COMPILED BY : YASIF ABBAS

CNS FLASH POINTS

1. Meningitis refers to an inflammatory process of the leptomeninges and CSF

within the subarachnoid space, while meningoencephalitis combines this with
inflammation of the brain parenchyma.
2. Acute Pyogenic (Bacterial/Purulent) Meningitis
• Neonates: Escherichia coli and the group B streptococci
• Infants and children: Haemophilus influenzae
• Adolescents and in young adults: Meningococcus
• (Neisseria meningitides) is the most common pathogen.
• Extremes of life: Streptococcus pneumoniae and Listeria monocytogenes.

■ CSF in acute pyogenic meningitis:

• Cloudy
• Proteins increased
• Sugar decreased
• Numerous polymorphonuclear leukocytes
■ CSF in tuberculous meningitis:
• Forms cobweb on standing
• Proteins increased
• Sugar decreased
• Chlorides decreased
• Lymphocytes
■ Acute Aseptic (Viral) Meningitis
• CSF Findings
• CSF Appearance: Clear.
• Protein: Moderately increased (>40 mg/100 mL).
• Glucose: Always normal.
• Microscopy: 10 to 100 lymphocytes/mL
■ Waterhouse-Friderichsen syndrome:
• Meningitis
• Septicemia
• Hemorrhagic infarction of the adrenal glands
• Cutaneous petechiae.
3. Infectious meningitis is broadly classified into acute pyogenic (usually
bacterial meningitis), aseptic (usually acute viral meningitis), and chronic
(usually tuberculous, spirochetal, or cryptococcal) on the basis of the
characteristics of inflammatory exudate on CSF examination and the clinical
evolution of the illness. Acute cases show neutrophils and chronic cases
lymphocytes.
4. In Rabies we find - Negri bodies, the pathognomonic microscopic finding, are
cytoplasmic, round to oval, eosinophilic inclusions that can be found in
pyramidal neurons of the hippocampus and Purkinje cells of the cerebellum,
sites usually devoid of inflammation
5. HIV encephalitis is best characterized microscopically as a chronic
inflammatory reaction with widely distributed infiltrates of microglial nodules,
sometimes with associated foci of tissue necrosis and reactive gliosis
6. Multiple sclerosis (MS) is an autoimmune demyelinating disorder
characterized by distinct episodes of neurologic deficits, separated in time,
attributable to white matter lesions that are separated in space.
7. Lesions in multiple sclerosis appear as multiple, well-circumscribed,
somewhat depressed, glassy, graytan, irregularly shaped plaques – active ,
inactive and shadow plaques.
8. The major microscopic abnormalities of Alzeihmer’s disease which form the
basis of the histologic diagnosis, are neuritic (senile) plaques – amyloid core
and neurofibrillary tangles
9. The major classes of primary brain tumors to be considered here include
• gliomas,
• neuronal tumors,
• poorly differentiated tumors, as well as a small collection of other tumors
• Tumor of meninges
• Familial tumor syndrome
10. Gliomas, the most common group of primary brain tumors, include
astrocytomas, oligodendrogliomas, and ependymomas.
11. The two major categories of astrocytic tumors are
• infiltrating astrocytomas and non-infiltrating neoplasms (localized),
of which the most common are the pilocytic astrocytomas seen in
children.
12. Infiltrating astrocytomas account for about 80% of adult primary
brain tumors in adults
13. Grading of astrocytomas : Infiltrating tumors range from diffuse
astrocytoma (grade II/IV) through anaplastic astrocytoma (grade III/IV) to
glioblastoma (grade IV/IV). (The grade I/IV category is limited to pilocytic
astrocytoma – non infiltrating.)
14. On microscopic examination, diffuse astrocytomas are characterized by
a mild to moderate increase in glial cellularity, variable nuclear
pleomorphism, and an intervening feltwork of fine, GFAP-positive astrocytic
processes that give the background a fibrillary appearance
15. Anaplastic astrocytomas show regions that are more densely cellular
and have greater nuclear pleomorphism; mitotic figures are often observed.
16. The histologic appearance of glioblastoma is similar to anaplastic
astrocytoma with the additional features of necrosis ( pseudopalisading
arrangement also seen) and vascular or endothelial cell proliferation ,
Glomeruloid body , It frequently crosses the midline (“butterfly tumor”) ,
Glioblastoma multiforme: high grade astrocytoma with worst prognosis.
17. The term gemistocytic astrocytoma is used for tumors in which the
predominant neoplastic astrocyte shows a brightly eosinophilic cell body
from which emanate abundant, stout processes.
18. Among the alterations that are most common in the low-grade
astrocytomas are mutations affecting p53 and overexpression of platelet-
derived growth factor α (PDGF-A) and its receptor
19. The transition to higher grade astrocytoma is associated with disruption
of two well-known tumor suppressor genes, RB and p16/CDKNaA, and an
unknown putative tumor suppressor on chromosome 19q.
20. Combinations of mutations that activate RAS and PI-3 kinase and
inactivate p53 and RB are present in 80% to 90% of primary
glioblastomas
21. On microscopic examination of a pilocytic astrocytoms ( presents
typically as cystic nodule on gross in kids ) the tumor is composed of bipolar
cells with long, thin “hairlike” processes that are GFAP-positive and form
