神经外科主治医师题专业实践能力

精品文档_______________________________________________________________________________________________________________________________________________________神经外科主治医师题-专业实践能力1、脑疝确诊后最先采取的治疗措施是()A.立即行脑室引流脑脊液B.立即行MRI查C.立即行CT检查D.立即钻孔探查E.立即静脉输给降颅压药物2、小脑幕切迹疝的典型临床表现)A.昏,病变同侧瞳孔扩,对侧偏瘫B.昏,病变对侧瞳孔扩,对侧偏瘫C.头,呕,突然呼吸衰竭D.昏,病变对侧瞳孔扩,同侧偏瘫E.昏,病变对侧瞳孔先小后大,同侧偏瘫3、幕上急性硬膜外血肿引起再次昏迷的主要原因()A.脑水肿B.小脑幕切迹疝C.脑干挫裂伤D.脑血管痉挛E.枕骨大孔疝_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________4、脑疝发生后下列哪项措施是禁忌的()A.保持呼吸道通畅B.脑室穿刺引流脑脊液C.立即静滴甘露醇D.积极明确病因，尽早去除病因E.腰椎穿刺引流脑脊液5、有明显颅内压增高症状和体征的病人哪项检查重()A.头颅X线摄片B.腰穿C.MRID.头颅CT描E.核素扫描6、颅内压增高患者的一般处理，哪项是错误的()A.吸氧B.保持呼吸道通畅C.观察生命征变化D.高位灌肠以疏通大便E.一抬高床头_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________7、颅内压增高的重要客观体征是()A.展神经麻痹B.头皮静脉怒张C.双侧视乳头水肿D.视力减退E.视野缩小8、正常成人颅内压为()A.0.7~2.0kPa(70~200mmHO)B.1.0~1.5kPa(100~150mmHO)C.0.5~1.0kPa(50~100mmHO)D.0.8~2.1kPa(80~210mmHO)E.1.0~2.5kPa(100~250mmHO0)9、颅内压增高引起最严重的后果)A.Cushing反应B.胃肠功能紊乱C.脑疝D.血管源性脑水肿E.细胞毒性脑水肿10、凹陷性骨折下列哪一项正()_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________A.均引起颅压增高B.均需手术C.均属开放性骨折D.非功能区,小面积不考虑手术E.压迫脑重要部位引起症状需手术11、对于严重颅内压增高病人，首选的降颅压药物是)A.20%甘露醇B.双氢克尿塞C.乙酰唑胺D.50%甘油盐水溶液E.地塞米松12、诊断血管疾病最有价值查是()A.MRIB.脑血管造影CCTD.头部X线摄片E.MRA13、颅内压增高病人的一般处理，下列哪项是错误的)A.抬高床头_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________B.吸氧C.观察生命征变化D.高位灌肠以疏通大便E.保持呼吸道通畅14、枕大孔疝与小脑幕切迹疝的主要鉴别点是()A.频繁呕吐B.烦躁不安C.血压下降D.早期发生吸骤停E.剧烈头痛15、下列哪一项可引起海绵窦症状()A.中颅底骨折B.前颅底骨折C.后颅窝骨折D.颅盖骨骨折E.开放性骨折16、精神症状常见于)A.顶叶肿瘤B.小脑肿瘤_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________C.肺叶肿瘤D.颞叶肿瘤E.额叶肿瘤1730下10侧瞳孔散大，光反射（-，左侧肢体偏瘫，左侧病理征(+)，诊断首先考虑()A.左枕部急性硬膜下血肿伴脑疝B.左枕部脑挫裂伤伴脑疝C.左枕部急性硬膜外血肿伴脑疝D.右额颞急性硬膜下血肿伴脑疝E.右额颞急性硬膜外血肿伴脑疝18、高血压脑出血最常见的部位是()A.脑叶B.基底核C.脑干D.小脑E.丘脑19、癫痫发常见于()A.额,颞,松果体区肿瘤_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________B.额,顶,肿瘤C.枕,额,肿瘤D.额,顶,瘤E.额,鞍,肿瘤20、性硬膜下血肿指伤后多长时间出现症状)A.2周内B.3周内C.l周内D.3周后E.2个月后21、开放脑损伤最重要的处施是()A.清创B.