问题 多项选择题

下述表现中和急性感染性脱髓鞘性多发性神经病有关的是()

A.小腿肌握痛

B.四肢无力

C.呼吸困难

D.三叉神经痛

E.吞咽费力

答案

参考答案:A, B, C, E

解析:

急性感染性脱髓鞘性多发性神经病可出现自发的肌肉疼痛和压痛

急性炎症性脱髓鞘性多发性神经病(acuteinflammatorydemyelinatingpolyneuropathies,aidp)又称为guillain-barre(gbs)综合征,主要损害多数脊神经根和周围神经,也常累及颅神经,是多发性神经炎中一种特殊类型。是目前导致全身性瘫痪的较常见的疾病。 临床表现有:

一、运动障碍 

1、肢体瘫痪: 

四肢呈对称性下运动神经元性瘫痪,且常自下肢开始,逐渐波及双上肢,也可从一侧到另一侧。通常在1至2周内病情发展至最高峰,以后趋于稳定,四肢无力常从远端向近端发展,或自近端开始向远端发展。四肢肌张力低下,腱反射减弱或消失,腹壁、提睾反射多正常。少数可因锥体束受累而出现病理反射征。起病2-3周后逐渐出现肌萎缩。 

2、躯干肌瘫痪: 

颈肌、躯干肌、肋间肌、隔肌也可出现瘫痪。当呼吸肌瘫痪时,可出现胸闷、气短、语音低沉、咳嗽无力、胸式或腹式呼吸动度减低、呼吸音减弱,严重者可因缺氧、呼吸衰竭或呼吸道并发症而导致昏迷、死亡。 

3、颅神经麻痹: 

约半数病人可有颅神经损害,以舌咽、迷走和一侧或两侧面神经的周围性瘫痪为多见,其次为动眼、涌车、外展神经。偶见视神经 * * 水肿,可能为视神经本身炎症改变或脑水肿所致,也可能和脑脊液蛋白的显著增高,阻塞了蛛网膜绒毛、影响脑脊液的吸收有关。除三叉神经感觉支外,其他感觉神经极少受累。 

二、感觉障碍: 

可为首发症状,以主观感觉障碍为主,多从四肢末端的麻木、针刺感开始。检查时牵拉神经根常可使疼痛加剧(如kernig征阳性),肌肉可有明显压痛,双侧腓肠肌尤著。客观检查感觉多正常,仅部分病人可有手套、袜套式感觉障碍。偶见节段性或传导束型感觉障碍。感觉障碍远较运动障碍为轻、是本病特点之一。 

三、植物神经功能障碍: 

初期或恢复期常有多汗、汗臭味较浓,可能系交感神经受刺激的结果。少数病人初期可有短期尿潴留,可能由于支配膀胱的植物神经功能暂时失调或支配外括约肌的脊神经受侵所致。大便常秘结。部分病人可出现血压不稳,心动过速和心电图异常等心血管功能障碍。 

判断题
问答题

Man first appeared on earth about 2 million years ago. Then he was little more than an animal; but early man had a big advantage over the animals. He had in his brain special groups of nerve cells, not present in animals, that enabled him to invent a language and use it to communicate with his fellow men. 46) This ability to speak was of great value because it allowed men to share ideas, and to plan together, so that tasks impossible for a single person could be successfully undertaken by intelligent team-work. Speech also enabled ideas to be passed on from generation to generation so that the stock of human knowledge slowly increased.
It was this special ability that put men far ahead of other living creatures in the struggle for existence. 47) He mastered darkness first with dim lights and later with brighter and brighter lamps, until he can now make for himself so dazzling a light with an arc lamp that, like the sun, it is too p for his naked eyes.
48) Man found that his own muscles were too weak for the work which he wanted to do; he explored many other forms of power until now he has his hands on the ultimate source of physical energy, the nuclear power. From man’s earliest days the flight of birds has raised his wonder and desire. Why should he not fly as they did Then he began to experiment. At last he learnt how to make the right machines to carry him through the air. Now he can fly faster than sound. Already he has plans for conquering space, and a series of experiments has been completed. 49) It will not be long now before man takes a giant step away from his planet and visits the moon, learning what it is like to have no weight to his body, no upward direction and no downward.
Man, always a wanderer, has to overcome the difficulty of adapting himself to different climates. 50) Fortunately, in spite of having no thick skin or warm fur to protect him, he is peculiarly p compared with other living creatures, most of whom are unable to live far outside the region that suits them best.