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2010天坛神经外科博士入学考试

2010天坛神经外科博士入学考试
2010天坛神经外科博士入学考试

首都医科大学2010年攻读博士学位研究生入学考试专业课试卷

(A卷)

科目名称:神经外科学报考导师:

一、简答题(2’×10)

1.微创神经外科的理念

2.GCS评分的意义

3.weber综合症的表现

4.脑膜刺激征的表现

5.椎管内肿瘤包括哪些

6.神经导航系统工作原理

7.猝死

8.心肺复苏

9.先天性脑积水病因

10.近代神经外科学历经百余年,大致可以

分为几个阶段

二、填空题(1分/空,共20分)

1.视神经检查包括,,和三方面。

2.MODS常见原发病是:,,和。

3.微创神经外科技术包括,,,,,。

4.大脑动脉环由,,,和。

5.神经系统由和组成。

三、单选题(1’×10题)

1.对颅内压增高的病人,下列处理中哪项最危险

A.腰椎穿刺放脑脊液减压

B.不限制出入水量

C.不规则使用利尿脱水剂

D.未服用镇静止痛剂

E.侧脑室穿刺脑脊液外引流

2.最容易引起枕大孔疝的颅内占位病变是

A.鞍区肿瘤

B.额顶叶肿瘤

C.颞叶脑脓肿

D.侧脑室肿瘤

E.第四脑室肿瘤

3.下列颅内站位病变中最早出现颅内压增高的是

A.颅前窝底肿瘤

B.枕叶肿瘤

C.第三脑室后部肿瘤

D.矢状窦旁肿瘤

E.听神经瘤

4.颅内压增高时,颅内压调节主要通过

A.脑组织从高压区向低压区移动

B.脑静脉血被排挤到颅腔外

C.脑血管的自动调节

D.颅内脑脊液量的减少

E.脑组织被压缩

5.患儿头呈舟状畸形原因是

A.冠状缝早闭

B.矢状缝早闭

C.额缝早闭

D.鳞状缝早闭

E.人字缝早闭

6.对脑干损伤昏迷的病人,治疗呼吸道梗阻最有效的方法

A.气管切开

B.通过鼻腔和口腔吸痰

C.经口腔气管插管

D.鼻腔置管吸氧

E.开口器侧卧位引流

7.颅内占位病变诊断首选检查手段

A.脑地形图

B.CT和MRI

C.SPECT

D.脑干诱发电位

E.脑血管造影

8.病人出现枕大孔疝,CT上有脑室扩大,首选最有效的急救措施是

A.20%甘露醇迅速静点

B.去骨瓣减压

C.侧脑室额角钻孔引流

D.快速静点地塞米松20mg

E.气管切开保持呼吸道通畅

9.多数儿童肿瘤是

A.转移癌

B.少枝胶质细胞瘤

C.多形胶质母细胞瘤

D.脑膜瘤

E.位于幕下

10.颅骨骨质增生最常见于

A.神经鞘瘤

B.垂体腺瘤

C.星形细胞瘤

D.脑膜瘤

E.血管网织细胞瘤

四、不定项选择(2.5’ ×4题)

女性,35岁,右侧面部阵发性电击样疼痛2年,刷牙和进冷食可诱发,曾行局部注射肉毒素封闭末梢神经治疗,效果欠佳。查体:右侧角膜反射减弱,右侧面部浅感觉下降,双侧咀嚼肌肌力不对称,右侧减弱。

问题一:正确的诊断和治疗包括

1.三叉神经痛

2.面肌痉挛

3.颅内压力增高

4.可行头颅MRI检查

5.癫痫

6.丘脑痛

MRI检查见图

问题二:正确的诊断包括

1.原发性三叉神经痛

2.继发三叉神经痛

3.畸胎瘤可能性大

4.表皮样囊肿的可能性大

5.听神经瘤可能性大

6.胶质瘤可能性大

问题三:对治疗正确的描述

1.不能手术,应该选择内科保守治疗

2.可以手术治疗

3.手术入路可以采用枕下乙状窦后入路

4.手术后可能出现面瘫

5.手术应采用乙状窦前入路

6.肿瘤包膜术中必须切净

问题四:病人术后出现发热,可能原因和处理包括

1.肿瘤残余物刺激脑干引起

2.再次手术切除残余肿瘤

3.可能为颅内感染

4.可行腰椎穿刺明确病因

5.有很大可能为颅内出血引起

6.可能为肿瘤内容物引起的化学性刺激

五、论述题(40分)

1.外科手术进程中的无菌原则。(10分)

2.医师与病家沟通的注意要点。(15分)

3.枕骨大孔疝发生的机制和临床表现。(15分)

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