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 defect in berry aneurysms?

Accepted Answer

Degeneration of media

Answer

Degeneration of internal elastic lamina

Answer

Deposition of mucoid material in media

Answer

Low-grade inflammation of the vessel wall

Question 2

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 3

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 4

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 5

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

Accepted Answer

Meningioma

Answer

Astrocytoma

Answer

Medulloblastoma

Answer

Oligodendroglioma

Question 6

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 7

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 8

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

Accepted Answer

APC

Answer

KRAS

Answer

TP53

Answer

PTEN

Question 9

Which brain tumour is characterized by high vascularity?

Accepted Answer

Glioblastoma

Answer

Meningiomas

Answer

CP angle epidermoid

Answer

Pituitary adenoma

Question 10

An 8-month-old boy exhibits severe motor, sensory, and cognitive impairments. Brain biopsy shows a disease of white matter characterized by the accumulation of "globoid cells." Biochemical studies reveal an absence of galactocerebroside b-galactosidase activity. What is the appropriate diagnosis?

Accepted Answer

Krabbe disease

Answer

Alexander disease

Answer

Hurler disease

Answer

Metachromatic leukodystrophy

Neuropathology — MCQs

Neuropathology — MCQs

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