[MCQ] Subarachnoid hemorrhage (SAH)- Part 1

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Subarachnoid hemorrhage (SAH)- Part 1

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Congratulations - you have completed Subarachnoid hemorrhage (SAH)- Part 1. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which of the following is false about idiopathic SAHs localized to perimesencephalic cisterns ?

A	Benign
B	Venous or capillary source
C	Angiography is unrevealing
D	None of the above

Question 1 Explanation:

Some idiopathic SAHs are localized to perimesencephalic cisterns and are benign with a venous or capillary source. Angiography is unrevealing.

Question 2

Which of the following is the most common cause of SAH ?

A	Rupture of a saccular aneurysm
B	Bleeding from a vascular anomaly
C	Extension into subarachnoid space from a primary intracerebral hemorrhage
D	Idiopathic

Question 2 Explanation:

After head trauma, the most common cause of SAH is rupture of a saccular aneurysm

Question 3

What percentage of adults harbor intracranial aneurysms ?

A	1 %
B	2 %
C	3 %
D	4 %

Question 3 Explanation:

Autopsy & angiography studies show that ~2% of adults harbor intracranial aneurysms.

Question 4

In SAH, the rate of rebleeding in the first month is about ?

A	20 %
B	30 %
C	40 %
D	50 %

Question 4 Explanation:

In SAH, if the patient survives but aneurysm is not obliterated, the rate of rebleeding is about 20% in first 2 weeks, 30% in first month.

Question 5

An aneurysm is termed ‘Giant’ when its diameter is ?

A	> 0.5 cm
B	> 1.0 cm
C	> 1.5 cm
D	> 2.5 cm

Question 5 Explanation:

Berry aneurysms >2.5 cm in diameter are called giant aneurysms.

Question 6

Most common location of an intracranial aneurysm is ?

A	Anterior communicating artery
B	Posterior communicating artery
C	Terminal internal carotid artery
D	Vertebral artery

Question 7

Most common location of an intracranial aneurysm is ?

A	Anterior communicating artery
B	MCA bifurcation
C	Posterior communicating artery
D	Middle of basilar artery

Question 8

Most common location of an intracranial aneurysm is ?

A	Anterior communicating artery
B	Posterior communicating artery
C	Top of basilar artery
D	Middle of basilar artery

Question 8 Explanation:

The three most common locations of berry aneurysms are the terminal internal carotid artery, MCA bifurcation, and top of basilar artery.

Question 9

Mycotic aneurysms are best related to ?

A	Hypertension
B	Diabetes mellitus
C	Bacterial endocarditis
D	Trauma

Question 10

Mycotic aneurysms are usually located distal to which bifurcation of major arteries of circle of Willis ?

A	1st
B	2nd
C	3rd
D	4th

Question 10 Explanation:

Mycotic aneurysms due to infected emboli are usually located distal to the first bifurcation of major arteries of the circle of Willis.

Question 11

Anterior circulation accounts for what percentage of all intracranial aneurysms ?

A	25 %
B	45 %
C	65 %
D	85 %

Question 11 Explanation:

~85 % of aneurysms occur in the anterior circulation, mostly on the circle of Willis

Question 12

What percentage of all intracranial aneurysms are multiple ?

A	5 %
B	10 %
C	20 %
D	40 %

Question 12 Explanation:

~20% of patients have multiple aneurysms, many at mirror sites bilaterally.

Question 13

Which of the following characteristics of a berry aneurysm make it at greater risk of rupture ?

A	>7 mm in diameter
B	At the top of basilar artery
C	At the origin of posterior communicating artery
D	Any of the above

Question 13 Explanation:

Those >7 mm in diameter and those at the top of the basilar artery and at the origin of the posterior communicating artery are at greater risk of rupture.

Question 14

The site of rupture of a berry aneurysm is ?

A	Base of the neck
B	Top of the neck
C	Dome
D	Any of the above

Question 14 Explanation:

The site of rupture of a berry aneurysm most often is the dome.

Question 15

Patients first complaint upon regaining consciousness in SAH is ?

A	Blurred vision
B	Headache
C	Thirst
D	Nausea

Question 15 Explanation:

Most patients first complain of headache upon regaining consciousness

Question 16

The location of headache in SAH is ?

A	Frontal
B	Occipital
C	Temporal
D	Generalized

Question 16 Explanation:

In SAH, headache is usually generalized, often with neck stiffness and vomiting.

Question 17

Common deficits that result due to middle cerebral bifurcation aneurysmal rupture include all except ?

