diff --git "a/Assistant/Theory_Questions/Year_3/Mock.json" "b/Assistant/Theory_Questions/Year_3/Mock.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_3/Mock.json" @@ -0,0 +1,2862 @@ +[ + { + "question_num": 1, + "query": "肺痨的四大主症是", + "options": { + "A": "咳嗽、胸痛、发热、汗出", + "B": "咳嗽、咯血、潮热、盗汗", + "C": "咳嗽、消瘦、低热、自汗", + "D": "咳嗽、神疲、心悸、盗汗", + "E": "干咳、气促、潮热、胸痛" + }, + "answer": "B", + "reason": "肺痨的四大主要症状走获血、潮热、盗汗" + }, + { + "question_num": 2, + "query": "治疗咳嗽痰多、气喘、脘腹胀满、纳呆食少者，宜选用的药物是", + "options": { + "A": "藿香", + "B": "佩兰", + "C": "厚朴", + "D": "苍术", + "E": "砂仁" + }, + "answer": "C", + "reason": "咳嗽的辨证。" + }, + { + "question_num": 3, + "query": "痞满肝胃不和证的治法是", + "options": { + "A": "消食和胃,行气消痞", + "B": "疏肝解郁,和胃消痞", + "C": "除湿化痰,理气和中", + "D": "清热化湿,和胃消痞", + "E": "补气健脾,升清降浊" + }, + "answer": "B", + "reason": "痞满肝胃不和证治法为豌肝解郁，和胃消痞，方药为柴胡疏肝散加减。" + }, + { + "question_num": 4, + "query": "哮病发作的病因病机关键是", + "options": { + "A": "宿痰凝结，内伏于肺", + "B": "外邪侵袭，触动伏痰", + "C": "痰气相搏，气道被阻", + "D": "邪客于肺，气道不利", + "E": "脏腑虚弱，气失所主" + }, + "answer": "B", + "reason": "哮病的基本病机是“伏痰”（宿痰）内伏于肺，每因外感、饮食、情志、劳倦等诱因而引触，致痰随气升，气因痰阻，痰气搏结，壅塞气道，肺管狭窄，气道挛急，通畅不利，肺气宣降失常，引动停积之痰，而致痰鸣气喘。" + }, + { + "question_num": 5, + "query": "感冒风寒束表证的方药是", + "options": { + "A": "荆防达表汤", + "B": "葱豉桔梗汤", + "C": "新加香薷饮", + "D": "参苏饮", + "E": "加减葳蕤汤" + }, + "answer": "A", + "reason": "感冒风寒束表证证候:恶寒重，发热轻，无汗，头痛，肢节酸疼,鼻塞声重,或鼻痒喷嚏,时流清涕、咽痒,咳嗽,咳痰稀薄色白，口不渴或渴喜热饮，舌苔薄白而润，脉浮或浮紧。治法:辛温解表。方药:荆防达表汤或荆防败毒散加减。" + }, + { + "question_num": 6, + "query": "治疗肾虚腰痛而无明显阴阳偏盛者，可选用的方剂是", + "options": { + "A": "杜仲丸", + "B": "青娥丸", + "C": "补髓丹", + "D": "虎潜丸", + "E": "补血荣筋丸" + }, + "answer": "B", + "reason": "肾虚腰痛，阴虚用左归丸，阳虚用右归丸，无明显偏盛者用青娥丸。" + }, + { + "question_num": 7, + "query": "症见心悸不宁,心烦少寐,头晕目眩,手足心热,盗汗,耳鸣,舌质红,少苔,脉细数,其治法为", + "options": { + "A": "镇惊定志,养心安神", + "B": "补血养心,益气安神", + "C": "滋阴清火,养心安神", + "D": "益气养阴,养心安神", + "E": "清热化痰,宁心安神" + }, + "answer": "C", + "reason": "心悸阴虚火旺证证候:心悸易惊，心烦失眠，五心烦热，口干,盗汗，思虑劳心则症状加重，头晕目眩，急躁易怒，舌红少津,脉细数。治法:滋阴清火，养心安神。方药:天王补心丹合朱砂安神丸加减。" + }, + { + "question_num": 8, + "query": "从腹痛的部位辨证，胁痛、少腹疼痛者多属", + "options": { + "A": "膀胱病", + "B": "虫证", + "C": "肠痈", + "D": "胃痛", + "E": "肝胆病" + }, + "answer": "E", + "reason": "胁腹、少腹痛多属肝经病变；脐以上大腹痛多为脾胃病证；脐以下小腹痛多属膀胱及大小肠病证。" + }, + { + "question_num": 9, + "query": "治疗胸痹,纠正脏腑偏衰时,尤其重视", + "options": { + "A": "补气温阳", + "B": "滋阴益肾", + "C": "活血通络", + "D": "养心和络", + "E": "补益心气" + }, + "answer": "E", + "reason": "胸痹治疗应先祛邪治标,后扶正治本。必要时根据虚实标本的主次，兼顾同治。标实当泻，尤重活血通脉治法;本虚宜补，尤其重视补益心气之不足。" + }, + { + "question_num": 10, + "query": "治疗胸痹心血瘀阻证，应首选", + "options": { + "A": "瓜蒌薤白白酒汤", + "B": "瓜蒌薤白半夏汤", + "C": "血府逐瘀汤", + "D": "八珍汤", + "E": "天王补心丹" + }, + "answer": "C", + "reason": "血府逐瘀汤祛瘀通脉，行气止痛，用于胸中瘀阻，血行不畅，心胸疼痛，痛有定处，胸闷心悸之胸痹。A项用于胸痹而痰浊较轻者；B项用于胸痹而痰浊较盛者；D项治疗胸痹之气血两虚证；E项治疗心阴亏虚证。" + }, + { + "question_num": 11, + "query": "《难经经释》说“所胜,我克也。脏气受制于我,则邪气不能深入,故为微邪。”