Neurosurg

Question 1

Brain tumours in adults are usually…

Answer 1

supratentorial

Question 2

Brain tumours in children are usually…

Answer 2

infratentorial

Question 3

what blood markers may be positive in germ cell brain tumours?

Answer 3

bHCG and alphafetoprotein

Question 4

prognosis of pilocytic astrocytoma?

Answer 4

curable

Question 5

prognosis of glioblastoma multiforme?

Answer 5

9-12 mo

Question 6

most common location for an oligodendroglioma

Answer 6

frontal lobe

Question 7

common first presentation for oligodendroglioma?

Answer 7

seizure

Question 8

where is the site of an ependymoma?

Answer 8

floor of 4th ventricle - arises from ependymal cells

Question 9

presentation of an acoustic neuroma?

Answer 9

hearing loss, tinnitus, dysequillibrium

Question 10

which population gets neuronal tumours? (ganglioma, medulloblastoma, neuroma)

Answer 10

children

Question 11

presentation of neuronal tumours?

Answer 11

obstructive hydrocephalus and cerebellar signs

Question 12

why do clots occur in 20-30% of patients with brain tumours?

Answer 12

-thromboplastin is released when the brain is injured

Question 13

ICP should be less than ___ mmHg

Answer 13

15

Question 14

what is cushing triad

Answer 14

hypertension, irregular breathing, bradycardia

Question 15

what are the layers of the scalp?

Answer 15

Skin, connective tissue, aponeurosis, loose areolar tissue, periosteum

Question 16

which layer of the scalp are the blood vessels in?

Answer 16

loose areolar tissue

Question 17

initial imaging following head injury?

Answer 17

non contrast CT

Question 18

what type of saline can be administered to decrease ICP ?

Answer 18

hypertonic

Question 19

which type of cranial bleed does not cross suture lines?

Answer 19

epidural bleed

Question 20

treatment of an epidural bleed?

Answer 20

• craniotomy and evacuation of hematoma

- coagulate bleeding vessel

Question 21

which vessels are bleeding in a subdural bleed?

Answer 21

bridging veins

Question 22

will a subdural bleed cross suture lines ?

Answer 22

yes

Question 23

risk factors for subdural bleed?

Answer 23

• elderly
• alcoholics
• anticoagulation

Question 24

treatment of subdural bleed?

Answer 24

DEPENDS on size.
Small - conservative
Large - catheter or craniotomy

Question 25

investgiations for subarachnoid hemorhage?

Answer 25

- non contract CT - Lumbar puncture - xanthochromia - CT angiogram - cerebral formal angiography

Question 26

where does the spinal cord end?

Answer 26

L1/L2

Question 27

roots of the brachial plexus?

Answer 27

C5-T1

Question 28

what is an UNSTABLE vertebral injury?

Answer 28

when 2 or more of the vertebral columns are disrupted OR 50% loss in vertebral height - implies more damage could occur

Question 29

what is a "complete" neurological injury?

Answer 29

-when there is no motor or sensory function more than 3 segments below the injury'

Question 30

what is an 'incomplete' neurological injury?

Answer 30

preservation of sacral function, toe flexion, sphinctor contraction

Question 31

MRC grading for strength

Answer 31

0 - no active contraction 1- flicker of contraction 2- contraction producing movement if gravity is eliminated 3- weak contraction and movement against gravity 4-active movement against some resistance 5-full resistance, full strenght

Question 32

which deficits occur in anterior cord syndrome?

Answer 32

- complete paralysis - loss of light touch and pain - DORSAL COLUMNS PRESERVED

Question 33

what may lead to anterior cord syndrome?

Answer 33

burst fracture

Question 34

what deficits occur in central cord syndrome?

Answer 34

- upper limbs affected more than lower limbs | - motor loss and sometimes sensory

Question 35

what kind of injury causes central cord syndrome?

Answer 35

hyperextension injury

Question 36

presentation of posterior cord syndrome?

Answer 36

loss of vibration, proprioception

Question 37

presentation of brown sequard syndrome?

Answer 37

- ipsilateral motor loss | - contralateral sensory loss

Question 38

presentaiton of cauda equina syndrome?

Answer 38

- bladder dysfunction - lower limb paralysis - sensory changes - saddle anesthesia