Download Examination of Neurosurgery Board

1. Ideal Lesion for stereotactic biopsy is that:
a. Located in the convexity of the frontal lobe.
b. deep , small enhanced lesion.
c. large unenhanced skull base lesion.
d. is not located in the eloquent cortex.
e. where the risk for craniotomy is mild.
2.
Bioabsorbable anterior cervical fixation plate and screw are now available; this can be used:
a. Only for one or two level operations.
b. Also for extensive procedures beyond 2 cervical disk spaces.
c. As strong as Titanium plate and screw system.
d. For strong and long necks.
e. In patients who has no osteopenia or osteoporosis.
3. The superior surface of the pituitary gland is covered by dura called:
a. diaphragmatic placation.
b. diaphragmatic eventration.
c. diaphragmatic attenuation.
d. diaphragma sella.
e. Diaphragmatic excursion.
4. Central nervous system (CNS) tumors arising from cells which are not normally found in the
nervous system include the following tumors :
a. Gliomas.
b. Meningeomas.
c. Germ cell tumors.
d. Primary lymphomas of the nervous system.
e. Craniopharyngeoma.
f. c. + d + e. are correct.
g. a + e + are correct.
5. Most urgent indications for surgical intervention for pituitary lesions are:
a. Pituitary apoplexy.
b. Progressive macroadenomas.
c. Hyperfunctioning pituitary adenomas.
d. Nonfunctioning sellar mass.
e. Other sellar masses.
6. Primary tumors infiltrating optic nerve is:
a. Optic nerve sheath meningeoma.
b. Retinoblastoma.
c. Glial tumors of the retina.
d. Optic glioma.
e. Metastatic carcinoma.
f. a + d are correct.
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7. Increased intracranial pressure causing papilledema can be caused by:
a. Mass lesion in the posterior fossa.
b. Optic nerve inflammation.
c. Demyelination.
d. Central retinal vein occlusion.
e. Pseudo tumor cerebri.
f. a + d+ e are correct.
g. a +c + e are correct.
8. Indications for posterior cervical foramenotomy are:
a. Symptoms refractory to conservative treatment.
b. Signs & symptoms of cervical myelopathy.
c. Spinal cord compression.
d. Cervical foramenal stenosis.
e. Central disc herniation.
9.
Spondylolisthesis in children can be diagnosed by:
a. Plain radiographs (often enough).
b. Clinical symptoms (alone enough).
c. Physical examination (alone enough).
d. Electrophysiological study must be included.
e. Vitamin D level in blood must be checke.
10. Indications for lumboperitoneal shunt operations are the followings except:
a. Pseudotumor cerebri.
b. Arnold Chiari malformation.
c. Rhinorrhea.
d. Otorrhea.
e. Cranial CSF leak of the wound after craniotomy after brain tumor resection.
11. Selective dorsal rhizotomy is a procedure of choice and is indicated
for treating the following conditions except:
a. Spasticity in patients with static encephalopathy.
b. Spasticity in patients with spinal cord injury with good intrinsic lower extremity motor strength.
c. Spasticity of lower limbs of patients with sufficient cognition.
d. Patients with cerebellar ataxia.
e. Spastic tetraplegics in whom a reduction in tone can facilitate nursing care.
12. Pronator syndrome is caused by compression of the median nerve at the following structures
except:
a. ligament of Struters.
b. Lacertus fibrosus.
c. Pronator teres.
d. Flexor digitorum superficialis.
e. Scalenus anterior muscle.
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13. Endoscopic surgery is an operation conducted entirely through the endoscope, this type of
surgery includes the following except:
a. Anterior third ventriculostomy.
b. Fenestration/resection of intracranial arachnoid cysts.
c. Intraventricular meningeomas.
d. Intracranial aneurysms.
e. Colloid cyst at foramen Monroi
14. Which of the following neurotransmitters is associated with the cells in the somatomtor cortex
that projectto the spinal cord as corticospinal fibers ?
a. Acetylcholine.
b. Dopamine.
c. Gamma aminobutyric acid.
d. Glutamate.
e. Serotonin.
