| Post Name | Assistant Professor in Neurosurgery- Medical Education |
|---|---|
| Question Paper Code | 038/2024/OL |
| Category Code | 337/2023 |
| Date of Test | 6 April 2024 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
Which of the following syndromes are NOT associated with lesions of the occipital lobe?
Answer
D. Autotopagnosia
2
Aura's in epilepsy is associated with which anatomical structure
Answer
B. Amygdala
3
Which of the following is not a synonym for "locked in state"?
Answer
D. Alpha Coma
4
Which of the following is TRUE for Chenye Stokes respiration?
Answer
A. Seen in diļ¬use forebrain lesions
5
Which of the following is NOT true for cerebral blood ļ¬ow?
Answer
A. Is about 100 ml/100 gms of brain tissue
6
The ICP waveform under physiological conditions has one of the following sentences TRUE:
Answer
A. Three peaks are recognizable-percussion wave, tidal wave, and dicrotic notch
7
The recurrent artery of Heubner's commonly arises from
Answer
A. A1
8
Which of the following about Brain is NOT true?
Answer
D. Delivers 20% of body's toxic wastes
9
Which are the values of blood ļ¬ow in the brain below which, the idling neurons start dying?
Answer
C. 5-10 mL/100g/min
10
Which of the following hormones is NOT produced by the anterior pituitary?
Answer
A. Corticotropin-releasing hormone
11
A 65-year-old male presented with sudden onset hemiplegia on the left side. CT scan showed a moderate-sized infarct over the right parietal lobe. Clinical examination revealed that he was conscious, alert and oriented, speech was preserved. However, he would blow his cheeks on being asked to show his teeth. What do you think he has?
Answer
A. Oral apraxia
12
A 60-year-old male is referred to you from Neurology for placement of deep brain stimulation for idiopathic Parkinson's disease. He also has issues with word ļ¬uency and has depression. What target would you prefer?
Answer
B. Globus Pallidus Pars Interna
13
Which of the cranial nerves does NOT decussate to the opposite side (either partially or completely)?
Answer
D. VIth nerve
14
A 45-year-old male presented with progressive myelopathy of all four limbs. He does not have any sensory loss. MRI spine revealed a mild prolapsed disc at the C3/4 level. On examination, you ļ¬nd fasciculations and atrophy of the upper limbs. Power in all limbs is 4+/5. Plantars are bilaterally extensor. The Patient has been referred to you for surgery. What will be your next plan of action?
Answer
B. Examine the tongue for fasciculations and also get complete nerve conduction studies done
15
Which of the following radiological features in NOT generally true for Normal Pressure Hydrocephalus?
Answer
D. Absence of trans ependymal edema (periventricular hypodensity)
16
Which of the following are NOT true regarding visual aļ¬ection in involvement of visual pathways?
Answer
C. The commonest ļ¬elds cuts following a temporal lobectomy is contralateral lower quadrantopia
17
Which of the following is NOT a clinical feature of frontal lobar dysfunction?
Answer
D. Recent memory loss
18
Which of the following is NOT a feature of nuclear IIIrd nerve paresis?
Answer
C. Internuclear ophthalmoplegia
19
A patient sustains a minor head injury, following which he starts complaining of diplopia especially when climbing down the stairs. Examination of the ocular movements are normal except for a mild lag of one when looking down. CT scan is normal. What would you do next?
Answer
A. The 3-step test for IVth carnial nerve palsy
20
Which of the following is NOT a clinical feature of instrinsic brain stem lesion?
Answer
C. Corticospinal with posterior column involvement
21
For the diagnosis of post operative diabetes insipidus after carniopharygioma resection, which of the following diagnostic criterion is incorrect?
Answer
A. Urine output >2ml/kg/hour
22
As per current guidelines, children with Traumatic Brain Injury (TBI) should have cerebral perfusion pressure maintained at what minimum ideal level?
Answer
A. 40 mm of Hg
23
Which of the following is a disorder of neuronal migration?
