Epidural hematomas are frequently followed by A. skull fractures



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Epidural hematomas are frequently followed by

A. skull fractures

B. nasal liquorrhoea

C. auricular liquorrhoea

D. ventricular hematomas

E. pneumocephalus

ANSWER: A

Epidural hematomas are mostly limited by

A. cerebral cortex

B. choroid plexuses

C. falciform processus

D. tentorium cerebelli

E. skull sutures

ANSWER: E

Acute traumatic intracranial hematomas are characterized by

A. foster-Kennedy syndrome

B. pulsatile exophthalmus

C. symptom "lucid period"

D. bruns' syndrome

E. complete block of subarachnoid space during Queckenstedt test

ANSWER: C

Acute traumatic intracranial hematomas are characterized by

A. anisocoria

B. anisocytosis

C. hemibalismus

D. hemihyperaesthesia

E. hemiathetosis

ANSWER: A

Acute traumatic intracranial hematomas are characterized by

A. hemiparesis or hemiplegia on the side of hematoma

B. hemiparesis or hemiplegia on the contralateral side

C. hemianaesthesia or hemiplegia on the side of hematoma

D. choreoathetosis on the contralateral side

E. uemibalismus on the contralateral sided

ANSWER: B

Acute traumatic intracranial hematomas are manifest with

A. hypersalivation

B. hyperhydrosis

C. seizures

D. acute adrenal failure

E. toxic shock

ANSWER: C

Bradycardia, hemiparesis and midriasis are classic presentation of

A. carotid-cavernous fistula

B. arnold-Chiari anomaly

C. pituitary tumor

D. compression vascular neuropathy

E. traumatic intracranial hematoma

ANSWER: E

Sources for formation of epidural hematomas are

A. cerebral arteries and veins

B. choroid plexus of the 4th ventricle

C. galen's vein

D. diploic vessels of cranial bones

E. meningeal arteries

ANSWER: E

Sources for formation of subdural hematomas are

A. anterior choroid artery

B. pial veins

C. choroid plexuses of the lateral ventricles

D. choroid plexus of the 4th ventricle

E. arteries of the circle of Willis

ANSWER: B

There exist the following types of intracranial hematomas

A. epidural

B. intradural

C. subdural

D. intracerebral

E. intraventricular

ANSWER: B

Major type of memory disorders in head injury are

A. congrade amnesia

B. anterograde amnesia

C. retrograde amnesia

D. anteroretrograde amnesia

E. cognitive amnesia

ANSWER: C

Anisocoria in right-side subdural hematoma presents with

A. left-side myosis

B. right-side ptosis

C. right-side myosis

D. left-side mydriasis

E. right-side mydriasis

ANSWER: D

The following types of pressed skull fractures are distinguished

A. impressive

B. expressive

C. depressive

D. linear

E. perforated

ANSWER: B

Causes of early prolapse of the brain are

A. brain edema and swelling

B. bevelopment of encephalitis

C. development of brain abscess

D. acute hydrocephalus

E. formation of intracranial hematomas

ANSWER: A

Acute intracranial hematomas are those which form

A. during the first 5 days

B. during the first 14 days

C. during the first 3 days

D. during the first 6 days

E. during the first 10 days

ANSWER: C

Subacute intracranial hematomas are those which form

A. during the first 3 days

B. during the first 3-14 days

C. during the first 6 days

D. during the first 7-20 days

E. during the first 1-30 days

ANSWER: B

Chronic intracranial hematomas are those which form

A. in 3 days

B. in 14 days

C. in 10 days

D. in 7 days

E. in 12 days

ANSWER: B

Cause of brain compression in head injury are

A. intracranial hematomas

B. impressed skull fractures

C. fractures of the cranial basis

D. pneumocephalus

E. subdural hydromas

ANSWER: A

As brain decompression measures in head injury the following are performed

A. decompression trepanations

B. defect cranioplasty

C. dehydratation

D. liquidation of the impressed fracture

E. removal of the intracranial hematomas

ANSWER: E

During decompressive skull trepanation

A. dura mater is dissected

B. dura mater is never cut open

C. all right

D. all wrong

E. it’s not important

ANSWER: A

Primary cranioplasty for the skull defect is performed

A. in the first 2 days

B. up to 14 days

C. to 2 months

D. after 2 months

E. after 2 years

ANSWER: A

Primarily-postponed cranioplasty of the skull defects is performed

A. in the first 2 days

B. up to 14 days

C. up to 2 months

D. after 2 months

E. after 2 years

ANSWER: B

In diffuse axonal injury clinical presentations determined by morphological changes occurring at the level

