diff --git "a/Assistant/Theory_Questions/Year_1/Mock.json" "b/Assistant/Theory_Questions/Year_1/Mock.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_1/Mock.json" @@ -0,0 +1,2888 @@ +[ + { + "question_num": 1, + "query": "止带方适用于带下病的证候是", + "options": { + "A": "肾阳虚", + "B": "肾阴虚", + "C": "脾虚", + "D": "湿热", + "E": "湿毒" + }, + "answer": "D", + "reason": "止带方专用于止带,猪苓、茯苓、车前子、泽泻利水渗湿止带;赤芍、丹皮清热凉血活血;黄柏、栀子、茵陈泻热解毒，燥湿止带;牛膝利水通淋,引诸药下行，使热清湿除带自止，适用于湿热下注证。带下过多湿热下注证证候:带下量多，色黄或呈脓性，质黏稠有臭气，或带下色白质黏，呈豆渣样，外阴瘙痒;小腹作痛，口苦口腻，胸闷纳呆，小便短赤:舌红，苔黄腻，脉滑数。治宜清热利湿，佐以解毒杀虫。" + }, + { + "question_num": 2, + "query": "治疗感冒的主穴是", + "options": { + "A": "列缺、合谷、肺俞、太渊、大椎", + "B": "太渊、肺俞、合谷、鱼际、三阴交", + "C": "列缺、合谷、大椎、太阳、风池", + "D": "鱼际、尺泽、膻中、肺俞、定喘", + "E": "尺泽、肺俞、膏肓、太溪、足三里" + }, + "answer": "C", + "reason": "治疗感冒的主穴是列缺、合谷、大椎、太阳、风池。" + }, + { + "question_num": 3, + "query": "妊娠腹痛,又称", + "options": { + "A": "子病", + "B": "脆脚", + "C": "子肿", + "D": "子气", + "E": "胞阻" + }, + "answer": "E", + "reason": "妊娠腹痛:因胞脉阻滞或失养，发生小腹疼痛者，称为妊娠腹痛，亦称“胞阻”" + }, + { + "question_num": 4, + "query": "少阴经头痛的特征是", + "options": { + "A": "前额连眉棱骨痛", + "B": "两侧太阳穴处痛", + "C": "后头部连项痛", + "D": "头痛连齿", + "E": "头痛晕沉" + }, + "answer": "D", + "reason": "阳明经与任脉行于头前，故前额连眉棱骨痛，病在阳明经；太阳经与督脉行于头后，故后头连项痛，病在太阳经；少阳经行于头两侧，故头两侧痛，病在少阳经；足厥阴经系目系达巅顶，故巅顶痛，病在厥阴经；太阴经头痛的特征是头痛且晕沉，少阴经头痛的特征是头痛连齿。" + }, + { + "question_num": 5, + "query": "不属于小儿汗证常见病因的是", + "options": { + "A": "肺卫不固", + "B": "营卫失调", + "C": "气阴亏虚", + "D": "湿热迫蒸", + "E": "情志失调" + }, + "answer": "E", + "reason": "小儿汗证的常见病因有肺卫不固、营卫失调、气阴亏虚、湿热迫蒸。" + }, + { + "question_num": 6, + "query": "治疗感冒可分别采用辛温解表或辛凉解表，此属于", + "options": { + "A": "辨病论治", + "B": "因人制宜", + "C": "同病异治", + "D": "异病同治", + "E": "对症论治" + }, + "answer": "C", + "reason": "同病异治，是同一种疾病，由于发病时间、地域不同，或所处疾病阶段或类型不同，或患者体质有异，其反映出的证不同，故而治疗也有异。" + }, + { + "question_num": 7, + "query": "预防HBeAg阳性母亲所生的新生儿HBV感染最有效的措施是", + "options": { + "A": "干扰素", + "B": "高效价乙肝免疫球蛋白", + "C": "乙肝疫苗", + "D": "乙肝疫苗加干扰素", + "E": "高效价乙肝免疫球蛋白加乙肝疫苗" + }, + "answer": "E", + "reason": "阻断乙型肝炎母婴传播可通过注射高效价乙肝免疫球蛋白加乙肝疫苗来实现。" + }, + { + "question_num": 8, + "query": "下列不属于实性病理反映的是", + "options": { + "A": "壮热", + "B": "精神亢奋", + "C": "脉实有力", + "D": "五心烦热", + "E": "二便不通" + }, + "answer": "D", + "reason": "所谓实，指邪气亢盛，是以邪盛为矛盾主要方面的一种病理反应。表现：体质壮实，精神亢奋，或壮热狂躁，或烦躁不宁，或疼痛拒按，或声高气粗，二便不通，脉实有力等症，或表现为痰涎壅盛、食积不化、水湿泛滥、气滞血瘀等病变。" + }, + { + "question_num": 9, + "query": "下列不属于小儿注意力缺陷多动障碍肝肾阴虚证的证候表现是", + "options": { + "A": "思维缓慢", + "B": "腰酸乏力", + "C": "五心烦热", + "D": "急躁易怒", + "E": "冲动任性" + }, + "answer": "A", + "reason": "小儿注意力缺陷障碍肝肾阴虚证证候表现:多动难静，急躁易怒，冲动任性，难以自控，神思涣散，注意力不集中，难以静坐,或有记忆力欠佳、学习成绩低下，或有遗尿、腰酸乏力,或有五心烦热、盗汗、大便秘结舌红，苔薄，脉弦细" + }, + { + "question_num": 10, + "query": "既是六腑，又是奇恒之腑的是", + "options": { + "A": "胆", + "B": "��", + "C": "大肠", + "D": "小肠", + "E": "三焦" + }, + "answer": "A", + "reason": "六腑，即胆、胃、大肠、小肠、膀胱、三焦的总称，其生理功能是腐熟、消化饮食物，传化糟粕。奇恒之腑，包括脑、髓、骨、脉、胆、女子胞，形态中空与腑相似，在功能上却不是饮食物消化排泄的通道，但又贮藏精气，与脏的生理功能特点相似。胆的主要生理功能是贮存和排泄胆汁，胆汁直接有助于饮食物的消化，故为六腑之一，但是胆本身无传化饮食物的生理功能，且藏精汁，又属奇恒之腑。" + }, + { + "question_num": 11, + "query": "幼儿急疹最多见的发病年龄是", + "options": { + "A": "小于6个月", + "B": "6~18个月", + "C": "1~3岁", + "D": "3~5岁", + "E": "5~7岁" + }, + "answer": "B", + "reason": "幼儿急疹,即奶麻,多发生于6~18个月小儿。" + }, + { + "question_num": 12, + "query": "水臌病证，当腹水严重，腹部胀满，二便不利时，应选用的治疗原则是", + "options": { + "A": "反治", + "B": "治本", + "C": "标本兼治", + "D": "从治", + "E": "治标" + }, + "answer": "E", + "reason": "急则治其标，缓则治其本。水臌病证，腹水严重、高热、大失血都应治标。" + }, + { + "question_num": 13, + "query": "小儿四肢厥冷,唇舌红赤,为", + "options": { + "A": "阳虚", + "B": "阴虚内热", + "C": "真热假寒", + "D": "虚寒", + "E": "热深厥甚" + }, + "answer": "C", + "reason": "小儿四肢厥冷，唇舌红赤者为真热假寒" + }, + { + "question_num": 14, + "query": "下列属于证的是", + "options": { + "A": "肝郁气滞", + "B": "腹痛", + "C": "积聚", + "D": "头痛", + "E": "恶寒发热" + }, + "answer": "A", + "reason": "证，即证候，是疾病过程中某一阶段或某一类型的病理概括。一般由一组相对固定的、有内在联系的、能揭示疾病某一阶段或某一类型病变本质的症状和体征构成。BCD项属于病，E项属于症。" + }, + { + "question_num": 15, + "query": "蛔虫病患者以腹痛为主要症状,其疼痛部位主要在", + "options": { + "A": "胃脘部", + "B": "左下腹", + "C": "脐周部", + "D": "右下腹", + "E": "痛无定处" + }, + "answer": "C", + "reason": "蛔虫病患者常腹痛,位于脐周部,不剧烈，喜按揉。" + }, + { + "question_num": 16, + "query": "精气血津液之间相互转化依靠气的", + "options": { + "A": "推动与调控作用", + "B": "温煦与凉润作用", + "C": "防御作用", + "D": "中介作用", + "E": "气化作用" + }, + "answer": "E", + "reason": "气的运动而产生的各种变化称为气化。体内精气血津液各自的代谢及其相互转化，是气化的基本形式。" + }, + { + "question_num": 17, + "query": "治疗小儿病毒性心肌炎,主张大量使用的维生素是", + "options": { + "A": "维生素A", + "B": "维生素B", + "C": "维生素C", + "D": "维生素D", + "E": "维生素E" + }, + "answer": "C", + "reason": "维生素C有减少细胞内和血液内脂质氧化物浓度，消除自由基，增加冠状动脉血流量，改善心肌代谢，促进心肌炎恢复等作用，主张大剂量使用。" + }, + { + "question_num": 18, + "query": "事物或现象阴阳属性的征兆是", + "options": { + "A": "寒热", + "B": "上下", + "C": "水火", + "D": "晦明", + "E": "动静" + }, + "answer": "C", + "reason": "《素问・阴阳应象大论》“故曰：天地者，万物之上下也；阴阳者，血气之男女也；左右者，阴阳之道路也；水火者，阴阳之征兆也；阴阳者，万物之能使也；故曰：阴在内，阳之守也；阳在外，阴之使也。”" + }, + { + "question_num": 19, + "query": "下列关于望小儿姿态的叙述,正确的是", + "options": { + "A": "喜蜷卧者,多为内伤乳食", + "B": "喜伏卧者,多为内寒或腹痛", + "C": "气促鼻扇,胸肋凹陷,常为哮喘", + "D": "端坐喘促,痰鸣哮吼,多为肺炎喘嗽", + "E": "翻滚不安,呼叫哭吵,双手捧腹,多为腹痛" + }, + "answer": "E", + "reason": "喜伏卧者,多为内伤乳食;喜蜷卧者，多为内寒或腹痛;翻滚不安，呼叫哭吵，双手捧腹,多为腹痛;端坐喘促,痰鸣哮吼多为哮喘;气促鼻扇，胸肋凹陷，常为肺炎喘嗽。" + }, + { + "question_num": 20, + "query": "在奇经八脉中，其循行多次与手、足三阳经及阳维脉交会的是", + "options": { + "A": "冲脉", + "B": "任脉", + "C": "督脉", + "D": "阴维脉", + "E": "阳跷脉" + }, + "answer": "C", + "reason": "督脉行于背部正中，其脉��次与手足三阳经及阳维脉交会，能总督一身之阳经，又称“阳脉之海”，对全身阳经气血起调节作用。" + }, + { + "question_num": 21, + "query": "与胎黄发病无关的脏腑是", + "options": { + "A": "脾", + "B": "胃", + "C": "肝", + "D": "胆", + "E": "肾" + }, + "answer": "E", + "reason": "胎黄的发病与先天禀赋因素及后天感受湿邪或湿热毒邪密切相关。病机为寒湿或湿热之邪阻滞脾胃，肝失疏泄，胆汁外溢，而发为胎黄，病位主要在脾、胃肝、胆。" + }, + { + "question_num": 22, + "query": "五脏藏神，则肝藏", + "options": { + "A": "魂", + "B": "神", + "C": "意", + "D": "魄", + "E": "志" + }, + "answer": "A", + "reason": "“神、魂、魄、意、志”，分别由心、肝、肺、脾、肾五脏主司。" + }, + { + "question_num": 23, + "query": "最常见的心搏骤停的病因是", + "options": { + "A": "冠心病", + "B": "高血压", + "C": "病态窦房结综合征", + "D": "QT间期延长综合征", + "E": "肥厚型梗阻性心肌病" + }, + "answer": "A", + "reason": "心搏骤停:80%由冠心病及其并发症引起，此外为心肌病(肥厚型、扩张型)、心瓣膜病、先天性心血管疾病、急性心包填塞、充血性心力衰竭、电解质失衡、QT间期延长综合征、神经内分泌等因素所引起。" + }, + { + "question_num": 24, + "query": "邪热内盛，深伏于里，阳气被遏，不能外达，手足厥冷，此属于", + "options": { + "A": "阳损及阴", + "B": "阳盛格阴", + "C": "阴盛格阳", + "D": "阴损及阳", + "E": "阴阳脱失" + }, + "answer": "B", + "reason": "阳盛格阴是指阳盛于内，实热炽盛，为疾病的本质，但由于格阴于外（实际是阳气不能外达），可表现出某些假寒之象，即为真热假寒证。" + }, + { + "question_num": 25, + "query": "成人细菌性痢疾治疗首选", + "options": { + "A": "环丙沙星", + "B": "青霉素", + "C": "头孢曲松钠", + "D": "氯霉素", + "E": "磺胺嘧啶" + }, + "answer": "A", + "reason": "成人细菌性痢疾治疗首选氟喹诺酮类药，如环丙沙星、氧氟沙星、加替沙星等" + }, + { + "question_num": 26, + "query": "被称为“传导之官”的是", + "options": { + "A": "胃", + "B": "小肠", + "C": "大肠", + "D": "膀胱", + "E": "三焦" + }, + "answer": "C", + "reason": "大肠接受由小肠下传的食物残渣，吸收其中多余的水液，形成粪便。大肠之气的运动，将粪便传送至大肠末端，并经肛门有节制地排出体外，故大肠有“传导之官”之称。" + }, + { + "question_num": 27, + "query": "伤寒患者出现特殊中毒面容是在", + "options": { + "A": "初期", + "B": "侵袭期", + "C": "极期", + "D": "缓解期", + "E": "恢复期" + }, + "answer": "C", + "reason": "伤寒极期神经系统表现:呈特殊的中毒面容，表情淡淡、反应迟钝、听力减退,重者可有谵妄、抓空、昏迷或出现脑膜刺激征。" + }, + { + "question_num": 28, + "query": "三焦的生理功能是", + "options": { + "A": "通行诸气", + "B": "传化水谷", + "C": "化生精气", + "D": "调畅气机", + "E": "宣发肃降" + }, + "answer": "A", + "reason": "三焦的生理功能有二：一是通行诸气，二是运行津液。" + }, + { + "question_num": 29, + "query": "中医学的基本特点是", + "options": { + "A": "整体观念和阴阳五行", + "B": "四诊八纲和辨证论治", + "C": "同病异治和异病同治", + "D": "整体观念和辨证论治", + "E": "阴阳五行和五运六气" + }, + "answer": "D", + "reason": "中医学理论体系的基本特点是整体观念和辨证论治。" + }, + { + "question_num": 30, + "query": "血淋与尿血的鉴别要点，在于", + "options": { + "A": "属虚属实", + "B": "在表在里", + "C": "属寒属热", + "D": "尿痛与不痛", + "E": "血在尿前尿后" + }, + "answer": "D", + "reason": "血淋和尿血共同症状为尿中带血，或尿色红赤，但血淋排尿时尿道刺痛，而尿血则无明显尿痛。" + }, + { + "question_num": 31, + "query": "属于“阴中之阴”的是", + "options": { + "A": "上午", + "B": "下午", + "C": "前半夜", + "D": "中午", + "E": "后半夜" + }, + "answer": "C", + "reason": "属于“阴中之阴”的是前半夜。" + }, + { + "question_num": 32, + "query": "毒邪致病的特点是", + "options": { + "A": "一般发病迅速，有的可具有传染性", + "B": "多侵犯人体上部", + "C": "侵袭人体，易致局部气血凝滞", + "D": "好发于身体下部", + "E": "易伤人体阴液" + }, + "answer": "A", + "reason": "B项多为风邪致病，C项多为寒邪致病，D项多为湿邪致病，E项多为燥邪致病。