神经内科出科考试7（Neurological examination 7）

神经内科出科考试7(Neurologicalexamination7)

Name:cultivateapass:60total:100secondsremainingtime:

Neurologicalexaminationname:mold

I.radioquestions(100questions,1pointseach)

1..Thelong-termcomplicationsoflevodopacontaining

compoundpreparationswere4~5yearslater

A.Nauseaandvomiting

Bglaucomaandpsychiatricsymptoms

C.Symptomswingsandmovementdisorders

D.Slowabsorptionofdrugsanddecreasedserumconcentration

E.Elevatedtransaminaseandpaleurine

2.thediagnosisofbasilarimpressionisbasedonthetipof

odontoidprocess

A.Chamberlainline2mmabove

B.Chamberlainline3mmabove

C.Chamberlain1ine4mmabove

D.Chamberlainline35mmabove

E.Chamberlainline58mmabove

3.determinewhichofthefollowingistrue

A.TheairandbonecortexareblackregardlessoftheT1or

T2weightedimages

B.TheheartcavityandthelargevesselsweredarkinT1and

T2weightedimages

C.Thereislesshydrogenintheairandcortex,andthemagnetic

resonancesignalsareweak

D.Allright

E.Allofthisisincorrect

4.ofthepatientshadcerebellartumors,andthemostprobable

symptomwas

A.Increasedmuscletone

B.Tendonreflexdisappeared

Cataxia

D.Silenttremor

Ehemiplegia

5.oftheopticnerveatrophy,andtheothereyeedema,often

becauseofthenipple

A.Increasedintracranialpressure

B.Thetumorofonesideofthefrontallobe

C.Opticdiscinflammationoftheweb

D.Onesidetemporallobelesion

E.Lesionsneartheorbitalfissure

6.thecharacteristicclinicalmanifestationsofcortical

syndromeare

A.Pathologicalsignnegative

B.Thedisappearanceoflightreflexes,thepresenceofcorneal

reflexes

C-wakefulness-thesleepcycledisappears

D.Upperlimbflexionandlower1imbextension

E.Consciousmasticationandswallowing

7.paralysisinthemotorcortexoftheprecentralgyrusis

mostlymanifestedas

Acrossparalysis

B.Theupperandlowerlimbsparalysisorunequalhemiplegia

C.Completeparalysisoftheupperandlowerextremities

D.Paralysisoflimbs

Eparaplegia

Thelocalizationofthesegmentofthe8.patellarreflexis

A.LIto2

B.L2to4

C.L4to5

D.SIto2

E.S3to5

9.whichofthefollowingiswrongabouttheanatomyofthe

cerebralvessels?

A.Comparedwithotherextracranialarteriesofthesame

diameter,thewallsofthecerebralarteriesarethinner,

especiallythemedialandoutermembranes

B.Cerebralveinsareaccompaniedbyarterieswithvenous

valves

Cthevenoussinusisthemostrigidvesselinthebody.Itis

inelastic

Dthecerebralvesselsincludethecerebralarterialsystemand

thecerebralvenoussystem,andthecerebralarterysystemis

dividedintothecarotidandvertebralbasilararterysystems

10.cerebralhemorrhage,clinicalappearanceofhemianopia,

contralateralhemiplegiaandcontralaterallimbsensory

disturbance,disturbanceofconsciousnessappearedearlyand

heavy,shouldbeconsidered

A.Basalgangliahemorrhage,medial

B.Basalgangliahemorrhage,lateraltype

C.Thalamichemorrhage

Dlobarhemorrhage.

11.cerebralvasospasmfollowingsubarachnoidhemorrhage

occursaftertheonsetofthedisease

A.Minutestohoursand4~12days,twotimeperiods

B.Minutestohoursand2~3days,twotimeperiods

C.Minutestohoursand15~20days,twotimeperiods

D.Minutestohoursand20~30days,twotimeperiods

12.whichofthefollowingstatementsiswrongwithregardto

thethrombosisoftheintracranialvenoussystem?

