diff --git "a/Assistant/Theory_Questions/Year_2/Past_Paper.json" "b/Assistant/Theory_Questions/Year_2/Past_Paper.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_2/Past_Paper.json" @@ -0,0 +1,2836 @@ +[ + { + "question_num": 1, + "query": "下列各项，具有化神作用的是", + "options": { + "A": "脉", + "B": "气", + "C": "血", + "D": "津", + "E": "液" + }, + "answer": "C", + "reason": "血由水谷之精、肾精化生,与心、脾、肺肾关系密切,具有濡养、化神作用。" + }, + { + "question_num": 2, + "query": "患者，女，24岁，已婚。停经49天时诊为早孕，近3天少量阴道流血，无腰痛，尿妊娠试验（＋），既往曾2次流产，其诊断是", + "options": { + "A": "妊娠腹痛", + "B": "胎动不安", + "C": "胎漏", + "D": "堕胎", + "E": "滑胎" + }, + "answer": "C", + "reason": "胎漏是指妊娠期间,阴道不时有少量出血，时出时止，或淋漓不断，而无腰酸、腹痛、小腹下坠。胎动不安有腰酸、腹痛下坠，或伴有少量的阴道出血、脉滑。妊娠疬是妊娠期因胞脉阻滞或失养，发生小腹疼痛。堕胎是凡妊娠12周内，胚胎自然殒堕。滑胎是凡堕胎或小产连续发生3次或3次以上。故本题选C项。" + }, + { + "question_num": 3, + "query": "分布于上肢内侧中线的是", + "options": { + "A": "手厥阴经", + "B": "手太阳经", + "C": "手阳明经", + "D": "足少阳经", + "E": "足阳明经" + }, + "answer": "A", + "reason": "十二经脉在上肢的分布:上肢内侧由前到后为太阴一厥阴一少阴,上肢外侧由前到后为阳明一少阳一太阳。" + }, + { + "question_num": 4, + "query": "八脉交会穴中，主治目内眦、颈项、耳、肩疾患的是", + "options": { + "A": "照海、阳陵泉", + "B": "后溪、申脉", + "C": "列缺、照海", + "D": "外关、足临泣", + "E": "内关、公孙" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 5, + "query": "寒邪伤人，导致毛发腠理闭塞，筋脉挛急收缩的理论依据是", + "options": { + "A": "寒性收引", + "B": "寒性主痛", + "C": "寒易伤气", + "D": "寒性凝滞", + "E": "寒易伤阳" + }, + "answer": "A", + "reason": "寒邪致病特点:①寒为阴邪，易伤阳气;②寒性凝滞，易致经脉血气运行不畅;③寒性收引,可致气机收敛,腠理、经络、筋脉挛急收缩。" + }, + { + "question_num": 6, + "query": "呃逆的基本治法是", + "options": { + "A": "疏肝解郁降逆", + "B": "和胃降逆止呃", + "C": "理气化瘀降逆", + "D": "健脾温中止呃", + "E": "清热和胃止呃" + }, + "answer": "B", + "reason": "呃逆的病机为胃气上逆,治法宜和胃降逆止呃。" + }, + { + "question_num": 7, + "query": "多重情志交织，易伤的脏是", + "options": { + "A": "肺脾肾", + "B": "心肝肾", + "C": "心肝脾", + "D": "肝脾肾", + "E": "心肺脾" + }, + "answer": "C", + "reason": "七情内伤致病,数情交织,易伤心肝脾,是因心肝脾三脏在人体生理和情志活动中发挥重要作用。" + }, + { + "question_num": 8, + "query": "患者，男，22岁。发热恶寒，寒重热轻。头痛身痛，鼻塞流涕，咳嗽，咳痰清稀，舌苔薄白，脉浮紧。治疗应首选", + "options": { + "A": "手太阴、手阳明、足太阳经穴", + "B": "手少阴、手太阳、手太阴经穴", + "C": "手太阴、足太阳、手少阳经穴", + "D": "手太阴、手少阳、足少阳经穴", + "E": "手阳明、足阳明、手太阴经穴" + }, + "answer": "A", + "reason": "由患者的症状可知本病为感冒之风寒感冒,所以应首选手太阴肺经疏风散寒;手阳明大肠经与肺经相表里，所以其经穴能协助肺经经穴疏风散寒;外感风寒首先犯太阳而伤肺卫，故选足太阳膀胱经的腧穴以解表宣肺。故本题选A项。" + }, + { + "question_num": 9, + "query": "下列各项，不属于瘀血致病特点的是", + "options": { + "A": "易于阻滞气机", + "B": "影响血脉运行", + "C": "影响新血生成", + "D": "病位相对固定", + "E": "易于蒙蔽心神" + }, + "answer": "E", + "reason": "瘀血致病特点:易于阻滞气机,影响血脉运行,影响新血生成,病位相对固定,病证繁多。E项为痰饮的致病特点。" + }, + { + "question_num": 10, + "query": "治疗鹅口疮虚火上浮证，应首选的方剂是", + "options": { + "A": "益黄散", + "B": "知柏地黄丸", + "C": "六味地黄丸", + "D": "沙参麦冬汤", + "E": "养胃增液汤" + }, + "answer": "B", + "reason": "鹅口疮虚火上浮证，冶且滋阴降火，方剂选知柏地黄丸。" + }, + { + "question_num": 11, + "query": "破伤风、狂犬病的发病类型是", + "options": { + "A": "徐发", + "B": "继发", + "C": "复发", + "D": "感邪即发", + "E": "伏而后发" + }, + "answer": "E", + "reason": "伏而后发:感受邪气后,并不立即发病,病邪在机体内潜伏一段时间，,或在诱因的作用下,过时而发病,多见于外感性疾病和某些外伤,如伏气温病、破伤风.狂犬病等。" + }, + { + "question_num": 12, + "query": "疮疡的半阴半阳证应选用的外用药物是", + "options": { + "A": "冲和膏", + "B": "太乙膏", + "C": "阳和解凝膏", + "D": "咬头膏", + "E": "玉露膏" + }, + "answer": "A", + "reason": "疮形肿而不高,痛而不甚,微红微热，属半阴半阳证者，可用冲和膏。" + }, + { + "question_num": 13, + "query": "肺、肝、脾、胃等脏腑功能失调，易导致气失常的病机是", + "options": { + "A": "气虚", + "B": "气脱", + "C": "气陷", + "D": "气滞", + "E": "气逆" + }, + "answer": "D", + "reason": "由于肝升肺降、脾升胃降。在调整全身气机中起着极其重要的作用,故脏腑气滞以肺、肝、脾、胃多见。气逆多见于肺、肝、胃。" + }, + { + "question_num": 14, + "query": "治疗瘾疹的主穴是", + "options": { + "A": "血海、曲池、合谷、膈俞、三阴交", + "B": "大椎、曲池、太冲、风池、中脘", + "C": "大椎、太冲、三阴交、血海、内庭", + "D": "血海、内庭、足三里、气海、天枢", + "E": "外关、风池、三阴交、大椎、膈俞" + }, + "answer": "A", + "reason": "瘾疹主穴:膈俞、曲池、合谷、血海、三阴交。曲池、合谷属手阳明经穴，与肺经相表里，可通经络、行气血、疏风清热;血海、膈俞合用意在“治风先治血，血行风自灭”两组穴位相配能疏风、活血、止痒;三阴交属足太阴经，乃足三阴经之交会穴，可养血活血、润燥祛风止痒。" + }, + { + "question_num": 15, + "query": "下列各项，其功能失常易致水湿停滞发生的是", + "options": { + "A": "脾肾", + "B": "肝肾", + "C": "脾胃", + "D": "心肾", + "E": "脾肺" + }, + "answer": "A", + "reason": "脾主运化水液,肾为主水之脏,二者协同主司水液代谢的平衡协调。若二者功能失常,则津液输布障碍,水湿痰饮停留，气机阻滞,形成水湿停滞。" + }, + { + "question_num": 16, + "query": "丹毒总的病因病机是", + "options": { + "A": "湿热蕴结", + "B": "血热火毒", + "C": "气血瘀滞", + "D": "气血不和", + "E": "肝郁脾虚" + }, + "answer": "B", + "reason": "丹毒总的病因病机为血热火毒。" + }, + { + "question_num": 17, + "query": "下列各项，可用“阴中求阳”治疗的是", + "options": { + "A": "实寒证", + "B": "实热证", + "C": "虚寒证", + "D": "虚热证", + "E": "真热假寒证" + }, + "answer": "C", + "reason": "阳偏衰产生“阳虚则寒\"的虚寒证,治宜“阴中求阳”。" + }, + { + "question_num": 18, + "query": "下列各项中，不属于期门穴主治病证的是", + "options": { + "A": "胸胁胀痛", + "B": "呕吐、腹胀", + "C": "奔豚气", + "D": "乳痈", + "E": "癃闭、遗尿" + }, + "answer": "E", + "reason": "期门穴主治:①胸胁胀痛、呕吐、吞酸、呃逆、腹胀、腹泻等肝胃病证;②奔豚气;③乳痈。数本题选E项。" + }, + { + "question_num": 19, + "query": "下列各项，临床表现为忽然昏倒，口吐涎沫，两目上视，四肢抽搐，醒后如常的是", + "options": { + "A": "狂病", + "B": "脏躁", + "C": "痴呆", + "D": "痫病", + "E": "癫病" + }, + "answer": "D", + "reason": "突然昏倒,口吐白沫,目睛上视,四肢抽搐,移时苏醒,醒后如常,其多由脏气失调,肝风挟痰上逆、蒙蔽清窍所致,属痫病。" + }, + { + "question_num": 20, + "query": "痰肿的临床表现是", + "options": { + "A": "肿势高突，根盘收束", + "B": "坚硬如石，皮色不变", + "C": "肿势软如棉或硬如馒", + "D": "皮紧内软，喜怒有变", + "E": "皮肤漫肿，其色青紫" + }, + "answer": "C", + "reason": "痰肿、肿势软如棉,或硬如馒，大小不一,形态各异,无处不生,不红不热，皮色不变，见于脂瘤等。" + }, + { + "question_num": 21, + "query": "患者肥而食少的临床意义是", + "options": { + "A": "形气有余", + "B": "形盛气虚", + "C": "形气不足", + "D": "中焦有火", + "E": "阴虚火旺" + }, + "answer": "B", + "reason": "形体肥胖,肉松皮缓,食少懒动,动则乏力气短,为形盛气虚。形体肥胖，肌肉坚实,食欲旺盛,为形气有余。形瘦食多为中焦有火，形瘦食少为中气虚弱。" + }, + { + "question_num": 22, + "query": "下列关于中风辨证要点的叙述，正确的是", + "options": { + "A": "首辨闭证与脱证", + "B": "中经络者辨闭证与脱证", + "C": "中经络者仅出现肢体不用，无口眼歪斜", + "D": "中经络者意识清楚，中脏腑者神志昏迷", + "E": "脱证常骤然起病" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 23, + "query": "在目的脏腑分属中，白睛所属的是", + "options": { + "A": "心", + "B": "肺", + "C": "肝", + "D": "肾", + "E": "脾" + }, + "answer": "B", + "reason": "目的脏腑分属:瞳仁属肾一一水轮;目内眦及外毗的血络属心一一血轮;黑睛属肝一一风轮;白睛属肺一一气轮#;眼胞属脾一一肉轮。" + }, + { + "question_num": 24, + "query": "胁痛的治疗原则是", + "options": { + "A": "疏肝理气止痛", + "B": "活血化瘀止痛", + "C": "清热化湿利胆", + "D": "养血柔肝止痛", + "E": "疏肝和络止痛" + }, + "answer": "E", + "reason": "胁病之治疗原则根据“通则不痛\"的理论，以疏肝和络止痛为基本治则，结合肝胆的生理特点，灵活运用。" + }, + { + "question_num": 25, + "query": "下列各项，属于斑的临床表现的是", + "options": { + "A": "色淡红", + "B": "点小如粟", + "C": "高出皮肤", + "D": "抚之碍手", + "E": "压之不褪色" + }, + "answer": "E", + "reason": "斑:深红或青紫色+片状斑块+平摊于皮肤+摸之不应手,压之不褪色。疹:深红或紫红色+高出皮肤+抚之碍手,压之褪色+粟粒状疹点。" + }, + { + "question_num": 26, + "query": "下列各项，哪项不是阴户的功能", + "options": { + "A": "排月经之出口", + "B": "排恶露之出口", + "C": "防御外邪入侵的第一道门户", + "D": "阴阳交合的入口", + "E": "孕育胎儿" + }, + "answer": "E", + "reason": "阴户是防御外邪入侵的第一道门户，是排月经、泌带下、排恶露之出口，是合阴阳之入口，又是娩出胎儿、胎盘之产门。" + }, + { + "question_num": 27, + "query": "小儿指纹淡白者，其临床意义是", + "options": { + "A": "外感表证", + "B": "里实热证", + "C": "疼痛，惊风", + "D": "血络郁闭", + "E": "脾虚，疳积" + }, + "answer": "E", + "reason": "小儿指纹颜色代表的临床意义:①鲜红,外感表证、寒证;②紫红,里热证;③色青,疼痛、惊风;④紫黑,血络郁闭,病危重；⑤淡白，脾虚、疳积。" + }, + { + "question_num": 28, + "query": "肛管直肠癌的早期症状除便血外，还可见", + "options": { + "A": "大便变形", + "B": "腹胀肠鸣", + "C": "脱出不纳", + "D": "排便习惯改变", + "E": "肛门潮湿" + }, + "answer": "D", + "reason": "初期直肠黏膜上或肛门皮肤上有一无痛性突起的硬结，无明显症状，以后可出现排便习惯改变，排便次数较多，便意频数，但无粪便排出;或便秘，有肛门内不适或下坠感。大便带血，血色鲜红或暗红，量不多，常伴有黏液便，往往被误诊为痔疮。因此肛管直肠癌的早期症状除便血外，还可见排便习惯改变。" + }, + { + "question_num": 29, + "query": "热盛又兼见血瘀的舌象是", + "options": { + "A": "淡红舌", + "B": "红舌", + "C": "青紫舌", + "D": "绛紫舌", + "E": "青舌" + }, + "answer": "D", + "reason": "舌紫红或绛紫而干枯少津为热盛伤津,气血壅滞。" + }, + { + "question_num": 30, + "query": "下列不属于慢性盆腔炎常见病因的是", + "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": "E", + "reason": "慢性盆腔炎常见病因有湿热瘀结、气滞血瘀、寒湿凝滞、气虚血瘀。" + }, + { + "question_num": 31, + "query": "自言自语、喃喃不休、见人语止、首尾不续者，称之为", + "options": { + "A": "谵语", + "B": "独语", + "C": "郑声", + "D": "错语", + "E": "言謇" + }, + "answer": "B", + "reason": "独语:自言自语,喃喃不休，见人语止,首尾不续。