Download B Type

91 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
A fixed and dilated pupil can be seen in the following except
A. Posttraumatic iridoplegia
B. Mydriatic eye drop
C. Pilocarpine eye drop
D. Posterior communicating cerebral artery aneurysm
E. Uncal herniation
002
One and a half syndrome involving the below mentioned lesion except:
A. Median longitudinal fasciculus ( MLF)
B. Rostral mesencephalon
C. Six nerve nucleus
D. Paramedian pontine reticular formation (PPRF)
E. Pontine tegmentum
003
About transient global amnesia, which of the following statement is not correct
A. Sudden inability to form new memory traces
B. Retrograde memory loss of events of the preceding days, weeks or even
years
C. Self-identification preserved
D. Impaired of immediate registration
E. Recurrent attacks less than 25%
004
A 60 y/o male patient who cannot perceive the identity of object held in his right hand
(astereognosis). Which brain lesion is most likely associated with this sign?
A. right frontal lobe lesion
B. left frontal lobe lesion
C. right parietal lobe lesion
D. left parietal lobe lesion
E. left temporal lobe lesion
005
About the disconnection syndrome due to destruction of whole corpus callosum,
which statement is INCORRECT?
A. Alexia to word which showed on left side visual field
B. Preserved reading ability to words which showed on right side visual field
C. Preserved praxis of right hand to a verbal command
D. Right hand apraxia to a verbal command
E. All of the above
006
Which of the following manifestations is the initial manifestation of normal pressure
hydrocephalus ?
A. Gait apraxia
B. Urinary incontinence
C. Dementia
D. Limb weakness
E. Aphasia
007
The "normal" aging change in the brain except:
A. Rare neurofibrillary tangle
B. Loss of brain weight
C. Decreased astrocyte size and number
D. Meningeal thickening
E. Lipofuscin thickening
008
The Duret hemorrhage is located in:
A. Frontal area
B. Pons
C. Cerebellum
D. Basal ganglion
E. Pineal gland
009
Which of the following is not amines neurotransmitter?
A. Dopamin
B. Acetylcholine
C. Serotonin
D. Gamma amino butyric acid (GABA)
E. Norepinephrine
010
All of the following statements are correct, EXCEPT
A. Delirium is a confusional state characterized by difficulty paying attention,
often with a fluctuating course
B. Delirium may be caused by sedative or anticholinergic medication
C. Aphasia is a form of delirium usually caused by a middle cerebral artery
thrombosis
D. In a patient with impaired intellectual function, it would be reasonable to
obtain serum electrolytes and thyroid study
E. None of the above
011
Vertical eyeball movements come through the following mechanisms except:
A. Interstitial nucleus of Cajal
B. Rostral interstitial nucleus of the median longitudinal fasciculus(ri MLF)
C. Nucleus and fibers of the posterior commissure
D. Red nucleus
E. Interstitial nucleus of Darkschewitsk
012
Which of the following manifestations is typically the first sign of Alzheimer's
disease ?
A. Disturbance in executive function
B. Agnosia
C. Apraxia
D. Impairment of recent memory
E. Aphasia
013
Chromosome that contain gene influencing the development of Alzheimer's disease:
A. Amyloid precursor protein gene on chromosome 21
B. Ataxin gene on chromosome 24
C. Connexin 32 on chromosome Xq
D. Myotonin gene on chromosome 19
E. Androgen receptor gene on chromosome Xp
014
Dandy Walker malformation, except:
A. Cerebellar vermis agenesis
B. Hydrocephalus
C. Cystic of the fourth ventricles
D. Myelomeningocele
E. Enlargement of the posterior fossa and elevation of the tentorium
015
Dementia is one of the several manifestations in the following diseases, except
A. Wilson disease
B. Hallervorden-Spatz disease
C. Cerebrotendinous xanthomatosis
D. Gaucher disease
E. Pompe disease
016
Which of the following two heavy metals have been linked to Amyotrophic Lateral
Sclerosis (ALS)
A. Arsenic and mercury
B. Mercury and lead
C. Lead and gold
D. Mercury and thallium
E. Thallium and lead
017
Which of the following is not a major clinical feature of dementia with Lewy bodies?
