,'[ Mu^'tbSu (g\ 't

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p4fis of the ventricular systern does not contain choroidpleSqs?

tffietion of the transverse and sigmoid sinus is:

C. The pteriou,',
,./ D. The astsrio&'"'
E. The I-ambda-

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5. The rnost common cause of sub arachnoid haemorrhage is:

A. Bleeding from an aneurysm. :

B. Bleeding from an AVM.

C. Bleeding from a tumor. itB
D. Hypertension.
,''' E. Trattrma
6. Following a road traffi,c accident a young man was admitted to hospital. Neurologi;i
examination revealed weakness of theLt.lower limb, and loss of pain and temperature
sensation up to the umbilicus on the left sidb. What is the most likely level of injury to :-r:
spinal cord?
A. T6 on the Rt.
B. T8 on the Rt.
C. T8 on the Lt.
D. T10 on the Rt.
,/ E. T10 on the Lt.
J.Painaud syndrome is a feature\of all the following except:
A. Pineal Germinoma. )

u/ B. Suprasellar Germinoma.
C. Pineocytoma.
D. Pineoblastorna.
E. Pineal Teratoma.
(Qa SO years old woman was being examined by an otolaryngologist for hearing proi.-::.
- The physician placed a tuning fork on the woman Rt. mastoid bone until she no lo::-
perceives a sound, then he moved the tuning fork to her Rt. external ear where agai:. :,:
sound was heard. This manoeuvre is described as:
A. Positive (normal) Renne test.
B. Negative (abnormal) Renne test.
V

C. Positive (normal) Weber test.

D. Negative (abnormal) Weber test.
E. The conduction of the test was wrong.
Visual field defects due to occipital cortical lesion may be associated with the
following features EXCEPT: i

A. Macular sparing
B. Preservation of the temporal crescent.
C. Isolated unilateral loss of the temporal orescent.
D. B ilateral cotg*lg.ltf (symmetrical) quadrantanopia.
/ E. Abnormal op'tbkin'6tic nystagmus test.

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10.'The followings are charucteristics of true recent papilledema EXCEPT:

A. Bilaterality.
,/ B. Impaired visual accuity.
C. Normal pupillary reaction
D. Normal coior vision.
, E. visual field-abnormality of an enlarged blind spot.
1 1.In the Orbital apex syndrome the cranial nerves involved includes all the following
: Except: i

A. The optic (II), l-l "B it g :r $ ..

B. The Oculomotor (IID. :-'---

C. The Trochlear (IV)
D. Thd ophthalmic division of the trigeminal nerve (V1).
t/' E. The Maxillary division of the trigeminal nerve CV2).
12. Fasciculations are not a feature ofi ? ?
A. Myopathy.
'/ B. Motpr neuron disease.
C. Spinbl tumors.
D. Poliomylitis.
E. Peripheral nerve injury.
13. Vasogenic brain ederna is the commonest seen in clinical practice,
it can be caused by:
A: various intoxication's.
B: sever hypothermia.
, C: Aggressive hemodialysis.
,,/ D; primary and metastatic tumors.
E: all of the above.
14. In vertebral hemangioma the following are true EXCEpT:
A: It is the most cornmon benign tumor of the vertebral column . ,,'
B: $'reqrrently changes on MRI are pathognomonic.
mI!, involve *r. than one vertebral body. ,.,/
(,/., D:
!i ltsurgery alone is safe and satisfactory in all cases.
E: Angiography is rnogt valuable in defining the nature and blood
,: supply ofthe !E
I .,;,' lgsion.
15. In nontraumatic CSF rhinorrhoea:
t
:

A: Anosinia is a frequent finding. r.

B: Headache is uncommon. x
c: Males atq,TBqfp commonly affected than females.
- D:
l,/ Intracraniai- aerocel"r tur.ly develop.
'E: The risk of meningitis is much higher
than in traurnatic leaks. {

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 176) In cardidiasis of the central nervous system the following are true EXCEPTi
\-'/ A: Candida albicans the most-e ommon'frrngus associatEd with cerebrgl, infections.
B: Involvement of the central nervous system by candida is most often the
. $esult ofhematogenous spread.
;

-z C: Rarly cause abscesses , and granulomas are never seen.

