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1、神经病学历年题一.单项选择题历年经验：绝大部分在宝典上。真题整理：I.Paralysiswithuppermotorneuronlesionmustbeconsideredbythefollowingcharacters,EXCEPT:A. Babinskisign;B. Increaseddeeptendonreflexes;C. Spasticcharacters;D. Pseudobulbarparalysis;E.Fasciculations.2. WhichoneofthefollowingsISNToneofthecomponentsofcircleofWillis?A. Inte
2、rnalcarotidartery;B. Middlecerebralartery;C. Anteriorcommunicatingartery;D. Posteriorcommunicatingartery;E. Posteriorcerebralartery.3. Thelocalizationoflowermotorneuronlesionsincludefollowingsites,EXCEPT:A. Anteriorhomcellsofspinalcord;B. Caudalequina;C. Conusmedullaris;D. Mesencephalicnucleusoftrig
3、eminal;4. Pyramidaltract.5. 1.ocalizationOfcerebellarhemispherelesionsmustbeconsideredbythefollowingfindings,EXCEPT:A. Ipsilateralintentiontremor;B. IpsilateralClysdiadochokinesia;C. Ipsilateraldysmetria;D. Ipsilateralhypotonicity;E. IpsilateralParalysis.6. WhichofthefollowingsarethecorefeaturesofPa
4、rkinsonsdisease?A. Bradykinesia,rigidity,andtremor;B. Rigidity,shufflinggait,andtremor;C. Rigidity,weakness,andtremor;D. Shufflinggait,akinesia,andweakness;E. Shufflinggait,pill-rolling,andakinesia.7. Aboutthefeaturesofspinalshock,whichoneofthefollowingsisWRONG?A. Completeabsenceofreflexbelowtheleve
5、loftheinjury;B. Completeabsenceofautonomicactivitybelowtheleveloftheinjury;C. Flaccidparalysis;D. Extensorplantarresponses;E. Alloftheabove-mentioned8. ThefollowingclinicalcriteriacanmakeadiagnosisofdefiniteMS(multiplesclerosis),butwhichonemustbeexcluded?A.Patientmusthavetwoseparatecentralnervoussys
6、temlesions;9. Symptomsmusthaveoccurredintwoormoreseparateepisodes;10. Symptomsmustinvolvethewhitematter;11. Symptomsmustinvolvethegraymatter;12. NeurologicalexaminationmustshowobjectiveabnOrmalities.8. Female,40.Unilateralheadacheaccompaniednauseaandvomitingforfiveyearswithvariousintensity,1astedana
7、verageof24hours(arangeof5to72hours).Thegeneralmedicalandneurologicalexaminationsofthispatientarenormal.Themostlikelydiagnosticpossibilityis:A.Tensionheadache;B.Clusterheadache;C.Migraine;D.Secondaryheadache;E.Hypochondriasis.9. A40-yearsoldmandevelopedbilateralfacialweaknessanddifficultyinclimbingst
8、airsforoneweekafterarespiratoryillness.Themostpossiblediagnosisis:A.Bellspalsy;B.Multiplesclerosis;C.Periodicparalysis;D.Guillain-BarrGsyndrome;E.Motorneurondisease.10. AboutthemainpresentationofIncreasedintracranialpressure(ICP),whichoneofthefollowingsisthebest?A. Seizure,headache,papilledema;B. Se
9、izure,vomiting,papilledema;C. Headache,vomiting,papilledema;D. Headache,seizure,focalneurologicalsigns;E. Vomiting,seizure,focalneurologicalsigns.11. TrigeminalneuralgiaisdescribedasabriefelectricshocktypepainlimitedtothedistributionofanybranchoftheTrigeminalnerve.Whichoneofthefollowingdrugsisthebes
10、tforitstreatment?A.Baclofen;BCarbamazepine;CVitaminB12;DValproate;EAlcoholblocks.12. MyastheniaGravis(MG)isadisorderofimpairingtheneuromuscularjunction.Thefollowingsarecorrect,EXCEPT:A.Thepatientshavenoabnormalityofmentalstate;B.Thepatientspresentwithmuscleweaknessandfatigue;C. ThehallmarkofMGispath
