南京医科大学药理学2013年考博真题

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南医考研药理大题

大题1.贝塔受体阻断剂的临床应用和不良反应2.氯丙嗪的中枢药理作用作用机制和临床应用3.强心苷正性肌力作用的特点和机制4.糖皮质激素的不良反应5.青霉素G的作用机制和不良反应大题三十分1耐药性耐受性的概念举例说明四分2以阿托品（给的英文）为例，说明药物的两重性（治疗效应不良反应）四分3比较吗啡和阿司匹林的镇痛机制和临床应用（给的英文）四分4抗心律失常药物的机制，分类和代表药物六分5强心苷的临床应用不良反应和防治措施六分6药动学和药效学并举例说明药物相互作用六分大题：毛果芸香碱，阿托品对眼的作用及应用（-）β应用＆不良反应心律失常药分类＆代表药不良反应n+类别糖皮质激素的应用问答题：30分，六道。

画图并解释，说明效能和效价强度的意义。

（4）阿托品的药理作用和临床应用（4）抗（快速型）心律失常的机制，以及抗心律失常药物的分类（6）强心苷的临床应用和不良反应。

（6）青霉素的不良反应和防治措施（4）结合例子说明联合用药的目的（6）三、简答题1. 不良反应（解释、举例）2. β受体阻断药3. 解热镇痛抗炎药的药理作用及其机制4. 抗心律失常药的基本电生理作用、分类5. 从药动学、药效学两方面解释药物的相互作用1.阐述药物作用的选择性、两重性和量效关系（20分）2.简述药物作用的靶点及其作用机制（10分）3.列举几种常用的给药方式以及药物吸收特征（10分）4.简述生物利用度、表观分布容积和半衰期的概念及其意义（10分）5.请列举临床应用的抗菌药物以及作用机制（10分）三、大题（完整版，分好少呀）1.强心苷的药理作用，药理学基础（4分）2.还有阿托品，毛果芸香碱在对眼睛的临床作用及眼科应用（4分）3.列出抗菌素的各类作用（4分）4．药效学，药代学阐述药物相互作用，并举例（10分）5.效价强度与效能的概念及意义（4分）6.阿司匹林的药理作用及机制（4分）1.药物消除半衰期的概念和意义（4分）2.以阿托品为例，说明药物的两重性（治疗效应不良反应）（4分）3.阿司匹林的作用与机制（4分）4.抗心律失常药物的机制，分类和代表药物（6分）5.糖皮质激素的临床应用（4分）6.联合用药适用于什么病与联合用药的意义1.简述aspirin的药理作用及临床应用 6`2.简述糖皮质激素的临床应用和不良反应10`3.抗菌药物的作用机制及其代表药物8`4.根据化学结构，消毒防腐药的分类及其代表药物8`5.抗肿瘤药物的作用机制及代表药物8`三、简答题（30分）1、耐受性和耐药性的概念，举例。

2013医学考博试题 4

2013广西医科大学内科博士考题，选择题：30分，都是临床的一些常见问题，难度不太大，估计至少能拿25分简答题：30分1.呼吸暂停综合征的定义及分型；2.上消化道出血的定义；3.心梗溶栓再通的指征；4.负反馈调节的机制，举例说明；5.小细胞低色素贫血有哪些。

论述题（内分泌专业）：40分1.病例分析（10分），给出一个病例（，难道不大应该是库欣）（1）诊断和鉴别诊断（2）要做哪些检查进行鉴别2.降糖药肠促胰素的分类和机制（15分）3.妊娠甲亢的治疗原则。

广西医科大学病理生理学博士考题，希望对来年报考的同学有帮助！一、名词解释（共5个）：钙超载、尿毒症、水中毒、混合性酸碱平衡紊乱、外源性致热源二、简答题（共3个小题）：1.低渗性脱水尿量有何改变？2.慢性肾功能衰竭时钾离子有何代谢紊乱？3.还有一题考完了之后一下子脑子短路想不起来了，等我想起来再补上三、论述题（共3个小题）：1.输入大量库存血所致缺氧与贫血性缺氧机制有何不同；2.心脏衰竭时机体如何代偿及其代偿的调控机制；3.DIC血液高凝的机制2013年广西医科大学基础医学院医学生物化学与分子生物学一名词解释1.蛋白质的二级结构2.启动子3.Klenow fragment4.内含子5.外显子6管家基因7顺式作用元件8蛋白伴侣9？10?二简答1真核生物RNA聚合酶的种类和功能？2大肠杆菌表达系统的条件3癌基因激活的方式？4简述酶的温度调节。

三讨论1蛋白质分离纯化的种类和原理2关于三羧酸循环和尿素循环的关联性？为什么说尿素循环的氮原子都直接或间接来源于体内的氨基酸？2013年广西医科大学病理学试题一、名词解释10 *3分：化生，肿瘤的异质性，围管浸润，炎性假瘤，机化，动脉瘤，肾病综合征，早期胃癌，R eed-Sternberg cell，infarction二、简答题4*5分1、一期愈合、二期愈合的主要区别？如何获得一期愈合？2、食管癌浸润性生长可引起哪些后果？3、炎症时血管通透性升高的发生机制。

南方医科大学药理学2012,2013年考博真题

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南方医科大学
2013年攻读博士学位研究生入学考试试题
考试科目：药理学注意：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、简答题（6选5） 1.非甾体类抗炎药和甾体类抗炎药的异同？ 2.什么是胰岛素抵抗及其机制？有什么防治策略？ 3.离子通道有几种类型及其特点？相关的药物及其药理作用特点？ 4.免疫抑制剂的分类？ 5.多巴胺通道有什么构成及其与氯丙嗪药理作用不不良反应的关系？ 6. 二、论述题（4选3） 1.老年痴呆病的病因及其药物分类及机制？ 2.帕金森病的病因及其药物分类及机制？ 3.细胞周期的特点及按周期特点抗肿瘤药的分类？信号通道靶向制剂的研究进展及意义？ 4.根据HIV病毒在人体的复制过程，相应的抗HIV药物分类？
第1页共1页攻读博Fra bibliotek学位研究生入学考试试卷
医学考博
历年真题试卷
南方医科大学
2012年攻读博士学位研究生入学考试试题
考试科目：药理学注意：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、简答题
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1、比较ACEI与AT1受体拮抗药药理作用的主要区别。 2、简述口服降糖药罗格列酮的药理作用。 3、氨基糖苷类主要不良反应。 4、抑制胃酸分泌的药物种类、代表药及主要作用机制。 5、简述恶性肿瘤的基因治疗药物种类及原理。二、论述题 1、根据α受体的体内的主要分布，阐述作用于α受体的药物种类及其应用。 2、根据药物的作用规律，从你最熟悉的专业中阐述开发某种新药的设计思路。要求设计思路侧重在药理上，包括作用靶点、可能的机制和与同类药物不同的具体内容等，不一定需要明确的结构和开发该类药物的具体试验内容。 3、药动学参数有哪些，如何计算。

2013年全国医学博士外语统一考试英语试卷-完整版

2013MD全国医学博士外语统一考试英语试卷答题须知1．请考生首先将自己的姓名、所在考点、准考证号在试卷一答题纸和试卷二标准答题卡上认真填写清楚，并按“考场指令”要求，将准考证号在标准答题卡上划好。

