西医综合(内科学)-试卷4
西医综合真题答案试题库完整
西医综合真题答案——内外科基础部分题目答案（标红部分为纠正内容）一、诊断学57. 下列可导致发绀的疾病中，属于混合性发绀的是C 20 页A. 肺栓塞B. 阻塞性肺气肿C. 心力衰竭D. 亚硝酸盐中毒58. 下列疾病中，可出现杵状指（趾）的是AA. 肝硬化B. 慢性支气管炎C. 肢端肥大症D. 缺铁性贫血59. 女性，32岁，患特发性肺动脉高压，可能出现的体征是BA. 心尖搏动呈抬举样B. 心尖搏动向左侧移位C. 心尖部可闻及收缩期杂音并向左腋下传导D. 心底部第2心音逆分裂女性，24岁。
3周前上感发热，咽痛，1周来乏力、头晕，晨起颜面发胀，继而出现下肢水肿、食欲下降、尿少。
自幼体弱，患有房隔缺损，平素活动尚可。
查体：T37.2摄氏度，P88次/分，BP150/90 mmHg，发育营养稍差，自主体位，双眼睑水肿，颈静脉无怒张，双肺（-），心界不大，心律整，心音正常。
P2>A2，腹软，肝脾未及，下肢凹陷性水肿（+）。
91、该患者水肿最可能的类型是BA. 心源性B. 肾源性C. 肝源性D. 营养不良92、导致该患者水肿最可能的机剂是AA. 钠、水潴留B. 血管通透性增高C. 低蛋白血症D. 静脉压增高二、内科学60. 男性，60 岁，因1 年来反复发生夜间阵发性呼吸困难，2 个月来心悸、气短、不能平卧、尿少、下肢水肿来院，3 年前患广泛前壁心肌梗死。
入院查体：T36.7︒C，P67 次/分，BP120/65 mmHg，半卧位，颈静脉充盈，双肺底均可闻及湿性啰音，心界扩大，心律不整，心率98 次/分，心音强弱不等，肝肋下50px，双下肢凹陷性水肿（++）。
该患者治疗中，不宜选用的药物是 CA. 洋地黄B. 华法林C.β受体拮抗剂D. 血管紧张素转换酶抑制剂见于内科学171 页。
61. 有关高血压急症治疗原则，不正确的是DA. 使用静脉制剂快速降压B.60 分钟内降压幅度不超过25%C.2~6 小时内将血压降至正常水平D. 无临床症状及靶器官损害证据者，可采取口服降压药治疗见于内科学268 页。
湖北省西医综合之内科学考试试卷
湖北省西医综合之内科学考试试卷一、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、下列脂蛋白形成障碍与脂肪肝的形成密切相关的是A．CM B．VLDL C．LDL D．HDL2、关于化脓性关节炎的治疗，下列哪项是错误的A．局部制动B．联合应用大剂量抗生素C．全身支持疗法D．急性期发生病理性脱位，应切开复位3、肾上腺皮质功能减退时可出现A．血容量减少B．血容量增多C．血浆钠浓度升高D．血浆钾浓度降低4、女性，50岁，因便血2个月就诊。
直肠镜检查发现距肛缘4cm的直肠前壁有2cm×2cm肿块，取活检病理检查为直肠乳头状腺癌，最佳的手术方式是A．经肛局部切除术B．骶后径路局部切除术C．腹会阴联合直肠癌根治术D．经腹直肠癌切除、骶前吻合术5、站立过久出现下肢水肿的主要原因是A．下肢静脉扩张B．下肢血流量增大C．下肢淋巴回流受阻D．毛细血管压升高6、下列关于DNA双螺旋结构的叙述，哪一项是正确的A．磷酸核糖在双螺旋外侧，碱基位于内侧B．碱基平面与螺旋轴平行C．遵循碱基配对原则，A与G配对，T与C配对D．两条多聚核苷酸链的走向呈正向平行7、室早夹在两个窦性心搏之间，其后无代偿间歇时称为__A．插入型室早B．偶发室早C．多源性室早D．RonT室早E．频发室早8、下列哪项是诱发心力衰竭的最重要因素?A．感染性心内膜炎B．摄入钠盐过多C．心房纤颤D．过度体力劳累9、关于胃十二指肠溃疡穿孔的叙述哪项是正确的?A．胃溃疡穿孔多见于老年男性B．包裹性穿孔同样形成侵蚀胃或十二指肠壁全层的溃疡孔洞C．胃溃疡穿孔多发生于胃窦部D．十二指肠溃疡多发生于球部后壁10、急进性肾小球肾炎的主要病理变化是A．内皮细胞增生B．脏层上皮细胞增生C．壁层上皮细胞增生D．系膜细胞增生11、诊断膀胱破裂最简便的方法是A．腹腔穿刺B．膀胱造影C．导尿并作注水试验D．膀胱镜检查12、机体能量代谢率最低的状态是A．基础条件下B．熟睡状态C．室温为20～25℃D．进食12小时后13、男性，43岁，上腹部疼痛10余天，近日加重，内镜和钡餐透视证实为十二指肠后壁溃疡，行手术治疗的恰当术式应是A．胃空肠吻合术B．毕Ⅰ式胃大部切除术C．毕Ⅱ式胃大部切除术D．溃疡切除术14、以下哪一项描述不符合硅肺的病变特点A．Ⅰ期硅肺以淋巴结内引起硅结节为特点B．硅结节可融合成团C．胸膜可有纤维组织增生、肥厚D．易合并恶性胸膜间皮瘤15、引起肺回缩的主要因素是__A．胸膜腔的耦联作用B．胸内负压C．肺泡表面张力D．支气管平滑肌收缩E．胸廓弹性组织的回缩力16、急性有机磷中毒的下列临床表现中，能提示中度中毒的是A．出汗、流涎B．呕吐、腹泻C．胸背部肌肉颤动D．瞳孔缩小17、不伴有细胞增生的肥大器官常是A．乳腺B．肾C．前列腺D．心脏18、关于钙通道拮抗剂治疗心绞痛的主要机制，下列哪项不正确?A．抑制心肌收缩，减少心肌氧耗B．减慢心率，减少心肌作功C．降低血液黏度，抗血小板聚集D．解除冠状动脉痉挛，改善心内膜下心肌的供血19、胸膜摩擦音的特点是A．吸气相和呼气相均可听到B．出现胸水时摩擦音增强C．摩擦音在肩胛下角区最易听到D．屏住呼吸更易听到E．摩擦音出现时胸痛减轻20、关于门脉高压症，哪项叙述是错误的A．脾大，脾功能亢进，消化道出血和腹水是主要临床表现B．脾功能亢进时都有血细胞减少，以白细胞和血小板改变明显C．外科治疗的主要目的是制止食管胃底静脉曲张破裂所致的大出血D．分流手术主要是阻断门奇静脉间的反常血流E．腹腔-静脉转流术可治疗肝硬化引起的顽固性腹水21、细胞内液与组织液具有相同的A．Na+浓度B．K+浓度C．胶体渗透压D．总渗透压22、正常人血液酸碱度(pH)的参考值为A．7．2～7．3B．7．25～7．35C．7．35～7．45D．7．45～7．5E．7．45～7．5523、在诊治疾病过程中，下列哪项不属于诊断学的基本内容__A．询问病史B．体格检查C．心电图测试D．药物治疗E．尿常规检测24、男性，36岁，12小时前工作中突然出现右上腹痛，继之出现豆油色尿，半小时前出现上腹痛向腰背部放射，俯首弯腰可减轻腹痛，血压120/80mmHg，呼吸18次/分。
上海2017年上半年西医综合之内科学试题
上海2021年上半年西医综合之内科学试题一、单项选择题〔共26 题，每题的备选项中，只有 1 个事最符合题意〕1、关于甲状腺生理解剖的表达，正确的选项是A．甲状腺上动脉来源于锁骨下动脉B．甲状腺中动脉来源于颈外动脉C．甲状腺下静脉回流至无名静脉D．甲状腺的淋巴液回流至颈浅淋巴结2、关于术后病人早期活动的优点，以下说法不恰当的是__A．增加肺活量，减少肺部并发症B．减少下肢静脉淤血及血栓C．有利于肠道功能恢复、减少腹胀D．有利于减少切口感染E．有利于膀胱功能的恢复、减少尿潴留3、女，45岁，经检查诊断为急性胆囊炎，胆石症并发梗阻性化脓性胆管炎，病人血压偏低，躁动不安，最好的处理是A．短时期的术前准备行胆总管探查引流术B．快速输液纠正水，电解质失衡，等待休克恢复C．立即给镇静剂，输液，给升压药及大剂量抗生素保守治疗D．即行胆囊切除术及胆总管切开探查术4、梨形心最常见于以下何种疾病A．心脏压塞B．冠状动脉粥样硬化性心脏病C．二尖瓣狭窄D．肥厚性心肌病E．主动脉瓣关闭不全5、结核性腹膜炎发生肠瘘多见于A．渗出型B．粘连型C．干酪型D．混合型6、Crolm病与肠结核最重要的鉴别在于A．有无发热、消瘦、乏力B．有无肠外结核C．肉芽肿有无干酪样坏死D．痫程的长短7、胸膜下界在锁骨中线处相交于__A．第6肋B．第8肋C．第10肋D．第9肋E．以上都不正确8、尿路感染诊断的最重要依据是A．腰痛和肾区叩击痛B．有尿痛、尿频、尿急病症C．有真性细菌尿D．有白细胞尿9、以下选项中，支持肾缺血性急性肾衰竭的实验室检查指标是A．尿渗透压＞500mmol/L B．尿钠浓度＞20mmol/L C．尿比重＞1.018 D．血尿素氮/血肌酐＞2010、5′-ATCGTACGGCTA-3′为一结构基因的有意义链，其转录产物为A．5′-TAGCCTACGAT-3′B．5′-TAGCATGCCGAT-3′C．5′-UAGCAUGCCGAU-3′D．5′-AUCGUACGGCUA-3′11、下述哪一项不符合矽肺的病理变化A．易并发肺结核B．可引起肺间质纤维化C．早期矽结节在肺实质内D．矽结节中央可发生坏死E．矽结节由呈同心环状胶原纤维组成12、男，50岁，急性肠梗阻2天。