. D: Cdndida meniirgitis carries very high mortality and best results are,achieved w'i'-:.
intrathecal amphoteripin B
E: May cause the formaiion of mycotic cerebral aneurysm. i

17. In an unconscious patient with head injury, hyperventilation breathing suggests a

lesion in the:
A. Cerebral cortex.
B. Midbrain.
*z c.Pons.
D. Medulla.
A, E. UPPer cervical cord lesion.
@)fhe dominant and most powerful ptirnulant for ADH secretion is:
-
l,/ A: increase plasma osmolaliry >295 mosm/Liter. s ee H 'g -ttl/
B: decrease urine specific gravity < 1.005.
C: hypovolemia >tsyo of blood volurne.
D: hypokalemia <2 meq.lLiter. : ,

---\ E,: the higher centers +

tt In bilateral acoustic neurofibrornatosis the following are true,EXCEPT: N F z
A: It is genetically distinct frorn Von Recklinghausen's neurofibronlgtosis.
' B: It shows great variability in expression and penetrance. ' I
C: Cutaneous stigmata are fewer and less cofilmon than.in VRNF.
/n, Symptoms of acoustic neuroma usually appear in teenagers.
E: Brain stem auditory evoked responses has proved useful in detecting early
acoustic neuromas in members of affected families
Q9 Anosmia:
A: Is failure to identiff an odor. F--> p* z-*' !'6vz'li "i'
/ B: can be congenital in albinos.
C: can be caused by lesions of the central olfactoly connections.
D: is a frequent presenting symptom in patients with olfactory groove meningicr:--
I E: All of the above.
21.' Proptosis is not associated with:
A: Crouzon's disease
B: Optic nerVd$fuma.
C: Cavernous hemangioma.
D: Pseudotumor of the orbit.
r,/ E: Tolosa-Hunt syndrome.

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 22: In Gamma Knife surgery the following are true Except:
j ',. " ;1r{: It is a'steriotartir, fnm.f image griO.O and comiut€r.controlled,procedure.
'B: source of Energy is
,T?ie Cobalt60. :

Ct.,It has been used in the treatment of vascular lesions of the brain.
r/ D: In brain tumors it has only been successfully used in malignant lesions.
E: Ilis very effective in the treatment of trigeminal neuralgia.
23.In slow (aching) pain the following are true EXCEPT:
t/ ai tt is mediatld thtoueh the A-delta system. i
B: The sensation co{nes on slowly after irjury. :
C: It is diffuse and poorly localized.
D: It is accompanied by an affective component (visceral responce).
E: It often far outlast the stimulus. '
24.Theindications for;;;il;;;"nt
of brain abscess Include all the following
Except:
A. Post traumatic abscess.
/ B. Eally cerebritis stage.
C. Par,aventricular abscess.
D. Mass effect, ffid raised ICP. \
E. Poor condition of the patient.
25. /'rnong the following anomalies the one that is commonly associated
with neurofibromatosis is:
A: Aplasia cutis congenita.
B: Cranium bifidum.
C: Parietal foramina.
lrrD: A genesis of a sphenoid bone.
.,^, E: Craniopagus twins.
(26)Acquired basilar invagination may be caused by atl of the following except:
\--l Ar. Paget's disease.
ls
g. fq"urnatoid artlritis.
C. Osteom alasia.
(-/ D. Osteogenesis irnperfecta.
E. Flyperparathyroidir*. 'I :

27
-i
. F'rtcephal ocel es that are more cornrnonly as s o ciated with neuro l ogi cal
.
li
abnormalities of psychomotor retardation, spasticity, and hydrocephalus are:
A:,Nasofrontal encephaloceles.
B : Frontoethmoidat.Enuephaloceles.
C: Frontal convexity encephaloceles.
u/ D : Occipital encephalocells.
F : Basal encephaloceles.

'*'-,
 28. In the prenatal diagnosis of spinal dysraphism in high risk
pregnants, the following are useful,procedtres EXCEkI} -:",-
A: Amniotic fluid alpha fetoprotein analysis.
B: Amniotic fluid Acetylcholinestrase activity analysis.
/ C: Amniotic fluid cells examination.
.'D:Fetoscopy. , - 1

E: Ultrasound examination.
29.The most common causative'micro-organisms in infection associated with
ruptured meningomyelocele are: ..

