[MCQ] Cerebrovascular Diseases Ischemic stroke- Part 8

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Cerebrovascular Diseases Ischemic stroke- Part 8

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Question 1

Which segment of the vertebral artery pierce the dura at the foramen magnum ?

A	1
B	2
C	3
D	4

Question 1 Explanation:

Third segment of vertebral artery (V3) passes through transverse foramen and circles around the arch of the atlas to pierce dura at foramen magnum.

Question 2

Which of the following statements about vertebral artery is false ?

A	Arises from innominate artery on right side
B	Consists of four segments
C	Atherothrombotic lesion has predilection for V3 segment
D	None of the above

Question 2 Explanation:

Atherothrombotic lesions have a predilection for V1 & V4 segments of vertebral artery. Atheromatous disease rarely narrows second and third segments of vertebral artery, but this region is subject to dissection, fibromusc

Question 3

“Subclavian steal” is best related to ?

A	Raynauds phenomenon
B	Posterior circulation TIA
C	Upper limb clubbing
D	All of the above

Question 3 Explanation:

If the subclavian artery is occluded proximal to the origin of vertebral artery, there is reversal in the direction of blood flow in the ipsilateral vertebral artery. Exercise of the ipsilateral arm may increase demand on vertebral flow, producing posterior circulation TIAs, or “subclavian steal.”

Question 4

In medial medullary syndrome, which of the following structures is involved ?

A	Ipsilateral twelfth nerve
B	Contralateral pyramidal tract
C	Contralateral medial lemniscus
D	All of the above

Question 4 Explanation:

Medial medullary syndrome is due to occlusion of vertebral artery or branch of vertebral or lower basilar artery. Paralysis with atrophy of half tongue due to ipsilateral XII nerve occurs. On the opposite side, due to involvement of pyramidal tract & medial lemniscus, paralysis of arm & leg, impaired tactile & proprioceptive sense over half the body occur. Face is spared.

Question 5

Occlusion of which of the following artery is responsible for producing lateral medullary syndrome ?

A	Vertebral
B	Posterior inferior cerebellar
C	Superior lateral medullary artery
D	All of the above

Question 5 Explanation:

Occlusion of any of the five vessels is responsible for producing lateral medullary syndrome. They are vertebral, posterior inferior cerebellar, superior, middle or inferior lateral medullary arteries

Question 6

Which of the following is false for lateral medullary syndrome ?

A	Falling to side of lesion
B	Horner’s syndrome
C	Impaired touch over opposite half of face
D	Loss of taste

Question 6 Explanation:

Due to damage to descending tract and nucleus of fifth nerve, pain, numbness, impaired sensation over half the face occurs on the side of lesion.

Question 7

Which of the following is false for lateral medullary syndrome ?

A	Oscillopsia
B	Nystagmus
C	Strabismus
D	Dysphagia

Question 7 Explanation:

Due to damage to vestibular nucleus, nystagmus, diplopia, oscillopsia, vertigo, nausea & vomiting occur in lateral medullary syndrome. Dysphagia, hoarseness, paralysis of palate & vocal cord, diminished gag reflex occur due to damage to issuing fibers of IX & X nerves.

Question 8

Loss of taste in lateral medullary syndrome is due to lesion in ?

A	Nucleus of fifth nerve
B	Vestibular nucleus
C	Nucleus and tractus solitarius
D	Cuneate and gracile nuclei

Question 8 Explanation:

Loss of taste in lateral medullary syndrome is due to lesion in nucleus & tractus solitarius on side of lesion.

Question 9

Nystagmus, diplopia, oscillopsia, vertigo, nausea, vomiting in lateral medullary syndrome is due to lesion in ?

A	Descending sympathetic tract
B	Cerebellar hemisphere
C	Vestibular nucleus
D	Spinocerebellar tract

Question 9 Explanation:

Nystagmus, diplopia, oscillopsia, vertigo, nausea, vomiting in lateral medullary syndrome is due to lesion in Vestibular nucleus.

Question 10

Numbness of ipsilateral arm, trunk, or leg in lateral medullary syndrome is due to lesion in ?

A	Nucleus of fifth nerve
B	Vestibular nucleus
C	Nucleus and tractus solitarius
D	Cuneate and gracile nuclei

Question 10 Explanation:

Numbness of ipsilateral arm, trunk, or leg in lateral medullary syndrome is due to lesion in cuneate and gracile nuclei.

Question 11

Which of the following is not a part of lateral medullary (or Wallenberg’s) syndrome ?

A	Vertigo
B	Numbness of ipsilateral face
C	Numbness of contralateral limbs
D	Contralateral Horner’s syndrome

Question 11 Explanation:

Horner’s syndrome (miosis, ptosis, decreased sweating) occurs on side of lesion in lateral medullary syndrome due to damage to descending sympathetic tract.

Question 12

Which of the following is not a feature of vertebral artery occlusion ?

