Neurosurgery

What is the incidence of myelomeningocele in the USA?
1. About 1 per 1,000 live births
2. About 1 per 10,000 live births
3. About 1 per 50,000 live births
4. About 1 per 100,000 live births
When a child has MM, how often is there a history of MM in the family?
1. 1 Percent
2. 5 Percent
3. 10 Percent
4. 15 Percent
T or F: mothers with insulin-dependent diabetes have an increased risk of MM in their offspring?
1. True
2. False
At what gestational age does the neural tube usually close?
1. 4 weeks
2. 8 weeks
3. 12 weeks
4. 16 weeks
T or F: secondary neural tube defects are associated with Chiari II malformation?
1. True
2. False
Which does NOT have neural element: myelocele, myelomeningocele, or meningocele?
1. Myelocele
2. Meningocele
3. Myelomeningocele
Careful double-blind studies involving the use of folic acid have proven that folic acid deficiency is not associated with meningomyelocele: True or false?
1. True
2. False
T or F: Alpha fetoprotein in amniotic fluid is very sensitive and reliable test for the presence of meningomyelocele?
1. True
2. False
True or false: Fetuses with known neural tube defects should be delivered by 32 weeks in order to prevent further neurologic damage?
1. True
2. False
True or false: Almost all children born with meningomyeloceles have some degree of hydrocephalus?
1. True
2. False
In 80% of MM, the defect involves the lumbar area. Which is NOT a component of the cystic mass on the back?
1. Neural placode
2. Dura
3. Arachnoid
4. All are components
What % of MM patients can walk?
1. 10 Percent
2. 25 Percent
3. 50 Percent
4. 75 Percent
What % of MM patients require CIC?
1. 25 Percent
2. 50 Percent
3. 70 Percent
4. 90 Percent
T or F: In the surgical treatment of MM, the neural placode is tubularized?
1. True
2. False
Describe the normal flow of CSF?
1. Lateral ventricle to Foramen of Munro
2. 3rd ventricle to Foramen of Munro
3. 4th vnetricle to aqueduct of Sylvius
4. 4th ventricle to 3rd ventricle
Which is NOT a cause of hydrocephalus?
1. No resorption from scarring or blood
2. Choroid plexus papilloma
3. Obstruction
4. All of above
Which is NOT one of the anatomic abnormalities associated with the Chiari II malformation?
1. Aqueductal stenosis from compression
2. Obstruction of 3rd ventricle
3. Obstruction of 4th ventricle
4. Obstruction of flow into subarachnoid space
What is the most common cause of death in patients with meningomyelocele?
1. Shunt infection
2. Intracranial bleed
3. Chiarii II malformation
What percent of children with hydrocephalus need a shunt?
1. Under 10 Percent
2. 25 - 50 Percent
3. 50 - 75 Percent
4. 75 - 90 Percent
T or F: Acetazolamide and lasix are any nonoperative treatments for hydrocephalus?
1. True
2. False
What fraction of patients with MM develop Chiari II symptoms?
1. 10-15 Percent
2. 20-40 Percent
3. 50-60 Percent
4. 75 Percent
Tethered cord is usually seen by what age?
1. By 3 months
2. By 6 months
3. By 2 years
4. By 5 years
T or F: Lipomyelomeningocele is associated with serious neurologic deficits at birth?
1. True
2. False
Spina bifida with cutaneous manifestations is often is associated with what?
1. Split notochord
2. Neurenteric malformations
3. Tethered cord
4. Hydrocephalus
T or F: Congenital dermal sinus travels cephalad and may penetrate a bifid spine, going through the dural sac and into the subarachnoid space. It may terminate in a dermoid tumor?
1. True
2. False
T or F: cranioynostosis is more common in females, with an incidence of 1 in 50,000?
1. True
2. False
Which fontanelle closes first: anterior or posterior?
1. Anterior
2. Posterior
T or F: Secondary craniosynostosis is an autosomally inherited disease?
1. True
2. False
What is the most common type of craniosynostosis?
1. Brachyocephaly
2. Scaphocephaly
3. Dolichocephaly
What type of craniosynostosis is associated with Crouzon's and Apert's syndromes?
1. Brachyocephaly
2. Scaphocephaly
3. Dolichocephaly

Neurosurgery

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