Neuropathology Practice Questions

Q: Glioblastoma multiforme may occur in the following locations, except:

Adrenal medulla of child. **Explanation:** The correct answer is **D. Adrenal medulla of child**. **Glioblastoma (GBM)** is a Grade 4 astrocytoma, which is a primary tumor of the central nervous system (CNS) arising from glial cells (astrocytes) [1]. The adrenal medulla, however, is derived from **neural crest cells** and is part of the peripheral nervous system. In children, the most common tumor arising from the adrenal medulla is **Neuroblastoma**, not Glioblastoma. **Analysis of Options:** * **A. Cerebrum of adult:** This is the most common site for GBM [2]. It typically presents as a large, necrotic mass in the cerebral hemispheres, often crossing the corpus callosum (Butterfly Glioma) [1]. * **B. Brain stem of child:** While GBM is primarily an adult tumor, high-grade gliomas (including Diffuse Intrinsic Pontine Gliomas or DIPG) occur in the brainstem of children and are histologically similar to GBM [2]. * **C. Spinal cord of adult:** Although rare compared to intracranial sites, GBM can occur anywhere in the CNS axis, including the spinal cord. **NEET-PG High-Yield Pearls:** 1. **Hallmark Histology:** Look for **pseudopalisading necrosis** and **microvascular (glomeruloid) proliferation** [1]. 2. **Molecular Marker:** **IDH-mutation status** is now critical for classification (WHO 2021). Most GBMs are IDH-wildtype [1]. 3. **Radiology:** Classically presents as a **ring-enhancing lesion** on MRI due to central necrosis [1]. 4. **GFAP Positivity:** As a glial tumor, GBM is strongly positive for Glial Fibrillary Acidic Protein (GFAP). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1308-1311. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 725-726.

Question 1

What is the most common location for diffuse axonal injuries?

Accepted Answer

Junction of grey and white matter

Answer

Brain stem

Answer

Corpus callosum

Answer

Anterior one-third of the spinal cord

Question 2

A 35-year-old man with Down syndrome dies of acute lymphoblastic leukemia. Gross examination of the patient's brain at autopsy shows mild microcephaly and underdevelopment of the superior temporal gyri. Histologic examination would most likely show which of the following neuropathologic changes?

Accepted Answer

Neurofibrillary tangles

Answer

AA amyloidosis

Answer

Lewy bodies

Answer

Negri bodies

Question 3

Which of the following findings is unusual for myasthenia gravis?

Accepted Answer

There is an increase in the postsynaptic membrane folds.

Answer

Antibodies bind to acetylcholine receptors.

Answer

Antibodies interfere with the binding of acetylcholine (ACh) to receptors.

Answer

Increased acetylcholine concentration at the neuromuscular junction.

Question 4

Mutations in the merlin protein are associated with which of the following tumors?

Accepted Answer

Meningioma

Answer

Astrocytoma

Answer

Medulloblastoma

Answer

Oligodendroglioma

Question 5

A 40-year-old lady is diagnosed to have a frontal lobe brain tumor. The lesion is characterized by focal necrosis surrounded by ring-like enhancement. What is the most likely diagnosis?

Accepted Answer

Glioblastoma multiforme

Answer

Oligodendroglioma

Answer

Ependymoma

Answer

Astrocytoma

Question 6

Glioblastoma multiforme may occur in the following locations, except:

Accepted Answer

Adrenal medulla of child

Answer

Cerebrum of adult

Answer

Brain stem of child

Answer

Spinal cord of adult

Question 7

Medulloblastoma associated Turcot syndrome is characterized by mutation in which of the following genes?

Accepted Answer

APC

Answer

KRAS

Answer

TP53

Answer

PTEN

Question 8

Which brain tumour is characterized by high vascularity?

Accepted Answer

Glioblastoma

Answer

Meningiomas

Answer

CP angle epidermoid

Answer

Pituitary adenoma

Question 9

What are the common primary sites of metastasis to the brain?

Accepted Answer

Lung Carcinoma

Answer

Thyroid Carcinoma

Answer

Tongue Carcinoma

Answer

Breast Carcinoma

Question 10

Which of the following cancers metastasize to the brain the least?

Accepted Answer

Prostatic carcinoma

Answer

Hypernephroma

Answer

Breast carcinoma

Answer

Choriocarcinoma

Neuropathology — MCQs

Neuropathology — MCQs

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