neuroradiology Flashcards
- Which of the following is a risk factor for clinically evident neurologic complications
in the first 24 hours after cerebral angiography?
I. age over 70 years - duration of angiogram over 90 minutes
- history of transient ischemic attack (TIA) or stroke
IV. history of systemic hypertension
A. I, 11, 111
B. 1, I11
C. 11, IV
D. IV
E. all of the above
Jawabannya : E
Morris p. 63. Other risk factors include patients with more than 50 to 70%
stenosis of the cerebral vessels, patients whose angiograms require a higher
volume of contrast, and patients referred for subarachnoid hemorrhage or
who are immediately postoperative.
- The most common nonneurologic complication of cerebral angiography via
femoral artery approach is
A. angina
B. allergic reaction
C. hematoma
D. myocardial infarction (MI)
E. pseudoaneurysm
jawabannya : B
Morris p. 72: Significant hematoma formation occurs at a rate of approximately
6.9 to 10.7%. Angina, allergic reaction. and myocardial infarction (MI)
all occur with an incidence of less than 1 to 2%. Pseudoaneurysms are rare.
occurring 0.05 to 0.55% of the time.
- Branches of the meningohypophysial trunk include the
I. tentorial artery
11. inferior hypophysial artery
111. dorsal meningeal artery
IV. superior hypophysial artery
A. I, 11, 111
B. I, 111
C. 11, IV
D. IV
E. all of the above
Jawabannya : A
Osb p. 87. The meningohypophysial trunk, the largest and most proximal branch
of the cavernous carotid artery, typically has three branches: the tentorial artery
(of Bernasconi and Cassanari), the dorsal meningeal artery, and the inferior
hypophysial artery (the inferolateral trunk). The superior hypophysial artery
is a branch of the supraclinoid carotid artery.
For questions 4 to 6, match the persistent anastomoses with the description. Each
response may be used once, more than once, or not at all.
A. cervical intersegmental artery
B. proatlantal intersegmental artery
C. primitive hypoglossal artery
D. primitive otic artery
E. primitive trigeminal artery
- the most comrrlbn of the persistent anastomoses
- petrous internal carotid artery to the basilar artery
- proximal cavernous internal carotid artery to basilar artery
Jawabannya :
- E,
- D,
- E.
For questions.4-6 see Apuzzo pp. 749-754.
- The precentral cerebellar vein usually drains into the
A. internal cerebral vein
B. lateral mesencephalic vein
C. posterior mesencephalic vein
D. straight sinds
E. vein of Galen
Jawabannya : E
Osb p. 233. The precentral cerebellar vein is a midline vessel that courses
medially over the brachium pontis, parallels the roof of the fourth ventricle,
and curves upward behind the inferior colliculus and precentral lobule of the
vermis to drain into the vein of Calen.
- Anterior temporal lobe masses characteristically displace the
A. anterior choroidal artery laterally
B. anterior choroidal artery medially
C. anterior choroidal artery upward
D. posterior choroidal artery downward
E. posterior choroidal artery upward
Jawabannya B
Osb p. 318.
For questions 9 to 14, match the blood products with their appearance on magnetic
resonance imaging (MRI). Each response may be used once, more than once, or not
at all.
A. isointense on TI, isointense to hyperintense on T2
B. hyperintense on Tl and T2
C. hypointense on Tl and T2
D. isointense on TI, hypointense on T2
E. hyperintense on TI, hypointense on T2
F. hypointense on TI, hyperintense on T2
- oxyhemoglobin (0-24 hours)
- deoxyhemoglobin (1-3 days)
- intracellular methemoglobin (3-14 days)
- extracellular methemoglobin (>2 weeks)
- nonparamagnetic heme pigments
- hemosiderin around periphery
Jawabannya
- A,
- D,
- E,
- B,
- F,
- C.
For questions 9-14 see ACR Trauma case 811.
For questions 15 to 23, match the branch of the internal carotid artery with the
statement that best describes it.