dense fibrillary meshworks; Rosenthal fibers and eosinophilic granular
bodies, are often present. Tumors are often biphasic with a loose microcystic
pattern in addition to the fibrillary areas
22. On microscopic examination, the oligodendrogliomas are composed of
sheets of regular cells with spherical nuclei containing finely granular
chromatin (similar to normal oligodendrocytes) surrounded by a clear halo of
cytoplasm (“fried egg” appearance). Often show calcification (which can be
seen on x-ray). Both oligodendroglioma and craniopharyngioma show
calcification fairly frequently, oligodendroglioma is often located in the
frontal lobe, whereas craniopharyngioma occurs around the third ventricle
and demonstrates suprasellar calcification
23. Tumor cells in ependymomas may form gland like round or elongated
structures (rosettes, canals) that resemble the embryologic ependymal canal,
with long, delicate processes extending into a lumen ; more frequently present
are perivascular pseudorosettes , MC Site of Ependymoma : In children:
typically near fourth ventricle whereas In adults: spinal cord
24. Medulloblastoma occurs predominantly in children and exclusively in
the cerebellum show round blue cells with hyperchromatic nuclei. Poorly
differentiated tumors. The tumor may express neuronal (neurosecretory
granules or Homer Wright rosettes, as occur in neuroblastoma. In
Retinoblastoma (eye tumor, not a CNS tumor) A characteristic feature is
Flexner Wintersteiner rosettes consisting of clusters of cuboidal or short
columnar cells arranged around a central lumen. The nuclei are displaced away
from the lumen and photoreceptor like elements are produced from it.
25. Medulloblastoma cells have a propensity to form linear chains of cells
infiltrating through cerebellar cortex to aggregate beneath the pia, penetrate the
pia, and seed into the subarachnoid space. Dissemination through the CSF is a
common complication, presenting as nodular masses elsewhere in the CNS,
including metastases to the cauda equina that are sometimes termed drop
metastases.
26. Meningiomas are predominantly benign tumors of adults, usually
attached to the dura, that arise from the meningothelial cell of the
arachnoid.
27. Most meningiomas have a relatively low risk of recurrence or aggressive
growth, and so are considered WHO grade I/IV
28. Variants of grade I meningiomas include
• syncytial
• transitional
• fibroblastic
• psamommatous
• secretory
• microcystic.
29. Atypical meningiomas are distinguished from lower grade
meningiomas by the presence of either a mitotic index of four or more mitoses
per 10 high power fields or at least three atypical features (increased cellularity,
small cells with a high nuclear-to-cytoplasmic ratio, prominent nucleoli,
patternless growth, or necrosis). Certain histologic patterns (clear cell and
chordoid) are also considered to be grade II/IV because of their more
aggressive behavior.
30. Anaplastic (malignant) meningioma (WHO grade III/IV) is a highly
aggressive tumor with the appearance of a high-grade sarcoma, but retaining
some histologic evidence of meningothelial origin. Mitotic rates are often
extremely high (>20 mitoses per 10 high power fields).Variants include
papillary and rhabdoid.
31. Metastasis : The five most common primary sites are lung, breast,
skin (melanoma), kidney, and gastrointestinal tract, accounting for about
80% of all metastases
32. Classic neurofibromatosis (NF-1) is an autosomal dominant
disorder. It is characterized by cafe-au-lait skin macules, axillary freckling,
multiple neurofibromas, plexiform neurofibromas, and Lisch nodules
(pigmented iris hamartomas). Lisch nodules are found in 95% of patients
after age 6. There is increased risk of developing meningiomas or even
pheochromocytoma. A major complication of NF-1 is the malignant
transformation of a neurofibroma to a neurofibrosarcoma. The gene for the
classic form (NF-1) is located on chromosome 17. It encodes for
neurofibromin, a protein that regulates the function of p21 oncoprotein.
33. Central neurofibromatosis (NF-2) is an autosomal-
dominant disorder in which patients develop a range of tumors, most
commonly bilateral VIII nerve schwannomas and multiple meningiomas.
Gliomas, typically ependymomas of the spinal cord, also occur in these
patients. Many individuals with NF2 also have non-neoplastic lesions, which
include nodular ingrowth of Schwann cells into the spinal cord (schwannosis),
meningioangiomatosis (a proliferation of meningeal cells and blood vessels that
grows into the brain), and glial hamartia (microscopic nodular collections of
glial cells at abnormal locations, often in the superficial and deep layers of
cerebral cortex). The NF2 gene is located on chromosome 22 and encodes
for merlin.
34. Epidural Hemorrhage : Accumulation of blood between
skull bone and the dura matter. Fracture of skull and tear in the middle
meningeal artery.
 35. Subdural hematoma is defined as accumulation of blood in
the subdural space, i.e. between the inner surface of the dura mater and the
outer arachnoid layer of the leptomeninges. Most commonly occurs due to
rupture of bridging veins.

