全诊断学基础复习题与复习资料电子版.doc

<p>第一篇 &nbsp; 常见症状
一、单项选择：
1、发热最常见的原因是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、无菌性坏死物质吸收 &nbsp; B、变态反应 &nbsp; &nbsp;C、病原体感染 &nbsp; D、体温调节中枢功能失调
2、吸收热见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、风湿热 &nbsp; &nbsp;B、败血症 &nbsp; C、细菌感染 &nbsp; D、大面积烧伤
3、稽留热见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、风湿热 &nbsp; &nbsp;B、败血症 &nbsp; C、肺炎球菌性肺炎 &nbsp; D、疟疾
4、弛张热见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、伤寒 &nbsp; B、败血症 &nbsp; C、 肺炎球菌性肺炎 &nbsp; &nbsp;D、疟疾
5、先昏迷后发热常见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、流行性乙型脑炎 &nbsp; B、伤寒 &nbsp; C、脑出血 &nbsp; D、中毒性菌痢
6、胆绞痛发作时出现右肩痛属于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、皮肤痛 &nbsp; B、牵涉痛 &nbsp; C、放射痛 &nbsp; D、内脏痛
7、由于产热过多所致发热见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、甲状腺功能亢进症 &nbsp; B、脱水 &nbsp; C、风湿热 &nbsp; D、急性溶血
8、男性，23岁，饱餐后突发剧烈上腹痛，呈刀割样，板状腹。最可能的诊断是 &nbsp;（ &nbsp; &nbsp;）
A、急性胰腺炎 &nbsp; B、急性胆囊炎 &nbsp; C、急性胃炎 &nbsp; D、胃肠穿孔
9、上腹痛反复发作十年，多于春秋季发作，主要表现为空腹痛，进食后缓解。最可能的诊断是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、慢性胃炎 &nbsp; B、胃溃疡 &nbsp; C、十二指肠溃疡 &nbsp; D、慢性胆囊炎
10、剧烈腹痛伴血尿见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、肾炎 &nbsp; B、肾结石 &nbsp; C、肾肿瘤 &nbsp; D、膀胱炎
11、肝源性水肿的主要特点是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、多从下肢开始继之遍及全身 &nbsp; B、多从眼睑颜面开始 &nbsp;
C、主要表现为腹水和踝部水肿 &nbsp; D、多有双上肢静脉压升高
12、三凹征见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、喉水肿 &nbsp; B、支气管哮喘 &nbsp; C、重症肺炎 &nbsp; D、大量胸腔积液
13、呼气性呼吸困难见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、气管肿瘤 &nbsp; B、 支气管哮喘 &nbsp; C、重症肺炎 &nbsp; D、大量胸腔积液
14、吸气性呼吸困难最主要的特点是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、鼻翼扇动 &nbsp; B、哮鸣音 &nbsp; C、三凹征 &nbsp; D、紫绀明显
15、呼气时间延长见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、严重肺炎 &nbsp; B、支气管哮喘 &nbsp; C、气管内异物 &nbsp; D、肺结核
16、大量胸腔积液临床上常表现为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、呼气性呼吸困难 &nbsp; B、吸气性呼吸困难 &nbsp;
C、混合性呼吸困难 &nbsp; D、夜间阵发性呼吸困难
17、心源性呼吸困难的特点是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、平卧时加重 &nbsp; B、平卧时减轻 &nbsp; C、与体位无关 &nbsp; D、与劳动无关
18、长期慢性咳嗽、咯血、咳大量脓痰见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、慢性支气管炎 &nbsp; B、支气管扩张 &nbsp; C、肺结核 &nbsp; D、肺癌