这句话是指", + "options": { + "A": "母病及子", + "B": "子病犯母", + "C": "相乘传变", + "D": "相侮传变", + "E": "表里传变" + }, + "answer": "D", + "reason": "“所胜,我克也。脏气受制于我，则邪气不能深入，故为微邪”是指相侮。" + }, + { + "question_num": 12, + "query": "寒湿痢的表现是", + "options": { + "A": "痢下赤白脓血，不甚臭秽", + "B": "痢下鲜紫脓血", + "C": "痢下赤多白少", + "D": "痢下纯为白冻", + "E": "痢下脓血黏稠" + }, + "answer": "D", + "reason": "寒湿痢大便白多赤少，或纯为白冻。" + }, + { + "question_num": 13, + "query": "失眠患者心烦、心悸、梦遗失精者,加用", + "options": { + "A": "温补肾阳", + "B": "健脾和胃", + "C": "温经散寒", + "D": "温通心阳", + "E": "引火归原" + }, + "answer": "E", + "reason": "肉桂具有引火归原之功效,失眠患者心烦、心悸、梦遗失精者，加用肉桂主要是为了引火归原。" + }, + { + "question_num": 14, + "query": "治疗黄疸之阴黄证，应首选", + "options": { + "A": "麻黄连翘赤小豆汤", + "B": "栀子柏皮汤", + "C": "茵陈五苓散", + "D": "茵陈术附汤", + "E": "茵陈蒿汤" + }, + "answer": "D", + "reason": "阴黄为中阳不振，寒湿滞留，肝胆失于疏泄，治当温中化湿，健脾和胃，方用茵陈术附汤加减。黄疸几个证型方剂的使用：阳黄热重于湿，方用茵陈蒿汤；湿重于热，方用茵陈五苓散；阴黄寒湿阻遏，方用茵陈术附汤。" + }, + { + "question_num": 15, + "query": "“真气”是指", + "options": { + "A": "正气", + "B": "元气", + "C": "营气", + "D": "宗气", + "E": "卫气" + }, + "answer": "B", + "reason": "元气,是人体最根本、最重要的气，是人体生命活动的原动力。元气，《难经》又称“原气”《黄帝内经》虽无“元气”或“原气”之称,但有“真气”之说。元气、原气、真气,三者的内涵是同一的，都是指先天之气。" + }, + { + "question_num": 16, + "query": "在血液运行中起关键作用的是", + "options": { + "A": "心血充盈", + "B": "脉道通利", + "C": "心气充沛", + "D": "心神安宁", + "E": "心阳亢盛" + }, + "answer": "C", + "reason": "心气充沛，心脏有规律的搏动，脉管有规律的收缩，血液则被输送到各脏腑形体官窍，发挥营养作用，以维持人体的正常生命活动。血液的正常运行决定于气的推动作用和气的固摄，故心气充沛，在血液运行中起关键作用。" + }, + { + "question_num": 17, + "query": "阳水辨证属风水相搏者,应首选", + "options": { + "A": "麻黄汤", + "B": "五苓散", + "C": "五皮饮", + "D": "越婢加术汤", + "E": "麻黄连翘赤小豆汤" + }, + "answer": "D", + "reason": "阳水风水相搏证证候:眼睑浮肿，继则四肢全身皆肿，来势迅速，多有恶风发热，肢节酸楚，小便不利等症。偏于风热者，伴咽喉红肿疼病，舌质红，脉浮滑数。偏于风寒者，兼恶寒,咳喘,舌苔薄白,脉浮滑或浮紧,如水肿较甚，亦可见沉脉。治法:散风清热，宣肺行水。方药:越婢加术汤加减。" + }, + { + "question_num": 18, + "query": "下列各脏，其生理特性以升为主的是", + "options": { + "A": "肺与脾", + "B": "肺与肝", + "C": "肝与肾", + "D": "心与肾", + "E": "肝与脾" + }, + "answer": "E", + "reason": "肝气升发，脾主升清，肺主肃降。以升为主的脏腑是肝和脾。" + }, + { + "question_num": 19, + "query": "“夺血者无汗,夺汗者无血”的理论依据是", + "options": { + "A": "血能生气", + "B": "气能化津", + "C": "气能摄血", + "D": "津能载气", + "E": "津血同源" + }, + "answer": "E", + "reason": "血与津液的关系是津血同源。津血同源是指血和津液都来源于水谷精气，并可相互化生，两者关系密切，盛则同盛:衰则俱衰。病理上，血和津液之间也多相互影响。《灵枢·营卫生会》所说的“夺血者无汗夺汗者无血”之说，即是“津血同源”理论的实际应用" + }, + { + "question_num": 20, + "query": "“木火刑金”在五行学说中属于", + "options": { + "A": "相乘", + "B": "相侮", + "C": "相生", + "D": "子病及母", + "E": "母病及子" + }, + "answer": "B", + "reason": "五行相侮，指五行中一行对其所不胜的反向制约和克制。相侮的次序：木侮金，金侮火，火侮水，水侮土，土侮木，故“木火刑金”属于相侮。" + }, + { + "question_num": 21, + "query": "脏与脏关系中,“乙癸同源”指的是", + "options": { + "A": "肺肾关系", + "B": "肺肝关系", + "C": "肝脾关系", + "D": "肝肾关系", + "E": "心肺关系" + }, + "answer": "D", + "reason": "肝血与肾精之间关系密切。