36. Subarachnoid Hemorrhage and Ruptured Saccular

Aneurysms : Accumulation of blood in the subarachnoid space, i.e. between
the inner surface of the arachnoid and pia matter. Due to Rupture of
congenital berry aneurysm. Berry aneurysm is associated with adult
polycystic kidney (ADPKD)

37. Intracerebral (Intraparenchymal) Hemorrhage:

Hemorrhages within the brain parenchyma. Usually spontaneous and occur in
middle to late adult life (peak during 60 years of age).Most are caused by
rupture of a small intraparenchymal vessel. The two major causes are
hypertension and cerebral amyloid angiopathy (CAA)
Last day not to be missed call :

• Revise WHO Grading of Astrocytomas with Genes altered in astrocytomas

• Meningiomas grading with variants list
• Medulloblastoma
• Pilocytic Astrocytoma
• Meningitis table

MCQS

Laboratory examination of the CSF obtained from a child of 2 years age. Who
presented with fever, headache, vomiting and neck rigidity, is suggestive of
acute pyogenic meningitis. The most likely etiological agent of this condition is:
a) Escherichia coli
b) Group B streptococci
c) Staphylococcus aureus
d) Hemophilus influenza
e) Streptococcus pneumonia

A 76-year-old man is admitted to the hospital for evaluation of progressive

memory loss and disorientation. The pupils are small but react normally to
light. Muscle tone is normal. A lumbar puncture returns clear, colorless CSF
under normal pressure. An electroencephalogram shows diffuse slowing. A CT
scan of the brain reveals moderate atrophy. Which of the following is the most
likely diagnosis?
(A) Alzheimer disease
(B) Creutzfeldt-Jakob disease
(C) Glioblastoma multiforme
(D) Huntington disease
(E) Pick disease