19、长期慢性咳嗽、咳痰，胸廓呈桶状见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、慢性支气管炎肺气肿 &nbsp; B、支气管扩张 &nbsp; C、肺结核 &nbsp; D、肺癌
20、肺部疾病引起大咯血最常见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肺结核 &nbsp; B、肺癌 &nbsp; C、肺炎 &nbsp; D、肺气肿
21、下列哪项不是二尖瓣狭窄引起大咯血的原因 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、肺淤血致肺泡壁毛细血管破裂 &nbsp; &nbsp; &nbsp; &nbsp; B、肺淤血致支气管内膜毛细血管破裂 &nbsp;
C、支气管粘膜下层支气管静脉曲张破裂 &nbsp; D、急性肺水肿致肺泡毛细血管通透性增强
22、大咯血是指一日咯血量 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、大于200 &nbsp; B、大于300 &nbsp; C、大于400 &nbsp; D、大于500
23、出血量较大的咯血常见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、支气管肺癌 &nbsp; B、支气管扩张 &nbsp; C、肺气肿 &nbsp; D、慢性支气管炎
24、毛细血管内还原血红蛋白增加到哪种情况可出现紫绀 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、大于30 &nbsp; B、大于40 &nbsp; &nbsp; C、大于50 &nbsp; D、大于60
25、心力衰竭引起的紫绀属于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、中心性紫绀 &nbsp; B、周围性紫绀 &nbsp; C、混合性紫绀 &nbsp; D、心性混血性紫绀
26、上消化道出血最常见的原因是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、食道静脉曲张破裂 &nbsp; B、食管炎 &nbsp; C、急性胃黏膜病变 &nbsp; D、消化性溃疡
27、呕血伴脾大、腹壁静脉曲张首先考虑 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肝硬化 &nbsp; B、肝癌 &nbsp; C、肝囊肿 &nbsp; D、肝脓肿
28、某一风湿热患者，服用阿斯匹林半个月，突然出现呕血，首先应考虑 &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、消化性溃疡 &nbsp; B、急性胃粘膜病变 &nbsp; C、肝硬化食道胃底静脉曲张破裂 &nbsp; D、慢性胃炎
29、持续性隐血便最常见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、慢性胃炎 &nbsp; &nbsp;B、消化性溃疡 &nbsp; C、肠炎 &nbsp; D、胃癌
30、血液中非结合胆红素明显升高见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、溶血性贫血 &nbsp; B、急性肝炎 &nbsp; C、胆总管结石 &nbsp; D、胰头癌
31、血液中结合胆红素明显升高见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、溶血性贫血 &nbsp; B、急性肝炎 &nbsp; C、胆囊结石 &nbsp; D、胆总管结石
32、意识障碍最严重的表现为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、嗜睡 &nbsp; B、昏睡 &nbsp; C、意识模糊 &nbsp; D、昏迷
33、病理性的持续睡眠状态，可被唤醒，能正确回答问题称为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、嗜睡 &nbsp; B、昏睡 &nbsp; C、谵妄 &nbsp;D、昏迷
34、下列叙述哪项是错误的： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、伤寒高热期——稽留热 &nbsp; B、重症肺结核——弛张热
C、布鲁菌病——波状热 &nbsp; &nbsp; D、风湿热——间歇热 &nbsp;
35、病人处于沉睡状态，回答问题含糊不清，甚至答非所问，这种表现是： &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、意识模糊 &nbsp; B、谵妄 &nbsp; C、昏睡 &nbsp; D、昏迷 &nbsp;
36、吸气性呼吸困难是由于： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、细支气管痉挛引起 &nbsp; &nbsp; &nbsp; B、肺部广泛病变所致
