重医七年制在儿科学双语试卷-A卷.doc

Type Ⅰ: Single choice (1 point for each, total 40 points).
1．What is the most serious and common complication（并发症） of neonatal sepsis（新生儿败血症）?
A．purulent meningitis（化脓性脑膜炎） B．pneumonia C．osteoarthritis（骨关节炎） D．infection of urinary tract
E．abscess（脓肿）
2．What is the most common couple of pathogen of neonatal sepsis in current China?
A．group B streptococcus (B群链球菌)，staphylococcus epidermidis (表皮葡萄球菌)
B．staphylococcus (葡萄球菌)，colon bacillus (大肠杆菌)
C．staphylococcus epidermidis (表皮葡萄球菌)，Klebsiella pneumonia (克雷伯杆菌) D．Pseudomonas aeruginosa (绿脓杆菌)，Acinetobacter (不动杆菌)
E．Bacteroides fragilis (脆弱类杆菌)，Clostridium agni (产气莢膜杆菌)
3．Which proof is the most valuable for diagnosis of hypoxic-ischemic encephalo- pathy (HIE)?
A．clinical manifestation B．cranial ultrasound C．cranial CT scan D．cranial MRI E．serum CPK-BB
4．What is the most common pathogen in neonatal TORCH infection?
A．Toxoplasma（弓形体） B．Herpesvirus（单纯疱疹病毒）
C．Syphilis（梅毒） D．Cytomegalovirus（巨细胞病毒）
E．Rubella virus（风疹病毒）
5．The most basic pathophysiology of bronchopneumonia is:
A．Hypoxia（低氧血症）; B．Hypercapnia （高碳酸血症）;
C．Sepsis （败血症）; D．Toxinemia（毒血症）;
E．Acidosis（酸中毒）
6．Point out the most common group of pathogens to induce bacterial meningitis in children.
A．Neissria meningitides（脑膜炎双球菌）, Streptoccus pneumoniae（肺炎链球菌）, Group B streptococci;
B．Neissria meningitides, Streptoccus pneumoniae, Haemophilus influenzae（流感嗜血杆菌）;
C．Neissria meningitides, Staphlococcus aureus, Haemophilus influenzae;
D．Staphlococcus aureus (金黄色葡萄球菌), Streptoccus pneumoniae, Haemophilus influenzae;
E．Neissria meningitides, Streptoccus pneumoniae, Staphlococcus aureus.
7．Which one is the most common complication of bacterial meningitis:
A．Ventriculitis（脑室管膜炎） B．Hydrocephalus（脑积水）
C．Subdural effusion（硬膜下积液） D．Deafness E．Epilepsy（癫痫）
8．In the following diseases, which one will usually not result in mirocytic/hypo- chromic anemia (小细胞低色素贫血).
A．Iron deficiency anemia B．Thalassemia （地中海贫血）
C．Ankylostomiasis （钩虫病） D．Chronic blood loss
E．Vitamin B12 deficiency
9．According to morphologic classification, mirocytic/hypochromic anemia is:
A．MCV 85fl, MCH 30, MCHC 33% B．MCV 96fl, MCH 33, MCHC 35%
C．MCV 70fl, MCH 25, MCHC 33% D．MCV 70fl, MCH 25, MCHC 30%
E．MCV 80fl, MCH 30, MCHC 33%
10．Which one is the most probable etiology of acute glomerulonephritis in children:
A．Group B, α-hemolytic streptococci（B组α溶血性链球菌）
B．Group A, β-hemolytic Staphylococcus（A组β溶血性葡萄球菌）
C．Group A, β-hemolytic streptococci（A组β溶血性链球菌）
D．Escherichia coli（大肠埃希氏菌）
E．Swine influenza（猪流感病毒）
11．The treatment rule of nephritic syndrome（肾炎综合征）is:
A．use steroids（激素） B．use diuresis（利尿剂）
C．use antibiotics D．hemodialysis（血液透析）
E．symptomatic treatment
12．What is the definition of mass proteinuria（蛋白尿） in nephrotic syndrome（肾病综合征）in children:
A．Proteinuria ≥10mg/kg/24h B．Proteinuria ≥20mg/kg/24h
C．Proteinuria ≥30mg/kg/24h D．Proteinuria ≥50mg/kg/24h
E．Proteinuria ≥100mg/kg/24h
13．Most common complication of nephrotic syndrome in children is:
A．Acute renal failure B．Hyperemia（循环充血）
C．Hypertensive encephalopathy（高血压脑病）
D．Thrombosis（血栓形成） E．Infection
14．Critical time of embryotic cardiac development（胚胎心脏发育） in ________ of gestation:
A．1~2 weeks B．2-4 months C．8~12 weeks
D．2~8 weeks E．2~8 months
15．Differential cyanosis（差异性青紫） is outstanding feature of:
A．ASD B．VSD C．PDA D．TOF E．PS
16．Changes of pulmonary（肺循环）and systemic circulatory（体循环） flow（血流） in VSD are:
A．both increased B．both insufficiency
C．Pulmonary insufficiency, systemic increased
D．both normal E．Pulmonary increased, systemic insufficiency
17．The most important pathological change and factor associating with pathophysio- logy and clinical manifestation in TOF is:
A．ASD B．VSD C．aorta overriding（主动脉骑跨）
D．Right ventricular hypertrophy（肥厚）
E．pulmonary stenosis (肺动脉狭窄)
18．About congenital hypothyrodism, what is the irreversible impairment（不可逆性损伤）?
A．low metabolism B．growth retardation（生长迟滞）
C．mental retardation（智力低下） D．unusual body features（异常体态）
E．delaying in development（发育延迟）
19．For diagnosis growth hormone deficiency（生长激素缺乏症）, what test is necessary for final diagnosis?
A．randomizing growth hormone test
