Inflammatory diseases of nervous system



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Inflammatory diseases of nervous system

1. Indicate symptom which is not related to meningeal syndrome:

1. Total hyperesthesia of skin

2. Lesage symptom

3. Rigidity of occipital muscles

4. Kernig's symptom

*5. Symptom of Wasserman

2. Indicate changes of spinal fluid which are not characteristic of meningococcal meningitis:

*1. Protein-cellular dissociation

2. Cellular-protein dissociation

3. Increased pressure

4. Neutrophilic pleocytosis

5. in cells of fluid found outside meningococci

3. Indicate at what kind of meningitis there is no purulent changes of spinal fluid:

1. It pneumococcal

2. It staphylococcal

*3. Tuberculous

4. Meningococcal

5. Due to bacterium of Afanas?eva-Pfeifer

4. Indicate which of the below mentioned microbes caused initial purulent meningitis:

1. Bacillus of Kohe

2. Pale spirochete

*3. Meningococcal

4. Staphylococcus

5. Streptococcus

5. Indicate which meningitis have serous changes of spinal fluid:

*1. Viral

2. Pneumococcal

3. Streptococcal

4. Staphylococcal

5. Meningococcal

6. Indicate symptom which is not related to meningococcal meningitis:

1. Headache, vomitting

2. Regidity of occipital muscles (stiff neck)

*3. Disturbance of sensitivity by segmentary type

4. Kernig's sign

5. Hyperthermium

7. Typical forms of meningococcal meningitis are all mentioned below except:

1. Lightning

* 2. Bulbar

3. Subacute

4. Recurring

5. Abortive

8. Indicate in what form of serous meningitis it is more often observed decreased sugar level of spinal fluid:

1. Herpes

2. Influenzal

3. Parotitis

* 4. Choriomeningitis

5. Tuberculous

9. Indicate changes of spinal fluid during tuberculous meningitis:

1. Purulent

2. Unclear

3. Normal pressure

4. Bloody

* 5. Opalescent

10. All of below mentioned features of lightning form of meningococcal meningitis are present except:

* 1. Gradual progress of disease

2. Loss of consciousness

3. Severe hyperthermia

4. Pale manifestation of meningeal symptoms

5. Disturbance of breathing and cardiac activity

11. All mentioned below are typical signs of tuberculous meningitis except:

* 1. Acute course

2. Subacute course

3. Lymphocytic pleocytosis

4. Lesion of cranial nerves

5. Cellular-protein dissociation in spinal fluid

12. Basic clinical attributes of secondary purulent meningitis are all indicated below except:

* 1. Lymphocytic pleocytosis

2. Neutrophilic pleocytosis

3. Meningeal syndrome

4. High body temperature

5. Cellular-protein dissociation in spinal fluid

13. Indicate in what type of meningitis observing decrease of glucose and chlorides in spinal fluid:

1. Herpetical

2. Parotitis

3. Choriomeningitis

4. Eneteroviral

* 5. Tuberculous

14. Which of below mentioned signs are not present with acute serous lymphocytic meningitis:

1.Acute start

* 2. Subacute course

3. Lymphocytic pleocytosis

4. Transparent spinal liquid

5. Meningeal syndrome

15. Which below mentioned medication is not used as treatment for purulent meningitis:

1. Penicillin

2. Levomycetin

* 3. Cerebral vasodilators

4. Corticosteroids

5. Biseptol

16. Which one from below mentioned medication is not used for treatment of viral meningitis:

1. Interferon

2. Acyclovir

* 3. Antibiotics

4. Deoxyribonuclease, ribonuclease

5. Corticosteroids

17. Which of below mentioned medication is not used for treatment of meningococcal meningitis:

1. Penicillin

2. Lasix, manitol

* 3. Interferon

4. Cephtriaxon

5. Prednisolone

18. Consequences of meningococcal meningitis are all indicated below except:

1. Vegetovascular syndrome

2. Hydrocephalus

3. Convulsive attacks

4. Cerebral arachnoiditis

* 5. Parkinson?s syndrome

19. Characteristical clinical signs of tuberculous meningitis are all indicated below except:

1. Lesion of membranes of basal brain, ependima of ventricles

* 2. Lesion mostly of membranes of convecsital surface of brain

3. Mildly expressed meningeal syndrome

4. Lesion of cranial nerves

5. Often vegetative-vascular disturbances

20. Indicate presence of what syndrome has deciding significance in making diagnosis of meningitis:

1. meningeal syndrome

2. Presence of focal neurological symptoms

3. Presence of general brain symptoms

* 4. Syndrome of inflammatory changes in spinal liquid

5. Syndrome of infectious disease

21. Basic covered symptoms - all are indicated below except:

1. Hyperesthesia of organs of sensation

2. General hyperesthesia

3. General brain symptoms

4. Increase of muscle tone or contractions

* 5. Sensational disturbances

22. Basic attributes of meningism:

1. Absence of meningeal syndrome

* 2. Presence of meningeal syndrome without changes of spinal fluid

3. Inflammatory changes in spinal fluid

4. Total brain symptoms

5. Focal neurological symptoms

23. Indicate in what part of nervous system prevailing changes due to lethargical ensepholitis:

1. Red nucleus

2. Occipital lobes

3. Cells of anterior horns of spinal cord

* 4. Reticular formation of medulla oblangata and nucleii of occulo-motor nerves

5. Back trunks of spinal cord

24. Typical clinical form of acute period of lethargical encephalitis:

1. Meningeal

2. Bulbar

* 3. Oculo-lethargic

4. Polyneuritic

5. Poliomyelolitical