15. A 57- year woman present with the main complaint of difficulty speaking. The examination
reveals that the woman’s tongue deviates to the right on attempted protrusion . When she say
“Ah” her soft palat elevates slightly on the left and the uvula deviates to the same side. This
combination of deficite woud most likely indicate a small lesion in which of the following ?
a. Crus cerebri on the right
b. Genu of the internal capsule on the left
c. Genu of the internal capsule on the right
d. Lateral medulla on the right
e. Medial medulla on the left
16. The first intracranial branch of the internal carotid artery is:
a. The anterior communicating artery.
b. The posterior communicating artery.
c. The central retinal artery.
d. The ophthalmic artery.
e. The middle meningeal artery.
17. A tumor in the frontal horn of the left lateral ventricle may be resect
by which approached:
a. The transcortical transventriclular approach through the superior frontal jyrus.
b. The transcortical transventriclular approach through the middle frontal jyrus.
c. The transcortical transventriclular approach through the inferior frontal jyrus.
d. The subfrontal approach.
e. The posterior transcalloswal approach.
18. Central spinal cord syndrome
a. Occurs after spinal trauma, thus is more common in young people.
b. The pathophysiological mechanism is buckling of the spinal cord between ossified posterior.
longitudinal ligament anteriorly and hypertophic ligamentum flavum posteriorly.
c. The lower extremities are affected more than the upper extremities.
d. Early surgery is indicated in the absence of neurological recovery.
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19. Tethered spinal cord may be caused by
a. Diastematomyelia.
b. Tight filum terminale.
c. Trauma.
d. A and B.
e. All of the above.
20. A 6 year old child is presented to you with fever and nuchal rigidity. His previous history is
remarkable for 2 previous episodes of bacterial meningitis and ENT follow up for nasal polyp
manifested by snoring. Your neurosurgical diagnosis would be:
a. Invasive pituitary macroadenoma extending.
b. Frontonasal encephalocele.
c. A syndromic form of craniosynostosis susch as Crouzon or Apert.
d. A metastatic tumor with anterior skull base destruction.
e. Chronic hydrocephalus with leading to CSF leakage.
21. Which of the following is most characteristic for the diagnosis of
dandy Walker:
a. Large posterior fossa, high torcula and agenesis of the cerebellar vermis.
b. Small posterior fossa, large cisterna magna and cerebral heterotopia.
c. Large posterior fossa, low torcula and obstructive hydrocephalus.
d. Small posterior fossa, retrocerebellar cyst and small fourth ventricle.
e. Posterior fossa cyst, large third ventricle and agenesis of the corpus callosum.
22. Spinal epidural abscess not related to previous spine surgery:
a. Always associated with neurological deficits.
b. Most commonly caused by gram negative bacteria from the GI tract.
c. May be missed on CT with contrast.
d. Always should be managed by surgery followed by IV antibiotics in.
e. The route of infection is always hematogenous.
23. Which of the following is not correct for a 60 year old patient with
cerebral cavernous hemangioma (cavernoma):
a. May present with intracerebral hemorrhage.
b. May present with seizures.
c. Follow-up with or without medications may be a good option.
d. Craniotomy and surgical removal may be indicated.
e. Angiography and embolization should be considered before surgery.
24. The most common pathology leading to spontaneous intracerebral
heamorrhage in the pediatric age group is:
a. AVM (areriovenous malformation)
b. Aneurysm of the anterior communicating artery
c. Cavernous hemangioma (cavernoma)
d. Congenital malformation of theVein of Galen
e. Moyamoya disease
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25. During surgical removal of acoustic neurinoma, the facial nerve is
usually located in which aspect of the lesion:
a. Anterior inferior.
b. Posteriorinferior.
c. Anterior superior.
d. Posterior superior.
e. Inside the tumor.
26. In a patient with a lesion in the left thalamus involving the left
geniculate body, the ophthalmological examination may reveal:
a. Left eye blindness.
b. Right eye blindness.
c. Bitemporal hemianopsia.
d. Left homonymous hemianopsia.
e. Right homonymous hemianopsia.
