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Total questions: 135

Worksheet time: 2hrs 26mins

Name
Class
Date
1.

Drilling IAC, batas anterior dan posterior ...

4 lines
2.

Berikut ini yang merupakan kontraindikasi pemasangan ICP adalah ...

(Marshall score CT scan, Marshall Gr 2, ga boleh dipasang ICP (NSA))

a)

Diffuse injury grade III

b)

Diffuse injury grade II

c)

Pasien dengan cedera thoraks berat dengan sedasi dalam

d)

....

e)

....

3.

Which one of the following is the least approprate indication for placement of ICP Monitor in TBI

a)

GCS 3-8

b)

Difuse injury type II (NSA)

4.

Absolute contraindication vertebral augmentation is ....

4 lines
5.

Spina bifida, dikasih gambar MRI : Patologi terkait apa? (Secondary to premature disjunction)

4 lines
6.

Prognosa GBM dari yang terbaik sampai yang terburuk :

a)

IDH Mutant Gr 3 > IDH Mutant Gr 4 > IDH Wildtype Gr 3 > IDH Wildtype Gr 4

b)

IDH mutant grade 3 > IDH wild type grade 3 > IDH mutant grade 4 > IDH wild type grade 4

c)

IDH Mutant Gr 3, IDH Mutant Gr 4, IDH Wildtype Gr 3, IDH Wildtype Gr 4

d)

....

e)

.....

7.

Bapak2, ada DM, ada demam, MRI nya T1 menyegat kontras cavernous kanan; Itu apa?

4 lines
8.

Dilakukan studi pada 30.000 orang pasien dari tahun 2001 – 2008, didapatkan hasil nyeri punggung terbanyak adalah ....

Jenis studi yang paling cocok adalah (Tanpa kunci)

a)

  1. Retrospektif kohort

b)

Crosssectional

9.

A 45 years old male present to an emergency room with fever, nausea, vomiting, and severe headache. CT of the brain is normal. Lumbar puncutre reveale sligthly elevated red blood cells, but normal protein, glucose, white blood cells count and no xantochromia. His Angiogram depicted below:

What is the most likely etiology of the abnormality depicted in the angiogram below?

a)

Infection

b)

Head trauma

c)

Genetic predisposition

d)

Collagen vascular disease

e)

Hypertension

10.

Pasien dengan stroke disartria dan hemiparese, onset 30 menit, dibawa EMS, curiga LVO. Pilihan terbaik selanjutnya pasien dibawa ke ....

Tanpa kunci

a)

RS dengan pelayanan stroke ready dengan jarak tempuh 45 menit

b)

RS dengan pelayanan comprehensive dengan jarak tempuh 60 menit

c)

.....

d)

......

e)

.....

11.

Seroang pasien usia 91 th, didapatkan penurunan kesadaran (GCS 8), didapatkan ICH supratentorial 35 cc, IVH (+), riwayat DM (+), hipertensi (+), berapakah angka mortalitas pasien tersebut dalam waktu 30 hari?

a)

26%

b)

72%

c)

97%

d)

100%

12.

Dibawah ini benar mengenai Baby shaken syndrome, kecuali...

(tidak ada kunci)

a)

Retinal hemorrage dengan subdural

b)

Retinal hemorage

c)

.....

d)

.....

13.

Translabyrinth approach , yang dimonitor apa?

(a)  

14.

Fungsi SSEP kecuali...

(a)  

15.

Dikasi gambar durante ETV uda jebol : dikasih panah , kayanya hipotalamus

(tidak ada kunci)

4 lines
16.

Pituitary adenoma, pituitarinya terdorong kemana?

4 lines
17.

Struktur diatas pituitary adenoma

(a)  

18.

Pituitary apoplexy, acute visual field loss, steroid (?)

4 lines
19.

Vestibular schwannoma, ada pembuluh darah diantara basilar dan tumor

(a)  

20.

Kejang dengan aura nya mual, dikasih MRI, sumber kejang dari mana?

(Tidak ada kunci)

a)

Gyrus Angularis

b)

Gyrus temporalis superior

c)

Insula

21.

Kejang dengan MRI yang di atas, patogenesisnya?

4 lines
22.

Perbedaan dari edema vasogenic pada tumor dengan edema sitotoksik adalah ...

