Ortho-Surgery b.

Femoral shaft fracture

c. Intertrochanteris fracture
1. Y-shaped intraarticular fracture base of 1st metacarpal: d. Pott’s fracture
a. Bennet’s fracture 14. Partially displaced femoral neck fracture:
b. Manteggla’s fracture a. Garden’s I (incomplete)
c. Jefferson’s fracture b. Garden’s II (complete w/o displacement)
d. Rolando’s fracture c. Garden’s III (complete w/ displacement)
2. Thurstan-Holland sign: Salter-Harrus (Epiphyseal injury children) d. Garden’s IV (complete w/ full displacement)
a. Type I 15. Cubitus varus is an example of:
b. Type II a. Non-union
c. Type III b. Mal-union
d. Type IV c. Delayed union
3. In Barlow’s test the hip is being: d. A & C
a. Dislocated 16. Period of observation for spontaneous recovery of radial nerve injury:
b. Peduced (Ortolany) a. 4 wks
c. Both b. 8 wks
d. Neither c. 12 wks
4. Most common complication of supracondylar fracture of the humerous: d. 16 wks
a. Volkmann’s ischemic contracture 17. Fracture neck of 5th metacarpal:
b. Cubitus varus a. Maliet finger
c. Genu varus b. Boxer’s fracture
d. Radial nerve palsy c. Baseball finger
5. Pauwel’s classification is related to: d. Rolando’s fracture
a. Intertrochanteric fracture 18. Special x-ray technique allowing visualization of the spinal cord:
b. Femoral neck fracture (Powel’s + Gardener’s) a. Discography
c. Supracondylar fracture b. Myelography
d. None of the above c. Arthography
6. A decrease in the normal carrying angle of the elbow: d. MRI
a. Coxa vera 19. Abduction deformity of the great toe through the metatarsophalageal joint:
b. Genu valgus a. Hallux valgus
c. Cubitus valgus b. Heel valgus
d. Cubitus varus c. Metatarsal adducts
7. Bone graft taken from the ileum and trasferred to the same individual: d. Tolipes equinovarus
a. Hemograft 20. Femoral neck shaft angle of 95 degree:
b. Heterograft a. Genu varum
c. Autograft b. Coxa varum
d. Paragraft c. Genu valgum
8. Drug that can delay fracture healing: d. Coxa valgum
a. Heparin 21. A fracture in a bone weakened by an underlying disease:
b. Corticosteroids a. Stress fracture
c. Dicumerol b. Comminuted fracture
d. All of the above c. Patholic fractures
9. The “Golden period”in the management of open fracture: d. All of the above
a. 6 hrs 22. Fractures heal by formation of:
b. 16 hrs a. Hematoma
c. 2 hrs b. Collus
d. 8 hrs c. Scar
10. The last stage in fracture healing: d. Clot
a. Inflammation 23. Maintenance of reduction can be achieve by:
b. Formation of blood clot a. External fixation
c. Hydroxypatite deposition b. Internal fixation
d. Remodeling c. Traction
11. Overlapping of fragments can result to: d. All of the above
a. Angulation 24. Absolute indications for open reduction:
b. Shortening a. No union
c. Rotation b. Delayed union
d. None of the above c. Multiple fractures
12. Contraindication for open reduction: d. All of the above
a. Active infection 25. Fat fad sign is related to:
b. Undisplaced fracture a. Clavicle fracture
c. Bone so weak b. Supracondylar fracture humerus
d. All of the above c. Colle’s fracture
13. Boyd & Griffin is a classification for: d. None of the above
a. Femoral neck fracture
26. The current treatment for osteoporosis due to menopause are the d. Inflammatory arthritis
following EXCEPT: e. None of the above
a. Estrogen because it decreases the calcium excretion 36. Corrective osteotomy is one of the surgical measures to:
b. Vitamin D which slows the resorption of bone mineral a. Prevent secondary arthritis
c. Giving parathyroid hormone b. Re-aligning the weight bearing surface of a joint
d. Administration of androgens as a sodium retentive effect c. Improve cosmetic appearance of a deformed limb
e. Fluoride treatment to cause new bone matrix to be deposited in the d. Improve the function of a diseased joint
trabeculae e. All of the above
27. A slowly progressive disease of synovial lined joints occurring late in life 37. Total joint replacement arthroplasty is reserved for:
characterized by focal degeneration of articular cartilage, subchondral bone a. Older arthritic individuals
thickening, osteophyte formation and deformity is known as EXCEPT: b. Severe joint destruction
a. Osteoarthritis c. Exquisite pain on motion of a deformed weight bearing joint
b. Osteoarthrosis d. Limitation of motion of a joint due to disease
c. Paget’s disease e. All of the above