A	Hemiparesis
B	Aphasia
C	Abulia
D	Acalculia

Question 17 Explanation:

ACA or MCA bifurcation aneurysms may rupture into adjacent brain or subdural space and form a hematoma large enough to produce mass effect resulting in hemiparesis, aphasia and abulia.

Question 18

III cranial nerve palsy, with pupillary dilatation, loss of ipsilateral light reflex and focal pain above or behind the eye suggests what location of an aneurysm ?

A	Posterior communicating artery aneurysm
B	Aneurysm in the cavernous sinus
C	Anterior cerebral artery aneurysm
D	Anterior inferior cerebellar artery aneurysm

Question 19

VI cranial nerve palsy suggests what location of an aneurysm ?

A	Posterior communicating artery aneurysm
B	Aneurysm in the cavernous sinus
C	Anterior cerebral artery aneurysm
D	Anterior inferior cerebellar artery aneurysm

Question 20

Occipital and posterior cervical pain suggests what location of an aneurysm ?

A	Posterior communicating artery aneurysm
B	Aneurysm in the cavernous sinus
C	Anterior cerebral artery aneurysm
D	Anterior inferior cerebellar artery aneurysm

Question 21

Visual field defects suggests what location of an aneurysm ?

A	Posterior communicating artery aneurysm
B	Aneurysm in the cavernous sinus
C	Anterior cerebral artery aneurysm
D	Anterior inferior cerebellar artery aneurysm

Question 22

Occipital and posterior cervical pain suggests what location of an aneurysm ?

A	Posterior communicating artery aneurysm
B	Aneurysm in the cavernous sinus
C	Anterior cerebral artery aneurysm
D	Posterior inferior cerebellar artery aneurysm

Question 23

Pain in or behind the eye and in the low temple suggests what location of an aneurysm ?

A	Posterior communicating artery aneurysm
B	Aneurysm in the cavernous sinus
C	Anterior cerebral artery aneurysm
D	MCA aneurysm

Question 23 Explanation:

III cranial nerve palsy associated with pupillary dilatation, loss of ipsilateral light reflex and focal pain above or behind the eye, may occur with an expanding aneurysm at the junction of posterior communicating artery and internal carotid artery. VI cranial nerve palsy may indicate an aneurysm in cavernous sinus, and visual field defects can occur with an anterior cerebral artery aneurysm. Occipital and posterior cervical pain may signal a posterior inferior cerebellar artery or anterior inferior cerebellar artery aneurysm. Pain in or behind the eye and in the low temple can occur with an expanding MCA aneurysm.

Question 24

‘Sentinel bleed’ is the term used for small aneurysmal rupture into ?

A	Subarachnoid space
B	White matter
C	Gray matter
D	Thalamus

Question 24 Explanation:

Aneurysms with small ruptures & leaks of blood into subarachnoid space are sentinel bleeds

Question 25

‘Wide-neck aneurysms’ are those in which the ratio of neck diameter to that of the largest dome is ?

A	> 0.2
B	> 0.3
C	> 0.4
D	> 0.5

Question 26

In a case of SAH who also has third-nerve palsy, which artery is possibly involved ?

A	Anterior communicating artery
B	Posterior communicating artery
C	Anterior cerebral artery
D	Middle cerebral artery

Question 27

In a case of SAH who also has bilateral weakness in legs or abulia, which artery is possibly involved ?

A	Anterior communicating artery
B	Posterior communicating artery
C	Anterior cerebral artery
D	Middle cerebral artery

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See all quizzes of Subarachnoid hemorrhage (SAH) at here:

1 Which of the following is false about idiopathic SAHs localized to
perimesencephalic cisterns ?A. Benign
B. Venous or capillary source
C. Angiography is unrevealing
D. None of the above

2 Which of the following is the most common cause of SAH ?
A. Rupture of a saccular aneurysm
B. Bleeding from a vascular anomaly
C. Extension into subarachnoid space from a primary
intracerebral hemorrhage
D. Idiopathic

3 What percentage of adults harbor intracranial aneurysms ?
A. 1 %
B. 2 %
C. 3 %
D. 4 %

3 In SAH, the rate of rebleeding in the first month is about ?
A. 20 %
B. 30 %
C. 40 %
D. 50 %

3 An aneurysm is termed ‘Giant’ when its diameter is ?
A. > 0.5 cm
B. > 1.0 cm
C. > 1.5 cm
D. > 2.5 cm

4 Most common location of an intracranial aneurysm is ?
A. Anterior communicating artery
B. Posterior communicating artery
C. Terminal internal carotid artery
D. Vertebral artery
5 Most common location of an intracranial aneurysm is ?
A. Anterior communicating artery
B. MCA bifurcation
C. Posterior communicating artery
D. Middle of basilar artery
6 Most common location of an intracranial aneurysm is ?
A. Anterior communicating artery
B. Posterior communicating artery
C. Top of basilar artery
D. Middle of basilar artery