(Tidak ada kunci)

a)

Mencapai gray white matter junction

b)

Tidak mencapai gray white matter junction

c)

Berbentuk oval

d)

Berbentuk

23.

Perbedaan dari edema vasogenic pada tumor dengan edema sitotoksik adalah ...

(tidak ada kunci)

a)

Mencapai gray white matter junction

b)

Tidak mencapai gray white matter junction

c)

Berbentuk oval

d)

Berbentuk ....

24.

Operasi schwannoma vestibular membutuhkan ...

(tidak ada kunci)

a)

BAER & VII

b)

SSEP & VII

c)

BAER & SSEP

25.

Bila didapatkan penurunan fungsi ... (???) maka pada pemeriksaan BAER gelombang yang akan menghilang adalah ...

(Tidak ada kunci)

a)

I

b)

II

c)

III

d)

IV

e)

V

26.

schwannoma vestibular, grading Koos....

a)

.

b)

.

c)

.

d)

.

27.

N. VII terdorong oleh schwannoma vestibular ke arah ....

(Tidak ada kunci)

a)

Anterosuperior

b)

Posterosuperior

c)

Anteroinferior

d)

Posteroinferior

28.

Mata kanan tertarik kemedial, jalan kepala harus melirik kekanan

(a)  

29.

Bias kalau sudah tau pengelompokannya.

(a)  

30.

Seorang ibu post trauma, mengeluh nyeri lengan...(dst), diagnosis ...

(Tidak ada kunci)

a)

Brachial plexitis

b)

Radiculopathy

c)

TOS (Thoracic outlet syndrome)

31.

Sebuah perusahaan melakukan trial obat untuk tatalaksana DM tipe 1 dalam jumlah populasi under optimal condition, hal ini dilakukan untuk menilai ....

(Tidak ada kunci)

a)

Efficacy

b)

Efficiency

c)

Safety

32.

Trial implantation boleh jadi permanen kalau perbaikannya berapa persen?

(Tidak ada kunci)

a)

75%

b)

50%

c)

55%

33.

Berikut tumor yang paling radiosensitive....

a)

Small lung cell carcinoma

b)

Melanoma maligna

c)

Adenocarcinoma

d)

Multipel mieloma

e)

Renal cell carcinoma

34.

Anak2 5 th, reseksi ependymoma, MRI Post op bersih :

(Tidak ada kunci)

a)

Observasi

b)

Radioterapy

c)

Chemoradiotherapy

35.

SAH Grading Fisher dikasih CT Scan


(a)  

36.

Choroid plexus papiloma, dapet vaskularisasi :

(a)  

37.

Numbness digiti 1,2 Tinnel (+) in forearm, formarm pain :

(a)  

38.

Anak2 paska dilakukan operasi jantung ai VSD, paska operasi didapatkan kelemahan kedua anggota gerak bawah. Hal yang menyebabkan hal ini adalah (a)  

39.

Prostat cancer, nyeri punggung, tumor di corpus dan pedicle (Xray) :
(tidak ada kunci)

a)

Workoup meta

b)

Instrumentasi

c)

Biopsi

40.

Seorang pasien laki-laki, paska operasi kraniotomi eksisi tumor, pasien cencerung tidur, tidak mau makan dan sulit untuk diajak berkomunikasi. Lokasi kelainan yang paling mungkin menyebabkan hal ini adalah

(tidak ada kunci)

a)

Bifrontal lobe

b)

Frontal lobe

c)

Anterior cingulate

41.

Nerve avulsion

(a)  

42.

Pasien setelah operasi vestibular schwannoma mengeluh sakit kepala yang tidak pernah dirasakan sebelumnya, nyeri kepala berkurang dengan pemberian morfin. Tatalaksana selanjutnya adalah .....

(Tidak ada kunci)

a)

MRI

b)

Psikiater

c)

Ganti obat

d)

Opioid lainnya

e)

RF

43.

Seorang pasien laki-laki, paska operasi kraniotomi eksisi tumor, pasien cencerung tidur, tidak mau makan dan sulit untuk diajak berkomunikasi. Lokasi kelainan yang paling mungkin menyebabkan hal ini adalah ....

a)

Bifrontal lobe

b)

Frontal lobe

c)

Anterior cingulate

44.

