AIM LEARNING CYCLE | FINAL YEAR MBBS
KMU Past Paper Practice
Topic 8. Intracranial Space-Occupying Lesions, Pediatric Macrocephaly & Head Injury
Neuroscience-III | 20 A-Type Single Best Answer MCQs
KMU-style practice questions — not claimed to be original past-paper questions.
MCQ 1
Question:
A 34-year-old woman presents with progressive headache and difficulty seeing objects on either side while looking straight ahead. Examination demonstrates loss of temporal visual fields in both eyes. MRI reveals a sellar mass extending superiorly. Which structure is most likely being compressed?
Optic nerves within the orbits
Optic chiasm
Lateral geniculate bodies
Occipital visual cortex
Oculomotor nerves
MCQ 2
Question:
A 52-year-old patient develops progressive unilateral hearing loss, tinnitus and imbalance. MRI reveals a well-defined enhancing mass at the cerebellopontine angle extending into the internal auditory canal. Which lesion is most likely?
Pituitary macroadenoma
Frontal lobe glioma
Craniopharyngioma
Vestibular schwannoma
Falx meningioma
MCQ 3
Question:
A 43-year-old patient experiences focal seizures affecting the right hand. MRI identifies a small lesion adjacent to the left precentral gyrus. Which feature most strongly determines the need for careful neurosurgical planning before removal?
Proximity to functionally important motor cortex
Presence of headache without vomiting
Absence of a family history of epilepsy
Normal findings on peripheral nerve examination
Patient age below fifty years
MCQ 4
Question:
A 48-year-old man presents with headache and progressive personality change. MRI demonstrates a deeply located intracranial lesion. Imaging cannot reliably distinguish between neoplastic and inflammatory causes, and major resection would carry substantial neurological risk. Which approach may establish the diagnosis while limiting surgical tissue injury?
Repeated electroencephalography
Diagnostic lumbar puncture in every case
Stereotactic tissue biopsy
Serial plain skull radiography
Empirical radiotherapy without tissue assessment
MCQ 5
Question:
A 26-year-old patient undergoes treatment for a cerebral abscess arising from a contiguous infection. Despite appropriate intravenous antibiotics, repeat imaging shows a large accessible collection and persistent neurological symptoms. Which additional intervention is most appropriate?
Long-term observation without reassessment
Routine prophylactic radiotherapy
Repeated diagnostic lumbar puncture
Discontinuation of antimicrobial treatment
Neurosurgical drainage of the collection
MCQ 6
Question:
A 50-year-old patient with an intracranial neoplasm develops increasing neurological disability. MRI demonstrates a mass associated with extensive high-signal changes in surrounding white matter on T2-weighted images. These changes are attributed to blood–brain barrier disruption. Which process is responsible?
Cytotoxic edema due to acute ischemia
Vasogenic edema from extracellular fluid accumulation
Primary neuronal demyelination without edema
Increased cerebrospinal fluid production
Physiological expansion of cerebral ventricles
MCQ 7
Question:
A 3-year-old child presents with progressively worsening morning vomiting, impaired balance and abnormal gait. MRI reveals a midline posterior fossa mass involving the cerebellar vermis. Which clinical finding is most consistent with the anatomical site of this lesion?
Isolated unilateral facial sensory loss
Pure loss of language comprehension
Complete unilateral visual field loss
Truncal instability with a broad-based gait
Isolated distal lower motor neuron weakness
MCQ 8
Question:
A 7-year-old child is evaluated for a large head. Head circumference is above the expected range, but serial measurements are stable. Neurological examination is normal. Imaging reveals an increased volume of brain tissue without ventricular dilatation or an intracranial mass. Which term best describes this finding?
Megalencephaly
Obstructive hydrocephalus
Subdural hygroma
Craniosynostosis
Intracranial hemorrhage
MCQ 9
Question:
A 10-month-old child previously treated with a ventriculoperitoneal shunt is brought to hospital with fever, irritability, vomiting and poor feeding. Examination reveals tenderness along the shunt tract. Which complication should be suspected?
Physiological cranial enlargement
Uncomplicated postoperative adaptation
Primary peripheral nerve injury
Normal developmental head growth
Ventriculoperitoneal shunt infection
MCQ 10
Question:
A 5-month-old infant is referred for suspected macrocephaly. The pediatrician reviews serial head circumference measurements and assesses developmental milestones, fontanelle tension and parental head size. Which finding most strongly supports the need for further neurological investigation?
