Deck 4: Brain

Question 1

This image reveals the presence of:

A) an epidural hematoma.
B) a subdural hematoma.
C) an acute ischemic stroke.
D) subarachnoid hemorrhage.

Answer 1

an epidural hematoma.

Question 2

The patient in this image has which of these conditions?

A) An epidural hematoma
B) A subdural hematoma
C) An acute ischemic stroke
D) A subarachnoid hemorrhage

Answer 2

A subdural hematoma

Question 3

The pathology shown in the image above is associated with:

A) chronic headache.
B) acute onset of aphasia.
C) chronic left-sided weakness.
D) acute onset of what was likely reported as the "worst headache of my life."

Answer 3

acute onset of what was likely reported as the "worst headache of my life."

Question 4

The very bright intensity in the above DWI indicates that this patient:

A) has metastatic disease.
B) had an acute ischemic stroke.
C) has an AVM.
D) has MS.

Question 5

The axial CT images shown are two different slices from one study on a pediatric patient. Your likely diagnosis is:

A) hemorrhagic stroke.
B) obstructive hydrocephalus.
C) subarachnoid hemorrhage.
D) uncal herniation.

Question 6

The patient in this image has:

A) a meningioma.
B) hydrocephalus.
C) a cephalhematoma.
D) uncal herniation.

Question 7

The above axial contrast-enhanced MRI is consistent with:

A) dementia.
B) metastatic breast cancer.
C) Kuru.
D) TIAs.

Question 8

This sagittal T2 FLAIR MRI is consistent with:

A) MS.
B) ischemic stroke.
C) primary brain tumor.
D) pituitary adenoma.

Question 9

This sagittal contrast-enhanced T1 MRI shows a patient with:

A) visual field defects.
B) chronic headache and papilledema.
C) lower extremity weakness.
D) facial paresthesias.

Question 10

For a patient with closed head trauma for whom imaging is needed, the initial imaging modality of choice is:

A) radiography.
B) unenhanced CT.
C) MRI without and with contrast enhancement.
D) ultrasound.

Question 11

There is a narrow therapeutic window for one of your patients with signs of an acute stroke. Which of the following is likely to be done in this narrow window of time?

A) Carotid Doppler ultrasound done at the bedside in the ED with CT arteriography if positive
B) Stat CT scan (and stat MRI if the CT shows no hemorrhage)
C) Cerebral radionuclide PET scan
D) Echocardiography to search for sources of thromboembolic disease to the cerebral circulation

Question 12

Diffusion-weighted MRI sequences (DWI) are the BEST modality for detecting which of the following?

A) Acute and early subacute ischemic stroke
B) Hyperacute hemorrhagic stroke
C) MS and other white matter diseases
D) Intracranial venous thrombosis

Question 13

A focus of intracranial magnetic susceptibility is associated with:

A) white matter disease.
B) old episode of intracranial bleeding.
C) pineal gland hypertrophy.
D) acute intracranial arterial occlusion.

Question 14

Which of the following would NOT be expected to be seen in an unenhanced CT scan of a patient with an acute cerebral infarction?

A) Insular ribbon sign
B) Hyperdense vessel sign
C) Obscuration of the basal ganglia
D) Dural tail sign

Question 15

Which of the following statements about vasogenic edema is NOT true?

A) It can be associated with a tumor.
B) It has a positive mass effect.
C) It may result from aging.
D) It appears as increased T2 signal in MRI.

Question 16

For MRI of the brain, the use of gadolinium-based contrast agents is usually avoided in which of the following types of patients?

A) Pregnant
B) Elderly
C) Children
D) Those with heart disease

Question 17

White matter disease is usually evident on:

A) the T2 weighted images used in MRI of the brain.
B) only the contrast-enhanced MRI sequences of the brain.
C) intracranial CT arteriography.
D) cisternography.

Question 18

Empty sella syndrome is associated with:

A) hypopituitarism.
B) visual disturbances.
C) NPH.
D) pituitary adenoma.

Question 19

Disproportionately decreased volume of the hippocampus is associated with:

A) tremors.
B) Alzheimer's disease.
C) dysarthria.
D) ataxia.

Question 20

UBOs are associated with:

A) epilepsy.
B) normal aging.
C) Parkinson's disease.
D) metastatic disease.