2010 Flashcards
C
C
D
B
B
B
B
B
E
C
A
C
- Statement below is true about CSF, except
A.In healthy adult, total volume is 150 cc
B.Formation rate is about 0,3 cc/minute
C.The absorption is volume dependent
D.In the spine, primary produced in the dura of the nerve root
E.In the cranium, produced from choroid plexus of ventricle
C
A
C
D
C
- The cavernosus sinus and its lateral wall contain all of the following structures except the :
A.Carotid siphon
B.CN. 3, 4, 6
C.Nervus oftalmikus dan maksilaris
D.Nervus optikus
E.Postganglionic simpatik fibers
D
- All of the following statements concerning astrocytes are correct except :
A.They possess many processes
B.They are found in both white and gray matter
C.They are considered to be the scavenger cells of the CNS
D.They have perivascular end feet
E.In damaged brain tissue, astrocytes form glial scars
C
B
B
- Stimulation of caudal paramedian pontine reticular formation will result this response
A.Conjugate horizontal deviation to opposite side
B.Vertical conjugates
C.No response
D.Conjugate horizontal deviation to same side
E.Nystagmus less than 5 minutes
D
A
B
C
C
C
C
- The thalamus is fed by
A.Medial posterior choroidal artery and anterior choroidal artery
B.Medial posterior choroidal artery and superior cerebellar artery (SCA)
C.Anterior choroidal artery and middle cerebral artery
D.Middle cerebral artery only
E.Medial posterior choroidal artery and PICA
A
- Medial longitudinal Fasciculus is descending fibers may arise from this structure below, except :
A.Superior colliculus and pontine reticular formation
B.Pontine reticular formation and interstitial nucleus of Cajal
C.Edinger westhpal nuclei and inferior colliculus
D.Medial vestibular nucleus
E.Interstitial nucleus of Cajal
C
B
E
A
E
D
C
B
C
A
A
D
E
Small peripheral myelinated fibers of this pathway synapse in the substantia gelatinosa of the dosrsal horn
I
These fibers pass through the superior cerebellar peduncle
J
This tract arises from Dieter’s nucleus
F
Conscious proprioception from the legs is mainly transmitted in this tract
B
Carries fibers from medial and inferior vestibular nuclei, tectospinal tract, and interstitial nucleus of Cajal
G
Fibers from this tract originate from layer V of the cerebral cortex
C
Carries fibers that ascend to either the thalamus, periaqueductal gray, reticular formation, or superior colliculus
I
Uncrossed pyramidal fibers mainly supplying the axial musculature
H
C
- All of the following statements concerning the trigeminal nerve are correct, except :
A.It is the nerve of the first branchial arch (mandibular)
B.It contains only GSA and SVE fibers
C.It innervates the stapedius muscle
D.It innervates the dura of the anterior and middle cranial fossae
E.It mediates the afferent limb of the corneal reflex
C
B
A
A
C
C
C
B
- All of the following are true about phenytoin, except that it :
A.Is highly bound to plasma proteins
B.Is mainly excreted unchanged in the urine
C.Has dose-dependent elimination kinetics
D.Is effective in grand mal seizures
E.Induces the metabolism of certain drugs
B
- After neurosurgical operations. Fever sometimes occuring in the first 24 hours. The most possibility is caused by :
A.Pneumoniae
B.Deep vein thrombosis
C.Urinary tract infection due to catetherization
D.Atelectasis
E.Wound infection
D
- What is the most likely explanation for the patient’s current prolactine level
A.Stalk effect
B.The macroadenoma no longer synthesizes prolactine
C.Hook effect
D.Prior bromocriptine therapy favored the growth of non-hormone-producing neoplastic pituitary cells (null-cell adenoma)
None of the above
C
- According to macroadenoma case above, the next laboratory exam revealed decreased TSH and decreased free T4. What do you think happened in this patients tiroid function
A.Hypothiroid due to hypothalamic origin
B.Hypothiroid due to pituitary origin
C.Stalk effect
D.A and B is the correct answer
E.A, B, C is the correct answer
E
C
C
- Choice of side and rule for initial burr hole in head injury patient are listed below, except :
A.Same side with blow pupil
B.If both pupil dilated, choose the first dilating side
C.If both pupil dilated, choose the same side with subgaleal hematoma
