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Neurosurgery Self Assesment > Part I: Basic Science > Flashcards

Part I: Basic Science Flashcards

1
Q

From inferior to superior (i.e. ascending), what is the 4th branch of the external carotid artery in the neck?
a. Maxillary artery
b. Occipital artery
c. Facial artery
d. Lingual artery
e. Posterior auricular artery

A

C

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2
Q

The pathway best describing how sympa- thetic fibers of the autonomic nervous system exit the spinal cord is:
a. Via the dorsal roots and white rami communicans
b. Via the ventral roots and white rami communicans
c. Via the dorsal roots and gray rami communicans
d. Via the ventral roots and gray rami communicans
e. Via the ventral roots and spinal nerves

A

B

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3
Q

The left vertebral artery usually arises from the:
a. Arch of the aorta
b. Brachiocephalic trunk c. Left common carotid
d. Left subclavian artery
e. Costocervical trunk

A

D

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4
Q

Hemiballismus results from lesioning which basal ganglia target?
a. Globus pallidus interna
b. Subthalamic nucleus
c. Substantia nigra pars reticularis d. Striatum
e. Pedunculopontine nucleus

A

B

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5
Q

Lesion of which structure increases extensor tone?
a. Dentate nucleus
b. Pedunculopontine nucleus c. Red nucleus
d. Ventral tegmentum
e. Superior olive

A

C

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6
Q

Which one of the following drain into the cavernous sinus?
a. Superior ophthalmic vein
b. Superior petrosal sinus
c. Inferior petrosal sinus
d. Basal vein of Rosenthal
e. Vein of Labbe

A

A

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7
Q

Persistent trigeminal artery is commonly:
a. Found in 3-5% of people
b. Found to connect to the proximal basilar
artery
c. Found to branch off from the ICA just
proximal to the meningohypophyseal
trunk
d. Found to have a vascular abnormality in
approximately 50% of cases
e. Found in conjunction with internalcarotid artery aplasia

A

C

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8
Q

The afferent loop of the Hering-Breuer inflation and deflation reflexes is mediated by:
a. CN XIII
b.CNIX
c. CN X
d.CNXI
e. C2

A

C

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9
Q

Which one of the following nerves is outside the annulus of Zinn?
a. Abducens
b. Nasociliary
c. Trochlear
d. Oculomotor (superior division)
e. Oculomotor (inferior division)

A

C

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10
Q

The C2 vertebra has how many secondary ossification centers?
a. 2
b.3
c. 4
d.5
e. 6

A

D

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11
Q

A line drawn between the highest point of the iliac crests across the back usually denotes:
a. L1/2 interspace b. L2/3 interspace c. L3/4 interspace d. L4/5 interspace e. L5/S1 interspace

A

D

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12
Q

Which one of the following is labeled X in the image below?
a. Ophthalmic division of the trigeminal nerve
b. Meckel’s cave
c. Oculomotor nerve
d. Maxillary division of trigeminal nerve
e. Abducens nerve

A

B

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13
Q

Which one of the following statements about the sympathetic nervous system is FALSE?
a. Innervation of thoracic viscera rises from T1-T4 spinal segments
b. Splanchnic nerves are unmyelinated
c. Preganglionic fibers enter the sympathetic chain via white rami communicans
d. Sensory afferent fibers are important for visceral pain sensation
e. Preganglionic fibers synapse in either the sympathetic chain or prevertebral ganglia

A

B

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14
Q

Nervi erigentes are responsible for:
a. Inhibition of the external anal sphincter
b. Inhibition of the internal vesicle sphincter
c. Inhibition of the internal anal sphincter
d. Inhibition of the external vesicle sphincter
e. Inhibition of the rectal muscles

A

B

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15
Q

Parasympathetic sensory afferents terminate in which one of the following?
a. Nucleus ambiguus
b. Solitary nucleus
c. Edinger-Westphal nucleus d. Red nucleus
e. Superior colliculus

A

B

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16
Q

Which one of the labels in the diagram below of the internal auditory canal identifies the facial nerve?

