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Question 1

Which of the following is correct regarding raised intracranial pressure?

a) Only solid masses in the cranial cavity increase intracranial pressure.

b) The typical symptoms are a headache worse in the evening, nausea, and vomiting.

c) Benign intracranial hypertension causes symptoms of raised intracranial in the absence of a space occupying lesion.

d) Tonsillar herniation occurs when the cerebellar tonsils are displaced over the free margin of the tentorium cerebelli.

Question 2

Which of the following is correct regarding cerebrovascular accidents (strokes)?

a) Cerebral infarction, intracerebral haemorrhage, and subarachnoid haemorrhage are the three commonest causes.

b) Cerebral infarction is usually due to thrombosis overlying a complicated atherosclerotic plaque.

c) Haemorrhagic infarcts are due to rupture of a Charcot-Bouchard aneurysm.

d) In young people, cerebral amyloid angiopathy is a common cause of intracerebral haemorrhage.

Question 3

Which of the following is correct regarding trauma to the central nervous system?

a) Trauma is the commonest cause of subarachnoid haemorrhage.

b) Trauma is the commonest cause of intracerebral haemorrhage.

c) Subdural haemorrhage may occur following minimal trauma in the elderly.

d) Patients with diffuse axonal injury usually regain good function.

Question 4

Which of the following is correct regarding meningitis?

a) Meningitis is an infection of the subdural space.

b) The most common organisms causing meningitis are Neisseria meningitidis and Streptococcus pneumoniae.

c) The key clinical features are fever, headache, photophobia, and neck stiffness.

d) In cases of suspected bacterial meningitis, blood cultures should always be taken before administering antibiotics.

Question 5

Which of the following is correct regarding multiple sclerosis?

a) It is a chronic relapsing and remitting disorder of the peripheral nervous system characterized by episodes of neurological deficit.

b) The neurological deficits are due to areas of grey matter demyelination within lesions called plaques.

c) The aetiology is now known to be infective.

d) Areas of predilection include the optic nerves, brainstem, cerebellum, and spinal cord.

Question 6

Which of the following is correct regarding Alzheimer's disease?

a) The cerebral cortex shows neuronal loss, Ab amyloid plaques, neurofibrillary tangles, dystrophic neurites, and neuropil threads.

b) Neurofibrillary tangles are thought to be the underlying pathogenic lesions.

c) Alzheimer's disease is the second most common cause of dementia.

d) A brain biopsy is required to make the diagnosis.

Question 7

Which of the following is correct regarding Parkinson's disease?

a) Tremor, rigidity, and bradycardia are the typical clinical features.

b) The movement disorder is caused by loss of dopaminergic input to the basal ganglia.

c) Macroscopically, the key feature is neuronal loss and the presence of Lewy bodies in surviving neurons.

d) There is usually a positive family history.

Question 8

Which of the following is correct regarding Huntington's disease?

a) An abnormally high number of triplet repeats of the sequence CAC in the huntingtin gene is responsible.

b) The length of the triplet repeat directly correlates with the age of onset of the disease.

c) Dementia is the typical clinical presentation.

d) Macroscopic examination of the brain reveals marked atrophy of the caudate nucleus, putamen, and globus pallidus.

Question 9

a) Accumulation of an abnormal form of prion protein is the underlying pathogenic mechanism.

b) Sporadic Creutzfeldt-Jacob disease is the commonest human prion disease, with an annual incidence of 1 in 100,000 people.

c) Iatrogenic Creutzfeldt-Jacob disease has been accidentally transmitted through treatment with recombinant growth hormone.

d) Variant Creutzfeldt-Jacob disease tends to affect middle aged and elderly individuals and has a shorter duration before death.

Question 10

Which of the following is correct regarding tumours of the central nervous system?

a) Metastases are much more common than primary neoplasms.

b) Oligodendrogliomas are the commonest type of primary central nervous system neoplasm.

c) Glioblastoma is a highly aggressive oligodendroglial tumour.

d) Diffuse large B cell lymphoma is the commonest type of primary central nervous system lymphoma.

Oxford University Press, Online Resource Centre, Chapter 18.

Chapter 18

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