C、上呼吸道狭窄阻塞引起 &nbsp; D、细支气管炎
37、呼气性呼吸困难是由于： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、细支气管痉挛或炎症使下呼吸道狭窄 &nbsp; &nbsp;B、急性喉炎
C、上呼吸道狭窄阻塞引起 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;D、气管异物
38、肾源性水肿早期首先出现于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、眼睑及颜面 &nbsp; &nbsp;B、上肢 &nbsp; &nbsp;C、下垂部位 &nbsp; D、腹腔
二、双项选择：
1、下列发热的疾病中，属致热原发热的疾病是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、麻疹 &nbsp; B、中暑 &nbsp; C、重度安眠药中毒 &nbsp; D、急性肾盂肾炎 &nbsp; E、脑外伤
2、尿中胆红素阳性可见于： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、溶血性黄疸 &nbsp; &nbsp;B、阻塞性黄疸 &nbsp; &nbsp;C、先天性黄疸 &nbsp; &nbsp;
D、肝细胞性黄疸 &nbsp;E、新生儿黄疸
3、有关黄疸的实验室检查结果，符合阻塞性黄疸特征的有 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、尿中胆红素阴性 &nbsp; B、尿中尿胆原增加
C、尿中胆红素阳性 &nbsp; D、粪中粪胆素增多
E、血清结合胆红素与总胆红素比值＞40％
4、气管异物引起的呼吸困难常同时出现下列两种改变，即 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肋间饱满 &nbsp; &nbsp; &nbsp; B、胸廓前后径增大 &nbsp; C、肋间凹陷 &nbsp;
D、呼气时间延长 &nbsp; E、吸气时间延长
三、多项选择：
1、 非感染性发热见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、变态反应 &nbsp; B、无菌性坏死组织吸收 &nbsp; C、体温调节中枢功能失调 &nbsp; D、内分泌和代谢疾病 &nbsp; E、病原体侵入机体
2、 弛张热常见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、大叶性肺炎 &nbsp; B、风湿热 &nbsp; C、重症肺结核 &nbsp; D、化脓性炎症 &nbsp; E、败血症
3、 感染性发热病原体包括 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、细菌 &nbsp; B、抗原抗体复合物 &nbsp; C、病毒 &nbsp; D、支原体 &nbsp; E、真菌
4、 热型变为不典型的原因有 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、应用抗生素 &nbsp; &nbsp; B、应用解热药 &nbsp; C、应用肾上腺激素 &nbsp;
D、个体反映不同 &nbsp; E、病程中出现并发症
5、 胸痛伴咳嗽、发热主要见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、肺炎 &nbsp; B、急性支气管炎 &nbsp; C、支气管扩张 &nbsp; D、肺脓肿 &nbsp; E、胸膜炎
6、 胸膜性疼痛的特点是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、变换体位时加重或减轻 &nbsp; &nbsp; B、深呼吸时加重，使呼吸运动受限 &nbsp; C、局部按压时减轻 &nbsp;
D、咳嗽时加重，屏气时减轻 &nbsp; E、呈尖锐刺痛
7、 引起胸痛常见疾病有 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、胸膜炎 &nbsp; B、心绞痛及心肌梗塞 &nbsp;C、肺肿瘤 &nbsp; D、非化脓性肋软骨炎 &nbsp; E、带状疱疹
8、 能引起心绞痛的疾病有 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、二尖瓣关闭不全 &nbsp; B、主动脉瓣关闭不全 &nbsp; C、二尖瓣狭窄 &nbsp;
D、主动脉瓣狭窄 &nbsp; &nbsp; E、冠状动脉粥样硬化
9、 全身性水肿包括 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、营养不良性水肿 &nbsp;B、上腔静脉阻塞 C、肝源性水肿 &nbsp;D、肾源性水肿 &nbsp;E、心源性水肿
