2010

Question 1

Answer 1

C

Question 2

Answer 2

C

Question 3

Answer 3

D

Question 4

Answer 4

B

Question 5

Answer 5

B

Question 6

Answer 6

B

Question 7

Answer 7

B

Question 8

Answer 8

B

Question 9

Answer 9

E

Question 10

Answer 10

C

Question 11

Answer 11

A

Question 12

Answer 12

C

Question 13

13. Statement below is true about CSF, except

A.In healthy adult, total volume is 150 cc
B.Formation rate is about 0,3 cc/minute
C.The absorption is volume dependent
D.In the spine, primary produced in the dura of the nerve root
E.In the cranium, produced from choroid plexus of ventricle

Answer 13

C

Question 14

Answer 14

A

Question 15

Answer 15

C

Question 16

Answer 16

D

Question 17

Answer 17

C

Question 18

18. The cavernosus sinus and its lateral wall contain all of the following structures except the :

A.Carotid siphon
B.CN. 3, 4, 6
C.Nervus oftalmikus dan maksilaris
D.Nervus optikus
E.Postganglionic simpatik fibers

Answer 18

D

Question 19

19. All of the following statements concerning astrocytes are correct except :

A.They possess many processes
B.They are found in both white and gray matter
C.They are considered to be the scavenger cells of the CNS
D.They have perivascular end feet
E.In damaged brain tissue, astrocytes form glial scars

Answer 19

C

Question 20

Answer 20

B

Question 21

Answer 21

B

Question 22

22. Stimulation of caudal paramedian pontine reticular formation will result this response

A.Conjugate horizontal deviation to opposite side
B.Vertical conjugates
C.No response
D.Conjugate horizontal deviation to same side
E.Nystagmus less than 5 minutes

Answer 22

D

Question 23

Answer 23

A

Question 24

Answer 24

B

Question 25

Answer 25

C

Question 26

Answer 26

C

Question 27

Answer 27

C

Question 28

Answer 28

C

Question 29

29. The thalamus is fed by A.Medial posterior choroidal artery and anterior choroidal artery B.Medial posterior choroidal artery and superior cerebellar artery (SCA) C.Anterior choroidal artery and middle cerebral artery D.Middle cerebral artery only E.Medial posterior choroidal artery and PICA

Answer 29

A

Question 30

30. Medial longitudinal Fasciculus is descending fibers may arise from this structure below, except : A.Superior colliculus and pontine reticular formation B.Pontine reticular formation and interstitial nucleus of Cajal C.Edinger westhpal nuclei and inferior colliculus D.Medial vestibular nucleus E.Interstitial nucleus of Cajal

Answer 30

C

Question 31

Answer 31

B

Question 32

Answer 32

E

Question 33

Answer 33

A

Question 34

Answer 34

E

Question 35

Answer 35

D

Question 36

Answer 36

C

Question 37

Answer 37

B

Question 38

Answer 38

C

Question 39

Answer 39

A

Question 40

Answer 40

A

Question 41

Answer 41

D

Question 42

Answer 42

E

Question 43

Small peripheral myelinated fibers of this pathway synapse in the substantia gelatinosa of the dosrsal horn

Answer 43

I

Question 44

These fibers pass through the superior cerebellar peduncle

Answer 44

J

Question 45

This tract arises from Dieter’s nucleus

Answer 45

F

Question 46

Conscious proprioception from the legs is mainly transmitted in this tract

Answer 46

B

Question 47

Carries fibers from medial and inferior vestibular nuclei, tectospinal tract, and interstitial nucleus of Cajal

Answer 47

G

Question 48

Fibers from this tract originate from layer V of the cerebral cortex

Answer 48

C

Question 49

Carries fibers that ascend to either the thalamus, periaqueductal gray, reticular formation, or superior colliculus

Answer 49

I

Question 50

Uncrossed pyramidal fibers mainly supplying the axial musculature

Answer 50

H

Question 51

Answer 51

C

Question 52

52. All of the following statements concerning the trigeminal nerve are correct, except : A.It is the nerve of the first branchial arch (mandibular) B.It contains only GSA and SVE fibers C.It innervates the stapedius muscle D.It innervates the dura of the anterior and middle cranial fossae E.It mediates the afferent limb of the corneal reflex

