Soal Ujian Flashcards
Each of the following is true regarding cerebrospinal fluid (CSF), EXCEPT :
A. 70% of CSF is secreted by the choroids plexus
B. Net production of CSF (in man) is 0,35/min
C. Volatile anesthetic agents and CO2 decrease CSF formation
D. The exit of the CSF via the arachnoid villi is pressure dependent
E. The choroid plexus regulates the production and composition of the CSF
C. volatile decrease CSF
Cholesterol granulomas have WHICH of the following features on T1-weighted MRI studies? A. T1 : Hyperintense, T2 : Hyperintense B. T1 : Hypointense, T2 : Hyperintense C. T1 : Hyperintense, T2 : Hypointense D. T1 : Hypointense, T2 : Hypointense E. T1 : Hypointense, T2 : Isointense
A. T1 : Hyperintense, T2 : Hyperintense
Increased signal within hemorrhage on a T1-weighted MRI is MOST LIKELY due to : A. oxyhemoglobin within the hemorrhage B. deoxyhemoglobin within the hemorrhage C. methemoglobin D. hemosiderin and ferritin E. hemosiderin only
C. methemoglobin
6 month years old baby boy with congenital hydrocephalus already been shunting (VP shunt), 6 days ago, got fver and leukocytosis. If thi is caused by shunt infection, what is the most possibility causes A. Coagulase-positive staphylocci B. H. Influenza C. Coagulase-negative staphylococci D. Strep Pneumoniae E. Klebsiella pneumoniae
C. Coagulase-negative staphylococci
A 63 year old right-handed male present with a three-year history of clumpsy gait. He was diagnosed one year ago with cervical spondylitic myelopathy and underwent a C5-7 posterior cervical decompressive laminectomy. He did well initially, but in the past view month his gait has worsened and he now complains of clumsiness of his hands. He denies any sensory deficits or incontinence. On examination, he has marked lower-extremity spasticity and weakness of hand graps billaterally with early atrophy of interossei. A lateral cervical spine x-ray demonstrates the laminectomy defect with no evidence of subluxatio. Which of the following would be least helpful in determining a diagnosis A. detailed sensory examination B. Oblique view of the cervical spine to assess foraminal narowing C. Electromyography/nerve conduction velocity studies of the upper and lower extremities D. Urodynamic studies and assesment of sphincter tone E. Examination f the tongue
B. Oblique view of the cervical spine to assess foraminal narowing
A 75 year old epileptic male with bitemporal hemianopsia is referred for transsphenoidalresectionof a nonfunctioning pituitary macroadenoma. His only medication is Dilantin for seizure control in neurosurgical departement Hasan Sadikin Hospital. He has mild cirrhosis secondary to chronic alcoholism. Endocrine tests reveal that he is hypothyroid with corticotropin deficiency. MRI showed that the tumor already grow into the anterior recess of 3rd ventricle and already down and localized perforation of sellar floor. Accoring to MODIFIED HARDY SYSTEM CLASSIFICATIN, how about the tumor condition? 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, Invasiongrade IV E. Extension grade B, Invasion grade III
E. Extension grade B, Invasion grade III
Neurotransmitter mana yang paling banyak ditemukan di thalamus?
A. Glutamate
B. Aspartate
C. GABA
D. Acetylcholine
E. Substance P
C. GABA
Halothane effect in neuroanesthesia, except A. Increases CBF B. Decreases CBV C. Decreases CSF absorption D. Affects EEG E. Produces isoelectric EEG at 4,5% concentration
B. Decreases CBV
Enflurane effect, EXCEPT A. Poor agent for neuroanesthesia B. Lowers seizure treshold C. CSF production decreases D. Increase ICP E.Can cause acute renal failur
C. CSF production decreases
Fentanyl effect in neurosurgery, except A. Crosses BBB B. Reduces CMR 2 C. Reduces CBV D. Increases ICP E. less potent than sufentanil
D. Increases ICP
Neurogenic pulmonary oedema, except A. Rare condition B. Seizures can presents C. Sudden increase of ICP D. Sympathetic discharge causing redistribution of blood E.Decrease permeability of endotellium lead to oedema
E.Decrease permeability of endotellium lead to oedema
Under normal condition, adrenal cortex secretes …. Mg/day hydrocortisone and …. Mg/day corticosterone A. 15-25 and 1-5 B. 12-30 and 2-6 C. 15-25 and 1,5-4 D. 14-23 and 2-4 E. 13-27 and 2-5
C. 15-25 and 1,5-4
Clinical correlates of serum osmolarity can make risk of renal failre if, value is more than …. And produces stupor if value more than … A. 295 and 321 B. 321 and 400 C. 320 and 360 D. 320 and 384 E. 321 and 400
D. 320 and 384
Central pontine myelinolisis, except : A. Caused by excessively very slow correction of hyponatremia B. Producing insidious spastic quadriplegia C. Can causemental status change D. Can cause cranial nerve abnormalities E. Can cause hepatic enchephalopaty
B. Producing insidious spastic quadriplegia
SIADH,except : A. Release of ADH in the absent of physiologic stimuli B. related with Schwartz-Bartter syndrome C. Can related with bronchogenic cancer D. Can occur in euvolemia E. Sometimes occur secondary to anemia
d. can occur in euvolemia
CSW, except : A. Renal loss of sodium B. Always also hypovolemia in CSW C. Fluid restriction many exacerbate vasospasm D. Haematocrytes increases E. Seizures sometimes present
B. Always also hypovolemia in CSW
Diabetes insipidus, EXCEPT A. due to low level of ADH B. high output of dilute urine C. often accompanied by craving for water D. if caused by nephrophaty called Sjorgen syndrome E. Can cause hypocalcemia
E. Can cause hypocalcemia
Recommended transfusion of platelets in spontaneous intracranialhaemorhages, EXCEPT A. thrombocytopenia less than
