重庆医科大学消化内科学2017年考博真题试卷

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消化内科考博试题及答案

消化内科考博试题及答案1. 胃黏膜表面细胞屏障功能的损害因子及其机制。

答：胃黏膜表面细胞屏障功能的损害因子包括非甾体类抗炎药物(NSAIDs)，幽门螺杆菌感染，酗酒，应激等。

机制主要涉及胃黏膜屏障完整性的破坏，抑制黏液-碳酸氢盐屏障的形成，促进胃酸分泌，减少黏膜血流以及促进炎症细胞浸润等。

2. 肝硬化门静脉高压症的病理生理改变及其影响。

答：肝硬化导致门脉高压，病理生理改变包括门静脉高压与肝内及体内门-体侧侧支循环的形成，肝内血流受阻，导致门脉高压并影响肝脏功能。

门静脉高压可引起脾大，食管静脉曲张，腹水和便血等并发症。

3. 胆囊结石的分类及其临床表现。

答：胆囊结石可分为胆固醇结石、黑色素结石和钙盐结石。

胆囊结石的临床表现包括右上腹疼痛，恶心、呕吐，黄疸，发热，消化不良等。

胆囊炎、胆囊积水以及胆总管梗阻是结石所引起的主要并发症。

4. 慢性胰腺炎的发病机制及临床特点。

答：慢性胰腺炎的发病机制主要包括酒精作用、胆道疾病、遗传因素、自身免疫等。

临床特点主要表现为腰背痛，消化不良，脂肪泻，营养不良，以及胰腺外分泌功能减退等。

5. 急性胃黏膜病变的病理变化及临床表现。

答：急性胃黏膜病变的病理变化包括黏膜充血、水肿，上皮细胞变性，黏液层减少等。

临床表现有胃痛、恶心、呕吐、消化道出血等症状。

6. 炎症性肠病的病理生理改变及其临床表现。

答：炎症性肠病的病理生理改变主要涉及肠道黏膜炎症、溃疡形成，肠道屏障功能障碍、免疫异常等。

临床表现主要有腹泻、腹痛、贫血、体重减轻等。

7. 消化系统肿瘤的常见类型及其临床特点。

答：消化系统肿瘤的常见类型包括肝癌、胃癌、食管癌、结直肠癌等。

临床特点因肿瘤部位不同而有所不同，主要表现为消瘦，乏力，食欲不振，恶心呕吐，腹痛，便血等。

8. 慢性病毒性肝炎的病理变化及临床表现。

答：慢性病毒性肝炎的病理变化主要涉及肝细胞坏死、间质纤维化以及结构改变等。

临床表现有乏力，食欲不振，恶心呕吐，肝区疼痛，黄疸等。

重庆医科大学博士入学考试(病理学)试题

重庆医科大学博士入学考试（病理学）试题一．名词解释：（2分/词，共20分。

1、凋亡2、交界性肿瘤3、肺褐色硬化4、风湿小体5、软化灶6、假小叶7、大红肾8、脂肪变性9、结核瘤10、趋化作用二、英译汉：（只翻译成汉语，不解释。

0.5分/个，共10分）。

Pathology EmbolusDegenerationGranulation tissue Proliferation SinusMetastasis Hypertension Viral hepatitisCarcinoma of breast Hemorrhage Infarct Karyolysis Septicemia Thyroid adenoma TeratomaArteriolosclerosis FistulaBronchiectasis Amoebiasis二．填空题：（0.5分/空，共10分）。

1、淤血的原因有，和。

2、胃溃疡的并发症为__________、___________、____________、_____________。

3、肾病综合征表现为___________、_________、___________、___________。

4、坏死的结局有，，wk_ad_begin({pid : 21});wk_ad_after(21, function(){$('.ad-hidden').hide();},function(){$('.ad-hidden').show();}); 和。

5、骨肉瘤易经转移。

6、葡萄胎光镜下的三大主要特征是___________、_____________、___________。

7、化脓菌入血，生长繁殖，产生毒素，细菌随血流到达身体各处，引起多发性小脓肿，称。

四、多选题：(1分/题，共30分)。

A型题：（在以下试题中，请从备选答案中选出1个最佳答案）。

1、下列各种组织和细胞，哪一种再生能力最弱A心肌B神经纤维C表皮D肝细胞E骨组织2、肿瘤血道播散最常见的部位是A肺,心,脑B肺,肾,胃,脾C肝,肺D心,肝,肠E肝,腹膜,脑3、下列各项急性炎症反应中，按顺序哪一种最先出现？A血管扩张B血流缓慢C白细胞附壁D白细胞游出E血流停止4、慢性风湿病，最常累及的瓣膜为A二尖瓣B二尖瓣+主动脉瓣C三尖瓣+主动脉瓣D三尖瓣E二尖瓣+三尖瓣。

2017年上半年重庆省西医综合之消化系统考试题

2017年上半年重庆省西医综合之消化系统考试题本卷共分为2大题60小题，作答时间为180分钟，总分120分，80分及格。

一、单项选择题(在每个小题列出的四个选项中只有一个是符合题目要求的，请将其代码填写在题干后的括号内。

错选、多选或未选均无分。

本大题共30小题，每小题2分，60分。

)1、要素饮食可能产生的代谢方面的合并症是A．高钠、高氯B．氮质血症C．凝血酶原过低D．高渗性非酮性昏迷E．以上都是2、肥厚型梗阻性心肌病的超声心动图特点是__A．二尖瓣前叶脱垂B．各房室腔增大C．室间隔与左室后壁厚度之比＞1.3D．左室流出道流速明显降低E．主动脉瓣开放受限3、RNA引物在DNA复制过程中的作用是A．提供起始模板B．激活引物酶C．提供复制所需的3′-羟基D．提供复制所需的5′-磷酸E．激活DNA-polⅢ4、TATA盒结构是典型的A．真核启动子B．原核启动子C．反式作用因子D．转录因子5、下列关于急性白血病骨髓移植治疗的叙述，正确的是A．自体骨髓移植应在第二次缓解期进行B．异基因骨髓移植应在第二次缓解期进行C．异基因骨髓移植患者的年龄应控制在40岁以内D．从完全缓解到自体骨髓移植的时间间隔以6个月以上为佳E．自体外周血干细胞移植较白体骨髓移植的造血功能恢复慢6、判断组织兴奋性高低最常用的指标是A．刺激频率B．刺激强度C．动作电位D．阈电位E．阈强度7、全胃肠营养液中必需氨基酸和非必需氨基酸的含量是A．1：1 B．1：2 C．1：3 D．2：18、影响神经系统发育最重要的激素是A．肾上腺素B．甲状腺激素C．生长素D．胰岛素E．醛固酮9、关于正常人外周血网织红细胞数量及其意义的叙述哪项正确A．外周血网织红细胞超过红细胞总数的2％B．网织红细胞增高，说明骨髓造血功能减低或衰竭C．网织红细胞长期增多，而不伴有红细胞增多者骨髓发育不全，即红系成熟受阻D．网织红细胞降低，表示骨髓造血功能明显活跃，至极度活跃E．网织红细胞增多或降低不代表骨髓造血功能10、引起肾前性少尿或无尿的常见原因有A．严重脱水、失血、急性肾小管坏死B．严重脱水、失血、肾病综合征、心力衰竭C．急性肾小球肾炎、急性肾小管坏死、肾病综合征、心力衰竭D．急性肾小球肾炎、急性肾小管坏死、肾结石或肾肿瘤11、下列哪种酶失活后会引起cAMP浓度降低A．蛋向激酶A B．蛋白激酶C C．腺苷酸环化酶D．磷脂酶C E．蛋白激酶G12、1型糖尿病的胰岛病变特点是A．早期胰岛无改变B．胰岛进行性破坏，B细胞减少C．胰岛体积正常D．胰岛数目正常13、女性，20岁，自幼出现发作性呼气性呼吸困难。