A. in the cortical regions of the frontal lobes

B. in the deep regions of the brain with impairment of the white matter, corpus callosum and subcortical structures

C. in the medulla with lesions of the nuclei of the cranial nerves

D. in the upper cervical region of the spinal cord and in the medulla

E. all right

ANSWER: B

Diffuse axonal injury most often presents with

A. prolonged comatose status

B. vegetative status

C. practically always with meningeal syndrome

D. pyramid-extrapyramid tetrasyndrome

E. mild transient and focal symptoms

ANSWER: B

In the syndrome of prolonged compression of the head primary surgical debridement of the head wounds

A. is early and is performed during the first hours in the injury admission ward

B. is postponed and is performed in the specialized facilities

C. surgical debridement is not performed

D. is late and is performed in the general surgical inpatient departments

E. is early and is performed in the general surgical inpatient departments

ANSWER: A

Fatty embolization of the cerebral vessels in head injury is observed

A. in fracture of the cranial basis

B. in multiple fractures of the calvarium

C. in joint cranioskeletal trauma

D. in gunshot skull fractures

E. in isolated intracranial hematomas

ANSWER: C

During emergency medical care in head injury foreign bodies off the brain

A. should be necessarily removed

B. are removed through active aspiration and dissection of the brain substance

C. it’s not important

D. are not removed

E. the foreign bodies with even edges made of hard material are predominantly removed

ANSWER: D

Combined head injury is

A. constellation of various injuries including head injury which develop as the result of simultaneous impact of various damaging factors

B. constellation of various injuries including head injury which develop as the result of simultaneous impact of mechanical factor on several regions of the body

C. constellation of various injuries including head injury which develop as the result of simultaneous impact of chemical factor on several regions of the body

D. fractures of the bones of the calvarium which combine with intracranial hematomas d intracranial hematomas which combine with trauma of the facial skeleton

E. constellation of various injuries including head injury which develop as the result of simultaneous impact of mechanical factor on several regions of the body

ANSWER: A

Joint head injury is

A. constellation of various injuries including head injury which develop as the result of simultaneous impact of mechanical factor on several regions of the body

B. constellation of various injuries including head injury which develop as the result of simultaneous impact of various damaging factors

C. combination of fractures of the bones of calvarium with intracranial hematomas or liquorrhoea

D. combination of fractures of the bones of calvarium with trauma of the facial skeleton

E. constellation of various injuries including head injury which develop as the result of simultaneous impact of various damaging factors

ANSWER: A

According to Glasgow coma scale a severe head injury would score

A. 1-2 points

B. 3-7 points

C. 8-10 points

D. 8 points

E. 10-12 points

ANSWER: B

According to Glasgow coma scale a moderately severe head injury would score

A. 1-2 points

B. 3-7 points

C. 12-15 points

D. 5-7 points

E. 8-12 points

ANSWER: E
According to Glasgow coma scale a mild head injury would score

A. 3-5 points

B. 7-10 points

C. 13-15 points

D. 10-12 points

E. 8 points

ANSWER: D

Nasal liquorrhoea most often occurs in fractures in the region of

A. frontal sinus

B. fetrosus part of the temporal bone pyramid

C. cribriform plate

D. ethmoidal bone

E. occipital bone

ANSWER: D

Auricular liquorrhoea most often occurs in fractures in the region of

A. petrosus part of the temporal bone pyramid

B. frontal sinus

C. cribriform plate

D. sphenoidal sinus

E. ethmoidal bone

ANSWER: A

Supplemental methods in diagnostics of liquorrhoea are

A. glucotest

B. endoscopic examination

C. echo-encephalography

D. radioisotope gamma-cisternography

E. ct-cisternography

ANSWER: E

Meningeal syndrome is most often in the clinical presentation of

A. brain concussion

B. brain contusion

C. chronic subdural hematoma

D. chronic subdural hydroma

E. subarachnoid hemorrhage

ANSWER: E

According to the type of wound canal there are no the following type of gunshot craniocerebral injury

