1.     Easy one.  Which affected several members of the English
royal family?

A.   hereditary Alzheimer's
B.   hereditary glaucoma
C.   hepatic porphyria (*)
D.   metachromatic leukodystrophy
E.   multiple sclerosis

2.   What is malformed in a coloboma?

A.   cornea and conjunctiva
B.   iris and ciliary body (*)
C.   lens and its suspensory ligament
D.   retinal blood vessels
E.   retinal cell layers

3.   In sudden blindness caused by anti-recoverin antibodies, the
usual underlying cause is

A.   lung cancer (*)
B.   Lyme spirochete infection
C.   multiple sclerosis
D.   recent viral infection
E.   temporal arteritis

4.   You might ask for genetic analysis of the alpha-synuclein
gene when you are investigating for

A.   familial Alzheimer's
B.   familial parkinsonism (*)
C.   familial prion disease
D.   malignant potential of a glioma
E.   progressive supranuclear palsy

5.   What virus is the cause of tropical spastic paralysis?

A.   Epstein-Barr
B.   HIV
C.   HTLV-I (*)
D.   herpes 8 / KSHV
E.   rhabdovirus

6.   Which is the most common neuropathology lesion caused by
Lyme disease?

A.   demyelination of the posterior columns
B.   giant cell encephalitis
C.   microglial nodules
D.   polyneuropathy (*)
E.   windswept cortex with loss of neurons diffusely



7.   Binswanger's is caused by

A.   alcohol abuse
B.   arsenic exposure (suspected but not proved)
C.   hypertensive small-artery disease (*)
D.   iron overload
E.   mutant genes affecting myelin processing

8.   Which is the most common location for a hypertensive
intracerebral bleed?

A.   cerebellum
B.   cortical gray matter
C.   pons
D.   putamen (*)
E.   thalamus

9.   A pathologist's report of "anisomorphic gliosis" indicates

A.   ammonia accumulation in the bloodstream
B.   healing by gliosis
C.   manganese toxicity
D.   neoplasia (*)
E.   slow virus infection

10.  In addition to folic acid deficiency, what other nutritional
problem is believed to help cause neural 
tube defects?

A.   vitamin A deficiency
B.   vitamin A toxicity (*)
C.   vitamin B12 deficiency
D.   vitamin D deficiency
E.   vitamin D toxicity

11.  Neurons at which location are considered to be the most
vulnerable to hypoxic injury?

A.   basis pontis
B.   hippocampus (*)
C.   inferior olive
D.   precentral motor cortex
E.   putamen

12.  ONE KODACHROME.  Silver stain.  What is your best diagnosis?

A.   Alzheimer's disease (*)
B.   multiple sclerosis
C.   Pick's disease
D.   spongiform encephalopathy of prion infection
E.   syphilis or Lyme disease



13.  ONE KODACHROME.  By appearance  and location, this is most
likely a(n)

A.   brain abscess
B.   ependymoma
C.   medulloblastoma
D.   schwannoma (*)
E.   subependymoma

14.  TWO KODACHROMES.  On the morphology alone, this is mostly
likely

A.   Alzheimer's disease
B.   Binswanger's disease
C.   Huntington's disease
D.   Parkinsonism
E.   Pick's disease (*)

15.  ONE KODACHROME.  Neuron most likely from a patient with

A.   Huntington's disease
B.   myoclonus epilepsy
C.   Parkinson's disease (*)
D.   Pick's disease
E.   Tay-Sach's disease

16.  TWO KODACHROMES.  This patient most likely had

A.   Alzheimer's disease
B.   leukodystrophy of some kind
C.   multiple sclerosis (*)
D.   sequelae of herniation
E.   Wernicke-Korsakoff's

17.  ONE KODACHROME.  Brain showing

A.   astrocytoma
B.   carbon monoxide effect
C.   old infarct (*)
D.   recent intracerebral hemorrhage
E.   remote subarachnoid hemorrhage 

18.  ONE KODACHROME.  Brain exhibiting

A.   chronic subdural hematoma
B.   contrecoup contusions (*)
C.   subarachnoid hemorrhage, fresh
D.   subarachnoid hemorrhage, organizing
E.   Wernicke-Korsakoff's disease



19.  TWO KODACHROMES.  The lesion is a(n)

A.   astrocytoma (*)
B.   hypertensive bleed
C.   medulloblastoma
D.   recent infarct with some organization
E.   subarachnoid bleed

20.  ONE KODACHROME.  The child most likely has

A.   cataracts
B.   erythropoietic porphyria
C.   nerve deafness (*)
D.   hepatic porphyria
E.   retinitis pigmentosa

21.  ONE KODACHROME.  On the histology, this brain tumor is
probably a(n)

A.   craniopharyngioma
B.   glioblastoma
C.   medulloblastoma
D.   meningioma
E.   oligodendroglioma (*)

22.  ONE KODACHROME.  Brain from a patient with

A.   agyria / lissencephaly (*)
B.   arhinencephaly
C.   Dandy-Walker
D.   holoprosencephaly
E.   porencephaly

23.  TWO KODACHROMES.  What is the brain lesion?

A.   Duret hemorrhage
B.   ependymoma (*)
C.   medulloblastoma
D.   meningioma
E.   organizing subarachnoid bleed

24.  ONE KODACHROME.  Silver stain.  What's the most likely
diagnosis?

A.   Alzheimer's disease
B.   astrocytoma
C.   contusion
D.   multiple sclerosis (*)
E.   healing infarct



25.  ONE KODACHROME.  On the gross morphology alone, what's the
most likely diagnosis?

A.   abscess
B.   glioblastoma (*)
C.   hypertensive hemorrhage
D.   medulloblastoma
E.   tuberculosis

26.  ONE KODACHROME.  What's the diagnosis?

A.   arteriovenous malformation (*)
B.   epidural hematoma
C.   hemangioblastoma
D.   intracerebral hemorrhage
E.   subdural hemangioma