// A: Staphylococci.
B: E-coli
C: Haemophilus.
D: Streptococci,
E: Pneumococci.
30. A diabetic patient with bilateral periorbital edema, fever, neck stiffness,
imp_aired pupillary and corneal re{exes most likely has:
A: Orbital cellulitis. i
(r,t B: cavernous sinus thrombosis.
C: carotid - cavernous fistula.
':

D: Tolosa-Hunt syndrome.
.,^ E: periarteritis nodosa
'\9 In A:intracranial extra dural abscess:
trauma and surgery are common causes.
,r' B: the
most corrunon organism isolated is Haemophilus Influenzae. t
C: most of the patients present with ftilminating picture, and are toxic, with high
fever and distinct nuchal rigidify.
D: seizures arq common.
E: All of the above.
32,In spinal extradural abscess, the following are true EXCEPT:
// A: It is less common than sudural abscess.
B: More than half the cases are due to hematological metastasis.
C: It;may extend over several sigments of the spinal;dura.
D. The most irnportant and constant clinical feature is Loc alized pain and
tenderness.
E: Surgical decompression and drainage with antibiotics is the standard teratmant.
33. In tuberculous meningitis:
A: adults arp*_q:pag commonely affected than children.
B: spread often occures from a previously implanted cortical focus.
C: hydrocephalus occure in more than 75% of cases.
D: diagnosis depends on isolation and culture of Mycobacterium tuberculosis.
// E: All of the above.

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34. In carotid stenosis the following are true Except:

u/ n. Commonly present as seizures.
; B. Transient ischemic attacks may progress into stroke.
C. Amaurosis fugas is seen sometimes.
D. Carotid endarterectomy is indicated in symptomatic patients with > TAyo
stehosrs
E. Endovascular ahgioplasty is under investigation at present.
;iffi ;il';;;*iv'-"*'",
mobility
A: impaired neck i

// B: spastiqweakness in the lower extremities.

C: weaknbss with loss of tendon reflexes in an arrn.
D: wastinget' and fasciculations in an affn.
"' -

36. In the lateral recess syndrome:

A: young patients are rnore commonly affected.
' B:'the most common cause is congenital deforrnity of the spinal canal.
G: radicular pain occurs chiefly on sitting, and is\ usually relieved by standing
and walking
/n: the straight leg raising test is characterististically negative.
E: All of the above.
37. The rnost corunon presentation of Moyamoya disease is:
rt"r- (/ A. Ischemia.
4o\*\t - B. Hemorrhage.
C. Seizures.
D. Progressive dernentia.
..-..\ E. Hydrocephalus.
( Sz) ln low grade gliomas the following are true except:
" r,z d,. Formpfuof.all Astrocytomas.
B. Peak incidence in young adults.
C. Can *differentiate into higher grade.
X D. The treatment of choice is radical resection'
E. Median survival is 5-10 years.
39. A 40 years old woman presented with pain and tingling sensation albng the medial
border sf the arm and forearm. On examination she was found to have atrophy of li
the hypothenar muscles and impaired pain prick sensation in the 4th. and 5th. fingers.
The most likely diagnosis is:
./^ A: Cervical+Sh[omyelia.
5 t B: Cervical disc herniation.
' l//
' C; Thoraoic outlei syndrome.
D: Anterior interosseous nerve syndrome.
E: Carpal hrnnel sYndrome.
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i:, 40. In high cervical cordotomy the following are true EXCEPT: r 'r
'

i A: Is indicated for any patient with intractable somatic pain below the level of
the mandible.
i B: It is not effective in controlling dysesthesias like buming, prickling and pressure.
\ L,/ C: For mid line or bilateral pain, bilateral open cordotomy is indicated.
- ,