肝主藏血，肾主藏精，肝血与肾精均来源于脾胃运化水谷产生的水谷精微，而精能生血，血能化精,精血互化,故称“精血同源”,也称“肝肾同源”或“乙癸同源”" + }, + { + "question_num": 22, + "query": "下列关于哮病发作期寒包热哮证的各项叙述中，错误的是", + "options": { + "A": "喉中哮鸣有声，胸膈烦闷，呼吸急促，咳痰不爽，痰黏色黄或黄白相兼", + "B": "用小青龙加石膏汤治疗", + "C": "证机概要为痰热壅肺，复感风寒，客寒包火，肺失宣降", + "D": "治法为解表散寒，清化痰热", + "E": "发热不恶寒，烦躁汗多，身痛，口干欲饮，大便偏干" + }, + "answer": "E", + "reason": "寒包热哮证可见喉中哮鸣有声，呼吸急促，喘咳气逆，烦躁，口干欲饮，胸膈烦闷，咳痰不爽，痰黏色黄，或黄白相间，便干，伴发热、恶寒、无汗、头身痛，舌苔白腻微黄，脉弦紧。病机为痰热壅肺，复感风寒，客寒包火，肺失宣降。治法：解表散寒，清化痰热，方选小青龙加石膏汤或厚朴麻黄汤加减。答案E项不正确，作为外寒，患者不可能不恶寒。" + }, + { + "question_num": 23, + "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": "起于目内眦,向上到达额部，左右交会于头顶部，直行者:从头顶部分出，向后行至枕骨处，进入颅腔，络脑，回出后下行至项部，下行交会于大椎穴，再分左右沿肩胛内侧、脊柱两旁下行,到达腰部,进入脊柱两旁的肌肉,深入体腔,终肾，属膀胱。" + }, + { + "question_num": 24, + "query": "热病之后，胃阴耗伤所致呃逆者，其特点为", + "options": { + "A": "呃声沉缓，遇寒更甚", + "B": "呃声洪亮，冲逆而出", + "C": "呃逆连声，遇怒加重", + "D": "呃声低弱，气难接续", + "E": "呃声急促，常不连续" + }, + "answer": "E", + "reason": "胃阴不足型呃逆的临床特点为呃声急促而不连续。A项为呃逆胃中寒冷证的特点，B项为呃逆胃火上逆证的特点，C项为呃逆气机郁滞证的特点，D项为呃逆脾胃阳虚证的特点。" + }, + { + "question_num": 25, + "query": "患者热病七八日,症见烦热口渴,呕逆时作,舌燥少津,应首选", + "options": { + "A": "黄芩", + "B": "知母", + "C": "天花粉", + "D": "芦根", + "E": "石膏" + }, + "answer": "D", + "reason": "黄芩清热燥湿,泻火解毒,止血，安胎，无生津止呕之功，可排除。知母清热泻火，滋阴润燥,无除烦止呕之功，可排除天花粉清热泻火，生津止渴，消肿排脓，无除烦止呕之功，可排除。石骨生用清热泻火，除烦止渴;煅用敛疮生肌，收湿，血，无止呕功效，可排除。芦根清热泻火，生津止渴，除烦，止呕，利尿，应首选。" + }, + { + "question_num": 26, + "query": "下列关于痴呆与脏躁的鉴别点中，无意义的是", + "options": { + "A": "年龄或性别的差异", + "B": "是否沉默寡言，情感淡漠，静而多喜", + "C": "是否呈间歇性发作", + "D": "是否出现智能、人格、情感方面的变化", + "E": "不发作时是否如常人" + }, + "answer": "B", + "reason": "脏躁证，多发于中青年女性，多在精神因素的刺激下呈间歇性发作，不发时如常人，无智能、人格、情感方面的变化。痴呆见于任何年龄，多见于中老年人，男女发病无明显差别。不能自行缓解，伴计算力、理解力、判断力及人格情感的变化。精神失常证候二者大体相同，不能作为二者鉴别点。" + }, + { + "question_num": 27, + "query": "阴阳偏盛形成的是", + "options": { + "A": "实证", + "B": "里证", + "C": "表证", + "D": "寒证", + "E": "热证" + }, + "answer": "A", + "reason": "阴阳偏胜,是指人休阴阳双方中某一方的病理性亢盛快态，属“邪气盛则成”的生河" + }, + { + "question_num": 28, + "query": "消渴“上消”的症状是", + "options": { + "A": "消谷善饥", + "B": "烦躁不安", + "C": "身体消瘦", + "D": "烦渴引饮", + "E": "尿频量多" + }, + "answer": "D", + "reason": "ABC项为中消常见症状，D项为上消常见症状，E项为下消常见症状。" + }, + { + "question_num": 29, + "query": "既有肠燥便秘,又有水肿腹满者应选用的药物是", + "options": { + "A": "火麻仁", + "B": "苦杏仁", + "C": "桃仁", + "D": "郁李仁", + "E": "商陆" + }, + "answer": "D", + "reason": "都李仁能够润肠通便,利水消肿。治疗肠燥便秘，又有水肿腹满者。" + }, + { + "question_num": 30, + "query": "提出“外疡实从内出论”观点的医家是", + "options": { + "A": "陈实功", + "B": "巢元方", + "C": "王惟德", + "D": "高锦庭", + "E": "汪机" + }, + "answer": "D", + "reason": "高锦庭提出了“外疡实从内出论”的观点。" + }, + { + "question_num": 31, + "query": "临床上见胁痛易怒、抽搐惊恐等症,应选用的药物是", + "options": { + "A": "归胃经的药物", + "B": "归肺经的药物", + "C": "归肝经的药物", + "D": "归肾经的药物", + "E": "归心经的药物" + }, + "answer": "C", + "reason": "肝主调畅情志,肝经布胸胁，依据题干，应选肝经药物。" + }, + { + "question_num": 32, + "query": "噎膈与梅核气最主要的鉴别点是", + "options": { + "A": "有无自觉咽中如物梗阻", + "B": "有无慢性胃病病史", + "C": "有无胸骨后不适，呈烧灼感", + "D": "有无情志不畅、酒食不洁史", + "E": "有无吞咽困难" + }, + "answer": "E", + "reason": "噎膈与梅核气共同点：均有咽中梗阻不适的症状。