ELM3 Pathology Exam 2024 Questions and Answers With A Complete Solution
1. Which of the following diseases leads
to peripheral neuropathy as a result
of inflammatory damage to the myelin
sheath?
a. Motor Neuron Disease (MND) c. Guillain-Barré Syndrome
b. Diabetic neuropathy
c. Guillain-Barré Syndrome
d. Charcot-Marie-Tooth disease
e. Multiple Sclerosis (MS)
2. The main constituent of myelin is:
a. Proteins from Schwann cell cytoplasm
b. Neurosecretory granules from neu-
ronal cytoplasm c. Lipids from Schwann cell membrane
c. Lipids from Schwann cell membrane
d. Fibrous tissue from endoneurium
e. Cell organelles
3. A 36-year-old man who had been
healthy all his life now has progressive,
symmetric muscular weakness. A year
ago, weakness started in the head and
neck area, which caused difficulty with
speech, eye movements, and swallow-
ing. Now he can no longer stand, walk,
or feed himself. His mental function re- a. Motor Neuron Disease (MND)
mains intact. Which of the following is the
most likely diagnosis in this case?
a. Motor Neuron Disease (MND)
b. Diabetic neuropathy
c. Guillain-Barré Syndrome
d. Charcot-Marie-Tooth disease
e. Multiple sclerosis
4. Which of the following is NOT true
regarding Guillain-Barré syndrome?
a. It is thought to be an immune reaction
b. It affects lower motor neurons leading
b. It affects lower motor neurons leading
to axonal degeneration
to axonal degeneration
c. Associated infectious agents in-
clude Campylobacter jejuni and cy-
,ELM3 Pathology Exam 2024 Questions and Answers With A Complete Solution
tomegalovirus
d. Associated infectious agents include
HIV
e. T-cell and humoral immune responses
are incriminated in its pathogenesis
5. Which of the following is typical of
diabetic neuropathy?
a. Leads to muscle atrophy
b. The lateral corticospinal tracts of the
spinal cord are affected
d. Commonest form is sensory, distal,
c. Commonest form is proximal, motor,
symmetric neuropathy
asymmetric neuropathy
d. Commonest form is sensory, distal,
symmetric neuropathy
e. It is independent of duration of dia-
betes and glycemic control
6. Which of the following is true regarding
diabetic neuropathy?
a. It is an uncommon complication of di-
abetes
b. Degeneration of lower motor neurons
is the cause
e. Thickening of endoneurial arterioles is
c. It is an immune-mediated attack
a contributing factor
against peripheral nerves in diabetic pa-
tients
d. Inflammatory demyelination is the hall-
mark
e. Thickening of endoneurial arterioles is
a contributing factor
7. A 41-year-old man had an influen-
za-like illness for 1 week; followed, 4
days later, by rapidly progressive, as-
cending motor weakness requiring me-
chanical ventilation. On physical exami- c. Guillain-Barré Syndrome
nation, he is afebrile. Despite supportive
therapy, he dies from respiratory failure.
At autopsy, inflammatory infiltrates and
segmental demyelination were seen in
,ELM3 Pathology Exam 2024 Questions and Answers With A Complete Solution
his peripheral nerves. Which of the fol-
lowing is the most likely diagnosis?
a. Motor Neuron Disease (MND)
b. Diabetic neuropathy
c. Guillain-Barré Syndrome
d. Charcot-Marie-Tooth disease
e. Multiple Sclerosis (MS)
8. Which of the following is implicated in
pathogenesis of ALS?
a. Superoxide Dismutase mutations
b. Previous Campylobacter jejuni infec-
tion
a. Superoxide Dismutase mutations
c. Nerve ischemia
d. Inflammatory attack on lower motor
neurons
e. Inflammatory attack on upper motor
neurons
9. Which of the following is NOT a feature
of ALS?