11、ologicfatigability;D. Eyefindingsare(hemostcommonwithptosis;E. MGmayeffectpupillarj,function.13.Musculardystrophiesaregeneticallydeteninedprimarydiseasesofmuscle,characterizedpathological1ybymusclefiberdegeneration.WhichoneofthefoilowingsisinheritedasX-Iinkedrecessivetraits?A. Myotonicdystrophy;B. D
12、uchennemusculardystrophy;C. 1.imb-girdledystrophy;D. Oculopharyngealmusculardystrophy;E. Facioscapulohumeralmusculardystrophy;14. Transversemyelitisisasyndromeofacuteinflammationactingacrosstheentirespinalcord.Thefollowingdiagnosticevaluationshouldbecarriedout,EXCEPT:A.MRIofthespinalcord;BLumbarpunc
13、ture;CVitaminB12oftheserum;DSedimentationrate;EDNAanalysis.15. Whichofthefollowingdescriptionsabouttransientischemicattacks(TIAs)isthebest?A. TIAsaretemporarydysfunctionofbraintissuecausedbyinadequatebloodflow;B. CarotidarteryterritoryTIAsoftenproduceipsilateralhandandanweaknessandsensoryloss;C. TIA
14、srefertobrief,reversiblefocalneurologicaldeficitsthattheymustrecovercompletelywithin24hours;D. TIAslastonlyminutesandmayoccurinanyvaseularterritory;E. TIAsofthecarotidterritorj,includebiocularblindnessandtransienthemisphereattacks.16. WhichoneofthefollowingsiscorrectaboutcomponentpartsofCorpusStriat
15、um?A.Paleostriatum,pallidum,andbasalganglia;B.Neostriatum,pallidum,andsubstantianigra;C.Lentifbrmnucleus,caudatenucleus,andpallidum;D.Pallidum,caudatenucleus,andneostriatum;E.Pallidum,putamennucleus,andcaudatenucleus.17. AboutthemainpresentationofIncreasedintracranialpressure,whichoneof(hefollowings
16、isthebest?A.Seizure,headache,papilledema;B. Seizure,vomiting,papilledema;C. Headache,vomiting,papilledema;D. Headache,seizure,focalneurologicalsigns;E. Vomiting,seizure,focalneurologicalsigns.18. Whichoneof(hefollowingsisacompleteneurolOgicalexamination?A. Mentalstatus,cranialnerves,coordinatefuncti
17、on,sensor),functionandreflexes;B. Mentalstatus,cranialnerves,coordinateandmotorfunction,sensoryfunctionandreflexes;C. Cranialnerves,coordinateandmotorfunction,sensoryfunctionandreflexes;D. Cranialnerves,peripherynerves,motorfunction,sensoryfunctionandreflexes;E. Noneoftheabove-mentioned.19. Apatient
18、complainsofthepowerofleftlimbsdecreasedforthreemonths.Theneurologicalexaminationshowedthepatienthadrightgazepreference,decreasedmuscleower(IIIIV)andincreaseddeeptendonreflexinleftlimbs.Thelocalizationofthispatientmaybe:A.Leftfrontallobe;B.Rightfrontallobe;C.Leftparietallobe;D.Rightparietallobe;E.Tha
19、lamus20. ThefeatureofBrown-Sequardsyndrome(hemisectionofthespinalcord)is:A. Ipsilateralthermanesthesia;B. Ipsilateralanesthesia;C. Contralateralhemiparesis;D. Ipsilaterallossofvibratorysense;E. Contralateralhemiparesisandhypalgesia.21.Managementofthepatientswithintracerebralhemorrhage(ICH)shouldbedi