Alzheimer disease is the most common cause of dementia in the elderly. Autopsy
of the patient died of this disease shows characteristic histological features in the
brain which of the following is not a feature of this disease.
a. Neuritic plaques
b. Neurofibrillary tangles
C. Cerebral amyloid angiopathy
d. Granulovacuolar degeneration
e. Lewy body

A 45-year-old woman is rushed to the emergency room following an automobile

accident. Ten hours after admission, the patient complains of a severe headache
and blurred vision. An X-ray fi lm of the cranium shows a fracture of the
temporal-parietal bone. Despite emergency craniotomy, the patient dies. Which
of the following pathologic findings would be expected at autopsy?
(A) Epidural hematoma
(B) Intracerebral hemorrhage
(C) Intraventricular hemorrhage
(D) Subarachnoid hemorrhage
(E) Subdural hematoma

A 12-year-old boy is rushed to the emergency room in a coma after falling from
an upper story window of his home. MRI shows a subdural hematoma over the
left hemisphere. What is the most likely source of intracranial bleeding in this
patient?
(A) Bridging veins
(B) Charcot-Bouchard aneurysm
(C) Internal carotid artery
(D) Middle meningeal artery
(E) Sagittal sinus

A 5-year-old boy is brought to the emergency room with fever, vomiting, and
convulsions. The patient is febrile to 39.5°C (104°F). Physical examination
reveals cervical rigidity and pain in the neck and knees. Acute inflammation
most likely involves which anatomic region of the patient’s brain?
(A) Choroid plexus
(B) Ependyma
(C) Hypothalamus
(D) Lateral ventricles
(E) Leptomeninges
A 32-year-old woman presents with a 2-day history of headache, vomiting, and
fever. Physical examination reveals cervical rigidity and knee pain with hip
flexion. Lumbar puncture demonstrates an abundance of neutrophils and
decreased levels of glucose. Which of the following diseases is most likely
associated with these clinical laboratory findings?
(A) Meningococcal meningitis
(B) Neurosarcoidosis
(C) Staphylococcal meningitis
(D) Tuberculous meningitis
(E) Viral meningitis

A female neonate is noted at birth to have a gross deformity of her lower back.
Examination of the subcutaneous lesion reveals disorganized neural tissue with
entrapment of nerve roots. What is the appropriate diagnosis?
(A) Meningocele
(B) Meningomyelocele
(C) Rachischisis
(D) Spina bifida occulta
(E) Syringomyelia

An 8 year’s old boy complains of severe headache and vomiting. On

examination his gait is also disturbed. On suspicion of brain tumor, CT scan
was ordered which showed a tumor located in the mid line of cerebellum. The
tumor is removed by surgery. Grossly it is gray and friable. On microscopic
examination extremely cellular neoplasm composed of sheets of small round
cells having hyperchromatic nuclei. The tumor is
A. Astrocytoma
B. Ependymoma
C. Meningioma
D. Medulloblastoma
E. Lymphoma

Glioblastoma multiforme a variant of infiltrating astrocytoma belongs to which

of the following WHO tumor grade
A. Grade 0/IV
B. Grade I/IV
C. Grade II/IV
D. Grade III/IV
E. Grade IV/IV

A 2-year-old boy is brought to the physician by his parents, who complain that
their son continually loses his balance. They also report that his speech seems
more slurred. Physical examination confirms the truncal ataxia and wide-based
gait. The child appears lethargic, and there is bobbing of the head while he is
sitting. Muscle tone is normal. This patient may have a midline tumor in which
anatomic portion of the brain?
(A) Cerebellum
(B) Corpus callosum
(C) Frontal lobes
(D) Hypothalamus
(E) Meninges

Which of the following is not a tumor of central nervous system?

a) Astrocytoma
b) Oligodendroglioma
c) meningioma
d) Ependymoma.
e) Retinoblastoma

Which of the following CNS tumor has the best prognosis?

