diff --git "a/Assistant/Theory_Questions/Year_2/Mock.json" "b/Assistant/Theory_Questions/Year_2/Mock.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_2/Mock.json" @@ -0,0 +1,2966 @@ +[ + { + "question_num": 1, + "query": "苓桂术甘汤治疗心悸的证候是", + "options": { + "A": "阴虚火旺证", + "B": "瘀阻心脉证", + "C": "水饮凌心证", + "D": "心阳不足证", + "E": "心虚胆怯证" + }, + "answer": "C", + "reason": "苓桂术甘汤具有振奋心阳,化气行水的作用，所以是治疗水饮凌心证的代表方剂。" + }, + { + "question_num": 2, + "query": "治疗风热头痛，应首选的方剂是", + "options": { + "A": "芎芷石膏汤", + "B": "天麻钩藤饮", + "C": "大补元煎", + "D": "龙胆泻肝汤", + "E": "半夏白术天麻汤" + }, + "answer": "A", + "reason": "风热头痛为风热外袭，上扰清空，窍络失和所致。治法：疏风清热和络。代表方：芎芷石膏汤。" + }, + { + "question_num": 3, + "query": "治疗肺痈溃脓期,应首选", + "options": { + "A": "如金解毒散", + "B": "犀黄丸", + "C": "桔梗白散", + "D": "千金苇茎汤", + "E": "加味桔梗汤" + }, + "answer": "E", + "reason": "如金解毒散降火解毒,清肺消痈,适用于肺痈之成痈期热毒较盛者。黄丸能清热解毒，活血止痛，适用于治疗乳岩、横痃、瘰疬、痰核、流注、肺痈、小肠痈。桔梗白散能攻逐水饮，温下寒湿，适用于治疗肺痈重症属寒湿者。千金苇茎汤清肺化痰，逐瘀排脓，适用于肺痈之成痈期，痰瘀较盛者，主治胸病，咳嗽，吐腥臭痰或吐脓血等症。加味桔梗汤清肺化痰,排脓泄壅,适应于肺痈溃脓期。" + }, + { + "question_num": 4, + "query": "治疗虚劳应以补益为主的脏腑是", + "options": { + "A": "心、肾", + "B": "心、肺", + "C": "肺、肾", + "D": "脾、肾", + "E": "肝、肾" + }, + "answer": "D", + "reason": "虚劳的病理性质主要为气、血、阴、阳亏虚，病损主要在五脏，但以脾、肾为主。因为肾为先天之本，脾为后天之本，五脏有相互资生和制约的整体关系，故治疗时应以补益脾、肾为主。" + }, + { + "question_num": 5, + "query": "下列不属于阴水特点的是", + "options": { + "A": "多由下而上,继及全身", + "B": "肿处皮肤绷紧光亮", + "C": "按之凹陷不起", + "D": "多逐渐发病", + "E": "肿多由足踝开始" + }, + "answer": "B", + "reason": "阴水发病缓慢,肿多由足踝开始，自下而上，继及全身，肿处皮肤松弛，按之凹陷不易恢复，其则按之如泥。" + }, + { + "question_num": 6, + "query": "临床上具有发作性痰鸣气喘特点的疾病是", + "options": { + "A": "咳嗽", + "B": "哮证", + "C": "喘证", + "D": "肺痈", + "E": "痫证" + }, + "answer": "B", + "reason": "哮证是以喉中哮鸣有声，呼吸气促困难，甚至喘息不能平卧为临床特征，是发作性的痰鸣气喘疾病，属于痰饮证的“伏饮”证。A项是以咳声或伴有咳痰为主要表现的一种病症；C项以呼吸困难，甚至张口抬肩，鼻翼扇动，不能平卧为临床特征；D项临床以咳嗽、胸痛、发热、咳吐腥臭浊痰，甚则脓血相间为主要特征；E项以口吐涎沫，两目上视，四肢抽搐，或作怪叫声，可自行苏醒为主要特征。" + }, + { + "question_num": 7, + "query": "下列腹痛的胸痹心痛应除外", + "options": { + "A": "外感时邪", + "B": "饮食不节", + "C": "情志失调", + "D": "阳气素虚", + "E": "外感风燥" + }, + "answer": "E", + "reason": "腹痛的病因为外感时邪,饮食不节，情志失调，阳气素虚。" + }, + { + "question_num": 8, + "query": "胸痹心痛的病位在", + "options": { + "A": "肾", + "B": "肝", + "C": "脾", + "D": "心", + "E": "肺" + }, + "answer": "D", + "reason": "胸痹心痛的病位在心。" + }, + { + "question_num": 9, + "query": "根据刘河间治疗痢疾的理论,里急后重症状显著者加用", + "options": { + "A": "养血药", + "B": "活血药", + "C": "理气药", + "D": "补气药", + "E": "升提中气药" + }, + "answer": "C", + "reason": "根据刘河间治疗痢疾的理论，里急后重症状显著者加用理气药。" + }, + { + "question_num": 10, + "query": "暑湿感冒，暑热偏盛，热盛烦渴者，治疗方剂宜首选", + "options": { + "A": "新加香薷饮", + "B": "黄连香薷饮", + "C": "藿朴夏苓饮", + "D": "三物香薷饮", + "E": "藿香正气散" + }, + "answer": "B", + "reason": "暑湿感冒方用新加香薷饮。暑湿兼加里热者可加黄连以清热燥湿。" + }, + { + "question_num": 11, + "query": "妇科疾病的常见病因是", + "options": { + "A": "寒、热、湿邪", + "B": "风、热、暑邪", + "C": "寒、暑、湿邪", + "D": "寒、热、风邪", + "E": "风、热、湿邪" + }, + "answer": "A", + "reason": "妇科疾病病因总属寒湿热邪。" + }, + { + "question_num": 12, + "query": "癫证的治疗应以下列哪项为主", + "options": { + "A": "清心泻火，涤痰醒神", + "B": "理气化痰，活血化瘀", + "C": "理气解郁，化痰醒神", + "D": "镇心祛痰，安神定志", + "E": "健脾养心，益气安神" + }, + "answer": "C", + "reason": "痫证基本病机是七情内伤，饮食失节，禀赋不足导致痰气郁结，或痰火壅盛，进而脏气不平，阴阳失调，闭塞心窍，神机逆乱，故痫证初期是以邪实为主，治疗宜理气解郁，畅达神机，降（泄）火涤痰，化瘀开窍；后期以正虚为主，治疗宜补益心脾，滋阴养血，调整阴阳。" + }, + { + "question_num": 13, + "query": "下列属于小肠功能的是", + "options": { + "A": "主受盛", + "B": "主运化", + "C": "主传化", + "D": "主受纳", + "E": "主腐熟水谷" + }, + "answer": "A", + "reason": "小肠的主要生理功能是主受盛化物和泌别清浊。" + }, + { + "question_num": 14, + "query": "下列不属于痢疾的诊断要点的是", + "options": { + "A": "腹痛", + "B": "里急后重", + "C": "大便次数增多", + "D": "泻下赤白脓血便", + "E": "肛门灼热" + }, + "answer": "E", + "reason": "痢疾是以腹痛腹泻，里急后重，排赤白脓血便，大便次数增多为主要临床表现。而E项也可见于痢疾，但不是其诊断要点。" + }, + { + "question_num": 15, + "query": "全身气机升降的枢纽为", + "options": { + "A": "心、肾", + "B": "肝、肺", + "C": "脾、肾", + "D": "脾、胃", + "E": "肝、肾" + }, + "answer": "D", + "reason": "脾与胃同居中焦,以膜相连,足太阴经属脾络胃，足阳明经属胃络脾，两者构成表里配合关系。脾胃同为气血生化之源后天之本，在饮食物的受纳、消化及水谷精微的吸收、转输等生理过程中起主要作用。脾与胃的关系，体现为水谷纳运相得、气机升降相因，阴阳慢混相济三个方面，晚胃民中，晚气主升而胃气主降，相反而相成。脾气升则肾气、肝气皆升,胃气降则心气、肺气皆降,故为脏腑气机上、下升降的枢纽。" + }, + { + "question_num": 16, + "query": "少阳头痛，选用哪组“引经药”", + "options": { + "A": "柴胡、黄芩、川芎", + "B": "吴茱萸、藁本", + "C": "羌活、蔓荆子、川芎", + "D": "葛根、白芷、知母", + "E": "川芎、吴茱萸" + }, + "answer": "A", + "reason": "太阳头痛选用羌活、蔓荆子、川芎；阳明头痛，选用葛根、白芷、知母；少阳头痛，选用柴胡、黄芩、川芎；厥阴头痛，选用吴茱萸、藁本等。" + }, + { + "question_num": 17, + "query": "下列各项中,属于相乘传变的是", + "options": { + "A": "肺病及肾", + "B": "肺病及心", + "C": "心病及肝", + "D": "肝病及肾", + "E": "脾病及肾" + }, + "answer": "E", + "reason": "五行相乘的次序与相克的次序相同，即木乘土、土乘水、水乘火、火乘金、金乘木，对应五脏疾病传变为肝病及脾、脾病及肾、肾病及心、心病及肺、肺病及肝。" + }, + { + "question_num": 18, + "query": "在调节女子月经和男子排精方面，关系密切的两脏是", + "options": { + "A": "心与脾", + "B": "肝与肾", + "C": "心与肾", + "D": "脾与肾", + "E": "肝与脾" + }, + "answer": "B", + "reason": "肝主疏泄与肾主封藏之间亦存在着相互制约、相反相成的关系，主要表现在女子月经来潮和男子排精方面的生理功能。心与脾关系主要表现在血液的生成和运行方面。心与肾关系主要表现在心火必须下降于肾，肾水必须上济于心，这样，心与肾的功能才能协调。脾与肾关系：脾为先天之本，肾为后天之本。肝与脾关系：肝主疏泄，脾主运化，肝与脾在血的生成、贮藏、运行和防止出血方面有密切联系。" + }, + { + "question_num": 19, + "query": "“一源而三歧”的奇经是指", + "options": { + "A": "督、冲、带脉", + "B": "任、督、带脉", + "C": "冲、任、督脉", + "D": "冲、维、跷脉", + "E": "冲、任、带脉" + }, + "answer": "C", + "reason": "一般认为八脉中的督、任、冲脉皆起于胞中，同出会阴，而循行路线又不相同，故将冲、任、督脉的循行线路特点称为“一源三歧”" + }, + { + "question_num": 20, + "query": "胃的特性是", + "options": { + "A": "喜燥", + "B": "喜满", + "C": "喜润", + "D": "喜升", + "E": "喜运" + }, + "answer": "C", + "reason": "胃喜润恶燥，是指胃当保持充足的津液以利饮食物的受纳和腐熟。胃的受纳腐熟，不仅依赖胃气的推动和蒸化，亦需胃中津液的濡润。胃中津液充足，则能维持其受纳腐熟的功能和通降下行的特性。胃为阳土，喜润而恶燥，故其病易成燥热之害，胃中津液每多受损。" + }, + { + "question_num": 21, + "query": "主胞胎的经脉是", + "options": { + "A": "任脉", + "B": "督脉", + "C": "冲脉", + "D": "带脉", + "E": "阴维脉" + }, + "answer": "A", + "reason": "任主胞胎《太平圣患方·卷一》说:“夫任者妊也，此是人之生养之本。”任脉起于胞中,与女子月经来潮及生殖功能有关。" + }, + { + "question_num": 22, + "query": "手足蠕动常见于", + "options": { + "A": "肝阳上亢证", + "B": "血虚生风证", + "C": "阴虚风动证", + "D": "热极生风证", + "E": "肝阳化风证" + }, + "answer": "C", + "reason": "阴虚风动：临床可见筋挛肉瞤、手足蠕动等动风症状，并见低热起伏、舌光红少苔、脉细如丝等阴气衰少表现。" + }, + { + "question_num": 23, + "query": "治疗咳嗽、头虱应首选的药物是", + "options": { + "A": "百部", + "B": "紫菀", + "C": "苦杏仁", + "D": "桑白皮", + "E": "葶苈子" + }, + "answer": "A", + "reason": "百部功效:润肺止咳,灭虱杀虫。治疗咳嗽、头虱应首选的药物是百部，" + }, + { + "question_num": 24, + "query": "宗气积聚之处为", + "options": { + "A": "息道", + "B": "喉咙", + "C": "气街", + "D": "丹田", + "E": "胸中" + }, + "answer": "E", + "reason": "宗气生成后聚积于胸中，其运行可上至喉咙，下蓄丹田，贯注于心肺之脉及沿三焦下行的方式布散全身。" + }, + { + "question_num": 25, + "query": "“六气”是指", + "options": { + "A": "六种时令疫邪", + "B": "六种致病因素", + "C": "六种病理产物", + "D": "六种外感病邪的总称", + "E": "六种自然界的气候变化" + }, + "answer": "E", + "reason": "六淫,即风、寒、暑、湿、燥、火(热)六种外感病邪的统称。在正常情况下，风、寒、暑、湿、燥、火是自然界六种不同的气候变化,是万物生、长、化、收、藏和人类赖以生存的必要条件，称为“六气”" + }, + { + "question_num": 26, + "query": "关于五脏与血液关系的叙述，错误的是", + "options": { + "A": "肝主藏血", + "B": "脾主统血", + "C": "肾精化生血", + "D": "肺气助心行血", + "E": "心调节血流量" + }, + "answer": "E", + "reason": "心主血脉,心气推动和调控血液在脉管中正常运行，流注全身。肝藏血，具有储藏血液、调节血量及防止出血的功能;脾统血，统摄血液在脉内运行，不使其溢出脉外;肾藏精，源于父母的先天之精以及机体从食物中摄取的营养成分和脏腑代谢所化生的精微物质皆藏于肾，为血的生成提供了本源;肺朝百脉，可使血液在此会聚，进行体内外清浊之气交换后再通过百脉输送到全身，是肺气的运动在血液循行中的具体体现。" + }, + { + "question_num": 27, + "query": "致病后病程较长,反复发作,缠绵难愈的邪气是", + "options": { + "A": "风", + "B": "寒", + "C": "湿", + "D": "暑", + "E": "燥" + }, + "answer": "C", + "reason": "湿性黏滞,易阻气机。湿邪致病，其黏腻停滞的特性主要表现在三个方面:一是症状的黏滞性，湿邪为患，易呈现分泌物和排泄物黏滞不爽的特征;一是病程的缠绵性，因湿性黏滞，易阻气机,气不行则湿不化,胶着难解，故湿邪为病，起病隐缓，病程较长，反复发作，或缠绵难愈;三是易阳气机。" + }, + { + "question_num": 28, + "query": "与毛发荣枯关系最密切的是", + "options": { + "A": "精与气", + "B": "精与血", + "C": "气与血", + "D": "气与津", + "E": "血与津" + }, + "answer": "B", + "reason": "发为血之余,发的生长,赖血以养。但发的生机根源于肾脏，肾脏其华在发，肾藏精,精化血，精血旺盛，则毛发粗壮而润泽。" + }, + { + "question_num": 29, + "query": "虚的病机概念,主要是指", + "options": { + "A": "卫气不固", + "B": "正气虚损", + "C": "脏腑功能低下", + "D": "气血生化不足", + "E": "气化无力" + }, + "answer": "B", + "reason": "虚,指正气不足,是以正气虚损为矛盾主要方面的一种病理反应，即机休的正气虚弱，防御能力和调节能力低下，对于致病邪气的斗争无力，而邪气已退或不明显，故难以出现邪正斗争剧烈的病理反应，" + }, + { + "question_num": 30, + "query": "咳嗽，咳吐粉红色泡沫痰，咳而气喘，呼吸困难者，多属", + "options": { + "A": "肺阴不足", + "B": "肺脾气虚", + "C": "肺肾气虚", + "D": "脾肾阳虚", + "E": "心肺阳虚" + }, + "answer": "E", + "reason": "咳嗽,咳吐粉红色泡沫痰咳而气喘，呼吸困难者，多属心肺阳虚，气不主血。" + }, + { + "question_num": 31, + "query": "下列证候可见于寒热往来的是", + "options": { + "A": "表寒", + "B": "里寒", + "C": "表热", + "D": "里热", + "E": "半表半里" + }, + "answer": "E", + "reason": "寒热往来有两种类型:①恶寒与发热交替发作，发无定时，因邪正交争于半表半里之间，邪胜则恶寒，正胜则发热，故恶寒与发热交替发作;②寒栗鼓领与壮热交替发作，发有定时，疟邪内入与阴争则恶寒战票，外出与阳争则身发壮热，故寒战与壮热交替出现。