海南省西医综合之内科学考试试卷
海南省西医综合之内科学考试试卷一、单项选择题（共27题，每题的备选项中，只有 1 个事最符合题意）1、关于电突触，下列叙述中错误的是A．与化学性突触比较，突触间隙狭窄B．也称为缝隙连接C．突触延搁较短D．通常为单向传递2、治疗弥散性血管内凝血时，监测肝素用量的试验是A．血小板计数B．3P试验C．出血时间D．APTT(活化的部分凝血活酶时间)3、属于生理性萎缩的是A．垂体坏死引起的乳腺萎缩B．青年男性睾丸生精细胞大量减少C．小儿麻痹引起的下肢萎缩D．青春期胸腺萎缩4、骨髓穿刺取材满意的指标哪项不符合A．可见骨髓小粒B．可见脂肪滴C．穿刺抽取骨髓液时病人有锐痛感D．可见浆细胞、网状细胞、组织嗜碱细胞等E．骨髓杆状核粒细胞/分叶核粒细胞≤外周血杆状核粒细胞/分叶核粒细胞5、真核生物中经RNA聚合酶Ⅲ催化转录的产物有A．mRNA B．tRNA C．5.8S-rRNA D．18S-rRNA6、体内合成胆碱和乙醇胺的原料是A．Met B．SAM C．Ser D．Gly7、门静脉高压症引起肝性脑病的原因是A．肝血流灌注不足B．氨直接进入体循环C．胃肠道大量出血D．血浆胶体渗透压降低8、关于淋巴回流的生理意义，下列哪一项是错误的?A．回收蛋白质B．运输吸收的脂肪C．回收部分组织液D．清除细菌E．调节血管内外的水分交换9、肿瘤的异型性主要反映了肿瘤的A．组织起源B．组织代谢异常C．生长速度D．细胞分化程度10、正常人血浆的pH值为A．6．35～6．45B．6．50～7．05C．7．10～7．30D．7．35～7．45E．7．50～7．6511、肾绞痛伴镜下血尿，进一步检查首选A．膀胱镜检查B．IVP C．KUB D．CT或MRI12、在一般情况下，收缩压的高低主要反映下列哪一项的变化A．外周阻力B．循环血量C．心脏每搏输出量D．主动脉管壁弹性13、不会使粪便化学法隐血试验出现假阳性的物质是A．铁剂B．铋剂C．维生素CD．动物血E．食物鱼肉14、胸腔积液病人，常采取的体位是A．健侧卧位B．患侧卧位C．自动体位D．端坐位E．被动体位15、输血后出现非溶血性发热反应最常见的原因是A．污染B．感染C．血液凝集D．致热源E．过敏反应16、关于肝性昏迷的处理，下列哪一项是错误的A．终止蛋白质饮食B．用肥皂水灌肠C．新霉素保留灌肠D．用冰帽降低颅内温度E．谷氨酸钾静滴17、丙二酸对于琥珀酸脱氢酶的影响属于A．反馈抑制B．底物抑制C．竞争性抑制D．非竞争性抑制E．别构调节18、男性，60岁。
西医综合考试真题及参考答案
西医综合考试真题及参考答案一、A型题：1～90小题，每题分；91～120小题，每题2分：共195分。
在每题给出的A、B、C、D四个选项中，请选出一项最符合题目要求的答案。
1 、人体功能维持相对稳固依托的调控系统是 BA、非自主操纵系统B 、负反馈操纵系统C 、正反馈操纵系统D 、前馈操纵系统2 、神经细胞膜上的Na泵活动受抑制时，可致使的转变是：CA、静息电位绝对值减小，动作电位幅度增大B、静息电位绝对值增大，动作电位幅度减小C、静息电位绝对值和动作电位幅度均减小D、静息电位绝对值和动作电位均增大3 、在神经--骨骼肌接头完成信息传递后，能排除接头处神经递质的酶是 BA、Na+-K+-ATP酶B、乙酰胆碱酯酶C、腺苷酸环化酶D、磷酸二酯酶4 、维持血浆平稳最要紧的缓冲对是 BA、Na2HPO4/NaH2PO4B、NaHCO3/H2CO3C、K2HPO4/K2PO4D、KHCO3/H2CO3五、凝血因子Ⅱ、Ⅶ、Ⅸ、Ⅹ在肝脏合成依托依托于 DA、维生素AB、维生素CC、维生素DD、维生素K六、心房和心室收缩在时刻上不重叠，后者必然落在前者完毕后的缘故是 CA、窦房结到心房距离近，而心室距离远B、心房传导速度快，心室肌传导速度慢C 、心房交壤处传导速度慢而形成房室延搁D、窦房结别离通过不同传导通路抵达心房和心室7、若是血管外周阻力不变，心脏每搏输出量增大，那么血压转变是 CA、收缩压不变，舒张压升高B、收缩压升高，舒张压不变C、收缩压升高比舒张压升高更明显D、舒张压升高比收缩压升高更明显八、某人潮气量为500ml，无效腔容积为150ML,功能残气量是2500ml，那么这人每次安静呼吸时肺泡更新气体量为：BA 、1/10B、 1/7C、 1/5D、1/39 、低氧时期呼吸活动增强的作用机制是 DA、刺激延髓呼吸中枢B、刺激脑桥呼吸调整中枢C、刺激中枢化学感受器D、兴奋外周化学感受器刺激脑桥10、胃大部切除的患者易患贫血的缘故是 AA、壁细胞数量减少，内因子分泌减少B、壁细胞数量减少，胃酸分泌减少C、主细胞分泌减少，蛋白酶原分泌减少D、胃容积减少，贮存食物量减少1一、胆汁中与消化有关的成份是 BA、消化酶B、胆盐C、卵磷脂D、胆固醇1二、安静状态下，人体产热量最高的脏器或组织是 CA、心脏B、脑C、肝脏D、肾脏13、循环系统实现体温调剂的要紧途径是 CA、增加心输出量B、调剂血液温度C、调剂皮肤血流量D、操纵血流速度14、葡萄糖几乎全数重吸收的要紧部位是 AA、近端小管B、髓袢降支C、髓袢升支粗段D、远曲小管和集合管1五、大量饮水后，尿量增多的要紧缘故是 CA、肾血流量增加B、醛固酮分泌减少C、抗利尿激素分泌减小D、血浆胶体渗透压降低1六、视网膜中央凹外对光灵敏性明显提高的要紧缘故是：DA、感光细胞密度大B、感光细胞兴奋性高C、感光细胞中感光色素含量高D、传入通路的汇聚程度小17、听觉器官的感应装换装置——螺旋体所在的部位是 CA、盖膜B、卵圆窗膜C、基底膜D、前庭膜1八、以下化学性突触传递特点表达正确的选项是 DA、双向传播B、不衰减传播C、兴奋节律不变D、对内环境转变灵敏1九、脑干结构当中网状上行激活系统的要紧功能 CA、形成模糊的感觉B、激发情绪生理反映C 、起上行唤醒作用D、维持躯体姿势的平稳20、生长激素增多的患者可显现 BA、尿氮含量增加B、血糖升高乃至显现尿糖C 、血中脂肪酸含量降低D、血中氨基酸含量降低2一、正常成年人调剂血中钙磷的激素是 BA 、皮质醇B 、甲状旁腺激素C、生长激素D 、甲状腺激素2二、以下那种激素能在排卵前一天左右诱发排卵所需的LH增高的激素是 AA 、雌二醇B 、孕酮C、卵泡刺激素D、雄激素23、安静呼吸时，吸气的阻力要紧来源于 AA、肺泡液气表面张力B 、肺的弹性回缩力C、胸廓弹性阻力D、气道阻力24 、血浆渗透压的高低要紧决定于 CA 、血浆蛋白总量B、白蛋白含量C、氯化钠浓度D、氯化钾浓度2五、在蛋白质的组成中，不含天然的氨基酸是 BA、精氨酸B、瓜氨酸C、半胱氨酸D、脯氨酸2六、蛋白质变性后的要紧表现是 CA、分子量变小B、粘度降低C、溶解度降低D 、不易被蛋白酶水解27以下DNA分子中，能够使Tm值达到最高的是：AA、腺嘌呤和胸腺嘧啶含量为20%B 、腺嘌呤和胸腺嘧啶含量为60%C 、鸟嘌呤和胞嘧啶含量为30%D、鸟嘌呤和胞嘧啶含量为50%2八、以下关于辅酶与辅基表达错误的选项是 DA、属于结合酶类的酶分子组成中才含有辅基或辅酶B、维生素B族多参与辅酶或辅基的组成C、辅酶或辅基直接参与酶促反映D、一种辅酶或辅基只能与一种酶蛋白结合成一种全酶2九、草酰乙酸不能直接转变生成的物质是 AA 乙酰乙酸B 柠檬酸C 天冬氨酸D 苹果酸30、乙酰COA羧化酶的变构激活剂是 BA、AMPB、柠檬酸C、ADPD、2,6-二磷酸果糖3一、以下氨基酸中，属于生糖兼生酮的是 DA、亮氨酸B、组氨酸C、赖氨酸D、苏氨酸3二、以下物质中，不属于高能化合物的是 CA 、二磷酸腺苷B、乙酰CoAC、3-磷酸甘油酸D、磷酸肌酸33、以下核苷酸经核糖核苷酸还原酶催化能转化生成脱氧核苷酸的是 BA、NMPB、NDPC、NTPD、dNTP34、以下关于逆转录酶的表达，正确的选项是 DA 以mRNA为模板催化合成RNA的酶B 其催化合成的方向是3——5C 