1
Q
- Which of the following is true of hemifacial spasm? A. Compression of the facial nerve by the superior cerebellar artery is the most common operative finding. B. Deafness is more common than permanent facial weakness as a complication of microvascular decompression. C. Men are more frequently affected than women. D. Symptoms typically begin in the buccal muscles and move cranially. E. The cure rate at 1 month after microvascular decompression is 95%.
A
B. Deafness is more common than permanent facial weakness as a complication of microvascular decompression.
2
Q
- Each of the following surgical approaches may be considered for an aneurysm of the vertebrobasilar junction except the A. extended extreme lateral inferior transcondylar approach B. lateral suboccipital approach C. presigmoid transtentorial approach D. retrolabyrinthine transigmoid approach E. subtemporal approach
A
E. subtemporal approach
3
Q
- The most common presenting symptom in patients with colloid cysts is A. headache B. dementia C. seizures D. sudden attacks of leg weakness E. sudden death
A
A. headache
4
Q
- The most common presenting symptom of neonates with vein of Galen aneurysms is A. congestive heart failure B. hydrocephalus C. intracerebral hemorrhage D. seizures E. subarachnoid hemorrhage
A
A. congestive heart failure
5
Q
- The most common upper thoracic spine injury is a A. burst fracture B. compression fracture C. fracture-dislocation D. seat-belt injury
A
B. compression fracture
6
Q
- Which is true of thoracolumbar spine fractures? A. Burst fractures are the most common. B. Fracture-dislocations involve all three columns. C. Seat-belt type injuries are generally stable. D. Wedge compression fractures are generally unstable. E. Wedge compression fractures involve the middle column.
A
B. Fracture-dislocations involve all three columns.
7
Q
- Each of the following is true of diffuse brain swelling except that it is A. a result of cerebrovascular congestion B. a result of cytotoxic edema C. associated with a 50% mortality rate in severely head-injured children D. manifested on computed tomography (CT) scan by a compression of the perimesencephalic cistern E. more common in children than in adults
A
B. a result of cytotoxic edema
8
Q
- Which of the following is least suggestive of child abuse? A. acute and healing long bone fractures B. interhemispheric subdural hematorna C. parietal skull fracture D. retinal hemorrhages E. tentorial subdural hematoma
A
C. parietal skull fracture
9
Q
- Trigonocephaly results from premature closure of the A. coronal suture bilaterally B. coronal suture unilaterally C. frontosphenoidal suture D. lambdoid suture E. metopic suture
A
E. metopic suture
10
Q
- The cleft in the spinal cord associated with diastematomyelia is most commonly located in the A. cervical region B. lumbar region C. sacral region D. thoracic region
A
B. lumbar region
11
Q
- Up to what percentage of patients with bacterial arterial (mycotic) aneurysms carry an underlying diagnosis of subacute bacterial endocarditis? A. 10% B. 20% C. 40% D. 60% E. 80%
A
E. 80%
12
Q
- Each is true of bacterial intracranial aneurysms except A. Infected emboli lodge in the vasa vasorum. B. The middle cerebral artery is most commonly affected. C. The peripherally located branches are most commonly affected D. Typical subarachnoid hemorrhage occurs in 18% of patients. E. Staphylococcus aureus and beta hemolytic streptococci are most commonly involved.
A
A. Infected emboli lodge in the vasa vasorum.
13
Q
- Each of the following is true of growing skull fractures except that they A. can cross suture lines B. may be associated with underlying brain injury C. occur if the edges of the initial fracture are separated by more than 3 mm D. occur most commonly in the parietal bone E. occur most commonly between the ages of 2 and 5
A
E. occur most commonly between the ages of 2 and 5
14
Q
- Approximately what percentage of infants with myelomeningocoele have magnetic resonance imaging (MRI) evidence of a Chiari I1 malformation? A. 20% B. 40% C. 60% D. 80% E. 100%
A
E. 100%
15
Q
- Cardiovascular disease involving the heart and great vessels gives rise to which of the following types of emboli in the retina? I. cholesterol 11. calcific 111. platelet-fibrin IV. fat A. I, 11, Ill B. I, 111 , C. 11, IV D. IV E. all of the above
A
A. I, 11, Ill I. cholesterol 11. calcific 111. platelet-fibrin
16
Q
- In the infratentorial supracerebellar approach to the pineal region, which of the following veins are usually sacrificed? I. superior vermian vein 11. posterior pericallosal vein Ill. precentral cerebellar vein IV. basal vein of Rosenthal A. I, 11,111 B. I, 111 C. 11, IV D. IV E. all of the above
A
B. I, 111 I. superior vermian vein ll. precentral cerebellar vein
17
Q
- In the infratentorial supracerebellar approach to the pineal region, which of the following veins are usually sacrificed? I. superior vermian vein 11. posterior pericallosal vein Ill. precentral cerebellar vein IV. basal vein of Rosenthal A. I, 11,111 B. I, 111 C. 11, IV D. IV E. all of the above
A
B. I. superior vermian vein, 111. precentral cerebellar vein
17
Q
120.Each of the following is characteristic of an acoustic neuroma except A. Bekesy type 111 or IV audiogram B. loudness recruitment C. low short-increment sensitivity index (SiSi) D. poor speech discrimination E. pronounced tone decay
A
B. loudness recruitment
18
Q
- Which of the following is true of hemifacial spasm? A. Compression of the facial nerve by the superior cerebellar artery is the most common operative finding. B. Deafness is more common than permanent facial weakness as a complication of microvascular decompression. C. Men are more frequently affected than women. D. Symptoms typically begin in the buccal muscles and move cranially. E. The cure rate at 1 month after microvascular decompression is 95%.