A.Themainfindingsarehighintracranialpressureandimaging,

suggestingthatthedevelopmentoftheintracranialvenous

systemisunclearorthecirculationtimeofthebrainis

prolonged

B.Thenatureofthrombusisinflammatory

C.Whenthethrombusisformed,thevenousbloodcirculation

ofthebraintissueinthecorrespondingpartisblocked,and

congestion,edemaandnecrosisoccurinthebraintissue,

resultinginanincreaseofintracranialpressure

D.Severeischemicinfarction,hemorrhagicinfarction,or

intracerebralhemorrhagemayoccur,

Itcanalsoinvolvethecranialnerves

13.aboutsubclavianstealsyndrome,whichofthefollowing

statementsiswrong?

A.Symptomsofoveractiveupper1imb

B.Manifestationofvertebrobasilarischemia

C.Ischemicmanifestationsofthecarotidsystem

Dthebloodpressureoftheipsilateralupperlimbwashigher

thanthatofthecontralateralside20mmHg

14.a35yearoldmalepresentedwithlessfrequentnauseaand

fever,andsmellthespecialsmelllikerottingfish,left

facialtwitchingandnotinafewminutesspeechwillbe

subsequently,thenconscioustrance,afterwardsnomemoryfor

theattack,ifMRIaremostlikelytobefoundinwhichbrain

lesions

Aleftfrontallobe

B.Rightfrontallobe

C.Sieveplate

D.Hookback

E.Leftparietallobe

ThetypicalmanifestationofCSFin15.MSpatientsis

Aglucoselevelswerelowerthan20%ofserumglucoselevels

Bproteinlevelscontinuedtorise

C.IgGlevelscontinuedtorise

D.Asinglecellcountsmorethan100/mm3

E.Redbloodcellcountexceeds10/mm3

16.female,28yearsold,doublelegsweakness,1weeks,this

dayurinatedifficult.Halfayearagoblurredvisionfor1

months,thatexaminationofopticneuritis,T2:significantly

decreasedpain,temperaturesensation,musclestrengthof

lowerlimbs2degrees,hyperreflexia,andpositiveBabinski

sign.Whichofthefollowingchecksismostmeaningful?

A.SerumIgG

B.Routineexaminationofcerebrospinalfluid

C.BrainMRI

DthoracicX-rayfilm

Visualevokedpotential,E

Myastheniagravisisthemostcommonmanifestationof17.MG

A-diaphragmaticmuscleweakness

B.Dropyourwrists

Cpedal.

D.Ocularmuscleweakness

E.Swallowingweakness

Thepathogenesisof18.DMDiscausedbyanabnormalgenewhich

isresponsibleforthesynthesisofthefollowingproteins

A.Glucose-6-phosphatase

BhexokinaseB

Cmyosin

D.Dystrophin

Eactin

19.female,32yearsold,therighteyelidptosisfor6months,

morninglightTwilightweight,5daystoswallow,chewand1imb

weakness,2daysfever,cough,speechweakness,breathing

difficulties10minutesago.Physicalexamination:ShenQing,

lefteyelidptosis.ThesoundoflowlimbmusclestrengthIII,

chestabdominalbreathingshallow,28/min,mildcyanosis1ip.

Immediatemeasuresare

A.Intravenousinjectionofdexamethasone

B.Intravenousinjectionofantibiotics

CchestX-rayfilm

D.Immediateoraladministrationofpyridiniumbromide

Eintravenousinjectionofedrophonium.

Themostprominentneurologicalcomplicationofinfectiousyon,

Economo,,sencephalitis(somnolenceencephalitis),

accompaniedbyviralinfluenzafrom20.1917to1928

A.Blindness

B.Hearingloss

Cparaplegia

D.Parkinson'sdisease

Eincontinence

21.alargecystisformedintheparasitebrainlesion,which

containsnumerouscysts

A.Taeniasolium

B.Schistosomamansoni

C.Echinococcus

D.Broadsectiontapeworm

E.Schistosomajaponicum

22.infectedwithBorreliaburgdorferiduetotickbite,the

skinaroundthebitesitewillappear

Aexfoliativedermatitis

Bpurpura

C.Localedema

D-chronicmigratoryerythema

E.Vesicularlesions

23.EWpostganglionicfibersaredistributedinthe

A.Sphincterofpupil

B.Majoropenmuscleofpupil

NoC.

Dsphincterofpupilandciliarymuscle.

Edilatorpupillaemuscleandciliarymuscle.