A. caroticotympanic artery
B. inferior hypophysial trunk
C. inferolateral trunk
D. mandibulovidian artery
E. McConnell’s capsular vessels
F. tentorial artery
- potential supply to vascular tumors of the middle ear
- vestigial hyoid artery
- common supply to juvenile angiofibromas
- also called the artery of Bernasconi and Cassanari
- Together with the inferior hypophysial artery, these vessels supply the
pituitary gland. - Together with the caroticotympanic artery, it is a branch of the petrous internal
carotid artery. - anastomoses with the superior hypophysial artery
- remnant of the embryonic dorsal ophthalmic artery
- provides important branches to some of the cranial nerves
For questions 15-23 see Morris pp. 117-130.
Jawabannya :
- A,
- A,
- D,
- F,
- E,
- D,
- B,
- C,
- C.
- The correct order of the named segments of the anterior choroidal artery is
A. cisternal segment, plexal point, plexal segment
B. cisternal segment, plexal segment, plexal point
C. plexal point, cisternal segment, plexal segment
D. plexal point, plexal segment, cisternal segment
E. plexal segment, plexal point, cisternal segment
Jawabannya : A
Osb pp. 100-101. The anterior choroidal artery (AChA) is best seen on the anteroposterior angiogram arising from the medial internal carotid artery. The cisternal AChA curves medially and posteriorly around the uncus. An
abrupt “kink is seen at the plexal point where the AChA enters the choroidal fissure. The plexal AChA then courses through the temporal horn.
- In the most common anatomic variation, the named branches of the proximal
right subclavian artery from proximal to distal are
A. internal mammary artery, thyrocervical trunk, vertebral artery, costocervical trunk
B. internal mammary artery, vertebral artery, thyrocervical trunk, costocervical trunk
C. vertebral artery, internal mammary artery, costocervical trunk, thyrocervical trunk
D. vertebral artery, internal mammary artery, thyrocervical trunk, costocervical trunk
E. vertebral artery, thyrocervical trunk, internal mammary artery. costocervical trunk
Jawabannya : D
Morris p. 101. Although this is the most common variation, others include the
inferior thyroid artery sharing a common trunk with the vertebral artery,
the vertebral artery from the thyrocervical trunk, the vertebral artery from
the proximal common carotid artery, and the vertebral artery from the
subclavian artery distal to the thyrocervical trunk.
- The most common site of origin of the recurrent artery of Heubner is the
A. A1 segment,
B. A2 segment
C. internal carotid artery
D. Ml segment
E. M2 segment
Jawabannya : B
Osb p. 120. The recurrent artery of Heubner (one of the medial striate
arteries) takes origin from the A2 segment 34 to 50% of the time, from the
A1 segment 17 to 45% of the time, and from the anterior communicating
artery 5 to 20% of the time.
- lntracranial hypotension related to leakage or removal of cerebrospinal fluid
(CSF) is most closely associated with which magnetic resonance finding?
A. diffuse dural enhancement
B. ependymal enhancement
C pneumocephalus
D. slitlike ventricles
E. ventriculomegaly
Jawabannya : A
Yock p. 333. This enhancement is thought to represent an increase in blood
volume in the dura. Inferior displacement of the structures in the posterior
fossa may accompany this finding in such cases of intracranial hypotension.
- Which of the following imaging characteristics is least likely for pleomorphic
xanthoastrocytoma?
A. calcification
B. cyst formation
C. multiple lesions
D. superficial location
E. temporal lobe location
Jawabannya : C
Yock p. 72. This variant of astrocytoma usually presents as a large single mass in a
young patient with a long history of seizures. The other options listed are typical.