谵语:神识不清,语无伦次,声高有力。郑声:神识不清,语言重复,时断时续,语声低弱模糊。错语:神识清楚,语言错乱,语后自知。狂言:精神错乱,语无伦次,狂叫骂詈,登高而歌。言謇:神志清楚,思维正常而吐字困难,或吐字不清。" + }, + { + "question_num": 32, + "query": "中医外科内治法中，温阳托毒法的代表方剂是", + "options": { + "A": "透脓散", + "B": "托里消毒散", + "C": "神功内托散", + "D": "右归丸", + "E": "桂附八味丸" + }, + "answer": "C", + "reason": "内托法中,透托法���代表方剂是透脓散。益气托毒法的代表方剂是托里消毒放;温阳托毒法的代表方剂是神功内托散;补益助阳法的代表方剂是右归丸和桂附八味丸。故本题选C项，" + }, + { + "question_num": 33, + "query": "恶寒发热的临床意义是", + "options": { + "A": "外邪袭表，卫阳被遏，肌表失煦", + "B": "外邪侵袭，阳热炽盛，腠理开泄", + "C": "邪正相争，相持不下，枢机不利", + "D": "邪气侵袭，阳气损伤，机体失温", + "E": "邪气侵袭，腠理疏松，阳气郁遏" + }, + "answer": "A", + "reason": "】恶寒发热:表证的特征性症状,提示外邪袭表,卫阳被遏,肌表失煦。" + }, + { + "question_num": 34, + "query": "伤食、积滞、疳证三者因果关系是", + "options": { + "A": "积滞→伤食→疳证", + "B": "伤食→积滞→疳证", + "C": "伤食→疳证→积滞", + "D": "积滞→疳证→伤食", + "E": "疳证→伤食→积滞" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 35, + "query": "睡眠时时惊醒，不易安卧的临床意义是", + "options": { + "A": "心肾不交", + "B": "胆郁痰扰", + "C": "食滞胃脘", + "D": "营血亏虚", + "E": "心脾两虚" + }, + "answer": "B", + "reason": "失眠:①不易入睡,彻夜不眠,心烦不寐,心肾不交；②睡后易醒,不易再睡,心脾两虚；③时时惊醒,不易安卧,胆郁痰扰；④夜卧不安,腹胀嗳气酸腐,食滞内停。" + }, + { + "question_num": 36, + "query": "膏淋的治疗原则是", + "options": { + "A": "补脾益肾固涩", + "B": "补中益气，升阳举陷", + "C": "清热利湿，分清泄浊", + "D": "益气养血通淋", + "E": "清热利湿通淋" + }, + "answer": "C", + "reason": "膏淋证候:小便浑浊,乳白或如米泔水，上有浮油，置之沉淀,或伴有絮状凝块物，或混有血液、血块，尿道热涩疼痛，尿时阻塞不畅，口干，苔黄腻，舌质红，脉濡数。治法:清热利湿，分清泄浊。代表方剂:程氏萆薢分清饮加减。" + }, + { + "question_num": 37, + "query": "下列各项，属月经先后不定期的临床意义是", + "options": { + "A": "脾气亏虚，生血不足", + "B": "肝脾郁滞、冲任失调", + "C": "阳盛血热，热扰冲任", + "D": "寒凝血瘀，冲任受阻", + "E": "痰湿阻滞，冲任不调" + }, + "answer": "B", + "reason": "月经先后不定期:肝气郁滞或脾肾虚损,冲任失调。月经先期(提前>7天):脾气亏虚、肾气不足、冲任不固；或阳盛血热、肝郁化热、阴虚火旺,热扰冲任。月经后期(延后>7天):营血亏损、肾精不足,或阳气虚衰，生血不足;或气滞、寒凝血瘀,痰湿阻滞,冲任受阻。" + }, + { + "question_num": 38, + "query": "耻骨联合上缘至股骨内上髁上缘的骨度分寸是", + "options": { + "A": "13寸", + "B": "14寸", + "C": "16寸", + "D": "18寸", + "E": "19寸" + }, + "answer": "D", + "reason": "耻骨联合上缘至股骨内上髁上缘的骨度分寸是18寸。" + }, + { + "question_num": 39, + "query": "脉诊指法中，指力最轻的运指指法是", + "options": { + "A": "举法", + "B": "摸法", + "C": "循法", + "D": "寻法", + "E": "按法" + }, + "answer": "A", + "reason": "举法,较轻的指力。按法：较重的指力。寻法：指力从轻到重或从重到轻,左右推寻。" + }, + { + "question_num": 40, + "query": "妊娠恶阻脾胃虚弱证的中医治法是", + "options": { + "A": "健脾养阴，和胃止呕", + "B": "健脾祛湿，豁痰止呕", + "C": "清肝和胃，降逆止呕", + "D": "健脾益气，降逆止呕", + "E": "健脾和胃，降逆止呕" + }, + "answer": "E", + "reason": "妊娠恶阻脾胃虚弱证主要证候:妊娠早期，恶心呕吐不食，甚则食入即吐;口淡，呕吐清涎，头晕体倦,脘痞腹胀;舌淡，苔白，脉缓滑无力。治法:健脾和胃，降逆止呕。代表方剂:香砂六君子汤。" + }, + { + "question_num": 41, + "query": "龟甲的正确用法是", + "options": { + "A": "另煎", + "B": "后下", + "C": "包煎", + "D": "先煎", + "E": "冲服" + }, + "answer": "D", + "reason": "先煎:①有效成分难溶于水的金石、矿物.介壳类药物，如磁石,代赭石、生石膏、龙骨、牡蛎、石决明、龟甲、鳖甲等;②附子、乌头等毒副作用强的也应先煎,久煎能降低毒性。" + }, + { + "question_num": 42, + "query": "治疗滑胎气血虚弱证的代表方剂是", + "options": { + "A": "泰山磐石散", + "B": "补肾固冲汤", + "C": "育阴汤", + "D": "安奠二天汤", + "E": "桂枝茯苓丸合寿胎丸" + }, + "answer": "A", + "reason": "滑胎气血虚弱证主要证侯：屡孕屡堕;头晕目眩，神疲乏力，面色㿠白、心悸气短;舌质淡，苔薄白，脉细弱。治法:益气养血，固冲安胎。代表方剂:泰山磐石散。" + }, + { + "question_num": 43, + "query": "治疗心悸、失眠、多梦，宜选用的药物是", + "options": { + "A": "山茱萸", + "B": "金樱子", + "C": "五味子", + "D": "覆盆子", + "E": "枸杞子" + }, + "answer": "C", + "reason": "五味子:收敛固涩,益气生津,补肾宁心。可用于:①久咳虚喘;②自汗、盗汗;③遗精、滑精;④久泻不止;⑤津伤口渴、消渴;⑥心悸、失眠、多梦。" + }, + { + "question_num": 44, + "query": "下列有关预产期的计算，正确的是", + "options": { + "A": "以末次月经结束后的第一天起计算", + "B": "以末次月经的最后一天起计算", + "C": "以尿检阳性的第一天起计算", + "D": "以末次月经的第一天起计算", + "E": "月数加9（或减3），日数加14" + }, + "answer": "D", + "reason": "预产期的计算:从末次月经的第一天算起，月数加9(或减3)，日数加7(阴历则加14)" + }, + { + "question_num": 45, + "query": "小青龙汤中具有温肺化饮作用的药物是", + "options": { + "A": "麻黄、桂枝", + "B": "桂枝、细辛", + "C": "干姜、细辛", + "D": "半夏、麻黄", + "E": "细辛、麻黄" + }, + "answer": "C", + "reason": "小青龙汤主治外寒里饮证。方中麻黄、桂枝相须为君药,发汗散寒解表,麻黄宣肺平喘，桂枝化气行水;干姜、细辛为臣药,温肺化饮,兼助麻、桂解表祛邪。" + }, + { + "question_num": 46, + "query": "循行“起于中焦，下络大肠”的经络是", + "options": { + "A": "手阳明大肠经", + "B": "足阳明胃经", + "C": "手厥阴心包经", + "D": "手太阳小肠经", + "E": "手太阴肺经" + }, + "answer": "E", + "reason": "《灵枢·经脉》原文指出:“肺手太阴之脉,起于中焦，下络大肠,还循胃口，上膈属肺。”故本题选E项。" + }, + { + "question_num": 47, + "query": "治疗妇人伤寒(中风)，经水适断，寒热发作有时，应选用的方剂是", + "options": { + "A": "逍遥散", + "B": "小柴胡汤", + "C": "大柴胡汤", + "D": "柴胡疏肝散", + "E": "蒿芩清胆汤" + }, + "answer": "B", + "reason": "小柴胡汤和解少阳,主治;①伤寒少阳证;②热入血宣证(妇人中风，经水适断,寒热发作有时);③黄疸、疟疾,内伤杂病见少阳证者。大柴胡汤，和解少阳,内泻热结，用于少阳阳明合病。" + }, + { + "question_num": 48, + "query": "下列各项，不属生理性闭经的是", + "options": { + "A": "育龄期闭经", + "B": "妊娠期闭经", + "C": "哺乳期闭经", + "D": "围绝经期闭经", + "E": "绝经期闭经" + }, + "answer": "A", + "reason": "对于青春期前、妊娠期、哺乳期、绝经前后的月经停闭不行，或月经初潮后1年内月经不行，又无其他不适者，均属于生理性闭经，需要注意鉴别。" + }, + { + "question_num": 49, + "query": "参苓白术散的病机是", + "options": { + "A": "脾失健运，湿无以化，湿聚成痰", + "B": "脾胃气虚，运化乏力", + "C": "脾胃气虚，运化失司，湿浊内盛", + "D": "脾胃虚弱，运化失常，饮食停滞", + "E": "脾胃气虚，清阳下陷" + }, + "answer": "C", + "reason": "参苓白术散为补益剂,益气健脾、渗湿止泻,用于脾胃气虚.运化失司、湿浊内盛所致的脾虚湿盛证。" + }, + { + "question_num": 50, + "query": "治疗久痹风、寒、湿偏盛不明显者，可选用的方剂是", + "options": { + "A": "薏苡仁汤", + "B": "宣痹汤", + "C": "防风汤", + "D": "祛痹汤", + "E": "乌头汤" + }, + "answer": "D", + "reason": "久痹风、寒、湿偏盛不明显者，可选用祛痹汤，为治疗风寒湿痹基本方剂，有益气和营,祛风胜湿，通络止痛之功，可根据感受外邪偏盛情况随证加减。" + }, + { + "question_num": 51, + "query": "天王补心丹的君药是", + "options": { + "A": "麦门冬", + "B": "天门冬", + "C": "生地黄", + "D": "酸枣仁", + "E": "柏子仁" + }, + "answer": "C", + "reason": "天王补心丹:滋阴清热,养血安神;用于阴虚血少,神志不安证。方中重用甘寒之生地黄,入心养血,入肾滋阴,滋阴养血,壮水以制虚火,是为君药。" + }, + { + "question_num": 52, + "query": "艾灸矫正胎位宜选", + "options": { + "A": "任脉的关元穴", + "B": "足太阴脾经的隐白穴", + "C": "足太阳膀胱经至阴穴", + "D": "督脉命门穴", + "E": "足少阴肾经涌泉穴" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 53, + "query": "具有行气散结，降逆化痰功用的方剂是", + "options": { + "A": "越鞠丸", + "B": "瓜蒌薤白白酒汤", + "C": "半夏厚朴汤", + "D": "苏子降气汤", + "E": "柴胡疏肝散" + }, + "answer": "C", + "reason": "半夏厚朴汤:行气散结、降逆化痰,用于梅核气。越鞠丸:行气解郁,用于六郁证。瓜蒌薤白白酒汤:通阳散结、行气祛痰,用于胸阳不振、痰气互结之胸痹轻证。苏子降气汤,降气平喘、祛痰止咳,用于上实下虚喘咳证。柴胡疏肝散:疏肝行气、活血止痛,用于肝气郁滞证。" + }, + { + "question_num": 54, + "query": "下列哪项不是内伤发热的病机", + "options": { + "A": "瘀血阻滞，壅遏不通", + "B": "中气不足，阴火内生", + "C": "肝气不舒，气郁化火", + "D": "邪气在表，卫表失和", + "E": "阴精亏虚，阳气偏盛" + }, + "answer": "D", + "reason": "内伤发热的基本病机是气血阴阳亏虚，脏腑功能失调，其且体包括气都化火、瘀血阻滞、痰湿停聚、气血阴阳虚损等。" + }, + { + "question_num": 55, + "query": "血府逐瘀汤的配伍特点是", + "options": { + "A": "既活血又行气", + "B": "既活血又补气", + "C": "既活血又温阳", + "D": "既活血又通阳", + "E": "既活血又泻热" + }, + "answer": "A", + "reason": "血府逐瘀汤;活血化瘀、行气止痛,用于胸中血瘀证。气血并调,既行血分瘀滞,又解气分郁结;养活同施,活血而无耗血之虑,行气又无伤阴之弊;升降兼顾,既能升达清阳,又佐降泄下行,使气血调和。" + }, + { + "question_num": 56, + "query": "发于躯干部的丹毒称为", + "options": { + "A": "缠腰火丹", + "B": "抱头火丹", + "C": "流火", + "D": "赤游丹", + "E": "内发丹毒" + }, + "answer": "E", + "reason": "丹毒的分类:生于躯干部者，称内发丹毒;发于头面部者，称抱头火丹;发于小腿足部者，称流火;新生儿多生于臀部:称赤游丹毒。" + }, + { + "question_num": 57, + "query": "补阳还五汤中用以通经活络的药物是", + "options": { + "A": "地龙", + "B": "黄芪", + "C": "当归尾", + "D": "川芎", + "E": "桃仁" + }, + "answer": "A", + "reason": "补阳还五汤:补气、活血、通络,用于中风之气虚血瘀证。黄芪为君大补脾胃之气;当归尾活血通络不伤血;桃仁、红花、赤芍、川芎活血祛瘀；地龙通经活络。" + }, + { + "question_num": 58, + "query": "下列各项，属带下过多脾虚证临床表现的是", + "options": { + "A": "腰酸如折，畏寒肢冷", + "B": "带下赤白相兼，有气味", + "C": "烘热汗出，失眠多梦", + "D": "四肢倦怠，纳少便溏", + "E": "烦热头晕，口苦咽干" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 59, + "query": "下列各项、不属旋覆代赭汤临床表现的是", + "options": { + "A": "胀满", + "B": "嗳气", + "C": "呕吐", + "D": "下利", + "E": "苔白腻" + }, + "answer": "D", + "reason": "旋覆代赭汤:降逆化痰、益气和胃,用于胃虚痰阻气逆证。