A

B

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17
Q

Blood supply to the posterior pituitary gland arises from branches of which internal carotid artery segment?
a. C1 (Cervical)
b. C2 (Petrous)
c. C3 (Lacerum)
d. C4 (Cavernous)
e. C5 (Clinoid)
f. C6 (ophthalmic/supraclinoid) g. C7 (communicating)

A

D

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18
Q

For each of the following descriptions, select the most appropriate answers from the diagram above. Each answer may be used once, more than once or not at all.
1. ACA
2. Maxillary division of CN V (V2) 3. Oculomotor nerve (III)

A
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19
Q

Which one of the following correctly describes the order of embryological stages of CNS development?
a. Blastogenesis, gastrulation, dorsal induction, ventral induction, neural proliferation, neuronal migration, and axonal myelination
b. Dorsal induction, ventral induction, gas- trulation, neural proliferation, neuronal migration, and axonal myelination
c. Gastrulation ventral induction, dorsal induction, neural proliferation, neuronal migration, and axonal myelination
d. Neural proliferation, gastrulation dorsal induction, ventral induction, neuronal migration, and axonal myelination
e. Ventral induction, gastrulation, dorsal induction, neural proliferation, axonal myelination, and neuronal migration

A

A

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20
Q

Which one of the following statements regarding gastrulation is most accurate?
a. It is the process by which the bilaminar
disc is converted into a trilaminar disc
b. It can result in lipomyelomeningocele if
disturbed
c. It is not dependent on bone morphogenetic protein expression
d. It starts with closure of the cranial neuropore
e. It occurs from embryonic days 10-12

A

A

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21
Q

Which one of the following statements about primary neurulation is most accurate?
a. Anterior neuropore closure approximately occurs on D19
b. Disjunction results in formation of the spi- nal canal below the posterior neuropore
c. Fusion of the neural folds starts at the anterior neuropore and proceeds caudally in a zip-like fashion until it reaches the posterior neuropore
d. Notochord induces the overlying ecto- derm to differentiate into a flat area of specialized neuroectoderm called the neural plate
e. SHH/morphogen secretion on D14 causes the neural plate to form median hinge points and start invaginating along its central axis to form a neural groove (with neural folds on either side)

A

D

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22
Q

Which one of the following statements about secondary neurulation and retrogressive differentiation is most accurate?
a. Important for the formation of the conus medullaris but not the filum terminale
b. Involves canalization of a caudal men-
senchymal cell mass
c. Is completed by days 24-26 of embryonic
development
d. Responsible for the formation of thoracic,
lumbar, sacral, and coccygeal neural tube e. Retrogressive differentiation is a mitotic
process

A

B

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23
Q

Which one of the following statements about ventral induction is most accurate?
a. It includes development of the primary brain fissure
b. It includes development of the secondary brain vesicles and brain flexures
c. It includes formation of the neural plate
d. It includes formation of the notochord
e. It includes primary neurulation

A

B

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24
Q

The disencephalon does not give rise to which one of the following?
a. 3rd ventricle
b. Mamillary bodies
c. Optic vesicle
d. Posterior pituitary
e. Superior colliculus

A

C

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25
Q

Mesencephalon does NOT give rise to which one of the following?
a. Cerebral aqueduct
b. Edinger-Westphal nucleus
c. Pineal body
d. Red nucleus
e. Substantia nigra

A

C

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26
Q

Which one of the following statements about the rhombencephalon is most accurate?
a. It contains the cerebral aqueduct at its center
b. It gives rise to diencephalon and myelencephalon secondary brain vesicles
c. It gives rise to the inferior colliculi and pons
d. Itisseparatedfromthemesencephalonby
the isthmus rhombencephalii
e. Pontine flexure indents the rhomben-
cephalon ventrally