2．试卷一(Paper One)答案和试卷二(Paper Two)答案都作答在标准答题卡上，不要做在试卷上。

3．试卷一答题时必须使用2B铅笔，将所选答案按要求在相应位置涂黑；如要更正，先用橡皮擦干净。

书面表达一定要用黑色签字笔或钢笔写在标准答题卡上指定区域。

4．标准答题卡不可折叠，同时答题卡须保持平整干净，以利评分。

5．听力考试只放一遍录音，每道题后有15秒左右的答题时间。

国家医学考试中心PAPER ONEPart 1 ：Listening comprehension（30%）Section ADirections:In this section you will hear fifteen short conversations between two speakers, At the end of each conversation, you will hear a questionabout what is said, The question will be read only once, After you hearthe question, read the four possible answers marked A, B, C, and D.Choose the best answers and mark the letter of your choice on theANSWER SHEET.Listen to the following exampleYou will hearWoman: I feel faint.Man: No wonder. You haven’t had a bite all day.Question: What’s the matter with the woman?You will read:A. She is sick.B. She was bitten by an ant.C. She is hungry.D. She spilled her paint.Here C is the right answer.Sample AnswerA B C DNow let’s begin with question Number 1.1. A. A cough B. Diarrhea C. A fever D. V omiting2. A. Tuberculosis B. Rhinitis C. Laryngitis D. Flu3. A. In his bag. B. By the lamp.C. In his house.D. No idea about where he left it.4. A. He’s nearly finished his work.B. He has to work for some more time.C. He wants to leave now.D. He has trouble finishing his work.5. A. A patient B. A doctor C. A teacher D. A student6. A. 2.6 B. 3.5 C. 3.9 D. 1367. A. He is the head of the hospital. B. He is in charge of Pediatrics.C. He went out looking for Dan.D. He went to Michigan on business.8. A. He has got a fever. B. He is a talented skier.C. He is very rich.D. He is a real ski enthusiast.9. A. To ask local people for help.B. To do as Romans do only when in Rome.C. Try to act like the people from that culture.D. Stay with your country fellows.10.A. She married because of loneliness.B. She married a millionaire.C. She married for money.D. She married for love.11.A. Aspirant B. Courageous C. Cautious D. Amiable12.A. He was unhappy. B. He was feeling a bit unwell.C. He went to see the doctor.D. The weather was nasty.13.A. You may find many of them on the bookseller’ shelves.B. You can buy it from almost every bookstore.C. It’s a very popular magazine.D. It doesn’t sell very well.14.A. A general practitioner. B. A gynecologist.B. An orthopedist D. A surgeon.15.A. Chemotherapy B. Radiation C. Injections D. Surgery Section BDirection:In this section you will hear one conversation and two passages, after each of which, you will hear five questions. After each question, readthe four possible answers marked A, B, C and D, Choose the bestanswer and mark the letter of your choice on the ANSWER SHEET. Dialogue16.A. It is a genetic disorder.B. It is a respiratory condition in pigs.C. It is an illness from birds to humans.D. It is a gastric ailment.17.A. Eating pork.B. Raising pigs.C. Eating chicken.D. Breeding birds.18.A. Running nose.B. Inappetence.C. Pains all over.D. Diarrhea.19.A. To stay from crowds. B. To see the doctor immediately.C. To avoid medications.D. To go to the nearby clinic.20.A. It is a debate.B. It is a TV program.C. It is a consultation.D. It is a workshop.Passage One21.A. About 10,000,000.B. About 1,000,000.C. About 100,000.D. About 10,000.22.A. A cocktail of vitamins.B. A cocktail of vitamins plus magnesium.C. The combination of vitamins A, C and E.D. The combination of minerals.23.A. The delicate structures of the inner ear. B. The inner ear cells.C. The eardrums.D. The inner ear ossicles.24.A. General Motors. B. The United Auto Workers.C. NIH.D. All of above.25.A. An industrial trial in Spain.B. Military trials in Spain and Sweden.C. Industrial trials in Spain and Sweden.D. A trial involving students at the University of Florida.Passage Two26.A. The link between obesity and birth defects.B. The link between obesity and diabetes.C. The risk of birth abnormalities.D. The harmful effects of obesity.27.A. Neural tube defects. B. Heart problems.C. Cleft lip and palate.D. Diabetes.28.A. 20 million. B. 200 million.C. 400 million.D. 40 million.29.A. A weight-loss surgery. B. A balanced diet.C. A change of life style.D. More exercise.30.A. Why obesity can cause birth defects.B. How obesity may cause birth defects.C. Why obesity can cause diabetes.D. How obesity may cause diabetes.Part II Vocabulary (10%)Section ADirection:In this section, all the sentences are incomplete. Four words or phrases, marked A B C and D .are given beneath each of them. You are tochoose the word or phrase that best completes the sentence. Then markyour answer on the ANSWER SHEET.31. Having a bird’s eye view from the helicopter, the vast pasture was __________ with beautiful houses.A. overlappedB. segregatedC. intersectedD. interspersed32. As usual, Singapore Airlines will reduce trans-pacific capacity in _________ seasons this year.A. sternB. slackC. sumptuousD. glamorous33. As to the living environment, bacteria’s needs vary, but most of them grow best ina slightly acid ___________.A. mechanismB. miniatureC. mediumD. means34. Under an unstable economic environment, employers in the construction industry place great value on ___________ in hiring and laying off workers as their volumes of work wax and wane.A. flexibilityB. moralityC. capacityD. productivity35. In a stark _________ of fortunes, the Philippines – once Asia’s second richest country – recently had to beg Vietnam to sell its rice for its hungry millions.A. denialB. reversalC. intervalD. withdrawal36. Web portal Sohu has gone a step further and called for netizens to join in an all-out boycott of __________ content.A. wholesomeB. contagiousC. vulgarD. stagnant37. Experts urge a reforesting of cleared areas, promotion of reduced-impact logging, and _____________ agriculture, to maintain the rain forest.A. sustainableB. renewableC. revivableD. merchandisable38. In the U.S., the Republican’s doctrines were slightly liberal, whereas the Democrats’ were hardly _____________.A. rationalB. radicalC. conservativeD. progressive39. Officials from the Department of Agriculture confirmed that the __________ floods and drought this summer did not affect the country’s grain output.A. ripplingB. waningC. fluctuatingD. devastating40. It is believed that the Black Death, rampant in the Medieval Europe __________, killed 1/3 of its population.A. at largeB. at randomC. on endD. on averageSection BDirections:Each of the following sentences has a word or phase underlined. There are four words or phases beneath each sentence, Choose the word orphase which can best keep the meaning of the original sentence if it issubstituted for the underlined part, Mark your answer on theANSWER SHEET.41. Christmas shoppers should be aware of the possible defects of the products sold ata discount.A. deficitsB. deviationsC. drawbacksD. discrepancies42. The goal of this training program is to raise children with a sense of responsibility and necessary courage to be willing to take on challenges in life.A. despiseB. evadeC. demandD. undertake43. After “9.11”, the Olympic Games severely taxed the security services of the host country.A. improvedB. burdenedC. inspectedD. tariffed44. The clown’s performance was so funny that the audience, adults and children alike, were all thrown into convulsions.A. a fit of enthusiasmB. a scream of frightC. a burst of laughterD. a cry of anguish45. We raised a mortgage from Bank of China and were informed to pay it off by the end of this year.A. loanB. paymentC. withdrawalD. retrieval46. The advocates highly value the “sport spirit”, while the opponent devalue it, asserting that it’s a sheer hypocrisy and self-deception.A. fineB. suddenC. finiteD. absolute47. Whenever a rattlesnake is agitated, it begins to move its tail and make a rattling noise.A. irritatedB. tamedC. stampedD. probed48. The detective had an unusual insight into criminal’s tricks and knew clearly how to track them.A. inductionB. perceptionC. interpretationD. penetration49. My little brother practices the speech repeatedly until his delivery and timing were perfect.A. presentationB. gestureC. rhythmD. pronunciation50. In recent weeks both housing and stock prices have started to retreat from their irrationally amazing highs.A. untimelyB. unexpectedlyC. unreasonablyD. unconventionallyPart III Cloze (10%)Directions: In this section there is a passage with ten numbered blanks. For each blank, there are four choices marked A, B, C, and D on the right side.Choose the best answer and mark the letter of your choice on theANSWER SHEET.Video game players may get an unexpected benefitfrom blowing away bad guys—better vision. Playing “action” video games improves a visual ability __51__ tasks like reading and driving at night, a new study says. The ability, called contrast sensitivity function, allows people to discern even subtle changes __52__ gray against a uniformly colored backdrop. It’s also one of the first visual aptitudes to fade with age. __53__ a regular regimen of action video game training can provide long-lasting visual power, according to work led by Daphne Bavelier of the University of Rochester.Previous research shows that gaming improves other visual skills, such as the ability to track several objects at the same time and __54__ attention to a series of fast-moving events. Bavelier said, “A lot of different aspects of the visual system are being enhanced, __55__.”The new work suggests that playing video games could someday become part of vision-correction treatments, which currently rely mainly on surgery or corrective lenses. “__56__ you’ve had eye surgery or get corrective lenses, exposing yourself to these games should help the optical system to recover faster and better, you need to retrain the brain to make use of the better, crisper information that’s coming in __57__ your improved eyesight,” Bavelier said.Expert action gamers in the study played first-person shooters Unreal Tournament 2004 and Call of Duty 2. A group of experienced nonaction gamers played The Sims 2, a “life simulation” video game. The players of nonaction video games didn’t see the same vision __58__, the study says. Bavelier and others are now trying to figure out exactly why action games __59__ seem to sharpen visual skill. It may be that locating enemies and aiming accurately is a strenuous, strength-building workout for the eyes, she said. Another possible __60__ is that the unpredictable, fast-changing environment of the typical action game requires players to constantly monitor entire landscapes and analyze optical data quickly.51. A. crucial forB. available inC. resulting fromD. ascribed to52. A. in disguise ofB. in shades ofC. in search ofD. in place of53. A. This is howB. That’s whyC. It is not thatD. There exists54. A. paidB. paysC. payD. paying55. A. thoughB. not to sayC. not just oneD. as well56. A. UntilB. WhileC. UnlessD. Once57. A. as opposed toB. in addition toC. as a result ofD. in spite of58. A. benefitsB. defectsC. approachesD. risks59. A. in caseB. in advanceC. in returnD. in particular60. A. effectB. reasonC. outcomeD. conclusionPart IV Reading Comprehension (30%)Directions:In this part there are six passages, each of which is followed by five questions. For each question there are four possible answers marked A, B,C, and D. Choose the best answer and mark the letter of your choice onthe ANSWER SHEET.Passage oneThere is plenty we don’t know about criminal behavior. Most crime goes unreported so it is hard to pick out trends from the data, and even reliable sets of statistics can be difficult to compare. But here is one thing we do know: those with a biological predisposition to violent behavior who are brought up in abusive homes are very likely to become lifelong criminals.Antisocial and criminal behavior tends to run in families, but no one was sure whether this was due mostly to social-environmental factors or biological ones. It turns out both are important, but the effect is most dramatic when they act together. This has been illustrated in several studies over the past six years which found that male victims of child abuse are several times as likely to become criminals and abusers themselves if they were born with a less-active version of a gene for the enzyme monoamine oxidase A (MAO-A), which breaks down neurotransmitters crucial to the regulation of aggression.Researchers recently made another key observation: kids with this “double whammy” of predisposition and an unfortunate upbringing are likely to show signs of what’s to come at a very early age. The risk factors for long-term criminality – attention deficit hyperactivity disorder, low IQ, language difficulties – can be spotted in kindergarten. So given what we now know, shouldn’t we be doing everything to protect the children most at risk?No one is suggesting testing all boys to see which variant of the MAO-A gene they have, but what the science is telling us is that we should redouble efforts to tackle abusive upbringings, and even simple neglect. This will help any child, but especially those whose biology makes them vulnerable. Thankfully there is already considerable enthusiasm in both the US and the UK for converting the latest in behavioral science into parenting and social skills: both governments have schemes in place to improve parenting in families where children are at risk of receiving poor care.Some people are uncomfortable with the idea of early intervention because it implies our behavior becomes “set” as we grow up, compromising the idea of free will. That view is understandable, but it would be negligent to ignore what the studies are telling us. Indeed, the cost to society of failing to intervene －in terms of criminal damage, dealing with offenders and helping victims of crime －is bound to be greater than the cost of improving parenting. The value to the children is immeasurable.61. Researchers have come to a consensus: to explain violent behavior ________.A. in terms of physical environmentB. form a biological perspectiveC. based on the empirical dataD. in a statistical way62. When we say that antisocial and criminal behavior tends to run in families, asindicated by the recent findings, we can probably mean that ___________.A. a particular gene is passed on in familiesB. child abuse will lead to domestic violenceC. the male victims of child abuse will pass on the tendencyD. the violent predisposition is exclusively born of child abuse63. The recent observation implicated that to check the development of antisocialand criminal behavior ___________.A. boys are to be screened for the biological predispositionB. high-risk kids should be brought up in kindergartenC. it is important to spot the genes for the risk factorsD. active measures ought to be taken at an early age64. To defend the argument against the unfavorable idea, the author makes it apoint to consider ___________.A. the immeasurable value of the genetic research on behaviorB. the consequences of compromising democracyC. the huge cost of improving parenting skillsD. the greater cost of failing to intervene65. Which of the following can be the best title for the passage?A. Parenting Strategies for KidsB. The Making of a CriminalC. Parental EducationD. Abusive ParentingPassage twoAfter 25 years battling the mother of all viruses, have we finally got the measure of HIV? Three developments featured in this issue collectively give grounds for optimism that would have been scarcely believable a year ago in the wake of another failed vaccine and continuing problems supplying drugs to all who need them.Perhaps the most compelling hope lies in the apparent “cure” of a man with HIV who had also developed leukemia. Doctors treated his leukemia with a bone marrow transplant that also vanquished the virus. Now US Company Sangamo Biosciences is hoping to emulate the effect patients being cured with a single shot of gene therapy, instead of taking antiretroviral drugs for life.Antiretroviral therapy (ART) is itself another reason for optimism. Researchers at the World Health Organization have calculated that HIV could be effectively eradicated in Africa and other hard-hit places using existing drugs. The trick is to test everyone often, and give those who test positive ART as soon as possible. Because the drugs rapidly reduce circulating levels of the virus to almost zero, it would stop people passing it on through sex. By blocking the cycle of infection in this way, the virus could be virtually eradicated by 2050.Bankrolling such a long-term program would cost serious money – initially around $3.5 billion a year in South Africa alone, ring to $85 billion in total. Huge as it sounds, however, it is peanuts compared with the estimated $1.9 trillion cost of the Iraq war, or the $700 billion spent in one go propping up the US banking sector. It also look small beer compared with the costs of carrying on as usual, which the WHO says can only lead to spiraling cases and costs.The final bit of good news is that the cost of ART could keep on falling. Last Friday, GlaxoSmithKline chairman Andrew Witty said that his company would offer all its medicines to the poorest countries for at least 25 per cent less than the typical price in rich countries. GSK has already been doing this for ART, but the hope is that the company may now offer it cheaper still and that other firms will follow their lead.No one doubt the devastation caused by AIDS. In 2007, 2 million people died and 2.7 million more contracted the virus. Those dismal numbers are not going to turn around soon – and they won’t turn around at all without huge effort and investment. But at least there is renewed belief that, given the time and money, we can finally start riddling the world of this most fearsome of viruses.66. Which is the following can be most probably perceived beyond the first paragraph?A. The end of the world.B. A candle of hope.C. A Nobel prize.D. A Quick Fix.67. According to the passage, the apparent “cure” of the HIV patient who had alsodeveloped leukemia would ___________.A. make a promising transition from antiretroviral medication to gene therapyB. facilitate the development of effective vaccines for the infectionC. compel people to draw an analogy between AIDS and leukemiaD. would change the way we look at those with AIDS68. As another bit of good news, ___________.A. HIV will be virtually wiped out first in AfricaB. the cycle of HIV infection can be broken with ARTC. the circulating levels of HIV have been limited to almost zeroD. the existing HIV drugs will be enhanced to be more effective in 25 years69. The last reason for optimism is that ___________.A. governments will invest more in improving ARTB. the cost of antiretroviral therapy is on the declineC. everybody can afford antiretroviral therapy in the worldD. the financial support of ART is coming to be no problem70. The whole passage carries a tone of ___________.A. idealismB. activismC. criticismD. optimismPassage ThreeArchaeology can tell us plenty about how humans looked and the way they lived tens of thousands of years ago. But what about the deeper questions? Could early humans speak, were they capable of self-conscious reflection, did they believe in anything?Such questions might seem to be beyond the scope of science. Not so. Answering them is the focus of a burgeoning field that brings together archaeology and neuroscience. It aims to chart the development of human cognitive powers. This is not easy to do. A skull gives no indication of whether its owner was capable of speech, for example. The task then is to find proxies (替代物)for key traits and behaviors that have stayed intact over millennia.Perhaps the most intriguing aspect of this endeavor is teasing out the role of culture as a force in the evolution of our mental skills. For decades, development of the brain has been seen as exclusively biological. But increasingly, that is being challenged.Take what the Cambridge archaeologist Colin Renfrew calls “the sapient (智人的) paradox (矛盾)”. Evidence suggests that the human genome, and hence the brain, has changed little in the past 60,000 years. Yet it wasn’t until about 10,000 years ago that profound changes took place in human behavior: people settled in villages and built shrines. Renfrew’s paradox is why, if the hardware was in place, did it take so long for humans to start changing the world?His answer is that the software – the culture – took a long time to develop. In particular, the intervening time saw humans vest (赋予) meaning in objects and symbols. Those meanings were developed by social interaction over successive generations,passed on through teaching, and stored in the neuronal connections of children.Culture also changes biology by modifying natural selection, sometimes in surprising ways. How is it, for example, that a human gene for making essential vitamin C became blocked by junk DNA? One answer is that our ancestors started eating fruit, so the pressure to make vitamin C “relaxed” and the gene became unnecessary. By this reasoning, early humans then became addicted to fruit, and any gene that helped them to find it was selected for.Evidence suggests that the brain is so plastic that, like genes, it can be changed by relaxing selection pressure. Our understanding of human cognitive development is still fragmented and confused, however. We have lots of proposed causes and effects, and hypotheses to explain them. Yet the potential pay-off makes answers worth searching for. If we know where the human mind came from and what changed it, perhaps we can gauge where it is going. Finding those answers will take all the ingenuity the modern human mind can muster.71. The questions presented in the first paragraph ___________.A. seem to have no answers whateverB. are intended to dig for ancient human mindsC. are not scientific enough to be answered hereD. are raised to explore the evolution of human appearance72. The scientists find the proxy to be ___________.A. the role of cultureB. the passage of timeC. the structure of a skullD. the biological makeup of the brain73. According to Renfrew’s paradox, the transition from 60,000 to 10,000 years agosuggests that ___________.A. human civilization came too lateB. the hardware retained biologically staticC. it took so long for the software to evolveD. there existed an interaction between gene and environment74. From the example illustrating the relation between culture and biology, wemight conclude that ___________.A. the mental development has not been exclusively biologicalB. the brain and culture have not developed at the same paceC. the theory of natural selection applies to human evolutionD. vitamin C contributes to the development of the brain75. Speaking of the human mind, the author would say that ___________.A. its cognitive development is extremely slowB. to know its past is to understand its futureC. its biological evolution is hard to predictD. as the brain develops, so as the mindPassage FourDespite the numerous warnings about extreme weather, rising sea levels and mass extinctions, one message seems to have got lost in the debate about the impact of climate change. A warmer world won’t just be inconvenient. Huge swathes (片) of it, including most of Europe, the US and Australia as well as all of Africa and China will actually be uninhabitable--- too hot, dry or stormy to sustain a human population.This is no mirage. It could materialize if the world warms by an average of just 4°C, which some models predict could happen as soon as 2050. This is the world our children and grandchildren are going to have to live in. So what are we going to do about it?One option is to start planning to move the at-risk human population to parts of the world where it will still be cool and wet. It might seem like a drastic move, but this thought experiment is not about scaremongering (危言耸听). Every scenario is extrapolated from predictions of the latest climate models, and some say that 4°C may actually turn out to be a conservative estimate.Clearly this glacier-free, desertified world---with its human population packed into high-rise cities closer to the poles---would be a last resort. Aside from anything else, it is far from being the most practical option: any attempt at mass migration is likely to fuel wars, political power struggles and infighting.So what are the alternatives? The most obvious answer is to radically reduce carbon dioxide levels now, by fast-tracking green technologies and urgently implementing energy-efficient measures. But the changes aren’t coming nearly quickly enough and global emissions are still rising. As a result, many scientists are now turning to “Earth’s plan B”.Plan B involves making sure we have large scale geoengineering technologies ready and waiting to either suck CO2 out of the atmosphere or deflect the sun’s heat. Most climate scientists were once firmly against fiddling with the Earth’s thermostat, fearing that it may make a bad situation even worse, or provide politicians with an excuse to sit on their hands and do nothing.Now they reluctantly acknowledge the sad truth that we haven’t managed to reorder the world fast enough to reduce CO2 emissions and that perhaps, given enough funding research and political muscle, we can indeed design, test and regulate geoengineering projects in time to avert the more horrifying consequences of climate change.Whatever we do, now is the time to act. The alternative is to plan for a hothouse world that none of us would recognize as home.76. To begin with, the author is trying to remind us of ____________.A. the likelihood of climate change making life inconvenientB. the warning against worsening climate changeC. the inevitable consequence of global warmingD. the misconception of a warmer world77. As the thought experiment shows, those at risk from global warming will ____________.A. live with the temperature raised by an average of 4°CB. have nowhere to go but live in the desertC. become victims as soon as 2050D. move closer to the poles78. It is clear from the passage that a practical approach to global warming is _________.A. to reduce massively CO2 emissionsB. to take protective measures by 2025C. to prepare a blueprint for mass migrationsD. to launch habitual constructions closer to the poles。

