Neurosurgery MCQ Bank

A 45/M presents with sudden onset severe headache described as "the worst headache of my life." CT scan shows hyperdense material in the basal cisterns. What is the most appropriate immediate management?

• Administer IV mannitol

• Perform lumbar puncture

• Secure airway and obtain neurosurgical consultation

• Start IV nimodipine

Which is the most common location for hypertensive intracerebral hemorrhage?

• Cerebellum

• Pons

• Putamen/basal ganglia

• Lobar (subcortical)

A 25/M presents after a motor vehicle accident with clear fluid draining from his nose. Which test would best confirm CSF rhinorrhea?

• Glucose level of nasal fluid

• Beta-2 transferrin

• Protein electrophoresis

• Specific gravity

What is the most common primary brain tumor in adults?

• Meningioma

• Glioblastoma multiforme

• Astrocytoma

• Oligodendroglioma

A patient with a traumatic brain injury has an ICP of 25 mmHg and CPP of 55 mmHg. What should be the immediate management priority?

• Hyperventilation to PCO2 of 25 mmHg

• IV mannitol 1 g/kg

• Elevate head of bed to 30 degrees

• Emergency craniectomy

Which cranial nerve is MOST commonly affected in acoustic neuroma?

• Facial nerve (VII)

• Vestibulocochlear nerve (VIII)

• Trigeminal nerve (V)

• Glossopharyngeal nerve (IX)

What is the gold standard imaging for diagnosing cerebral aneurysms?

• CT angiography

• MR angiography

• Digital subtraction angiography

• Transcranial Doppler

A 70/F presents with progressive gait instability, urinary incontinence, and dementia. Imaging shows enlarged ventricles. What is the most likely diagnosis?

• Alzheimer's disease

• Normal pressure hydrocephalus

• Multi-infarct dementia

• Parkinson's disease

What is the most appropriate initial treatment for an epidural hematoma in a conscious patient?

• Observation with serial neurological exams

• Medical management with mannitol and steroids

• Immediate surgical evacuation

• Lumbar drain placement

Which type of cerebral edema responds best to corticosteroids?

• Cytotoxic edema

• Vasogenic edema

• Interstitial edema

• Osmotic edema