Raised Intracranial Pressure

Question 1

Diagnosis of idiopathic intracranial hypertension:
a. clinical picture
b. ICT for lumbar puncture more than 25 cm
c. MR staining of meninges

Answer 1

b. ICT for lumbar puncture more than 25 cm

Question 2

What is not an elevated ICT?
a. hemianopsia
b. headache and vomiting
c. disorders of consciousness

Answer 2

a. hemianopsia

Question 3

Signs of transtentorial herniation include:
a. wide and light-unresponsive pupil
b. ipsilateral hemiparesis
c. contralateral hemiparesis
d. narrow and unresponsive pupil
e. irregular breathing
f. quantitatively disturbed consciousness

Answer 3

a. wide and light-unresponsive pupil
b. ipsilateral hemiparesis
f. quantitatively disturbed consciousness

Question 4

In which patient will we first use imaging before lumbar puncture:
a. a student with tingling in all four limbs
b. A forester with a fever
c. a pensioner brought in in a coma with a stiff neck and fever

Answer 4

c. a pensioner brought in in a coma with a stiff neck and fever

Question 5

Craniospinal pressure starts to rise sharply when the added volume of cranispinal
contents exceeds:
a. 30 ml
b. 40 ml
c. 50 ml

Answer 5

c. 50 ml

Question 6

What is the first sign of transtentorial herniation?
a. wide and light-unresponsive pupil ipsilaterally
b. narrow and unresponsive pupil ipsilaterally
c. wide and light-unresponsive pupil contralaterally
d. narrow and unresponsive pupil contralaterally

Answer 6

a. wide and light-unresponsive pupil ipsilaterally

Question 7

How to reduce ICP in intracerebral haemorrhage:
a. reduction in arterial blood
b. reduction of venous blood
c. reduction of liquor

Answer 7

c. reduction of liquor

Question 8

On puncture, clear fluid at a pressure of 250 mmH2 O. Which of the following
cannot be?
a. bacterial meningitis
b. idiopathic intracranial hypertension
c. venous sinus thrombosis
d. all of the above are possible

Answer 8

d. all of the above are possible

Question 9

What kind of liquor can be obtained in healthy people?
a. bloody
b. moten
c. yellow

Answer 9

a. bloody

Question 10

Who won’t have a lumbar puncture?
a. patient with INR = 2.8
b. patient with 100,000 platelets/mm3
(> 50,000 mm3
)
c. in the case of very thick
d. such as those with headache and fever

Answer 10

a. patient with INR = 2.8

Question 11

For lumbar puncture:
a. possible formation of a stiff neck
b. headache improves when standing

Answer 11

a. possible formation of a stiff neck

Question 12

A gentleman with cognitive decline and frequent falls at walking has enlarged
ventricles on MRI. What other information would be useful:
a. incontinence
b. whether a tremor is present
c. has a drop foot

Answer 12

a. incontinence

Question 13

Normotensive hydrocephalus is characterised by:
a. normal cognition, gait apraxia, incontinence
b. cognitive decline, gait apraxia, incontinence
c. cognitive decline, paraparesis, incontinence
d. cognitive decline, paraparesis, gait apraxia
e. incontinence, blindness, deafness, apraxia of dressing

Answer 13

b. cognitive decline, gait apraxia, incontinence

Question 14

Normotensive hydrocephalus - what will the liquor look like?
a. normal colour with increased opening pressure
b. normal colour with normal opening pressure
c. disturbed by increased opening pressure
d. disturbed by normal opening pressure

Answer 14

b. normal colour with normal opening pressure

Question 15

What is not characteristic of normotensive hydrocephalus?
a. Epileptic seizures
b. Dementia
c. Incontinence
d. Atactic-apractical walking
e. Polyneuropathy

Answer 15

e. Polyneuropathy

Question 16

What is not characteristic of normotensive hydrocephalus?
a. Dementia
b. Incontinence
c. Atactic-apractical walking
d. Psychosis

Answer 16

d. Psychosis