K-Type: Multiple True-False (A) If 1,2,3 Are True (B) If 1,3 Are True (C) If 2,4 Are True (D) If Only 4 Is True (E) If All Are True

K-type: Multiple true-false (A) if 1,2,3 are true (B) if 1,3 are true (C) if 2,4 are true (D) if only 4 is true (E) if all are true

( ) 1. About catamenial epilepsy, which of the following descriptions is (are) correct? 1. The possible physiological basis might be related to the activating effects of estrogens of seizures 2. Adrenal steroid hormones and related pituitary peptides have neuroactive effects that can also influence seizures 3. The possible physiological basis might be related to the suppressive effects of progesterone on epileptiform discharges 4. Glucocorticoids facilitate epileptiform discharges and seizures in animal models through mineralocorticoid receptors in the brain.

解答：E 題目之出處：NICP 4th ed. P.1972

( ) 2. In an epilepsy patient with liver cirrhosis, Which AED is most suitable for him (her)? 1. Oxcarbazepine 2. Levetiracetam 3. Valproate 4. Gabapentin

解答：C 題目之出處：Handbook of epilepsy, 4th edition 2008, P. 183

1 ( ) 3. Which of the following description(s) about anisocoria is (are) true? 1. Anisocoria in Horner syndrome was most significant when in dark 2. Anisocoria in uncal herniation was most significant when in light 3. Anisocoria without change in light or dark environment could be normal variant 4. Retina lesion could also cause anisocoria

解答：A 題目之出處：Merritt’s neurology 11th ed. P22-23

( ) 4. The elicitation of blink reflex established the integrity of the following structure(s)? 1. Trigeminal nerve 2. Facial nerve 3. Interneuron in the pons 4. Caudal medulla

解答：E 題目之出處：Principles of Neurology, 8th ed. p.1100

( ) 5. The effect of aging on the autonomic nervous system are heterogeneous, including： 1. Cardiovagal function is impaired. 2. Orthostatic hypotension is prevalent in the elderly. 3. Sudomotor function is affected. 4. Impotence and incontinence increase with age.

解答：E 題目之出處：Principle of Neurology 8th ed., P452-462

2 ( ) 6. Which of the following may suggest raised intracranial pressure: 1. Elevation of the optic disc 2. Disappear pulsations of the retinal veins 3. Peripapillary hemorrhages 4. Progressive paresis of adduction of the eyes

解答: A 題目之出處: Adams Principles of Neurology, 8/e, p211, 212

( ) 7. Which of the following statement(s) about neuropathic tremor is (are) true? 1. The tremor frequency usually ranges from 3-6 Hz 2. Valproic acid is the most effective agent for the treatment of neuropathic tremor 3. The tremors are usually postural or kinetic 4. Neuropathic tremors are caused by cerebellar dysfunction

Ans: B NICP: 2147

( ) 8. Which statement(s) about Huntington’s chorea is(are) true? 1. Is a dominantly inherited condition caused by an unstable expanded CAG trinucleotide repeat in the huntingtin gene of chromosome 4 2. The juvenile phenotype tends to manifest with prominent features of chorea 3. Pathology may reveal prominent neuronal loss and gliosis in the caudate nucleus 4. Chorea usually resolved spontaneously

Ans: B NICP: 2148

3 ( ) 9. About Sydenham chorea, which one is (are) correct? 1. Sydenham chorea usually developed after infection of group A beta-hemolytics Streptococcus 2. Clinical symptoms include irritability, emotional labiality, attention deficit 3. Sydenham chorea often is a benign disease, and complete recovery is rule in uncomplicated cases 4. The chorea usually developed soon after infection

解答：A 題目之出處：Merritt’s 11th ed 807-809

( ) 10. A 77 y/o man with Parkinson’s disease developed nocturnal agitation and visual hallucination. He has taken antiparkinsonian drugs for 13 years. The present medications were amantadine, selegiline, ropinirole, and levodopa. The appropriate management(s) will be 1. Add an acetylcholinesterase inhibitor or NMDA antagonist 2. Add risperidone 3. Add quetiapine and stop all antiparkinsonian medications 4. Stepwise discontinue antiparkinsonian medications