发病迅速，具有传染性，多为毒邪引起。" + }, + { + "question_num": 33, + "query": "下列不会导致失眠的是", + "options": { + "A": "痰湿内盛", + "B": "食积胃脘", + "C": "阴虚火旺", + "D": "痰火扰心", + "E": "心胆气虚" + }, + "answer": "A", + "reason": "A项痰湿内盛,湿邪困脾清阳不升，头失所养而致嗜睡;B项饮食停滞、脾胃受伤，气机被阻，腹中不适，故失眠;C项肾水不足，心火独亢，虚热上扰神明,故失眠;D项胸膈有痰饮，积痰生热，痰火扰心，故失眠;E项心胆气虚,神摇不安,故失眠。" + }, + { + "question_num": 34, + "query": "内伤咳嗽的病理因素有痰、湿、饮、火、虚等，其中主要是", + "options": { + "A": "痰与火", + "B": "痰与饮", + "C": "痰与湿", + "D": "湿与虚", + "E": "痰与瘀" + }, + "answer": "A", + "reason": "内伤咳嗽，主要与肝、脾、肾有关。与肝有关主要是因为情志不遂，郁怒伤肝，肝失条达，气机不畅，日久气郁化火，肝脉上注于肺，肝火犯肺，发为咳嗽，因此火为咳嗽的主要病理因素。与脾有关主要是因为饮食不当损伤脾胃，或者平时脾运不健，饮食精微不能运化，反而生成痰浊，肺脉连接胃，痰邪犯肺，发生咳嗽，因此痰也是咳嗽的主要病理因素。" + }, + { + "question_num": 35, + "query": "前胸高起,按之气喘者为", + "options": { + "A": "肺胀", + "B": "悬饮", + "C": "支饮", + "D": "痰饮", + "E": "肺痈" + }, + "answer": "A", + "reason": "前胸高起,按之气喘者为肺胀。" + }, + { + "question_num": 36, + "query": "胸痹的表现，总属", + "options": { + "A": "气血失和", + "B": "寒热错杂", + "C": "气血两虚", + "D": "本虚标实", + "E": "上盛下虚" + }, + "answer": "D", + "reason": "胸痹临床主要表现为本虚标实，发作期以标实为主，缓解期以本虚为主。" + }, + { + "question_num": 37, + "query": "为“血中气药”,能“上行头目,下调经水”的药物是", + "options": { + "A": "川芎", + "B": "延胡索", + "C": "姜黄", + "D": "莪术", + "E": "郁金" + }, + "answer": "A", + "reason": "川芎行气活血,祛风止痛,被称为“血中气药”,能“上行头目，下调经水”" + }, + { + "question_num": 38, + "query": "气瘿的特点是", + "options": { + "A": "肿块坚硬", + "B": "疼痛", + "C": "随喜怒消长", + "D": "肿块局限", + "E": "红肿热痛" + }, + "answer": "C", + "reason": "气瘿表现为颈部一侧或双侧呈弥漫性肿大，边缘不清，软而不坚，皮色如常，一般不痛，随喜怒而消长是其特殊的临床表现。" + }, + { + "question_num": 39, + "query": "观察舌苔以辨别病邪深浅的主要依据是", + "options": { + "A": "舌苔的有无", + "B": "苔质的厚薄", + "C": "苔色的黄白", + "D": "苔质的润燥", + "E": "舌苔的真假" + }, + "answer": "B", + "reason": "A项主要辨别胃气的有无;C项主要辨别病邪的寒热，苔色黄属热，白属寒;D项可了解津液的变化;E项辨舌苔真假，可判断疾病的轻重与预后。" + }, + { + "question_num": 40, + "query": "下列不属于瘤和岩的病因的是", + "options": { + "A": "六淫之邪", + "B": "情志郁结", + "C": "脏腑失调", + "D": "瘀血阻滞", + "E": "饮食不节" + }, + "answer": "D", + "reason": "瘤:由饮食失节,脏腑功能失调，气血逆乱，导致浊气、痰凝留着聚结而成。岩:外因为六淫之邪，内因为正气不足和七情刺激。" + }, + { + "question_num": 41, + "query": "阴虚证典型的舌象、脉象是", + "options": { + "A": "舌红,脉数有力", + "B": "舌淡,脉细无力", + "C": "舌红少苔,脉细数", + "D": "舌红苔黄,脉细数", + "E": "舌红,脉滑数" + }, + "answer": "C", + "reason": "A项为实热之征;B项为气血虚之征;D项为阴虚火旺之征;E项为热痰火之征。" + }, + { + "question_num": 42, + "query": "阴黄的最主要病机是", + "options": { + "A": "寒湿阻滞，脾阳不足", + "B": "肺失宣发，水湿内停", + "C": "瘀阻肝脾，水气内盛", + "D": "湿热熏蒸，湿遏热伏", + "E": "肝胆郁热，气机阻滞" + }, + "answer": "A", + "reason": "黄疸病理性质有阴阳之分。湿热交蒸，发为阳黄;寒湿阻滞,发为阴黄。寒湿为阴邪，黄色晦暗,或如烟熏。" + }, + { + "question_num": 43, + "query": "不出现眩晕症状的���胆病是", + "options": { + "A": "胆郁痰扰", + "B": "肝阳上亢", + "C": "肝气郁结", + "D": "肝血虚", + "E": "肝阴虚" + }, + "answer": "C", + "reason": "肝气郁结证以情志抑郁,胸胁或少腹胀痛、窜痛，或妇女月经失调等为主要表现，无眩晕的症状。解价胖岗气屈的临床表现定脱痛，食少，便溏，" + }, + { + "question_num": 44, + "query": "下列各项，不属血瘤的特点的是", + "options": { + "A": "边界不清", + "B": "触之如海绵状", + "C": "柔软而局限", + "D": "色泽鲜红或暗紫", + "E": "盘曲如蚯蚓状" + }, + "answer": "E", + "reason": "血瘤可发生于身体任何部位，但以四肢、躯干、面颈部多见。瘤体外观呈暗红色或紫蓝色，亦可为正常皮色，小如豆粒，大如拳头，质地柔软，边界不清，状如海绵，压之可缩小，肢体活动时胀大。" + }, + { + "question_num": 45, + "query": "脾胃气虚的临床表现是", + "options": { + "A": "脘痞,嗳腐吞酸", + "B": "脘痛,食少,便溏", + "C": "脘痞,纳呆,呕恶,苔腻", + "D": "脘痞,胃脘有振水声", + "E": "脘痞,饥不欲食,干呕" + }, + "answer": "B", + "reason": "麻黄的功效:发汗解表,宣肺平喘，利水消肿" + }, + { + "question_num": 46, + "query": "外科辨肿，肿势平坦，根盘散漫，其成因是", + "options": { + "A": "火", + "B": "风", + "C": "气", + "D": "郁", + "E": "虚" + }, + "answer": "E", + "reason": "肿势平坦,根盘散漫,常见于正虚不能托毒之疮疡。肿分为热肿、寒肿、风肿、湿肿、痰肿、气肿、瘀血肿、脓肿、实肿、虚肿等。外科辨肿，肿势平坦，根盘散漫，无热无寒,是虚所致。" + }, + { + "question_num": 47, + "query": "麻黄具有的功效是", + "options": { + "A": "解鱼蟹毒", + "B": "平喘利水", + "C": "祛风胜湿", + "D": "行气宽中", + "E": "温经通阳" + }, + "answer": "D", + "reason": "耳鸣如蝉多由肾虚精亏,髓海不充，耳失所养而致。" + }, + { + "question_num": 48, + "query": "风寒感冒和风热感冒的辨证依据，错误的是", + "options": { + "A": "恶寒、发热的轻重", + "B": "渴与不渴", + "C": "舌苔黄与白", + "D": "脉浮与不浮", + "E": "咽喉红肿疼痛与否" + }, + "answer": "D", + "reason": "风寒、风热感冒都属表证,都见脉浮，不同的是，风寒感冒脉浮紧，而风热感冒脉浮数。" + }, + { + "question_num": 49, + "query": "下列不属于气虚证的表现是", + "options": { + "A": "自汗", + "B": "神疲乏力", + "C": "头晕目眩", + "D": "耳鸣如蝉", + "E": "语声低微" + }, + "answer": "E", + "reason": "霍乱补液原则:早期、快速:足量，先盐后糖，先快后慢,纠酸补钙，见尿补钾;静脉补液以5:4:1溶液为主;轻、中度脱水患者可予以口服补液;重度患者在补液过程中若出现低钾综合征可口服氟化钾或静脉滴注氟化钾;最初24小时总入量按临床分型的轻、中、重分别给3000~4000mml、4000~8000ml8000~12000m1." + }, + { + "question_num": 50, + "query": "治疗水肿湿毒浸淫证，应首选", + "options": { + "A": "越婢加术汤", + "B": "麻黄连翘赤小豆汤合五味消毒饮", + "C": "五皮饮合胃苓汤", + "D": "实脾饮", + "E": "疏凿饮子" + }, + "answer": "B", + "reason": "麻黄连翘赤小豆汤合五味消毒饮具有宣肺解毒、利湿消肿的作用。肌肤乃脾肺所主之城，混青未能及时清解消散，则内归脏腑，使肺不能通调水道而小便不利，脾不能运化水湿，失其升清降浊之能，所以应宣肺解毒、利湿消肿，" + }, + { + "question_num": 51, + "query": "百合固金汤所治阴虚证的主要脏腑是", + "options": { + "A": "肺、肾", + "B": "肝、胃", + "C": "心、肝", + "D": "脾、胃", + "E": "肺、胃" + }, + "answer": "A", + "reason": "百合固金汤滋养肺肾、止咳化痰，用于肺肾阴亏、虚火上炎证，症见咳嗽气喘，痰中带血,咽喉燥痛，头晕目眩,午后潮热,舌红少苔,脉细数。" + }, + { + "question_num": 52, + "query": "睾丸及附睾的急性化脓性感染称为", + "options": { + "A": "子痰", + "B": "囊痈", + "C": "子痈", + "D": "脱囊", + "E": "卵子瘟" + }, + "answer": "C", + "reason": "子痈是指睾丸及附睾的化脓性疾病。中医称睾九和附睾为肾子。" + }, + { + "question_num": 53, + "query": "下列关于治疗霍乱补液原则的叙述，不正确的是", + "options": { + "A": "中型患者24小时补液量为4000~8000ml", + "B": "轻、中型患者可予以口服补液", + "C": "静脉补液以5:4:1溶液为主", + "D": "重型患者治疗应早期快速静脉补液", + "E": "重型患者应积极补钾" + }, + "answer": "E", + "reason": "霍乱补液原则:早期、快速:足量，先盐后糖，先快后慢,纠酸补钙，见尿补钾;静脉补液以5:4:1溶液为主;轻、中度脱水患者可予以口服补液;重度患者在补液过程中若出现低钾综合征可口服氟化钾或静脉滴注氟化钾;最初24小时总入量按临床分型的轻、中、重分别给3000~4000mml、4000~8000ml8000~12000m1." + }, + { + "question_num": 54, + "query": "治疗胸痹心肾阴虚证，应首选", + "options": { + "A": "生脉散合人参养荣汤", + "B": "六味地黄丸", + "C": "麦味地黄丸", + "D": "天王补心丹合炙甘草汤", + "E": "沙参麦冬汤" + }, + "answer": "D", + "reason": "本证治宜滋阴清火,养心和络。天王补心丹合炙甘草汤，两方均为滋阴养心之剂，用于气阴两虚,心动悸,脉结代。" + }, + { + "question_num": 55, + "query": "治疗流行性脑脊髓膜炎，应首选的抗菌药物是", + "options": { + "A": "磺胺嘧啶", + "B": "氯霉素", + "C": "红霉素", + "D": "磷霉素", + "E": "青霉素" + }, + "answer": "E", + "reason": "青盘素对脑膜炎球菌仍是一种高度敏感的杀菌药物，尚未出现明显的耐药，为治疗流行性脑脊髓膜炎首选的抗菌药物。主治风寒感冒，脾胃气滞，胸闷呕吐，解鱼蟹毒。" + }, + { + "question_num": 56, + "query": "肠痈的临床表现有", + "options": { + "A": "腹痛多起于脐周或上腹部", + "B": "腹痛转移并固定在右下腹部", + "C": "疼痛呈持续性、进行性加重", + "D": "右下腹明显压痛、反跳痛，局限性腹皮挛急", + "E": "以上都是" + }, + "answer": "E", + "reason": "肠痈相当于阑尾炎,初期有中上腹或脐周疼痛，数小时后腹痛转移并固定于右下腹。当炎症波及浆膜层和壁腹膜时，疼痛固定于右下腹，原中上腹或脐周痛减轻或消失。" + }, + { + "question_num": 57, + "query": "紫苏不具有的功效是", + "options": { + "A": "发汗解表", + "B": "行气宽中", + "C": "行气安胎", + "D": "解鱼蟹毒", + "E": "平喘利水" + }, + "answer": "B", + "reason": "大黄可泻下攻积,清热泻火,凉血解毒，逐瘀通经;芒硝可泻下攻积,润燥软坚，清热消肿;芦荟可泻下通便,清肝,杀虫;郁李仁可润肠通便,利水消肿;番泻叶可泻下通便。" + }, + { + "question_num": 58, + "query": "下列不属于月经生理现象的是", + "options": { + "A": "周期21～35天", + "B": "经期3～7天", + "C": "经量100～150ml", + "D": "经色暗红", + "E": "经质不稀不稠，无血块，无特殊气味" + }, + "answer": "C", + "reason": "正常月经周期为28天左右，21～35天也属于正常范围；正常经期为3～7天，多数为4～5天；经量一般为20～60ml；正常经色多为暗红色；正常经血应是不稀不稠，不凝结，无血块，无特殊气味。" + }, + { + "question_num": 59, + "query": "具有泻下,软坚,清热功效的药物是", + "options": { + "A": "大黄", + "B": "芒硝", + "C": "芦荟", + "D": "郁李仁", + "E": "番泻叶" + }, + "answer": "C", + "reason": "银翘散组成药物:连翘、银花、桔梗、荷、竹叶、生甘草、荆芥穗、淡豆豉、牛蒡子、鲜苇根。桑菊饮组成药物:桑叶、菊花、杏仁、连翘、薄荷、桔梗、生甘草、苇根。