27. All of the following are true of cerebral oligodendroglioma except:
a. Typically affect middle aged patients but may occur also in children.
b. Comprise about 17% of primary brain tumors.
c. Calcification within the tumor is frequent.
d. Seizures are common as a presenting symptom.
e. Usually occur in the white matter of the cerebral hemispheres.
28. Ependymoma:
a. In the spinal cord, the usual location is intradural extramedullary.
b. In adults, the common location is infratentorial.
c. In children, usually present with seizures.
d. Is the most common supratentorial tumor in children.
e. None of the above.
29. A 35 year old patient with headache. MRI showed a tumor in the anterior portion of the third
ventricle and frontal horn of the right lateral ventricle, the most likely histolgical diagnosis of this
tumor would be:
a. Astrocytoma.
b- Colloid cyst.
b. Chorid plexus papilloma.
c. Meningioma.
d. Metastatic tumor.
30. In the above patient, surgery may be performed through the anterior transcallosal approach.
Which of the following complications is least common for this approach:
a. Hemiparesis.
b. Memory disturbances.
c. Disconnection syndrome.
d. Diabetes insipidus.
e. Mutism.
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31. In patients with neurofibromatosis NF1, the most common CNS tumor is:
a. Unilateral acoustic neurinoma
b. Bilaetral acoustic neurinoma
c. Meningioma
d. Astrocytoma
e. Central neurocytoma
32. A 43 year old woman with spastic paraparesis due to calcified central disc herniation at D8-D9.
The preferred surgical approach in this patient would be
a. Transthoracic.
b. Transpedicular.
c. Costotransversectomy.
d. Hemilamincetomy and facetectomy.
e. Bilateral laminectomy and facetectomy.
33. During operation for a cerebelloppontine angle tumor in the sitting position, in order to improve
visualization and access to the tumor, you would prefer to put the head-neck in which situation:
a. The neck in flexion with rotation to the side of the lesion.
b. The neck in flexion with rotation to the contralateral side from the lesion.
c. The neck in neutral position and the head in midposition (no rotation).
d. The neck in neurtral position with rotation to the contralateral side.
e. All of the above positions are equally appropriate.
34. Which of the following is true for benign intracranial hypertension
(pseudotumor cerebri):
a. The incidence in women is twice the incidence in men.
b. Lumbar puncture reveals high pressure and high protein in the CSF.
c. MRI of the brain shows no S.O.L or signs of sinus thrombosis.
d. In a patient with paseudotumor cerebri, pregnancy is usually associated with severe deterioration.
e. Ophthalmological examination shows papilledema but without.
f. disturbances of eye movements or visual field defects.
35. Osteoblastoma and osteoid osteoma are bone tumors that may
involve the spine. The main difference between these tumors is:
a. The radiological features on MRI.
b. The histopathological features.
c. The first appears after.
d. The one affects mainly children, while the others affects elderly patients.
e. The difference is only in the size of the tumor.
36. A far lateral lumbar disc herniationa at L4-5 may cause which of the
following:
a. Weakness of the extensor hallucis longus.
b. Weakness of the knee extensor.
c. Cauda equine syndrome.
d. Weakness of plantar flexion of the foot.
e. Weakness of the dorsiflexion of the foot (drop foot).
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37. In patients with intracranial hemorrhage secondary to rupture of aneurysm, the risk for
vasospasm is roughly estimated by looking at the blood on CT scan. This grading scale is named:
a. Fisher grade.
b. Hunt and Hess classification.
c. Spetzler-Martin scale.
d. Yasargil grading system.
e. None of the above..
38. The first extracranial branches of the external carotid artery is:
a. The internal maxillary artery.
b. The occipital artery.
c. The ascending pharyngeal artery.
d. The posterior auricular artery.
e. None of the above.
39. A76- year old man presents with a resting tremor , bradykinesia,
and stooped posture. These observations suggest loss of a prominent
population of cells in the brain. Which of the following structures is
most likely affected in this patient ?
a. Lateral cerebellar nucleus.
b. Locus ceruleus.
c. Red nucleus.
d. Substantia nigra.
e. Subthalamic nucleus.