A项可见恶寒重，发热轻;B项可见畏寒喜暖;C项可见发热重，恶寒轻;D项可见壮热等。" + }, + { + "question_num": 32, + "query": "下列各项，不属特殊之毒中脏腑而致失和的是", + "options": { + "A": "虫毒", + "B": "蛇毒", + "C": "冻伤", + "D": "狂犬毒", + "E": "疫毒" + }, + "answer": "C", + "reason": "特殊之毒包括虫毒、蛇毒、疯犬毒、漆毒、药毒、食物毒和疫毒、无名毒。" + }, + { + "question_num": 33, + "query": "七情配伍中,可以提高药效的是", + "options": { + "A": "相畏、相杀", + "B": "相杀、相使", + "C": "相须、相使", + "D": "相须、相恶", + "E": "相恶、相反" + }, + "answer": "C", + "reason": "七情中增加疗效的是相须和相使，增加毒性的是相反，减轻毒性的是相杀、相畏。歌诀:相须为用互增效，相使一药助一药，减轻疗效是相恶。" + }, + { + "question_num": 34, + "query": "治疗哮病缓解期肺脾气虚证，应首选", + "options": { + "A": "理中汤", + "B": "六君子汤", + "C": "黄芪建中汤", + "D": "苏子降气汤", + "E": "补中益气汤" + }, + "answer": "B", + "reason": "哮病肺脾气虚证应健脾益气，补土生金,故用六君子汤加减。" + }, + { + "question_num": 35, + "query": "既能泻火凉血,活血祛瘀，又能清泻湿热的药物是", + "options": { + "A": "大黄", + "B": "牡丹皮", + "C": "紫草", + "D": "黄连", + "E": "栀子" + }, + "answer": "A", + "reason": "大黄作为泻下药,作用较多,能够泻下攻积，清热泻火，凉血解毒，逐瘀通经，和栀子、茵陈合用能治湿热黄疸，故可清利湿热。" + }, + { + "question_num": 36, + "query": "关于乳癖疼痛特点的描述，错误的是", + "options": { + "A": "多以胀痛为主", + "B": "多在经前加重", + "C": "可随情绪变化", + "D": "多为隐隐作痛", + "E": "可涉及肩背部" + }, + "answer": "D", + "reason": "乳癖的病因大多为实(如肝气郁结、痰浊凝结等)，隐隐作痛为虚证表现。" + }, + { + "question_num": 37, + "query": "齿燥如枯骨者,属", + "options": { + "A": "热盛伤津", + "B": "阳明热盛", + "C": "肾阴枯涸", + "D": "胃阴不足", + "E": "肾气亏虚" + }, + "answer": "C", + "reason": "牙齿燥如枯骨是肾阴枯涸，精不上荣，见于温热病的晚期。" + }, + { + "question_num": 38, + "query": "痴呆的病位在", + "options": { + "A": "心", + "B": "肝", + "C": "肾", + "D": "脾", + "E": "脑" + }, + "answer": "E", + "reason": "痴呆的病位在脑,与心、肝、肾、脾四脏功能失调相关，尤其与肾虚关系密切。" + }, + { + "question_num": 39, + "query": "治疗瘰疬初期首选", + "options": { + "A": "开郁散", + "B": "清骨散", + "C": "六味地黄丸", + "D": "香贝养荣汤", + "E": "活血散瘀汤" + }, + "answer": "A", + "reason": "治疗瘰疬初期证属气滞痰凝，方用逍遥散合二陈汤加减，或用开郁散;中期阴虚火旺方用六味地黄丸合清骨散加减;晚期气血两虚方用香贝养荣汤，" + }, + { + "question_num": 40, + "query": "在下列外科致病因素中，烧伤属于", + "options": { + "A": "外感六淫", + "B": "外来伤害", + "C": "情志内伤", + "D": "房事损伤", + "E": "感受特殊之毒" + }, + "answer": "B", + "reason": "外来伤害包括跌仆损伤、沸水、火焰、寒冷及金刃竹刀创伤等理化因素引起的伤害。特殊之毒包括虫毒、蛇毒、疯犬毒、药毒、食物、疫毒。六淫包括风、寒、湿、燥、火。情志内容包括喜、怒、忧、思等超过人体调节的情志活动。房事损伤是指房事过度所致的损伤。" + }, + { + "question_num": 41, + "query": "治疗蛇串疮的主穴是", + "options": { + "A": "曲池、血海", + "B": "阿是穴、夹脊", + "C": "太冲、三阴交", + "D": "血海、内庭", + "E": "大椎、曲池" + }, + "answer": "B", + "reason": "治疗蛇串疮的主穴是阿是穴、夹脊。" + }, + { + "question_num": 42, + "query": "岩的主要病因病机是", + "options": { + "A": "正气不足", + "B": "情志郁结", + "C": "饮食不节", + "D": "瘀血阻滞", + "E": "脏腑失调" + }, + "answer": "A", + "reason": "岩的病因病机主要有内、外因两方面。外因为六淫之邪，内因为正气不足和七情刺激，主要是正气不足，即机体抗病力降低，加之邪毒侵袭，日积月累，导致肿瘤形成。" + }, + { + "question_num": 43, + "query": "肛门直肠周围脓肿的病因病理是", + "options": { + "A": "湿热内生,破损染毒,肺脾两虚", + "B": "湿热内生,肝肾阴虚,脾肾阳虚", + "C": "外感寒湿,内伤生冷,气血两虚", + "D": "外感风热,肝脾不和,燥热内生", + "E": "热结肠燥,气血瘀滞,湿热内生" + }, + "answer": "A", + "reason": "肛痈是指肛管直肠周围间隙发生急慢性感染而形成的脓肿，多因过食肥甘、辛辣、醇酒等物,湿热内生,下注大肠,蕴阻肛门,或肛门破损染毒，致经络阻塞，气血凝滞而成。" + }, + { + "question_num": 44, + "query": "治疗痞满的基本原则是", + "options": { + "A": "疏肝解郁行气，化湿和胃消痞", + "B": "清热化湿行气，健脾和胃消痞", + "C": "理气宽胸止呕，补泻升降并用", + "D": "补气健脾化湿，升清降浊和胃", + "E": "调理脾胃升降，行气除痞消满" + }, + "answer": "E", + "reason": "痞满治疗总以调理脾胃升降、行气除痞消满为基本法则。实者泻之，虚者补之，虚实夹杂补消并用。扶正重在健脾益胃，补中益气，或养阴益胃。祛邪重在消食导滞、除湿化痰、理气解郁、清热祛湿。" + }, + { + "question_num": 45, + "query": "不出现肛门部肿痛症状的疾病是", + "options": { + "A": "肛痈", + "B": "内痔嵌顿", + "C": "血栓性外痔", + "D": "息肉痔", + "E": "肛漏" + }, + "answer": "D", + "reason": "不出现肛门部肿痛症状的疾病是息肉痔，" + }, + { + "question_num": 46, + "query": "治疗邪犯胸肺之悬饮宜选用", + "options": { + "A": "柴枳半夏汤", + "B": "柴胡疏肝散", + "C": "香附旋覆花汤", + "D": "己椒苈黄丸", + "E": "椒目瓜蒌汤" + }, + "answer": "A", + "reason": "悬饮之邪犯胸肺证治宜和解宣利，方用柴枳半夏汤。" + }, + { + "question_num": 47, + "query": "血精的病机是", + "options": { + "A": "脾不统血", + "B": "瘀血阻络", + "C": "心火亢盛,迫血妄行", + "D": "肾阳不足,固摄无力", + "E": "肾阴不足,火扰精室" + }, + "answer": "E", + "reason": "血精多由于病人肾阴不足,相火偏旺，火扰精室所致。" + }, + { + "question_num": 48, + "query": "热疮的西医病名是", + "options": { + "A": "带状疱疹", + "B": "脓疱疮", + "C": "单纯疱疹", + "D": "湿疹", + "E": "接触性皮炎" + }, + "answer": "C", + "reason": "热疮是指发热或高热过程中所发生的一种急性疱疹性皮肤病，相当于西医的单纯疱疹。" + }, + { + "question_num": 49, + "query": "血热证的表现,不包括哪项", + "options": { + "A": "月经量多而色淡", + "B": "身热面赤而发斑", + "C": "肌肤生疮疖疔痈", + "D": "温热病之血分证", + "E": "迫血妄行而出血" + }, + "answer": "A", + "reason": "“血热证”是脏腑火热炽盛,热迫血分所表现的证候，A项应为月经量多而色红，红为热象。" + }, + { + "question_num": 50, + "query": "蛇串疮的特点是", + "options": { + "A": "皮肤上出现红斑、水疱或丘疱疹", + "B": "排列成带状，沿一侧周围神经分布区出现", + "C": "好发于胸胁部", + "D": "好发于春秋季节", + "E": "以上都是" + }, + "answer": "E", + "reason": "蛇串疮以成簇水疤,沿一侧周围神经作带状分布，伴刺痛为临床特征。多见于成年人，好发于春秋季节。相当于西医的带状疱疹。皮损好发于腰肋、胸部、头面、颈部，亦可见于四肢、阴部及眼、鼻、口等处。" + }, + { + "question_num": 51, + "query": "心气虚与心阳虚的共有症状是", + "options": { + "A": "心悸怔忡,胸闷气短", + "B": "五心烦热，潮热盗汗", + "C": "头晕目眩，面白无华", + "D": "畏寒肢冷,面色?白", + "E": "���汗淋漓,四肢厥冷" + }, + "answer": "A", + "reason": "心气虚证指心脏及全身功能活动衰弱，心阳虚证，在心气虚的基础上出则心悸,重则怔忡;心位胸中，心气不足;胸中中气运转无力，则胸闷气短。B项为阴虚证;C项为血虚证;D项为阳虚证;E项为心阳暴脱证" + }, + { + "question_num": 52, + "query": "外感病汗出热退身凉者，表示", + "options": { + "A": "表邪入里", + "B": "阳气衰少", + "C": "汗出亡阳", + "D": "真热假寒", + "E": "邪去正安" + }, + "answer": "E", + "reason": "外感病汗出热退身凉者,表明正胜邪退，是疾病好转的表现。ABCD项均为疾病发展阶段的病机或表现。" + }, + { + "question_num": 53, + "query": "内痔的主要症状是", + "options": { + "A": "便血,疼痛", + "B": "便血,有分泌物", + "C": "便血,脱出", + "D": "便血,肛门痒", + "E": "便血，异物感" + }, + "answer": "C", + "reason": "内痔是指肛门齿状线以上、直肠末端黏膜下的痔内静脉丛扩大曲张和充血所形成的柔软静脉团，是肛门直肠病中最常见的疾病。好发于截石位的3、7、11点处，又称为母痔区，其余部位发生的内痔均称为子痔，其临床特点是便血，痔核脱出，肛门不适感。" + }, + { + "question_num": 54, + "query": "温病发斑，应属于", + "options": { + "A": "气分热盛", + "B": "热入营血", + "C": "湿热蕴结", + "D": "阳明经热", + "E": "阴虚火旺" + }, + "answer": "B", + "reason": "斑和疹都是皮肤上的病变;是疾病过程中的一个症状。斑色红，点大成片，平摊于皮肤下，摸不应手。由于病机不同，而有阳斑与阴斑之别。阳斑通称发斑，是温病邪入营分、血分所呈现的一种症状。" + }, + { + "question_num": 55, + "query": "主治壮热面赤,汗出恶热的首选方剂是", + "options": { + "A": "竹叶石膏汤", + "B": "犀角地黄汤", + "C": "黄连解毒汤", + "D": "白虎汤", + "E": "清营汤" + }, + "answer": "D", + "reason": "白虎汤有清热生津之效。主治气分热盛证，症见壮热面赤，烦渴引饮，汗出恶热，脉洪大有力。" + }, + { + "question_num": 56, + "query": "阴虚证典型的舌、脉表现是", + "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": "舌红而脉滑数" + }, + "answer": "C", + "reason": "阴虚证则见舌红少苔,脉细数。ADE项见于实证、热证;B项常见于虚弱性疾病。" + }, + { + "question_num": 57, + "query": "阴虚阳亢头痛及肺燥伤阴咳嗽当忌用的药是", + "options": { + "A": "麻黄", + "B": "桂枝", + "C": "生姜", + "D": "细辛", + "E": "白芷" + }, + "answer": "D", + "reason": "以上选项均为发散风寒药。麻黄发汗宣肺力强，凡表虚自汗、阴虚盗汗及肺肾虚喘者均当慎用。桂枝辛温助热，易伤阴动血，凡外感热病、阴虚火旺、血热妄行等证,均当忌用，孕妇及月经过多者慎用。生姜助火伤阴，故热盛及阴虚内热者忌服。细辛辛温走窜，阴虚阳亢头痛，肺燥伤阴干咳者忌用。白芷辛香温燥，阴虚血热者忌服。" + }, + { + "question_num": 58, + "query": "舌绛少苔最常见的情形是", + "options": { + "A": "热盛", + "B": "血瘀", + "C": "气虚", + "D": "阴虚", + "E": "痰火" + }, + "answer": "D", + "reason": "绛舌是比红舌更深的舌质，主热入营血，阴虚火旺及瘀血。热邪耗伤营阴，血液浓缩，而充斥于舌终，则舌绛;阴虚水涸、虚火上炎于舌络，舌亦红绛。舌色愈红，提示热势愈盛，故绛舌比红舌的病情重。绛舌见于外感热病热盛期，为温病热入营血之征；舌绛而少苔或无苔，或有裂纹，则为阴虚火旺；若舌绛而色暗或有瘀斑、瘀点，是血瘀挟热证。" + }, + { + "question_num": 59, + "query": "具有疏散风热功效的药物是", + "options": { + "A": "金银花", + "B": "大青叶", + "C": "鱼腥草", + "D": "穿心莲", + "E": "淡竹叶" + }, + "answer": "A", + "reason": "金银花可清热解毒,疏散风热;大青叶可清热解毒，凉血消斑;鱼腥草可清热解毒，消痈排脓，利尿通淋;穿心莲可清热解毒，凉血，消肿，燥湿;淡竹叶可清热泻火，除烦,利尿。" + }, + { + "question_num": 60, + "query": "哮与喘的主要鉴别点是", + "options": { + "A": "呼吸困难", + "B": "短促急迫", + "C": "喉中痰鸣", + "D": "鼻翼扇动", + "E": "张口抬肩" + }, + "answer": "C", + "reason": "哮和喘常同时出现，所以往往称为哮喘。但应注意两者���区别，哮有夙根，反复发作，表现为发作性痰鸣气喘，以呼吸急促，喉间哮鸣为特征。而喘则多并发于多种急慢性疾病中，虽呼吸急促，而喉间无哮鸣音。正如《医学正传》所说：“哮以声响名，喘以气息言”。" + }, + { + "question_num": 61, + "query": "大黄牡丹汤的组成药物除大黄、牡丹皮外,其余的是", + "options": { + "A": "连翘、贝母、炙甘草", + "B": "桃仁、芒硝、冬瓜子", + "C": "桃仁、红花、赤芍", + "D": "赤芍、连翘、金银花", + "E": "连翘、甘草、金银花" + }, + "answer": "B", + "reason": "方歌:金质大黄牡丹汤,桃仁瓜子芒硝襄。