(完整版)各大名校历年考博士真题及答案消化内科部分

名词解释肝肾综合征(HRS)（北医2001）：又称功能性肾衰，以自发性少尿或无尿，氮质血症，稀释性低钠血症和低尿钠为特征，而肾脏无明显病理改变。

机理：肾血管收缩，致肾皮质血流量和肾小球滤过率持续降低。

交感神经兴奋性增高，去甲肾分泌增加；肾素-血管紧张素系统活性增强；肾PGs合成减少，血栓素（TXA2）增多；内毒素血症：增加肾血管阻力；白细胞三烯产生增加，引起肾血管收缩. 肝肺综合征: 指严重肝病、肺血管扩张和低氧血症组成的三联征.肠易激综合征(IBS)（同济2008）：是一种腹痛或腹部不适伴排便习惯改变为特征的功能性肠病，经检查排除可引起这些症状的器质性疾病。

Zollinger-Ellison综合征，卓－艾综合征（北医2002）（胃泌素瘤）：胰腺非β细胞瘤分泌大量胃泌素所致，肿瘤一般很小（<1cm)，生长缓慢，半数为恶性。

大量胃泌素可刺激壁细胞增生，分泌大量胃酸，使上消化道处于高酸状态，导致胃，十二指肠球部和不典型部位发生多发性溃疡。

胃泌素瘤与普通消化性溃疡的鉴别要点是该病溃疡发生在不典型部位，具有难治的特点，高胃酸分泌，血清胃泌素>200pg/ml。

库瓦济埃（Courvoisier）征（哈医大2008）：在胰头癌压迫胆总管导致阻塞时，发生明显黄疸，且逐渐加深，胆囊显著肿大，但无压痛，称为Courvoisier征，又称胆总管渐进阻塞征。

在胆总管结石梗阻所致的黄疸病人中，由于胆囊也常有慢性炎症，囊壁因纤维而皱缩，且与周围组织粘连而失去移动性，因而有黄疸但胆囊常不肿大，称为Courvoisier征阴性。

TIPS（同济）：经颈静脉肝内门体分流术，是一种以血管介入的方法在肝内的门静分支和肝静脉分支间建立分流通道。

它能有效降低门静脉压力，适用于食道静脉曲张破裂大出血、难治性腹水，易诱发肝性脑病.virchow淋巴结：（哈医大2008）胃癌的癌细胞向远处淋巴结转移，因胃的淋巴系统与锁骨上的淋巴结相连接，癌细胞转移到该处时称为virchow淋巴结。