10、心源性水肿与肾源性水肿的鉴别点包括 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、水肿性质 &nbsp; B、水肿开始部位 &nbsp;C、水肿发展速度 &nbsp; D、水肿的压陷性 &nbsp; E、伴随症状
11、心源性水肿的特点是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、从身体下垂部位开始 &nbsp; B、双上肢腹中也很明显 &nbsp; C、浮肿比较坚实、移动性小 &nbsp;
D、伴静脉压升高 &nbsp; &nbsp; &nbsp; &nbsp; E、多伴有低蛋白血症
12、水肿伴低蛋白血症常见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、肝硬化 &nbsp; B、右心衰竭 &nbsp; C、肾病综合征 &nbsp; D、慢性消耗性疾病 &nbsp; E、药物性水肿
13、肺原性呼吸困难临床上分为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A劳累性呼吸困难 &nbsp; B、吸气性呼吸困难 &nbsp; C、夜间阵发性呼吸困难
D、呼气性呼吸困难 &nbsp;E、混合性呼吸困难
14、夜间阵发性呼吸困难的发生机制为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、平卧位静脉回心血量增多 &nbsp; B、卧位肺活量降低 &nbsp; C、夜间迷走神经兴奋性增高 &nbsp;
D、心肌耗氧量增加 &nbsp; E、夜间呼吸中枢兴奋性增高
15、呼吸困难的发病原因包括 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、呼吸系统疾病 &nbsp; &nbsp;B、循环系统疾病 &nbsp; &nbsp;C、中毒性疾病
D、神经精神性因素 &nbsp;E、血液病
16、呼吸困难可以表现出： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、鼻翼扇动 &nbsp; &nbsp;B、张口呼吸 &nbsp; &nbsp;C、口唇发绀 &nbsp;
D、呼吸频率深度与节律异常 &nbsp; &nbsp; E、呼吸辅助肌参与呼吸运动
17、关于呼气性呼吸困难正确的是： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肺泡弹性减弱 B、小支气管狭窄阻塞 &nbsp; C、肺部病变广泛 &nbsp;
D、呼气费力、延长而缓慢 &nbsp; E、常伴有哮鸣音
18、吸气性呼吸困难见于： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、支气管哮喘 B、肺间质纤维化 &nbsp;C、喉痉挛 &nbsp; D、气管异物 &nbsp; E、气管肿瘤
19、混合性呼吸困难见于： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肺气肿 B、肺炎 &nbsp;C、肺不张 &nbsp;D、气胸 &nbsp; E、胸腔积液
20、“三凹征”是指下列何部位在吸气时明显凹陷： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、胸骨上窝 B、锁骨上窝 &nbsp;C、腹上角 &nbsp; D、肋间隙 &nbsp; E、肋脊角
21、肺源性呼吸困难是由于： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肺通气功能不良 &nbsp; &nbsp;B、血液中2潴留 &nbsp; &nbsp;C、肺活量降低 &nbsp;
D、缺氧 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;E、肺换气功能不良
22、心源性呼吸困难可出现： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、劳力性呼吸困难 &nbsp; B、夜间阵发性呼吸困难 &nbsp; &nbsp;C、端坐呼吸
D、呼吸 &nbsp; &nbsp; E、心源性哮喘
23、心源性哮喘可出现： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、口唇发绀 &nbsp; B、哮鸣音 &nbsp; C、双肺湿性啰音 &nbsp; D、端坐呼吸 &nbsp; E、惊恐不安
24、下列各种呼吸困难，哪组是正确的： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、吸气性呼吸困难是由于上部气道的狭窄或阻塞所致
B、呼气性呼吸困难是由于肺组织弹性减弱及小支气管痉挛性狭窄所致
C、左心功能不全的呼吸困难主要是由于肺循环瘀血所致
D、右心功能不全的呼吸困难主要是由于体循环瘀血所致
E、酸中毒时的呼吸困难系由于血中酸性代谢产物强烈刺激呼吸中枢所致
25、意识障碍有哪些表现 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、嗜睡 &nbsp; B、意识模糊 &nbsp; C、昏迷 &nbsp; D、谵妄 &nbsp; E、昏睡
