“There are forces in life working  for you and against you. One must distinguish the beneficialforces from the malevolent ...
Quick Pathology ReviewPathology ofCNS Tumors & Meningitis            Shashidhar Venkatesh Murthy            A/Prof.& Head ...
CPC 35 – CNS- Seizure – Tumours, meningitisMajor CLI:• Increased intracranial pressure – Pathogenesis &  pathology. Pathol...
Look for good in others…no one is without faults and everyone has some good         qualities!             BK.
A 36y woman with 18month history of progressively increasing headaches whichincreases with her menstrual cycle. Her daught...
A 3 year old boy with a history of headaches and morning vomiting for 10 dayspresents to the ER after a bad episode of vom...
A 56 year old woman has a grand mal seizure. Her CSF values reveal a highprotein, normal glucose and a normal WBC counts, ...
52y, F, morning headache 1year, mood changes:            Specimen of brain. ? diagnosisA. Glioblastoma multiforme.B. Astro...
52y, Fem, Menstrual headache: ? diagnosis1.   Glioblastoma m.2.   Astrocytoma3.   Metastases4.   Medulloblastoma5.   Menin...
52y, Fem, Headache, seizure 4 weeks. ? diagnosisA. AV malformation.B. GlioblastomaC. AstrocytomaD. MeningiomaE. ACA Stroke...
52y, F, parasagittal tum attached to falx: ? diagnosisA. Glioblastoma m.B. AstrocytomaC. MeningiomaD. EpendymomaE. Medullo...
Commonest primary CNS tumor in Adults ?A. Glioblastoma multiformeB. Lowgrade AstrocytomaC. MeningiomaD. EpendymomaE. Medul...
60y smoker, chronic bronchitis complains of difficultywalking. PE: stiff, expressionless face. A resting tremorof his fing...
55y Female. Died following car crash. Coronersautopsy Image shows Brain stem- What is the likelycause of death?A. Herniati...
56y, F Rapidly growing parietal lobe tumor:? diagnosisA. Glioblastoma m.B. AstrocytomaC. MeningiomaD. EpendymomaE. Medullo...
49y, M, CNS tumor: ? diagnosisA. MetastasesB. Astrocytoma sy.C. MeningiomatosisD. NeurofibromatosisE. Lipomatosis0%    0% ...
54y woman dies 48 hours after suffering severe head injuriesin an automobile accident. Just before her death, her left pup...
48y male, headache 2months, Frontal lobe welldemarcated mass lesion. Most likely diagnosis? A. Glioblastoma multiforme. B....
A 49y man with a 3 month history of worsening headaches, vomiting and blurringvision has a seizure. Image shows MRI of her...
A 49y man presents with rapidly progressive decline in mental function over 4 weeks.He has clumsiness of motor movements, ...
A 19y female develops sore throat, 3 days later presents with severe headache, neckrigidity. CSF examination reveals High ...
A 61 year old woman with a 8 month history of worsening headaches develops newunilateral anosmia. She has also developed o...
A 8 year old girl presents with severe headache, abnormal gait & MRI reveals third andlateral ventricular enlargement. Ima...
A 31 year old man with no significant past medical history has a sudden new-onsetgrand mal seizure. No Diabetes, he is nor...
A 51 year old previously healthy woman with a sudden severe headache has thevertebral artery angiogram shown. What is the ...
A 86 year old man with a 7 year history of progressive withdrawal and apathy is foundon formal examination to have severe ...
A 68 year old woman with a 4 year history of progressive withdrawal, irritable,irresponsible with speech difficulties. The...
A 4 year old boy presents with a wide based gait and truncal ataxia. MRI reveals thisrdand lateral ventricular enlargement...
A 56 year old man develops 2 year history of increasing hand and forearm weaknessand clumsiness. Later develops dysarthria...
50y Female, Smoker, Headache, Diagnosis?   1.   Glioblastoma   2.   Astrocytoma   3.   Ependymoma   4.   Medulloblastoma  ...
• 40y fem, post therapy for Breast Ca – seizures, cognitive changes.    38y Man with AIDS – Headache, arm weakness, gait d...
“If we are not free, no one will           respect us.”- Wings of Fire: An Autobiography of Dr. APJ Abdul Kalam.