2017年医学博士外语真题试卷一(精选).doc

2017年医学博士外语真题试卷一（精选）(总分：126.00，做题时间：90分钟)1.Section A（分数：2.00）__________________________________________________________________________________________ 2.Rheumatologist advises that those with ongoing aches and pains first seek medical help to______ the problem.（分数：2.00）A.affiliateB.alleviateC.aggravateD.accelerate3.An allergy results when the body have a(n)______reaction to certain substances introduced to it.（分数：2.00）A.spontaneousB.negativeC.adverseD.prompt4.Diabetes is one of the most______and potentially dangerous diseases in the world.（分数：2.00）A.crucialB.virulentC.colossalD.prevalent5.Generally, vaccine makers______the virus in fertilized chicken eggs in a process that can take four to six months.（分数：2.00）A.penetrateB.designateC.generateD.exaggerate6.Drinking more water is good for the rest of your body, helping to lubricate jointsand______toxins and impurities.（分数：2.00）A.screen outB.knock outC.flush outD.rule out7.Despite their good service provided, most inns are less expensive than hotels of______standards.（分数：2.00）A.equivalentB.likelyC.alikeD.uniform8.Chronic high-dose intake of vitamin A has been shown to have______effects on bones.（分数：2.00）A.adverseB.prevalentC.instantD.purposeful9.According to the Geneva______no prisoners of war shall be subject to abuse.（分数：2.00）A.CustomsB.CongressesC.ConventionsD.Routines10.Environmental officials insist that something be done to______acid rain.（分数：2.00）A.curbB.sueC.detoxifyD.condemn11.It is impossible to say how it will take place, because it will happen______, and it will not be a long process.（分数：2.00）A.spontaneouslyB.simultaneouslyC.principallyD.approximately12.Section B（分数：2.00）__________________________________________________________________________________________13.The patient's condition has worsened since last night.（分数：2.00）A.improvedB.returnedC.deterioratedD.changed14.Beijing Television-Station Transmitting Tower really looks magnificent at night when it's lit up .（分数：2.00）A.decoratedB.illustratedC.illuminatedD.entertained15.Because of adverse weather conditions, the travelers stopped to camp.（分数：2.00）A.localB.unfamiliarC.goodD.unfavorablerm the manager if you are on medication that makes you drowsy .（分数：2.00）A.uneasyB.sleepyC.guiltyD.fiery17.The period from 3, 000 to 1, 000 B. C. E. , when the use of bronze became common , is normally referred to as the Bronze Age.（分数：2.00）A.obviousB.significantC.necessaryD.widespread18.Diabetes is one of the most prevalent and potentially dangerous diseases in the world.（分数：2.00）A.crucialB.virulentC.colossalD.widespread19.Likewise , soot and smoke from fire contain a multitude of carcinogens.（分数：2.00）A.a matter ofB.a body ofC.plenty ofD.sort of20.Many questions about estrogen's effects remain to be elucidated , and investigations are seeking answers through ongoing laboratory and clinical studies.（分数：2.00）A.implicatedB.impliedC.illuminatedD.initiated21.The defect occurs in the first eight weeks of pregnancy, though no one understands why.（分数：2.00）A.faultB.deviationC.discretionD.discrepancy22.The applications of genetic engineering are abundant and choosing one appropriate for this case can be rather difficult.（分数：2.00）A.sufficientB.plentifulC.adequateD.countable三、PartⅢ Cloze(总题数：1，分数：20.00)It was the kind of research that gave insight into how flu strains could mutate so quickly. (One theory behind the 1918 version's sudden demise after wreaking so much devastation was that it mutated to a nonlethal form. ) The same branch of research concluded in 2005 that the 1918 flu started in birds before passing to humans. Parsing this animal-human【C1】______could provide clues to【C2】______the next potential superflu, which already has a name: H5N1, also known as avian flu or bird flu. This potential killer also has a number: 59 percent. According to the World Health Organization, nearly three-fifths of the people who【C3】______H5N1 since 2003 died from the virus, which was first reported【C4】______humans in Hong Kong in 1997 before a more serious 【C5】______occurred in Southeast Asia between 2003 and 2004. (It has since spread to Africa and Europe. ) Some researchers argue that those mortality numbers are exaggerated because WHO only 【C6】______cases in which victims are sick enough to go to the hospital for treatment【C7】______compare that to the worldwide mortality rate of the 1918 pandemic; it may have killed roughly50 million people, but that was only 10 percent of the number of people infected, according toa 2006 estimate. H5N1's saving grace — and the only reason we're not running around masked up in public right now — is that the strain doesn't jump from birds to humans, or from humans to humans, easily. There have been just over 600 cases (and 359 deaths) since 2003. But【C8】______its lethality, and the chance it could turn into something far more transmissible, one might expect H5N1 research to be exploding, with labs【C9】______the virus's molecular components to understand how it spreads between animals and【C10】______to humans, and hoping to discover a vaccine that could head off a pandemic.（分数：20.00）(1).【C1】（分数：2.00）A.interactB.interfaceC.connectionD.contamination(2).【C2】（分数：2.00）A.stoppingB.stoppedC.have stoppedD.stop(3).【C3】（分数：2.00）A.contactedB.contractedC.concentratedD.infected(4).【C4】（分数：2.00）A.onB.inC.ofD.with(5).【C5】（分数：2.00）A.breakoutB.take placeC.happenD.outbreak(6).【C6】（分数：2.00）A.accountsB.numbersC.countsD.takes(7).【C7】（分数：2.00）A.MoreoverB.StillC.FurthermoreD.Thereafter(8).【C8】（分数：2.00）A.givenB.givingC.to giveD.speaking of(9).【C9】（分数：2.00）A.parsingB.parsedC.to parseD.having parsed(10).【C10】（分数：2.00）A.presentlyB.potentiallyC.potentlyD.importantly四、PartⅣ Reading Compre(总题数：6，分数：60.00)If you are reading this article, antibiotics have probably saved your life—and not once but several times. A rotten tooth, a knee operation, a brush with pneumonia; any number of minor infections that never turned nasty. You may not remember taking the pills, so unremarkable havethese one-time wonder drugs become. Modern medicine relies on antibiotics — not just to cure diseases, but to augment the success of surgery, childbirth and cancer treatments. Yet now health authorities are warning, in uncharacteristically apocalyptic terms, that the era of antibiotics is about to end. In some ways, bacteria are continually evolving to resist the drugs. But in the past we've always developed new ones that killed them again. Not this time. Infections that once succumbed to everyday antibiotics now require last-resort drugs with unpleasant side effects. Others have become so difficult to treat that they kill some 25, 000 Europeans yearly. And some bacteria now resist every known antibiotic. Regular readers will know why: New Scientist has reported warnings about this for years. We have misused antibiotics appallingly, handing them out to humans like medicinal candy and feeding them to livestock by the tonne, mostly not for health reasons but to make meat cheaper. Now antibiotic-resistant bacteria can be found all over the world — not just in medical facilities, but everywhere from muddy puddles in India to the snows of Antarctica (南极洲) . How did we reach this point without viable successors to today's increasingly ineffectual drugs? The answer lies not in evolution but economics. Over the past 20 years, nearly every major pharmaceutical company has abandoned antibiotics. Companies must make money, and there isn't much in short-term drugs that should be used sparingly. So researchers have discovered promising candidates, but can't reach into the deep pockets needed to develop them. This can be fixed. As we report this week, regulatory agencies, worried medical bodies and Big Pharma are finally hatching ways to remedy this market failure. Delinking profits from the volume of drug sold (by adjusting patent rights, say, or offering prizes for innovation) has worked for other drugs, and should work for antibiotics — although there may be a worryingly long wait before they reach the market. One day, though, these will fall to resistance too. Ultimately, we need, evolution-proof cures for bacterial infection: treatments that stop bacteria from causing disease, but don't otherwise inconvenience the little blighters. When resisting drugs confers no selective advantage, drugs will stop breeding resistance. Researchers have a couple of candidates for such treatment. But they fear regulators will drag their feet over such radical approaches. That, too, can be fixed. We must not neglect development of the sustainable medicine we need, the way we have neglected simple antibiotic R&D. If we do, one day another top doctor will be telling us that the drugs no longer work—and there really will be no help on the way.（分数：10.00）(1).In the first paragraph, the author is trying to______.（分数：2.00）A.warn us against the rampant abuse of antibiotics everywhereB.suggest a course of action to reduce antibiotic resistanceC.tell us a time race between humans and bacteriaD.remind us of the universal benefit of antibiotics(2).The warning from health authorities implies that______.（分数：2.00）A.the pre-antibiotic era will returnB.the antibiotic crisis is about to repeatC.the wonder drugs are a double-edged swordD.the development of new antibiotics is too slow(3).The appalling misuse of antibiotics, according to the passage, ______.（分数：2.00）A.has developed resistant bacteria worldwideB.has been mainly practiced for health reasonsC.has been seldom reported as a warning in the worldD.has been particularly worsened in the developing countries(4).The market failure refers to______.（分数：2.00）A.the inability to develop more powerful antibioticsB.the existing increasingly ineffectual drugs in the marketC.the poor management of the major pharmaceutical companiesD.the deprived investment in developing new classes of antibiotics(5).During the presentation of the two solutions, the author carries a tone of______.（分数：2.00）A.doubtB.urgencyC.indifferenceD.helplessnessWhere one stage of child development has been left out, or not sufficiently experienced, the child may have to go back and capture the experience of it. A good home makes this possible, for example by providing the opportunity for the child to play with a clockwork car or toy railway train up to any age if he still needs to do so. This principle, in fact, underlies all psychological treatment of children in difficulties with their development, and is the basis of work in child clinics. The beginnings of discipline are in the nursery. Even the youngest baby is taught by gradual stages to wait for food, to sleep and wake at regular intervals and so on. If the child feels the world around him is a warm and friendly one, he slowly accepts its rhythm and accustoms himself to conforming to its demands. Learning to wait for things, particularly for food, is a very important element in upbringing, and is achieved successfully only if too great demands are not made before the child can understand them. Every parent watches eagerly the child's acquisition of each new skill—the first spoken words, the first independent steps, or the beginning of reading and writing. It is often tempting to hurry the child beyond his natural learning rate, but this can set up dangerous feeling of failure and states of anxiety in the child. This might happen at any stage. A baby might be forced to use a toilet too early, a young child might be encouraged to learn to read before he knows the meaning of the words he reads. On the other hand, though, if a child is left alone too much, or without any learning opportunities, he loses his natural zest for life and his desire to find out new things for himself. Learning together is a fruit source of relationship between children and parents. By playing together, parents learn more about their children and children learn more from their parents. Toys and games which both parents and children can share are an important means of achieving this co-operation. Building-block toys, jigsaw puzzles and crossword are good examples. Parents vary greatly in their degree of strictness or indulgence towards their children. Some may be especially strict in money matters, others are severe over times of coming home at night, punctuality for meals or personal cleanliness. In general, the controls imposed represent the needs of the parents and the values of the community as much as the child's own happiness and well-being.（分数：10.00）(1).The principle underlying all treatment of developmental difficulties in children______.（分数：2.00）A.is to send them to clinicsB.offers recapture of earlier experiencesC.is in the provision of clockwork toys and trainsD.is to capture them before they are sufficiently experienced(2).The child in the nursery______.（分数：2.00）A.quickly learns to wait for foodB.doesn't initially sleep and wake at regular intervalsC.always accepts the rhythm of the world around themD.always feels the world around him is warm and friendly(3).The encouragement of children to achieve new skills______.（分数：2.00）A.can never be taken too farB.should be left to school teachersC.will always assist their developmentD.should be balanced between two extremes(4).Jigsaw puzzles are______.（分数：2.00）A.too difficult for childrenB.a kind of building-block toyC.not very entertaining for adultsD.suitable exercises for parent-child cooperation(5).Parental controls and discipline______.