26、心功能不全引起呼吸困难的特点有 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、劳动时发生或加重 &nbsp; &nbsp;B、休息时缓解或减轻 &nbsp; &nbsp;C、仰卧位时加重
D、坐位时减轻 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;E、左侧卧位下肢垫高可减轻
27、心源性哮喘可见于： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、支气管哮喘B、高血压性心脏病C、冠心病 &nbsp;D、心肌炎 &nbsp;E、心肌病
28、肝细胞性黄疸时胆红素代谢特点是： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、血清总胆红素含量增高 &nbsp;B、血清非结合胆红素含量增高 C、尿胆原增多尿胆红素阳性
D、结合胆红素／总胆红素比值＜20% &nbsp; &nbsp; E、尿胆原增多
29、胆汁淤积性黄疸的表现有： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、白陶土样大便 &nbsp; &nbsp; B、血中结合胆红素升高 &nbsp; &nbsp; &nbsp;C、血中非结合胆红素升高
D、尿胆红素阳性 &nbsp; &nbsp; E、尿胆原增加
四、填空题：
1、肺源性呼吸困难临床上分三型，分别是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
2、肺部广泛病变使呼吸面积减少往往产生 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;性呼吸困难；小气道痉挛产生
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 性呼吸困难；大气道阻塞产生 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;性呼吸困难。
3、当急性左心功能不全时产生 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ，临床表现为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ，常咳 &nbsp; &nbsp; &nbsp; &nbsp;痰。
4、血液中还原性血红蛋白增多可出现紫绀，按其病因可分为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;，以及 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
5、右心功能不全可产生 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;性紫绀；先天性心脏病可引起 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;性紫绀；肺部疾病引起 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 性紫绀；休克时产生 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;性紫绀。
6、便血患者大便颜色取决于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 。
7、黄疸在临床上分三型，分别是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;， &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
8、实验室检查血清间接胆红素增高提示 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;性黄疸；直接胆红素增高提示 &nbsp; &nbsp; &nbsp; &nbsp; 性黄疸；二者均增高提示 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;性黄疸。
9、患者为阻塞性黄疸，血清直接胆红素 &nbsp; &nbsp; &nbsp;，间接胆红素 &nbsp; &nbsp; &nbsp;，尿胆原 &nbsp; &nbsp; &nbsp;，便色 &nbsp; &nbsp; 。
10、三凹征指 &nbsp; &nbsp; &nbsp; 、 &nbsp; &nbsp; &nbsp;、 &nbsp; &nbsp; &nbsp;的凹陷。
11、引起发热的病因甚多，临床上可区分为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;两大类。
五、名词解释：