40. Patients who have survived a subarachnoid hemorrhage from a
ruptured intracranial aneurysm are at risk for:
a. Rehemorrhage.
b. Cerebral artery vasospasm.
c. Ischemic stroke.
d. Hydrocephalus.
e. All of the above.
f. A + B + D are correct.
41. The evaluation of a comatose patient with a head injury begins with:
a. The cardiovascular system.
b. Pupillary reflexes.
c. Establishment of an airway.
d. Computed tomography (CT) of the brain.
e. By glasco-coma scale.
42. Which of the following statements is/are true?
a. Cranial osteomyelitis most frequently arises from the spread of bacteria
through the bloodstream from an infection elsewhere in the body.
b. Subdural empyema is ordinarily treated by administration of antibiotics
without the need for surgical drainage.
c. Bacterial meningitis may lead to the development of hydrocephalus.
d. A bacterial brain abscess commonly presents as a mass lesion of the
brain, without systemic signs of infection such as fever or eukocytosis.
e. Bacterial brain abscesses are difficult to visualize by CT.
f. A+C are corrects.
g. C+D are corrects.
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43. Complete excision of a brain abscess used to be the preferred method of treatment, and it is still
performed occasionally today. Most commonly now, a brain abscess is treated by:
a. Systemic antibiotic administration.
b. Aspiration and drainage of the abscess through a small opening in the skull.
c. Injection of antibiotics into the abscess.
d. Aspiration and drainage of the abscess plus systemic antibiotic administration.
e. Marsupialization of the abscess.
44. Which of the following statements are true?
a. Extradural neoplasms are usually benign.
b. A typical type of intramedullary tumor is a meningioma.
c. An intradural extramedullary neoplasm is ordinarily treated by a combination of surgical resection
and radiotherapy.
d. Extradural neoplasms are usually malignant.
e. A hemangioblastoma is a benign intramedullary tumor that has the potential for surgical cure.
f. A+C+E are corectes.
g. D+E are correct.
45. The physician is most effective in treating:
a. Cerebral contusions.
b. Epidural hematomas.
c. Cerebral lacerations.
d. Hypoxia.
e. B + D are correct
f. A + B are corrects
46. Which of the following lesions is not one of the cutaneous stigmata
of occult spinal dysraphism?
a. Midline lumbar capillary hemangioma.
b. Focal hairy patch over the thoracolumbar spine.
c. Dermal sinus located above the midsacrum.
d. Midline subcutaneous lipoma.
e. Café-au-lait spot over the thoracolumbar spine.
47. Surgical therapy for epilepsy should be considered in patients with:
a. Seizures poorly controlled with antiepileptic medications.
b. A single epileptic focus.
c. Seizures arising from multiple areas of cerebral cortex.
d. Seizures arising within the cortical motor strip.
e. A + B are corrects.
f. A+ B+D are corrects.
48. Are correct All intracranial nervous system tumors can be malignant in behavior due to their
location. Which of the following tumor(s) is/are usually considered to be histologically benign?
a. Astrocytoma.
b. Meningioma.
c. Schwannoma.
d. Medulloblastoma.
e. Craniopharyngioma.
f. b+C+e are corrects.
g. b+c+d are corrects.
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49. The management of a skull fracture is highly dependent on the type and location of the fracture.
Which of the following statement(s) is/are true concerning skull fractures?
a. A simple nondepressed linear skull fracture is of no significant
consequence.
b. Most depressed skull fractures require surgery to elevate the depressed
Bone fragment regardless of neurologic status.
c. CSF rhinorrhea associated with a basal skull fracture requires prompt surgical exploration and repair
of the defect.
d. Prophylactic antibiotics are indicated in all basal skull fractures associated with CSF rhinorrhea or
otorrhea.
e. b + d are corrects.
