Deck 33: Brain and Spinal Cord

Question 1

The part of a vertebra most commonly involved with osteomyelitis is the __________.

A) lamina
B) pedicles
C) vertebral body
D) spinous processes

Answer 1

vertebral body

Question 2

Which of the following is the most likely location of brain abscesses that result from spread of pathogens from the sinuses?

A) Supratentorial
B) Frontal lobe
C) Brainstem
D) Parietal lobe

Answer 2

Frontal lobe

Question 3

What tissue is found between the vessels of an intracranial arteriovenous malformation?

A) Endothelium
B) Brain parenchyma
C) Lymphatic
D) Dura mater

Answer 3

Brain parenchyma

Question 4

Diffusion-weighted imaging and apparent diffusion coefficient are types of MRI pulse sequences useful in evaluating water diffusion in the brain in patients affected by __________.

A) stroke
B) subdural hematoma
C) epidural hemorrhage
D) tuberous sclerosis

Question 5

Which of the following tests is diagnostic for bacterial meningitis?

A) Lumbar puncture with culture of CSF
B) CT
C) MRI
D) Contrast-enhanced MRI

Question 6

Extravasated blood in acute subdural hematomas is most fatally the result of damage to __________.

A) veins
B) arteries
C) lymphatics
D) dural venous sinuses

Question 7

Traumatic pseudoaneurysms are created by rupture of the __________.

A) tunica intima and tunica media
B) tunica media and tunica adventitia
C) tunica intima, tunica media, and tunica adventitia
D) fibrous tissue in the adventitia surrounding an artery

Question 8

The most common location for cortical contusions in the brain following trauma are the __________.

A) parietal lobes
B) occipital and temporal lobes
C) frontal and temporal lobes
D) cerebellar hemispheres

Question 9

Which the following imaging protocols is considered prudent for assessment of the cervical spine following trauma if there is suspicion of fracture?

A) Anteroposterior (AP), lateral, and AP open-mouth radiographs
B) AP, lateral, AP open mouth, and flexion/extension radiographs
C) AP, lateral, AP open mouth, flexion/extension, and right and left oblique radiographs
D) AP, lateral, and AP open-mouth radiographs with computed tomography (CT)

Question 10

Which of the following indicates a patient with weakness, paresis, and tremor of an extremity may have a diagnosis other than multiple sclerosis?

A) Absence of visual disturbances
B) Clinical remission
C) Sensory abnormalities
D) CSF abnormality

Question 11

Acute encephalitis usually results from __________.

A) lumbar puncture
B) Staphylococcus infection
C) viral infection
D) Neisseria meningitides

Question 12

Which of the following types of hematoma is associated with potential to develop noncommunicating hydrocephalus due to blood barrier for cerebrospinal fluid (CSF) flow through the third or fourth ventricle?

A) Acute epidural
B) Acute subdural
C) Subacute subdural
D) Acute subarachnoid

Question 13

A lentiform shaped hyperdensity on CT examination located between the dura and surrounding calvarium describes a(an) __________.

A) cortical contusion
B) epidural hematoma
C) subdural hematoma
D) subarachnoid hematoma

Question 14

Inflammation of what tissue helps differentiate encephalitis from meningitis?

A) Pia mater
B) Arachnoid mater
C) Brain parenchyma
D) Leptomeninges

Question 15

Which of the following diagnostic imaging modalities in not appropriate in evaluating vascular injury?

A) Magnetic resonance angiography
B) Catheter angiography
C) Conventional radiography
D) Duplex ultrasound

Question 16

Hemosiderin deposition in the soft tissues demonstrates which of the following MRI signal characteristics?

A) Low T1, low T2
B) High T1, high T2
C) Intermediate T1, high T2, low T2 rim
D) Intermediate T1, low T2

Question 17

Spinal epidural abscesses are most often caused by __________.

A) Staphylococcus
B) Streptococcus
C) fungus
D) Haemophilus

Question 18

Most non-traumatic subarachnoid hemorrhages are the result of __________.

A) emissary vein disruption
B) metastasis
C) aneurysm rupture
D) tunica intima dissection

Question 19

Which of the following diagnostic imaging studies best demonstrates injury to ligaments, intervertebral discs, and soft tissues of the spinal canal or intervertebral foramina?