D: Pqpcutaneous cordotomy is generally indicatgd for debilitated patie4$:with

malignant pain, ' I i

E:Barbituratesandnarcoticsarecontraindicatedaftersurgery.
41. Amorg the following the one that most likely produces focal blastic spinal
metastatic lesion is:
A: Lung carcinoma,
' B: Thyroid carcinoma. .
g/ C: Breast carcinoma.
D: Renal carcinoma,
E: Lymphoma.
42. Spinal neurofibroma :
\ A, Is the commonest extradural spina\ tumor.
" y' B: Arises from the ventral root of any, spinal nerve.
C:May pr"sent as amass in the neck, ot the mediastinum,
D: The CSF is normal.
E: All ofthe above.
43. In spinal meningiomas the following are uue Except:
A. More common in females.
g,t B. Mostly affect the cervical spine.
C. Is sometimes Dumbbell shaped.
D. Are commonly sammomatus.
E. When extradural tend to be aggressive.
44. In acute spinal trauma all the following are true except:
A. Prognosis depends on patient neurological grade on admission.
B, Neurological deterioration is highest following early surgery.
C. Spinal cord injury with out radiological abnormality (SCIWORA) is
commonest among children. ,
D. In incbmplete injury delayed surgery (more than 6 mcinths) is associated with
, neurological recovery in a large number ofpatients.
y' E.Methylprednisolone is proved to be effeictive only in injuries below the conus
medullaris.
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45. The systemic manifestations of head injury may include:

A: Excessive caloric consumption-and negative nitrogen balance
B: Pseudodiabetes mellitus.
C: Subendocardial hemorrhage, cardiac anhythmias and decreased
''cardiac outlrut.
D; Dissemenated intravascular coagulation,
r/ E:All of the above.
46. Coup conhisions most commonly occur at the: i

lr' A: Cerebral convexities. ".

B: Fronlal and temporal poles.

C: Orbifhl surface of frontal lobes.
D: Ventral surface of temporallobe. '
:

E: Posterior Fossa
47. The: following are common pathological manifestations of traumatic brain head
motion injury EXCEPT:
A. Concussion syndrome.
B. Subdural henlatoma. \
t/ C. Epidural hemlrtoma.
D. Diffi.rse axonal injury.
E. Brain stem injury.
48. In arteiiovenous malformations of the brain. The following are true EXCEPT:
,A: They have significant familial tendency.
B: Are more frequently associated with the rniddle cerebral artery.
,/ Ct spontaneous d.isappearance is rare.
D: Larger A-V malformations are more likely to first present as
siezures than as hemorrhage.
E: They are associated with saccular aneurysrns in 10-15% of cases.
49.The Pterional approach is used in the surgical treatment of the following aneurysms
except:
A. Anterior communicating.
B. Posterior communication.
t/ C. Distal anterior cerebral. i
D. Middle cerebral.
F. Basilar apex
50. In aneurysrns of the vein of galen the following are true EXCEPT:
A: It may be associated with a close or a rernote angioma.
B : May presenfBsrheartfailure.
C: Craniomegaly is often seen in young children.
D: Older children may have subarachnoid hemorrhage.
V E, Surgical treatment soon after birth carries good prognosis.

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5I. The followi ng are useful measures to rqduce the cerebral vasospasm due to ,r
,

aneurysmal subarachnoid hernorrhage {xcept: :

,,/ B. $ntifrbrolytic therapy.

"
'J

C. Clot removal.
D.'Hef.nodilution. ' :
rf
$.,
E. Transluminal angioplasty. l
,

52.Mycotic aneurysms:
A. Qsually complicates nasopharyngeal infection. .,.

B. Commonly involves the circle of Willis.

.' C. Are usually Sacular
D. Never stroke or hemorrhage.
n. "uur. with antibiotics.
J May resolve
q (59 In the syndromes of brain ischemia the following are true EXCEPT:
' A: TIAs of 10- 15 rninutes duration are most likely due to an atheroembolic
\ g:disease of the internal carotid artery. \

J TIAs carries the highest incidence of d, completed stroke in the 1st.

month following the episode
t/ C: Angiography is more often normal in reversible ischernic neurological deficit
(RII{D) patients than in those with either TIAs and completed stroke.
D: Progressing stroke most commonly involves the middle cerebral artery.
E: Homonymous hemianopsia occurs in both carotid and vertebral TIAs.
n Amaurosis fugas (episodic, transient, unioccular blindness) the
following are true EXCEPT:
A: Is usually caused by occlusive disease of the internal carotid artery.
B: Is sometirnes seen in migraine.
,/- C: The attack usually last less than 5 minutes.
1/ e D: The attack may be associated with ipglglg13l hemiparesis or nurnbness.
A E: Ernbolectomy or arterial bypass is indicated in these patients.
55. Neuroblastoma
A: Is the most comrnon solid extra cranial tumor of childhood.
B: Arises from elements of the sympathetic nervous systqm.
C: May present as mediastinal tumor.
D: In 60-7Ao/o of cases produces substances,that can be detected in the serum or
urine as catabolites of catecholamines.
/ E: All of the above.
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56. In reculrant meningiomas the following are true EXCEPT:

,/ B: Recurrence rate is'very high in the hemangiopericytic type. :

C:-Should be suspected on CT if there is mass effect, edema or enhancement more

./ than a year after surgery.
/ O, The basic histological characteristics are usually different from
tumor.
the original i
E: Surgery,is the treatment in most cases. I

57.In sphenoid wing meningioma e4 plaque:

A: There is usually history of progressive painless proptosis.
B: Total removal is usualiy possiUle.
C: Radiotherapy'is necessary when total removal is.not possible':
- D: Improvement in proptosis is the aim of surgery.
// E: Af of the above.
58. Dermoid tumors:
A: are commoner t$an epidermoids.
B: more often are found in older patients than epidermoids.
C: grow more slowiy than epidermoids.
y{ D: arc found most often in the cerebellar midline, the cauda equina, the scalp, orbit
and the pranasal sinuses.
E: All of the above.
59. Intracranial epidermoids :
A: usually cause symptoms in the fifth decade.
B: in the suprasellar region usually present as visual impairment
C:.may presgnt as trigeminal neuralgia.
D: of the cerebellopontine angle and the fourth ventricle rareiy cause hydrocephalus.
1/E: Allof Se above.
, 60. The follciwing are common features of veltibular shwaruroma except:
' A., Sensoneural deafiiess. ^"--
B, Tinnitus.
C. Facial palsy.
i T
y^/ F,, iHydrocephalus f;:
Et
It
61. Ependymomas: :
/.,r A: are the most common primary tumors of the conus rnedullaris
and the cauda equina.
B: intra craniEtffilft majority occur above the tentorium.
C: frequently give rise to spinal seeding when they occur supratentorially
than infratentorial ly.
D: can often be totally (macroscopically) removed.
E: All of the above.

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 T2

62,Inprimary CNS lymphoma the following are true except:

A. Median age in irnmunocompetent is > 60.
B. Median age in immunocompromised is 35.
ul C.,-surgical resection is the treatment of choice.
D.-. Intrathecal
!..-
Methotrexate can be used in young patients.
E. ih patients with Aids the mean survival is < 6:rnonths.
63. The commonest source of brain met4stasis is:
A, the lung.
vt/
B; the breasts. -.

C:'the urinary tract.

, D: leukemia.
E: melanoma.
64. Neoplastic meningitis is most common in:
A: lung carcinoma.
/B: breast carcinoma.
\ C: lymphoma. \
, D: leukemia. ,:

E: melanorna.
65. Common associated lesions of Von Hippel-Lindau complex include:
A: renal cell carcinoma. i
B: Pheochromocytoma
C: Blindness l

D: polycythemia.
t/ E: AII of the above.
66. In the management of posterior fossa hemangioblastoma: tt
A: the tumor should be removed piecemeal.
B: the cyst wall or tumor capsule should be included in the resection.
C: biopsy and radiotherapy is the treatment of choice for solid
inaccessible lesions.
,./ multiple, small deep lesions are best left and followed up.
Ot
E: the dura should be left open in all cases to facilitate future re-exploration.
67 .In The prima4/ empfy sella syndrome the following are true EXCEPT:
A: Is more common in women.
fr B: Clinical features include headache, balance impairrnent,
dizziness, seizures and papilledema.
C: Is UtqgUg"?fgogiated with sever clinical endocrine dysfunction. r-crv-;
D: Moderat"e"fijiii€rprolactinemia is seen in some patients.
E: Surgery is only indicated in cases of CSF rhinorrhea.

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68. In all,the.following pituitary turnors surgery is the primary teatment except:

-
/AProlactinqma.- ;
,

C. Adrinocorticotrophic secreting.
D. Thyroid stimtrlating horrnone secreting.
E. Non fuTctioning tumors.
69. The clinical Gatures of colloid cyst of the 3rd. ventricle rarelj include:
A: features of raised intracranial pressure.
B: progressive or paroxysmal dementia.
C: paroxysmal transient loss of conciousness.
D: exagerated deeptendon reflexes.
u'{ E: C.S.F fistula.
70. The rnost corffnon brain tumor in the elderly is:
/ A. Metastatic.
B. Meningiomq.
C. Glioma. \
D. Lyrnphoma. 'i

E. Ependymoma.

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