Answer 52

C

Question 53

Answer 53

B

Question 54

Answer 54

A

Question 55

Answer 55

A

Question 56

Answer 56

C

Question 57

Answer 57

C

Question 58

Answer 58

C

Question 59

Answer 59

B

Question 60

60. All of the following are true about phenytoin, except that it : A.Is highly bound to plasma proteins B.Is mainly excreted unchanged in the urine C.Has dose-dependent elimination kinetics D.Is effective in grand mal seizures E.Induces the metabolism of certain drugs

Answer 60

B

Question 61

61. After neurosurgical operations. Fever sometimes occuring in the first 24 hours. The most possibility is caused by : A.Pneumoniae B.Deep vein thrombosis C.Urinary tract infection due to catetherization D.Atelectasis E.Wound infection

Answer 61

D

Question 62

62. What is the most likely explanation for the patient’s current prolactine level A.Stalk effect B.The macroadenoma no longer synthesizes prolactine C.Hook effect D.Prior bromocriptine therapy favored the growth of non-hormone-producing neoplastic pituitary cells (null-cell adenoma) None of the above

Answer 62

C

Question 63

63. According to macroadenoma case above, the next laboratory exam revealed decreased TSH and decreased free T4. What do you think happened in this patients tiroid function A.Hypothiroid due to hypothalamic origin B.Hypothiroid due to pituitary origin C.Stalk effect D.A and B is the correct answer E.A, B, C is the correct answer

Answer 63

E

Question 64

Answer 64

C

Question 65

Answer 65

C

Question 66

66. Choice of side and rule for initial burr hole in head injury patient are listed below, except : A.Same side with blow pupil B.If both pupil dilated, choose the first dilating side C.If both pupil dilated, choose the same side with subgaleal hematoma D.If no localizing clue, always place on left side E.If epidural hematoma not present, but duramater was bluish, continue with opening the duramater and decompression

Answer 66

E

Question 67

67. What is most risk factor for intracranial hypertension in trauma patient with normal CT A.Age more than 40 years old B.Sistolik blood pressure more than 100 mmHg C.Haemoglobin less than 10 gr% D.Time interval E.Potassium serum less than 3,5 mEq

Answer 67

A

Question 68

Answer 68

C

Question 69

69. Which is not true about Lefort fractures A.Lefort I : Transverse B.Lefort II : Pyramidal C.Lefort III : Fractures lines extent upwards across inferior orbita rim, orbita floor to the medial wall of orbita and also included nasofrontal suture D.Sometimes can result CSF leak E.Sometimes can result pneumocephalus

Answer 69

C

Question 70

70. Posterior fossa epidural hematoma A.Comprise about 17% of EDH B.More common in 6th decades of life C.Mortality is more than 40% D.Cerebellar sign is rare when happened in trauma patient E.Surgical evacuation must be done if the lesion is more than 5 cc

Answer 70

D

Question 71

71. Accumulation of blood in the scalp, occur almost exclusively in children, what statement is NOT TRUE : A.There was 2 types; subgaleal hematoma and subperiosteal hematoma B.Subgaleal hematoma may cross suture C.Subperiosteal hematoma limited by sutures D.Subperiosteal hematoma can only be absorb about 23% in 3 weeks E.Subgaleal hematoma is soft and fluctunt mass

Answer 71

D

Question 72

A.The coagulopathy should be corrected and the child observed B.This is a problem of septic shock. A limbar puncture should be performed to assess the efficacy of the antibiotics being given C.Percutaneous needle aspiration of the scalp hematoma D.Sepsis is the underlying problem in this case. The risk of anesthesia and surgical exploration of the scalp is prohibitive continue intravenous antibiotics E.While the coagulopathy is being corrected, the child should be treated surgically with debridement of the scalp wound and exploration of the fracture site and underlying dura