d. Degenerative arthritis 38. Still’s disease is manifested by all EXCEPT:
e. Hypertrophic arthritis a. Fever with rash
f. Arthritis deformans b. Splenomegaly
28. In severe and disabling degenerative arthritis of the knee, the surgical c. Lymphadenopathy
treatment of choice is: d. Bouchard’s nodes
a. Intraarticular steroid injection of steroids e. Iridocyclitis
b. Total knee replacement arthoplasty 39. Gout is a condition of disturbed uric acid metabolism in which ureate salts
c. Fusion of the joint are deposited in the articular, periarticular and subcutaneous tissues is
d. Physical therapy characterized to be:
e. None of the above a. Hereditary
29. Sickle cell joint disease is an example of: b. Of male preponderance
a. Non-inflammatory arthritis c. Predilection to 2nd to 4th decade of life
b. Infectious arthritis d. Decreased urinary 17-ketosteroids
c. Inflammatory arthritis e. All of the above
d. Hemorrhagic arthritis f. None of the above
30. Herberden’s node are bony enlargement of the: 40. In degenerative arthritis the causative factors are:
a. Distal interphallangeal joints of the fingers a. Age
b. DIP joints of the foot b. Hereditary
c. Medial compartment of the knee c. Obesity
d. Metacarpophallangeal joints of the hand d. All of the above
e. None of the above e. None of the above
31. A patient manifesting with ulcers on the palms and soles with urethritis is 41. Non-inflammatory arthritis includes EXCEPT:
suffering from: a. Osteoarthritis
a. Ankylosing spondylitis b. Neuroplathic arthropathy
b. Juvenile rheumatoid arthritis c. Acute rheumatic fever
c. Gouty arthritis d. Gout
d. Fungal arthritis e. All of the above
e. None of the above 42. Secondary arthritis is a resultant of:
32. Reiter’s syndrome is manifested as EXCEPT: a. No underlying cause is present
a. Triad of urethritis conjunctivitis and oligoarticular arthritis b. Cartilage is worn out because of disuse
b. Predominant in adult females c. Previous trauma or congenital deformities
c. Keratodermic lesions d. All of the above
d. All of the above 43. RF (rheumatoid factor) is negative in:
e. None of the above a. Rheumatic fever
33. Systemic manifestation of Rheumatoid Arthritis includes EXCEPT: b. Ankylosing spondylitis
a. Vasculitis c. osteoarthritis
b. Podagra d. All of the above
c. Pericarditis e. None of the above
d. Pulmonary disease 44. Sausage digits is a hallmark of:
e. GI bleed a. Psoriatic arthritis
34. Charcot Joint is usually a manifestation of: b. Tuberculous arthritis
a. Tabes Dorsalis c. Gouty arthritis
b. Syringomyelia d. Ankylosing spondylitis
c. Hansen’s Disease e. None of the above
d. All of the above 45. Except one, acute hematogenous osteomyelitis is the:
e. None of the above a. The most frequent and common type of bone infection
35. Pigmented villonodular synovitis is one of the: b. Affects more males than females
a. Hemorrhagic arthritis c. Affects the diaphyseal part of the bone
b. Infectious arthritis d. Usually caused by cateremia
c. Non-inflammatory arthritis e. All of the above
46. Stripping of the periosteum in acute hematogenous osteomyelitis provokes iv. Xray whole upper extremity APL
an osteoblastic response producing a sleeve of new bone formation known c. X-ray examination showed no fracture at the area of the elbow but (+)
as: fat pad sign. Most likely diagnosis is:
a. Cloaca i. Olecranon Fx
b. Sequestra ii. Capitellar Fx
c. Pereostitis iii. Lateral epicondyle Fx
d. Myositis ossificans iv. Supracondylar Fx
e. Involurun d. This patient should be managed by:
47. In the neonates, the most common causative organisms isolated is i. Open reduction int. fixation (ORIF)
osteomyelitis is: ii. Closed reduction and immobilization
a. Staphylococcus iii. Immobilization w/ long arm posterior mold
b. Enteric bacilli iv. Shoulder spicu cast
c. Group B hemolytic streptococcus e. The most serious complication of this case is:
d. None of the above i. Malunion
e. All of the above ii. Volkmann’s ischemic
48. In the early stage of acute hematogenous osteomyelitis, the most constant iii. Delayed union
finding is: iv. All of the above
a. Positive x-ray picture 52. F.U., 70y/o female, slipped inside the bathroom hitting her right buttock on
b. Leukocytosis the floor. Patient was unable to ambulate after accident and was
c. Positive blood culture subsequently brought to the ER.
