MCQ Quiz

1. The most characteristic presenting symptom of subarachnoid hemorrhage is:

Sudden severe “worst headache of life”

Progressive focal neurological deficit

Gradual loss of consciousness

Isolated seizures

Explanation:
Subarachnoid hemorrhage classically presents with a sudden, severe “thunderclap” headache.

2. Xanthochromia in CSF indicates:

Acute bacterial meningitis

Traumatic lumbar puncture

Subarachnoid hemorrhage

Intraventricular tumor

Explanation:
Xanthochromia reflects breakdown of blood in CSF and is typical of subarachnoid hemorrhage.

3. The most serious acute complication of subarachnoid hemorrhage occurring about 1 week later is:

Re-bleeding

Hydrocephalus

Cerebral edema

Vasospasm leading to infarction

Explanation:
Vasospasm peaks at about 1 week and can cause secondary ischemia and infarction.

4. Re-bleeding after subarachnoid hemorrhage is most likely during:

First 24 hours

First 2 weeks

After 1 month

After 6 months

Explanation:
Risk of re-bleeding is highest in the first 2 weeks and is associated with increased mortality.

5. Communicating hydrocephalus following subarachnoid hemorrhage is caused by:

Aqueductal stenosis

Intraventricular clot

Fibrosis of leptomeninges

Brain edema

Explanation:
Fibrosis of leptomeninges leads to sluggish CSF flow and chronic communicating hydrocephalus.

6. The most common congenital vascular abnormality of the brain is:

Arteriovenous malformation

Cavernous hemangioma

Capillary telangiectasia

Venous angioma

Explanation:
AVMs are the most common congenital vascular malformations of the CNS.

7. Gliotic brain tissue between abnormal vessels is characteristic of:

Cavernous hemangioma

Capillary telangiectasia

Venous angioma

Arteriovenous malformation

Explanation:
AVMs show abnormal arteries and veins with intervening gliotic brain tissue.

8. Dilated thin-walled vascular channels without intervening brain tissue describe:

AVM

Cavernous hemangioma

Berry aneurysm

Capillary telangiectasia

Explanation:
Cavernous hemangiomas consist of thin-walled vascular channels without brain tissue between them.

9. The source of bleeding in epidural hematoma is usually:

Bridging veins

Cortical veins

Middle meningeal artery

Superior sagittal sinus

Explanation:
Epidural hematoma results from rupture of the middle meningeal artery.

10. The classic clinical course of epidural hematoma includes:

Lucid interval followed by rapid loss of consciousness

Immediate coma

Slow progressive dementia

Recurrent seizures only

Explanation:
A lucid interval followed by rapid deterioration is classic for epidural hematoma.

11. Subdural hematoma most commonly results from rupture of:

Middle meningeal artery

Cortical arteries

Venous sinuses

Bridging veins

Explanation:
Subdural hematomas result from disruption of bridging veins.

12. Chronic subdural hematoma is most commonly seen in:

Young athletes

Elderly patients with brain atrophy

Patients with skull fractures

Patients with AVMs

Explanation:
Brain atrophy stretches bridging veins, predisposing elderly patients to chronic subdural hematoma.

13. Which feature best distinguishes epidural from subdural hematoma?

Presence of headache

Raised intracranial pressure

Lucid interval

History of trauma

Explanation:
A lucid interval followed by rapid deterioration is characteristic of epidural hematoma.

14. Concussion is best defined as:

Reversible functional brain disturbance without structural lesion

Diffuse axonal injury

Cortical contusion

Intracerebral hemorrhage

Explanation:
Concussion causes temporary altered consciousness with no demonstrable lesion.

15. Contrecoup injuries occur due to:

Direct impact at site of trauma

Penetrating head injury

Local vascular rupture

Rotational and deceleration forces

Explanation:
Contrecoup injuries occur opposite the site of impact due to rotational and deceleration forces.

16. Diffuse axonal injury primarily affects:

Cortex only

White matter at grey–white junction

Basal ganglia

Brainstem nuclei only

Explanation:
DAI affects white matter tracts, especially at the grey–white matter junction.

17. Retraction balls are characteristic of:

Concussion

Cortical contusion

Diffuse axonal injury

Subdural hematoma

Explanation:
Retraction balls represent swollen disrupted axons seen in diffuse axonal injury.

18. A patient with post-traumatic coma and later vegetative state most likely has:

Epidural hematoma

Subarachnoid hemorrhage

Cortical contusions

Diffuse axonal injury

Explanation:
Diffuse axonal injury commonly leads to prolonged coma and vegetative state.

19. A cervical spinal cord injury above C4 results in:

Paralysis of the diaphragm

Paraplegia

Loss of bladder control only

Quadriplegia with intact respiration

Explanation:
Injury above C4 paralyzes the diaphragm, leading to respiratory failure.

20. A typical long-term complication of spinal cord trauma is:

Migraine

Ascending and descending tract degeneration

Hydrocephalus

Cerebral vasospasm

Explanation:
Spinal cord injury leads to ascending and descending degeneration of nerve tracts with systemic complications.

3# Vascular Diseases of CNS II

1. The most characteristic presenting symptom of subarachnoid hemorrhage is:

2. Xanthochromia in CSF indicates:

3. The most serious acute complication of subarachnoid hemorrhage occurring about 1 week later is:

4. Re-bleeding after subarachnoid hemorrhage is most likely during:

5. Communicating hydrocephalus following subarachnoid hemorrhage is caused by:

6. The most common congenital vascular abnormality of the brain is:

7. Gliotic brain tissue between abnormal vessels is characteristic of:

8. Dilated thin-walled vascular channels without intervening brain tissue describe:

9. The source of bleeding in epidural hematoma is usually:

10. The classic clinical course of epidural hematoma includes:

11. Subdural hematoma most commonly results from rupture of:

12. Chronic subdural hematoma is most commonly seen in:

13. Which feature best distinguishes epidural from subdural hematoma?

14. Concussion is best defined as:

15. Contrecoup injuries occur due to:

16. Diffuse axonal injury primarily affects:

17. Retraction balls are characteristic of:

18. A patient with post-traumatic coma and later vegetative state most likely has:

19. A cervical spinal cord injury above C4 results in:

20. A typical long-term complication of spinal cord trauma is: