FCPS IMM Surgery Neurosurgery MCQs: High-Yield Practice Questions & Prep

Neurosurgery is one of the subject blocks in the FCPS IMM Surgery QBank. It covers head injury, intracranial haemorrhage, brain and spinal tumours, hydrocephalus and spinal trauma. Below is a sample set in the style of the bank, with the reasoning after each answer.

Sample MCQs

1. A 6-year-old with headache, projectile vomiting, papilloedema and sun-setting eyes has:

• A) Hydrocephalus ✅
• B) Migraine
• C) Meningitis
• D) Subdural haematoma

Why: Raised ICP causes sun-setting sign by pressure on the tectum.

2. The most common benign brain tumour is:

• A) Glioma
• B) Medulloblastoma
• C) Meningioma ✅
• D) Ependymoma

Why: Meningiomas show psammoma bodies and arise from arachnoid cells.

3. Prognosis of head injury is best given by

• A) APGAR chart
• B) CT head
• C) Glasgow coma scale ✅
• D) Sliding Scale

Why: The Glasgow Coma Scale best predicts prognosis in head injury.

4. The evaluation of a comatose patient with a head injury begins with:

• A) The cardiovascular system.
• B) Pupillary reflexes.
• C) Establishment of an airway. ✅
• D) Computed tomography (CT) of the brain.

Why: ATLS principles apply: airway with cervical spine protection comes first, then breathing, circulation and neurological assessment.

5. Which hormone is controlled by an inhibitory factor from the hypothalamus?

• A) Prolactin (inhibited by dopamine) ✅
• B) Growth hormone only
• C) TSH
• D) ACTH

Why: Dopamine tonically inhibits prolactin release from the anterior pituitary.

6. Projection fibres of the cerebral hemisphere pass through which structure?

• A) Corpus callosum
• B) Anterior commissure
• C) Fornix
• D) Internal capsule ✅

Why: The internal capsule carries ascending and descending projection fibres between cortex and brainstem/spinal cord.

7. Which osmotic diuretic is used in raised intracranial pressure?

• A) Furosemide
• B) Mannitol ✅
• C) Hydrochlorothiazide
• D) Spironolactone

Why: Mannitol is an osmotic diuretic that reduces brain edema and ICP.

8. Which anaesthetic induction agent should be avoided in neurosurgery because it raises intracranial pressure?

• A) Ketamine ✅
• B) Thiopentone
• C) Propofol
• D) Etomidate

Why: Ketamine increases cerebral blood flow and ICP; it is useful in children and hypotensive patients.

9. Extradural haematoma is caused by rupture of:

• A) Bridging veins
• B) Berry aneurysm
• C) Basilar artery
• D) Middle meningeal artery ✅

Why: EDH typically has a lucid interval and a lentiform CT appearance.

10. Port-wine stains are low flow vascular malformations. They are characterised by all of the following EXCEPT:

• A) Pale to deep red in colour
• B) With ageing, the surface often becomes studded with nodular lesions
• C) Pyogenic granuloma may develop within the port-wine stain
• D) X-ray shows typical intracranial calcifications ✅

Why: Intracranial calcification is a feature of Sturge-Weber, not of simple port-wine stains.

How to Study This Block

• Learn the Glasgow Coma Scale and the indication for CT in head injury.
• Distinguish extradural, subdural and subarachnoid bleeds by CT appearance and tempo.
• Know the red flags for cord compression.

Each subject in the QBank can be filtered on its own, so you can drill neurosurgery until your accuracy is stable. Confirm the exam format and syllabus against the current CPSP guidelines.

Frequently Asked Questions

How is neurosurgery tested in IMM?

Mostly as emergency presentations: head injury, intracranial bleeds, raised intracranial pressure and cord compression.

Does it include spinal surgery?

Yes, spinal trauma, disc disease and tumours are covered.

Practise With the Full QBank

The FCPS IMM Surgery QBank has a free trial batch in Tutor mode, subject filters and Timed mode. Related: complete exam guide, how to use recalls.