d. None of the above a. On PE, patient’s right lower extremity was noted to be externally
e. All of the above rotated. Positive tenderness right hip area. Possible diagnosis is:
49. All is true in subacute osteomyelitis EXCEPT: i. Femoral neck fx
a. Elevated ESR ii. Intertrochanteric fx
b. Blood culture is usually positive iii. Hip dislocation
c. Loss of function of the limb is minimal iv. Acetobular fx
d. Pain is mild to moderate b. The position of the right lower extremity (external rotation), is 2
e. WBC is normal degree, to the action of:
50. K.L., 30 y/o male, while playing basketball had inversion injury of his right i. Short lateral rotators of the hip
ankle. PPE: swollen right ankle joint, (+) tenderness, limited ROM: ii. Hip adductors
a. Possible diagnosis in the above case: iii. Hamstring muscles
i. Ankle sprain iv. Quadriceps muscles
ii. Fracture post lip of tibia c. Common complications of this fracture:
iii. Fracture medial malleise i. Femoral nerve injury
iv. All of the above ii. A vascular necrosis of the femoral head
b. X-ray of the ankle and foot was done and showed fracture of medial iii. Sclatic nerve injury
and lateral melleoli. Diagnosis is: iv. All of the above
i. Pott’s Fx d. Prior to admission, this should be done at the ER:
ii. Lisfranc’s Fx i. Skeletal traction
iii. Cotton’s Fx ii. Skin traction
iv. Gosselin’s Fx iii. Spica cast
c. If the above x-ray findings is accompanied by fracture of the posterior iv. Multiple pinning on the hip
of tibia, the dx would be: 53. C.K. 58y/o male, while walking slipped and supported his weight w/ an
i. Pott’s Fx oustreched R upper extremity. PPE: (+) swelling right wrist, (+) deformity.
ii. Lisfranc’s Fx a. The deformity of the right wrist was noted to be dinner fork. This
iii. Cotton’s Fx deformity is associated with
iv. Chopart Fx i. Monteggia’s fx
d. The above case (reference to b) is best managed by: ii. Barton’s fx
i. Application of elastic bandage iii. Smith’s fx
ii. Short leg circular cast iv. Colle’s fx
iii. Long leg circular cast b. X-ray examination to requested in this case:
iv. ORIF i. X-ray right wrist APL
51. G.S. 5y/o male come in at the ER because of pain and swelling of the right ii. X-ray R whole upper ext. APL
elbow. History of fall hitting his right elbow on the ground few minutes PTC. iii. X-ray R wrist and hand APO
PPE: severe swelling Right elbow, (+) hematoma post aspect distal arm. iv. X-ray R forearm including wrist and elbow APL
a. Possible diagnosis c. Expected x-ray findings in this case:
i. Colle’s Fx i. Fx of the distal radius with the distal fragment displaced ventrally
ii. Supracondylar Fx ii. Fx of the distal radius with the distal fragment displaced dorsally
iii. Smith’s Fx iii. Undisplaced fx of the radius and una
iv. All of the above iv. Any of the above
b. X-ray examination to be requested: 54. Closed reduction under L.A. was done. To maintain reduction we have to
i. Xray R forearm APL apply:
ii. Xray R elbow APO a. Long arm posterior mold
iii. Xray R elbow APL b. Short arm posterior mold
 c. Long arm circular cast b. Short leg circular cast
d. Shoulder spica cast c. Spica cast
55. Special x-ray technique allowing visualization of spinal cord: d. Sugar tong cast
a. Discography 68. Boyd and ??? is a classification for
b. Myolography a. Femoral neck fx
c. Arthography b. Femoral shaft fx
d. MRI c. Intertrochanteric fx
56. A decrease in the normal carrying angle of spinal cords: d. Pott’s fx
a. Coxa vara 69. Partially displaced femoral neck fracture
b. Genu valgus a. Garden’s I
c. Cubitus valgus b. Garden’s II
d. Cubitus varus c. Garden’s III
57. Joint replacements d. Garden’s IV
a. Arthrodesis 70. Cabitus vasus is an example of
b. Arthroplasty a. Nonunion
c. Arthrotomy b. Malunion
d. Arthrogryposis c. Delayed union
58. The position of comfort for the wrist: d. A & C
a. Dorsifexion 71. Period of observation for spontaneous recovery of radial nerve injury
b. Palmar flexion a. 4wks
c. Neutral b. 8wks
d. None of the above c. 12wks
59. A decrease in femoral neck shaft angle less than 1300 d. 16wks
a. Genu valgus 72. In development dysplasia of the hip, if we do Barlow’s test, the hip is being
b. Coxa vara a. Dislocation
c. Coxa valgu b. Reduced
d. Genu varum c. Abducted
60. March fracture is an example of: d. Adducted
a. Pathologic fracture 73. The management of ??? in infants 8 months old
b. Stress fracture a. Traction
c. Segmental fracture b. Manipulation
d. None of the above c. Casting
61. Overlapping of fragments can results to d. All of the above
a. Angulation
b. Shortening NeuroSx
c. Rotation
d. None of the above 1. Cushing triad is the response of the body to increased intracranial pressure.