Answer 72

E

Question 73

Answer 73

C

Question 74

74. Which one is NOT TRUE about craniosynostosis from the list below : A.The incidence about 0,6-1/1000 live births B.Rarely associated with hydrocephalus C.CT scan may help to visualize abnormality D.The most common is sagittal synostosis and affecting female 63% E.Treatment is usually surgical

Answer 74

D

Question 75

75. Which one is TRUE about Dandy Walker malformation from the list below : A.Atresia of Luschka foraminal only B.Hydrocephalus occure less than 45% od Dandy Walker case C.Dandy Walker appear only 2-4% of all Hydrocephalus case in pediatric D.Shunting the ventricle alone is the first choice of surgical management E.Chance of survival less than 46%

Answer 75

C

Question 76

Answer 76

D

Question 77

Answer 77

D

Question 78

Answer 78

D

Question 79

Answer 79

D

Question 80

80. Which is NOT TRUE about Chiari malformation below : A.Type I is called cerebellar ectopia B.Brainstem not involved in type I C.The most common symptom is weakness more than 69% D.Central cord syndrome may occure E.Platybasia may included in this malformation

Answer 80

C

Question 81

Answer 81

D

Question 82

A.Detailed sensory examination B.Oblique views of the cervical spine to assess foraminal narrowing C.Electromyography/ nerve conduction velocity studies of the upper and lower extremities D.Urodynamic studies and assessment of sphincter tone E.Examination of the tongue

Answer 82

B

Question 83

Answer 83

C

Question 84

Answer 84

B

Question 85

Answer 85

D

Question 86

86. These statements below are correct about lumbar disc syndrome, except : A.L5-S1 is the most common compromised about 45-50% B.L3-L4 has quadriceps motor weakness as a symptom C.Achilles reflex diminished for L5-S1 level D.Decreased sensation at medial malleolus for L4-L5 level E.Pain distribution around anterior of the thigh for L3-L4 level

Answer 86

D

Question 87

87. Statement below are true about Cauda Equina syndrome, except : A.Motor weakness is not significant and rare B.Usually due to massive compression at the midline C.Saddle anesthesia is the most common sensory deficit D.Low back pain can present E.Performing surgery within 48 hours is recommended

Answer 87

A

Question 88

Answer 88

D

Question 89

Answer 89

D

Question 90

Answer 90

E

Question 91

Answer 91

A

Question 92

Answer 92

B

Question 93

Answer 93

B

Question 94

Answer 94

C

Question 95

Answer 95

A

Question 96

Answer 96

D

Question 97

Answer 97

D

Question 98

Answer 98

A

Question 99

Answer 99

D

Question 100

Answer 100

E

Question 101

Answer 101

A

Question 102

Injury of the median nerve at the level of the elbow

Answer 102

B

Question 103

Injury of the ulnar nerve at the elbow

Answer 103

A

Question 104

Answer 104

A

Question 105

Anterior interosseous nerve injury

Answer 105

C

Question 106

Klumke’s paralysis

Answer 106

D

Question 107

C8 root lesion

Answer 107

C

Question 108

108. All the following are true of neurofibromatosis (NF), except : A.Chromosome 17 is abnormal in NF 1 B.Lisch bodies usually do not cause visual problems C.Acoustic neuromas are mostly found in NF 2 D.Meningioma and gliomas are a common finding in NF E.Patients with NF 1 often lose their vision

Answer 108

E

Question 109

Answer 109

A

Question 110

Answer 110

A

Question 111

Answer 111

D

Question 112

Answer 112

B

Question 113

Answer 113

A

Question 114

Answer 114

D

Question 115

A.CNS toxoplasmosis occur late in the course of HIV infection and usually when CD4 counts less than 200 cells/mm3 B.The differential diagnosis includes toxoplasmosis, lymphoma, cryptococcal abscess, and metastatic carcinoma C.Stereotactic biopsy is not indicated because a definitive diagnosis will not alter the patient’s outcome D.A diagnosis of toxoplasmosis can be made on a biopsy even if tachyzoites are not identified E.The risk of transmission of HIV from the patient to the surgeon and surgical team can be reduced by the use of universal precautions and double gloving