A

D

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27
Q

Which one of the following statements about cerebellar development is most accurate?
a. Brainstem input to the cerebellum is via parallel and climbing fibers
b. Commences at week 15
c. Golgi cells come to reside in the
molecular layer
d. Granule cells develop axons called Mossy
fibers
e. Granule cells migrate inward past Purkinje cells with the help of Bergmann glia

A

E

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28
Q

Which one of the following is important in dorsoventral patterning of the neural tube?
a. BF-1
b. BMP-4 and BMP-7
c. EMX1 and EMX2
d. FGF-8
e. HOX
f. SHH

A

F

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29
Q

Which one of the following best describes cells forming the mantle layer in the develop- ing neural tube?
a. Ependymal cells
b. Glioblasts
c. Neuroblasts
d. Postmitotic young neurons
e. Radial cells

A

D

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30
Q

Whichoneofthefollowingstatementsabout cerebral cortex formation is most accurate?
a. Cortical layers are laid down from most superficial to deep
b. Germinal matrix zone is superficial to the ventricular zone
c. Intermediate zone contains axons of cortical pyramidal neurons
d. Migration of cortical pyramidal neurons occurs tangentially
e. The neocortex usually has four layers in the adult

A

C

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31
Q

Which one of the following is the first to form in the developing brain?
a. Anterior commissure
b. Genu of corpus callosum
c. Hippocampal commissure
d. Posterior commissure
e. Splenium of corpus callosum

A

A

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32
Q

Which one of the following statements about the developing spinal cord are most accurate?
a. Alar columns form the intermediolateral
horn
b. Alar columns form the ventral horns
c. Dorsally the floor plate marks where the
paired basal columns meet
d. Laterally, the alar and basal plates abut at a
groove called the sulcus limitans
e. Ventrally the roof plate marks where the
paired alar columns meet

A

D

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33
Q

Which one of the following is NOT a component of the blood-brain barrier?
a. Capillary endothelial cells
b. Astrocytic foot processes
c. Basement membrane
d. Tight junctions
e. Microglia

A

E

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34
Q

Which one of the following regions has an intact blood-brain barrier?
a. Subforniceal organ
b. Area postrema
c. Median eminence
d. Posterior pituitary
e. Pineal gland
f. Subcommissural organ
g. Organum vasculosum of lamina terminalis

A

F

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35
Q

Which one of the following statements regarding the area postrema is LEAST accurate?
a. It is located in the dorsomedial medulla in the caudal part of the fourth ventricle
b. Its blood supply is mostly from the ante-
rior inferior cerebellar artery
c. It is a circumventricular organ
d. It plays a role as a chemoreceptor
trigger zone
e. It expresses 5-HT3 receptors

A

A

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36
Q

Which one of the following statements regarding the production of CSF by choroid plexus cells is LEAST accurate?
a. Requires ultrafiltration of plasma to form extracellular fluid at basolateral membrane
b. Formation is primarily generated by net secretion of Na+, Cl, and HCO3 into ventricles
c. Water is actively pumped into the ventri- cles via Aquaporin 1 channels in the apical membrane
d. Active transport of Na+ into the ventricles via Na+/K+ ATPase occurs at the basolat- eral membrane
e. Basolateral membrane Na influx via Na+/H+ exchange and Na+/HCO3 cotransport channels.

A

B

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37
Q

Which one of the following statements regarding axonal transport is LEAST accurate?
a. Large membranous organelles are trans- ported by fast kinesin dependent antero- grade transport and dynein dependent retrograde transport
b. Cytosolic proteins are transported by fast transport
c. Occurs by retrograde transport
d. Anterograde transport is dependent upon
microtubules and the ATPase kinesin
e. Rabies virus spreads by retrograde axonal
transport