南京大学医学院2005-2020年博士病理生理学考试真题

南京大学医学院2005-2020年博士考试病理生理学真题汇总一、2020年真题南京大学医学院病理生理学真题1、《新型冠状病毒肺炎诊疗方案》（试行第7版）中建议重症患者行连续性肾脏替代治疗，请对该方案的具体指征和病理生理学基础进行分析。

2、请结合《新型冠状病毒肺炎诊疗方案》（试行第7版）对新冠肺炎患者呼吸衰竭的建议分析，新冠肺炎患者呼吸衰竭的机制及治疗的病理生理学基础。

3、案例分析题(1)诊断：高渗性脱水、低容量行休克、失代偿性酸中毒、缺氧、发热、电解质紊乱、高钠血症。

(2)分析该患者休克的病因，休克所处的阶段及该阶段的病理生理特点。

二、2015-2019南京大学医学院病理生理学真题1.慢性肾衰竭何时出现低钾血症、高钾血症？答：慢性肾脏病（chronic kidney disease，CKD）：1.肾损害（病理，血，尿，影像学异常）≥3个月；2.GFR<60 ml/min/1.73m2，持续时间3个月；具有以上两条中的任何一条，即可诊断为chronic kidney disease.Chronic kidney disease的特点是肾单位减少，排泌K+的集合管数量减少。

而长期远端肾单位和集合管结构损伤导致残余肾单位代偿性K+排泌增加。

此外，肾单位减少还可导致残余肾单位血流量增加、远端钠转运增加。

1）低钾血症一般在钾摄入不足，胃肠道丢钾过多（胃肠引流，反复呕吐），利用排钾利尿剂等情况时发生。

慢性肾脏疾病，如肾小管性酸中毒，Bartter综合征，Liddle综合征，肾素分泌瘤、库欣综合征等。

2）CKD患者代偿性变化可维持血钾<5.5 mmol/L，但当GFR<15 ml/min/1.73m2，少尿，钾摄入过多，组织分解增加，醛固酮分泌减少时，肾脏失代偿，即可出现高钾血症。

2.左心衰出现呼吸困难的机制?端坐呼吸的机制？答：1）左心衰患者可发生肺淤血，严重时可出现肺水肿。

肺淤血、肺水肿的共同表现是呼吸困难。

考博外科学——精选推荐

考博外科学外科学总论（共50分）⼀名词解释：1.基因诊断2.⾼温灭菌法3.NHSTR4.GHTRS5.MODS⼆简答题：1 简述外科疾病的分类2 外科⼿术进⾏中的⽆菌原则3 感染性休克的治疗三问答题低渗性缺⽔的定义病因临床表现诊断治疗普外科各论（50分）⼀名词解释mastopathy 原发性腹膜炎strangulated hernia （狂晕刚意识到答成绞窄性肠梗阻了）abdominal compartment syndrome 第五个忘了⾼选择⾏迷⾛神经切断术（英⽂）⼆问答题甲状腺功能亢进症的病因术前术中注意事项⼿术适应症⼿术禁忌症术后常见并发症及处理原则原发性肝癌的病因病理临床表现诊断和鉴别诊断治疗2007年第⼆军医⼤学考博普通外科学⼀、多选题（12题，每题1分）1、腹腔镜⼿术禁忌：2、能叩诊出移动性浊⾳的腹腔积液：A、100ml B、200ml C、300ml D、400ml E、⼤于500ml3、急性胰腺炎⾎淀粉酶的变化：4、胆囊癌最佳的诊断⽅法：B超、CT、ERCP、？、？5、⼩⼉肠扭转病例6、肝脓肿病例7、以下胃、⼗⼆指肠穿孔描述不正确的是：⼆、填空题（8分）1、影响胃癌预后的因素有：（7空）2、下消化道出⾎的诊断⽅法有：（5空）3、下肢深静脉栓塞分为四型：_____型（4空）三、名词解释（6分，每题2分）1、buerger病2、charcot 综合征3、TME四、问答题1、家族性结肠息⾁病的发病原理、诊断、⼿术⽅式、术后随访原则？（20分）2、甲亢术后并发症及处理？（24分）3、肠梗阻按梗阻原因的分类；肠梗阻的治疗原则以及⾮⼿术治疗⽅法？（30分）第三军医⼤学2013博⼠普外专业⼀、名词解释1、richer疝2、倾倒综合征（英⽂）3、布加综合征（英⽂）4、⼆、简答题1、乳腺癌根治术切除范围2、胰腺癌⼿术切除范围3、简述直肠癌超低位保肛术4、chiold分级及其临床意义三、问答题1、急性梗阻性黄疸治疗原则2、论述胃癌外科治疗的最新进展2013南京医科⼤学普外科学（总论+普外）考博真题回忆版简答4分*61、创伤组织修补基本过程？2、30秒内确定⼼搏骤停的⽅法？3、输⾎后常见并发症？4、低钾的常见病因？5、营养⽀持⽅法选择原则？6、⼿术中的⽆菌原则？问答19分*41、胰腺假性囊肿的⼿术指征、⽅式、要点？2、甲状腺⼿术并发症及治疗？3、腹膜后⼗⼆指肠破裂诊断依据及治疗？4、完善的科研设计标志有哪些？第三军医⼤学2013年外科专业基础之⼈体解剖真题名词解释：胸⾻⾓纵隔膜迷路动脉韧带肺段简答脑屏障的主要特点喉的结构，运动及功能的关系胆汁的产⽣，排出的主要特点问答⽪质核束的主要特点内脏传导通路的主要特点迷⾛神经的主要特点腰丛的主要特点2013中⼭⼤学博⼠⽣⼊学考试（普外）1糖⽪质激素外科感染性休克2糖尿病围术期准备要点3开放⽓胸处理原则4影像学在泌尿系结⽯的诊断应⽤5胃癌腹腔镜禁忌6胆管囊性扩张的分型7下肢静脉体格检查名称8外科真菌感染因素和抗真菌药物9切⼝裂开预防10⿊⾊素瘤的临床表现11CEA.AFP.CA199.CA125.PSA，中⽂名称及诊断价值12门脉⾼压⾮⼿术治疗及贲门⾎管离断理由13 低渗性缺⽔的原因14乳腺癌分⼦分型及治疗建议15胃癌根治原则，根治划分，远端胃癌根治切除范围16慢性胰腺炎⼿术指征，⼿术原则，⼿术⽅式。

132药理学试卷【附答案】@南医大

ⅠⅣⅡⅢ Examination Paper in Pharmacology for Students Majored inBasic Medicine (2001)1．agonist ：2．first pass effect ：3．bioavailability ：4．steady state concentration(Css)：5．multidrug resistance ：1. The time-concentration relationship of a drug is shown in the figure. Please judge that the drug belongs to what kind of elimination kinetics(first-order or zero-order) ? And please describe the properties of this kind of elimination kinetics. (6%)2. Give a brife discription of the pharmacological action of Ca 2+3. Give a brife discription of the mechanism of Morphine’s relieving pain action in the central nervous system. (6%)channel blockers. (6%)4.Describe the molecular mechanism and clinical uses of furosemide.(6%)5.Describe the common properties of quinolones(喹诺酮类).（6%）6. Please discuss the whole course of a drug from its oral absorption to excretion. (10%)7.What are the strategies for the treatment of congestine heart failure (CHF)? List the classes of drugs that can be used in CHF and give an example for each class. (10%)1、通常药物与受体以______、 _______、_______键方式结合时容易解离，不易产生持久作用。