Ibu hamil 14 minggu, datang dengan keluhan penurunan kesadaran, setelah pemberian deksamethasone kondisi pasien perbaikan, tapi masih ada hemiparese. Tumor ukuran 5 cm dengan edema perifokal, tindakan selanjutnya ....

(tidak ada kunci)

a)

Terminasi kehamilan

b)

Tunggu sampai trimester 2 atau 3

c)

Radioterapi

d)

Operasi lanjut kemoradiasi

45.

  1. Anak2 dirujuk dengan masa frontal. Riwayat trauma. CT Scan growing fracture frontal. Tatalaksana?



(a)  

46.

  1. MRI Leptomeningeal cyst



(a)  

47.

  1. Vagal nerve stimulator (VNS) batas usia boleh dipasang. Dan efikasi berapa lama



(a)  

48.

  1. Pemeriksaan imaging yg membantu deteksi CSF leakage pada fraktur depressed



(a)  

49.

  1. Beberapa soal kasus yg pilihan opsinya ada Piriformis syndrome, Sciatica



(a)  

50.

  1. Ada soal kasus dgn Tinnel positif (ada pilihan Carpal Tunnel Syndrome)



(a)  

51.

Pasien post fusi L4-S1, 1 minggu post fusi membaik 85%, datang lagi nyeri (FBS) : Studi selanjutnya :

(a)  

52.

Vagal nerve stimulator (VNS) batas usia boleh dipasang. Dan efikasi berapa lama?

(a)  

53.

Pemeriksaan imaging yg membantu deteksi CSF leakage pada fraktur depressed

4 lines
54.

Beberapa soal kasus yg pilihan opsinya ada Piriformis syndrome, Sciatica

4 lines
55.

Ada soal kasus dgn Tinnel positif (ada pilihan Carpal Tunnel Syndrome)

4 lines
56.

Spine: ada gambar MRI T2 lumbosacral terus L4-5 ada hiperintense bulat (tidak ada kunci)

a)

epidural abcess

b)

epidural metastasis

c)

....

d)

.....

57.

Gambaran coronal MRI dgn massa suprasella kemudian ditunjuk struktur apa? (Pilihan optic nerve, stalk)

4 lines
58.

Gambaran coronal MRI dgn massa kistik suprasella pituitary terdorong ke arah mana (anterior inferior, anterior lateral dll)

4 lines
59.

Untuk tumor yang terletak pada bagian posterior dari ventrikel III approach mana yg sulit (ada pilihan jenis2 via trans callosal)

4 lines
60.

Endoscopic transnasal akan terhalangi struktur apa (medial turbinate, superior turbinate, septum nasi dll)

4 lines
61.

Pasien sudah terpasang ventrikulostomi dgn peningkatan ICP, apa tindakan yg dapat lgsg menurunkan TIK (CSF drainase, manitol, hiperventilasi dll)

4 lines
62.

Foto gambaran tension pneumocephalus. Apa tindakan yg kurang tepat dilakukan (pasang EVD untuk air suction, decompressive craniecromy)

4 lines
63.

Lokasi CN VII tertekan ke arah mana terhadap Schwannoma. Pilihan ada Anterior inferior dll)

4 lines
64.

Ada soal kata kuncinya Germinoma, PALP, bHCG

4 lines
65.

Klinis Horner syndrome diplopia kira2 lokasi tumor dimana yg terlewatkan dari pemeriksaan yg ada (opsi cavernous sinus, dll)

4 lines
66.

Lateral Supracerebellar infratentorial alat diletakan di atas apa bagian pada cerebellum (klo ga salah opsi semilunar, vermis, dll)

4 lines
67.

Tumor vasogenic edema karakteristiknya pada imagin apa (circle, oval, daerah antara grey matter dan white matter dll)

4 lines
68.

Gambaran MRI Fibrous dysplasia os frontal mana tindakan lanjutan yg kurang sesuai (observation, re surgery, radioterapi, kemoterapi)

4 lines
69.

Pasien mengalami perubahan sifat tidak nafsu makan, cuek, tumor lokasi di mana (opsi frontal bilateral, temporal dll)

4 lines
70.

Pemeriksaan imaging yg membantu deteksi CSF leakage pada fraktur depressed


(a)  

71.