A

B

38
Q

Which one of the following statements regarding the concentration of ions in extra- cellular and intracellular compartments is LEAST accurate?
a. Extracellular sodium ion concentration is approximately 140 mM (140 mEq/l)
b. Intracellular potassium ion concentration is approximately 160 mmol/l (160 mEq/L)
c. Extracellular chloride ion concentration is
approximately 110 mM (110 mEq/l)
d. Intracellular calcium ion concentration is
approximately 2 mM (4 mEq/l)
e. Extracellular bicarbonate ion concentra-
tion is approximately 22-26 mmol/l

A

D

39
Q

Which one of the following statements con- cerning the resting membrane potential is most accurate?
a. Maintenance of the resting membrane potential is an energy dependent process requiring Na/K-ATPase
b. A membrane is depolarized when there is an increase in separation of the charge across it from baseline
c. Neurons become depolarized when the charge inside the cell becomes more negative compared to its resting state
d. Hyperpolarization of a cell membrane occurs when the outside of the cell becomes more negatively charged com- pared to its resting state
e. Resting potential difference across a membrane is not dependent on the sepa- ration of charged ions across it

A

A

40
Q

Which one of the following statements regarding ion channels is LEAST accurate?
a. Nicotinic AChR is a ligand-gated ion channel
b. NMDA receptor is a ligand-gated cation channel
c. Voltage-gated sodium channels open in response to hyperpolarization of the cell membrane
d. Cyclic AMP is generated by activation of beta-adrenoceptors
e. GABA-B receptor is a ligand-gated ion channel

A

E

41
Q

Which one of the following statements regarding the membrane potentials is most accurate?
a. The Nernst equation can be used to calcu- late the resting membrane potential of a cell
b. The Goldman equation can be used to calculate the intracellular concentration of sodium
c. The equilibrium potential for potassium is approximately +70 mV
d. Equilibrium potential of an ion maintains a unique ion gradient for it exists across a cell membrane
e. At electrochemical equilibrium, the chemical and electrical driving forces act- ing on an ion are equal and opposite, and no further net diffusion occurs

A

E

42
Q

Which one of the following best describes ions responsible for membrane hyperpolarization?
a. Chloride and sodium
b. Chloride and potassium
c. Potassium and sodium
d. Sodium and calcium
e. Sodium only

A

B

43
Q

Which one of the following statements regarding the passive membrane properties of neurons is LEAST accurate?
a. The length constant is the distance where the initial voltage response to current flow decays to 1/e (or 37%) of its value
b. Smaller length constant means passive flow of an action potential will stop at a shorter distance along an axon
c. Length constant is greater in unmyelin- ated and large diameter axons
d. The time constant is a function of the membrane’s resistance and capacitance
e. The time constant characterizes how rap-
idly current flow changes the membrane potential

A

C

44
Q

Which one of the following statements regarding the generation of the action poten- tial is LEAST accurate?
a. It is an all-or-nothing, regenerative wave of depolarization
b. It can propagate bidirectionally
c. Repolarization is due to inactivation of sodium channels combined with increased
conductance in potassium channels
d. Hyperpolarization occurs due to increases in potassium conductance lasting beyond the point of return to resting membrane
potential
e. Repolarization is required for inactivated
sodium channels to return to the closed state

A

B

45
Q

Which one of the following sites acts as the trigger zone that integrates incoming signals from other cells and initiates the action potential?
a. Soma
b. Dendritic shaft
c. Dendritic spines
d. Axon hillock and initial segment
e. Axon trunk

A

D

46
Q

Which one of the following statements regarding phenomena relevant to action potential conduction is LEAST accurate?
a. Accommodation is dependent on postsyn- aptic receptor phagocytosis
b. Saltatory conduction occurs to high resis- tance to transmembrane current leak in myelinated segments of nerve
c. Absolute refractory period is due to inac- tivation of voltage-gated sodium channels
d. Relative refractory period occurs when populations of inactivated voltage-gated sodium channels return to the closed state
e. Unidirectional propagation is function of the refractory periods associated with
action potentials