噎膈为有形之痰气瘀阻结于食道，饮食咽下梗阻，甚则食不得入；梅核气为无形之痰气阻于咽喉，自觉咽中如有物梗阻，吐之不出，咽之不下，但饮食咽下顺利。" + }, + { + "question_num": 33, + "query": "治疗顽固性偏头痛,应首选", + "options": { + "A": "川芎", + "B": "白芷", + "C": "细辛", + "D": "苍耳子", + "E": "全蝎" + }, + "answer": "E", + "reason": "顽固性偏头痛宜选全蝎、蜈蚣，久病入络，全蝎、蜈蚣能搜风别络，" + }, + { + "question_num": 34, + "query": "下列关于十枣汤的服用方法，错误的是", + "options": { + "A": "剂量均从小量递增", + "B": "注意顾护胃气，中病即止", + "C": "一般连服3～5日", + "D": "药后出现呕吐、腹痛可续服", + "E": "必要时停两三日再服" + }, + "answer": "D", + "reason": "十枣汤或控涎丹峻下逐水，剂量应从小量递增，一般连服3～5日，必要时停两三日再服。必须注意顾护胃气，中病即止，如药后出现呕吐、腹痛、腹泻过剧，应减量或停服。" + }, + { + "question_num": 35, + "query": "琥珀具有的功效是", + "options": { + "A": "养血安神", + "B": "润肠通便", + "C": "收敛固涩", + "D": "平肝潜阳", + "E": "活血散瘀" + }, + "answer": "E", + "reason": "琥珀的功效:镇惊安神,活血散瘀，利尿通淋" + }, + { + "question_num": 36, + "query": "乳痈的主要病因病机中，错误的是", + "options": { + "A": "乳汁淤积，阻塞乳络", + "B": "肝郁痰凝，积聚乳络", + "C": "肝郁胃热，闭阻乳络", + "D": "感受外邪，瘀滞乳络", + "E": "胎气上冲，蕴阻乳络" + }, + "answer": "B", + "reason": "乳痈的基本病机是肝郁气滞、胃热壅滞、乳汁瘀滞，与痰无关。" + }, + { + "question_num": 37, + "query": "痰热阻闭心窍之神昏、口噤等症，当选用的药物是", + "options": { + "A": "黄芩", + "B": "栀子", + "C": "玄参", + "D": "牛黄", + "E": "黄连" + }, + "answer": "D", + "reason": "牛黄化痰开窍,凉肝息风,清热解毒,善治温热病热入心包及中风、惊风、癫痫等痰热阻闭心窍证。" + }, + { + "question_num": 38, + "query": "瘿的发病部位是", + "options": { + "A": "颈部左侧", + "B": "颈项右侧", + "C": "喉咙两侧", + "D": "项背两侧", + "E": "颈前结喉两侧" + }, + "answer": "E", + "reason": "瘿是颈前结喉两侧肿大的一类疾病，其特征为颈前结喉两侧漫肿或结块，皮色不变，逐渐增大。" + }, + { + "question_num": 39, + "query": "舌的脏腑分部,舌尖属于", + "options": { + "A": "心、肺", + "B": "肺、胃", + "C": "肺、肾", + "D": "脾、胃", + "E": "肝、胆" + }, + "answer": "A", + "reason": "舌尖属心、肺;舌中属脾胃;舌边属肝、胆;舌根属肾。" + }, + { + "question_num": 40, + "query": "肝胆疾病日久不愈，引发结石或癥积，属于", + "options": { + "A": "感邪即发", + "B": "徐发", + "C": "伏而后发", + "D": "复发", + "E": "继发" + }, + "answer": "E", + "reason": "在原发疾病的基础上，继而发生新病，称为继发，如���胆疾病日久不愈，引发结石或癥积。" + }, + { + "question_num": 41, + "query": "小柴胡汤中能解“寒热往来”的主要药组是", + "options": { + "A": "柴胡与半夏", + "B": "黄芩与人参", + "C": "半夏与生姜", + "D": "柴胡与黄芩", + "E": "黄芩与半夏" + }, + "answer": "D", + "reason": "寒热往来属少阳枢机不利。小柴胡汤和解少阳，主治伤寒少阳证，方用柴胡配黄芩清透并用，和解少阳，" + }, + { + "question_num": 42, + "query": "久病重病，突见语声嘶哑，多属", + "options": { + "A": "气血两虚", + "B": "脏气将绝", + "C": "痰湿阻肺", + "D": "风痰阻络", + "E": "肺肾阴虚" + }, + "answer": "B", + "reason": "久病重病，突见语声嘶哑，多是脏气将绝之危象。" + }, + { + "question_num": 43, + "query": "五味的阴阳属性,属于阴的一组是", + "options": { + "A": "酸、苦、辛", + "B": "酸、苦、咸", + "C": "甘、淡、酸", + "D": "辛、甘、淡", + "E": "辛、甘、苦" + }, + "answer": "B", + "reason": "五味划分阴阳，辛甘淡为阳,酸苦咸为阴。" + }, + { + "question_num": 44, + "query": "切脉时三指沿寸口脉长轴循行，诊察脉之长短，比较寸关尺三部脉象特点的是", + "options": { + "A": "寻法", + "B": "举法", + "C": "循法", + "D": "单诊", + "E": "总按" + }, + "answer": "C", + "reason": "循是切脉时三指沿寸口脉长轴循行，诊察脉之长短，比较寸关尺三部脉象的特点。" + }, + { + "question_num": 45, + "query": "脂瘤独有的特征是", + "options": { + "A": "数目不等,大小不一,肿形如馒,推之可移", + "B": "青筋垒垒,盘曲成团,质地柔软,表面青蓝", + "C": "瘤中心有粗大毛囊孔,可挤出臭味脂浆", + "D": "瘤体单发,质地硬韧,界限清楚,推之可移", + "E": "瘤体深隐,质地坚硬,境界清楚,推之不移" + }, + "answer": "C", + "reason": "脂瘤多因痰气凝结而成。