因此大黄牡丹汤中除大黄、牡丹皮外还含的是桃仁、芒硝、冬瓜子。" + }, + { + "question_num": 62, + "query": "儿童头皮有圆形或不规则的覆盖灰白鳞屑的斑片，头发易于拔落且不疼痛，自觉瘙痒，应诊断为", + "options": { + "A": "白秃疮", + "B": "肥疮", + "C": "鹅掌风", + "D": "阴癣", + "E": "花斑癣" + }, + "answer": "A", + "reason": "白秃疮相当于西医的白癣。多见于学龄儿童，男性多于女性。皮损特征是在头皮有圆形或不规则的覆盖灰白鳞屑的斑片。病损区毛发干枯无泽，常在距头皮0.3～0.8cm处折断而呈参差不齐。头发易于拔落且不疼痛，病发根部包绕有白色鳞屑形成的菌鞘，自觉瘙痒。发病部位以头顶、枕部居多，但发缘处一般不被累及。青春期可自愈，秃发也能再生，不遗留瘢痕。" + }, + { + "question_num": 63, + "query": "能上助心阳,中温脾阳,下补肾阳的药物是", + "options": { + "A": "附子", + "B": "干姜", + "C": "丁香", + "D": "吴茱萸", + "E": "小茴香" + }, + "answer": "A", + "reason": "附子具有回阳救逆、补火助阳、散寒止痛的功效，用于亡阳证，能上助心阳、中温脾阳、下补肾阳,为“回阳救逆第一品药”。千姜亦可用于亡阳证，有温阳守中、回阳通脉的功效。丁香可温中降逆，散寒止病，温肾助阳。吴茱英可散寒止痛，降逆止呕，助阳止泻。小茴香可散寒止痛，理气和胃。" + }, + { + "question_num": 64, + "query": "失荣相当于西医的哪一类病", + "options": { + "A": "甲状腺癌", + "B": "鼻咽癌", + "C": "恶性肿瘤颈部转移", + "D": "唇癌", + "E": "舌癌" + }, + "answer": "C", + "reason": "失荣是发于颈部及耳之前后的岩肿，因其晚期气血亏乏，面容憔悴，形体消瘦，状如树木枝叶发枯，失去荣华而命名。相当于西医的颈部淋巴结转移癌和原发性恶性肿瘤。" + }, + { + "question_num": 65, + "query": "麦门冬汤的功用是", + "options": { + "A": "滋阴润肺,清热安神", + "B": "养阴清肺,解毒利咽", + "C": "滋阴益气,固肾止渴", + "D": "滋阴填精,益气壮阳", + "E": "清养肺胃,降逆下气" + }, + "answer": "E", + "reason": "麦门冬汤功用:清养肺胃，降逆下气。主治肺胃阴虚证，症见咳嗽气喘，呕吐，纳少,呃逆。" + }, + { + "question_num": 66, + "query": "疥疮的特异性皮损是", + "options": { + "A": "丘疹", + "B": "丘疱疹", + "C": "小水疱", + "D": "隧道", + "E": "结节" + }, + "answer": "D", + "reason": "隧道为疥疮的特异性皮损，微隆起，呈淡灰色或皮色。" + }, + { + "question_num": 67, + "query": "竹茹的功效是", + "options": { + "A": "止咳化痰,降逆和胃", + "B": "化痰行水,降逆止呕", + "C": "清热化痰,除烦止呕", + "D": "燥湿化痰,降逆止呕", + "E": "温肺止咳，和胃止呕" + }, + "answer": "C", + "reason": "竹茹甘寒性润,善清化热痰，可用于痰热、肺热咳嗽，痰热心烦不寐;又能清热降逆止呕，为治热性呕逆之要药。此外，本品还有凉血止血作用，可用于吐血、衄血、崩漏等。" + }, + { + "question_num": 68, + "query": "对诊断锁肛痔有重要意义的简易方法是", + "options": { + "A": "直肠指检", + "B": "B超检查", + "C": "X线检查", + "D": "病理组织学检查", + "E": "纤维结肠镜检查" + }, + "answer": "A", + "reason": "直肠指检是诊断直肠癌（锁肛痔）最重要的方法。80％的直肠癌位于手指可触及的部位，肿瘤较大时指检可以清楚地扪到肠壁上的硬块、巨大溃疡或肠腔狭窄。退指后可见指套上染有血、脓和黏液。" + }, + { + "question_num": 69, + "query": "地龙具有的功效是", + "options": { + "A": "解毒,通络", + "B": "平喘,利尿", + "C": "息风,止血", + "D": "活血,平喘", + "E": "降逆,止呕" + }, + "answer": "B", + "reason": "地龙清热定惊,通络,平喘,利尿。可用于治疗高热惊痫，疲狂;气虚血滞，半身不遂;痹证;肺热哮喘;小便不利,尿闭不通。" + }, + { + "question_num": 70, + "query": "治疗不孕症肝郁证，应首选", + "options": { + "A": "柴胡疏肝散", + "B": "加味逍遥散", + "C": "开郁种玉汤", + "D": "桃红四物汤", + "E": "少腹逐瘀汤" + }, + "answer": "C", + "reason": "不孕症之肝气郁结证主要证候：婚久不孕，月经或先或后，经量多少不一，或经来腹痛；或经前烦躁易怒，胸胁乳房胀痛，精神抑郁，善太息；舌暗红或舌边有瘀斑，脉弦细。治法：疏肝解郁，理血调经。方药：开郁种玉汤或百灵调肝汤。" + }, + { + "question_num": 71, + "query": "肺热咳嗽,甚则气急欲喘,皮肤蒸热,日晡尤甚,舌红苔黄,脉象细数者,治宜选用", + "options": { + "A": "麻黄杏仁甘草石膏汤", + "B": "止嗽散", + "C": "定喘汤", + "D": "泻白散", + "E": "清气化痰丸" + }, + "answer": "D", + "reason": "泻白散主治肺热喘咳证,症见气喘咳嗽，皮肤蒸热，日晡尤甚，舌红苔黄,脉家细潋" + }, + { + "question_num": 72, + "query": "治疗恶阻脾胃虚弱证应首选的方剂是", + "options": { + "A": "参苓白术散", + "B": "四君子汤", + "C": "香砂六君子汤", + "D": "小半夏加茯苓汤", + "E": "苏叶黄连汤" + }, + "answer": "C", + "reason": "治疗妊娠恶阻脾胃虚弱证，治宜健脾和胃，降逆止呕，方选香砂六君子汤加减。" + }, + { + "question_num": 73, + "query": "寒热往来,发有定时,属于", + "options": { + "A": "表寒证", + "B": "疟疾", + "C": "热入血室", + "D": "阳明病", + "E": "少阳病" + }, + "answer": "B", + "reason": "寒热往来见于疟疾和少阳证区别在于疟疾发有定时，而少阳证发无定时。" + }, + { + "question_num": 74, + "query": "桑毛虫皮炎应外用", + "options": { + "A": "50％百部酊", + "B": "1％薄荷三黄洗剂", + "C": "5％碘酒", + "D": "紫金锭", + "E": "青黛散油剂" + }, + "answer": "C", + "reason": "松毛虫、桑毛虫可用橡皮膏黏去毛刺，外涂5％碘酒。" + }, + { + "question_num": 75, + "query": "按寸口脉分候脏腑。右关脉可候", + "options": { + "A": "心与膻中", + "B": "肾与小腹", + "C": "脾与胃", + "D": "肝、胆与膈", + "E": "肺与胸中" + }, + "answer": "C", + "reason": "寸口脉被具体划分为寸关、尺三部，用以分候不同的脏腑。左寸可候心与膻中，右寸可候肺与胸中;左关可候肝胆与膈，右关可候脾与胃;左尺、右尺均可候肾与小腹。因此，右关脉可候脾与胃。" + }, + { + "question_num": 76, + "query": "知柏地黄汤治疗子淋适用的证候是", + "options": { + "A": "心火偏旺证", + "B": "湿热下注证", + "C": "阴虚津亏证", + "D": "感染湿毒证", + "E": "湿热瘀结证" + }, + "answer": "C", + "reason": "治疗子淋阴虚津亏证，治宜滋阴清热，润燥通淋，方选知柏地黄汤加减。" + }, + { + "question_num": 77, + "query": "九味羌活汤的功用是", + "options": { + "A": "散风除湿,宣痹止痛", + "B": "疏风通络,散寒除湿", + "C": "发汗祛湿,兼清里热", + "D": "疏风清热,宣痹止痛", + "E": "发汗解表,祛风胜湿" + }, + "answer": "C", + "reason": "九味羌活汤的功用是发汗祛湿，兼清里热，适用于治疗外感风寒湿邪，兼有里热证。" + }, + { + "question_num": 78, + "query": "下列与血瘀无关的病证是", + "options": { + "A": "产后腹痛", + "B": "产后发热", + "C": "产后恶露不绝", + "D": "产后抑郁", + "E": "产后缺乳" + }, + "answer": "E", + "reason": "缺乳的病因多为化源不足，气滞不行，与血瘀无关。" + }, + { + "question_num": 79, + "query": "左归丸与一贯煎相同的功用是", + "options": { + "A": "滋阴", + "B": "疏肝", + "C": "补脾", + "D": "降火", + "E": "益气" + }, + "answer": "A", + "reason": "左归丸的功用有滋阴补肾:益精填髓。一贯煎的功用是滋阴疏肝。左归丸与一贯煎都具有滋阴的作用，" + }, + { + "question_num": 80, + "query": "下列各项，由禀赋不耐而发病的是", + "options": { + "A": "红丝疔", + "B": "疔疮", + "C": "药毒", + "D": "流注", + "E": "脱疽" + }, + "answer": "C", + "reason": "药毒总由禀赋不耐，邪毒侵犯所致。" + }, + { + "question_num": 81, + "query": "“至虚有盛候”“大实有羸状”之语,是对下列哪一项的最好说明", + "options": { + "A": "虚实转化", + "B": "虚实错杂", + "C": "真虚假实", + "D": "真实假虚", + "E": "虚实真假" + }, + "answer": "E", + "reason": "“至虚有盛候”是指真虚假实，大实有羸状”是指真实假虚，所以“至虚有盛候”“大实有羸状”之语，是对虚实真假的最好说明。" + }, + { + "question_num": 82, + "query": "产后恶露不绝的辨证要点是", + "options": { + "A": "根据恶露的量、色、质、气味", + "B": "根据恶露持续的时间", + "C": "根据恶露的色、质和持续时间", + "D": "根据恶露的量、质、气味", + "E": "根据恶露的色、质、气味" + }, + "answer": "A", + "reason": "产后恶露不绝是由于气虚，或血热损伤冲任，或血瘀冲任而致血不归经、冲任不固等因素导致的，均可导致恶露的量、色、质、气味的异常改变，故辨证时要从这四点入手。" + }, + { + "question_num": 83, + "query": "逍遥散与柴胡疏肝散中均含有", + "options": { + "A": "柴胡、白芍", + "B": "柴胡、当归", + "C": "当归、甘草", + "D": "白芍、甘草", + "E": "柴胡、薄荷" + }, + "answer": "A", + "reason": "逍遥散用当归芍,柴苓术草加姜薄。柴胡疏肝芍川芎，积壳陈皮革香附。" + }, + { + "question_num": 84, + "query": "下列哪项不是人工流产的禁忌证", + "options": { + "A": "阴道炎", + "B": "疾病的急性期", + "C": "妊娠剧吐酸中毒尚未纠正者", + "D": "术前相隔4小时的两次体温在37.5℃以上者", + "E": "过敏体质者" + }, + "answer": "E", + "reason": "人工流产禁忌证：生殖器官急性炎症，如阴道炎、宫颈炎、盆腔炎等（治疗后方可手术）；各种疾病的急性期，或严重的全身性疾病不能耐受手术者；妊娠剧吐酸中毒尚未纠正者；术前相隔4小时两次体温在37.5℃以上者。" + }, + { + "question_num": 85, + "query": "组成药物中含有熟地黄、肉桂的方剂是", + "options": { + "A": "一贯煎", + "B": "暖肝煎", + "C": "肾气丸", + "D": "炙甘草汤", + "E": "地黄饮子" + }, + "answer": "E", + "reason": "地黄饮子的药物组成有熟地黄、巴戟天、山茱萸、石斛、肉苁蓉、熟附子、五味子、肉桂、白茯苓、麦冬、石莒蒲、远志、薄荷、生姜、大枣" + }, + { + "question_num": 86, + "query": "小儿易患五迟、五软、解颅、遗尿等病原因主要是", + "options": { + "A": "肺脏娇嫩", + "B": "脾常不足", + "C": "肾常虚", + "D": "稚阴稚阳", + "E": "纯阳之体" + }, + "answer": "C", + "reason": "小儿易患五迟、五软、解颅、遗尿等病的共同病因均有肾虚（包括先天、后天）。" + }, + { + "question_num": 87, + "query": "尿路结石的临床表现是", + "options": { + "A": "胁的一侧或两侧疼痛", + "B": "胃脘痛", + "C": "全腹痛,伴压痛、反跳痛", + "D": "脐外侧及下腹部突然剧烈绞痛,向大腿内侧及阴部放射,尿血", + "E": "腹部持续性疼痛,阵发性加剧,伴腹胀，呕吐,便秘" + }, + "answer": "D", + "reason": "尿路结石的临床表现脐外侧及下腹部突然剧烈纹痛，向大腿内侧及阴部放射，伴随症状主要是血尿。" + }, + { + "question_num": 88, + "query": "小儿易感冒、咳喘，原因主要是", + "options": { + "A": "脾常不足", + "B": "肺脏娇嫩", + "C": "肾常虚", + "D": "稚阳未充", + "E": "稚阴未长" + }, + "answer": "B", + "reason": "肺本为娇脏，小儿肺脏更为娇嫩，风邪首先犯肺，故小儿易感冒、咳嗽。" + }, + { + "question_num": 89, + "query": "紫癜气不摄血证的治法是", + "options": { + "A": "益气养阴,内清虚热", + "B": "养阴润肺,益气健脾", + "C": "清暑益气,养阴生津", + "D": "健脾养心,益气摄血", + "E": "滋阴降火,凉血止血" + }, + "answer": "D", + "reason": "紫癜气不摄血证治法宜健脾养心，益气摄血，方药为归脾汤加减。" + }, + { + "question_num": 90, + "query": "下列各项，不属于子宫功能的是", + "options": { + "A": "产生月经", + "B": "排出月经", + "C": "孕育胎儿", + "D": "分娩胎儿", + "E": "调节冲任" + }, + "answer": "E", + "reason": "子宫功能是产生、排出月经，孕育、分娩胎儿，排出余血浊液，分泌生理性带下。" + }, + { + "question_num": 91, + "query": "治疗痢疾、便秘、肠痈常选", + "options": { + "A": "内庭", + "B": "丰隆", + "C": "下巨虚", + "D": "条口", + "E": "上巨虚" + }, + "answer": "E", + "reason": "内庭治疗齿痛,咽喉肿痛;鼻衄;热病;胃肠疾病;足背肿痛，跖趾关节痛。丰隆治疗头痛，眩晕，疯狂;咳嗽痰多;下肢���痹。下巨虚治疗腹泻，痢疾，小腹痛;下肢痿痹;乳痈。条口治疗下肢痿痹，转筋;肩臂痛;脘腹疼痛。上巨虚治疗肠鸣，腹痛，腹泻，便秘，肠痈等肠胃疾患;下肢痿痹。" + }, + { + "question_num": 92, + "query": "《达生编》提出的临产调护六字要诀是", + "options": { + "A": "惜力、忍痛、勿慌", + "B": "睡、忍痛、少活动", + "C": "安静、忍痛、整洁", + "D": "安静、睡眠、忍痛", + "E": "睡、忍痛、慢临盆" + }, + "answer": "E", + "reason": "《达生篇》提出临产的六字真言，即“睡、忍痛、慢临盆”。" + }, + { + "question_num": 93, + "query": "神阙穴旁开2寸处的腧穴是", + "options": { + "A": "三阴交", + "B": "水分", + "C": "天枢", + "D": "气海", + "E": "大横" + }, + "answer": "C", + "reason": "天枢穴在腹中部,平脐中距脐中2寸。