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Pathology of CNS Tumors - Quiz

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CNS tumors - In-class quiz using Electgronic Student Response System (ESRS).

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Pathology of CNS Tumors - Quiz

  1. 1. “There are forces in life working for you and against you. One must distinguish the beneficialforces from the malevolent ones and choose correctly between them” - Wings of Fire: An Autobiography of Dr. APJ Abdul Kalam.
  2. 2. Quick Pathology ReviewPathology ofCNS Tumors & Meningitis Shashidhar Venkatesh Murthy A/Prof.& Head of Pathology School of Medicine & Dentistry James Cook University Australia.
  3. 3. CPC 35 – CNS- Seizure – Tumours, meningitisMajor CLI:• Increased intracranial pressure – Pathogenesis & pathology. Pathology of common CNS tumours.• Astrocytoma – grades, clinical types, presentation & complications.• Pathology & Microbiology of Meningitis – common types * Bacterial, Viral & TB.Minor CLI:• Epilepsy, types, clinical features & Pathogenesis.• Toxic meningitis – Kernicterus.• Meningitis other types – viral, fungal (Cryptococcus), carcinomatous etc.
  4. 4. Look for good in others…no one is without faults and everyone has some good qualities! BK.
  5. 5. A 36y woman with 18month history of progressively increasing headaches whichincreases with her menstrual cycle. Her daughter is also concerned with her recentmemory problem and emotional outbursts. Image shows MRI of her head.What is the most likely diagnosis?A. ACA infarct.B. Glioblastoma multiforme.C. Frontotemporal dementia.D. Brain Metastases.E. Meningioma. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 gross and Microscopic feature of this disease?C. What is the relation to menstrual cycle.
  6. 6. A 3 year old boy with a history of headaches and morning vomiting for 10 dayspresents to the ER after a bad episode of vomiting. He is afebrile. The diagnosticstudies might include all of the following ExceptA. Fundoscopy.B. CSF examination.C. GI Endoscopy.D. MRI.E. Haemogram/FBC. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss complications of spinal tap?B. List 3 laboratory features of CSF in infective types of meningitis?C. Briefly discuss locations and clinical features of brain herniation?
  7. 7. A 56 year old woman has a grand mal seizure. Her CSF values reveal a highprotein, normal glucose and a normal WBC counts, culture was negatie. A large rightcerebral mass is resected and has the microscopic appearance shown.What is the most likely diagnosis?A. Cerebral infarct.B. Fungal Abscess.C. Glioblastoma multiforme.D. Brain Metastases.E. Meningioma. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 gross and Microscopic feature of this disease?C. Briefly discuss prognosis of this condition?
  8. 8. 52y, F, morning headache 1year, mood changes: Specimen of brain. ? diagnosisA. Glioblastoma multiforme.B. Astrocytoma grade 2.C. Meningioma.D. Ependymoma.E. Metastases. 0% 0% 0% 0% 0% A. B. C. D. E.
  9. 9. 52y, Fem, Menstrual headache: ? diagnosis1. Glioblastoma m.2. Astrocytoma3. Metastases4. Medulloblastoma5. Meningioma 0% 0% 0% 0% 0% 1 2 3 4 5
  10. 10. 52y, Fem, Headache, seizure 4 weeks. ? diagnosisA. AV malformation.B. GlioblastomaC. AstrocytomaD. MeningiomaE. ACA Stroke 20% 20% 20% 20% 20% A. B. C. D. E.
  11. 11. 52y, F, parasagittal tum attached to falx: ? diagnosisA. Glioblastoma m.B. AstrocytomaC. MeningiomaD. EpendymomaE. Medulloblastoma 0% 0% 0% 0% 0% A. B. C. D. E.
  12. 12. Commonest primary CNS tumor in Adults ?A. Glioblastoma multiformeB. Lowgrade AstrocytomaC. MeningiomaD. EpendymomaE. Medulloblastoma 0% 0% 0% 0% 0% A. B. C. D. E.
  13. 13. 60y smoker, chronic bronchitis complains of difficultywalking. PE: stiff, expressionless face. A resting tremorof his fingers (pill rolling). Image shows his brain stem .Diagnosis ?A. Alzheimers diseaseB. Lacunar infarctsC. Picks diseaseD. Parkinsons diseaseE. Durett hemorrhages 0% 0% 0% 0% 0% A. B. C. D. E.