Trus ada satu soal lagi post tumor resection dan chemo atau radio , trus satu tahun kemudian MRI ada temuan, pilihannya ada recurrence, radiasi necrosis atau pseudoprogression

(a)  

72.

Soal ttg fluorescent pada reseksi tumor, salah satu pilihan jawabannya fluorescent tergantung dari kerusakan bbb

4 lines
73.

Which form of systemic cancer therapy is associated with an increased risk of radiation necrosis after stereotactic radiosurgery for cerebral metastases?

a)

Angiogenesis Inhibitors (e.g. Anti-VEGF antibody)

b)

Glucocorticoid Therapy

c)

Tumor Targeted Chemotherapy (e.g. EGFR or ALK antagonists)

d)

Systemic Immunotherapy (e.g. PD-1 inhibitors)

e)

Cytotoxic Chemotherapy (e.g. DNA synthesis / Mitosis Inhibitors)

74.

Laki-laki usia 45 tahun menjalani operasi dengan pendekatan subtemporal untuk kasus tumor dengan elevasidura dari lantai fossa media dan tulang petros (?) reseksi tumor. Tindakan apa yang dapat membantu ahli bedah menyelesaikan masalah ini

a)

Identifikasi segitiga Trautman, dan ekspos ke arah medial dari landmark ini – presigmoid, schwannoma vestibular translabirinti transkoklear

b)

Drilling lebih lanjut arcuate eminence

c)

Drilling lebih lanjut dari segitiga Glasscock'

d)

Ekspos tambahan melalui kawase quadrilateral

e)

Modifikasi pendekatan dengan mengutilisasi koridor presigmoid

75.

A 45 yeard old male undergoes a subtemporal approach for tumor resection with elevation of the dura from the middle fossa floor and petrous bone

Structure visible on the floor of the middle cranial fossa during this exposure may include all of the following EXCEPT?

a)

Middle meningeal artery

b)

Trigeminal nerve

c)

Lesser superficial petrosal nerve

d)

Hyppglossal nerve

e)

Greater superficial petrosal nerve

76.

A 45 yeard old male undergoes a subtemporal approach for tumor resection with elevation of the dura from the middle fossa floor and petrous bone.

Post operatively the patient has decrease lacrimation on ipsilateral side. What is etiology problem?

a)

geniculate ganglion injury

b)

Chorda tympani injury

c)

Lesser petrosal nerve injury

d)

Injury of Jacobson nerve

e)

Greater petrosal nerve injury

77.

A 45 yeard old male undergoes a subtemporal approach for tumor resection with elevation of the dura from the middle fossa floor and petrous bone.

During surgery, additional expose is needed to access the upper petroclival region for tumor ressection. Which manuver may assist the surgeon in accomplishing this task?

a)

Further drilling of glasscock's triangle

b)

Additional drilling through kawase's quadrilateral

c)

further drilling to arcuate eminense

d)

Identifying Trautmanns triangle and exposing medially to this landmark

e)

Modifying the approach by utilizing presigmoid corridor

78.

Parkinsonian tremor can be diminished by high frequency stimulation of:

a)

Globus pallidus externa

b)

Subcaudate white matter

c)

ViM thalamus

d)

Cingulate bundle

e)

Dorsomedial thalamus

79.

During resection of a WHO grade II insular glioma, what white matter language tracts run through the tumor and under the insula?

a)

Arcuate fasciculus and medial longitudinal fasciculus

b)

Uncinate fasciculus and inferior fronto-occipital fasciculus

c)

Inferior fronto-occipital fasciculus and superior longitudinal fasciculus-temporal parietal portion

d)

Uncinate fasciculus and arcuate fasciculus

e)

Superior longitudinal fasciculus Ill and arcuate fasciculus

80.

A 42 year old male presents with a 5 year history of Parkinson disease (PD) with severe motor fluctuations. What would be his expected benefit from deep (?):

a)

BS will provide improvement in freezing of gait, a motor symptom frequently associated with Parkinson disease

b)

DBS will result in reduction in progression of the natural history of Parkinson disease.

c)

DBS will eliminate the need for Parkinson medications.

d)

DBS will provide no benefit, because he has not had the disease long enough.

e)

DBS will provide improvement in motor symptoms comparable to the effects of Levadopa medication, with less motor fluctuations and without the medication induced dyskinesia

81.

