a)

Acute disseminated encephalomyelitis

b)

Multiple sclerosis

c)

Leukodystrophy

d)

Glioblastoma

e)

Bacterial meningitis

7.

A 5-year-old child has truncal ataxia. MRI: posterior fossa tumor. Histology: small round blue cells. Diagnosis?

a)

Medulloblastoma

b)

Pilocytic astrocytoma

c)

Oligodendroglioma

d)

Meningioma

e)

Ependymoma

8.

A 62-year-old alcoholic develops ataxia, ophthalmoplegia, and confusion. Which deficiency is responsible?

a)

Thiamine (B1)

b)

Vitamin B12

c)

Folate

d)

Niacin

e)

Vitamin E

9.

A 70-year-old man presents with resting tremor, rigidity, and bradykinesia. Which pathological finding is typical?

a)

Loss of dopaminergic neurons in substantia nigra

b)

Hippocampal neuronal loss

c)

Anterior horn cell degeneration

d)

Optic nerve demyelination

e)

Viral oligodendrocyte infection

10.

A 30-year-old man develops severe headache after head trauma. CT: biconvex hyperdense lesion. Which vessel is ruptured?

a)

Middle meningeal artery

b)

Bridging veins

c)

Superior sagittal sinus

d)

Internal carotid artery

e)

Posterior cerebral artery

11.

A 48-year-old hypertensive woman collapses suddenly. CT: deep basal ganglia hemorrhage. Cause?

a)

Charcot-Bouchard microaneurysm rupture

b)

Berry aneurysm rupture

c)

Cavernoma hemorrhage

d)

Venous sinus thrombosis

e)

Trauma

12.

A 30-year-old woman has progressive ataxia and visual decline. MRI: symmetric white matter involvement. Diagnosis?

a)

Leukodystrophy

b)

Multiple sclerosis

c)

Amyotrophic lateral sclerosis

d)

Glioblastoma

e)

Bacterial meningitis

13.

A 22-year-old man develops fever, seizures, and confusion. CSF: lymphocytic pleocytosis. MRI: temporal lobe hyperintensity. Likely cause?

a)

HSV-1 encephalitis

b)

VZV infection

c)

Arbovirus

d)

Listeria meningitis

e)

Rabies

14.

A 36-year-old man with headache and focal weakness has a ring-enhancing brain lesion. LP contraindicated due to mass effect. Diagnosis?

a)

Brain abscess

b)

Viral encephalitis

c)

Multiple sclerosis plaque

d)

Glioblastoma

e)

Subdural empyema

15.

A newborn has seizures and periventricular calcifications. What is the likely cause?

a)

Cytomegalovirus

b)

HSV-2

c)

Toxoplasma gondii

d)

Rubella

e)

Listeria

16.

A 70-year-old woman has memory loss and cortical atrophy. Pathology: neurofibrillary tangles. Which protein is involved?

a)

Tau

b)

α-Synuclein

c)

TDP-43

d)

Prion protein

e)

GFAP

17.

A 40-year-old man presents with fasciculations and flaccid paralysis. Which finding is expected?

a)

Loss of anterior horn cells

b)

Loss of substantia nigra neurons

c)

Abnormal oligodendrocytes

d)

Hippocampal atrophy

e)

Optic nerve demyelination

18.

A 50-year-old patient deteriorates rapidly. MRI: necrotic, hemorrhagic mass crossing the corpus callosum (“butterfly lesion”). Diagnosis?

a)

Glioblastoma

b)

Oligodendroglioma

c)

Meningioma

d)

Ependymoma

e)

Pilocytic astrocytoma

19.

A 28-year-old man with fever and headache has MRI evidence of subdural empyema. Most common source?

a)

Sinusitis

b)

Lung abscess

c)

Dental caries

d)

Urinary infection

e)

GI infection

20.

A 60-year-old alcoholic with hyponatremia receives rapid sodium correction and develops quadriplegia. Diagnosis?

a)

Central pontine myelinolysis

b)

Multiple sclerosis

c)

ALS

d)

Stroke

e)

ADEM