Assistant Professor in Neurosurgery 560/2017 Answer Key

Post: Assistant Professor in Neurosurgery
Department: Medical Education
Category Code: 560/17
Qualification: M.Ch /DNB (Neuro Surgery) + Three years Teaching Experience
Date of Test: 07-08-2018

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Which of the following statement about Oligodendroglioma in FALSE?
- around 70% of tumours show histological calcification
- most common location is the frontal lobe
- tumours with codeletion of chromosome 1p 19q have poor response to radiotherapy and chemotherapy
- they usually do not stain for GFAP
Which of the following is not a component of the triad of idiopathic normal pressure hydrocephalus?
- head ache
- gait disturbance
- dementia
- urinary incontinence
In which of the following clinical conditions an Endoscopic third ventriculostomy will have the maximum success rate
- post meningitic hydrocephalus
- hydrocephalus following intraventricular hemorrhage
- hydrocephalus associated with tectal gliomas
- for aqueductal stenosis when it is done before the age of 6 months
Which of the following statement is FALSE regarding Esthesioneuroblastoma?
- it is a tumor of olfactory neuroepithelium
- can present with epistaxis
- the commonest site of metastasis is cervical lymphnodes
- bony erosion of the skull base is rare
The commonest site of intracranial arachnoid cyst is
- sylvian fissure
- interhemispheric fissure
- cerebello pontine angle
- suprasellar
Scaphocephaly occurs due to the premature closure of
- Coronal suture
- Sagittal suture
- Lamdoid suture
- Metopic suture
Which of the following type of spinal cord lipoma is caused by a secondary neurulation defect?
- Dorsal lipoma
- Transitional lipoma
- Terminal lipoma
- None of these
Which of the following is NOT a feature of Dandy Walker Malformation?
- Posterior fossa cyst communicating with fourth ventricle
- Hypoplasia of cerebellar vermis
- Hydrocephalus
- Low lying torcula
Which of the following statement is FALSE regarding Chiair 1 malformation?
- refers to caudal displacement of cerebellar tonsils 5 mm or more below the foramen magnum
- hydrocephalus is uncommon
- syringomyelia is common
- may be associated with an occipital encephalocele
Which of the following tracts in the spinal cord has a somatotopic organization with the sacral fibres arranged medially and cervical fibres latterally?
- Lateral corticospinal tract
- Spinothalamic tract
- Posterior column
- None of these
Corticosteroids are effective in the treatment of
- Cytotoxic edema
- Vasogenic edema
- Interstitial edema
- Osmotic edema
Which of the following is the most common functioning pituitary adenoma?
- Prolactinoma
- Growth hormone adenoma
- Corticotroph adenoma
- TSH adenoma
Which of the following statements is FALSE regarding primary CNS lymphomas?
- vast majority are B cell lymphomas
- the detection of Epstein Barr virus in CSF is highly specific diagnostic marker for AIDS related primary CNS lymphoma
- steroids are better avoided before taking the biopsy
- magnetic resonance spectroscopy shows low lipid levels
Normal intracranial pressure in adults is
- 1-7 mm Hg
- 7-15 mm Hg
- 15-25 mm Hg
- 20-30 mm Hg
Which of the following pineal region tumours show elevated levels of β HCG in CSF?
- Germinoma
- Yolk sac carcinoma
- Immature teratoma
- Embryonal carcinoma

Question Error

Most common primary malignant tumour in pediatric age group is
- Astrocytoma
- Ependymoma
- Medulloblastoma
- Choroid plexus carcinoma
At what level does the spinal cord end in adults?
- Lower border of D12
- Lower border of L1
- Lower border of L2
- Lower border of L3
Hook effect is
- blockage of inhibitory effect of dopamine on prolactin secretion due to compression of pituitary stalk leading to moderate elevation of prolactin levels
- low serum values of prolactin obtained by radioimminoassay when serum prolactin levels are very high
- very low levels of serum cortisol following pituitary apoplexy
- high levels of ADH following pituitary surgery
Which of the following drain into the cavernous sinus?
- superior petrosal sinus
- inferior petrosal sinus
- superior ophthalmic vein
- vein of Labbe
A 60 years old man comes to the emergency department following a Road traffic accident. He complains of paraethesia of both upper limbs and bilateral hand grip weakness. On examination there was grade 3 power of both upper limbs with bilateral hand grip weakness. The motor power was normal in both lower limbs. The most likely diagnosis is
- Anterior cord syndrome
- Posterior cord syndrome
- Central cord syndrome
- Brown-Sequard syndrome
Late subacute subdural hematoma is most likely to display which one of the characteristics of MRI?