- Choroid plexus papillomas in children are most common in the
A. fourth ventricle
B. left lateral ventricle
C. right lateral ventricle
D. third ventricle
Jawabannya : B
Yock p. 204. This propensity to lateralize has not been explained. These large
bulky tumors usually arise in the tri
- Choroid plexus papillomas in adults occur most commonly in the
A. fourth ventricle
B. left lateral ventricle
C. right lateral ventricle
D. third ventricle
Jawabannya : A
Yock pp. 204-205. These tumors in the adult population are often found at
the caudal aspect of the fourth ventricle and frequently calcify
- Which one of the following white matter lesions usually initially involves the
parieto-occipital regions?
A. adrenoleukodystrophy
B. Canavan’s disease
C. metachromatic leukodystrophy
D. multiple sclerosis
E. Schilder’s disease
Jawabannya : A
Yock p. 252. The lesions of adrenoleukodystrophy are usually symmetrical,
begin in the parieto-occipital region, and spread anteriorly.
For questions 32 to 37, match the description with the malformation.
A. Chiari l malformation
B. Chiari II malformation
C. both
D. neither
- caudal displacement of cerebellar tonsils
- Beaking of the midbrain tectum is characteristic.
- A meningomyelocoele is virtually always present.
- Medullary kinking is seen.
- Occipital or high cervical encephalocele is present.
- usually presents in young adulthood
For questions 32-37 see Yock pp. 520-521. Chiari I malformations consist of inferior displacement of the cerebellar tonsils through the foramen magnum. They usually occur in early adulthood. In Chiari II malformations, the caudal displacement of the hindbrain is more severe, with beaking of the tectum and medullary kinking often seen. Myelomeningoceles are virtually always present. Chiari II malformations usually present in infancy. Chiari III malformations display the most severe displacement of posterior fossa structures and are often associated with a high cervical or occipital meningocele.
Jawabannya :
- C,
- B,
- B,
- B,
- D,
- A.
- The term bovine arch refers to
A. bi-innominate arteries
B. left common carotid artery origin from the aortic arch
C. left common carotid artery origin from the right brachiocephalic trunk
D. right aortic arch
E. right subclavian artery distal to the left subclavian artery
Jawabannya : C
Morris pp. 99-101. The left common carotid artery usually arises from the aortic arch distal to the right brachiocephalic artery. In the bovine arch variant, the left common carotid artery arises from the proximal right brachiocephalic artery. Variant A is rare. A right aortic arch may be incidental or associated with congenital heart disease. Variant E is associated with Down syndrome
- The differential diagnosis of colpocephaly, or dilatation of the posterior portion of the lateral ventricles, includes
I. agenesis of the corpus callosum
II. Leigh’s disease
III. periventricular leukomalacia
IV. Hallervorden-Spatz disease
A. I, II. Ill
B. I, III
C. II, IV
D. IV
E. all of the abov
Jawabannya : B
Yock pp. 367.525. Agenesis of the corpus callosum and periventricular leukomalacia can both result in olpocephaly. Leigh’s disease and Hallervorden-Spatz disease can both cause symmetric lesions of the globus pallidus but are not associated with colpocephaly.
- Schizencephaly is essentially a
A. demyelinating illness
B. disease that first develops in the elderly
C. disorder of neuronal migration
D. neurodegenerative disorder
E. psychiatric disorder
Jawabannya C
Yock pp. 540-522. The cleft of schizoencephaly can be unilateral or bilateral,
but it usually involves the region near the central sulcus. Patients can present
with seizures or focal deficits
- The differential diagnosis of optic nerve thickening includes
I. optic nerve sheath meningioma
II. orbit4 pseudotumor
III. optic nerve glioma
IV. Graves’ disease
A. I,II,III
B. I, III
C. II. IV
D. IV
E. all of the above
Jawabannya E
Yock p. 305. Optic nerve thickening may be caused by nonneoplastic processes
like Graves’ disease, orbital pseudotumor, optic neuritis, papilledema, and vascular
malformations, or by tumors like gliomas, meningiomas, lymphomas,
leukemia, and metastases
- The most common primary benign tumor of the adult orbit is (a)
A. cavernous hemangioma
B. dermoid cyst
C. lymphangioma
D. optic nerve glioma
E. sarcoidosis
Jawabannya : A
Y p. 1373. Cavernous hemangiomas of the orbit are usually well demarcated,
vascular, intraconal lesions with smooth or lobulated borders
- Which of the following is a branch of the ophthalmic artery?