  14. 14. 55y Female. Died following car crash. Coronersautopsy Image shows Brain stem- What is the likelycause of death?A. Herniation of cerebral tonsilB. Intracerebral hemorrhage.C. Subdural hemotomaD. Subarachnoid hemorrhage.E. Glioblastoma multiforme. 0% 0% 0% 0% 0% A. B. C. D. E.
  15. 15. 56y, F Rapidly growing parietal lobe tumor:? diagnosisA. Glioblastoma m.B. AstrocytomaC. MeningiomaD. EpendymomaE. Medulloblastoma 0% 0% 0% 0% 0% 1 2 3 4 5
  16. 16. 49y, M, CNS tumor: ? diagnosisA. MetastasesB. Astrocytoma sy.C. MeningiomatosisD. NeurofibromatosisE. Lipomatosis0% 0% 0% 0% 0%1 2 3 4 5
  17. 17. 54y woman dies 48 hours after suffering severe head injuriesin an automobile accident. Just before her death, her left pupilbecomes fixed and dilated. An inferior view of the patientsbrain at autopsy is shown. Most likely cause of death?A. Diffuse axonal shearingB. Laminar necrosisC. Thrombosis of sagittal sinusD. Transtentorial herniationE. Watershed infarct 0% 0% 0% 0% 0% A. B. C. D. E.
  18. 18. 48y male, headache 2months, Frontal lobe welldemarcated mass lesion. Most likely diagnosis? A. Glioblastoma multiforme. B. Astrocytoma Lowgrade C. Meningioma D. Ependymoma E. Medulloblastoma 20% 20% 20% 20% 20% 1 2 3 4 5
  19. 19. A 49y man with a 3 month history of worsening headaches, vomiting and blurringvision has a seizure. Image shows MRI of her head. He undergoes surgical debulkingfollowed by radiation and chemotherapy.What is the most likely diagnosis?A. ACA infarct.B. MeningiomaC. Glioblastoma multiforme.D. Frontotemporal dementia.E. Brain Metastases.F. . 0% 0% 0% 0% 0% 0% A. B. C. D. E. F.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 gross and Microscopic feature of this disease?C. Briefly discuss prognosis of this condition?
  20. 20. A 49y man presents with rapidly progressive decline in mental function over 4 weeks.He has clumsiness of motor movements, difficulty eating or walking. Impaired attentionspan, memory, and judgement. Image shows microscopic appearance of hiscerebrum. What is the most likely diagnosis?A. ACA infarct.B. Viral Meningitis.C. Creutzfeldt-Jakob diseaseD. Pick’s disease.E. Spongiform encephalopathy. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 gross and Microscopic feature of this disease?C. Briefly discuss prognosis of this condition?
  21. 21. A 19y female develops sore throat, 3 days later presents with severe headache, neckrigidity. CSF examination reveals High protein, low sugar with plenty of neutrophils.Image shows appearance of CSF Gram stain. What is the most likely diagnosis?A. Tuberculous meningitis.B. Viral Meningitis.C. Candida meningitis.D. Streptococcal meningitis.E. Neisseria meningitidis. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 gross and Microscopic feature seen in her cerebrum?C. Differentiate CSF findings in different types of meningitis?
  22. 22. A 61 year old woman with a 8 month history of worsening headaches develops newunilateral anosmia. She has also developed obsessive anxiety about her health andher children safety with no apparent reason. A left subfrontal 3 cm discrete mass isresected. Image shows it’s histopathological appearance.What is the most likely diagnosis?A. Olfactory Neuroblastoma.B. Lowgrade Glioma.C. Brain Metastases.D. Meningioma.E. Glioblastoma multiforme. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 gross and Microscopic feature of this disease?C. Briefly discuss prognosis of this condition?
  23. 23. A 8 year old girl presents with severe headache, abnormal gait & MRI reveals third andlateral ventricular enlargement. Image shows gross specimen showing likely grossfeatures. What is the most likely diagnosis?A. MedulloblastomaB. Pilocytic astrocytoma.C. Neuroblastoma.D. Retinoblastoma metastases.E. Ruptured AV malformation. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly describe pathological features seen in the image?B. Explain the symptoms? What is the prognosis?C. List two microscopic features?