催化合成时需要先合成冈崎片段D 此酶具有RNase活性3五、真核生物RNA聚合酶II催化转录后的产物是 BA tRNAB hnRNACD 5S-rRNA3六、对真核和原核生物反映进程均有干扰作用，故能用作抗菌药物的是 DA、四环素B、链霉素C、卡那霉素D、嘌呤霉素37、一个tRNA的反密码为5’UGC3’,它可识别的密码是 AA、5’GCA3’B、5’ACG3’C、5’GCU3’D、5’GGC3’3八、基因表达调控的大体操纵点是 BA、MRNA从细胞核转移到细胞质B、转录的起始C、转录后加工D、蛋白质翻译及翻译后加工3九、以下选项中不属于重组DNA的工具酶的是 AA、拓扑异构酶B、DNA连接酶C、逆转录酶D、限制性核酸内切酶40、血浆中能够转运胆红素和磺胺的蛋白质是 AA、清蛋白B、运铁蛋白C、铜蓝蛋白D、纤维蛋白4一、以下选项中，不符合萎缩特点的是 DA 自噬小体增多B 器官均匀性缩小C 器官功能降低D 细胞核固缩4二、以下选项中属于稳固细胞的是 CA 表皮细胞B 消化道黏膜被覆上皮细胞C 肾小管上皮细胞D 神经细胞43、维生素C缺乏常致使创伤愈合不良的要紧缘故是 BA、表皮再生困难B、难以形成前胶原分子C、炎症难以操纵D、局部神经营养不良44、溶酶体内显现弥散散布的，在胞浆内存在大量含铁血黄素的颗粒的巨噬细胞最多见于 DA、大叶性肺炎B、小叶性肺炎C、间质性肺炎D、左心衰4五、血栓形成最要紧的因素是 CA、血管内血流缓慢B、血流轴流消失C 、内皮细胞损伤D 、血小板增加4六、假膜性炎是发生于 BA、黏膜的化脓性炎B、黏膜的纤维素性炎C、黏膜的出血性炎D、黏膜的浆液性炎47、肿瘤的分级是指：DA、肿瘤的大小B、肿瘤的侵润范围C、肿瘤是不是累计淋巴结D、肿瘤的分化程度48 、中性粒细胞浸出过少的大叶性肺炎引发的 AA、肺实质变B、肺脓肿C、脓胸D、败血症4九、肺癌中恶性程度最高的是 DA、鳞癌B、腺癌C、细支气管肺泡细胞癌D、小细胞癌50、急性一般型肝炎的典型病变是 AA、肝细胞普遍水样变性伴点状坏死B、肝细胞普遍脂肪变性伴点状坏死C、肝细胞普遍水样变性伴桥接坏死D、肝细胞普遍脂肪变性伴碎片坏死5一、快速进行性肾小球肾炎要紧增生的细胞是 DA、内皮细胞B、系膜细胞C、脏层上皮细胞D、壁层上皮细胞5二、乳腺浸润性小叶癌的要紧病理学特点是 CA、癌细胞呈巢形散布B、间质中有大量淋巴细胞浸润C 、癌细胞呈单排散布D、间质中有特点性淀粉样物质沉积53 、乙型脑炎的特点性病变是 BA 、血管淋巴套形成B、软化灶形成C、胶质细胞增生D、卫星现象54、易发生贫血性梗死的脏器是 AA、脾心肾B、脾心肺C、肾心肺D、心脑肠5五、风湿病时，心内膜疣状赘生物属于 AA 、白色血栓B、红色血栓C、混合血栓D 、透明血栓5六、以下肝硬化的病变中符合假小叶的是 CA 、肉眼下肝内大小不等的结节B 、再生的肝细胞所形成的结节C、普遍增生的纤维组织包绕的肝细胞结节D、异型增生肝细胞所形成的结节57、猛烈呕吐后，患者呕出鲜血的最多见病因是 DA、消化性溃疡B、食管裂孔疝C、急性胃炎D、Mallory-Weiss综合征5八、患者显现进行性呼吸困难，吸气时双肺中下野可闻及VELO啰音，最可能是诊断是 CA、肺癌B、肺结核C、特发性肺纤维化D、肺大泡5九、以下关于心力衰竭医治的表达正确的选项是 DA、为保证休息，心衰患者应常规服用镇定剂B、每日钠摄入量应操纵在3-5g之间C、在应用利尿剂时，没必要操纵钠的摄入D、严格限制钠摄入时，可没必要严格操纵液体入量60、慢性心房哆嗦应用洋地黄的要紧目的是 AA 、操纵心室率B、转复房颤律C、预防室性心率失常D、为实施电转复做预备6一、患者,男、58岁，因疲劳后突发心悸，呼吸困难，咳嗽、咳泡沫血痰而来院就医，既往高血压病、心肌梗死史,查体：HP 90/60mlHg，端坐位，喘息状。
西医综合(内科学)-试卷42
西医综合（内科学）-试卷42(总分：114.00，做题时间：90分钟)一、 A1型题(总题数：33，分数：66.00)1.慢性支气管炎最突出的病理变化是A.支气管平滑肌痉挛B.支气管黏膜腺体增生、肥大、分泌亢进√C.支气管黏膜充血水肿D.支气管平滑肌及弹性纤维破坏2.慢性支气管炎所致阻塞性肺气肿多为A.小叶中央型√B.全小叶型C.混合型D.旁间隔型3.目前确诊COPD最可靠的检查手段是A.胸部高分辨CTB.血气分析C.肺功能√D.肺通气-灌注扫描4.男性，55岁。
反复咳嗽并有吸烟史10年，冬春季咳嗽加重。
体查：双肺呼吸音稍减低，右下肺可闻少量湿性啰音。
胸片示肺纹理增多。
肺功能检查残气量占肺总量的25％，1秒率为55％。
最可能的诊断是A.肺纤维化B.慢性支气管炎并肺部感染√C.阻塞性肺气肿D.肺不张5.诊断早期肺源性心脏病的主要依据是A.慢性肺部疾病史B.肺气肿体征C.右心功能不全体征D.肺动脉高压症√6.肺心病呼吸衰竭急性加重期治疗的关键是A.增加饮食中碳水化合物含量B.及时使用强心剂C.适量利尿剂D.控制呼吸道感染，改善呼吸功能√7.女性，60岁，慢性肺心病顽同性心力衰竭，经综合治疗及强心利尿效果不佳，应进一步采取的措施是A.应用血管扩张剂√B.人工呼吸机C.给予激素D.高压氧治疗8.支气管哮喘的肺功能异常主要表现在A.肺活量减少B.最大通气量增加C.第一秒钟用力呼气容积减少√D.弥散量下降9.支气管舒张试验阳性患者其吸入支气管舒张剂后FEV 1改善率增加A.5％B.10％C.15％√D.20％10.支气管哮喘患者伴阵发性室上性心动过速时，可用下列哪种药物治疗A.普萘洛尔(心得安)B.阿替洛尔(胺酰心安)C.新斯的明D.洋地黄√11.男性，25岁，2天前不明原因出现干咳、胸闷，继之明显喘憋。
给予静滴青霉素治疗无效。
近3年来，患者常于秋季出现发作性咳嗽、气短。
查体：端坐呼吸，呼吸急促，皮肤黏膜轻度发绀，双肺呼吸音减低，散在哮鸣音，心界不大，脉搏120次／分，无杂音，有奇脉。
【精品医学】西医综合(内科学)-试卷4
A．支气管扩张 B．肺脓肿 C．慢性支气管炎伴发肺气肿 D．肺癌 E．支气管哮喘（分数：6.00） (1).慢性咳嗽、咳痰、气短 8 年余，并进行性加重（分数：2.00）
A. B. C. √ D. E. 解析： (2).发作性咳嗽、呼吸困难、伴有哮鸣音（分数：2.00） A. B. C. D. E. √ 解析：
精 品 医 学 试
卷
西医综合（内科学）-试卷 4
(总分：66.00，做题时间：90 分钟)
一、 A1 型题(总题数：14，分数：28.00)
1.肺结核合并肺外结核治疗的疗程至少需 （分数：2.00）
A.9 个月 B.12 个月 C.18 个月 √ D.24 个月 解析： 2.需常规加用激素治疗的结核病有 （分数：2.00） A.支气管淋巴结结核 B.继发性肺结核 C.结核性脑膜炎 √ D.肾结核 解析： 3.肺结核化疗方案中应警惕肾功能损害的是 （分数：2.00） A.异烟肼、链霉素、吡嗪酰胺 √ B.异烟肼、利福平、乙胺丁醇 C.异烟肼、吡嗪酰胺、利福平、乙胺丁醇 D.异烟肼、吡嗪酰胺、利福平 解析： 4.结核预防性化疗适用于 （分数：2.00） A.涂阳肺结核患者的密切接触者 B.HIV 感染者 C.肺部硬结、纤维病灶(无活动性) 皮试强阳性者 √ 解析： 5.男性患者，60 岁，患糖尿病 10 年，近 1 年血糖控制不佳，并出现明显乏力，食欲不振，消瘦，该患者可能出 现的新问题为 （分数：2.00） A.糖尿病酮症 酸中毒 B.糖尿病加重
A. B. √ C. D. E. 解析： (2).肺炎球菌肺炎（分数：2.00） A. B. C. D. √ E. 解析： (3).支气管扩张（分数：2.00） A. √ B. C. D. E. 解析： (4).肺结核（分数：2.00） A. B. C. D. E. √ 解析： A．胸片示片状致密影，呈肺叶或肺段分布 B．胸片示薄壁空洞，病灶周围可见卫星灶 C．胸片示肺纹理增粗， 紊乱，有蜂窝状和卷发样阴影 D．侧位胸片示叶间梭形密度增高影 E．胸片示肺动脉段突出，右下肺动脉干横径 ≥16mm（分数：6.00） (1).肺结核（分数：2.00） A. B. √ C. D.