A
B. Deafness is more common than permanent facial weakness as a complication of microvascular decompression.
18
Q
- Which of the following structures provides a marker for the most dorsal extent of the incision for anterolateral cordotomy for pain control? A. dentate ligament B. orsal root entry zone C. posterior intermediate sulcus D. posterior median sulcus E. zone of Lissauer
A
A. dentate ligament
19
Q
- Occlusion of the anterior choroidal artery results in I. contralateral hemiplegia 11. hemihypesthesia 111. homonymous hemianopia IV. impaired cognition A. I, 11,111 B. I, 111 C. 11, IV D. IV E. all of the above
A
A. I, . contralateral hemiplegia 11. hemihypesthesia 111. homonymous hemianopia
20
Q
- Which of the following symptoms of Parkinson’s disease is most likely to respond to a stereotactic lesion in the posterior ventral oval (VOP)/ventral intermediate (VIM) (ventrolateral) thalamus? A. bradykinesia B. gait disturbance C. rigidity D. speech disturbance E. tremor
A
E. tremor
21
Q
- autosomal recessive inheritance A. Apert’s syndrome B. Crouzon’sdisease C. Both D. Neither
A
D. Neither
22
Q
- exorbitism A. Apert’s syndrome B. Crouzon’sdisease C. Both D. Neither
A
C. Both
23
134. syndactyly A. Apert's syndrome B. Crouzon'sdisease C. Both D. Neither
A. Apert's syndrome
24
135. he majority of patients have preoperative intelligence quotients (IQs) greater than 90. A. Apert's syndrome B. Crouzon'sdisease C. Both D. Neither
B. Crouzon'sdisease
25
136. Anterior open bite is common. A. Apert's syndrome B. Crouzon'sdisease C. Both D. Neither
A. Apert's syndrome
26
137. occurs primarily in women A. primary empty sella syndrome B. secondary empty sella syndrome C. both D. neither
A. primary empty sella syndrome
27
138. Visual disturbance may occur. A. primary empty sella syndrome B. secondary empty sella syndrome C. both D. neither
C. both
28
139. The most common etiology of os odontoideum is A. congenital B. iatrogenic C. infectious D. neoplastic E. traumatic
E. traumatic
29
140. The most common mechanism of translational C1-C2 subluxation is A. axial loading B. distraction C. extension D. flexion
D. flexion
30
141. The factor or substance with the least important role in the pathogenesis of cerebral vasospasm is probably A. bilirubin B. endothelin C. intimal proliferation D. lipid peroxides E. oxyhemoglobin
C. intimal proliferation
31
149. most common type of spinal AVM A. type I spinal AVMs B. type I1 spinal AVMs C. type 111 spinal AVMs D. type lV spinal AVMs E. types I1 and 111 spinal AVMs
A. type I spinal AVMs
32
150. etiology beliewd to be acquired A. type I spinal AVMs B. type I1 spinal AVMs C. type 111 spinal AVMs D. type lV spinal AVMs E. types I1 and 111 spinal AVMs
A. type I spinal AVMs
33
151. also known as juvenile malformations A. type I spinal AVMs B. type I1 spinal AVMs C. type 111 spinal AVMs D. type lV spinal AVMs E. types I1 and 111 spinal AVMs
C. type 111 spinal AVMs
34
152. also known as glomus AVMs A. type I spinal AVMs B. type I1 spinal AVMs C. type 111 spinal AVMs D. type lV spinal AVMs E. types I1 and 111 spinal AVMs
B. type I1 spinal AVMs
35
153. Low flow and high pressure dynamics can be seen in type IV and this type. A. type I spinal AVMs B. type I1 spinal AVMs C. type 111 spinal AVMs D. type lV spinal AVMs E. types I1 and 111 spinal AVMs
A. type I spinal AVMs
36
154. High flow and high pressure dynamics can be seen in type Nand this type. A. type I spinal AVMs B. type I1 spinal AVMs C. type 111 spinal AVMs D. type lV spinal AVMs E. types I1 and 111 spinal AVMs
E. types I1 and 111 spinal AVMs
37
155. Type IV and this type typically present with progressively worsening symptoms without significant clinical improvement. A. type I spinal AVMs B. type I1 spinal AVMs C. type 111 spinal AVMs D. type lV spinal AVMs E. types I1 and 111 spinal AVMs
A. type I spinal AVMs
38
156. Which of the following represents the correct sequence of removal of clamps from the arteries following carotid endarterectomy? A. common carotid, external carotid, internal carotid B. common carotid, internal carotid, external carotid C external carotid, common carotid, internal carotid D. external carotid, internal carotid, common carotid E. internal carotid, common carotid, external carotid
C external carotid, common carotid, internal carotid
39
175. Which of the following is most important in determining the propensity of a dural AVM to an aggressive clinical course? A. duration of symptoms B. leptomeningeal venous drainage C. location D. presentation E. size
B. leptomeningeal venous drainage
40
178. Of the following, the least common location of intracranial meningiomas is (the) A. intraventricular B. olfactory groove C. posterior fossa D. sphenoid ridge E. tuberculum sella
A. intraventricular
41
179. Each of the following statements is true of AVMs except A. Higher pressures have been measured in the feeding arteries of smaller as compared with larger AVMs. B. Smaller AVMs are more likely to bleed than larger AVMs. C. The annual risk of death from a ruptured AVM is 1%. D. The risk of bleeding from an unruptured AVM is 3 to 4% a year. E. The risk of rebleed in the first year after hemorrhage is highest in the first 2 weeks.