62. Absolute indications for open reduction These are:
a. Nonunion a. Systemic arterial hypertension, respiratory irregularities and
b. Delayed bradycardia
c. Multiple fractures b. Systemic arterial hypotension, respiratory irregularities and
d. All of the above bradycardia
63. Contraindications for open reductions c. Systemic arterial hypertension, respiratory irregularities and
a. Active infection tachycardia
b. Undisplaced fractures d. Systemic arterial hypotension, respiratory irregularities and
c. Bone so weak tachycardia
d. All of the above e. Normal systemic blood pressure, respiratory irregularities and
64. Most common complications of humeral shaft fractures tachycardia
a. Ulnar nerve injury 2. Increased intracranial pressure is pressure above:
b. Radial nerve injury a. 50mm water
c. Median nerve injury b. 100mm water
d. All of the above c. 150 mm water
65. Maximum weight that can be used for skin traction: d. 15mmHg water
a. 6-7lbs e. 25mm water
b. 6-7kgs 3. A sign of basal skull fracture is
c. 10lbs a. Doll’s eye reflex
d. 10kgs b. Battle’s sign
66. Pauwel’s classification is related to: c. Cheyne-stroke respiration
a. Intertrochanteric fx d. Deteriorating Glasgow coma score
b. Femoral neck fx 4. Spontaneous intracerebral hemorrhage is caused by
c. Supracondylar fx a. Tumor
d. None of the above b. Aneurysm
67. What cast is ideal for femoral shaft fractures: c. Arteriovenous malformation
a. Long leg circular cast d. Hypertension
5. A 56 year male with hypertension complained of headache with severe a. MRI of the spine spinal cord; plain and with contrast
dizziness. There was associated vomiting. His most likely diagnosis is b. CT scan of the spine/spinal cord, plain and with contrast
a. Pontine hemorrhage c. Myelogram
b. Lobar hemorrhage d. Spine X-ray
c. Cerebellar hemorrhage e. CI myelogram
d. Subarachnoid hemorrhage 16. What is an example of a primitive neuroectodermal tumor?
6. Battle’s sign is a. Astrocytoma
a. Discoloration of the eyelids b. Meningioma
b. Discoloration over the mastoid c. Pituitary adenoma
c. Contusion of the temporal lobe d. Medulloblastoma
d. Counter coup injury e. All of the above
e. A sign of brainstem contusion 17. What is an example of a nerve sheath tumor?
7. Hydrocephalus because of increased production of CSF can be caused by a. Meningioma
a. Fibrosis along the subarchnoid space b. Astrocytoma
b. Choroid plexus papilloma c. Schwannoma
c. Ependymoma of the 4th ventricle d. Ependymoma
d. Aqueductal stenosis e. Metastatic tumor
e. Thalamic glioma 18. What is the most common posterior fossa tumor in adults?
