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患者男，72岁，因“周期性意识模糊3年”来诊。3年前突发意识模糊及定向力障碍，短时间内症状消失。在随后的3年里，患者渐渐变得抑郁、社交能力下降，近记忆力越来越差。同时，还间断出现与周期性意识模糊状态相伴随的视幻觉。家人发现其步态变得不稳，容易向后退。既往体健。查体：内科情况无特殊；神经系统主要表现为显著的对称性帕金森表现，包括“面具脸”和手的姿势性震颤。精神状态检查发现严重的延时记忆障碍，经过

其诊断和鉴别诊断包括（提示或练习试验也无提高。）（）

A.阿尔茨海默病

B.帕金森病痴呆

C.路易体痴呆

D.肌萎缩侧索硬化

E.血管性痴呆

F.脑出血

答案

参考答案：A, B, C, E

单项选择题 A2型题

女性，63岁，3小时前生气时突然头痛、呕吐和左侧肢体无力，10分钟后昏迷。检查：血压210/120mmHg，中昏迷，右鼻唇沟浅，右侧肢体痛刺激无反应，右Babinski征（+），脑CT示右基底节有一直径为5cm左右类圆形的高密度影，入院2小时后，右瞳孔5mm，对光反应消失；左瞳孔2mm，光反应存在。最可能的诊断为（）。

A.脑出血合并脑疝

B.脑栓塞合并脑疝

C.蛛网膜下腔出血

D.脑血栓形成合并脑疝

E.脑出血
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单项选择题

The effect of the baby boom on the schools helped to make possible a shift in thinking about the role of public education in the 1920’s. In the 1920’s, but especially (1) the Depression of the 1930’s, the United States experienced a (2) birth rate. Then with the prosperity (3) on by the Second World War and the economic boom that followed it, young people married and (4) households earlier and began to (5) larger families than had their (6) during the Depression. Birth rates rose to 102 per thousand in 1946, 106.2 in 1950, and 118 in 1955. (7) economics was probably the most important (8) , it is not the only explanation for the baby boom. The increased value placed (9) the idea of the family also helps to (10) this rise in birth rates. The baby boomers began streaming (11) the first grade by the mid-1940’s and became a (12) by 1950. The public school system suddenly found itself (13) The wartime economy meant that few new schools were buih between 1940 and 1945. (14) , large numbers of teachers left their profession during that period for better-paying jobs elsewhere.

(15) , in the 1950’s, the baby boom hit an antiquated and inadequate school system. Consequently, the custodial rhetoric of the 1930’s no longer made (16) ; keeping youths ages sixteen and older out of the labor market by keeping them in school could no longer be a high (17) for an institution unable to find space and staff to teach younger children. With the baby boom, the focus of educators (18) turned toward the lower grades and back to basic academic skills and (19) . The system no longer had much (20) in offering nontraditional, new, and extra services to older youths.

7（）

A.Since

B.Despite

C.Although

D.Unless
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