脐中为神阙穴" + }, + { + "question_num": 94, + "query": "治疗外感湿热导致的带下病，应首选的方剂是", + "options": { + "A": "止带方", + "B": "完带汤", + "C": "启宫丸", + "D": "苍附导痰丸", + "E": "易黄汤" + }, + "answer": "A", + "reason": "带下过多湿热下注证治宜清热利湿，佐以解毒杀虫，代表方为止带方。" + }, + { + "question_num": 95, + "query": "属于腧穴远治作用的是", + "options": { + "A": "气病胸闷取膻中", + "B": "头项强痛取昆仑", + "C": "腰痛取大肠俞", + "D": "失眠多梦取神门", + "E": "皮肤瘙痒取膈俞" + }, + "answer": "B", + "reason": "远治作用是指腧穴具有治疗其远隔部位的脏腑、组织器官病证的作用。昆仑在外踝尖与跟腱之前的凹陷处，头项强痛取昆仑属于远治作用。" + }, + { + "question_num": 96, + "query": "治疗月经先期之阳盛血热证，应首选", + "options": { + "A": "苍附导痰丸", + "B": "逍遥散", + "C": "当归芍药散", + "D": "导赤散", + "E": "清经散" + }, + "answer": "E", + "reason": "月经先期阳盛血热证的临床表现为经来先期，量多，色深红或紫红，质黏稠；或伴心烦，面红口干，小便短黄，大便燥结；舌质红，苔黄，脉数或滑数。治宜清热凉血调经，其代表方剂是清经散。" + }, + { + "question_num": 97, + "query": "二陈汤主治之咳嗽属于", + "options": { + "A": "湿痰", + "B": "寒痰", + "C": "热痰", + "D": "风痰", + "E": "燥痰" + }, + "answer": "A", + "reason": "二陈汤燥湿化痰,理气和中。主治湿痰证，症见咳嗽痰多，色白易咯，恶心呕吐，胸膈痞闷，肢体困重，或头眩心悸，舌苔白滑或腻,脉滑。" + }, + { + "question_num": 98, + "query": "治疗小儿风寒感冒的首选方剂是", + "options": { + "A": "麻黄汤", + "B": "杏苏散", + "C": "小青龙汤", + "D": "新加香薷饮", + "E": "荆防败毒散" + }, + "answer": "E", + "reason": "小儿风寒感冒，治以辛温解表，方药选择荆防败毒散。" + }, + { + "question_num": 99, + "query": "流行性腮腺炎可出现腮腺管开口处黏膜红肿，其部位在", + "options": { + "A": "上颌第2臼齿相对应的颊黏膜上", + "B": "下颌第2臼齿相对应的颊黏膜上", + "C": "上颌第4臼齿相对应的颊黏膜上", + "D": "上颌第1臼齿相对应的颊黏膜上", + "E": "下颌第1臼齿相对应的颊黏膜上" + }, + "answer": "A", + "reason": "腮腺管位于颧骨下1.5cm处,横过咀嚼肌表面，开口相当于上颌第二臼齿相对应的颊黏膜上。" + }, + { + "question_num": 100, + "query": "举元煎适宜治疗下列哪组症状", + "options": { + "A": "经行淋漓不净，色红，手足心热，舌红，脉细数", + "B": "经来或先或后，头晕耳鸣，腰痛", + "C": "月经量多，色淡质稀，面色㿠白，气短懒言，小腹空坠", + "D": "经来量少，色淡或点滴即净，面色萎黄，舌淡，脉细弱", + "E": "经来量少，色紫黯有块，小腹胀痛拒按，舌紫黯，脉涩" + }, + "answer": "C", + "reason": "举元煎由人参、黄芪、升麻、白术、甘草组成，具有补气摄血固冲的作用，用于气虚出血类疾病。C项为气虚型月经过多的表现。" + }, + { + "question_num": 101, + "query": "肾气丸组成中含有而六味地黄丸组成中不含有的药物是", + "options": { + "A": "地黄", + "B": "茯苓", + "C": "山茱萸", + "D": "桂枝", + "E": "牡丹皮" + }, + "answer": "D", + "reason": "肾气丸的组成:干地黄、山药、山茱萸、泽泻、茯苓、牡丹皮、桂枝、附子。六味地黄丸的组成:热地黄、酒萸肉、牡丹皮、山药、茯苓、泽泻，" + }, + { + "question_num": 102, + "query": "治疗积滞乳食内积证的首选方是", + "options": { + "A": "健脾丸", + "B": "七味白术散", + "C": "枳实导滞丸", + "D": "肥儿丸或疳积散", + "E": "消乳丸或保和丸" + }, + "answer": "E", + "reason": "治疗积滞乳食内积证，治宜消乳消食，导滞和中，方选消乳丸或保和丸加减。" + }, + { + "question_num": 103, + "query": "桑螵蛸散证的病机要点是", + "options": { + "A": "心脾两虚", + "B": "心肾两虚", + "C": "脾肾两虚", + "D": "下元虚冷", + "E": "肾虚精亏" + }, + "answer": "B", + "reason": "桑螵蛸散调补心肾,固精止遗,适用于心肾两虚的尿频或滑精证。" + }, + { + "question_num": 104, + "query": "治疗汗证营卫失调的首选方剂是", + "options": { + "A": "桂枝汤", + "B": "黄芪桂枝五物汤", + "C": "当归六黄汤", + "D": "生脉散", + "E": "牡蛎散" + }, + "answer": "B", + "reason": "治疗汗证营卫失调，治宜调和营卫，方选黄芪桂枝五物汤。生脉散也是治疗汗证的方剂，但其主治气阴亏虚型汗证。" + }, + { + "question_num": 105, + "query": "白术与苍术并用的方剂是", + "options": { + "A": "健脾丸", + "B": "完带汤", + "C": "参苓白术散", + "D": "藿香正气散", + "E": "九味羌活汤" + }, + "answer": "B", + "reason": "ACD项中均只有白术,E项中是苍术,B项组成白术、山药、人参、白芍、车前子、苍术、甘草、陈皮、黑芥穗、柴胡。" + }, + { + "question_num": 106, + "query": "下列各项，不符合颤证气血亏虚证主证特点的是", + "options": { + "A": "头摇肢颤", + "B": "面色淡白", + "C": "表情淡漠", + "D": "心情紧张时颤动加重", + "E": "心悸健忘，眩晕" + }, + "answer": "D", + "reason": "颤证气血亏虚证证候：头摇肢颤，面色淡白，表情淡漠，神疲乏力，动则气短，心悸健忘，眩晕，纳呆，舌体胖大，舌质淡红，舌苔薄白滑，脉沉濡无力或沉细弱。心情紧张时颤动加重是风阳内动证的表现。" + }, + { + "question_num": 107, + "query": "在支气管哮喘与心源性哮喘鉴别困难时应选用的药物是", + "options": { + "A": "吗啡", + "B": "氨茶碱", + "C": "肾上腺素", + "D": "呋塞米", + "E": "毒毛花苷K或毛花苷C" + }, + "answer": "B", + "reason": "支气管哮喘与心源性哮喘鉴别困难时，可应用氨茶碱或B，受体激动剂作诊断性治疗，若迅速缓解，则可排除心源性哮喘。在未确诊前忌用肾上腺素和吗啡，以免造成生命危险。" + }, + { + "question_num": 108, + "query": "下列不属于蒿芩清胆汤组成药物的是", + "options": { + "A": "猪苓、枳实", + "B": "青蒿脑、青子芩", + "C": "陈广皮、碧玉散", + "D": "生枳壳、赤茯苓", + "E": "淡竹茹、仙半夏" + }, + "answer": "A", + "reason": "蒿芩清胆汤的组成药物：青蒿脑、淡竹茹、仙半夏、赤茯苓、青子芩、生枳壳、陈广皮、碧玉散（滑石、甘草、青黛）。" + }, + { + "question_num": 109, + "query": "肘横纹中,肱二头肌腱桡侧凹陷中的一腧穴是", + "options": { + "A": "尺泽", + "B": "曲泽", + "C": "少海", + "D": "小海", + "E": "曲池" + }, + "answer": "A", + "reason": "尺泽穴为手太阴肺经的合穴，在肘横纹中，肱二头肌腱桡侧凹陷处;曲泽穴为手厥阴心包经的合穴，在时横纹中，当肱二肌腱的尺侧缘;曲池穴为手阳明大肠经的合穴，在肘横纹外侧端，屈肘时当尺泽与肱骨外上髁连线中点;小海穴为手太阳小肠经的合穴，在肘内侧，当尺骨鹰嘴与肱骨内上髁之间凹陷处;少海穴为手少阴心经的合穴，屈肘时在肘横纹内侧端与肱骨内上课连线的中点处，" + }, + { + "question_num": 110, + "query": "下列药物中可以除湿止痛的是", + "options": { + "A": "辛夷", + "B": "薄荷", + "C": "细辛", + "D": "麻黄", + "E": "藁本" + }, + "answer": "E", + "reason": "藁本功效：祛风散寒，除湿止痛。主治：①风寒感冒，巅顶疼痛；②风寒湿痹。" + }, + { + "question_num": 111, + "query": "下列五输穴中,属“荥”的是", + "options": { + "A": "内庭", + "B": "厉兑", + "C": "足三里", + "D": "解溪", + "E": "陷谷" + }, + "answer": "A", + "reason": "内庭是足阳明经的荥穴,厉兑是足阳明经的井穴，足三里是足阳明经的合穴，解溪是足阳明经的经穴，陷谷是足阳明经的输穴。" + }, + { + "question_num": 112, + "query": "补中益气汤中用量最大的药物是", + "options": { + "A": "人参", + "B": "升麻", + "C": "甘草", + "D": "黄芪", + "E": "白术" + }, + "answer": "D", + "reason": "补中益气汤的组成是黄芪18g，甘草9g，人参6g，当归3g，陈皮6g，升麻6g，柴胡6g，白术9g，其中用量最大的是黄芪，取其补中益气、升阳固表之功。" + }, + { + "question_num": 113, + "query": "既可治疗脾胃病,又多用于泌尿、生殖系统疾病的穴位为", + "options": { + "A": "三阴交", + "B": "梁丘", + "C": "公孙", + "D": "阴陵泉", + "E": "胃俞" + }, + "answer": "A", + "reason": "三阴交穴为肝、脾、肾三经交会穴，在小腿内侧，当足内踝尖上3寸，胫骨内侧缘后方，可以健脾、补肾、和肝，主治脾胃病，妇科病、前阴病等泌尿、生殖系统疾病，水肿、小便不利等。" + }, + { + "question_num": 114, + "query": "主治梅核气的常用方剂是", + "options": { + "A": "苏子降气汤", + "B": "枳实薤白桂枝汤", + "C": "越鞠丸", + "D": "半夏厚朴汤", + "E": "旋覆代赭汤" + }, + "answer": "D", + "reason": "半夏厚朴汤的功用是行气散结，降逆化痰，主治梅核气，梅核气以咽如物阻，吞吐不得，苔白腻，脉弦滑为辨证要点。苏子降气汤主治实喘，功用是降气平喘，祛痰止咳。枳实薤白桂枝汤主治胸痹，功用是通阳散结，祛痰下气。越鞠丸主治郁证，功用是行气解郁。旋覆代赭汤主治胃气虚弱，痰浊内阻证，功用是降逆化痰，益气和胃。" + }, + { + "question_num": 115, + "query": "足太阳膀胱经在躯干部的循行部位是", + "options": { + "A": "前面", + "B": "侧面", + "C": "后背", + "D": "上部", + "E": "下部" + }, + "answer": "C", + "reason": "足太阳膀胱经与督脉循行于后背，任脉、足少阴肾经、足厥阴肝经、足太阴脾经、足阳明胃经皆循行于躯干的前面。" + }, + { + "question_num": 116, + "query": "小儿泄泻的病因很多，其中最重要的是", + "options": { + "A": "风", + "B": "寒", + "C": "热", + "D": "湿", + "E": "食" + }, + "answer": "D", + "reason": "泄泻的病理因素主要是湿，病位主要在脾胃。" + }, + { + "question_num": 117, + "query": "COPD患者用力后突发一侧撕裂样胸痛伴呼吸困难加重,最可能发生的是", + "options": { + "A": "呼吸衰竭", + "B": "肺部感染加重", + "C": "自发性气胸", + "D": "急性肺栓塞", + "E": "肺性脑病" + }, + "answer": "C", + "reason": "自发性气胸为慢阻肺急性并发症，多表现为用力后突发一侧撕裂样胸痛，呼吸困难加重，胸片显示患侧透光度增加:并可见被压缩肺边缘，" + }, + { + "question_num": 118, + "query": "我国高血压病最常见的死亡原因是", + "options": { + "A": "高血压危象", + "B": "急性脑血管病", + "C": "尿毒症", + "D": "心力衰竭", + "E": "缺血性心脏病" + }, + "answer": "B", + "reason": "我国高血压病最常见的死亡原因是急性脑血管病。" + }, + { + "question_num": 119, + "query": "肩峰前下方,当肩峰与肱骨大结节之间的腧穴是", + "options": { + "A": "肩髎", + "B": "肩髃", + "C": "肩贞", + "D": "天宗", + "E": "曲垣" + }, + "answer": "B", + "reason": "肩髎:肩髃后方,于肩.峰后下方凹陷处。肩祸:肩部，三角肌上，当肩峰与肱骨大结节之间取穴。肩贞:肩关节后，腋后纹头上1寸。天宗:肩胛部，当冈下窝中央凹陷处，与第4胸椎平。曲垣:肩胛部，当冈上窝内侧凹陷处同，约当臑俞与第二胸椎连线的中点。" + }, + { + "question_num": 120, + "query": "下列除哪项外，均属病理性胎黄", + "options": { + "A": "生后24小时内出现", + "B": "黄疸21～28天消退", + "C": "黄疸退而复现", + "D": "黄疸持续加深", + "E": "黄疸3周后仍不消退" + }, + "answer": "B", + "reason": "病理性胎黄：新生儿出生24小时内即出现黄疸，2～3周仍不消退，甚至继续加深，或黄疸退而复现，或于出生后一周甚至数周后开始出现黄疸。生理性胎黄：婴儿出生后2～3天出现黄疸，足月儿于出生后10～14天自行消退，早产儿21～28天消退。" + }, + { + "question_num": 121, + "query": "小肠的下合穴是", + "options": { + "A": "上巨虚", + "B": "下巨虚", + "C": "足三里", + "D": "阳陵泉", + "E": "委中" + }, + "answer": "B", + "reason": "小肠的下合穴是下巨虚上巨虚是大肠的下合穴;足三里是胃的下合穴;阳陵泉是胆的下合穴;委中是膀胱的下合穴。" + }, + { + "question_num": 122, + "query": "小儿汗证的常见病因是", + "options": { + "A": "气血两虚", + "B": "阴虚", + "C": "阳虚", + "D": "血虚", + "E": "气虚" + }, + "answer": "E", + "reason": "汗证是指小儿在安静状态下，正常环境中，全身或局部出汗过多甚则大汗淋漓的一种病证。多见于5岁以内的小儿。小儿汗证的常见病因有表虚不固，卫气失于外护，是表气虚；营卫失调，腠理不密，主要责之于小儿时期形气未充，营卫之气不足，肌肤疏薄，亦是气虚表现；气阴两虚，汗液外泄，这是外有气虚固摄作用减弱，内有阴虚发热。综合来说，当以气虚为其常见病因。" + }, + { + "question_num": 123, + "query": "主要治疗心、胸、胃、神志病证的经脉是", + "options": { + "A": "手太阴肺经", + "B": "手少阴心经", + "C": "足阳明胃经", + "D": "手厥阴心包经", + "E": "足太阴脾经" + }, + "answer": "D", + "reason": "手太阴肺经主治咳喘、咯血、咽喉痛等肺系疾病;手少阴心经主治心胸神志等病证;足阳明胃经主治胃肠病、头面五官病、神志病、皮肤病、热病等疾病;足太阴脾经主治脾胃病、妇科、前阴病等疾病:手厥阴心包经主治心、心包、胸、胃、神志病等疾病。" + }, + { + "question_num": 124, + "query": "下列属于风湿热皮肤表现的是", + "options": { + "A": "蝶形红斑", + "B": "环形红斑", + "C": "出血点", + "D": "紫癜", + "E": "瘀斑" + }, + "answer": "B", + "reason": "风湿热的皮肤表现如下：①皮下结节，主要是位于肘、腕、膝、踝关节伸侧的骨质隆起或肌腱附着处，呈圆形，质硬，可活动，无压痛，对称分布，分批出现，2～4周消失；②环形、结节形、多形性红斑。" + }, + { + "question_num": 125, + "query": "眶上神经痛取攒竹穴的刺法为", + "options": { + "A": "向外平刺", + "B": "直刺", + "C": "向下斜刺", + "D": "向内平刺", + "E": "向上斜刺" + }, + "answer": "A", + "reason": "平刺适用于皮薄肉少部位的腧穴。