1 / 33

Board Questions and Answers

Board Questions and Answers. Question 4. Surgical procedures utilized in the treatment of spasmodic torticollis include: Upper cervical ventral rhizotomies and spinal accessory neurectomy Stereotactic thalamotomy Microvascular decompression of the spinal accessory nerve myotomy.

dianthe
Télécharger la présentation

Board Questions and Answers

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Board Questions and Answers

  2. Question 4 • Surgical procedures utilized in the treatment of spasmodic torticollis include: • Upper cervical ventral rhizotomies and spinal accessory neurectomy • Stereotactic thalamotomy • Microvascular decompression of the spinal accessory nerve • myotomy • I, II, III • I, III • II, IV • IV • All of the above

  3. Answer 4 • Torticollis that is refractory to medical therapies and relaxation techniques can be treated with selective rhizotomy of the spinal accessory nerve-81-97% improve • Myotomy was the earliest surgical procedure used to treat torticollis • 70% patients improve after MVD of spinal accessory nerve • Roughly 2/3 patients have good result after stereotactic thalamotomy

  4. Question 5 • Which surgical approach for thoracic disk herniations is associated with the highest rate of neurologic injury • Costotransversectomy • Lateral extracavitary • Midline Laminectomy • Transpedicular • Thransthoracic

  5. Answer 5 • There are reports that thoracic laminectomy performed for thoracic diskectomy is associated with unacceptably high rates of morbidity and mortality. It is estimated that there is at least a 45% chance of experiencing neurological deterioration or no benefit with this approach.

  6. Answer 5

  7. Question 6 • Most patients with intrinsic brainstem gliomas initially present with: • Cranial neuropathies • Headache • Hydrocephalus • Nausea and vomiting • Papilledema

  8. Answer 6 • Cranial nerve palsies and weakness/ataxia (in that order) are the initial symptoms • Headache, N/V, Papilledema are late findings. • These are symptoms related to hydrocephalus

  9. Question 7 • Each of the following is characteristic of complex regional pain syndrome II (causalgia) except: • Atrophic changes in the limb • Hypesthesia • Increased sweating • Lack of major motor deficit • Good relief with sympathetic block

  10. Answer 7

  11. Question 8 • For the following questions, match the description with the structure. • A. Dermoid cyst • B. Epidermoid cyst • C. both • D. Neither • 1. Bacterial meningitis • 2. Aseptic meningitis • 3. Associated congenital malformations • 4. Most often midline • 5. Responsive to radiation therapy

  12. Answer 8 • Dermoid Cyst: • Occur in midline (lumbosacral spine, parasellar, post. Fossa) • Capsular calcification sometimes bright on T1 • 0.3% brain tumors • Occur when cell rests with dermal and epidermal componenets are included in neural ectoderm • Communication with exterior predisposes to bacterial meningitis • Seen mostly in peds-congenital malformations • Epidermoid Cyst: • Found off midline (CPA, parasellar, middle fossa) • Signal characteristics of csf-increased signal on dwi • Comprise 0.5-1.8% brain tumors • Result from epidermal cell rests • Spillage casuses aseptic meningitis • Seen mostly in adults

  13. Question 9 • Ventricular enlargement from choroid plexus papillomas can be secondary to : • I. Entrapment of CSF • II. Decreased absorption of CSF from hemorrhage-indrucedarachnoiditis • III. Tumor Growth • IV. Excessive production of CSF • A. I, II, III • B. I, III • C. II, IV • D. IV • E. all of the above

  14. Answer 9 • Cause hydrocephalus by obstruction of CSF pathways and overproduction of CSF • Most common in lateral ventricles in children/ fourth ventricle in adults • Vascular tumor that occasionally cause intraventricular hemorrhage • Prominent enhancement with contrast-usually show feeding vessels from choroidal vessels on angiography. • Surgical removal is the treatment of choice.