E. The risk of rebleed in the first year after hemorrhage is highest in the first 2 weeks.
42
180. The most common complication of percutaneous radiofrequency trigeminal gangliolysis is A. anesthesia dolorosa B. decreased hearing C. keratitis D. masticatory weakness E. paresthesias or dysesthesi
E. paresthesias or dysesthesi
43
181. In the technique of percutaneous radio frequency trigeminal gangliolysis, the needle is inserted into the I. foramen rotundum 11. trigeminal cistern 111. foramen spinosum IV. foramen ovale A. I, 11, I11 \* B. I, I11 C. 11, IV D. IV E. all of the above
C. 11 trigeminal cistern IV foramen ovale
44
190. brachial plexus avulsion A. cingulotomy B. dorsal root entry zone (DREZ) rhizotomy C. morphine infusion D. pallidotomy E. sympathectomy F. ventral rhizotomy
B. dorsal root entry zone (DREZ) rhizotomy
45
191. causalgia A. cingulotomy B. dorsal root entry zone (DREZ) rhizotomy C. morphine infusion D. pallidotomy E. sympathectomy F. ventral rhizotomy
E. sympathectomy
46
192. obsessive-compulsive disorder A. cingulotomy B. dorsal root entry zone (DREZ) rhizotomy C. morphine infusion D. pallidotomy E. sympathectomy F. ventral rhizotomy
A. cingulotomy
47
193. nociceptive cancer pain above C5 A. cingulotomy B. dorsal root entry zone (DREZ) rhizotomy C. morphine infusion D. pallidotomy E. sympathectomy F. ventral rhizotomy
C. morphine infusion
48
194. Parkinson's disease A. cingulotomy B. dorsal root entry zone (DREZ) rhizotomy C. morphine infusion D. pallidotomy E. sympathectomy F. ventral rhizotomy
D. pallidotomy
49
195. spasmodic torticollis A. cingulotomy B. dorsal root entry zone (DREZ) rhizotomy C. morphine infusion D. pallidotomy E. sympathectomy F. ventral rhizotomy
F. ventral rhizotomy
50
196. Donor nerves that may be used for neurotization after brachial plexus avulsion include 1. intercostal nerves 11. spinal accessory nerve 111. cervical plexus IV. phrenic nerve A. I, 11.111 B. I, 111 C. 11, IV D. IV E. all of the above
E. all of the above
51
197. The pterion is formed by which of the following bones? A. frontal, greater wing of the sphenoid, parietal, and squamous part of the temporal B. frontal, lesser wing of the sphenoid, parietal, and squamous part of the temporal C. frontal, greater wing of the sphenoid, parietal, and zygomatic arch D. frontal, lesser wing of the sphenoid, parietal, and zygomatic arch E. frontal, lesser wing
A. frontal, greater wing of the sphenoid, parietal, and squamous part of the temporal
52
198. The most common external beam radiation therapy regimen for brain metastases is A. 30 Gy in 2 weeks B. 30 Gy in 4 weeks C. 60 Gy in 2 weeks D. 60 Gy in 4 weeks E. 45 Gy in 4 weeks
C. 60 Gy in 2 weeks
53
199. The most appropriate radiation treatment protocol for gliomas is A. 8000 cGY in 400 cGY daily fractions B. 6000 cGY in 200 cGy daily fractions C. 6000 cGy in 100 cGy daily fractions D. 4000 cGy in 400 cGy daily fractions E. 4000 cGytn 200 cGy daily fractions
B. 6000 cGY in 200 cGy daily fractions
54
200. Cerebral salt wasting and syndrome of inappropriate antidiuretic hormone (SIADH) may best be distinguished by measuring A. plasma arginine vasopressin (AVP) B. serum osmolality C. serum sodium D. urine sodium E. volume status
E. volume status
CBR Neurosurgery
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