Answer
B. Lissencephaly
24
Dandy Walker malformation does not include
Answer
D. Low lying torcula
25
Von Hippel Lindau disease does not include the following
Answer
D. Renal angiomyoliopoma
26
True about dermoid cyst are all of the following except,
Answer
C. Most common location is the spine
27
Neuroepithelial cysts occur due to a defect in which stage of embryogenesis
Answer
A. Early gastrulation
28
Closed neural tube defects have an association with,
Answer
D. All of the above
29
Lhermitte Duclos disease has an association with all except,
Answer
D. Aqueductal stenosis
30
The angiogram of Suzuki Stage 1 of Moya-Moya disease shows
Answer
A. Narrowing of carotid fork
31
Hounsļ¬eld unit for grey matter of the brain is
Answer
A. 30-40 HU
32
Susceptibility Weighted Images (SWI) in MRI are useful in the diagnosis of
Answer
B. Cerebral microbleeds
33
The Hunter's angle in MR-spectroscopy in a normal MRI brain is
Answer
B. 45 degrees
34
CISS-3D MRI sequences would be useful for the evaluation of
Answer
D. All of the above
35
Trigonocephaly is characterised by premature fusion of which suture?
Answer
A. Metopic
36
Cerebral vasculitis due to fungal infections may occur due to
Answer
D. All of the above
37
The vesicular stage of Neurocysticercosis is seen radiologically after the parasite is lodged in the brain for
Answer
A. 2-3 months
38
Which cytokine is critical in the development of CNS TB?
Answer
A. TNF-
39
CNS infection commonly associated with AIDS includes all except,
Answer
A. Neurocysticercosis
40
Late cerebritis stage of a brain abscess usually lasts from
Answer
A. 4-10 days
41
Mycotic aneurysms in the brain are most commonly associated with
Answer
A. Viridans streptococci
42
Tethered cord is usually associated with
Answer
A. Thickened ļ¬lum terminale
43
Artery of Percheron territory infarcts are,
Answer
A. Usually bilateral
44
Areas with absent blood brain barrier include all except,
Answer
C. Band of Giacomini
45
As per the Bouthiller classiļ¬cation, the C4 segment of the internal carotid artery is
Answer
C. Cavernous segment
46
The craniometric measure that helps to assess the volume of the posterior fossa is
Answer
D. Klaus index
47
Tonsillar descent in Chiari malformation is measured with reference to an imaginary line connecting,
Answer
A. Opisthion to Basion
48
NF-1 associated lesions include all except,
Answer
D. Cutaneous hamartoma
49
Tuberous Sclerosis is not usually associated with
Answer
A. Leptomeningeal angiomatosis
50
Lesions which are T1 hyper on MRI include all except
Answer
B. Calcium
51
A 55 year old man brought to the Trauma care department following a road traļ¬c accident. On arrival he is able to open his eyes to pain, incomprehensible verbal response and localizing to painful stimulus. His GCS score is
Answer
C. E2 V2 M5
52
Which of the following is a single major criteria for indication of non contrast head CT scan in patients with minor head injury?