  15. Question 10 • Which approach is favored for a patient with an 8 mm acoustic neuroma in which hearing preservation is a goal

  16. Answer 10 • Good results of hearing preservation have been reported with both the suboccipital approach and middle fossa approach to acoustic neuromas. • The middle fossa approach is best used for small laterally placed tumors in the IAC. • Hearing preservation results ranging from 52% to 100% have been described in the literature. • The hearing preservation rates for the middle fossa approach and suboccipital approach were 57% and 47%, respectively • tumors between 1 and 2 cm, hearing preservation rates for the middle fossa approach and retrosigmoid approach were 0% and 47%,

  17. Question 11 • Uncinate seizures typically produce: • A. Auditory hallucinations • B. Gustatory hallucinations • C. Olfactory hallucinations • D. Vertiginous sensations • E. Visual seizures

  18. Answer 11 • C. Olfactory hallucinations. • olfactory auras are more commonly associated with temporal lobe tumors (hamartomas and gliomas) than with other causes of temporal lobe epilepsy • pathway may be from the amygdala which receives input from the olfactory tract to the corticomedial nucleus under the pyriform cortex • pyriform cortex is the primary olfactory cortex

  19. Question 12 • Match the description with the structure • A. Calcarinesulcus • B. Lateral mesencephalicsulcus • C. Posterior communicating artery • D. Tectal plate • Separates the P1 and P2A segments of the PCA • Separates the P2A and P2P segments of the PCA • Separates the P2P and P3 segments of the PCA • Separates the P3 and P4 segments of the PCA

  20. Answer 12 • The PCA was divided into four segments: • P1 was the segment proximal to the posterior communicating artery (PCoA); • P2 extended from the PCoA to the posterior margin of the midbrain and was subdivided into an equal anterior (P2A) and posterior (P2P) half; • P3 began at the posterior midbrain, ran within the quadrigeminal cistern, and ended at the anterior limit of the calcarine fissure

  21. Question 13 • The radial nerve or one of its branches innervates each of the following except the: • A. Abductor pollicislongus • B. Adductor pollicis • C. Brachioradialis • D. Extensor pollicisbrevis • E. Supinator

  22. Answer 13 • Musculocutaneous: • Coracobrachialis, biceps brachii, brachialis • Axillary: • Teres minor and deltoid • Radial: • Triceps, anconeus, brachioradialis, extesnorcarpiradialis (brevis/longus), supinator • PIN: abductor pollicislongus, extensor pollicislongus/brevis, extensor indices, extensor carpiulnaris, extensor digitorum, extensor digitiminimi

  23. Answer 13 • Median: • Flexor carpiradialis, palmarislongus, flexor pollicisbrevis (sup head), flexor digitorumsuperficialis, flexor digitorumprofundus, abductor pollicisbrevis, opponenspollicis, lumbricals (2,3) • AIN: flexor pollicislongus, pronatorquadratus, flexor digitorumprofundus • Ulnar: • Flexor carpiulnaris, flexor digitorumprofundus, adductor pollicis, palmarisbrevis, flexor pollicisbrevis (deep head), lumbricals (4,5), hypothenar muscles, palmar and dorsal interossei

  24. Question 14 • Each of the following is true of intraventricular hemorrhage in the newbown except: • A. Periventricular hemorrhagic infarction is one sequela • B. Posthemorrhagic hydrocephalus can result in peristentbradycarida and apneic spells. • C. The capillary bed of the germinal matrix is composed of large irregular vessels. • D. The germinal matrix is the most common site of IVH in the full-term neonate • E. The risk of IVH is greater in the preterm than in the term infant

  25. Answer 14 • The most common site of IVH in a full term neonate is the choroid plexus • The most common site of IVH in a pre-term neonate is the germinal matrix • Pathogenesis of hemorrhage involves hypoxic injury to the fragile microcirculation of the germinal matrix, which leads to loss of autoregulation, overperfusion, and hemorrhage

  26. Question 15 • The ossification centers of the odontoid consist of: • A. One primary and two secondary centers • B. One secondary and three primary centers • C. Three secondary and one primary center • D. Two primary centers • E. Two primary and one secondary center

  27. Answer 15 • E. Two primary and one secondary centers • The secondary center is apical • The primary centers lie inferiorly on either side of midline

  28. Question 16 • The most common single-suture synostosis is: • A. Coronal • B. Lambdoid • C. Metopic • D. Sagittal • E. Sphenozygomatic

  29. Answer 16 • Sagittal (scaphocephaly) • Accounts for up to 50% in some studies • Increased AO skull diameter and narrowed biparietal diameter. • Coronal synostosis • Brachycephaly-increased bitemporal diameter and bulging forehead • Oxycephaly-slightly retroverted forehead • Turricephaly-high/vertical forehead • Metopic (Trigonocephaly) • Wedge-shaped head

More Related