A. perforating

B. blind

C. open

D. yangent

E. subaponeurotic

ANSWER: E

Inflammatory craniocerebral complications of the head injury not include

A. ventriculitis

B. liquorrhoea

C. abscess

D. meningitis

E. encephalitis

ANSWER: B

None-inflammatory craniocerebral complications of the head injury include

A. posttraumatic granulomas

B. dislocation syndromes

C. thromboembolism of cerebral vessels, brain infarction

D. late prolapse of the brain

E. collapse of the brain

ANSWER: B

Extracranial complications not include

A. shock


B. dic syndrome

C. pneumonia

D. liquorrhoea

E. acute cardiovascular failure, cardiac rhythm disorders

ANSWER: D
In which cases should head injury be considered an open one

A. injury of the skull and brain with contusions and wounds of the soft tissues without lesion of the aponeurosis

B. injury of the skull and brain with contusions and wounds of the soft tissues with the lesion of aponeurosis

C. all cases of CCT with liquorrhoea

D. head injury with any types of calvarium fractures

E. all right

ANSWER: B

Penetrating head injury is considered to be

A. open head injury with rupture of the arachnoid

B. open head injury with injury of the dura mater

C. open head injury with pneumocephalus

D. open head injury with hydrocephalus

E. open head injury with rupture of the aponeurosis

ANSWER: B

The following changes occurs in brain concussion

A. solitary ruptures of axons in the diencephalic regions of the brain

B. ultra structural changes such as injury of the synaptic membranes, cellular organelles, redistribution of the cellular fluid

C. small focal changes in the cortical regions of frontal and temporal lobes as well as microscopic hemorrhages in the paraventricular zones

D. cerebral hemorrhage

E. subarachnoid hemorrhage

ANSWER: B

The course of head injury has the following periods

A. acute

B. final

C. remote

D. a and b right

E. all right

ANSWER: D

Cephalohematoma is

A. subcutaneous hematoma

B. subaponeurotic hematoma

C. subperiostal hematoma

D. subdural hematoma

E. multi-storey hematoma

ANSWER: C

The optimal treatment method in cephalohematomas is

A. dissection with further drainage

B. puncture removal

C. total removal with its capsule

D. total removal with bone resection

E. decompressive cranial trepanation

ANSWER: B

Type of consciousness disorders in severe head injury are

A. torpor

B. sopor

C. coma


D. shock

E. amnesia

ANSWER: C

For brain concussion typical consciousness disorder is

A. short-term unconsciousness

B. multiple vomiting

C. one-time vomiting

D. headache

E. presence of mild dislocation syndromes

ANSWER: A

Among the trasient focal symptoms in brain concussion the most frequent is

A. spontaneous horizontal nystagmus

B. brudzinskiy symptom

C. marinesku-Radovici symptom

D. lasseg's symptom

E. weakness of convergence

ANSWER: C

The method of choice in therapeutic tactics in traumatic subarachnoid hemorrhages is