27.  ONE KODACHROME.  What's the most likely lesion?

A.   congenital rubella (*)
B.   Dandy-Walker
C.   longstanding post-hypoxic coma
D.   multiple sclerosis
E.   tabes dorsalis

28.  TWO KODACHROMES.  What's the diagnosis?

A.   astrocytoma
B.   coup contusion
C.   holoprosencephaly
D.   old infarct (*)
E.   polymicrogyria

29.  ONE KODACHROME.  What's the diagnosis?

A.   coup contusion
B.   epidural hematoma (*)
C.   medulloblastoma
D.   meningioma
E.   subdural hematoma

30.  TWO KODACHROMES.  Your best diagnosis, please?

A.   Alzheimer's disease
B.   Huntington's disease
C.   Pick's disease
D.   prion disease (*)
E.   trauma with edema



31.  ONE KODACHROME.  Just on the gross morphology, what's your
best choice?

abscess
astrocytoma
bacterial meningitis
medulloblastoma
meningioma (*)

32.  ONE KODACHROME. Eye changes of

A.   diabetes
B.   glaucoma
C.   high blood pressure (*)
D.   von Hippel-Lindau
E.   uh, this is an intraocular melanoma

33.  ONE KODACHROME.  Brain lesion caused by

A.   cryptococcus
B.   hemorrhage
C.   hypoxia (*)
D.   radiation therapy
E.   trauma

34.  TWO KODACHROMES. What's the lesion?

A.   Duret hemorrhage
B.   epidural hematoma
C.   hemorrhagic infarct
D.   subarachnoid bleed
E.   subdural hematoma (*)

35.  ONE KODACHROME.  Your best diagnosis?

A.   berry aneurysm (*)
B.   chordoma
C.   Duret hemorrhage
D.   hemangioblastoma
E.   medulloblastoma of the brainstem

36.  ONE KODACHROME.  Some things you just have to remember. 
Metachromatic dystrophy 
features a deficiency of

A.   arylsulfatase A (*)
B.   alanine aminotransferase
C.   alkaline phosphatase
D.   aspartate aminotransferase
E.   lactate dehydrogenase



37.  TWO KODACHROMES.  What's your best diagnosis?

A.   craniopharyngioma (*)
B.   medulloblastoma
C.   meningioma
D.   metastatic adenocarcinoma
E.   oligodendroglioma

38.  ONE KODACHROME.  Which is this?

A.   glioblastoma
B.   Lewy body dementia
C.   medulloblastoma
D.   meningioma
E.   sarcoidosis (*)

39.  ONE KODACHROME.  What's the most likely pathology?

A.   healing contusion
B.   herpes infection (*)
C.   medulloblastoma
D.   progressive multifocal leukoencephalopathy
E.   rabies

40.  ONE KODACHROME.  What's this?

A.   bacterial meningitis (*)
B.   cryptococcal meningitis
C.   epidural hematoma
D.   herpetic encephalitis
E.   neurosyphilis

41.  ONE KODACHROME.  Diagnose this brain tumor.

A.   astrocytoma
B.   glioblastoma
C.   medulloblastoma
D.   meningioma
E.   metastatic lung cancer (*)

42.  ONE KODACHROME.  And what do you think this is?

A.   arachnoid cyst (*)
B.   epidural hematoma
C.   meningioma
D.   neurosyphilis
E.   recent coup lesion




BONUS ITEMS

43.  TWO KODACHROMES.  What's the eye lesion?

[retinoblastoma]



44.  TWO KODACHROMES.  What's the brain lesion?

[agenesis of the corpus callosum]




45.  TWO KODACHROMES.  What's the brain lesion?

[Arnold-Chiari]




46.  THREE KODACHROMES. Your best diagnosis, please!

[tuberous sclerosis / Bourneville's / epiloia / hamartomas]




47.  ONE KODACHROME.  Mystery stain.  Give your best diagnosis.

[central pontine myelinolysis]




48.  ONE KODACHROME.  What's the eye lesion?

[keratoconus]




49.  What bacterium is the usual cause of "malignant" otitis
externa?

[pseudomonas]



50.  Coexisting deficiency of what nutrient is likely to make
infection with trachoma much more severe?

[vitamin A / retinoic acid]




51.  What's the eponym for the little areas on the iris that fail
to develop properly in people with trisomy 
21?

[Brushfield's]



52.  What common autosomal-dominant disease puts a person at
extra risk for berry aneurysms?

[polycystic kidney]





53.  What's the easiest way, in your office, to tell whether
somebody's runny nose or ear is CSF 
rhinorrhea?

[glucose reagent test strip]




54.  What name do we give to edematous brain with lots of
gemistocytes?

[spongiosis]




55.  What name do we give to an acquired cavity, not an infarct
or traumatic lesion, down the center of 
the cervical spinal cord, surrounded by gliosis?

[syringomyelia]




56.  What's a hyphemia?  Be very specific.

[blood in the anterior chamber]




NAME: _______________________________
21 points maximum

Who is sitting near you?





UHS PATHOLOGY
Neuroscience
2001-2002




INSTRUCTIONS:

This exam is intended to be a challenge.  Don't feel bad if you
do not 
get a perfect score.
 






Good Luck!