解答：D 題目之出處：Merritts Neurology, 11thed. p. 837-845

( ) 11. Which of the following are provisional criteria for vascular parkinsonism? 1. Acute or subacute onset with stepwise evolution of akinesia and rigidity 2. Presence of risk factors for cerebrovascular disease 3. Two or more basal ganglia infarcts or more widespread subcortical white-matter lesions evident on neuroimaging 4. Parkinsonian motor signs may be poor responsive to L-dopa or amantadine

解答：A 題目之出處：Neurology in Clinical Practice, 4th edition, 2004, p.1929

4 ( ) 12. Dementia with Lewy bodies is differentiated from Alzheimer’s disease by which of the following features? 1. Parkinsonism features 2. Visual hallicunations 3. Fluctuation of consciousness 4. More severe loss of short-term memory

Ans：A Reference：NICP 4th ed., P.1924

( ) 13. A 28-year-old Oriental man had history of recurrent episode limbs paralysis in the morning, caused him difficulty arising from bed. Hyperthyrodism and hypokalemia state were found in emergency department, which of the following conditions is correct? 1. Related to calcium channel gene defect 2. Replaced oral form KCl 3. Autosomal dominant inheritance disorder 4. Propranolol therapy is indicated

解答：C 題目之出處：Principal of Neurology, 8th edition, pp1272

( ) 14. A 56-year-old man with weakness of four limbs and neck muscle for one month, his serum CK is up to 4300 U/L, anti-Jo1 is positive, clinical examination showed weakness over proximal part of limbs, which the following associated illness could be involved too? 1. Interstitial lung disease 2. Arthritis 3. Raynaud syndrome 4. Thickening of the skin of the hands

解答：E 題目之出處：Principal of Neurology, 8th edition, pp 1206

5 ( ) 15. Which of the following descriptions about Isaacs syndrome are true? 1. The main symptoms of myokymia and stiffness get subside in sleep 2. The common associated symptoms included hypohydrosis and cramps 3. The needle EMG disclosed spontaneous activities of either myokymia or myotonia 4. Response to low dose phenytoin or carbamazepine

解答： D 題目之出處：Merritt’s neurology 11th ed. p925-927

( ) 16. Which is (are) the clinical manifestations of syringomyelia? 1. Dissociated sensory loss 2. Scoliosis 3. Brachial amyotrophy 4. Deep and aching pain

解答：E 題目之出處：Merritt’s Neurology 11th edition , p 871

( ) 17. A 23-year-old lady complained of numbness over the fifth digit and median aspect of the left hand whenever she flexed her elbow for the past one week. She did not recall any trauma of the left upper extremity. The result of nerve conduction studies was normal. Which of the following diagnosis is (are) correct? 1. Compressive neuropathy at the lateral epicondyle 2. Cubital tunnel syndrome 3. Tradive ulnar palsy 4. Compressive ulnar neuropathy

解答：C 題目之出處：Adams & Victor’s Principles of Neurology, 8th edition, p1168

6 ( ) 18. This patient was a 53-year-old man with 1 year of gradually progressive painless weakness and atrophy, initially affecting the right leg then spreading to the left, without sensory loss, bladder or bowel disturbance, back pain, or other nonmotor involvement. The examination demonstrated markedly asymmetric lower extremity weakness of a lower motor neuron type without any upper motor neuron signs. Imaging of the spine, spinal fluid analysis, and routine laboratory studies were normal. What is the possible diagnosis? 1. Anterior horn cell disease 2. Polyradiculopathy of the lumbosacral segments 3. Multifocal motor neuropathy 4. Polymyositis

解答：A 題目之出處：Adams & Victor’s Principles of Neurology, 8th edition, p940

( ) 19. Thyrotoxic myopathy is characterized by 1. Hyporeflexia 2. Involvement of distal limbs 3. Elevated CPK 4. Myokymia

解答：D 題目之出處：Merritt, 10th ed. P.855; Harrison 16th ed. P.2538

( ) 20. Akinetic mutism 1. Motionless and mute, lack of motivation 2. Preserved awareness, retention of ability to move and speak but failure to do so 3. May attributed to bilateral lesions in the ventromedial frontal lobe regions 4. May attributed to bilateral lesions in the frontal-diencephalic connections