海南省西医综合之内科学考试试题
海南省西医综合之内科学考试试题一、单项选择题（共27题，每题的备选项中，只有 1 个事最符合题意）1、成人24小时尿量超过多少毫升，而血尿素氮、肌酐呈进行性增高，则称作非少尿性急性肾功衰竭A．400ml B．500ml C．800ml D．1000ml2、男性，17岁，右大腿下端肿痛3个月，X线摄片报告：右股骨下端骨肉瘤，下一步处理是A．立即行高位截肢B．先作活检，根据病理报告决定处理C．摄胸片D．准备截肢，术时先作活检，快速切片决定是否截肢3、男，56岁，双眼球突出3个月余，夜间闭目困难，流泪，畏光，2周来复视，T3、T4正常，最可能的诊断是A．Graves病B．眶后肿瘤C．甲状腺功能正常的Graves眼病D．颅内占位病变4、胸廓弹性阻力为0的呼吸时相是A．深吸气时B．平静呼气中C．平静吸气中D．平静吸气末5、脊髓后索受损时A．闭眼能确定关节的位置B．闭眼能指鼻准确C．闭眼能维持身体直立不摇晃D．受损的对侧有痛觉障碍E．闭眼不能确定各关节的位置6、戴无菌手套时，只允许没戴手套的手接触A．手套的掌侧B．手套的背侧C．手套的手指部D．手套套口向外翻折部的外面7、肠扭转发生的原因是A．肠袢及系膜过长B．肠内容物重量骤增C．突然改变体位D．肠管动力异常8、恶性肿瘤的诊断中，准确性最高的是__A．症状与体征B．肿瘤标志物检查C．X线检查D．磁共振成像检查E．病理检查9、肉芽组织和肉芽肿的区别点在于A．是否为慢性炎症B．是否导致局部纤维化C．是否由急性转化而来D．组成成分不同10、能促进支持细胞分泌抑制素的激素是A．LH B．ACTH C．TSH D．FSH11、下述哪一项不是Crohn病的特征性表现A．病变可发生于全消化道B．病变肠段呈连续性分布C．X线检查回肠末端出现“线样征”D．病变肠段有非干酪型肉芽肿12、能引起生物机体发生反应的各种环境变化，统称为A．反射B．兴奋C．刺激D．反映E．兴奋性13、急性肾小球肾炎引起少尿的主要原因是A．血浆胶体渗透压升高B．囊内压升高C．滤过膜通透性增大D．肾小球滤过总面积减小14、正常人的血压是由下列哪项活动维持稳定的?A．压力感受性反射B．化学感受性反射C．脑缺血反应D．体液调节15、下列关于管家基因的叙述，确切的是A．在生物个体生长的某一个阶段的所有细胞中持续表达B．在生物个体各个生长阶段的几乎所有细胞中持续表达C．在生物个体整个生命过程的部分细胞中持续表达D．在特定环境下的生物个体的所有细胞中持续表达16、AIDS病人肺结核病的特点不包括A．病灶很少位于肺尖部B．空洞常见C．纵隔淋巴结结核常见D．肺外结核常见17、对顽固的胃溃疡病首选的手术方式是A．胃大部切除术B．迷走神经干切断术C．选择性迷走神经切断术D．高选择性迷走神经切断术18、对早期食管癌，简单易行的确诊方法是A．X线钡餐检查B．食管镜检查C．带网气囊食管脱落细胞检查D．CT19、不是急性感染性心内膜炎瓣膜赘生物的特点是A．有多量嗜中性粒细胞B．有坏死组织C．有细菌菌落D．有大量肉芽组织20、关于房性心动过速的心电图表现，不正确的是A．心房率通常为150～200次/分B．常出现二度Ⅰ型或Ⅱ型房室传导阻滞C．P波之间的等电位线存在D．刺激迷走神经可终止心动过速21、组织兴奋后处于绝对不应期时，其兴奋性为A．零B．无限大C．大于正常D．小于正常22、下列关于胆管癌的描述，哪项正确A．下段发病率最高B．病理组织大多是腺鳞癌C．癌肿生长缓慢，极少发生远处转移D．放射治疗敏感23、组织兴奋性高低常用的指标是A．刺激的频率B．刺激的强度与时间变化率C．刺激作用时间D．阈强度24、关于耳蜗声波频率分析的行波学说，错误的叙述是A．不同频率的声波引起的行波均从基底膜底部开始B．声波频率愈低，行波的传播距离愈远C．行波的起点与终点之间有一个振幅最大的部位D．高频声波的最大行波振幅出现在蜗顶部附近25、由dUMP转变成dTMP的甲基化反应中，甲基供给体是A．S-腺苷蛋氨酸B．S-腺苷同型半胱氨酸C．N5，N10-甲烯四氢叶酸D．N5-甲烯四氢叶酸26、下列选项中，属于转移性钙化的是A．结核病灶钙化B．肺间质钙化C．粥瘤钙化D．血栓钙化27、起源于T细胞的淋巴瘤是A．套细胞淋巴瘤B．Burkitt淋巴瘤C．蕈样霉菌病D．滤泡性淋巴瘤28、下列选项中，出入肺门的是A．气管B．主支气管C．肺叶支气管D．气管杈E．段支气管二、多项选择题（共27题，每题的备选项中，有 2 个或 2 个以上符合题意，至少有1 个错项。
2024西医综合真题及解析完整版.pptx
C.坏死 D.附亡 解析：脂褐素多见于老年人及一些校性消耗性疾病患者的心、肝和肾细胞内.同时也可见于正常人的附睾上皮细 胞、黎丸间质细胞和神经细胞的胞浆中.留意与含铁血黄素相鉴别. 42、虎我心的组织学变更是：C A.心肌纤维间大量淋巴细胞浸涧 B,心肌纤济间出现曲肪沉枳 C.心肌细胞中出现曲腐沉枳 D.心肌细恂中出现透亮蛋白小体 解析：慢性酒精中毒或缺乳,可引起心肌脂肪变.常累及左心室内染下和乳头肌部位.脂肪变心肌呈黄色，马正附 心肌的暗红色相间，形成黄红色旗纹,称为虎如心。 43、在下列坏死中有特征性朽史形成的是：D A.凝固性坏死 B.液化性坏死 C.干酪性坏死
C.-C D.淋巴给 解析：血普外破环红细胤的主要场所是肿脏.今年考的是红细胞血管外灭活的主要场所，次要场所足骨腾.
