Systemic pathology: amyotrophic lateral sclerosis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Systemic pathology: amyotrophic lateral sclerosis

Sample item

A 58-year-old man has progressive limb weakness with muscle wasting and fasciculations, together with brisk reflexes and extensor plantar responses. Sensation and eye movements are normal. Which pathological change is expected?

ALoss of upper and lower motor neurons with corticospinal tract degenerationBLoss of dopaminergic neurons with Lewy bodiesCNeurofibrillary tangles in the hippocampusDPerivenular demyelinating plaques in white matter

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Loss of upper and lower motor neurons with corticospinal tract degeneration

Amyotrophic lateral sclerosis combines degeneration of anterior horn and brainstem motor neurons with loss of corticospinal fibres, giving both lower and upper motor neuron signs. Sensory systems and eye movements are spared.

Option by option

A. Loss of upper and lower motor neurons with corticospinal tract degeneration (correct)
Correct. Combined upper and lower motor neuron loss with lateral corticospinal degeneration gives this mixed picture.
B. Loss of dopaminergic neurons with Lewy bodies
Lewy bodies and nigral neuron loss characterise Parkinson disease, with rigidity and tremor.
C. Neurofibrillary tangles in the hippocampus
Hippocampal tangles are typical of Alzheimer disease, a disorder of memory.
D. Perivenular demyelinating plaques in white matter
Perivenular demyelination is the lesion of multiple sclerosis, which has sensory and optic involvement.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Loss of upper and lower motor neurons with corticospinal tract degeneration. Amyotrophic lateral sclerosis combines degeneration of anterior horn and brainstem motor neurons with loss of corticospinal fibres, giving both lower and upper motor neuron signs.

Why is "Loss of dopaminergic neurons with Lewy bodies" not the answer?

Lewy bodies and nigral neuron loss characterise Parkinson disease, with rigidity and tremor.

Why is "Neurofibrillary tangles in the hippocampus" not the answer?

Hippocampal tangles are typical of Alzheimer disease, a disorder of memory.

Why is "Perivenular demyelinating plaques in white matter" not the answer?

Perivenular demyelination is the lesion of multiple sclerosis, which has sensory and optic involvement.

What concept does this question test?

It tests Systemic pathology: amyotrophic lateral sclerosis in Pathology. Sensory systems and eye movements are spared.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic pathology: amyotrophic lateral sclerosis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.