Neuro group 6 2010/2011

1. With regards to intracranial pressure (ICP)
a. Intracranial hypertension is defined by persistent ICP > 10mmHg F
b. Sedation and analgesia may reduce ICP T
c. Vetriculostomy allows drainage of CSF to reduce ICP T
d. Parenchymal ICP monitoring is more accurate than ventricular ICP F
e. Hyperventilaation to PCO2 20-25 mmHg is recommended F
2. With regard to spinal cord injury (SCI)
a. Associated finding suggestive of spinal cord injury include abdominal
breathing and priapism T
b. Tetraparesis with sensory level at C6 suggesting the lesion at C2 level F
c. Intravenous Methylprednisolone is not indicated in SCI more than 3 hours
duration T
d. Complete SCI predicts poor outcome T
e. C4 cervical cord injury may lead to sudden apnoe T
3. Regarding stroke
a. Hemorrhage stroke is less common among Caucasian compared to Asian T
intracerebral hemorrhage to be more common in Asian
b. Cerebellar is the commonest anatomical location for haemorrhagic stroke
c. Most of patient with basal ganglia hemorrhage would not benefit from
surgery T
d. Basal ganglia hemorrhage is associated with 30% risk of seizure T
e. Pontine hemorrhage may cause dilated pupils F
4. 18 y/o student was brought in comatose following MVA. His GCS on admission
was 9/15 (E2V3M4). His vital sign was normal. (5M)
a. M4 signifies the patient is localized to painful stimulus. F
b. The verbal response is the best prognosticator compared to motor and
eye responses. F
c. CT scan showed left frontal contusion. T
d. CT scan showed an intraventricular hemorrhage. T
e. CT scan showed subfalcine hemorrhage T
5. Regarding status epilepticus of seizure
6. Select true (T) or false (F) for the following statement
a. 50% of EDH is caused by
b. 50% of
c. ASDH commonly caused by
d. EDH is
e. All EDH should be treated surgically F
7. Currently the best strategy for preventing further damage in patient with a
spinal cord injury is:
a) High dose corticosteroids
b) Urgent exploratory surgery

Primary CNS lymphoma d. Abnormal cerebral MRI 10. Germ cell tumor d. Orthotastic hypotension d. In the ventral pons e. Near the caudal extremity of medulla c. A central cord syndrome c. ………. Early falls e. Pineoblastoma 14. Unilateral resting tremor b. Kaposi’s sarcoma b. A patient is brought to ER following MVA. Medullobalstoma e. A right spinal cord hemisection syndrome 9. Carbidopa e. Meningioma c. On examination he has weakness of his left arm and leg and loss of fine touch on the left with loss of pain and temperature sensation on the right. Above the sensory decussation d.The following is the most common CNS neoplasm in immunocompromised a.The decussation of corticospinaL tract occurs a. Hemangioblastoma b. 11. This clinical picture is most consistent with: a. An anterior spinal cord syndrome d. Supranuclear downgazes palsy c. Which of this following signs is most suggestive of Parkinson’s disease rather than the other nuerodegenarative disease? a. Metochlopramide c. Meningeal carcinomalosis c. In the spinal cord 12. In the internal capsule b.An upper homonymous quadrantanopia can arise from . Primary brain lymphoma e. Trihexyphenidyl b. A complete cord syndrome b. A left spinal cord hemisection syndrome e. Which of the following medications would be the most likely to cause druginduced Parkinsonism? a. Diazepam d.c) Maintenance of oxygenation and spinal cord perfusion d) Intravenous diuretic therapy e) Prolonged bed rest 8. Pleomorphic xanthoastrcytoma 13. A brain which sometimes contains psammoma bodies and progesterone receptor is a.

Salivatory nucleus projections to the dorsal motor nuclei of the vagus e.Which fibers are associated with gag reflex? a. It is usually self limited and resolve over weeks to months e. b. Migraine d.a. Postconcussive e. In the upper midbrain b.Which of the following factors increase intracranial pressure (ICP)? a. All of the above e. Of an arterial injury b. of bleeding from periosteal injury d. In the lower midbrain c. In the lower pons 20. It is associated with increase risk of post traumatic epilepsy 16. Due to temporal arteritis . It is only found in patients who are involved in frigation d. of bone oozing c. d. Spinal trigeminal nucleus projections to the nucleus ambiguous b. b. Solitary projections to the nucleus ambiguous c. e. Cluster b. It is an uncommon sequalae of the traumatic brain injury b. c.The most common type headache is a. A characteristic symptom would be progressively increasing lethargy c. Area striate Ipsilateral occipital lobe Contralateral temporal lobe Caontralateral parietal lobe Optic chiasm 15.The motor nucleus of the trigeminal nerve is located a. Movement Pain Fever Valsalva all of the above 17. Tension c.epidural hematoma in the children are the result a. Solitary projections to the salivatory nucleus d. None of the above 18. In the middle pons e. e.Which of the following is true regarding post concussion syndrome a. d. In the upper pons d. None of the above 19. c.

Epidural space B. Gliosarcoma c. Increased tone D. Basilar b. Decreased strength B. Glioblastoma multiforme 23. Any of the above E. Subdural space D. the tip of the needle located in A. Subarachnoid space C. Oligodendroglioma e.21.Which of the following is the most frequent brain tumor in the first year of life a.In both spasticity and parkinsonian rigidity. Cerebral aqueduct D.Occlusion of the following arteries is most likely to result in homonymous hemianopia a. None of these seen in above conditions 25. Anterior spinal c.As CSF is being withdrawn during a lumbar puncture. AICA 22. Which of the following is the best method to differentiate between viral and bacterial meningitis? A)Sensorium B)Nuchal rigidity C) Lumbar puncture D) CT scan brain E) Electrocephalography 27) Which of the following is false regarding evaluation of unresponsive and dilated pupil? . Muscular space 26. Increased stretch reflex C. Cystic astrocytoma d. Choroid plexus tumor b. One interventricular foramen C.A 35 years old woman noted to have a stiff neck. None of the above 24. PCA e. which of the following is seen in the extensors of the lower limb extremity A. Vertebral d.Non-communicating hydrocephalus would be caused by obstruction of A. fever and photophobia. All three apertures of the fourth ventricle B. Subpial space E. All of the above E.

MRI of brain is the study of choice B) The history including associated symptoms is critical in determining severity C) Additional clinical finding is useful in differentiating various causes of unresponsive pupil D) There are benign causes of unresponsive pupil E) Maybe due to uncal herniation 28-30 (choose the most likely site of damage for each of description) A) Left frontal B) Left parietal C) Left temporal D) Right parietal E) Right temporal 28) A patient who speaks fluently but have many content error and has difficulty comprehending written and spoken language C (wernicke area) 29) A patient who ignores one half of his body and failing to dress it and even denying that part is the side of his body D (non dominant parietal lobe—important in concept of bod image and awareness of external environment) 30) A patient who comprehends the literal meaning of language but has difficulty distinguishing the intonation in speech of others E (non dominant temporal lobe—hearing of sound.A) In acute setting. rhythm and music) .