Neuropathology Essentials: Edema, OmpathStudy

MOUNT KENYA UNIVERSITY — SCHOOL OF MEDICINE Reg No: BMS/2023/... Unit: Neuropathology Assessment: CAT 1 — Semester III, 2026 --- Q1. Which inclusion is seen in Parkinson disease? A. Negri bodies B. Lewy bodies C. Cowdry A bodies D. Rosenthal fibres E. Corpora amylacea Answer: B — Lewy bodies A = rabies; C = HSV/CMV inclusions; D = pilocytic astrocytoma/Alexander disease; E = normal aging (not disease-specific). Q2. Gliosis primarily involves proliferation of: A. Neurons B. Microglia C. Astrocytes D. Oligodendrocytes E. Ependymal cells Answer: C — Astrocytes Gliosis = astrocytic scarring in CNS injury. Neurons don't proliferate; microglia react but don't cause "gliosis" per se; oligodendrocytes/ependymal cells aren't the scarring cell type. Q3. Reactive astrocytes are also called: A. Foamy macrophages B. Gemistocytic astrocytes C. Satellite cells D. Microglial nodules E. Schwann cells Answer: B — Gemistocytic astrocytes A = lipid-laden macrophages in infarcts; C = perineuronal oligodendrocytes; D = clusters of activated microglia; E = PNS myelinating cells, not CNS. Q4. Alzheimer type II astrocytes are associated with: A. Hypoglycaemia B. Hyperammonaemia C. Hypoxia D. Trauma E. Viral infection Answer: B — Hyperammonaemia Classic in hepatic encephalopathy. Other conditions cause different histological patterns (e.g., hypoxia → red neurons). Q5. Microglial nodules are most associated with: A. Tumours B. Infection C. Trauma D. Degeneration E. Haemorrhage Answer: B — Infection (paper marked D — worth confirming with your lecturer) Microglial nodules are classic in viral encephalitis (e.g., rabies "Babes nodules," HIV encephalitis). Tumours/trauma/haemorrhage cause different reactive patterns. Q6. Vasogenic oedema results from: A. Intracellular fluid accumulation B. Blood–brain barrier disruption C. Mitochondrial failure D. Sodium pump failure E. Neuronal apoptosis Answer: B — Blood–brain barrier disruption Vasogenic oedema = plasma protein/fluid leak into extracellular space via a damaged BBB (e.g., tumours). A, C, D describe cytotoxic oedema mechanisms. Q7. Cytotoxic oedema primarily affects: A. Extracellular space B. Intracellular compartment C. CSF D. Blood vessels E. Subarachnoid space Answer: B — Intracellular compartment (paper marked A — this is incorrect; cytotoxic oedema is intracellular) Caused by ATP/Na⁺-K⁺ pump failure (ischaemia) → cells swell as fluid shifts inward. Vasogenic oedema (not cytotoxic) is the extracellular one. Q8. Non-communicating hydrocephalus is caused by: A. Increased CSF absorption B. Obstruction within ventricular system C. Reduced CSF production D. Meningitis only E. Brain atrophy Answer: B — Obstruction within ventricular system A structural block (e.g., tumour, aqueduct stenosis) prevents CSF flow between ventricles. A/C would reduce CSF volume, not obstruct it; E causes hydrocephalus ex vacuo. Q9. Hydrocephalus ex vacuo results from: A. Tumour obstruction B. CSF overproduction C. Brain tissue loss D. Infection E. Trauma Answer: C — Brain tissue loss Passive ventricular enlargement filling space left by atrophy (e.g., Alzheimer's) — not a true CSF flow/production problem. Q10. Subfalcine herniation compresses: A. Middle Cerebral Artery B. Posterior Cerebral Artery C. Anterior Cerebral Artery D. Basilar artery E. Vertebral artery Answer: C — Anterior Cerebral Artery Cingulate gyrus shifts under the falx cerebri, compressing the ACA. PCA is compressed in transtentorial herniation instead. Q11. Transtentorial herniation affects: A. CN II B. CN III C. CN V D. CN VII E. CN XII Answer: B — CN III Uncal herniation compresses the oculomotor nerve → fixed dilated pupil. Other cranial nerves aren't in this anatomical path. Q12. Tonsillar herniation leads to: A. Visual loss B. Seizures C. Brainstem compression D. Aphasia E. Hemiplegia Answer: C — Brainstem compression Cerebellar tonsils herniate through the foramen magnum, compressing the medulla (cardiorespiratory centres) — life-threatening. Others aren't the direct/immediate effect. Q13. A coup injury occurs: A. Opposite side of impact B. Same side as impact C. Brainstem only D. Cerebellum only E. Diffusely Answer: B — Same side as impact "Contrecoup" (not listed as correct here) would be opposite side. Coup = direct site of impact. Q14. Diffuse axonal injury is due to: A. Infection B. Shearing forces C. Hypoxia D. Tumour growth E. Haemorrhage Answer: B — Shearing forces Rotational/deceleration forces stretch and tear axons, classically at grey-white matter junctions. Q15. Epidural haematoma commonly involves: A. Middle meningeal artery B. Internal carotid artery C. Jugular vein D. Basilar artery E. Circle of Willis Answer: A — Middle meningeal artery (paper marked C — this is incorrect) Classically torn by temporal bone fracture. The other vessels aren't the typical source. Q16. A lucid interval is typical of: A. Subdural haematoma B. Epidural haematoma C. Subarachnoid haemorrhage D. Stroke E. Concussion Answer: B — Epidural haemato