药理学博士考试真题

药理学博士考试真题G蛋白偶联受体在信号传导中的主要作用是？
A. 直接激活效应蛋白
B. 识别并结合配体
C. 催化化学反应
D. 转运离子
下列哪种药物是细胞周期非特异性药物？
A. 紫杉醇
B. 阿霉素
C. 顺铂
D. 氟尿嘧啶
哪种药物主要用于治疗支气管哮喘的急性发作？
A. 去甲肾上腺素
B. 氨茶碱
C. 沙丁胺醇
D. 麻黄碱
糖皮质激素大剂量突击疗法最适用于哪种情况？
A. 恶性淋巴瘤
B. 肾病综合征
C. 感染中毒性休克
D. 结缔组织病
下列哪种药物通过阻断M受体来抑制胃酸分泌？
A. 氢氧化铝
B. 雷尼替丁
C. 奥美拉唑
D. 哌仑西平
苯二氮卓类药物的中枢作用机制是什么？
A. 直接激动GABA受体
B. 增强GABA能神经功能
C. 直接抑制中枢
D. 直接促进氯离子内流
下列哪种情况不宜使用糖皮质激素治疗？
A. 湿疹
B. 麻疹
C. 荨麻疹
D. 皮肌炎
哪种药物主要用于治疗心室纤颤？
A. 奎尼丁
B. 维拉帕米
C. 利多卡因
D. 普萘洛尔。

南医大药理考试题

较新一篇 / 较旧一篇【药理】【2011级（康达全科）药理试卷】好友可见2013-07-09 19:31 |(分类:默认分类)选择60*1（53+7道配伍题）红霉素适用军团菌。

1血浆结合蛋白特点：可逆2消除半衰期10H，问口服后多长时间药物消除3不良反应考到缺少什么酶--特异质反应4静外滴注是5高血压伴心动过速选什么药等等大题8*5试述阿托品与毛果芸香碱对眼的药理作用及临床应用试述比较吗啡与阿司匹林的镇痛作用试述正性肌力机制及特点试述胰岛素的不良反应青霉素G的耐菌机制及抗药机制【药理】【2010级（临床）药理重修试卷】好友可见2013-06-09 11:24 |(分类:默认分类) 2010级临床专业药理重修试卷选择（1*60）阿司匹林在碱性尿液中：解离；再吸收；排泄半衰期，基本消除时间药物产生副作用的药理学基础竞争性拮抗药特点抗胆碱酯酶药的适应症不包括治疗外周血管痉挛可选用普鲁卡因不用于癫痫大发作合并小发作对惊厥治疗无效的是阵发性室上性心动过速宜用治疗变异性心绞痛较好的药物预防支气管哮喘发作的首选药甲状腺手术前给药使甲状腺腺体变小的药物化疗指数的表达方式与意义治疗军团菌感染应首选问答（8*5）1.阿托品对眼的药理作用，作用机制，临床应用2.阿司匹林与吗啡镇痛作用的比较3.强心苷的不良反应及防治措施4.糖皮质激素的临床应用5.抗菌药物的作用机制，并各举一例【药理】【2010级（口腔）药理试卷】好友可见2013-06-09 11:20 |(分类:默认分类) 2010级口腔药理（A）单选60x1‘包括53个纯单选和7个配伍题十分非常的细节考了好多314道题我后悔没有多看几遍啊举例肝素的禁忌症，可乐定的降压机制，体外抗菌作用最强的喹诺酮类药物等等问答5x8’β-受体阻断剂的临床应用和不良反应；吗啡和阿司匹林镇痛作用的比较；强心苷的不良反应和抢救措施；糖皮质激素的临床应用；β-内酰胺类抗生素的抗菌机制和耐药性的产生较新一篇 / 较旧一篇【药理】【药学专业药理试卷】好友可见2012-07-21 20:10 |(分类:默认分类)2011.01.19 药学专业药理一.选择题25个，忽略二.名词解释1. 肾上腺素的翻转作用2.竞争性拮抗药3.治疗指数4.生物利用度5.多药耐药性三.简答1.毛果芸香碱对眼睛的作用及临床用途2.强心苷的不良反应3.阿司匹林对血小板的影响及作用机制4.磺酰脲类、双胍类降糖药特点的对比5.抗菌药耐药性的作用机制四.问答1.ACE降压药的降压特点及作用机制2.β受体阻断药的药理作用3.氯丙嗪的药理作用及机制4.抗肿瘤药的不良反应5.糖皮质激素的药理作用较新一篇 / 较旧一篇【药理】【2010级（医检）药理试卷】好友可见2013-02-11 12:39 |(分类:默认分类) 2012年下医检药理名解：1.首过效应2.效能3.二重感染4.抗菌后效应5.副作用问答：1.阿托品的药理作用及临床应用2.氯丙嗪和阿司匹林解热机制的不同3.强心苷的不良反应和防治措施4.糖皮质激素的药理作用及临床应用5.青霉素的不良反应及防治措施较新一篇 / 较旧一篇1．选择：（1分×60）第一题是生物利用度高的药物怎么样？（选项有：脂溶性、经肾脏排泄、与蛋白结合等等）pKa 值是指什么？根据药物的半衰期算几天到达稳态浓度。

南医大真题

2000一.名词解释(每小题 2 分)1.药物作用(Drug action)2.药理效应(Pharmacology effect)3.药物的副作用(Side reaction)4.药物的毒性反应(Toxic reaction)5.药物的剂量-效应关系(Dose-effect relationship)6.耐受性(Tolerence)7.药物的安全范围(Margin of safety)8.耐药性(Drug resistance)9.药物的消除半衰期(Elimination half-life time) 10.绝对口服生物利用度二.问答题(每小题 10 分)1.试写出 5 种参与细胞内信息转化的主要物质(包括细胞内第二信使)2.试写出 9 种不同的给药途径,并指出哪些给药途径可避免首关消除3.四类器官组织:a.皮肤和黏膜;b.腹腔内脏;c.骨骼肌;d.冠状动脉;它们血管平滑肌的收缩和舒张,分别收什么神经递质受体的调控?试分别写出这些受体(受体亚型) 被激动或被阻断时所产生的药理效应,并写出它们的激动药和阻断药各一个.4.苯二氮卓类药物与巴比妥药物对神经中枢的作用和作用机制有什么异同?5.理论上预计钙拮抗药有广泛的药理效应,然而到目前为止临床上使用的钙拮抗药仅作用于心血管系统,对其他器官组织的影响较少,为什么?6.试述洋地黄类强心甘对心脏的主要药理效应及可能的作用机制.7.糖皮质激素对免疫过程的哪些环节具有抑制作用?8.试按对生物大分子的作用方式,将恶性肿瘤药进行分类,每类列出二个代表药物.2002一.名词解释(每小题 2 分)1.Toxic reaction2.Drug dependence3.Agonist and antagonist4.Half-life5.Efficacy6. Tolerence7.Marginof safety8.Withdraw reaction9. Maximum efficacy10.Modian Effective dose二.问答题(每小题 10 分)A 卷1.效价强度与效能在临床用药上有什么意义?2.比较吗啡和乙酰水杨酸在镇痛机制,镇痛部位及临床应用的区别.3.请叙述阿托品的临床应用.4.请列表比较红霉素,链霉素,四环素及氯霉素的临床应用(首选)及不良反应5.治疗充血性心力衰竭的药物类型有哪些,各举一例代表药,并简单评价各类药物目前在心脏治疗中的地位.6.简述卡托扑利的药理作用及临床应用.7.简述糖皮质激素类药物的抗炎机制.8.简述一,二,三,四代头孢菌素各自的作用特点.二.问答题(每小题 10 分)B 卷1.比较吗啡和阿司匹林的镇痛作用机制2.简述糖皮质激素的临床应用3.呕吐是临床上常见的症状,各种原因引起的呕吐,请从药物治疗的角度分析有哪些方法可以止吐,并各举一例代表药.4.简述抗心律失常的分类并各举一例代表药.5.请写出三种常用的强心苷类药物的名称,应用药物之前应考虑药物本身的哪些因素.6.新斯的明治疗重症肌无力及中毒的作用机制.7.试简述青霉素的作用机制和耐药性产生的原因.8.试简述青霉素 G 的抗菌谱,重要不良反应及防治.2004一. 请翻译下列名词并用中文解释(20 分，每个4 分) 1．Biopharmaceutics2．Injectiones ( Injectio )3．Limit test4．QSAR5. Combinatorial Chemistry二．简答题（30 分，每道6 分）1．常用的液体制剂及制法要点是什么？2．软膏剂的质量要求是什么？3．药物中的杂质是什么？其来源有哪些？4．硝酸甘油的特异性鉴定反应包括哪些内容？5．简述阿司匹林的抗炎作用机制。

药理学考研考博试题汇总

2004年山东大学药理试题（博士）一、翻译并解释（英文）1.G-蛋白耦联受体G protein-coupled receptor 是一类由GTP结合调节蛋白组成的受体超家族，可将配体带来的信号传送至效应蛋白，产生生物效应。

G蛋白的调节的效应器包括酶类，如AC、PLC等及某些离子通道2.摄取1Uptake-1也称神经摄取（neuroal uptake），是机体消除神经递质作用的一种方式，神经末梢依靠突触前膜上的特殊转运蛋白把释放的神经递质主动转运进入神经细胞内的机制，进入细胞内的递质可重新进入囊泡储存备用，或者被酶破坏。

比如去甲肾上腺素主要依赖这种方式失活。

（许多非神经组织如心肌、血管、肠道平滑肌也可摄取NA，这种摄取对NA的容量较大，但其亲和力远低于摄取-1。

且被摄取-2摄入组织的NA并不储存而是很快被酶破坏。

也称为非神经摄取）3.单胺氧化酶Mono-anine oxidase（MAO），使儿茶酚胺类神经递质失活的酶4.细胞周期非特异性药物细胞周期非特异性药物是指对处于细胞增殖周期中的各期(G1、S、G2、M)或是休止期的细胞(C0期)均具有杀灭作用的药物。

它们大多能与细胞中的DNA结合，阻断其复制，从而表现其杀伤细胞的作用。

抗肿瘤药物中的烷化剂及阿霉素、博莱霉素等即属于此类药物。

5.孤儿受体属于核受体家族，大多根据基因组测序发现的一类结构与甾体激素受体类似的蛋白表达产物，但是到目前为止尚未发现这些蛋白表达产物与某种激素结合，即尚未发现其配体。

因此把它们称为孤儿受体或孤儿核受体6.细胞色素P450细胞色素P450(cytochrome,CYP450)是一类以还原态与CO结合后在450nm处具有最高吸收峰的含血红素的单链蛋白质。

它参与内源性物质和包括药物、环境化合物在内的外源性物质的代谢。

7.受体上调Receptor up-regulation，某种受体激动剂水平降低或长期应用拮抗药造成组织或细胞上表达的该种受体的数量增加的现象，称为受体上调8.折返激动折返激动是所有的快速性心律失常最常见的发生机制。

南京中医药大学西医内科学2013年考博真题试卷

南京中医药大学
医学考博真题试卷
攻读博士学位研究生入学考试试卷
南京中医药大学
2013年攻读博士学位研究生入学考试试题
考试科目：西医内科学注意：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、名词解释
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阿斯综合征甲状腺危象运动性失语症脑膜刺激征 charot三联征高血压脑病转移性低钾血症二、简答题 1. 糖尿病肝肾昏迷的临床特点 2. 肾病综合征的诊断标准 3. 血小板减少性紫癜的诊断标准 4. 血液透析的适应症 5. 急性心梗的处理原则 6. ards的临床表现 7. 急性上消化道出血的处理原则 8. 造成全血细胞减少的疾病三、问答题 1. 肝硬化腹水的发生机制、鉴别诊断、处理原则 2. 心功能分级、左心衰

