Epidural hematomas are frequently followed by Skull fractures

Mass of the bullet. Velocity of the bullet

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Mass of the bullet.

  • Velocity of the bullet.

  • Shape of the bullet.

  • None of the above.

  • *All of the above

  • The most common location for spontaneous intracerebral hemorrhage secondary to hypertension is:

    1. Cerebellum

    2. Cerebral white matter

    3. *Basal ganglia

    4. Cortex

    5. Brainstem

  • Venous angiomas are frequently associated with:

    1. *Cavernous angiomas

    2. Capillary telangiectasias

    3. Arteriovenous malformations

    4. None of the above.

    5. All of the above

  • Which of the follow findings on lumbar puncture is not suggestive of subarachnoid hemorrhage:

    1. Nonclotting blood

    2. Xanthochromia

    3. Red blood cell count greater than 100,000

    4. *Low opening pressure

    5. None of the above

  • Indications for treatment of unruptured intracerebral aneurysm include all of the following but:

    1. Symptomatic lesion

    2. Size greater than 10 mm

    3. Size less than 10 mm

    4. *History of subarachnoid hemorrhage secondary to another treated aneurysm

    5. None of the above

  • Indications for carotid endarterectomy include (select all that apply):

    1. 50% carotid stenosis in an asymptomatic patient

    2. *80% carotid stenosis in an asymptomatic patient

    3. 30% carotid stenosis in a patient having frequent TIAs

    4. 60% carotid stenosis in a patient who has only had a single episode of AF

    5. All of the above

  • The Frankel grade of a patient with sensation below the level of the injury but no motor function below the level of the injury is:

    1. A

    2. *B

    3. C

    4. D

    5. E

    Situational tasks
    1. A patient has been hospitalized due to closed craniocerebral trauma, fracture of the left temporal bone. 6 hours after trauma patient's status has abruptly deteriorated, patient is unconscious, respiration disorders have developed, tonic seizures occur periodically, pupils are wide, reaction to light is weak, left pupil is somewhat wider than the right one. What caused deterioration of patient's status?

      1. Meningoencephalitis;

      2. Stroke;

      3. *Development of epidural hematoma;

      4. Development of brain abscess;

      5. Peculiarities of clinical course of brain contusion.

    2. A 9-year old boy has fallen from the tree and has hit his occipital region; a short loss of consciousness has taken place. Child's status is satisfactory, patient reports headaches and dizziness. Cranial radiograms have demonstrated an impressed comminuted fracture of the occipital bone. What treatment is indicated to this patient?

      1. Anti-inflammatory therapy;

      2. *Surgical intervention;

      3. Hemostatic therapy;

      4. Unloading lumbar punctures;

      5. Complex conservative treatment.

    3. Patient has a cut wound of the inferior 1/3 of the left shoulder. After the injury left hand has hung down. Patient can not extend his wrist, abduct his thumb and extend his fingers. Which nerve has been injured?

      1. Median nerve;

      2. Ulnar nerve;

      3. *Radial nerve;

      4. Brachial plexus;

      5. Axillary nerve.

    4. Patient has been transported to the specialized traumatological department in the status of alcoholic intoxication. Psychomotor agitation was noted. A subcutaneous hemorrhage has been detected in the left temporal region; hemorrhagic fluid is continuously flowing out of the external acustic meatus. Patient has been diagnosed with alcohol intoxication and therapy has been prescribed. 6 hours after admission patient has developed tonic seizures, anisocoria (left pupil is wider than the right one) and a status of deep spoor. What is the diagnosis?

      1. Alcohol delirium;

      2. Brain concussion;

      3. *Epidural hematoma;

      4. Acute disorder of cerebral circulation;

      5. Meningoencephalitis.

    5. Patient became a victim of traffic accident and has hit his head against pavement. Patient's status is severe, unconscious state, respiration is intermittent and noisy. A large wound of soft tissues is detected in the frontal region, bone fragments are visualized as well as brain detritus, wound is bleeding.

    Indicate management tactics at the pre-hospital stage.
      1. Removal of bone fragments;

      2. Wound suturing;

      3. *Hemostasis, aseptic dressing;

      4. Removal of brain detritus;

      5. Anti-edema therapy.

    1. A 42-year old patient was admitted to the clinic with complaints on headache which is worsening in the morning hours and is followed by vomiting, unsteady gait and absent hearing in the right ear. Patient reports "darkening" in her eyes when changing her body position. She has been ill for about 5 years. First, tinnitus in her right ear developed; she has been examined and treated by otorhinolaryngologists with no improvement. Than her hearing in the right ear started to deteriorate. Two years ago deafness of the right ear has occurred. During the last year patient reports headaches in the pre-morning hours. Currently her headache is constant and the above mentioned symptoms have developed. Determine the type of brain lesion.

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