皮肤可见圆形质软肿块，边界清楚，中央有粗大毛孔，可挤出有臭味的粉渣样物，" + }, + { + "question_num": 46, + "query": "假神的病机是", + "options": { + "A": "气血不足，精神亏损", + "B": "机体阴阳严重失调", + "C": "脏腑虚衰，功能低下", + "D": "精气衰竭，虚阳外越", + "E": "阴盛于内，格阳于外" + }, + "answer": "D", + "reason": "假神提示脏腑精气耗竭殆尽，正气将绝，阴不敛阳，虚阳外越，阴阳即将离决，属病危。" + }, + { + "question_num": 47, + "query": "下列各项,与饮食停滞无关的脉象是", + "options": { + "A": "促脉", + "B": "紧脉", + "C": "滑脉", + "D": "结脉", + "E": "涩脉" + }, + "answer": "D", + "reason": "促脉多见于阳盛实热、气血痰食停滞。紧脉见于实寒证、疼痛和食积。滑脉多见于痰湿、食积和实热。结脉多见于阴盛-12气结、寒痰血瘀。涩脉多见于气滞、血瘀和精伤、血少，痰食内停" + }, + { + "question_num": 48, + "query": "危重患者，突然额头冷汗大出，四肢厥冷。属于", + "options": { + "A": "亡阴", + "B": "亡阳", + "C": "阳虚", + "D": "阴虚", + "E": "以上均非" + }, + "answer": "B", + "reason": "亡阳证的表现冷汗淋漓，汗质稀淡，手足厥冷，呼吸气微，神情淡漠。" + }, + { + "question_num": 49, + "query": "危重病人,突然头额冷汗大出，四肢厥冷,属于", + "options": { + "A": "亡阴", + "B": "亡阳", + "C": "阳虚", + "D": "阴虚", + "E": "气虚" + }, + "answer": "B", + "reason": "亡阴、亡阳均是疾病的危险证候，亡阴者，因阴虚则阳亢，表现一系列热象;亡阳者，因阳衰则寒，表现一系列寒证，如头额冷汗大出，四肢厥冷。阴虚与阳虚不会是危重病人”所见之证候。" + }, + { + "question_num": 50, + "query": "石瘿的病因病理是", + "options": { + "A": "肝郁胃热，夹痰上壅，气血凝滞，郁滞结喉", + "B": "情志内伤，肝脾气逆，气血湿痰，凝滞结喉", + "C": "肝肾不足，肾火郁结，夹痰上攻，凝滞结喉", + "D": "脾肾阳虚，脾虚不运，津液留聚，凝结颈部", + "E": "肺脾两亏，津液不布，留聚炎痰，凝结颈部" + }, + "answer": "B", + "reason": "石瘿是甲状腺的恶性肿瘤，因肿块坚硬如石，故称之。多因情志不畅，肝气郁滞，气、痰、血郁结于颈前结喉而成。也可由气瘿、肉瘿恶变而来。" + }, + { + "question_num": 51, + "query": "左金丸中黄连与吴茱萸的用量比例为", + "options": { + "A": "7:1", + "B": "2:1", + "C": "6:1", + "D": "3:1", + "E": "1:1" + }, + "answer": "C", + "reason": "左金九中黄连与吴茱萸用量比例为6:1。方中重用黄连为君，清泻肝火，使肝火得清，自不横逆犯胃;黄连亦善清泻胃热，胃火降则其气自和，一药而两清肝胃，标本兼顾。然气郁化火之证，纯用大苦大寒既恐都结不并，又虑折伤中阳，故又少佐辛热之吴茱萸。" + }, + { + "question_num": 52, + "query": "治疗虚劳的基本原则是", + "options": { + "A": "益气", + "B": "温阳", + "C": "滋阴", + "D": "养血", + "E": "补益" + }, + "answer": "E", + "reason": "对于虚劳的治疗，根据“虚则补之”“损者益之”的理论，当以补益为基本原则。" + }, + { + "question_num": 53, + "query": "下列属于热极生风证的表现是", + "options": { + "A": "手足震颤", + "B": "肢体麻木", + "C": "手足蠕动", + "D": "角弓反张", + "E": "肌肉瞤动" + }, + "answer": "D", + "reason": "ABE三项均为血虚生风的表现，肝主筋，血虚筋脉失养,则拘挛急迫，感觉迟钝，因而发生肢体麻木，手足震额，肌肉动;C项为阴虚动风的表现，肝阴亏虚，筋脉失养，则手足蠕动;D项因热灼肝经,津液受烁，引动肝风，故见角弓反张。" + }, + { + "question_num": 54, + "query": "慢性前列腺炎的病因病机是", + "options": { + "A": "肾虚、湿热、瘀滞", + "B": "湿热、瘀滞、血热", + "C": "肾虚、瘀滞、痰浊", + "D": "肾虚、血热、瘀滞", + "E": "肾虚、血热、湿热" + }, + "answer": "A", + "reason": "中医学认为相火妄动，所愿不遂，或忍精不泄，肾火郁而不散，离位之精化成白浊；或房事不洁，精室空虚，湿热从精道内侵，湿热壅滞，气血瘀阻而成；病久伤阴，肾阴暗耗，可出现阴虚火旺证候；亦有体质偏阳虚者，久则火势衰微，易见肾虚不足之象。" + }, + { + "question_num": 55, + "query": "咽喉腐烂,溃烂成片属于", + "options": { + "A": "肺胃热轻", + "B": "肺胃热盛", + "C": "肺胃热毒", + "D": "阴虚火旺", + "E": "以上都不是" + }, + "answer": "C", + "reason": "咽喉腐烂,溃烂成片或凹陷者，为肺胃热毒壅盛。" + }, + { + "question_num": 56, + "query": "脱疽局部缺血期，患者足背动脉、胫后动脉的脉象是", + "options": { + "A": "弦数", + "B": "洪大", + "C": "结代", + "D": "微弱", + "E": "沉迟" + }, + "answer": "D", + "reason": "脱疽初起，患者可出现轻度肌肉萎缩，皮肤干燥，皮色变灰，皮温稍低于健侧，足背动脉搏动减弱。" + }, + { + "question_num": 57, + "query": "长于清肺热的药物是", + "options": { + "A": "黄芩", + "B": "黄连", + "C": "黄柏", + "D": "夏枯草", + "E": "龙胆" + }, + "answer": "A", + "reason": "夏枯草善泻肝火。