两者都含连翘、薄荷、桔梗、生甘草、苇根。" + }, + { + "question_num": 60, + "query": "猩红热的临床表现不包括", + "options": { + "A": "发热、咽峡炎", + "B": "草莓舌", + "C": "帕氏线", + "D": "环口苍白圈", + "E": "麻疹黏膜斑" + }, + "answer": "E", + "reason": "麻疹黏膜斑是麻疹的特有体征，发热、咽峡炎、草莓舌、帕氏线、环口苍白圈均是猩红热的临床表现。" + }, + { + "question_num": 61, + "query": "银翘散和桑菊饮两方组成中均含有的药物是", + "options": { + "A": "连翘、杏仁、桔梗", + "B": "银花、桔梗、杏仁", + "C": "连翘、薄荷、苇根", + "D": "银花、薄荷、苇根", + "E": "甘草、杏仁、苇根" + }, + "answer": "D", + "reason": "牡蛎散组成药物:黄芪、麻黄根、煅牡蛎(入小麦百余粒同煎)。主治体虚自汗、盗汗证。" + }, + { + "question_num": 62, + "query": "以阴阳失调来阐释真寒假热或真热假寒，其病机是", + "options": { + "A": "阴阳偏盛", + "B": "阴阳偏衰", + "C": "阴阳格拒", + "D": "阴阳互损", + "E": "阴阳离决" + }, + "answer": "C", + "reason": "真寒假热或真热假寒是因阴或阳的一方偏盛至��，壅遏于内，将另一方排斥格拒于外，迫使阴阳之间不能维系，以阴阳失调来阐释，即阴阳格拒。" + }, + { + "question_num": 63, + "query": "牡蛎散煎煮时,原方注明应加入的药物是", + "options": { + "A": "桔梗", + "B": "乌梅", + "C": "白果", + "D": "小麦", + "E": "诃子" + }, + "answer": "E", + "reason": "炙甘草汤组成:炙甘草、生姜、人参、生地黄、桂枝、阿胶、麦门冬、麻仁、大枣、清酒。ABCD项均不属于炙甘草汤的组成药物，可排除。阿胶的功效:补血，滋阴，润肺止血。" + }, + { + "question_num": 64, + "query": "导致疾病发生的基础是", + "options": { + "A": "邪气偏盛", + "B": "正气不足", + "C": "邪胜正衰", + "D": "正胜邪退", + "E": "邪正相持" + }, + "answer": "B", + "reason": "正气不足是疾病发生的基础，邪气是发病的重要条件。" + }, + { + "question_num": 65, + "query": "炙甘草汤中具有补血作用的药物是", + "options": { + "A": "熟地黄", + "B": "白芍", + "C": "龙眼肉", + "D": "当归", + "E": "阿胶" + }, + "answer": "B", + "reason": "治头痛的要药是川芎。本品具有活血行气、祛风止痛的功效，其性辛温升散，能“上行头目”，祛风止痛，为治头痛要药，无论风寒、风热、风湿、血虚、血瘀头痛均可随证配伍用之" + }, + { + "question_num": 66, + "query": "在脉象上濡脉与弱脉的主要区别是", + "options": { + "A": "节律", + "B": "至数", + "C": "脉力", + "D": "脉位", + "E": "流利度" + }, + "answer": "D", + "reason": "濡脉浮细而无力，弱脉沉细而无力，因此二者脉位相反。" + }, + { + "question_num": 67, + "query": "善“上行头目”,功能祛风止痛,为治头痛要药的是", + "options": { + "A": "羌活", + "B": "川芎", + "C": "细辛", + "D": "白芷", + "E": "吴茱萸" + }, + "answer": "E", + "reason": "菟丝子具有补肾益精、养肝明目、止泻、安胎的功效。因其可滋补肝肾、益精养血而明目，故可治疗肝肾不足，目暗不明!又因其能补肝肾安胎，故可用于治疗肾虚胎动不安,常与续断、桑寄生、阿胶同用，治肾虚胎元不固，如胎动不安、滑胎等。" + }, + { + "question_num": 68, + "query": "下列不属于弦脉所主病证的是", + "options": { + "A": "肝郁", + "B": "胃热", + "C": "疼痛", + "D": "痰饮", + "E": "疟疾" + }, + "answer": "B", + "reason": "弦脉主肝胆病、疼痛、痰饮，以及老年健康者。胃热可见数脉。" + }, + { + "question_num": 69, + "query": "既治肝肾不足、目暗不明，又治胎动不安的药物是", + "options": { + "A": "杜仲", + "B": "巴戟天", + "C": "狗脊", + "D": "桑寄生", + "E": "菟丝子" + }, + "answer": "E", + "reason": "菟丝子具有补肾益精、养肝明目、止泻、安胎的功效。因其可滋补肝肾、益精养血而明目，故可治疗肝肾不足，目暗不明!又因其能补肝肾安胎，故可用于治疗肾虚胎动不安,常与续断、桑寄生、阿胶同用，治肾虚胎元不固，如胎动不安、滑胎等。" + }, + { + "question_num": 70, + "query": "表情淡漠，神识痴呆，喃喃自语，哭笑无常，悲观失望，其临床意义是", + "options": { + "A": "心胆气虚，心神失养", + "B": "痰火扰心", + "C": "肝风挟痰，蒙蔽清窍", + "D": "痰浊蒙蔽心神", + "E": "脏腑精气耗竭" + }, + "answer": "D", + "reason": "淡漠痴呆是指表情淡漠，神识痴呆，喃喃自语，哭笑无常，悲观失望。多由痰浊蒙蔽心神，或先天禀赋不足所致，常见于癫痫、痴呆等。" + }, + { + "question_num": 71, + "query": "外用杀虫,主治疥疮,内服可助阳通便的药物是", + "options": { + "A": "雄黄", + "B": "硫黄", + "C": "蛇床子", + "D": "樟脑", + "E": "土荆皮" + }, + "answer": "B", + "reason": "雄黄内服燥湿祛痰,截疟。硫黄内服治阳痿，虚喘冷哮，虚寒便秘。蛇床子内服可燥湿，温肾壮阳。樟脑内服可治疗痧胀腹痛，吐泻神昏。土荆皮只供外用，不可内服。" + }, + { + "question_num": 72, + "query": "口腔黏膜灰白色小溃疡，周围红晕，局部痛者，称为", + "options": { + "A": "口糜", + "B": "口疮", + "C": "鹅口疮", + "D": "口噤", + "E": "口撮" + }, + "answer": "B", + "reason": "口疮：唇内和口腔黏膜出现灰白色小溃疡，周围红晕，局部疼痛。口糜：口腔黏膜糜烂成片，口气臭秽。鹅口疮：口腔、舌上出现片状白屑，状如鹅口。口噤：口闭而难开，牙关紧急。口撮：上下口唇紧聚，不能���吸。" + }, + { + "question_num": 73, + "query": "能利尿通淋、清热解暑、收湿敛疮的药物是", + "options": { + "A": "滑石", + "B": "车前子", + "C": "地肤子", + "D": "木通", + "E": "石韦" + }, + "answer": "A", + "reason": "滑石可以利尿通淋,清热解暑，收湿敛疮。车前子利尿通淋，渗湿止泻，明目，祛痰。地肤子利尿通淋，清热利湿，止痒木通利尿通淋，清心火，通经下乳。石韦利尿通淋，清肺止咳，凉血止血。" + }, + { + "question_num": 74, + "query": "治疗阴痒肝肾阴虚证，应首选", + "options": { + "A": "左归丸", + "B": "归肾丸", + "C": "保阴煎", + "D": "固阴煎", + "E": "知柏地黄汤" + }, + "answer": "E", + "reason": "素体肝肾不足；或年老体衰，精血亏损；或久病不愈，阴血不足，以致肝肾阴虚。肝脉过阴器，肾司二阴，精血亏少，冲任血虚，阴部肌肤失养，血燥生风，风动则痒，发为阴痒，其治法为调补肝肾，滋阴降火。方用知柏地黄汤。" + }, + { + "question_num": 75, + "query": "止泻宜煨用的药物是", + "options": { + "A": "葛根", + "B": "柴胡", + "C": "升麻", + "D": "桑叶", + "E": "薄荷" + }, + "answer": "A", + "reason": "葛根解肌退热、透疹、生津宜生用，升阳止泻宜煨用。柴胡解表退热宜生用，疏肝解郁宜醋炙，升阳可生用或酒炙。升麻可解表透疹，清热解毒，升举阳气。桑叶可疏散风热，清肺润燥，平抑肝阳，清肝明目，肺燥咳嗽多用蜜炙桑叶。薄荷可疏散风热，清利头目，利咽透疹，疏肝行气，宜生用。" + }, + { + "question_num": 76, + "query": "乳岩的特点是", + "options": { + "A": "乳块肿痛，固定不移，按后痛甚", + "B": "肿块高低不平，质硬，推之不动", + "C": "乳块呈卵圆形，表面光滑，推之活动", + "D": "乳块质地较软，月经后缩小", + "E": "乳块皮肉相连，溃破脓稀薄如痰" + }, + "answer": "B", + "reason": "乳岩是指乳房部的恶性肿瘤，相当于西医的乳腺癌，其特点是乳房部出现无痛、无热、皮色不变而质地坚硬的肿块，推之不移，表面不光滑，或乳头溢血，晚期溃烂，凸如泛莲。" + }, + { + "question_num": 77, + "query": "小承气汤与厚朴三物汤之间的变化属于", + "options": { + "A": "药味加减的变化", + "B": "药量增减的变化", + "C": "剂型更换的变化", + "D": "药味加减与药量增减变化联合运用", + "E": "药味加减与剂型更换变化联合运用" + }, + "answer": "B", + "reason": "小承气汤以大黄4两(12g)为君，积实3枚(9g)为臣，厚朴2两(6g)为佐;而厚朴三物汤:厚朴8两(24g)，积实5枚(15g)，大黄4两(12g)" + }, + { + "question_num": 78, + "query": "关于一次切开挂线法治疗肛痈的适应证错误的是", + "options": { + "A": "肛门旁皮下脓肿", + "B": "坐骨直肠间隙脓肿", + "C": "骨盆直肠间隙脓肿", + "D": "直肠后间隙脓肿", + "E": "马蹄形脓肿" + }, + "answer": "A", + "reason": "一次切开挂线法治疗肛痈的适应证：高位脓肿，如由肛隐窝感染而致坐骨直肠间隙脓肿、骨盆直肠间隙脓肿、直肠后间隙脓肿及马蹄形脓肿等。" + }, + { + "question_num": 79, + "query": "补中益气汤主治病证的临床表现,不包括", + "options": { + "A": "胸脘闷胀", + "B": "气短乏力", + "C": "渴喜热饮", + "D": "体倦肢软", + "E": "脉洪而虚" + }, + "answer": "A", + "reason": "补中益气汤主治包括以下几点:①脾胃气虚证为饮食减少，体倦肢软，少气懒言，面色萎黄,大便稀溏,脉虚软;②气虚下陷证为脱肛、子宫脱垂、久泻、久痢、崩漏等,伴气短乏力，舌淡，脉虚;③气虚发热证为身热自汗,渴喜热饮,气短乏力,舌淡,脉虚大无力。" + }, + { + "question_num": 80, + "query": "治疗不孕症肾阳虚证，应首选的方剂是", + "options": { + "A": "温胞饮", + "B": "金匮肾气丸", + "C": "毓麟珠", + "D": "温冲汤", + "E": "二仙汤" + }, + "answer": "A", + "reason": "不孕症肾阳虚证，治以温肾助阳，化湿固精，方选温胞饮。毓麟珠也可治疗不孕症，但其主治肾气虚证。" + }, + { + "question_num": 81, + "query": "神识不清,语言重复,时断时续,语声低弱,称为", + "options": { + "A": "谵语", + "B": "郑声", + "C": "短气", + "D": "错语", + "E": "哮喘" + }, + "answer": "B", + "reason": "谵语表现为神志不清,语无伦次，声高有力;郑声表现为神识不清，语言重复，时断时续，语声低弱模糊;语言错乱，说后自知称错语;短气指呼吸气急而短���不足以息，数而不能接续，似喘而不抬肩，喉中无痰鸣音:哮喘指喉中哮鸣有声,喉中痰鸣，主要表现为呼吸困难。" + }, + { + "question_num": 82, + "query": "治疗不孕症痰湿内阻证，应首选的方剂是", + "options": { + "A": "苍附导痰丸", + "B": "启宫丸", + "C": "半夏白术天麻汤", + "D": "开郁二陈汤", + "E": "陈夏六君子汤" + }, + "answer": "A", + "reason": "治疗不孕症痰湿内阻证，治宜燥湿化痰，行滞调经，方选苍附导痰丸。" + }, + { + "question_num": 83, + "query": "下列哪项不是引起血瘀的常见因素", + "options": { + "A": "寒凝", + "B": "气滞", + "C": "气虚", + "D": "外伤", + "E": "阴虚" + }, + "answer": "E", + "reason": "外伤可致血瘀,因外伤损伤血络，血液不能正常运行，可致血瘀;寒凝可致血瘀，因寒邪凝滞，血液运行缓慢，可出现血瘀;气虚可致血瘀，因其推动血液运行的功能障碍，故可形成血瘀;气滞也可致血瘀，气滞使血运不畅，故可引起血瘀。阴虚则火旺，热盛则迫血妄行，多表现为出血。" + }, + { + "question_num": 84, + "query": "房劳过度而致肾虚腰痛者，治疗应首选的方剂是", + "options": { + "A": "左归丸", + "B": "右归丸", + "C": "杜仲丸", + "D": "青蛾丸", + "E": "河车大造丸" + }, + "answer": "E", + "reason": "A项用于肾阴虚腰痛；B项用于肾阳虚腰痛；C项用于虚劳腰痛，日久不愈，阴阳俱虚，阴虚内热者；D项用于肾虚腰痛无明显阴阳偏胜者；E项用于房劳过度而致肾虚腰痛者。" + }, + { + "question_num": 85, + "query": "小儿鼻柱、眉间及口唇四周青紫的临床意义是", + "options": { + "A": "肝郁脾虚", + "B": "瘀血内阻", + "C": "小儿惊风", + "D": "疼痛剧烈", + "E": "寒凝气滞" + }, + "answer": "C", + "reason": "小儿鼻柱、眉间及口唇四周青紫，提示惊风欲作。" + }, + { + "question_num": 86, + "query": "慢性盆腔炎与急性盆腔炎共有的证型是", + "options": { + "A": "湿热瘀结", + "B": "气滞血瘀", + "C": "寒湿凝滞", + "D": "气虚血瘀", + "E": "热毒炽盛" + }, + "answer": "A", + "reason": "慢性盆腔炎的证型：湿热瘀结、气滞血瘀、寒湿凝滞、气虚血瘀；急性盆腔炎的证型：湿热瘀结、热毒炽盛。" + }, + { + "question_num": 87, + "query": "旋覆代赭汤中用量最大的药物是", + "options": { + "A": "旋覆花", + "B": "代赭石", + "C": "甘草", + "D": "半夏", + "E": "生姜" + }, + "answer": "E", + "reason": "旋覆代赭汤中旋覆花9g,代赭石3g,半夏(汤泡)9g,人参6g,甘草9g,生姜15g,大枣12枚。" + }, + { + "question_num": 88, + "query": "小儿易发生好动、惊惕、抽风等症，原因主要是", + "options": { + "A": "心常有余", + "B": "肝常有余", + "C": "脾常不足", + "D": "稚阳未充", + "E": "肾常虚" + }, + "answer": "B", + "reason": "小儿肝常有余，外感、内伤均可使肝气亢盛，刚性之脏，易于动风，风阳上扰，伤及头面，故见头面部肌肉不自主抽动；肝气不舒，肝风内动，欲畅其通达之性，故喉中有异声或口出秽语；肝阳上亢故抽动有力而频繁，声音响亮，且性情急躁、好动。" + }, + { + "question_num": 89, + "query": "组成中含有茵陈、川楝子、生麦芽的方剂是", + "options": { + "A": "越鞠丸", + "B": "茵陈蒿汤", + "C": "保和丸", + "D": "一贯煎", + "E": "镇肝熄风汤" + }, + "answer": "E", + "reason": "镇肝熄风汤的组成为怀牛膝、生赭石、生龙骨、生牡蛎、生龟甲、生杭芍、玄参、天冬、川楝子、生麦芽、茵陈、甘草。" + }, + { + "question_num": 