A	Vertigo
B	Diplopia
C	Hoarseness
D	Hemiparesis

Question 13

Constellation of bilateral long tract signs with signs of cranial nerve and cerebellar dysfunction is suggestive of ?

A	Complete basilar artery occlusion
B	Complete posterior cerebral artery occlusion
C	Complete middle cerebral artery occlusion
D	Complete anterior cerebral artery occlusion

Question 13 Explanation:

Constellation of bilateral long tract signs (sensory and motor) with signs of cranial nerve and cerebellar dysfunction is suggestive of complete basilar artery occlusion

Question 14

Which of the following syndromes occur due to occlusion of vertebral artery ?

A	Medial medullary syndrome
B	Lateral medullary syndrome
C	Total unilateral medullary syndrome
D	All of the above

Question 14 Explanation:

Occlusion of vertebral artery can produce medial and lateral and total unilateral medullary syndrome. The last one being a combination of medial and lateral syndromes.

Question 15

Lateral pontomedullary syndrome is due to occlusion of which of the following vessel ?

A	Vertebral artery
B	Basilar artery
C	Anterior inferior cerebellar artery
D	Superior cerebellar artery

Question 15 Explanation:

Lateral pontomedullary syndrome is due to occlusion of vertebral artery.

Question 16

Which of the following syndromes occur due to occlusion of anterior inferior cerebellar artery ?

A	Medial medullary syndrome
B	Medial inferior pontine syndrome
C	Lateral inferior pontine syndrome
D	All of the above

Question 16 Explanation:

Occlusion of anterior inferior cerebellar artery produces lateral inferior pontine syndrome

Question 17

Which of the following syndrome occurs due to occlusion of superior cerebellar artery ?

A	Lateral midpontine syndrome
B	Medial superior pontine syndrome
C	Lateral superior pontine syndrome
D	Total unilateral medullary syndrome

Question 17 Explanation:

Lateral superior pontine syndrome occurs due to occlusion of superior cerebellar artery - a branch of basilar artery.

Question 18

Corticobulbar and corticospinal tracts are damaged bilaterally due to occlusion of ?

A	Vertebral artery
B	Basilar artery
C	Anterior inferior cerebellar artery
D	Superior cerebellar artery

Question 18 Explanation:

Basilar artery or lone vertebral artery occlusion can damage corticobulbar and corticospinal tracts bilaterally. Complete basilar occlusion leads to a constellation of bilateral long tract signs (sensory and motor) with signs of cranial nerve and cerebellar dysfunction.

Question 19

Horner’s syndrome is produced by occlusion of which of the following arteries ?

A	Anterior inferior cerebellar artery
B	Superior cerebellar artery
C	Vertebral artery
D	All of the above

Question 19 Explanation:

In lateral medullary syndrome due to occlusion of vertebral artery, Horner’s syndrome occurs due to damage to descending sympathetic tract. Lateral inferior pontine syndrome due to occlusion of anterior inferior cerebellar artery produces Horner’s syndrome. Lateral superior pontine syndrome due to occlusion of superior cerebellar artery sometimes produces Horner’s syndrome.

Question 20

Deafness is produced by occlusion of which of the following arteries ?

A	Anterior inferior cerebellar artery
B	Upper basilar artery
C	Anterior cerebral artery
D	Any of the above

Question 21

Which of the following is not reliably detected by CT radiographic images ?

A	Cerebral infarction for first 24 to 48 hours
B	Ischemic strokes in posterior fossa
C	Small cortical infarcts
D	All of the above

Question 21 Explanation:

Cerebral infarction infarct may not be seen reliably for 24 to 48 hours. Also, CT may fail to show small ischemic strokes in posterior fossa and small infarcts on cortical surface.

Question 22

“Insular ribbon sign” is an earliest indicator of ?

A	Meningitis
B	Subarachnoid hemorrhage
C	Cerebral infarction
D	All of the above

Question 22 Explanation:

“Insular ribbon sign” is caused by edema within insular cortex and basal ganglia and is an earliest indicator of cerebral infarction in MCA territory.

Question 23

Which of the following is used to visualize extra- or intracranial arterial dissection ?

A	MR angiography
B	MRI with fat saturation
C	MRI with IV gadolinium contrast
D	All of the above

Question 23 Explanation:

MRI with fat saturation is used to visualize extra- or intracranial arterial dissection as it images clotted blood within dissected vessel wall.