D.If no localizing clue, always place on left side
E.If epidural hematoma not present, but duramater was bluish, continue with opening the duramater and decompression
E
- What is most risk factor for intracranial hypertension in trauma patient with normal CT
A.Age more than 40 years old
B.Sistolik blood pressure more than 100 mmHg
C.Haemoglobin less than 10 gr%
D.Time interval
E.Potassium serum less than 3,5 mEq
A
C
- Which is not true about Lefort fractures
A.Lefort I : Transverse
B.Lefort II : Pyramidal
C.Lefort III : Fractures lines extent upwards across inferior orbita rim, orbita floor to the medial wall of orbita and also included nasofrontal suture
D.Sometimes can result CSF leak
E.Sometimes can result pneumocephalus
C
- Posterior fossa epidural hematoma
A.Comprise about 17% of EDH
B.More common in 6th decades of life
C.Mortality is more than 40%
D.Cerebellar sign is rare when happened in trauma patient
E.Surgical evacuation must be done if the lesion is more than 5 cc
D
- Accumulation of blood in the scalp, occur almost exclusively in children, what statement is NOT TRUE :
A.There was 2 types; subgaleal hematoma and subperiosteal hematoma
B.Subgaleal hematoma may cross suture
C.Subperiosteal hematoma limited by sutures
D.Subperiosteal hematoma can only be absorb about 23% in 3 weeks
E.Subgaleal hematoma is soft and fluctunt mass
D
A.The coagulopathy should be corrected and the child observed
B.This is a problem of septic shock. A limbar puncture should be performed to assess the efficacy of the antibiotics being given
C.Percutaneous needle aspiration of the scalp hematoma
D.Sepsis is the underlying problem in this case. The risk of anesthesia and surgical exploration of the scalp is prohibitive continue intravenous antibiotics
E.While the coagulopathy is being corrected, the child should be treated surgically with debridement of the scalp wound and exploration of the fracture site and underlying dura
E
C
- Which one is NOT TRUE about craniosynostosis from the list below :
A.The incidence about 0,6-1/1000 live births
B.Rarely associated with hydrocephalus
C.CT scan may help to visualize abnormality
D.The most common is sagittal synostosis and affecting female 63%
E.Treatment is usually surgical
D
- Which one is TRUE about Dandy Walker malformation from the list below :
A.Atresia of Luschka foraminal only
B.Hydrocephalus occure less than 45% od Dandy Walker case
C.Dandy Walker appear only 2-4% of all Hydrocephalus case in pediatric
D.Shunting the ventricle alone is the first choice of surgical management
E.Chance of survival less than 46%
C
D
D
D
D
- Which is NOT TRUE about Chiari malformation below :
A.Type I is called cerebellar ectopia
B.Brainstem not involved in type I
C.The most common symptom is weakness more than 69%
D.Central cord syndrome may occure
E.Platybasia may included in this malformation
C
D
A.Detailed sensory examination
B.Oblique views of the cervical spine to assess foraminal narrowing
C.Electromyography/ nerve conduction velocity studies of the upper and lower extremities
D.Urodynamic studies and assessment of sphincter tone
E.Examination of the tongue
B
C
B
D
- These statements below are correct about lumbar disc syndrome, except :
A.L5-S1 is the most common compromised about 45-50%
B.L3-L4 has quadriceps motor weakness as a symptom
C.Achilles reflex diminished for L5-S1 level
D.Decreased sensation at medial malleolus for L4-L5 level
E.Pain distribution around anterior of the thigh for L3-L4 level
D
- Statement below are true about Cauda Equina syndrome, except :
A.Motor weakness is not significant and rare
B.Usually due to massive compression at the midline
C.Saddle anesthesia is the most common sensory deficit
D.Low back pain can present
E.Performing surgery within 48 hours is recommended
A
D
D
E
A
B
B
C
A
D
D
A
D
E
A
Injury of the median nerve at the level of the elbow
B
Injury of the ulnar nerve at the elbow
A
A
Anterior interosseous nerve injury
C
Klumke’s paralysis
D
C8 root lesion
C
- All the following are true of neurofibromatosis (NF), except :
A.Chromosome 17 is abnormal in NF 1
B.Lisch bodies usually do not cause visual problems
C.Acoustic neuromas are mostly found in NF 2
D.Meningioma and gliomas are a common finding in NF