25. Indicate what attributes have diagnostic value for lethargical encephalitis:

1. Cerebellar ataxia

2. Atrophy of optic nerves

* 3. Oculomotor disturbances and disturbance sleep cycle

4. Disturbance of function of cranial nerves

5. Central paresises of extremities

26. Attributes which arise in acute period of epidemic encephalitis are all indicated below except:

1. meningeal symptoms

2. Diplopia, ptosis, squint

* 3. Paralyses of extremities

4. Pathological drowsiness

5. Recurrent syndrome of Argile-Robertson

27. Indicate syndrome which is characteristic for chronic stage of lethargical encephalitis:

1. Argile-Robertson

2. Parinaud's syndrome

3. Bernard-horner

4. Meningeal

* 5. Parkinsonism

28. Attributes which are inherent to chronic stage of lethargic encephalitis are all indicated below except:

1. Amimia or hypomimia

2. Bradykinesia

* 3. Kojevnikov?s epilepsy

4. Hypertonus of muscles by plastical type

5. Tremor of extremities

29. All mentioned below attributes have diagnostic value at tick-borne encephalitis except:

1. Bulbar palsy

2. Meningeal syndrome

* 3. Disturbance of sleep cycle

4. Upper flabby paraparesis

5. Symptom of "hanging down" head

30. Attributes which are characteristic for acute period of tick-borne encephalitis are all mentioned below except:

1. Bulbar disturbances

2. Meningeal syndrome

3. Flabby paresises of upper limb

* 4. Kojevnikov?s epilepsy

5. Flabby paresises of neck muscles

31. Basic clinical forms of acute period of tick-borne encephalitis are all indicated below except:

1. Bulbar

2. Encephalitical

3. Meningeal

4. Poliomyelitical

* 5. Occulo-lethargical

32. Indicate syndrome which is characteristic for chronic stage of tick-borne encephalitis:

1. Parkinsonism

2. Syndrome of syringomyelitic syndrome

3. Meningeal

* 4. Cortical epilepsy

5. Upper spastic paraparesis

33. Indicate causative agent of tick-borne encephalitis:

1. Pale spirochete

* 2. Arbovirus

3. Gulf coast tick

4. Staphylococcus

5. Cytomegalovirus

34. For treatment of Parkinson?s disease all are used of below mentioned preparations except:

1. Isnakom

* 2. Enapa

3. Cyclodole

4. Midantane

5. Youmexa

35. For treatment of tick-borne encephalitis all the following preparations are used except:

1. Serum of previously sick patients

2. Hyperimmune horse serum

* 3. Sulfa drugs

4. Immunoglobulin

5. Ribonuclease

36. For diagnoses of encephalitis all following symptoms are significant except:

* 1. Protein-cellular dissociation in spinal fluid

2. General brain syndromes

3. Focal neurological symptoms

4. General infectious symptoms

5. Disorders of consciousness

37. Indicate basic clinical criteria with differential diagnosis of meningitis and encephalitis:

1. Age of patient

2. Loss or preservation of consciousness

* 3. Presence or absence of meningeal syndrome or focal symptoms

4. Presence or absence of general brain symptoms

5. Presence or absence of disturbance of consciousness

38. All of the following will relate to parainfectious encephalitis except:

1. Cow

2. Parotitis



3. Rubella

* 4. Serum

5. Influenza

39. All of the following encephalitis by pathogenesis are secondary except:

* 1. Lethargical

2. Rubellar

3. Parotitis

4. Cow


5. Rheumatic

40. Clinical forms of cerebral arachnoiditises are mentioned below except:

1. Pontocerebellar corner

2. Posterior cranial fossa

* 3. Subcortical

4. Convexital

5. Optico-chiasmal

41. Indicate which of the mentioned below symptoms are characteristic of optico-chiasmal of arachnoiditis:

* 1. Decrease in visual acuity

2. Hemiplegia

3. Visual agnosia

4. Disturbances of vegetative regulation

5. Coordinatory disturbances

42. Indicate characteristic symptom of convexital arachnoiditis:

1. Pathologic reflexes

2. Concentric decrease of visual fields

3. Bitemporal hemianopsia

* 4. Focal seizures

5. Diplopia

43. Symptoms which are characteristic of arachnoiditis of pontocerebellum corner are all indicated below except:

1. Neuralgia V pair of cranial nerves

2. Peripheral paresises of muscles of expression

3. Coordinatory disturbances

4. Hearing reduction

* 5. Motor Jackson?s epilepsy

44. Indicate in which type of arachnoiditis vision is sharply reduced:

1. Posterior cranial fossa

2. Convexital

3. Pontocerebellar corner

* 4. Optico-chiasmal

5. Spinal

45. Indicate which type of arachnoiditis has attacks of focal Jackson?s epilepsy:

1. Posterior cranial fossa

* 2. Convexital

3. Pontocerebellar corner

4. Optico-chiasmal

5. Spinal

46. Indicate which type of arachnoiditis have quickly developing hypertensive syndrome:

* 1. Posterior cranial fossa

2. Convexital

3. Pontocerebellar corner

4. Optico-chiasmal

5. Spinal

47. Indicate Major additional method of diagnosis of cerebral arachnoiditises:

1. Electroencephalography

2. Research of retina

3. Craniography

4. Spondilography

* 5. Computer tomography of brain

48. All of the following attributes are characteristic of myelitis except:

* 1. Bulbar disturbances

2. Disturbances of sensitivity by conduction type

3. Disturbances of function of pelvic organs

4. Motor disturbances

5. Trophic disturbances

49. Major clinical attributes of acute stage of myelitis in lower thoracic part of spinal cord are all indicated below except:

1. Paralysis of legs

2. Backache

* 3. Tetraplegia

4. Disturbance of function of pelvic organs

5. Disturbance of sensitivity by conducting type

50. Major clinical attributes of acute stage of myelitis of lumbar part of spinal cord are all indicated below except:

1. Trophic disturbances, bedsores

2. Disturbance of function of pelvic organs

* 3. Spastic lower paraplegia

4. Pain in lumbar zone

5. Flaccid lower paraplegia

51. All of the following preparations are used in acute period of myelitis except:

1. Antibiotics

* 2. Biostimulators

3. Dehydrating preparations

4. Corticosteroids

5. Uroseptic

52. All of the following mentioned means are used in recovory period of myelitis except:

1. Massage

* 2. Dehydrating preparations

3. Anticholine esterase preparations

4. Vitamins, ATP, amino acids

5. Sport

53. It is necessary to differentiate myelitis with all the following indicated diseases except:

* 1. Amyotrophic lateral sclerosis

2. Disturbance of spinal blood circulation

3. Poliomyelitis

4. Spinal cord tumors

5. Spinal form of multiple sclerosis

54. All below indicated clinical features are characteristic of brain abscess except:

1. Headache

2. Hypertermia, leukocytosis, increase of ESR

* 3. Lower flaccid paraplegia

4. Focal neurological symptomatology

5. Stagnant disks of optic nerves

55. Which research will be more informative for diagnosis of brain abscess:

1. Research of retina

* 2. Computer tomography of brain

3. Contrast myelography

4. Rheoencephalography

5. Pneumoencephalography

56. All of the following diseases may be complicated with cerebral abscess except:

1. Purulent otitis

2. Frontitis

3. Lung abscess

* 4. Pulmonary tuberculosis

5. Osteomyelitis of hip

57. Indicate which of following changes of spinal fluid is observed with meningococcal meningitis:

1. Bloody

2. Xanthochromatic

* 3. Purulent

4. Transparent

5. Opalescent

58. Indicate what brain structures are damaged with small chorea:

1. Red nucleus

2. Black substance

3. Globus pallidus

* 4. Striar system

5. Cerebellum

59. Indicate which symptoms are arising in acute stage of cerebral arachnoiditis:

1. Stagnant disks of optic nerves

*2. Headache, nausea, vomiting, and mild lymphocytic pleocytosis.

3. Bradikinesia, Oligokinesia

4. Amblyopia, Amaurosis

5. Disturbance of urination

60. Indicate symptoms which are characteristic for arachnoiditis of posterior cranial fossa:

1. Amblyopia, amaurosis

2. Afatical disturbances

* 3. Stagnant disks of optic nerves

4. Focal seizures

5. Disturbance of urination

61. Indicate which of the following agents cause acute poliomyelitis:

1. Herpes simplex virus

2. Pneumococcus

3. Staphylococcus

* 4. Filtering virus from group of enterovirus

5. Cytomegalovirus

62. Indicate where mostly localized pathological lesion of poliomyelitis:

1. Posterior and lateral cords of spinal cord

* 2. Anterior horns of spinal cord and motor nuclei of cranial nerves

3. Anterior and posterior rootlets of spinal cord

4. Cranial and peripheral spinal nerves

5. White substance of brain spinal cord

63. Indicate particular motor disturbances of paralytic form of poliomyelitis:

1. Central paralysis

* 2. Peripheral paralysis

3. Disturbances of coordination

4. Hyperkinesis

5. Jackson?s epilepsy

64. Indicate in which form of poliomyelitis breathing is disturbed:

1. Abortional

2. Asymptomatic

* 3. Bulbar

4. Meningeal

5. Pontine

65. Indicate what symptoms are characteristic of Pontinal form of poliomyelitis:

1. Acoustic disturbance

2. Disturbance of facial sensitivity

* 3. Peripheral paresis of muscles of expression

4. Central paresis of muscles of expression

5. Atrophy of optic nerves

66. Inflammation of brain membrane can be caused by:

1. Bacteria

2. Viruses

3. Fungi

4. Single celled organism (amoebae)

* 5. All of the above

67. Pathological symptoms of acute stage of encephalitis Economo (disturbance of sleep and function of occulo motor nerves) Due to lesion of:

1. Visual hump

2. Black substance

3. Marsupial body

4. Premotor zone of frontal lobe

* 5. Zone of Silvious aqueduct

68. Virus of spring-summer tick-born encephalitis can penetrate central nervous system by:

1. Alimentary way

2. Hematogenous way

3. Perineural

4. Perineural and hematogenous way

* 5. Alimentary and hematogenous way

69. Indicate most important neurological complication lethargic encephalitis Economo:

1. Ataxia

2. Blindness

* 3. Parkinsonism

4. Deafness

5. Epileptic seizures

70. Small chorea is a disease which is developed owing to:

1. Herpetic encephalitis

2. Hereditary degeneration of caudate nucleus

* 3. Rheumatism

4. Subacute bacterial endocarditis

5. Meningitis

71. All below indicated is connected with infection caused by diphtheritic bacteria except:

1. Polyneuropathies

2. Disturbance of oculomotor and vagus nerves

3. Disturbance of vision

4. Myocarditis

* 5. Neuphritis

72. All below indicated reasons render cooperation to develop pneumococcal meningitis except:

1. leaking of spinal fluid

2. Acute frontitis

3. Acute otitis

* 4. Gastritis

5. Lung absyss

73. What syndrome is characteristic for chronic stage of epidemical encephalitis:

1. Hyperkinetic

* 2. Parkinson?s

3. Meningeal

4. Atactial

5. Convulsive

74. Drowsiness, oculomotor, vestibular dissorders, hypersalivation, and hiccups are characteristic for:

1. Tick-born encephalitis

* 2. Acute stage of epidemic encephalitis

3. Chronic stage of epidemic encephalitis

4. Influenzal encephalitis

5. Arachnoiditis

75. Serous meningitis is more often observed in:

1. Spring-summer period

2. Winter-summer period

3. Fall-winter period

4. summer-fall period

* 5. Sporadically all year round

76. Indicate major pathogenetic mechanism of lesion of nervous system of serous meningitis:

1. Infectious-toxic

2. Infectious-allergic

3. Infectional, toxical, allergic

4. Allergic

* 5. Hypertensive-hydrocephalitical

77. What methods of virologic research have immediate importance in etiological diagnosis of virus meningitis:

1. Allocation of virus from nasopharyngeal washout

2. Allocation of virus of excrements

3. Allocation of virus from spinal fluid

4. Allocation of virus from blood

* 5. All of the above

78. Major pathogenetic direction in treatment of serous meningitis includes:

1. Disintoxication therapy

2. Dehydrational therapy

3. Antiviral therapy

4. Vasoactive lipostabilisative therapy

* 5. Symptomatic therapy

79.


Indicate major pathogenetic mechanism of lesion of nervous system at purulent meningitis:

1. Bacterial-toxic

2. Hypertensive-hydrocephalic

3. Hypoxy-ischemical

* 4. Infectional, toxical, allergic

5. Allergic

80. Major clinical syndromes are all indicated diagnostic of meningococcal meningitis except:

1. Infectious

2. Total brain one?s with prevalence of toxicosis

3. Meningeal

* 4. Diffusive lesion of rootlets of cranial nerves

5. Hemorrhagic rash

81. Etiological diagnostic of purulent meningitises is based on:

1. On particular features during illness

2. Only on particular symptomatic

3. On basis of clinical research

* 4. On basis of bacteriological investigation of spinal fluid

5. On basis of clinical blood examination

82. Pathogenetical treatment of purulent meningitises includes:

1. Only antibacterial preparations

2. Only desintoxication preparations

3. Only dehydrational therapy

* 4. Antibiotics and disintoxication therapy

5. Only vasoactive therapy

83. Desintoxication therapy for treatment of purulent meningitises includes:

1. Transfusion of small amounts of blood and plasma

2. Unloading spinal punctures

3. Osmodiuretic

4. Hypertonic glucose solutions

* 5. Intravenous low-molecular dextran, salt solvents

84. Indicate major pathogenetic mechanism of cns damage at initial viral encephalitises:

1. Cephaledemum

2. Initial lesion virus of neurons and glia cells

3. Vasculitis with small-cell haemorrhage

4. Hypoxium with secondary neuronal degeneration

* 5. Hypertensive-hydrocephalic

85. At what children's infectious disease more often arising infectious-allergic (secondary) encephalitises:

1. Enteric infections

* 2. Exanthema infections

3. Respiratory virus infections

4. Influenza

5. Diphtheria

86. Indicate most often periods of occurrences of infectious-allergic (secondary) encephalitises at exanthema infections:

1. In prodromal period of basic disease

2. In first day of enanthesis

* 3. Through 3-7 days from beginning of occurrence of rash

4. Through 2 weeks from beginning of basic disease

5. After disappearance of enanthesis

87. What mostly defines the character of neurological symptomatics of myelitis is mainly determined:

1. Causative agent

* 2. Localization and size of distribution of myelinical lesion

3. Patient with premorbid condition

4. Provoking factors (intoxications, stress, overcooling)

5. Immunobiological condition of organism

88. Where most often localization of myelinical lesions:

1. Above neck thickening

* 2. In thoracic segments

3. In cervical-chest segments

4. In lumbar segments

5. In brainstem

89. Disturbance of movement in acute period of lumbar myelitis occurs as:

* 1. Peripheral paresises

2. Spastic paresises

3. Combined paresises

4. Hyperkinesis

5. Akinesis-rigid syndrome

90. What type of sensible disturbances in acute period of lumbar myelitis prevail:

1. Radicular

2. Segmentary

3. Mononeuretic

4. Polyneuritic

* 5. Conductive

91. For disseminated myelitis characteristic presence of:

1. One lesion only on length of spinal cord

2. One lesion only on diameter of spinal cord

* 3. More than one lesion on only length and diameter of spinal cord

4. Half cross spinal cord injury

5. Full cross spinal cord injury

92. When recovery started after myelitis, what recovers first?

1. Motion functions

* 2. Sensitivity

3. Trophism of tissues

4. Function of pelvic bodies

5. Function of pelvic bodies and trophism of tissue

93. Poliomyelitis mostly affects:

1. Cortex

2. Rootlets, nerves

3. Subcortical ganglia

* 4. Anterior horn of spinal cord

5. White substance of spinal cord

94. Indicate major syndromes characteristic for acute paralyzing poliomyelitis:

1. Sensible disturbances by conduction type

2. Spastic paralyses

* 3. Flaccid proximal paresises

4. Hyperkinesis

5. disturbance of function of pelvic organs

95. Indicate character of paralyses of extremities at poliomyelitis:

1. Flaccid symmetrical

* 2. Flaccid asymmetrical

3. Flaccid distal

4. Central symmetric

5. Central asymmetric

96. Acute poliomyelitis proceeds in different forms which are caused by:

1. Type of causative agent

2. Patient?s age

* 3. Phase of development of infectious process

4. Way of penetration of causative agent in the organism

5. Premorbid state of the patient

97. Lesion of which segments of spinal cord develops in most grave spinal form of sharp poliomyelitis?

* 1. Cervical-thoracic

2. lower-thoracic

3. Lumbar

4. Sacral

5. Thoracic and lumbar

98. What are major clinical differences of Landry paralysis?

1. Development of bulbar palsy

2. Respiratory disturbances of central genesis

* 3. Ascending type of development of paralyses

4. Infringement of function of pelvic bodies

5. Trophic infringements

99.What means and methods of therapy are not applied in acute period of polyradiculoneuropathy of Hyenna-Barre?

1. Intravenous immunoglobulins

2. Plasmaphoresis

*3.Biostimulators

4. Disintoxication therapy

5. Antihistamine drugs

100. Indicate prevailing localization of lesion of meninges of brain with tuberculous meningitis:

1. Convexital

*2.Basal

3. Is spinal

4. Diffusive

5. Postcranial fossa

101.Which of cranial nerves are more often affected in initial stage of tuberculous meningitis:

1. Olfactory, visual

*2.Oculomotor

3. Pontocerebellum triangle

4. Trigeminal

5. Caudal group

10 2. Indicate absolute diagnostic character allowing to confirm diagnosis of tuberculous meningitis:

1. Characteristic changes in spinal fluid

2. Revealing of somatic tuberculosis

3. Positive Mantoux reaction

*4.Bacteriological acknowledgement of causation of disease at

Research of spinal fluid

5. Focal changes in neurological status

10 3. Patient with hypertensive syndrome, central hemiparesis, hyperthermium, raised ESR, displacement of middle ear on ECHO-EGon 7 mm.Indicate preceding diagnosis:

1. Purulent meningitis

2. Subdural hematom

3. Arachnoiditis

4. Cerebral atherosclerosis

*5. Brain abscess

10 4. Patient with subfebrile temperature, drowsiness, hyperhidrosis, sialorrhea, diplopia, ptosis, increase of tone of muscles behind plastic type.In spinal fluid - lymphocytic pleocytosis, in blood - leukocytosis. Indicate most possible diagnosis:

1. Arachnoiditis

2. Meningitis

*3. Epidemic Encephalitis

4. Tick-borne encephalitis

5. Acute cerebral circulatory disturbance

10 5.One year after grave acute respiratory disease patient steadily developed constrained movements, shaking of fingers of hands, difficulty of course.Objectively -- Masklike oily face, greasiness of person, calming down speech, hypersalivation, old man gait, bradykinesia. Indicate most possible diagnosis:

1. Arachnoiditis

2. Toxic Parkinsonism

3. Atherosclerotic Parkinsonism

*4.Postencephalitic Parkinsonism

5. Tick-borne encephalitis

106.Soon after acute respiratory disease, patient developed pain in occiput and neck and later all the head complaints on attacks of headaches, it is frequent with dizziness and nausea, it is primary in the morning, foggy vision, voice changed.Objectively -- mild bulbar palsy, pyramidal and coordination insufficiency.On retina of eye expanded veins. Spinal fluid is normal. Displacement M-echo is not observed. Indicate most possible diagnosis:

1. Meningitis

2. Encephalitis

3. Arachnoiditis of pontocerebellum corner

*4.Arachnoiditis of posterior cranial fossa

5. Arachnoiditis optico-chiasmal

107. Patient has headache, nausea, vomitting, seizures, body temperature 40 ш . Objectively --

Patient is somnolent. Meningeal symptoms. Spinal fluid- unclear, yellowish, at microscopy: 10 thousand leukocytes in 1 ¬¬ 3. Indicate most possible diagnosis:

*1.Purulent meningitis

2. Serous meningitis

3. Arachnoiditis

4. Encephalitis

5. Tuberculous meningitis

108. Patient acutely along with high temperatures developed weakness in lower extremities, disturbance of pain sensitivity on from level of right and left hand hypochondrium, urinary difficulty. Indicate most possible diagnosis:

1. Poliomyelitis

*2. Acute cross myelitis

3. Multiple sclerosis

4. Acute multiple encephalomyelitis

5. Encephalitis

109.At patient develops bilateral paresis of facial muscle with absence of conductive disturbances developed, What disease can we think of?