A 16 year old male with NF1 presents for follow-up 4 years after a diagnosis of a low-grade optic pathway glioma. After initial progression during early puberty, the tumor has been radiographically stable, no visual decline, What is the patients visual prognosis and need for follow-up?

a)

Vision will likely decline until tumor stabilizes, monitor until stabilization is confirmed.

b)

Vision will likely remain stable; no need for continued follow-up.

c)

Vision will likely decline until end of adolescence; monitor until age 18.

d)

Vision will continuously decline in adulthood; long-term follow-up is needed.

82.

Sisterna apakah yang di dalamnya terdapat arteri koroidalis anterior, arteri posterior serebri, arteri koroidalis posterior medial, dan basal vein Rosenthal?

a)

Quadrigeminal

b)

Ambient

c)

Crural

d)

Interpeduncular

e)

Carotid

83.

Manakah dari berikut ini yang paling akurat mengenai penempatan pedicle screw torakal?

a)

Entry poin dari titik prosesus transversus bertemu dengan posesus artikularis superior sedikit medial dari pars interarticularis

b)

Bervariasi luas tergantung dari level

c)

Pars interarticularis merupakan landmark yang kurang bermanfaat

d)

Trajektori Straight-head screw paralael ke joint facet

e)

Trajektori screw anatomi sepanjang axis panjang dari pedikel

84.

Site of entry for thoracic pedicle screw is best described as which one of the following?

a)

Where the facet joint and transverse process intersect

b)

Where the pars interarticularis and lam-ina intersect

c)

Where the superior facet and lamina intersect

d)

Where the inferior facet and lamina intersect

e)

Where the transverse process and lamina intersect

85.

Tampilan endoskopi dari dalam sinus sphenoid. Manakah dari label berikut yang secara tepat mengidentifikasi resesus optikokarotis?

a)

E

b)

F

c)

H

d)

D

e)

G

86.

What are the borders of Kawase's triangle?

a)

GSPN, arcuate eminence, inferior petrosal sinus, V2

b)

Arcuate eminence, inferior petrosal sinus, V2, V3

c)

V2, V3, and a line from the foramen rotundum and foramen ovale

d)

GSPN, arcuate eminence, superior petrosal sinus, V3

e)

Foramen spinosum, arcuate eminence, superior petrosal sinus, V3

87.

What is the most common presentation of a vein of Galen malformation in an adolescent patient?

a)

Hydrocephalus

b)

Headache or seizure

c)

Hemorrhage

d)

Heart failure

e)

Focal neurological deficit

88.

After being struck in the head, a 12 year old boy presents with a scalp laceration over a palpable skull deformity. A CT scan is obtained (Figure 1). His GCS 14. What is the most appropriate management for this injury?

a)

Venticulostomy for ICP management

b)

Bedside irrigation, debridement, and wound closure

c)

Bedside wound closure and IV antibiotics

d)

Allow wound to heal by secondary intention

e)

Surgical exploration, fracture elevation, and debridement

89.

When undertaking a trans-callosal approach for resection of a colloid cyst of the third ventricle, which of the following structures is the most useful landmark?

a)

Body of the thalamus

b)

Septum pellucidum

c)

Head of the caudate nucleus

d)

Septal vein

e)

Thalamostriate vein

90.

Pasien anak laki-laki, lahir secara per vaginam, didapatkan klinis seperti pada gambar. Bagaimana kemungkinan

a)

Ambulasi independen

b)

Berdiri tidak bisa ambulasi

c)

Bukan salah satu di atas

d)

Ambulasi dengan ortose atau alat bantu berjalan

e)

Ambulasi dengan kursi roda

91.

If the tumor demonstrated in this MRI is a functioning tumor, what is the most likely hormone being produced (keluhannya LUPA):

a)

Prolactin

b)

ACTH

c)

LH/FSH

d)

GH

e)

ADH

92.

Pasien laki laki lahir dengan kondisi seperti digambar, penatalaksanaan?

a)

Penutupan defek dalam 24 jam

b)

Penutupan defek dalam 72 jam

c)

Penutupan defek segera

d)

Penutupan defek efektif saat usia 3 bulan

e)

Konservatif

93.