（分数：2.00）A.serve a dual purposeB.should be avoided as much as possibleC.reflect the values of the communityD.are designed to promote the child's happinessFor 150 years scientists have tried to determine the solar constant, the amount of solar energy that reaches the Earth. Yet, even in the most cloud-free regions of the planet, the solar constant cannot be measured precisely. Gas molecules and dust particles in the atmosphere absorb and scatter sunlight and prevent some wavelengths of the light from ever reaching the ground. With the advent of satellites, however, scientists have finally been able to measure the Sun's output without being impeded by the Earth's atmosphere. Solar Max, a satellite from the National Aeronautics and Space Administration (NASA), has been measuring the Sun's output since February 1980. Although a malfunction in the satellite's control system limited its observation for a few years, the satellite was repaired in orbit by astronauts from the space shuffle in 1984. Max's observations indicate that the solar constant is not really constant after all. The satellite's instruments have detected frequent, small variations in the Sun's energy output, generally amounting to no more than 0. 05 percent of the Sun's mean energy output and lasting from a few days to a few weeks. Scientists believe these fluctuations coincide with the appearance and disappearance of large groups of sunspots on the Sun's disk. Sunspots are relatively dark regions on the Sun's surface that have strong magnetic fields and a temperature about 2, 000 degrees Fahrenheit cooler than the rest of the Sun's surface. Particularly large fluctuations in the solar constant have coincided with sightings of large sunspot groups. In 1980, for example, Solar Max's instruments registered a 0. 3 percent drop in the solar energy reaching the Earth. At that time a sunspot group covered about 0. 6 percent of the solar disk, an area 20 times larger than the Earth's surface. Long-term variations in the solar constant are more difficult to determine. Although Solar Max's data have indicated a slow and steady decline in the Sun's output. Some scientists have thought that the satellite's aging detectors might have become less sensitive over the years, thus falsely indicating a drop in the solar constant. This possibility was dismissed, however, by comparing solar Max's observations with data from a similar instrument operating on NASA's Nimbus 7 weather satellite since 1978.（分数：10.00）(1).According to the passage, scientists believe variations in the solar constant are related to______.（分数：2.00）A.sunspot activityB.unusual weather patternsC.increased levels of dustD.fluctuations in the Earth's temperature(2).Why is it not possible to measure the solar constant accurately without a satellite?（分数：2.00）A.The Earth is too far from the Sun.B.Some areas on Earth receive more solar energy than others.C.There is not enough sunlight during the day.D.The Earth's atmosphere interferes with the sunlight.(3).Why did scientists think that Solar Max might be giving unreliable information?（分数：2.00）A.Solar Max did not work for the first few years.B.Solar Max's instruments were getting old.C.The space shuttle could not fix Solar Max's instruments.D.Nimbus 7 interfered with Solar Max's detectors.(4).The attempt to describe the solar constant can best be described as______.（分数：2.00）A.an ongoing research effortB.a question that can never be answeredC.an issue that has been resolvedD.historically interesting, but irrelevant to contemporary concerns(5).What does this passage mainly discuss?（分数：2.00）A.The components of the Earth's atmosphere,B.The launching of a weather satellite.C.The measurement of variations in the solar constant.D.The interaction of sunlight and air pollution.Optical illusions are like magic, thrilling us because of their capacity to reveal the fallibility of our senses. But there's more to them than that, according to Dr. Beau Lotto, who is wowing the scientific world with work that crosses the boundaries of art, neurology, natural history and philosophy. What they reveal, he says, is that the whole world is the creation of our brain. What we see, what we hear, feel and what we think we know is not a photographic reflection of the world, but an instantaneous unthinking calculation as to what is the most useful way of seeing the world. It's a best guess based on the past experience of the individual, a long evolutionary past that has shaped the structure of our brains. The world is literally shaped by our pasts. Dr. Lotto, 40, an American who is a reader in neuroscience at University College London, has set out to prove it in stunning visual illusions, sculptures and installations, which have been included in art-science exhibitions. He explains his complex ideas from the starting point of visual illusions, which far from revealing how fragile our senses are show how remarkably robust they are at providing a picture of the world that serves a purpose to us. For centuries, artists and scientists have noted that a grey dot looks lighter against a dark background than being against a light background. The conventional belief was that it was because of some way the brain and eye is intrinsically wired. But Dr. Lotto believes it's a learnt response; in other words, we see the world not as it is but as it is useful to us. "Context is everything, because our brains have evolved to constantly re-define normality, " says Dr. Lotto. "What we see is defined by our own experiences of the past, but also by what the human race has experienced through its history, " This is illustrated by the fact that different cultures and communities have different viewpoints of the world, conditioned over generations. For example, Japanese people have a famous inability to distinguish between the "R" and the "L" sound. This arises because in Japanese the sounds are totally interchangeable. "Differentiating between them has never been useful, so the brain has never learnt to do it. It's not just that Japanese people find it hard to tell the difference. They literally cannot hear the difference. " Dr. Lotto's experiments are grounding more and more hypotheses in hard science. "Yes, my work is idea-driven, " he says. "But lots of research, such as MRI brain scanning, is technique-driven. I don't believe you can understand the brain by taking it out of its natural environment and looking at it in a laboratory. You have to look at what it evolved to do, and look at it in relationship to its ecology. "（分数：10.00）(1).What does the word "them" in the first paragraph refer to?（分数：2.00）A.Human senses.B.The fallibility of senses.C.Revealing capacity.D.Optical illusions.(2).According to the passage, what is known about Dr. Beau Lotto?（分数：2.00）A.Though he is a neuroscientist, he has shocked the scientific world with his extensive research in art, neurology, natural history and philosophy.B.Dr. Lotto is a professor at University College London who is specialized in a number of disciplines such as art, neurology, natural history and philosophy.C.Dr. Lotto has been attempting to exhibit his creative productions in art-science exhibitions in the hope of proving his idea on optical illusions.D.Dr. Lotto has set out to create visual illusions, sculptures and installations which well combined the knowledge of art, neurology, natural history and philosophy.(3).Which of the following statements can be inferred from Dr. Lotto's study?（分数：2.00）A.People should believe their brains rather than their eyes as the world, to a great measure, is created and shaped by human brain.B.People should never believe their senses for what they see, hear, feel, and the truth may be contrary to the photographic image of the world.C.People should never believe their eyes for what they see are only accidental and temporary forms of the world, which varies in accordance with contexts.D.People should be aware that their eyes can play tricks on them as what they see is actually created by their brains which are shaped by their past experiences.(4).According to Dr. Lotto, what is the reason for the fact that a grey dot looks lighter againsta dark background than being against a light background?（分数：2.00）A.It is a fact that the dot emerged to be lighter against a dark background than being against a light one.B.Human senses are remarkably robust at providing a picture of the world that serves a purpose to us through what they have learnt from past experiences.C.It is because of some way the brain and eye is intrinsically wired.D.Because the context in which the little dot placed has changed to be lighter.(5).Which of the following statements is true about the research in neuroscience?（分数：2.00）A.Investigation on the brain involves scrutinizing a network in which both environment and the brain itself function together.B.Both idea-driven and technique-driven are popular research methods in research study in neuroscience.C.People cannot carry out research study on brain in laboratory where it is isolated from human body.D.Brain can be investigated in isolation with other faculties and organs as long as the research is carried out in proper natural context.The biggest thing in operating rooms these days is a million-dollar, multi-armed robot named da Vinci, used in nearly 400, 000 surgeries nationwide last year—triple the number just four years earlier. But now the high-tech helper is under scrutiny over reports of problems, including several deaths that may be linked with it and the high cost of using the robotic system. There also have been a few disturbing, freak incidents: a robotic hand that wouldn't let go of tissue grasped during surgery and a robotic arm hitting a patient in the face as she lay on the operating table. Is it time to curb the robot enthusiasm? Some doctors say yes, concerned that the "wow" factor and heavy marketing have boosted use. They argue that there is not enough robust research showing that robotic surgery is at least as good or better than conventional surgeries. Many U. S. hospitals promote robotic surgery in patient brochures, online and even on highway billboards. Their aim is partly to attract business that helps pay for the costly robot. The da Vinci is used for operations that include removing prostates, gallbladders and wombs, repairing heart valves, shrinking stomachs and transplanting organs. Its use has increased worldwide, but the system is most popular in the United States. For surgeons, who control the robot while sitting at a computer screen rather than standing over the patient, these operations can be less tiring. Plus robothands don't shake. Advocates say patients sometimes have less bleeding and often are sent home sooner than with conventional laparoscopic surgeries and operations involving large incisions. But the Food and Drug Administration is looking into a spike in reported problems during robotic surgeries. Earlier this year, the FDA began a survey of surgeons using the robotic system. The agency conducts such surveys of devices routinely, but FDA spokeswoman Synim Rivers said the reason for it now "is the increase in number of reports received" about da Vinci. Reports filed since early last year include at least five deaths. Whether there truly are more problems recently is uncertain. Rivers said she couldn't quantify the increase and that it may simply reflect more awareness among doctors and hospitals about the need to report problems. Doctors aren't required to report such things; device makers and hospitals are. Company spokesman Geoff Curtis said Intuitive Surgical has physician-educators and other trainers who teach surgeons how to use the robot. But they don't train them how to do specific procedures robotically, he said, and that it's up to hospitals and surgeons to decide "if and when a surgeon is ready to perform robotic cases. " A 2010 New England Journal of Medicine essay by a doctor and a health policy analyst said surgeons must do at least 150 procedures to become adept at using the robotic system. But there is no expert consensus on how much training is needed. New Jersey banker Alexis Grattan did a lot of online research before her gallbladder was removed last month at Hackensack University Medical Center. She said the surgeon's many years of experience with robotic operations was an important factor. She also had heard that the surgeon was among the first to do the robotic operation with just one small incision in the belly button, instead of four cuts in conventional keyhole surgery.（分数：10.00）(1).Why did FDA begin to scrutinize da Vinci?（分数：2.00）A.The number used in operation has been tripled.B.It is too expensive.C.It is reported to have frequent mechanical breakdown.wsuits increase with death case reports.(2).According to some doctors, which of the following is NOT the reason to curb the enthusiasm for da Vinci?（分数：2.00）A.The high cost causes unreasonable marketing.B.It is not as good as traditional surgeries.C.It needs more statistics to prove its value.D.It is necessary for doctors to consider some problems.(3).What does FDA spokeswoman Synim Rivers mean?（分数：2.00）A.Doctors and hospitals should be responsible for those problems.B.It is doctors that think da Vinci robots are problematic.C.There are so many problems reports that FDA has to do an enquiry.D.FDA hasn't finished the previous enquiry about the surgeons who used robots.(4).What is correct about training according to the Geoff Curtis?（分数：2.00）A.A lack of sufficient training on the part of surgeons.B.A lack of sufficient training on the part of company.C.Doctors and hospitals are not sufficiently trained on specific procedures.D.Doctors and hospitals are not sufficiently trained on how to used robots.(5).What is the best title for this passage?（分数：2.00）A.Four Hands Better than Two?B.Too Good to Be TrueC.Smart RobotsD.Who Is the Killer?Despite Denmark's manifest virtues, Danes never talk about how proud they are to be Danes. This would sound weird in Danish. When Danes talk to foreigners about Denmark, they always begin by。