A) Radionuclide scintigraphy
B) Conventional radiography
C) CT
D) Magnetic resonance imaging (MRI)

Question 20

In what percent of patients affected by multiple sclerosis are the associated lesions isolated to the spinal cord?

A) 10%
B) 20%
C) 30%
D) 40%

Question 21

Sarcoidosis of the central nervous system (CNS) is localized to the __________.

A) brainstem
B) leptomeninges
C) Virchow-Robin spaces
D) brain parenchyma

Question 22

The most common intrinsic primary spinal cord tumor is a(n) __________.

A) oligodendroglioma
B) ependymoma
C) glioblastoma multiforme
D) astrocytoma

Question 23

Which type of Chiari malformation exhibits differing symptoms between infants and children, and is associated with lumbar meningoencephalocele?

A) I
B) II
C) III
D) IV

Question 24

The most common type of glial cell tumor is a(n) __________.

A) mixed astrocytoma
B) glioblastoma multiforme
C) astrocytoma
D) ependymoma

Question 25

The clinical symptoms of medulloblastoma are often related to __________.

A) demyelination
B) hormone imbalance
C) obstructive hydrocephalus
D) nonobstructive hydrocephalus

Question 26

The increased metabolic rate of aggressive tumors is best detected with which of the following diagnostic imaging modalities?

A) Single photon emission CT
B) MRI
C) Positron emission tomography
D) Contrast-enhanced CT

Question 27

The majority of medulloblastomas arise from the __________.

A) floor of the fourth ventricle
B) lateral ventricles
C) third ventricle
D) cisterna magna

Question 28

The use of immunosuppressive drugs and spread of autoimmune disease has dramatically increased the incidence of __________.

A) CNS metastasis
B) CNS lymphoma
C) craniopharyngioma
D) meningitis

Question 29

Neurofibromatous tumors that erode the neuroforamina are seen in patients with __________.

A) neurofibromatosis type 1
B) neurofibromatosis type 2
C) schwannomatosis
D) vestibular schwannomas

Question 30

Extension of the cerebellar tonsils __________ mm below the foramen magnum, is considered borderline for the presence of Arnold-Chiari malformation.

A) 1-2
B) 3-5
C) 6-7
D) 8-10

Question 31

Seeding of primary brain tumors to other sites via CSF is characteristic of __________.

A) medulloblastoma and ependymoma
B) astrocytoma and craniopharyngioma
C) oligodendroglioma and lymphoma
D) pinealoblastoma and meningioma

Question 32

Which type of meningioma is described as "a compact rounded mass with invagination of brain parenchyma?"

A) Globular
B) Meningioma-en-plaque
C) Multicentric
D) Lenticular

Question 33

A fluid-filled cavitation in the central canal and spinal cord is known as a(n) __________.

A) meningocele
B) arachnoid cyst
C) syrinx
D) Tarlov cyst

Question 34

Which of the following tumor types is the most common neoplastic process to affect the brain?

A) Metastasis
B) Glioma
C) Meningioma
D) Pituitary adenoma

Question 35

MRI evaluation of the brain of a 67-year-old male patient shows an enhancing mass that has eroded the sella turcica and extends superiorly into the brain parenchyma. Which of the following is the most likely diagnosis?

A) Glioblastoma multiforme
B) Aneurysm
C) Pituitary microadenoma
D) Pituitary macroadenoma

Question 36

Which of the following is the most common brain tumor of the newborn?

A) Lymphoma
B) Craniopharyngioma
C) Metastasis
D) Teratoma

Question 37

Which of the following is the imaging modality of choice for detection of brain and spinal metastatic disease?

A) Radionuclide scintigraphy
B) Conventional radiography
C) CT
D) Gadolinium-enhanced MRI

Question 38

Which of the following primary CNS tumors is found along remnants of Rathke cleft?

A) Medulloblastoma
B) Pinealoblastoma
C) Craniopharyngioma
D) Ependymoma

Question 39

Which of the following best characterizes the enhancement pattern of meningiomas with contrast-enhanced MRI?

A) Weak, homogeneous
B) Weak, heterogeneous
C) Intense, heterogeneous
D) Intense, homogeneous

Question 40

The normal sella turcica should measure no larger than __________ (vertical x horizontal) on lateral radiographs.

A) 6 mm x 8 mm
B) 8 mm x 12 mm
C) 10 mm x 14 mm
D) 12 mm x 16 mm