分层缝合头皮C.止血D.缝合修补膜损伤E.切除碎骨片22、急性颅脑损的临床分型型的GCS评分()A.6~10分B.8~15分_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________C.3~5分D.9~12分E.13~20分23枕下棒击伤双侧瞳不等大双侧增高；双侧病理征阳性，头颅CT未见明显血肿，最可能的诊断()A.小脑幕切迹疝B.原发性脑干损伤C.弥散性轴索损伤D.脑挫裂伤E.脑震荡24据伤后出现症状的时间分为性,亚急性,慢性颅内血肿的标准是()A.3天以内,3天至3周,3周以上B.2天以内,2天至2周,2周以上C.3天以内,3天至2周,2周以上D.1天以内,1天至1周,1周以上E.3天以内,3天至4周,4周以上25、下列哪项不属于原发性脑损伤()A.脑内血肿_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________B.脑干损伤C.脑震荡D.脑挫裂伤E.弥漫性轴索损伤26、关于脑震荡下列哪项不正()A.神经系统检查无阳性体征B.逆行性遗忘C.CT检查可见点状出血D.伤后短暂识障碍E.腰穿无红细胞27、脑挫裂伤意障碍下列哪正确()A.程度和持续时与脑挫裂伤相关B.多在半小时以上C.伤后立即出现D.程度和持续时与脑挫裂伤相关E.中间清醒期是其特点28、颅脑损伤伴视损伤下列哪项不正确()A.伤后立即出现瞳孔散大B.间接光反应消失_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________C.常为前颅窝骨折所致D.直接光反应消失E.间接光反应存在29、脑震荡的治疗正确的)A.激素治疗B.脱水治疗C.不需治疗D.止血治疗E.对症治疗30、急性硬膜下血肿不正确的()A.可由脑内血至硬脑膜下B.中间清醒期是其特点C.好发于额,颞极及其底面D.病情一般多较重E.大多由对冲挫裂伤所致31、急性硬膜外血肿意识障碍最典型的特征)A.昏-清-迷B.昏-清醒C.昏-昏迷_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________D.清-昏迷E.昏-好-迷32、幕上急性硬膜外血肿最多见于()A.额顶区B.顶枕区C.颞区D.额极区E.矢状窦区33、下列哪项属于原发性脑损()A.开放性颅骨骨折B.脑水肿C.脑挫裂伤D.脑内血肿E.脑疝34、小儿慢性硬脑血肿发生率最龄段是()A.6个月内B.12个月内C.3个月内D.18个月内_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________E.24个月内35、颅中窝发生脑脊液耳漏时的则是()A.给予镇静止痛药B.保持外耳道清但不堵塞外耳道C.立即堵塞外耳道使之愈合D.卧床休息头低位E.行头颅X线摄片检查，寻找骨折线36、小脑幕切迹时瞳孔扩大理是()A.动眼神经核损伤B.动眼神经麻痹C.交感神经受刺激D.瞳孔扩大肌麻痹E.脑干受压迫37、小脑幕切时瞳孔变化和肢体活动障关系是()A.双侧瞳孔散大伴四肢瘫痪B.病变同侧瞳孔散大变对侧半身瘫痪C.病变对侧瞳孔伴对侧半身瘫痪D.病变同侧瞳孔伴同侧半身瘫痪E.病变对侧瞳孔散大变同侧半身瘫痪_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________38、防治脑水当前应用广泛且效果最好水剂是()A.30%尿素溶液B.25%山梨醇溶液C.20%甘露醇溶液D.浓缩血清溶液E.50%葡萄糖溶液39、小脑幕切迹疝体活动障碍的特点是()A.病变同侧体瘫痪B.病变对侧体瘫痪C.病变同侧上肢和对侧下肢瘫痪D.病变同侧下肢和对侧上肢瘫痪’E.四肢瘫痪40、下列表现不是大脑半球不足()A.失语B.一时性黑矇C.耳鸣D.感觉麻木E.单侧肢体无力_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________41、有可能引起颅内压增高症状的幕上血肿出血量为)A.10ml以上B.15ml以上C.5ml上D.20ml以上E.30ml以上42、成年人以胶质瘤和脑膜瘤多见，发最高的部位是()A.脑室内B.脑干C.鞍,脑桥小脑角D.小脑E.大脑半球43、明确有脑脊液外漏的措包括()A.将漏出液滴色滤纸上血迹外周是否有样淡浸渍圈B.查看伤员的鼓膜是整，有无外漏液C.