解答: E 題目之出處: Adams Principles of Neurology, 8/e, p305, 306,394

7 ( ) 21. About collateral vessels in the brain circulation, which of the following(s) is (are) right? 1. Subarachonid interarterial anastomoses: linking ACA,MCA, PCA 2. Ophthalmic artery: linking ECA and ICA 3. Persistent trigeminal artery: linking basilar artery and ICA 4. Muscular braches of cervical arteries: linking vertebral artery and ICA

解答: A 題目之出處:Adams p665

( ) 22. Which of the following statement(s) about SAH is (are) true? 1. Subhyaloid hemorrhage is pathognomonic of SAH 2. Screening for unruptured intracranial aneurysm is indicated in patients with polycystic kidney disease 3. Most patients with perimescencephalic SAH have a benign clinical course 4. Grade 0 in Hunt & Hess Grading scale means asymptomatic SAH

解答：A 題目之出處：Merrit’s 11th p329-330

8 ( ) 23. A 36 y/o young man visited Emergency Department for an acute onset of slurred speech, and limbs weakness. Neurological Examinations showed a central type facial palsy, mild degree limbs weakness, brisker DTR, and

positive Babinski sign in right side; the T/P/R were 36.2℃/72/min/16/min; and, BP was 226/138 mm-Hg. MRI images are as below. What the impression is (are)?

1. Brainstem infarct 2. Subcortical infarct 3. Posterior cerebral artery infarct 4. Posterior reversible hypertensive encephalopathy

解答：C 題目之出處：Merritts Neurology, 11thed., p. 308

( ) 24. Which statement(s) about the following “MRI scan” is (are) correct?

DWI DWI FLAIR 1. May result in paraplegia and incontinence 2. May be embolic or surgical (following operations on ACOM aneurysms) 3. May result in abulia, motor aphasia and personality change 4. May occur while occlusion of the stem of the anterior cerebral artery proximal to its connection with the ACOM

解答: A 題目之出處: Adams Principles of Neurology, 8/e, p.672

9 ( ) 25. Which of the following statements concerning about neurological complications in uremic patients is/are true? 1. Uremic myopathy fails to fully respond to hemodialysis 2. The use of immunosuppressive drugs after renal transplantation can cause reversible posterior leukoencephalopathy 3. Dysequilibrium syndrome could be related to hemodialysis 4. Uemic encephalopathy easily developed in patients who received long term hemodialysis

解答：A 題目之出處：Neurological Complications in Uremia, Acta Neurologica Taiwanica Vol 17 No2 June 2008

( ) 26. Risk factors of sudden unexpected death in epilepsy include: 1. History of generalised tonic clonic seizures 2. High seizure frequency 3. Polytherapy 4. Alcohol abuse

解答：A 題目之出處：Sudden Unexpected Death in Epilepsy. Risk Factors, Possible Mechanisms and Prevention: A Reappraisal. Acta Neurol Taiwan 2006;15:72-83

( ) 27. Which of the following statement(s) about brain abscess is (are) true? 1. Patient is often febrile with elevated ESR. 2. Brain abscess is almost never a consequence of bacterial meningitis. 3. Pneumococcus is a major cause of a brain abscess. 4. Anticonvulsant may be given for prophylaxis.

解答：C 題目之出處：Merrit’s, 11th, p168-173

10 ( ) 28. The neurological disease induced and complicated by human immuno- deficient virus (HIV) including the followings: 1. Primary CNS lymphoma 2. Mononeuritis multiplex 3. Cryptococeal meningitis 4. Metabolic encephalopathies

解答：E (all are true) 題目之出處：Adams and Victors: Principlas of Neurology 8th edition Chap 33 p644-647

( ) 29. About Marchiafava-Bignami disease, which one is (are) correct? 1. Clinical presentation as alerted mental status, seizure and multi-focal neurological signs. 2. Pathology usually has evidence of inflammation aside form few perivascular lymphocytes. 3. The disease is usually slowly progressive and results in death within 3 to 6 years. 4. Pathology showed necrosis of peripheral zone of corpus callosum.