1、症状 &nbsp; 2、体征 &nbsp; 3、发热 &nbsp; 4、稽留热 &nbsp; 5、驰张热 &nbsp; 6、呼吸困难 &nbsp; 7、三凹征
8、发绀 &nbsp; 9、咯血 &nbsp; 10、呕血 &nbsp; 11、隐性黄疸 &nbsp; 12、水肿 &nbsp; 13、柏油便 &nbsp; 14、隐血便
六、简答题：
1、试述咯血与呕血的鉴别、
2、何谓心源性哮喘?有何主要临床表现?临床意义是什么？心绞痛、心肌梗塞引起胸痛有何异同点？
3、心绞痛、心肌梗塞引起胸痛有何异同点？
4、临床上如何判定浅昏迷还是深昏迷？
七、论述题：
试从实验室检查方面鉴别溶血性黄疸、肝细胞性黄疸和胆汁瘀积性黄疸。

参考答案
一、单项选择：
1-5 &nbsp; &nbsp; 6-10 &nbsp; &nbsp; 11-15 &nbsp; &nbsp; 16-20 &nbsp; &nbsp;
21-25 &nbsp; &nbsp; 26-30 &nbsp; &nbsp;31-35 &nbsp; &nbsp; 36-38
二、双项选择：
1、 &nbsp; 2、 &nbsp; 3、 &nbsp; 4、
三、多项选择：
1、 2、 3、 4、 5、 6、 7、 8、 9、 10、
11、 12、 13、 14、 15、 16、 17、 18、 19、 20、
21、 22、 23、 24、 25、 26、 27、 28、 29、
四、填空题：
1、 吸气性呼吸困难；呼气性呼吸困难；混合性呼吸困难
2、 混合性；呼气性；吸气性
3、 肺淤血；呼吸困难；浆液性粉红色泡沫样痰
4、 中心性发绀；周围性发绀；混合性发绀
5、 周围性发绀；心性混合性发绀；肺性发绀；缺血性周围性发绀
6、 出血部位；出血量；血液在肠腔内停留的时间
7、 溶血性黄疸；肝细胞性黄疸；胆汁淤积性黄疸
8、 溶血性黄疸；胆汁淤积性黄疸；肝细胞性黄疸
9、 升高；正常；减少或消失；白陶土色
10、 肋间隙；胸骨上窝；锁骨上窝
11、 感染性发热；非感染性发热
五、名词解释：
1、症状：患者主观感受到不适或痛苦的异常感受或病态改变。
2、体征：患者的体表或内部结构发生可察觉的改变,如皮肤黄染,肝脾肿大,心脏杂音等。
3、发热：当机体在致热源作用下或各种原因引起体温调节中枢的功能障碍时,体温升高超出正常范围。
4、稽留热：指体温恒定地维持在39-40℃以上的高水平,达数天或数周,24h内体温波动范围不超过1℃。常见于大叶性肺炎,斑疹伤寒及伤寒高热期。
5、弛张热：又称败血症热型，体温常在39℃以上,波动幅度大,24H内波动范围超过2℃,但都在正常水平以上。常见于败血症、风湿热、重型肺结核及化脓性炎症。
6、呼吸困难：患者主观感到空气不足，呼吸费力；客观表现呼吸运动费力，重者鼻翼扇动，张口抬肩，甚至出现发绀，呼吸辅助肌也参与活动，并伴有呼吸节律、深度和频率的改变。
7、三凹征：上呼吸道部分阻塞患者，因气流不能顺利进入肺，故当吸气时呼吸及收缩，造成肺内负压极度增高，从而引起胸骨上窝、锁骨上窝及肋间隙向内凹陷，称为“三凹征”。
8、发绀：发绀亦称紫绀，是指血液中还原血红蛋白增多，使皮肤、粘膜呈青紫色的表现。广义的发绀还包括少数由于异常血红蛋白衍化物（高铁血红蛋白、硫化血红蛋白）所致皮肤粘膜青紫现象。
9、咯血：是指喉及喉以下的呼吸器官出血，经咳嗽从口腔排出体外,主要见于呼吸系统和心血管疾病。
10、呕血：是由上消化道疾病（指屈氏韧带以上的消化器官，包括食管、胃、十二指肠、肝、胆、胰疾病）或全身性疾病所致的急性上消化道出血，血液经胃从口腔呕出。
11、隐性黄疸：血清胆红素在17.1～34.2,临床不易察觉，称为隐形黄疸。
12、水肿：人体组织间隙有过多的体液积聚使组织肿胀称为水肿。
13、柏油便：上消化道或小肠出血并在肠内停留时间较长，因红细胞破坏后，血红蛋白在肠道内与硫化亚物结合形成硫化亚铁，使粪便呈黑色，更由于附有粘液而发亮，类似柏油，故又称为柏油便。
14、隐血便：少量的消化道出血，每日5以下，无肉眼可见的粪便颜色改变，须用隐血试验才能确定者，称为隐血便。
六、简答题：
1、试述咯血与呕血的鉴别。
答：咯血呕血的鉴别：
项目
咯血
呕血
病因
呼吸系统疾病：炎症，结核，肿瘤等;心脏疾病：二尖瓣狭窄等;其它：血液病、传染病等
胃肠道疾病：溃疡,炎症肿瘤等;肝脏疾病,胆道疾病
出血前症状
咽部轻痒、咳嗽、胸闷等
上腹部不适，恶心，呕吐等
出血方式
咳出，伴咳嗽
呕出
血色
鲜红
暗红、棕黑色、咖啡色
血中混有物
痰液，泡沫
食物残渣，胃液
反应性
碱性
酸性
黑便
无
有，柏油样
出血前痰的性状
常有血痰
无血痰
2、何谓心源性哮喘?有何主要临床表现?临床意义是什么？
答：心源性哮喘：严重急性左心衰竭时，常出现阵发性呼吸困难，患者气喘，面色青紫、出汗，有哮鸣音，咯浆液性粉红色泡沫样痰两肺底部有湿啰音，心率加快，有奔马律。此种呼吸困难又称心源性哮喘。常见于高心病、冠心病、风湿性心瓣膜病和心肌炎、心肌病等。
3、心绞痛、心肌梗塞引起胸痛有何异同点？
答：心绞痛和心梗都能引起心前区疼痛，疼痛呈压榨性。心梗引起的疼痛比心绞痛引起的疼痛更剧烈并伴濒死感，持续时间更长，多持续半小时以上。
4、临床上如何判定浅昏迷还是深昏迷？
