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89 年考題
C
A Type 第 001~065 題 、 A Type 第 066~130 題 、 B
Type 、 K
Type 、
Type 、 A-II Type
001
The least likely cause of seizure in the late life (over 60 years) is
(A) vascular disease
(B) neoplasm
(C) degenerative disease
(D) idiopathic
(E) demyelinating disease
002
The post-ictal psychosis
(A) Postictal psychosis usually occurs after seizure termination immediately
(B) Post-ictal psychosis typically lasts over 24 hours to several days
(C) Because post-ictal psychosis may terminate spontaneously, it may not be
necessary to use psychotropic agents
(D) The patient's psychiatric history or psychosocial background appear to
impact upon the risk for post-ictal psychosis
(E) It is impossible to differentiate the delirium from post-ictal psychosis
003
Which of the following statements is true?
(A) Vertigo is a sensation of body whirling, this symptom can only originated
from labyrinthine dysfunction
(B) The fact that vertigo may constitute the aura of an epileptic seizure
supports the view that this symptom may originate in a cerebral cortical
lesion
(C) Large, destructive processes in the cerebellar hemispheres and vermis
usually cause severe vertigo
(D) The occurrence of vertigo as the initial symptom of a seizure is infrequent,
it is called vestibulogenic seizures.
(E) Vertiginous epilepsy is a rare form of reflex epilepsy, in which excessive
vestibular discharge serves as the stimulus for a seizure
004
For Absence epilepsy which of the following antiepileptic drug is appropriate
(A) Phenytoin
(B) Carmabazepine
(C) Vigabatrin
(D) Valproic acid
(E) Lamictal
005
Which one of the following statements concerning febrile seizures (FS) is NOT true:
(A) FS is a benign condition with a strong tendency to be inherited.
(B) In retrospective studies, FS during infancy and childhood were found to
have a higher incidence of seizures with mesial temporal sclerosis in the
adulthood.
(C) Long term anti-epileptic drug therapy for two years is indicated to prevent
from recurrence of FS or development of epilepsy.
(D) EEGs in children with FS usually show normal findings.
(E) FS with prolonged seizures (>30 minutes) or focal features tends to be
associated with afebrile seizures later.
006
In the management of epilepsy which concept is incorrect.
(A) Sudden cessation of treatment may result in status epilepticus.
(B) Monitoring plasma concentration of drugs is solely a research tool.
(C) The majority of patients can be controlled on a single drug.
(D) The physician needs to know and to use the pharmacokinetic properties of
each drug prescribed.
(E) Most patients can be relieved of their fits within half a year to one year after
starting treatment.
007
Which of the following may responsible for motor neuron disease?
(A)Virus infection
(B)Heavy metal intoxication
(C)Autoimmune reaction
(D)SOD gene mutation
(E)All of above
008
Anti-GM1 antibodies are mostly found in which of the following
(A) ALS (amyotrophic lateral sclerosis)
(B) LMND (lower motor neuron disease)
(C) Gullain Barre syndrome
(D) Peripheral polyneuropathy
(E) None of the above
009
Duchenne and Becker muscular dystrophy (DMD/BMD)
(A) mainly result from alterations of the dystrophin gene, which is located on
chromosome Xp21.
(B) The deletion rates by multiplex PCR investigation were around 90% in
literatures and in Taiwan families till now
(C) The age of onset in DMD usually begin from early adult
(D) The clinical manifestations may include cataract, retinitis pigmentosa and
even ophthalmoplegia
(E) none of above
010
Dermatomyositis in adults is frequently associated with the following diseases,
except:
(A) carcinoma
(B) vasculitis
(C) stomach ulcer
(D) collagen diseases
(E) rheumatism
011
Myopathy(ies) may associate with encephalopathy:
(A) mitochondrial myopathy
(B) Duchenne type muscular dystrophy
(C) Myotonic muscular dystrophy (Thompsen's disease)
(D) all of the above
(E) none of the above
012
The earliest symptom/sign of diabetic mononeuropathy multiplex is:
(A) Pain (rapid onset)
(B) Motor weakness
(C) Muscle wasting
(D) Sensory loss
(E) Diminished or absent tendon reflexes
013
The most sensitive electrophysiological parameter for diagnosis of the carpal tunnel
syndrome is:
(A) Motor conduction velocity
(B) Compound muscle action potential
(C) Sensory action potential
(D) Motor unit potential
(E) F-latency
014
Characteristic MRI findings in chronic hemorrhage (3 months):
(A) The low signal from hemosiderin in the periphery of the hematoma is more
obvious on T2W1 and gradient echo
(B) high signal on T1W1 because of methemoglobin
(C) low signal on T2W1 because of methemoglobin
(D) low signal on T2W1 because of deoxyhemoglobin
(E) high signal on T2W1 because of deoxyhemoglobin
015
The most loud neck bruit when carotid stenosis is at about
(A) 10% diameter stenosis
(B) 30% diameter stenosis
(C) 50% diameter stenosis
(D) 70% diameter stenosis
(E) 90% diameter stenosis
016
Among the following descriptions which one is Correct?