E.Patients with NF 1 often lose their vision
E
A
A
D
B
A
D
A.CNS toxoplasmosis occur late in the course of HIV infection and usually when CD4 counts less than 200 cells/mm3
B.The differential diagnosis includes toxoplasmosis, lymphoma, cryptococcal abscess, and metastatic carcinoma
C.Stereotactic biopsy is not indicated because a definitive diagnosis will not alter the patient’s outcome
D.A diagnosis of toxoplasmosis can be made on a biopsy even if tachyzoites are not identified
E.The risk of transmission of HIV from the patient to the surgeon and surgical team can be reduced by the use of universal precautions and double gloving
C
C
D
B
C
B
D
E
- Statements below are correct about acoustic neurinoma, excepted
A.Abnormality in chromosome 22
B.Also known as vestibular schwannoma
C.Tinnitus nearly always become the first symptom and the most frequent
D.Occur at the junction called Obersteiner-Redlich zone
E.Obstructive hydrocephalus usually occur when tumor diameter about 4 cm
C
A. Extension grade A, Invasion grade II
B. Extension grade D, Invasion grade IV
C. Extension grade C, Invasion grade III
D. Extension grade C, Invasion grade IV
E. Extension grade B, Invasion grade III
E
B
A
A.Surgery, with definitive removal of the entire AVM
B.Embolization, followed by surgery
C.Embolization only, with follow up angiography
D.No teratment, the risk of hemorrhage is low and surgical removal of the lesion carries significant risk
E.Stereotactic radiation
E
A.Cerebellar venous angioma have a greater tendency to bleed than those occuring in the cerebral hemispheres
B.There is a 6% chance of recurrent from this lesion during the first year
C.Angiographic appearance of the angioma is key in deciding the approach to treatment
D.This cerebellar venous angioma does not need surgical treatment
E.If this lesion extended into the brainstem, gamma knife radiosurgery might be the best option
D
C
- Which one is correct for natural history of AVM
A.Seizures is the most frequent symptom in small and deep seated AVM
B.Spinal AVM type 1 is high flow and located intramedullary
C.Rehemorrhages rate is 6% in 6 months and then 3% a year
D.Most happened at 5th decades of life
E.Vasospasm after AVM ruptur is very frequent compare to basilar tip aneurysm
C
- What do you know about CCF is listed below, excepted :
A.Endovascular ballon embolization is always not necessary
B.There’s two category, traumatic or spontaneous
C.50% of low flow CCF spontaneously thrombose
D.Retro orbital pain, pulsatile proptosis is one of the symptom
E.Intra occular pressure could raise > 25 mmHg
A
Angular Gyrus
Match each of the descriptions with the most appropriate artery
A.Located at the midline frontonasal suture
B.Located at the junction of coronal and sagittal sutures
C.Located at the junction of lambdoid and sagittal sutures
D.Located at the posterior margin of the foramen magnum in the midline
E.Located usually just above the pinna
F.Located at the indentation under the external occipital protuberance
G.Located at the external surface of greater wing of sphenoid
H.Located at the junction of mastoid sutures and lambdoid
E
Opisthion
Match each of the descriptions with the most appropriate artery
A.Located at the midline frontonasal suture
B.Located at the junction of coronal and sagittal sutures
C.Located at the junction of lambdoid and sagittal sutures
D.Located at the posterior margin of the foramen magnum in the midline
E.Located usually just above the pinna
F.Located at the indentation under the external occipital protuberance
G.Located at the external surface of greater wing of sphenoid
H.Located at the junction of mastoid sutures and lambdoid
D
Lambda
Match each of the descriptions with the most appropriate artery
A.Located at the midline frontonasal suture
B.Located at the junction of coronal and sagittal sutures
C.Located at the junction of lambdoid and sagittal sutures
D.Located at the posterior margin of the foramen magnum in the midline
E.Located usually just above the pinna
F.Located at the indentation under the external occipital protuberance
G.Located at the external surface of greater wing of sphenoid
H.Located at the junction of mastoid sutures and lambdoid
C
Nasion