攒竹穴进针宜向外平刺，以免损伤神经。" + }, + { + "question_num": 126, + "query": "对冠心病最有确诊意义的检查是", + "options": { + "A": "普通心电图", + "B": "选择性冠状动脉造影", + "C": "24小时动态心电图", + "D": "超声心动图", + "E": "心功能检查" + }, + "answer": "B", + "reason": "选择性冠状动脉造影用特制定型的心导管经股动脉、肱动脉或桡动脉送到主动脉根部，分别插入左、右冠状动脉口，手推注射器注入少量含碘造影剂。这种选择性冠状动脉造影在不同的投射方位下摄影可使左、右冠状动脉及其主要分支得到清楚的显影，可发现各支动脉狭窄性病变的部位并估计其程度，是目前诊断冠心病最有意义的检查。" + }, + { + "question_num": 127, + "query": "下列可引起变态反应性发热的是", + "options": { + "A": "血型不合的输血", + "B": "重度脱水", + "C": "大面积烧伤", + "D": "心肌梗死", + "E": "中暑" + }, + "answer": "A", + "reason": "绝大多数是因误输了A、B0血型不合的血液引起发热，是由补体介导、以红细胞破坏为主的免疫反应，" + }, + { + "question_num": 128, + "query": "治疗肠虫证，应首选", + "options": { + "A": "使君子散", + "B": "乌梅丸", + "C": "驱蛔承气汤", + "D": "驱虫粉", + "E": "百部散" + }, + "answer": "A", + "reason": "肠虫证治法：驱蛔杀虫，调理脾胃。代表方剂：使君子散。乌梅丸用于蛔厥证，驱蛔承气汤用于虫瘕证，驱虫粉用于蛲虫病，百部散用于小儿咳嗽发热。" + }, + { + "question_num": 129, + "query": "医疗机构施行手术、特殊检查或特殊治疗时,如果无法取得患者意见又无家属或关系人在场,应该", + "options": { + "A": "经治医师提出医疗处置方案,在取得医疗机构负责人或者被授权负责人员的批准后实施", + "B": "经治医师提出医疗处置方案,在取得群众认可后实施", + "C": "经治医师提出医疗处置方案,在取得第三者证实有效后实施", + "D": "经治医师提出医疗处置方案,在取得县级以上卫生行政部门批准后实施", + "E": "经治医师提出医疗处置方案,在取得同行讨论批准后实施" + }, + "answer": "A", + "reason": "尊重原则要求医务人员尊重患者知情同意和选择的权利。对于缺乏或丧失知情同意和选择能力的患者，应该尊重亲属或监护人知情同意和选择的权利。当在生命的危急时刻，亲属或监护人不在场而又来不及赶到医院时，医务人员出于患者的利益和责任，可以行使家长决定权" + }, + { + "question_num": 130, + "query": "骨髓巨核细胞增多的血液病是", + "options": { + "A": "急性白血病", + "B": "再生障碍性贫血", + "C": "白细胞减少症", + "D": "特发性血小板减少性紫癜", + "E": "骨髓增生异常综合征" + }, + "answer": "D", + "reason": "特发性血小板减少性紫癜的诊断要点包括以下几方面：①广泛出血累及皮肤、黏膜及内脏；②多次检验血小板计数减少；③脾不大；④骨髓巨核细胞增多或正常，有成熟障碍；⑤泼尼松或脾切除治疗有效；⑥排除其他继发性血小板减少症。" + }, + { + "question_num": 131, + "query": "下列各项,不属全国突发事件应急预案内容的是", + "options": { + "A": "突发事件应急处理技术和监测机构及其任务", + "B": "突发事件应急处理专业队伍的建设和培训", + "C": "突发事件信息的收集、分析、报告、通报制度", + "D": "突发事件的立法规划方案", + "E": "突发事件的分级和应急处理工作方案" + }, + "answer": "D", + "reason": "全国突发事件应急预案内容:①突发事件应急处理指挥部的组成和相关部门的职贵;②突发事件的监测与预警;③突发事件信息的收集、分析、报告、通报制度;④突发事件应急处理技术和监测机构及其任务;⑤突发事件的分级和应急处理工作方案;突发事件预防、现场控制，应急设施、设备6)救治药品和医疗器械以及其他物资和技术的储备与调度;⑦突发事件应急处理专业队伍的建设和培训。" + }, + { + "question_num": 132, + "query": "丹痧疹后阴伤证的治法是", + "options": { + "A": "辛凉宜透，清热利咽", + "B": "养阴清热，宣肺止咳", + "C": "清气凉营，泻火解毒", + "D": "益气养阴，润肺止咳", + "E": "养阴生津，清热润喉" + }, + "answer": "E", + "reason": "丹痧疹后阴伤证治法：养阴生津，清热润喉。代表方剂：沙参麦冬汤。" + }, + { + "question_num": 133, + "query": "下列关于蜘蛛痣的叙述,正确的是", + "options": { + "A": "皮肤小动脉扩张所致", + "B": "皮肤毛细血管扩张所致", + "C": "多分布于下腔静脉回流区", + "D": "体内雌激素相对增多所致", + "E": "皮肤小静脉扩张所致" + }, + "answer": "D", + "reason": "皮肤小动脉末端分支扩张所形成的血管痣，形似蜘蛛，称为蜘蛛痣。多见于上腔静脉分布所形成的区域内，如面、颈手臂、上臂、前胸和肩部等处。一般认为蜘蛛痣的出现与肝对雌激素的灭活作用减弱有关。" + }, + { + "question_num": 134, + "query": "厌食与积滞的主要区别是", + "options": { + "A": "食欲不振", + "B": "形体消瘦", + "C": "精神异常", + "D": "脘腹胀满", + "E": "腹部疼痛" + }, + "answer": "D", + "reason": "厌食由脾胃纳化失职所致，以不思乳食为主证。而积滞乃由乳食停聚中焦，气滞不行所致，虽有食欲不振，却以脘腹胀满，嗳吐酸腐为主证，故脘腹胀满为二者之主要区别点。" + }, + { + "question_num": 135, + "query": "执业医师的合法处方权", + "options": { + "A": "变换执业范围后依然具有", + "B": "实习一年后即取得", + "C": "医师资格考试合格后取得", + "D": "在经注册的执业地点取得", + "E": "到任何聘用单位就有处方权" + }, + "answer": "D", + "reason": "经注册的执业医师在执业地点取得相应的处方权。" + }, + { + "question_num": 136, + "query": "痢疾的特异性表现是", + "options": { + "A": "里急后重", + "B": "腹部疼痛", + "C": "恶心呕吐", + "D": "大便溏泻", + "E": "肛门灼热" + }, + "answer": "A", + "reason": "患者腹泻，有脓血便或黏液便或水样便或稀便，或伴有里急后重症状，里急后重为痢疾的特异表现。" + }, + { + "question_num": 137, + "query": "在下列部位中闻及支气管呼吸音可判断为病理性呼吸音的是", + "options": { + "A": "喉部", + "B": "胸骨上窝", + "C": "背部第6、第7颈椎附近", + "D": "背部第1、第2胸椎附近", + "E": "右下肺" + }, + "answer": "E", + "reason": "在前后背部右肺下叶附近闻及的支气管呼吸音属于病理性呼吸音，而支气管呼吸音在喉部、胸骨上窝,背部第6、第7颈椎附近,背部第1、第2胸椎附近均是生理性呼吸音。" + }, + { + "question_num": 138, + "query": "既可治疗晕厥又可治疗闪挫腰痛的穴位为", + "options": { + "A": "百会", + "B": "内关", + "C": "水泉", + "D": "水道", + "E": "水沟" + }, + "answer": "E", + "reason": "水沟主治：①昏迷、晕厥、中风、中暑、休克；②癔症、癫狂痫、急慢惊风等神志病证；③鼻塞、鼻衄、面肿、口歪、齿痛、牙关紧闭；④闪挫腰痛；⑤风水面肿。" + }, + { + "question_num": 139, + "query": "医师在执业活动中违反卫生行政规章制度或者技术操作规范,造成严重后果的,责令暂停执业活动,暂停期限是", + "options": { + "A": "3个月以上，6个月以下", + "B": "6个月以上,2年以下", + "C": "6个月以上,1年以下", + "D": "1年以上,3年以下", + "E": "1年以上,1年半以下" + }, + "answer": "C", + "reason": "《中华人民共和国医师法》规定，医师在执业活动中有下列行为之一的，由县级以上人民政府卫生健康主管部门责令改正,给子警告;情节严重的，责令暂停六个月以上一年以下执业活动直至吊销医师执业证书:①在提供医疗卫生服务或者开展医学临床研究中，未按照规定履行告知义务或者取得知情同意;②对需要紧急救治的患者，拒绝急救处置，或者由于不负责任延误诊治;③遇有自然灾害、事故灾难、公共卫生事件和社会安全事件等严重威胁人民生命健康的突发事件时:不服从卫生健康主管部门调道;④未按照规定报告有关情形;⑤违反法律、法规、规章或者执业规范，造成医疗事故或者其他严重后果。本例医师在执业活动中违反卫生行政规章制度或者技术操作规范，造成严重后果的，责令暂停执业活动，暂停期限是六个月以上一年以下执业活动直至吊销医师执业证书，符合人民共和国医师法》本条规定。" + }, + { + "question_num": 140, + "query": "HIV主要感染的细胞是", + "options": { + "A": "CD4⁺淋巴细胞", + "B": "淋巴细胞", + "C": "单核细胞", + "D": "神经胶质细胞", + "E": "直肠黏膜上皮细胞" + }, + "answer": "A", + "reason": "CD4⁺T淋巴细胞在HIV直接和间接作用下，细胞功能受损和大量破坏，导致细胞免疫缺陷。" + }, + { + "question_num": 141, + "query": "引起中性粒细胞减少最常见的疾病是", + "options": { + "A": "流行性感冒", + "B": "阑尾炎", + "C": "狂犬病", + "D": "肺炎", + "E": "肝癌" + }, + "answer": "A", + "reason": "中性粒细胞减少的常见疾病:①感染,如伤寒、副伤寒、流行性感冒、麻疹、风疹、病毒性肝炎等;②某些血液病,如再生障碍性贫血、急性白血病、骨髓转移癌、白血病前期、骨髓纤维化;③结缔组织疾病及自身免疫性疾病，如系统性红斑狼疮、类风湿关节炎、慢性活动性肝炎等。" + }, + { + "question_num": 142, + "query": "关于SARS的临床表现，错误的是", + "options": { + "A": "常以发热为首发和主要症状", + "B": "严重者出现呼吸窘迫", + "C": "肺部体征不明显", + "D": "常伴有呼吸道卡他症状", + "E": "部分患者有腹泻" + }, + "answer": "D", + "reason": "急性呼吸窘迫综合征患者可有咳嗽，常无上呼吸道卡他症状。可有胸闷，严重者逐渐出现呼吸加速、气促，甚至呼吸窘迫。" + }, + { + "question_num": 143, + "query": "血小板增多,可见于", + "options": { + "A": "再生障碍性贫血", + "B": "急性白血病", + "C": "脾功能亢进", + "D": "弥散性血管内凝血", + "E": "急性出血后" + }, + "answer": "E", + "reason": "血小板数超过400x10°/L称为血小板增多。原发性血小板增多见于骨髓增生性疾病。反应性血小板增多见于急性感染、急性溶血、某些癌症患者，这种增多是轻度的，多在500X10°/L以下。" + }, + { + "question_num": 144, + "query": "足太阳经的主治特点是", + "options": { + "A": "胸腹、咽喉、头面病", + "B": "前头、鼻、口、齿病", + "C": "侧头、耳病，胁肋病", + "D": "后头、背腰病，脏腑病", + "E": "前头、口齿、胃肠病" + }, + "answer": "D", + "reason": "足太阳经的主治：头面五官病证，项、背、腰、下肢病证，神志病，位于背部两条侧线的腧穴主治相应脏腑及相关组织器官病证。" + }, + { + "question_num": 145, + "query": "腰穿进行脑脊液检查的禁忌证是", + "options": { + "A": "颈项强直", + "B": "Kernig征阳性", + "C": "Brudzinski征阳性", + "D": "双侧瞳孔不等大伴有视盘水肿", + "E": "昏迷" + }, + "answer": "D", + "reason": "腰穿进行脑脊液检查的禁忌证:凡疑有颅内压升高者必须先做眼底检查，凡患者处于休克、衰竭或濒危状态及局部皮肤有炎症、颅后窝有占位性病变者均列为禁忌。" + }, + { + "question_num": 146, + "query": "普通型流行性脑脊髓膜炎的典型表现，不包括", + "options": { + "A": "头痛", + "B": "呕吐", + "C": "出血点", + "D": "抽搐", + "E": "Babinski征阳性" + }, + "answer": "E", + "reason": "普通型流行性脑脊髓膜炎可出现头痛、呕吐、出血点和抽搐等症状，而Babinski征阳性一般为暴发型流脑的典型表现。" + }, + { + "question_num": 147, + "query": "在霍乱的临床表现中哪项是错误的", + "options": { + "A": "寒战、高热、急性起病", + "B": "先泻后吐", + "C": "无痛性腹泻", + "D": "“米泔水”样吐泻物", + "E": "严重者有痛性肌肉痉挛" + }, + "answer": "A", + "reason": "多数霍乱是以剧烈腹泻开始，继以呕吐，多无腹痛，无里急后重，典型的有“米泔水”样吐泻物，大量电解质丢失,低钠可引起痛性肌肉痉挛，低钾引起全身肌肉张力减低,甚至麻痹、心律失常等。一般无发热，或仅有低热，更无寒战。" + }, + { + "question_num": 148, + "query": "有关脑膜炎奈瑟菌的描述，正确的是", + "options": { + "A": "革兰染色阳性，体外抵抗力很弱，能产生自溶酶", + "B": "特异性荚膜多糖抗原与其致病作用无关", + "C": "能产生毒力较强的外毒素", + "D": "目前我国流行株以C群为主", + "E": "革兰染色阴性双球菌" + }, + "answer": "E", + "reason": "脑膜炎球菌属于脑膜炎奈瑟菌，为革兰染色阴性双球菌，内毒素是重要致病因素，仅存于人体，细胞内寄生，抵抗力弱，产生自溶酶，需要巧克力色血琼脂培养基培养。" + }, + { + "question_num": 149, + "query": "黄疸伴右上腹钻顶样痛见于", + "options": { + "A": "急性肝炎", + "B": "急性胆囊炎", + "C": "胆道蛔虫病", + "D": "急性胰腺炎", + "E": "胃穿孔" + }, + "answer": "C", + "reason": "黄疸伴上腹剧烈疼痛者可见于胆道结石、肝脓肿或胆道蛔虫病，而右上腹钻顶样痛为胆道蛔虫病的特征性表现。" + }, + { + "question_num": 150, + "query": "空腹时，听诊出现振水音，可见于", + "options": { + "A": "幽门梗阻", + "B": "肾病综合征", + "C": "结核性腹膜炎", + "D": "肝硬化", + "E": "急性肠炎" + }, + "answer": "A", + "reason": "振水音是胃内液体与气体相撞击的声音，正常人餐后或饮入多量液体时，上腹部可出现振水音。若在空腹或餐后6～8小时以上仍有此音，则提示胃内有液体潴留，见于胃扩张、幽门梗阻及胃液分泌过多等。" + }, + { + "question_num": 151, + "query": "流感的传染源是", + "options": { + "A": "猪", + "B": "马", + "C": "禽类", + "D": "隐性感染者", + "E": "未接种流感疫苗者" + }, + "answer": "D", + "reason": "流感的传染源是患者和隐性感染者。