90, + "query": "经行头痛肝火证治疗首选", + "options": { + "A": "羚角钩藤汤", + "B": "通窍活血汤", + "C": "半夏白术天麻汤", + "D": "八珍汤", + "E": "龙胆泻肝汤" + }, + "answer": "A", + "reason": "经行头痛肝火证治当清热平肝息风，方选羚角钩藤汤。" + }, + { + "question_num": 91, + "query": "消风散的组成药物中含有", + "options": { + "A": "防风、羌活", + "B": "荆芥、白芷", + "C": "防风、细辛", + "D": "白芍、木通", + "E": "知母、石膏" + }, + "answer": "E", + "reason": "消风散的药物组成为荆芥防风、牛蒡子、蝉蜕、苍术、苦参、石膏、知母、当归、胡麻仁、生地黄、木通、甘草。" + }, + { + "question_num": 92, + "query": "新生儿中药用量占成人量的比例是", + "options": { + "A": "1/6", + "B": "1/3", + "C": "1/2", + "D": "2/3", + "E": "1/4" + }, + "answer": "A", + "reason": "新生儿用成人量1/6，乳婴儿用成人量1/3，幼童用成人量2/3，学龄期儿童用成人量。" + }, + { + "question_num": 93, + "query": "关于步态检查,下列哪一项是错误的", + "options": { + "A": "痉挛性偏瘫步态见于急性脑血管疾病的后遗症", + "B": "醉酒步态见于小脑病变", + "C": "间歇性跛行见于严重下肢动脉硬化", + "D": "慌张步态见于进行性肌营养不良", + "E": "蹒跚步态见于佝偻病、大骨节病" + }, + "answer": "D", + "reason": "痉挛性偏瘫步态见于急性脑血管疾病的后遗症;解酒步态见于小脑病变、酒精中毒等;间歇性跛行见于严重下肢动脉硬化;慌张步态见于帕金森病;蹒跚步态见于佝偻病、大骨节病、进行性肌营养不良、先天性双髋关节脱位等。" + }, + { + "question_num": 94, + "query": "不适宜给小儿断奶的季节是", + "options": { + "A": "春季", + "B": "夏季", + "C": "秋季", + "D": "冬季", + "E": "初冬" + }, + "answer": "B", + "reason": "夏季天气热，小儿本来就很难受，断奶会让他大哭大闹，还会因胃肠对食物的不适应发生呕吐或腹泻。" + }, + { + "question_num": 95, + "query": "具有推动呼吸和血行功能的气是", + "options": { + "A": "心气", + "B": "宗气", + "C": "肺气", + "D": "营气", + "E": "卫气" + }, + "answer": "B", + "reason": "宗气的生理功能主要有走息道以行呼吸、贯心脉以行血气和下畜丹田以资先天三个方面。" + }, + { + "question_num": 96, + "query": "深静脉血栓形成的最大危险性是", + "options": { + "A": "水肿", + "B": "肺栓塞", + "C": "下肢坏死", + "D": "患肢增粗", + "E": "浅静脉扩张" + }, + "answer": "B", + "reason": "深静脉血栓形成的最大危险并发症是肺栓塞，可导致肺梗死而危及生命。" + }, + { + "question_num": 97, + "query": "支气管肺炎发生在小儿,主要表现是", + "options": { + "A": "可出现三角形的肺不张,尖端指向肺门", + "B": "脊柱旁及心脏边缘部病变较多", + "C": "肺门增大、模糊,伴局限性肺气肿改变", + "D": "局限于一个肺叶或肺段的密度增高阴影", + "E": "两肺中下部内、外带,沿肺纹理分布的病变" + }, + "answer": "E", + "reason": "支气管肺炎X线表现:病变常见于两肺下野的中内带，表现为沿增粗的肺纹理分布有散在的、多数密度不均匀的、边界模糊的小斑片状致密阴影。" + }, + { + "question_num": 98, + "query": "小儿肺炎喘嗽痰热闭肺证的治法是", + "options": { + "A": "辛温宣肺，化痰止咳", + "B": "辛凉宣肺，清热化痰", + "C": "开肺化痰，止咳平喘", + "D": "清热涤痰，开肺定喘", + "E": "清热解毒，泻肺开闭" + }, + "answer": "D", + "reason": "治疗小儿肺炎喘嗽痰热闭肺证，治宜清热涤痰，开肺定喘，方选五虎汤合葶苈大枣泻肺汤加减。" + }, + { + "question_num": 99, + "query": "下列不是保和丸组成药物的是", + "options": { + "A": "麦芽", + "B": "山楂", + "C": "神曲", + "D": "连翘", + "E": "茯苓" + }, + "answer": "A", + "reason": "保和丸的组成为山楂、神曲、半夏、茯苓、陈皮、连翘、菜菔子。功用是消食和胃，主治食积。" + }, + { + "question_num": 100, + "query": "易导致妇产科疾病发生的是", + "options": { + "A": "风、寒、湿", + "B": "风、湿、热", + "C": "寒、热、湿", + "D": "寒、暑、热", + "E": "暑、燥、火" + }, + "answer": "C", + "reason": "六淫与五邪中与妇科关系最大的是寒、热、湿邪。此三邪与经带胎产关系密切。" + }, + { + "question_num": 101, + "query": "具有清胃凉血功用的方剂是", + "options": { + "A": "玉女煎", + "B": "清气化痰丸", + "C": "蒿芩清胆汤", + "D": "温胆汤", + "E": "清胃散" + }, + "answer": "E", + "reason": "玉女煎清胃热,滋肾阴,适用于胃热阴虚证。清气化痰丸清热化痰，理气止咳，适用于痰热咳嗽。蒿芬清胆汤清胆利湿，和胃化痰，适用于治疗少阳湿热证。温胆汤理气化痰，清胆和胃，适用于胆胃不和,痰热内扰证。清胃散清胃凉血，适用于胃火牙痛。" + }, + { + "question_num": 102, + "query": "虚寒型月经后期的主要证候，下列哪项是错误的", + "options": { + "A": "小腹冷痛，拒按", + "B": "经行延后，量少", + "C": "经血色淡，质稀", + "D": "小便清长，大便稀溏", + "E": "舌淡苔薄白，脉沉迟无力" + }, + "answer": "A", + "reason": "月经病的辨证主要是根据月经的期、��、色、质辨证，同时也要参考全身症状及舌、脉。“量少、经血色淡、质稀、小便清长、大便稀溏、舌淡苔薄白、脉沉迟无力”均为虚寒证表现，“小腹冷痛、拒按”为实证表现。" + }, + { + "question_num": 103, + "query": "蜘蛛痣不应出现的部位是", + "options": { + "A": "手背", + "B": "前胸", + "C": "面部", + "D": "腹部", + "E": "颈部" + }, + "answer": "D", + "reason": "蜘蛛痣多出现在上腔静脉分布区，如面、颈、手背、上臂、前胸等，腹部为下腔静脉分布区。" + }, + { + "question_num": 104, + "query": "月经先后无定期的主要发病机制是", + "options": { + "A": "寒凝血瘀，冲任不畅", + "B": "外感邪热，热扰冲任", + "C": "脾虚统摄无权", + "D": "痰阻经脉，血行不畅", + "E": "气血失于调节，血海蓄溢失常" + }, + "answer": "E", + "reason": "月经先后无定期的发病机制主要是肝肾脾功能失调，冲任功能紊乱，血海蓄溢失常，其病因多为肝郁、肾虚、脾虚。" + }, + { + "question_num": 105, + "query": "有助于肺心病与二尖瓣瓣膜病鉴别的是", + "options": { + "A": "二尖瓣听诊区可闻及舒张中晚期隆隆样杂音", + "B": "右心室肥大", + "C": "易并发肺感染", + "D": "心电图示右室面高电压", + "E": "肺动脉高压" + }, + "answer": "A", + "reason": "肺心病听诊呼吸音普遍减弱,常可听到干、湿啰音。肺动脉瓣区第二心音亢进(此体征也可因肺气肿存在而不明显)，提示有肺动脉高压存在。三尖瓣区可听到心脏收缩期杂音，一尖瓣瓣膜病往往伴随血管杂音，二尖瓣关闭不全心尖区收缩期吹风样杂音;二尖瓣狭窄心尖区有低调的舒张中晚期隆隆样杂音。" + }, + { + "question_num": 106, + "query": "治疗小儿遗尿肺脾气虚证的首选方剂是", + "options": { + "A": "菟丝子散", + "B": "导赤散", + "C": "缩泉丸", + "D": "补中益气汤合缩泉丸", + "E": "桑螵蛸散" + }, + "answer": "D", + "reason": "遗尿肺脾气虚证，治法为益气健脾，固涩小便，方药选择补中益气汤合缩泉丸。" + }, + { + "question_num": 107, + "query": "被称为“血海”的经脉是", + "options": { + "A": "任脉", + "B": "督脉", + "C": "冲脉", + "D": "带脉", + "E": "阴维脉" + }, + "answer": "C", + "reason": "任脉调节全身阴经经气,称“阴脉之海”;督脉调节全身阳经经气,称“阳脉之海”;冲脉含蓄十二经气血，称为“十二经之海”或“血海”;带脉约束纵行躯干的诸条经脉;阴维脉调节六阴经经气，" + }, + { + "question_num": 108, + "query": "小儿流行性乙型脑炎的恢复期、后遗症期的证型不包括", + "options": { + "A": "阴虚内热", + "B": "营卫不和", + "C": "痰蒙清窍", + "D": "痰火内扰", + "E": "邪陷心肝" + }, + "answer": "E", + "reason": "小儿流行性乙型脑炎病至恢复期、后遗症期，余热未尽，故见阴虚内热；气阳受伤，故见营卫不和；痰湿内阻，蒙蔽清窍，久则内扰，心肝火旺。" + }, + { + "question_num": 109, + "query": "下列各项中,哪项是构成传染过程的必备因素", + "options": { + "A": "传染源、传播途径和易感人群", + "B": "微生物、媒介及宿主", + "C": "病原体、人体和它们所处的环境", + "D": "寄生虫、中间宿生及终末宿主", + "E": "患者、污染物及外界环境" + }, + "answer": "A", + "reason": "传染病流行过程的基本条件(三环节):传染源、传播途径、易感人群。" + }, + { + "question_num": 110, + "query": "肺结核早期诊断最主要的方法是", + "options": { + "A": "痰结核菌检查", + "B": "X线检查", + "C": "结核菌素试验", + "D": "红细胞沉降率", + "E": "白细胞计数和分类" + }, + "answer": "B", + "reason": "肺结核早期诊断最主要的方法是X线检查；结核菌素试验是诊断结核感染的参考指标；痰结核菌检查是确诊肺结核最具特异性的方法。" + }, + { + "question_num": 111, + "query": "治疗痢疾、便秘、肠痛常选", + "options": { + "A": "内庭", + "B": "丰隆", + "C": "下巨虚", + "D": "条口", + "E": "上巨虚" + }, + "answer": "E", + "reason": "上巨虚为大肠经的下合穴,主治痢疾、便秘、肠痛、腹胀、腹痛等;内庭为足阳明胃经的荥穴，主治牙痛、鼻衄、热病等;丰隆为足阳明胃经的络穴，主治痰多、哮喘、咳嗽、胸痛等;下巨虚为小肠经的下合穴,主治小腹痛、腰脊痛引睾丸、乳痛等;条口主治肩臂不得举、下肢冷痛等。" + }, + { + "question_num": 112, + "query": "肝硬化患者出现血性腹水最有可能合并的疾病是", + "options": { + "A": "原发性腹膜炎", + "B": "原发性肝癌", + "C": "胆汁性腹膜炎", + "D": "肝门静脉血栓形成", + "E": "结核性腹膜炎" + }, + "answer": "B", + "reason": "并发原发性肝癌者多在大结节性或大小结节混合性肝硬化基础上发生。患者短期内出现腹水呈血性或肝迅速增大、持续性肝区疼痛、肝表面出现肿块等，应怀疑并发原发性肝癌。" + }, + { + "question_num": 113, + "query": "下列各项,治疗产后乳少,应首选", + "options": { + "A": "少泽", + "B": "少商", + "C": "中冲", + "D": "涌泉", + "E": "至阴" + }, + "answer": "A", + "reason": "少泽穴为手太阳小肠经的井穴,能清热、利咽、通乳,用于治疗产后乳少，再配以乳根、膻中穴。" + }, + { + "question_num": 114, + "query": "下列不属于导致颤动舌的病因是", + "options": { + "A": "热极生风", + "B": "肝阳化风", + "C": "阴虚动风", + "D": "心脾有热", + "E": "酒毒内蕴" + }, + "answer": "D", + "reason": "舌颤动以舌体不自主的颤动为特点。气血虚弱、阴液亏损，舌失濡养而无力平稳伸展舌体，或热极动风、肝阳化风等均可产生舌颤。心脾有热多发生吐弄舌。" + }, + { + "question_num": 115, + "query": "支气管哮喘发作的典型表现是", + "options": { + "A": "哮喘发作24小时以上,伴咯血", + "B": "先兆症状后出现有哮鸣音的呼气性呼吸困难", + "C": "伴哮鸣音的混合性呼吸困难", + "D": "伴哮鸣音的呼吸困难,粉红色泡沫痰", + "E": "先兆症状后出现吸气困难" + }, + "answer": "B", + "reason": "支气管哮喘发作时胸部呈过度通气状态，两肺可闻及弥漫性哮鸣音，以呼气性呼吸困难为主，严重者呈强迫端坐位，甚至出现紫绀、心率增快、奇脉、胸腹反常运动等。" + }, + { + "question_num": 116, + "query": "下列各项，不属于水停证临床表现的是", + "options": { + "A": "全身水肿，按之内陷不能即起", + "B": "小便不利", + "C": "身体困重", + "D": "腹部胀满，叩之呈鼓音", + "E": "腹部膨隆，按之如囊裹水" + }, + "answer": "D", + "reason": "水停证：头面、肢体甚或全身水肿，按之凹陷不易起，或为腹水而见腹部膨隆、叩之音浊，小便短少不利，身体困重，舌淡胖，苔白滑，脉濡缓等。" + }, + { + "question_num": 117, + "query": "血海穴位于", + "options": { + "A": "髌骨上缘中点上2寸", + "B": "髌骨内上缘上2寸", + "C": "髌骨外上缘上2寸", + "D": "髌骨内下缘上2寸", + "E": "髌骨外下缘上2寸" + }, + "answer": "B", + "reason": "血海定位:当屈膝,在大腿内侧，髌骨内侧端上2寸,当股四头肌内侧头的隆起处。" + }, + { + "question_num": 118, + "query": "心胸憋闷刺痛，痛处不移的心脉痹阻证，其病因是", + "options": { + "A": "寒凝", + "B": "瘀阻", + "C": "气滞", + "D": "痰阻", + "E": "气虚" + }, + "answer": "B", + "reason": "心胸憋闷刺痛，痛处不移的心脉痹阻证，其病因是瘀血阻滞，血行不畅，如胸、胁、脘、腹等部位刺痛。" + }, + { + "question_num": 119, + "query": "关于缺铁性贫血患者的临床表现,下列哪项不正确", + "options": { + "A": "感染发生率减低", + "B": "口角炎、舌炎、舌乳头萎缩较常见", + "C": "胃酸缺乏及胃肠功能障碍", + "D": "毛发无泽、易断、易脱", + "E": "指甲扁平,甚至“反甲”" + }, + "answer": "A", + "reason": "铁是人体必需的微量元素,:除参加血红蛋白的合成之外，还参与体内的一些生物化学过程。