*1.Poliomyelitis

2. Trunk encephalitis

3. Tumour of brainstem

4. Polyneuropathy

5. Cerebral ischemia in vertebrobasillar pool

110. 32 year old man during last four days noticed increasing weakness and pain in legs. 10 months ago he had acute respiratory infection transferred acute respiratory infection. In neurological status: sharp pain on course of nervous trunks, lower peripheral paraparesis, disturbance of sensitivity in distal parts of lower extremities. In spinal fluid small increase of quantity of protein. Indicate major etiological factors of progress of disease:

*1.Infectious

2. Vertebrogenic

3. Traumatic

4. Toxic

5. Hereditary

111.37 year old man after acute respiratory infection over week gradually developed weakness of legs , then of muscles of trunk, hands, neck, face, difficulty of speech, swallowing, In neurological status:Bulbar syndrome:Dysphagium, dysarthrium, dysphonia, airflow obstruction, disturbances of cardiac activity, combined tetraparesis. What from listed is necessary to apply in the first place concerning patient:

*1.Hospitalization in reanimation unit

2. Hospitalization in medical part

3. Hospitalization in contagious isolation ward

4. Hospitalization in neurology unit

5.Out-patient treatment

112. 12 year old child complaining on sharp headache , nausea, high temperature.

Objectively -- Child is sleepy, craing. Often vomitting. Temperature of 40 ‘. Sharply expressed sympthome of Kernig, Brudzinsky, stiff neck. On skin of trunk and hands - hemorrhagic rash. Spinal fluid: Color unclear, yellowish, 9 thousand leukocytes in 1 mm3, 0, 9 g /Lprotein. Indicate most possible causative agent wich can be found in spinal fluid:

*1.Meningococcal

2.Staphylococcus

3.Pneumococcus

4.Hemolytic streptococcus

5.Colibacillus

113.33 year old woman complains on headache, nausea, vomitting, seizures. She felt sick yesterday after overcooling.Objectively -- Temperature 40‘. Drowziness. Rigidity of occipital muscles , bilateral symptom of Kernig , general hyperesthesia are determined.

In blood: Leukocytosis, acceleration ESR. Spinal fluid unclear, yellowish. What characteristic changes of spinal fluid most possible:

*1.Neutrophilic pleocytosis

2.Lymphocytic pleocytosis

3.Albuminous-cellular dissociation

4.Sanguine in spinal fluid

5.Xanthochromatic spinal fluid

114. Woman of 54 years of age addressed to doctor with complaints on Tremor of hands, constraint, that developed gradually through 2 years after heavy acute respiratory-viral infection. Objectively --

General constraint, masklike, greasiness of face, calming down speech, gait is slowed, shuffling, tremor of fingers of hands at rest. Indicate most possible reason of disease:

*1.Postencephalitic parkinsonism

2.Vascular parkinsonism

3.Toxic parkinsonism

4.Posttraumatic parkinsonism

5.Paralysis agitans(Parkinson disease)

115. 4-year old boy during 3 days noticed rise in temperature to 39‘ And impossibility to bend his back. Examination in emergency room revealed: boy has red nasopharynx, enlarged tonsils, anterior and posterior cervical lymph nodes, stiff neck. What immediate action should be done by doctor:

1. General blood test

2. X-ray inspection of lungs

3. Introduction of antibiotics

4. Dab of pharunx and nasopharynx

* 5. Lumbar puncture

116. 33 year old man arrived in emergency room of city hospital in stupor. He is sick by the words of his wife for about three weeks, during wich time noticed subfebrile temperature ,, headache, nausea. Several months before disease he had treatment of pulmonary tuberculosis. Neurological status: Meningeal syndrome, lesion of III, VI, VII pairs of cranial nerves. After lumbar puncture established previous diagnosis - tuberculous meningitis. What changes in spinal fluid allowed establish diagnosis:

1. High pressure of liquor (600 mm. )

2. Increased pleocytosis (500 cells.

on 1 mm3)

3. Cellular-albuminous dissociation in liquor

4. Xanthochromatic color of liquor

* 5. Occurrence of web-like film throughout 12 hours

117. Woman of 34 years of age addressed to doctor with complaints on arm tremor, constraint.

In anemnesis: 2 years ago she had acute respiratory infection with marked drowsiness, double vision. One year ago above-stated complaints appeared. In neurological status mildly expressed Parcinson syndrome. What?s the reason of pointed disturbances:

1. Paralysis agitans(Parkinson disease)

2. Parkinson?s syndrome of vascular genesis

3. Consequence of neuroleptics use

4. Consequence of of brain injury

* 5. Consequence of carrying encephalitis Economo

118. 5 year old child during 2 weeks complains on irritability, tearfulness, decreased appetite, headache, evening subfebrile condition were observed. Temperature afterwards raised to 39, headache sharply amplified, cloudiness of consciousness gradually came. Neurological status: Ptosis at the left, converging squint. Reflexes are torpid on hands and legs. Rigidity of occipital muscles , positive symptoms of Kernig and Brudzinsky. Broad ,firm dermographism. On chest x-ray- no pathohistological changes .Spinal fluid transparent, little xantochromic, cytosis - 200 per 1 ¬Є« (70 % lymphocytes, 30 % neutrophils) protein - 0, 97

g / l, chlorides - 100 millimole / l, glucose - 1, 0 millimole / l. Throughout 24 hours in spinal fluid was found gentle fibrinous film . Make the diagnosis:

1. Epidemic cerebrospinal meningitis

* 2. Tuberculous meningitis

3. Arachnoiditis

4. Encephalitis

5. Subarachnoid hemorrhage

119. 35 year old woman during almost a month had subfebrile condition, backaches, headache, periodic rhinitis, appetite loss, irritability . She was treated as having acute respiratory disease.