猪、禽类等动物为储存宿主或中间宿主。" + }, + { + "question_num": 152, + "query": "检查者用钝尖物在被检查者外踝下方由后向前划至跖趾关节处，此方法是检查", + "options": { + "A": "Babinski征", + "B": "Kernig征", + "C": "Gordon征", + "D": "Chaddock征", + "E": "Oppenheim征" + }, + "answer": "D", + "reason": "Babinski征是医师以手持患者踝部用叩诊锤柄部末端的钝尖部在足底外侧从后向前快速轻划至小趾跟部，再转向拇趾侧。Kernig征患者去枕仰卧，一腿伸直，医师将另一下肢先屈髋、屈膝成直角，然后抬小腿伸进其膝部，正常人膝关节可伸达135°。Gordon征是检查者用手以适当的力量握腓肠肌。Chaddock征由检查者用钝尖物在被检查者外踝下方由后向前划至跖趾关节处。Oppenheim征由检查者用拇指和食指沿患者胫骨前缘用力由上而下滑压。" + }, + { + "question_num": 153, + "query": "多尿是指24小时尿量多于", + "options": { + "A": "2000ml", + "B": "1000ml", + "C": "1500ml", + "D": "3000ml", + "E": "2500ml" + }, + "answer": "E", + "reason": "成人正常的尿量24小时为1000~2000ml;尿量超过2500ml,称为多尿。" + }, + { + "question_num": 154, + "query": "下列可引起血钾降低的情况不包括", + "options": { + "A": "严重呕吐、腹泻", + "B": "大量应用肾上腺皮质激素", + "C": "大量应用胰岛素", + "D": "代谢性酸中毒", + "E": "代谢性碱中毒" + }, + "answer": "D", + "reason": "血清钾降低常见于以下几种情况：①钾盐摄入不足，如长期低钾饮食、禁食、厌食等；②钾丢失过多，如严重呕吐、腹泻，大量应用肾上腺皮质激素及排钾利尿药；肾上腺功能亢进或醛固酮增多症、恶性肿瘤、代谢性碱中毒等；③钾在体内分布异常，如心功能不全、肾性水肿等，大量应用胰岛素、碱中毒、甲亢等。" + }, + { + "question_num": 155, + "query": "X线显示食管受压向后移位表示", + "options": { + "A": "左心室增大", + "B": "右心室增大", + "C": "左心��增大", + "D": "右心房增大", + "E": "主动脉增宽" + }, + "answer": "C", + "reason": "左心房增大时,食管受压向后移位，心右缘双弧形、心底部双心房影，心左缘可见左心耳突出，左主支气管受压抬高，" + }, + { + "question_num": 156, + "query": "当实质性器官被含气组织覆盖时，其叩诊音为", + "options": { + "A": "清音", + "B": "鼓音", + "C": "实音", + "D": "浊音", + "E": "过清音" + }, + "answer": "D", + "reason": "当实质性器官被含气组织覆盖时，其叩诊音为浊音。" + }, + { + "question_num": 157, + "query": "确诊流行性出血热的依据是", + "options": { + "A": "鼠类接触史", + "B": "全身感染和中毒症状", + "C": "“三痛”和“三红”征", + "D": "特异性IgM抗体滴度升高", + "E": "异型淋巴细胞增多" + }, + "answer": "D", + "reason": "血清特异性抗体IgM阳性,血或尿标本病毒抗原或病毒RNA阳性可确诊。" + }, + { + "question_num": 158, + "query": "冬天小儿的尿液冷却后呈白色浑浊是由于", + "options": { + "A": "尿酸盐沉积", + "B": "乳糜尿", + "C": "脓尿", + "D": "肾盂肾炎", + "E": "泌尿系结石" + }, + "answer": "A", + "reason": "正常新鲜尿液清澈透明。尿液颜色受食物、尿色素、药物等影响，一般呈淡黄色至深黄色。酸性尿冷却后，可有淡红色的尿酸盐结晶析出，加热或加碱皆可溶解；而小儿的碱性尿液在冬天冷却后，可有白色的尿酸盐结晶析出。" + }, + { + "question_num": 159, + "query": "卫生法中的法律责任,分别是", + "options": { + "A": "赔偿责任、补偿责任、刑事责任", + "B": "经济责任、民事责任、刑事责任", + "C": "行政处分、经济补偿、刑事责任", + "D": "行政处罚、经济赔偿、刑事责任", + "E": "民事责任、行政责任、刑事责任" + }, + "answer": "E", + "reason": "卫生法中的法律责任可分为民事责任、行政责任、刑事责任3种" + }, + { + "question_num": 160, + "query": "患者，男性，35岁。胃脘灼热疼痛，痛势急迫，易怒，口苦，泛吐酸水，舌红苔薄黄，脉弦数，其治法是", + "options": { + "A": "疏肝理气止痛", + "B": "清肝泄热化湿", + "C": "疏肝泄热和胃", + "D": "疏肝理气和胃", + "E": "理气和胃止痛" + }, + "answer": "C", + "reason": "患者肝胃不和，气机郁滞，久而化热，热积于胃，则胃脘灼热疼痛，痛势急迫；舌红苔薄黄，脉弦数，均为肝胃蕴热证。辨证分析本患者为胃痛肝胃郁热证。" + }, + { + "question_num": 161, + "query": "因严重违反《中华人民共和国传染病防治法》及有关法律规定,按照《刑法》,判处3年以下有期徒刑或拘役,并处或单处罚金的违法犯罪行为是", + "options": { + "A": "引起甲类传染病传播或有传播危险的", + "B": "引起乙类传染病传播或有传播危险的", + "C": "从事实验、保藏传染病菌种、毒种的人员违反国家规定,造成传染病菌种、毒种扩散，后果严重的", + "D": "违反国境卫生检疫规定,引起检疫传染病传播或有传播严重危险的", + "E": "从事传染病防治工作的人员严重不负责任,导致传染病传播流行的" + }, + "answer": "A", + "reason": "《中华人民共和国传染病防治法》规定，构成犯罪的，依法追究刑事责任。这里的构成犯罪，是指《中华人民共和国刑法》中规定，引起甲类传染病传播或有传播危险的处3年以下有期徒刑或拘役。" + }, + { + "question_num": 162, + "query": "患者，男性，56岁。喘咳气急，胸部胀闷，不得卧，痰稀白，恶寒发热，无汗，舌苔薄白，脉浮紧。治疗应首选", + "options": { + "A": "木防己汤", + "B": "苓桂术甘汤", + "C": "葶苈大枣泻肺汤", + "D": "麻黄汤", + "E": "越婢加半夏汤" + }, + "answer": "D", + "reason": "由于风寒客肺，邪气壅实，肺气不宣则咳喘气逆，呼吸急促，胸部胀闷；寒邪伤肺，津聚成痰则痰多稀薄而带泡沫，色白质黏；风寒袭表，皮毛闭塞则头痛、鼻塞、无汗、恶寒、发热；风寒在表之证可见苔薄白而滑，脉浮紧，故诊断为喘证之风寒壅肺证，治宜宣肺散寒，方用麻黄汤。" + }, + { + "question_num": 163, + "query": "1976年美国学者提出的医患关系基本模式是", + "options": { + "A": "主动一被动型,互相一合作型,平等参与型", + "B": "主动一合作型,相互一指导型,共同参与型", + "C": "主动一配合型,指导一合作型,共同参与型", + "D": "主动一被动型,指导一合作型,共同参与型", + "E": "主动一被动型,共同参与型,父权主义型" + }, + "answer": "D", + "reason": "在医疗活动中,医患关系一五包括医冬人员与病人在医疗措旅决定和执行中的技术关系，另一方面表现为医务人员对病人的服务质量和伦理道德的非技术关系:这是医患关系的基本内容。根据医患关系的内容，美国学者提出了“主动一被动型，指导一合作型，共同参与型”这一基本模式。" + }, + { + "question_num": 164, + "query": "患者，男性，23岁。反复发作气急痰鸣8年余。半小时前感寒后，自觉鼻、咽、眼、耳发痒，喷嚏，鼻塞，流涕，胸部憋塞，随之迅即发作。现症见：喉中痰涎壅盛，声如拽锯，喘急胸满，但坐不得卧，咳痰黏腻难出，面色晦暗，舌苔厚浊，脉滑实，其治疗应首选的方剂是", + "options": { + "A": "苏子降气汤", + "B": "定喘汤", + "C": "三子养亲汤", + "D": "二陈平胃散", + "E": "桑白皮汤" + }, + "answer": "C", + "reason": "风痰哮的特征性表现为喉中痰涎壅盛、声如拽锯，治法为祛风涤痰、降气平喘，代表方为三子养亲汤。" + }, + { + "question_num": 165, + "query": "下列义务中应该经病人知情同意后才能合法履行的是", + "options": { + "A": "如实提供病情信息", + "B": "尊重医务人员的劳动", + "C": "避免将疾病传播给他人", + "D": "遵守住院规章制度", + "E": "支持医学生实习和发展医学" + }, + "answer": "E", + "reason": "患者的权利内容包括基本医疗权、疾病认知权、知情同意权、保护隐私权、监督医疗权、免除一定的社会责任权、要求赔偿权。而以上只有巨项符合知情同意权的范畴。" + }, + { + "question_num": 166, + "query": "患者，男，32岁。发热微恶寒，咳嗽，咳白色黏沫痰，痰量渐多，胸痛，咳时痛甚，呼吸不利，口干鼻燥，舌苔薄黄，脉浮滑数。诊断为肺痈，其病期是", + "options": { + "A": "初期", + "B": "成痈期", + "C": "溃脓期", + "D": "恢复期", + "E": "消散期" + }, + "answer": "A", + "reason": "发热微恶寒，咳嗽，咳白色黏沫痰，痰量渐多，胸痛，咳时痛甚，呼吸不利，口干鼻燥，舌苔薄黄，脉浮滑数，诊断为肺痈。患者表证非常明显，应该是肺痈初期，方选银翘散。" + }, + { + "question_num": 167, + "query": "患者,女,27岁。口舌生疮,心烦失眠,小便黄赤,尿道灼热涩痛,口渴,舌红无苔,脉数,其病位在", + "options": { + "A": "心、脾", + "B": "肺、大肠", + "C": "膀胱", + "D": "心、小肠", + "E": "肾、膀胱" + }, + "answer": "D", + "reason": "口舌生疮,心烦失眠等症状说明患者有心火。小便黄赤、尿道灼热涩痛是小肠实火的症状。心与小肠的关系，在生理上相互为用，在病理上相互影响，心经实火，可下移于小肠，引起尿少、小便黄赤、尿道灼热涩痛等小肠实火的症状。反之，小肠有热，亦可循经脉上熏于心，可见口舌生疮、心烦失眠等症状。" + }, + { + "question_num": 168, + "query": "患者，女，45岁。结喉正中偏右有一半圆形包块，边界清楚，表面光滑，皮色如常，可随吞咽上下移动，其诊断是", + "options": { + "A": "气瘿", + "B": "肉瘿", + "C": "筋瘿", + "D": "血瘿", + "E": "石瘿" + }, + "answer": "B", + "reason": "肉瘿是以颈前结喉正中附近出现半球形柔软肿块，能随吞咽而上下移动为主要表现的甲状腺良性肿瘤。" + }, + { + "question_num": 169, + "query": "患者,男,30岁。夜间外出着衣薄,次日恶寒发热，头身疼痛,后背发凉,无汗,舌苔薄白,脉浮紧。用药宜首选", + "options": { + "A": "荆芥、防风", + "B": "麻黄、桂枝", + "C": "薄荷、牛蒡子", + "D": "羌活、白芷", + "E": "紫苏、香薷" + }, + "answer": "B", + "reason": "该证属风寒表实证,麻黄味辛发散,性温散寒,功能开腠理，透毛窍,发汗解表以散风寒,为辛温解表要药，多用于外感风寒，恶寒无汗，发热头痛，脉浮而紧的感冒重证，即风寒表实证，每与桂枝相须为用，如麻黄汤，" + }, + { + "question_num": 170, + "query": "患者，男，63岁。年老体虚，近1年来，心悸气短，劳则尤甚，自汗，面色白，头昏神疲，肢体无力，舌苔淡白，脉细软弱。治疗应首选", + "options": { + "A": "天王补心丹", + "B": "养心汤", + "C": "大补元煎", + "D": "七福饮", + "E": "加味四君子汤" + }, + "answer": "D", + "reason": "该患者为虚劳心气虚证，治宜益气养心，代表方为七福饮加减。" + }, + { + "question_num": 171, + "query": "患者崩漏下血,色紫黑、有块,小腹疼痛拒按,血块排���后痛减,舌质紫暗、脉涩。治疗应选用", + "options": { + "A": "藕节", + "B": "仙鹤草", + "C": "地榆", + "D": "三七", + "E": "艾叶" + }, + "answer": "D", + "reason": "崩漏下血,色紫黑、有块,舌质紫暗、脉涩。此为瘀血证，化瘀止血、活血定痛是三七之效。" + }, + { + "question_num": 172, + "query": "患者平素头晕头痛，突然昏倒，不省人事，半侧身体不遂，牙关紧闭，面红身热，舌红苔黄腻，脉弦滑数，其诊断是", + "options": { + "A": "中风（中经络络脉空虚风邪人中）", + "B": "中风（中经络肝肾阴虚风阳上扰）", + "C": "中风（中脏腑脱证）", + "D": "中风（中脏腑闭证阴闭）", + "E": "中风（中脏腑闭证阳闭）" + }, + "answer": "E", + "reason": "不省人事—中脏腑；牙关紧闭—闭证；面红身热，舌红苔黄腻，脉弦滑数—热象，为阳证。" + }, + { + "question_num": 173, + "query": "患者,女,30岁。产后5天,右侧乳房红肿胀痛,触摸到硬块,大便如常,小便色黄。治疗应首选", + "options": { + "A": "大青叶", + "B": "蒲公英", + "C": "淡竹叶", + "D": "栀子", + "E": "知母" + }, + "answer": "B", + "reason": "根据题干辨证为乳痈。蒲公英的功效:清热解毒，消肿散结，利湿通淋兼能疏郁通乳，是治乳痈的要药，" + }, + { + "question_num": 174, + "query": "患者突然昏仆，不省人事，目合口开，鼻鼾息微，汗多，大小便自遗，脉微欲绝。治疗应首选的方剂是", + "options": { + "A": "镇肝熄风汤", + "B": "桃核承气汤", + "C": "羚角钩藤汤合至宝丹", + "D": "涤痰汤", + "E": "参附汤合生脉散" + }, + "answer": "E", + "reason": "该患者诊为中风中脏腑脱证，应回阳救阴，益气固脱。代表方：参附汤合生脉散加味。亦可用参麦注射液或生脉注射液静脉滴注。" + }, + { + "question_num": 175, + "query": "患者,男性,25岁。胁肋胀痛1个月，伴见恶心、呕吐，舌红,苔黄腻。治疗应取何经穴为主", + "options": { + "A": "足少阳、足厥阴经", + "B": "足少阳、足阳明经", + "C": "足阳明、足太阴经", + "D": "足厥阴、足太阳经", + "E": "足太阳、足太阴经" + }, + "answer": "A", + "reason": "患者主诉是胁肋胀病1个月，胁肋部主要分布有足少阳胆、足厥阴肝经，恶心呕吐，舌红苔黄腻是肝胆湿热内郁的表现，因此针灸治疗时取胆经和肝经的腧穴清利肝胆湿热。" + }, + { + "question_num": 176, + "query": "患者多梦易醒，心悸健忘，眩晕，肢倦神疲，纳呆，面色少华，舌淡，苔薄，脉细弱，其证候是", + "options": { + "A": "心脾两虚", + "B": "肝火扰心", + "C": "痰热扰心", + "D": "心胆气虚", + "E": "心肾不交" + }, + "answer": "A", + "reason": "本患者为不寐心脾两虚证。不易入睡，多梦易醒是由于心脾亏虚，生血无源，运血无力，血不养心；心悸健忘是由于血虚神失所养；气血亏虚，不能上奉于脑，清阳不升，脑失所养可出现目眩；脾虚运化失职可见纳呆；面色少华，舌质淡是由于血虚不能上荣；脉细无力是气虚血少之象。本患者治疗宜补益心脾，养血安神。" + }, + { + "question_num": 177, + "query": "患者,男性,45岁。自觉心慌心烦,时息时作,健忘失眠。治疗应首选", + "options": { + "A": "三阴交", + "B": "神门", + "C": "足三里", + "D": "太溪", + "E": "合谷" + }, + "answer": "B", + "reason": "本证为不寐,治疗时以宁心安神为主，不寐的病位在心，故取心经的原穴神门为主穴以宁心安神，其余穴皆为配穴。" + }, + { + "question_num": 178, + "query": "患者，女，34岁。咳嗽3个月，咳声无力，气短声低，痰中带血，血色淡红，潮热，热度不高，盗汗，面色㿠白，舌质嫩红，边有齿痕，脉细弱。诊断是", + "options": { + "A": "肺痨气阴耗伤证", + "B": "喘证肺阴虚证", + "C": "喘证肾阴虚证", + "D": "虚劳肺阴虚证", + "E": "咳血肺阴亏损证" + }, + "answer": "A", + "reason": "该患者咳嗽、咯血、潮热、盗汗，应诊为肺痨。