Thecauseofthe24.Shy-Dragersyndromeis

A.Smallarteryspasm

B.Smallandmediumarteryspasm

C.Smallarterydilatation

D.Degenerationofspinalcordlateralhorncells

E.Sympatheticgangliondegeneration

25..A28yearoldmanpresentedwithstutteringandconfusion

ofspeechafewmonthsago,andwasslowlyincreased.Hewas

foundtohaveintermittentspeech,nystagmus,limbdeviation,

andmotortremor,andhewasmentallynormal.Hematocritwas

0.inthispatient

55,urineroutinefoundredbloodcellsandincreasedprotein,

urineculturenegative.Preliminaryexaminationfound

hepatosplenomegaly,furtherexaminationmaybefound

A.TheK-Fringaroundthecornea

B.Lowpigmentedleukoplakiaofthetrunk

C.Retinaltelangiectasia

Dbilateralhearingloss

E.Reductionofgeneralreflex

26.,a67yearoldmanpresentedwithprogressivememoryloss

for2years,andnoabnormalitiesweredetectedinotherareas,

diagnosedasAlzheimer'sdisease.Whatkindofmedicineslows

downtheprogressionofthedisease?

A.Donepezil

B.L-dopa

Crisperidone(Risperidone)

D.Prednisone

E.VitaminB12

27.thefollowingarenotthecommonclinicalmanifestations

ofacuteviralmyocarditis

Afeverfirst,thenpalpitations,chesttightness

B.Nausea,vomitingandotherdigestivesymptoms

C.Cancombineal1kindsofarrhythmia

D.Organicheartmurmuroftenoccurs

E.Tachycardiaisparalleltothedegreeoffever

28.malepatients,27yearsold,complainedofrecurrent

weakness,every2or3Dwererecovered,andtodaysudden

weakness,onexamination,emergencydepartmentvisits,limbs

musclestrengthofgrade1,thedepthoffeelingnormal,tendon

reflexes,Babinskisignisnegative,thepatientsshoulddois

check

A.Cerebrospinalfluid

B.Electromyogram

C.EEG

D.MRIofthespinalcord

E.Urgentexaminationofbloodpotassiumandelectrocardiogram

29.,malepatients,68yearsold,nearly1yearshavepoor

urination,urinedripping,almostIDsuddenlyappearurine

volumedecrease,nohematuria,abdominalpain,pain,kidney

areapercussionpain(+),themostlikelydiagnosisis

A.Renaltumor

B.Renaltuberculosis

C.Kidneystones

D.Polycystickidney

E.Obstructivenephropathy

30.whichofthefollowingdiseasesappearnotpulmonary

cyanosiscyanosis

Aobstructiveemphysema

B.Primarypulmonaryhypertension

Cpneumonia

D.Pneumothorax

EFallottetrad

31.aboutthesystolicextraheartsound,thefollowingis

correct

A.Thepulmonaryarteryejectionsoundsmostloudlyattheright

edgeofthesternumandthesecond,thirdintercostalspaces

B.Theaorticejectionsoundsattheleftedgeofthesternum

andthesecond,thirdintercostalsounds

C.Pulmonaryarteryejectionsoundscanbeseeninatrialseptal

defect

D.Earlysystolicejectionsoundsarecommoninmitralvalve

prolapse

E.Aorticejectionsoundsaffectedbyrespiration

32.stoolwithalargeamountofmucus,andnopathological

componentsshouldbeconsidered

Acholera

B.Acuteenteritis

C.Acutebacillarydysentery

D.Chronicdiarrhea

Eirritablebowelsyndrome

33.femalepatients,13yearsold,physicalexaminationfound

pulse78/min,pulseirregularity,inspiratorypulserhythm

increases,slowdownwhenbreathing.Thisisdueto

A.Alternatingpulses

Bazygospulse

C.Sinusarrhythmia

D.Atrialanteriorcontraction

E.Atrialfibrillation

34.femalepatients,aged28years,whohadbeendiagnosedwith

dysenteryaftervomitinganddiarrhea,werediagnosedwith

amebicdysentery.Thepatienthadtypicalbowelmovements

OccultbloodwasA.

B.Washthestoolwithwater

C.Jamlikestools

D.Purulentstool

E.Looksnormal

35.totalbilirubinconcentrationismorethanhowmany,can

discoverictericontheclinical

A.1.7mol/L

B.7.1mol/L

C.13.4mol/L

D.17.1mol/L

E.34.2mol/L

36.whichofthefollowingissuitableforpleuralbiopsy?