A. progressive cognitive decline
B. fluctuating cognition with variations in attention
C. parkinsonism in the early stage
D. incontinence
E. visual hallucination
018
Which is NOT correct in the treatment of multiple sclerosis?
A. Beta-interferon is effective in decreasing new lesions on neuroimage followup
B. Methylprednisolone is used during acute exacerbation
C. The clinical improvement is not marked in patients treated with betainterferon
D. ACTH is also used during acute exacerbation
E. Beta-interferon is used in acute exacerbation
019
The most important electrophysiologic sign(s) in Guillian-Barre syndrome within the
first two weeks is(are)
A. Loss of the sural sensory nerve action potential
B. Conduction block
C. Increased temporal dispersion
D. Slowed conduction velocities
E. All of the above
020
In either acute or chronic inflammatory demyelinating polyneuropathies
A. Absent F responses suggest another diagnosis
B. Decremental responses to motor nerve stimulation at lower rates are common
C. Average motor responses less than 50% of the lower limits of normal
indicate a poor prognosis
D. Electrodiagnosis findings consistent with segmental demyelination are a
common findings
E. All of the above
021
In AIDP a poor prognosis is suggested by
A. profound conduction block
B. Severe reduced CMAPs amplitudes
C. Absence ofsural and sensory responses
D. Absence of DTR
E. None of the above
022
The use of phenytoin (diphenylhydantoin) in the control of seizures may be
implicated by all of the following EXCEPT :
A. hyperplasia of the gums
B. development ofmegaloblastic anemia in sensitive patients
C. lymphadenopathy (pseudolymphoma)
D. drowsiness
E. ataxia
023
Which of the following statements is wrong about benign febrile convulsions?
A. Prolonged convulsions (15 minutes) can be treated with dilantin
B. 2-4% of children 3months to 5 years old
C. There may be a family history
D. The probability of developing a chronic seizure disorder is 2-6%
E. They are usually self-limited
024
Juvenile myoclonus epilepsy, except:
A. Onset in adolescence, usually about age 15
B. Patient may has myoclonic jerks of the arm and upper trunk.
C. Valproic acid is effective in eliminating the seizure and myoclonus
D. The EEG characteristically shows bursts of 3 Hz spike-and wave
E. Usually it is presented with a generalized seizure
025
醫病人癲癇發作突然覺得懼怕(Fear Sensation)，呼叫親人，親人見其兩眼直視，
嘴角及手有不自覺的動作，依 1981 International League against Epilepsy 之分類其
屬
A. Absence seizure
B. Complex partial seizure
C. Simple partial seizure
D. Simple partial seizure with secondary generalization
E. Simple partial seizure evolving to complex partial seizure
026
關於 eclampsia 之敘述下列何者為非?
A. 發生 seizure 可以是 partial or generalized
B. 最常在 second semester 發生
C. MgS04 是目前認為最適當的選擇
D. 使用 phenytoin 15mg/kg loading 是適當的處置
E. 常合併 headache, confusion 與 blindness
027
病人服用單一抗癲癇藥物，因感冒在診所求診，處方中含 erythromycin 病人服
用後開始 diplopia, unsteady, nausea，原來之抗癲癇藥物最可能為何?
A Carbmazepine
B Phenytoin
C Phenobarbital
D Valproic acid
E Clonazepam
028
Which statement is incorrect about posttraumatic seizures?
A. The risk of seizure is related to severity of injury
B. Children are more likely to develop early posttraumatic seizures than are
adults
C. The risk of seizure decreases gradually after a severe head injury
D. Many practitioners begin anticonvulsant therapy only after a second seizure
occurs
E. None of above
029
Which of the following neurotransmitter is crucial to migraine pathogenesis for the
animal model of 'trigemino vascular theory'?
A. Noradrenaline
B. Dopamine
C. Prostaglandins
D. Serotonin
E. Acetylcholine
030
The primary pharmacological action ofdonepezil or rivastigmine used for the
treatment of Alzheimer's disease is:
A. facilitating synaptic release of acetylcholine
B. as an anticholinesterase
C. as a nicotinic receptor agonist
D. as a serotonin reuptake inhibitor
E. as a monoamine oxidase-B inhibitor
031
Clinical manifestation of giant cell arteritis:
A. Headache usually precede by visual scintillations
B. The occipital neuralgia is common
C. Optic neuropathy is one of the most feared complications.
D. All of the above
E. None of the above
032
About cerebral venous thrombosis and headache, which statement is incorrect?