龙胆善清下焦湿热。黄芩、黄连、黄柏三药性味皆苦寒，而黄连为苦寒之最，三药均以清热湿、泻火解毒为主要功效，但黄芩偏泻上焦肺火，肺热咳嗽者多用;黄连偏泻中焦胃火,并长于泻心火，中焦湿热、痞满呕逆及心火亢旺、高热心烦者多用;黄柏偏泻下焦相火、除骨蒸,湿热下注诸证及骨蒸劳热者多用。" + }, + { + "question_num": 58, + "query": "乳痈正虚毒恋，治宜选取", + "options": { + "A": "托里消毒散", + "B": "透脓散加味", + "C": "瓜蒌牛蒡汤加减", + "D": "四妙勇安汤", + "E": "逍遥蒌贝散" + }, + "answer": "A", + "reason": "乳痈正虚毒恋证治当益气和营托毒。方选托里消毒散加减。" + }, + { + "question_num": 59, + "query": "下列各项中,除哪项外均属八正散的组成药物", + "options": { + "A": "大黄、炙甘草", + "B": "瞿麦、萹蓄", + "C": "木通、栀子仁", + "D": "茯苓、猪苓", + "E": "滑石、车前子" + }, + "answer": "D", + "reason": "八正散组成药物:车前子、瞿麦、篇蓄、滑石、山栀子、炙甘草、木通、煨大黄、灯心草。" + }, + { + "question_num": 60, + "query": "直接损伤冲任，导致妇科疾病的是", + "options": { + "A": "气血失调，脏腑功能失常", + "B": "情志不畅，肝气郁结", + "C": "思虑过度，劳伤心脾", + "D": "阴虚肺燥，虚火内生", + "E": "经期产时，感染邪毒" + }, + "answer": "E", + "reason": "经期产时，忽视卫生，感染邪毒，搏结胞宫，损伤冲任。" + }, + { + "question_num": 61, + "query": "尤其善治下半身风湿痹痛的药物是", + "options": { + "A": "威灵仙", + "B": "白花蛇舌草", + "C": "羌活", + "D": "独活", + "E": "防己" + }, + "answer": "D", + "reason": "独活具有祛风���、止痛、解表的功效，其辛散苦燥，气香温通，功善袂风湿，止痹病，为治风湿痹病主药，凡风寒湿邪所致之痹证，无论新久，均可应用;因其主入将经，性善下行,尤以腰膝、腿足关节疼病属下部寒湿者为宜。治感受风寒湿邪的风寒湿，肌肉、腰背、手足疼病,常与当归、白术、牛膝等同用。" + }, + { + "question_num": 62, + "query": "温经汤（《妇人大全良方》）适用于月经后期的证型是", + "options": { + "A": "实寒", + "B": "虚寒", + "C": "血瘀", + "D": "血虚", + "E": "气滞" + }, + "answer": "A", + "reason": "温经汤中肉桂温经散寒，通脉调经；当归、川芎养血活血调经；人参甘温补气，助肉桂通阳散寒；莪术、牡丹皮、牛膝活血祛瘀，助当归、川芎通行血滞；白芍、甘草缓急止痛。全方共奏温经散寒、活血调经之效，用于月经后期实寒证。" + }, + { + "question_num": 63, + "query": "半夏泻心汤适用于", + "options": { + "A": "脾胃虚弱,寒热错杂。症见脘腹痞胀，恶食懒倦,大便不畅者", + "B": "脾胃虚弱,寒热错杂。症见心下痞满，但满不痛,呕吐下利者", + "C": "脾胃虚弱,水热互结。症见心下硬满，干噫食臭，肠鸣下利者", + "D": "脾胃虚弱,痰浊内阻。症见心下痞硬，噫气不除,苔腻脉滑者", + "E": "胃虚有热,和降失常。症见心胸烦闷，气逆欲呕，口干喜饮者" + }, + "answer": "B", + "reason": "半夏泻心汤体现辛开苦降、寒热并用的治法，能够治疗寒热错杂的痞满。症见心下痞满，但满不痛，呕吐下利!" + }, + { + "question_num": 64, + "query": "附睾及睾丸的急性化脓性感染，称为", + "options": { + "A": "子痰", + "B": "子痈", + "C": "囊痈", + "D": "水疝", + "E": "脱囊" + }, + "answer": "B", + "reason": "子痈是指睾丸及附睾的化脓性疾病。中医称睾丸和附睾为肾子，故以名之。以睾丸或附睾肿胀疼痛为特点。相当于西医的急、慢性附睾炎或睾丸炎。" + }, + { + "question_num": 65, + "query": "鸡内金具有的功效是", + "options": { + "A": "除痰浊", + "B": "化湿浊", + "C": "行气血", + "D": "化结石", + "E": "散郁结" + }, + "answer": "D", + "reason": "鸡内金性甘,平。归脾、胃、小肠、膀胱经。具有消食健胃、涩精止遗的功效。