答：浅昏迷：患者随意运动丧失，对周围事物及声、光刺激无反应，对疼痛刺激有反应，但不能唤醒。吞咽反射、咳嗽反射、角膜反射、瞳孔对光反射存在，眼球能转动；深昏迷：对一切刺激均无反应，全身肌肉松弛，深浅反射、吞咽反射及咳嗽反射均消失。
七、论述题：
试从实验室检查方面鉴别溶血性黄疸、肝细胞性黄疸和胆汁瘀积性黄疸。
答：三者鉴别如下：
项目
溶血性
肝细胞性
胆汁瘀积性

增加
增加
增加

正常
增加
明显增加&lt;15-20%&gt;30-40%
&gt;50-60%
尿胆红素
－
＋
＋＋
尿胆原
增加
轻度增加
减少或缺如
、
正常
明显增高
可增高
、
正常
增高
明显增高

正常
延长
延长
对反应
无
差
好
胆固醇
正常
轻度增加或降低
明显增加
血浆蛋白
正常
白蛋白降低球蛋白升高
正常

第二篇 &nbsp; 问诊
一、单项选择：
1、现病史是指 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、主要症状的特点 &nbsp; B、病人就诊的主要原因 &nbsp; C、发病的原因和诱因
D、疾病诊治经过 &nbsp; &nbsp; E、该病发生发展的全部情况
2、主诉的含义哪项正确 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、病人的主要症状或体征及其看病的时间 &nbsp; &nbsp; B、病人的主要症状及其起病的时间 &nbsp;
C、病人的主要症状或体征及其持续的时间 &nbsp; &nbsp;D、病人的主要症状或体征及其发作频率 &nbsp; E、病人的主要症状或体征及其严重程度
3、病史的核心是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、主诉 &nbsp; B、现病史 &nbsp; C、家族史 &nbsp; D、一般项目 &nbsp; E、既往史
4、病史的主体部分是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、系统回顾 &nbsp; B、月经生育史 &nbsp; C、现病史 &nbsp; D、主诉 &nbsp; E、既往史
5、符合书写要求的主诉是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、寒战 高热 咳嗽 右胸痛2天 &nbsp; &nbsp;B、风心病5年 &nbsp; &nbsp;
C、2年前开始多饮多食多尿 &nbsp; &nbsp; &nbsp; D、已患高血压5年
二、双项选择：
下列哪些是特定意义的医学术语 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、咳嗽、咳痰 &nbsp; B、鼻衄 &nbsp; C、澹妄 &nbsp; D、咯血 &nbsp; E、腹泻
三、多项选择：
1、既往史包括： &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、预防接种史 &nbsp; &nbsp; B、手术史 &nbsp; &nbsp; C、社会经历 &nbsp; D、过敏史 &nbsp; &nbsp; E、婚姻史
2、下列哪些情况属于需要采用特殊问诊技巧的 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、多话与唠叨者 &nbsp; B、愤怒与敌意者 &nbsp; C、传染病患者 &nbsp; D、妊娠妇女 &nbsp; E、老年人
四、填空题：
病史中的主体部分是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
五、名词解释：
主诉
六、简答题：
1、 问诊包括哪些内容？
2、 现病史包含哪些内容？

参考答案
一、单项选择：
1-5
二、双项选择：

三、多项选择题：
1、 &nbsp; 2、
四、填空题：
现病史
五、名词解释：
主诉：患者感受最明显的痛苦或嘴明显的症状或（和）体征，也就是本次就诊最主要的原因及其持续时间。
六、简答题：
1、 问诊包括哪些内容？
答：问诊的内容包括：①一般项目。②主诉。③现病史。④既往史。⑤系统回顾。⑥个人史。⑦婚姻史。⑧月经与生育史⑨家族史。
2、 现病史包含哪些内容？
答：现病史的内容包括：起病情况与患病的时间；主要症状的特点；病因与诱因；病情的发展与演变；伴随症状；诊治经过；病程中的一般情况。

第三篇 &nbsp; 检体诊断
第一章 &nbsp; &nbsp;基本检查方法
一、单项选择：
1、正常肺部的叩诊音是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、鼓音 &nbsp; B、清音 &nbsp; C、浊音 &nbsp; D、实音 &nbsp; E、过清音
2、肺组织实变时叩诊音是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、鼓音 &nbsp; B、清音 &nbsp; C、浊音或实音 &nbsp; D、过清音 &nbsp; E、实音