2013医学考博试题1

2013医学考博试题12013南京医科大学细胞生物学（专业基础）考博真题回忆版1、什么是端粒酶？有什么特点，请简述端粒酶的表达水平与细胞增殖的关系2、什么是蛋白质的分选？及影响其分选的关键因素是什么？3、主动运输与被动运输的特点4、简述胚胎干细胞、终端分化细胞核癌细胞的生长和分化特点5、从细胞分化角度说明多利羊诞生的启示6、个体低密度脂蛋白（LDL）受体缺失引起高胆固醇血症的原理7、大题一（20分）：什么是细胞周期蛋白，有几类，各有什么功能，举例说明8、大题二（20分）：什么是细胞凋亡？有何特点？举例说明细胞凋亡的检测方法及其原理南京医科大学生物化学与分子生物学（我考的A卷）一、简答题（6X10分）1、酶活性调节的方式和机理2、什么是TCA循环，为什么TCA循环是三大物质代谢的枢纽3、什么是尿素循环，及其生理和病理意义4、什么是操纵子，乳糖操纵子的结构和正负性调节的机理5、什么是第二信使，举例说明第二信使如何参与信号转导通路6、转录与复制的异同二、问答题（2x20分）1、举例说明蛋白质构象改变与功能的关系2、写出至少6种RNA的名称，并简述其结构特点和功能南京医科大学老年医学一.简答题（6X10分）1.肠结核的诊断线索2.何谓肾上腺危象3.何谓DKA4.主动脉夹层的分型和临床表现5.中晚期食管癌的临床表现6.支气管哮喘的诊断标准二.问答题（2X20）1.原发性高血压的预后判断2.什么是肺血栓栓塞症，及其临床表现和诊断依据南京医科大学2013年药理学博士试题一、简答题（6×10）1、评价药物效应的指标有哪些？2、肾上腺素受体的分离及其临床应用？3、心律失常药的分类，代表药物及作用机制？、4、抗哮喘药物的分类及机制？5、糖皮质激素的临床应用及不良反应？6、简述怎样合理应用抗生素？二、论述题（任选两题，2×20）1、药物不良反应的类型，药物代谢酶对药物不良反应的影响？2、强心苷的临床应用，与ACEI相比有何优点？、3、中枢多巴胺紊乱所导致的疾病及其应对策略？4、抗肿瘤药物的分类及其机制？南京医科大学2013年生理学博士试题一、简答题（6×10）1、细胞兴奋后其兴奋性如何变化？与各期动作电位有何对应关系？2、什么是中心静脉压？其影响因素及临床意义？3、简述氧离曲线的影响因素？4、胃排空的过程及其影响因素？5、比较兴奋性突触传递及抑制性突触传递过程的异同？6、长期饮食缺乏碘为什么会引起甲状腺肿大？二、问答题（2×20）1、糖皮质激素的作用及其调节？2、兴奋交感神经对心肌细胞生理特性有什么影响，并设计实验加以证明。

药理学试卷四套南医大大三上学期药理学

2001年级临床、护理本科药理学考试题（A）学号班级姓名成绩：一、选择题（每题1分，共50分）（一）A型题（答题说明: 从A、B、C、D、E五个备选答案中选择一最佳答案, 并在答卷上将相应题号的相应字母涂黑）。

1. 药效学是研究A. 药物临床疗效和不良反应B. 药物剂量与疗效关系C. 药物的安全性D. 药物的作用机制和构效关系E. 以上都是2.药物作用的基本类型是指A．原有机能的提高或兴奋 B．原有机能的提高或降低C．原有机能的降低或抑制 D．治疗作用与不良反应E．对因治疗与对症治疗3.用麻黄碱滴鼻治疗鼻塞时，病人出现心悸、失眠反应为麻黄碱的A. 兴奋作用B. 变态反应C. 治疗作用D. 毒性反应E. 副作用4.A药的ED50 > B药的ED50 , 则A．A药的半数致死量 > B药的半数致死量B．A药的LD50 < B药的LD50C．A药的最大效应 > B药的最大效应D．A药的效价强度 > B药的效价强度E．A药的效价强度 < B药的效价强度5.部分激动剂的特点是A．与受体无亲和力，但有部分内在活性B．与受体亲和力弱，内在活性强C．与受体亲和力强，但内在活性弱D．与受体亲和力强，内在活性亦强E．与受体亲和力强，但无内在活性6.下列有关药物主动转运的叙述哪一种是错误的?A. 要消耗能量B. 只能逆浓度梯度转运C. 有化学结构特异性D. 需要载体协助E. 转运速度有饱和限制7.下列叙述哪一种不正确？A．药物作用的选择性低，则药物副作用多B．两药化学结构相似，则两药作用相似C．两药口服剂量相同，但血药浓度可以相差很大D．两药治疗指数相同，但两药安全性不一定相同E．受体激动剂不一定都产生兴奋作用8.某药物口服和静脉注射相同剂量后获得的AUC相同，这表明A．该药口服吸收迅速 B．该药口服吸收完全C．该药属一级动力学消除 D．该药属零级动力学消除E．该药口服可以获得静脉注射相同的效应9.支气管哮喘伴有尿路梗阻的病人应禁用A．阿托品 B．东莨菪碱C．新斯的明 D．后马托品E．山莨菪碱10.毛果芸香碱对眼的作用是A. 缩瞳，升高眼压B. 扩瞳，升高眼压C. 缩瞳，降低眼压D. 扩瞳，降低眼压E. 升高眼压，治疗青光眼11.下列哪种不是新斯的明的适应症A．重症肌无力 B．阵发性室上性心动过速C．筒箭毒碱过量中毒 D．腹气涨和尿潴留E．有机磷酸酯中毒12.全身麻醉前常给予阿托品，目的是A. 协助松弛骨骼肌B. 防止胃肠道痉挛C. 防止低血压D. 兴奋心脏E. 减少唾液腺和呼吸道腺体分泌13.心脏骤停复苏优先选用A．去甲肾上腺素 B．肾上腺素C．异丙肾上腺素 D．多巴胺E．多巴酚丁胺14.下列哪种药物最易引起心律失常A．去甲肾上腺素 B．间羟胺C．肾上腺素 D．麻黄碱E．多巴胺15.对琥珀胆碱过量引起的窒息可用下列哪种措施急救A．毒扁豆碱 B．新斯的明C．纳络酮 D．东莨菪碱E．人工呼吸16.去甲肾上腺素静脉滴注外漏引起局部缺血，可用何药处理A．酚妥拉明 B．阿托品C．去氧肾上腺素 D．多巴胺E．普萘洛尔17.巴比妥类药物中毒解救药是A．碳酸氢钠 B．丙磺酸钠C．氯化钠 D．硫代硫酸钠E．乳酸钙18.苯巴比妥连续用药较快产生耐受性的主要原因是A．与血浆蛋白结合率增高，使血浆中游离型药物减少B．诱导肝药酶使自身代谢加快C．被血浆单胺氧化酶迅速水解破坏D．以原型经肾脏排泄加快E．重新分布，贮存于脂肪组织内19.主要用于癫痫小发作治疗的药物是A．苯妥英钠 B．乙琥胺C．硝基安定 D．硫酸镁E．卡马西平（酰胺咪嗪）20.下列药物哪一种是中枢多巴胺受体拮抗药 A．阿托品 B．安定C．尼可刹米 D．氯丙嗪E．度冷丁21. 下列药物哪一种属抗精神分裂症药A．乙醚 B．氯丙嗪C．吗啡 D．苯巴比妥钠E．丙咪嗪22.氯丙嗪没有以下哪种作用A．镇吐作用 B．抗胆碱作用C．抗α肾上腺素受体作用 D．抗惊厥E．抑制下丘脑释放神经激素23.氯丙嗪中毒引起血压下降时禁用哪种措施A、注射肾上腺素B、补充血容量C、注射去甲肾上腺素D、中枢兴奋药E、吸氧24.吗啡作用有A．镇痛镇静催眠 B．镇痛镇静镇咳C．镇痛呼吸兴奋 D．镇痛镇静止吐E．镇痛镇静扩瞳25.治疗月经痛应选用药A．阿司匹林 B．吗啡C．度冷丁 D．阿托品E．可待因26.阿斯匹林有哪种药理作用A．抑制血小板疑集 B．利尿C．扩张血管 D．抗溃疡E．对剧烈疼痛止痛作用强27.哪种药属于钙拮抗剂A．普萘洛尔 B．利多卡因C．胺碘酮 D．奎尼丁E．维拉帕米28.治疗室性早搏的首选药物是A．普萘洛尔(心得安) B．胺碘酮C．维拉帕米 D．利多卡因E．苯妥英钠29.用于治疗阵发性室上性心动过速的最佳药物是A．奎尼丁 B．苯妥英钠C．维拉帕米 D．普鲁卡因胺E．利多卡因30.属于血管紧张素I转化酶抑制剂的降压药是A.卡托普利B.利舍（血）平C.可乐定D.普萘洛尔(心得安)E.哌唑嗪31.肼屈嗪降压作用方式A.直接扩张小动脉B.阻断外周α受体C.耗竭肾上腺素能神经末梢的NAD.抑制肾素释放E.阻断中枢α受体32.强心苷的不良反应以下哪项除外A.恶心呕吐B.视力模糊C.室性心律失常D.窦性心动过缓<60次/分E.水钠潴留33、西咪替丁的作用机理A.中和胃酸B.阻断H2受体C.激动H2受体D.抑制H+，K+-ATP酶E.阻断H1、 H2受体34.具有成瘾性的中枢性镇咳药A.氯化铵B.痰易净C.舒喘灵D.可待因E.喷托维林（咳必清）35.甲亢手术前准备，应采用治疗方案是A.单纯用硫氧嘧啶类B.先用小剂量碘剂，后用硫氧嘧啶类药C.先用硫氧嘧啶类，后用大剂量碘D.单纯用大剂量碘E.单纯用小剂量碘36.糖皮质激素诱发和加重感染的主要原因是A.在治疗的同时未用足够量的抗菌素B.由于抑制炎症反应和免疫反应降低了机体的防御机能C.用量不足，无法控制症状D.它能促使多种细菌生长E.病人对糖皮质激素产生耐受性37.抗菌药的疗效取决于A.药物的抗菌活力B.机体的抗病能力C.药物的不良反应D.药物的副作用E.A 和B38.下列抗菌药合用不合理者为A.青霉素G+庆大霉素B.青霉素G+多西环素（强力霉素）C.链霉素+四环素D.TMP+四环素E.SMZ+TMP39.金黄色葡萄球菌引起的骨髓炎优先选用A.红霉素B.克林霉素C.氨苄西林D.氯霉素E.万古霉素40.对支原体肺炎首选药是A．红霉素 B．异烟肼C．庆大霉素 D．羧苄西林E．头孢他定（二）X型题（答题说明: 从A、B、C、D、E五个备选答案中选出所有正确答案, 并在答卷上将相应题号的相应字母涂黑）41.药动学研究的内容A. 机体对药物的处置B. 药物剂量与药物效应强弱关系B. 药物在体内的化学结构改变D. 体内药量随时间变化的规律E. 药物作用的两重性42.可用来反应药物安全性的指标有A.ED50B.LD50C.LD50/ED50D.LD5/ED95E.pA243.普萘洛尔的应用有A.心律失常B.心绞痛和心肌梗死C.高血压D.窦性心动过缓E.甲亢44.哪些属于地西泮（安定）的作用与应用A.抗惊厥B.抗焦虑C.抗癫痫D.麻醉作用E.抗精神病作用45.氯丙嗪不良反应有 A.体位性低血压 B.嗜睡、无力、鼻塞、心动过速C.帕金森氏综合症D.肝损害E.迟发性运动障碍46. 呋塞米 (速尿、呋喃苯胺酸)的不良反应有A.胃肠道反应B.电解质紊乱(低钾等)C.休克D.心衰E.耳毒性47.肾上腺皮质激素的禁忌症是A.糖尿病患者B.骨质疏松症和药物不能控制的感染患者C.精神病或癫痫史患者D.动脉硬化，高血压E.胃溃疡48.下列哪些是正确的A.单纯性甲状腺肿可用小剂量碘和甲状腺素治疗B.硫脲类可用于甲亢手术前准备C.硫脲类的严重不良反应是白细胞减少D.大剂量的碘可用于甲亢危象和甲亢手术前准备E.硫脲类治疗甲亢的机理是抑制过氧化物酶49.青霉素G高度敏感的细菌包括A.溶血性链球菌B.肺炎球菌C.白喉杆菌D.炭疽杆菌E.大肠杆菌属50.通过干扰细菌细胞壁合成而产生抗菌作用的抗菌药物A. 万古霉素B. 青霉素C. 多粘菌素BD. 庆大霉素E. 头孢菌素二、简答题（50分）1．简述药物一级和零级消除动力学的特点。