Pasien perempuan 52 tahun dengan keluhan sakit kepala, dan hemiparesis sejak 4 jam yang lalu. CT scan dilakukan 2 jam pasca onset. Penatalaksaan pada pasien tersebut?

a)

Evakuasi hematoma

b)

Kraniektomi dekompresi

c)

Hiperventilasi

d)

Observasi dan pengaturan tekanan darah

e)

Pemberian steroid

94.

The ventral cervical plate pictured below spans three vertebral levels, and reveals a pseudoarthrosis. It consists of two screws at each end that are rigidly affixed to the plate. Which of following biomechanical properties best describe the type of fixation pictured in the radiograph that lead to the pseudoarthrosis?

a)

Constrained cantilever beam.

b)

Constrained three-point bending.

c)

Constrained dynamic.

d)

Semi-constrained cantilever beam.

e)

Semi-constrained four-point bending.

95.

What is a contraindication for posterior cervical foraminotomy as a treatment for cervical radiculopathy due to disc herniation?

a)

Degenerative changes at other levels

b)

Ipsilateral vocal cord palsy

c)

Kyphotic neck deformity

d)

Associated osteophyte formation

e)

Central disc herniation

96.

A 19-year-old man presents following a motor vehicle collision complaining of lower extremity weakness. He is found to have a thoracic spine Chance fracture. He has full strength in his upper extremities. He has sensation in his lower extrem-ities and perineum, and his motor strength in his lower extremities ranges from 4-/5 to 4/5. What is his American Spinal Injury Association (ASIA) impairment scale score?

a)

A

b)

B

c)

C

d)

D

e)

E

97.

What imaging feature favors a pilocytic astrocy-toma over a hemangioblastoma?

a)

High relative cerebral blood volumes

b)

Presence of small vascular flow voids

c)

Enhancing nodule abutting the pia

d)

Enhancement of the cyst wall

98.

A 74-year-old woman presents to the emergency room complaining of vertigo and nausea increas-ing in severity over the past several hours. CT and MRI studies were performed, and representative images are shown here. This lesion likely repгe-sents a(n):

a)

Primary neoplasm

b)

Acute infarction

c)

Metastatic disease

d)

Arachnoid cyst

e)

Epidermoid cyst

99.

Which one of the following is most accurate regarding placement of thoracic pedicle screws?

a)

Varies widely depending on level

b)

Straight-head screw trajectory is parallel to the facet joint

c)

Anatomic screw trajectory is along the long axis of the pedicle

d)

Entry point is where the transverse pro-cess joins the superior articular process just medial to the pars interarticularis

e)

The pars interarticularis is the LEAST useful landmark

100.

Following surgical resection of glioblastoma, standard therapy includes radiotherapy with concomitant temozolomide. What is the standard radiation dose given over 30 fractions?

a)

40 Gy

b)

20 Gy

c)

60 Gy

d)

50 Gy

e)

30 Gy

101.

What type of metastatic brain tumor generally is considered radiosensitive to whole brain radiation therapy?

a)

Thyroid

b)

Renal

c)

Melanoma

d)

Breast

e)

Sarcoma

102.

A 58 year-old right handed male presents with bifrontal headaches and a partial left ophthalmoplegia. MRI results are shown. Biopsy revealed this tumor to be a chordoma. An extensive subtotal skull-based resection was performed. Which is the best choice for adjuvant therapy regimen?

a)

Proton beam radiotherapy

b)

Brachytherapy

c)

Stereotactic radiosurgery

d)

Conventional fractionated radiotherapy

e)

Procarbazine, CCNU and vincristine (PCV) chemotherapy

103.

A 55-year-old male presents with progressive gait disturbance and impotence. Coronal Magnetic resonance angiogram and angio-grams are shown in the lumbar spine. There is no evidence of hemorrhage. VHL screen is negative. Which one of the following diagnoses is most likely?

a)

Aneurysm of artery of Adamkiewicz

b)

Cavernoma

c)

Hemangioblastoma

d)

Type I Dural AVF

e)

Type II intramedullary glomus AVM

104.