  24. 24. A 31 year old man with no significant past medical history has a sudden new-onsetgrand mal seizure. No Diabetes, he is normotensive. Image shows the angiogram ofhis left internal carotid artery. What is the most likely diagnosis?A. Berry aneurysm.B. Vascular malformation.C. AV fistula in MCA.D. Atherosclerosis of MCA.E. Fusiform aneurysm. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 clinical features of this disease?C. Briefly discuss prognosis of this condition?
  25. 25. A 51 year old previously healthy woman with a sudden severe headache has thevertebral artery angiogram shown. What is the most likely diagnosis?A. AV malformation.B. Fusiform aneurysm.C. AV fistula in MCA.D. Atherosclerosis of MCA.E. Berry aneurysm. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly discuss origin & pathogenesis of this condition?B. List 3 complications of this condition? How common is this?C. Briefly discuss prognosis of this condition?
  26. 26. A 86 year old man with a 7 year history of progressive withdrawal and apathy is foundon formal examination to have severe short term memory loss and is unoriented toplace or time. The image shows brain appearance similar to his. What is the mostlikely diagnosis?A. Parkinson’s diseaseB. Alzheimer’s diseaseC. Astrocytome low grade.D. Vascular dementia.E. Pick’s disease 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly describe pathological features seen in the image?B. Explain the symptoms? What is the prognosis?C. List three microscopic features?
  27. 27. A 68 year old woman with a 4 year history of progressive withdrawal, irritable,irresponsible with speech difficulties. The image shows brain appearance similar toher. What is the most likely diagnosis?A. Parkinson’s diseaseB. Alzheimer’s diseaseC. Astrocytome low grade.D. Vascular dementia.E. Pick’s disease 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly describe pathological features seen in the image?B. Explain the symptoms? What is the prognosis?C. List two microscopic features?
  28. 28. A 4 year old boy presents with a wide based gait and truncal ataxia. MRI reveals thisrdand lateral ventricular enlargement, along with the lesion shown. What is the mostlikely diagnosis?A. MedulloblastomaB. Pilocytic astrocytoma.C. Neuroblastoma.D. Retinoblastoma metastases.E. Ruptured AV malformation. 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly describe pathological features seen in the image?B. Explain the symptoms? What is the prognosis?C. List two microscopic features?
  29. 29. A 56 year old man develops 2 year history of increasing hand and forearm weaknessand clumsiness. Later develops dysarthria and dysphagia. A year later he dies ofpneumonia. Image shows two sections of spinal cord with arrows showing thepathology. What is the most likely diagnosis? MND .. many subtypes: • Amyotrophic Lateral Sclerosis.A. Parkinsonism. • Progressive muscle atrophy (LMN)B. Multiple Sclerosis. • Primary lateral sclerosis (UMN) • Progressive bulbar palsyC. Vitamin B12 deficiency (CDC)D. Motor Neurone Disease (MND)E. Amyotrophic Lateral Sclerosis (ALS) 0% 0% 0% 0% 0% A. B. C. D. E.A. Briefly describe pathological features seen in the image?B. Explain the symptoms? What is the prognosis?C. List one microscopic feature?
  30. 30. 50y Female, Smoker, Headache, Diagnosis? 1. Glioblastoma 2. Astrocytoma 3. Ependymoma 4. Medulloblastoma 5. MeningiomaA. Briefly describe pathological features seen in the images?B. Explain 0% symptoms? What0% the prognosis? 0% the 0% 0% isC. List two microscopic features? 1 2 3 4 5
  31. 31. • 40y fem, post therapy for Breast Ca – seizures, cognitive changes. 38y Man with AIDS – Headache, arm weakness, gait disorder. Images Gross & MRI Diagnosis? 1. Glioblastoma 2. Astrocytoma 3. PML 4. Ependymoma 5. MedulloblastomaA. Briefly describe pathological features seen in the images?B. 0% What 0% the0% is Etiology? 0% 0% - JC virus 1 2 3 4 5C. What is the pathogenesis? - Oligodendrocytes - demyelination
  32. 32. “If we are not free, no one will respect us.”- Wings of Fire: An Autobiography of Dr. APJ Abdul Kalam.
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