5、血凝块回缗的缘由是：D A.血凝块纤维蛋白收缩 B.红细胞登连而压缩 C.白细胞变形运动 D.血小板的收缩 解折：此题是2024年真题.2024年答案是B,今年只是把答案的依次换了一下. 6、Rh血型的主要抗体是：C A.IgA
B.(IUMP的甲地化 C.腺吟核甘酸的从头合成 D.黄嗓岭就化筋催化的作用 解析：抑制物的抑制机理毡上课反究讲过的内容.谷基陈胺类似物是氮杂丝氨酸，可以抑制往底物上加策的反应 。dUMP的甲基化须要一碳的f；3甲纹蝶吟可以抑制：抑制黄嗓吟就化质伟化作用的是别嚏吟醉. 33、下列反应中原于丽化学修饰的是：C A.强酸使的变性失活 B.M入辅曲使命具有活性 C.肽链苏氨酸妓基陵酸化 D.小分子物质使陆构象变更 解析：«酸化修饰是陆化学修饰的最常见形式，书上带“用”字的都要无点驾驭， 34、式核生物DNA亚制的主要而是：C DNA聚合种β DNA聚合的γ DNA聚合酹δ
1.0 解析：此例是一个简洁的计。遨。通气/血流比值是指每分件肺泡通气状和每分铮肺m流信之间的比做，正常成 年人宇船时约为0.84.那我们通过一个简洁的计算:(70∞-100X20)/5000=1,所以通气/血流比值等于1.0. Ih关于Hb和0：结合的叙述，错误的是：D A∙Hb的4个亚基间有协同作用 1个分子Hb最多结合4分子。? Hb和6的结合和解息曲线呈S形
甘肃省西医综合之内科学考试题
甘肃省西医综合之内科学考试题一、单项选择题（每题的备选项中，只有 1 个事最符合题意）1、天冬氨酸分解为CO2、H2O和NH3时可净生成ATF，摩尔数为A．10 B．15 C．18 D．142、正常人体内环境的理化特性经常保持状态A．固定不变B．绝对平衡C．随机多变D．相对恒定3、肾上腺皮质功能低下时可出现A．血容量减少B．血浆Na+浓度升高C．血浆K+浓度降低D．血压升高4、腹股沟斜疝发生嵌顿的主要原因是A．疝环小，疝内容物有粘连B．疝环小，腹内压骤然增加C．疝环大、疝内容物脱出较多D．腹壁肌肉紧张收缩内环5、女性，47岁，胆囊结石病史4年，曾先后发作性胆绞痛4次，BUS显示胆囊内充满型结石。
首选的治疗方法是下列哪一种A．胆囊切除术B．口服熊去氧胆酸片C．口服利胆素片D．口服排石饮液6、原核生物中具有GTP酶活性的翻译起始因子是A．IFl B．IF2 C．IF3 D．elF27、女性，28岁，发作性呼气性呼吸困难2h入院，既往支气管哮喘病史5年余。
查体：双肺布满哮鸣音，心率110次/分，无杂音，最适宜的治疗是A．静脉滴注抗生素B．静脉滴注糖皮质激素C．吸氧D．静脉滴注氨茶碱8、阵发性室上性心动过速治疗时抗心律失常药物首选__A．苯妥英钠B．静脉注射腺苷C．西地兰D．奎尼丁E．β受体阻滞剂9、急进性肾小球肾炎的主要病理变化是A．内皮细胞增生B．脏层上皮细胞增生C．壁层上皮细胞增生D．系膜细胞增生10、无尿期后如出现多尿期，24小时尿量增加至A．200mL以上B．240mL以上C．300mL以上D．350mL以上E．400mL以上11、尿沉渣计数(Addis计数)中管型的参考值为A．12、下列选项中，符合前体B细胞淋巴母细胞白血病/淋巴瘤的叙述是A．老年患者多见B．95%TdT阳性C．白细胞计数超过100×109/LD．Bcl-2蛋白过度表达13、患者女性，16岁，因低热、乏力、盗汗、咳嗽、痰中带血，拟诊肺结核，为早期诊断应做__A．x线检查B．血常规C．结核菌素试验D．血沉E．痰细菌培养14、对肾病综合征患者预防性抗凝治疗的指征是A．血浆白蛋白＜20g/L B．血浆白蛋白＜25g/L C．凝血酶原时间INR＜1 D．血清总脂＞7g/L15、容量血管指的是__A．大动脉B．微动脉C．肺动脉D．微静脉E．静脉16、肺炎球菌肺炎患者，在抗生素治疗下热退又再发热，白细胞增高，应考虑是A．抗生素剂量不够B．细菌产生耐药性C．出现并发症D．没有配用退热剂E．机体反应性差17、判断组织兴奋性高低常用的指标是A．阈电位B．时值C．阈强度D．刺激强度相对时间的变化率E．刺激的频率18、嘌呤环中第四位和第五位碳原子来自A．甘氨酸B．一碳单位C．天冬氨酸D．谷氨酰胺19、酶Km值的大小所代表的含义是：A．酶对底物的亲和力B．最适的酶浓度C．酶促反映的速度D．酶抑制剂的类型20、关于输血的适应证，下面哪项是错误的A．大出血时补充血容量B．纠正贫血或低蛋白血症C．增加营养和供应能量D．凝血异常补充各种凝血因子21、在延髓腹外侧浅表部位，本身无化学感受性但受损后化学感受性反射将不能进行的区域是A．头区B．中区C．外区D．尾区22、下列检查中，对判定渗出液和漏出液意义最大的是__A．蛋白定量B．比重C．pHD．细胞数E．细胞分类二、多项选择题（每题的备选项中，有 2 个或 2 个以上符合题意，至少有1 个错项。
河北省西医综合之内科学考试试题
河北省西医综合之内科学考试试题一、单项选择题（共27题，每题的备选项中，只有 1 个事最符合题意）1、下列出现吸气性呼吸困难的是A．喉头水肿B．心源性哮喘C．支气管哮喘D．肺源性心脏病E．肺梗死2、下列凝血因子都具有某种相同的生化结构特点，但例外的凝血因子是A．FⅡB．FⅢC．FⅣD．FⅦ3、下列选项中，能促进胃排空的神经或体液因素是A．迷走-迷走反射B．肠-胃反射C．胃酸D．促胰液素4、兴奋性突触后电位的电变化是A．极化B．除极化C．超极化D．反极化E．复极化5、以下关于精卵结合的描述，哪项是错误的A．精子需要经过子宫、输卵管，在输卵管壶腹部与卵子相遇B．受精通常发生在输卵管的间质部C．精子与卵子相融合即成为受精卵D．精子和卵子各含23条染色体，受精卵则含有23对染色体6、成人白细胞减少或粒细胞减少症，是指外周血白细胞计数或中性粒细胞绝对值持续低于下列哪项A．白细胞总数＜6×10 9/L，中性粒细胞绝对值＜2×10 9/LB．白细胞总数＜5×10 9/L，中性粒细胞绝对值＜1.8×10 9/LC．白细胞总数＜4×10 9/L，中性粒细胞绝对值＜1.5×10 9/LD．白细胞总数＜3×10 9/L，中性粒细胞绝对值＜1.9×10 9/LE．白细胞总数＜3×10 9/L，中性粒细胞绝对值＜3.0×10 9/L7、变构调节的机制是A．变构效应剂与酶分子结合后，可稳定其构象B．变构效应剂与酶分子必需基团结合，而使酶活化C．代谢终产物往往是该途径中关键酶的变构激活剂D．变构效应剂与酶分子的调节部位结合，使酶分子变构而改变活性8、女性，55岁，患风湿性心脏病合并心房颤动多年，一天前突然发生腹部阵发性剧烈绞痛，频繁恶心呕吐，经解痉，消炎治疗无效，体检腹部稍微膨隆，未见肠型，脐周有压痛，肠鸣音稍活跃。
腹部平片显示小肠中等度扩张，有数个散在液面，结肠无气，为了明确诊断进一步的检查应选择A．腹部CT B．肠系膜血管造影C．定期腹部B超复查D．腹部MRI 检查9、下列关于嘧啶核苷酸合成的叙述哪个是正确的?A．游离的氨是氨甲酰磷酸合成酶的底物B．利用线粒体的氨基甲酰磷酸合成酶C．二氢乳清酸脱氢酶是限速酶D．嘧啶环中的一个碳原子来自CO2 10、输血最严重的并发症是A．非溶血性发热B．细菌污染反应C．病毒性肝炎D．溶血反应11、沿腹主动脉排列的淋巴结是A．腰淋巴结B．腹腔淋巴结C．髂总淋巴结D．肠系膜上淋巴结E．肠系膜下淋巴结12、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13、肺结核患者做x线检查，出现大小不等、边缘模糊的云絮状阴影，应诊断为__A．原发型肺结核B．血行播散型肺结核C．空洞型肺结核D．浸润型肺结核E．结核性胸膜炎14、一肝昏迷患者，pH7.5，血钾3.0mmol/L，血钠125mmol/L。
2017年贵州西医综合之内科学考试试题
2017年贵州西医综合之内科学考试试题一、单项选择题（共23题，每题的备选项中，只有 1 个事最符合题意）1、关于抑制性突触后电位的产生过程，正确的叙述是A．突触前轴突末梢超极化B．突触后膜对Ca2+、K+的通透性增大C．突触后膜去极化D．突触后膜电位增大，出现超极化2、低血钾引起代谢性碱中毒是由于肾小管A．H+ -K+交换增强B．H+ -Na+交换增强C．K+ -Na+交换增强D．HCO3ˉ重吸收增强3、鼻咽癌最常见于鼻咽的A．顶部B．外侧壁C．咽隐窝D．前壁4、骨骼肌收缩的基本功能单位是A．肌原纤维B．细肌丝C．肌纤维D．粗肌丝E．肌小节5、不属于正常粪便成分的是A．食物残渣B．消化道分泌物C．寄生虫及其虫卵胞囊D．大肠杆菌E．肠球菌6、金属样音调咳嗽可见于A．支气管肺癌B．急性支气管炎C．急性喉炎D．肺结核E．肺梗死7、ATP从线粒体转运至胞液是通过A．简单扩散B．易化扩散C．通过载体与ADP交换D．逆浓度梯度主动转运8、在一个甲状腺球蛋白分子上T4与T3的比为A．10:1 B．5:1 C．20:1 D．30:19、男性，65岁，慢性喘息性支气管炎病史20余年，近5年来间断出现下肢浮肿，7天前受凉后咳、痰、喘加重，难以入睡，时有躁动，以下治疗错误的是A．抗感染B．化痰C．营养支持D．安眠药镇静10、下列因素中可使骨骼肌收缩加强的是A．阻断神经-肌肉接头处神经末梢上Ca2+的通道B．阻断神经末梢ACh的释放C．抑制神经-肌肉接头处的胆碱酯酶D．阻断终板膜上的ACh受体门控通道11、明显阻塞性黄疸病人，B超检查胆总管及肝内胆管均不扩张，进一步应选择下列哪项检查?A．放射性核素胰腺扫描B．十二指肠低张造影C．经皮肝穿刺胆道造影D．逆行胆胰管造影12、右心衰竭时，产生水肿的始动因素是A．毛细血管滤过压增高B．毛细血管通透性增高C．肾小球滤过率下降D．血浆胶体渗透压降低13、男，66岁，因慢性心功能不全接受药物治疗。
西医综合(内科学)模拟试卷104(题后含答案及解析)
西医综合（内科学）模拟试卷104(题后含答案及解析) 题型有：1. A1型题 2. B1型题 3. 案例分析题 4. X型题1．判断心功能失代偿的主要依据是A．心率加快B．心肌肥厚与心脏扩大C．心排出量明显降低D．心室舒张末期容量增加正确答案：C 涉及知识点：循环系统疾病2．下列选项中，对诊断左心室衰竭最有价值的体征是A．肺部湿?音B．第一心音减弱C．收缩中期喀喇音D．舒张期奔马律正确答案：D 涉及知识点：循环系统疾病3．利尿剂治疗心功能不全的作用是通过A．排钠排水B．提高心肌收缩力C．增加心排血量D．减轻水肿正确答案：A 涉及知识点：循环系统疾病4．心力衰竭并发心房扑动时首选A．心得安B．心律平C．奎尼丁D．快速洋地黄制剂正确答案：D 涉及知识点：循环系统疾病5．男性，60岁。
因疲劳后突发心悸、呼吸困难、咳嗽、咳泡沫血痰而来院急诊。
既往有高血压病、心肌梗死史。
查体：血压90／60 mmHg，端坐位，喘息状，口唇发绀，双肺满布中小水泡音，心率140次／分，心音听不清。
下列急诊处理中，不正确的是A．高流量吸氧B．选用中枢交感神经抑制剂C．使用短效β受体阻滞剂D．应用外周动静脉血管扩张剂正确答案：C 涉及知识点：循环系统疾病6．室性心动过速伴血压降低的患者治疗首选A．奎尼丁B．利多卡因C．同步电复律D．维拉帕米(异搏定)正确答案：C 涉及知识点：循环系统疾病7．下列哪项不符合室性逸搏的心电图特征A．在一个较窦性周期为长的间歇之后，出现一个宽大、畸形的QRS波群B．常在窦性停搏或窦房阻滞时出现C．一般其QRS波群前后无逆行P′波D．ST段、T波的方向与QRS波群的主波方向相同正确答案：D 涉及知识点：循环系统疾病8．有关食管心房调搏的描述，错误的是A．对常见室上性心动过速发生机制的判断可提供帮助B．诱发和终止房室结折返性心动过速C．有助于鉴别室上性心动过速伴有室内差异性传导与室性心动过速D．有助于对自主神经功能的检测正确答案：D 涉及知识点：循环系统疾病9．男性，50岁，因健康查体发现心房颤动而入院，平日无心悸感，既往体健，无高血压、糖尿病、甲亢病史。
西医综合-内科学-4_真题-无答案
西医综合-内科学-4(总分100,考试时间90分钟)Section Ⅰ Use of EnglishDirections:Read the following text. Choose the best word(s) for each numbered blank and mark A, B, C or D on ANSWER SHEET 1. (10 points)When anyone opens a current account at a bank, he is lending the bank money. He may (1) the repayment of the money at any time, either (2) cash or by drawing a check in favor of another person. (3) , the banker customer relationship is that of debtor and creditor who is (4) depending on whether the customer's account is (5) credit or is overdrawn. But, in (6) to that basically simple concept," the bank and its customer (7) a large number of obligations to one another. Many of these obligations can give (8) to problems **plications but a bank customer, unlike, say, a buyer of goods, **plain that the law is (9) against him.The bank must (10) its customer's instructions, and not those of anyone else. (11) , for example, a customer opens an account, he instructs the bank to debit his account only in (12) of checks drawn by himself. He gives the bank (13) of his signature, and there is a very firm rule that the bank has no right or (14) to pay out a customer's money (15) a check on which its customer's signature has been (16) . It makes no difference that the forgery may have been a very (17) one, the bank must recognize its customer's signature. For this reason there is no (18) to the customer in the practice, (19) by banks, of printing the customer's name on his checks. If this (20) forgery, it is the bank that will lose, not the customer.1. [A] acquire [B] deposit [C] demand [D] derive2. [A] for [B] through [C] as [D] in3. [A] However [B] Primarily [C] Moreover [D] Presumably4. [A] which [B] what [C] how [D] that5. [A] on [B] with [C] in [D] for6. [A] support [B] contrast [C] regard [D] addition7. [A] owe [B] commit [C] attribute [D] embark8. [A] purpose [B] rise [C] priority [D] thought9. [A] loaded [B] offended [C] discriminated [D] directed10. [A] conform [B] comply [C] obey [D] abide11. [A] Unless [B] Although [C] Since [D] When12. [A] respect [B] charge [C] line [D] place13. [A] specifics [B] signs [C] symbols [D] specimens14. [A] reputation [B] prestige [C] authority [D] impact15. [A] by [B] on [C] with [D] for16. [A] printed [B] confirmed [C] forged [D] justified17. [A] delicate [B] skillful [C] unusual [D] unique18. [A] risk [B] guarantee [C] fault [D] benefit19. [A] engaged [B] intended [C] adapted [D] adopted20. [A] contributes [B] facilitates [C] results [D] leadsSection Ⅱ Reading ComprehensionPart ADirections:Read the following four texts. Answer the questions below each text by choosing A, B, C or D. Mark your answers on ANSWER SHEET 1. (40 points)Text 1The history of responses to the work of the artist Sandro Botticelli (1444 ～1510) suggests that widespread appreciation by critics is a relatively recent phenomenon. Writing in 1550, Vasari expressed an unease with Botticelli's work, admitting that the artist fitted awkwardly into his evolutionary scheme of the history of art. Over the next two centuries, academic art historians defamed Botticelli in favor of his fellows Florentine, Michelangelo. Even when anti-academic art historians of the early nineteenth century rejected many of the standards of evaluation adopted by their predecessors, Botticelli's work remained outside of accepted taste, pleasing neither amateur observers nor connoisseurs. (Many of his best paintings, however, remained hidden away in obscure churches and private homes. )The primary reason for Botticelli's unpopularity is not difficult to understand: most observers, up until the midnineteenth century, did not consider him to be noteworthy, because his work, for the most part, did not seem to these observers to exhibit the traditional characteristics of fifteenth-century Florentine art. For example, Botticelli rarely employed the technique of strict perspective and, unlike Michelangelo, never used chiaroscuro.Another reason for Botticelli's unpopularity may have been that his attitude toward the style of classical art was very different from that of his contemporaries. Although he was thoroughly exposed to classical art, he showed little interest in borrowing from the classical style. Indeed, it isparadoxical that a painter of large-scale classical subjects adopted a style that was only slightly similar to that of classical art.In any case, when viewers began to examine more closely the relationship of Botticelli's work to the tradition of fifteenth-century Florentine art, his 'reputation began to grow. Analyses and assessments of Botticelli made between 1850 and 1870 by the artists of the Pre Raphaelite movement, as well as by the writer Pater (although he, unfortunately, based his assessment on an incorrect analysis of Botticelli's personality), inspired a new appreciation of Botticelli throughout the English-speaking world. Yet Botticelli's work, especially the Sistine frescoes, did not generate worldwide attention until it was finally subjected to a comprehensive and scrupulous analysis by Home in 1908. Home rightly demonstrated that the frescoes shared important features with paintings by other fifteenth-century Florentines features such as skillful representation of anatomical proportions, and of the human figure in motion. However, Home argued that Botticelli did not treat these qualities as ends in themselves--rather, that he emphasized clear depletion of a story, a unique achievement and one that made the traditional Florentine qualities less central. Because of Home's emphasis crucial to any study of art, the twentieth century **e to appreciate Bottieelli's achievements.21. Which of the following would be the best title for the text?[A] The Role of Standard Art Analyses and Appraisals.[B] Sandro Botticelli: From Rejection to Appreciation.[C] Causes for Botticelli's Rejection in Earlier Times.[D] Botticelli and Florentine: A Comparative Study.22. We can learn from the text that art critics have a history of[A] suppressing painters' art initiatives.[B] favoring a Botticelli's best paintings.[C] rejecting traditional art characteristics.[D] undervaluing Botticelli's achievements.23. The views of Vasari and Home on Botticelli's products are[A] identical.[B] complementary.[C] opposite.[D] similar.24. The word "connoisseurs" (Paragraph 1) most probably means[A] representatives in the Pre-Raphaelite Movement.[B] people who are in favor of Florentine.[C] critics who are likely to make assessments.[D] conservatives clinging to classical art.25. What does the author think of Botticelli's representation skills?[A] They are to be fully appreciated.[B] They evolve from an uncertain source.[C] They underlie his personality.[D] They conform to the classical style.Text 2With one eye turned towards keeping its own economy on track and the other trained fearfully on the impact of the global economic downturn, China has announced a four trillion yuan ($ 586 billion) stimulus package, the largest in the country's history.Unveiled by China's State Council on the evening of Sunday November 9th, the two-year spending initiative will inject funds into ten sectors, including health care, education, low- income housing, environmental protection, schemes to promote technological innovation, and transport and other infrastructure projects. The government also says that some of the spending will be directed to reconstruction efforts in areas battered by natural disasters, such as Sichuan province which was devastated by a massive earthquake in May."Over the past two months, the global financial crisis has been intensifying daily," the State Council said in a statement. "In expanding investment, we must be fast and heavy- handed. " News of the stimulus package has been welcomed by global investors. Asian and European stock markets rose on Monday, with American markets also climbing. China's decisive move is likely to please foreign governments which are now grappling with the global downturn. It comes a few days before the Chinese president is scheduled to attend a global economic summit in Washington D. C. , and a day after Hu Jintao had spoken by phone to the American president-elect, Barack Obama, about the global economic crisis and other issues.China's government has so far provided few details of when the money will be spent or how it will be divided. Officials do say that fourth quarter investment for this year will total 400 billion yuan, including 20 billion yuan brought forward from next year's central government budget. If fully realised, the two-year spending spree would amount to about 16% of China's annual gross domestic product.The newly announced measures also include a loosening of