A 28-year-old left-handed female who is 14 weeks pregnant presented to the emer-gency department with worsening headache, vomiting and drowsiness. CT head scan showed a large right frontal tumor with sig-nificant edema. After 48 h of dexamethasone her headache has improved but she still has a mild left-sided arm weakness. Which one of the following would be most appropriate?

a)

Permit gestational advancement to second trimester

b)

Craniotomy and tumor resection followed by chemoradiotherapy

c)

Cesarean section followed by neuro-surgery

d)

Iatrogenic termination followed by neuro-surgery

e)

Radiotherapy alone until fetal maturity established

105.

Tidak ada soal

a)

Multifocal glioblastoma multiforme

b)

Multiple sclerosis

c)

Metastatic carcinoma

d)

Neurocytoma

e)

Tuberous sclerosis

106.

Axial noncontrast CT and T2-weighted MRI are shown in these images. What is the likely diagnosis?

a)

Langerhans cell histiocytosis

b)

Epidermoid

c)

Abscess

d)

Leptomeningeal cyst

107.

During an endonasal transsphenoidal approach, what structure limits the working space and ma-neuverability of the instruments?

a)

Inferior turbinate

b)

Middle turbinate

c)

Superior turbinate

d)

Anterior nasal septum

108.

What is the most common location for dural arteriovenous fistulae to drain?

a)

Superior sagittal sinus

b)

Junction of the transverse and sigmoid sinus

c)

Cavernous sinus

d)

Inferior petrosal sinus

e)

Junction of the sigmoid sinus and jugular vein

109.

How much of the superior sagittal sinus can be sacrificed without a high risk of inducing venous infarctions?

a)

Anterior two thirds

b)

No more than one third of any portion

c)

Anterior one third

d)

Entire sinus as long as the cortical bridging veins are left intact

e)

None of the sinus but all of the cortical bridg-ing veins can be sacrificed without risk of venous infarctions.

110.

A patient presents with subarachnoid hemorrhage due to a ruptured aneurysm. What is the approxi-mate risk of re-rupture over the next 14 days if the aneurysm is not treated?

a)

1 to 2%

b)

5 to 10%

c)

15 to 20%

d)

50%

e)

75%

111.

A 21-year-old man presents with a brachial plexus avulsion type injury. What is the recommended treatment option?

a)

Periodic electromyography/nerve conduction studies starting 3 to 12 weeks following the injury with consideration of surgical neu-rotization at 3 to 6 months if there is no improvement

b)

Periodic electromyography/nerve conduction studies starting 3 to 12 weeks following the injury with consideration of surgical neu-rolysis at 3 to 6 months if there is no improvement

c)

Periodic electromyography/nerve conduction studies starting 3 to 12 weeks following the injury with consideration of a spinal cord stimulator if pain remains after 3 to 6 months

d)

Exploration and surgical repair within 3 days

e)

Exploration at 2 to 3 weeks

112.

An 82-year-old woman presents to the neurosur-gery clinic with typical trigeminal neuralgia. She has substantial medical comorbidities and would like to avoid surgery. The patient opts for stereo-tactic radiosurgery. What factor would predict a favorable outcome?

a)

Absence of atypical pain

b)

Using a radiation dose less than 60 Gy

c)

Prior successful decompression surgical microvascular

d)

Decreased sensation in the affected nerve prior to treatment

e)

Trigeminal neuralgia related to multiple sclerosis

113.

A patient presents with a blunt cerebrovascular injury after a motor vehicle collision. The patient has no intracranial hemorrhage. CT angiogram reveals an internal carotid artery luminal irregu-larity with < 25% stenosis. What is the next step in the management of this patient?

a)

No acute intervention; repeat imaging in 4 to 6 weeks.

b)

Initiate a heparin drip if there are no contraindications.

c)

Perform endovascular stenting.

d)

Perform a ligation/occlusion of carotid artery.

e)

Initiate antiplatelet therapy if there are no

contraindications.

114.

Which one of the following is not a normal variant seen in the pediatric cervical spine?

a)

Pseudosubluxation of C2 on C3

b)

Localized kyphosis in mid-cervical area

c)

Overriding C1 over tip of odontoid peg in extension

d)

Persistence synchondrosis of basilar odontoid

e)

Anterior wedging of vertebral bodies

115.