A

A

47
Q

Which one of the following synapse types is characterized by gap junctions?
a. Axodendritic synapses
b. Axoaxonic synapses
c. Axosomatic synapses
d. Dendrodendritic synapses
e. Electrical synapses

A

E

48
Q

Which one of the following statements regarding neurotransmission at chemical synapses is LEAST accurate?
a. The action potential stimulates the postsynaptic terminal to release neurotransmitter
b. Release of the transmitter into the synaptic cleft by exocytosis is triggered by an influx of Ca2+ through voltage-gated channels
c. Postsynaptic current produces an excitatory or inhibitory postsynaptic potential
d. Neurotransmitters may undergo degradation in the synaptic cleft or be transported
back into the presynaptic terminal
e. Vesicular membrane is retrieved from the
plasma membrane after exocytosis

A

A

49
Q

Which one of the following statements regarding cholinergic neurotransmission is LEAST likely?
a. synthesized in nerve terminals from the precursors acetyl coenzyme A
b. acetylcholinesterase (AChE) hydrolysis Ach into acetate and choline
c. Nicotinic AChR are a nonselective cation channel complex consisting of five subunits arranged around a central membrane- spanning pore
d. α-bungarotoxin binds to muscarinic AChRs
e. mAChRs are metabotropic G-protein coupled receptors

A

D

50
Q

Which one of the following statements regarding glutamatergic neurotransmission is LEAST accurate?
a. At depolarized membrane potentials, an Mg2+ blocks the pore of the NMDA receptor
b. most prevalent precursor for glutamate synthesis is glutamine
c. glutamine is taken up into presynaptic ter- minals and metabolized to glutamate by the mitochondrial enzyme glutaminase
d. ActivationofmetabotropicGluRsleadsto inhibition of postsynaptic Ca2+ and Na+ channels
e. AMPA receptors are a type of metabotropic GluR

A

E

51
Q

Which one of the following enzymatic con- version pathways is LEAST accurate?
a. Tyrosine-tyrosine hydroxylase-DOPA (dihydroxyphenylalanine)
b. DOPA-catechol O-methyltransferase-dopamine
c. Histidine-histidine decarboxylase-Histamine
d. Dopamine-Dopamine beta-hydroxylase- Norepinephrine
e. Tryptophan is converted to serotonin by tryptophan 5-hydroxylase and a decarboxylase

A

B

52
Q

Which one of the following statements regarding dopaminergic neurotransmission is LEAST accurate?
a. Dopamine is loaded into synaptic vesicles via a vesicular monoamine transporter (VMAT)
b. The neostriatum is the major site of dopaminergic transmission in the brain
c. Dopamine is derived from norepinephrine
d. Cocaine inhibits the Na-dependent dopamine transporter
e. monoamine oxidase (MAO) and catechol O-methyltransferase (COMT)

A

C

53
Q

Which one of the following statements regarding GABAergic neurotransmission is LEAST accurate?
a. Glutamic acid decarboxylase (GAD) con- version of glutamate to GABA
b. Vitamin B6 is important in the function of glutamic acid decarboxylase
c. The mechanism of GABA removal from the synaptic cleft is similar to that for glutamate
d. GABAA and GABAC receptors are iono- tropic receptors and are Ca2+ conductors
e. GABAB receptors are metabotropic and
increase K conductance

A

D

54
Q

Which one of the following areas does the superior temporal gyrus (Heschl’s gyrus) primarily receive inputs from?
a. Centromedian thalamic nucleus
b. Medial geniculate thalamic nucleus
c. Dorsomedial thalamic nucleus
d. Anterior thalamic nucleus
e. Centromedian-parafascicular nucleus

A

B

55
Q

Which one of the following cell types involved in vision is able to generate an action potential?
a. Ganglion cells
b. Bipolar cells
c. Horizontal cells
d. Rods and cones
e. Amacrine cells