50. Which of the following statement is incorecte concerning spinal cord injuries?
a. Incomplete spinal cord lesions may result in the Brown-Sequard syndrome which is manifest by
contralateral loss of motor function and position- vibratory sensation with ipsilateral loss of pain and
temperature sensation below the level of the injury.
b. The presence of hypotension associated with a cervical spine injury following blunt trauma could
associated the cord injury.
c. Cervical spine malalignment can almost always be reduced by skeletal traction.
d. An indication for early operation following spinal cord injury is neurologic deterioration in a patient
with initially incomplete cord lesion.
e. The natural history of a cord injury in which some function is preserved immediately after the injury
is progressive loss of function despite appropriate treatment.
51. Which of the following statement is incorrect concerning
intracranial aneurysms?
a. Over 85% of cerebral aneurysms occur in the carotid or anterior
circulation.
b. Most intracranial aneurysms are congenital.
c. Up to 20% of patients with cerebral aneurysms have multiple
aneurysms.
d. Most patients with intracranial aneurysms present with signs and
symptoms of subarachnoid hemorrhage with severe headache followed by neck stiffness and
photophobia.
e. Once the diagnosis of aneurysmal rupture is confirmed, surgery should be performed.
52. The severity of a brain injury reflects the result of both the primary injury and resulting
complications constituting the secondary injury. Which of the following statement(s) concerning
brain injury is/are true?
a. Increased intracranial pressure (ICP) contributes to secondary brain injury by reducing cerebral
perfusion pressure producing cerebral ischemia.
b. Intracranial hypertension is one of the most important factors affecting outcome for brain injury.
c. In using the Glasgow Coma Scale (GCS), the higher the score, the poorer the neurologic status.
d. Comatose patients who require emergent surgery for other injuries should have their ICP monitored.
e. Corticosteroids are the first line treatment for elevation of ICP.
f. a+b+d are correct.
g. a+b+e are correct..
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53. A 15-year-old boy is struck by a baseball in the side of the head. He briefly looses consciousness but
quickly returns to a lucid state. Which of the following statement is incorecte concerning his
subsequent course.
a. The initial neurologic finding may be dilatation of the ipsilateral pupil.
b. If the patient has a normal neurologic examination at the time of emergency room assessment, he must
be admitted in the hospitale.
c. A head computed tomography (CT) scan should be performed regardless of the current neurologic
examination.
d. The likely mechanism of injury arises from a tear of a branch of the middle meningeal artery as it
courses through a grove in the skull at the area of impact.
e. If, after an initial lucid interval, a rapid progression to coma with fixed and dilated pupils and
decerebration occurs, the most likely CT finding would be a subdural hematoma.
54. Which of the following statement is true regarding peripheral nerve
injuries?
a. Neuropraxia is perminante loss of function with axonal injury; structure damage does occur.
b. Axonotmesis is disruption of the axon and axon sheath associated with traumatic injury.
c. Neurotmesis is disruption of the axon with preservation of the axon sheath which usually preserves
sensory and motor function.
d. Electromyography (EMG) is useful in the early assessment of nerve injuries.
e. Regeneration in a peripheral nerve occurs at a rate of 1 mm/day, so improvement may not be obvious
for many months.
55. Which is the most common location of cerebral contusions?
a. Frontal.
b. Parietal.
c. Temporal.
d. Cerebellum.
e. Occipital.
56. Which is the most common type of traumatic brain injury?
a. Traumatic subarachnoid hemorrhage.
b. Diffuse axonal injury.
c. Subdural hematoma.
d. Epidural hematoma.
e. Cerebral contusion.
57. What is the name of this midbrain hemorrhage caused by
herniation?
a. Duret´s hemorrhage.
b.
c.
d.
e.
Ecchymosis.
Kernohan´s hemorrhage.
Contre-coup.
Germinal matrix hemorrhage.
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58. Which is the most likely diagnosis?
a.
b.
c.
d.
e.
Fibrous dysplasia.
Osteosarcoma.
Chordoma.
Enchondroma.
Teratoma.
59. Which is the most common infratentorial tumor among adults?
a.
b.
c.
d.
e.
Schwanoma.
Epidermoid.
Hemangioblastoma.
Meningeoma.
Metastases.
60. Which is the most common benign cartilaginous tumor of the skull?
a.
b.
c.
d.
e.
