Neurosurgical MCQs

Which of the following statements is TRUE?

Patients with spinal infections typically present with fever.

Clinical examination is not helpful in ruling in or ruling out spinal stenosis.

Staphylococcus aureus and Pseudomonas are common pathogens found in

IVDU with spinal infection.

Steroids have no role in treatment of patients presenting acutely with back

pain and compromised neurological function.

Answer

I
In a patients with severe head injury

Emergency burr holes if required would be best initially performed in the

temporal region on the contra-lateral side to pupillary dilatation.

25% will proceed to develop DIC.

Skull fractures are rarely associated with extradural haematoma.

CSF rhinorrhoea is routinely treated with antibiotics until resolution.

Answer

Regarding Raised intracranial pressure

Transport to a facility with neurosurgical services is mandatory

Mannitol is indicated in all patients with raised ICP

Suxamethonium should be avoided in RSI for the patient with raised ICP

Hypertension should be aggressively treated to maintain a MAP of no

greater than 90

Answer

Regarding SAH, which is the MOST COMMON location of aneurysm?

Vertebrobasilar

Anterior circle of Willis

Junction- anterior cerebral artery and anterior communicating artery

Junction- internal carotid and posterior communicating artery

Answer

Which of the following is NOT associated with a higher risk of subarachnoid

haemorrhage?

Cigarette smoking

Hypertension

Cocaine use

Diabetes

Answer

A 52 M patient presents with a sudden onset altered conscious state with no

clear precipitant, ECG reveals widespread deep T inversion. The MOST
likely diagnosis is:

Wellens Syndrome

Subarachnoid Haemorrhage

Subdural Haemorrhage

Hyponatraemia

Answer

Answers
1. C
2. B
3. A
4. B

85% (a-5%, c-30%, d-25%, e-25%)

5. D
6. B

Dunn A Does not cause altered conscious state without features of

cardiogenic shock secondary to AMI B Most likely cause of sudden altered
consciousness with ECG signs of an unhappy brain C Not likely to cause a
sudden change unless due to an arterial bleed secondary to trauma
D Does not cause deep T inversion