a. Death of lower motor neurons
b. Denervation atrophy d. Distal, symmetric, sensory loss
c. Death of upper motor neurons
d. Distal, symmetric, sensory loss
e. Degeneration of corticospinal tracts
10. Which of the following is the cause
of muscle weakness following demyeli-
nation?
a. Retrograde neuronal death
b. Acceleration of the neural action po- d. Slowing down of the neural action po-
tential tential
c. Downstream axonal degeneration
d. Slowing down of the neural action po-
tential
e. Denervation muscle atrophy
1. A 23 year old patient was involved in
a car crash. He was initially unconscious
then regained consciousness. Shortly af-
ter, he collapsed and was taken to ED.
, ELM3 Pathology Exam 2024 Questions and Answers With A Complete Solution
A skull fracture and intracranial haemor-
rhage were diagnosed on CT. Where is
this hemorrhage most likely to be?
a. Subarachnoid
c. Epidural (extradural)
b. Subdural
c. Epidural (extradural)
d. Intraparenchymal
e. Intraventricular
2. The abovementioned intracranial he-
morrhage would have been diagnosed
by which of the following appearances on
CT?
a. Punctate (dot-like) hypodense e. Biconvex hyperdense
b. Slit-like hyperdense
c. Biconcave hyperdense
d. Crescentic isodense
e. Biconvex hyperdense
3. One day following a traumatic head
injury, this 39 year old woman became
comatose and developed left pupillary
dilation and hemiparesis. Her brain is b. Tentorial herniation
represented in this gross photograph.
Which of the following lesions best ex-
plains these findings?
a. Chronic subdural hematoma
b. Tentorial herniation
c. Subarachnoid hemorrhage
d. Diffuse axonal injury
e. Subfalcine herniation
4. A 27 year old patient is deeply co-
matose immediately following a high
speed car accident. No skull fractures or
brain lacerations were detected. Which
of the following is the most likely injury b. Diffuse axonal injury
they have suffered?
a. Subdural hemorrhage
b. Diffuse axonal injury
c. Epidural hemorrhage
1. Which of the following diseases leads
to peripheral neuropathy as a result
of inflammatory damage to the myelin
sheath?
a. Motor Neuron Disease (MND) c. Guillain-Barré Syndrome
b. Diabetic neuropathy
c. Guillain-Barré Syndrome
d. Charcot-Marie-Tooth disease
e. Multiple Sclerosis (MS)
2. The main constituent of myelin is:
a. Proteins from Schwann cell cytoplasm
b. Neurosecretory granules from neu-
ronal cytoplasm c. Lipids from Schwann cell membrane
c. Lipids from Schwann cell membrane
d. Fibrous tissue from endoneurium
e. Cell organelles
3. A 36-year-old man who had been
healthy all his life now has progressive,
symmetric muscular weakness. A year
ago, weakness started in the head and
neck area, which caused difficulty with
speech, eye movements, and swallow-
ing. Now he can no longer stand, walk,
or feed himself. His mental function re- a. Motor Neuron Disease (MND)
mains intact. Which of the following is the
most likely diagnosis in this case?
a. Motor Neuron Disease (MND)
b. Diabetic neuropathy
c. Guillain-Barré Syndrome
d. Charcot-Marie-Tooth disease
e. Multiple sclerosis
4. Which of the following is NOT true
regarding Guillain-Barré syndrome?
a. It is thought to be an immune reaction
b. It affects lower motor neurons leading
b. It affects lower motor neurons leading
to axonal degeneration
to axonal degeneration
c. Associated infectious agents in-
clude Campylobacter jejuni and cy-
,ELM3 Pathology Exam 2024 Questions and Answers With A Complete Solution
tomegalovirus
d. Associated infectious agents include
HIV
e. T-cell and humoral immune responses
are incriminated in its pathogenesis
5. Which of the following is typical of
diabetic neuropathy?