A.Pleuralgranulomalesions

B-thrombocytopeniaassociatedwithsystemiclupus

erythematosus

Cempyema

D.Pulmonarytuberculosisleadstopleuralfistula

E.Notallofthem

37.themostimportantcauseofdeathisacuteorganophosphorus

pesticidepoisoning

A.Toxicshock

B.Acuterenalfailure

C.Respiratoryfailure

D.Toxicmyocarditis

E.

Disturbanceofelectrolyteacid-basebalance

38.femalepatients,aged45,halfayeartoheartburn,acid

regurgitation,chestdiscomfort,showednopositivesigns,no

abnormalendoscopicexamination,ECGexaminationshowedno

abnormalities,furtherdiagnosisandtreatmentplanfor

A.X-rayexaminationofbariumswallowofesophagus

B.Repeatedstoolroutine+occultbloodtest

C.24hesophagealpHmonitoring

D.Tumormarkers

E.Exfoliativecytologyofesophagealmucosa

The39.yearoldmalepatient,30,hypertension1years,fever,

sorethroat,hematuria,3D,ID.Physicalexamination:theblood

pressureis160/100mmHg,thepharynxisred,thetonsilsare

swollen,andthelowerextremitiesarenotswollen.Laboratory

examination:urineprotein2.5g/d,urinesedimentmicroscopy,

redbloodcellfullfieldofvision,serumcreatinine200mu

mol/L,urinarygravity1.018,liverfunctionnormal,denialof

hepatitisBhistory,bloodIgAhigh.Denyingfamilyhistoryof

hypertension.Themostprobableclinicaldiagnosisis

Aacuteglomerulonephritis

B.Acutenephritis

C.Acuteattackofchronicglomerulonephritis

Doccultglomerulonephritis

Enephroticsyndrome

40.women,28yearsold,6monthspregnant,whitebloodcell

from40to50/HPexaminationfound,withoutfrequent

micturition,urgencyanddysuria,nopain,nofever.Further

cleaningofmidstreamurineculturesshowedEscherichiacoli

growth.Themainmeasuresfortreatmentare

A.Nocure

B.Antituberculosistreatment

C.Oralantibiotics

D.Intravenousantibiotics

Elongcourselowdoseantibacterialtherapy

41.whenmultipleepisodesofacuteexacerbationsor

exacerbationsoccur,priorityshouldbegiventoselection

A.Antibiotics

B.Painkiller

C.Vitamins

D.Adrenergiccorticalhormone

E.Neurotrophicagents

42.oneofthepatientswithcerebralvasculardisease,oneside

ofthenerveandabducensnerveparalysis,accompaniedby

contralateralupperandlowerlimbscentralparalysis,the

lesionsitein

A.Cerebralcortex

B.Internalcapsule

C.Midbrain

D.Pons

E.Medullaoblongata

43.ofthepatients,female,63yearsold,havebeendiagnosed

withdiabetesfor1months,andnearly2yearshaveoften

sufferedtransientlossofconsciousness,fall,and

immediatelywakeupandstandupafterfallingdown.Consider

thepatient,sdiagnosisas

A.Vertebrobasilarinsufficiency

B.Syncope

Cabsenceseizures

D.Lossoftensionepisodes

E.Lowbloodsugar

44.malepatients,50yearsold,sufferedfromheadacheand

vomiting,bodytemperatureof40DEGC,accompaniedby

agitation,frequentepilepticseizuresandcomaafter2D,and

deathafter3D.Thepathologicalexaminationincluded

intracerebralhemorrhagenecrosisandintranuclearinclusion

bodies.Thediseaseis

A.Adenovirusencephalitis

B.Cytomegalovirusencephalitis

Cacutedisseminatedencephalomyelitis

D.Herpeszosterencephalitis

E.Herpessimplexencephalitis

45.,sulfuricacidmistakenlyattractedtheskinmucous

membraneburns,skinandmucouscrustswerepresented

A.White

B.Red

C.Black

DBrown

E.Yellow

46.malepatients,aged58years,withahistoryofliver

cirrhosisfor3years,wereadmittedwith,'consciousnesstrance

3D“asthechiefcomplaint.Whichofthefollowingiswrongwith

thediagnosisofhepaticencephalopathy?

