Q.1 Which of the following is the most common primary brain tumor in adults?
Astrocytoma
Glioblastoma multiforme
Oligodendroglioma
Meningioma
Explanation - Meningioma is the most common primary brain tumor in adults, though glioblastoma is the most common malignant one.
Correct answer is: Meningioma
Q.2 Cushing's triad includes all EXCEPT:
Hypertension
Bradycardia
Irregular respiration
Hypothermia
Explanation - Cushing’s triad is a sign of raised intracranial pressure and includes hypertension, bradycardia, and irregular respiration. Hypothermia is not part of it.
Correct answer is: Hypothermia
Q.3 The most common site of intracranial aneurysm is:
Anterior communicating artery
Posterior communicating artery
Middle cerebral artery
Basilar artery
Explanation - The anterior communicating artery is the most common site for berry aneurysms leading to subarachnoid hemorrhage.
Correct answer is: Anterior communicating artery
Q.4 Which brain herniation causes compression of the ipsilateral third cranial nerve?
Subfalcine
Uncal
Tonsillar
Transcalvarial
Explanation - Uncal herniation compresses the ipsilateral oculomotor nerve, causing a dilated pupil.
Correct answer is: Uncal
Q.5 What is the gold standard investigation for subarachnoid hemorrhage?
CT scan without contrast
MRI brain
Cerebral angiography
Lumbar puncture
Explanation - While CT scan is the first test, cerebral angiography remains the gold standard for detecting and characterizing aneurysms.
Correct answer is: Cerebral angiography
Q.6 Chiari malformation type I is characterized by:
Downward displacement of cerebellar tonsils
Absence of cerebellar vermis
Meningomyelocele
Dandy-Walker cyst
Explanation - Type I Chiari malformation involves herniation of cerebellar tonsils into the foramen magnum.
Correct answer is: Downward displacement of cerebellar tonsils
Q.7 The Glasgow Coma Scale assesses all EXCEPT:
Eye opening
Verbal response
Motor response
Pupillary size
Explanation - GCS assesses eye opening, motor, and verbal responses, not pupil size.
Correct answer is: Pupillary size
Q.8 Which spinal level is most commonly affected by herniated intervertebral disc?
C5-C6
T6-T7
L4-L5
S1-S2
Explanation - Lumbar disc herniation is most common at L4-L5 and L5-S1 levels.
Correct answer is: L4-L5
Q.9 An epidural hematoma is classically caused by rupture of:
Middle cerebral artery
Bridging veins
Middle meningeal artery
Superior sagittal sinus
Explanation - Epidural hematomas are usually due to middle meningeal artery rupture, often associated with temporal bone fractures.
Correct answer is: Middle meningeal artery
Q.10 Kernohan’s notch phenomenon occurs due to:
Contralateral cerebral peduncle compression
Ipsilateral optic nerve compression
Brainstem ischemia
Cerebellar tonsillar herniation
Explanation - In uncal herniation, the contralateral cerebral peduncle may be compressed against the tentorial edge, causing ipsilateral motor deficits.
Correct answer is: Contralateral cerebral peduncle compression
Q.11 The most common presenting symptom of spinal cord tumors is:
Motor weakness
Back pain
Sensory loss
Sphincter disturbance
Explanation - Back pain is the earliest and most common symptom of spinal cord tumors.
Correct answer is: Back pain
Q.12 Which investigation is most sensitive for detecting early ischemic stroke?
CT scan
MRI with diffusion-weighted imaging
Cerebral angiography
EEG
Explanation - Diffusion-weighted MRI is highly sensitive for early detection of cerebral ischemia.
Correct answer is: MRI with diffusion-weighted imaging
Q.13 What is the most common site of spinal meningioma?
Cervical spine
Thoracic spine
Lumbar spine
Sacral spine
Explanation - Spinal meningiomas are most common in the thoracic region and often occur in middle-aged women.
Correct answer is: Thoracic spine
Q.14 Which of the following is NOT a feature of raised intracranial pressure?
Headache
Papilledema
Vomiting
Hypotension
Explanation - Raised ICP commonly presents with headache, vomiting, and papilledema; hypotension is not typical.
Correct answer is: Hypotension
Q.15 The Arnold-Chiari malformation is associated with:
Meningomyelocele
Spina bifida occulta
Craniosynostosis
Hydrocephalus
Explanation - Arnold-Chiari II malformation is strongly associated with meningomyelocele.
Correct answer is: Meningomyelocele
Q.16 Which artery is most commonly affected in epidural spinal hematoma?
Vertebral artery
Radicular artery
Middle meningeal artery
Anterior spinal artery
Explanation - Epidural spinal hematomas are commonly due to rupture of radicular arteries or venous plexus.
Correct answer is: Radicular artery
Q.17 Which neurosurgical procedure is performed to relieve hydrocephalus?
Craniotomy
Ventriculoperitoneal shunt
Laminectomy
Carotid endarterectomy
Explanation - A VP shunt diverts cerebrospinal fluid to the peritoneal cavity, relieving hydrocephalus.
Correct answer is: Ventriculoperitoneal shunt
Q.18 The most common cause of spontaneous intracerebral hemorrhage is:
Trauma
Hypertension
Aneurysm rupture
Coagulopathy
Explanation - Hypertensive vasculopathy is the leading cause of spontaneous intracerebral hemorrhage.
Correct answer is: Hypertension
Q.19 Which nerve is most commonly injured in posterior fossa surgery?
Facial nerve
Abducens nerve
Glossopharyngeal nerve
Hypoglossal nerve
Explanation - Facial nerve injury is common in posterior fossa and cerebellopontine angle surgeries.
Correct answer is: Facial nerve
Q.20 The most common site of hypertensive intracerebral hemorrhage is:
Pons
Thalamus
Basal ganglia
Cerebellum
Explanation - Hypertensive hemorrhages most often occur in the basal ganglia due to small penetrating artery rupture.
Correct answer is: Basal ganglia
Q.21 The term 'lucid interval' is classically associated with:
Subdural hematoma
Epidural hematoma
Subarachnoid hemorrhage
Intracerebral hemorrhage
Explanation - Epidural hematomas may have an initial loss of consciousness, followed by a lucid interval, then deterioration.
Correct answer is: Epidural hematoma
Q.22 Which cranial nerve passes through the cavernous sinus?
Optic nerve
Trochlear nerve
Olfactory nerve
Hypoglossal nerve
Explanation - The cavernous sinus contains CN III, IV, V1, V2, and VI. The trochlear nerve is one of them.
Correct answer is: Trochlear nerve
Q.23 The Monro-Kellie doctrine refers to:
Blood-brain barrier
Balance between CSF, blood, and brain volume
Cerebral autoregulation
Neuroplasticity
Explanation - The Monro-Kellie doctrine states that the cranial cavity volume is constant; an increase in one component must be compensated by a decrease in another.
Correct answer is: Balance between CSF, blood, and brain volume
Q.24 Which brain tumor is most radiosensitive?
Meningioma
Glioblastoma
Medulloblastoma
Astrocytoma
Explanation - Medulloblastomas are highly radiosensitive and often treated with craniospinal irradiation.
Correct answer is: Medulloblastoma
Q.25 Which investigation is contraindicated in suspected raised intracranial pressure before ruling out mass lesion?
CT scan
MRI brain
Lumbar puncture
X-ray skull
Explanation - Lumbar puncture is contraindicated in raised ICP due to risk of brain herniation.
Correct answer is: Lumbar puncture