Condition afterwards sharply worsened - headache amplified, repeated vomitting appeared, temperature raised to 39.7 c and she became stuporous. Relatives reported that her boyfriend was sick with tuberculosis. Neurological status: bilateral ptosis, more at the left,left pupil the more dilated. Sharply expressed rigidity of occipital muscles , symptoms of Kernig and Brudzinsky. On roentgenogram of lungs single petrificates are seen. Spinal fluid transparent, ksanthochromic, pressure of 290 mm . ‘в., cytosis of 150 in of 1 mkl, lymphocytes prevail, protein - 0, 8 g / l, glucose of 1, 34 millimole / l. Most possible causative agent for this patient is:

* 1.Mycobacterium of Tuberculousis.

2. Staphylococcus

3. Meningococcy

4. Pneumococcus

5. Virus

120. 32 year old patient developed pain and paresthesia in extremities, general weakness, temperature raised to 39.0c. Weakness in legs afterwards came, lower paraplegia developed.

Later developed weakness of hands and muscles of expression, hypotrophy of muscles of calf . There is no Knee and Achilles reflexes . Carporadial reflexes are decreased.

Decreased sensitivity in distal parts of extremities by the type "glove" and "socks ".

In blood leukocytosis with shift of formula to the left. Pressure of spinal fluid raised, cytosis of 8 per 1 ¬Є«, lymphocytes, protein - 2, 1 g / l. Establish diagnosis:

1. Meningitis

* 2. Syndrome of Giyoma-Barre

3. Multiple sclerosis

4. Acute diffuse encephalomyelitis

5. Brain tumor

121. 23 year old patient on background of catarrhal phenomena and pain in muscles of thorax temperature suddenly raised to 38, 50, appeared severe headache, pain in the eye-balls, repeated vomitting. In neurological status: Anisoreflexy. Hyperesthesia of derma. Rigidity of muscles of nape, positive symptoms of Kernig and Brudzinsky. On fundu of eye lightly swelled optic nerve. Spinal fluid: Transparent, colourless, pressure of 230 mm. Waters. ‘в., cytosis of 40 in 1 mcl. Lymphocytes, glucose - 3, 1 millimole / l, Reaction of Wassermann - negative. Right after lumbar puncture headache decreased. Diagnose:

1. Purulent meningitis

* 2. Serous meningitis

3. Tuberculous meningitis

4. Encephalitis

5. Arachnoiditis

122. 6-year-old patient 7 days after tumescence of parotid glands temperature raised to 39, 3 ш , Severe headache appeared, repeated vomitting. In neurological status: Stiff neck, symptom of Kernig and Brudzinsky. Spinal fluid: Transparent, colourless, pressure of 260 ml.

Waters. ‘в., protein - 0, 8 g / l, cytosis - 300 per of 1 mcl, sugar - 2, 5 millimole / l. Diagnose:

1. Landry's disease

* 2. Acute serous meningitis

3. Epidemic cerebrospinal meningitis

4. Tuberculous meningitis

5. Acute encephalomyelitis

123. 38 year old patient after overcooling weakness appeared, temperature 37, rhinitis. Patient was treated in the out-patient department during 10 days, her condition has worsened, temperature raised to 37, 6-38.0c, appeared headache, on height of which nausea developed. Patient hospitalized with suspicion on pneumonia into internal medicine department , where treated with penicillin, dimedrol, vitamins of B, ‘, analgetics. Patient is examined by neurologist: Revealed general hyperesthesia, painfull trigeminal points, she cannot incline head (feels severe headache), positive symptoms of Kernig, Brudzinsky. Painfulness of paravertebral points in all parts of backbone revealed also, tendons hyporeflexia, slight strabismus, diplopia.

What disease of nervous system it is possible to assume:

1. Pneumonia with signs of general intoxication

2. Osteochondrosis, radicular syndrome

* 3. Meningitis

4. Neuritis of third cranial nerves

5. Subarachnoid hemorrhage

124. Patient last sunday developed general weakness , headache, pain in lumbar-sacral part of backbone, high temperature. In 3 days lower extremities ceased to move, delay of urine and stool appeared.

Objectively -- lower spastic paraplegia, abdominal reflexes are absent, conduction disturbances of sensation. Diagnose:

1. Encephalitis

* 2. Myelitis

3. Arachnoiditis

4. Meningitis

5. Polyradiculoneuritis

125. 32 year old man complaints on constraint of all movements, tremor of fingers .

It is known from anamnesis, what patient 8 years ago had disease with catarrhal phenomena, raised body temperature, there also were headache, drowsiness, double vision.

Patient recovered, but year ago indicated complaints appeared again. In neurological status:

Hypomimia, mask-like face, speech silent, monotonous. Paresis of convergence, being absent reaction of pupils on accommodation and convergence. Increased salivation. Tone of extremities increased by plastic type. At rest there is tremor of extremities. Diagnose:

1. Paralysis agitans

2. Vascular parkinsonism

* 3. Postencephalitic parkinsonism

4. Toxic parkinsonism

5. Multiple sclerosis

126. Patient 49 years, directed in ‹®а-branch concerning polypoidal ethmoiditis.

Operate: Removed polyps, opened cells of ethmoid labyrinth. Temperature in the evening raised to 38, there was fever. Following day temperature 39, sharp headache, seasonly cloudiness of consciousness. In neurological status: Stiff neck, Kernig's sign, maxillary symptom of Bechterev, illnesses when movings eyeballs. Blood test: Leukocytes - 18е109 G (l, ˜®п - 49 mm (з. Liquor: Pressure of 350 mm. Waters. ‘в., muddy, cytosis - 1200 Є« in 1 ¬Є«. ,Neutrophils, fiber - 1, 8 g (l., glucose of 2, 9 millimole (l. Diagnose:

1. Encephalitis

* 2. Purulent meningitis

3. Serous meningitis

4. Brain tumor

5. Cerebral hemorrage

127. Patient 23 years leaded holiday in taiga area. Through two days on returning to house felt indisposition, weakness, headache, body temperature raised to 38, 20. Was hospitalized.