Enchondroma
Multiple myeloma
Epidermoid
Paraganglioma
Schwannoma
61. What is the most likely diagnosis?
a.
b.
c.
d.
e.
High-grade astrocytoma.
Low-grade astrocytoma.
Meningeoma.
Metastasis.
PNET.
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62. Which is the most common pineal tumor?
a. Germinoma..
b. Teratoma.
c. Carcinoma.
d. Choriocarcinoma.
e. Yolk sac tumor.
63. Which of the following statements is NOT correct about cavernous internal carotid artery
aneurysm?
a. A pterional approach can be used.
b. Symptoms might be caused by mass effect.
c. Hemorrhage is not intradural.
d. High tendency to rupture.
e. Rupture might lead to carotid-cavernous fistula.
64. A 37-year old man brought to emergency room from the site of an automobile collisson, has
extensive injuries to the face and head. CT shows numerous fractures of the face and skull and
blood in the rostral areas of the frontal lobes and in the rostral 3-4 cm of the temporal lobes ,
bilaterally. After several weeks of recovery the man is moved to along term care facility. His
behavior is characterized by (1) difficulty recognizing sounds (2) a propensity to place
inappropriate objects in his mouth; (3) tendency to eat excessively; and (4) a tendency to touch his
genitalia. Based on the totality of this man difficits he is most likely suffering from which of the
following| ?
a. Klüver – Bucy syndrome
b. Korsakoff syndrome
c. Senile dementia
d. Wallenberg syndrome
e. Wernicke aphasia
65. Which of the following statments about mycotic aneurysms is NOT correct?
a. Early surgical ligation is usually recommended.
b. Account for less than 5% of intracranial aneurysm.
c. Usually fusiform.
d. Streptococcus viridans is a common finding from blood culture.
e. Associated with subacute bacterial endocarditics.
66. Wernicke´s encephalopathy is associated with:
a. Vitamin A deficiency.
b. Pyridoxine deficiency.
c. Cobalamin deficiency.
d. Vitamin D deficiency.
e. Thiamin deficiency.
67. Which of the following structures is usually not supplied by perforators from posterior
communicating artery?
a.
b.
c.
d.
e.
Subthalamus.
Posterior hypothalamus.
Posterior limb of the internal capsule.
Anterior thalamus.
Head of the caudate nucleus bottom of form.
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68. Which is the most common brain tumor among neonates and infants (<2 years)?
a. Choroid plexus papilloma.
b. Ependymoma.
c. Astrocytoma.
d. PNET.
e. Teratoma.
69. Which spinal bone tumor is described.Usually in the vertebral body CT demonstrate polka dot
lesions. Usually asymptomatic. Female predominance
a. Osteid osteoma.
b. Osteochondroma.
c. Hemangioma.
d. Giant cell tumor.
e. Osteoblastoma.
70. Which of the following statements is NOT correct about chordomas?
a. Histological picture characterized by eggshell cortical bone.
b. Peak age 50-60 years.
c. Often located in sacrum.
d. Derived from notochord remnants.
e. Often located in clivus.
71. Which is the most common intramedullary tumor in children?
a. Astrocytoma.
b. Schwannoma.
c. Epedymoma.
d. Ganglioglioma.
e. Hemangioblastoma.
72. Which is the most frequent progressive motor neuron disease among adults?
a. Wohlfart-Kugelberg-Welander disease.
b. Fabry´s disease.
c. Amyotrophic lateral sclerosis.
d. Werdnig-Hoffman disease.
e. Wilson´s disease.
73. Which of the following is NOT transmitted via the dorsal column system?
a. Pressure.
b. Vibration.
c. Fine touch.
d. Pain.
e. Position.
74. Which Brodmann´s area is associated with primary auditory cortex?
a. 8
b. 4
c. 43
d. 41
e. 18
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75. Where does the major neuroblast proliferation in the CNS take place?
a. Thalamus.
b. Cerebral cortex.
c. Periventricular ependymal region.
d. White matte.
e. Pons.