重庆省2017年上半年西医综合之内科学试题

重庆省2017年上半年西医综合之内科学试题本卷共分为2大题60小题，作答时间为180分钟，总分120分，80分及格。

一、单项选择题(在每个小题列出的四个选项中只有一个是符合题目要求的，请将其代码填写在题干后的括号内。

错选、多选或未选均无分。

本大题共30小题，每小题2分，60分。

)1、男性，30岁，患消化性溃疡2年余，经常反复发作，曾用过多种药物治疗。

下列用过的治疗药物中，属于保护胃黏膜的药物是A．法莫替丁B．奥美拉唑C．氢氧化铝D．西沙必利E．硫糖铝2、人体功能保持相对稳定依靠的调控系统是A．非自动控制系统B．负反馈控制系统C．正反馈控制系统D．前馈控制系统3、不符合类风湿关节炎关节病变特征的是A．对称性关节肿B．远端指间关节肿C．近端指间关节肿D．掌指关节肿4、不能触及的是A．腰椎椎体B．横结肠C．胰腺D．带粪块的乙状结肠5、男性，32岁，发生右下胸部撞击伤3小时。

检查：神志清，血压10.0/8.0kPa，心率110次/分，血红蛋白112μ/L，右侧腹压痛，有肌紧张及反跳痛。

下列哪项处理最恰当A．输血、输液并观察B．应用抗生素治疗C．密切观察，一旦血压下降，即剖腹探查D．输血的同时，考虑立即剖腹探查6、艾滋病患者最常见的恶性肿瘤是A．霍奇金淋巴瘤B．非霍奇金淋巴瘤C．Kaposi肉瘤D．子宫颈癌7、风湿性心内膜炎疣状赘生物的实质是A．风湿性肉芽肿B．机化的瘢痕C．混合血栓D．白色血栓8、Crohn病与肠结核最重要的鉴别在于A．有无发热、乏力、腹泻B．病变是否见于回肠末段C．肉芽肿有无干酪样坏死D．有无血沉增快9、下列关于碳酸酐酶的叙述哪一项是错误的?A．是一种含锌的酶B．存在于红细胞C．它催化：D．催化的反应方向取决于PCO210、呕吐后腹痛缓解者可能是A．急性胰腺炎B．急性胆囊炎C．幽门梗阻D．急性胃肠炎E．急性心肌梗死11、对于M型受体的叙述．错误的是A．属于胆碱受体B．能与毒蕈碱发生特异性结合C．存在于副交感神经节后纤维的效应器细胞膜上D．存在于神经一肌肉接头的终板膜上E．其阻断剂为阿托品12、心电图示心率180次/分，QRS波群时间0.10秒，R-R间期绝对匀齐。

重庆省2017年主治医师(消化科)中级(师)考试题

重庆省2017年主治医师(消化科)中级（师）考试题一、单项选择题（共25题，每题2分，每题的备选项中，只有1个事最符合题意）1、患者女性，46岁，反复上腹痛3年，近来症状加重，疼痛多发生于餐前，进食后缓解。

内镜检查见十二指肠壶腹前壁线形溃疡，中心覆盖白苔，周围水肿明显。

该患者十二指肠壶腹部溃疡的分期为A．活动期A1B．活动期A2C．愈合期H1D．愈合期H2E．瘢痕期S2、库欣病最有诊断意义的发现是A．X线检查蝶鞍增大B．大剂量地塞米松抑制试验不能抑制C．小剂量地塞米松抑制试验不能抑制D．用美替拉酮(甲吡酮)不能增加ACTH产生E．血皮质醇增高3、当临床上怀疑有肝硬化癌变时，下列哪项的诊断意义最大A．明显消瘦B．血性腹水C．肝区可闻及血管杂音D．进行性脾大E．AFP增高4、中毒性巨结肠常见诱因不包括的是A．低钾B．钡剂灌肠C．使用抗胆碱能药物D．使用阿片类药物E．进食高脂肪类食物5、影响急性胰腺炎预后的因素不包括A．低血压B．低白蛋白C．低氧血症D．低血钙E．低血淀粉酶6、肾脏损害在下列哪种疾病最常见A．系统性红斑狼疮B．类风湿关节炎C．多发性肌炎D．系统性硬化病E．干燥综合征7、可在心尖部听到病理性第四心音的疾病不包括A．冠心病伴心房颤动B．高血压病伴左心室肥厚C．急性心肌梗死D．主动脉瓣狭窄伴左心室肥厚E．肥厚型心肌病8、不能引起急性胰腺炎胰腺疾病的是A．胰管结石B．胰管狭窄C．胰管肿瘤D．胰腺分裂症E．胰岛细胞瘤9、患者女性，28岁，6个月前出现腹痛、腹泻，伴低热。

查体：腹平坦，无压痛，肝脾未触及，右下腹可触及3cm×4cm包块。

下列哪项检查诊断的价值最小A．结肠镜B．钡剂灌肠C．下腹部CTD．腹腔镜检查E．CEA10、关于许氏位(Suhller's)摄影的叙述，错误的是A．患者俯卧B．头呈标准侧位C．被检侧耳郭前折D．需摄双侧以资对比E．中心线入射点为对侧外耳孔11、关于急性胰腺炎假性囊肿，下列说法错误的是A．由胰液和液化的坏死组织在胰腺内或其周围包裹所致B．多位于胰体尾部C．可压迫邻近组织引起相应症状D．大小几毫米至几十厘米E．囊壁上皮完整，可见坏死肉芽和纤维组织12、患者女性，68岁，诊断为慢性萎缩性胃炎，二度房室传导阻滞。