a) Anaplastic astrocytoma (WHO grade III)
b) Glioblastoma multiforme,
c) Pilocytic astrocytoma (WHO grade I )
d) Medulloblastoma.
e) Oligodendroglioma (WHO grade II)
Flexner Winter Steiner rosettes is one of the characteristic histological features
of:
a) Retinoblastoma
b) Glioma
c) Neuroblastoma
d) Meningioma
d) Medulloblastoma
Which of the following is truly characteristic of a meningioma?
a) Intracerebral tumor
b) Tumor cells arranged in a rosette pattern
c) Origin of tumor cells in arachnoid matter
d) Fried egg appearance of tumor cells
e) Multiple areas of necrosis and hemorrhages within the tumor
Which of the following is a diagnostic feature of acute pyogenic meningitis?
a) Decrease in CSF protein
b) Increase in CSF glucose
c) Clear transparent CSF
d) Presence of increased number of lymphocyte in CSF
e) Presence of gram negative cocci on gram stain smear of CSF
Which of the following carries a very poor prognosis?
a) Ependymoma
b) Giloblastoma multiforme
c) Meningioma
d) Schwannoma
e) Oligodendroglioma
A previously healthy 31 years old female experiences a sudden severe headache
and loses consciousness within an hour. CT scan reveals extensive subarachnoid
hemorrhage at the base of the brain. She is afebrile.A lumbar puncture yields
cerebrospinal fluid with many red blood cells, but no white blood cells. The CSF
protein is slightly increased, but the glucose is normal. Which of the following is
the most likely diagnosis?
a. Acute bacterial meningitis
b. Ruptured berry aneurysm
c. Progressive multifocal leukoencephalopathy
d. Hypertensive hemorrhage
e. Amyloid arteriopathy

The following lab findings are correct In acute pyogenic meningitis except:
a) CSF color - Usually turbid
b) CSF pressure - Increased
c) Leucocyte count - High
d) CSF Protein: Elevated
e) CSF glucose: elevated
An elderly man presents with loss of memory for recent events. He frequently
forgets names of his spouse and grand children. He often losses his way while
driving to familiar location. Which of the following is he most probably
suffering from?
a) Parkinson's disease
b) Transient ischemic attacks
c) Alzheimer's disease
d) Slow viral infection,
e) Multiple sclerosis
A young patient presented with polyurea, polydipsia and visual disturbance.
The diagnosis of brain tumor was made. Which of the following brain Tumor
may be responsible for this symptoms complex:
a) Meningioma
b) Astrocytoma
c) Retinoblastoma
d) Ependymoma
e) Craniopharyngioma
A 68-year-old man presents with a 2-week history of tonic-clonic seizures that
initially involve his left arm but have more recently progressed to involve his left
leg. The seizures are accompanied by muscle weakness but no other neurologic
signs. The cranial nerves are intact, and the Babinski sign is present. A CT scan
reveals a mass in the left cerebral hemisphere. A left frontoparietal craniotomy
is performed. Which of the following is the appropriate diagnosis?
(A) Craniopharyngioma
(B) Ependymoma
(C) Ganglioglioma
(D) Glioblastoma multiforme
(E) Meningioma
A child develops a tumor of the brainstem, which on biopsy demonstrates
bizarre, pleomorphic tumor cells accompanied by necrosis and hemorrhage.
Which of the following is the likely diagnosis?
A. Glioblastoma Multiforme.
B. Ependymoma.
C. Astrocytoma.
D. Oligodendroglioma.
E. Pilocytic astrocytoma.
Which of the following CNS tumors has the best prognosis:
A. Anaplastic astrocytoma (WHO grade III)
B. Glioblastoma multiforme.
C. Well differentiated astrocytoma (WHO grade II)
D. Medulloblastoma.
E. Oligodendroglioma

A 65-year-old woman presents with a 3-week history of intractable headaches.