A. anterior ethmoidal artery
B. posterior ethmoidal artery
C. both
D. neither
Jawabannya : C
Morris pp. 135-137. The ethmoidal arteries are branches of the ophthalmic artery. They supply a portion of the anterior cranial fossa and the mucosa of the nasal septum. During embolization of the internal maxillary artery, dangerous potential anastomoses from the sphenopalatine branches of the internal maxillary to branches of the ophthalmic artery.
- Which of the following set of findings on a lumbar MRI scan performed immediately after contrast injection is most characteristic of a recurrent disk
herniation and epidural fibrosis, respectively?
A. a rim of enhancement in the recurrent disk, diffuse enhancement in the fibrosis
B. a rim of enhancement in the fibrosis, diffuse enhancement in the recurrent disk
C a rim of enhancement in the recurrent disk, no enhancement in the fibrosis
D. diffuse enhancement in the recurrent disk, no enhancement in the fibrosis
E. no enhancement of either the recurrent disk or fibrosis
Jawabannya : A
Yock pp. 582-583. Scar tissue contains vascular granulation tissue that
enhances more diffusely than a residual or recurrent disk.
- Lesions in diffuse axonal injury are commonly found in the
I. corpus callosum
II. gray-white junction
III. rostra1 brainstem
IV. temporal lobe
A. I, II, III
B. I. III
C. II, IV
D. IV
E. all of the above
Jawabannya : A
GIT p. 1426
- Acute subarachnoid hemorrhage is more difficult to diagnose on MRI than on computed tomography (m)be cause
A. Extracellular methemoglobin is isointense on TI and R.
B. Hemosiderin is isointense on TI and T2.
C. Most radiologists are not familiar with the appearance of acute subarachnoid hemorrhage on MRI.
D. The high oxygen tension in the subarachnoid space prevents conversion of oxyhemoglobin to deoxyhemoglobin.
E. The low oxygen tension in the subarachnoid space prevents conversion of deoxyhemoglobin to oxyhemoglobin.
Jawabannya : D
GlT pp. 1437-1438.
- Which of the following is true of the choroidal blush?
A. It is an indicator of the choroidal plexus in the lateral ventricle.
B. It is best seen on the anteroposterior projection.
C. It is from the posterior ethmoidal branches of the ophthalmic artery.
D. Its configuration is usually a thin, dense crescent.
E. Its presence usually indicates an elevated intraocular pressure.
Jawabannya D
Morris p. 137. The choroidal blush signifies the choroidal plexus of the eye and is supplied by the ciliary branches of the ophthalmic artery. It is characteristically seen as a thin crescent on the lateral projection of the internal carotid angiogram. Its absence can be an indirect sign of elevated intraorbital or intraocular pressure
For questions 48 to 109, match the figure with the most appropriate response
- The most likely etiology of this neonate’s pathology is
A. astrocytoma
B. metastatic tumor
C. Staphyloc~ccuas ureus
D. Citrobacter
Jawabannya D
CNBR Fig. 3-24A, p. 177. Large neonatal brain abscesses are usually caused by
Citrobacter, Bacteroides, hoteus, and various gram-negative bacilli
For questions 49 to 54, identify the lesions.
49.
A eosinophilic granuloma
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma
Jawabannya C
Burg 3 Fig. 1.1, p. 2. (Courtesy of Dr. John A. Goree, Durham, NC.) Note involvement
of the left facial bones.
For questions 49 to 54, identify the lesions.
50.
A eosinophilic granuloma
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma
Jawabannya : A
Burg Fig. 1.12, p. 5. (Courtesy of Dr. John A. Goree, Durham, NC.) A discrete
radiolucent area is seen
For questions 49 to 54, identify the lesions.