8. The most common location primary intracerebral hematoma is a. Meningioma
a. Cerebellum b. Astrocytoma
b. Vassal ganglia c. Glioblastoma multiforme
c. Thalamus d. Acoustic schwannoma
d. Pons e. Pontine glioma
e. Ventricle 19. This most likely diagnosis is
9. The most common malignant tumor of the brain is a. Cerebral contusion
a. Glioblastoma multiforme b. Cerebral concussion
b. Malignant astrocytoma c. Acute subdural hematoma
c. Malignant meningioma d. Epidural hematoma
d. Metastatic tumor e. Chronic subdural hematoma
e. Malignant oligodendraglioma 20. Cranial CT scan on this patient would reveal
10. Where is the most common location of brain tumors in children a. Non-homogenous areas in the brain
a. Frontal lobe b. Diffuse edema of the brain
b. Lateral ventricle c. Crescent-shaped lesion beneath the skull
c. Infratentorial region d. Lens-shaped lesion beneath the skull
d. Supratentorial region e. A ruptured aneurysm
e. Pineal region 21. Chronic subdural hematomas are usually caused by
11. Management of intracerebral hemorrhage include a. Laceration of the middle meningeal artery
a. Antiplatelet and antihypertensive drugs b. Bleeding from the bone
b. Ventilatory support and tissue-dehydrating agents c. Ruptured aneurysm
c. Ventilatory support and antiplatelet medications d. Laceration of the bridging veins of the cerebral cortex
d. Antiplatelet medication and surgery e. Cerebral contusion
12. Secondary injury to the nervous system is 22. The most common cause of subarachnoid hemorrhage is
a. An evolving process that results in additional progressive a. Ruptured aneurysm
cellular damage b. Head trauma
b. A direct result of inappropriate intervention done on the patient c. Lacerated middle meningeal artery
c. Initial biomechanical damage that occurs immediately upon d. Ruptured AVM
injury e. All of the above
d. Ischemia due inadequate blood supply to the brain 23. What should a physician suspect in a patient with Raccoon’s eye?
e. None of the above a. Ruptured aneurysm
13. The most common complain of patients with subarachnoid hemorrhage b. Ruptured AVM
because of a ruptured aneurysm is c. Intracranial tumor
a. Nuchal rigidity d. Basal skull fracture
b. Loss of consciousness e. Bacterial meningitis
c. Nausea 24. A 65 y/o head-injured patient was brought to the ER. A companion said
d. Vomiting that he was crossing the street when he was hit by a passing car. There
e. Headache was immediate loss of consciousness. The patient was noted to be
14. Intracranial hematoma characterized by a lucid interval as part of the vomiting at the ER. He was examined. There was no verbal output, reacted
history is by extension of the extremities and eye opening to painful stimuli. His GCS
a. MRI of brain score an initial examination at the ER
b. Cranial CT scan a. 10
c. Skull X-Ray b. 8
d. EEG of the brain c. 6
e. Cranial ultrasound d. 5
15. What is the diagnostic procedure of choice for spinal cord tumors? e. 4
25. He was resuscitated and given medical decompression. His post d. Scalp and the bone
resuscitation response were eye ??? to painful stimulus, no verbal output e. Cortex and the ventricle
and localizes painful stimulus. His GCS post-resuscitation is 35. Acetozolamides is used to
a. 10 a. Decrease CSF production
b. 8 b. Decrease peritumoral edema
c. 6 c. Reduce vascular resistance
d. 5 d. Increase CSF production
e. 4 e. Increase CSF absorption
26. What is the diagnostic procedure of choice for head trauma? 36. The diagnostic procedure of choice in brain abscess is
a. MRI of brain a. Lumbar puncture
b. Cranial CT scan b. Blood culture
c. Skull x-ray c. Cranial CT scan with contrast
d. EEG of the brain d. Skull x-ray
e. Cranial ultrasound e. 4-vessel cerebral angiogram
27. Treatment of increased intracranial pressure with the fastest effect is 37. The most common location primary intracerebral hematoma is
a. Mannitol a. Cerebellum
b. Decompressive craniectomy b. Basal ganglia
c. Hyperventilation c. Thalamus
d. Dexamethasone d. Pons
e. Furosemide e. Ventricle
28. In a head injured patient, when the left pupil dilates, the pathology is 38. A 50y/o female, complaining of tinnitus, was noted to have decreased
commonly in the hearing of the left ear with difficulty in balancing. Her most probably
a. Left side diagnosis is:
b. Brainstem a. Acoustic neuroma at the left cerebellopontine angle
c. Ventricle b. Acoustic neuroma at the right cerebellopontine angle
d. Right side c. Ependymoma of the fourth ventricle
e. Cerebellum d. Cystic astrocytoma of the left cerebellar hemisphere
29. The most accurate intracranial pressure monitor is e. Metastatic tumor of the left cerebellar hemisphere
a. Epidural monitor 39. CT scan finding in a head injured man is a crescentic hyper dense mass of