症见胃脘痞闷或涨满，按之不痛，频频嗳气；或见纳差,呃逆、恶心，甚或呕吐，舌苦白腻,脉缓或滑。" + }, + { + "question_num": 60, + "query": "十二经脉之海是指", + "options": { + "A": "任脉", + "B": "冲脉", + "C": "督脉", + "D": "带脉", + "E": "阴维脉" + }, + "answer": "B", + "reason": "冲脉上至头,下至足,通贯全身，可涵蓄调节十二经气血，故有“十二经脉之海”之称。" + }, + { + "question_num": 61, + "query": "主治肝热生风的方剂是", + "options": { + "A": "一贯煎", + "B": "羚角钩藤汤", + "C": "镇肝息风汤", + "D": "龙胆泻肝汤", + "E": "天麻钩藤饮" + }, + "answer": "B", + "reason": "羚角钩藤汤:凉肝息风、增液舒筋,用于肝热生风证。一贯煎:滋阴疏肝，用于肝肾阴虚、肝气郁滞证。镇肝息风汤:镇肝息风、滋阴潜阳,用于类中凤。龙胆泻肝汤：清泄肝胆实火、清利肝经湿热,用于肝胆实火上炎证、肝经湿热下注证。天麻钓藤饮;平肝息风、清热活血、补益肝肾,用于肝阳偏亢、肝风上扰证。" + }, + { + "question_num": 62, + "query": "针刺治疗太阳头痛应选取腧穴是", + "options": { + "A": "天柱、后溪、昆仑", + "B": "印堂、合谷、内庭", + "C": "率谷、外关、足临泣", + "D": "四神聪、太冲、内关", + "E": "风门、列缺、足三里" + }, + "answer": "A", + "reason": "头痛治疗宜疏调经脉、通络止痛，按局部穴位和远端循经���穴为主，太阳经头痛为后枕部疼痛，天柱位于后枕部，属局部取穴、疏导头部经气、后谈、昆仑为远端循经取穴。故本题选A项。" + }, + { + "question_num": 63, + "query": "桃核承气汤中配伍桂枝的作用是", + "options": { + "A": "解肌发表", + "B": "温阳散寒", + "C": "通行血脉", + "D": "调和营卫", + "E": "降逆平冲" + }, + "answer": "C", + "reason": "桃核承气汤：逐瘀泻热,用于下焦蓄血证。方中桂枝通行血脉,助桃仁活血化瘀,防芒硝、大黄寒凉凝血之弊。" + }, + { + "question_num": 64, + "query": "治疗风热型目赤肿痛除主穴外还应配用", + "options": { + "A": "鱼腰、四白", + "B": "行间、侠溪", + "C": "少商、外关", + "D": "肾俞、光明", + "E": "太溪、侠溪" + }, + "answer": "C", + "reason": "目赤肿病的治法:疏风散热，消肿止痛、以局部腧穴及手阳明、足厥阴经穴为主。主穴:晴明、太阳、风池、合谷、太冲；配穴:外感风热配少商、外关；肝胆火盛配行间、侠溪。" + }, + { + "question_num": 65, + "query": "体现“培土生金”治法的是", + "options": { + "A": "黄土汤", + "B": "理中丸", + "C": "补中益气汤", + "D": "麦门冬汤", + "E": "小建中汤" + }, + "answer": "D", + "reason": "麦门冬汤:清养肺胃，降逆下气。方中粳米、大枣益脾胃，人参益气生津，寓“培土生金\"之意。" + }, + { + "question_num": 66, + "query": "下述哪项是崩漏和经行泄泻所共有的病机", + "options": { + "A": "脾虚，肾虚", + "B": "肝郁，脾虚", + "C": "血热，血瘀", + "D": "肝虚，肾虚", + "E": "气虚，血虚" + }, + "answer": "A", + "reason": "崩漏的常见病因有脾虚、肾虚、血热和血瘀。与经行泄泻的发生所共有的病机为脾肾虚弱。" + }, + { + "question_num": 67, + "query": "组成中含有黄芪，白术的方剂是", + "options": { + "A": "理中丸", + "B": "健脾丸", + "C": "参苓白术散", + "D": "防己黄芪汤", + "E": "四君子汤" + }, + "answer": "D", + "reason": "防己黄芪汤;防已、黄英、甘草、白术、生姜、大枣。理中丸：人参、干姜、白术、炙甘草。健脾丸:白术、木香、酒炒黄连、甘草、茯苓、人参、神曲、陈皮、砂仁、炒麦芽、山楂、山药、肉豆蔻。参苓白术散:莲子肉、山药、薏苡仁、白扁豆、人参、炒甘草、白术、茯苓、砂仁、桔梗、大枣。四君子汤:人参、白术、茯苓、炙甘草。" + }, + { + "question_num": 68, + "query": "治疗腹痛中脏虚寒证，首选的方剂是", + "options": { + "A": "枳实导滞丸", + "B": "吴茱萸汤", + "C": "小建中汤", + "D": "少腹逐瘀汤", + "E": "理中丸" + }, + "answer": "C", + "reason": "腹痛中脏虚寒证,治当温中补虚、缓急止痛、方剂选小建中汤加减。积实导滞丸适用于饮食积滞证，少腹逐瘀汤适用于瘀血内停证，理中丸适用于脾胃虚寒证，吴茱萸汤适用于胃寒呕吐证。故本题选C项。" + }, + { + "question_num": 69, + "query": "具有温阳健脾，行气利水作用的方剂是", + "options": { + "A": "五苓散", + "B": "实脾散", + "C": "真武汤", + "D": "苓甘五味姜辛汤", + "E": "半夏厚朴汤" + }, + "answer": "B", + "reason": "实脾散:温阳健脾、行气利水,用于脾肾阳虚、水气内停之阴水(身半以下肿甚)。五苓散:利水渗湿、温阳化气,用于膀胱气化不利之蓄水证。真武汤:温阳利水,用于阳虚水泛证。苓甘五味姜辛汤:温肺化饮，用于寒饮咳嗽。半夏厚朴汤:行气散结,降逆化痰，用于梅核气。" + }, + { + "question_num": 70, + "query": "“痔、疟、狂、癫疾”是哪个经病候", + "options": { + "A": "足少阳胆经", + "B": "足阳明胃经", + "C": "足太阳膀胱经", + "D": "手太阳小肠经", + "E": "手少阳三焦经" + }, + "answer": "C", + "reason": "足太阳膀胱经主治脏腑病证;神志病证疯、狂、痫;头面五官病证,头痛、鼻塞等;经脉循行部位的其他病证，项、背、腰、下肢痹痛等。" + }, + { + "question_num": 71, + "query": "体现寒热并用、辛开苦降、补泻兼施配伍特点的方剂是", + "options": { + "A": "旋覆代赭汤", + "B": "半夏泻心汤", + "C": "枳实导滞丸", + "D": "木香槟榔丸", + "E": "厚朴温中汤" + }, + "answer": "B", + "reason": "半夏渴心汤:寒热平调，消痞散结,用于寒热错杂之痞证。特点:寒热并用,辛开苦降,补泄兼施。" + }, + { + "question_num": 72, + "query": "最典型的神经毒类毒蛇有", + "options": { + "A": "眼镜蛇", + "B": "眼镜��蛇", + "C": "蝮蛇", + "D": "烙铁头蛇", + "E": "银环蛇" + }, + "answer": "E", + "reason": "神经毒者有银环蛇、金环蛇、海蛇;血循毒者有蛙蛇、尖吻蝮蛇、竹叶青蛇和烙铁头蛇;混合毒者有眼镜蛇、眼镜王蛇和蝮蛇。" + }, + { + "question_num": 73, + "query": "治疗寒热夹杂，气血不足的久泻久痢，首选", + "options": { + "A": "补中益气汤", + "B": "真人养脏汤", + "C": "参苓白术散", + "D": "乌梅丸", + "E": "黄土汤" + }, + "answer": "D", + "reason": "乌梅丸:温脏安蛔,用于脏寒蛔厥证。症见脘腹阵痛,烦闷呕吐,时发时止,得食则吐,甚则吐蛔,手足厥冷;或久泻久痢(气血不足,湿热积滞未去之寒热虚实错杂证候)。" + }, + { + "question_num": 74, + "query": "深Ⅱ度烧伤的临床表现是", + "options": { + "A": "局部红肿，有疼痛和烧灼感，皮肤温度增高", + "B": "水疱较饱满，有剧痛，皮温增高", + "C": "水疱饱满，感觉迟钝，皮温低", + "D": "水疱较小或偏薄，感觉较迟钝，皮温稍低", + "E": "创面无水疱，感觉消失，皮温低" + }, + "answer": "D", + "reason": "深Ⅱ度烧伤临床表现:伤及皮肤的真皮深层，深浅不尽一致，尚残留皮肤附件;也可有水疱，但去疱皮后创面微湿，红白相间，痛觉较迟钝，如不发生感染，3~4周可愈合，常有瘢痕形成。" + }, + { + "question_num": 75, + "query": "下列各项，抗原-抗体反应发热的是", + "options": { + "A": "白血病", + "B": "甲状腺功能亢进症", + "C": "鱼鳞病", + "D": "药物热", + "E": "安眠药中毒" + }, + "answer": "D", + "reason": "抗原一抗体反应发热:风湿热、血清病、药物热、结缔组织病等。A项为无菌性坏死物质吸收发热;B项为内分泌代谢障碍发热;C项为皮肤散热减少的发热;E项为体温调节中枢功能失常发热。" + }, + { + "question_num": 76, + "query": "关于切开法切开方向的叙述，错误的是", + "options": { + "A": "一般疮疡，宜循经直开，刀头向上", + "B": "乳部宜放射形切开", + "C": "面部脓肿沿皮肤纹理切开", + "D": "手指脓肿，最好从正面切开，以免伤及屈伸功能", + "E": "关节附近宜用横切口" + }, + "answer": "D", + "reason": "切开法适用于一切外疡。确已成脓者，操作时宜选择脓腔最低点或最薄弱处进刀。一般疮疡宜循经直切;乳房部应以乳头为中心，放射状切开;面部脓肿应尽量沿皮肤自然纹理切开;手指脓肿，应从侧方切开;关节区附近的脓肿，切口尽量避免越过关节;关节区脓肿，一般施行横切口、弧形切口“S”形切口;肛旁低位脓肿，应以肛管为中心作放射状切开。" + }, + { + "question_num": 77, + "query": "典型心绞痛的疼痛性质是", + "options": { + "A": "刀割样痛", + "B": "刺痛", + "C": "压榨样痛", + "D": "灼痛", + "E": "闷痛" + }, + "answer": "C", + "reason": "心绞痛星压榨样痛,可伴有室息感。" + }, + { + "question_num": 78, + "query": "水肿属风水相搏者，最佳选用的方剂是", + "options": { + "A": "越婢加术汤", + "B": "五苓散", + "C": "五皮饮", + "D": "桂枝汤", + "E": "麻黄连翘赤小豆汤" + }, + "answer": "A", + "reason": "水肿风水相搏证。治法:疏风清热，宣肺行水。代表方剂:越婢加术汤加减。" + }, + { + "question_num": 79, + "query": "表现为吸气性呼吸困难的疾病是", + "options": { + "A": "支气管哮喘", + "B": "慢性支气管炎", + "C": "重症肺结核", + "D": "气管异物", + "E": "气胸" + }, + "answer": "D", + "reason": "吸气性呼吸困难;三凹征，伴干咳及喘鸣音,见于急性喉炎、喉水肿、喉痉挛、白喉、气管异物,支气管肿瘤、气管受压(喉管肿压)等。呼气性呼吸困难:广泛哮鸣音,见于支气管哮喘,喘息性慢性支气管炎.慢性阻塞性肺疾病等。重症肺结核、气胸为混合性呼吸困难。" + }, + { + "question_num": 80, + "query": "下列不符合十二经脉循行流注次序的是", + "options": { + "A": "胆、肝、肺经", + "B": "大肠、胃、脾经", + "C": "心、小肠、肾经", + "D": "肾、心包、三焦经", + "E": "三焦、胆、肝经" + }, + "answer": "C", + "reason": "十二经脉循行流注次序为肺大胃脾心小肠，膀肾包焦胆肝藏。" + }, + { + "question_num": 81, + "query": "下列各项，出现水肿伴颈静脉怒张的是", + "options": { + "A": "心源性水肿", + "B": "肝源性水肿", + "C": "肾源性水肿", + "D": "营养不良性水肿", + "E": "内分泌水肿" + }, + "answer": "A", + "reason": "心源��水肿的特点:下垂性水肿,常伴呼吸困难,心脏扩大,心率加快、颈静脉怒张、肝颈静脉回流征为阳性。" + }, + { + "question_num": 82, + "query": "水痘邪伤肺卫证的治法是", + "options": { + "A": "宣肺解毒，利湿清热", + "B": "辛凉解表，清热渗湿", + "C": "疏风清热，利湿解毒", + "D": "清热渗湿，解毒凉营", + "E": "宣肺解表，清热化湿" + }, + "answer": "C", + "reason": "水痘邪伤肺卫证:发热轻微,或无发热，鼻塞流涕,喷嚏,咳嗽,起病后1~2天出皮疹，疹色红润，疱浆清亮，根盘红晕，皮疹瘙痒，分布稀疏，此起彼伏，以躯干为多，舌苔薄白，脉浮数。治法:疏风清热，利湿解毒。代表方剂：银翘散。" + }, + { + "question_num": 83, + "query": "表现为面色晦暗、双颊紫红、口唇轻度发绀的面容是", + "options": { + "A": "慢性病容", + "B": "甲亢面容", + "C": "二尖瓣面容", + "D": "伤寒面容", + "E": "贫血面容" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 84, + "query": "下列腧穴在五行配属中属金的是", + "options": { + "A": "后溪", + "B": "经渠", + "C": "少府", + "D": "大陵", + "E": "阳溪" + }, + "answer": "B", + "reason": "十二经脉中每条经各有5个穴位属于五输穴;五输穴不仅有经脉归属，而且具有自身的五行属性，少府为手少阴心经之荣穴，属火;大陵为手厥阴心包经之输穴，属土;阳溪为手阳明大肠经之经穴，属火;后溪为手太阳小肠经之输穴，属木;经渠为手太阴肺经之经穴，属金。" + }, + { + "question_num": 85, + "query": "引起全身淋巴结肿大的疾病是", + "options": { + "A": "化脓性扁桃体炎", + "B": "淋巴结结核", + "C": "胃癌", + "D": "系统性红斑狼疮", + "E": "乳腺癌" + }, + "answer": "D", + "reason": "全身淋巴结肿大常见于传染性单核细胞增多症.状巴细胞白血病.淋巴瘤、系统性红班狼疮。" + }, + { + "question_num": 86, + "query": "下列关于虚体感冒治疗的叙述，错误的是", + "options": { + "A": "忌用大剂量发汗之品", + "B": "忌用大剂量寒凉药物", + "C": "忌用辛温重剂", + "D": "疗程宜长", + "E": "解表药物用量宜轻宜少" + }, + "answer": "D", + "reason": "体虚之人,卫外不固,感受外邪，常缠绵难愈，或反复不已。治疗当扶正达邪,在疏散药中酌加补正之品。对气虚感冒者，用药忌大剂量发汗之品，如麻黄、桂枝，解表药物用量宜轻宜少，疗程宜短，以免出汗过多、气随津脱。对阳虚感冒者，忌用大剂量寒虚感冒者，忌用辛湿重剂，以防损伤阴血之弊。" + }, + { + "question_num": 87, + "query": "引起触觉语颤增强的病变是", + "options": { + "A": "肺气肿", + "B": "气胸", + "C": "肺实变", + "D": "胸膜肥厚", + "E": "胸腔积液" + }, + "answer": "C", + "reason": "语颤增强,肺实变、压迫性肺不张、较浅而大的肺空洞。