Which one of the following statements regarding history of spine trauma is LEAST accurate?

a)

In young children aged 0-9 years, the pre-dominant cause of injury is falls and automobile-versus-pedestrian accidents (>75%)

b)

In children aged 10-14 years, motor vehi-cle accidents (40%) are the major cause of lumbar fractures, and falls and automobile-versus-pedestrian accidents are less prevalent

c)

In children 15-17 years of age, motor vehicle and motorcycle accidents become the leading cause of spine injuries (>70%), and there is also an increase in sports-related spine trauma

d)

SCI should be suspected if the child reports transient neurological symptoms at the time of injury, even if they are now resolved

e)

Children with Down's syndrome are at higher risk of cervical injuries as it is asso-ciated with congenital fusion of cervical vertebrae

116.

An 8-month-old female child who previously fell from a changing table. She presented on referral from her pediatrician for evaluation of a left frontoparietal mass. Which one of the following management strategies is most appropriate?

a)

Cranioplasty

b)

Conservative management

c)

Dural repair

d)

Duraplasty and autologous cranioplasty

e)

Head bandage

117.

⁠Which one of the following is the LEAST appropriate indication for placement of ICP monitor in TBI?

a)

GCS 3-8 with abnormal CT scan

b)

GCS 3-8 with normal CT scan age >40 years and SBP <90 mmHg

c)

Postoperative period after removal of acute subdural hematoma

d)

GCS of 3-8 and diffuse injury type III (Marshall CT classification)

e)

Diffuse injury type II (Marshall CT classification)

118.

Which one of the following statements regarding fluorescein sodium is LEAST accurate?

Tidak ada kunci

a)

It emits light in the 600-700 nm range

b)

It is preferentially taken up by neoplastic cells

c)

It relies on breakdown of the blood-brain barrier

d)

It can guide where laser scanning confocal microscope should be focused

e)

It can assess patency of EC-IC bypass and at risk vessels during aneurysm surgery

119.

A sagittal T2-weighted image of a patient with a tethered cord is shown in this image. What is a characteristic of the pathology represented here?

a)

Reduced risk following folic acid supplementation

b)

Associated with Chiari 2 malformations

c)

Secondary to premature disjunction of the neural ectoderm Lipomyslomeningocate

d)

Most cases are familial

120.

Panah kuning?

a)

Optic chiasm

b)

Pituitary stalk

c)

Tip of basilar artery

d)

Fornix

e)

Mammillary bodies

121.

Brain metastasis dengan ecog score 3-4, pilihan managementnya :

tidak ada kunci

a)

WBRT

b)

WBRTdenganhippocampalavoidance

c)

..

d)

..

122.

Which one of the following is the most likely diagnosis demonstrated in this histological section?

(tidak ada kunci)

a)

Angiocentric glioma

b)

Central nerocytoma

c)

Chordoma

d)

Medulloblastoma

e)

Psammomatous meningioma

123.

DSA anak 17 th, gambaran moya2

tatalaksana

(a)  

124.

A frontal view of DSA following a right carotid artery injection is shown in this image. what is the likely etiology of the lession demonstrated?

a)

Atherosclerosis

b)

Immune vasculitis

c)

Congenital

d)

Endocarditis

125.

DSA seperti CCF, ditanya klinis yang baru

(a)  

126.

dikasih gambar tethered cord

(a)  

127.

Ada gambar cervical, chiari + syring : Pemeriksaan selanjutnya?

(a)  

128.

Spine abis kecelakan, sadar, gada apa, ga nyeri, pemeriksaan radiologi selanjutnya :

a)

CT scan

b)

MRI

c)

Tidak perlu dilakukan pemeriksaan radiologi

129.

Inferior choroidal point, dimananya uncus?

(a)  

130.

Intratechal morfin, boleh dikasih kalau harapan hidup lebih dari ..... bulan atau minimal .... bulan

(a)  

131.

Tumor meningioma sphenoid, dikasih gambar DSA dan MRI, dapet feeder dari mana?

(a)  

132.

AVM dikasih DSA dari ICA, feeder dari mana?


(a)  

133.

Cubital tunnel, gejalanya


(a)  

134.

Lateral SCIT, melewati lobulus cerebellum Quadrangular


(a)  

135.

Tumor di ventrikel 3 posterior, melewati apa?

(a)  

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