可用于治疗饮食积滞，小儿疳积;肾虚遗精、遗尿;砂石淋证,胆结石。" + }, + { + "question_num": 66, + "query": "红丝疔砭镰法的操作要点，正确的是", + "options": { + "A": "沿红线两头，针刺出血", + "B": "梅花针沿红线打刺，并加神灯照法", + "C": "梅花针沿红线打刺，微微出血", + "D": "用三棱针从中挑断红线，微令其出血", + "E": "用三棱针沿红线寸寸挑断，微令其出血" + }, + "answer": "E", + "reason": "红丝细者宜用砭镰法，局部皮肤消毒后，以刀针沿红丝行走途径，寸寸挑断，并用拇指和食指轻捏针孔周围皮肤，微令出血，或在红丝尽头挑断，挑破处均盖贴太乙膏掺红灵丹。" + }, + { + "question_num": 67, + "query": "治疗痰涎壅盛、喘咳不得平卧之证的首选药物为", + "options": { + "A": "紫苏子", + "B": "葶苈子", + "C": "白芥子", + "D": "桑白皮", + "E": "白果" + }, + "answer": "B", + "reason": "痰涎壅盛、喘咳不得平卧为痰饮停于胸中，莩苈子苦降辛散，性寒清热，具有泻肺平喘、利水消肿的功效，专泻肺中水饮及痰火而平喘咳，常佐大枣以缓其性，如葶苈大枣泻肺汤,还常配紫苏子、桑白皮、杏仁等共用。" + }, + { + "question_num": 68, + "query": "治疗血瘀不孕症，应首选", + "options": { + "A": "血府逐瘀汤", + "B": "膈下逐瘀汤", + "C": "少腹逐瘀汤", + "D": "桃红四物汤", + "E": "开郁种玉汤" + }, + "answer": "C", + "reason": "经期产后，余血未净之际，或房事不禁，或涉水感寒，邪与血结，瘀血内阻；或恚怒伤肝，气滞血瘀，瘀血内停，冲任受阻，瘀滞胞脉，以致不能摄精成孕，其治疗原则为活血化瘀，温经通络。方选少腹逐瘀汤。" + }, + { + "question_num": 69, + "query": "下列哪项属于脏腑阴虚证的共同临床表现", + "options": { + "A": "遗精早泄", + "B": "干咳痰少", + "C": "饥不欲食", + "D": "心烦不寐", + "E": "舌红少津" + }, + "answer": "E", + "reason": "遗精早泄是肾阴虚的症状;干咳少痰是肺阴虚的症状;饥不欲食是胃阴虚内尿的衣现;而津是阴虚证的共有症状。" + }, + { + "question_num": 70, + "query": "以下关于乳癖的论述除哪项外均正确", + "options": { + "A": "乳癖是乳腺组织的非炎症非肿瘤的良性增生病", + "B": "肿块生长与月经无关", + "C": "肿块可表现出不同形态", + "D": "症状与情志变化关系密切", + "E": "好发于25～45岁中青年妇女" + }, + "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，其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。乳房肿块大小不等，边界不清，质地不硬，活动度好。本病好发于中青年妇女。" + }, + { + "question_num": 71, + "query": "治疗阳痿,滑精,腰膝冷痛,尿频,宜选用", + "options": { + "A": "西洋参", + "B": "枸杞子", + "C": "熟地黄", + "D": "补骨脂", + "E": "山药" + }, + "answer": "D", + "reason": "阳痿、滑精、腰滕冷痛、尿频为肾虚所致，补骨脂有补肾壮阳、固精缩尿、温脾止泻、纳气平喘的功效。因其善壮肾阳，暖水脏，可用于治疗肾虚阳痿、腰膝冷痛。" + }, + { + "question_num": 72, + "query": "虫咬皮炎热毒蕴结证内治首选", + "options": { + "A": "五味消毒饮合黄连解毒汤", + "B": "龙胆泻肝汤", + "C": "萆薢渗湿汤", + "D": "清暑汤", + "E": "银翘散" + }, + "answer": "A", + "reason": "虫咬皮炎热毒蕴结证内治应清热解毒，消肿止痒，首选五味消毒饮合黄连解毒汤。" + }, + { + "question_num": 73, + "query": "主水饮、肾虚水泛,气血受困的面色特点是", + "options": { + "A": "面黑而干焦", + "B": "面色黧黑", + "C": "眼眶黑", + "D": "面色紫黑", + "E": "黄如烟熏" + }, + "answer": "C", + "reason": "眼眶黑主肾虚水饮,寒湿带下，故主水饮、肾虚水泛,气血受困的面色应为眼眶黑。" + }, + { + "question_num": 74, + "query": "清热固经汤适用的病证是", + "options": { + "A": "崩漏实热证", + "B": "崩漏虚热证", + "C": "崩漏血瘀证", + "D": "月经过多血热证", + "E": "经期延长血热证" + }, + "answer": "A", + "reason": "崩漏实热证，方用清热固经汤加减；崩漏虚热证，方用上下相资汤加减；崩漏血瘀证，方用逐瘀止血汤加减；月经过多血热证，方用保阴煎加减；经期延长血热证，方用两地汤合二至丸或固经丸。" + }, + { + "question_num": 75, + "query": "血府逐瘀汤主治何证", + "options": { + "A": "胸中血瘀证", + "B": "少腹血瘀证", + "C": "脑中瘀血证", + "D": "腰部瘀血证", + "E": "气虚血瘀证" + }, + "answer": "A", + "reason": "血府逐瘀汤能够活血化瘀行气止痛，主治胸中血瘀证。" + }, + { + "question_num": 76, + "query": "以轻宣凉燥，理肺化痰为主要功用的方剂是", + "options": { + "A": "杏苏散", + "B": "桑杏汤", + "C": "清燥救肺汤", + "D": "养阴清肺汤", + "E": "麦门冬汤" + }, + "answer": "A", + "reason": "杏苏散：轻宣凉燥、理肺化痰，主治外感凉燥证。" + }, + { + "question_num": 77, + "query": "以“疏风清热,宣肺止咳”为功用的方剂是", + "options": { + "A": "银翘散", + "B": "桑菊饮", + "C": "麻黄汤", + "D": "小青龙汤", + "E": "麻杏石甘汤" + }, + "answer": "B", + "reason": "银翘散的功用是辛凉透表,清热解毒。桑菊饮的功用是疏风清热，宣肺止咳。麻黄汤的功用是发汗解表，宣肺平喘。