A. urgent surgical intervention aimed at arresting of the bleeding and decompression of the brain

B. unloading lumbar punctures

C. selective neurosurgical intervention aimed at decompression of the brain in 7-10 days after injury

D. stereotactic clipping of the pia mater vessels in 7-10 days after injury

E. all right

ANSWER: B

Subdural hematomas are located

A. between the aponeurosis and the periosteum

B. between the dura and the arachnoid mater

C. between the dura and the periosteum

D. in the great occipital cistern

E. all are wrong

ANSWER: B

In case of subdural hematoma and dislocation of the brain is indicated

A. urgent neurosurgical intervention

B. dynamic follow-up in the intensive care unit

C. hemostatic therapy and dynamic follow-up in the neurologic department

D. urgent lumbar puncture, especially in hematomas of the posterior cranial fossa

E. all are wrong

ANSWER: A

Method of surgical treatment of acute subdural hematomas is

A. removal through the drilled openings

B. removal during skull trepanation

C. endovascular removal

D. stereotactic removal

E. puncture removal of the hematoma

ANSWER: B

Subdural hydromas are

A. subarachnoid accumulation of CSF

B. accumulation of exudate under the dura

C. accumulation of CSF under the dura

D. accumulation of liquid blood under the dura

E. accumulation of transsudate under the dura

ANSWER: C

Methods of surgical threatment of subdural hydromas

A. puncture emptying through the drilled opening

B. stereotactic removal

C. prolonged endolumbar drainage

D. endovascular removal

E. all are wrong

ANSWER: A

Peculiarities of head injury in the eldery and senile age

A. hypertensive syndrome is mildly prominent

B. hypertensive syndrome is almost always present

C. severe consciousness disorders develop frequently

D. relatively severe lesions of the brain

E. brain lesions are relatively milder than those in young and middle-aged patients

ANSWER: A

Peculiarities of head injury in alcoholic intoxication are

A. relatively mild course

B. consciousness disorders are often more prominent and prolonged

C. quick progression of intracranial hypertension

D. hypertensive syndrome is mildly prominent

E. prominent vestibular and vegetative disorders

ANSWER: B

Growing cranial bone fractures are most typical for

A. children younger than 3 years old

B. elderly and senior people

C. for patients with skull base fractures

D. for patients with injuries of the calvarium

E. all right

ANSWER: B

Peculiarity of epidural hematomas in children is

A. limitation to a single bone (along the suture line)

B. frequently spreads beyond the limits of cranial sutures

C. a and b right

D. don’t spreads beyond the limits of cranial sutures

E. all right

ANSWER: B

Shock in isolated head injury

A. is rather frequent (in 10-15% of cases)

B. is practically never observed (1-2% cases)

C. in 50% of cases

D. in 100% of cases

E. all wrong

ANSWER: A

In case of epidural hematoma the following is indicated

A. urgent neurosurgical intervention

B. urgent lumbar puncture to determine the size of hematoma

C. dynamic follow-up (control CT or MRI) in the settings of intensive care unit

D. stereotactic removal

E. endovascular removal

ANSWER: A

The method of choice for surgical treatment of acute epidural hematomas is

A. removal by means of trepanation

B. endovascular removal

C. puncture removal through the drilled openings

D. stereotactic removal

E. urgent lumbar puncture

ANSWER: A

Major indirect mechanism of spine injury are

A. hyperflexion

B. traction

C. hyperextension

D. rotation

E. axial compression

ANSWER: A

Clinical signs of dislocation in the cervical spine are

A. forced position of the head, severe pain, especially during head movements, neck muscle

tension


B. free course of the disease, mild crackle during maximal rotations of the head

C. continuous vomiting, generalized epileptic seizures, presence of alternating syndromes

D. a and b right

E. b and c right

ANSWER: A

Hematomyelia is

A. hemorrhage under the spinal meninges

B. hemorrhage into the white matter of the spinal cord

C. hemorrhage into the grey matter of the spinal cord

D. hemorrhage into the peripheral nerves

E. all wrong

ANSWER: C

Major method for treatment of hematomyelia is

A. urgent neurosurgical intervention with resection of obviously non-viable regions

B. conservative (medical) treatment (hemostatic therapy, hypothermia etc.)

C. combmation of a neurosurgical intervention aimed at resection of non-viable regions of the spinal cord and intensive conservative treatment