A

A

56
Q

Which one of the following statements regarding cones and rods is LEAST accurate?
a. In the dark, rods have a high resting membrane potential of about 70 mV
b. In the dark, both rods and cones tonically release glutamate onto synapsing bipolar cells
c. Photon absorption by rhodopsin results in reduced cyclic GMP and hyperpolariza- tion of the rod cell
d. Photon absorption by cone opsin results in reduced cyclic GMP and hyperpolari- zation of the rod cell
e. Reduced glutamate secretion can cause both hyperpolarization or depolarization in bipolar cells

A

A

57
Q

Which one of the following events during visual processing is LEAST accurate?
a. The on-center bipolar depolarizes in response to reduced tonic glutamate release
b. The on-center ganglion cell will produce a burst of action potentials if a spot of light is shone on the receptive field center
c. The ganglion cell that receives its input from an off-center bipolar cell will reduce its firing rate in response a spot of light is shone on the receptive field center
d. The receptive fields of on-center and off- center ganglion cells do not overlap
e. Glutamate released from a cone cell has differential effect in different cells with which it synapses

A

D

58
Q

Which one of the following statements about olfaction is LEAST accurate?
a. Bowman glands secrete a fluid that bathes the cilia of the receptors and acts as a sol- vent for odorant molecules
b. Mucus-coated olfactory epithelium lines the anterodorsal parts of the nasal cavities
c. Binding of odor molecules generates action potentials in a G-protein coupled
mechanism
d. Fibers of CN I synapse with the mitral
cells of the olfactory bulb
e. Olfactory tract and lateral olfactory stria
project to the primary olfactory cortex and amygdala

A

D

59
Q

Which one of the following statements regarding taste sensation is LEAST accurate?
a. Receptors for molecules associated with sweet and bitter tastes utilize second
messengers
b. Sour and salty-tasting molecules act
directly upon the ion channels
c. Taste buds on the anterior two thirds of the tongue send signals through the lingual nerve to the chorda tympani and
finally into CN VII (facial)
d. Posterior one-third of the tongue detects
bitter and sour tastes and signal through
glossopharyngeal and vagus nerves
e. All taste fibers synapse in the nucleus ambiguus

A

E

60
Q

Which one of the following statements concerning neurotransmission at the neuromuscular junction is most accurate?
a. It is dependent upon the release of norepinephrine from the nerve ending
b. End plate potential amplitude can be much larger than that of excitatory or inhibitory postsynaptic potentials
c. It is an all-or-none response
d. It is not directly related to the concentra-
tion of transmitter released from the pre-
synaptic terminals
e. It is dependent on the opening of ligand-
gated calcium channels

A

B

61
Q

Which one of the following statements regarding peripheral nerve injury is most accurate?
a. Neuropraxia involves disruption of the myelin sheath only with some evidence of Wallerian degeneration
b. Recovery after neuropraxia is likely to be incomplete
c. Neurotmesis is ideally managed with expectant management
d. Axonotmesis shows Wallerian degenera- tion distal to injury
e. A dense motor and sensory deficit following a penetrating injury is due to neuropraxia

A

D

62
Q

Which one of the following ensures sufficient contraction of the striated portion of intrafu- sal fibers to enable monitor changes in mus- cle length?
a. Unmyelinated C fibers
b. 1A fibers
c. Gamma motor neurons
d. Alpha motor neurons
e. General visceral efferent fibers

A

C

63
Q

A 43-year-old South Asian man is brought into the emergency department with general- ized seizures and fever >38 (101F). CT head does not show any abnormality. LP is per- formed with an opening pressure of 22 cm H2O and CSF analysis shows: WCC 748 (Polymorphs 113, Lymphocytes 635), RBC 28, normal protein and normal glucose. Which one of the following is the most likely cause?
a. Enterovirus
b. Listeria monocytogenes
c. Mycobacterium tuberculosis d. Streptococcus pneumoniae e. Wegener’s granulomatosis