语颤减弱:肺气肿、支气管哮喘发作、气胸、阻塞性肺不张、气管内分泌物增多、胸腔积液、胸膜肥厚、胸膜粘连、体质衰弱。" + }, + { + "question_num": 88, + "query": "主客原络配穴是指", + "options": { + "A": "先病经脉的原穴与后病的相表里经脉的络穴相配合", + "B": "后病经脉的原穴与先病的相表里经脉的络穴相配合", + "C": "阴经的原穴与后病的相表里阳经的络穴相配合", + "D": "阳经的原穴与后病的相表里阴经的络穴相配合", + "E": "同一条经脉的原穴与络穴相配合" + }, + "answer": "A", + "reason": "临床上把先病经脉的原穴与后病的相表里经脉的络穴相配合，称为原络配穴法或主客原络配穴法。" + }, + { + "question_num": 89, + "query": "胸骨左缘第三、四肋间听到响亮粗糙的收缩期杂音，应考虑的疾病是", + "options": { + "A": "二尖瓣狭窄", + "B": "室间隔缺损", + "C": "肺动脉瓣狭窄", + "D": "二尖瓣关闭不全", + "E": "肺动脉瓣关闭不全" + }, + "answer": "B", + "reason": "胸骨左缘第三、四肋间听到响亮粗糙的收缩期杂音,可能为室间隔缺损。杂音在心尖部最响,病变在二尖瓣。在主动脉瓣区或肺动脉瓣区最响,病变在主动脉瓣或肺动脉瓣。在胸骨下端近剑突偏左或偏右最响，病变在三尖瓣。" + }, + { + "question_num": 90, + "query": "治疗经期延长血瘀证，应首选的方剂是", + "options": { + "A": "失笑散加味", + "B": "桂枝茯苓丸合失笑散加味", + "C": "逐瘀止血汤合失笑散加味", + "D": "桃红四物汤合失笑散加味", + "E": "血府逐瘀汤合失笑散加味" + }, + "answer": "D", + "reason": "血瘀证方药为桃红四物汤含失笑散加味或桂枝茯苓丸加味" + }, + { + "question_num": 91, + "query": "触诊肝脏呈弥漫性肿大，应首先考虑的是", + "options": { + "A": "肝囊肿", + "B": "肝癌", + "C": "肝包虫病", + "D": "脂肪肝", + "E": "肝脓肿" + }, + "answer": "D", + "reason": "肝脏弥漫性肿大:肝炎、脂肪肝、肝淤血、早期肝硬化、白血病、血吸虫病等。局限性肝肿大:肝肪肿、肝囊肿(包括肝包虫病)、肝肿瘤等。" + }, + { + "question_num": 92, + "query": "分布于胸腹第二侧线的经脉是", + "options": { + "A": "足太阴脾经", + "B": "足少阴肾经", + "C": "足阳明胃经", + "D": "足厥阴肝经", + "E": "足少阳胆经" + }, + "answer": "C", + "reason": "胸腹部第一侧线为足少阴肾经，第二侧线为足阳明胃经，第三侧线为足太阴脾经，第四侧线为足厥阴肝经。" + }, + { + "question_num": 93, + "query": "肢体远端对称性完全感觉缺失，呈手套状、袜子状分布，其感觉障碍的类型是", + "options": { + "A": "末梢型", + "B": "神经根型", + "C": "脊髓型", + "D": "内囊型", + "E": "脑干型" + }, + "answer": "A", + "reason": "感党障碍末梢型:肢体远端对称性完全感觉缺失,呈手套状.袜子状分布。" + }, + { + "question_num": 94, + "query": "下列各项，不属于产后发热感染邪毒证临床表现的是", + "options": { + "A": "小腹疼痛拒按", + "B": "产后高热寒战，热势不退", + "C": "肢体酸痛，无汗", + "D": "恶露量或多或少，色紫暗如败酱，气臭秽", + "E": "心烦口渴，尿少色黄，大便燥结" + }, + "answer": "C", + "reason": "产后发热感染邪毒证主要证候:产后高热寒战，热势不退，小腹疼痛拒按，恶露量或多或少，色紫暗如败酱，气臭秽;心烦口涡，尿少色黄，大便燥结:舌红苔黄，脉数有力。治法:清热解康，凉血化瘀。代表方剂:五味消毒饮合失笑散加减或解毒活血汤加减。" + }, + { + "question_num": 95, + "query": "缺铁性贫血给予铁剂治疗后，网织红细胞计数达到的高峰时间是", + "options": { + "A": "3～5天", + "B": "5～7天", + "C": "7～10天", + "D": "11～13天", + "E": "14天以后" + }, + "answer": "C", + "reason": "网织红细胞为红细胞的“前身”，缺铁性贫血铁剂治疗有效,最先升高的是网织红细胞,常于7～10天达到高峰。2周后血红蛋白开始上升,一般2个月恢复正常。" + }, + { + "question_num": 96, + "query": "药毒气阴两虚证的治疗方剂首选", + "options": { + "A": "萆薢渗湿汤", + "B": "清营汤", + "C": "增液汤合益胃汤", + "D": "消风散", + "E": "五神汤" + }, + "answer": "C", + "reason": "药毒分三型,湿毒蕴肤证方刑用草薢渗湿汤加减，热毒入营证方剂用清营汤、气阴两虚证方剂用增液汤合益胃汤。" + }, + { + "question_num": 97, + "query": "溶血性黄疸时，实验室检查结果为阴性的指标是", + "options": { + "A": "血清总胆红素", + "B": "结合胆红素", + "C": "非结合胆红素", + "D": "尿胆原", + "E": "尿胆红素" + }, + "answer": "E", + "reason": "" + }, + { + "question_num": 98, + "query": "烧伤面积的计算按中国九分法，双上肢面积占", + "options": { + "A": "9％", + "B": "18％", + "C": "27％", + "D": "36％", + "E": "45％" + }, + "answer": "B", + "reason": "中国九分法将全身体表面积分为11个9等份。成人头、面、颈部为9%;双上肢为2x9%;躯干前后包括外阴部为3X9%;双下肢包括臀部为5x9%+1%=46%。" + }, + { + "question_num": 99, + "query": "内生肌酐清除率(Ccr)为48ml/min，肾功能的分期是", + "options": { + "A": "肾功能正常", + "B": "肾衰竭代偿期", + "C": "背衰竭失代偿期", + "D": "肾衰竭期", + "E": "肾衰竭终末期" + }, + "answer": "C", + "reason": "评估肾功能损害的程度,根据Ccr一般可将肾功能分为4期:①肾衰竭代偿期,Ccr50～80ml/min;②肾衰竭失代偿期，Ccr20～50ml/min;③肾衰竭期(尿毒症早期)，Ccr10～19ml/min;④肾衰竭终末期(尿毒症晚期),Ccr<10ml/min。" + }, + { + "question_num": 100, + "query": "妊娠期痹阻胎元、使用活血化瘀药的原则是", + "options": { + "A": "治病与安胎并举", + "B": "衰其大半而止", + "C": "禁止使用", + "D": "病去即止", + "E": "慎用" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 101, + "query": "出现空腹血糖(FBG)增高的疾病是", + "options": { + "A": "糖尿病", + "B": "重型肝���", + "C": "胰岛β细胞瘤", + "D": "甲状腺功能减退症", + "E": "急性酒精中毒" + }, + "answer": "A", + "reason": "]空腹血糖(FBG)增高:①生理性增高,见于餐后1一2小时、高糖饮食、剧烈运动、情绪激动等;②病理性增高,见于各型糖尿病;内分关疾沉,如甲状腺功能亢进症、嗜铬细胞瘤、胰高血糖素瘤等;应激性因素,如颅脑外伤、心肌梗死、大面积烧伤;肝脏和胰腺疾病,如严重肝损害、环死性胰腺炎、胰腺癌等；呕吐、脱水、缺氧、麻醉等。" + }, + { + "question_num": 102, + "query": "痄腮热毒壅盛证，宜选用的方剂是", + "options": { + "A": "柴胡葛根汤", + "B": "银翘散", + "C": "普济消毒饮", + "D": "清瘟败毒饮", + "E": "龙胆泻肝汤" + }, + "answer": "C", + "reason": "炸腮热毒壅盛证:高热，一侧或两侧耳下腮部肿胀疼痛，坚硬拒按，张口咀嚼困难，或有烦躁不安，口渴欲饮，头痛，咽红肿痛，颌下肿块胀痛，纳少，大便秘结，尿少而黄，舌质红，舌苔黄，脉滑数。治宜清热解毒，软坚散结。方剂宜选用普济消毒饮。" + }, + { + "question_num": 103, + "query": "下列各项，反映左、右心室除极过程的电位与时间变化的是", + "options": { + "A": "P波", + "B": "QRS波群", + "C": "U波", + "D": "Ta波", + "E": "T波" + }, + "answer": "B", + "reason": "A项为心房除极波,反映左、右心房除极过程的电位和时间变化。B项为心宝除极波,反映左、右心室除极过程的电位和时间变化。C项为T波后的小波,机制不明。D项代表心房复极,方向与P波相反。E项为心室复极波,反映心室晚期快速复极的电位和时间变化。" + }, + { + "question_num": 104, + "query": "肺炎喘嗽的病机主要是", + "options": { + "A": "肺卫失宣", + "B": "肺失宣肃", + "C": "肺气郁闭", + "D": "痰饮内伏", + "E": "痰阻气道" + }, + "answer": "C", + "reason": "肺炎喘嗽外因感受风邪,或由其它疾病传变而来。内因小儿肺脏娇嫩，卫外不固。病变部位主要在肺，病机关键是肺气郁闭。痰热是其病理产物。" + }, + { + "question_num": 105, + "query": "下壁心肌梗死时，病理性Q波出现的导联是", + "options": { + "A": "V1、V2、V3", + "B": "V4、V5、V6", + "C": "Ⅱ、Ⅲ、aVF", + "D": "Ⅰ、aVL、V6", + "E": "V7、V8、V9" + }, + "answer": "C", + "reason": "心肌梗死部位:①前间壁，V1～V3:②前壁,V3～V5；③广泛前壁,V1一V6；④下壁,II、III、aVF;⑤高侧壁,I、aVL;⑥正后壁,V7一V8;⑦右心室,V3R一V7R。" + }, + { + "question_num": 106, + "query": "治疗疳积，应首选", + "options": { + "A": "印堂", + "B": "二白", + "C": "太阳", + "D": "四缝", + "E": "八风" + }, + "answer": "D", + "reason": "四缝穴主治小儿疳积、百日咳。故选择D。" + }, + { + "question_num": 107, + "query": "下列各项，不属于慢性支气管炎X线特点的是", + "options": { + "A": "两肺纹理增多", + "B": "支气管充气征", + "C": "两肺纹理紊乱", + "D": "两肺纹理增粗", + "E": "肺纹理延伸到肺野外带" + }, + "answer": "B", + "reason": "慢性支气管炎的早期X线无异常。典型慢性支气管炎表现为两肺纹理增多、增粗、紊乱,肺纹理延伸至肺野外带。" + }, + { + "question_num": 108, + "query": "确认成脓的方法，错误的是", + "options": { + "A": "按触法", + "B": "透光法", + "C": "点压法", + "D": "穿刺法", + "E": "切开法" + }, + "answer": "E", + "reason": "确认成脓的方法：接触法、透光法、点压法、穿刺法、B超。" + }, + { + "question_num": 109, + "query": "CT见脑内圆形均匀密度增高影，边界清楚、周围有环形密度减低影。应首先考虑的诊断是", + "options": { + "A": "脑出血", + "B": "蛛网膜下隙出血", + "C": "脑梗死", + "D": "脑肿瘤", + "E": "颅脑外伤" + }, + "answer": "A", + "reason": "脑出血急性期CT表现:圆形、椭圆形或不规则形均匀密度增高影,边界清楚,周围有环形密度减低影。脑梗死:①缺血性,可见三角形或扇形大范围低密度区②出血性,可见不规则斑点状或片状高密度出血灶影,有占位效应;③腔隙性,可见小片状密度减低影,边缘模糊,无占位效应。" + }, + { + "question_num": 110, + "query": "治疗哮病缓解期肺肾两虚证，应首选的方剂是", + "options": { + "A": "平喘固本汤", + "B": "六君子汤", + "C": "定喘汤", + "D": "三子养亲汤", + "E": "生脉地黄汤合金水六君煎" + }, + "answer": "E", + "reason": "哮病缓解期肺肾两虚证证候:脑转��鸣,腰酸腿软,心慌,不耐劳累;或五心烦热，颧红，口干，舌质红少苔，脉细数;或畏寒肢冷，面色苍白，舌苔淡白，质胖，脉沉细。治法:补肺益肾。代表方剂:生脉地黄汤合金水六君煎加减。" + }, + { + "question_num": 111, + "query": "既是西方医学的创始人，也是西方传统医德的奠基人，指的是", + "options": { + "A": "希波克拉底", + "B": "亚里士多德", + "C": "盖伦", + "D": "迈蒙尼提斯", + "E": "帕茨瓦尔" + }, + "answer": "A", + "reason": "希波克拉底是西方传统医德奠基人，其著名的《希波克拉底誓言》提出不伤害原则.为患者利益原则和保密原则,成为西方的医德传统和规范,也成为后来学医者宣誓的誓词。" + }, + { + "question_num": 112, + "query": "头空痛，眉棱骨痛，出血后痛重，属头痛血虚型，其治法为", + "options": { + "A": "养阴补肾，填精生髓", + "B": "养血滋阴，和络止痛", + "C": "健脾益气升清", + "D": "活血化瘀，通窍止痛", + "E": "补益气血，调养心脾" + }, + "answer": "B", + "reason": "血虚头痛证候:头痛隐隐,时时昏晕，心悸失眠，面色少华,神疲乏力，遇劳加重，舌质淡，苔薄白;脉细弱。治法:养血滋阴，和络止痛。代表方剂：加味四物汤加减。" + }, + { + "question_num": 113, + "query": "下列不符合无伤原则的是", + "options": { + "A": "对症下药，合理配伍", + "B": "避免操作失误造成医疗伤害", + "C": "对孕妇行X线检查且未告知可能的风险", + "D": "适当地限制约束精神病患者的自由", + "E": "选择受益最大、伤害最小的治疗方案" + }, + "answer": "C", + "reason": "无伤原则(底线原则)：①努力避免不应有的医疗伤害;②杜绝有意和责任伤害,若不能有利于,至少不伤害。" + }, + { + "question_num": 114, + "query": "治疗热结型便秘，除取主穴外，还应加", + "options": { + "A": "气海、神阙", + "B": "关元、命门", + "C": "脾俞、胃俞", + "D": "合谷、曲池", + "E": "中脘、行间" + }, + "answer": "D", + "reason": "便秘治宜理肠通便,取大肠的背俞穴及下合穴为主。主穴:天枢、大肠俞、上巨虚；配穴:热秘配合谷、曲池；气秘配太冲、中脘；冷秘配神阙、吴元；虚秘配足三里、脾俞、气海，兼阴伤津亏者加照海、太溪。故木题选D项。" + }, + { + "question_num": 115, + "query": "临床诊疗道德中，最优化原则是指", + "options": { + "A": "积极充分利用现实条件，严肃认真做出符合病情实际的判断", + "B": "认真实施有效治疗", + "C": "疗效最佳，安全无害，痛苦最小，耗费最少", + "D": "尊重患者的生命价值，不随意泄露患者的隐私", + "E": "力争尽快地对疾病做出诊断，主动迅速地治疗" + }, + "answer": "C", + "reason": "最优化原则;以最小的代价获得最大效益的决策。