十五单元神系统疾病选择题与核心知识点提炼.pdfVIP

Unit5NervousSystemDiseases

项选择题

1.Ifaninfantdevelopspurulentmeningitisandissuspectedtobeaccompaniedbysubduraleffusion,theeasiestwaytoassistindiagnosisis

A.Cranialtranslucency

examinationB.CranialMRI

examinationC.Cranial

B-ultrasoundexaminationD.

Lumbarpuncture

cerebrospinalfluid

examinationE.Experimental

subduralpuncture

Referenceanswer:A

[Analysis]Whensuppurativemeningitisininfantsissuspectedtobecomplicatedbysubduraleffusion,cranialtranslucencyexaminationandCTscan

canassistinthediagnosis,andsubduralpuncturetoreleasetheeffusioncanservethepurposeofdiagnosisandtreatment.Mastertheknowledge

pointsofpurulentmeningitis.

2.Themaindifferencesweenpurulentmeningitisandtuberculousmeningitisare

A.Medicalhistory

B.PPDtestC.Chest

X-rayexamination

D.Peripheralblood

imagechangesE.

Cerebrospinalfluid

examination

Referenceanswer:

E

【解析】

Mastertheknowledgepointsofpurulent

meningitis.

3.Themostreliablebasisfordiagnosisofpurulentmeningitisinchildrenis

A.Theappearanceof

cerebrospinalfluidisturbidor

purulentB.Thenumberofcellsi

ncerebrospinalfluidincreases

significantlyC.Theamountof

sugardecreasesD.The

cerebrospinalfluidtestfor

bacteriaispositive

E.脑膜刺激征阳性

参：D

【解析】确认致病菌对明确诊断和指导治疗均有重要意义，涂片革兰染色检查致病菌简便易行，检出阳性率

甚至较细菌培养高。细菌培养阳性者应做药物敏感试验。以乳胶颗粒凝聚试验为基础的多种免疫学方法可检

测出脑脊液中致病菌的特异性抗原，对涂片和培养未能检测到致病菌的患者诊断有参考价值。掌握“化脓性

脑膜炎”知识点。

4.小儿化脓性脑膜炎合并脑积水是

A.由于炎症累及下丘脑和垂体

B.由于不规律用药

C.由于血脑屏障功能差

D.由于炎性渗出物脑脊液循环而致

E.以上都不是

参：D

【解析】患脑膜炎时，脓性渗出物易狭小孔道或发生粘连而引起脑脊髓循环，产生脑积水。常见于

治疗不当或治疗过晚的，尤其多见于儿和小婴儿。粘连性蛛网膜炎好发于枕骨大孔，可脑脊液

循环；或脑室膜炎形成粘连，均为常见的引起梗阻性脑积水的