Answer
B. GCS score <15
53
Which of the following are true in case of a/c Epidural Hematoma (EDH)? i. Most EDH result from arterial bleeding from a branch of the middle meningeal artery ii. Nearby 10% of EDH are caused by venous bleeding iii. Usually venous EDH expand aggressively iv. Presence of low density areas within an EDH in imaging is associated with poor prognosis
Answer
D. i, ii, iv
54
Which of the following are true regarding the management of hypertension in traumatic brain injury? i. It is unwise to reduce systemic blood pressure in patients with untreated intracranial mass lesion. ii. Vasodialating anti hypertensive drugs hydralazine, nicardipine and nitroprusside consistently increase ICP iii. Sympathomimetic - blocking anti hypertensive drugs such as beta blocking agents are preferred iv. Better avoid centrally acting Alpha-receptor agonists
Answer
A. i, ii, iii
55
The third clinical Randomization of an antiļ¬brinolytic in signiļ¬cant head injury (CRASH-3) trial data suggested i. Early treatment with tranexamic acid within 3 hours of injury is more eļ¬ective than standard treatment time (within 8 hours) but did not reach statistical signiļ¬cance ii. Methyl prednisolone was recommended by the study group for early TBI management iii. Tnanexamic acid was recommended by the study group as a treatment option early in TBI management iv. Methyl prednisolne and Tranexamic acid are not useful in TBI management
Answer
C. i, iii
56
Indications for surgery in a case of acute subdural hematoma include i. Thickness of hematoma more than 10 mm ii. Midline shift more than 5 mm regardless of the patients GCS score iii. Post traumatic seizure and more than 3 episodes of vomiting iv. ICP more than 20 mm of Hg with anisocoria
Answer
C. i, ii, iv
57
Which of the following are accepted criteria for surgical treatment of depressed skull fracture? i. Fracture over dural sinus without compromising venous drainage ii. Compound fractures with depression greater than the thickness of the skull iii. Simple or compound fractures if associated with signiļ¬cant cosmetic defect iv. Depressed fracture involving frontal sinus and causing CSF leak
Answer
B. ii, iii, iv
58
Anterior odontoid screw ļ¬xation can be used for acute type II and type III odontoid fracture. Contra indication for the procedure are all except
Answer
B. Odontoid fracture type II B
59
Which of the following are true regarding Hangman's fracture? i. Bilateral fracture through pars interarticularis of vertebra ii. Traumatic subluxation of over iii. Most often due to hyperļ¬exian and axial rotation iv. Usually stable with no neurological deļ¬cit.
Answer
A. i, ii, iv
60
In Maroon and Bailes classiļ¬cation of athletic spinal injuries
Answer
B. Type II injuries otherwise called spinal concussion, are transient in nature and radiographically occult
61
Which of the following is not true regarding Glioblastoma?
Answer
A. Glioblastoma isocitrate dehydrogenase (IDH) wild type is known as Secondary or progressive glioblastoma
62
Which of the following is not true regarding Anti-Vascular endothelial growth factor (VEGF) Bevacizumab?
Answer
B. It has no role in the management of radiation induced necrosis
63
The current standard of care for Brain Metastases include all except
Answer
A. Targeted Molecular Therapy
64
A 45 yrs old female patient, known case of Von Hippel - Lindav disease presented with headache and gait ataxia. MRI showed solid and cystic lesion with perilesional oedema. Intra operatively the lesion appears bright red and large abnormal veins draining the tumour. The tumour is well encapsulated with intra tumoral cysts. The probable diagnosis is
Answer
C. Hemangioblastoma
65
Which of the following is not true in patients with Brain Metastases?
Answer
D. Brain metastases from both small cell and non small cell lung cancer have higher incidence in male compared with female
66
Which of the following is true regarding the pathology of meningioma? i. The cell of origin of all meningioma is believed to be the Arachnoid cap cell ii. Meningioma en plaque is more common in the area of parietal bone iii. Meningiothelial meningioma microscopially showed minearlized whorls containing calcium apatite and collagen are called psammoma bodies iv. Common distinguishing feature in meningioma is the presence of Orphan Annie's eye nuclei which is taregt like nuclei with central clearing and peripheral margination of the chromatin
Answer
A. i, iii, iv
67
Which is not true in Solitary Fibrous Tumour/Hemangiopericytoma (SFT/HPC), a common sub type of intracranial sarcoma?
Answer
D. SFT/HPC tumours that exhibits SFT phenotype has a high rate of recurrence following resection
68
What is the earliest and most frequent symptom of vestibular schwanoma?