A

A

64
Q

A 45-year-old woman presents with sudden onset headache and photophobia. CT head is unremarkable and she undergoes a lumbar puncture. CSF analysis shows WCC 3, RBC 15000 and subarachnoid hemorrhage cannot be excluded due to the presence of oxyhemoglobin. CSF xanthochromia is detected by which one of the following assays?
a. Fluorescence in situ hybridization b. Immunoprecipitation
c. Light microscopy
d. Spectroscopy
e. Western blotting

A

D

65
Q

Which one of the following is the most appropriate marker for tumor proliferation?
a. GFAP
b. Ki-67
c. LDH
d. P53
e. S100

A

B

66
Q

Which one of the following pathologies is most likely to exhibit the finding shown?
a. Ataxia telangiectasia
b. Neurofibromatosis-1
c. Neurofibromatosis-2
d. Sturge-Weber syndrome e. Tuberous sclerosis

A

B

67
Q

Which one of the following is most accurate regarding tumors with 0-6-methylguanine- DNA methyltransferase methylation?
a. More susceptible to alkylating agents
b. More susceptible to antimetabolites
c. More susceptible to antitumor antibiotics
d. More susceptible to topoisomerase
inhibitors
e.More susceptible to ribunucleotide reductase inhibitors

A

A

68
Q

Which one of the following genetic mutations are associated with improved brain tumor prognosis?
a. Loss of 1p/19q
b. Loss of 1p/22q
c. Loss of 1p/10q
d. Loss of 1p/10q
e. Loss of 1p/10q

A

A

69
Q

Which one of the following types of cerebral edema is seen in malignant hypertension?
a. Cytotoxic
b. Hydrostatic
c. Interstitial
d. Osmotic
e. Vasogenic

A

B

70
Q

Cerebralischemiaisusuallyseenwhenglobal cerebral blood flow is below:
a. 60 ml per 100 g tissue per min
b. 50 ml per 100 g tissue per min
c. 40 ml per 100 g tissue per min
d. 30 ml per 100 g tissue per min
e. 20 ml per 100 g tissue per min

A

E

71
Q

Which one of the following descriptions suggest WHO grade II astrocytoma?
a. Microcystic change
b. Nuclear atypia and hyperchromasia
c. >10 mitoses per high power field
d. Numerous mitoses and anaplasia
e. Microvascular proliferation or necrosis

A

B

72
Q

Which one of the following best describes the finding below?
a. Ash-leaf (macule)
b. Café-au-lait spot
c. Plexiform neurofibroma d. Port wine stain
e. Shagreen patch

A

A

73
Q

Which one of the following best describes the finding below?
a. Cowden syndrome
b. Gorlin syndrome
c. MEN1
d. Tuberous sclerosis
e. Von Hippel Lindau

A

D

74
Q

Which one of the following genetic mutations is most likely seen with the finding below
a. 9q34/16p13
b. 3p25
c. 17p13
d. 9q22
e. 5q21

A

A

75
Q

Which one of the following best describes the finding shown?
a. Angiofibroma
b. Collagenoma
c. Neurofibroma
d. Neuroma
e. Periungual fibroma

A

E

76
Q

Which one of the following findings are most likely associated with the clinical feature below?
a. Brainstem arteriovenous malformation
b. GI polyps
c. Optic glioma
d. Retinal hamartoma
e. Sensorineural deafness

A

E

77
Q

Which one of the following best describes the finding shown?
a. Cowden syndrome
b. McCune-Albright syndrome c. Neurofibromatosis type 1
d. Neurofibromatosis type 2
e. Rhabdoid tumor syndrome

A

C

78
Q

Which one of the following best describes the finding shown?
a. Acanthosis nigricans
b. Legius syndrome
c. Muenke syndrome
d. Neurofibromatosis type 2
e. Pfeiffer syndrome

A

B

79
Q

Which one of the following best describes
the finding shown?
a. Cowden syndrome
b. Legius syndrome
c. Neurofibromatosis type 1
d. Rhabdoid tumor syndrome
e. Tuberous sclerosis complex