76. Occlusion of this vessel often causes Wallenberg (lateral medullary) syndrome:
a. AICA.
b. cerebelli sup.
c. spinalis ant.
d. Basilaris.
e. PICA.
77. What is the name of this foramen?
a. Foramen rotundum.
b. Foramen jugulare.
c. Foramen spinosum.
d. Foramen ovale.
e. Foramen lacerum.
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78. Which cranial nerve passes this foramen?
a.
b.
c.
d.
e.
Zygomaticofacial nerve.
Hypoglossal nerve.
Vagal nerve.
Glossopharyngeal nerve.
Accessory nerve.
79. Which is the most common congenital CNS infection?
a. Rubella.
b. HSV.
c. CMV.
d. Listeria.
e. Toxomplasma.
80. Which of the following statements is NOT correct for juveline pilocytic astrocytoma?
a. Frequently located in cerebellum and brain stem.
b. Histological picture associated with Rosenthal fibers.
c. Histological picture associated with fried-egg yolk-appering cells and nucleus.
d. The second most common pediatric brain tumor.
e. The peak age is 10 years.
81. Which of the following receptors is activated by vibration?
a.
b.
c.
d.
e.
Ruffini end organs.
Merkel´s disc.
Free nerve endings.
Pacinian corpuscle.
Meissner´s corpuscles.
82. Which of the following is Chiari I malformation never associated with?
a.
b.
c.
d.
e.
Pain.
Syringomyelia.
Callosal dysgenesis.
Basilar invagination.
Skeletal abnormities.
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83. Which of the following is not a branch from the external carotid artery?
a. Superior thyroid artery.
b. Ophthalmic artery.
c. Facial artery.
d. Ascending pharyngeal artery.
e. Lingual artery.
84. Which congenital infection is associated with cortical and basal ganglia calcification, cataracts and
deafness?
a. HIV.
b. Listeria.
c. CMV.
d. Rubella.
e. Toxoplasma.
85. Which of the following structures is not a circumventricular organ?
a. Pineal gland.
b. Subcommisural organ.
c. Neurohypophysis.
d. Habenulum.
e. Subforniceal organ.
86. Which of the following conditions can be evaluated by magnetic resonance imaging (MRI)?
a. Stroke is suspected in a patient with a cardiac pacemaker.
b. Computed tomography (CT) shows a skull base tumor.
c. A coma patient with CT-demonstrated subarachnoid hemorrhage and an
d. aneurysmal clip.
e. A patient with intractable complex partial seizure.
f. A lung cancer patient whose plain film of the lumbar spine shows a
g. compression fracture of the L2 vertebral body.
h. B + D + E are correct.
i. A + B + D are correct.
87. Which of the following statements about intraspinal dermoid and epidermoid tumors and lipomas
is not true?
a. They are benign lesions.
b. They can be found within the spinal subarachnoid space.
c. They can be found within the spinal cord.
d. They are most common in the dorsal(thorax spine) area.
e. They are at times associated with spinal dysraphism..
88. A 36-year-old man developed neck and left arm pain. He noted paresthesias in the left index and
long fingers. He was found to have weakness of the left triceps muscle and a diminished left triceps
jerk. His left-sided disc herniation is most likely to be at:
a. C3–C4.
b. C4–C5.
c. C5–C6.
d. C6–C7.
e. C7–T1.
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89. Which of the following statements are true?
a. The Hoffmann-Tinel sign localizes the level of a nerve injury.
b. Causalgia is a term used to denote the etiology of pain.
c. Secondary repair of a lacerated nerve 3 to 8 weeks after injury has several advantages.
d. A surgeon who finds at delayed (3 to 8 weeks) exploration that a clinically nonfunctioning nerve is in
continuity should resect the injured portion of the nerve and suture together the ends.
e. If a nerve is found to be disrupted at delayed (3 to 8 weeks) exploration, the surgeon should find the
two ends of the nerve and suture them together.
91. Myelomeningoceles are congenital malformations of the spinal cord. Which of the following
findings are not commonly associated?
a. Hydrocephalus.
b. Chiari II malformation.
c. A midline dorsal spinal mass easily noted at birth.
d. Skin, bone, and dural defects superficial to the neural placode.
e. Mandatory urinary incontinence.