b. Subdural monitor the right frontotemporarietal area. His diagnosis is:
c. Ventricular monitor a. Acute epidural hematoma
d. Parenchymal monitor b. Acute subdural hematoma
e. Subgaleal monitor c. Chronic subdural hematoma
30. The intracranial monitor which can be sued for monitoring and therapeutic d. Cerebral contusion
purposes is e. Subarachnoid hemorrhage
a. Epidural 40. Spinal cord injury characterized by ipsilateral motor paralysis, contra lateral
b. Subdural sensory deficit below the level of injury and ipsilateral sensory deficit at the
c. Parenchymal level of the injury is:
d. Ventricular a. Anterior cord syndrome
e. Vascular b. Central cord syndrome
31. A 40 y/o male consulted and was complaining of sudden severe headache c. Posterior cord syndrome
with associated nuchal rigidity. He was afebrile and the headache was not d. Hemistransection of the spinal cord
relived by analgesics. He most probably has e. Complete transaction of the spinal cord
a. Spontaneous intracerebral hemorrhage 41. The primary source of energy of the brain is
b. Ruptured aneurysm a. Glucose
c. Brain tumor b. Lipids
d. Hydrocephalus c. Proteins
e. Brain abscess d. Free fatty acids
32. The most common benign tumor in the pediatric age group is e. Glycogen
a. Glioblastoma multiforme 42. Increased intracranial pressure can be secondary to the following, EXCEPT
b. Benign cystic astrocytoma a. Blood clot
c. Grade III astrocytoma b. Increased CSF
d. Medullablastoma c. Decreased blood flow
e. Fibrillary astroyctoma d. Edema of the brain
33. An example of primary brain injury is e. Neoplastic lesion in the brain
a. Cerebral contusion 43. CSF production is
b. Epidural hematoma a. 3-6 ml/min
c. Subdural hematoma b. 3-5 ml/min
d. Cerebral edema c. 5-10 ml/min
e. Infection d. 10-15 ml/min
34. Epidural hematomas are located between the e. 15-20 ml/min
a. Bone and the golea 44. Hydrocephalus because o f increased production of CSF can be caused by
b. Cerebral cortex and the dura a. Fibrosis along the subarachnoid space
c. Bone and the dura b. Choroid plexus papilloma
 c. Ependymoma of the 4th ventricle c. Systemic arterial hypertension, respiratory irregularities and
d. Aqueductal stenosis tachycardia
e. Thalamic glioma d. Systemic arterial hypotension, respiratory irregularities and
45. Subdural hematomas are hematomas found between the tachycardia
a. Dural and the skull e. Normal systemic blood pressure, respiratory irregularities and
b. Dura and the arachnoid tachycardia
c. Arachnoid and the brain 53. Increased intracranial pressure is pressure above
d. Skull and the brain a. 50mm water
e. Scalp and the skull b. 100 mm water
46. A 15y/o boy fell from a bicycle and hits the right side of his head on the side c. 150 mm water
walk. He was dazed. He recovered after a couple of minutes and was able d. 200 mm water
to go home. One hour after he experienced severe headache. This was e. 25 mm water
followed by vomiting and drowsiness. He was brought to a hospital for 54. A sign of basal skull fracture is
treatment. The hospital he was noted to be sleeping. He has eye opening a. Doll’s eye
on verbal command. His GCS is b. Battle’s sign
a. 15 c. Dilated pupils
b. 12 d. Cheyne-stroke’s respiration
c. 10 e. Deteriorating Glasgow coma scale
d. 8 55. A head injured patient who does not open his eyes even to pain, mumbles
e. 6 incomprehensible sounds and localizes to painful stimulus has a Glasgow
coma scale of
A 10y/o boy fell while riding a bicycle. He hits his head on the sidewalk. He was a. 6
initially dazed but recovered and continued to bike. After 1 hour, he experienced b. 8
slight headache and decided to go home after 2 hours, the headache increased in c. 10
severity and he vomited twice. He was brought to the ER by his parents. At the d. 12
ER, he was noted to drowsy. He opens his eyes with painful stimulus. It was e. 14
noted localized painful stimulus and said incomprehensible sounds. 56. Intracranial hematoma characterized by a lucid interval as part of the
history is
47. His Glasgow coma score is a. Epidural hematoma
a. 10 b. Subgaleal hematoma
b. 9 c. Subdural hematoma
c. 8 d. Intracranial hematoma
d. 7 e. Intraventricular hematoma
e. 6 57. Epidural hematomas are commonly caused by
48. His most probable diagnosis is a. Laceration of the middle meningeal artery
a. Acute epidural hematoma b. Laceration of the superficial temporal artery
b. Acute subdural hematoma c. Laceration of the cortical bridging veins
c. Chronic subdural hematoma d. Burst fracture of cerebral cortex
d. Intracerebral hematoma e. Laceration of the intracranial internal carotid artery
e. Cerebral concussion 58. What is the most common cause of no-traumatic subarachnoid