用尿糖试纸测出液中是否含糖D.观察并问伤员是否经有腥味液体流部引起吞咽E.漏出液RBC计数与周围血的RBC比较是否被稀释44、颅脑对冲常见部位是()_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________A.顶叶B.脑干C.小脑D.枕叶E.额颞叶450X摄片示左颞骨折脑膜中动脉。诊断首先考虑()A.急性硬膜外血肿B.左颞侧脑挫裂伤C.急性硬膜下血肿D.原发脑干损伤E.弥漫性轴索损伤46、头皮裂伤的处理原()A.妥善止血,清创,抗感染B.不需特别处理C.均需输血,抗休克治疗D.降颅压治疗E.加压包扎47、下列哪项不是中颅底骨折表现()_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________A.脑脊液耳漏B.CT使脑室受压,中线结构移位C.视神经损伤D.脑脊液鼻漏E.面,听神经损伤48、头皮血肿的处理原()A.抗感染治疗B.均需切开引流C.降颅压治疗D.局部适当加压E.均需穿刺抽吸49、全层撕脱伤下列处理哪正确()A.尽早清创B.防治休克C.妥善止血，D.抗感染E.中厚皮片植皮50、男性，42岁，肢端肥大症，经蝶垂体瘤切除后2个月，临床症状无明显缓解I复查肿瘤残留甚少，但血中GH值0.56nmol/L，_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________此时应采取()A.开颅再次手术B.放射治疗C.经蝶再次手术D.药物治疗E.继续观察518,晕15天，加伴烦,呕吐1入部MRI显示第四脑室伴幕上脑室扩大脑脊液出后病人突然昏迷。双瞳散大，光反应。首先考虑的原因可能为()A.小脑幕切迹上疝B.肿瘤卒中C.穿刺损伤D.休克E.低颅压5216自幼发育痛,呕吐1周温38.5℃，力4初步考虑诊断()A.偏头痛B.脑肿瘤_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________C.脑膜炎D.脑脓肿E.脑出血53、首先考的诊断()A.蛛网膜下腔出血B.外伤性颅内血肿致小脑幕切迹疝C.脑梗死D.高血压脑出血E.原发性脑干损伤54、首选的助检查()A.B超B.核素扫描C.MRADCTE.MRI55、最可能诊断是A.慢性硬膜下血肿B.脑出血C.脑梗塞_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________D.颅内占位性病变E.颅内感染56、首选的检查手段是A.腰椎穿刺测定脊液性状及压力B.全脑血管造影术C.脑电图D.头颅CTE.头颅MRI57、首选的治疗手段是A.开颅血肿清除术B.钻孔引流术C.溶栓治疗D.颅内占位性病变切除术E.抗感染治疗58、最可能诊断是A.慢性硬膜外血肿B.慢性硬膜下血肿C.亚急性硬外血肿D.亚急性硬下血肿_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________E.硬膜下水瘤59、治疗首选A.开颅血肿清除术B.去骨瓣减压术C.钻孔引流术D.保守治疗E.以上都不对60、此患者Glasgow昏迷评分()A.4分B.6分C.8分D.10分E.12分61、最可能的诊断()A.脑震荡B.脑干损伤C.左侧硬膜下血肿D.左侧硬膜外血肿E.右侧硬膜外血肿_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________62、确诊的佳检查()A.头颅CTB.腰穿C.脑电图D.头颅X线摄片E.头颅MRA63、下列哪项措施不可()A.快速静点甘露醇B.小壶加速尿C.吸氧D.腰穿E.保持呼吸道通畅64、明确血肿采取的治疗()A.腰穿B.手术C.保守治疗D.观察E.输血_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________65、初步诊()A.脑震荡B.脑挫裂伤C.脑供血不足D.脑水肿E.脑疝66、若X线摄片提示左颞骨折线通过脑膜中动沟，应警惕()A.头皮血肿B.硬膜下血肿C.脑室内血肿D.硬膜外血肿E.脑内血肿67、若伤后5小时出现渐进性意识障碍，应首选检查()A.脑血管造影B.腰穿C.头颅X线摄片D.头颅CTE.放射性核素扫描68、最可能诊断是()_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________A.