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<p>神经病学历年题
BBS历年题全部（包括2010、2009年题目）
一．单项选择题
历年经验：绝大部分在宝典上。
真题整理：
1. Paralysis with upper motor neuron lesion must be considered by the following characters, EXCEPT:
A. Babinski sign;
B. Increased deep tendon reflexes;
C. Spastic characters;
D. Pseudobulbar paralysis;
E. Fasciculations.
2. Which one of the followings ISN'T one of the components of circle of Willis?
A. Internal carotid artery;
B. Middle cerebral artery;
C. Anterior communicating artery;
D. Posterior communicating artery;
E. Posterior cerebral artery.
3. The localization of lower motor neuron lesions include following sites, EXCEPT:
A. Anterior horn cells of spinal cord;
B. Caudal equina;
C. Conus medullaris;
D. Mesencephalic nucleus of trigeminal;
E. Pyramidal tract.
4. Localization of cerebellar hemisphere lesions must be considered by the following findings, EXCEPT:
A. Ipsilateral intention tremor;
B. Ipsilateral dysdiadochokinesia;
C. Ipsilateral dysmetria;
D. Ipsilateral hypotonicity;
E. Ipsilateral Paralysis.
5. Which of the followings are the core features of Parkinson's disease?
A. Bradykinesia, rigidity, and tremor;
B. Rigidity, shuffling gait, and tremor;
C. Rigidity, weakness, and tremor;
D. Shuffling gait, akinesia, and weakness;
E. Shuffling gait, pill-rolling, and akinesia.
6. About the features of "spinal shock", which one of the followings is WRONG?
A. Complete absence of reflex below the level of the injury;
B. Complete absence of autonomic activity below the level of the injury;
C. Flaccid paralysis;
D. Extensor plantar responses;
E. All of the above-mentioned
7. The following clinical criteria can make a diagnosis of definite MS (multiple sclerosis), but which one must be excluded?
A. Patient must have two separate central nervous system lesions;
B. Symptoms must have occurred in two or more separate episodes;
C. Symptoms must involve the white matter;
D. Symptoms must involve the gray matter;
E. Neurological examination must show objective abnormalities.
8. Female, 40. Unilateral headache accompanied nausea and vomiting for five years with various intensity, lasted an average of 24 hours (a range of 5 to 72 hours). The general medical and neurological examinations of this patient are normal. The most likely diagnostic possibility is:
A. Tension headache; B. Cluster headache;
C. Migraine; D. Secondary headache;
E. Hypochondriasis.
9. A 40-years old man developed bilateral facial weakness and difficulty in climbing stairs for one week after a respiratory illness. The most possible diagnosis is:
A. Bell's palsy; B. Multiple sclerosis;
C. Periodic paralysis; D. Guillain-Barré syndrome;
E. Motor neuron disease.
10. About the main presentation of Increased intracranial pressure (ICP), which one of the followings is the best?
A. Seizure, headache, papilledema;
B. Seizure, vomiting, papilledema;
C. Headache, vomiting, papilledema;
D. Headache, seizure, focal neurological signs;
E. Vomiting, seizure, focal neurological signs.
11. Trigeminal neuralgia is described as a brief electric shocktype pain limited to the distribution of any branch of the Trigeminal nerve. Which one of the following drugs is the best for its treatment?
A. Baclofen; B Carbamazepine;
C Vitamin B12; D Valproate;
E Alcohol blocks.
12. Myasthenia Gravis (MG) is a disorder of impairing the neuromuscular junction. The followings are correct, EXCEPT:
A. The patients have no abnormality of mental state;
B. The patients present with muscle weakness and fatigue;
C. The hallmark of MG is pathologic fatigability;
D. Eye findings are the most common with ptosis;
E. MG may effect pupillary function.
13. Muscular dystrophies are genetically determined primary diseases of muscle,characterized pathologically by muscle fiber degeneration. Which one of the followings is inherited as X-linked recessive traits?
A. Myotonic dystrophy;
B. Duchenne muscular dystrophy;
C. Limb-girdle dystrophy;
D. Oculopharyngeal muscular dystrophy;
E. Facioscapulohumeral muscular dystrophy;
14. Transverse myelitis is a syndrome of acute inflammation acting across the entire spinal cord. The following diagnostic evaluation should be carried out, EXCEPT:
A. MRI of the spinal cord; B Lumbar puncture;
C Vitamin B12 of the serum; D Sedimentation rate;
E DNA analysis.
15. Which of the following descriptions about transient ischemic attacks (TIAs)is the best?
A. TIAs are temporary dysfunction of brain tissue caused by inadequate blood flow;
B. Carotid artery territory TIAs often produce ipsilateral hand and arm weakness and sensory loss;
C. TIAs refer to brief, reversible focal neurological deficits that they must recover completely within 24 hours;
D. TIAs last only minutes and may occur in any vascular territory;
E. TIAs of the carotid territory include biocular blindness and transient hemisphere attacks.
16. Which one of the followings is correct about component parts of Corpus Striatum? A. Paleostriatum, pallidum, and basal ganglia;
B. Neostriatum, pallidum, and substantia nigra;
C. Lentiform nucleus, caudate nucleus, and pallidum;
D. Pallidum, caudate nucleus, and neostriatum;
E. Pallidum, putamen nucleus, and caudate nucleus.
17. About the main presentation of Increased intracranial pressure, which one of the followings is the best?
A. Seizure, headache, papilledema;
B. Seizure, vomiting, papilledema;
C. Headache, vomiting, papilledema;
D. Headache, seizure, focal neurological signs;
E. Vomiting, seizure, focal neurological signs.
18. Which one of the followings is a complete neurological examination?
A. Mental status, cranial nerves, coordinate function, sensory function and reflexes;
B. Mental status, cranial nerves, coordinate and motor function, sensory function and reflexes;
C. Cranial nerves, coordinate and motor function, sensory function and reflexes;
D. Cranial nerves, periphery nerves, motor function, sensory function and reflexes;
E. None of the above-mentioned.
19. A patient complains of the power of left limbs decreased for three months. The neurological examination showed the patient had right gaze preference, decreased muscle power(Ⅲ~Ⅳ) and increased deep tendon reflex in left limbs. The localization of this patient may be:
A. Left frontal lobe; B. Right frontal lobe;
C. Left parietal lobe; D. Right parietal lobe;
E. Thalamus
20. The feature of Brown-Sequard syndrome(hemisection of the spinal cord) is:
A. Ipsilateral thermanesthesia;
B. Ipsilateral anesthesia;
C. Contralateral hemiparesis;
D. Ipsilateral loss of vibratory sense;
E. Contralateral hemiparesis and hypalgesia.
21. Management of the patients with intracerebral hemorrhage (ICH) should be directed toward preserving remaining neurological function and preventing deterioration due to elevated ICP (intracranial pressure) with resultant coma or death. The following treatment methods are correct, EXCEPT:
A. An airway should be established;
B. The patients should be kept at bed rest;
C. CT scan of the brain should be executed immediately;
D. Blood pressure of the patients should be elevated by some drugs to increase cerebral blood flow;
E. The management of increased ICP includes the use of hyperventilation.
22. 男性，23岁。既往体健，两周前出现双下肢无力伴尿潴溜而入院。检查发现：双下肢肌力Ⅱ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，最有效的药物为：
A L－多巴制剂； B 安坦； C 金刚烷胺；
D 溴隐亭； 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3－4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。因单侧面颊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；
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（referred pain）*3
2．放射痛（radiating pain）*4
3．灼性神经痛（causalgia）
4．感觉异常（paresthesia）*2
5．脊髓半切综合症（Brown-Sequard syndrome）*2
6．静止性震颤（static tremor）*3
7．扭转痉挛（torsion spasm）*2
8．铅管样强直（lead-pipe rigidity）*3
9．齿轮样强直（cogwheel rigidity）*3
10．抽动症（tic）*3
11．辨距不良（dysmetria）
12．闭目难立征（Romberg sign）*5
13．福维尔综合征、脑桥腹内侧核综合征（Foville syndrome）
14．霍夫曼征（Hoffmann sign）
15．总体反射（mass reflex）
16．韦伯综合症、中脑腹侧部综合征（Weber syndrome）*3
17．米亚尔-居布勒综合症、脑桥腹下部综合征（Millard-Gubler syndrome）*2
18．闭锁综合征、去传出状态、脑桥腹侧综合征、Monte-Gristo综合征（locked-in syndrome、deefferented state、Monte-Cristo syndrome）*2
19．中脑顶盖综合征（Parinaud syndrome）
20．延髓背外侧综合征（Wallenberg syndrome）
21．核间性眼肌麻痹
22．霍纳综合征（Horner syndrome）*2
23．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（motor aphasia）
26．命名性失语、遗忘性失语（anomic aphasia）
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（spinal shock）
31．Gower征
32．肌无力危象（myasthenic crisis）
33．癫痫（epilepsy）
34．发作（seizure）
35．短暂性脑缺血发作、小卒中（transient ischemic attach、TIA、minor stroke）*3
36．可逆性缺血性脑功能缺失（reversible ischemic neurologic deficits、RIND）
37．脑底动脉环（Willis circle）*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*3
5．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*3
8．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*2
10．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*3
15．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*2
18．试述脑出血的主要处理原则*3
19．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*4
22．谈谈你对脑梗死急性期治疗的认识
23．缺血性中风的鉴别*2
24．出血性卒中的鉴别诊断或列表写出鉴别方法*2
25．格林巴利综合征的诊断和鉴别诊断*3
26．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。*2
29．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；*3
32．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*2
33．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？
34．试述急性横断性脊髓炎的临床表现与主要处理原则*3
35．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Ⅲ级，双下肢肌力Ⅳ级，肌张力低下，双侧二头肌反射（-），膝反射（-），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。*2
39．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。</p>
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