49. His CT scan findings will probably show hemorrhage?
a. A lens-shaped hyperdense lesion beneath the skull a. Arteriovenous malformation
b. A crescentic-shaped hyperdense lesion beneath the skull b. Ruptured aneurysm
c. A crescentic-shaped hypodense lesion beneath the skull c. Intracerebral hematoma
d. Areas of hyperdense and hypodense lesion beneath the skull d. Tumors
e. Diffuse brain swelling e. Trauma
50. This lesion is commonly associated with 59. Spinal cord injury characterized by ipsilateral motor paralysis contralateral
a. Skull fracture sensory deficit below the level of injury and ipsilateral sensory deficit at the
b. Cerebral contusion level of the injury is:
c. Lacerated bridging vein a. Anterior cord syndrome
d. Hydrocephalus b. Central cord syndrome
e. Cerebral concussion c. Posterior cord syndrome
51. The vessel that caused the hematoma is d. Hemitransection of the spinal cord
a. Meningeal artery e. Complete transaction of the spinal cord
b. Bridging vein 60. The most common malignant tumor of the brain is
c. Cortical vein a. Malignant astrocytoma
d. Cortical artery b. Glioblastoma multiforme
e. Internal carotid artery c. Metastatic tumor
52. Cushing’s triad is the response o f the body to increased intracranial d. Malignant meningioma
pressure. These are: e. Malignant ependymoma
a. Systemic arterial hypertension, respiratory irregularities and 61. What is an example of an intramedullary spinal cord?
bradycardia a. Meningioma
b. Systemic arterial hypotension, respiratory irregularities and b. Schwannoma
bradycardia c. Neurofibroma
 d. Astrocytoma a. Putaminal
e. Metastatic tumor b. Cerebellar
62. What is the diagnostic procedure of choice for head trauma? c. Pontine
a. MRI of brain d. Subarachnoid
b. Cranial CT scan e. Thalamus
c. Skull x-ray 73. If sacral sparing is noted in a spinal cord tumor patient, where is the tumor
d. EEG of the brain most probably located?
e. Cranial ultrasound a. Extradural
63. What tumor can present as bitemporal homonymous hemianopsia and b. Intradural but extramedullary
acromegaly? c. Intradural and intramedullary
a. Pituitary adenoma d. Vertebral body
b. Craniopharyngioma e. Lamina
c. Meningioma 74. In what type of tumor is calcification seen in 50% of cases?
d. Astrocytoma a. Oligodendroglioma
e. Epenymoma b. Glioblastoma multiforme
64. Most commonly used for edema in head injured patient is c. Schwannoma
a. Methasome d. Hemagioblastoma
b. Phenytoin e. Meningioma
c. Mannitol 75. What is the fastest measure to decrease increased intracranial pressure?
d. Antibiotics a. Mannitol
65. What is the most common primary site of metastatic brain tumor? b. Furosemide
a. Breast c. Hyperventilation
b. Lung d. Surgery
c. GIT e. Steroids
d. Prostate 76. A patient with an intracerebral hematoma is hemiparetic. The sensory
e. GUT deficit is greater than the motor weakeness. His hematoma is probably in
66. The most common complain of patients with subarachnoid hemorrhage the
because of a ruptured aneurysm is: a. Basal ganglia
a. Seizure b. Thalamus
b. Loss of consciousness c. Ventricle
c. Nausea d. Pons
d. Vomiting e. Cerebellum
e. Headache 77. What herniation syndrome will manifest with small, reactive pupils,
67. Increased intracranial pressure can be secondary to the following EXCEPT repiratory irregularities and impaired consciousness?
a. Blood clot a. Subfalcine herniation
b. Increased CSF b. ??? herniation
c. Decreased blood flow c. Central transtentorial herniation
d. Edema of the brain d. Tonsillar herniation
e. Neoplastic lesion in the brain e. Brainstem herniation
68. What is the diagnostic procedure of choice for spinal cord tumors? 78. Which is an example of primary brain injury?
a. MRI of the spinal cord a. Cerebral infarction
b. CT scan of the spinal cord b. Epidural hematoma
c. Spine x-ray c. Brain infection
d. Myelography d. Cerebral ischemia
e. CT myelography e. Cerebral contusion
69. Spontaneous intracerebral hemorrhage is caused by 79. An evolving process that results in additional, progressive cellular damage
a. Tumor and dysfunction is
b. Aneurysm a. Cerebral contusion
c. Arteriovenous malformation b. Cerebral concussion
d. Hypertension c. Primary brain injury
e. Trauma d. Secondary brain injury
70. What should a physician suspect in a patient with Racoon’s eye? e. Counter coup injury
a. Ruptured aneurysm 80. What is an example of diffuse injury?
