Unit 1

Question 1

Male neonate with pronounced enlargement of the head, MRI reveals excessive accumulation of CSF and ventricular enlargement. Most likely cause is?

Answer 1

Atresia of cerebral aqueduct (non-communicating hydrocephalus)

Question 2

75 year old male with dementia, urinary incontinence, wide based gait. MRI shows enlarged ventricles

Answer 2

Normal pressure hydrocephalus (NPH)

Question 3

Supplementation of maternal diet with which of the following nutrients decreased the incidence of neural tube defects?

Answer 3

Folic Acid (B9)

Question 4

A female neonate is noted at birth to have a gross deformity of lower back. Examination reveals disorganized neural lesion with entrapment of nerve roots.

Answer 4

Meningomyelocele

Question 5

What is the most important maternal blood test to diagnose neural tube defects

Answer 5

Alpha fetoprotein

Question 6

A baby with an enlarged head is diagnosed with Dandy Walker Syndrome. What is the underlying mechanism?

Answer 6

Absence of cerebellum (vermis)

Question 7

Most common cause of Arnold Chiari malformation type 2?

Answer 7

Hydrocephalus

Question 8

Coup injury occurs where?

Answer 8

At the site of impact

Question 9

A 27 year old man received a blow to the weak side of the head. CT scan shows lens shaped hematoma; what vessel is involved? (Epidural hematoma)

Answer 9

Middle meningeal artery

Question 10

Pt presents with weakness of right upper extremity and recovers within 12 hours of initial symptoms. No treatment was given; what is it?

Answer 10

TIA

Question 11

Which of the following develops emboli that may result in embolic stroke?

Answer 11

Atrial fibrillation

Question 12

Which of the following arteries is most commonly involved in lacunar infarcts?

Answer 12

Deep penetrating arteries

Question 13

Most common cause of intracerebral hemorrhage is?

Answer 13

High blood pressure

Question 14

Most common location of berry “saccular” aneurysms?

Answer 14

Anterior communicating artery

Question 15

Pt presents with sudden excruciating headache, the worst one of his life, what is it?

Answer 15

Aneurysm

Question 16

Pale infarction is typically seen in which condition?

Answer 16

Thrombotic stroke - clot still attached to wall

Question 17

Syringomyelia occurs at what vertebral level?

Answer 17

C7-T3 (shoulder)

Question 18

Characteristic feature syringomyelia?

Answer 18

Decreased pain sensation in the hands (Neurotrophic arthropy)

Question 19

Pt presents with atrophy of hand muscles, fasciculations in arms, shoulders, tongue. Leg weakness that progresses to difficulty walking, slurred speech, trouble swallowing, difficulty holding head up and keeping good posture. As disease advances, muscles become progressively weaker and troubles speaking, swallowing, chewing, and breathing. On exam both upper and lower motor neuron signs are present and there are no sensory changes.

Answer 19

ALS

Question 20

What is the underlying cause of Freidrich’s ataxia?

Answer 20

Frataxin deficiency

Question 21

What disorder presents early in childhood with gait ataxia, loss of DTR, impaired vibratory sensations, and loss of position sense?

Answer 21

Freidrich’s ataxia

Question 22

5 year old boy has headache, fever, vomiting, and convulsions. 104 degree fever, cervical rigidity, pain in neck and knees, acute inflammation. This included what region of the brain?

Answer 22

Leptomeninges (meningitis)

Question 23

Viral infection complains of fever, headache, nausea, vomiting. In CSF sample, no bacteria, lymphpcytes are increased, normal protein levels. What is the glucose CSF level?

Answer 23

Normal

Question 24

Most common cause of meningitis in 35 year old male?

Answer 24

Strep Pneumonia

Question 25

Common complication of meningitis

Answer 25

Hearing loss

Question 26

Most common route of CNS infection

Answer 26

Hematogenous

Question 27

``` 65 year old male, loss of memory, cognition, dementia. Discovered that there is an apolipoprotein gene mutation. Which of the following is not a feature of his disease? A. Tau Protein B. Senile plaques C. Alpha-beta-amyloid deposition D. Psammoma bodies ```

Answer 27

Psammoma bodies

Question 28

Diagnosis of Alzheimer’s disease is confirmed by what?

Answer 28

Pathology on autopsy

Question 29

Which neurons are lost in Parkinson’s disease?

Answer 29

Dopaminergic

Question 30

Pt has slow movement, rigid, course tremor of distal extremities, expressionless face, stooped posture, and dementia. What is the microscopic feature of his disease?

Answer 30

Lewy bodies (Parkinson’s)

Question 31

40 year old female has chorea and athetosis and progresses to dementia and depression. Older brother committed suicide, MRI shows atrophy of caudate nucleus and hydrocephalus.

Answer 31

Huntington’s disease

Question 32

Most common malignant tumor of brain in children?

Answer 32

Medulloblastoma

Question 33

Characteristic feature of pilocytic astrocytoma?

Answer 33

Rosenthal fibers

Question 34

Pt presents with drop foot, atrophy of leg muscles, high foot arches, curled toes, autosomal dominant?

Answer 34

Charcot Marie tooth disease

Question 35

Most important component in history of pt with Guillain Barre?

Answer 35

History of diarrhea and tracheobronchitis

Question 36

Part of body that is initially involved with Guillain Barre?

Answer 36

Legs

Question 37

HSV involves the temporal lobe of brain (T/F)?

Answer 37

True

Question 38

MS is a disease of the gray matter (T/F)?

Answer 38

False (disease of white matter)

Question 39

Calcification present in 90% of cases of oligodendroglioma of the brain (T/F)?

Answer 39

True

Question 40

Decreased ICP can lead to brain herniation (T/F)?

Answer 40

False (Increased ICP)

Question 41

Prostate surgery, has problems and has hypoxic-ischemic injury to brain. What happens in the brain?

Answer 41

Watershed infarcts

Question 42

Woman who has trouble writing, no mental impairment, increased IG with oligoclonal IgG bands.

Answer 42

MS; demyelination of white axons

Question 43

Girl drinks some liquid in garage, dealing with blindness.

Answer 43

Methanol