Neuro group 6 2010/2011

1. With regards to intracranial pressure (ICP)

a. Intracranial hypertension is defined by persistent ICP > 10mmHg F
(14mmHg)
b. Sedation and analgesia may reduce ICP T
c. Vetriculostomy allows drainage of CSF to reduce ICP T
d. Parenchymal ICP monitoring is more accurate than ventricular ICP F
e. Hyperventilaation to PCO2 20-25 mmHg is recommended F
2. With regard to spinal cord injury (SCI)
a. Associated finding suggestive of spinal cord injury include abdominal
breathing and priapism T
b. Tetraparesis with sensory level at C6 suggesting the lesion at C2 level F
c. Intravenous Methylprednisolone is not indicated in SCI more than 3 hours
duration T
d. Complete SCI predicts poor outcome T
e. C4 cervical cord injury may lead to sudden apnoe T
3. Regarding stroke
a. Hemorrhage stroke is less common among Caucasian compared to Asian T
intracerebral hemorrhage to be more common in Asian
b. Cerebellar is the commonest anatomical location for haemorrhagic stroke
F
c. Most of patient with basal ganglia hemorrhage would not benefit from
surgery T
d. Basal ganglia hemorrhage is associated with 30% risk of seizure T
e. Pontine hemorrhage may cause dilated pupils F
4. 18 y/o student was brought in comatose following MVA. His GCS on admission
was 9/15 (E2V3M4). His vital sign was normal. (5M)
a. M4 signifies the patient is localized to painful stimulus. F
b. The verbal response is the best prognosticator compared to motor and
eye responses. F
c. CT scan showed left frontal contusion. T
d. CT scan showed an intraventricular hemorrhage. T
e. CT scan showed subfalcine hemorrhage T
FFTTT
5. Regarding status epilepticus of seizure
6. Select true (T) or false (F) for the following statement
a. 50% of EDH is caused by
b. 50% of
c. ASDH commonly caused by
d. EDH is
e. All EDH should be treated surgically F
7. Currently the best strategy for preventing further damage in patient with a
spinal cord injury is:
a) High dose corticosteroids
b) Urgent exploratory surgery

c) Maintenance of oxygenation and spinal cord perfusion

d) Intravenous diuretic therapy
e) Prolonged bed rest
8. A patient is brought to ER following MVA. On examination he has weakness of
his left arm and leg and loss of fine touch on the left with loss of pain and
temperature sensation on the right. This clinical picture is most consistent
with:
a. A complete cord syndrome
b. A central cord syndrome
c. An anterior spinal cord syndrome
d. A left spinal cord hemisection syndrome
e. A right spinal cord hemisection syndrome
9. Which of this following signs is most suggestive of Parkinsons disease rather
than the other nuerodegenarative disease?
a. Unilateral resting tremor
b. Supranuclear downgazes palsy
c. Orthotastic hypotension
d. Early falls
e. Abnormal cerebral MRI
10. Which of the following medications would be the most likely to cause druginduced Parkinsonism?
a.
Trihexyphenidyl
b.
Metochlopramide
c.
Diazepam
d.
Carbidopa
e.
.
11.The decussation of corticospinaL tract occurs
a. In the internal capsule
b. Near the caudal extremity of medulla
c. Above the sensory decussation
d. In the ventral pons
e. In the spinal cord
12.The following is the most common CNS neoplasm in immunocompromised
a. Kaposis sarcoma
b. Meningeal carcinomalosis
c. Primary CNS lymphoma
d. Medullobalstoma
e. Pleomorphic xanthoastrcytoma
13. A brain which sometimes contains psammoma bodies and progesterone
receptor is
a. Hemangioblastoma
b. Meningioma
c. Germ cell tumor
d. Primary brain lymphoma
e. Pineoblastoma
14.An upper homonymous quadrantanopia can arise from

a.
b.
c.
d.
e.

Area striate
Ipsilateral occipital lobe
Contralateral temporal lobe
Caontralateral parietal lobe
Optic chiasm

15.Which of the following is true regarding post concussion syndrome

a. It is an uncommon sequalae of the traumatic brain injury
b. A characteristic symptom would be progressively increasing lethargy
c. It is only found in patients who are involved in frigation
d. It is usually self limited and resolve over weeks to months
e. It is associated with increase risk of post traumatic epilepsy
16.Which of the following factors increase intracranial pressure (ICP)?
a.
b.
c.
d.
e.

Movement
Pain
Fever
Valsalva
all of the above

17.epidural hematoma in the children are the result

a. Of an arterial injury
b. of bone oozing
c. of bleeding from periosteal injury
d. All of the above
e. None of the above
18.Which fibers are associated with gag reflex?
a. Spinal trigeminal nucleus projections to the nucleus ambiguous
b. Solitary projections to the nucleus ambiguous
c. Solitary projections to the salivatory nucleus
d. Salivatory nucleus projections to the dorsal motor nuclei of the vagus
e. None of the above
19.The motor nucleus of the trigeminal nerve is located
a. In the upper midbrain
b. In the lower midbrain
c. In the upper pons
d. In the middle pons
e. In the lower pons
20.The most common type headache is
a. Cluster
b. Tension
c. Migraine
d. Postconcussive
e. Due to temporal arteritis

21.Occlusion of the following arteries is most likely to result in homonymous

hemianopia
a. Basilar
b. Anterior spinal
c. Vertebral
d. PCA
e. AICA
22.Which of the following is the most frequent brain tumor in the first year of life
a. Choroid plexus tumor
b. Gliosarcoma
c. Cystic astrocytoma
d. Oligodendroglioma
e. Glioblastoma multiforme
23.Non-communicating hydrocephalus would be caused by obstruction of
A. All three apertures of the fourth ventricle
B. One interventricular foramen
C. Cerebral aqueduct
D. Any of the above
E. None of the above
24.In both spasticity and parkinsonian rigidity, which of the following is seen in
the extensors of the lower limb extremity
A. Decreased strength
B. Increased stretch reflex
C. Increased tone
D. All of the above
E. None of these seen in above conditions

25.As CSF is being withdrawn during a lumbar puncture, the tip of the needle
located in
A. Epidural space
B. Subarachnoid space
C. Subdural space
D. Subpial space
E. Muscular space
26.A 35 years old woman noted to have a stiff neck, fever and photophobia.
Which of the following is the best method to differentiate between viral and
bacterial meningitis?
A)Sensorium
B)Nuchal rigidity
C) Lumbar puncture
D) CT scan brain
E) Electrocephalography
27) Which of the following is false regarding evaluation of unresponsive and dilated
pupil?

A) In acute setting, MRI of brain is the study of choice

B) The history including associated symptoms is critical in determining
severity
C) Additional clinical finding is useful in differentiating various causes of
unresponsive pupil
D) There are benign causes of unresponsive pupil
E) Maybe due to uncal herniation
28-30 (choose the most likely site of damage for each of description)
A) Left frontal
B) Left parietal
C) Left temporal
D) Right parietal
E) Right temporal
28) A patient who speaks fluently but have many content error and has difficulty
comprehending written and spoken language
C (wernicke area)
29) A patient who ignores one half of his body and failing to dress it and even
denying that part is the side of his body
D (non dominant parietal
lobeimportant in concept of bod image and awareness of external
environment)
30) A patient who comprehends the literal meaning of language but has difficulty
distinguishing the intonation in speech of others
E (non dominant
temporal lobehearing of sound, rhythm
and music)