缺铁时由于髓过氧化物酶和氧化爆发活动性降低，致巨噬细胞功能和脾自然杀伤细胞功能障碍，故缺铁性贫血患者感染的发生率不但不会减低，反而会升高，其余各项均见于缺铁性贫血患者。" + }, + { + "question_num": 120, + "query": "脓血便常见于", + "options": { + "A": "肠癌", + "B": "脾虚", + "C": "肝郁", + "D": "积热", + "E": "食滞" + }, + "answer": "A", + "reason": "脓血便：大便中还有脓血黏液，多见于痢疾或肠癌，常因湿热疫毒阻滞肠道，肠络受损所致。" + }, + { + "question_num": 121, + "query": "位于脐下3寸的穴位为", + "options": { + "A": "关元", + "B": "石门", + "C": "气海", + "D": "阴交", + "E": "中极" + }, + "answer": "A", + "reason": "关元在下腹部,前正中线上，当脐中下3寸;石门在下腹部,前正中线上，当脐中下:2寸;气海在下腹部，前正中线上，当脐中下1.5寸;阴��在下腹部,前正中线上,当脐中下1寸;中极在下腹部,前正中线上,当脐中下4寸。" + }, + { + "question_num": 122, + "query": "风湿性心脏病最常见的瓣膜损害部位是", + "options": { + "A": "二尖瓣", + "B": "三尖瓣", + "C": "主动脉瓣", + "D": "肺动脉瓣", + "E": "联合瓣膜病变" + }, + "answer": "A", + "reason": "心脏瓣膜病是由于炎症、黏液样变性、退行性改变、先天性畸形、缺血性坏死、创伤等原因引起的单个或多个瓣膜结构（包括瓣叶、瓣环、腱索或乳头肌）的功能或结构异常，导致瓣口狭窄和（或）关闭不全。心室和主动脉、肺动脉根部严重扩张也可产生相应房室瓣和半月瓣的相对性关闭不全。二尖瓣最常受累，其次为主动脉瓣。" + }, + { + "question_num": 123, + "query": "中脘配胃俞治疗胃痛,应属于", + "options": { + "A": "上下配穴", + "B": "前后配穴", + "C": "左右配穴", + "D": "表里经配穴", + "E": "同名经配穴" + }, + "answer": "B", + "reason": "中脘是足阳明胃经的募穴胃俞是足阳明胃经的背俞穴，故两穴配合应用治疗胃痛，属于前后配穴，亦名腹背阴阳配穴法、俞募配穴法。上下配穴法是指将腰部以上腧穴和腰部以下腧穴配合应用的方法。" + }, + { + "question_num": 124, + "query": "抗链球菌感染的首选药物是", + "options": { + "A": "头孢霉素", + "B": "林可霉素", + "C": "庆大霉素", + "D": "氯霉素", + "E": "青霉素" + }, + "answer": "E", + "reason": "致病菌链球菌的用药方案以青霉素为主或加庆大霉素，青霉素320万～400万U静脉滴注，每4～6小时1次，庆大霉素剂量每日160～240mg静脉注射。" + }, + { + "question_num": 125, + "query": "下列疾病,可见板状腹的是", + "options": { + "A": "急性阑尾炎", + "B": "急性胆囊炎", + "C": "肠结核", + "D": "急性胃肠穿孔", + "E": "大量腹水" + }, + "answer": "D", + "reason": "弥漫性腹肌紧张多见于胃肠道穿孔或实质脏器破裂所致的急性弥漫性腹膜炎,此时腹壁常强直，硬如木板,故称为板状腹。" + }, + { + "question_num": 126, + "query": "下列各项中不属小儿生理特点的是", + "options": { + "A": "易趋康复", + "B": "生机蓬勃", + "C": "行气未充", + "D": "脏腑娇嫩", + "E": "发育迅速" + }, + "answer": "A", + "reason": "易趋康复是小儿病理特点，其余四项均为小儿生理特点。" + }, + { + "question_num": 127, + "query": "体温在39℃以上,一日内波动范围超过2℃者,多见于", + "options": { + "A": "风湿热", + "B": "伤寒", + "C": "疟疾", + "D": "大叶性肺炎", + "E": "中暑" + }, + "answer": "A", + "reason": "弛张热一般体温在39℃以上，一日内波动范围超过2℃,常见于败血症、风湿热、重症肺结核等。" + }, + { + "question_num": 128, + "query": "甲状腺功能亢进症患者，由甲状腺素分泌过多引起的临床表现是", + "options": { + "A": "突眼", + "B": "甲状腺增大", + "C": "怕热，多汗，多食而消瘦", + "D": "畏寒", + "E": "眼裂增宽，凝视" + }, + "answer": "C", + "reason": "甲状腺激素分泌增多导致交感神经兴奋性增高和新陈代谢加速，患者常有疲乏无力、怕热多汗、皮肤潮湿、多食善饥、体重显著下降等。" + }, + { + "question_num": 129, + "query": "属于丙类传染病的病种是", + "options": { + "A": "鼠疫", + "B": "肺结核", + "C": "传染性非典型性肺炎", + "D": "人感染高致病性禽流感", + "E": "流行性和地方性斑疹伤寒" + }, + "answer": "E", + "reason": "丙类传染病是指:流行性感冒、流行性腮腺炎、风疹、急性出血性结膜炎、麻风病、流行性和地方性斑疹伤寒、黑热病、棘球蚴病、丝虫病，除霍乱、细菌性和阿米巴性痢疾、伤寒和副伤寒以外的感染性腹泻病。" + }, + { + "question_num": 130, + "query": "不属于儿科内治用药原则的一项是", + "options": { + "A": "治疗及时审慎", + "B": "重视先证而治", + "C": "注意顾护脾胃", + "D": "处方峻剂速攻", + "E": "不可乱投补益" + }, + "answer": "D", + "reason": "儿科用药原则：①治疗及时准确；②代表方精简灵巧；③重视先证而治；④注意顾护脾胃；⑤掌握用药剂量，小儿发病易虚易实，不能用峻剂速攻。" + }, + { + "question_num": 131, + "query": "临床上对于急性上消化道出血，首选的辅助检查是", + "options": { + "A": "X线钡剂造影", + "B": "胃镜检查", + "C": "腹部超声", + "D": "腹部CT", + "E": "选择性动脉造��" + }, + "answer": "B", + "reason": "急性上消化道出血且不明原因者，早期最宜胃镜检查，不仅可获病因诊断，同时还可进行治疗。" + }, + { + "question_num": 132, + "query": "再生障碍性贫血一般无", + "options": { + "A": "红细胞减少", + "B": "中性粒细胞减少", + "C": "血小板减少", + "D": "网织红细胞减少", + "E": "肝大脾大" + }, + "answer": "E", + "reason": "再生障碍性贫血诊断标准：①全血细胞减少，网织红细胞百分数＜0.01，淋巴细胞比例增高；②一般无肝大、脾大；③骨髓多部位增生减低，造血细胞减少，非造血细胞比例增高，骨髓小粒空虚，有条件者做骨髓活检，可见造血组织均匀减少；④除外引起全血细胞减少的其他疾病。⑤一般抗贫血治疗无效。" + }, + { + "question_num": 133, + "query": "医疗机构执业医师违反卫生行政管理的法律、法规应承担的行政责任中不属于行政处罚的是", + "options": { + "A": "警告", + "B": "罚款", + "C": "降职", + "D": "吊销执业医师证书", + "E": "没收违法所得" + }, + "answer": "C", + "reason": "行政处罚包括罚款、警告:没收违法所得、吊销执业医师证书、吊销营业执照等，降职属行政处分" + }, + { + "question_num": 134, + "query": "急性中毒者，瞳孔扩大，可见于", + "options": { + "A": "阿托品中毒", + "B": "有机磷农药中毒", + "C": "催眠药中毒", + "D": "吗啡中毒", + "E": "甲醇中毒" + }, + "answer": "A", + "reason": "急性中毒者阿托品化指征为瞳孔较前扩大、口干、皮肤干燥、心率增快（90～100/min）和肺湿啰音消失。" + }, + { + "question_num": 135, + "query": "眩晕的辨证中,应首辨的要点是", + "options": { + "A": "病变脏腑", + "B": "寒热虚实", + "C": "标本虚实", + "D": "虚实缓急", + "E": "外感内伤" + }, + "answer": "A", + "reason": "眩晕辨证首先应辨明相关脏腑，其次辨标本虚实。肝阳上亢之眩晕兼见头胀痛、面色潮红、急踩易怒、口苦脉弦等症状。脾胃虚弱，气血不足之眩晕，兼有纳呆、乏力、面色觥白等症状。脾失健运，痰湿中阻之眩晕，兼见纳呆呕恶、头痛、苔腻诸症。肾精不足之眩晕，多兼有腰酸腿软、耳鸣如蝉等症。" + }, + { + "question_num": 136, + "query": "治疗心动过缓、过速都可以用的穴位是", + "options": { + "A": "郄门", + "B": "间使", + "C": "内关", + "D": "劳宫", + "E": "中冲" + }, + "answer": "C", + "reason": "内关穴有双向的良性调整作用，对心动过速及心动过缓均有效。" + }, + { + "question_num": 137, + "query": "蛇串疮之脾虚湿蕴证的治法为", + "options": { + "A": "清泻肝火,解毒止痛", + "B": "健脾利湿,解毒止痛", + "C": "理气活血,通络止痛", + "D": "祛风除湿,杀虫止痒", + "E": "养血润肤,祛风止痒" + }, + "answer": "B", + "reason": "蛇串疮脾虚湿蕴证治法:健脾利湿，解毒止痛。方药:除湿胃苓汤加减。" + }, + { + "question_num": 138, + "query": "治疗呕吐的基本穴组是", + "options": { + "A": "内关、公孙、三阴交", + "B": "内关、足三里、三阴交", + "C": "内关、足三里、丰隆", + "D": "内关、阳陵泉、中脘", + "E": "内关、足三里、中脘" + }, + "answer": "E", + "reason": "呕吐的处方主穴：中脘、足三里、内关。配穴：寒邪客胃配上脘、胃俞；热邪内蕴配合谷、金津、玉液；饮食停滞配梁门、天枢；肝气犯胃配期门、太冲；痰饮内停配丰隆、公孙；脾胃虚寒配脾俞、胃俞。" + }, + { + "question_num": 139, + "query": "足三阳经腧穴主治的相同病证是", + "options": { + "A": "胃肠病", + "B": "咽喉病", + "C": "头面病", + "D": "神志病", + "E": "耳病" + }, + "answer": "D", + "reason": "足三阳经腧穴主治的相同病证是眼病、神志病和热病。" + }, + { + "question_num": 140, + "query": "治疗滞产，应首选", + "options": { + "A": "合谷", + "B": "膈俞", + "C": "足三里", + "D": "血海", + "E": "至阴" + }, + "answer": "A", + "reason": "合谷主治：①头痛、目赤肿痛、鼻衄、齿痛、口眼歪斜、耳聋等头面五官诸疾；②发热恶寒等外感病证；③热病无汗或多汗；④经闭、滞产等妇产科病证；⑤上肢疼痛、不遂；⑥牙拔除术、甲状腺手术等口面五官及颈部手术针麻常用穴。" + }, + { + "question_num": 141, + "query": "治疗遗尿伴夜梦多,除主穴外,应加", + "options": { + "A": "肾俞、内关", + "B": "肾俞、肺俞", + "C": "肺俞、足三里", + "D": "百会、神门", + "E": "脾俞、内关" + }, + "answer": "D", + "reason": "遗尿治宜调理膀胱,温肾健脾。主穴:关元、中极、膀胱俞、三阴交。夜梦多者，配百会、神门，百会与神门可宁心安神" + }, + { + "question_num": 142, + "query": "脾经中用于治疗慢性出血证的常用穴位是", + "options": { + "A": "阴陵泉", + "B": "隐白", + "C": "公孙", + "D": "商丘", + "E": "大横" + }, + "answer": "B", + "reason": "隐白主治：①月经过多、崩漏等妇科病证；②便血、尿血等出血证；③癫狂，多梦；④惊风；⑤腹满，暴泻。" + }, + { + "question_num": 143, + "query": "治疗厥阴头痛,除主穴外,还应选取的配穴是", + "options": { + "A": "印堂、内庭", + "B": "率谷、外关、足临泣", + "C": "天柱、后溪", + "D": "太冲、内关、四神聪", + "E": "阴陵泉、头维" + }, + "answer": "D", + "reason": "治疗头痛主穴为合谷、百会、太阳、风池、阿是穴。厥阴头痛配四神聪、太冲、内关。" + }, + { + "question_num": 144, + "query": "斜刺时，针身与皮肤表面约呈", + "options": { + "A": "15°", + "B": "30°", + "C": "45°", + "D": "60°", + "E": "90°" + }, + "answer": "C", + "reason": "斜刺是针身与皮肤表面约呈45°刺入。此法适用于肌肉浅薄处或内有重要脏器，或不宜直刺、深刺的腧穴。直刺是针身与皮肤表面呈90°刺入。此法适用于人体大部分腧穴。平刺也称横刺、沿皮刺，是针身与皮肤表面呈约15°或沿皮以更小的角度刺入。此法适用于皮薄肉少部位的腧穴，如头部的腧穴等。" + }, + { + "question_num": 145, + "query": "病原体侵袭人体后,不出现或仅出现不明显的临床表现,但通过免疫学检查可发现对入国家执业医师资格考试中医执业助理医师考侵病原体产生了特异性免疫反应,应称为", + "options": { + "A": "不典型病例", + "B": "潜在性感染", + "C": "隐性感染", + "D": "显性感染", + "E": "健康携带者" + }, + "answer": "C", + "reason": "隐性感染又称亚临床感染,是指病原体侵袭人体后，仅导致机体发生特异性免疫应答，而不引起或只引起轻微的组织损伤，因而在临床上不显出任何症状和体征，甚至亦无生化变化，只能通过免疫学检查才能发现的感染。" + }, + { + "question_num": 146, + "query": "治疗霍乱首选的抗菌药物为", + "options": { + "A": "青霉素", + "B": "黄连素", + "C": "诺氟沙星(氟哌酸)", + "D": "复方磺胺甲噁唑", + "E": "庆大霉素" + }, + "answer": "C", + "reason": "霍乱患者抗菌药物治疗可以减少腹泻量，缩短泻吐期和排菌期，但不能替代补液措施。首选氟哌酸类制剂。" + }, + { + "question_num": 147, + "query": "喷射性呕吐,可见于", + "options": { + "A": "耳源性眩晕", + "B": "胃炎", + "C": "肠梗阻", + "D": "尿毒症", + "E": "脑炎" + }, + "answer": "E", + "reason": "喷射性呕吐常发生在患有脑部疾病时，如患脑膜炎或脑部肿瘤，因颅内高压增高而出现喷射性呕吐。" + }, + { + "question_num": 148, + "query": "翳风穴位于", + "options": { + "A": "胸锁乳突肌后缘，平下颌角处", + "B": "耳垂后方，乳突下端前方凹陷中", + "C": "乳突后下方凹陷中", + "D": "胸锁乳突肌与斜方肌上端之间的凹陷中", + "E": "后发际正中直上0.5寸，旁开1.3寸，当斜方肌外缘凹陷中" + }, + "answer": "B", + "reason": "翳风位于耳垂后方，乳突下端前方凹陷中。