3、叩诊实质性脏器所产生的音响是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、鼓音 &nbsp; B、清音 &nbsp; C、浊音 &nbsp; D、实音 &nbsp; E、过清音
4、肺气肿时肺部叩诊音是 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、鼓音 &nbsp; B、清音 &nbsp; C、浊音 &nbsp; D、过清音 &nbsp; E、实音
5、呼吸有烂苹果味最常见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肝昏迷 &nbsp; B、尿毒症 &nbsp; C、有机磷中毒 &nbsp; D、糖尿病酮症酸中毒 &nbsp; E、肠梗阻
6、呼吸有刺激性蒜味见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肝昏迷 &nbsp; B、尿毒症 &nbsp; C、有机磷中毒 &nbsp; D、糖尿病酮症酸中毒 &nbsp; E、肠梗阻
7、呼吸有氨味见于 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、肝昏迷 &nbsp; B、尿毒症 &nbsp; C、有机磷中毒 &nbsp; D、糖尿病酮症酸中毒 &nbsp; E、肠梗阻
8、有关间接叩诊方法，下列哪项是错误的？ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、右手指自然弯曲，以中指指端叩击左手中指第二指骨的前端，叩击方向应与叩诊部位的体表垂直
B、叩诊时应以腕关节与指掌关节的活动为主
C、叩击后右手应立即抬起
D、确定心、肝的相对浊音界应轻叩
E、确定心、肝的绝对浊音界应重叩
二、双项选择：
浅部触诊法适用于下列哪项检查？ &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （ &nbsp; &nbsp;）
A、阑尾压痛点 &nbsp; B、腹肌紧张度 &nbsp; C、腹部压痛 &nbsp; D、胆囊压痛点 &nbsp; E、肝、脾触诊
三、多项选择：
1、基本检查方法有 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、视诊 &nbsp;B、叩诊 &nbsp;C、触诊 &nbsp;D、听诊 &nbsp;E、嗅诊
2、深部触诊法包括 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、 深部滑行触诊法B、双手对应触诊法 &nbsp;C、深压触诊法 D、冲击触诊法 E、单手触诊法
3、叩诊在胸、腹部检查方面尤为重要，常可用于下列哪些检查 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;（ &nbsp; &nbsp;）
A、肺尖的宽度和肺下界的定位 &nbsp;
B、胸腔积液或积气含量的多寡
C、肺部病变的范围与性质 &nbsp;
D、肝脾的边界，腹水的多少
E、膀胱有无充盈，子宫、卵巢有无肿大
四、填空题：
1、深部触诊法 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;、 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;、 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;和 &nbsp; &nbsp; &nbsp; &nbsp; 四种。
2、依据叩诊的手法与目的不同，一般可分为 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;和 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;。
五、名词解释：
反跳痛
六、简答题：
深部触诊法分为哪几种？各适用于什么检查？
七、论述题：
在正常情况下，鼓音、过清音、浊音及实音各在何处可叩得？在病理情况下各见于哪些疾病？

参考答案
一、单项选择：
1-5 &nbsp; &nbsp;6-8
二、双项选择：

三、多项选择：
1、 &nbsp; 2、 &nbsp; 3、
四、填空题：
1、深部滑行触诊法；深压触诊法；双手触诊法；冲击触诊法
2、直接叩诊法；间接叩诊法
五、名词解释：
反跳痛:在手指深压的基础上迅速将手抬起,并询问病人是否感觉疼痛加重或察看面部是否出现痛苦表情，表明局部有炎症病变向腹膜壁层扩散。
六、简答题：
深部触诊法分为哪几种？各适用于什么检查？
答：深部触诊法分为以下四种：
1）、深部滑行触诊法，常用于腹腔深部包块和胃肠病变的检查。
2）、双手触诊法，常用于肝、脾、肾和腹腔肿物的检查。
3）、深压触诊法，常用来探测腹腔深在病变的部位或确定腹腔压痛点，如阑尾压痛点及胆囊压痛点。
4）、冲击触诊法，仅用于大量腹水患者的肝、脾的触诊。
七、论述题：
在正常情况下，鼓音、过清音、浊音及实音各在何处可叩得？在病理情况下各见于哪些疾病？
答：鼓音在正常情况下叩</p><!--15-20%-->