南京医科大学历年复试真题Ⅰ

一、内科学（一）名词解释1.Broca 失语2.GERD3.Graham steel 杂音4.ITP5.kussmaul 呼吸6.OSAHS7.PGD8.SHPT9.sleep apnea syndrome10.SSS11.TTP12.奔马律13.胆红素的肠肝循环14.淡漠型甲亢15.隐性感染16.肝性脑病17.有先兆偏头痛18.核左移19.脊髓半切综合症（英文）20.抗磷脂综合征21.内生肌酐清除率22.妊娠糖尿病23.糖耐量试验24.新发传染病25.延髓背外侧综合症(英文)26.谵妄（二）简答题1.AD 病理和临床特征，可能的鉴别诊断2.AKI3.CREST 综合症4.disseminated intravascular coagulation5.Fisher 综合征6.Hepatic cirrhosis7.Hunt 综合征8.Pancoast 癌9.PD 临床表现，药物及作用机制10.SIADH11.蛋白尿的分类及特点12.二型呼衰治疗原则13.发热病人的问诊要点14.肥厚型心肌病的药物及非药物治疗15.肺湿罗音的分类和临床意义16.肺血栓栓塞诊断治疗17.咯血与呕血的鉴别18.何为肿瘤标志物19.核上性眼肌麻痹20.基底动脉聊综合征21.急性白血病完全缓解标准22.急性重症胰腺炎治疗原则23.脊髓半切综合征（Brown-Sequard Syndrome）24.甲亢病因分类25.甲亢治疗26.甲状腺的触诊要点，及甲状腺的分度27.简述 2 型糖尿病胰岛β细胞功能缺陷的表现28.简述ST 段抬高型心梗心电图的变化特征29.简述超敏C-反应蛋白的临床意义30.简述淡漠型甲亢31.简述肝硬化的体征32.简述干性啰音及湿性啰音的定义，发生机制及相关特征33.简述急性左心衰竭的治疗34.简述抗凝CHA2DS2 VASc 评分和出血HAS BLED 评分35.简述临床触诊的分类及应用36.简述心绞痛的ABCDE 预防37.简述胸痛的常见病因38.局灶节段性肾小球硬化治疗原则39.抗菌素按化学结构的分类及其治疗的原则40.抗磷脂抗体出现在哪些疾病41.抗磷脂抗体综合征表现42.狼疮肾炎的病理分型43.列举两个糖蛋白的肿瘤标志物，说明其临床意义44.淋巴瘤分期45.慢性肾衰定义，分期46.缺铁性贫血的实验室检查改变47.什么是狼疮危象，其治疗原则48.什么是慢性肾病继发性甲旁亢，治疗方法49.什么是院内感染，常见耐药菌，耐药机制50.什么是院内感染、有哪些细菌、耐药机制51.肾病综合征定义，分类52.食管静脉曲张破裂出血原则53.糖尿病肾病分期，治疗54.糖尿病视网膜病变分期55.为何联用激素和β2 受体激动剂治疗支气管哮喘56.消化性溃疡的内科治疗原则57.硝酸酯类药物的禁忌症和注意事项58.心梗并发心衰根据其血流动力学及临床表现可有哪几种分类方法59.心梗的心电图变化60.心音强弱和什么因素相关61.心脏压塞的体征及处理原则62.炎性腰背痛的临床特征63.右心衰的病因及发病机制64.院内感染65.再障的诊断及鉴别诊断66.窄QRS 波型规律的快速型心律失常的分类及处理原则67.肢端肥大症的临床表现、治疗方案68.癫痫持续状态及治疗原则69.高血压治疗的六类药物及举例70.腰穿禁忌症和适应症（三）论述题1.ARDS 定义，诊断标准2.ST 抬高的心梗溶栓的适应症3.阿尔兹海默病的病理表现和临床特征4.丙肝病程，治疗5.阐述急性缺血性脑血管病的治疗原则和方法6.阐述神经系统疾病的定位诊断7.二型糖尿病 b 细胞功能受损的表现8.反流性食管炎的诊断方法和治疗原则9.房颤的分类和治疗原则10.检测hp 的方法11.克罗恩病和肠结核的鉴别12.狼疮危象，治疗原则13.缺铁性贫血的病历分析（题目是：细胞形态学诊断和病因诊断，诊断依据，进一步的检查）14.如何判定消化道活动性出血15.胃癌的癌前病变16.一个病人coombs 阳性的病例分析17.胰腺炎的局部和全身并发症18.晕厥见于哪些疾病2016 年南京医科大学内科学复试真题（一）名词解释1.Grahamsteell 杂音2.kussmaul 呼吸3.OGTT 试验4.内生肌酐清除率（二）简答题1.发热除了临床症状还有哪些问诊内容2.简述2008 版肺高血压定义及分类3.影响心脏杂音的因素（三）论述题1.COPD 的综合性评估及用药2.关于低色素性贫血的病例分析2014 年南京医科大学内科学复试真题（一）简答题1.心脏压塞的体征及处理原则2.Pancoast 癌3.Hepatic cirrhosis4.AKI5.SIADH6.CREST 综合症7.院内感染8.disseminated intravascular coagulation（二）论述题1.心血管内科：（1）心梗并发心衰根据其血流动力学及临床表现可有哪几种分类方法（2）窄QRS 波型规律的快速型心律失常的分类及处理原则（3）右心衰的病因及发病机制2.内分泌内科：（1）甲抗病因（2）甲抗治疗（3）糖尿病视网膜病变分期3.风湿免疫科：（1）狼疮肾炎的病理分型（2）抗磷脂抗体出现在哪些疾病（3）炎性腰背痛的临床特征4.肾内科：（1）什么是慢性肾病继发性甲旁亢？治疗方法？（2）糖尿病肾病分期，治疗（3）肾病综合征定义，分类5.血液内科：（1）哪类疾病或临床情况可继发自免溶贫（2）白血病增殖浸润表现（3）诊断淋巴瘤的主要依据6.传染病学：（1）举例说明我国感染性疾病防治进展（2）血清氨基转移酶升高的原因（3）抗菌药按化学结构分类及治疗性应用的基本原则2013 年南京医科大学内科学复试真题（一）简答题（8 选6）1.心内的CHADS2 评分2.二型呼衰治疗原则3.急性重症胰腺炎治疗原则4.慢性肾衰定义及分期5.抗磷脂抗体综合征表现6.简述淡漠型甲亢7.什么是院内感染，常见耐药菌及其耐药机制8.淋巴瘤分期（二）论述题（8 选2）1.ST 抬高的心梗溶栓的适应症2.ARDS 定义及诊断标准3.消化科的一个病例分析4.肾内的一个病例分析5.狼疮危象及治疗原则6.二型糖尿病 B 细胞功能受损的表现7.丙肝病程及治疗8.一个病人coombs 阳性的病例分析2012 年南京医科大学内科学复试真题（一）名词解释1.GERD2.ITP3.PGD4.sleep apnea syndrome5.淡漠型甲亢6.抗磷脂综合征7.新发传染病（二）简答题（8 选6）1.肥厚型心肌病的药物及非药物治疗2.为何联用激素和β2 受体激动剂治疗支气管哮喘？3.再障的诊断及鉴别诊断4.什么是狼疮危象？其治疗原则足细胞病有哪些及治疗？5.简述 2 型糖尿病胰岛β细胞功能缺陷的表现6.消化性溃疡的内科治疗原则7.抗菌素按化学结构的分类及其治疗的原则8.高血压治疗的六类药物及举例2011 年南京医科大学内科学复试真题（一）名词解释1.SSS2.OSAHS3.肝性脑病4.SHPT5.妊娠糖尿病6.抗磷脂综合征7.TTP8.隐性感染（二）论述题1.关于心肌梗死病例分析2.肺血栓栓塞诊断治疗3.食管静脉曲张破裂出血原则4.局灶节段性肾小球硬化治疗原则5.什么是狼疮危象6.甲亢病因分类7.急性白血病完全缓解标准8.什么是院内感染？有哪些细菌？耐药机制？二、呼吸内科2016 年南京医科大学呼吸内科复试真题（一）名词解释1.Kussmaul 呼吸2.内生肌酐清除率3.Graham steell 杂音4.OGTT 试验（二）简答题1.发热除了临床症状还有哪些问诊内容？2.影响心脏杂音的有哪些因素？3.小细胞低色素贫血的诊断及依据4.severe pneumoniad 的诊断依据5.COPD 的综合性评估及用药6.简述2008 版肺高血压定义及分类。