主治：耳鸣耳聋；口眼歪斜，牙关紧闭，颊肿；瘰疬。" + }, + { + "question_num": 149, + "query": "出现“三偏征”，常见的病变部位是", + "options": { + "A": "脑干", + "B": "深皮质", + "C": "基底节", + "D": "内囊", + "E": "脊髓" + }, + "answer": "D", + "reason": "因感觉、运动传导通路都经过内囊，且内囊较窄，如有病变常表现为对侧半身感觉障碍及伴有偏瘫、同向偏盲,即三偏征," + }, + { + "question_num": 150, + "query": "有关标准预防的叙述，错误的是", + "options": { + "A": "要防止血源性疾病的传播，也要防止非血源性疾病的传播", + "B": "强调双向防护", + "C": "所有的患者均被视为具有潜在感染者", + "D": "要根据疾病的主要传播途径，采取相应的隔离措施", + "E": "脱去手套后可以不洗手" + }, + "answer": "E", + "reason": "标准预防是指医院将普遍预防和体内物质隔离的许多特点进行综合，认定患者血液、体液、分泌物、排泄物均具有传染性，需进行隔离，不论��否有明显的血迹污染或是否接触非完整的皮肤与黏膜，接触上述物质者必须采取防护措施的一种预防手段。操作完毕，脱去手套后应洗手，必要时手消毒，为标准预防的操作原则之一。" + }, + { + "question_num": 151, + "query": "关于腹痛的部位,下列叙述正确的是", + "options": { + "A": "胃、十二指肠溃疡疼痛多在脐周", + "B": "急性阑尾炎疼痛在右下腹", + "C": "小肠疾病疼痛多在右上腹", + "D": "胆囊炎疼痛多在左上腹", + "E": "肝脓肿疼痛多在中下腹" + }, + "answer": "B", + "reason": "胃、十二指肠和胰腺疾病疼痛多在中上腹部;胆囊炎、胆石症、肝脓肿等疼痛多在右上腹部;急性阑尾炎疼痛在右下腹;小肠疾病疼痛多在脉部或脐周;结肠疾病疼痛多在下腹或左下腹部。" + }, + { + "question_num": 152, + "query": "尺泽穴位于", + "options": { + "A": "肱二头肌腱尺侧缘向外0.5寸处", + "B": "肱二头肌腱尺侧缘", + "C": "肱二头肌腱桡侧缘的肘横纹中", + "D": "肱二头肌腱尺侧缘的肘横纹中", + "E": "肱二头肌腱桡侧缘" + }, + "answer": "C", + "reason": "尺泽，肺经合穴，位于肘横纹中、肱二头肌腱桡侧凹陷处。主治：肺系实热病；肘臂挛痛；急性吐泻；中暑；小儿惊风。" + }, + { + "question_num": 153, + "query": "下列最不符合三度房室传导阻滞的是", + "options": { + "A": "P波与QRS波无传导关系", + "B": "心房率快于心室率", + "C": "P波与QRS波无传导关系,心房率快", + "D": "心房率慢于心室率", + "E": "P波与QRS波无传导关系,QRS波慢并且畸形" + }, + "answer": "D", + "reason": "三度房室传导阻滞心电图上表现:P波与QRS波毫无关系(P-R间期不固定)，心房率快于心室率。如果偶尔出现P波下传心室者,称为几乎完全性房室传导阻滞，" + }, + { + "question_num": 154, + "query": "下列哪项不属足太阴经的主治范围", + "options": { + "A": "妇科病", + "B": "口舌病", + "C": "前阴病", + "D": "肾脏病", + "E": "脾胃病" + }, + "answer": "D", + "reason": "足太阴脾经起于足大趾，经膝股部内侧前缘，入腹属脾络胃，上膈，经过咽，止于舌。经脉所过，主治所及，故脾经主治脾胃病、妇科病、前阴病及经脉循行部位的其他病证。" + }, + { + "question_num": 155, + "query": "下列乙类传染病应按甲类传染病处理的是", + "options": { + "A": "流行性出血热", + "B": "流行性乙型脑炎", + "C": "肺炭疽", + "D": "流行性脑脊髓膜炎", + "E": "布鲁菌病" + }, + "answer": "C", + "reason": "参见《中华人民共和国传染病防治法》第四条:对乙类传染病中传染性非典型肺炎、炭疽中的肺炭疽和人感染高致病性禽流感，采取本法所称甲类传染病的预防、控制措施。" + }, + { + "question_num": 156, + "query": "患者胸胁胀痛，走窜不定，情绪不佳则加重，胸闷气短，嗳气频作，舌苔薄，脉弦，其证候是", + "options": { + "A": "肝胃不和", + "B": "肝络瘀阻", + "C": "肝气郁结", + "D": "肝郁化热", + "E": "肝脾不调" + }, + "answer": "C", + "reason": "根据题干所述，可以明确诊断为胁痛，证型为肝气郁结。肝失条达，气机郁滞，络脉失和，故可出现上述症状。肝胃不和表现为胃脘胀满疼痛，两胁作胀，情志不舒则加重。肝络瘀阻表现为胁肋胀痛，痛有定处，痛处拒按，入夜痛甚，胁肋下或兼有癥块。肝郁化热表现为心烦易怒、沉不住气等。肝脾不调表现为胸胁胀满窜痛，善太息，情志抑郁或急躁易怒。" + }, + { + "question_num": 157, + "query": "肾绞痛患者常采取的体位是", + "options": { + "A": "强迫侧卧位", + "B": "角弓反张位", + "C": "强迫俯卧位", + "D": "强迫坐位", + "E": "辗转体位" + }, + "answer": "E", + "reason": "辗转体位:患者辗转反侧,坐卧不安,见于胆石症、胆道蛔虫症、肾绞痛等" + }, + { + "question_num": 158, + "query": "患者肝火犯肺，咳嗽痰稠带血，咯吐不爽，心烦易怒，胸胁作痛，颊赤便秘，舌红苔黄，脉弦数。治疗应首选", + "options": { + "A": "十灰散", + "B": "泻白散", + "C": "咳血方", + "D": "贝母瓜蒌散", + "E": "养阴清肺汤" + }, + "answer": "C", + "reason": "咳血方具有清肝宁肺，凉血止血之功效。主治肝火犯肺之咳血证。症见咳嗽痰稠带血，咯吐不爽，心烦易怒，胸胁作痛，咽干口苦，颊赤便秘，舌红苔黄，脉弦数。" + }, + { + "question_num": 159, + "query": "五输穴中,主治身热的是", + "options": { + "A": "井穴", + "B": "荥穴", + "C": "输穴", + "D": "经穴", + "E": "合穴" + }, + "answer": "B", + "reason": "《难经·六十八难》载:“井主心下满,荥主身热,输主体重节痛,经主喘咳寒热，合主逆气而泄。”" + }, + { + "question_num": 160, + "query": "患者，女性，38岁。咳嗽声重，痰略稀白，恶寒无汗，舌苔薄白，脉浮紧，其证候是", + "options": { + "A": "风寒袭肺", + "B": "痰湿蕴肺", + "C": "风热犯肺", + "D": "肝火犯肺", + "E": "风燥伤肺" + }, + "answer": "A", + "reason": "风寒束肺，肺气壅遏，不得宣通则咳嗽声重；寒邪袭肺，气不布津，津液凝聚为痰则咳痰稀薄色白；风寒外束，郁于肌表则恶寒发热无汗；苔薄白，脉浮紧为风寒表象。辨证分析属咳嗽风寒袭肺证。B项可见咳嗽反复发作，咳声重浊，痰黏腻，或稠厚成块，痰多易咳；C项为咳嗽频剧气粗，或咳声喑哑，痰不爽，痰黏稠或稠黄；D项上气咳逆阵作，咳时面赤，口苦咽干，痰少质黏，或如絮条，咳之难出；E项可见干咳，连声作呛。" + }, + { + "question_num": 161, + "query": "《突发公共卫生事件应急条例》规定:突发事件应急工作应当遵循的方针是", + "options": { + "A": "完善并建立监测与预警手段", + "B": "预防为主,常备不懈", + "C": "积极预防,认真报告", + "D": "及时调查,认真处理", + "E": "监测分析,综合评价" + }, + "answer": "B", + "reason": "《突发公共卫生事件应急条例》第五条明确规定:“突发事件应急工作，应当遵循预防为主、常备不懈的方针。贯彻统一领导、分级责任、反应及时、措施果断、依靠科学、加强合作的原则。" + }, + { + "question_num": 162, + "query": "患者，女，42岁。全身水肿，下肢明显，按之没指，小便短少，身体困重，胸闷，纳呆，泛恶，舌苔白腻，脉沉缓。治疗应首选", + "options": { + "A": "五皮饮合胃苓汤", + "B": "麻黄连翘赤小豆汤", + "C": "济生肾气丸", + "D": "实脾饮", + "E": "疏凿饮子" + }, + "answer": "A", + "reason": "依据患者表现，属水湿浸渍型水肿，故选五皮饮合胃苓汤。" + }, + { + "question_num": 163, + "query": "下列人体试验类型中,不需要付出道德代价的是", + "options": { + "A": "自体试验", + "B": "自愿试验", + "C": "欺骗试验", + "D": "强迫试验", + "E": "天然试验" + }, + "answer": "E", + "reason": "天然试验是不受研究者控制的，在天然条件(如战争、早灾、水灾、地震、瘟疫以及疾病高发区等)下提供的人体试验，人体试验类型中，不需要付出道德代价的就只有天然试验" + }, + { + "question_num": 164, + "query": "患者小便频数，浑浊如膏，面色黧黑，耳轮焦干，腰膝酸软，形寒畏冷，舌淡苔白，脉沉细无力，其治法是", + "options": { + "A": "清胃泻火，养阴增液", + "B": "清热润肺，生津止渴", + "C": "滋阴固肾", + "D": "温阳滋肾固摄", + "E": "养阴清热，镇肝潜阳" + }, + "answer": "D", + "reason": "本患者出现的症状属于膏淋病久不已，肾阴阳两虚证，治宜温阳滋肾固摄。" + }, + { + "question_num": 165, + "query": "医生在器官移植问题上的道德责任，错误的是", + "options": { + "A": "对活体的捐献,要保证供者的利他动机", + "B": "杜绝任何商业目的的器官移植活动", + "C": "对尸体捐献需要有亲属签订的知情同意书", + "D": "对器官分配应按价值遵循医学与社会", + "E": "医生在被抢救的患者病故后,可立即摘取器官" + }, + "answer": "E", + "reason": "对尸体捐赠者,坚持亲属知情同意，医师准确无误地判定死亡后摘取器官，并且抢救人员不参加移植手术。" + }, + { + "question_num": 166, + "query": "患者头痛时作，痛连项背，遇风尤甚，恶风寒，肢体酸楚，口不渴，舌苔薄白，脉浮。治疗应首选", + "options": { + "A": "川芎茶调散", + "B": "芎芷石膏汤", + "C": "羌活胜湿汤", + "D": "大补元煎", + "E": "天麻钩藤饮" + }, + "answer": "A", + "reason": "由于风寒外袭，上犯巅顶，凝滞经脉则出现风寒头痛，治宜疏风散寒止痛，方用川芎茶调散。B项治疗风热头痛；C项治疗风湿头痛；D项治疗肾虚头痛；E项治疗肝阳头痛。" + }, + { + "question_num": 167, + "query": "患者,女,30岁。经来淋漓不尽，经色鲜红,诊为崩漏。近日颜面长有痤疮,色红肿痛,舌红苔少,脉细数。治疗应首选", + "options": { + "A": "槐花、侧柏叶", + "B": "大蓟、小蓟", + "C": "地榆、白及", + "D": "艾叶、地榆", + "E": "白茅根、芦根" + }, + "answer": "B", + "reason": "此患者经色鲜红,舌红苔少，脉细数，可判断为虚热型崩漏;颜面长有痤疮，应解毒。而大蓟、小蓟都可以凉血止血，散瘀解毒消痈。" + }, + { + "question_num": 168, + "query": "患者，男，57岁。形体肥胖，一周来心悸善惊，烦躁痰多，食少泛恶，舌苔黄腻，脉象滑数。此病例应辨证为", + "options": { + "A": "水饮凌心", + "B": "痰火扰心", + "C": "心阳不振", + "D": "阴虚火旺", + "E": "心胆虚怯" + }, + "answer": "B", + "reason": "形体肥胖，烦躁痰多，舌苔黄腻，为痰热之象，出现心悸善惊，为心悸痰火扰心证。" + }, + { + "question_num": 169, + "query": "患者久病,畏寒喜暖,形寒肢冷,面色?白,蜷卧神疲,小便清长,下利清谷,偶见小腿水肿,按之凹陷如泥,舌淡,脉迟,其病机是", + "options": { + "A": "阳气亡失", + "B": "阳盛格阴", + "C": "阳损及阴", + "D": "阳气偏衰", + "E": "阳盛耗阴" + }, + "answer": "D", + "reason": "阳气偏衰是指机体阳气虚损，机能减退或衰弱，阳热不足的病理状态。畏寒喜暖，形寒肢冷,面色就白,蜷卧神疲,小便清长，下利清谷，小腿水肿，按之凹陷如泥舌淡，脉迟均为阳气衰弱的表现。" + }, + { + "question_num": 170, + "query": "患者积块软而不坚，固定不移，胀与痛并存，舌苔薄，脉沉实，其证候是", + "options": { + "A": "气机阻滞", + "B": "血瘀气结", + "C": "气滞血阻", + "D": "气滞湿阻", + "E": "湿热蕴结" + }, + "answer": "C", + "reason": "气滞血阻，脉络不和则结为积块，固定不移；由于气滞则胀与痛并存；因疾病初起，故积块软而不坚。辨证为积证气滞血阻证。" + }, + { + "question_num": 171, + "query": "患者,女,63岁。便秘多年,三四日一行,舌红少苔。以下各项,不宜使用的药物是", + "options": { + "A": "硫黄", + "B": "杏仁", + "C": "火麻仁", + "D": "当归", + "E": "桃仁" + }, + "answer": "A", + "reason": "硫黄壮阳通便,治疗虚寒便秘，而题目所示的是阴虚便秘，" + }, + { + "question_num": 172, + "query": "患者，男性，26岁。下利清水，脐腹疼痛，按之坚硬有块，口干舌燥，脉滑实。治疗应首选", + "options": { + "A": "葛根黄芩黄连汤", + "B": "大承气汤", + "C": "芍药汤", + "D": "温脾汤", + "E": "大柴胡汤" + }, + "answer": "B", + "reason": "大承气汤具有软坚润燥、破结除满、荡涤肠胃的功效，适用于腑气不通，大便秘结，腹痛拒按，发热汗出者。本患者为阳明腑实证，适宜用大承气汤治疗。A项治疗泄泻湿热伤中证；C项治疗湿热痢疾；D项治疗大肠虚寒，积冷便秘；E项具有和解少阳、内泻热结的功效，能治疗少阳阳明合病。" + }, + { + "question_num": 173, + "query": "患者,男,42岁。全头胀痛，急躁易怒，口苦胁痛，面红目赤,便秘溲赤,舌边尖红,苔黄,脉弦数。用药应首选的是", + "options": { + "A": "全蝎、蜈蚣", + "B": "磁石、牡蛎", + "C": "龙胆草、栀子", + "D": "蝉蜕、天麻", + "E": "川芎、川牛膝" + }, + "answer": "C", + "reason": "患者全头胀痛,急躁易怒口苦胁痛,脉弦数，属肝火上炎证，答案中善清肝火的是龙胆草、栀子" + }, + { + "question_num": 174, + "query": "患者，男，64岁。近一月来寒热持续不解，恶寒较甚，发热无汗，身楚倦怠，咳嗽，咳痰无力，舌淡苔白，脉浮无力。治疗方剂宜首选", + "options": { + "A": "新加香薷饮", + "B": "葱白七味饮", + "C": "参苏饮", + "D": "再造散", + "E": "加减葳蕤汤" + }, + "answer": "C", + "reason": "气虚感冒证候主症：恶寒较甚，发热，无汗，头痛身楚，咳嗽，痰白，咳痰无力，平素神疲体弱，气短懒言，反复易感，舌淡苔白，脉浮而无力。