内容:疗效最佳，安全无害,痛苦最小,耗费最少。是最普通、最基本的治疗原则。" + }, + { + "question_num": 116, + "query": "治疗扭伤取穴原则是", + "options": { + "A": "以循经取穴为主", + "B": "以远端取穴为主", + "C": "以受伤局部取穴为主", + "D": "以受伤局部阳经取穴为主", + "E": "以受伤局部阴经取穴为主" + }, + "answer": "C", + "reason": "扭伤多发于腰、踝、膝、腕、肘、髋等部住,病住在经筋。扭伤的治法:祛瘀消肿，舒筋通络。扭伤以局部取穴为主。" + }, + { + "question_num": 117, + "query": "在医德评价标准中、医疗行为是否有利于人类生存环境的保护和改善、属于", + "options": { + "A": "疗效标准", + "B": "社会标准", + "C": "科学标准", + "D": "质量标准", + "E": "操作标准" + }, + "answer": "B", + "reason": "社会标准,医疗行为是否有利于人类生存环境的保护和改善." + }, + { + "question_num": 118, + "query": "“痛无定处，忽彼忽此，走注甚速”，其疼痛的原因是", + "options": { + "A": "风痛", + "B": "湿痛", + "C": "痰痛", + "D": "热痛", + "E": "化脓痛" + }, + "answer": "A", + "reason": "风善行而数变,故其病无定处，忽彼忽此,走注其速,遇风则剧。湿病痛而我成，火原光流滋。痰痛疼痛轻微，或隐隐作病，皮色不变，压之酸痛。热痛皮色炊热疼痛，遇冷则减。化脓痛痛势急胀，痛无止时，如同鸡啄，按之中软应指。故本题选A项。" + }, + { + "question_num": 119, + "query": "法律效力仅次于《宪法》的卫生法渊源是", + "options": { + "A": "卫生自治条例", + "B": "卫生法律", + "C": "国际卫生条约", + "D": "卫生部门规章", + "E": "卫生行政法规" + }, + "answer": "B", + "reason": "法律作为卫生法的渊源,其决律效力仅次于《中华人民共和国宪法》。" + }, + { + "question_num": 120, + "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": "气虚统摄无权", + "C": "水亏火旺，热扰冲任", + "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,其病机为脏腑受损，气血失调，冲任功能紊乱，血海蓄溢失常所致。" + }, + { + "question_num": 121, + "query": "下列各项，属于《中华人民共和国医师法》规定执业医师义务的是", + "options": { + "A": "依法参与所在机构的民主管理", + "B": "人格尊严、人身安全不受侵犯", + "C": "接受继续医学教育", + "D": "宣传健康科普知识，对患者进行健康教育", + "E": "参加专业学术团体" + }, + "answer": "D", + "reason": "D项为医师的义务，" + }, + { + "question_num": 122, + "query": "瘢痕灸治疗的病证是", + "options": { + "A": "肺痨、瘰疬", + "B": "虚寒病证", + "C": "风寒痹痛", + "D": "阳痿早泄", + "E": "疮疡久溃不敛" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 123, + "query": "突发公共卫生事件检测机构发现传染病菌种丢失，向有关部门报告的时限要求是", + "options": { + "A": "2小时内", + "B": "24小时内", + "C": "30日内", + "D": "6个月内", + "E": "1年内" + }, + "answer": "A", + "reason": "发生或可能发生传染病暴发、流行的,发生或发现不明原因群体性疾病的，发生传染病菌种、毒物丢失的、发生或可能发生重大食物和职业中毒事件的,2小时内上报。" + }, + { + "question_num": 124, + "query": "不寐的病机总属", + "options": { + "A": "阴虚火旺，心肾不交", + "B": "脾虚不运，心神失养", + "C": "阳盛阴衰，阴阳失交", + "D": "邪扰心神，心神不宁", + "E": "气血阴阳亏虚，心失所养" + }, + "answer": "C", + "reason": "不寐的病因虽多,但其病理变化，总属阳盛阴衰，阴阳失交。一为阴虚不能纳阳、一为阳盛不得入于阴，其病位主要在心,与肝、脾、肾密切相关。故本题选C项。" + }, + { + "question_num": 125, + "query": "造成患者中度残疾的医疗事故，所属的医疗事故级别是", + "options": { + "A": "一级", + "B": "二级", + "C": "三级", + "D": "四级", + "E": "五级" + }, + "answer": "B", + "reason": "一级:死亡、重度残疾;二级:中度残疾、严重功能障碍;三级,轻度残疾、一般功能障碍;四级:明显人身损害。" + }, + { + "question_num": 126, + "query": "患儿，10个月。高热烦躁，气急鼻煽，张口抬肩，喉中痰鸣，声如拽锯，口唇紫绀，其治法是", + "options": { + "A": "清热宣肺，涤痰定喘", + "B": "清热解毒，止咳化痰", + "C": "辛凉开肺，清热化痰", + "D": "清热活血，泻肺化痰", + "E": "泻肺镇咳，清热化痰" + }, + "answer": "A", + "reason": "本证多见于肺炎喘嗽的中期,痰热俱甚,郁闭于肺,而见上述诸症。临床以发热、咳嗽、痰壅、气急、鼻煽为特征,治疗宜清热宣肺,涤痰定喘。故本题选A项。" + }, + { + "question_num": 127, + "query": "能杀灭细菌芽孢的消毒方法是", + "options": { + "A": "超声波消毒法", + "B": "酒精浸泡法", + "C": "碘伏浸泡法", + "D": "环氧乙烷灭菌法", + "E": "氯己定消毒法" + }, + "answer": "E", + "reason": "高效消毒法杀灭一切细菌繁殖体(包括分枝杆菌)、病毒、真菌及其孢子，并对细菌芽胞有显著杀灭作用;主要有紫外线消毒法和奥氧、含氮消毒剂.过氧化氢等。中效消毒法杀灭除细菌芽胞以外的各种微生物;主要有超声波消毒法和中效消毒剂如醇类、碘类、酚类消毒剂等。" + }, + { + "question_num": 128, + "query": "患者，女性，28岁，已婚。月经50天一次，量少、色淡、质稀，小腹隐痛，喜热喜按，腰酸无力，大便溏薄，小便清长，舌淡苔白，脉沉细而迟。治疗应首选", + "options": { + "A": "乌药汤", + "B": "艾附暖宫丸", + "C": "温胞饮", + "D": "大补元煎", + "E": "人参养荣汤" + }, + "answer": "B", + "reason": "根据月经50天一次可诊断为月经后期量少、色淡、质稀,小腹隐痛,喜热喜按,腰酸无力，大便溏薄，小便清长，舌淡苔白，脉沉细而迟，为血寒之虚寒证的典型表现，此证为月经后期之虚寒证。治法:扶阳祛寒调经���代表方剂:温经汤(《金匮要略》)或艾附暖宫丸。" + }, + { + "question_num": 129, + "query": "脏腑关系中，“燥湿相济”指的是哪种关系", + "options": { + "A": "心与小肠", + "B": "肝与胆", + "C": "脾与胃", + "D": "肺与大肠", + "E": "肾与膀胱" + }, + "answer": "C", + "reason": "脾为阴脏,喜燥而恶湿;胃为阳腑,喜润而恶燥。脾胃阴阳燥湿相济。" + }, + { + "question_num": 130, + "query": "患者，女，40岁。平素善惊易恐，因受惊而心悸1月余，坐卧不安，少寐多梦，舌苔薄白，脉虚弦。治疗应首选", + "options": { + "A": "炙甘草汤", + "B": "朱砂安神丸", + "C": "归脾汤", + "D": "天王补心丹", + "E": "安神定志丸" + }, + "answer": "E", + "reason": "善惊易恐,因受惊而心悸为心悸心虚胆怯证，治以镇惊定志，养心安神为法。代表方剂:安神定志丸。" + }, + { + "question_num": 131, + "query": "巴豆内服的用量是", + "options": { + "A": "0.1～0.3g", + "B": "0.5～1g", + "C": "1.5～3g", + "D": "3～5g", + "E": "5～10g" + }, + "answer": "A", + "reason": "巴豆入丸散,每次0.1～0.3g。大多制成巴豆霜用,以减低毒性。外用适量。" + }, + { + "question_num": 132, + "query": "患者，64岁。眼睑浮肿，延及全身，皮肤光亮，尿少色赤，身发疮痍，甚则溃烂，恶风发热，舌质红，苔薄黄，脉浮数或滑数。治疗应首选的方剂是", + "options": { + "A": "麻黄连翘赤小豆汤合五味消毒饮加减", + "B": "五味消毒饮合小蓟饮子", + "C": "龙胆泻肝汤合羚角钩藤汤", + "D": "龙胆泻肝汤合小蓟饮子", + "E": "甘露消毒丹合羚角钩藤汤" + }, + "answer": "A", + "reason": "根据题干描述,可以明确诊断为水肿、证型为湿毒浸淫证。治法:宣肺解毒、利湿消肿。代表方刑:麻黄连翘赤小豆汤合五味消毒饮加浊，" + }, + { + "question_num": 133, + "query": "湿热和热毒导致的带下过多的治则是", + "options": { + "A": "宜消，宜利", + "B": "宜消，宜升", + "C": "宜消，宜泻", + "D": "宜清，宜利", + "E": "宜散，宜补" + }, + "answer": "D", + "reason": "带下过多者,治疗以除湿为主。一般治脾宜运、宜升、宜燥;治肾宜补、宜固、宜涩;湿热和热毒宜清、宜利;阴虚夹湿则补清兼施。虚实夹杂证及实证治疗还需配合外治法。" + }, + { + "question_num": 134, + "query": "某女，23岁。2年前经期淋雨后出现痛经。经期腹痛拒按，经色紫红有块，得温痛减，舌淡苔白，脉沉。针灸取穴为", + "options": { + "A": "肾俞、大赫、命门、关元、血海、三阴交", + "B": "肾俞、肝俞、太溪、太冲、血海、三阴交", + "C": "中极、地机、次髎、三阴交、关元、归来", + "D": "中极、地机、太冲、三阴交、期门、关元", + "E": "肾俞、肝俞、太冲、三阴交、关元、命门" + }, + "answer": "C", + "reason": "痛经实证主穴为中极、次髎、地机、三阴交。气滞血瘀配太冲、血海；寒凝血鼎配关元、归来。" + }, + { + "question_num": 135, + "query": "下列妇科病证不适宜选用直肠导入法的是", + "options": { + "A": "慢性盆腔炎", + "B": "盆腔淤血综合征", + "C": "癥瘕", + "D": "产后发热", + "E": "异位妊娠" + }, + "answer": "E", + "reason": "直肠导入法有利于盆腔、胞中癓积,慢性盆腔炎、盆腔淤血综合征,以及产后发热、大便秘结等病证的治疗。月经期、阴道出血时及妊娠期需甚用。" + }, + { + "question_num": 136, + "query": "患者大便秘结、胸胁痞满、甚则腹中胀痛，嗳气，食少，苔薄腻、脉弦。治疗上应首选", + "options": { + "A": "柴胡疏肝散", + "B": "黄芪汤", + "C": "润肠丸", + "D": "保和丸", + "E": "六磨汤" + }, + "answer": "E", + "reason": "本患者出现症状为情志失和、肝气都结所致的便秘、即气秘。治疗宜顺气导滞。代表方剂:六磨汤。" + }, + { + "question_num": 137, + "query": "治疗产后身痛风寒证，应首选的方剂是", + "options": { + "A": "独活寄生汤", + "B": "身痛逐瘀汤", + "C": "生化汤", + "D": "养荣壮肾汤", + "E": "黄芪桂枝五物汤" + }, + "answer": "A", + "reason": "产后身痛风寒证治法:养血祛风,散寒除湿。代表方剂:独活寄生汤或趁痛散、防风汤。" + }, + { + "question_num": 138, + "query": "患者，女性，26岁，已婚。月经错后半个月，量少、色淡、质稀，少腹空痛，头晕眼花，心悸失眠，面色萎黄，舌淡苔少，脉细弱。治疗应首选", + "options": { + "A": "十全大补汤", + "B": "人参养营汤", + "C": "大营煎", + "D": "大补元煎", + "E": "滋血汤" + }, + "answer": "D", + "reason": "根据题干可诊断为月经后期、辨证为血虚证。治法:补血益气调经。代表方剂:大补元煎。" + }, + { + "question_num": 139, + "query": "月经过少肾虚证的治法是", + "options": { + "A": "补肾益精、养血调经", + "B": "补肾益精，活血调经", + "C": "温肾健脾，养血调经", + "D": "温肾健脾，活血调经", + "E": "温肾健脾，疏肝调经" + }, + "answer": "A", + "reason": "月经过少肾虚证治法;补肾益精,养血调经。代表方剂;归肾丸或当归地黄饮。" + }, + { + "question_num": 140, + "query": "患者，男性，25岁。晨起跑步时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。治疗应首选的方剂是", + "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": "患者晨起跑步时遇风后全身泛发风团，应考虑为风寒束表而发为瘾疹，治法应以疏风散寒为主，方剂用麻黄桂枝各半汤最为妥当。消风散和当归饮子亦可用于瘾疹的治疗，前者主治风热犯表，后者主治血虚风燥证。" + }, + { + "question_num": 141, + "query": "下列各项，不属于药物流产适应证的是", + "options": { + "A": "正常宫内妊娠7周之内者", + "B": "自愿要求药物终止妊娠的健康孕妇", + "C": "高危人流对象", + "D": "对手术流产有恐惧心理者", + "E": "带器妊娠或可疑宫外孕者" + }, + "answer": "E", + "reason": "药物流产适应证:正常宫内妊娠7周以内:自愿要求药物终止妊娠的健康妇女:高危人流对象;对手术流产有恐惧心理者。带器姓娠或可疑宫外孕者属于禁忌证。" + }, + { + "question_num": 142, + "query": "李某，女，82岁。平素时常头晕，沉默寡言。近年来智力衰退，终日无语，呆若木鸡，不思饮食，胃痞不适，头重如裹，舌质淡，苔白腻，脉滑，其诊断为", + "options": { + "A": "癫证痰气郁结证", + "B": "郁证痰气郁结证", + "C": "痴呆痰浊蒙窍证", + "D": "癫证心脾两虚证", + "E": "痴呆髓海不足证" + }, + "answer": "C", + "reason": "痴呆痰浊蒙窍证证候:表情呆钝，智力衰退，或哭笑无常，喃喃自语，或终日无语，呆若木鸡，伴不思饮食，脘腹胀痛，胃痞不适，口多诞沫，头重如裹,舌质淡,苔白腻,脉滑。" + }, + { + "question_num": 143, + "query": "按公式推算，2周岁幼儿正常的身长(cm)是", + "options": { + "A": "75", + "B": "80", + "C": "89", + "D": "90", + "E": "95" + }, + "answer": "C", + "reason": "2岁至6岁儿童的身高计算公式:身高(cm)=75+7*年龄。