A eosinophilic granuloma
51.
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma
Jawabannya : D
Burg 3 Fig. 1.38, p. 22. The honeycomb pattern is characteristic.
For questions 49 to 54, identify the lesions.
52
A eosinophilic granuloma
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma
Jawabannya : F
Burg Fig. 1.52, p. 21. A discrete high-density lesion with smooth contours is seen.
For questions 49 to 54, identify the lesions.
53.
A eosinophilic granuloma
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma
Jawabannya : E
Burg 3 Fig. 1.90, p. 48. Multiple round discrete lesions are characteristic.
For questions 49 to 54, identify the lesions.
54.
A eosinophilic granuloma
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma
Jawabannya : B
Burg Fig. 1.96, p. 37. (Courtesy of Dr. John A. Goree, Durham, NC.) The scalloped
border and sclerotic rim are characteristic.
55.
A. hemangioblastoma
B. juvenile pilocytic astrocytoma
C. cysticercosis
D. medulloblastoma
Jawabannya : C
CNBR Fig. 3-32B, p. 184. The smooth and thin-walled intraventricular cyst
with a mural nodule is classic for cysticercosis.
56.
A. fetal origin of the posterior cerebral artery
B. moyamoya disease
C. persistent acoustic artery
D. persistent hypoglossal artery
E. persistent trigeminal artery
Jawabannya : A
CNBR Fig. 1-5. A fetal origin of the posterior cerebral artery from the internal
carotid circulation is seen in about 20% of anatomic dissections.
57.
A. corpus callosum lipoma
B. craniopharyngioma
C. giant aneurysm
D. glioblastoma multiforme
E. growing skull fracture
Jawabannya : A
CNBR Fig. 3-127A. Peripheral calcification is common in these lipomas.
58.
A. cysticercosis
B. infarct
C. low-grade astrocytoma
D. mycotic aneurysm
E. neurocytoma
Jawabannya A
CNBR Fig. 3-32A. A small ring-enhancing lesion surrounded by a zone of low
density is typical of cysticercosis.
59.
A. multifocal glioblastoma multiforme (GBM)
B. multiple sclerosis
C. metastatic carcinoma
D. neurocytoma
E. tuberous sclerosis
Jawabannya : E
CNBR Fig. 3-176A. Shown are giant-cell subependymal astrocytomas of tuberous
sclerosis. These hamartomatous lesions in the subependymal region are
sometimes called “candle guttering.”
60.
A. ganglioglioma
B. S. aureus
C. herpes simplex virus
D. lymphoma
Jawabannya : C
CNBR Fig. 3-36C, p. 189. The inflammation of the mesial temporal lobe with
diffuse edema is most characteristic of herpes encephalitis. There is often
associated hemorrhage
61.
A. aqueductal stenosis
B. brainstem astrocytoma
C. Chiari malformation
D. pituitary tumor
E. polymicrogyria
Jawabannya : B
CNBR Fig. 3-66A. Diffuse enlargement of the pons is seen.
62.
A. congestive heart failure
B. fever and chills
C. headaches
D. hemiparesis
E. subarachnoid hemorrhage
Jawabannya : C
CNBR Fig. 140B. The signal intensity of colloid cysts is variable on either
TI- or T2-weighted MRI. Short TI values (hyperintense images) reflect
proteinaceous material. These masses arise from the anterior roof of the
third ventricle.
63.
A. arteriovenous malformation (AVM)
B. cavernous hemangioma
C. CBM
D. metastatic carcinoma
E. tuberculoma
Jawabannya : B
CNBR Fig. 3-235D. The dark halo of decreased signal is caused by iron in
hemosiderin in this T2-weighted MRI. This is an almost diagnostic image of a
cavernous hemangioma.
64.
A. astrocytoma
B. Chiari malformation
C. diskitis
D. metastatic disease
E. syringomyelia
Jawabannya : A
CNBR Fig. 3-267A. The diffuse fusiform widening of the cord with variable
signal intensity is consistent with a diffuse or fibrillary astrocytoma.