咳声无力，气短声低，为气虚的表现。潮热，盗汗，脉细，为阴虚的表现，故为肺痨气阴耗伤证。" + }, + { + "question_num": 179, + "query": "患者,女,35岁。肢体关节酸痛,游走不定,屈伸不利,恶风发热,舌苔薄白,脉浮。治疗应首选", + "options": { + "A": "薏苡仁汤", + "B": "桂枝芍药知母汤", + "C": "乌头汤", + "D": "防风汤", + "E": "白虎加桂枝汤" + }, + "answer": "D", + "reason": "该患者可辨证为行痹,治法为��风通络，散寒除湿，方剂可选用防风汤。" + }, + { + "question_num": 180, + "query": "老年患者，眩晕耳鸣，头痛且胀，面时潮红，急躁易怒，少寐多梦，目赤口苦，便干溲赤，舌苔黄燥，脉象弦数，其治疗主方应为", + "options": { + "A": "天麻钩藤饮", + "B": "镇肝熄风汤", + "C": "龙胆泻肝汤", + "D": "丹栀逍遥散", + "E": "当归龙荟丸" + }, + "answer": "A", + "reason": "据其主症分析，此为肝阳上亢之眩晕。肝阳上亢，上冒清空，故头晕头痛。方选天麻钩藤饮。" + }, + { + "question_num": 181, + "query": "患者,男,45岁。漏管在外括约肌深部以下,截石位4点和8点处各有一外口,其内口在截石位6点处,其诊断是", + "options": { + "A": "低位单纯性肛漏", + "B": "高位单纯性肛漏", + "C": "高位复杂性肛漏", + "D": "低位复杂性肛漏", + "E": "多口外漏" + }, + "answer": "D", + "reason": "本题考查肛漏的诊断。漏管在外括约肌深部以下，截石位4点和8点处各有一外口，其内口在截石位6点处，其诊断是低位复杂性肛漏。" + }, + { + "question_num": 182, + "query": "患者，女性，40岁。低热3个月，热势常随情绪波动而起伏，烦躁易怒，口干而苦，舌红苔黄，脉弦数。诊断为内伤发热，其证候是", + "options": { + "A": "瘀血", + "B": "气虚", + "C": "血虚", + "D": "气郁", + "E": "阴虚" + }, + "answer": "D", + "reason": "肝气郁结化火可见发热，因情志所伤，则可见发热随情绪波动而起伏；肝火灼津，胃肠有热则见口干而苦；舌红苔黄，脉弦数为热象。辨证分析为内伤发热之气郁发热证。" + }, + { + "question_num": 183, + "query": "患儿,4岁。形体消瘦,面色不华,山根青筋显露,容易感冒,腹泻,食欲不佳,舌淡红，其舌苔应见", + "options": { + "A": "白厚", + "B": "白腻", + "C": "黄腻", + "D": "花剥", + "E": "薄白" + }, + "answer": "E", + "reason": "“形体消瘦,面色不华,腹泻，食欲不佳”为脾胃虚弱之象，“容易感冒”为气虚之象，故本证辨为脾气虚证。选项中唯有薄白苔为适宜。脾气虚证以消瘦、食少、便溏及气虚证为主要辨证依据，" + }, + { + "question_num": 184, + "query": "患者，男性，50岁。1周前项后发际处突发一肿块，红肿热痛，渐渐加剧，其后出现多个粟米样脓头，部分溃破溢脓，其治法是", + "options": { + "A": "凉血祛风，行瘀通络", + "B": "凉血清热，解毒利湿", + "C": "和营托毒，清热利湿", + "D": "清热解毒，活血通络", + "E": "养阴清热，托毒透邪" + }, + "answer": "C", + "reason": "透托法用于肿疡不能消散即将成脓或溃后脓出不畅的毒盛正不虚的实证，疮形已成不可用透托法。补托法用于疮形平塌，肿势散漫或溃后脓液稀少、肿势不消的毒盛正已虚的虚实夹杂证。毒盛正不虚的实证及虚证都不可用补托法。ABD项单用外治法，E项为补托法，不适合。该患者肿疡不能消散，溃后脓出不畅，为毒盛正不虚的实证。" + }, + { + "question_num": 185, + "query": "患者,女,35岁。哮喘咳嗽,痰多气急，咳吐黄稠痰,微恶风寒,舌苔黄腻,脉滑数。治疗应选用", + "options": { + "A": "止嗽散", + "B": "贝母瓜蒌散", + "C": "清气化痰丸", + "D": "麻杏石甘汤", + "E": "定喘汤" + }, + "answer": "E", + "reason": "定喘汤主治风寒外束,痰热内蕴证。症见咳嗽，痰多气急，咳吐黄稠痰，微恶风寒，舌苔黄腻，脉滑数。" + }, + { + "question_num": 186, + "query": "患者左前臂部有一肿块，呈扁平隆起，质地柔软，状如海绵，皮色略紫，按之肿块可缩小，其诊断是", + "options": { + "A": "气瘤", + "B": "脂瘤", + "C": "筋瘤", + "D": "血瘤", + "E": "肉瘤" + }, + "answer": "D", + "reason": "质地柔软，状如海绵，按之缩小为血瘤的典型症状。" + }, + { + "question_num": 187, + "query": "患者,男,38岁。主诉腹中肿块时聚时散,按之无形,痛无定处,其诊断是", + "options": { + "A": "癥积", + "B": "痕聚", + "C": "结胸", + "D": "水数", + "E": "痞证" + }, + "answer": "B", + "reason": "腹中肿块时聚时散,按之无形，痛无定处，病在气分，其诊断是疲聚。" + }, + { + "question_num": 188, + "query": "患者，女，23岁。患尖锐湿疣，外生殖器及肛门出现疣状赘生物，色灰，质柔软，表面秽浊潮湿，触之易出血，恶臭，小便色黄，不畅。舌苔黄腻，脉弦数。治拟利湿化浊，清热解毒。应首选", + "options": { + "A": "黄连解毒汤", + "B": "萆薢化毒汤", + "C": "龙胆泻肝汤", + "D": "知柏地黄丸", + "E": "土茯苓合剂" + }, + "answer": "B", + "reason": "患尖锐湿疣见表面秽浊潮湿，触之易出血，恶臭，小便色黄，不畅，舌苔黄腻，脉弦数，可诊为湿毒下注证，方选萆薢化毒汤酌加黄柏、土茯苓、大青叶。" + }, + { + "question_num": 189, + "query": "患者，女.19岁、未婚。月事非时而下，量多如崩，色深红，质稠，伴心烦，口渴欲饮,便干溲黄，面部痤疮，舌红、苔黄、脉数,其治法是", + "options": { + "A": "滋阴清热，止血调经", + "B": "消热凉血，止血调经", + "C": "滋水益阴，止血调经", + "D": "活血化瘀，止血调经", + "E": "益气摄血，止血调经" + }, + "answer": "B", + "reason": "患者可诊断为崩漏,色深红，质稠，伴心烦，口渴欲饮，便干溲黄，面部痤疮，舌红，苔薄黄，脉数，为血热之表现。辨证属血热，治以清热凉血，固冲止血。" + }, + { + "question_num": 190, + "query": "患者，女性，红蝴蝶疮，红斑暗滞，角质栓形成及皮肤萎缩，伴倦怠乏力，舌暗红，苔白，脉沉细。治疗应首选的方剂是", + "options": { + "A": "四君子汤合丹栀逍遥散", + "B": "逍遥散合血府逐瘀汤", + "C": "六味地黄丸合大补阴丸", + "D": "附桂八味丸", + "E": "补中益气汤" + }, + "answer": "B", + "reason": "患者疮斑暗滞，倦怠乏力，舌暗红等症状可判断其为气滞血瘀型红蝴蝶疮，治宜疏肝理气，活血化瘀，方选逍遥散合血府逐瘀汤。ACD项也可用于治疗红蝴蝶疮。A项用于脾虚肝旺型；C项用于阴虚火旺型；D项用于脾肾阳虚型。" + }, + { + "question_num": 191, + "query": "患者，男,16岁。不明原因的发热、牙龈出血1間。查体发现轻度贫血貌,颌下及腹股沟淋巴结肿大,胸骨压痛,肝脏肋下2指。应考虑为", + "options": { + "A": "败血症", + "B": "淋巴结结核", + "C": "再生障碍性贫血", + "D": "急性病毒性肝炎", + "E": "急性白血病" + }, + "answer": "E", + "reason": "胸骨压痛,肝大,淋巴结肿大，加上贫血貌，诊断为急性白血病" + }, + { + "question_num": 192, + "query": "患者，男性，55岁，排便时出血，量不多，肛门脱出肿物大小如李，表面色紫，微带白色，需用手推挤方能还纳，病已10年，近来加重，其诊断是", + "options": { + "A": "直肠息肉", + "B": "直肠脱垂", + "C": "直肠癌", + "D": "Ⅱ期内痔", + "E": "Ⅲ期内痔" + }, + "answer": "E", + "reason": "患者排便时出血，肛门脱出肿物大小如李，表而色紫，微带白色，需用手推挤方能还纳，此为Ⅲ期内痔。" + }, + { + "question_num": 193, + "query": "患者多食,大便每日2~3次。查体:血压140/60mmHg,双眼突出,心律不齐,脉搏短绌。应首先考虑的是", + "options": { + "A": "糖尿病合并缺血性心脏病", + "B": "左心衰竭合并心房纤颤", + "C": "高血压性心脏病伴心房纤颤", + "D": "肺心病伴心房纤颤", + "E": "甲状腺功能亢进症伴心房纤颤" + }, + "answer": "E", + "reason": "患者心律不齐、脉搏短绌,首先考虑是房颤。双眼突出、多食、脉压增大提示甲状腺功能亢进。甲亢会并发心脏病-房颤，" + }, + { + "question_num": 194, + "query": "患者，男，40岁。病发于夏季，小便艰涩疼痛，尿道窘迫，曾排尿中断，腰腹绞痛难忍，舌红苔黄腻，脉弦数。应首先考虑的是", + "options": { + "A": "膏淋", + "B": "石淋", + "C": "热淋", + "D": "劳淋", + "E": "血淋" + }, + "answer": "B", + "reason": "湿热下注，煎熬尿液，结为砂石，故为石淋。砂石不能随尿排出，则小便艰涩，尿时疼痛。若砂粒较大，阻塞尿路，则尿时突然中断，阻塞不通而致疼痛难忍。" + }, + { + "question_num": 195, + "query": "患者,女,70岁。冠心病史5年。今日突然心悸气短,不能平卧,咳嗽,咳粉红色泡沫样痰。应首先考虑的是", + "options": { + "A": "肺癌", + "B": "肺脓肿", + "C": "肺结核", + "D": "急性肺水肿", + "E": "支气管扩张" + }, + "answer": "D", + "reason": "冠心病史5年,突然心体气短,不能平卧,咳嗽,咳粉红色泡沫释痰。应首先考虑的是急性左心衰竭，急性肺永肿是左心衰竭的表现之一，" + }, + { + "question_num": 196, + "query": "患者，女性，24岁。8个月前因食用鱼虾后全身起风团，后反复发作，迁延日久，每次发作时原因不明，瘙痒明显，舌淡红，苔白，脉沉细。治疗应首选的方剂是", + "options": { + "A": "桂枝汤", + "B": "四物消风散", + "C": "当归饮子", + "D": "八珍汤", + "E": "消风散" + }, + "answer": "C", + "reason": "患者主因鱼虾过敏，结合其他表现可诊断为瘾疹。舌淡红、苔白、脉沉细提示患者有血虚的症状，风团瘙痒明显，故可诊断为血虚风燥型，治宜养血祛风润燥，方选当归饮子加减。" + }, + { + "question_num": 197, + "query": "憨丸,男、10个月。大便呈果断色,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": 198, + "query": "患者，女，46岁。双乳肿块疼痛10余年，平素体弱，神疲倦怠，短气乏力，腰膝酸软，畏寒肢冷，月经失调。查双乳腺体增厚，于多个象限可触及片块结节，质韧，活动可，与皮肤无粘连，压痛，乳头有少量清水样溢液。舌淡苔白，脉沉细，其中医诊断及证型考虑为", + "options": { + "A": "乳痨肝郁痰凝证", + "B": "乳癖冲任失调证", + "C": "乳岩正虚毒恋证", + "D": "乳核血瘀痰凝证", + "E": "乳痨肝肾不足证" + }, + "answer": "B", + "reason": "乳癖是乳腺组织的既非炎症也非肿瘤的良性增生性疾病。相当于西医的乳腺增生病。特点是单侧或双侧乳房疼痛并出现肿块，与月经周期及情志变化密切相关，其冲任失调证多见于中年妇女，乳房肿块月经前加重，伴有腰酸乏力，神疲倦怠。治法：调摄冲任。方药：二仙汤合四物汤加减。" + }, + { + "question_num": 199, + "query": "患几,女,3岁。筋骨萎弱,发育迟缓，坐、立、行走、牙齿的发育都晚于同龄小儿，颈项萎软;目无神采:夜卧不安,舌淡，苔少,其证候是", + "options": { + "A": "脾肾气虚", + "B": "痰瘀阻滞", + "C": "肝肾亏损", + "D": "心脾两虚", + "E": "肾阳亏虚" + }, + "answer": "C", + "reason": "患儿是一个五迟的患者,苦渎，苔少是气虚所致，又目无神采，夜卧不安，辨证为肝肾亏损证。" + }, + { + "question_num": 200, + "query": "患者，男，28岁。左肩部可及5cm×3cm×3cm的肿物，质地软，呈分叶状，推之可移，无明显压痛，局部皮色正常，病史已有5年。应首先考虑的是", + "options": { + "A": "肉瘤", + "B": "气瘤", + "C": "脂瘤", + "D": "血瘤", + "E": "骨瘤" + }, + "answer": "A", + "reason": "肉瘤是发于皮里膜外，由脂肪组织过度增生而形成的良性肿瘤，其特点是软似棉，肿似馒，皮色不变，不紧不宽，如肉之隆起。气瘤与神经走行有关，硬韧而有弹性，必要时可做活组织检查进行鉴别，相当于西医的多发性神经纤维瘤；脂瘤相当于西医的皮脂腺囊肿；血瘤相当于西医的海绵状血管瘤；骨瘤有良性恶性之分，相当于西医的骨良性肿瘤和骨恶性肿瘤。" + }, + { + "question_num": 201, + "query": "患儿,男,2岁,精神萎靡,嗜睡露睛，面色萎黄,不欲饮食,大便稀溏,色带青绿,时有肠鸣,四肢不温,抽搐无力,时作时止,舌淡苔白,脉沉弱,其病机可能是", + "options": { + "A": "阴虚风动", + "B": "脾肾阳虚", + "C": "土虚木亢", + "D": "湿热内蕴", + "E": "脾阳虚衰" + }, + "answer": "C", + "reason": "患儿精神萎靡,嗜睡露睛:面色萎黄，不欲饮食，大便稀溏等症状提示有脾虚的症状，四肢抽搞，时作时止，为肝风内扰的表现,故可诊断为脾虚肝亢。" + }, + { + "question_num": 202, + "query": "患者，女性，19岁。月经29天一行，量多，色紫红，质稠，心烦，口渴，舌红苔黄，脉滑数有力，其诊断是", + "options": { + "A": "月经过多血热证", + "B": "月经先期血热证", + "C": "月经先期虚热证", + "D": "月经先期肝热证", + "E": "月经过多气虚证" + }, + "answer": "A", + "reason": "阳热内盛，伏于冲任，经行之际，热迫血行，故经行量多；血为热灼，故经色红而质稠；热邪伤津，口渴饮冷，尿黄便结；热扰心神，故心烦多梦；舌红，苔黄，脉滑数，为血热之证。" + }, + { + "question_num": 203, + "query": "患者,男,60岁。慢性支气管炎病史20年,肺心病病史5年。近1周感冒后咳嗽，咳黄痰,心悸气短加重。下列哪项治疗原则是最重要的", + "options": { + "A": "止咳", + "B": "祛痰", + "C": "抗感染", + "D": "强心", + "E": "利尿" + }, + "answer": "C", + "reason": "慢性支气管炎急性发作肺心病心力衰竭发作时，抗感染是最重要的。感染纠正不了，心力衰竭难以纠正。因为感染是急性发作的始动因素，慢性支气管炎及肺心病为基础疾病，所以控制急性期的临床症状，首先应控制感染。" + }, + { + "question_num": 204, + "query": "患者，女性，26岁，未婚。既往月经量少，现停经6个月，形体日渐肥胖，伴神疲倦怠，肢体沉重，面浮足肿，舌苔白腻，脉滑，其证候是", + "options": { + "A": "气滞血瘀", + "B": "痰湿阻滞", + "C": "肝肾不足", + "D": "气血虚弱", + "E": "肾阳不足" + }, + "answer": "B", + "reason": "痰湿阻于冲任，占据血海，经血不能满溢，故月经不行；痰湿下注，损伤带脉，故带下量多，色白；痰湿内盛，故形体肥胖；痰湿停于心下，清阳不升，故胸脘满闷，时欲呕吐；苔腻，脉滑也为痰湿之证。" + }, + { + "question_num": 205, + "query": "患者,男,41岁。养鸡专业户,2天来体温39℃,伴随鼻塞、流涕、咳嗽咽痛,体征可一见眼结膜轻度充血,咽部充血,肺部有干啰音。