SOAL UJIAN AKHIR FINAL2011 Flashcards
1
Q
- CPP berhubungan dengan MAP dan ICP Sebab
CPP faktor penting dalam metabolisme parenkim otak
A
B
2
Q
- Epilepsi pasca trauma dapat diakibatkan oleh peningkatan tekanan intrakranial akut
Sebab
Peningkatan tekanan intrakranial akan membentuk fokus epileptogenik pada parenkim otak
A
C
3
Q
- Herniasi tonsiler dapat mengakibatkan iskemia pada lobus oksipitalis
Sebab
Lobus oksipitalis mendapat vaskularisasi dari arteri serebri posterior
A
D
4
Q
- Edema sitotoksik sering diakibatkan oleh adanya iskemia atau hipoksia
Sebab
Iskemia dan hipoksia akan merusak sawar darah otak
A
B
5
Q
- Perdarahan subarakhnoid pasca trauma dapat mengakibatkan iskhemia
Sebab
SAH traumatika dapat mengakibatkan hidrosefalus komunikan
A
B
6
Q
- Hiperpireksia paska trauma kepala dapat terjadi akibat kerusakan batang otak
Sebab
Hiperpireksia paska trauma kepada dapat sebagai prediktor mortalitas yang signifikan
A
B
7
Q
- Perdarahan subdural pada trauma kepala biasanya diikuti adanya kerusakan akson yang difus
Sebab
Mekanisme gaya yang bekerja pada SDH dan DAI adalah sama yaitu gaya rotasi dan akselerasi deselerasi.
A
A
8
Q
- Epidural hematoma pada trauma kepala adalah akibat ruptur dari cabang arteri meningika media
Sebab
Arteri meningika media adalah cabang dari arteri karotis interna
A
C
9
Q
- Herniasi lateral tentorial dapat terjadi akibat perdarahan epidural pada temporal basal
Sebab
Pupil melebar pada sisi ipsilateral adalah tanda adanya kerusakan pada serat motoris n.III
A
C
10
Q
- Cidera otak primer dapat diakibatkan oleh gaya yang dirambatkan pada kepala
Sebab
Kerusakan otak primer dapat berupa DAI
A
B
11
Q
- Peningkatan tekanan intrakranial dapat mengakibatkan gangguan pola napas
Sebab
Pola napas dapat dipakai sebagai pertanda level kerusakan otak
A
B
12
Q
- Talk and die pada penderita trauma kepala, paling sering akibat perdarahan intrakranial
Sebab
Perdarahan intrakranial tidak selalu tampak pada CT scan inisial
A
B
13
Q
- Periorbital ecchymoses adalah tanda dari adanya fraktur basis kranii media
Sebab
Perdarahan dan kebocoran liquor pada fraktur basis kranii jarang memerlukan intervensi bedah
A
D
14
Q
- Gejala hipertensi intrakranial dapat berupa triad cushing
Sebab
Bradikardi, hipertensi dan respirasi ireguler adalah dalam upaya menjaga ICP dalam batas normal
A
C
15
Q
- Pengukuran tekanan intrakranial yang paling akurat adalah metoda intraventrikel
Sebab
Pemasangan monitor intraventrikel paling mudah dilakukan
A
C
16
Q
- Manitol adalah osmotik terapi pada hipertensi intrakranial
Sebab
Pemberian manitol dapat dilakukan pada penderita hipertensi intrakranial akibat trauma kepala pada kondisi apapun.
A
C
17
Q
A. Hiponatremi B. Hipokalsemia C. Hipernatrimea D. Hipokalemia E. Hipofasfatemia 17. Kelemahan otot, gangguan mental, gangguan ECG (gelombang U)
A
D
18
Q
A. Hiponatremi B. Hipokalsemia C. Hipernatrimea D. Hipokalemia E. Hipofasfatemia 18. Kelemahan otot, penurunan kardiak output, hemolitik anemia
A
E
19
Q
A. Hiponatremi B. Hipokalsemia C. Hipernatrimea D. Hipokalemia E. Hipofasfatemia 19. Penurunan cardiac output, hiperrefleksia, tetani
A
B
20
Q
A. Hiponatremi B. Hipokalsemia C. Hipernatrimea D. Hipokalemia E. Hipofasfatemia 20. Ensefalopati, edema otak, kejang
A
A
21
Q
A. Hiponatremi B. Hipokalsemia C. Hipernatrimea D. Hipokalemia E. Hipofasfatemia 21. Multiple cranial palsy, penurunan kesadaran
A
C
22
Q
- Respon metabolik pada cidera otak adalah:
- Peningkatan turn over protein
- Hipometabolism
- Peningkatan lipolisis
- Penurunan katabolisme
A
B
23
Q
- Penyebab hiponatremia pada cidera otak adalah:
- Pemberian manitol
- SIADH
- Gangguan sistem andrenokortikal
- Polidipsi
A
B
24
Q
- Kriteria diagnosa SIADH
- Hipotonik hiponatremia
- Osmolalitas urin lebih rendah dari plasma
- Ekskresi natrium urin lebih 20 mmol/liter
- Dapat dikoreksi dengan minum banyak
A
E
25
Q
- Penyebab hipernatremia adalah:
- Diabetes insipidus
- Pemberian salin hipertonik
- Diare
- Emboli lemak
A
E
26
Q
26. What structure is most often compressed by herniation of the L4-5 disc ? A. L4 nerve root B. L5 nerve root C. S1 nerve root D. L5 and S1 nerve roots E. Cauda equine
A
B
27
Q
- For 8 mo, a 59-yr-oldman has had radiating upper extremity pain that extends from the neck down the lateral left arm and forearm and into the thumb and index finger. He complained of numbness over the tip of the thumb and dorsum of the left hand. On physical examination there was restricted motion of the cervical spine resulting from pain (especially in extension), weakness of the biceps muscle, and depression of the biceps reflex. There was no neurologic involvement in the lower extremities. Nonoperative treatment did not relieve his symptoms. An MRI scan (sagittal and axial) of the cervical spine is shown in Fig. 1A,B. The most appropriate treatment for this problem is:
A. Orthotic immobilization for 6 wk.
B. A neck extension exercise program.
C. Posterior decompressive laminectomy.
D. Anterior disc excision with fusion.
E. Posterior laminoplasty.
A
D
28
Q
28. A 45-yr-old woman presented with complains of low back pain radiating into her anterior left thigh. She stated that, although there was some gradual relief from the back pain, her leg pain continued. Physical examination revealed a positive femoral stretch sign on the right. An MRI scan of the lumbar spine (L3-4) is shown in Fig.2. The most likely diagnosis is: A. Spinal stenosis B. Dic Herniation C. Facet Syndrome D. Conjoined root E. Back strain
A
B
29
Q
29. What structure is at risk for possible injury if a right-sided surgical approach between C4-6 is used? A. Superior Laryngeal nerve B. Recurrent laryngeal nerve C. Internal Laryngeal nerve D. Thoracic duct E. Esophagus
A
B
30
Q
- The primary treatment for a 33-yr-old man with acute onset low back pain with no leg pain or other symptoms should include:
A. 1 to 2 days of bed rest
B. 1 to 2 wk of bed rest
C. Transcutaneous electrical nerve stimulation
D. Muscle relaxants
E. Traction
A
A
31
Q
- The most consistent finding in patients who have a cauda equine syndrome (CES) is:
A. Paralysis
B. Sensory deficits in the foot and ankle
C. Motor and sensory deficits distal to the knee
D. Fecal incontinence
E. Urinary retention
A
E
32
Q
- A 48-yr-old man injured his neck in a motor vehicle accident 4 wk prior to presentation. He complained of serve, non-radiating neck pain. Physical examination revealed restricted neck motion and no neurologic deficits. Anteroposterior and lateral radiographs revealed no abnormalities. The most appropriate diagnosis test would be:
A. MRI Scan
B. CT Scan/ discography
C. Myelography
D. Flexion and extension lateral radiographs
E. Lateral tomograms
A
D
33
Q
33. After vigorous activity, a 48-yr-old man experienced pain in his right keg. He sought medical attention ad was initially treated with rest and nonsteroidal anti-inflammatory agents. A CT scan of the lumbar spine was performed. His symptoms did not hinder his ability to work, but he had continued minimal low back pain and mild lower extremity pain after vigorous sports activity. Neurologic examination was normal, with a straight leg raising test equivocal at 80 degrees. Recommended treatment should be: A. Percutaneous discectomy B. Open surgical disc excision C. Lumbar spine fusion D. Continued nonsurgical care E. Chemonucleolysis
A
D
34
Q
34. What is the occurrence of abnormality on MRI scan of the cervical spine in asymptomatic subjects over the age of 40? A. 81% to 100 % B. 61% to 80% C. 41 % to 60% D. 21% to 40% E. 0% - 20%
A
D
35
Q
35. Among normal subjects under the age of 40, what is the likelihood that anatomic evidence of a herniated disc of the lumbar spine will be found by imaging techniques such as myelography, CT, or MRI ? A. 10% to 15% B. 21% to 30% C. 31% - 40% D. 41% - 50% E. Greater than 50%
A
B
36
Q
- A 40-yr-old woman presented with complaints of neck pain radiating to the dorsum of her right hand and extending to her middle finger and the radial aspect of her ring finger. She also had weakness of the right wrist flexors, pronation of the right forearm, and a mild decrease in the triceps reflex of the right arm. Biceps and brachioradialis reflexes were normal. The most likely diagnosis is :
A. Herniated disc at C4-5
B. Herniated disc at C5-6
C. Herniated disc at C6-7
D. Syrinx of the cervical spinal cord
E. Intramedullary spinal cord tumor at C-5
A
C
37
Q
37. The most sensitive test for early diagnosis of discitis is: A. CT scan B. MRI scan C. Gallium scan D. Technetium bone scan E. Plain radiograph
A
B
38
Q
38. A 55-yr-old woman had a 12 yr progressive history of low back pain radiating to her thighs bilaterally. She had undergone at L4-S1 posterior fusion 15 yr ago. Radiographs show 7mm of displacement of L-3 on L-4 in flexion as compared to in extension. Based on these clinical and radiographic findings, the most likely diagnosis is: A. Pseudoarthrosis B. Isthmic psondylolisthesis C. Vertebral metastatic destruction D. L3-4 “instability” E. L4-S1 spinal stenosis
A
D
39
Q
39. A 48-yr –old woman presented with severe L5 radiculopathy caused by a herniated disc at L4-5.A CT scan confirmed the diagnosis, and surgical disc excision was performed. Lower extremity pain was relieved by the surgery, but the moderate low back pain persisted. The long-term (10-yr) prognosis is: A. Continued moderate low back pain B. Progressive, severe low back pain C. Gradual resolution of low back pain D. Recurrent lower extremity symptoms E. Spinal instability
A
C
40
Q
40. The prevelance of disc degeneration and/or bulging of a lumbar disc at one or more levels in patients over age 60 yr is: A. 0% to 10 % B. 11% to 25 % C. 26% to 50% D. 51% to 755 E. 76% to 100%
A
E
41
Q
41. In a primary care setting, approximately 45 of patients who present with back pain will have spinal compression fractures and 3% will have spondylolisthesis. What percentage are thought to have a spinal neoplasm (primary or metastatic)? A. Less than 1% B. 5 % C. 10% D. 20% E. 25%
A
A