药理问答【南医大历年各专业考题整理+上课重点】

药理问答涟星月整理版PART1：近年测试问答【各种等级要求】▲一级、零级消除动力学比较【087*】▲影响药物分布地因素【087临】毛果芸香碱对眼睛地作用及临床用途【08药】【药理作用】1、眼：<1）缩瞳：收缩瞳孔括约肌<2）降低眼内压<3）调节痉挛：环状肌向瞳孔中心方向收缩,悬韧带放松,晶状体变凸,屈光度增加,只适合看近物2、腺体：分泌增加【临床应用】1、青光眼<闭角型、开角型青光眼）2、虹膜炎阿托品地药理作用、临床作用【09护】和不良反应【087*、08医检、087临】【药理作用及作用机制】1、腺体：抑制腺体分泌2、眼：扩瞳、眼内压升高、调节麻痹3、平滑肌：对多种内脏平滑肌有松弛作用,对过度活动或痉挛地平滑肌效果更好4、心脏：<1）心率：小剂量减慢心率,大剂量增加心率<2）房室传导5、血管与血压：较大剂量时可引起皮肤血管扩张6、中枢神经系统：大剂量可兴奋大脑【临床应用】1、解除平滑肌痉挛：用于各种内脏绞痛,对胃肠绞痛好2、制止腺体分泌：用于全身麻醉前给药、3、眼科：<1）虹膜睫状体炎：可松弛虹膜括约肌和睫状肌,可预防虹膜和晶状体地粘连<2）验光配眼镜：用于儿童验光,因儿童地睫状肌调节功能较强4、缓慢性心率失常：用于迷走神经过度兴奋5、抗休克：舒张外周血管,改善微循环6、解救有机磷酸酯类中毒：早期足量,反复使用【不良反应】大：瞳孔扩大,视力模糊红：皮肤潮红干：口干快：心率加快胀：腹气胀毛果芸香碱和阿托品对眼睛地不同地作用及临床应用毛果芸香碱【作用】<1）缩瞳：收缩瞳孔括约肌<2）降低眼内压<3）调节痉挛：环状肌向瞳孔中心方向收缩,悬韧带放松,晶状体变凸,屈光度增加,只适合看近物【临床应用】1、青光眼<闭角型、开角型青光眼）2、虹膜炎阿托品【作用】扩瞳、眼内压升高、调节麻痹【临床应用】<1）虹膜睫状体炎：可松弛虹膜括约肌和睫状肌,可预防虹膜和晶状体地粘连<2）验光配眼镜：用于儿童验光,因儿童地睫状肌调节功能较强▲酚妥拉明地临床应用【08临】1．外周血管痉挛性疾病2．静脉滴注NA外漏3．嗜铬细胞瘤地鉴别诊断、骤发高血压危象4．抗休克+NA：对抗α作用,保留β作用5．急性心肌梗死及充血性心力衰竭6. 其他▲Β受体阻断药地药理作用【08药】▲Β受体阻断药地临床应用和不良反应【？】【药理作用】1．β受体阻断作用<1）心血管系统：∙心脏：心率↓,收缩力↓,传导↓→ CO↓∙血管：(->β2 血管收缩<肝,肾,骨骼肌,冠状血管><2）支气管平滑肌：阻断β2 受体→增加支气管阻力→加重哮喘<3）代谢：①糖尿病：抑制糖原分解,掩盖胰岛素引起地低血糖反应；②甲亢：↓对儿茶酚胺地敏感性,抑制T4 →T3<4）肾素：阻断肾小球旁器β1受体,抑制肾素释放 AngⅡ↓ BP↓2．内在拟交感活性 intrinsic sympathomimetic activity,ISA∙ 1.抑制心脏和收缩支气管平滑肌作用弱∙ 2.增加药物剂量或体内儿茶酚胺处于低水平时,可产生心率加快,心输出量增加等作用3．膜稳定作用：局部麻醉作用和奎尼丁样作用4．其他：抗血小板聚集【临床应用】1.心律失常 (房颤、房扑、窦性心动过速>2.心绞痛3.高血压4.心衰早期5.其他：甲亢,偏头痛；肌震颤；青光眼<噻吗洛尔）【不良反应】1.心血管反应:①加重房室传导阻滞,心动过缓尤其是+维拉帕M ②雷诺氏现象2.诱发或加剧支气管哮喘：应选具有ISA活性药3.反跳现象：长期应用,突然停药使原病加重4.其它：低血糖加重和掩盖降糖药引起地低血糖氯丙嗪地药理作用及机制【08药】【药理作用】1.中枢神经系统：(1>抗精神病作用 (2>镇吐作用(3>对体温调节地影响：不但降低发热机体地体温,也能降低正常体温2.对植物神经系统地作用：阻断肾上腺素α受体和M胆碱受体3.对内分泌系统地影响：增加催乳素地分泌,抑制促性腺激素和糖皮质【临床应用】1、精神分裂症：主要用于Ⅰ型精神分裂症2、呕吐和顽固性呃逆3、低温麻醉与人工冬眠【用于人工冬眠地药物】▲氯丙嗪、异丙嗪、哌替啶【不良反应】1、常见不良反应：包括中枢抑制症状、M受体阻断症状、α受体阻断症状等.2、锥体外系反应：包括帕金森综合征、静坐不能、急性肌张力障碍、迟发性运动障碍.氯丙嗪地垂体外系反应及其产生机制【087临】黑质－纹状体通路D2样受体↓：帕金森综合征、静坐不能、急性肌张力障碍黑质－纹状体通路D2样受体↑：迟发性运动障碍阿片类镇痛药地临床应用【087*】【吗啡】1.镇痛：急性锐痛：严重创伤,烧伤,战伤心梗引起地心绞痛：血压正常内脏绞痛：+阿托品2.心源性哮喘：3.止泻：急慢性消耗性腹泻细菌感染者+抗生素【可待因 codeine 甲基吗啡】剧烈干咳和中等程度疼痛【哌替啶<度冷丁 dolantin）】<1）镇痛：替代吗啡<2）麻醉前给药和人工冬眠(3>心源性哮喘阿司匹林地药理作用【？】阿司匹林对血小板地影响及作用机制【08药】阿司匹林地不良反应【?】和治疗措施【药理作用及临床应用】1、解热镇痛及抗风湿2、影响血小板地功能【不良反应】1、胃肠道反应：最为常见.口服可直接刺激胃黏膜,引起恶心、呕吐,较大剂量口服(抗风湿治疗>可引起胃溃疡2、加重出血倾向：抑制血小板凝集3、水杨酸反应：剂量过大(5g/d>时,可出现头痛、炫晕、恶心、呕吐、耳鸣、听力减退4、过敏反应：少数患者出现荨麻疹、血管神经性水肿和过敏性休克.某些哮喘患者服用后,可诱发哮喘,称之”阿司匹林哮喘”5、瑞夷综合征：在儿童感染病毒性疾病如：流感、水痘、麻疹等使用阿司匹林退热后,偶可引起急性肝脂肪变性－脑病综合症6、对肾脏地影响：对正常肾功能无影响.但对老年人,伴有心、肝、肾功能损害地患者,即是用药前肾功能正常,也可引起水肿、多尿阿司匹林和吗啡地比较【08临】1.急性肺水肿和脑水肿2.其它严重水肿：心、肝、肾性水肿3.急慢性肾功能衰竭：增加尿量,K＋排出4.高钙血症：抑制Ca2＋重吸收,降血钙5.加速某些毒物排泄【不良反应】★1.水和电解质紊乱：表现为低血容量、低血钾、低血钠、低氯性碱血症、低血镁2.耳毒性：表现为耳鸣、听力减退、暂时性耳聋3.高尿酸血症：诱发痛风4.其它：表现为恶心、呕吐、胃肠出血、过敏反应、皮疹强心苷地不良反应【08药】和防治【08临、087*】强心苷地中毒机制【09护、087*】【药理作用】一、对心脏地作用1.正性肌力作用★(1>加强心肌收缩性：提高心肌收缩最高张力和最大缩短速率,舒张期相对延长(2>降低衰竭心脏耗氧量：心肌收缩力↑,心率↓,心室容积↓(3>增加心输出量：心肌收缩力↑,交感张力↓2.减慢心率作用3.对传导组织和心肌电生理特性地影响二、对神经内分泌地作用：兴奋CTZ/交感中枢/副交感中枢,抑制肾素活性三、利尿作用：正性肌力作用,抑制肾小管Na+-K+-ATP酶四、血管地作用：收缩血管平滑肌【作用机制】1.抑制Na+-K+-ATP酶2.激活Na+-Ca2+双向交换机制3.胞内Ca2+增加4.并促进以Ca2+释Ca2+过程【临床应用】1.治疗慢性心功能不全：伴房颤、房扑或心室率快地CHF疗效最佳2.治疗某些心律失常：(1>心房纤颤:减慢房室结传导, 增加隐匿性传导(2>心房扑动:缩短心房ERP,使房扑转为房颤3.阵发性室上性或室性心动过速：可增强迷走神经功能【不良反应】☆B1.心脏毒性：(1>快速失型室性心律常：室早,室颤迟后除极(2>房室阻滞(3>窦性心动过缓2.胃肠道反应：兴奋CTZ3.神经系统反应：眩晕、头痛、疲倦、失眠、谵妄、黄视症、绿视症【中毒防治】☆B1.快速型心律失常：补钾、苯妥英钠、利多卡因2.缓慢型心律失常：阿托品3.致死性中毒：地高辛抗体糖皮质激素地药理作用【08药】糖皮质激素抗炎作用及抗炎机制【087*】糖皮质激素地临床应用糖皮质激素地不良反应【09护、08临、087临、08医检】【药理作用】<生理作用是第1、2点）1.对代谢地影响：糖、蛋白质、脂肪、核酸、水和电解质地代谢2.允许作用3.抗炎作用：★☆B利：炎症早期：减轻渗出、水肿、毛细血管扩张、白细胞浸润及吞噬反应,改善红、肿、热、痛等症状后期：抑制毛细血管和纤维母细胞地增生,延缓肉芽组织生成,防止粘连及瘢痕形成,减轻后遗症弊：降低机体地防御功能,可致感染扩散、阻碍创口愈合4.免疫抑制和抗过敏作用5.抗休克作用：常用于严重休克,如：感染中毒性休克地治疗6.其它作用：(1>退热作用：用于严重地中毒性感染,抑制体温中枢对致热原地反应(2>血液和造血系统：使淋巴细胞减少(3>中枢神经系统：提高中枢地兴奋性(4>骨骼：成人骨质疏松、儿童生长抑制【临床应用】★1.严重感染或炎症：(1>严重急性感染：用于严重地中毒性感染或同时伴有休克者(2>抗炎治疗及防止某些炎症地后遗症2.自身免疫性疾病、器官移植排斥反应和过敏性疾病3.抗休克治疗：用于感染中毒性休克4.血液病：用于儿童急性淋巴细胞性白血病5.局部应用：用于湿疹、牛皮癣、接触性皮炎6.替代疗法：用于急、慢性肾上腺皮质功能不全、脑垂体前叶功能减退【不良反应】★1.长期大剂量应用引起地不良反应☆A(1>消化系统并发症：可诱发或加剧胃、十二指肠溃疡(2>诱发或加重感染(3>医源性肾上腺皮质功能亢进：表现为满月脸、水牛背、皮肤变薄、多毛、浮肿、低血钾、高血压、糖尿病等；停药后消失(4>心血管系统并发症：引起高血压、动脉粥样硬化(5>骨质疏松、肌肉萎缩、伤口愈合迟缓(6>其它：有癫痫或精神病史者禁用或慎用2.停药反应(1>医源性肾上腺皮质功能不全(2>反跳现象：病人对激素产生依赖性或病情未完全控制,突然停药使原病复发磺酰脲类、双胍类降糖药特点地对比【08药】举例说明抗菌药地分类【？】1.窄谱 iv青霉素G、po青霉素V2.耐酶：iv氯唑西林po甲氧西林3.广谱：iv氨苄西林、 po阿莫西林、4.抗铜绿假单孢菌广谱 iv羧苄西林5.抗G(->杆菌：iv美西林 po匹美西林抗菌作用地机制【08临087临】及代表药物【09护】★☆1.抑制细菌细胞壁合成：青霉素、头孢菌素2.影响胞膜地通透性：多烯类、多粘菌素类3.抑制蛋白质合成：氨基苷类、四环素类、氯霉素、红霉素4.影响叶酸合成：磺胺类5.影响RNA合成：利福霉素类抗菌药耐药性地作用机制【08药、？】1.降低外膜通透性：革兰阴性菌膜孔蛋白数量、孔径减小2.产生灭活酶：b-内酰胺酶、氨基糖苷类钝化酶、氯霉素乙酰转移酶3.改变靶位地结构：降低与抗菌药地亲和力4.加强药物外排作用：四环素类、大环内酯类、氯霉素、 b-内酰胺类5.改变代谢途径：拮抗剂地增加或细菌酶系地变化青霉素抗菌机制与特点【08医检】青霉素地临床应用青霉素中毒地防治【09护、08医检】青霉素地耐药性【抗菌作用】1.G+ 球菌：溶血性链球菌、肺炎球菌、不耐酶金葡菌、表皮葡萄球菌2.G+杆菌：白喉杆菌、炭疽杆菌、破伤风杆菌、芽胞杆菌3.G- 球菌：脑膜炎双球菌、淋球菌4.G- 杆菌5.螺旋体：梅毒、放线杆菌【临床应用】敏感G＋/ G-球菌、 G＋杆菌、螺旋体感染首选药1. 溶血性链球菌：咽炎、猩红热、败血症等肺炎球菌：大叶性肺炎、中耳炎脑膜炎球菌：脑膜炎草绿色链球菌：心内膜炎螺旋体：梅毒、钩端螺旋体病、回归热2. G＋杆菌：破伤风、白喉、炭疽杆菌【不良反应】1.过敏反应：过敏性休克症状~呼吸困难、循环衰竭、中枢抑制2.赫氏反应：治疗梅毒、炭疽时,症状加剧,表现为发热、喉痛、心动过速等.3.其它神经毒性：鞘内注射或大剂量全身用药可引起肌肉痉挛、抽搐、昏迷等<青霉素脑病）,大剂量iv 水、电解质紊乱【防治原则】一问、二试、三避、四观察、五抢救1.询问过敏史2.皮试>30min3.避免饥饿时注射4.用药后观察30min5.用肾上腺素抢救,必要时加糖皮质激素、氨茶碱和抗组胺链霉素地不良反应和防治措施【087*】【临床应用】抗G<-）和铜菌最小1.鼠疫与土拉菌病地首选药 +四环素2.+青霉素或氨苄西林心内膜炎3.+其他抗结核药多重耐药结核病【不良反应】1.耳毒性：前庭损害2.过敏反应：过敏性休克现用现配肾毒性最小3.神经肌肉接头阻滞抗肿瘤药地不良反应【08药】PART2：没有考到但是也很重点有机磷中毒★☆B ~P71【中毒机制】与胆碱酯酶牢固结合,抑制胆碱酯酶活性,且可使胆碱酯酶老化【中毒诊断及防治】1、诊断：接触史、临床症状、胆碱酯酶活性等2、预防：加强生产人员及使用农药人员地保护措施和安全知识教育3、急性中毒地治疗<1）消除毒物：1）立即把患者移出现场,去除污染衣物2）对皮肤吸收者,用温水和肥皂清洗皮肤3）经口中毒者,抽出胃液和毒物,用1％盐水反复洗胃,给硫酸镁导泻<2）解毒药物：1）阿托品：早期、足量2）胆碱酯酶<ACE）复活药吗啡<morphine）★~P173【药理作用】1、中枢神经系统<三镇一抑制）<1）镇痛作用<2）镇静、致欣快作用<3）镇咳<4）抑制呼吸：吗啡急性中毒致死地主因<5）其它中枢作用2、平滑肌<1）胃肠道平滑肌：升高胃平滑肌张力、减少其蠕动,引起便秘<2）胆道平滑肌：胆囊内压升高,引起上腹不适、胆绞痛<3）其它平滑肌：降低子宫张力可延长产妇分娩时程；提高输尿管平滑肌和膀胱括约肌张力,引起尿潴留3、心血管系统<1）体位性低血压<2）抑制呼吸4、其它：对免疫系统有抑制作用【临床应用】1、镇痛2、心源性哮喘：左心衰竭突发急性肺水肿所致呼吸困难3、止泻【不良反应】1、治疗量可引起眩晕、恶心、呕吐、便秘、尿少、胆绞痛、直立性低血压等2、耐受性及依赖性：长期反复应用易引起3、急性中毒：昏迷、深度呼吸抑制、瞳孔极度缩小试述硝酸酯类和β受体阻断药用于心绞痛地作用？两者在临床上合用地益处？影响心肌耗氧因【硝酸甘油地药理作用】1、降低心肌耗氧量2、扩张冠状动脉,增加缺血区血液灌注3、降低左室充盈压,增加心内膜供血,改善左室顺应性4、保护缺血地心肌细胞减轻缺血损伤【β受体阻断药地药理作用】1、降低心肌耗氧量2、改善缺血区供血3、抑制脂肪分解酶活性,减少心肌游离脂肪酸含量【两者合用地益处】1.可互相取长补短2.合用时用量减少3.副作用也减少4.两类药都可降压,如血压下降过多,冠脉流量减少【影响心肌耗氧因素】1半数有效量<ED50）能引起50％地实验动物出现阳性反应2半数致死量<LD50）能够引起50％实验动物死亡地药物剂量3治疗指数<TI）：LD50/ ED50为LD50和ED50地比值,是药物安全性地指标之一.该值越大越安全.可靠安全系数<CSF）：LD1/ ED99＞1肾上腺素<adrenaine）★~P95【临床应用】1、心脏骤停：一般用心室内注射2、过敏性疾病：<1）过敏性休克：降低毛细血管通透性,减少过敏介质释放,过敏性休克首选药<2）支气管哮喘<3）血管神经性水肿及血清病3、与局麻药配伍及局部止血局部麻醉药地局麻作用及作用机制【局麻作用】1、阻滞神经冲动地产生和传导：<与神经类别、剂量、浓度、刺激强度有关）2、神经阻滞特点：神经直径细快于粗无髓神经阻滞早于有髓神经钝痛—锐痛—冷觉---温觉---触觉---压觉可逆性【作用机制】1、阻滞电压门控性Na+通道,使传导阻滞,产生局麻作用.<与Na+通道内侧结合后,引起Na+通道蛋白构象变化）2、与解离速率、解离常数及体液pH密切相关3、具有频率和电压依赖性常用局麻药普鲁卡因地临床应用及不良反应、利多卡因地临床应用、丁卡因地临床应用及不良反应普鲁卡因：短效酯类1. 粘膜穿透力弱,表麻不用.2.用于浸润麻醉、传导麻醉、腰麻和硬膜外麻醉和局部封闭 +Adr,维持1-2h3.不良反应:毒性反应和变态反应利多卡因：酰胺类1. 作用快、强、持久,局麻时效及毒性与药物浓度有关.2.全能局麻药3.具抗心律失常作用.丁卡因：酯类1. 麻醉强度比普鲁卡因强10倍,可维持2-3h.2. 常用于表面麻醉,不用于浸润麻醉.地西泮地药理作用、机制及临床应用【药理作用及临床应用】1．抗焦虑作用：边缘系统焦虑2．镇静催眠作用：缩短睡眠诱导t,延长睡眠持续t,延长NREM2期,缩短4期3．抗惊厥、抗癫痫作用：促进GABA突触传递功能,癫痫持续状态地首选4．中枢性肌肉松弛作用【作用机制】5促进GABA与GABAA受体结合6增加Cl-通道地开放频率7增强GABA能神经传递功能和突触抑制效应8抗焦虑：杏仁核和海马9镇静催眠：脑干核苯妥英钠地作用机制和临床应用【作用机制】细胞膜地稳定性1.阻断电压依赖性钠通道2.阻断电压依赖性钙通道L、N-Ca 2+通道3.抑制钙调素激酶系统【临床应用】1.抗癫痫：为大发作和局限性发作地首选药2.抗中枢疼痛综合征：三叉N痛,舌咽N痛3.抗心律失常卡马西平地药理作用及临床应用1.强效广谱抗癫痫药2.抗躁狂和抗抑郁3.局限性发作、大发作等首选药4.中枢疼痛综合征苯巴比妥、扑M酮地临床应用乙琥胺地临床应用及不良反应丙戊酸钠地临床应用及不良反应硫酸镁地药理作用及临床应用【药理作用】∙中枢抑制和肌肉松弛∙机制∙特异地竞争Ca2+受点,拮抗Ca2+作用【临床应用】∙各种原因所致地惊厥,尤其是子痫中毒救治∙人工呼吸 / 静脉缓慢注射CaCl2左旋多巴地体内过程、药理作用及临床应用、不良反应【不良反应】1、早期∙胃肠道反应吗丁林∙心血管反应体位性低血压、心律不齐β受体阻断药2、长期∙运动过多症：异常动作舞蹈症,DA过多左旋千金藤啶碱∙开-关反应<ON-OFF）：症状波动,开时活动正常或几近正常,关时突然出现严重地PD症状 L-DOPA/ADCC抑制药 /DA受体激动剂/ MAO抑制药∙精神障碍氯氮平卡比多巴地药理作用及临床应用苯海索地药理作用及临床应用掌握丙M嗪地药理作用及临床应用掌握碳酸锂地药理作用及不良反应体内过程特点：吸收快,显效慢；自肾排泄；安全范围窄解救：立即停药,静滴生理盐水应用：急性躁狂和轻度躁狂症 / 躁狂抑郁症哌替啶地药理作用、临床应用及不良反应喷他佐辛地药理作用及临床应用镇痛作用=1/3吗啡拟精神症状大剂量：加快心率,升高血压非麻醉品慢性疼痛乙酰氨基酚药理作用、临床应用及不良反应布洛芬地药理作用和临床应用掌握钙拮抗药地分类及药名<一）选择性钙拮抗药1．苯烷胺类 phenylalkylamines PAAs：维拉帕M、加洛帕M2．二氢吡啶类 dihydropyridines DHPs：硝苯地平、尼莫地平、氨氯地平3．地尔硫卓类benzothiazepines BTZs:地尔硫卓<二）非选择性钙拮抗药1．氟桂利嗪类,氟桂利嗪、桂利嗪等2．普尼拉明类,普尼拉明3．其他类,哌克昔林等掌握钙拮抗药地药理作用及临床应用【药理作用】1．对心肌地作用<1）负性肌力Ca2+内流↓®“兴奋-收缩脱耦联”®心肌收缩力↓,血管扩张®耗氧量↓.<整体与离体区别？）扩血管→交感↑→收缩力↑抵消<硝苯地平）作用强度： ver<4）＞ dil<2）＞nif<1）<2）负性频率和负性传导Ca2+内流↓®4相自发除极速率↓®窦房结自律↓0相除极↓®房室结传导速度↓®心率↓作用强度： Ver、 dil<5）＞ nif<0～1）室上性心动过速2．对平滑肌地作用(1>松弛血管平滑肌特点：扩小Ａ＞Ｖ→外周阻力↓→后负荷↓。