Answer 115

C

Question 116

Answer 116

C

Question 117

Answer 117

D

Question 118

Answer 118

B

Question 119

Answer 119

C

Question 120

Answer 120

B

Question 121

Answer 121

D

Question 122

Answer 122

E

Question 123

123. Statements below are correct about acoustic neurinoma, excepted A.Abnormality in chromosome 22 B.Also known as vestibular schwannoma C.Tinnitus nearly always become the first symptom and the most frequent D.Occur at the junction called Obersteiner-Redlich zone E.Obstructive hydrocephalus usually occur when tumor diameter about 4 cm

Answer 123

C

Question 124

A. Extension grade A, Invasion grade II B. Extension grade D, Invasion grade IV C. Extension grade C, Invasion grade III D. Extension grade C, Invasion grade IV E. Extension grade B, Invasion grade III

Answer 124

E

Question 125

Answer 125

B

Question 126

Answer 126

A

Question 127

A.Surgery, with definitive removal of the entire AVM B.Embolization, followed by surgery C.Embolization only, with follow up angiography D.No teratment, the risk of hemorrhage is low and surgical removal of the lesion carries significant risk E.Stereotactic radiation

Answer 127

E

Question 128

A.Cerebellar venous angioma have a greater tendency to bleed than those occuring in the cerebral hemispheres B.There is a 6% chance of recurrent from this lesion during the first year C.Angiographic appearance of the angioma is key in deciding the approach to treatment D.This cerebellar venous angioma does not need surgical treatment E.If this lesion extended into the brainstem, gamma knife radiosurgery might be the best option

Answer 128

D

Question 129

Answer 129

C

Question 130

130. Which one is correct for natural history of AVM A.Seizures is the most frequent symptom in small and deep seated AVM B.Spinal AVM type 1 is high flow and located intramedullary C.Rehemorrhages rate is 6% in 6 months and then 3% a year D.Most happened at 5th decades of life E.Vasospasm after AVM ruptur is very frequent compare to basilar tip aneurysm

Answer 130

C

Question 131

131. What do you know about CCF is listed below, excepted : A.Endovascular ballon embolization is always not necessary B.There’s two category, traumatic or spontaneous C.50% of low flow CCF spontaneously thrombose D.Retro orbital pain, pulsatile proptosis is one of the symptom E.Intra occular pressure could raise \> 25 mmHg

Answer 131

A

Question 132

Angular Gyrus Match each of the descriptions with the most appropriate artery A.Located at the midline frontonasal suture B.Located at the junction of coronal and sagittal sutures C.Located at the junction of lambdoid and sagittal sutures D.Located at the posterior margin of the foramen magnum in the midline E.Located usually just above the pinna F.Located at the indentation under the external occipital protuberance G.Located at the external surface of greater wing of sphenoid H.Located at the junction of mastoid sutures and lambdoid

Answer 132

E

Question 133

Opisthion Match each of the descriptions with the most appropriate artery A.Located at the midline frontonasal suture B.Located at the junction of coronal and sagittal sutures C.Located at the junction of lambdoid and sagittal sutures D.Located at the posterior margin of the foramen magnum in the midline E.Located usually just above the pinna F.Located at the indentation under the external occipital protuberance G.Located at the external surface of greater wing of sphenoid H.Located at the junction of mastoid sutures and lambdoid

Answer 133

D

Question 134

Lambda Match each of the descriptions with the most appropriate artery A.Located at the midline frontonasal suture B.Located at the junction of coronal and sagittal sutures C.Located at the junction of lambdoid and sagittal sutures D.Located at the posterior margin of the foramen magnum in the midline E.Located usually just above the pinna F.Located at the indentation under the external occipital protuberance G.Located at the external surface of greater wing of sphenoid H.Located at the junction of mastoid sutures and lambdoid

Answer 134

C

Question 135

Nasion Match each of the descriptions with the most appropriate artery A.Located at the midline frontonasal suture B.Located at the junction of coronal and sagittal sutures C.Located at the junction of lambdoid and sagittal sutures D.Located at the posterior margin of the foramen magnum in the midline E.Located usually just above the pinna F.Located at the indentation under the external occipital protuberance G.Located at the external surface of greater wing of sphenoid H.Located at the junction of mastoid sutures and lambdoid

