住院医师出科试题（神经内科）

姓名： 时间：

一、英译中（70分）：

Stroke is the third most common cause of death in the United states and the most common disabling neurologic disorder.About 750,000 new strokes occur and about 150,000 people die from stroke in the United states each year.The incidence increases with age,with about two-thirds of all strokes occuring in those over age 65 years,and is somewhat higher in men than in women and in African-Amerricans than in whites.Risk factors for stroke include systolic or diastolic hypertension,hypercholesterolemia,cigarette smoking,heavy alcohol consumption,and oral contraceptive use. The incidence of stroke has decreased in recent decades, largely because of improved treatment of hypertension.

Stroke is a syndrome characterized by the acute onset of a neurologic deficit that persists for at least 24 hours,reflects focal involvement of the central nervous system,and is the result of a disturbance of the cerebral circulation. The acute onset and subsequent duration of symptoms are documented by the history. The site of central nervous system involvement is suggested by the nature of the symptoms.It is delineated more precisely by the neurologic examination and confirmed by imaging studies[computed tomography (CT) scans or magnetic resonance imaging(MRI)].A vascular etiology may be inferred form the acute onset of symptoms and often from the patient’s age, the presence of risk factors for stroke,and the occurrence of symptoms and signs referable to the territory of a particular cerebral blood vessel.When this is confirmed by imaging studies,further investigations can be undertaken to identify a specific cause.

Rest tremor usually has a frequency of 4-6Hz and is characteristic of parkinsonism whether the disorder is idiopathic or secondary(ie.postencephalitic,toxic,or drug-induced in origin).The rate of the tremor,its relationship to activity,and the presence of rigidity or hypokinesia usually distinguish the tremor of parkinsonism from other forms of tremor.Tremor in the hands may appear as a “pill-rolling” maneuver—thythmic,opposing circular movements of the thumb and index finger. There may be alternating flexion and extension of the fingers or hand, or alternating pronation and supination of the forearm;in the feet,rhythmic alternating flexion and extension are common.

二、中译英（30分）

纯运动性轻偏瘫—面部、上肢和下肢受累程度相同，但无感觉、视觉或言语障碍。如果示腔梗所致，病变常位于对侧内囊或桥脑。纯运动性轻偏瘫也可由颈内动脉或大脑中动脉闭塞、硬膜下血肿或颅内占位性病变引起。

第二篇：神经内科出科考试试题2

神经内科出科考试试题

一、 名词解释：

1、脑膜刺激征

2、癫痫持续状态

3、假性球麻痹

4、脊髓半切综合征

二、 填空：

1、颅内高压三联征是____、____、____。

2、若锥体束受损，则可以表现为________阳性。

3、若某一部位痛觉消失，但深感觉存在，则称为________感觉障碍。

4、壳核出血表现出三偏征为_____、_____、_____。

5、若左侧瞳孔直接对光反应存在，间接对光反应消失，则说明____侧____神经受损。

三、 简答：

1、格林-巴利综合征的主要临床表现

2、腰穿的适应症及禁忌症

四、 病案分析：

患者，男性，68岁，以“突发右侧肢体无力12小时”入院。12小时前在活动时突然感头胀痛，以两颞侧为主，伴有恶心，未吐。随即感右侧肢体无力，不能行走，并出现说话不流利，在当地医院测血压180/100mmHg，做头颅CT提示“脑萎缩”、心电图示“房颤”。随给予心痛定10mg口服，半小时后血压降至150/80mmHg，但肢体无力无明显好转，并渐出现意识模糊，反应迟钝。随转入我院。既往有高血压病8年。平素口服心痛定治疗，血压维持在150/80mmHg左右。风心病xx年。入院查体：体温36.7℃，脉搏78次/分，呼吸18次/分，血压165/90mmHg。右利手，嗜睡，混合性失语，双侧瞳孔等大等圆D=3 mm，双侧对光反射灵敏，眼球活动自如，眼底视神经乳头边界清楚，无高起，色淡

红，生理凹陷存在，视网膜A：V=1：2，动脉反光增强。双侧额纹等深，闭目紧，右侧鼻唇沟变浅，伸舌偏右，咽反射存在，颈软，左侧肢体无异常，右侧上肢肌力Ⅰ级，右下肢肌力0级，右侧肌张力减低，腱反射活跃，右侧病理反射阳性，右侧偏身痛温觉减退。脑膜刺激征（—），余神经系统未见异常。

1.此患者的定位诊断是什么？列出诊断依据。

2.此患者的定性诊断是什么？列出诊断依据。

3.下一步应做何检查确诊？

1、