{"id":6140,"date":"2017-06-28T13:08:23","date_gmt":"2017-06-28T05:08:23","guid":{"rendered":"http:\/\/https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=6140"},"modified":"2023-04-03T14:20:43","modified_gmt":"2023-04-03T06:20:43","slug":"cns-exercises","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/cns-demys\/cns-exercises\/","title":{"rendered":"Central Nervous System Pathology: Exercises"},"content":{"rendered":"\n\n\t<p>Here are some gross and micro pictures for you to practise your diagnostic and observational skills on. Click on the accordions to view sample descriptions.<\/p>\n\t<h4><strong>1. 38 year old man with headache, nausea and high fever.\u00a0<\/strong><\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/Abscess-ed-zf2hoy.jpg\" alt=\"Abscess-ed-zf2hoy\" itemprop=\"image\" height=\"755\" width=\"899\" title=\"Abscess-ed-zf2hoy\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Click for sample description and diagnosis<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p>This is a coronal section of the brain. There is\u00a0an irregular cavity in the right cerebral hemisphere. The inner lining appears to be covered by a creamy pale tan exudate. (This would have been yellowish green in the fresh specimen, and the cavity would have contained purulent material).<\/p>\n<p><strong>Diagnosis: Cerebral abscess<\/strong><\/p>\n\t<h4><strong>2.\u00a046 year old man. Progressively severe headaches.\u00a0<\/strong><\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/Meningioma-gross-ed-2jk2jqi-618x517-1.jpg\" alt=\"Meningioma-gross-ed-2jk2jqi-618x517\" itemprop=\"image\" height=\"517\" width=\"618\" title=\"Meningioma-gross-ed-2jk2jqi-618x517\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Click for sample description and diagnosis<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p>This is a coronal slice of the brain, showing a large, relatively well defined mass between the cerebral hemispheres. The edges of the mass are sharply circumscribed and show no demonstrable invasion into the brain parenchyma. The cut surface of the mass is pale tan and whorled, and there is no haemorrhage or necrosis.<\/p>\n<p><strong>Diagnosis: Meningioma<\/strong><\/p>\n\t<h4><strong>3. \u00a0A 58 year old lady with seizures.\u00a0<\/strong><\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/GBM-gross-ed-10oeym1-618x492-1.jpg\" alt=\"GBM-gross-ed\" itemprop=\"image\" height=\"492\" width=\"618\" title=\"GBM-gross-ed\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Click for sample description and diagnosis<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p>This a coronal slice of the brain, showing an ill-defined mass in the right cerebral hemisphere just deep to the cortex. The mass is irregular and exhibits a friable cut surface, suggestive of areas of necrosis.<\/p>\n<p>Microscopy would show areas of pseudopalisading necrosis (circled below).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/GMB-micro-palis-nec-14jw548.jpg\" alt=\"\" width=\"1112\" height=\"700\" \/><\/p>\n<p><strong>Diagnosis: Glioblastoma multiforme<\/strong><\/p>\n<p>Note:<\/p>\n<p>-The appearance suggests a high grade or aggressive tumour. In the brain, for primary tumours, possibilities include high grade glial tumours such as GBM).<\/p>\n<p>-Metastases are more likely to be multiple, though occasionally they can be single.<\/p>\n\t<p><strong>4. \u00a0A 72 year old man presented at the emergency department with confusion which progressed to loss of consciousness. He is a chronic hypertensive. This is a section from his brain. Try describing the microscopic features, and what is the diagnosis?\u00a0<\/strong><\/p>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2017\/06\/Infarct-micro-fina-qqukwz-768x611-1.jpg\" alt=\"Infarct-micro-fina-qqukwz-768x611\" itemprop=\"image\" height=\"611\" width=\"768\" title=\"Infarct-micro-fina-qqukwz-768x611\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Click for sample description and diagnosis<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\"><i>Expand<\/i><\/a>\n\t\t\t\t\t<p>There are sheets of foamy macrophages on a background of pink amorphous material. Features are those of liquefactive necrosis.<\/p>\n<p><b>Diagnosis<\/b><b>: Cerebral infarction<\/b><\/p>\n\t<p>See also the <a href=\"https:\/\/vimeo.com\/202882103\" target=\"_blank\" rel=\"noopener noreferrer\">Talking Pot<\/a>\u00a0and <a href=\"https:\/\/vimeo.com\/211777709\" target=\"_blank\" rel=\"noopener noreferrer\">Talking Slide <\/a>for this case.<\/p>\n<p>If you can&#8217;t play the video, watch it here on YouTube: <a href=\"https:\/\/youtu.be\/spSsqe6XX1k\" target=\"_blank\" rel=\"noopener\">Talking Pot<\/a> and <a href=\"https:\/\/youtu.be\/WqNi41kjaQk\" target=\"_blank\" rel=\"noopener\">Talking Slide<\/a>.<\/p>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/cns-exercises\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tI. Central Nervous System Pathology: Exercises\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/cns-demys\/cns-talking-pots-and-slides\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tII. Central Nervous System: Talking Pots and Slides\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/cns-demys\/cns-quiz\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tIII. Central Nervous System: Quizzes\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/cns-demys\/cns-study_notes\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tCentral Nervous System: Study Notes\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/cns-demys\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tCentral Nervous System Chapter Home\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/\" target=\"_self\" role=\"button\" rel=\"noopener\">\n\t\t\t\t\t\t\tPathology Demystified\n\t\t\t\t\t<\/a>\n\n","protected":false},"excerpt":{"rendered":"<p>Here are some gross and micro pictures for you to practise your diagnostic and observational skills on. Click on the accordions to view sample descriptions. 1. 38 year old man with headache, nausea and high fever.\u00a0 Click for sample description and diagnosis Expand &nbsp; This is a coronal section of the brain. There is\u00a0an irregular [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":6132,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-6140","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/pathology-demystified\/cns-demys\/cns-exercises\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"Here are some gross and micro pictures for you to practise your diagnostic and observational skills on. 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