- associated with all, but
a. renal cell carcinoma
b. ash-leaf macules
c. shagreen pathces
d. cardiac rhabdomyoma
Jawabannya A
CNBR Fig. 3-53B, p. 207. The enhancing intraventricular mass near the foramen
of Monro is a subependymal giant-cell astrocytoma that is associated with
tuberous sclerosis. The right ventricular calcified mass is a subependymal
tuber. Renal cell carcinoma is associated with von Hippel-Lindau syndrome
66.
A.astrocytoma
B. ependymoma
C. meningioma
D. myelomeningocele
E. tuberculosis
Jawabannya : B
CNBR Fig. 3-266. The discrete lobulated appearance of the myxopapillary
ependymoma is illustrated. These tumors originate from the conus medullaris
or filum terminale
67.
A. aneurysmal bone cyst
B. hemangioma
C metastatic disease
D. osteomyelitis
E. radiation change
jawabannya : B
GlT Fig. 85.10, p. 1299. The typical polka-dot appearance of a hemangioma of
the vertebral body is seen.
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 treatmen
Jawabannnya : C
CNBR Fig. 3-200A. The angiogram illustrates a carotid dissection. The internal
carotid gradually tapers distal to its origin: the “string sign.”
69.
A. AVM
B. low-grade astrocytoma
C. multiple sclerosis
D. normal CI’
E. sagittal sinus thrombosis
Jawabannya : E
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
70.
A. astrocytoma
B. arachnoid cyst
C. abscess
D. metastatic tumor
Jawabannya : B
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
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
72.
A. calcified disk herniation
B. epidural hematoma
C. meningioma
D. metastatic tumor
E. ossification of the posterior longitudinal ligament
Jawabannya E
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
73.
A. disk herniation
B. diskitis
C. ependymoma
D. meningioma
E. metastatic tumor
Jawabannya : A
This postmyelogram CT illustrates a left-sided, partially calcified herniated
soft disk.
74.
A. astrocytoma
B. diastematomyelia
C. ependymoma
D. lipoma
E. meningioma
Jawabannya 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
75.
A. craniopharyngioma
B. chordoma
C. pituitary adenoma
D. Rathke’s cleft cyst
Jawabannya : C
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.
76.
A. arachnoid cyst
B. Dandy-Walker malformation
C. epidermoid cyst
D. porencephaly
E. vein of Calen aneurysm
Jawabannya : B
CNBR Fig. 3-15B. A hypoplastic vermis, high transverse sinus, and cystic dilatation
of the fourth ventricle are characteristic of the Dandy-Walker malformation.
77.
A. arachnoid cyst
B. ependymoma
C. lipomyelomeningocele
D. meningioma
E. neurenteric cyst
Jawabannya : C
CNBR Fig. 3-250. A subcutaneous lipoma that extends into the low-lying tethered
spinal cord is seen.
78.
A. has developmental cysts
B. has multiple cafk au lait lesions
C. is asymptomatic
D. was recently diagnosed with lung cancer
E. was thrown from a motorcycle
Jawabannya : E
GlT Fig. 190.6, p. 2867. The classic appearance of pseudomeningoceles from
lower cervical nerve root avulsion is seen in this myelogram
79.
A. AVM
B. carotid occlusion
C. dural AVM
D. meningioma
E. moyamoya disease
Jawabannya : D
CNBR Fig. 3-92. This lateral venous phase angiogram shows the tumor stain of
a convexity meningioma.
80.
A. glioblastoma
B. lymphoma
C. Fahr’s disease
D. herpes simplex virus
Jawabannya : B
CNBR Fig. 3-138B. pp. 253,293. Bilateral periventricular enhancing masses are most consistent with lymphoma. They usually enhance quite brightly. Fahr’s disease is idiopathic basal ganglia calcification and should be low-intensity on MRI. Herpes simplex virus (HSV) infection usually involves the temporal Lobes.