Her vital signs and CBC are normal. Two weeks later, the patient develops left-
sided hemiparesis. MRI reveals a large, necrotic tumor in the right hemisphere
of the cerebrum, extending across the corpus callosum into the left hemisphere.
This tumor is most likely derived from which of the following cell types?
(A) Astrocytes
(B) Ependymal lining cells
(C) Microglia
(D) Neurons
(E) Oligodendroglia
A 20-year-old man complains of increasing diffi culty in hearing over the past
several years. Physical examination confirms bilateral sensorineural hearing
deficits. MRI discloses bilateral cerebellopontine angle tumors, consistent with
schwannomas. This patient has a strong family history for benign tumors,
including low-grade gliomas and meningiomas on his mother’s side of the
family. Which of the following is the probable diagnosis?
(A) Neurofibromatosis type 1
(B) Neurofibromatosis type 2
(C) Sturge-Weber syndrome
(D) Tuberous sclerosis
(E) Von Hippel-Lindau syndrome
A 60-year-old man, a suicide victim, comes to autopsy. Before dying, he had
been despondent after being informed that he had an extremely aggressive
brain tumor. There had been a recent onset of headache, seizures, and mental
status changes, and MRI had demonstrated an infiltrating neoplasm invading
the cerebral hemispheres and crossing the midline, with areas of necrosis and
abnormal blood vessels. The autopsy confirms the MRI findings and also
demonstrates hemorrhage and a pseudopalisade arrangement of tumor cells.
The tumor is most likely a.
(A) ependymoma.
(B) glioblastoma multiforme.
(C) meningioma.
(D) neurilemmoma (schwannoma).
(E) oligodendroglioma.
A 63-year-old woman is hospitalized secondary to markedly decreased
vision. She has no history of polydipsia or nocturia. Physical examination
finds bilateral sluggish light reflexes and a bitemporal hemianopsia. No
papilledema is present, and her urine specific gravity is within normal limits.
A CT scan of the head finds a suprasellar mass with calcification. Which of
the following is the most likely diagnosis?
a. Craniopharyngioma
b. Germinoma
c. Juvenile pilocytic astrocytoma
d. Medulloblastoma
e. Meningioma

A 38-year-old woman presents with increasing frequency of severe headaches.

The previous day she had a seizure that lasted several minutes. Her past medical
history is otherwise unremarkable, and she has no previous history of seizure
activity. She is admitted to the hospital and a CT scan of her head finds a 2-cm
mass attached to the dura in her right frontal area. Which of the following
histologic changes is most likely to be seen in a biopsy specimen taken from this
tumor?
a. Antoni A areas with Verocay bodies
b. A whorled pattern with Psammoma bodies
c. Endothelial proliferation with serpentine areas of necrosis
d. “Fried-egg” appearance of tumor cells without necrosis
e. True rosettes and pseudo rosettes
A 44-year-old woman presents with the new onset of seizures along with
increasing frequency of severe headaches. Her medical history is otherwise
unremarkable. Physical examination finds bilateral neurologic defects. Workup
reveals a large, ill-defined, necrotic mass that involves both the right and left
cerebral cortex. Histologic sections from this lesion reveal a hypercellular tumor
with pseudopalisading of tumor cells around large areas of serpentine necrosis.
Marked vascular endoneural proliferation is present. Numerous atypical nuclei
and mitoses are seen. This tumor is best classified as what type of high-grade
neoplasm?
a. Astrocytoma
b. Lymphoma
c. Medulloblastoma
d. Oligodendroglioma
e. Schwannoma
A 50 years old man is noted by his wife to have undergone personality changes
over the last year. He has become more forgetful and sloppy and does not
appear to take an interest in his work. MR imaging of the brain is performed
and shows a 3 cm diameter left frontal lobe mass with areas of calcification.
Which of the following diagnoses is most likely to be made on microscopic
examination of this mass?
A) Vascular malformation
B) Oligodendroglioma
C) Meningioma
D) Schwannoma
E) Organizing abscess
A 52 years old man has headaches and difficulty concentrating for the past 2
months. He then suffers a grand mal seizure, and is admitted to the hospital.
MR imaging of the brain reveals a large mass with extensive necrosis in the left
cerebral hemisphere extending across corpus callosum into the right
hemisphere. Which of the following neoplasms is he most likely to have?
A) Meningioma
B) Glioblastoma
C) Medulloblastoma
D) Ependymoma
E) Pilocytic astrocytoma