A. Headache is the most frequent symptom of CVT
B. The headache may associate with papilloedema
C. The best current diagnostic tool is MRI
D. All of the above
E. None of the above
033
All of the following signs/symptoms are associated with tabes dorsalis except
A. abdominal and rectal pain
B. increased reflexes
C. Charcot joints
D. loss of vibratory and position sense
E. None of the above
034
Which is the cause of progressive multifocal leukoencephalopathy(PML) ?
A.EBV
B.HSV
C. J C virus
D.VZV
E.CMV
035
Lyme disease may include the following manifestations except
A. Erythema chronicum migrans
B. Facial nerve palsy
C. Meningoradiculitis
D. Chancre
E. Myocarditis
036
The most common organism associated with the development of mycotic aneurysm:
A. Candida
B. Cryptococcus
C. Aspergillus
D. Mucor
E. Blastomycosis
037
About neurosyphilis, which statement is inadequate?
A. The diagnosis of neurosyphilis requires appropriate blood serology and a
reactive CSF-VDRL
B. The asymptomatic type may show meningeal enhancement on MRI
C. Seizure may occur in case ofparetic neurosyphilis
D. The signs of tabes dorsalis include loss ofDTR at the knees and ankles,
impairment of vibration and position sense in the legs.
E. Argyll-Robertson pupils occur in about 98 % of patients
038
Which of the following is not a typical clinical feature of AIDS dementia?
A. generalized cognitive slowing
B. diminished motor control
C. behavioral changes
D. severe amnesia
E. poor concentration
039
Which description about intracranial arterio-venous malformation (AVM) of Carotid
Doppler is correct?
A. The higher PSV of ICA, the lower resistance of ICA.
B. The nidus of AVM had the lowest flow velocity.
C. The larger feeder of AVM, the lower resistance ofICA.
D. The resistance index is the only indicator for severity of AVM.
E. The higher PSV of feeder, the lower pulsatility index of the feeder.
PSV: peak systolic velocity. ICA: internal carotid artery.
040
The advantage for carotid endarterectomy in asymptomatic patients with carotid
artery stenosis greater than _ _% (diameter) ?
A. 20%
B. 30%
C. 40%
D. 50%
E. 60%
041
Which of the following fmding(s) in EMG study may suggest myopathic abnormality
A. Short duration polyphasic waves
B. Fibrillation
C. Early recruitement pattern
D. Myotonic discharge
E. All of the above
042
Muscles innervated by the ulnar nerve are, except:
A. Interossei muscles
B. Abductor digit minimi
C. Flexor carpi ulnalis
D. Extensor pollicis brevis
E. Flexor pollicis brevis
043
The following structures are components of the auditory pathway, EXCEPT :
A. cochlear nerve
B. superior olivary nucleus
C. medial lemniscus
D. inferior colliculus
E. medial geniculate body
044
Brain stem auditory evoked potential (BAEP)
A. Normal BAEP in comatose patient suggests the possibility of metabolic
process such as drug intoxication.
B. Prolongation of the I-III interpeak latency suggests disturbance of central
auditory conduction within the brainstem.
C. Is the most sensitive test for early detection of cerebellopontine angle tumor
D. All of the above
E. None of the above
045
Which of the following statement concerning Axonotmesis is wrong?
A. The structure of axon still preserved
B. Conduction ceases immediately across the site of nerve injury
C. Wallerian degeneration of the distal segment
D. All of the above
E. None of the above
046
The electrophysiological hallmark ofaxonal degeneration is:
A. Severe conduction block
B. Abnormal temporal dispersion
C. Diminution of the amplitude of the compound muscle action potential and
sensory nerve action potential
D. Marked slowing in the nerve conduction velocities
E. Prolonged (>150% of normal limits) F wave latency
047
Which one is NOT characteristic feature ofH-reflex response?