Glioblastoma may be multicentric, but this picture is most likely a lymphom
81.
A. disk herniation
B. epidural abscess
C. meningioma
D. metastatic disease
E. radiation change
Jawabannya : B
CNBR Fig. 3-273A, B. An epidural infection is iso- or hypointense to the cord
on TI-weighted, and hyperintense on R-weighted and proton density unenhanced
MRls. With contrast, the solid portion of the abscess or the periphery
of a liquid collection enhances
82.
The lesion shown is associated with
A. Ehlers-Danlos disease
B. endocarditis
C. fibromuscular dysplasia
D. radiation therapy
E. renal cysts
Jawabannya : E
CNBR Fig. 3-99C. Cerebellar hemangioblastomas (tumor stain is seen in this
arterial phase) are associated with renal and pancreatic cysts.
83.
A. dural AVM
B. moyamoya disease
C. sagittal sinus thrombosis
D. subdural hematoma
E. vein of Calen aneurysm
Jawabannya E
CNBR Fig. 3-231A, B. Lateral basilar angiogram shows early filling of the vein of
Galen. Vein of Galen aneurysms usually present with high-output cardiac failure
in the neonate. They also may present with hydrocephalus in the infant, or subarachnoid
hemorrhage, epilepsy, or mental retardation in the older child (adult).
84.
A. chordoma
B. diskitis
C. metastatic disease
D. neurofibroma
E. normal lumbosacral radiograph
Jawabannya : B
CNBR Fig. 3-271A. Erosion of the inferior anterior L5 end plate is noted. Plain
film abnormalities in diskitis may not become evident for weeks. They include
irregularities of the end plate, loss of disk space height, and bony sclerosis
85.
A. human immunodeficiency virus (HN)
B. glioma
C. rapid correction of hyponatremia
D. methotrexate toxicity
Jawabannya : C
CNBR Fig. 3-183, p. 281. Central pontine myelinolysis is associated with the
rapid correction of hyponatremia and usually occurs in malnourished or
alcoholic patients
- The etiology of the process shown is
A. developmental
B. iatrogenic
C. infectious
D. neoplastic
E. traumatic
Jawabannya : A
CNBR Fig. 3-255. This CT shows the bony spur of diastematomyelia. Each
hemicord is enclosed in its own dural sheath
87.
A. AVM
B. fusiform aneurysm
C. misplaced shunt catheter
D. schizencephaly
E. venous malformation
Jawabannya : E
CBNR Fig. 3-237B. A linear or curvilinear structure with a nidus from which emenates numerous small vein is the typical MRI appereance of a venous angioma. The angiographic appereance is that of a caput medusae
- This 8-year-old boy who presented with headaches, nausea and vomiting ismost likely to have a(n)
A. astrocytoma
B. Dandy-Walker cyst
C. hemangioblastoma
D. medulloblastoma
E. metastatic tumor
Jawabannya : A
CBNR fig 3-50D. the brightly enhanching mural nodule in a large cyst is the typical appereance of the cerebella astrocytoma in this age of group. A cerebellar hemangioblastoma, which would be more common in an adult, may also have this appearance on MRI.
89.
A. acoustic neuroma
B. chordoma
C. giant-cell tumor
D. glomus jugulare
E. meningioma
Jawabannya : D
GlT Fig. 67.7B, p. 1011. The heterogeneous “salt and pepper” appearance of
the glomus jugulare tumor is appreciated. These relatively rare tumors arise
from rests of paraganglionic tissue along the jugular bulb. Glomus typanicum
tumors occur in the middle ear.
90.
A. no intervening normal brain
B. usually multiple
C. often associated with cavernous malformation
D. frequently hemorrhage
Jawabannya : C
CNBR Fig.3-237A, p. 331. Venous malformations consist of a large draining
cortical vein receiving a collection of medullary veins (caput medusae). There
usually is intervening normal brain, unlike with arteriovenous malformations
(AVMs) and capillary telangiectasias. They are usually single, unlike capillarytelangiectasias.