治法：益气解表。代表方：参苏饮加减。" + }, + { + "question_num": 175, + "query": "患者,女,30岁。下痢时发时止，迁延不愈,遇寒即发。症见下痢白冻,倦怠少食,舌淡苔白,脉沉。治疗应首选", + "options": { + "A": "连理汤", + "B": "桃花汤", + "C": "温脾汤", + "D": "驻车丸", + "E": "香连丸" + }, + "answer": "C", + "reason": "休息痢:下痢时发时止，迁延不愈，常因饮食不当、受凉、劳累而发，发时大便次数增多，夹有赤白黏冻，腹胀食少，倦息嗜卧，舌质淡苔腻,脉濡软或虚数。若脾阳虚极，肠中寒积不化，遇寒即发，症见下痢白冻:倦怠少食，舌淡苔白,脉沉者,用温脾汤加减以温中散寒、消积导滞，" + }, + { + "question_num": 176, + "query": "患者，男。身倦乏力，少气自汗，腹痛拒按，舌暗且有瘀斑，辨证当为", + "options": { + "A": "气滞血瘀证", + "B": "血瘀血虚证", + "C": "气虚血瘀证", + "D": "气血两虚证", + "E": "寒凝血瘀证" + }, + "answer": "C", + "reason": "气虚血瘀：面色淡白，神疲乏力，气短懒言，食少纳呆，面色晦暗，局部青紫、肿胀、刺痛不移而拒按，或肢体瘫痪、麻木，或可触及肿块，舌淡紫或有瘀点瘀斑，脉细涩。" + }, + { + "question_num": 177, + "query": "患者,男,37岁。突然跌倒,意识不清，口吐涎沫,两目上视,四肢抽搐，口中如作猪羊叫声,移时苏醒,舌苔白腻,脉弦滑。治疗应首选", + "options": { + "A": "定痫丸", + "B": "导痰汤", + "C": "二阴煎", + "D": "涤痰汤", + "E": "控涎丹" + }, + "answer": "A", + "reason": "突然跌倒,意识不清,口吐涎沫，两目上视，四肢抽搐，口中如作猪羊叫声，移时苏醒，舌苔白腻，脉弦滑，可辨证为痫病风痰闭阻证，治疗方剂首选定痛九。导痰汤燥湿化疲和胃，理气开郁消病，适用于痰湿内盛，气机壅滞等证;二阴煎重在滋阴降火,安神饭照忙桥工实华旧点认之证;涤痰汤以涤痰开窍见长，用于痰浊闭窍者;控涎丹攻逐水饮，用于形体壮实，积饮量多者。" + }, + { + "question_num": 178, + "query": "患者，男。因气郁而致胸膈痞闷，脘腹胀痛，嗳腐吞酸，恶心呕吐，饮食不消等症，治宜用", + "options": { + "A": "越鞠丸", + "B": "保和丸", + "C": "半夏厚朴汤", + "D": "平胃散", + "E": "厚朴温中汤" + }, + "answer": "A", + "reason": "越鞠丸主治证候：胸膈痞闷，脘腹胀痛，嗳腐吞酸，恶心呕吐，饮食不消。" + }, + { + "question_num": 179, + "query": "患者,男,55岁。1个月前患脑血管疾病，现左半侧肢体瘫痪,口眼歪斜,口角流涎,语言不清,舌质胖淡,脉细弱无力。用药应首选", + "options": { + "A": "白芍", + "B": "熟地黄", + "C": "黄芪", + "D": "人参", + "E": "白术" + }, + "answer": "C", + "reason": "黄芪功用:补气健脾,升阳举陷，益卫固表，利尿消肿，托毒生肌。此外，本品尚有补气行滞，补气摄血，补气生津作用，还可用于因气虚所致的中风后遗症、痹痛麻木等病证。该患者为中风后遗症，故用药首选黄芪。" + }, + { + "question_num": 180, + "query": "患者，男，45岁。近1年来心悸头晕，倦怠无力，面色无华，舌淡红，脉象细弱，其治法是", + "options": { + "A": "镇惊定志，养心安神", + "B": "补血养心，益气安神", + "C": "滋阴降火，养心安神", + "D": "温补心阳，安神定志", + "E": "振奋心阳，化气行水" + }, + "answer": "B", + "reason": "结合题中症状，考虑为心悸心血不足证。治法：补血养心，益气安神。代表方：归脾汤加减。" + }, + { + "question_num": 181, + "query": "患者肩背痛不可回顾,头痛身重，腰脊疼痛,舌苔白,脉浮。治疗应选用", + "options": { + "A": "独活寄生汤", + "B": "三仁汤", + "C": "小青龙汤", + "D": "羌活胜湿汤", + "E": "麻黄汤" + }, + "answer": "D", + "reason": "羌活胜湿汤祛风、胜湿、止痛，用于风湿在表之痹证，症见肩背痛不可回顾，头痛身重，或腰脊疼痛，难以转侧，苔白,脉浮。" + }, + { + "question_num": 182, + "query": "患者，男，50岁。有长期肝病史，近年来乏力，腹胀明显，反复齿龈出血，近1个月下肢水肿。今呕血后神志不清。应首先考虑的是", + "options": { + "A": "脑血栓形成", + "B": "糖尿病高渗昏迷", + "C": "内囊出血", + "D": "尿毒症昏迷", + "E": "肝性昏迷" + }, + "answer": "E", + "reason": "题中患者考虑为肝硬化。肝硬化最常见的并发症为急性上消化道出血，表现为呕血和黑便，大量出血时可引起出血性休克，并诱发腹水和肝性脑病。结合题中症状，考虑为肝性昏迷。" + }, + { + "question_num": 183, + "query": "患者,男,58岁。胸满而痛，遇冷易诱发,伴下利,口不渴,不欲饮食,舌淡苔白,脉沉细而弦。治疗应选用", + "options": { + "A": "大建中汤", + "B": "小建中汤", + "C": "天台乌药散", + "D": "吴茱萸汤", + "E": "理中丸" + }, + "answer": "E", + "reason": "根据题意:患者症状属于脾胃虚寒证。理中九主要适用于脾胃虚寒，" + }, + { + "question_num": 184, + "query": "患者，女，45岁。反复尿频急、刺痛伴肉眼血尿2年余，目前尿色淡红，尿痛涩滞不显著，腰膝酸软，神疲乏力，舌质淡，苔白腻，脉沉缓。治疗应首选的方剂是", + "options": { + "A": "八正散", + "B": "小蓟饮子", + "C": "六味地黄丸", + "D": "知柏地黄丸", + "E": "无比山药丸" + }, + "answer": "E", + "reason": "患者本是血淋，缠绵不愈2年，伴随尿痛涩滞不显著，腰膝酸软，神疲乏力，舌质淡，苔白腻，脉沉缓，诊为劳淋，方选无比山药丸。" + }, + { + "question_num": 185, + "query": "患者外感风寒不愈,现症见身热不退,咽红肿痛,大便干结,脉略数,其舌苔变化是", + "options": { + "A": "由白转黄", + "B": "由腻转松", + "C": "由厚转薄", + "D": "由腐转剥", + "E": "由燥转润" + }, + "answer": "A", + "reason": "舌苔可以辨别邪气的深浅和胃气的存亡。患者初起为外感风寒，舌苔应为白苔，随病情发展又见身热，咽红，大便干，则转为热象，黄苔主热，故其舌苔变化应为由白转黄。" + }, + { + "question_num": 186, + "query": "患者，女，70岁。数月来饮食难下，或虽下而复吐出，甚或呕出物如赤豆汁，胸膈疼痛，固着不移，肌肤枯燥，形体消瘦，舌质紫暗，脉细涩。治疗当选", + "options": { + "A": "启膈散加减", + "B": "沙参麦冬汤加减", + "C": "通幽汤加减", + "D": "补气运脾汤加减", + "E": "右归丸加减" + }, + "answer": "C", + "reason": "数月来饮食难下，或虽下而复吐出，甚或呕出物如赤豆汁，胸膈疼痛，固着不移，肌肤枯燥，形体消瘦，舌质紫暗，脉细涩。病为噎膈，证属瘀血内结证，治疗当滋阴养血，破血行瘀。方选通幽汤加减。" + }, + { + "question_num": 187, + "query": "患者身灼肢温,汗热味咸而黏,如珠如油，虚烦躁扰,舌红而干,脉疾无力,其证型是", + "options": { + "A": "亡阳", + "B": "亡阴", + "C": "阴虚", + "D": "里热", + "E": "以上均非" + }, + "answer": "B", + "reason": "患者身热肢温,汗热说明有热象，但舌红而干，脉疾无力，说明为虚热。汗出如珠如油、虚烦躁扰是亡阴的特异表现。本患者是阴液虚衰已极，阴不敛阳致虚阳外越之亡阴证。而亡阳证因阳气衰竭，温胸功能下降，主要表现为四肢厥冷、汗冷、舌白润;里热证表现为脉疾有力。" + }, + { + "question_num": 188, + "query": "患者，男性，21岁。双手背起结节1年，如豆般大，坚硬粗糙，表面蓬松枯槁，色黄，皮损范围有扩大趋势，无任何不适，舌红，苔薄，脉弦数，其诊断是", + "options": { + "A": "扁瘊", + "B": "跖疣", + "C": "鼠乳", + "D": "疣目", + "E": "丝状疣" + }, + "answer": "D", + "reason": "结节坚硬粗糙，表面蓬松枯槁，此为疣目的典型表现。疣目相当于西医的寻常疣。" + }, + { + "question_num": 189, + "query": "患者,女,48岁。一周来出现尿频、尿急、尿痛,体温38.3℃,肾部叩击痛。血常规:白细胞14.0X10°/L。应考虑此患者为", + "options": { + "A": "膀胱炎", + "B": "急性肾盂肾炎", + "C": "慢性肾盂肾炎", + "D": "慢性肾炎", + "E": "急性肾炎" + }, + "answer": "B", + "reason": "患者患膀胱刺激征,结合发热，腰部叩击痛，白细胞升高,诊断为急性肾孟肾炎。" + }, + { + "question_num": 190, + "query": "患者，男性，40岁。结喉两侧各有1个3cm×2cm×1cm，表面光滑，质地韧，无压痛，随吞咽上、下活动的肿物。为明确诊断，应首选的检查方法是", + "options": { + "A": "胸颈部X线片", + "B": "血常规", + "C": "血气分析", + "D": "T3、T4", + "E": "¹³¹I扫描" + }, + "answer": "E", + "reason": "表面光滑，质地韧，无压痛，随吞咽上、下活动的肿物，考虑是气瘿患者。西医病名：单纯性甲状腺肿，地方性甲状腺肿。主要考虑碘的缺乏。" + }, + { + "question_num": 191, + "query": "患者,男,30岁。便后肛门部疼痛、出血反复发作10年。查体:梭形裂口通向肛内，边缘不齐，创面较深,术中见肛管狭窄明显。应首选的治疗措施是", + "options": { + "A": "注射疗法", + "B": "扩肛疗法", + "C": "切除疗法", + "D": "纵切横缝", + "E": "肛裂切开" + }, + "answer": "D", + "reason": "肛裂手术治疗的不同方法及其适应证。①扩肛法:适用于早期肛裂，无结缔组织外痔、肛乳头肥大等合并症者;②切开疗法:适用于陈旧性肛裂，伴有结缔组织外痔、肛乳头肥大等;③肛裂侧切术:适用于不伴有结缔组织外痔、皮下瘿等的陈旧性肛裂;纵切横缝法:适用于陈旧性肛裂伴有肛管狭窄者。" + }, + { + "question_num": 192, + "query": "一男性患者左足第1趾皮色暗红，趾甲变厚，肌肉萎缩，趺阳脉消失，患肢持续性静止痛，夜间尤���，舌紫暗，脉沉细涩。最适宜的内服方是", + "options": { + "A": "桃红四物汤", + "B": "四妙勇安汤", + "C": "四妙散", + "D": "血府逐瘀汤", + "E": "阳和汤" + }, + "answer": "A", + "reason": "脱疽血脉瘀阻证症见：患趾（指）坠胀疼痛加重，皮色暗红，皮肤发凉干燥，趺阳脉搏动消失，患肢持久性疼痛，夜间尤甚。治法：活血化瘀，通络止痛。方药：桃红四物汤加减。" + }, + { + "question_num": 193, + "query": "患者,男,24岁。转移性右下腹痛6小时,临床诊为肠痈。现除轻度腹痛外，尚有轻度发热,恶心纳呆,小便微黄,大便干结,舌苔厚腻,脉弦滑,其治法是", + "options": { + "A": "理气行瘀,疏化导滞", + "B": "行气祛瘀,通腑泄热", + "C": "理气透脓,通腑泄热", + "D": "行气祛瘀,通腑排脓", + "E": "理气活血,通腑透脓" + }, + "answer": "B", + "reason": "患者恶心纳呆，小便微黄大便干结，舌苔厚腻，脉弦滑，辨证为湿热证,通腑泄热是治疗的关键。另外，此为肠痈初期，有气滞血瘀的病机存在，治疗当配合行气祛瘀药物。" + }, + { + "question_num": 194, + "query": "患者腹痛肠鸣，泻下粪便臭如败卵，但泻而不爽，脘腹胀满，舌苔白厚而腐，脉滑。治疗应首选", + "options": { + "A": "保和丸", + "B": "藿香正气散", + "C": "葛根芩连汤", + "D": "附子理中汤", + "E": "龙胆泻肝汤" + }, + "answer": "A", + "reason": "泻下粪便臭如败卵为宿食内停泄泻的特征，治当消食导滞，方用保和丸加减。" + }, + { + "question_num": 195, + "query": "患者,女,39岁。2018年6月初诊,腹泻已3年,常因受冷、饮食不慎而反复发作，曾多次就诊，服用中药、西药抗生素治疗，虽有好转,但停药后很快复发,难以治愈。诊见:面色萎黄,倦怠乏力,口渴,纳差,大便稀溏,日5~6次,小便清长。舌淡,苔薄腻,脉细缓。主要治疗原则是", + "options": { + "A": "疏风清热", + "B": "通腑泄热", + "C": "清热凉血", + "D": "清热凉营", + "E": "健脾补肾化湿" + }, + "answer": "E", + "reason": "该患者的证型为脾肾阳虚、水湿运化失职之泄泻。因此，健脾补肾化湿为主要治则。" + }, + { + "question_num": 196, + "query": "患者，女，55岁。6天前左足3、4趾缝足癣水疱溃破，次日局部红肿疼痛，并见红线1条向上走窜至小腿中段，边界清晰，伴有发热，左胯腹部淋巴结肿痛，其诊断是", + "options": { + "A": "流火", + "B": "赤游丹毒", + "C": "青蛇毒", + "D": "蛇串疮", + "E": "红丝疔" + }, + "answer": "E", + "reason": "红丝疔是发于四肢，皮肤呈红丝显露，迅速向上走窜的急性感染性疾病，其特点是先有手足疔疮或皮肤破损，红肿热痛，继则患肢内侧皮肤出现红丝一条或数条，迅速向躯干方向走窜，可伴恶寒发热等症状，邪重者可内攻脏腑，发生走黄。该患者足癣水疱破溃后小腿出现红线，伴有发热，符合红丝疔的表现。" + }, + { + "question_num": 197, + "query": "患者久病湿疹,面垢多眵,大便溏泄，时发下痢脓血,小溲浑浊不清,湿疹浸淫流水，舌苔白厚腻,脉濡滑。病属湿邪为患，此证反映了湿邪的哪种性质", + "options": { + "A": "类水", + "B": "黏腻", + "C": "升散", + "D": "秽浊", + "E": "重着" + }, + "answer": "D", + "reason": "秽浊指分泌物秽浊不清。湿邪致病可出现各种秽浊症状。题干中患者出现的面垢多眵，大便溏泄，时发下痢脓血，小溲浑浊不清，湿疹浸淫流水等症状都与湿邪秽浊的性质相符。" + }, + { + "question_num": 198, + "query": "患者，女性，38岁，已婚。近半年来，月经40天一行，量少，色暗红，时有血块，小腹及乳房作胀，舌略暗，苔薄，脉弦。应首先考虑的是", + "options": { + "A": "月经后期", + "B": "月经过多", + "C": "痛经", + "D": "行经乳房胀痛", + "E": "崩漏" + }, + "answer": "A", + "reason": "该患者考虑为月经后期气滞证。肝气郁结，血为气滞，冲任气血运行不畅，血海不得按时满溢，故月经错后，量少；气滞血瘀，故经色暗红，时有血块；气机不畅，经脉壅滞，故少腹胀闷，胸胁乳房作胀；舌略暗，苔薄，脉弦乃气滞之征。" + }, + { + "question_num": 199, + "query": "患者,男,20岁。近2周自觉乏力,食欲不振,厌油,腹胀。检查:巩膜无黄染,肝肋缘下2cm,有压痛,谷丙转氨酶升高。