A.Whitevinegarenema+arginine

B.Proteinfreediet+levodopa

Cneomycin+sodiumglutamate.

Dlactuloseenema+arginine

E.Soapenema+levodopa

47.patients,female,25.Gumandnasalbleeding7dadmitted.

Conjunctivaandnailbedpale,limbsandtrunkskinvisible

bleedingandecchymosis.Hb52g/L,WBC31x109/L,PLT20*109/L,

bloodsmearshowedalargenumberofimmaturecells,alarge

amountofpurpleredgranulesinthecytoplasm,andvisible

purpleredstick.Themostprobablediagnosisis

Aacutepromyelocyticleukemia,AML

B.Aplasticanemia

Cacutemyeloidleukemia,AML

D.Primarythrombocytopenicpurpura

Eacutelymphoblasticleukemia

48.malepatients,aged36and3weeksago,hadacold,

Fever,cough,runnynose,1weeksEryu,inrecentdays,butalso

asenseofdizziness,chesttightness,shortnessofbreath,

physicalexamination:heartrate106/min,thelawisneat,

smelland2/6levelofapicalsystolicmurmur.AssaysofWBC10.8

*109/L,ESR25mm/lh,CK-MBandLDHwereincreased,Twaveof

ECGisgenerallyloworinverted,clinicaldiagnosisismost

likely

A.Rheumaticmyocarditis

B.Viralmyocarditis

C.Infectiveendocarditis

Doccultcoronaryheartdisease

E.Endomyocardialinfarction

49.malepatients,aged20,hasbeentakingantihypertensive

drugsfor2years,thepooreffectofbloodpressure,

26.6/14.6kPa(200/1lOmmHg),leftupperabdominalvascular

murmurcanbeheard,forreasonsofhypertension,themost

valuableisthecheck

A.Intravenouspyelography

B.Abdominal(doublekidney)Bultrasound

C.Radionucliderenaltomography

D.Renalarteriography

E.Determinationofvenousplasmareninactivity

50.farmersuseherbicides(ORDRAM)farmtospraycrops,

dizziness,nauseaandvomiting,sweating,salivation,

fasciculation.Tothepatientaftertreatmentapplication

A.Diazepam

B.Atropine

C.Atropine+phosphorusphosphate

D.VitaminC

Ehormone

51.malepatients,aged38,bilateralwristjoint,proximal

interphalangealjointswellingofthehandsof6months,with

morningstiffness.Physicalexamination:redpatchesonthe

scaleswereseenatthehairline,andhandX-rayshowedthe

fingersoftheproximalphalanxwereabsorbed.Themost

probablediagnosisis

A.Ankylosingspondylitis

B.Rheumatoidarthritis

C.Osteoarthritis

DReitersyndrome

E.Psoriaticarthritis

52.enhancedspeechtremoriscommoninchestpalpation

Alargechangestageoflobarpneumonia

B.Subcutaneousemphysemaofchestwall

C.Emphysema

D.Massivepleuraleffusion

E.Pneumothorax

53.whichofthefollowingperiodsarethemostfrequent

floodingsounds?

A.Earlyinspiratory

B.Middleinspiratoryperiod

C.Latebreathing

D.Midexpiratoryperiod

E.Latebreath

54.ofthemostcommondiseasesarehematemesis

Aesophagealorgastricvaricesrupture

B.Acutegastricmucosallesion

Cpepticulcer

D.Pancreaticcancer

E.Esophagealcarcinoma

55.patients,27yearsold,recurrentepigastricpain,hunger

occurs,aftereatingrelief,thepatient,sabdominalpainis

dueto

Apancreatitis

Bcholecystitis

Cpepticulcer

Dhemophilia

E.Cholelithiasis

56.femalepatients,41yearsold,checktheleftsternalmargin

ofthechest,third,fourthintercostalabnormalpulse,the

diagnosismaybe

A.Rightventricularhypertrophy

B.Rightheart

C.Ascendingaorticdilatation

D.Leftventricularhypertrophy

E.Peritonealeffusion

57.femalepatients,60yearsold,suddenprecordialpain,

sustained1Hdoesnotrelieve,ECGshowedVItoV5STsegment

shift,nausea,vomiting,stomachcontent,thecauseofvomiting

belongsto

A.Centralvomiting

B.Neurogenicvomiting

C-reflexvomiting

D.Intestinalvomiting

E.Gastricvomiting

58.whichofthefollowingiswrongabouttheconceptofspider

moles?