Match each of the descriptions with the most appropriate artery
A.Located at the midline frontonasal suture
B.Located at the junction of coronal and sagittal sutures
C.Located at the junction of lambdoid and sagittal sutures
D.Located at the posterior margin of the foramen magnum in the midline
E.Located usually just above the pinna
F.Located at the indentation under the external occipital protuberance
G.Located at the external surface of greater wing of sphenoid
H.Located at the junction of mastoid sutures and lambdoid
A
Bregma
Match each of the descriptions with the most appropriate artery
A.Located at the midline frontonasal suture
B.Located at the junction of coronal and sagittal sutures
C.Located at the junction of lambdoid and sagittal sutures
D.Located at the posterior margin of the foramen magnum in the midline
E.Located usually just above the pinna
F.Located at the indentation under the external occipital protuberance
G.Located at the external surface of greater wing of sphenoid
H.Located at the junction of mastoid sutures and lambdoid
B
Inion
Match each of the descriptions with the most appropriate artery
A.Located at the midline frontonasal suture
B.Located at the junction of coronal and sagittal sutures
C.Located at the junction of lambdoid and sagittal sutures
D.Located at the posterior margin of the foramen magnum in the midline
E.Located usually just above the pinna
F.Located at the indentation under the external occipital protuberance
G.Located at the external surface of greater wing of sphenoid
H.Located at the junction of mastoid sutures and lambdoid
F
Pterion
Match each of the descriptions with the most appropriate artery
A.Located at the midline frontonasal suture
B.Located at the junction of coronal and sagittal sutures
C.Located at the junction of lambdoid and sagittal sutures
D.Located at the posterior margin of the foramen magnum in the midline
E.Located usually just above the pinna
F.Located at the indentation under the external occipital protuberance
G.Located at the external surface of greater wing of sphenoid
H.Located at the junction of mastoid sutures and lambdoid
G
Linear or horse shoe incision with subtemporal and anterior petrosectomy
F
Linear incision with suboccipital craniotomy
G
Linear incision with retrosigmoid craniotomy
E
Linear curved or horse shoe incision with frontal craniotomy
A
Linear , reverse question mark or isle of man incision with temporal craniotomy
B
Linear incision with temporal craniotomy
C
Linear Or horse shoe incision with parietal craniotomy
D
Burst fracture corpus C5 with spondylolisthesis and retropuls disc C4-5 in 23 years old male
Match each of the descriptions with the most appropriate artery
A.Posterolateral thoracotomy, transpleural approach
B.Posterior lumbal interbody fusion
C.Pedicle screw fixation
D.Open door laminoplasty
E.Anterior corpectomy discectomy and Robinson fusion
E
Male, 72 years old with disc bulging C3-4, C4-5, C5-6, C6-7 with continous OPLL
Match each of the descriptions with the most appropriate artery
A.Posterolateral thoracotomy, transpleural approach
B.Posterior lumbal interbody fusion
C.Pedicle screw fixation
D.Open door laminoplasty
E.Anterior corpectomy discectomy and Robinson fusion
D
Post traumatic spondylolisthesis > 35%, L2-L3, Fr. C, Unstable
Match each of the descriptions with the most appropriate artery
A.Posterolateral thoracotomy, transpleural approach
B.Posterior lumbal interbody fusion
C.Pedicle screw fixation
D.Open door laminoplasty
E.Anterior corpectomy discectomy and Robinson fusion
C
Female 53 years old with L4-5 Disc bulging, no history of trauma
Match each of the descriptions with the most appropriate artery
A.Posterolateral thoracotomy, transpleural approach
B.Posterior lumbal interbody fusion
C.Pedicle screw fixation
D.Open door laminoplasty
E.Anterior corpectomy discectomy and Robinson fusion
B
Pott disease with abscess pouch extent to the disc, and mediastinum area, paraparesis inferior
Match each of the descriptions with the most appropriate artery
A.Posterolateral thoracotomy, transpleural approach
B.Posterior lumbal interbody fusion
C.Pedicle screw fixation
D.Open door laminoplasty
E.Anterior corpectomy discectomy and Robinson fusion
A
C