(A) The anterior limb of internal capsule is supplied by anterior choroidal artery
(B) Corona radiata, most of the posterior limb of internal capsule and thalamus
are supplied by middle cerebral artery
(C) The lowest portion of the posterior limb of internal capsule is supplied by
the Heubner's artery
(D) Caudate nucleus receives its blood supply from the middle cerebral srtery
and anterior cerebral artery
(E) The centrum semiovale is supplied by medullary arteries that descend from
anterior cerebral artery
017
The prognosis of intracerebral hemorrhage is best predicted by
(A) Level of consciousness
(B) Age
(C) High blood pressure
(D) High blood sugar
(E) High fever
018
Stroke in young adults is usually defined as those occurring before age of
(A) 35
(B) 40
(C) 45
(D) 50
(E) 55
019
Which period after a stroke carries the greatest risk for recurrent stroke
(A) First week
(B) First month
(C) Six months
(D) First year
(E) Three years
020
In the critical management of acute stroke, which one of the followings is Wrong?
(A) When systolic BP 180-230 mmHg and/or diastolic BP 100-120 mmHg,
antihypertensive drug should be used.
(B) Neurogenic heart disease is caused mainly by sympathetic overdrive and
benzodiazepine, barbiturate, β-blockers and calcium channel blockers
may be favorable.
(C) Hyperglycemia is frequently seen after acute stroke and should be treated if
glucose level > 200 mg/dl.
(D) In case of hyponatremia, rapid correction with hypertonic saline should be
avoided.
(E) Low-molecular-weight hypertonic solutions such as glycerol, mannitol and
sorbitol are frequently used to reduce brain water content.
021
Dopaminergic agonists are used for the treatment of Parkinson disease, which of the
following dose not belong to dopamine agonist?
(A) Apomorphine
(B) Pergolide mesylate (Celance)
(C) Bromocriptine (Parlodel)
(D) Trihexyphenidyl (Artane)
(E) Pramipexole
022
Which of the following is categorized in the disease group of the "taupathy"
(A) Parkinson's disease
(B) corticobasal degeneration
(C) Alzheimer's disease
(D) Wilson's disease
(E) Adrenoleukodystrophy
023
Which of the following description of the progressive supranuclear palsy is Wrong?
(A) the onset age usually older than 40 years
(B) always having vertical gaze palsy
(C) postural instability is rarely noted
(D) usually having symmetric signs
(E) tend to have dysphagia and dysarthria
024
Which of the following disease(s) may have gaze plasy
(A) progressive supranuclear palsy
(B) corticobasal degeneration
(C) Whipple's disease
(D) Machado-Joseph disease
(E) all of above
025
A 45-year-old male undergoes psychiatric evaluation for recent psychotic behavior.
During the interview, he exhibits twitching movements of his arms.
Which of the following findings is LEAST consistent with the probable underlying
disease process:
(A) Family history of a similar disorder
(B) Mild atrophy of the caudate on CT scan
(C) Progression of the disease
(D) Improvement with L-dopa medication
(E) Loss of GABA neurotransmitter
026
Which of the following medications is recommended for "periodic leg movements of
sleep"?
(A) L-dopa
(B) Clonazepam
(C) Bromocriptine
(D) All of the above
(E) None of the above
027
The most likely diagnosis for a patient with periodic generalized sharp wave
occurring at intervals of 3-20 seconds:
(A) Hepatic encephalopathy
(B) Herpes simplex encephalitis
(C) Jacob-Creutzfeldt disease
(D) SSPE
(E) Subdural hematoma
028
Absent doll's eye sign in a comatose patient suggests:
(A) Midbrain/pons not working
(B) Medulla not working
(C) Thalamus not working
(D) Cerebral hemisphere not working
(E) Cerebellum not working
029
After acute neuropathic lesion, which of the following electromyographic
abnormalities appears first?
(A) Duration of motor unit potential
(B) Amplitude of motor unit potential
(C) Spontaneous activities
(D) Polyphasic waves
(E) Interference pattern
030
A 18-year-old male with a history of borderline personality disorder complains of a
gradual loss of sensation extending from his shoulders to his hands. Examination
reveals loss of pain sensation and position sense but intact touch perception in both
hands. Reflexes are absent in both arms and the muscles of her hands are atrophied.