credit policies and tax cuts. The plan calls for reforms in the country's value-added tax regime that would save industry 120 billion yuan, according to an estimate by the government. Credit ceilings **mercial banks are to be abolished in the hope of channelling more capital to small enterprises, rural areas and unspecified "priority projects".The government is concerned about the potential for frivolous or speculative investments, so the State Council also decreed at its meeting on Sunday that credit expansion must be "rational" and should "target spheres that would promote and consolidate the expansion of consumer credit". Finding ways to get Chinese consumers spending should be a priority. Unleashing domestic demand has been a longstanding goal of Chinese policymakers, but Chinese consumers-with few of their health-care or retirement needs reliably met either by employers or the state-often prefer to save.China has sustained double-digit economic growth rates over the past five years but the economy has been slowing, considerably in some sectors. The economy logged a growth rate of 11.9% last year, but many forecasters believe that it will dip below 10% this year, with fourth-quarter growth down to 6% or even lower.Growth rates in that range may be the envy of recession-battered economies, but mark signs of trouble for China. It is an article of faith among many economists-and a view publicly statedearlier this year by the Chinese Prime Minister, Wen Jiabao-that China needs a growth rate of at least 7% to avoid massive unemployment. The country has been hurt in recent months by softening export markets, depressed domestic property values and stock markets, and declining consumer and investor confidence.26. According to the second paragraph, which of the following is NOT within the scope of the first two years' stimulus package?[A] A residence district built for low-income citizens.[B] New railway connecting two provinces in Western China.[C] Environment pollution control project in Taihu Lake area.[D] Development of aerospace technology for space exploration.27. According to the text, what is the "loosening of credit policies and tax cuts" aiming at?[A] Reduce the burdens of the enterprises, and help the small and medium enterprises get loans more easily.[B] Enhance the effectiveness of the government in this economical downturn.[C] Implement of policies that have been adopted years before.[D] Response to the requirements put forward by US government.28. Which of the following is NOT the reason why Chinese consumers prefer to save?[A] To secure their health-care in case of diseases.[B] To prepare for their life after retirement.[C] To use this as a way of investment due to high interest rate.[D] Insufficient coverage of social welfare.29. What can be inferred from the sentence "Growth rates in that range may be the envy of recession-battered economies, but mark signs of trouble for China" ?[A] Consecutive fall in economic growth rate is devastating to China, as this is a key period for China's economic development.[B] That range of growth rate may be insufficient to maintain the stability of the national economy.[C] Too fast an economic growth rate will probably cause turbulence as many industries in China may not have that capacity.[D] Other countries have only 1% or 2% economic growth rate while only China has a 5% above growth rate.30. According to the text, which of the following is NOT the phenomenon caused by the economic downturn?[A] The export markets are being softened.[B] Domestic property value is being depressed.[C] Number of people that go vacation abroad sharply reduced.[D] Consumer and investor confidence declined daily.Text 3The simple act of surrendering a telephone number to a store clerk may seem innocuous—so much so that many consumers do it with no questions asked. Yet that one action can set in motion a cascade of silent events, as that data point is acquired, analyzed, categorized, stored and sold over and over again. Future attacks on your privacy **e from anywhere, from anyone with money to purchase that phone number you surrendered. If you doubt the multiplier effect, consider your e-mail inbox. If it's loaded with spam, it's undoubtedly because at some point in time you unknowingly surrendered your e-mail to the wrong Web site.Do you think your telephone number or address are handled differently? A cottage industry of **panies with names you've probably never heard of—like Acxiom or Merlin—buy and sell your personal information the way **modities like corn or cattle futures are bartered. You may think your cell phone is unlisted, but if you've ever ordered a pizza, it might not be. Merlin is one of **mercial data brokers that advertises sale of unlisted phone **piled from various sources—including pizza **panies. These unintended, unpredictable consequences that flow from simple actions make privacy issues difficult to grasp, and grapple with.In a larger sense, privacy also is often cast as a tale of "Big Brother"—the government is watching you or a big corporation is watching you. But privacy issues don't necessarily involve large faceless institutions: A spouse takes a casual glance at her husband's Blackberry, a co-worker looks at e-mail over your shoulder or a friend glances at a cell phone text message from the next seat on the bus. While very little of this is news to anyone—people are now well aware there are video cameras and Internet cookies everywhere—there is abundant evidence that people live their lives ignorant of the monitoring, assuming a mythical level of privacy. People write e-mails and type instant messages they never expect anyone to see. Just ask Mark Foley or even Bill Gates, whose e-mails were a cornerstone of the Justice Department's antitrust case against Microsoft.And polls and studies have repeatedly shown that Americans are indifferent to privacy concerns. The general defense for such indifference is summed up a single phrase: "I have nothing to hide. " If you have nothing to hide, why shouldn't the government be able to peek at your phone records, your wife see your e-mail or a company send you junk mail? It's a powerful argument, one that privacy advocates spend considerable time discussing and strategizing over.It is hard to deny, however, that people behave different when they're being watched. And it is also impossible to deny that Americans are now being watched more than at any time in history.31. The email example shows[A] email has become the predominant means of communication.[B] careless surrendering of personal information can be harmful.[C] **munication via email is replacing that via telephone.[D] email will become an area for potential attacks on privacy.32. Companies like Acxiom or Merlin[A] make a profit by acquiring and selling personal information.