Consistent familial large head size
Normal neurological examination
Progressive developmental regression
Stable percentile tracking since birth
Normal feeding and activity pattern
MCQ 11
Question:
A 32-year-old patient sustains a head injury after falling from a height. Examination reveals bruising around both eyes and clear fluid draining from the nose. CT suggests an anterior cranial fossa fracture. Which complication is most likely?
Peripheral facial nerve paralysis
Cerebrospinal fluid rhinorrhea
Isolated optic neuritis
Acute middle ear infection
Primary retinal detachment
MCQ 12
Question:
A 28-year-old man sustains blunt head trauma. On neurological assessment he opens his eyes only to pain, produces incomprehensible sounds and withdraws his arm from a painful stimulus. What is his total Glasgow Coma Scale score?
7
9
10
8
11
MCQ 13
Question:
A 67-year-old man receiving oral anticoagulant therapy falls at home and strikes his head. He remains alert but complains of a persistent headache. Which factor particularly increases concern for significant intracranial bleeding despite an initially reassuring examination?
Regular use of corrective spectacles
Absence of scalp laceration
Normal peripheral pulses
Preserved orientation to time
Current anticoagulant treatment
MCQ 14
Question:
A 36-year-old patient is admitted following head trauma. Neurological examination shows an abnormal flexion response of both upper limbs to painful stimulation. Which Glasgow Coma Scale motor response category describes this finding?
Normal flexion withdrawal
Abnormal flexion to pain
Localization of painful stimulus
Abnormal extension to pain
Obeying verbal commands
MCQ 15
Question:
A 40-year-old patient with severe traumatic brain injury is being monitored in a neurosurgical unit. His intracranial pressure increases while systemic mean arterial pressure remains unchanged. What is the expected effect on cerebral perfusion pressure?
It increases proportionally to intracranial pressure
It becomes independent of systemic blood pressure
It falls as intracranial pressure rises
It remains unchanged despite pressure elevation
It rises because cerebral venous pressure decreases
MCQ 16
Question:
A 22-year-old man is involved in a road traffic accident. Examination reveals a depressed skull fracture with an overlying scalp wound and suspected contamination. Which complication is particularly associated with this injury pattern?
Intracranial infection due to an open fracture
Progressive benign cranial enlargement
Idiopathic intracranial hypertension
Isolated degenerative cervical disease
Primary hereditary cerebral atrophy
MCQ 17
Question:
A 30-year-old patient is evaluated after a severe head injury. CT demonstrates scattered areas of hemorrhage and edema within the frontal and temporal cerebral parenchyma, particularly near the inferior surfaces of the brain. Which injury best explains these findings?
Isolated cranial suture separation
Chronic ventricular obstruction
Primary pituitary neoplasm
Traumatic cerebral contusions
Congenital arachnoid malformation
MCQ 18
Question:
A 45-year-old patient with severe traumatic brain injury develops increasing agitation and declining consciousness. The treating team decides that repeated neurological assessments are necessary. Which change provides the clearest evidence of neurological deterioration?
Improvement in response to verbal commands
New reduction in Glasgow Coma Scale motor response
Maintenance of symmetrical reactive pupils
Stable respiratory and circulatory parameters
Recovery of previously reduced limb movement
MCQ 19
Question:
A 35-year-old man is reviewed after cranial surgery for traumatic brain injury. His neurological condition has improved, but the family reports that he has stopped taking prescribed antiseizure medication without consulting the treating team. Which counselling point is most appropriate?
All antiseizure medicines should continue indefinitely after head injury
Prescribed treatment can be stopped whenever symptoms improve
Medication decisions are unrelated to postoperative neurological status
Antiseizure treatment removes the need for follow-up visits
Medication should be taken as prescribed and reviewed with the treating clinician
MCQ 20
Question:
A 54-year-old patient is preparing for discharge following neurosurgical treatment of a traumatic cranial injury. The family lives far from the hospital and is concerned about caring for him at home. Which discharge plan best supports safe postoperative care?
Discharge without written advice because the patient is conscious
Allow unrestricted physical activity as soon as the wound is dry
Provide wound-care guidance, warning signs, medicines and a follow-up plan
Advise the family to avoid communicating with the surgical team
Arrange follow-up only if a new skull fracture develops
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