7 Mycotic aneurysms are best related to ?
A. Hypertension
B. Diabetes mellitus
C. Bacterial endocarditis
D. Trauma

8 Mycotic aneurysms are usually located distal to which bifurcation
of major arteries of circle of Willis ?
A. 1st
B. 2nd
C. 3rd
D. 4th

9 Anterior circulation accounts for what percentage of all
intracranial aneurysms ?
A. 25 %
B. 45 %
C. 65 %
D. 85 %

10 What percentage of all intracranial aneurysms are multiple ?
Harrison’s 17th Ed. 1727
A. 5 %
B. 10 %
C. 20 %
D. 40 %

11 Which of the following characteristics of a berry aneurysm make
it at greater risk of rupture ?
A. >7 mm in diameter
B. At the top of basilar artery
C. At the origin of posterior communicating artery
D. Any of the above

11 The site of rupture of a berry aneurysm is ?
A. Base of the neck
B. Top of the neck
C. Dome
D. Any of the above

12 Patients first complaint upon regaining consciousness in SAH is ?
A. Blurred vision
B. Headache
C. Thirst
D. Nausea

13 The location of headache in SAH is ?
A. Frontal
B. Occipital
C. Temporal
D. Generalized

14 Common deficits that result due to middle cerebral bifurcation
aneurysmal rupture include all except ?
A. Hemiparesis
B. Aphasia
C. Abulia
D. Acalculia

15 III cranial nerve palsy, with pupillary dilatation, loss of ipsilateral
light reflex and focal pain above or behind the eye suggests what
location of an aneurysm ?
A. Posterior communicating artery aneurysm
B. Aneurysm in the cavernous sinus
C. Anterior cerebral artery aneurysm
D. Anterior inferior cerebellar artery aneurysm
16 VI cranial nerve palsy suggests what location of an aneurysm ?
A. Posterior communicating artery aneurysm
B. Aneurysm in the cavernous sinus
C. Anterior cerebral artery aneurysm
D. Anterior inferior cerebellar artery aneurysm
17 Occipital and posterior cervical pain suggests what location of an
aneurysm ?
A. Posterior communicating artery aneurysm
B. Aneurysm in the cavernous sinus
C. Anterior cerebral artery aneurysm
D. Anterior inferior cerebellar artery aneurysm
18 Visual field defects suggests what location of an aneurysm ?
A. Posterior communicating artery aneurysm
B. Aneurysm in the cavernous sinus
C. Anterior cerebral artery aneurysm
D. Anterior inferior cerebellar artery aneurysm
19 Occipital and posterior cervical pain suggests what location of an
aneurysm ?
A. Posterior communicating artery aneurysm
B. Aneurysm in the cavernous sinus
C. Anterior cerebral artery aneurysm
D. Posterior inferior cerebellar artery aneurysm
20 Pain in or behind the eye and in the low temple suggests what
location of an aneurysm ?
A. Posterior communicating artery aneurysm
B. Aneurysm in the cavernous sinus
C. Anterior cerebral artery aneurysm
D. MCA aneurysm

21 ‘Sentinel bleed’ is the term used for small aneurysmal rupture
into ?
A. Subarachnoid space
B. White matter
C. Gray matter
D. Thalamus

22 ‘Wide-neck aneurysms’ are those in which the ratio of neck diameter
to that of the largest dome is ?
A. > 0.2
B. > 0.3
C. > 0.4
D. > 0.5
23 In a case of SAH who also has third-nerve palsy, which artery is
possibly involved ?
A. Anterior communicating artery
B. Posterior communicating artery
C. Anterior cerebral artery
D. Middle cerebral artery
24 In a case of SAH who also has bilateral weakness in legs or
abulia, which artery is possibly involved ?
A. Anterior communicating artery
B. Posterior communicating artery
C. Anterior cerebral artery

D. Middle cerebral artery

Subarachnoid hemorrhage (SAH)

[MCQ] Subarachnoid hemorrhage (SAH)- Part 1

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Subarachnoid hemorrhage (SAH)- Part 1

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