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1# CNS Inflammatory Conditions
1. Which glial cell change is most characteristic of chronic brain tumors?
Microglial nodules
Gemistocytic astrocytes
Rod cells
Gitter cells
Explanation:
Gemistocytes are swollen reactive astrocytes with abundant eosinophilic cytoplasm and increased GFAP, commonly seen in chronic conditions such as brain tumors.
2. Rosenthal fibers are most commonly associated with:
Acute cerebral infarction
Viral encephalitis
Old gliosis or low-grade glial tumors
Demyelinating plaques
Explanation:
Rosenthal fibers are thick eosinophilic astrocytic fibers seen in old gliosis and certain low-grade astrocytomas.
3. Which glial cell is primarily affected in Progressive Multifocal Leukoencephalopathy?
Oligodendrocytes
Astrocytes
Microglia
Ependymal cells
Explanation:
JC virus infects oligodendrocytes, leading to progressive demyelination of white matter in immunosuppressed patients.
4. Elongated microglial cells seen in neurosyphilis are termed:
Gitter cells
Gemistocytes
Microglial nodules
Rod cells
Explanation:
Rod cells are elongated microglia classically seen in syphilitic involvement of the CNS.
5. The most common route of CNS infection is:
Direct trauma
Hematogenous spread
Congenital transmission
Peripheral nerve spread
Explanation:
Hematogenous spread is the most common route of CNS infections.
6. Subdural empyema is dangerous primarily because it causes:
Early hydrocephalus
Diffuse cerebritis
Mass effect and raised intracranial pressure
Ventricular rupture
Explanation:
Subdural empyema produces mass effect and increased ICP and may lead to cortical thrombophlebitis and infarction.
7. The most likely causative organism of meningitis in elderly patients is:
Streptococcus pneumoniae
Neisseria meningitidis
Group B Streptococcus
E. coli
Explanation:
In elderly patients, S. pneumoniae and Listeria monocytogenes are the most common causes.
8. Which CSF finding is typical of viral meningitis?
Low glucose
Neutrophilic pleocytosis
Markedly elevated protein
Lymphocytic pleocytosis with normal glucose
Explanation:
Viral meningitis shows clear CSF, normal glucose, mildly increased protein, and lymphocytic predominance.
9. Basal cistern involvement with caseating granulomas is characteristic of:
Neurosyphilis
Tuberculous meningitis
Cryptococcal meningitis
HSV encephalitis
Explanation:
TB meningitis shows thick exudate, caseating granulomas, and preferential involvement of basal cisterns.
10. Obliterative endarteritis with plasma cell-rich infiltrate suggests:
Meningovascular neurosyphilis
HSV encephalitis
TB meningitis
HIV encephalopathy
Explanation:
Meningovascular neurosyphilis is characterized by obliterative endarteritis and plasma cell infiltration.
11. Lightning pains and loss of deep tendon reflexes are features of:
Paretic neurosyphilis
Meningovascular neurosyphilis
Tabes dorsalis
Poliomyelitis
Explanation:
Tabes dorsalis involves dorsal columns, causing sensory loss, ataxia, lightning pains, and absent reflexes.
12. A brain abscess is most commonly complicated by:
Subarachnoid hemorrhage
Hydrocephalus only
Cerebral aneurysm
Raised intracranial pressure
Explanation:
Severe edema around abscesses commonly leads to increased intracranial pressure.
13. Diabetic ketoacidosis predisposes patients to infection by:
Candida
Mucor
Cryptococcus
Aspergillus
Explanation:
Mucormycosis commonly affects diabetics with ketoacidosis, spreading from nose or sinuses.
14. Hemorrhagic infarction due to angioinvasion is typical of:
Candida
Cryptococcus
Aspergillus
Toxoplasma
Explanation:
Aspergillus invades blood vessels, causing thrombosis and hemorrhagic infarction.
15. HSV encephalitis most commonly affects which brain region?
Temporal lobe
Occipital lobe
Cerebellum
Brainstem
Explanation:
HSV shows hemorrhagic necrotizing inflammation in temporal and orbital frontal lobes.
16. Cowdry type A inclusions are seen in:
Rabies
CMV
Polio
Herpes simplex virus
Explanation:
HSV produces eosinophilic intranuclear Cowdry type A inclusions.
17. Negri bodies are classically found in:
Motor neurons of spinal cord
Hippocampal pyramidal neurons
Oligodendrocytes
Astrocytes
Explanation:
Rabies shows cytoplasmic Negri bodies in hippocampal pyramidal neurons and Purkinje cells.
18. Poliovirus preferentially destroys:
Anterior horn cells
Dorsal root ganglia
Corticospinal tracts
Basal ganglia
Explanation:
Poliovirus causes neuronophagia of anterior motor neurons, leading to paralysis.
19. The most common cause of dementia in young adults is:
Alzheimer disease
Creutzfeldt-Jakob disease
HIV-associated neurocognitive disorder
Lewy body dementia
Explanation:
HAND (HIV-associated neurocognitive disorder) is the most common cause of dementia in young adults.
20. Absence of inflammatory response with spongiform change suggests:
HSV encephalitis
Creutzfeldt-Jakob disease
Tuberculous meningitis
Progressive multifocal leukoencephalopathy
Explanation:
Prion diseases show spongiform transformation without inflammatory response.