B．exercise test（运动试验） C．sleep test D．one drug provocative test（单药刺激试验）
E．two drugs provocative test（双药刺激试验）
20．Presentation may imply primary immunodeficiency(s) is:
A．Recurrent infection B．Failure to thrive（发育障碍）
C．Autoimmunity（自身免疫疾病） D．Positive family history
E．Malignance（恶性肿瘤）
21．The embryonic period（胚胎期）ends and the fetal period begins at gestational age:
A．5 weeks B．9 weeks C．12 weeks D．16 weeks E．20 weeks
22．The age of peak of height velocity (PHV) for most children is：
A．9-11 years old for boys, 8-10 years old for girls
B．11-13 years old for boys, 11-13 years old for girls
C．11-13 years old for boys, 9-11 years old for girls
D．14-16 years old for boys, 12-14 years old for girls
E．9-11 years old for boys, 11-13 years old for girls
23. The number of primary teeth （乳牙）that generally erupt（萌出） in children by 3 years of age is:
A．4 B．8 C．12 D．16 E．20
24. Which of the following is not an expected finding in an 18-month-old?
A．Uses scissors（剪刀） B．Scribbles on paper
C．Pulls self to stand D．Understands “no”
E．Indicates wants
25. Pincer grip is an expected finding at what age?
A．3 months B．6 months C．9 months
D．14 months E．12 months
26. Which of the following is not an expected milestone during two to four months of age?
A. Posterior fontanel（后囟）closes
B. Transfers objects from one hand to the other
C. Decrease in head lag when pulled to sit
D. Follows objects 180 degrees
E. Smiles to others responsively
27. Correct sequence for attainment of gross motor milestones is:
A．head control, rolling over, pulls to stand, sits without support
B．head control, rolling over, sitting up, pulls to stand
C．rolls over, sits without support, head control, pulls to stand
D．sits without support, lifting head, pulls to stand, walks along
E．pulls to stand, walks along table, sits without support, head control
28．Based on an infants caloric requirements, how many calories per day does a 8-month-old who weights 10 kg require?
A．950kcal B．1200kcal C．1100kcal D．800kcal E．850kcal
29．Besides swelling of parotids（腮腺）, which manifestation below is most commonly found in mumps（腮腺炎）?
A．pancreatitis（胰腺炎） B．carditis（心脏炎） C．pneumonia
D．meningoencephalitis（脑膜脑炎） E．hepatitis
30．Which of the following statement is false:
A．Both mumps patient with apparent parotitis and the subclinical patient are of the transmission sources of mumps
B．Most mumps parotitis are bilateral, other than one side parotid involvement
C．Pain, swelling, tenderness and redness over the glands are characteristics of mumps
D．Some patients have the submandibular gland inflammation
E．Epididymitis is associated with orchitis in most cases
31．The most common complication of measles is：
A．otitis media B. pneumonia C．laryngitis D．exacerbation of tuberculosis E．cutaneous infection
32．Which of the following is the most sever complication of Hand-foot-mouth disease (手足口病)?
A．secondary cutaneous bacterial infections（皮肤继发细菌感染）
B．cervical lymph adenitis C．encephalitis
D．actue bacterial sepsis E．arthritis
33．The most reliable evidence for the diagnosis of Tuberculosis Meningitis（结核性脑膜炎，TBM）is:
A．Mental status changes B．Positive result of PPD
C．Headache and vomiting D．Convulsion and coma
E．Detected mycobacterium tuberculosis in CSF
34．The most commonly impaired cranial nerve in TBM is:
A．Facial nerve B．Oculomotor nerver (动眼神经)
C．Abducens nerve (外展神经) D．Trochlear nerve (滑车神经)
E．Auditory nerve (听神经)
35．The most reliable evidence for Tuberculosis Meningitis（TBM）diagnosis is:
A．mental status changes B．positive result of PPD
C．headache and vomiting D．detected mycobacterium tuberculosis in CSF
E．convulsion and coma
36．The characteristics in Excitive stage of Rabies（狂犬病） is:
A．numbness at the site of bite B．convulsion and coma
C．aggressiveness（攻击性） D．numbness（感觉麻木） of whole body
E．hydrophobia（恐水症）
37．All the following statements about Toxic Bacillary Dysentery（中毒性菌痢） are true except:
A．The age of peak incidence is 2~7 years old
B．Its pathogen is different from other types of Bacillary Dysentery
C．The season of peak incidence is in summer
D．It onsets abruptly and progresses rapidly