亚急性硬下血肿B.亚急性硬外血肿C.慢性硬膜下血肿D.慢性硬膜外血肿E.急性硬膜下血肿69、为确定诊断应首选哪项检()A.头颅X线检查B.检眼镜C.神经系统检查D.头颅CTE.腰穿70、若确定为颅内血肿，最适合的治疗方法是()A.脱水降颅压B.神经营养治疗C.功能锻炼D.观察生命体,志,瞳孔变化E.手术治疗71、最可能诊断是()A.蛛网膜下腔出血(SAH)_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________B.脑出血C.脑梗死D.脑瘤卒中E.TIA72、首选的检()A.MRIBCTC.MRAD.腰穿E.核素扫描73、若CT为阴性应进一步行)A.MRAB.MRIC.核素扫描D.头部X线平片E.腰穿74、对SAH的处理，下列哪一项除外()A.绝对卧床B.应用抗纤溶药物_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________C.提高血压,增加脑灌注量D.镇,止痛E.积极查找病因75、前颅折常出现()A.逆行性遗忘B.腰穿脑脊呈血性C.乳突部皮下淤血D.熊猫眼征E.面神经损伤76、后颅折常出现()A.逆行性遗忘B.腰穿脑脊呈血性C.乳突部皮下淤血D.熊猫眼征E.面神经损伤77、脑挫裂常出现()A.逆行性遗忘B.腰穿脑脊呈血性C.乳突部皮下淤血_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________D.熊猫眼征E.面神经损伤78、脑震荡常出现()A.逆行性遗忘B.腰穿脑脊呈血性C.乳突部皮下淤血D.熊猫眼征E.面神经损伤79、颅内血肿脑疝患者的急救措施()A.手术清除血肿B.快速静点甘露醇C.CT检查D.气管切开E.腰穿80、颅内血肿脑疝患者的根本治疗()A.手术清除血肿B.快速静点甘露醇C.CT检查D.气管切开_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________E.腰穿81、颅内血肿脑疝病人的急救措施()A.手术清除血肿B.气管切开C.CT检查D.腰穿E.快速静点甘露醇82、颅内血肿脑疝病人的根本治疗()A.手术清除血肿B.气管切开C.CT检查D.腰穿E.快速静点甘露醇83、小脑迹疝可致()A.同侧偏瘫B.对侧偏瘫C.交叉瘫D.四肢全瘫E.突发呼吸骤停而死亡_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________84、枕骨大疝可致()A.同侧偏瘫B.对侧偏瘫C.交叉瘫D.四肢全瘫E.突发呼吸骤停而死亡85、硬膜外肿特征()A.中间清醒期B.搏动性突眼C.腰穿呈血脑脊液D.视神经乳头水肿E.两侧瞳孔不等大86、颅内压增高的客观体)A.中间清醒期B.搏动性突眼C.腰穿呈血陛脑脊液D.视神经乳头水肿E.两侧瞳孔不等大_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档_______________________________________________________________________________________________________________________________________________________87、颈内动脉海绵窦瘘的典型症状()A.中间清醒期B.搏动性突眼C.腰穿呈血脑脊液D.视神经乳头水肿E.两侧瞳孔不等大88、可作为脑挫裂伤的诊断依()A.中间清醒期B.搏动性突眼C.腰穿呈血脑脊液D.视神经乳头水肿E.两侧瞳孔不等大89、顶叶肿瘤出现()A.精神症状B.运动障碍C.感觉障碍D.失语症E.视野缺损90、颞叶深部叶肿瘤出现()_______________________________________________________________________________________________________________________________________________________专业试，强推荐精品文档______________________________________________________________________________________