- T1 hyperintense T2 hypointense
- T1 isointese T2 hyperintense
- T1 hyperintense T2 isointense
- T1 hyperintense T2 hyperintense
Which of the following utilizes Cobalt 60 source of photon production?
- LINAC based radiosurgery
- Proton beam therapy
- Gamma knife surgery
- Carbon ion therapy
Which of the following is horizontal gaze center?
- Paramedian pontine reticular formation
- Medial longitudinal fasciculus
- Superior colliculus
- Rostral interstitial nucleus of MLF
Which of the following statements is LEAST accurate regarding the Neurofibromatosis Type 2?
- Presence of Bilateral vestibular schwannoma
- Unilateral vestibular schannoma and family history of NF2 can be considered as a diagnostic criteria
- Juvenile posterior subcapsular cataracts are common in NF2 patients
- Caused by a mutation or deletion of the neurofibromin gene on the long arm of chromosome 17
Which of the following screw placement may be risky in presence of a normal anatomical variant ponticulus ponticus?
- C1 lateral mass screw placement
- C2 pars screw placement
- C2 pedicle screw placement
- C1-C2 transarticular screw placement
Tectorial membrane is a continuation of
- Anterior longitudinal ligament
- Posterior longitudinal ligament
- Ligamentum flavum
- Interspinous ligament
Which of the following tracts carries pain and temperature sensation?
- Anterior spinothalamic tract
- Lateral spinothalamic tract
- Posterior column
- Lateral corticospinal tract
The mechanism of injury in Jafferson's fracture is
- Hyperflexion
- Hyperextension
- Flexion distraction
- Axial loading
According to the American Spinal Injury association Impairment Scale, a spine injury patient with preserved motor function below the neurological level and majority of the key muscles below the neurological level having less than grade 3 power is classified as
- ASIA A
- ASIA B
- ASIA C
- ASIA D
Which of the following is the commonest blood vessel thought to cause compression of the trigeminal root to produce trigeminal neuralgia?
- Superior cerebellar artery
- Anterior inferior cerebellar artery
- Posterior inferior cerebellar artery
- Basilar artery
Which of the following movement disorder is caused by the damage to the subthalamic nucleus?
- Myoclonus
- Dystonic tremor
- Athetosis
- Hemiballism
A patient with subarachnoid hemorrhage has a GCS of 13 and has no motor deficits. What is his WFNS grade?
- I
- II
- III
- IV
Which of the following is not a component of Cushing's triad?
- Hypertension
- Bradycardia
- Pupillary asymmetry
- Irregular respiration
Vasospasm following aneurysm rupture is maximum during
- Day 1 to day 5
- Day 4 to day 14
- Day 12 to day 21
- Day 21 to day 30
Which one of the following nerves is outside the annulus of Zinn?
- Abducens
- Trochlear
- Nasociliary
- Oculomotor
Which projection of the Anterior communicating artery aneurysm has the highest change of rupture during the retraction of frontal lobe?
- Superior
- Inferior
- Anterior
- Posterior
Which of the following surgical approaches is NOT suitable for an upper clival lesion?
- Frontotemporal approach with orbitozygomatic osteotomy
- Subtemporal approach with zygomatic osteotomy and anterior petrosectomy
- Extreme lateral transcondylar approach
- Endoscopic trans sphenoidal approach
All are features of Parinaud syndrome except
- Downward gaze paralysis
- Defective convergence
- Light near dissociation
- Lid retraction
Which of the following statements is NOT true regarding Glomus Jugular Tumors?
- They arise from paraganglia in the adventitia of the jugular vein
- Men are affected more frequently than females
- They can present with conductive hearing loss
- They are highly vascular tumours
A patient presents with low back pain radiating to right leg with paraesthesia along the lateral aspect of leg. On examination he had a weakness of extension of the right big toe and all deep tendon reflexes were normal. The most likely disc prolapse expected in the MRI is
- L2-L3
- L3-L4
- L4-L5
- L5-S1
According to Mayerding classification of spondylolisthesis, 26-50% of slippage is classified as
- Grade I
- Grade II
- Grade III
- Grade IV
A 10 year old boy presents with head ache and visual disturbances. MRI brain shows a suprasellar cystic lesion with evidence of calcification. The most probable diagnosis among the following is
- Pituitary adenoma
- Rathke's cleft cyst
- Craniopharyngioma
- Central neurocytoma
All are diagnostic features of Neurofibromatosis type 1 except
- Café-au-lait spots
- Iris Lisch nodules
- Optic glioma
- Adenoma sebaceum
The Maxillary division of trigeminal nerve exits the cranium through
- Foramen spinosum
- Foramen lacerum
- Foramen rotundum
- Foramen ovale
All are features of neurogenic claudication except
- exertional pain over thigh and buttocks
- symptoms are more pronounced while walking downstairs than walking upstairs
- sitting and leaning forward may relieve the symptoms
- bicycling can aggravate the symptoms
The internal cerebral vein drains into
- Deep middle cerebral vein
- Basal vein of Rosenthal
- Vein of Galen
- Straight sinus
Commonest presenting symptom of vestibular schwannoma is
- unilateral hearing loss
- tinnitus
- disequilibrium
- facial numbness
The clinical grade (House Brackmann) of a patient with total facial paralysis with no perceptible movement is
- Grade 0
- Grade I
- Grade V
- Grade VI
Which of the following approach is NOT suitable for a vestibular schwannoma when you are aiming for hearing preservation?