A.Mostofthemappearinthedistributionareaofsuperiorvena

cava

B.Thepressureisgone

C.Physicalexaminationrevealedspidernevussuggesting

abnormal1iverfunction

D.Theappearanceofspiderneviisrelatedtotheinactivation

ofestrogenbytheliver

E.Varyinsize

59.ofthefollowingdiseasesarepronetoearlychangesin

cellularlungdisease

A.Chronicbronchitis

B.Bronchiectasis

C.Idiopathicpulmonaryfibrosis

D.Lupuspneumonia

Esilicosis

60.aboutrheumatoidfactor(RF)description,thecorrectthing

isthat

A.Thatis,rheumatoidarthritisshouldbeconsidered

B.Exceptforrheumatoidarthritis

C.Ithasnothingtodowiththeactivityofthedisease

D.

Rheumatoidnodulesoftenassociatedwith

E.Thetiterisobviouslyhigher.Itcanbeseeninankylosing

spondylitis

The61.FroinsignreferstotheamountofCSFproteinthatis

morethanthenumberofautocoagulation

A.0.Ig/L

B.Ig/L

C.lOg/L

D.lOOg/L

E.lOOOg/L

Poisoningmechanismof62.benzeneandtwonitrogendrugs

AisassociatedwiththeenhancedGABAergicfunctionofthe

nerve

Bmainlyactsontheascendingactivationsystemofreticular

formation

Cinhibitsdopaminereceptorsinthecentralnervoussystem

Dcaninhibitthebrainstemvascularmotorcenter

E.Blockingalphaadrenergicreceptors

63.malepatient,48yearsold,wasdiagnosedwithfever,7d,

accompaniedbygeneralmalaise,headache,anorexia,nausea,

myalgia,arthralgiaandlymphadenopathy.Pasthistory:the

patienthadlostimportedbloodproductspriortoadmissionto

thehospitalatlOd.Afteradmissiontestsbloodsmearnegative

Plasmodium,serumHIVmarkersandRNAcheckonlyHIVp24antigen,

WBC6.4*109/L,PLT20*109/L,ALT36U/L,ALB41g/L,CD8+Tcells

increased;urineroutineexamination:proteinnegative,WBCO

~2/HPRBCO〜1/HP.ThepatientshouldbediagnosedwithAIDS,

whichphaseoftheclinic?

A.Incubationperiod

B,phaseI

StageCII

StageDIII

EIV.stageIV.

64.atpresent,themostrecognizedetiologyandpathogenesis

ofTIAare

A.Theoryofcerebralvasospasm

B.Hemorheologytheory

C.Hemodynamicstheory

D.Embolizationtheory

E.Brainstealblood

65.themostcommoninitialsymptomofParkinson'sdiseaseis

A.Gearlikerigidity

B.Silenttremor

C.Wrotesmallsigns

D.Flusteredgait

E.Weakarticulation

66.patients,male,23yearsold,angryaftertherightside

ofthebrainseverepain,accompaniedbyrighteyelidptosis,

diplopia,righteyefixation,pupillightreactiondisappeared,

headCTnoobviousabnormalities,themostneedtoidentifywith

whichdisease

A.Subarachnoidhemorrhage

B.VertebrobasilararteryTIA

C.Migrainewithoutaura

D.Migrainewithaura

E.Migrainewithspecificcharacteristics

67.patients,female,34yearsold,3yearsagobecauseof

binoculardiplopia,ataxia,gaitinstability,hospitalization,

2monthsafterthedisappearanceofsymptoms.2weeksafterthe

lossofbinocularvision,withtheretentionofurineandurine,

paraplegiaandrehospitalization.Thediagnosistobe

consideredisthat

A.Acutepoliomyelitis

B.Multiplesclerosis

C.Spinalcordcompression

D.Motorneurondisease

E.Acutemyelitis

68.whichofthefollowingstatementsiswrongaboutcovert

infections?

A.