Continues Assessment 8

Batch 21
2013.01.16

MCQ

01. Regarding head injury
A. Increased intracranial pressure leads to herniation of brain contents.
B. Persistent hypoxia will damage the brain tissue further after the head injury.
C. Retrograde amnesia following head injury is not correlated with degree of cerebral
dysfunction.
D. Bruising over mastoid process (Battle sign) is a manifestation of skull fracture.
E. B/L cataract of the patient may interact with eye response of a head injured person.

02. Chronic subdural hemorrhage
A. Common in young adults.
B. Present with headache.
C. More common in alcoholics.
D. Associated with fluctuating level of consciousness.
E. Treated with surgical drainage.

03. Regarding narcolepsy
A. Sleep paralysis is a clinical feature.
B. Hypnogonic hallucinations is present.
C. Occurs in middle age.
D. Has a familial tendency.
E. Third person auditory hallucination is a clinical feature.

04. With regard to cerebral palsy
A. Upper limbs more hypertonic than lower limbs in diplegic CP.
B. IQ level is normal in quadriplegic CP.
C. Lower limbs are more hypertonic than the upper limbs in hemiplegic CP.
D. Hypertonia is a characteristic of dyskinetic CP.
E. Patellar clonus is seen in quadriplegic CP.

05. Features of a child having a lumbosacral myelomeningocele
A. Loss of ankle jerk.
B. Faecal incontinence.
C. Loss of cremesteric reflex.
D. Bladder hypertonia with overflow incontinence.
E. Upward planter response.

06. Following features are present in increased intracranial pressure
A. Papillloedema.
B. Headache worsening on the end of the day.
C. Headache relieved with bending forward.
D. Headache worsening with cough.
E. Headache present at the waking up in the morning.

07. Regarding management of acute bacterial meningitis
A. Lumber puncture is done in all patients.
B. CT brain is mandatory.
C. Steroids are contraindicated.
D. Blood culture is a useful investigation.
E. Ampicillin is useful in treating elderly patients.

08. What are the features of viral encephalitis
A. Focal brain swelling.
B. Accumulate exudates at the base.
C. Flattened gyri.
D. Haemorrhagic & cavitated areas.
E. Cerebral suppuration.

09. CNS tumors
A. Ependymoma occurs related to ventricles.
B. Meningioma has glial tissue origin.
C. Glioblastoma is a high grade tumor.
D. Astrocytoma is the commonest primary tumors in adults.
E. Primary lymphoma is a commonly in immune-compromised people.

10. Regarding Haemophilus influenza
A. There are 2 subtypes.
B. It is the most common cause of meningitis in elderly.
C. A vaccine against strain a is included in the immunization schedule in srilanka.
D. It grows well in heated blood agar.
E. It grows well near Staph aureas colonies in blood agar.




SBA

11. 25 years old boy admitted as having a head injury. His BP is 100/60mmHg & pulse rate
is 60Beats/min. On examination he is found to have palpable L/S boggy mass & L/S
dilated pupils. What would be the most probable diagnosis?
A. R/S EDH.
B. L/S EDH.
C. R/S EDH with midline shift.
D. L/S EDH with midline shift.
E. R/S EDH with midline shift & base of skull fracture.

12. 25 years old girl having 85kg body weight diagnosed to having migraine. What is the
most appropriate drug for her?
A. Sumatriptan.
B. Propanolol.
C. Phenytoin.
D. Sodium valproate.
E. Flunarazine.

13. 2 years old boy presented with headache,vomiting,ataxia. He is diagnosed to having a
tumor. It was resected during sugery & sample sent to histological investigation.
histology report revealed closely packed cells with densely stained nuclei. What is the
most likely tumor he had?
A. Astrocytoma.
B. Medulloblastoma.
C.
D.
E.

14. The drug of choice for status epilepticus
A. Ethosuxime.
B. Sodium valproate.
C. Carbamezepin.
D. Imipramine.
E. Diazepam.

15. 10 year old child presented with headache for 2 months duration. His mother has
observed he I presented vomiting since 2 weeks duration. So mother has brought child to
hospital. On examination child had papiloedema & difficulty in moving right eye
medially. Investigations confirms he has a brain tumour. Where is the lesion?
A. Left motor cortex.
B. Left internal capsule.
C. Left midbrain.
D. Left cerebro-pontine angle.
E. Left brain stem.

16. A 10 month old boy was admitted to the paediatric casualty ward with a history of short
lasting tonic clonic convulsions.He was noted to be having an upper respiratory tract
infection with fever during last 24 hours.PMHx revealed no significant problem & his
development was age appropriate.Physical examination shows a well built child with
normal systemic examination.His FBC & CRP counts within the normal limit.
What is the management of this child?
A. Start IV antibiotic after blood culture.
B. Perform a lumbar puncture.
C. Start sodium valproate to prevent further convulsions.
D. Arrange an EEG.
E. Reassure patient.

17. 6 years old boy presented with difficulty of getting up from sitting position.Mother
noticed since 6 monthsthat boy is struggling to stand from sitting during toileting.He has
taken medication previously only for minor illness.On examination lower limb reflexes
are diminished,muscle power was grade III & muscle bulk was normal. What would be
the most likely diagnosis?
A. Cerebral palsy.
B. Duchene muscular dystrophy.
C. Large cerebral haemorraghe.
D. Gilluen barre syndrome.
E. Degenerative brain disease.

18. What is the drug of first choice for a 25 year old female presented with partial seizures?
A. Carbamazepine.
B. Phenobarbitone.
C. Sodium valproate.
D. Topiramide.
E. Phenytoin.

19. What is the following clinical feature best suggestive of spinal cord lesion?
A. Hyper reflexia.
B. Spasticity.
C. Extensor planter response.
D. Urinary incontinence.
E. Sensory level.

20. Which of the following management steps you would perform first in a 65 years old man
having headache for 2 weeks duration?
A. CT brain.
B. MRI brain.
C. EEG.
D. ESR.
E. Reassurance.

21.

22.

23. A 10 year old boy presented with vomiting,headache,ataxia for 2 months duration.MRI
performed revealed tumour near the 4
th
ventricle.The tumour was excised surgically and
sent for histology.The histology shows small compacted cells with hyperpugmented
nuclei.
What is the most probable tumour?
A. Astrocytoma.
B. Medulloblastoma.
C. Meningioma.
D. Glioblastoma.
E. Metastatic lymphoma.

24. A 5 year old boy was admitted to the paediatric unit of CNTH.He was diagnosed as
meningitis.A lumber puncture was done and CSF was sent to microbiology lab.When
collecting & transporting what is the most important step?
A. Collect them to 4 screw cap bottles.
B. Sent to lab immediately.
C. Sent with a request form.
D. Write date & time on request form.
E. Do not put in a refrigerator.

25. 21 years old previously healthy male was admitted to the ward was diagnosed having
schizophrenia.He was not on treatments previously.What would be the best management
step of this patient?
A. Reassurance.
B. Rispiridone.
C. Clozapam.
D. Cognitive behavior therapy.
E. Electroconvulsive therapy.