经计算,2周岁幼儿正常的身长应为89cm。" + }, + { + "question_num": 144, + "query": "患者呕吐多为清水痰涎，脘闷不食，头晕心悸，舌苔白腻，脉滑，其证候为", + "options": { + "A": "饮食积滞", + "B": "痰饮内阻", + "C": "脾胃虚弱", + "D": "脾阳虚衰", + "E": "气滞痰阻" + }, + "answer": "B", + "reason": "根据题干所述,可以明确诊断为呕吐，证型为痰饮内阻。痰饮内停，中阳不振，胃气上逆，故可出现上述症状。饮食积滞证表现为呕吐酸腐,脘腹胀满,嗳气厌食，大便溏或结，苔厚腻,脉滑实。脾胃虚弱表现为食欲缺乏,食入难化,恶心呕吐,脘部痞闷，大便不畅，苔白腻，脉虚弦。脾阳虚衰证表现为饮食稍多即吐，时作时止，兼有虚寒证，如面色白，恶寒喜暖，四肢不温，口干而不欲饮，舌质淡，脉濡弱。气滞痰阻表现为恶心呕吐痰涎，不思饮食,食入即吐,胸胁胀痛，嗳气,脘腹胀满，苔滑腻,脉滑数。" + }, + { + "question_num": 145, + "query": "下列小儿疾病，不宜用推拿手法治疗的是", + "options": { + "A": "厌食", + "B": "紫癜", + "C": "咳嗽", + "D": "腹痛", + "E": "遗尿" + }, + "answer": "B", + "reason": "推拿疗法禁忌证：急性出血性疾病、急性外伤、脊背皮肤感染等。" + }, + { + "question_num": 146, + "query": "患者，女性，45岁。头痛多年，后头部疼痛固定不移，痛如锥刺，舌暗，脉细涩，针灸治疗除百会、风池、足三里外，宜取", + "options": { + "A": "太阳、列缺、曲池", + "B": "后溪、申脉、悬钟", + "C": "三阴交、肝俞、脾俞", + "D": "太冲、太溪、侠溪", + "E": "阿是穴、血海、膈俞" + }, + "answer": "E", + "reason": "患者头���多年,应为内伤头痛。疼痛部位固定不移、痛如锥刺、舌暗,应考虑为瘀血头痛。故取主穴百会、风池、足三里，配以阿是穴、血海、膈俞、内关等。" + }, + { + "question_num": 147, + "query": "下列各项，不属于急惊风病因的是", + "options": { + "A": "外感风热", + "B": "外感暑热", + "C": "感受疫疠", + "D": "暴受惊恐", + "E": "久病体虚" + }, + "answer": "E", + "reason": "急惊风为痰、热、惊、风四证俱备,临床以高热、抽凤、神昏为主要表现，多由外感时邪(风寒、风热、暑湿)、内蕴湿热和暴受惊控而引发。" + }, + { + "question_num": 148, + "query": "患者牙痛，隐隐而痛，时作时止，口不臭，有齿浮动，脉细。应选穴", + "options": { + "A": "合谷、颊车、外关", + "B": "合谷、下关、风池", + "C": "合谷、颊车、内庭、二间", + "D": "合谷、颊车、太溪、行间", + "E": "合谷、下关、内庭、外关" + }, + "answer": "D", + "reason": "牙痛祛风泻火,通络止痛。取手、足阳明经穴为主。主穴:合谷、颊车、下关;虚火牙痛配太溪、行间。" + }, + { + "question_num": 149, + "query": "治疗鹅口疮心脾积热证，应首选的方剂是", + "options": { + "A": "银翘散", + "B": "泻白散", + "C": "泻心导赤散", + "D": "清热泻脾散", + "E": "知柏地黄丸" + }, + "answer": "D", + "reason": "鹅口疮治法:清心泻脾。代表方剂:清热泻脾散。" + }, + { + "question_num": 150, + "query": "患者，女，45岁。3天来尿频急，尿色深红，尿痛，心烦，舌尖红，苔黄腻，脉滑数。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": "B", + "reason": "血淋证候:小便热涩刺痛,尿色深红，或夹有血块，疼痛满急加剧，或见心烦，舌尖红，苔黄，脉滑数。治法为清热通淋，凉血止血。代表方为小蓟饮子加减。" + }, + { + "question_num": 151, + "query": "下列各项，属于传染性单核细胞增多症临床特点的是", + "options": { + "A": "白细胞明显升高", + "B": "白细胞明显降低", + "C": "单核细胞明显升高", + "D": "淋巴细胞明显降低", + "E": "异形淋巴细胞增多" + }, + "answer": "E", + "reason": "传染性单核细胞增多症(简称传单)临床表现多样,以发热、咽峡炎、淋巴结肿大、肝脾大、外周血中淋巴细胞增多并出现异型淋巴细胞增多为特征。" + }, + { + "question_num": 152, + "query": "患儿持续发热4天，口渴多饮，目赤流泪流涕，耳后发际可见红色疹点，继之全身都可见到，疹点细小，触之碍手，先红后暗，舌红苔黄，脉浮数。治疗首选", + "options": { + "A": "柴葛解肌汤", + "B": "透疹凉解汤", + "C": "清解透表汤", + "D": "解肌透痧汤", + "E": "宣毒发表汤" + }, + "answer": "C", + "reason": "根据题干可辨证为麻疹邪入肺胃证(出疹期)，证候:壮热持续，起伏如潮，肤有微汗,烦躁不安，目赤眵多,咳嗽阵作,皮疹布发，疹点由细小稀少而逐渐稠密，疹色先红后暗，皮疹凸起，触之碍手,压之褪色，大便干结，小便短少，舌质红赤,舌黄腻，脉数有力。治法:清凉解毒，透疹达邪。代表方剂:清解透表汤。" + }, + { + "question_num": 153, + "query": "治疗蛔厥证，应首选的方剂是", + "options": { + "A": "使君子散", + "B": "驱蛔承气汤", + "C": "乌梅丸", + "D": "芍药甘草汤", + "E": "人参五味子汤" + }, + "answer": "C", + "reason": "蛔厥证治法:安蛔定痛,继则驱虫。代表方剂:乌梅丸。" + }, + { + "question_num": 154, + "query": "患者表情淡漠，神志痴呆，喃喃独语，精神抑郁，不思饮食，舌苔白腻，脉弦滑，其治法是", + "options": { + "A": "养心健脾，益气安神", + "B": "理气化痰，活血通络", + "C": "豁痰开窍，健脾化浊", + "D": "镇心涤痰，安神定志", + "E": "化痰健脾，养心宁神" + }, + "answer": "C", + "reason": "辨证为痴呆痰浊蒙窍证。治法:豁痰开窍，健脾化浊。代表方剂:涤痰汤加减。" + }, + { + "question_num": 155, + "query": "菟丝子散治疗小儿遗尿的证型是", + "options": { + "A": "肺脾气虚证", + "B": "肾气不足证", + "C": "肝经湿热证", + "D": "心肾失交证", + "E": "脾虚肝亢证" + }, + "answer": "B", + "reason": "遗尿治法:温补肾阳,固涩膀胱。代表方剂:菟丝子散。肺脾气虚证用补中益气汤合缩泉丸。肝经湿热证用龙胆泻肝汤。心肾失交证用交泰丸合��赤散。" + }, + { + "question_num": 156, + "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": "从症状描述可知,此为心血不足之心悸,治以补血养心，益气安神,方剂用归脾汤。故本题选B项。" + }, + { + "question_num": 157, + "query": "下列各项，不属于疳气证临床表现的是", + "options": { + "A": "精神欠佳", + "B": "形体略瘦", + "C": "不思伙食", + "D": "大便干稀不调", + "E": "面貌如老人" + }, + "answer": "E", + "reason": "疳气证临床表现:形体略瘦,面色少华,毛发稀疏,不思饮食,精神欠佳，性急易怒,大便干稀不调，舌质略淡，苦薄微腻,脉细有力。面貌如老人是干疳证的临床表现。" + }, + { + "question_num": 158, + "query": "患儿，5岁。发热1天，颜面、躯干见丘疹及水疱疹，低热，恶寒，鼻塞流涕，疹色红润，疱浆清亮，疹粒稀疏，舌质红，苔薄白，脉浮数，其病证诊断为", + "options": { + "A": "幼儿急疹，邪郁肌表证", + "B": "风疹，邪犯肺卫证", + "C": "麻疹，邪犯肺卫证", + "D": "水痘，毒炽气营证", + "E": "水痘，邪伤肺卫证" + }, + "answer": "E", + "reason": "水痘之邪伤肺卫证。" + }, + { + "question_num": 159, + "query": "根据腧穴主治规律、足三阳经腧穴主治相同的病证是", + "options": { + "A": "胃肠病", + "B": "咽喉病", + "C": "头面病", + "D": "神志病", + "E": "耳病" + }, + "answer": "D", + "reason": "足三阳经相同的主治病征是神志病、热病。" + }, + { + "question_num": 160, + "query": "患者王某，心痛憋闷，心悸盗汗，虚烦不寐，腰酸膝软，头晕耳鸣，口干便秘，舌红少津，苔剥，脉细数。中医辨病为胸痹。治法宜选用", + "options": { + "A": "滋阴清火，养心和络", + "B": "益气养阴，活血通脉", + "C": "温补阳气，振奋心阳", + "D": "辛温散寒，宣通心阳", + "E": "通阳泄浊，豁痰宣痹" + }, + "answer": "A", + "reason": "胸痹之心肾阴虚证。证候主症:心痛憋闷，心悸盗汗，虚烦不寐，腰酸膝软，头晕耳鸣，口干便秘，舌红少津，苔薄或剥，脉细数或促代。治法:滋阴清火，养心和络。" + }, + { + "question_num": 161, + "query": "流行性脑脊髓膜炎带菌者细菌在体内寄生的部位是", + "options": { + "A": "汗腺", + "B": "血管内皮", + "C": "蛛网膜", + "D": "肺部", + "E": "鼻咽部" + }, + "answer": "E", + "reason": "脑膜炎奈瑟菌存在于带菌者鼻咽部及患者的血液、脑背液,皮肤瘀点中。" + }, + { + "question_num": 162, + "query": "患者，25岁。3天前与人吵架后，今日出现鼻衄，头痛，目眩，口苦，目赤耳鸣，烦躁易怒，其诊断与治法为", + "options": { + "A": "血证；清肝泻火，凉血止血", + "B": "血证；清胃泻火，凉血止血", + "C": "血证；清泻肺热，凉血止血", + "D": "血证；滋肾阴泻肾火", + "E": "血证；清心泻火，凉血止血" + }, + "answer": "A", + "reason": "血证肝火上炎证证候:鼻衄，头痛，目眩,耳鸣，烦踩易怒,两目红赤，口苦，舌红，脉弦数。治法：清肝泻火，凉血止血。代表方剂:龙胆泻肝汤加减。" + }, + { + "question_num": 163, + "query": "流行性出血热判断少尿的标准为24小时尿量少于", + "options": { + "A": "400ml", + "B": "300ml", + "C": "200ml", + "D": "100ml", + "E": "50ml" + }, + "answer": "A", + "reason": "24小时尿量少于400ml为少尿,少于50ml为无尿。" + }, + { + "question_num": 164, + "query": "患儿，2岁4个月。发热恶风，喷嚏流涕，轻微咳嗽，皮疹分布均匀，疹点稀疏细小，疹色淡红，肌肤轻度瘙痒，耳后及枕部臖核肿大触痛，舌质偏红，舌苔薄黄，指纹浮紫。治疗应首选的方剂是", + "options": { + "A": "银翘散", + "B": "桑菊饮", + "C": "桑杏汤", + "D": "香苏散", + "E": "麻杏石甘汤" + }, + "answer": "A", + "reason": "风痧邪犯肺卫证:发热恶风,喷嚏流涕,轻微咳嗽,精神倦急,饮食欠佳皮疹先起于头面、躯干,随即遍及四肢,分布均匀，疹点稀疏细小，疹色淡红，一般2~3日渐见消退，肌肤轻度瘙痒、耳后及枕部界核肿大触痛、舌质偏红、苔薄白或薄黄、脉浮数。治宜疏风清热透疹，方剂选银翘散、故本题选A项。" + }, + { + "question_num": 165, + "query": "霍乱剧烈腹泻的主要致病因素是", + "options": { + "A": "神经氨酸酶", + "B": "血凝素", + "C": "霍乱内毒素", + "D": "霍乱肠毒素", + "E": "菌体裂解" + }, + "answer": "D", + "reason": "霍乱肠毒素是霍乱的主要致病物质,可导致剧烈水样腹泻。" + }, + { + "question_num": 166, + "query": "患者，女，44岁。咳喘较甚，伴有胸中烦热，呼吸气涌，胸中胀痛，痰多色黄黏稠，渴喜冷饮，面红咽干，尿赤，便秘，或痰中夹血，苔黄腻，脉滑数，其诊断与治法为", + "options": { + "A": "痰浊壅肺；化痰降气，二陈汤合三子养亲汤", + "B": "痰热郁肺；清热化痰，桑白皮汤加减", + "C": "风热犯肺；清热解表，宣肺平喘，麻杏石甘汤", + "D": "痰热郁肺；清热化痰，白虎汤合五磨饮子", + "E": "肝火犯肺；清肝泻肺，百合固金汤" + }, + "answer": "B", + "reason": "喘证痰热郁肺证证候:喘促气涌，胸部胀痛，咳嗽痰多,质黏色黄,或兼有血色、伴胸中烦闷、身热、有汗、口渴而喜冷饮,面赤、咽干、小便赤涩、大便或秘、舌质红,苔薄黄或腻，脉滑数。治法:清热化痰，宣肺平喘。代表方剂:桑白皮汤加减。" + }, + { + "question_num": 167, + "query": "鉴别中毒型菌痢与流行性乙型脑炎的重要依据是", + "options": { + "A": "高热、昏迷、惊厥", + "B": "肠道症状", + "C": "血清抗体检测", + "D": "脑脊液常规检查", + "E": "血常规检查" + }, + "answer": "D", + "reason": "中毒型细菌性痢疾与流行性乙型脑炎鉴别:流行性乙型脑炎起病及进展相对缓慢;循环衰竭少见；意识障碍及脑膜刺激征明显;脑脊液可有蛋白及白细胞增高,粪便检查多无异常;乙脑病毒特异性抗体IgM阳性可资鉴别。" + }, + { + "question_num": 168, + "query": "患者，男，50岁。颜面部红肿疼痛伴发热2天，皮色鲜红，色如涂丹，压之褪色，扪之灼手，边界清楚，触痛明显。大便2日未行。治疗应首选", + "options": { + "A": "五味消毒饮加减", + "B": "萆薢渗湿汤加减", + "C": "普济消毒饮加减", + "D": "黄连解毒汤加减", + "E": "犀角地黄汤加减" + }, + "answer": "C", + "reason": "该患者诊断为丹毒风热毒蕴证。治法:疏风清热解毒。方药:普济消毒饮加减。故本题选C项" + }, + { + "question_num": 169, + "query": "化脓灸所属的灸法是", + "options": { + "A": "直接灸", + "B": "间接灸", + "C": "悬起灸", + "D": "实按灸", + "E": "天灸" + }, + "answer": "A", + "reason": "化脓炙又名瘢痕灸,属于直接炙。" + }, + { + "question_num": 170, + "query": "一患者非经期阴道突然大量出血，淋沥日久不净，血色深红，质地黏稠，口干欲饮，烦躁面赤。应诊断为", + "options": { + "A": "血热型，月经过多", + "B": "血热型，崩中漏下", + "C": "血虚型，月经过多", + "D": "血瘀型，崩中漏下", + "E": "血虚型，崩中漏下" + }, + "answer": "B", + "reason": "根据题干描述,可以明确诊断为崩漏，证型为血热证—实热证。治法:清热凉血，固冲止血。