A 36 years old woman has noted increasing numbers of disfiguring nodular

masses involving the skin of her trunk and extremities. On physical examination
these 0.5 to 2 cm subcutaneous masses are firm and non-tender. MR imaging of
the brain shows an ill-defined 4 cm mass of the right parietal lobe. An
abdominal CT scan shows a 3 cm mass involving the left adrenal gland.
Laboratory studies show increased urinary free catecholamines. A mutation
involving which of the following genes is most likely to be present in this
woman?
A) APC
B) CFTR
C) K-RAS
D) NF-1
E) NF-2
A 9 years old boy has the new onset of headaches for the past 4 months. The
headaches are becoming more frequent and prolonged. MRI imaging reveals
enlargement of the lateral ventricles. There is a 4 cm homogenous, well-
circumscribed mass within the fourth ventricle. Which of the following is the
most likely diagnosis?
A) Astrocytoma
B) Choroid plexus papilloma
C) Ependymoma
D) Meningioma
E) Schwannoma
Which of the following responses is false regarding Medulloblastoma?
a) Predominantly occurs in childhood
b) Occurs in cerebrum
c) Has a desmoplastic variant
d) is highly malignant
e) Is radiosensitive
A 20 yrs old male presents in the surgical OPD with multiple slightly painful
slowly growing swellings on his back. Biopsy of one of the swellings reveals
fibrousstroma and interspersed short fascicles of spindle cells having wavy
nuclei. The lesion is
a. Schwannoma
b. Neurofibroma
c. Meningioma
d. Fibroma
e. Metastatic carcinoma

Which of the following intracranial neoplasms has the best prognosis following
surgery:
a. Schwannoma
b. Glioblastoma multiforme
c. Astrocytoma
d. Medulloblastoma
e. Solitary metastasis
A 2 years old boy with gross motor delays presented with wide-based, unsteady
gait and headaches over 1 month. A brain MRI reveals a large posterior fossa
mass. He underwent total resection and microscopy showed small blue round
cell, homer wright rosettes and high mitotic count. The most likely diagnosis is:
A) Meningioma
B) Glioblastoma
C) Astrocytoma
D) Choroid plexus tumor
E) Medulloblastoma
A 5-year-old boy presents with projectile vomiting and progressive ataxia.
Workup finds obstructive hydrocephalus due to an infiltrative tumor located in
the posterior fossa and originating from the midline of the cerebellum. What is
the most likely diagnosis for a tumor located in this location in this child?
a. Glioblastoma multiforme
b. Dysembryoplastic neuroepithelial tumor
c. Primary CNS lymphoma
d. Primary germ cell tumor
e. Primitive neuroendocrine tumor
Meningioma is benign tumor arising from:
A. Glial cells
B. Squamous epithelial cells
C. Columnar epithelial cells
D. Meningothelial cells
E. Ependymal cells
Glioblastoma is:
A. Well differentiated astrocytoma
B. Poorly differentiated astrocytoma
C. Lymphoma of CNS
D. Teratoma of CNS
E. Metastatic tumor
A 48-year-old man with AIDS is admitted to the hospital with a headache, fever
of 38.7°C (103°F), and persistent cough. His CD4 cell count is less than 500/mL.
Lumbar puncture returns cloudy fluid, and microscopic examination shows
numerous encapsulated microorganisms and Soap bubble appearance in brain
on MRI Which of the following pathogens is the most likely cause of meningitis
in this patient?
(A) Aspergillus flavus
(B) Cryptococcus neoformans
(C) Mycobacterium tuberculosis
(D) Neisseria meningitidis
(E) Toxoplasma gondii