a. Leads to muscle atrophy
b. The lateral corticospinal tracts of the
spinal cord are affected
d. Commonest form is sensory, distal,
c. Commonest form is proximal, motor,
symmetric neuropathy
asymmetric neuropathy
d. Commonest form is sensory, distal,
symmetric neuropathy
e. It is independent of duration of dia-
betes and glycemic control
6. Which of the following is true regarding
diabetic neuropathy?
a. It is an uncommon complication of di-
abetes
b. Degeneration of lower motor neurons
is the cause
e. Thickening of endoneurial arterioles is
c. It is an immune-mediated attack
a contributing factor
against peripheral nerves in diabetic pa-
tients
d. Inflammatory demyelination is the hall-
mark
e. Thickening of endoneurial arterioles is
a contributing factor
7. A 41-year-old man had an influen-
za-like illness for 1 week; followed, 4
days later, by rapidly progressive, as-
cending motor weakness requiring me-
chanical ventilation. On physical exami- c. Guillain-Barré Syndrome
nation, he is afebrile. Despite supportive
therapy, he dies from respiratory failure.
At autopsy, inflammatory infiltrates and
segmental demyelination were seen in
,ELM3 Pathology Exam 2024 Questions and Answers With A Complete Solution
his peripheral nerves. Which of the fol-
lowing is the most likely diagnosis?
a. Motor Neuron Disease (MND)
b. Diabetic neuropathy
c. Guillain-Barré Syndrome
d. Charcot-Marie-Tooth disease
e. Multiple Sclerosis (MS)
8. Which of the following is implicated in
pathogenesis of ALS?
a. Superoxide Dismutase mutations
b. Previous Campylobacter jejuni infec-
tion
a. Superoxide Dismutase mutations
c. Nerve ischemia
d. Inflammatory attack on lower motor
neurons
e. Inflammatory attack on upper motor
neurons
9. Which of the following is NOT a feature
of ALS?
a. Death of lower motor neurons
b. Denervation atrophy d. Distal, symmetric, sensory loss
c. Death of upper motor neurons
d. Distal, symmetric, sensory loss
e. Degeneration of corticospinal tracts
10. Which of the following is the cause
of muscle weakness following demyeli-
nation?
a. Retrograde neuronal death
b. Acceleration of the neural action po- d. Slowing down of the neural action po-
tential tential
c. Downstream axonal degeneration
d. Slowing down of the neural action po-
tential
e. Denervation muscle atrophy
1. A 23 year old patient was involved in
a car crash. He was initially unconscious
then regained consciousness. Shortly af-
ter, he collapsed and was taken to ED.
, ELM3 Pathology Exam 2024 Questions and Answers With A Complete Solution
A skull fracture and intracranial haemor-
rhage were diagnosed on CT. Where is
this hemorrhage most likely to be?
a. Subarachnoid
c. Epidural (extradural)
b. Subdural
c. Epidural (extradural)
d. Intraparenchymal
e. Intraventricular
2. The abovementioned intracranial he-
morrhage would have been diagnosed
by which of the following appearances on
CT?
a. Punctate (dot-like) hypodense e. Biconvex hyperdense
b. Slit-like hyperdense
c. Biconcave hyperdense
d. Crescentic isodense
e. Biconvex hyperdense
3. One day following a traumatic head
injury, this 39 year old woman became
comatose and developed left pupillary
dilation and hemiparesis. Her brain is b. Tentorial herniation
represented in this gross photograph.
Which of the following lesions best ex-
plains these findings?
a. Chronic subdural hematoma
b. Tentorial herniation
c. Subarachnoid hemorrhage
d. Diffuse axonal injury
e. Subfalcine herniation
4. A 27 year old patient is deeply co-
matose immediately following a high
speed car accident. No skull fractures or
brain lacerations were detected. Which
of the following is the most likely injury b. Diffuse axonal injury
they have suffered?
a. Subdural hemorrhage
b. Diffuse axonal injury
c. Epidural hemorrhage