代表方剂:清热固经汤。" + }, + { + "question_num": 171, + "query": "黄疸进行性加重并伴有明显神经、精神症状的肝炎是", + "options": { + "A": "急性黄疸型肝炎", + "B": "重度慢性肝炎", + "C": "急性重型肝炎", + "D": "淤胆型肝炎", + "E": "中度慢性肝炎" + }, + "answer": "C", + "reason": "急性重型肝炎亦称暴发型肝炎,其以急性黄疸型肝炎起病,病程2周内出现极度乏力,明显消化道症状(无食欲、恶心、频繁呕吐等),常有高热,迅速出现神经精神症状(如性格改变、行为反常、嗜睡、烦踩不安,甚至昏迷等),肝浊音界进行性缩小,黄疸急剧加深,血白细胞计数及中性粒细胞增高,血小板减少,凝血酶原时间延长，PTA≤40%。" + }, + { + "question_num": 172, + "query": "患者，男性，28岁。左肩部可扪及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": "肉瘤好发于四肢、躯干,多单发。局部表现:肿块生长缓慢，质地柔软，或有囊性感，不伴有疼痛，皮色不变,界限清楚,呈分叶状。" + }, + { + "question_num": 173, + "query": "下列不属于流行性乙型脑炎流行病学特征的是", + "options": { + "A": "人畜共患疾病", + "B": "人是本病的主要传染源", + "C": "东南亚是��要的流行区", + "D": "人群对流行性乙型脑炎普遍易感", + "E": "流行性乙型脑炎经蚊虫叮咬传播" + }, + "answer": "B", + "reason": "流行性乙型脑炎是人畜共患的自然疫源性疾病,人不是主要的传染源，猪是本病主要的传染源。东南亚和西太平洋地区是主要流行区。人和群对流行性乙型脑类病毒普遍易感。流行性乙型脑炎主要通过蚊虫叮咬而传播。" + }, + { + "question_num": 174, + "query": "患者，男，27岁。左眉上出现一坚硬肿块约1cm×1cm，中有一粟粒样脓头，坚硬根深，如钉之状，疼痛剧烈，左上眼睑肿胀明显，不能睁眼，伴发热头痛，其诊断是", + "options": { + "A": "痈", + "B": "发", + "C": "疖", + "D": "疔疮", + "E": "有头疽" + }, + "answer": "D", + "reason": "疔疮是常见的外科急症,好发于面部和指端。因其初起形小根深，底脚坚硬如钉，故名疔疮。本病初起状如粟粒，色或黄或紫，或起脓水疱、脓疱，根结坚硬如钉，自觉麻痒而疼痛轻微，继则红肿灼热，疼痛增剧，多有寒热。" + }, + { + "question_num": 175, + "query": "归来穴归属的经脉是", + "options": { + "A": "手太阴肺经", + "B": "手阳明大肠经", + "C": "足阳明胃经", + "D": "足太阴脾经", + "E": "手太阴心经" + }, + "answer": "C", + "reason": "归来穴归属足阳明胃经。主治小腹痛,疝气,月经不调、带下、阴挺、闭经等妇科病证。" + }, + { + "question_num": 176, + "query": "患者，女性，28岁，已婚。妊娠3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": "羚角钩藤汤", + "B": "半夏白术天麻汤", + "C": "镇肝熄风汤", + "D": "杞菊地黄丸", + "E": "天仙藤散" + }, + "answer": "E", + "reason": "妊娠肿胀气滞证,主要证候:妊娠3~4月后，肢体肿胀，始于两足，渐延于腿，皮色不变,随按随起,胸闷胁胀，头晕胀痛;苔薄腻,脉弦滑。治法:理气行滞，除湿消肿。代表方剂:天仙藤散或正气天香散。" + }, + { + "question_num": 177, + "query": "患者、女，66岁。头晕，耳鸣15天。伴头目胀痛、两侧为重，心烦易怒，夜寐不宁，口苦面红，伴有肢体麻木，舌红苔黄，脉弦。治疗应首选的方剂是", + "options": { + "A": "芎芷石膏汤", + "B": "天麻钩藤饮", + "C": "银翘散", + "D": "龙胆泻肝汤", + "E": "镇肝息风汤" + }, + "answer": "B", + "reason": "患者头晕,耳鸣15天，诊为眩晕。头目胀痛,两侧为重,心烦易怒,夜寐不宁，口苦面红,伴有肢体麻木,舌红苔黄,脉弦，为肝阳上亢的表现。故诊为眩晕肝阳上亢证。治法:平肝潜阳,清火息风。代表方剂:天麻钩藤饮。" + }, + { + "question_num": 178, + "query": "患儿，6岁。因左腮部肿痛3天，抽搐1次就诊。现症见发热，耳下腮部漫肿，神昏，嗜睡，项强，呕吐，舌红，苔黄，脉弦数。治疗应首选的方剂是", + "options": { + "A": "仙方活命饮", + "B": "普济消毒饮", + "C": "黄连解毒汤", + "D": "羚角钩藤汤", + "E": "清瘟败毒饮" + }, + "answer": "E", + "reason": "痄腮以发热、耳下腮部肿胀疼痛为主要特征。根据题干描述可知，本病证型为炸腮之变证邪陷心肝证。治法:清热解毒,熄风开窍。代表方剂:清瘟败毒饮。" + }, + { + "question_num": 179, + "query": "患者，女，17岁。昨晚进食火锅后出现呕吐酸腐，脘腹胀满，嗳气厌食，大便溏，舌苔厚腻，脉滑实。治疗应首选的方剂是", + "options": { + "A": "藿香正气散", + "B": "理中丸", + "C": "竹茹汤", + "D": "保和丸", + "E": "平胃散" + }, + "answer": "D", + "reason": "昨晚进食火锅后出现呕吐酸腐,脘腹胀满,嗳气厌食,大便溏,舌苔厚腻,脉滑实,为饮食内停的表现。故诊为呕吐饮食内停证。治法:消食和胃，行气消痞。代表方剂;保和丸加减。" + }, + { + "question_num": 180, + "query": "患者，心痛彻背，气短心悸，感寒痛甚，四肢不温，冷汗出，舌苔薄白，脉紧，其证候是", + "options": { + "A": "寒凝心脉", + "B": "心肾阳虚", + "C": "气阴两虚", + "D": "痰浊痹阻", + "E": "心肾阴虚" + }, + "answer": "A", + "reason": "根据题干描述,可以明确诊断为胸痹，证型为寒凝心脉证。" + }, + { + "question_num": 181, + "query": "患者，女，5岁。大便干结7天。腹胀腹痛，面红身热，口干口臭，心烦不安，小便短赤，舌红苔黄燥，脉滑数，其治法是", + "options": { + "A": "清热通腑，健脾和胃", + "B": "清肠化湿，调气和血", + "C": "清热解毒，通腑止痛", + "D": "泻热通腑，化瘀导滞", + "E": "泻热导滞，润肠通便" + }, + "answer": "E", + "reason": "患者大使干结7天，诊为便秘。腹胀腹痛,面红身热,口干口臭,心烦不安,小便短赤,舌红苔黄燥,脉滑数,为热秘的典型表现。治法:泻热导滞,润肠通便。代表方剂：麻子仁丸。" + }, + { + "question_num": 182, + "query": "李某，男，49岁。头晕头痛，手足麻木，突然发生口舌歪斜，口角流涎，舌强语謇，半身不遂，舌质紫暗有瘀斑，苔薄白，脉弦涩，其诊断是", + "options": { + "A": "中经络，风阳上扰证", + "B": "中经络，风痰瘀阻证", + "C": "中经络，阴虚风动证", + "D": "中脏腑，阳闭证", + "E": "恢复期，气虚络瘀证" + }, + "answer": "B", + "reason": "根据题干描述,可以明确诊断为中风，患者无神志异常，故可明确为中经络、舌质紫暗有瘀斑、苔薄白，脉弦涩、证为风痰瘀阻证。故本题选B项。" + }, + { + "question_num": 183, + "query": "患者，女，56岁。反复发热半年，为低热。发热而欲近衣，形寒怯冷，四肢不温，少气懒言，头晕嗜卧，腰膝酸软，纳少便溏，舌质淡胖，苔白润，脉沉细无力，其治法是", + "options": { + "A": "温补阳气，引火归原", + "B": "补中益气，甘温除热", + "C": "滋补肾阴，清火泄热", + "D": "滋补肝肾，清退虚热", + "E": "补气养阴，清退虚热" + }, + "answer": "A", + "reason": "患者反复低热半年,诊为内伤发热。发热而欲近衣,形寒怯冷,四肢不温，少气懒言,头晕嗜卧,腰膝酸软,纳少便溏。舌质淡胖,苔白润,脉沉细无力,为阳虚发热的典型表现。治法:温补阳气,引火归原。代表方剂:金匮肾气丸加减。" + }, + { + "question_num": 184, + "query": "患儿，2岁。形体极度消瘦，面呈老人貌，皮包骨头，腹凹如舟，精神萎靡，大便溏薄，舌淡苔薄腻，其证候是", + "options": { + "A": "疳肿胀", + "B": "疳气", + "C": "疳积", + "D": "干疳", + "E": "心疳" + }, + "answer": "D", + "reason": "患儿形休极度消瘦,面呈老人貌，皮包骨头，腹凹如舟，精神萎靡，大便溏薄，舌淡苔薄腻，属干疳。" + }, + { + "question_num": 185, + "query": "患者，男，39岁。反复鼻衄3个月。伴头痛，目眩，烦躁易怒，两目红赤，口苦，舌红，脉弦数，其治法是", + "options": { + "A": "疏肝理气，活血化瘀", + "B": "疏肝理气，凉血止血", + "C": "清肝泻火，凉血止血", + "D": "清泻肝胆，活血化瘀", + "E": "清热解毒，宁络止血" + }, + "answer": "C", + "reason": "患者反复鼻衄3个月,诊为鼻衄。头痛,目眩,烦躁易怒,两目红赤，口苦，舌红,脉弦数,为肝火上炎的典型表现。治法，清肝泻火,凉血止血。代表方剂;龙胆泻肝汤加减。" + }, + { + "question_num": 186, + "query": "患者，女性，32岁，已婚。孕后腰酸腹痛，胎动下坠，伴阴道少量出血，头晕耳鸣，小便频数，舌淡苔白，脉沉细滑。治疗应首选", + "options": { + "A": "加味圣愈汤", + "B": "胎元饮", + "C": "举元煎", + "D": "补肾安胎饮", + "E": "寿胎丸" + }, + "answer": "E", + "reason": "妊娠期由现腰酸腹病,胎动下坠，或阴道少最出血者，称为胎动不安，又称胎气不安。根据题干描述可明确证型为肾虚证，治宜补贤健脾、益肾安胎。代表方剂:寿胎九。" + }, + { + "question_num": 187, + "query": "患者，男，78岁。表情呆钝，智力衰退，哭笑无常，喃喃自语，不思饮食，脘腹胀痛，痞满不适，口多涎沬，头重如包裹，舌质淡，苔白腻，脉滑，其病证诊断是", + "options": { + "A": "癫证心脾两虚证", + "B": "癫证痰气郁结证", + "C": "痴呆痰浊蒙窍证", + "D": "痴呆脾肾两虚证", + "E": "痫病风痰闭阻证" + }, + "answer": "C", + "reason": "患者表情呆钝,智力衰退，诊为痴呆。哭笑无常,喃喃自语。不思饮食，脘腹胀痛,痞满不适，口多涎沫,头重如包裹，舌质淡，苔白腻,脉滑,为痰浊上蒙,清窍被阻的典型表现,故诊为痴呆痰浊蒙窍证。治法:豁痰开窍，健脾化浊。代表方剂:涤痰汤加减。" + }, + { + "question_num": 188, + "query": "患儿，6岁。发热2天，出现淡红色小丘疹，根盘红晕，丘疹上部可见疱疹，形态椭圆，疱浆清亮，皮疹以躯干为多，苔薄白，脉浮数，其治法是", + "options": { + "A": "疏风清热，利湿解毒", + "B": "清气凉营，解毒化湿", + "C": "发散风寒，清热利湿", + "D": "芳香化湿，兼以健脾", + "E": "清解郁热，活血化瘀" + }, + "answer": "A", + "reason": "发热，丘疹、疱疹并见，皮疹以躯干为多，所以诊断为水痘。“苔薄白，脉浮数”，表明是水痘的风热轻症，邪伤肺卫证，治当疏风清热，利湿解毒。故本题选A项。" + }, + { + "question_num": 189, + "query": "患者，女，35岁。胁痛反复发作5年，加重3天。现症见：胁肋胀痛，走窜不定，胸闷腹胀，苦苔薄白，脉弦，其证型是", + "options": { + "A": "肝郁脾虚证", + "B": "肝胃不和证", + "C": "肝郁气滞证", + "D": "肝胆湿热证", + "E": "肝络失养证" + }, + "answer": "C", + "reason": "胁肋胀病,走窜不定,胸闷腹胀,脉弦,为肝郁气滞的典型表现。患者无脾胃方面的症状,可排除A.B项,无湿热的表现,可排除D项,无阴虚的表现,可排除E项。" + }, + { + "question_num": 190, + "query": "患者，女性，26岁，已婚。妊娠3个月，尿少色黄，尿时艰涩而痛，心烦，口舌生疮，舌红少苔，脉数。治疗应首选", + "options": { + "A": "导赤散", + "B": "加味五淋散", + "C": "知柏地黄汤", + "D": "清热通淋汤", + "E": "龙胆泻肝汤" + }, + "answer": "A", + "reason": "妊娠小便淋痛以小便频数淋沥涩痛，量少色黄，面赤心烦，甚者口舌生疮，舌红，苔薄黄，脉细滑数为主要表现，其为心火偏亢，热移小肠所致，治宜清心泻火解毒:方剂用导赤散。" + }, + { + "question_num": 191, + "query": "患者，男，58岁。口渴多饮，尿频量多，口苦舌燥6个月，伴烦热多汗，舌边尖红，苔薄黄，脉洪数，其证型是", + "options": { + "A": "上消肺阴亏虚证", + "B": "下消气阴两虚证", + "C": "上消肺气不足证", + "D": "中消肺胃郁热证", + "E": "上消肺热津伤证" + }, + "answer": "E", + "reason": "该患者以口渴多饮为主要表现,诊为上消。口苦舌燥,烦热多汗,脉洪数,为肺热津伤的典型表现，故诊为上消肺热津伤证。" + }, + { + "question_num": 192, + "query": "患者，心烦不寐，心悸不安，头晕，耳鸣健忘，腰酸梦遗，五心烦热，口干津少，舌红，脉细数，其治法是", + "options": { + "A": "清心宁神，养阴除烦", + "B": "养阴生津，除烦宁神", + "C": "清火除烦，宁心安神", + "D": "滋阴降火，养心安神", + "E": "滋阴宁心，镇惊安神" + }, + "answer": "D", + "reason": "根据题干所述,可以明确诊断为不寐，证型为心肾不交证。肾水亏虚，不能上济于心，心火炽盛，不能下交于肾,故可出现上述症状，治疗宜选用滋阴降火，养心安神之法。" + }, + { + "question_num": 193, + "query": "患者、男、34岁。全身泛发疖肿10天。成脓收口时间长、脓水稀薄。伴面色萎黄，纳少便溏，舌质淡，边有齿痕，脉濡。治疗应首选的方剂是", + "options": { + "A": "补中益气汤合五味消毒饮", + "B": "黄芪建中汤合萆薢渗湿汤", + "C": "仙方活命饮合五味消毒饮", + "D": "五味消毒饮合四物汤", + "E": "参苓白术散合五神汤" + }, + "answer": "E", + "reason": "患者全身泛发疖肿10天，故诊为疖。面色萎黄,纳少便溏。舌质淡,边有齿痕，,脉濡,为脾虚的表现,故诊为疖体虚毒恋,脾胃虚弱证。治法：健脾和胃，清化湿热。代表方剂:参苓白术散合五神汤，" + }, + { + "question_num": 194, + "query": "患者，女性，27岁。已婚。近几个月来带下量多、黏稠、色黄，胸闷心烦，纳少便溏，舌淡红，苔黄略腻，脉细滑，其治法是", + "options": { + "A": "清热利湿止带", + "B": "健脾利湿止带", + "C": "健脾益气止带", + "D": "清热解毒止带", + "E": "补肾健脾止带" + }, + "answer": "A", + "reason": "患者带下量多、黏稠、色黄是有湿热之象，胸闷心烦，纳少便溏，舌淡红苔黄略腻，脉细滑是湿热内阻，治当清热利湿止带。" + }, + { + "question_num": 195, + "query": "患者臀部湿烂溃脓，伴恶寒发热，头痛骨楚，食欲不振，舌红苔黄，脉数，其治法是", + "options": { + "A": "清热利湿，活血化瘀", + "B": "清热解毒，和营化湿", + "C": "清热解毒，散风通络", + "D": "清肝泻火，活血化瘀", + "E": "凉血清热，解毒通络" + }, + "answer": "B", + "reason": "患者臀部湿烂溃脓,伴恶寒发热,头痛骨楚,食欲不振,舌红苔黄,脉数,为臀痈湿火蕴结证。