E．There maybe no Diarrhea when septic shock occurs
38．The key step to treat septic shock（感染性休克） is:
A．Corticosteroids（皮质激素） B．Vasoactive agents（血管活性剂）
C．Initial fluid resuscitation D．Cardiants（强心剂）
E．Heparin
39．Which of the following about infantile hepatitis syndrome is wrong?
A．CMV is the main pathogen.
B．Fat-soluble avitaminosis（维生素缺乏症）can be occurred.
C．Hereditary and genetic metabolic disorders are the most common causes of infantile hepatitis syndrome.
D．Biliary atresia（胆道闭锁）is common cause of infantile hepatitis syndrome.
E．The main route infants get HBV infection is mother-to-child transmission.
40．The course of the anti-tuberculous theray in children with TBM is:
A．3~6months B．6~9 months C．9~12months
D．12~15months E．18~24months
Type Ⅱ: True or false ( 1 point for each, total 10 points).
1．Adenovirus（腺病毒）is the most common pathogen of bronchiolitis. ( )
2．Children with iron deficiency anemia（缺铁性贫血） may have decreased attention span （注意力）and alertness（反应性）, problem with learning ability. These problems are due to the anemia caused hypoxia in brain. ( )
3．APSGN（急性链感后肾炎） in children is a kind of immune associated disease, so it is a self-limited disease. ( )
4．The most common of cyanotic congenital heart disease（青紫型先心病）after one-year-old is TOF. ( )
5．For treatment of congenital hypothyroidism, when symptoms improve, we may stop thyroxine（甲状腺素）. ( )
6．The development delayed for a child aged 5 months will be suggested by being unable to lift his head steadily. ( )
7．Macronutrients include protein, fat and carbohydrate. ( )
8．Pathogenesis of rabies is related to viremia。 ( )
9．The rashes of Varicella（水痘） mainly appear on the extremities. ( )
10．Meningeal Irritation（脑膜刺激征）occurs in the stage 2 of tuberculous meningitis. ( )
Type Ⅲ: Fill in blanks ( 0.5 point for each, total 10 points).
1．The common causes for childhood iron deficiency anemia（缺铁性贫血）： ___________________、____________________、______________________、_____________________和____________________________。
2．Typical manifestations of severe nephritic syndrome（重症肾炎）include ___________________、______________________、_______________________。
3．___________________ is the most common seizure disorder in childhood.
4．The categories of nutrients include _________________，___________________，____________________，________________________。
5．The common ways to cause Tuberculous meningitis （结核性脑膜炎）in children are __________ and __________________ .
6．According to clinical manifestations, Toxic Bacillary Dysentery（中毒性菌痢） can be typed as __________ , _____________ and _____________ __ .
7． in sialaden(唾液腺) in mumps flows back into bloodstream, therefore its level is elevated in blood and urine in mumps patient.
8．The diarrheal mechanism caused by dysentery bacilli （痢疾杆菌）is ___________________.
Type Ⅳ: Questions and answers ( 23 points).
1．What are risk factors for recurrent febrile seizures? （6 points）

2．Please describe the laboratory findings in the process of IDA （缺铁发展到缺铁性贫血的过程）（4 points）

3．Would you please describe how to assess the growth and development of a 7-month old infant? (8 point)

4．Please describe the clinical manifestations of Exanthem stage（出疹期） in typical measles. (5 points)

Type Ⅴ: Case discussion (17 points)
1．Julie, a girl, 3 days and 12 hours postnatal, became progressively jaundice for 3 days. She was G1P1, term baby, delivered vaginally with birth weight 3.2kg. Her mother’s blood type was type O, DdEEcc, and her father’s was type A, DDEecc. When admission, the lab tests showed: serum total bilirubin (TB) 22mg/dl (373umol/L), Hb180g/L; urine urobilinogen （尿胆原）(+), urine bilirubin (-); feces’ routine examination (-). ( 6 points )
(1) What’s the most possible diagnosis? （1.5 points）

(2) What is the most serious complication of this case? For the infant’s safety, which clinical manifestation should you pay attention to? （1.5 points）

(3) Which lab tests are needed for confirming your diagnosis（确诊）? （1.5 points）

(4) How to treat the baby? （1.5 points）

2．Tod, age four months, is sent at home by his general practitioner because of two days of rapid, laboured br