重庆省2017年考试试题

重庆省2017年考试试题一、单项选择题1、拔牙前一般不需要给予抗菌药物的患者是A．风湿性心脏病患者B．甲状腺功能亢进患者C．放疗后拔牙D．糖尿病E．妊娠妇女2、甘遂炮制后，可A．改变药性B．质地疏脆C．降低毒性D．矫臭矫味E．增强疗效3、脑脊液白细胞数明显升高多见于A．病毒性脑膜炎B．脑出血C．化脓性脑膜炎D．脑瘤E．结核性脑膜炎4、下列哪一种是纤溶系统抑制物？（）A．α2巨球蛋白和纤溶酶原激活抑制物PAIB．α1-抗膜蛋白酶和纤溶酶原激活抑制物PAIC．α2-抗纤溶酶(α2-A和纤溶酶原激活抑制物PAID．C1-灭活剂和α2-APE．AT-m和α2-AP5、从疾病监测的角度，常规传染病报告属于A．主动监测B．被动监测C．哨点监测D．主动与被动监测E．主动与口肖点监测6、在干细胞培养中，加入EP后可形成下列何种集落__A．CFU-GB．CFU-MC．CFU-ED．CFU-MegE．CFU-GM7、对双嘧达莫和硝苯地平具有一些相同药理作用，两者作用不同的是哪一条A．降低心肌耗氧量B．增加缺血区心肌血流量C．在扩张冠脉同时，有可能产生“窃流”现象D．扩张冠脉作用E．大量时可因扩张外周血管而引起低血压8、以下为缺乏细胞壁的原核细胞型微生物的是A．细菌B．支原体C．衣原体D．立克次体E．真菌9、从出生到儿岁全身骨髓的髓腔内均为红骨髓A．6个月B．1岁C．2岁D．4岁E．10岁10、心脏中主要含有的LD同工酶是A．LD1B．LD2C．LD3D．LD4E．LD5511、弱酸性药物在碱性尿液中A．解离度↑，重吸收量↓，排泄量↓B．解离度↑，重吸收量↓，排泄量↑C．解离度↓，重吸收量↓，排泄量↓D．解离度↑，重吸收量↑，排泄量↑E．解离度↑，重吸收量↑，排泄量↓12、不属于连续监测法中干扰因素是A．样品本身含有与化学反应有关的酶B．工具酶中混有杂酶C．样品中某些代谢物或药物的干扰D．分析容器的污染E．自动生化分仪的类型13、Ficoll密度梯度分层液主要用于分离外周血中的A．粒细胞B．单个核细胞C．红细胞D．巨噬细胞E．血小板14、API试剂条中，需要用液状石蜡封口的试验是A．UREB．CITC．TDAD．ONPGE．GLU15、显微镜检验时，原则上要观察几个高倍视野A．1个B．3个C．5个D．10个以上E．20个以上16、磷酸盐包埋材料固化后体积A．收缩B．膨胀C．不变D．不一定E．先膨胀后收缩17、用于尿蛋白成分保存的是A．甲苯B．甲醛C．麝香草酚D．浓盐酸E．稀盐酸18、各种有害物质在大气中容许存在的限量浓度，称为A．最低限量浓度B．最高有害浓度C．最高容许浓度D．最低安全浓度E．最低有害浓度19、ICSH推荐血红蛋白测定的参考方法是A．HiCN法B．SDS法C．HiN3法D．AHD575法E．沙利酸化血红蛋白法20、二甲双胍最佳的服药时间A．清晨空服B．饭前15minC．睡前顿服D．饭中或饭后E．每6h一次21、下列有关淀粉酶的错误叙述是A．最适反应pH6.9～7.0B．分子量较小，可以自由通过肾小球滤过C．需氯离子活化D．不能采用EDTA抗凝血检测E．淀粉酶升高即可确诊胰腺炎二、多项选择题1、T细胞的主要功能不包括A．细胞识别B．细胞免疫C．分泌调节D．分泌细胞因子E．抗原递呈2、空腹血糖浓度在6～7mmol/L之间，又有糖尿病症状时宜做A．空腹血浆葡萄糖浓度测定B．尿糖测定C．糖化血红蛋白水平测定D．糖耐量试验(OGTE．C肽测定3、化脓性脑膜炎时，脑脊液抽取后，开始出现凝块的时间常为A．1hB．5hC．3hD．7hE．10h4、有关新生儿溶血症描述不正确的是__A．抗体是天然IgMB．使胎儿Rh+RBC发生溶解破坏的抗体是免疫双价IgG抗体C．天然IgG抗体造成Rh+RBC溶解D．IgM抗体造成Rh+RBC溶解E．IgE引起5、制备蜜丸时，处方中含糖类、胶质类及油脂类药粉较多时，蜂蜜与药粉比例以多少为宜A．1:0.5B．1:1C．1:2D．1:0.8E．1:0.66、吸入气雾剂中药物的主要吸收部位是A．气管B．咽喉C．鼻黏膜D．肺泡E．支气管7、用单克隆抗体测定细胞膜上的哪种成分，可将淋巴细胞分成不同的亚群A．HLAB．受体C．分化抗原D．糖基E．胆固醇酯8、氯霉素的不良反应中，哪种与抑制蛋白的合成有关A．二重感染B．皮疹等变态反应C．消化道反应D．灰婴综合征E．不可逆性再生障碍性贫血9、凝集反庆形成的反应现象A．肉眼可见B．肉眼不可见C．必须用精密仪器测定D．必须染色才可见E．必须借显微镜10、细胞因子表达过高可见于__A．浆细胞瘤B．AIDSC．类风湿关节炎D．超敏反应E．细菌性脓毒血症休克11、下列不符合正常骨髓象特征的是A．粒红比例为5:1B．早幼粒细胞＜5%C．红系占有核细胞的20%D．原始淋巴细胞和幼稚淋巴细胞罕见E．全片可见巨核细胞15个12、关于单克隆丙种球蛋白病不正确的是A．由单株浆细胞增殖引起B．由多株浆细胞增殖引起C．理化性质十分均一的Ig增高D．可分为原发恶性、原发良性、继发性E．原发性巨球蛋白血症属于此类疾病13、我国生产的电子血细胞计数仪多属于A．光电检测型B．激光检测型C．电学检测型D．静电阻抗型E．电阻抗型14、MIU试验是A．甲基红吲哚尿素酶试验B．甘露醇吲哚尿素酶试验C．动力吲哚尿素酶试验D．动力吲哚枸橼酸盐利用试验E．麦芽糖吲哚尿素酶试验15、立克次体常用的染色方法为A．Giemsa、Macchiavello、Giménez B．革兰染色、镀银染色、荧光染色C．Giemsa、荧光染色、GiménezD．Macchiavello、荧光染色、GiménezE．Giménez、荧光染色、fontana16、关于α-丁酸萘酚酯酶(α-NBE)染色，下述概念不正确的是__ A．粒细胞系统均为阴性反应B．幼单核细胞为阳性反应，不被NaF抑制C．组织细胞呈阳性反应，不被NaF抑制D．非T非B细胞可呈颗粒状阳性E．幼单核细胞为阳性反应，可被NaF抑制17、排毒系数是A．污染源危害作用的相对指标B．污染物排放量的相对指标C．污染源及污染物相对危害程度的相对指标D．污染物毒作用的相对指标E．污染源排放污染物对人群健康慢性危害程度的相对指标18、接触系统的凝血因子是指A．因子Ⅱ、Ⅶ、Ⅸ、ⅩB．因子Ⅱ、Ⅴ、Ⅶ、ⅩC．因子Ⅷ、Ⅸ、PK、HMWKD．因子Ⅻ、Ⅺ、PK、HMWKE．因子PK、Ⅶ、Ⅺ、Ⅻ19、与火焰光度法相比较，离子选择电极法测K+. Na+的优点在于A．自动化程度高，操作简便B．标本用量少C．寿命长，可永久使用D．电极法属于经典的标准参考方法E．不须用燃料，安全20、瑞氏染色时间长短与下列哪项无关A．染色液与缓冲液的比例B．室内温度C．与有核细胞数量D．染液存放的时间E．与血膜的长短21、毒理学试验中溶剂的选择原则主要有以下几条，除了A．受试物溶解后稳定B．本身无毒C．与受试物不发生反应D．不改变受试物的理化性质及生物学活性E．不被机体吸收。

消化内科考试试题及答案

消化内科考试试题及答案（总4页）-本页仅作为文档封面，使用时请直接删除即可--内页可以根据需求调整合适字体及大小-消化内科实习出科考试题一、填空题（1分x24）1. 当腹水量大于1000 ml时能查出移动性浊音。

2. ______ 是消化性渍疡的主要病因。

3肠梗阻时腹部视诊通常可见到____ 、______ o4. ______ 、 ____、______ 称腹膜刺激征，亦称腹膜炎三联征。

5•消化道出血临床上最常见原因有____ 、_____ 、_______ 、 ____ 。

6•胃溃疡的并发症有____ 、 ______ 、______ 、____ o7._______ 、_____ 是我国肝硬化最常见原因。

8•肝癌最常见的症状是__________ c9•早期胃癌是指病灶局限且深度不超过______ 的胃癌，不论有无局部淋巴结转移。

10.__________________________ 典型的慢性胰腺炎五联征_____ 、_、、、O二、选择题（3分42）1•下列哪项不是克罗恩病的组织学特点：（）A非干酪性肉芽肿B干酪性肉芽肿C裂隙溃疡D肠壁各层炎症2•下列关于溃疡性结肠炎描述错误的是：（）A脓血便多见B肠腔狭窄多见C肛管肛周病变少见D直肠受累多见3下列关于肠易激综合症描述错i吴的是：（）A睡眠中痛醒者极少B少见脓血便C可出现腹泻于便秘交替D全身健康状况不受影响4•肝硬化门脉高压症的临床表现是：（）6.C腹水、脾大、侧支循环的建立与开放D黄疸、腹水、侧支循环的建立与开放75下列哪项不符合急性腹膜炎的表现？（）8.A腹肌紧张度增强B肠型C压痛及反跳痛D腹式呼吸消失96下列哪项对肝癌的诊断最有价值：（）10.A肝区痛，肝边缘钝B肝表面有结节感11.C腹水经久不消D肝进行性肿大，质地坚硬12.7.诊断幽门梗阻时，下列哪项最有意义：（）13.A上腹部饱满不适B上腹可见蠕动波C呕吐大量有酸酵味的宿食D胃部有震水音8•下列哪项不是消化性溃疡形成的侵袭因素：（）9.A幽门螺杆菌B胃酸、胃蛋白酶C前列腺素D氧自由基109下列不属于早期食管癌的X线领餐表现：（）11.A粘膜皱嬖增粗，迂曲及中断B小充盈缺损及小龛影C局限性管壁僵硬或有顿剂停留D食管下段呈漏斗状或鸟嘴状10.下列哪项不符合漏出性腹水：（）A白蛋白23g/L B白细胞600*106/L C腹水比重D静置不凝固11•关于梗阻性黄疸，正确的是：（）A非结合胆红素明显升高B尿胆红素阴性C尿胆原升高DGGT、ALP均升高12.患者乙肝两对半提示乙肝小三阳，乙肝病毒DNA定量＞105/L, 1年三次转氨酶正常，腹部彩超未见肝硬化、腹水，该患者合理诊断：（）A慢性乙型病毒性肝炎B乙肝病毒携带者C乙肝表面抗原携带者D隐匿性慢性乙型肝炎三、问答题1•临床上如何判断仍有活动性消化道出血？8分2.简述肝硬化常见并发症。