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See all quizzes of Cerebrovascular Diseases Ischemic stroke at here:

Cerebrovascular Diseases Ischemic stroke- Part 1| Cerebrovascular Diseases Ischemic stroke- Part 2| Cerebrovascular Diseases Ischemic stroke- Part 3|Cerebrovascular Diseases Ischemic stroke- Part 4|Cerebrovascular Diseases Ischemic stroke- Part 5| Cerebrovascular Diseases Ischemic stroke- Part 6| Cerebrovascular Diseases Ischemic stroke- Part 7|Cerebrovascular Diseases Ischemic stroke- Part 8

1 Which segment of the vertebral artery pierce the dura at the foramen
magnum ?
A. 1
B. 2
C. 3
D. 4

2 Which of the following statements about vertebral artery is false ?
A. Arises from innominate artery on right side
B. Consists of four segments
C. Atherothrombotic lesion has predilection for V3 segment
D. None of the above

3 “Subclavian steal” is best related to ?
A. Raynauds phenomenon
B. Posterior circulation TIA
C. Upper limb clubbing
D. All of the above

4 In medial medullary syndrome, which of the following structures
is involved ?
A. Ipsilateral twelfth nerve
B. Contralateral pyramidal tract
C. Contralateral medial lemniscus
D. All of the above

5 Occlusion of which of the following artery is responsible for
producing lateral medullary syndrome ?
A. Vertebral
B. Posterior inferior cerebellar
C. Superior lateral medullary artery
D. All of the above

6 Which of the following is false for lateral medullary syndrome ?
A. Falling to side of lesion
B. Horner’s syndrome
C. Impaired touch over opposite half of face
D. Loss of taste

7 Which of the following is false for lateral medullary syndrome ?
A. Oscillopsia
B. Nystagmus
C. Strabismus
D. Dysphagia

8 Loss of taste in lateral medullary syndrome is due to lesion in ?
A. Nucleus of fifth nerve
B. Vestibular nucleus
C. Nucleus and tractus solitarius
D. Cuneate and gracile nuclei

9 Nystagmus, diplopia, oscillopsia, vertigo, nausea, vomiting in
lateral medullary syndrome is due to lesion in ?
A. Descending sympathetic tract
B. Cerebellar hemisphere
C. Vestibular nucleus
D. Spinocerebellar tract

10Numbness of ipsilateral arm, trunk, or leg in lateral medullary
syndrome is due to lesion in ?
A. Nucleus of fifth nerve
B. Vestibular nucleus
C. Nucleus and tractus solitarius
D. Cuneate and gracile nuclei

11 Which of the following is not a part of lateral medullary (or
Wallenberg’s) syndrome ?
A. Vertigo
B. Numbness of ipsilateral face
C. Numbness of contralateral limbs
D. Contralateral Horner’s syndrome

12 Which of the following is not a feature of vertebral artery occlusion ?
A. Vertigo
B. Diplopia
C. Hoarseness
D. Hemiparesis

13 Constellation of bilateral long tract signs with signs of cranial
nerve and cerebellar dysfunction is suggestive of ?
A. Complete basilar artery occlusion
B. Complete posterior cerebral artery occlusion
C. Complete middle cerebral artery occlusion
D. Complete anterior cerebral artery occlusion

14 Which of the following syndromes occur due to occlusion of
vertebral artery ?
A. Medial medullary syndrome
B. Lateral medullary syndrome
C. Total unilateral medullary syndrome
D. All of the above

15 Lateral pontomedullary syndrome is due to occlusion of which of
the following vessel ?
A. Vertebral artery
B. Basilar artery
C. Anterior inferior cerebellar artery
D. Superior cerebellar artery

16 Which of the following syndromes occur due to occlusion of
anterior inferior cerebellar artery ?
A. Medial medullary syndrome
B. Medial inferior pontine syndrome
C. Lateral inferior pontine syndrome
D. All of the above

18 Which of the following syndrome occurs due to occlusion of
superior cerebellar artery ?
A. Lateral midpontine syndrome
B. Medial superior pontine syndrome
C. Lateral superior pontine syndrome
D. Total unilateral medullary syndrome

19 Corticobulbar and corticospinal tracts are damaged bilaterally
due to occlusion of ?
A. Vertebral artery
B. Basilar artery
C. Anterior inferior cerebellar artery
D. Superior cerebellar artery

20 Horner’s syndrome is produced by occlusion of which of the
following arteries ?
A. Anterior inferior cerebellar artery
B. Superior cerebellar artery
C. Vertebral artery
D. All of the above

21 Deafness is produced by occlusion of which of the following
arteries ?
A. Anterior inferior cerebellar artery
B. Upper basilar artery
C. Anterior cerebral artery
D. Any of the above
22 Which of the following is not reliably detected by CT radiographic
images ?
A. Cerebral infarction for first 24 to 48 hours
B. Ischemic strokes in posterior fossa
C. Small cortical infarcts
D. All of the above

23 “Insular ribbon sign” is an earliest indicator of ?
A. Meningitis
B. Subarachnoid hemorrhage
C. Cerebral infarction
D. All of the above

24 Which of the following is used to visualize extra- or intracranial
arterial dissection ?
A. MR angiography
B. MRI with fat saturation
C. MRI with IV gadolinium contrast
D. All of the above

Cerebrovascular Diseases Ischemic stroke

[MCQ] Cerebrovascular Diseases Ischemic stroke- Part 8

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Cerebrovascular Diseases Ischemic stroke- Part 8

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