- suboccipital retrosigmoid approach
- translabyrinthine approach
- middle fossa approach
- none of these
Simpson grading is used to assess the completeness of surgical removal of
- Gliomas
- Meningiomas
- Pituitary adenomas
- Vestibular schwannomas
Which of the following intracranial tumours can occur as an association of von Hippel-Lindau Syndrome?
- Meningioma
- Medulloblastoma
- Hemangioblastoma
- Ependymoma
Which of the following histological type of meningioma is considered as a malignant meningioma?
- Meningothelial meningioma
- Fibroblastic meningioma
- Papillary meningioma
- Angiomatous meningioma
The classical visual field defect in pituitary adenoma is
- Homonymous hemianopia
- Bitemporal hemianopia
- Binasal hemianopia
- Junctional scotoma
The therapeutic ranges of phenytoin in adults is
- 10-20 μg/ml
- 20-30 μg/ml
- 30-40 μg/ml
- 40-50 μg/ml
All of the following are true regarding pseudotumour cerebri except
- Can cause blindness
- Intra cranial pressure will be elevated
- Majority of cases show moderate to severe dilatation of ventricles
- CSF shunt is a treatment option
Anterior petrosectomy is done in
- Kawase triangle
- Glasscock's triangle
- Parkinson's triangle
- Mullan's triangle
Rapid correction of hyponatremia can lead to
- Cerebral edema
- Metabolic encephalopathy
- Cerebral salt wasting
- Central pontine myelinolysis
Which of the following primary site is the commonest source of cerebral metastasis?
- Lungs
- Breast
- Kidney
- Gastro intestinal
The Hounsfield unit for fat is
- -90 to -120
- zero
- 70 to 140
- more than 300
A head injury patient is confused, opens eyes to painful stimuli and localizes pain. His GCS score is
- 13
- 11
- 9
- 7
Which of the following is not a component of Gerstmann syndrome?
- Alexia
- Agraphia
- Acalculia
- Right-Light disorientation
A patient admitted with severe head injury has a blood pressure reading of 150/90 mmHg. His ICP was 30 mmHg. What is the Cerebral Perfusion Pressure?
- 60 mmHg
- 70 mmHg
- 80 mmHg
- 90 mmHg
Commonest false localizing sign in raised intracranial pressure is
- Oculomotor nerve palsy
- Abducent nerve palsy
- Facial nerve palsy
- Papilloedema
Foster Kennedy Syndrome is commonly seen in
- Third ventricular tumours
- Fourth ventricular tumours
- Pineal region tumours
- Olfactory groove meningioma
A 65 year old hypertensive lady presents with acute onset of severe head ache and neck pain. CT scan of brain revealed subarachnoid bleed in the right sylvian fissure and a right temporal lobe hematoma. The most probable diagnosis is
- Hypertensive bleed
- Aneurysm bleed
- AVM bleed
- Temporal lobe metastatic lesion with bleed
Which of the following is not a component of triple H therapy?
- Hyperventilation
- Hypertension
- Hypervolemia
- Hemodilution
Which of the following cranial nerves exits from the dorsal aspect of brainstem?
- Oculomotor nerve
- Trochlear nerve
- Abducent nerve
- Vestibulocochlear nerve
A patient who has undergone surgical clipping for a ruptured A-Com aneurysm becomes drowsy on the 6th open operative day. What could be the probable cause for the drowsiness?
- Vasospasm
- Hydrocephalus
- Hyponatremia
- Any of these
Which of the following cisterns is in closest relation to superior and inferior colliculi?
