A 45 year old male complained of a severe headache. He was noted on physical examination to have papilledema on the right. He then became obtunded and died. The gross pathologic finding seen here is most likely to have been produced as a consequence of:
|
A)
|
Ocular melanoma
|
|
B)
|
Berry aneurysm rupture
|
|
C)
|
Glioblastoma multiforme
|
|
D)
|
Multiple sclerosis
|
|
E)
|
Meningococcemia
|
This microscopic appearance with trichrome stain demonstrates the findings in a 3 cm lesion from the right parietal lobe that was ring enhancing by CT scan. The patient, a 48 year old female, had headaches for several weeks and then presented to the emergency room with a grand mal seizure. The most likely diagnosis is:
|
A)
|
Glioblastoma multiforme
|
|
B)
|
Herpes simplex encephalitis
|
|
C)
|
Arteriovenous malformation
|
|
D)
|
Cerebral abscess
|
|
E)
|
Acute infarction
|
A 42 year old male has had increasing difficulty with activities of daily living for the past year, mainly because of choreiform movements. His family has also noted that he has exhibited behavioral changes, though his memory remains intact. His brother is similarly affected. Based upon the appearance of the coronal section of brain shown here, the disease most likely to explain these changes is:
|
A)
|
Huntington's disease
|
|
B)
|
Parkinson's disease
|
|
C)
|
Alzheimer's disease
|
|
D)
|
Amyotrophic lateral sclerosis
|
|
E)
|
Multiple sclerosis
|
This lesion appeared on CT scan as a discreet mass beneath the dura and was seen to compress the underlying cerebral hemisphere. The patient is a 45 year old female who presented with headaches for the past month. The best diagnosis is:
A) Meningioma ![](04218180.png) B) Astrocytoma, low grade ![](04218180.png) C) Ependymoma ![](04218180.png) D) Metastasis ![](04218180.png) E) Tuberculoma
This 79 year old woman was driving her car when she had the sudden onset of a severe headache. She pulled in to a service station and stopped the car. Then she slumped over the wheel. She was taken to the emergency room, where she remained comatose and died hours later. The most likely explanation for the gross appearance seen here is:
|
A)
|
Glioblastoma multiforme
|
|
B)
|
Thromboembolization with cerebral infarction
|
|
C)
|
Multiple sclerosis
|
|
D)
|
Ruptured berry aneurysm
|
|
E)
|
Huntington's disease
|
A 60 year old male has the lesion shown here at autopsy. He had suddenly lost consciousness, and when he again became alert, he was unable to move his left arm or speak. Which of the following underlying disease processes is he most likely to have to explain these findings:
|
A)
|
Hypertension with chronic renal failure
|
|
B)
|
Rheumatic heart disease with left atrial mural thrombosis
|
|
C)
|
Chronic alcoholism with micronodular cirrhosis
|
|
D)
|
Acquired immunodeficiency syndrome with low CD4 count
|
|
E)
|
Papillary thyroid carcinoma with metastases to bone
|
A 20 year old male has a severe headache, present for about a day. Physical examination reveals nuchal rigidity. His vital signs reveal a temperature of 38.8 C, respirations 26, pulse 98, and blood pressure 95/45. The gross appearance of the surface of the brain is shown here. Which of the following organisms is most likely to be responsible for these findings:
![](04218180.png) A) Cryptococcus neoformans ![](04218180.png) B) Mycobacterium tuberculosis ![](04218180.png) C) Toxoplasma gondii ![](04218180.png) D) JC Papovavirus ![](04218180.png) E) Neisseria meningitidis
For the past year, a 34 year old woman has been treated with high dose immunosuppressive therapy, including prednisone and cytoxan, for high grade lupus nephritis. She now presents with increasing headache and decreased mentation for about a week. A complete blood count reveals that her WBC count is markedly decreased. Based upon the microscopic appearance of the lesion seen here with Gomori methenamine silver stain, the most likely explanation for these findings is:
![](04218180.png) A) Progressive multifocal leukoencephalopathy ![](04218180.png) B) Multiple sclerosis ![](04218180.png) C) Aspergillosis ![](04218180.png) D) Herpes simplex encephalitis ![](04218180.png) E) Cryptococcosis
A 28 year old previously healthy male has the onset of seizures that continue for several weeks. A head CT scan reveals a mass lesion with surrounding hemorrhage in the right cerebral hemisphere. A sterotactic biopsy is performed, and the high power microscopic appearance of the lesion is shown here. The most probable diagnosis is:
|
A)
|
Organizing cerebral abscess
|
|
B)
|
Herpes simplex encephalitis
|
|
C)
|
Berry aneurysm
|
|
D)
|
Glioblastoma multiforme
|
|
E)
|
Vascular malformation
|
A 75 year old female has had progressively worsening mental function, as indicated by her son when he brings his mother to see you. The son states that his mother is now frequently getting lost in the neighborhood. He relates that she cannot easily feed or dress herself. She often does not seem to know who he his. After a year-long course in a nursing home, she dies from a respiratory infection. The brain at autopsy weighs 1025 gm and demonstrates frontal and parietal atrophy, with ex vacuo ventricular dilation. The light microscopic appearance of the frontal cortex is seen here with Bielschowsky silver stain. Which of the following statements best characterizes this process:
|
A)
|
A bloodborne pathogen led to this illness
|
|
B)
|
An amyloid angiopathy can be present
|
|
C)
|
Inheritance of this disease occurs in an autosomal dominant fashion
|
|
D)
|
A response to dopaminergic pharmacologic agents is often observed
|
|
E)
|
Aluminum toxicity can explain these findings
|
|