A. Supressed by supramaximal stimulation
B. May exceed M-response in amplitude
C. Constant latency
D. Variable morphology
E. Optimal with submaximal stimulation
048
Among many physiological factors that will affect nerve conduction velocity, which
one is the most important?
A. Sex
B. Height
C. Weight
D. Race
E. Temperature
049
The most useful procedure in diagnosis of radiculopathy is
A. Motor and sensory conduction studies
B. F-wave measurement
C. Somatosensory evoked potentials
D. Needle EMG study
E. Motor evoked potentials
050
Abnormal temporal dispersion of the compound muscle action potential
A. Reflects markedly prolonged distal latencies
B. Reflects disproportionate slowing of small fiber conduction velocity
C. Is one of the most common early findings in AIDP
D. Usually indicated submaximal percutaneous nerve stimulation
E. None of the above
051
Assuming no entrapment, which nerve is most likely to show electrodiagnosis
abnormality in subclinical diabetic peripheral neuropathy ?
A. Sural nerve
B. Common peroneal nerve
C. Median nerve
D. Medial plantar nerve
E. Ulnar nerve
052
Which is the most sensitive needle electromyography (EMG) indicator of mild axon
loss?
A. Decreased SNAP amplitudes
B. Reduced motor amplitudes
C. Neurogenic firing on needle examination
D. Fibrillation potentials
E. Slowing of conduction time
053
The complex repetitive discharge
A. represents of single fiber discharge from fiber of damaged area
B. discharge of a group of muscles from a same motor unit
C. the burst is initiated by one fiber as pacemaker and spread ephatically
D. the cesssation of the waves is gradually waning
E. the wave are usually biphasic only
054
Steroid myopathy may be distinguished from relapsing polymyositis by:
A. the absence of abnormal spontaneous activity
B. Increased polyphasia of motor unit action potentials
C. Rapid recruitment of motor unite action potentials
D. The presence of brief duration motor unit action potentials
E. All of the above
055
What is not seen in the lesion of dominant temporal lobe?
A. Wernickes aphasia
B. Homonymous lower quadrantanopia
C. Amusia
D. Dysnomia aphasia
E. None of the above
056
Botulism 的病人不會出現:
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
057
The most sensitive neurons vulnerable to anoxic damage are:
A. Cortex layer IV
B. Endplate of hippocampus
C. Sommer sector
D. Pons
E. Cerebellar Granular cells
058
Which of the following is not the diagnostic criterion for Tuberous Sclerosis?
A. facial angiofibromas
B. Shagreen patch
C. Renal cysts
D. Axillary freckles
E. Multiple retinal astrocytomas
059
Which of the following syndrome is not a mitochondria disease?
A. Myoclonic epilepsy with rag-red fiber (MERRF)
B. Mitochondrial encephalopathy with lactic acidosis and stroke like episodes
(MELAS)
C. Churg-Strauss syndrome
D. Leber hereditary optic neuropathy (LHON)
E. Leigh syndrome
060
Narcolepsy, except
A. Cataplexy
B. Sleep paralysis
C. Hypnagogic hallucination
D. Sleepiness
E. Increased of muscle tone
061
Korsakoff syndrome
A. is caused by folate deficiency
B. is equivalent to Wernicke's encephalopathy
C. is best treated with antipsychotic medications
D. has prominent muscle spastiticity
E. often has confabulation as a prominent symptom
062
The causes of delirium include
A. antihitamines
B. cerebral meningitis
C. hypoglycemia
D. urinary tract infection
E. All of the above
063
Characteristic signs of conversion disorder included all of the following except:
A. Astasia-abasia
B. Stocking -and -glove anesthesia
C. Hemianesthesia of the body beginning precisely at the midline
D. Normal reflexes
E. Cogwheel rigidity
064
Hypersomnia is associated with
A. Kleine-Levin syndrome
B. trypanosomiasis
C. Depression
D. amphetamine withdrawal
E. all of the above
065
Which of the following antipsychotic drugs is least likely to cause tardive dyskinesia?
A. Clozapine
B. Haloperidol
C. Olanzapine
D. Risperidone
E. Sertindole