2022年南京中医药大学临床医学专业《药理学》科目期末试卷A(有答案)

2022年南京中医药大学临床医学专业《药理学》科目期末试卷A(有答案)一、名词解释1、特异质反应（idiosyncrasy）2、一级消除动力学3、利尿药4、人工冬眠5、正性肌力药物6、糖皮质激素抵抗7、二重感染8、MBC9、自体活性物质二、填空题10、我国《药品管理法》等规定的新药是指未曾_______在上市销售的药品，对已上市的_______，_______，_______药均不属于新药。

11、为避免药液流入鼻腔增加吸收而产生不良反应，应用毛果芸香碱滴眼时应_______12、左旋多巴与_________按4：1剂量合用，制成的复方制剂称为_________。

13、伴有脑血管痉挛的高血压病人可选用______；伴消化性溃疡的高血压病人不宜用______；伴有心动过速的高血压病人宜选用______或______14、氨基糖苷类抗生素治疗全身性感染必须采用_______或_______给药，因口服_______15、泻药根据作用机制可分为________、________和________三大类。

三、选择题16、关于药物相互作用说法不正确的是（）A.只在两种或两种以上药物同时应用时出现B.可能表现为药理作用的改变C.有时表现为毒性反应的增强D.可改变药物的体内过程E.机体对药物的反应性改变17、具有膜稳定作用的β受体阻断药是（）A.普萘洛尔B.阿替洛尔C.噻吗洛尔D.纳多洛尔E.艾司洛尔18、不属于肝素适应证的是（）A.心脏瓣膜置换术B.下肢深静脉血栓C.血液透析D.急性肺栓塞E.DIC中期19、子宫兴奋作用最强、最快的药物是（）A.麦角新碱B.麦角胺C.麦角毒D.缩宫素E.垂体后叶素20、以下属于抗肿瘤分子靶向药物的是（）A.吉非替尼B.他莫替芬C.巯嘌呤D.卡铂E.博来霉素21、适用于烧伤创面绿脓杆菌感染的药物是（）A.磺胺醋酰（SA）B.磺胺嘧啶银C.氯霉素D.林可霉素E.利福平22、维生素B6与左旋多巴合用可（）A.增强L-DOPA的副作用B.减少L-DOPA的副作用C.增加左旋多巴的血药浓度D.增强左旋多巴的作用E.抑制多巴胺脱羧酶的活性23、克林霉素（氯林可霉素）可引起下列哪种不良反应（）A.胆汁阻塞性肝炎B.听力下降C.伪膜性肠炎D.肝功能严重损害E.肾功能严重损害24、患者，男，28岁，因车祸右侧股骨开放性骨折入院，行静脉诱导麻醉下骨固定手术。

2022年南京医科大学护理学专业《药理学》科目期末试卷A(有答案)

2022年南京医科大学护理学专业《药理学》科目期末试卷A(有答案)一、填空题1、我国最早的药学著作《_______》.收载_______种药物。

我国第一部由政府颁发的“药典“是《_______》，收我药物《_______》种2、乙酰胆碱可使内脏平滑肌_______，血管平滑肌_______，瞳孔_______。

3、左旋多巴主要用于_________，但对_________所引的帕金森综合征无效。

4、拉贝洛尔可阻断______受体、______受体和______受体。

5、链霉素过敏性休克发生时应立即静脉注射_______和_______。

6、抑制胃酸分泌的药物种类有________、________、________、________。

二、选择题7、有关特异质反应说法正确的是（）A.是一种常见的不良反应B.多数反应比较轻微C.发生与否取决于药物剂量D.通常与遗传变异有关E.是一种免疫反应8、治疗外周血管痉挛性疾病宜选用的药物是（）A.M受体激动药B.N受体激动药C.a受体阻断药D.β受体阻断药E.β受体激动药9、有关尿激酶的叙述，正确的是（）A.由细菌中提取B.直接激活纤溶酶原C.纤溶酶原结合成复合物，激活游离纤溶酶原转变成纤溶酶D.对血栓部位具有选择性E.常见不良反应为出血和过敏10、麦角胺治疗偏头痛的作用机制是（）A.阻断血管平滑肌a受体B.抑制前列腺素合成C.增加脑血流量D.收缩脑血管E.镇痛作用11、阻碍细胞有丝分裂的抗癌药是（）A.丝裂霉素B.氟尿嘧啶C.紫杉醇D.甲氨蝶呤E.顺铂12、TMP的抗菌作用机制是抑制（）A.二氢叶酸还原酶B.过氧化物酶C.二氢蝶酸合酶D.DNA回旋酶E.β-内酰胺酶13、只有透过血脑屏障在脑内变成多巴胺才能产生抗帕金森病作用的药物是（）A.司来吉兰B.苯海索C.金刚烷胺D.左旋多巴E.以上都不是14、大环内酯类抗生素抗菌作用机制是（）A.影响细菌细胞壁的合成B.改变胞浆膜的通透性C.抑制依赖于DNA的RNA多聚酶D.抑制70S始动复合物的形成E.与核蛋白体50S亚基结合，抑制mRNA移位，阻滞肽链延长15、患者，男，31岁，因呼吸困难急诊，有哮喘史。