20、rectedtowardpreservingremainingneurologicalfunctionandpreventingdeteriorationduetoelevatedICP(intracranialpressure)withresultantcomaordeath.Thefollowingtreatmentmethodsarecorrect,EXCEPT:A. Anairwayshouldbeestablished;B. Thepatientsshouldbekeptatbedrest;C. CTscanofthebrainshouldbeexecutedimmediately;
21、D. Bloodpressureofthepatientsshouldbeelevatedbysomedrugstoincreasecerebralbloodflow;E. ThemanagementofincreasedICPincludestheuseofhyperventilation.22 .男性，23岁。既往体健，两周前出现双卜肢无力伴尿潴溜而入院。检查发现：双下肢肌力11级，脐以下感觉缺失。入院后进行腰穿，脑脊液检查结果正常。根据以上的临床表现，患者最可能的诊断是：A脊髓空洞症；B急性脊髓炎：C脊髓压迫症；D格林巴利综合症；E脊髓蛛网膜炎。23 .目前有关帕金森氏病的治疗，最有效的
22、药物为:AL一多巴制剂；B安坦；C金刚烷胺；D溟隐亭；E多巴胺。24 .男性，11岁。癫痫大发作史三年，服用苯妥英纳治疗后，病情较稳定，现每年发作34次，以下哪项是错误的：A坚持上课；B少看电视；C暑期天天去游泳，加强体质锻炼；D不乘坐高空游艺机：E养成规律的生活习惯。25.女性，30岁。睁眼困难伴复视二年，晨轻暮重，休息后好转。下列检查有助于明显诊断，除外：A新期的明试验；B疲劳试验；C胸部CT扫描；D乙酰胆碱受体抗体测定；E椎管造影。26.女性，45岁。因单侧面烦部发作性针刺疼痛一年余就诊。疼痛持续时间较短，数秒钟至2分钟不等。体检该病人时应特别注意：A面颊部有无压痛；B两侧瞳孔是否等大；
23、C两侧眼球运动及光反射是否正常；D面部疼痛觉及角膜反射是否异常：E咽部感觉、运动是否异常。二.名词解释1 .牵涉痛(referredpain)*32 .放射痛(radiatingpain)*43 .灼性神经痛(causalgia)4 .感觉异常(paresthesia)*25 .脊髓半切综合症(Brown-Sequardsyndrome)*26 .静止性震颤(statictremor)*37 .扭转痉挛(K)rsionspasm)*28 .铅管样强直(lead-piperigidity)*39 .齿轮样强直(cogwheelrigidity)*310 .抽动症(tic)*311 .辨距不良(d
24、ysmetria)12 .闭目难立征(Rombergsign)*513 .福维尔综合征、脑桥腹内侧核综合征(Fovillesyndrome)14 .霍夫曼征(Hoffmannsign)15 .总体反射(massreflex)16 .韦伯综合症、中脑腹侧部综合征(Webersyndrome)*317 .米亚尔-居布勒综合症、脑桥腹下部综合征(Millard-Gublersyndrome)*218 .闭锁综合征、去传出状态、脑桥腹侧综合征、Monte-Gristo综合征(IOCkedinsyndromedeefferentedstateMonte-Cristosyndrome)*219 .中脑顶盖
25、综合征(PariIlaUdSyndrome)20 .延髓背外侧综合征(Wallenbergsyndrome)21 .核间性眼肌麻痹22 .霍纳综合征(HOrnerSyndrome)*223 .阿罗瞳孔、Argyll-Robertson瞳孔24 .感觉性失语、听觉性失语、Wernicke失语25 .运动性失语、表达性失语、Broca失语(motoraphasia)26 .命名性失语、遗忘性失语(anomicaphasia)27 .失用症、运用不能(apraxia)28 .折刀样肌张力增高29 .Jackson癫痫30 .脊髓休克(spinalshock)31 .Gower征32 .肌无力危象(m
26、yastheniccrisis)33 .癫痫(epilepsy)34 .发作(SeiZUre)35 .短暂性脑缺血发作、小卒中(transientischemicattachTIA、minorstroke)*336 .可逆性缺血性脑功能缺失(reversibleischemicneurologicdeficits、RIND)37 .脑底动脉环（Williscircle）*2三.大题1 .Brown-Sequard综合症的诊断与鉴别诊断2 .脊髓性感觉障碍的分型和表现3 .脑干病变的特点4 .癫痫药物治疗的基本原则*35 .癫痫的治疗原则6 .癫痫与其它发作性疾病的鉴别、癫痫的鉴别诊断*38 .
27、癫痫持续状态的定义和治疗9 .试述癫痫大发作间隙期药物治疗原则与注意事项*210 .对于一名初发癫痫的患者，应当如何做出全面的诊断？11 .试述癫痫药物治疗的原则以及违反原则可能给病人带来的后果12 .失神发作的主要临床表现和脑电图特点13 .全身强直阵挛发作单纯性失神发作精神运动性发作的特点与首选药14 .帕金森病的治疗*315 .帕金森病的药物治疗16 .帕金森病的主要临床表现（用英语回答）17 .脑出血和蛛网膜下腔出血鉴别*218 .试述脑出血的主要处理原则*319 .脑血栓发作和脑梗塞的鉴别诊断20 .急性脑血栓形成与脑出血鉴别21 .蛛网膜下隙出血的治疗*422 .谈谈你对脑梗死急性
28、期治疗的认识23 .缺血性中风的鉴别*224 .出血性卒中的鉴别诊断或列表写出鉴别方法*225 .格林巴利综合征的诊断和鉴别诊断*326 .格林-巴利综合征的临床表现27 .试述急性感染性多发性周围神经病的诊断要点及主要处理原则。*229 .重症肌无力的诊断和治疗30 .重症肌无力的主要临床特点是什么？何谓肌无力危象？31 .试述各型重症肌无力危象的鉴别诊断及肌无力危象处理原则；*332 .重症肌无力病例诊断及诊断依据确诊需哪些进一步检查治疗*233 .病例题，延髓肌型重症肌无力患者，女，28岁。1）该患者最可能的诊断？要和哪些疾病鉴别？2）需要进一步做哪些检查？3）该疾病的治疗方法有哪些？3
29、4 .试述急性横断性脊髓炎的临床表现与主要处理原则*335 .上下运动神经元瘫痪的鉴别诊断要点36 .上下运动神经元组成及鉴别37 .试述硬膜内髓内、外脊髓压迫症的鉴别诊断要点；38 .女性，40岁。入院前二周曾发热，流清水鼻涕，在本院门诊拟诊”上呼吸道感染”。入院前一天患者感四肢末端发麻、乏力。入院时体检：神清。双侧额纹减少及眼裂闭合欠佳，双侧鼻唇沟浅。双上肢肌力In级，双下肢肌力IV级，肌张力低下，双侧二头肌反射（一）,膝反射（一）,肘、膝关节远端肢体痛觉减退。试分析该病人的诊断及主要处理原则。*239 .男性，58岁。言语不清半天伴右侧肢体活动障碍。查体：运动性失语，右侧中枢性面舌瘫，右侧肢体瘫痪，右侧偏身感觉障碍。急查头颅CT未见异常。分析该病人可能的诊断及处理原则。