重庆省2017年上半年主治医师(消化科)相关专业知识试题

重庆省2017年上半年主治医师(消化科)相关专业知识试题一、单项选择题（共25题，每题2分，每题的备选项中，只有1个事最符合题意）1、十二指肠壶腹部溃疡患者近2天来每天排成形黑粪1次，量约50g，下列哪项组合处理最佳A．禁食、输液、冷盐水洗胃、雷尼替丁注射B．流质食物、输液、口服去甲肾上腺素、硫糖铝C．禁食、输液、注射酚磺乙胺、雷尼替丁注射D．流质食物、输液、硫糖铝、雷尼替丁口服E．禁食、输液、注射酚磺乙胺、雷尼替丁注射2、钩端螺旋体病多流行于A．夏秋季B．冬春季C．冬秋季D．冬夏季E．夏季3、女性，27岁。

因腹痛、腹泻、便秘交替3个月就诊。

门诊行胃肠钡剂检查，见回盲部激惹，有钡影跳跃征象，最可能的诊断是A．慢性阑尾炎B．克罗恩病C．肠结核D．肠伤寒E．回盲部肿瘤4、患者女性，60岁，平时喜饮浓茶，3年来常出现右上腹痛，夜间痛，疼痛放射至背部，先后曾呕血3次。

查体：右上腹轻压痛，无反跳痛及肌紧张，肝区无叩痛。

胃肠钡剂透视及肝胆脾超声均未见异常。

最可能的诊断是A．慢性胆囊炎B．十二指肠壶腹后溃疡C．胃癌D．胆石症E．十二指肠溃疡5、下列哪种情况可以拟诊冠心病A．40岁以上男性阵发性心悸憋气B．可疑心绞痛C．血脂增高D．高血压，心悸，气促E．心电图明显心肌缺血表现6、胃溃疡的好发部位是A．胃窦部大弯侧B．胃窦部小弯侧C．胃体部大弯侧D．胃体部小弯侧E．贲门食管联合部7、γ值大于1的胶片可以A．放大物体对比B．缩小物体对比C．增加影像模糊D．减少影像模糊E．减少影像失真8、患者男性，57岁，既往消化性溃疡10余年，近1个月加重。

24h前合并上消化道大出血，入院经积极治疗，出血仍未停止，下列哪项处置最适合A．静脉注射质子泵抑制药B．胃内去甲肾上腺素灌注C．手术治疗D．立即输血输液E．静脉注射垂体后叶素9、Crohn病治疗方法错误的是A．少渣或无渣饮食B．对于结肠Crohn病者首选氨基水杨酸制剂C．有肠外表现者选择肾上腺糖皮质激素效果较好D．肾上腺糖皮质激素与免疫抑制药联合使用，可以减少二者的剂量和副作用E．环孢素不作为常规治疗10、患者女性，75岁，2年前确诊为肝癌伴腹水。

重医检验考博真题

临床检验诊断学1.病例分析（全英文的病例）去年考的是梗阻性黄疸2.名词解释（1）APTT（2）CTnT CTnI（3）FQ-PCR(4) 增强免疫比浊法（5）DNA芯片/基因芯片（6）TrFIA（7）AG（阴离子间隙）3.简答题，分析题（1）脂蛋白与AS的关系？（2）影响酶促动力学的因素？（3）肾小管与集合管的功能检测？（4）实验室生物安全防护？（5）对一个已知基因序列片段的功能分析（其蛋白质水平上的功能分析），设计你的实验思路分析化学1.名词解释（1）DNA芯片采用光导原位合成或微量点样等方法，将大量生物大分子比如核酸片段、多肽分子甚至组织切片、细胞等等生物样品有序地高密度固化于支持物（如玻片、硅片、聚丙烯酰胺凝胶、尼龙膜等载体）的表面，制成点阵，然后与已标记的待测生物样品中靶分子杂交，通过特定的仪器比如激光共聚焦扫描对杂交信号的强度进行快速、并行、高效地检测分析，从而判断样品中靶分子的数量。

根据芯片上固定的探针不同，生物芯片包括基因芯片、蛋白质芯片、细胞芯片、组织芯片。

如果芯片上固定的是肽或蛋白，则称为肽芯片或蛋白芯片；如果芯片上固定的分子是寡核苷酸探针或DNA，就是DNA芯片。

DNA芯片技术包含四个基本要点：DNA方阵的构建、样品的制备、杂交,杂交图谱的检测及读出。

DNA芯片技术的应用：基因表达分析，基因型和多态性分析，疾病的诊断与治疗，肿瘤检测研究及抗肿瘤药物筛选，临床应用蛋白质芯片(protein array)是近年来蛋白质组学研究中兴起的一种新的方法，它类似于基因芯片，是将蛋白质点到固相物质上，然后与要检测的组织或细胞等进行“杂交”，再通过自动化仪器分析得出结果。

这里所指的“杂交”是指蛋白与蛋白之间如(抗体与抗原)在空间构象上能特异性的相互识别。

此方法与传统的研究方法相比具有如下优点:①蛋白质芯片是一种高通量的研究方法，能在一次实验中提供相当大的信息量，使我们能够全面、准确的研究蛋白表达谱，这是传统的蛋白研究方法无法做到的。

消化内科考博试题及答案

消化内科考博试题及答案一、单项选择题（每题2分，共20分）1. 胃溃疡最常见的并发症是：A. 出血B. 穿孔C. 癌变D. 幽门梗阻答案：A2. 慢性胃炎的常见病因不包括：A. 幽门螺杆菌感染B. 长期服用非甾体抗炎药C. 胆汁反流D. 长期饮酒答案：C3. 以下哪种情况最常见于十二指肠溃疡：A. 餐后疼痛B. 空腹疼痛C. 餐后缓解D. 夜间疼痛答案：B4. 胃食管反流病的典型症状是：A. 吞咽困难B. 胸痛C. 反酸D. 嗳气答案：C5. 以下哪种药物是治疗消化性溃疡的首选药物：A. 奥美拉唑B. 阿莫西林C. 甲硝唑D. 克拉霉素答案：A6. 急性胰腺炎最常见的病因是：A. 胆石症B. 酒精C. 高脂血症D. 病毒感染答案：A7. 以下哪种情况是慢性肝炎的典型表现：A. 黄疸B. 肝大C. 肝区疼痛D. 腹水答案：B8. 肝硬化最常见的并发症是：A. 肝性脑病B. 肝癌C. 腹水D. 食管静脉曲张破裂出血答案：C9. 以下哪种情况是急性胆囊炎的典型表现：A. 右上腹疼痛B. 黄疸C. 恶心呕吐D. 腹泻答案：A10. 以下哪种检查是诊断炎症性肠病的金标准：A. 血常规B. 粪便常规C. 内镜检查D. 腹部CT答案：C二、多项选择题（每题3分，共15分）1. 以下哪些因素可以增加胃癌的风险：A. 长期食用腌制食品B. 幽门螺杆菌感染C. 家族遗传D. 长期吸烟答案：ABCD2. 以下哪些是慢性胃炎的临床表现：A. 上腹痛B. 反酸C. 恶心呕吐D. 黄疸答案：ABC3. 以下哪些是急性胰腺炎的临床表现：A. 剧烈腹痛B. 恶心呕吐C. 血尿D. 黄疸答案：AB4. 以下哪些是肝硬化的临床表现：A. 腹水B. 黄疸C. 肝掌D. 蜘蛛痣答案：ABCD5. 以下哪些是炎症性肠病的临床表现：A. 腹泻B. 腹痛C. 体重减轻D. 贫血答案：ABCD三、判断题（每题1分，共10分）1. 胃溃疡和十二指肠溃疡的疼痛特点相同。