b. Ruptured AVM a. Cerebral contusion
c. Intracranial tumor b. Cerebral concussion
d. Basal skull fracture c. Intracerebral hematoma
e. Bacterial meningitis d. Comminuted skull fracture
71. Countre coup injury is e. Subdural hematoma
a. Injury to the dura resulting in a hematoma 81. In the management of a severely head-injured patient, what is the first step
b. Injury to the blood vessels causing hematoma formation in the management of the patient?
c. Injury opposite or remote from the site of direct trauma a. Quick neurologic exam
d. Injury at the site of trauma b. Cranial CT scan
e. Brain injury caused by head injury c. Check for a patent airway
72. The most common location of an intracerebral hemorrhage is d. Have intravenous access for medications
 e. Transport the patient to trauma center b. Seizures
82. What herniation syndrome will manifest with progressive deterioration of c. Hydrocephalus
consciousness hemiplegia and dilation of one pupil? d. Metabolic changes
a. Subfalcine herniation e. Vasospasm
b. Uncal herniation 91. What type of malformation is most clinically significant and has the
c. Central transtentorial herniation greatest tendency to bleed?
d. Tonsillar herniation a. Venous malformation
e. Brainstem herniation b. Capillary telangiectasia
83. The initial chemical damage that occurs immediately upon injury is c. Cavernous malformation
a. Primary injury d. Arteriovenous malformation
b. Secondary injury e. Cavernoma
c. Cerebral ischemia 92. Which tumors is characterized by the following histopathologic findings
d. Intracerebral hematoma anaplasia mitosis endothelial proliferation and necrosis?
e. Counter coup injury a. Glioblastoma multiforme
84. What type of intracranial hematoma is usually seen in older patients with b. Anaplastic astrocytoma
brain atrophy? c. Medullablastoma
a. Epidural hematoma d. Oligodendroglioma
b. Acute subdural hematoma e. Pituitary adenoma
c. Cerebral contusion 93. What tumor is commonly associated with increased CSF production
d. Diffuse axonal injury a. Ependymoma
e. Chronic subdural hematoma b. Medulloblastoma
85. What is the drug of choice in acute spinal injury? c. Pineal tumor
a. Dexamethasone d. Pituitary adenoma
b. Mannitol e. Choroid plexus papilloma
c. Furosemide
d. Acetazolamide A 65y/o head injured patient was brought the ER. A companion said that he was
e. Methylprednisolone crossing the street when he was hit by a passing car. There was immediate loss
86. Which of the following condition cause non-communicating type of of consciousness. The patient was noted to be vomiting at the ER he was
hydrocephalus? examined. There was no verbal output reacted by extension of the extremities
a. Subarachnoid hemorrhage and no eye opening even to the painful stimulus
b. Meningitis
c. Superior sinus thrombosis 94. His GCS score on initial examination a the ER is
d. Aqueductal stenosis a. 10
e. Spinal cord tumor b. 8
c. 6
A 15y/o boy fell from his scooter and hits his right side of his head on the d. 5
sidewalk. He is initially dazed. He recovered after a couple of minutes and was e. 4
able to go home. After one hour he experienced a severe headache. This was 95. He was resuscitated and given medical decompression. His post
followed by vomiting and drowsiness. He was brought to a hospital for further resuscitation response were eye opening to painful stimulus no verbal
treatment. In the hospital, he was noted to be sleeping. He has spontaneous eye output even to pain and localize painful stimulus. His GCS post-
opening localizes, painful stimuli and gave confused answers to question. resuscitation is
a. 9
87. His Glasgow Coma score is b. 8
a. 13 c. 6
b. 11 d. 5
c. 10 e. 4
d. 8 96. On cranial CT scan it showed homogenous areas of increased density with
e. 6 areas of edema or hypodensity within the brain parenchyma. Based on the
88. The diagnosis of the patient above is CT scan, his diagnosis is
a. Cerebral concussion a. Epidural hematoma
b. Epidural hematoma b. Acute subdural hematoma
c. Cerebral contusion c. Chronic subdural hematoma
d. Diffuse axonal injury d. Cerebral contusion
89. Where is the most probable location of the hematoma in a patient that e. Cerebral concussion
presents with paralysis decerebrate posturing on painful stimuli and small
pinpoint pupils?
a. Cerebellum
b. Basal ganglia
c. Thalamus
d. Pons
e. Putamen
90. What complication of subarachnoid hemorrhage is commonly seen
between the 4th and 10th day after the bleed?
a. Cardiac abnormalities