[B] compile telephone directories for local business transaction.[C] are law firms specializing in dealing with privacy issues.[D] are agencies whose major mission is to protect privacy.33. We can infer from the third paragraph that[A] cases of intrusion on privacy are the most serious in large institutions.[B] people are now clearly aware how their privacy can be invaded.[C] the Justice Department has done nothing about privacy issues so far.[D] Bill Gates' email messages have been used against him in his lawsuit.34. To the popular saying "I have nothing to hide," the author's response is one of[A] admiration. [B] contempt. [C] disapproval. [D] puzzlement.35. What advice might the author give to the ordinary people?[A] Never leave your telephone number anywhere.[B] Raise your awareness of self-protection.[C] Use your ceil phone and email wisely.[D] Don't respond too readily to telephone messages.Text 4Increasingly, historians are blaming diseases imported from the Old World for the great disparity between the native population of America in 1492--new estimates of which jump as high as 100 million, or approximately one-sixth of the human race at that time--and the few million full-blooded Native Americans alive at the end of the nineteenth century. There is no doubt that chronic disease was an important factor in the sharp decline, and it is highly probable that the greatest killer was epidemic disease, especially as manifested in virgin-soil epidemics.Virgin-soil epidemics are those in which the populations at risk have had no previous contact with the diseases that strike them and are therefore immunologically almost defenseless. That virgin-soil epidemics were important in American history is strongly indicated by evidence that a number of dangerous maladies--smallpox, measles, malaria, yellow fever, and undoubtedly several more--were unknown in the pre-Columbian New World. The effects of their sudden introduction are demonstrated in the early chronicles of America, which contain reports of horrible epidemics and steep population declines, confirmed in many cases by quantitative analyzes of Spanish tribute records and other sources. The evidence provided by the documents of British and French colonies is not as definitive because the conquerors of those areas did not establish permanent settlements and began to keep continuous records until the seventeenth century, by which time the worst epidemics had probably already taken place. Furthermore, the British tended to drive the native populations away, rather than to enslave them as the Spaniards did; so that the epidemics of British America occurred beyond the range of colonists' direct observation.Even so, the surviving records of North America do contain references to deadly epidemics among the native population. In 1616--1619 an epidemic, possibly of pneumonic plague, swept coastal New England, killing as many as nine out of ten. During the 1630's smallpox, the disease most fatal to the Native American people, eliminated half the population of the Huron and Iroquois confederations. In the 1820's fever ruined the people of the Columbia River area, killing eight out of ten of them.Unfortunately, the documentation of these and other epidemics is slight and frequently unreliable, and it is necessary to supplement what little we de know with evidence from recent epidemics among Native Americans. For example, in 1952 an outbreak of measles among the Native American inhabitants of Ungava Bay, Quebec, affected 99 percent of the population andkilled 7 percent, even though some had the benefit of modern medicine. Cases such as this demonstrate that even diseases that are not normally fatal can have destroying consequences when they strike an immunologically **munity.Notes: disparity 差距。
【精品医学】西医综合(内科学)-试卷44
精 品 医 学 试
卷
西医综合（内科学）-试卷 44
(总分：80.00，做题时间：90 分钟)
一、2 B1 型题(总题数：6，分数：24.00)
A、突然，几秒钟内症状达高峰 B、急骤，几 min 后症状可达高峰 C、稍缓几 h 至 1～2d 症状达高峰 D、逐渐发生， 至少 1 周后症状达高峰 E、缓慢，一周后症状达高峰（分数：4.00） (1).脑血栓形成起病（ ）（分数：2.00）
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西医综合（内科学）-试卷4
(总分：66.00，做题时间：90分钟)
一、 A1型题(总题数：14，分数：28.00)
1.肺结核合并肺外结核治疗的疗程至少需
A.9个月
B.12个月
C.18个月√
D.24个月
2.需常规加用激素治疗的结核病有
A.支气管淋巴结结核
B.继发性肺结核
C.结核性脑膜炎√
D.肾结核
3.肺结核化疗方案中应警惕肾功能损害的是
A.异烟肼、链霉素、吡嗪酰胺√
B.异烟肼、利福平、乙胺丁醇
C.异烟肼、吡嗪酰胺、利福平、乙胺丁醇
D.异烟肼、吡嗪酰胺、利福平
4.结核预防性化疗适用于
A.涂阳肺结核患者的密切接触者
B.HIV感染者
C.肺部硬结、纤维病灶(无活动性)
D.PPD皮试强阳性者√
5.男性患者，60岁，患糖尿病10年，近1年血糖控制不佳，并出现明显乏力，食欲不振，消瘦，该患者可能出现的新问题为
A.糖尿病酮症酸中毒
B.糖尿病加重
C.合并肺结核√
D.合并肺炎
6.男性患者，23岁，诊为肺结核1个月，对利福平、吡嗪酰胺过敏，如需采用含氨基糖苷类药物治疗，正确的选择应是
A.先链霉素，后卡那霉素或阿米卡星(丁胺卡那霉素) √
B.先丁胺卡那霉素，后链霉素
C.先卡那霉素，后丁胺卡那霉素
D.同时卡那霉素和丁胺卡那霉素
7.男性患者，45岁，2个月来周身不适，乏力，发热，咳嗽，胸片显示右上肺小斑片阴影，痰结核分枝杆菌阳性，患慢性肾炎5年，最不应采用的抗结核治疗方案是
A.异烟肼、利福喷丁、乙胺丁醇
B.异烟肼、吡嗪酰胺、利福平、链霉素√
C.异烟肼、利福平、乙胺丁醇
D.异烟肼、利福喷丁、吡嗪酰胺、左氧氟沙星
8.患者，女，23岁，发热，乏力伴咳嗽，咯血痰，左肺门部斑片阴影有1cm×1cm空洞，痰结核分枝杆菌涂片阳性，2年前患糖尿病已采用胰岛素治疗，抗结核治疗方案宜选择
A.异烟肼、吡嗪酰胺、利福平、链霉素√
B.异烟肼、吡嗪酰胺、链霉素
C.异烟肼、利福平、乙胺丁醇
D.异烟肼、吡嗪酰胺、利福平、乙胺丁醇
9.男性患者，31岁，因发热，头痛，呕吐1周，确诊为结核性脑膜炎，其治疗除降颅压外，抗结核治疗应选择的药物依次为
A.异烟肼、吡嗪酰胺、利福平、乙胺丁醇√
B.吡嗪酰胺、乙胺丁醇、异烟肼、利福平
C.异烟肼、利福平、乙胺丁醇、吡嗪酰胺
D.异烟肼、乙胺丁醇、吡嗪酰胺、利福平
10.患者，女，39岁，2个月前患结核性胸膜炎，经胸腔抽液及异烟肼、利福平、链霉素、吡嗪酰胺化疗，胸腔积液吸收，但复查肝功能仅显示胆红素轻度升高，考虑与药物代谢有关，最可能引起此现象的药物为
A.吡嗪酰胺
B.利福平√
C.异烟肼
D.异烟肼加链霉素
11.患者，女，25岁，因低热，乏力，轻咳少痰，右上肺斑片状阴影和痰结核分枝杆菌阳性而确诊为肺结核，经异烟肼、利福平、吡嗪酰胺、乙胺丁醇治疗2个月，上述症状消失，痰菌转阴，各项化验指标正常。
但出现极少量右胸腔积液，应考虑
A.肺结核病恶化进展
B.出现类赫反应√
C.伴发新感染
D.患结核性胸膜炎
12.男性患者，30岁，体检发现右肺第2肋间局限斑点状纤维硬结病灶，痰结核分枝杆菌阴性。
其处理的方法是
A.采用4H治疗
B.不需要药物治疗，定期观察
C.采用2HRZ／4HE或2H3R3234：H3R3治疗√
D.采用2HE／4H治疗
13.患者，女，50岁，确诊肺结核3年，近日发现卡那霉素耐药，结核病恶化选择最佳方案是
A.2HL2AKTM6H12E
B.2HRSE／6HRE
C.2HRZE／6HRE √
D.2HRZE／4HR
14.男性患者，21岁，近2个月来咳嗽，痰中带血丝，午后手心足底发热、盗汗、心悸，X线胸片：右上肺大片状阴影，密度不均，其内可见一薄壁空洞，最可能的诊断是
A.右肺脓肿
B.继发性肺结核空洞形成√
C.右上肺癌性空洞形成
D.右上肺炎
二、 B1型题(总题数：4，分数：26.00)
A．支气管扩张B．肺脓肿C．慢性支气管炎伴发肺气肿D．肺癌E．支气管哮喘（分数：6.00）
(1).慢性咳嗽、咳痰、气短8年余，并进行性加重
A.
B.
C. √
D.
E.
(2).发作性咳嗽、呼吸困难、伴有哮鸣音
A.
B.
C.
D.
E. √
(3).反复咳嗽、咳黄痰，并间断咯血
A. √
B.
C.
D.
E.
A．慢性咳嗽、大量脓痰，反复咯血常见于B．咳嗽、咳痰伴喘息五年持续3个月、连续2年以上常见于C．劳力性呼吸困难伴咳嗽、咯血常见于D．寒战、高热、胸痛、铁锈色痰常见于E．午后低热、盗汗、咳嗽、咳痰、痰中带血常见于（分数：8.00）
(1).慢性支气管炎
A.
B. √
C.
D.
E.
(2).肺炎球菌肺炎
A.
B.
C.
D. √
E.
(3).支气管扩张
A. √
B.
C.
D.
E.
(4).肺结核
A.
B.
C.
D.
E. √
A．胸片示片状致密影，呈肺叶或肺段分布B．胸片示薄壁空洞，病灶周围可见卫星灶C．胸片示肺纹理增粗，紊乱，有蜂窝状和卷发样阴影D．侧位胸片示叶间梭形密度增高影E．胸片示肺动脉段突出，右下肺动脉干横径≥16mm（分数：6.00）
(1).肺结核
A.
B. √
C.
D.
E.
(2).叶间积液
A.
B.
C.
D. √
E.
(3).肺动脉高压症
A.
B.
C.
D.
E. √
A．Crohn病B．肠结核C．结肠癌D．阿米巴肠炎E．溃疡性结肠炎（分数：6.00）
(1).腹痛、腹泻，右下腹压痛，伴乏力、消瘦，最可能的诊断是
A.
B. √
C.
D.
E.
(2).男性，45岁，以血便为主，伴里急后重，最可能的诊断是
A.
B.
C. √
D.
E.
(3).近期曾生食螃蟹，出现脓血便，最可能的诊断是
A.
B.
C.
D. √
E.
三、 X型题(总题数：6，分数：12.00)
15.通过全国第3次、第4次结核病流行病学调查，我国疫情特点显示
A.高患病率，肺结核的菌阳患病率约367／10万√
B.我国结核病高感染率，约5．5亿人感染了结核分枝杆菌√
C.高耐药率，2000年获得性耐药为46．5％√
D.低死亡率
16.Horner综合征具有下列哪几项表现
A.患侧上眼睑下垂√
B.患侧瞳孔缩小√
C.患侧眼球内陷√
D.患侧额部少汗√
17.下述哪类肺结核患者有手术指征
A.大块干酪病灶√
B.内科抗结核治疗无效√
C.结核性脓胸√
D.支气管胸膜瘘√
18.下述哪些属于特殊性哮喘
A.咳嗽变异性哮喘√
B.职业性哮喘√
C.运动性哮喘√
D.鼻后滴漏综合征
19.可引起COPD急性加重的因素有
A.吸烟
B.冷空气刺激√
C.细菌感染√
D.病毒感染√
20.COPD的危险人群是
A.儿童时期的下呼吸道感染√
B.长期重度吸烟√
C.伴有湿疹
D.老年男性√。