2017年上半年重庆省主治医师(消化科)相关专业知识考试试题

2017年上半年重庆省主治医师(消化科)相关专业知识考试试题一、单项选择题（共25题，每题2分，每题的备选项中，只有1个事最符合题意）1、常出现血清促胃液素减少的疾病是A．卓-艾综合征B．慢性浅表性胃炎C．胃溃疡D．慢性萎缩性胃炎E．十二指肠壶腹溃疡2、患者男性，35岁，锅炉工人。

连续工作8h后感到头痛、头晕、恶心。

呼吸26/min，口唇樱桃红色考虑为何种物质中毒A．煤尘B．一氧化碳C．二氧化碳D．氰化物E．苯3、患者男性，43岁，近1年反复出现左下腹痛，腹泻，每日4或5次，糊样便，有黏液无脓血，偶有黑粪，无恶心、呕吐，伴有焦虑、失眠、消瘦。

X线立位腹平片、腹部超声及肠镜未见异常。

对该患者的下一步诊治正确的是A．静脉应用抗生素B．给予微生态制剂以调整肠道菌群C．反复便常规+隐血检查D．对症治疗1个月后复查肠镜E．彻底检查，直到找到病因4、患者男性，44岁，腹胀2年，查体示巨脾，脾切除术能治疗下列哪种疾病A．缺铁性贫血B．遗传性球形细胞增多症C．自身免疫性溶血性贫血D．海洋性贫血E．丙酮酸激酶缺乏5、患者男性，78岁，肺癌，发热，寒战，皮肤广泛瘀斑，考虑存在DIC，应用肝素治疗，肝素抗凝的主要机制是A．抑制凝血酶原的激活B．抑制因子X的激活C．促进纤维蛋白吸附凝血酶D．增强抗凝血酶Ⅲ活性E．抑制血小板聚集6、下列哪种消化酶可引起急性胰腺炎并发出血和血栓A．磷脂酶AB．血管舒缓素C．胰舒血管素D．弹性蛋白酶E．脂肪酶7、患者男性，29岁，大量饮酒后出现胃痛，恶心，呕咖啡样胃内容物约300m1，既往无肝病史和胃病史，该患者应该选择下列哪种药物治疗A．磷酸铝凝胶B．质子泵抑制药C．铋剂D．生长抑察E．前列腺素8、碘过敏试验最常用的方法是A．皮内试验B．眼结膜试验C．舌下试验D．肌肉注射试验E．静脉注射试验9、下列关于腹水形成原因的描述错误的是A．门脉压力＞300mmH2OB．血清白蛋白＜30g/LC．肝淋巴液生成过多D．继发醛固酮减少E．有效循环血容量不足10、患者男性，60岁，糖尿病史20年，口服降糖药物治疗，餐前血糖6～8mm0l/L，餐后2h血糖10～12mm01/L，近4周出现双下肢水肿，血压160/90mmHg，尿常规：蛋白3+，红细胞3个/HP，血白蛋白30g/L，血肌酐150μmol/L，肾穿刺活检示结节性肾小球硬化，肾小球系膜细胞及基质重度增生，肾小囊腔壁层可见“囊滴”，最可能的诊断是A．糖尿病伴淀粉样变B．糖尿病肾病C．糖尿病伴膜性肾病D．糖尿病伴系膜毛细血管性肾炎E．糖尿病伴硬化性肾炎11、中至大量胸腔积液时，下列哪项体征是错误的A．胸式呼吸增强B．患侧呼吸音减弱C．胸廓饱满，肋间隙增宽D．患侧叩诊浊音E．语颤减弱或消失12、下列哪项可引起神经精神性呼吸困难A．糖尿病酮症酸中毒B．脑出血C．有机磷农药中毒D．重症肌无力E．重症贫血13、弥散性肝实质性病变简易实用的影像学检查方法是A．MRIB．CTC．选择性肝动脉造影D．核医学(SPECE．超声14、某公司获得银行贷款100万元，年利率6%，期限为三年，按年计息，复利计算，则到期后应偿还银行本息共为__万元。

解放军医学院(301医院)消化内科学2017年考博真题试卷

301医院
医学考博真题试卷
攻读博士学位研究生入学考试试卷
解放军医学院（301医院）
2017年攻读博士学位研究生入学考试试题
考试科目：消化内科学注意：所有答案一律写在答题纸上，写在试题纸上或其他地方一律不给分。一、选择题（2*10=20 3.Charot三联征。 4.急性胰腺炎常见病因。 5.水杨酸制剂在溃结最适用于。 6.黑便日出血量。 7.自发性腹膜炎。 8.肠易激。 9.Hp检测最常用的方法。 10.治疗重症GERD首选。二、名词解释（4*5=20分） 1. Grey-Turner征 2.GERD 3.EMR 4.peptic ulcer 5.肝性脑病三、简答题（5*6=30分） 1.溃疡性结肠炎的并发症。 2.门脉高压时的侧枝循环。 3.胰腺炎的病因。 4.食管胃底静脉曲张出血的治疗。 5.原发性肝癌的并发症。 6.食管癌的扩散和转移方式。四、论述题（2*15＝30分） 1.良恶性溃疡的鉴别。 2.肝性脑病的临床表现。
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2020年重庆市《消化内科学》测试卷(第46套)

2020年重庆市《消化内科学》测试卷考试须知：1、考试时间：180分钟。

2、请首先按要求在试卷的指定位置填写您的姓名、准考证号和所在单位的名称。

3、请仔细阅读各种题目的回答要求，在规定的位置填写您的答案。

4、由于不同的科目的题型不同，文档中可能会只有大分标题而没有题的情况发生，这是正常情况。

5、答案与解析在最后。

姓名:___________考号:___________一、A1(共30题)1.早期肝癌普查时最有效和实用的方法是( )。

A.超声检査+血清甲胎蛋白测定B.CT+碱性磷酸酶测定D.肝内肿块B超引导下的活检E.肝动脉造影+血清甲胎蛋白测定2.在肝脏参与乙醇代谢的酶系按主次分别是( )。

A.乙醇脱氢酶(ADH)、乙醇氧化酶系统(MEOS)、过氧化物酶B.乙醇氧化酶系统(MEOS)、乙醇脱氢酶(ADH)、过氧化物酶C.过氧化物酶、乙醇脱氢酶(ADH)、乙醇氧化酶系统(MEOS)D.乙醇脱氢酶(ADH)、过氧化物酶、乙醇氧化酶系统(MEOS)E.乙醇氧化酶系统(MEOS)、过氧化物酶、乙醇脱氢酶(ADH)3.重症急性胰腺炎的临床表现是( )。

A.腹痛剧烈B.血淀粉酶、脂肪酶水平升高后持续不降C.全腹膨隆、广泛压痛、肠鸣音消失D.血白细胞计数>15×10°L,以中性粒细胞增多为主E.C反应蛋白较正常值升高2倍4.关于强酸所致腐蚀性食管炎的治疗不恰当的是( )。

A.立即洗胃及内镜检查B.应用抗生素C.补液D.口服牛乳E.镇痛5.低蛋白血症型营养不良的临床表现不正确的是( )。

A.淋巴细胞计数下降B.血浆清蛋白明显下降C.臂围和脂肪储备正常D.内脏蛋白量迅速下降,毛发易脱落E.水胂,伤口延迟愈合6.消化性溃疡合并幽门梗阻,腹胀痛最宜采用( )。

A.阿托品B.1%普鲁卡因C.胃灌洗术D.罗通定(颅通定)E.丙胺太林(普鲁本辛)7.对结核性腹膜炎最有诊断价值的检查是( )。

A.腹水常规B.结肠镜检查C.PPD试验D.血沉及C-反应蛋白E.腹腔镜检查+腹膜活检8.以下指标对溃疡性结肠炎病情轻重的判断没有帮助的是( )A.体温B.血红蛋白C.红细胞沉降率D.排便次数E.血白细胞计数9.晚期食管癌的X线检查常表现为( )。