Neurological status: Head hangs down, dysarthrium, difficulty on swallowing. Pharyngeal reflex is caused no. Deviation of language to the right, fibrillations. Hypotrophy of muscles of neck, shoulder girdle. Reflexes are caused no on hands, belly - lowered, on lower extremities reflexes alive. Sensitivity is not mentioned. Blood: Leuc. - 14е10 , SOYA of 26 mm / з. Liquor transparent, fiber 1, 0 g. cytosis 20 cells in 1 ¬Є«, lymphocytes.

About what disease it is possible to think:

1. Encephalitis of Economo

* 2. Tick-borne encephalitis

3. Meningitis

4. Encephalomyelitis

5. Cerebral hemorrage

128. Man 40 years, acted in hospital in sopor. Was taken ill several weeks back, headache appeared, nausea, general weakness. It was at night marked reusable vomitting. In anemnesis chronic suppurative otitis. Neurologic inspection found presence of meningeal syndrome.

Indicate what inspection You will appoint in first turn in that case:

* 1. Research of spinal fluid

2. General blood test

3. X-raying of lungs

4. Electroencephalography

5. Computer tomography of head

129. Man, 27 years, acted with complaints on elevated temperature to 40, headache, nausea, hypersensitivity to light. Was taken ill sharply 3 day back, symptoms of Acute respirate infection appeared.

Neurological status: General hyperesthesia, stiff neck, Kernig's sign. Liquor: Transparent, lymphocytic, pleocytosis - 450 / 3, pressure of 250 mm. Waters. ‘в., fiber - 0, 49 g / l. Your preceding diagnosis:

1. Purulent meningitis

* 2. Virus meningitis

3. Tuberculous meningitis

4. Pneumonia

5. Subarachnoid hemorrhage

130. Boy, 11 years, complains on headache, easy fatiguability, sweating. Marks indicated complaints over two weeks. Last three days condition of boy worsened, was marked vomitting, subfebrile temperature, headache amplified. Neurologic condition: Lays on party with deserted head. Rigidity of muscles of nape, Kernig's sign. Hemiptosis right century. Liquor: Transparent, pressure - 380 mm. Waters. ‘в., cytosis 540 / 3 lymphocytic. Laboratory research of liquor lets establish basis preceding diagnosis - tuberculous meningitis. What changes of liquor allow to make such conclusion:

1. Increase of content of glucose

2. Increase of content of gamma-globulins

3. Albuminous-cellular dissociation

4. Cellular-albuminous dissociation

* 5. Decrease of content of glucose

131. In branch 7-years boy in sopor acted. Was taken ill from words of mother week back, temperature appeared 39, 5? , Headache, phenomena of Acute respirate infection. After treatment temperature decreased, state of health improved.

Per day to hospitalization temperature again raised, was marked vomitting, weakness appeared Neurologic review was found by meningeal syndrome, facial asymmetry, absence of tendon reflexes on right finitenesses, hyperkinesisnes in the right hand were observed.

What most possible preceding diagnosis:

* 1. Parainfectious meningoencephalitis

2. Coronary disease

3. Hemorrhagic insult

4. Disseminated sclerosis

5. Tick-borne encephalitis

132. In woman, 38 years, on background of chronic suppurative otitis intensive headache appeared, vomitting, psychic inhibition, epileptic seizure afterwards developed. What most possible preceding diagnosis:

* 1. Brain abscess

2. Coronary disease

3. Hemorrhagic insult

4. Epilepsy

5. Brain tumor

133. What inspection before in all needs to be leaded by man 42 years, at which clinical attributes of oncogenic brain abscess:

1. Electroencephalography

2. Rheoencephalography

3. Angiography

* 4. CT


5. Myography

134. At man, 50 years, is established diagnosis of brain abscess. What treatment policy is shown for this patient:

1. Hemodilution

* 2. Surgical treatment

3. Symptomatic therapy

4. Vitaminotherapy

5. Therapy vascular preparations

135. Man, 40 years, addressed with complaints on gradual increase of unsteadiness at gait in darkness, "shooting" onychalgium. In patient unsuccessful social history. Objectively --

Anisocoria, pupils deformed, positive symptom of Argile-Robertson(absence of reaction of pupils on world at preservation on accommodation and convergence). Knee and Achilles reflexes will not be caused. Hypesthesia deep kinds of sensitivity. Sensitive ataxium.

What most possible diagnosis:

1. Sharp cerebral circulatory disturbance

2. Chronic cerebral circulatory disturbance

* 3. Syphilis of nervous system

4. Brain tumor

5. Spinal cord tumor

136. Woman, 27 years, addressed with complaints on headache, tinnitus, dizziness, morbidity on movings the eyeballs, general weakness, sleeplessness, irritability. In anemnesis: 2 year was back treated concerning syphilis. Objectively -- Sensitive stiff neck. Focal symptom is not revealed. What research is most expedient to use for specification of diagnosis of neurosyphilis:

* 1. Research of liquor

2. Rheoencephalography

3. Electroencephalography

4. Echoencephaloscopy



5. Angiography
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