The most likely diagnosis is
(A) tabes dorsalis
(B) vitamin B12 deficiency
(C) alcoholic neuropathy
(D) amyotrophic lateral sclerosis
(E) syringomyelia
031
In brainstem auditory evoked potentials (BAEP) study, delayed wave V with normal
waves I, and III suggests:
(A) acoustic nerve lesion
(B) cerebellopontine angle lesion
(C) pontine lesion
(D) midbrain lesion
(E) cortical lesion
032
The most common pseudo-localizing sign
(A) 3rd nerve palsy
(B) 4th nerve palsy
(C) 5th nerve palsy
(D) 6th nerve palsy
(E) 7th nerve palsy
033
A patient can repeat phrases and sentences, but can neither comprehend nor
spontaneously speak. The ability of reading and writing are also impaired.
What is the deficit?
(A) severe dysarthria, not aphasia
(B) transcortical motor aphasia
(C) global aphasia
(D) mixed type transcortical aphasia
(E) transcortical sensory aphasia
034
A lateral disc protrusion at the L4-L5 level usually involves which root?
(A) L4
(B) L5
(C) S1
(D) S2
(E) None of the above
035
The function of Heschl's gyri
(A) Smell
(B) Hearing
(C) Emotion
(D) Vestibular function
(E) Vision
036
The most common "persistent embryonic carotid-basilar anastomosis" is:
(A) primitive trigeminal artery
(B) persistent otic artery
(C) persistent hypoglossal artery
(D) proatlantal intersegmental artery
(E) none of the above
037
Where is the lesion that causes Broca's aphasia?
(A) Brodmann area 21,22
(B) Brodmann area 39,40
(C) Brodmann area 40,41
(D) Brodmann area 42,43
(E) Brodmann area 44,45
038
What is the first language disturbance most patient of AD will experience?
(A) Word finding
(B) Comprehension
(C) Fluency
(D) Repetition
(E) None
039
Which is related to transient global amnesia?
(A) A seizure disorder involved temporal lobe
(B) A transient ischemic attack
(C) No medication treatment is required
(D) A sequel of head trauma
(E) None of above
040
What are the risk factors for AD?
(A) Presence of Apo E4
(B) Low education level
(C) Positive family history
(D) Post-menopausal estrogen deficiency
(E) All of above
041
All the following delusions are common in Alzheimer's disease EXCEPT:
(A) theft of one's property
(B) grandiosity (e.g. Belief that one is a world leader)
(C) spousal infidelity
(D) abandonment
(E) one's house is not one's home
042
Which of the patient's clinical features are LEAST helpful in distinguishing dementia
with Lewy bodies from Alzheimer's disease?
(A) progressive dementia with insidious onset with prominent deficits in
visuospatial abilities
(B) spontaneous parkinsonism
(C) marked fluctuations in alertness or cognitive abilities
(D) unproved falls
(E) neuroleptic sensitivity
043
Lorenzo oil (glycerol trieurcate oil and glycerol trioleate oil) has been proposed to
treat
(A) Adrenoleukodystrophy
(B) Ischemic cerebral stroke
(C) Multiple sclerosis
(D) Metachromatic leukodystrophy
(E) Progressive multifocal leukoencephalopathy
044
In AIDP (Acute Inflammatory Demyelinating Polyneuropathy) a poor prognosis is
suggested by:
(A) profound conduction block
(B) severe reduced CMAPs amplitudes
(C) Absence of sural and sensory responses
(D) Absence of DTR
(E) none of the above
045
What is the prevalence rate/per year of multiple sclerosis in Taiwan
(A) 1/100,000
(B) 10/100,000
(C) 100/100,000
(D) 1000/100,000
(E) 10000/100,000
046
In Guillain-Barre syndrome, the earliest abnormality in electrophysiological study is
(A) motor nerve conduction velocity
(B) sensory nerve conduction velocity
(C) electromyography
(D) F wave
(E) Sympathetic skin response
047
Patients with fatal familial insomnia have prominent neuronal loss and gliosis in
(A) Mesial temporal lobe
(B) Cingulate gyrus
(C) Basal nucleus of Meynert
(D) Thalamus
(E) Parietal lobe
048
The following disease(s) is (are) spongiform encephalopathy:
(A) scrapie
(B) Gerstmann-Straussler-Scheinker disease
(C) fatal familiar insomnia
(D) all of the above
(E) none of the above
049
The following diseases are prion diseases, Except:
(A) Marchiafava-Bignami disease
(B) mad cow disease
(C) feline spongiform encephalopathy
(D) varied form CJD
(E) kuru
050
Concerning radiation myelopathy, which one of the followings is correct?