治法:清热解毒,和营化湿。代表方剂;黄连解毒汤合仙方活命饮加减。" + }, + { + "question_num": 196, + "query": "某男，65岁。糖尿病10余年，半年来项部近发际处，经常出现红肿块，灼热疼痛，出脓后即愈合，触之突起根浅，服用消炎药，无明显效果，常��渴唇燥，舌红苔薄，脉细数。中医诊断", + "options": { + "A": "有头疖", + "B": "无头疖", + "C": "蝼蛄疖", + "D": "疖病", + "E": "粉刺" + }, + "answer": "D", + "reason": "疖病好发于项后发际、背部、臀部;几个到几十个,反复发作,缠绵不愈；也可在身体各处散发疖肿，一处将愈，他处续发，或间隔周余、月余再发;患消渴病、习惯性便秘或营养不良者易患本病;突起根浅，易脓、易溃、易敛。" + }, + { + "question_num": 197, + "query": "患者，男，25岁。头发干枯脱落，头皮瘙痒，头屑多，头面部皮肤干燥脱屑，并见淡红色斑片，伴口干便秘，舌红，苔薄白，脉细数，其证型是", + "options": { + "A": "肠胃湿热证", + "B": "热毒蕴结证", + "C": "气血两虚证", + "D": "气滞血瘀证", + "E": "风热血燥证" + }, + "answer": "E", + "reason": "患者头发干枯脱落,头皮瘙痒,头屑多,头面部皮肤千燥脱屑,并见淡红色斑片,为脂溢性皮炎的典型表现。伴口千便秘,舌红，苔薄白,脉细数,为风热血燥证。治法:祛风清热,养血润燥。代表方剂:消风散合当归饮子加减。" + }, + { + "question_num": 198, + "query": "患者，男，34岁。身目黄色鲜明如橘皮，发热口渴，心中懊侬，恶心欲吐，小便短少，色黄赤，大便秘结，舌苔黄腻，脉弦数。治疗应首选的方剂是", + "options": { + "A": "茵陈五苓散", + "B": "麻黄连翘赤小豆汤", + "C": "茵陈蒿汤", + "D": "茵陈术附汤", + "E": "大柴胡汤" + }, + "answer": "C", + "reason": "黄疸的辨证论治。患者由于湿热熏蒸，爽滞肝胆，胆汁泛滥导致黄疸阳黄由现、经辨证分析为热重于湿，治宜清热通腑，利湿退黄。代表方剂:茵陈蒿汤加减。" + }, + { + "question_num": 199, + "query": "患者急性子痈2天，恶寒发热。睾丸肿大疼痛，疼痛引及子系，舌红，苔黄腻，脉滑数。外治应首选", + "options": { + "A": "红油膏外敷", + "B": "苦参汤熏洗", + "C": "冲和膏外敷", + "D": "葱归溻肿汤坐浴", + "E": "金黄散水调冷敷" + }, + "answer": "E", + "reason": "急性子痈:未成脓者,可用金黄散或玉露散水调匀，冷敷。病灶有波动感，穿刺有脓者,应及时切开引流。脓稠、腐肉较多时，可选用九一丹或八二丹药线引流,脓液已净，外用生肌白玉膏。" + }, + { + "question_num": 200, + "query": "王某，女，55岁。进行性吞咽困难伴消瘦1年，现症：食人格拒不，入而复出，心烦口干，胃脘灼热，大便干结如羊屎，形体消瘦，皮肤干枯，小便短赤，舌质光红，干裂少津，脉细数，其治法是", + "options": { + "A": "滋养津液，泻热散结", + "B": "滋阴养血，破血行瘀", + "C": "开郁化痰，润燥降气", + "D": "温补脾肾", + "E": "清热凉血" + }, + "answer": "A", + "reason": "噎膈津亏热结证证候:吞咽粳涩而痛，食入而复出，甚则水饮难进、心烦口干，胃脘灼热、大便干结如羊屎，形体消瘦，皮肤干枯、小便短赤，舌质光红，干裂少津，脉细数。治法:滋养津液，泻热散结。代表方剂:沙参麦冬汤加减。" + }, + { + "question_num": 201, + "query": "脱疽患者，患趾坠胀疼痛，夜难人眠，步履艰难，患趾皮色暗红，下垂更甚，皮肤发凉干燥，肌肉萎缩，趺阳脉搏动消失，舌暗红，苔薄白，脉弦涩，其证型是", + "options": { + "A": "寒湿阻络证", + "B": "血脉瘀阻证", + "C": "湿热毒盛证", + "D": "热毒伤阴证", + "E": "气阴两虚证" + }, + "answer": "B", + "reason": "脱疽血脉瘀阻证证候:患趾(指)酸胀疼痛加重,夜难入寐,步履艰难,患趾(指)皮色暗红或紫暗,下垂更甚,皮肤发凉干燥,肌肉萎缩，跌阳脉搏动消失;舌暗红或有瘀斑,苔薄白,脉弦涩。该患者临床表现符合脱疽血脉瘀阻证。" + }, + { + "question_num": 202, + "query": "患者，男，30岁。便后肛门部疼痛、出血反复发作10年。检查：肛门外观截石位6点有结缔组织外痔，并有梭形裂口通向肛内，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": "本病属于陈旧性肛裂伴有肛管狭窄者，应选择纵切横缝。扩肛法适应证为早期肛裂，陈旧性肛裂且无结缔组织外痔，肛乳头肥大者，切除疗法适应证为陈旧性肛裂伴有结缔组织外痔或肛乳头肥大者" + }, + { + "question_num": 203, + "query": "患者，女，38岁，已婚。近半年月经时而提前10天，时而延后2周，经量时多时少，色黯红，经行不畅，经行乳房胀痛，脘闷不舒，时叹息，苔薄白，脉弦，其证型是", + "options": { + "A": "肝郁证", + "B": "肝郁肾虚证", + "C": "血瘀证", + "D": "肝郁脾虚证", + "E": "气滞血瘀证" + }, + "answer": "A", + "reason": "患者近半年月经时而提前10天,时而延后2周,经量时多时少,诊为月经先后无定期。经行不畅,经行乳房胀病,脘闷不舒,时叹息,脉弦,为肝气郁结的典型表现，故该患者为月经先后无定期肝郁证。" + }, + { + "question_num": 204, + "query": "王某，男，75岁。反复咳喘22年多。胸部膨满，喘息气粗，烦躁，目胀睛突，痰黄，黏稠难咯。身热微恶寒，有汗不多，口渴欲饮，溲赤，便干，舌边尖红，苔黄腻，脉滑数，其治疗应首选的方剂是", + "options": { + "A": "苏子降气汤", + "B": "越婢加半夏汤", + "C": "三子养亲汤", + "D": "二陈平胃散", + "E": "清金化痰汤" + }, + "answer": "B", + "reason": "患者胸部膨满,喘息气粗辨病为肺胀,烦躁,痰黄,黏稠难略。身热微恶寒,有汗不多，口渴欲饮，溲赤，便干，舌边尖红，苔黄腻,脉滑数，辨证为痰热郁肺证。治法:清肺化痰，降逆平喘。代表方剂:越婢加半夏汤或桑白皮汤加减。" + }, + { + "question_num": 205, + "query": "患者，哮喘多年，喘促气短，动则喘甚，汗出肢冷，舌淡，脉沉细。治疗除手太阴经穴外，还应选取的是", + "options": { + "A": "足太阴、任脉穴", + "B": "足太阴、足少阴经穴", + "C": "足厥阴、督脉穴", + "D": "足少阴、背俞穴", + "E": "足少阴、督脉穴" + }, + "answer": "D", + "reason": "患者哮喘多年,气息短促,动则喘甚，舌淡，脉沉细者为虚证(肾气虚)。治宜补益肺肾，止哮平喘，治取相应背俞穴及手太阴、足少阴经穴为主。" + }, + { + "question_num": 206, + "query": "患者，男，36岁。饮酒后出现便血，呈喷射状，色鲜红，无疼痛，便时肛门内无物脱出，该患者最可能的诊断是", + "options": { + "A": "直肠息肉", + "B": "肛裂", + "C": "内痔", + "D": "肛管直肠癌", + "E": "肛瘘" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 207, + "query": "患者，女，21岁。带下量多，质稀，腰膝酸软，小便频数，大便溏，舌淡，苔白，脉沉迟。最佳的方剂是", + "options": { + "A": "完带汤", + "B": "易黄汤", + "C": "内补丸", + "D": "止带方", + "E": "龙胆泻肝汤" + }, + "answer": "C", + "reason": "患者带下量多,质稀,腰膝酸软，小便频数，大便溏，舌淡，苔白，脉沉迟，诊断为带下过多肾阳虚证，治宜温肾培元，固涩止带。代表方剂;内补丸。" + }, + { + "question_num": 208, + "query": "患者，女，32岁。平素嗜食生冷。近期心下坚满，自利，利后反快，虽利，心下续坚满，肠间沥沥有声，腹满，便秘，口舌干燥，舌苔黄腻，脉沉弦。本病的证候诊断是", + "options": { + "A": "痰饮脾阳虚弱证", + "B": "痰饮饮留胃肠证", + "C": "悬饮邪犯胸肺证", + "D": "悬饮饮停胸胁证", + "E": "支饮脾肾阳虚证" + }, + "answer": "B", + "reason": "根据题干所述，可以明确珍断为痰饮，心下坚满或痛，自利，利后反快，虽利，心下续坚满，或水走肠间，沥沥有声，腹满，便秘，口舌干燥，舌苔腻，色白或黄，脉沉弦或伏。治法:攻下逐饮。代表方剂:甘遂半夏汤或已椒苈黄丸加减。" + }, + { + "question_num": 209, + "query": "患者，女，32岁。身起皮疹为大小不等风团，色鲜红，灼热剧痒，遇热加重，得冷则减；伴有发热，恶寒，咽喉肿痛；舌质红，苔薄白或薄黄，脉浮数。治疗可选用", + "options": { + "A": "桑菊饮", + "B": "银翘散", + "C": "龙胆泻肝汤", + "D": "防风通圣散", + "E": "消风散" + }, + "answer": "E", + "reason": "瘾疹,风热犯表证,证候:凤团鲜红，灼热剧痒，遇热加重,得冷则减;伴有发热，恶寒，咽喉肿痛;舌质红，苔薄白或薄黄,脉浮数。治法:疏风清热止痒。代表方剂:消风散加减。" + }, + { + "question_num": 210, + "query": "患者，女性，48岁。颈前肿物，生长迅速，质地较硬，轻度疼痛，表面不平，推之不动，声音嘶哑，随吞咽活动减弱，放射性核素131I扫描显示为冷结节。应首选的治疗措施是", + "options": { + "A": "中药外敷", + "B": "中药内服", + "C": "中药内服、外敷", + "D": "内服、外敷、熏洗", + "E": "手术治疗" + }, + "answer": "E", + "reason": "石瘿是甲状腺的恶性肿瘤，因肿块坚硬如石，故称之，其多因情志不畅,肝气郁滞,气痰、血郁结于颈前结喉侧而成，也可由气瘿、肉瘿恶变而来。石瘿是恶性肿瘤，一旦确诊，宜早期行手术治疗，" + }, + { + "question_num": 211, + "query": "患者，男，38岁。胸闷反复发作3年。近日来，胸闷重而心痛微，痰多气短，肢体沉重，倦怠乏力，纳呆便溏。舌体胖大且边有齿痕，苔白滑，脉滑。治疗应首选", + "options": { + "A": "半夏厚朴汤合黄连温胆汤", + "B": "参苓白术散合二陈汤", + "C": "枳实薤白桂枝汤合当归四逆汤", + "D": "栝蒌薤白半夏汤合涤痰汤", + "E": "生脉散合人参养荣汤" + }, + "answer": "D", + "reason": "胸痹痰浊闭阻证证候:胸闷重而心痛微，痰多气短，肢体沉重，形体肥胖，遇阴雨天而易发作或加重，伴有心悸眩晕，纳呆便溏，咯吐痰延，舌体胖大且边有齿痕，苔浊腻或白滑，脉滑。治法:通阳泄浊，豁痰宣痹。代表方剂:栝蒌薤白半夏汤合涤痰汤加减。" + }, + { + "question_num": 212, + "query": "患儿，男，8岁。症见多动多语，冲动任性，难于制约，注意力不集中，胸中烦热，懊侬不眠，便秘尿赤，舌质红，苔黄腻，脉滑数。治疗应首选的方剂是", + "options": { + "A": "龙胆泻肝汤", + "B": "泻心导赤散", + "C": "泻心汤", + "D": "清心涤痰汤", + "E": "黄连温胆汤" + }, + "answer": "E", + "reason": "辨病为注意力缺陷多动症，证型为痰火内扰证，临床见多动多语，烦躁不宁，冲动任性，难以制约，兴趣多变,注意力不集中,胸中烦热,懊侬不眠,纳少口苦,便秘尿赤，舌质红，苔黄腻，脉滑数。治法:清热泻火，化痰宁心。代表方剂:黄连温胆汤。" + }, + { + "question_num": 213, + "query": "患者钱某，年过16周岁尚未行经，体质虚弱，全身发育欠佳，第二性征发育不良，腰腿酸软，头晕耳鸣，倦怠乏力，夜尿频多；舌淡黯，苔薄白，脉沉细。辩证为", + "options": { + "A": "闭经气滞血瘀证", + "B": "闭经肾气亏损证", + "C": "闭经肝肾不足证", + "D": "痛经痰瘀阻滞证", + "E": "月经后期气虚血瘀证" + }, + "answer": "B", + "reason": "闭经肾气亏损证，主要证候:年逾16岁尚未行经，或月经初潮偏迟，时有月经停闭，或月经周期建立后，由月经周期延后、经量减少渐至月经停闭;或体质虚弱，全身发育欠佳，第二性征发育不良，或腰腿酸软,头晕耳鸣，倦怠乏力,夜尿频多;舌淡黯,苔薄白,脉沉细。" + }, + { + "question_num": 214, + "query": "患者胁部皮肤灼热疼痛，2天后患部皮肤出现簇集粟粒大小丘状疱疹，呈带状排列，疱壁紧张，口苦，心烦，脉弦数。治疗本病除局部阿是穴、夹脊穴外，宜选取", + "options": { + "A": "神门、大陵", + "B": "合谷、列缺", + "C": "血海、三阴交", + "D": "阴陵泉、内庭", + "E": "行间、侠溪" + }, + "answer": "E", + "reason": "由簇集粟粒大小丘状疱疹，呈带状排列，可辨病为蛇串疮，患者口苦，心烦，脉弦效偶肝胆火盛，除主穴外，应配合:行间、侠溪进行治疗，故本题选E项。" + }, + { + "question_num": 215, + "query": "患者，男，62岁。咳喘病史20年，近1月来咳喘促，时有神志恍惚，谵妄，烦躁不安，或有嗜睡，下肢水肿，舌淡胖，苔白腻，脉沉细。诊断为肺胀，其证候是", + "options": { + "A": "肺肾气虚", + "B": "阳虚水泛", + "C": "痰浊壅肺", + "D": "痰热郁肺", + "E": "痰蒙神窍" + }, + "answer": "E", + "reason": "患者有神志恍惚,谵妄,烦躁不安,或有嗜睡的表现，为神志异常，属于痰蒙神窍。故本题选E项。" + }, + { + "question_num": 216, + "query": "患儿，女，4岁。患心肌炎5个月，面黄少华，形瘦倦怠，气短乏力，动则汗出，烦热口渴，夜寐不安，纳差便溏，舌光红少苔。治疗应首选的方剂是", + "options": { + "A": "失笑散", + "B": "栝蒌薤白半夏汤", + "C": "葛根黄芩黄连汤", + "D": "炙甘草汤合生脉散", + "E": "桂枝甘草龙骨牡蛎汤" + }, + "answer": "D", + "reason": "患者为病毒性心肌炎,形瘦倦怠,气短乏力，动则汗出,烦热口渴,夜寐不安，纳差便溏，舌光红少苔可诊断为气阴亏虚证。治法:益气养阴，宁心复脉。代表方剂。炙甘草沥合生脉散。" + }, + { + "question_num": 217, + "query": "患者，男，65岁。耳中如蝉鸣，时作时止，拨之鸣声减弱，听力亦下降，同时伴神疲乏力，食少腹胀，便溏，脉细弱。治疗宜在听宫、翳风、太溪、肾俞基础上，加用", + "options": { + "A": "行间、丘墟", + "B": "外关、合谷", + "C": "丰隆、阴陵泉", + "D": "气海、足三里", + "E": "肾俞、肝俞" + }, + "answer": "D", + "reason": "耳聋虚证主穴:听宫、翳风、太溪、肾俞；配：、脾胃虚弱配气海、足三里。" + }, + { + "question_num": 218, + "query": "患者，女，35岁，已婚。产后半个月余，全身关节疼痛，肢体酸楚麻木，头晕心悸，舌淡红，少苔，脉细无力。治疗应首选", + "options": { + "A": "黄芪桂枝五物汤", + "B": "养荣壮肾汤", + "C": "独活寄生汤", + "D": "八珍汤", + "E": "黄芪汤" + }, + "answer": "A", + "reason": "产后身病血虚证,方选黄芪桂枝五物汤。故本题选A项。" + } +] \ No newline at end of file