VIQ - Central Nervous System and Head & Neck - Warm Up Flashcards
@# 1. The following are causes of a ‘hair-on-end’ appearance of the skull vault: (T/F)
a) Haemangioma
b) Thalassaemia major
c) Hereditary spherocytosis
d) Rickets
e) Sickle cell anaemia
1.
a. True
b) True
c) True
d) False
e) True
@# 2. Secondary metastases to the brain: (T/F)
a) Are the commonest cause of brain tumour in adults
b) Are usually multiple
c) Are supratentorial in 75-90%
d) Are usually hypodense on non-contrast CT
e) Are almost always high signal on T2 weighted MRI
a) False - approximately two thirds of brain tumours are primary tumours, whereas one third
are secondary metastases
b) True
c) True - however, from renal cell carcinoma are usually located in the posterior fossa
d) True - however, haemorrhagic metastases may be hyperdense precontrast
e) False - variable signal intensity on T2 weighted images
@# 4. Concerning the submandibular space: (T/F)
a) Anteriorly there is free communication between the submandibular space and the
sublingual space
b) The superficial lobe of the submandibular gland lies inferolateral to mylohyoid
c) Intraglandular ducts are seen as linear hypoechoic structures on ultrasound
d) As with the parotid gland, normal lymph nodes are found within the submandibular gland
e) Stenson’s duct exits in the floor of the mouth at the base of the frenulum
4.
a) False - posteriorly
b) True
c) False - linear hyperechoic structures
d) False - due to early glandular encapsulation normal lymph nodes are not found within the
submandibular gland
e) False - Wharton’s duct
@# 6. The following cause wide cranial sutures in children: (T/F)
a) Subdural haematoma
b) Hypophosphatasia
c) Lead intoxication
d) Lymphoma
e) Neuroblastoma
6.
a) True - only seen in children less than 10 years of age
b) True
c) True
d) True
e) True - also +/- sunray spiculation
@# 7. Regarding subarachnoid haemorrhage: (T/F)
a) It occurs secondary to arteriovenous malformation in 10% of cases
b) It is associated with subdural haemorrhage in 20% of cases
c) 15-20% of patients will have multiple aneurysms
d) Cerebral vasospasm is maximal from 48 to 72 hours after the event
e) MRI is the best modality for detecting early subarachnoid haemorrhage
7.
a) True
b) False - 5%
c) True
d) False - 5-17 days
e) False - may not be seen on MRI for 48 hours. When haemorrhage occurs, oxyHb is
converted to deoxyHb at a rate depending on oxygen tension and local pH. This can be
delayed when oxygen- containing CSF surrounds the haemorrhage. This is why it is
difficult to detect subarachnoid haemorrhage on MRI
@# 10. Klippel-Feil syndrome is associated with the following: (T/F)
a) Sprengel’s deformity
b) Syringomyelia
c) Cranial asymmetry
d) Low posterior hair line
e) Schmorl nodes
10.
a) True - in 25-40% - Sprengel’s Deformity is a congenital condition characterized by a small and undescended scapula often associated with scapular winging and scapular hypoplasia.
b) True - Syringomyelia is a neurological disorder in which a fluid-filled cyst (syrinx) forms within the spinal cord.
c) True
d) True
e) False
@# 11. Chemodectomas: (T/F)
a) Are derived from chemoreceptor cells
b) Are bilateral in 20% of cases
c) Normally arise from the adventitial layer of the common carotid artery
d) Normally cause splaying of the internal and external carotid arteries
e) Normally cause narrowing of the internal and external carotid arteries
11.
a) False - chemodectoma is a misnomer
b) False - 5%
c) True
d) True
e) False
@# 13. Concerning orbital mass lesions: (T/F)
a) 60-80% of children with retinoblastoma have bilateral tumours
b) On MRI, retinoblastoma usually enhances following intravenous gadolinium
c) Rhabdomyosarcoma of the orbit presents with rapid onset proptosis and visual loss
d) Inflammatory orbital pseudotumour involves the muscle tendons
e) 50% of patients with optic nerve glioma have neurofibromatosis Type 1
13.
a) False - 20-40%, and this is most often the autosomal dominant type
b) True
c) False - vision is preserved
d) True
e) False - 25%. 15% of patients with neurofibromatosis Type 1 have optic nerve glioma
@# 14. The following cause basal ganglia calcification: (T/F)
a) Pseudopseudohypoparathyroidism
b) Hyperparathyroidism
c) Carbon monoxide poisoning
d) Toxoplasmosis
e) Cockayne’s syndrome
14.
a) True
b) True
c) True
d) True
e) True - autosomal recessive demyelinating disease associated with deafness and dwarfism
@# 15. Regarding cerebral interventional procedures: (T/F)
a) An 8-French catheter is normally used
b) The right brachial artery is usually catheterised
c) Most interventional procedures are better done under local anaesthetic with mild sedation
d) Guidewires may safely remain within a catheter for up to 5 minutes without withdrawal
and flushing
e) Injection of 25 ml of contrast by hand in about 1.5 seconds is safe in the internal carotid
artery
15.
a) False - 5 or 6-French
b) False - right femoral artery
c) False - general anaesthetic is best for cerebral interventional procedures
d) False - up to 1 minute
e) False - 7 ml
@# 16. The following are true of MRI: (T/F)
a) The net magnetisation factor rotates at the Larmor frequency
b) The Larmor frequency is 42.6 MHz at a magnetic field strength of 1.5 Tesla
c) The repetition time controls the amount of T1 weighting
d) T1 weighted images have an echo time less than 80 ms
e) T1 recovery is also called longitudinal relaxation
- 16
a) True
b) False - 63.9 MHz
c) True
d) False - less than 20 ms
e) True
@# 17. Multiple wormian bones are seen in the following: (T/F)
a) Down’s syndrome
b) Osteogenesis imperfecta
c) Hyperphosphatasia
d) Osteopetrosis
e) Pyknodysostosis
17.
a) True
b) True
c) False - hypophosphatasia
d) False
e) True
@# 19. A generalised increase in skull vault density is seen in the following: (T/F)
a) Fibrous dysplasia
b) Fluorosis
c) Phenytoin therapy
d) Craniometaphyseal dysplasia
e) Myelofibrosis
19.
a) True
b) True - calcification of muscle attachments is also seen
c) True
d) True - associated with metaphyseal splaying of the long bones
e) True - the spleen is greatly enlarged
@# 20. Concerning pituitary adenomas: (T/F)
a) Hormonally active pituitary adenomas are usually microadenomas
b) The normal posterior pituitary is hyperintense to grey matter on T1 weighted images
c) Prolactinoma is the most commonly encountered pituitary adenoma
d) They are five times more common than craniopharyngiomas
e) Immediately after injection of gadolinium, pituitary adenomas remain hypointense to grey
matter on T1 weighted imaging
20.
a) True - 75% of pituitary adenomas are hormonally active
b) True
c) True
d) True
e) True - they become isointense or hyperintense after half an hour
@# 21. Causes of thickening of the skull calvarium include: (T/F)
a) Acromegaly
b) Sickle cell anaemia
c) Rickets
d) Phenytoin
e) Hyperparathyroidism
21.
a) True - also causes an enlarged sella
b) True - due to extramedullary haematopoesis
c) False - causes thinning of skull
d) True
e) False - causes thinning of skull