(A) the clinical neurologic deficit is rapidly progressive
(B) in most patients, the onset of symptoms occurs within 3 months after
completion of radiation therapy
(C) the spinal cord is usually atrophic at presentation
(D) it most commonly involves the cervical cord
(E) the gray matter is more severely affected than white matter
051
Case of Botulism intoxication do not present:
(A) Weakness of jaw muscles
(B) Extraocular movements paresis
(C) Mydriasis, sluggish or no pupil light reflex
(D) Clouding of consciousness
(E) Decreased saliva production, constipation and urine retention
052
Which statement about the treatment of ethanol withdrawal is Wrong?
(A) Prevention or reduction of early symptoms
(B) Phenytoin sodium is essential to prevent withdrawal seizure
(C) Neither haloperidol nor phenothiazines have a specific effect on
hallucinations
(D) Thiamine and multivitamin replacement
(E) Prevent or correct hypoglycemia
053
In non-habituated person at which blood alcohol level ataxia was obvious
(A) 40 mg/dL
(B) 100 mg/dL
(C) 200 mg/dL
(D) 400 mg/dL
(E) 500 mg/dL
054
Which statement about neurological consequences of hyperthyroidism is Not Correct
(A) Almost all patients exhibit a fine tremor
(B) Chorea is rarely associated with hyperthyroidism
(C) Neuropathy is frequently associated with hyperthyroidism
(D) Myopathy occurs quite frequently in hyperthyroidism
(E) Hasimoto disease may associate with myasthenia gravis
055
Which is Not the common syndromes of diabetic neuropathy?
(A) diabetic ophthalmoplegia
(B) distal symmetrical sensory polyneuropathy
(C) symmetrical, proximal motor weakness with wasting
(D) autonomic neuropathy
(E) asymmetrical, distal motor weakness with wasting
056
A 54-year-old female with headaches for the past week has a lumbar puncture
performed. The cerebrospinal fluid (CSF) opening pressure is 220 mm H2O, the CSF
protein 60 mg/dl, and the CSF glucose 75 mg/dl (serum glucose 105 mg/dl). A CT
scan reveals a 3 cm ring-enhancing mass in the right parietal region. Biopsy of the
mass reveals gliosis and fibrosis with necrosis, neutrophilis, and lymphocytes.
These findings most strongly suggest a diagnosis of:
(A) Glioblastoma multiforme
(B) Herpes simplex type II encephalitis
(C) Vascular malformation
(D) Subacute infarction
(E) Cerebral abscess
057
Most cases of Bell's palsy are due to the infection of:
(A) Herpes simplex virus type I
(B) Cytomegalovirus
(C) Epstein-Barr virus
(D) Coxasckie virus
(E) Mycoplasma pneumoniae
058
A 64 year-old man was sent to the emergency room with a history of low grade fever
for two weeks, some automatism-like behavior for 4 days, and repetitive focal
seizures for one day. The likely diagnosis should be:
(A) Stroke
(B) Alcohol-withdrawal symptoms
(C) Hereditary disorder
(D) Herpes simplex type II encephalitis
(E) Herpes simplex type I encephalitis
059
Most frequently encountered pathogen in postoperative meningitis is:
(A) H. influenza
(B) L. monocytogenes
(C) N. meningitidis
(D) Staphylococci
(E) S. pneumoniae
060
Which region is the most frequently involved dermatome in syndrome of herpes
zoster infection?
(A) Cranial region
(B) Cervical region
(C) Thoracic region
(D) Lumbar region
(E) Sacral region
061
The primary CNS neoplasm most frequently encountered is
(A) craniopharyngioma
(B) glioblastoma multiforme
(C) meningioma
(D) oligodendroglioma
(E) ependymoma
062
Which is the uncommon symptom or sign in acoustic neuroma
(A) Tinnitus
(B) Facial palsy
(C) Dysequilibrium
(D) Hearing loss
(E) Headache
063
Which is the most common cervical root compressed by ruptured intervertebral disc
(A) C4
(B) C5
(C) C6
(D) C7
(E) C8
064
Concerning hamartomas of the tuber cinereum, which one of the followings is
correct?
(A) they are typically associated with delayed puberty
(B) they are usually isointense relative to gray matter on both T1- and T2
-weighted MR images
(C) they are associated with gelastic seizures
(D) they are typically contrast enhancing
(E) they are usually pedunculated
065
Which of the following neurotransmitter is related to migraine pathogenesis for the
model of "trigeminovascular theory"?
(A) Noradrenaline
(B) Dopamine
(C) Prostaglandins
(D) Serotonin
(E) Acetylcholine