- interpeduncular cistern
- crural cistern
- supra sellar cistern
- quadrigeminal cistern
Rosenthal fibres are commonly seen in
- Pilocytic Astrocytoma
- Oligodendroglioma
- Medulloblastoma
- Ependymoma
Brodmann's area 17 is
- Broca's area
- Primary auditory area
- Primary somatosensory area
- Primary visual area
The cranial nerve that passes through the anterosuperior compartment of Internal acoustic meatus is
- Facial nerve
- Cochlear nerve
- Superor vestibular nerve
- Inferior vestibular nerve
Which among the following glial tumour is not a Grade I tumour according to the latest WHO classification?
- Pilocytic astrocyotma
- Subependymal Giant cell astrocytoma
- Pleomorphic Xanthoastrocytoma
- Desmoplatic infantile astrocytoma
Which of the following extra ocular muscle caused depression of eye in abducted position?
- Inferior Rectus
- Inferior Oblique
- Superior Rectus
- Superior Oblique
Lamina terminalis
- Is in the roof of fourth ventricle
- Is in the roof of third ventricle
- Forms the floor of third ventricle
- Forms the anterior wall of third ventricle
Which among the following MRI sequences helps to differentiate an arachnoid cyst from an epidermoid?
- Gradient Echo
- FLAIR
- Perfusion weighted images
- Diffusion weighted images
The type of Glioma commonly associated with Tuberous sclerosis is
- Pilocytic astrocytoma
- Oligodendroglioma
- Ependymoma
- Subependymal giant cell astrocytoma
The pituitary adenomas are called macroadenomas when the size is more than
- 1 cm
- 1 mm
- 2.5 cm
- 2.5 mm
Repetition is well preserved in
- Brocas aphasia
- Wernickes aphasia
- Transcortical aphasia
- Conduction aphasia
Thalamotomy is done is Parkinson's disease to relieve
- Tremor
- Dystonia
- Dyskinesia
- Depression
The viceroy who introduced budget system in India is
- Lord Mayo
- Lord Ripon
- Lord Canning
- Lytton
Out of the following which is not a novel of Tagore?
- Gora
- Chaturanga
- Ghare Baire
- Purobi
Who is the first Indian to join the Viceroy's Executive Council?
- Vithal bhai Patel
- Satyendra Prasad Sinha
- C.R. Das
- Sarojini Naidu
The real name of sister Nivedita was
- Margaret Elizabeth
- Catherine Noble
- Mary
- Nivedita
The longest river in India is
- Yamuna
- Ganga
- Godavari
- Krishna
In the first ministry of independent India, Jagjeevan Ram had the portfolio of
- Labour
- Health
- Industries
- Railway
Moulana Mohammedali was the president of Indian National Congress in its session held at
- Lucknow
- Viyayawada
- Kakkinada
- Nagpur
Who is popularly known as the 'Christian Viceroy'?
- Irwin
- Minto
- Wavell
- Linlithgo
In Travancore which ruler was known as 'Kizhavan raja'?
- Avittom Thirunal Balarama Varma
- Ayiliam Thirunal Rama Varma
- Swathi Thirunal Rama Varma
- Karthika Thirunal Rama Varma
'Aruvikkuzhi' waterfalls is in
- Idukki
- Kottayam
- Palakkad
- Pathanam Thitta
Digging wells for the use of the people was an important work of
- Vagbhatananda
- Kumara Guru
- Pandit Karuppan
- Vaikunta Swamikal
'Athamabodhodaya Samghom' was founded by
- T.K. Madhavan
- Subhananda Gurudevan
- Velukkutty Arayan
- Arattupuzha Velayudha Panikkar
'Savarnajatha' from Nagarcovil to Trivandrum was led by
- Mannathy Padmanabhan
- K. Kelappan
- K.P. Kesava Menon
- Dr. M.E. Naidu
The publication of 'Swadeshabhimani' was started from
- Trivandrum
- Vakkom
- Attingal
- Kollam
From which constituency, E.M.S. Namboodirippad was elected in the Kerala Assembly Election, 1957?
- Pattambi
- Kannur
- Neeleswaram
- Thrithala
The National award for best feature film of 2017 was bagged by
- Mom
- Village Rockstars
- Nagar Kirtan
- Bhayanakam
The winner of 2017 Ranji Trophy Cricket Tournament is
- Vidarbha
- Karnataka
- Mumbai
- Sourashtra
The minimum age to become President in India is
- 21
- 25
- 30
- 35
Which is the first state that introduced Panchayathiraj system?
- Rajasthan
- Kerala
- Andhra Pradesh
- Haryana
The Atal Pension Yojana was introduced in
- April 2015
- May 2015
- June 2015
- July 2015