66-75

Question 1

A. Astrocytoma

B. ependymoma

C. meningioma

D. myelomeningocele

E. tuberculosis

Answer 1

66.B. ependymoma

CNBR Fig. 3-266. The discrete lobulated appearance of the myxopapillary
ependymoma is illustrated. These tumors originate from the conus medullaris
or filum terminale.

Question 2

A. aneurysmal bone cyst
B. hemangioma
C metastatic disease
D. osteomyelitis
E. radiation change

Answer 2

67.B. hemangioma

GlT Fig. 85.10, p. 1299. The typical polka-dot appearance of a hemangioma of
the vertebral body is seen.

Question 3

68. The most appropriate treatment for a patient with multiple ischemic events and
    the accompanying angiogram is
    A. carotid endarterectomy
    B. encephalomyosynangiosis
    C heparinization
    D. superficial temporal artery to middle cerebral artery bypass
    E. no treatment

Answer 3

68.C. heparinization

CNBR Fig. 3-200A. The angiogram illustrates a carotid dissection. The internal carotid gradually tapers distal to its origin: the “string sign.”

Question 4

A. AVM
B. low-grade astrocytoma
C. multiple sclerosis
D. normal CI’
E. sagittal sinus thrombosis

Answer 4

69.E. sagittal sinus thrombosis

McKhann Fig. 165. This contrast fl scan illustrates the “empty delta sign” suggestive of sagittal sinus thrombosis. The triangle develops because of enhancement of vascular channels around the occluded sinus.

Question 5

A. astrocytoma
B. arachnoid cyst
C. abscess
D. metastatic tumor

Answer 5

70.B. arachnoid cyst

CNBR Fig. 3-142, p. 256. This low-intensity extra-axial mass without surrounding edema is consistent with an arachnoid cyst. The most common location is the middle fossa.

Question 6

71. A patient with low back pain only and the accompanying radiograph should undergo (a)
    A. a-guided biopsy
    B. metastatic workup
    C. multilevel decompressive laminectomy
    D. radiation therapy
    E. serum antigen testing

Answer 6

71.E. serum antigen testing

GlT Fig. 156.1, p. 2394. The radiograph shows the classic “bamboo spine” configuration of ankylosing spondylitis. Although HLA-B27 testing is indicated. the results should be interpreted with caution. Although 90% of patients with clinical ankylosing spondylitis are HLA-B27 positive, < 2% of HLA-B27 patients eventually develop ankylosing spondylitis.

Question 7

A. calcified disk herniation
B. epidural hematoma
C. meningioma
D. metastatic tumor
E. ossification of the posterior longitudinal ligament

Answer 7

72.E. ossification of the posterior longitudinal ligament

CNBR Fig. 3-292A. Ossification of the posterior longitudinal ligament is a common cause of cervical myelopathy in patients of Asian descent. Fibrosis and hyperplasia develop initially, followed by calcification. The ossification may be diffuse or localized, and may involve the dura.

Question 8

A. disk herniation
B. diskitis
C. ependymoma
D. meningioma
E. metastatic tumor

Answer 8

73 A. This postmyelogram CT illustrates a left-sided, partially calcified herniated soft disk.

Question 9

A. astrocytoma
B. diastematomyelia
C. ependymoma
D. lipoma
E. meningioma

Answer 9

74.B. GIT Fig. 170.4, p. 2587. The split cord malformation and cartilaginous septum can be seen. Patients may present with signs of a tethered cord or kyphoscoliosis.

Question 10

A. craniopharyngioma
B. chordoma
C. pituitary adenoma
D. Rathke’s cleft cyst

Answer 10

75. C. pituitary adenoma

CNBR Fig. 3-114A, p. 240. The tumor fills and expands the sella and also extends to the suprasellar space. Craniopharyngiomas are more likely to be mainly suprasellar. Rathke’s cleft cysts should be cystic, and not usually this large with upward extension (though they may be). Chordomas usually involve more bony invasion of the clivus.