Neuro-surgery MCQ 56+

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• J-shaped Sella is found in
  ক

  Pituitary macro adenoma

  খ

  Achondroplasia

  গ

  Mucopolysaccharoidosis

  ঘ

  5% normal children

  ঙ

  Craniopharyngioma
• The following lesions produce midline cystic lesion in brain
  ক

  Cavum veli interpositi

  খ

  Arachnoid cyst

  গ

  Colloid cyst

  ঘ

  Epidermoid

  ঙ

  Pilocystic astrocytoma
• Cerebellar lesion will cause
  ক

  Vertigo

  খ

  Slurring of speech

  গ

  Nystagmus

  ঘ

  Contralateral motor weakness

  ঙ

  Visual blurring
• Which structures appear hyperdense in non-contrast CT scan
  ক

  Acute hemorrhage

  খ

  Calculi (opaqu

  গ

  Bone

  ঘ

  Air

  ঙ

  Fat
• A person met with an accident and the fracture of the 10th thoracic vertebra was found. It had damaged the left half of the spinal cord. Following clinical signs are seen in the patient on examination below the level of lesion
  ক

  Contralateral loss of pain

  খ

  Ipsilateral Babinski's sign is present

  গ

  Ipsilateral loss of total sensation

  ঘ

  Contralateral spastic paralysis

  ঙ

  Ipsilateral flaccid paralysis
• Brown sequards syndrome is characterized by the loss of
  ক

  Voluntary movement on the same side

  খ

  Fine touch on the same side

  গ

  Pain sensation on the same side

  ঘ

  Thermal sensation on the same side

  ঙ

  Position sensation of the opposite side
• Cauda-equina syndrome
  ক

  MRI is diagnostic

  খ

  Nucmbness and hyposthasia around perineum

  গ

  Usually bowel and bladder involved

  ঘ

  Pain is not severe.

  ঙ

  Usually restricted SLR unilaterally
• Signs of brain stem death includes
  ক

  Loss of CO2 responsiveness in the absence of hypoxia

  খ

  Loss of pupillary light reflex

  গ

  Unconsciousness

  ঘ

  Loss of tendon reflexes in the arms and legs

  ঙ

  Nystgmus in response to cold water irrigation in the external auditory canal
• Reflexes used to test for brain stem death are
  ক

  Gag reflex

  খ

  Vestibulo occular reflex

  গ

  Pupillary reflex

  ঘ

  Knee jerk reflex

  ঙ

  Babinski's reflex
• Signs of brain stem death are
  ক

  Loss of pupillary light reflex

  খ

  Loss of response to CO2 in absence of hypoxia

  গ

  Nystagmus when cold water is poured in the external auditory canal

  ঘ

  Unconsciousness

  ঙ

  Loss of knee jerk
• Essential features of brain death
  ক

  No gag reflex

  খ

  No respiration when PCO2 exceeds 7 KPa

  গ

  Flat ECG

  ঘ

  Absence of spinal reflex

  ঙ

  Doll’s eye test negative
• Features of brain death are
  ক

  Dilated fixed pupils

  খ

  Absent occulo-cephalic reflex

  গ

  Absent gag reflex

  ঘ

  Intact corneal reflex

  ঙ

  Intact occulo-vestibular reflex
• Criteria of brain death are
  ক

  Absent corneal reflexes

  খ

  Absent vestibulo-ocular response to calorie testing

  গ

  Absence of spontaneous respiration

  ঘ

  Pin point pupils

  ঙ

  Hypothermia
• Signs of brain death include
  ক

  Loss of pupillary reaction to light

  খ

  Loss of respiratory movement with PaCO2 above 6.7 pka

  গ

  Nystagmus in presence of cold water in external auditory canal

  ঘ

  Deeply comatose

  ঙ

  Loss of knee jerk
• Ancillary tests for brain death declaration includes
  ক

  30 min EEG

  খ

  Cerebral angiogram

  গ

  Absence of brainstem reflex

  ঘ

  Absence of hypothermia

  ঙ

  Apnoea test
• Vital signs monitored in head injury include
  ক

  Pulse

  খ

  Blood pressure

  গ

  Pupillary size & reaction

  ঘ

  Level of consciousness

  ঙ

  Sensory deficit
• Techniques of maintaining airway in unconscious patients are
  ক

  Oropharyngeal suction

  খ

  Endotracheal intubation

  গ

  Right lateral position

  ঘ

  Laryngeal mask insertion

  ঙ

  Tracheostomy
• Glasgow coma scale
  ক

  Includes scoring upto 6 points for best motor response

  খ

  Ranges from 1-20

  গ

  Reliably assesses brainstem function

  ঘ

  Is suitable for use in children under 5 years of age

  ঙ

  Suggests elective hyperventilation for a score of 7 is appropriate
• The Glasgow coma scale assesses head injury patients in the following criteria
  ক

  Eye opening

  খ

  Motor response

  গ

  Verbal response

  ঘ

  Pupillary size

  ঙ

  Respiratory rate and rhythm
• Glasgow coma scale score is obtained from
  ক

  Eye opening

  খ

  Best motor response

  গ

  Best verbal response

  ঘ

  Visual analogue scale

  ঙ

  Verbal rating score
• Glasgow coma scale score include
  ক

  Eye opening

  খ

  Motor response

  গ

  Verbal response

  ঘ

  Extensor planter reflex

  ঙ

  Tongue tremor
• Components of Glasgow Coma Scale
  ক

  Eye opening

  খ

  Best verbal response

  গ

  Best motor response

  ঘ

  Pupillary light reflex

  ঙ

  Plantar response
• Indication of craniotomy in case of head injury are
  ক

  Deepening level of consciousness

  খ

  Progressive neurological deficit

  গ

  Shock

  ঘ

  Bleeding from the external ear

  ঙ

  Retention of urine
• In head injury investigations required are
  ক

  X-ray skull

  খ

  CT scan

  গ

  MRI

  ঘ

  Trans-cranial Doppler

  ঙ

  PET scan of brain
• Lucid interval is related to
  ক

  Intracerebral haemorrhage

  খ

  Acute traumatic extradural haemorrhage

  গ

  Depressed fracture with extradural haemorrhage

  ঘ

  Cerebral infarction

  ঙ

  Acute sub dural haemorrhage
• Risk factors of spontaneous subdural hematoma are
  ক

  Vascular abnormalities

  খ

  Alcoholism

  গ

  Coagulopathies

  ঘ

  Hypotension

  ঙ

  Hypervitaminosis-C
• Regarding brain abscess
  ক

  Common pathogen is streptococcus

  খ

  Common pathogen is staphylococcus

  গ

  CSOM causes cerebellar abscess

  ঘ

  Is associated with Fallot’s Tetralogy

  ঙ

  Commonly occurs in temporal lobe by haematogenous route
• Intra-cranial brain tumours in children below 5 years are
  ক

  Brain stem glioma

  খ

  Pilocystic astrocytoma

  গ

  Glioblastoma multiforme

  ঘ

  Optic nerve sheath glioma

  ঙ

  Haemangioblastoma
• Calcification may be found in the following intracranial tumours
  ক

  Meningioma

  খ

  Ependymoma

  গ

  Oligodendroglioma

  ঘ

  Glioblastoma multiforme (GB

  ঙ

  Astrocytoma
• Neuroblostoma
  ক

  Commonly occurs in children

  খ

  May differentiate into a benign tumour

  গ

  Is more common in the adrenal medulla

  ঘ

  May arise from the sympathetic ganglion

  ঙ

  May arise from the floor of the 4th ventricle