They rarely hemorrhage and are often found along with
cavernous malformations.
For questions 91 to 99, identify the vessels. Each response may be used once, more
than once, or not at all.
A. anterior caudate vein
B. atrial vein
C. basal vein of Rosentha
D. internal cerebral vein
E. septal vein
F. terminal vein
G. thalamostriate vein
H. vein of Galen
I. venous angle
- structure 1
- structure 2
- structure 3
- structure 4
- structure 5
- structure 6
- structure 7
- structure 8
- structure 9
For questions 91-99 see Osb 1 Fig. 11-18, p. 345
Jawabannya :
- E,
- A,
- F,
- G,
- B,
- C,
- H,
- D,
- I.
100.
A. hemangioblastoma
B. lymphoma
C. meningioma
D. myxopapillary ependymoma
E. schwannoma
Jawabannya : C
CNBR Fig. 3-264-A. Large schwannomas usually show more heterogeneous
contrast enhancement.
- The axial postcontrast MRI shown was obtained in a patient with
A. acquired immunodeficiency syndrome (AIDS)
B. Chiari malformation
C. disk disease
D. neurofibromatosis
E. severe spinal cord trauma
Jawabannya : A
Yock case 1148, p. 702. Cytomegalovirus (CMV) is a frequent cause of polyradiculitis
and myelitis in patients with acquired immunodeficiency syndrome
(AIDS). The pial enhancement seen is characteristic of this condition.
102.
A. giant-cell tumor
B. osteoblastoma
C. aneurysmal bone cyst
D. osteoid osteoma
Jawabannya : D
CNBR Fig. 3-257, p. 343. The lytic lesion with surrounding sclerosis and a
central nidus is classic for osteoid osteoma. These usually present with pain
that resolves with aspirin.
- This Post Contrast T1-weighted MRI illustrates?
A. abscesses
B. gliomatosis cerebri
C. metastatic disease
D. multiple infarcts
E. neurofibromatosis type 2
Jawabannya : E
CNBR Fig. 3-175. The bilateral acoustic neuromas and multiple meningiomas
are consistent with neurofibromatosis type 2.
- This postcontrast TI -weighted MRI illustrates a(n)
A. aneurysm
B. colloid cyst
C GBM
D. meningioma
E. metastasis
Jawabannya : D
Yock case 47, p. 29. A parafalcine meningioma is shown.
105.
A. abscess
B. artifact
C. hemangioblastoma
D. infarct
E. metastasis
Jawabannya : D
Yock case 580, p. 360. A gyriform pattern of contrast enhancement in the
distribution of the left anterocerebral artery (ACA) is suggestive of subacute
infarction.
106.
A. aneurysm
B. AVM
C. infarct
D. normal angiogram
E. persistent trigeminal artery
Jawabannya : C
Osb 1 Fig. 9-38A, p. 283. Occlusion of the central sulcus artery is shown.
107.
A. type 11 fracture
B. usually requires surgery
C. requires traction
D. treated with external orthosis
Jawabannya :
D
CNBR Fig. 3-298C Type I11 odontoid fractures usually heal well with an external
orthosis (e.g., halo, Somi. Minerva). Type I1 fractures will more often require
surgical stabilization, especially if there is more than 6 mm of displacement.
108.
A. Abcess
B. Lyphoma
C. Multiple sclerosis
D. Periventrikuler leukomalacia
E. Tuberus Sclerosis
Jawabannya : B
Yock case 434, p. 271. Periventricular involvement by primary central
nervous system lymphomas is common.
109.
A. acute infarction
B. chronic subdural hematoma
C. epidermoid cyst
D. intracranial hypotension
E. Sturge-Weber syndrome
Jawabannya : E
CNBR Fig. 180C. The layer of enhancement covering the hypoplastic right
hemisphere represents the meningeal angioma.