Answer
B. Unilateral sensorineurel hearing loss
69
Regarding pharmacotherapy of Acromegaly all of the following are true except
Answer
B. Reduction in tumour size is observed in more than half of the patients
70
Which of the following are true in chordoma and chondrosarcoma? i. Methotrexate at a dose of 3.5-8 g/ is eļ¬ective in the treatment of chordoma and chondrosarcoma ii. Surgical enblock resesction with negative margin is the mainstay of treatment iii. High dose radiation (>5 Gy) is recommeded as adjuvant therapy or primary therapy in case of unresectable lesion iv. Medium overall survival among all spinal chondrosarcoma is 6.9 years
Answer
C. ii, iii, iv
71
A 50 year old male was diagnosed to have SAH following rupture of A-com aneurysm, underwent carniotomy and clipping, following which he developed hemiparaesis with facial and brachial predominance. The artery most likely to be involved is
Answer
C. Recurrent Artery of Heubner
72
Regarding Mycotic aneurysms. All are true EXCEPT
Answer
B. Most commonly seen in proximal MCA-M1 segment
73
Lateral medullary syndrome is characterised by all EXCEPT
Answer
C. Impaired pain and temperature sensation in ipsilateral half of the body
74
All the following are true of moyamoya disease EXCEPT
Answer
A. Majority of adults with this disease presents with ischemia
75
CREST trial compares
Answer
D. Carotid endarterectomy Vs stending for carotid stenosis
76
MRI scan of a patient with right Capsulo ganglionic haematoma showed a lesion which is hyper intense on T1 and hyper intense on T2. What could be the stage of haematoma?
Answer
C. Late sub acute
77
Which of the following was described for the surgical exposure of the intra cavernous ICA for the treatment of carotico-cavernous ļ¬stula?
Answer
D. Parkinson's triangle
78
Which of the following is caused by vascular loop compression?
Answer
D. Hemifacial spasm
79
The location of blood in PNSAH is typically
Answer
A. Pre pontine
80
Which of the following is FALSE regarding Carotico-Cavernous Fistula?
Answer
C. Type C: Direct high ļ¬ow between cavernous sinus and External Carotid Artery (ECA)
81
Which of the following is a feature of Neurogenic shock?
Answer
D. Bradycardia
82
During a thalamotomy for Parkinson tremor, the patient complaints of paraesthesias of ļ¬ngertips and mouth. This could be due to the electrode being too
Answer
B. Posterior to the target
83
Which of the following is often associated with chronic temporal lobe epilepsy?
Answer
B. Ganglioglioma
84
Regarding fMRI, which is FALSE
Answer
C. Areas that do not surpass the chosen threshold are functionally inert
85
Diagnostic criteria for diabetes incipidus following pituitary surgery includes ALL EXCEPT
Answer
D. Urine speciļ¬c gravity >1.010
86
Which of the following syndrome is unlikely to improve in Parkinson's disease after DBS?
Answer
C. Postural instability and "on" - period gait freezing
87
Which of the following anaesthetic agent decreases the intracranial pressure?
Answer
C. Thiopental
88
The following complications can occur in patients in ICU on Total Parental Nutrition EXCEPT
Answer
A. Calculous cholecystitis
89
Biot's breathing suggests the lesion in
Answer
C. Medulla
90
All are true regarding intracranial pressure monitoring EXCEPT
Answer
D. Frequent irrigation of tubing prevent the rate of infection
91
A 60 year old male with progressive cervical spondylotic myelopathy comes to OPD with spasticity involving all four limbs and is able to move with the support of another person only. His Nurick's grade is
Answer
D. Grade 4
92
The changes occurring in degenerated intervertebral discs include ALL EXCEPT
Answer
C. Type I collagen within the nucleus pulposus is replaced with type II collagen
93
Which of the following trials compared surgical decompression of central cord syndrome with conservative management?
Answer
B. COSMIC
94
Regarding Torg-Pavlov ratio all are true EXCEPT
Answer
B. the normal Torg-Pavlov ratio is 2
95
In Meyerding classiļ¬cation, Grade 5 refers to
Answer
A. Spondyloptosis
96
Which of the following is FALSE?
Answer
C. In DISH the intervertebral disk space is narrowed with evidence of spondylodiskitis
97
Which of the following combinations is NOT CORRECT?
Answer
C. Wackenheim's line-dorsum sellae to opisthion
98
Which of the following formulas is correct in terms of the relationship of Pelvic Tilt(PT), Pelvic Incidence(PI) and Sacral Slope(SS)?
Answer
B. PI=PT+SS
99
Cubital tunnel syndrome
Answer
C. Ulnar nerve entrapment between two heads of FCU
100
A patient with H/o road traļ¬c accident came to OPD. O/E he is able to dorsiļ¬ex and invert his foot but unable to evert his foot. The most likely nerve damaged is
Answer
C. Superļ¬cial Peroneal Nerve
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