B. PC less than 20 K even if no bleeding
For headache therapy, this true about acetaminophen,except A. infant 10-15 mg/kg PO q 4-6 hours B. adult dose don’t exceed 4000 mg/day C. hepatic toxicity can present D. cytochrome p-450 increase toxicity E. ceiling effect sometimes appear
E. ceiling effect sometimes appear
Analgesics for mild-moderate pain, except A. codeine B. propoxyphene C. pentazocine D. hydrocodone E. tramadol
D. hydrocodone
Antispasmodics effect for neurosurgery patient, except : A. cyclobenzaprine B. methocarbamol C. diazepam D. carisoprodol E. oxazepam
E. oxazepam
True about midazolam, Except A. 4x potent than diazepam B. dissolve in aqueous solution C. amnestic effect not as stong as valium D. do not exceed 2,5 mg with initial dose E. Lipid soluble
C. amnestic effect not as strong as valium
Dementia, Except A. loss of memory B. loss of judgement C. affect 5-15% of community dwelling adults D. risk factor apolipoprotein E-4 alele E. memory eficit is the cardinal feature
C. affect 5-15% of community dwelling adults
About migrane is true, EXCEPT A. classic type may have headache B. classic type resolve completely inless than 24 hour C. cluster type happened more in male with 7:1 ratio D. basilar artery type can present with scotomata E. Hemiplegic type : hemiplegic may persist even after headache resolve
C. cluster type more in male with 7:1 ratio
This statement correct about Multiple sclerosis, Except : A. demyelinating disease B. affect white matter only C. Corticospinal tracts and posterior columns involved D. usual age of onset 16-59 years old E. deficits present > 6 months usually persist
D. age of onset 16-59 years old
Amyotrophic lateral sclerosis, Except A. also known as Lou Gehrigs disease B. etiology is still not known C. true upper motor neuron disease D. onset usually after 40 years of age E. tongue atrophy may occur
C. true upper motor neuron disease
You are asked to evaluate a patient in the neurology clinic. Your neurological examination reveals the following symptoms: (1) loss of pain and temperature sensation over the left side of the face (2) loss of pain and temperature sensation in the right arm and leg (3) normal tactile and vibratory sensations on the face, body and extremities. Where is the lesion? A. mesencephalon at the level of the inferior colliculus B. spinal cord at the cervical enlargement C. dorsolateral medulla D. posterior limb of the internal capsule E. diencephalons at the level of the massa intermedia
C. dorsolateral medulla
All of the following muscles are innervated by the mandibular division of the trigeminal nerve EXCEPT the A. lateral pterygoid B. masseter C. buccinator D. anterior belly of the diagnostic E. temporalis
C. buccinator
The facial nerve provides the parasympathetic innervation for all of the following glands EXCEPT the A. Lacrimal B. Submandibular C. Parotid D. Nasal E. Palatine
C. Parotid
symptoms of cerebellar disease EXCEPT A. resting tremor B. wide-based stance or staggering gait C. hypometria D. kinetic tremor E. dysdiadochokinesia
A. resting tremor
Charasteritic signs and symptoms that indicate damage to the corticospinal system include all of the following EXCEPT A. spasticity b. the Babinski sign c. loss of deep tendon reflexes d. immediate muscle degeneration and atrophy e. hypertonia
b. Babinski sign
Axon that originate from neurons in the globus pallidus pars interna A. lateral spinothalamic tract B. ansa lenticularis C. spinal trigeminal tract D. dorsal spinocerebellar tract E. anencephaly F. meningomyelocele
B. ansa lenticularis
Carries pain sensation from the teeth A. lateral spinothalamic tract B. ansa lenticularis C. spinal trigeminal tract D. dorsal spinocerebellar tract E. anencephaly F. meningomyelocele
C. spinal trigeminal tract
Failure of the anterior neuropore to close A. lateral spinothalamic tract B. ansa lenticularis C. spinal trigeminal tract D. dorsal spinocerebellar tract E. anencephaly F. meningomyelocele
E. anencephaly
Axon that originate from cells in the nucleus dorsalis of clarke A. lateral spinothalamic tract B. ansa lenticularis C. spinal trigeminal tract D. dorsal spinocerebellar tract E. anencephaly F. meningomyelocele
D. dorsal spinocerebellar tract
Tremor by a cerebellar lesion is differentiated from that caused by loss of the dopaminergic nigrostriatal tracts in that A. it it present at rest B. it is decreased during activity C. it only occurs during voluntary movements D. its frequency is very regular E. its amplitude remains constant during voluntary movements
C. it only occurs during voluntary movements
You see a patient with damage to the left cervical sympathetic chain ganglia as results of a neck tumor. Which of the following physical signs would be expected? A. ptosis (hanging of the upper eye lid) on the left B. pupil dilatation of the left eye C. lateral deviation of the left eye D. pale skin on the left side of the face E. increased sweat secretion on the left side of the face
D. pale skin on the left side of the face
All of the following are specific functions of the parasympathetic nerves EXCEPT A. increased gastrointestinal motility B. decreased gastrointestinal sphincter tone C. penile erection D. semen ejaculation E. emptying uf urinary bladder and rectum
D. semen ejaculation
A chronic demyelinating neurologic disorder of young adults that is characterized by plaques within the central nervous system and cerebrospinal fluid oligoclonal immunoglobulin is A. multiple sclerosis B. Huntington disease C. pemphigus vulgaris D. amyotrophic lateral sclerosis E. spinocerebellar degeneration
A. multiple sclerosis