Answer 135

A

Question 136

Bregma Match each of the descriptions with the most appropriate artery A.Located at the midline frontonasal suture B.Located at the junction of coronal and sagittal sutures C.Located at the junction of lambdoid and sagittal sutures D.Located at the posterior margin of the foramen magnum in the midline E.Located usually just above the pinna F.Located at the indentation under the external occipital protuberance G.Located at the external surface of greater wing of sphenoid H.Located at the junction of mastoid sutures and lambdoid

Answer 136

B

Question 137

Inion Match each of the descriptions with the most appropriate artery A.Located at the midline frontonasal suture B.Located at the junction of coronal and sagittal sutures C.Located at the junction of lambdoid and sagittal sutures D.Located at the posterior margin of the foramen magnum in the midline E.Located usually just above the pinna F.Located at the indentation under the external occipital protuberance G.Located at the external surface of greater wing of sphenoid H.Located at the junction of mastoid sutures and lambdoid

Answer 137

F

Question 138

Pterion Match each of the descriptions with the most appropriate artery A.Located at the midline frontonasal suture B.Located at the junction of coronal and sagittal sutures C.Located at the junction of lambdoid and sagittal sutures D.Located at the posterior margin of the foramen magnum in the midline E.Located usually just above the pinna F.Located at the indentation under the external occipital protuberance G.Located at the external surface of greater wing of sphenoid H.Located at the junction of mastoid sutures and lambdoid

Answer 138

G

Question 139

Linear or horse shoe incision with subtemporal and anterior petrosectomy

Answer 139

F

Question 140

Linear incision with suboccipital craniotomy

Answer 140

G

Question 141

Linear incision with retrosigmoid craniotomy

Answer 141

E

Question 142

Linear curved or horse shoe incision with frontal craniotomy

Answer 142

A

Question 143

Linear , reverse question mark or isle of man incision with temporal craniotomy

Answer 143

B

Question 144

Linear incision with temporal craniotomy

Answer 144

C

Question 145

Linear Or horse shoe incision with parietal craniotomy

Answer 145

D

Question 146

Burst fracture corpus C5 with spondylolisthesis and retropuls disc C4-5 in 23 years old male Match each of the descriptions with the most appropriate artery A.Posterolateral thoracotomy, transpleural approach B.Posterior lumbal interbody fusion C.Pedicle screw fixation D.Open door laminoplasty E.Anterior corpectomy discectomy and Robinson fusion

Answer 146

E

Question 147

Male, 72 years old with disc bulging C3-4, C4-5, C5-6, C6-7 with continous OPLL Match each of the descriptions with the most appropriate artery A.Posterolateral thoracotomy, transpleural approach B.Posterior lumbal interbody fusion C.Pedicle screw fixation D.Open door laminoplasty E.Anterior corpectomy discectomy and Robinson fusion

Answer 147

D

Question 148

Post traumatic spondylolisthesis \> 35%, L2-L3, Fr. C, Unstable Match each of the descriptions with the most appropriate artery A.Posterolateral thoracotomy, transpleural approach B.Posterior lumbal interbody fusion C.Pedicle screw fixation D.Open door laminoplasty E.Anterior corpectomy discectomy and Robinson fusion

Answer 148

C

Question 149

Female 53 years old with L4-5 Disc bulging, no history of trauma Match each of the descriptions with the most appropriate artery A.Posterolateral thoracotomy, transpleural approach B.Posterior lumbal interbody fusion C.Pedicle screw fixation D.Open door laminoplasty E.Anterior corpectomy discectomy and Robinson fusion

Answer 149

B

Question 150

Pott disease with abscess pouch extent to the disc, and mediastinum area, paraparesis inferior Match each of the descriptions with the most appropriate artery A.Posterolateral thoracotomy, transpleural approach B.Posterior lumbal interbody fusion C.Pedicle screw fixation D.Open door laminoplasty E.Anterior corpectomy discectomy and Robinson fusion

Answer 150

A

Question 151

Answer 151

C