D. a and b right

E. b and c right

ANSWER: B

Most common cause of spinal cord compression in trauma are

A. spinal meningeal hematomas

B. bones or their fragments

C. ligaments

D. foreign bodies

E. intervertebral disks

ANSWER: B

Most typical signs of injury of the thoracic spine at the level of Th4-Th5 are

A. spastic tetraplegia, central-type disorders of urinary bladder function

B. superior flaccid paralysis and inferior spastic paralysis

C. inferior spastic paralysis, central-type disorders of urinary bladder function

D. inferior flaccid paralysis, peripheral- type disorders of urinary bladder function

E. all wrong

ANSWER: C

Most typical signs of the cervical spine at the level of C3- C4 are

A. spastic tetraplegia, central-type disorders of urinary bladder function

B. superior flaccid paralysis and inferior spastic paralysis, central-type disorders of urinary bladder function

C. superior spastic paralysis, central-type disorders of urinary bladder function d spastic tetraplegia, peripheral-type disorders of urinary bladder function

D. a and b right

E. all right

ANSWER: A

Which spinal cord injury should undergo surgical treatment

A. concussion

B. contusion

C. compression

D. complete anatomic rupture

E. hematomyelia

ANSWER: C

To prevent urosepsis in patients with spinal injury the following are necessary

A. constant catheterization of the urinary bladder with periodical irrigation with antiseptics

B. application of the inflow-outflow Monroe system

C. urethral plastics

D. subarachnoid space dranage

E. all right

ANSWER: A

Short–term inflammatory complications of the spinal injury include

A. purulent epiduritis

B. purulent meningomyelitis

C. spinal cord abscess

D. posttraumatic aseptic arachnoiditis

E. all right

ANSWER: A

Which is the major absolute contraindication for spinal puncture

A. high blood pressure

B. soporous consciousness disorders

C. pregnancy

D. acute urinary retention

E. hypertensive syndrome

ANSWER: E

Which radiographic signs are not the evidence of increased cranial pressure

A. enlarged digital impressions

B. emphasized sutures of the calvarium

C. osteoporosis of the dorsum of sella turcica

D. hyperostosis of the temporal bone

E. all right

ANSWER: D

Indicate the reasons of increased cranial pressure

A. brain abscess

B. brain tumor

C. edema-swelling of the brain, trauma

D. all of the mentioned above

E. none of the mentioned above

ANSWER: D

Select indications for carotid cerebral angiography

A. meningitis

B. suspicion of the cerebellar tumor

C. suspicion of the craniospinal tumor

D. spontaneous subarachnoid hemorrhage

E. none of the abovementioned

ANSWER: D

Which are the major clinical signs of traumatic subarachnoid hemorrhage

A. blood in the CSF

B. severe headache

C. meningeal signs

D. fever


E. all of the above mentioned

ANSWER: E

In what nosologic forms of brain injury disease is symptom “lucid period”

A. brain contusion

B. brain concussion

C. subdural hematoma

D. subarachnoid hemorrhage

E. none of the listed

ANSWER: C

Transition from prolonged coma to stable or transient vegetative status is taking place in

A. brain concussion

B. diffuse axonal lesion of the brain

C. subdural hematoma

D. brain tumor

E. epidural hematoma

ANSWER: B

Which of the listed methods of investigation should the patient with head injury undergo first of all:

A. chest X-ray

B. general blood analysis

C. ultrasonography of chest organs

D. skull X-ray in two projections

E. ecg


ANSWER: D

Which of the listed symptoms is not informative in fracture of the cranial basis:

A. auricular liquorrhoea

B. "eyeglasses" symptom

C. eosinophilia

D. subarachnoid hemorrhage

E. anemia

ANSWER: A

Detection of blood in the CSF is typical in:

A. brain concussion

B. epidural hematoma

C. spinal cord concussion

D. subarachnoid hemorrhage

E. tuberculous meningitis

ANSWER: D

Persistent anisocoria with stagnant disks of the optic nerves can be observed in case of:

A. chronic subdural hematoma

B. contusion of the cervical spinal cord

C. subarachnoid hemorrhage

D. linear fracture of the temporal bone

E. brain concussion

ANSWER: A

Indicate major clinical signs of the cerebellar tumor

A. insomnia

B. unsteady gait

C. position headaches

D. impaired movement coordination

E. none of the above mentioned

ANSWER: D

Indicate major clinical signs of the tumor of ponto-cerebellar angle

A. tinnitus in one ear with decreased hearing in the same ear

B. vestibular disorders

C. spontaneous nystagmus

D. polydipsia

E. none of the above mentioned

ANSWER: C

Which of the listed symptoms indicate eosinophilic adenoma:

A. acromegaly, gigantism

B. amenorrhoea, decreased libido

C. bitemporal hemianopsia

D. fever

E. none of the above mentioned

ANSWER: A

In basophilic pituitary adenoma (Itsenko-Cushing`s syndrome) the following clinical signs are observed

A. cachexia

B. arterial hypotension

C. callergy

D. fever


E. none of the above mentioned

ANSWER: E

Indicate direct radiologic signs of the brain tumor

A. disconnection of sutures, their emphasis

B. dislocation of pineal body

C. hyperostosis or osteoporosis of the adjacent to the tumor bone section

D. bone destruction

E. none of the abovementioned

ANSWER: C

Meningeal tumors of the brain do not include:

A. meningioma

B. sarcoma

C. glioblastoma

D. meningosarcoma

E. none of the abovementioned

ANSWER: B

Focal neurologic symptoms in brain tumors are devided into

A. primary and secondary focal

B. dislocation symptoms

C. neighboring symptoms

D. none of the abovementioned

E. all of above mentioned

ANSWER: A

Foster-Kennedy symptom is observed in:

A. tumors of the pole of the frontal lobe

B. tumors of the occipital lobes

C. tumors of the temporal lobe

D. tumors of the parietal lobes

E. cerebellar tumors

ANSWER: A

For tumors of the pineal gland most typical is:

A. endocrine and metabolic disorders

B. epileptic seizures

C. homonymic hemianopsia

D. central paralysis

E. movement coordination disorders

ANSWER: A

Which of the listed factors is not typical for spinal osteochondrosis

A. degenerative changes of the intervertebral disks

B. reactive changes in the vertebrae

C. reactive changes m the ligaments

D. impaired congruence of the intervertebral joints

E. osteoporosis of bodies and arches of the vertebrae

ANSWER: E

Direct causes for initial manifestations of osteochondrosis are:

A. mechanical factor (weight lifting, abrupt movement)

B. weakening of the abdominal press after surgeries and deliveries

C. consequences of previous infections and hypothermia

D. all of the above mentioned

E. none of above mentioned

ANSWER: A

Which of the symptoms is not typical for subarachnoid hemorrhage in rupture of arterial aneyrism of cerebral vessels:

A. kernig's symptom

B. brudzinskiy's symptom

C. occipital stiffness

D. paresis of the oculomotor nerve

E. horner's symptom

ANSWER: E

Which of the listed clinical manifestations is not typical for arteriovenous malformations of the brain:

A. epileptic seizure

B. syndrome of the intracranial hypotension

C. recurrent ischemic disorders of the cerebral circulation

D. intracranial hemorrhage

E. none of about mentioned

ANSWER: D

Intracranial surgeries in prosopalgis include

A. transection of the 1 branch of trigeminal nerve

B. janet's surgery

C. transection of the 2 branch of trigeminal nerve

D. transection of the 3 branch of trigeminal nerve

E. transection of glossopharyngeal nerve

ANSWER: C

In what type of prosopalgia “status neuralgicus” developes most frequently

A. trigeminal neuralgia

B. neuralgia of occipital nerves

C. glossopharyngeal neuralgia,

D. periodic facial neuralgia

E. migrame

ANSWER: A

Which of the listed factors is etiologic for pevelopment of pain paroxysm in the zone of V pair of cranial nerves?

A. foci of chronic infection in the oral cavity

B. narrowing of bone canals

C. malocclusion

D. compression of the nerve root by the superior cerebellar artery

E. all of the abovementioned

ANSWER: E

Symptomatic trigeminal neuralgia can develop in:

A. spinal cord tumors

B. arterial aneurism

C. narrowing of the bone canals

D. compression of the nerve root by superior cerebellar artery

E. all of the mentioned above



ANSWER: E


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