92. Cordotomy results in which of the following?
a. Ipsilateral loss of pin appreciation.
b. Vagal instability.
c. Contralateral loss of temperature appreciation.
d. Ipsilateral loss of pin and temperature appreciation.
e. Contralateral loss of two-point discrimination.
93. What is the most conspicuous function of the vestibulospinal tracts?
a. Responding to proprioceptive signals from the lower limbs.
b. Mediating voluntary movements that keep the trunk upright.
c. Relaying the activity of the pontocerebellum to the spinal cord.
d. Stimulation of grasping movements, such as are used to prevent falling.
e. Stimulation of the extensor musculature of the lower limbs.
94. After occlusion of a branch of an artery supplying the brain, a patient has weakness of the limbs
on the right side, a Babinski's sign (upgoing plantar reflex), and loss of joint position sense and
cutaneous two-point discrimination on the right side. Facial sensation and movement are normal,
but the tongue deviates to the left when protruded. What single, small, destructive lesion accounts
for these symptoms and signs?
a. Infarction of an area of cortex in the left frontal lobe.
b. Infarction in the centre of the spinal cord at level C1-C2.
c. Infarction in the left cerebral peduncle.
d. Infarction in the medial part of the left side of the medulla.
e. Infarction somewhere in the right side of the pons or medulla.
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95. Cerebral AVMs:
a. the most common clinical presentations are intracerebral hemorrhage and steel
syndrome.
b. are the most common reason for subarachnoid hemorrhage in children.
c. the mortality from hemorrhage is higher than for hemorrhage from aneurysms.
d. the risk for hemorrhage is higher with large AVMs low hemodynamic
resistance
e. treatment options include surgery, embolization or radiosurgery but not
combinations of these modalities in the same patient.
96. A 60 year old patient with mild arterial hypertension and diabetes mellitus
is admitted with pain in the middle of her back and spastic paraparesis. Seven
years ago she was treated for breast cancer by surgery, radiation and
chemotherapy. Three years ago she was operated for cerebellar
hemangioblastoma. MRI shows the following: 1- a lesion at T10,T11 with
epidural soft tissue mass, lytic destruction of both vertebral bodies, involving
the T10-11 disc space and surrounding endplates. 2- significant local kyphosis
and cord compression. 3- a T2 hyperintensity signal within the spinal cord. The
most likely diagnosis is:
a. extradural-intradural metastatic tumor from the breast.
b. spinal epidural abscess and osteomyelitis with focal myelomalacia.
c. extradural metastatic tumor from breast and intradural drop metastasis drop metastasis from
hemangioblastoma.
d. extradural metastatic tumor from the breast with focal myelomalacia.
e. all the above are equally possible.
DIRECTIONS: The group of questions below consists of lettered options followed by numbered items.
For each numbered item, select the appropriate lettered option(s). Each lettered option may be used
once, more than once, or not at all. Choose exactly the number of options indicted following each item.
Items 97-100. Match each clinical scenario below with the appropriate type of tumor.
a. Medulloblastoma.
b. Oligodendroglioma.
c. Optic glioma.
d. Carcinomatous meningitis.
e. Schwannoma.
f. Choriocrcinoma.
g. Metastatic carcinoma.
h. Pineocytomaq.
i. Primary CNS lymphoma.
97. A 30-years-old man with the acquired immunodeficiency synacquired (AIDS)
develops headaches and left hemiparesis and is found to have a right frontal white
matter homogeneously enhancing lesion. (SELECT 1 TUMOR.)
98. A 16-years-old boy with café au lait spots and cutaneous nodules complains of
decreased vision from the left eye. (SELECT 1 TUMOR)
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99. A 13-years-old girl with headaches and diplopia. On examination, she has impaired upward gaze,
lid retraction, and covergenceretraction nystagmus. Her pupils react on convergence but not to
light. (SELECT 1 TUMOR).
1 00. Identified the structure 1 to 6.
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