应首先考虑的是", + "options": { + "A": "急性肝炎", + "B": "慢性肝炎", + "C": "重型肝炎", + "D": "淤胆型肝炎", + "E": "肝炎肝硬化" + }, + "answer": "A", + "reason": "淤胆型肝炎一般可见黄疸;慢性肝炎、肝炎肝硬化一般肝脏会缩小;重型肝炎的临床症状与本案不符。本病是急性无黄疸型肝炎。" + }, + { + "question_num": 200, + "query": "患者，女性，26岁，已婚。月经错后半个月，量少、色淡红、质稀，少腹空痛，头晕眼花，心悸失眠，面色萎黄，舌质淡红，脉细弱。治疗应首选", + "options": { + "A": "十全大补汤", + "B": "人参养荣汤", + "C": "大营煎", + "D": "大补元煎", + "E": "滋血汤" + }, + "answer": "D", + "reason": "该患者诊断为月经后期血虚证。血虚证主要证候：周期延后，量少，色淡红，质清稀，或小腹绵绵作痛；或头晕眼花，心悸少寐，面色苍白或萎黄；舌质淡红，脉细弱。治法：补血益气调经。方药：大补元煎。" + }, + { + "question_num": 201, + "query": "患儿，6岁。高热3天，伴呕吐。查体:全身皮肤散在出血点,颈项强直,克氏征阳性。应首先考虑的是", + "options": { + "A": "中毒性菌痢", + "B": "流行性脑脊髓膜炎", + "C": "流行性乙型脑炎", + "D": "霍乱", + "E": "结核性脑膜炎" + }, + "answer": "B", + "reason": "流行性脑脊髓膜炎主要临床表现是突发高热、剧烈头疼、频繁呕吐、皮肤黏膜瘀点瘀斑及脑膜刺激征，严重者可有败血症休克和脑实质损害，脑脊液呈化脓性改变儿童易患。流行性乙型脑炎临床上以高热、意识障碍、抽搞、病理反射及脑膜刺激征为特征。结核性脑膜炎起病慢、病程长,有低热、盗汗、消瘦等症状，神经系统症状出现晚，无瘀点瘀斑。" + }, + { + "question_num": 202, + "query": "患者,女性,18岁。月经紊乱，现阴道出血20天,开始1周量多如注,以后淋漓不止,色深红,质稠,溲黄便干,舌红苔黄,脉洪数、治疗应首选", + "options": { + "A": "清经散", + "B": "保阴煎", + "C": "清热固经汤", + "D": "清热调血汤", + "E": "清肝止淋汤" + }, + "answer": "C", + "reason": "热伤冲任，迫血妄行，故经血非时而下，量多如崩，或淋漓不断；血为热灼，故血色深红，质稠；邪热内积，津液耗损，故小便黄、大便干；舌红苔黄，脉洪数为血热之象，其治疗原则为清热凉血，固冲止血。" + }, + { + "question_num": 203, + "query": "患者,男,16岁。发热10天伴食欲减退，软弱。查体:T39.6℃,P74次/分，肝肋下2.0cm,脾肋下1.0cm。实验室检查:WBC26X10°/L;N0.85,L0.14,E0.01。临床上拟诊为伤寒,为确诊应首选", + "options": { + "A": "粪便培养", + "B": "血培养", + "C": "尿液培养", + "D": "胆汁培养", + "E": "肥达反应" + }, + "answer": "B", + "reason": "血培养是伤寒最主要的确诊依据之一，病程1~2周时血培养阳性率最高:为80%~90%，而血清中各种相应抗体的凝集效价一般自病程第2周以后才逐渐增加;尿培养及粪便培养在第3~4周阳性率最高:" + }, + { + "question_num": 204, + "query": "患者,男,50岁。5年前腰部因疼痛，外贴膏药后皮肤出现局限性红肿，后起水疱伴瘙痒，自行治疗后皮损结痂，有色素沉着，5年中病情反复发作,皮损肥厚干燥,有鳞屑，瘙痒剧烈，舌淡红，苔薄,脉弦细数。治疗应首选", + "options": { + "A": "黄连解毒汤加减", + "B": "凉膈散加减", + "C": "消风散合当归饮子加减", + "D": "龙胆泻肝汤加减", + "E": "化斑解毒汤合龙胆泻肝汤加减" + }, + "answer": "C", + "reason": "该患者诊为接触性皮炎血虚风燥证，治宜养血润燥，祛风止痒，方选当归饮子合消风散加减。" + }, + { + "question_num": 205, + "query": "患者,女,22岁。晨起跑步时偶遇风后全身泛发风团，色白，伴瘙痒，发无定处，成批发生，用温水清洗后皮损很快消退，口不渴，舌淡,苔白，脉浮紧。宜选用何方治疗", + "options": { + "A": "消风散", + "B": "麻黄桂枝各半汤", + "C": "麻黄附子细辛汤", + "D": "当归饮子", + "E": "四物消风散" + }, + "answer": "B", + "reason": "该患者诊为瘾疹风寒束表证，治宜疏风散寒止痒，方选麻黄桂枝各半汤加减。" + }, + { + "question_num": 206, + "query": "患者,女性,18岁,未婚。每逢经期鼻衄,量较多,色鲜红,经行量少,伴心烦易怒,两胁胀痛,舌红,苔黄,脉弦数。治疗应首选", + "options": { + "A": "加味逍遥散", + "B": "清肝引经汤", + "C": "顺经汤", + "D": "清经散", + "E": "清热固经汤" + }, + "answer": "B", + "reason": "该患者诊断为经行吐衄肝经郁火证。肝经郁火证主要证候：经前或经期吐血、衄血，量较多，色鲜红，月经可提前、量少甚或不行；心烦易���，或两胁胀痛，口苦咽干，头晕耳鸣，尿黄便结；舌红，苔黄，脉弦数。治法：清肝调经。方药：清肝引经汤。" + }, + { + "question_num": 207, + "query": "患者,女性,36岁,已婚。带下量多,色白,质黏,无味,纳少便溏,神疲肢倦舌淡苔白腻,脉缓弱。治疗应首选", + "options": { + "A": "完带汤", + "B": "止带方", + "C": "草薜渗湿汤", + "D": "参苓白术散", + "E": "香砂六君子汤" + }, + "answer": "A", + "reason": "脾阳虚弱，运化失职，水湿内停，湿浊下注，损伤任带二脉，故带下量多，色白，质黏，无味；脾虚中阳不振，则神疲肢倦；脾虚运化失职则纳少便溏；舌淡苔白腻，脉缓弱为脾阳虚之征，其治法为健脾益气，升阳除湿。方选完带汤。" + }, + { + "question_num": 208, + "query": "患者,女性,29岁,已婚。妊娠2.个月!胎动不安,阴道少最出血,色淡,质稀,腰酸腹痛神疲肢倦,面色白,脉细滑缓,其证候是", + "options": { + "A": "肾虚", + "B": "血热", + "C": "阴虚", + "D": "气血虚弱", + "E": "外伤" + }, + "answer": "D", + "reason": "气血虚弱，则冲任不固，胎失摄载，故孕后腰酸腹痛，阴道少量出血；气虚不化，则流血色淡质稀；气虚中阳不振，清阳不升，神疲肢倦，面色㿠白；脉细滑缓为气血虚弱之证。" + }, + { + "question_num": 209, + "query": "患者,男,32岁。患脱疽2年,目前左小腿足趾紫红，下垂时更甚,抬高则见苍白,足背希毛脱落,皮肤、肌肉萎缩,趾甲变厚,跌阳脉搏动消失,患肢持久性静止痛,尤以夜间较甚,舌紫暗苔薄白,脉沉细。治疗应首选", + "options": { + "A": "仙方活命饮", + "B": "顾步汤", + "C": "四妙勇安汤", + "D": "桃红四物汤", + "E": "独活寄生汤" + }, + "answer": "D", + "reason": "此证属血脉瘀阻证，瘀血阻于血脉，运行不畅，则小腿足趾紫红，下垂更甚；舌质紫暗亦为瘀血阻滞之征，方选桃红四物汤以活血化瘀，通络止痛。" + }, + { + "question_num": 210, + "query": "患者,女,32岁,已婚。曾孕3次,均自然流产,平日头晕耳鸣,腰膝酸软,精神萎靡,现又妊娠33天,夜尿频多,面色晦暗,舌淡苔白,脉沉弱。治疗应首选", + "options": { + "A": "补肾固冲丸", + "B": "补肾安胎饮", + "C": "泰山磐石散", + "D": "加味阿胶汤", + "E": "以上均非" + }, + "answer": "A", + "reason": "曾孕3次，均自然流产——滑胎。“头晕耳鸣，腰膝酸软，精神萎靡，夜尿频多，面色晦暗，舌淡苔白，脉沉弱”为肾气不足的表现。因此，此为滑胎肾虚证之肾气不足证。治宜补肾健脾，调理冲任，故选补肾固冲丸。" + }, + { + "question_num": 211, + "query": "患者，女，25岁。风湿热病史3年，听诊心尖区闻及响亮、粗糙、音调高的全收缩期杂音，X线检查左房、左室增大。据此可诊断为风心病", + "options": { + "A": "三尖瓣狭窄", + "B": "二尖瓣关闭不全", + "C": "主动脉瓣狭窄", + "D": "肺动脉瓣关闭不全", + "E": "联合瓣膜病变" + }, + "answer": "B", + "reason": "二尖瓣关闭不全患者可闻及心尖区收缩期杂音：于心尖区听到一响亮、较粗糙、音调高、时限较长的全收缩期吹风样杂音。X线检查可见：急性者心影正常或左房轻度增大不明显。慢性者可见左房、左室扩大，肺淤血，可见二尖瓣环和瓣膜钙化。" + }, + { + "question_num": 212, + "query": "患儿，10个月。大便呈果酱色，伴阵发性哭吵，腹胀，其诊断是", + "options": { + "A": "痢疾", + "B": "肠炎", + "C": "积滞", + "D": "虫积", + "E": "肠套叠" + }, + "answer": "E", + "reason": "大便呈果酱色，为肠套叠的典型表现。" + }, + { + "question_num": 213, + "query": "患者，女，25岁，已婚。近半年来常感小腹部隐痛，拒按。痛连腰骶，劳累时加重。带下量多，色黄，质黏稠，胸闷纳呆，口干便秘，小便黄赤，舌体胖大，色红，苔黄腻。脉滑数。治疗应首选", + "options": { + "A": "膈下逐瘀汤", + "B": "完带汤", + "C": "银甲丸", + "D": "理冲汤", + "E": "止带方" + }, + "answer": "C", + "reason": "题中患者已婚，近半年来常感小腹部隐痛，拒按，痛连腰骶，劳累时加重，可诊断为慢性盆腔炎。患者又见带下量多，色黄，质黏稠，胸闷纳呆，口干便秘，小便黄赤，舌体胖大，色红，苔黄腻，脉滑数，即可辨证为湿热瘀结证。治宜清热利湿，化瘀止痛。选用方：银甲丸。" + }, + { + "question_num": 214, + "query": "患儿，7岁。诊断为肾病综合征，症见全身浮肿，面目为著，小便减少，面白身重，神疲乏力，纳少便溏，自汗出，易感冒，偶有咳嗽，舌淡胖，脉虚弱，其证候是", + "options": { + "A": "肺脾气虚", + "B": "脾虚湿困", + "C": "肝肾阴虚", + "D": "脾肾阳虚", + "E": "脾肾气虚" + }, + "answer": "A", + "reason": "患儿自汗出，为气虚卫表不固；易感冒，咳嗽提示肺气虚；神疲乏力，面白身重为脾气虚，故可诊断为肺脾气虚证。" + }, + { + "question_num": 215, + "query": "患者，女性，68岁。有慢性支气管炎病史12年，肺源性心脏病史5年。近1周感冒后咳嗽，咳黄痰，心悸、气短加重。下列治疗原则最重要的是", + "options": { + "A": "止咳", + "B": "祛痰", + "C": "抗感染", + "D": "强心", + "E": "利尿" + }, + "answer": "C", + "reason": "有慢性支气管炎病史，且近1周感冒，说明慢性支气管炎为急性发作期，应以控制感染为主要的治疗原则。" + }, + { + "question_num": 216, + "query": "病人频发房性期前收缩，自觉心悸不适，心率90次/min。可以选用以下何种药物治疗", + "options": { + "A": "普萘洛尔(心得安)", + "B": "美西律", + "C": "地西泮(安定)", + "D": "地高辛", + "E": "奎尼丁" + }, + "answer": "A", + "reason": "普萘洛尔（心得安）是β肾上腺素受体阻滞药，临床上用于治疗多种原因所致的心律失常，如房性及室性期前收缩（效果较好）、窦性及室上性心动过速、心房颤动等，但室性心动过速宜慎用。" + }, + { + "question_num": 217, + "query": "患儿，3岁。面色苍白，唇淡甲白，发黄稀疏，平素嗜食茶叶、泥土，神疲乏力，形体消瘦3个月，诊断为“营养性缺铁性贫血”。西药选用铁剂治疗后，正确的停药时间为血红蛋白", + "options": { + "A": "开始升高时", + "B": "达正常时", + "C": "达正常后2个月左右", + "D": "达正常后4个月左右", + "E": "达正常后6个月左右" + }, + "answer": "C", + "reason": "营养性缺铁性贫血西药选用铁剂治疗，一般用硫酸亚铁口服，同时服维生素C有助于铁剂的吸收。铁剂治疗有效的判断标准：铁剂治疗6周后，血红蛋白上升20g/L。应服用至血红蛋白达正常水平后2个月左右再停药。" + }, + { + "question_num": 218, + "query": "患者肘关节肌肉酸痛重着不移2个月，伴有肿胀，肌肤麻木不仁，阴雨天加重，苔白腻，脉濡缓。针灸治疗除主穴外，应加取", + "options": { + "A": "膈俞、血海", + "B": "曲池、尺泽", + "C": "曲池、大椎", + "D": "肾俞、关元", + "E": "足三里、阴陵泉" + }, + "answer": "E", + "reason": "该患者诊断为着痹，应加取阴陵泉、足三里。" + }, + { + "question_num": 219, + "query": "患者，男性，50岁。生气后突感前胸闷痛，有压榨感，同时疼痛牵涉至左臂，休息后自行缓解，约3分钟。最可能的诊断是", + "options": { + "A": "肋间神经痛", + "B": "急性心肌梗死", + "C": "急性左心衰竭", + "D": "心绞痛", + "E": "急性肺梗死" + }, + "answer": "D", + "reason": "心绞痛以发作性胸痛为主要表现，胸痛常为压迫、发闷或紧缩感，也可有烧灼感。疼痛发生于劳动或激动的时候，在3～5分钟逐渐消失，一般在停止诱发症状的活动后即可缓解，舌下含用硝酸甘油也能在几分钟内缓解。" + }, + { + "question_num": 220, + "query": "患者，男性，28岁。高度水肿近1年，血压140/90mmHg。检查：尿蛋白(++++)，镜检红细胞0～8/HP。白蛋白/球蛋白为2.2/2.0，酚红排泄率42％，血胆固醇7mmol/L，其诊断是", + "options": { + "A": "慢性肾炎普通型", + "B": "慢性肾炎肾病型", + "C": "慢性肾炎高血压型", + "D": "慢性肾炎急性发作型", + "E": "慢性肾盂肾炎" + }, + "answer": "B", + "reason": "肾病型除具有普通型的表现外，主要表现为肾病综合征，24小时尿蛋白定量＞3.5g，血清白蛋白低于30g/L，水肿一般较重和伴有或不伴高脂血症。" + }, + { + "question_num": 221, + "query": "患者,女,23岁。痛经9年,经行不畅,小腹胀痛,拒按,经色紫红。夹有血块，血块下后痛即缓解,脉沉涩。治疗应首选", + "options": { + "A": "足三里、太冲、三阴交", + "B": "中极、次髎、地机、三阴交", + "C": "关元、太冲", + "D": "曲池、内庭", + "E": "合谷、归来" + }, + "answer": "B", + "reason": "痛经实证主穴：中极、次髎、地机、三阴交。配穴：气滞血瘀配太冲、血海；寒凝血瘀配关元、归来。患者病属痛经实证之气滞血瘀证。" + }, + { + "question_num": 222, + "query": "患者,女,22岁。食海鲜后皮肤出现大小不等、形状不一的风团,高起皮肤,边界清楚,色红,瘙痒,伴恶心,肠鸣泄泻,舌红,苔黄)腻,脉滑数。除主穴外,应加取", + "options": { + "A": "大椎、风门", + "B": "足三里、天枢", + "C": "风门、肺俞", + "D": "足三里、脾俞", + "E": "三阴交、风池" + }, + "answer": "B", + "reason": "瘾疹治疗宜疏风和营。取手阳明、足太阴经穴为主。处方主穴：曲池、合谷、血海、膈俞、三阴交。配穴：风热犯表配大椎、风门；风寒束表配风门、肺俞；胃肠积热配天枢、足三里；血虚风燥配脾俞、足三里。呼吸困难配天突；恶心呕吐配内关。患者瘾疹的同时伴恶心，肠鸣泄泻，舌红，苔黄腻，脉滑数等胃肠热盛表现，配天枢、足三里。" + } +] \ No newline at end of file