A

C

80
Q

Which one of the following is most likely in the image shown?
a. Basal cell naevus syndrome (Gorlin)
b. Hereditary Hemorrhagic Telangiectasia
c. Neurofibromatosis type 2
d. Sturge-Weber syndrome
e. Tuberous sclerosis

A

C

81
Q

Which one of the following is most likely in the image shown?
a. Crouzon syndrome
b. Familial adenomatous polyposis syndrome
c. Gardener’s syndrome
d. Gorlin syndrome
e. Osler-Weber-Rendu syndrome

A

D

82
Q

Which one of the following CNS manifestations are associated with the condition suggested below?
a. Aqueduct stenosis
b. DNET
c. Leptomeningeal angiomatosis
d. Skull base meningioma
e. Sphenoid wing dysplasia

A

C

83
Q

Which one of the following best describes the main mechanism of propofol sedation?
a. Cyclo-oxygenase inhibition
b. Depolarizing neuromuscular blockade
c. Endocannabinoid activation
d. Non-depolarizing neuromuscular blockade
e. Potentiates GABA-A receptor activity

A

E

84
Q

Which one of the following combinations of clotting factors are affected by warfarin?
a. II, IX, X, Protein C
b. II, VII, IX, X
c. II, VII, IX, X, Protein C, Protein S
d. II, VII, X, Protein C
e. II, VII, X, XII

A

C

85
Q

Which one of the following blood tests would you perform to monitor the effect of low molecular weight heparin?
a. Factor VII
b. Factor VIII
c. Factor Xa activity
d. Prothrombin time
e. Von Willebran Factor

A

C

86
Q

A 75-year-old patient presents with GCS E3V4M5 and due to ICH. INR is 5.0 on warfarin for atrial fibrillation. Assuming you have access to all of the following therapies, which one of the following is the most appropriate next treatment?
a. Fresh frozen plasma
b. Protamine
c. Prothrombin complex concentrate d. Recombinant factor VIIa
e. Vitamin K

A

C

87
Q

A patient with a right extradural hematoma fixes and dilates his right pupil on the way to theater. The anesthetist administers 100 ml of 20% mannitol and his pupil normalizes after 2 min. Which one of the following best explains the immediate effect of mannitol?
a. Autoregulatory vasoconstriction
b. Diuretic effect
c. Increased cerebral blood volume
d. Osmotic effect reducing interstitial
brain fluid
e. Local effect on pupillary constrictors

A

A

88
Q

Which one of the following best describes the mechanism of dexamethasone action in reducing cerebral edema?
a. Reduces cytotoxic edema through nitric oxide inhibition
b. Reduces cytotoxic edema through VEGF inhibition
c. Reduces vasogenic edema through VEGF inhibition
d. Reduces vasogenic edema through upregulation of aquaporins
e. Reduces vasogenic edema through nitric oxide signaling

A

C

89
Q

Propofol-related infusion syndrome is usually characterized by which one of the following?
a. Acute refractory bradycardia with metabolic alkalosis
b. Acute refractory bradycardia with metabolic acidosis
c. Acute refractory bradycardia with respiratory alkalosis
d. Acute refractory bradycardia with respiratory acidosis
e. Acute refractory bradycardia with normal acid-base balance

A

B

90
Q

Redman syndrome is seen with which one of the following medications?
a. Levodopa
b. Procyclidine
c. Propofol
d. Rifampicin
e. Vancomycin

A

E

91
Q

Which one of the following is the initial treatment for a dystonic reaction to levodopa?
a. Adenosine
b. Bromocriptine
c. Cyclizine
d. Procyclidine
e. Topiramate

A

D

92
Q

Which one of the following would you monitor during infusion of an intravenous loading dose of phenytoin?
a. Capillary blood glucose
b. Cardiac monitoring
c. Nystagmus
d. Peak flow rate
e. Urine output

A

B

Neurosurgery Self Assesment (3 decks)

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