疑为人感染高致病性禽流感,应做何种检查进行确诊", + "options": { + "A": "血常规", + "B": "血生化", + "C": "X线", + "D": "CT", + "E": "呼吸道标本病毒分离" + }, + "answer": "E", + "reason": "对于感染性疾病,病毒分离大都是确诊依据。" + }, + { + "question_num": 206, + "query": "患者，女性，26岁，已婚。近半年来经行第1天少腹胀痛明显，拒按，伴乳房胀痛，月经量少，色暗有血块，血块排出后痛减。舌紫苔白，脉弦，其治法是", + "options": { + "A": "温经暖宫止痛", + "B": "除湿散寒止痛", + "C": "补气活血止痛", + "D": "益肾养肝止痛", + "E": "理气化瘀止痛" + }, + "answer": "E", + "reason": "根据题干可诊断为痛经气滞血瘀证。肝郁气滞，瘀滞冲任，气血运行不畅，经前经时，气血下注冲任，胞脉气血更加壅滞，“不通则痛”，故经行少腹胀痛拒按，其治疗原则为行气活血，祛瘀止痛。" + }, + { + "question_num": 207, + "query": "患者,男,17岁。乏力、食欲减退、黄疸进行性加深10天，神志不清1天。查体:明显黄疸,烦躁不安,皮肤瘀斑,肝右肋下未扪及,肝浊音界在第7~8肋间,扑翼样震颤阳性，血清总胆红素255μmol/L,ALT200U/L,凝血酶原活动度28%。诊断应考虑", + "options": { + "A": "急性黄疸型肝炎", + "B": "慢性重症肝炎", + "C": "亚急性重型肝炎", + "D": "急性重型肝炎", + "E": "淤胆型肝炎" + }, + "answer": "D", + "reason": "黄疸进行性加深,伴意识型肝炎。只要凝血酶原活动度小于40%，即可考虑重型肝炎。结合神志不清1天，考虑急性重型肝炎。" + }, + { + "question_num": 208, + "query": "患者，女，21岁，未婚。经行鼻衄3年，量较多，色红，月经周期提前，经量偏少，经行第2天鼻衄，情绪波动影响出血量，舌质红，脉细弦。治疗应首选", + "options": { + "A": "丹栀逍遥散", + "B": "顺经汤加牛膝", + "C": "清热固经汤", + "D": "清肝止淋汤", + "E": "清肝引经汤" + }, + "answer": "E", + "reason": "患者主症“经行鼻衄”，即经行吐衄，“情绪波动影响出血量，舌质红，脉细弦”，即病位在肝。经行吐衄本因血热气逆而发，所以此为经行吐衄肝经郁火证。治宜清肝调经。代表方为清肝引经汤。" + }, + { + "question_num": 209, + "query": "患者高热3天,头痛,伴呕吐。检查:颈项强直,克氏征阳性,脑脊液外观浑浊,细胞数2X10°/L,以中性粒细胞为主。应首先考虑的是", + "options": { + "A": "结核性脑膜炎", + "B": "流行性脑脊髓膜炎", + "C": "流行性乙型脑炎", + "D": "伤寒", + "E": "中毒型菌痢" + }, + "answer": "B", + "reason": "流行性脑脊髓膜炎有上呼吸道感染病史，突发高热，头痛，频繁呕吐，皮肤瘀点、瘀斑。查体:颈项强直，克氏征阳性，脑脊液检查外观浑浊，白细胞计数升高。" + }, + { + "question_num": 210, + "query": "患者，女，50岁。因恼怒致胃脘胀痛，嗳气，反酸，舌苔薄白，脉弦。依据“近部取穴”的原则，治疗应首选", + "options": { + "A": "足三里", + "B": "膻中", + "C": "太冲", + "D": "天枢", + "E": "中脘" + }, + "answer": "E", + "reason": "中脘为胃之募穴，腑会，常治疗脾胃疾病。" + }, + { + "question_num": 211, + "query": "患者,女，35岁。诊断为伤寒,退热1~2周后临床症状再度出现，血培养阳性,应诊断为", + "options": { + "A": "伤寒复发", + "B": "伤寒再燃", + "C": "并发肠出血", + "D": "并发肠穿孔", + "E": "急性胆囊炎" + }, + "answer": "A", + "reason": "再燃是指体温未降至正常又重新升高。伤寒复发是指患者进入恢复期体温正常1~3周后，发热等临��症状再度出现。" + }, + { + "question_num": 212, + "query": "患者，男，42岁。哮喘反复发作5年，本次发作喘促不能平卧，咳痰清稀，无汗，头痛，脉浮紧。治疗应首选", + "options": { + "A": "膻中、太渊、太溪、肾俞", + "B": "膻中、列缺、肺俞、尺泽", + "C": "肺俞、风门、丰隆、太渊", + "D": "天突、定喘、尺泽、膻中", + "E": "膏肓、肾俞、太溪、丰隆" + }, + "answer": "B", + "reason": "本证为哮喘实证，为风寒外袭所致，故取手太阴肺经之背俞穴肺俞，宣发太阳经气，祛邪外出；膻中乃气之会穴，宽胸理气；列缺为肺经的络穴；尺泽为肺经合穴，肃肺化痰，降逆平喘。痰盛者配丰隆，喘甚者配定喘，肾气虚者配太溪、肾俞。" + }, + { + "question_num": 213, + "query": "患者，女，29岁，已婚。妊娠8个半月，头晕胀痛，面目、肢体肿胀，但皮色不变，压痕不明显，舌苔薄腻，脉弦滑。治疗应首选", + "options": { + "A": "镇肝熄风汤", + "B": "杞菊地黄丸", + "C": "天仙藤散", + "D": "羚角钩藤汤", + "E": "半夏白术天麻汤" + }, + "answer": "C", + "reason": "患者主症为妊娠中晚期面目肢体肿胀，由此可诊为子肿。子肿证型有脾虚证、肾虚证、气滞证。皮色不变，压痕不明显—病在无形之气，所以此证为子肿之气滞证。治宜理气行滞，除湿消肿。代表方为天仙藤散。" + }, + { + "question_num": 214, + "query": "患者半年来少腹部胀痛，经行加重，经血量多、有块，排出痛减，伴经前情志抑郁，乳房胀痛，舌紫暗，脉弦涩。治疗应首选的方剂是", + "options": { + "A": "膈下逐瘀汤", + "B": "血府逐瘀汤", + "C": "少腹逐瘀汤", + "D": "大黄牡丹汤", + "E": "逍遥散" + }, + "answer": "A", + "reason": "患者经行腹痛有血块，提示血瘀；情志抑郁，乳房胀痛，说明患者气机不畅，故可诊断为气滞血瘀型痛经，治宜行气活血，祛瘀止痛，方选膈下逐瘀汤加减。" + }, + { + "question_num": 215, + "query": "患儿，8个月。素来体弱，泄泻2天，大便日行二十余次，质稀如水，精神萎靡，时而烦闹，皮肤干燥，囟门凹陷，啼哭无泪，小便量少，舌红少津，其治法是", + "options": { + "A": "健脾温阳，助运止泻", + "B": "健脾益气，酸甘敛阴", + "C": "补肾滋阴，平肝降火", + "D": "补肾温阳，涩肠止泻", + "E": "挽阴回阳，救逆固脱" + }, + "answer": "B", + "reason": "小儿大便日行二十余次，皮肤干燥，囟门凹陷，津液匮乏。津能载气，气随着津液的流失而日益不足，形成气阴两虚之证，故治法以健脾益气，酸甘敛阴。" + }, + { + "question_num": 216, + "query": "患者，女，25岁。月经提前9天，量多，色淡、质稀，神疲，肢软，少腹空坠，纳少便溏，舌淡苔薄，脉缓弱，其诊断是", + "options": { + "A": "月经过多气虚证", + "B": "月经先期气虚证", + "C": "崩漏脾虚证", + "D": "经行泄泻脾虚证", + "E": "月经先期血热证" + }, + "answer": "B", + "reason": "患者月经提前8天，诊为月经先期。量多、色淡、质稀，神疲，肢软，少腹空坠，纳少便溏，舌淡苔薄，脉缓弱，为气虚的表现，故其诊断是月经先期气虚证。" + }, + { + "question_num": 217, + "query": "患儿，2岁。经常在入睡后出汗，有时白天也汗出较多。形体消瘦，精神倦怠，心烦少寐，时有低热、口干、手足心灼热，哭声无力，口唇淡红，舌质淡，可见花剥苔，脉细弱。治疗首选方剂是", + "options": { + "A": "玉屏风散", + "B": "黄芪桂枝五物汤", + "C": "当归六黄汤", + "D": "牡蛎散", + "E": "生脉散" + }, + "answer": "E", + "reason": "入睡后汗出，为盗汗，提示有阴虚的症状。形体消瘦，精神倦怠等症状提示小儿正气不足，故可诊断为气阴两虚型汗证，治宜益气养阴，方选生脉散。" + }, + { + "question_num": 218, + "query": "患儿，9岁。身体瘦弱，汗出较多，心烦少寐，寐后汗多，低热，口干，手足心热，唇舌色淡，脉细弱。治疗应首选", + "options": { + "A": "沙参麦冬汤", + "B": "牡蛎散", + "C": "黄芪桂枝五物汤", + "D": "玉屏风散", + "E": "生脉散" + }, + "answer": "E", + "reason": "此病症自汗、盗汗兼见，当诊断为汗证。心烦少寐，低热，口干，手足心热，脉细—阴虚之象。唇舌色淡，脉弱—气虚之象。由此诊断为汗证之气阴两虚。治宜益气养阴。方用生脉散。" + }, + { + "question_num": 219, + "query": "患儿，1岁。口腔内白屑散在，周围红晕不著，形体���弱，颧红，手足心热，口干不渴，舌红，苔少，指纹紫。治疗应首选", + "options": { + "A": "知柏地黄丸", + "B": "清热泻脾散", + "C": "黄连解毒汤", + "D": "五味消毒饮", + "E": "大黄黄连泻心汤" + }, + "answer": "A", + "reason": "据患儿口腔内白屑散在，周围红晕不著，形体瘦弱，颧红，手足心热，应诊为鹅口疮虚火上浮证，治宜滋阴降火，方选知柏地黄丸。" + }, + { + "question_num": 220, + "query": "患者，男性，52岁。有多年吸烟史，出现刺激性干咳伴咳血痰。应首先考虑", + "options": { + "A": "支气管肺癌", + "B": "肺脓肿", + "C": "支气管扩张", + "D": "肺气肿", + "E": "慢性支气管炎" + }, + "answer": "A", + "reason": "支气管肺癌的患者，有多年的吸烟史，发生刺激性咳嗽，常有反复发生或持续血痰。肺脓肿起病急，中毒症状明显，常有寒战、高热、咳嗽、咳大量脓臭痰。支气管扩张具有咳嗽、咳痰反复发作的特点。慢性支气管炎主要表现为咳嗽、咳痰或伴喘息。本题题干分析，有多年吸烟史、刺激性干咳、血痰，符合支气管肺癌的表现。" + }, + { + "question_num": 221, + "query": "某患者对奎尼丁过敏，心房颤动复律后最好选用何种药物预防复发", + "options": { + "A": "普萘洛尔", + "B": "胺碘酮", + "C": "维拉帕米", + "D": "地高辛", + "E": "普鲁卡因胺" + }, + "answer": "B", + "reason": "普萘洛尔用于多种原因所致的心律失常；维拉帕米可用于抗心律失常及抗心绞痛。地高辛用于充血性心力衰竭，室上性心动过速，心房颤动和心房扑动；普鲁卡因胺适用于阵发性心动过速、频发期前收缩（对室性期前收缩疗效较好）、心房颤动和心房扑动；胺碘酮适用于房性期前收缩及室性期前收缩；对阵发性室上性心动过速、心房颤动、心房扑动、室性心动过速及室颤可防止反复发作，也可防止预激综合征伴室上性心律失常的发作及用于心房颤动或心房扑动电转复后的维持治疗。" + }, + { + "question_num": 222, + "query": "患者，男性，50岁。有高血压病史10年。今日剧烈头痛，眩晕，呕吐。查体：无肢体活动障碍，血压200/120mmHg（26.6/16kPa），意识模糊。应首先考虑的是", + "options": { + "A": "急进型高血压", + "B": "高血压脑病", + "C": "高血压心脏病", + "D": "脑出血", + "E": "脑血栓形成" + }, + "answer": "B", + "reason": "高血压脑病主要是脑水肿和颅内压增高的表现，如严重头痛、呕吐、神志改变。急进型高血压危重，虽然也有血压显著升高、头痛等症状，还表现为视物模糊、眼底出血渗出、视盘水肿、持续蛋白尿、血尿及管型等，一般无意识模糊；高血压心脏病有心脏病的表现；脑出血、脑血栓多有肢体活动障碍。" + }, + { + "question_num": 223, + "query": "患者，女，45岁。2天前感觉胁肋部皮肤灼热疼痛，皮色发红，继则出现簇集性粟粒状大小丘疱疹，呈带状排列，兼见口苦，心烦，易怒，脉弦数。治疗除取主穴外，还应选用的穴位是", + "options": { + "A": "大椎、曲池、合谷", + "B": "行间、侠溪", + "C": "血海、三阴交", + "D": "阴陵泉、内庭", + "E": "内庭、曲池、太白" + }, + "answer": "B", + "reason": "该患者为蛇串疮肝胆火盛证，除主穴外，应取行间、侠溪清肝胆之火。" + }, + { + "question_num": 224, + "query": "患者，男，65岁。素有高血压史，晨五时起床小便，突然左侧肢体麻木，活动不利，并伴有头晕目眩，苔白腻，脉弦滑，治疗应选取", + "options": { + "A": "曲池、外关、合谷、尺泽", + "B": "阳陵泉、曲泉、大敦、太溪", + "C": "廉泉、太阳、支沟、劳宫", + "D": "足三里、三阴交、阴陵泉、风池", + "E": "内关、水沟、三阴交、极泉、尺泽、委中" + }, + "answer": "E", + "reason": "本题是中风中经络的风痰阻络型，治法应醒脑开窍，滋补肝肾，疏通经络。以手厥阴、督脉、足太阴经穴为主。心主血脉，内关为心包经络穴，可调理心气，疏通气血。脑为元神之府，督脉入络脑，水沟为督脉穴，可醒脑开窍，调神导气。三阴交为足三阴经交会穴，可滋补肝肾。极泉、尺泽、委中，疏通肢体经络。" + }, + { + "question_num": 225, + "query": "患者，男，20岁。咳嗽伴低热，盗汗，乏力1个月。X线显示右肺上云雾状阴影。应首先考虑的是", + "options": { + "A": "原发性肺结核", + "B": "血行播散型肺结核", + "C": "浸润型肺结核", + "D": "慢性纤维空洞型肺结核", + "E": "���核性胸膜炎" + }, + "answer": "C", + "reason": "原发型肺结核多见于少年儿童，无症状或症状轻微，X线胸片表现为哑铃形阴影，即原发病灶、引流淋巴管炎和肿大的肺门淋巴结。血行播散型肺结核起病急，持续高热，中毒症状严重，X线胸片呈双上、中肺野为主的大小不等、密度不同和分布不均的粟粒状或结节状阴影。浸润型肺结核多发生于成年人，病程长，易反复，影像学检查表现为小片状或斑点状阴影或云雾状阴影。慢性纤维空洞型肺结核X线检查可见空洞。结核性胸膜炎X线检查可见积液影。" + }, + { + "question_num": 226, + "query": "患者，女性，23岁。被人发现时躺在地板上，呈昏迷状态，口吐白沫。查体：神志不清，两瞳孔针尖大小，口唇紫绀，两肺满布水泡音，心率60次/分，肌肉震颤。应首先考虑的是", + "options": { + "A": "癫痫大发作", + "B": "肝性脑病", + "C": "尿毒症", + "D": "有机磷农药中毒", + "E": "催眠药中毒" + }, + "answer": "D", + "reason": "癫痫大发作以发作性意识丧失和全身抽搐为其特征；肝性脑病，发生于严重肝病患者，肝性脑病出现前病人常有先兆症状，主要表现有精神行为异常。尿毒症常见症状有食欲减退、感觉迟钝、情感淡漠、嗜睡、尿量减少、颜面和下肢水肿、贫血、皮肤瘙痒、肌痉挛，有时可以辗转不安，甚至出现癫痫。有机磷农药中毒，出现恶心、呕吐、头晕、流涎、多汗、瞳孔缩小如针尖，心率减慢；严重者并有肌束颤动、呼吸困难、嗜睡、昏迷、抽搐、呼吸衰竭等。催眠药中毒出现昏睡不醒，肌痉挛，血压下降，呼吸变浅变慢，心搏缓慢，脉搏细弱，甚至出现深昏迷和反射消失。" + }, + { + "question_num": 227, + "query": "患者,男,50岁。腰部伤,痛在腰部正中,舌质淡红,脉弦。针灸治疗除阿是穴、腰痛点、委中外,宜选取", + "options": { + "A": "太冲", + "B": "阳陵泉", + "C": "太溪", + "D": "手三里", + "E": "后溪" + }, + "answer": "E", + "reason": "扭伤治法：祛瘀消肿，舒筋通络。取扭伤局部腧穴为主。处方主穴：阿是穴、局部腧穴。腰部：阿是穴、大肠俞、腰痛点、委中，如急性腰扭伤，督脉病证（正中）配水沟或后溪。" + }, + { + "question_num": 228, + "query": "患者,男,49岁。失眠日久,兼头晕耳鸣腰膝酸软,五心烦热,遗精盗汗,舌质红脉细数。针灸治疗除取主穴外，应配取", + "options": { + "A": "心俞、脾俞、厥阴俞", + "B": "心俞、肾俞、太溪", + "C": "心俞、胆俞、丘墟", + "D": "心俞、肝俞、太冲", + "E": "心俞、胃俞、足三里" + }, + "answer": "B", + "reason": "从患者的症状可辨证为不寐心肾不交型，治疗除取主穴外应加补肾阴、清心火的穴位。B项中的肾俞、太溪能补益肾阴，心俞可清心降火。" + } +] \ No newline at end of file