解答：B 題目之出處：Merritt’s 11th ed. P.963-964

( ) 30. Interferon-β may modify the multiple sclerosis via the following mechanism, 1. Inhibiting proinflammatory and increasing regulatory cytokine levels 2. Inhibition of T cell proliferation 3. Limiting the trafficking of inflammatory cells in the CNS 4. Up-regulating expression of MHC molecules on antigen-presenting cells

解答：A 題目之出處：Harrison’s Principles of Internal Medicine, 16th ed., page 2467

11 ( ) 31. Which answer is correct about the revised criteria of migraine headache? 1. Throbbing type headache in character 2. Headache duration lasted for several weeks 3. Photophobia or nausea associated 4. Aura must be a precipitating factor

解答：B 題目之出處：The International Classification of Headache Disorders, 2004

( ) 32. Neurological complications from hematopoietic stem cell transplantation include: 1. Myasthenia gravis 2. Polymyositis 3. Guillain-Barre-like syndromes 4. Cerebrovascular disorder

解答：E 題目之出處：Merritt’s neurology, 11th ed, P.1171-1172

( ) 33. Treatment of tetanus include 1. Toxoid 2. Surgical cleaning of wound 3. Metronidazole 4. Trivalent antitoxin

解答：A 題目之出處：Merritt’s neurology, 11th ed, p196-197

12 ( ) 34. Which statement(s) is (are) true about the management of Wilson’s disease? 1. Avoid chocolate, nuts, shellfish, mushrooms and liver intake 2. Zinc sulfate may be used in patients who could not tolerate penicillamine 3. Neurologic deterioration may occur in 20~50﹪of persons starting penicillamine treatment 4. Orthotopic liver transplantation is a potential curative treatment

解答：E 題目之出處：Parkinson’s Disease & Movement Disorders, 4th edition, P247-250

( ) 35. Which are nutritional disturbances in alcoholics 1. Wernicke syndrome 2. Korsakoff syndrome 3. Cerebellar degeneration 4. Amblyopia

解答：E 題目之出處: Merritt’s 11th page 1155, table 163.5

( ) 36. Which statement(s) about AVM (arteriovenous malformation) is (are) true? 1. Hemorrhage occurred most commonly in the middle age 2. The risk of hemorrhage increased when deep venous drainage 3. The risk of hemorrhage decreased when superficial location 4. The hemorrhage usually comes arises from the nidus

解答：E 題目之出處：Merritt’s neurology 11th ed. p 4450-452

13 ( ) 37. Which statement(s) about transient global amnesia is (are) true? 1. Patients are usually middle-aged or elderly and otherwise healthy 2. Sudden onset anterograde amnesia without self-identification disturbance or retrograde amnesia 3. Both verbal and non-verbal memory was affected during attack 4. Patient usually recovered gradually in one week

解答：B 題目之出處：Merritt’s neurology 11th ed. p 1017

( ) 38. Causes and pathogenetic associations of pseudotumor cerebri? 1. Hypervitaminosis A 2. Lead 3. Tetracycline 4. Baclofen

解答：A 題目之出處：Adams And Victor'S Principles Of Neurology 8th Ed. p 538.

( ) 39. Which of the following statements concerning about normal pressure hydrocephalus is/are true? 1. Progressive gait disturbance is an early sign 2. In most cases the cause of normal pressure hydrocephalus cannot be established 3. Impairment of mental function, especially frontal lobe syndrome, was noted 4. Grasp reflexes in the feet and falling attacks may also occur but there are no Babinski signs

解答： E 題目之出處：Adams and Victor 8th edition p535-536

14 ( ) 40. Regarding hemispheric specialization and asymmetry, the following statements is or are correct most of time for right handedness? 1. Left hemisphere for praxis 2. Right hemisphere for face identification 3. Right hemisphere for spatial function 4. Right hemisphere for emotion and affect

解答：E 題目之出處：Principles of Behavioral and Cognitive Neurology. 2nd ed. M.-Marsel Mesulum. P80

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