小青龙汤的功用是解表散寒，温肺化饮。麻杏甘石汤的功用是辛凉宣肺，清热平喘。" + }, + { + "question_num": 78, + "query": "栀子的归经是", + "options": { + "A": "心、肺、三焦经", + "B": "心、肝、胃、肺经", + "C": "心、肺、胆、膀胱经", + "D": "心、胃、肝、胆经", + "E": "心、胃、肺、膀胱经" + }, + "answer": "A", + "reason": "栀子：苦、寒，归心、肺、三焦经。" + }, + { + "question_num": 79, + "query": "治疗因肺脾气虚所致的小儿遗尿，首选的方剂是", + "options": { + "A": "菟丝子散", + "B": "龙胆泻肝汤", + "C": "人参五味子汤", + "D": "交泰丸合导赤散", + "E": "补中益气汤合缩泉丸" + }, + "answer": "E", + "reason": "小儿遗尿之肺脾气虚证证候:睡中遗尿，尿频量多，易感冒，面色无华,神疲乏力，少气懒言,食欲不振,大便溏薄，舌淡红，苔薄白，脉沉无力。治法:补肺益脾，固涩膀胱。方药:补中益气汤合缩泉九。" + }, + { + "question_num": 80, + "query": "既能补脾益气、润肺止咳，又能缓急止痛、清热解毒、调和药性的药物是", + "options": { + "A": "甘草", + "B": "白术", + "C": "山药", + "D": "黄芪", + "E": "西洋参" + }, + "answer": "A", + "reason": "甘草的功效：补脾益气，祛痰止咳，缓急止痛，清热解毒，调和药性。" + }, + { + "question_num": 81, + "query": "治疗小儿蛔虫病蛔厥证,首选的方剂是", + "options": { + "A": "使君子散", + "B": "乌梅丸", + "C": "肥儿丸", + "D": "资生健脾丸", + "E": "驱蛔承气汤" + }, + "answer": "B", + "reason": "蛔虫病蛔虫证治宜驱蛔杀虫、调理脾胃,方用使君子散加减;蛔厥证治宜安蛔定痛、继以驱虫,方用乌梅丸。" + }, + { + "question_num": 82, + "query": "黄芩具有而黄柏不具有的功效是", + "options": { + "A": "燥湿", + "B": "泻火", + "C": "解毒", + "D": "清肺热", + "E": "退虚热" + }, + "answer": "D", + "reason": "黄芩：清热燥湿，泻火解毒，凉血止血，除热安胎，且善清上焦热邪，并善清肺热。黄柏：清热燥湿，泻火解毒，退热除蒸，且善清下焦热邪。因此黄芩具有而黄柏不具有的功效是凉血止血，除热安胎，清上焦肺热。" + }, + { + "question_num": 83, + "query": "6~7个月婴儿应会的动作是", + "options": { + "A": "爬", + "B": "扶站", + "C": "独坐", + "D": "独走", + "E": "双脚跳" + }, + "answer": "C", + "reason": "口诀:二抬四翻六会坐,七滚八爬周会走。" + }, + { + "question_num": 84, + "query": "治疗湿浊中阻之呕吐，应首选的药物是", + "options": { + "A": "紫苏", + "B": "香薷", + "C": "生姜", + "D": "黄连", + "E": "藿香" + }, + "answer": "E", + "reason": "藿香：化湿，止呕，解暑。用于湿滞中焦、呕吐、暑湿或湿温初起。" + }, + { + "question_num": 85, + "query": "小儿形体望诊的顺序是", + "options": { + "A": "躯干、四肢、毛发、指甲、头面", + "B": "指甲、毛发、四肢、躯干、头囟", + "C": "头囟、躯干、四肢、毛发、指甲", + "D": "毛发、指甲、四肢、躯干、头囟", + "E": "四肢、躯干、头囟、毛发、指甲" + }, + "answer": "C", + "reason": "小儿望诊中望形体时应按顺序观察头囟、躯干、四肢、毛发、指甲等部位。" + }, + { + "question_num": 86, + "query": "胎儿期大约的时间是", + "options": { + "A": "240天", + "B": "280天", + "C": "300天", + "D": "310天", + "E": "360天" + }, + "answer": "B", + "reason": "胎儿期指从受孕到分娩共40周。" + }, + { + "question_num": 87, + "query": "天王补心丹的主治证候中有", + "options": { + "A": "高热", + "B": "头痛", + "C": "虚烦", + "D": "便溏", + "E": "胸闷" + }, + "answer": "C", + "reason": "天王补心丹的功用是滋阴养血，补心安神，适用于治疗阴虚血少，神志不安证。主要症状有心悸失眠，虚烦神疲，梦遗健忘，手足心热，口舌生疮，舌红少苔,脉细数。" + }, + { + "question_num": 88, + "query": "阴户又称", + "options": { + "A": "四边", + "B": "子户", + "C": "子门", + "D": "胞室", + "E": "子处" + }, + "answer": "A", + "reason": "阴户又称四边，系指女性外阴，包括阴蒂、大小阴唇、阴唇系带及前庭部位。子户、子门均指宫颈口。胞室、子处均指子宫。" + }, + { + "question_num": 89, + "query": "下列关于血尿素氮的改变及临床意义的叙述,正确的是", + "options": { + "A": "上消化道出血时,血尿素氮减少", + "B": "大面积烧伤时,血尿素氮减少", + "C": "严重的肾盂肾炎,血尿素氮减少", + "D": "血尿素氮对早期肾功能损害的敏感性差", + "E": "血尿素氮对早期肾功能损害的敏感性强" + }, + "answer": "D", + "reason": "各种肾脏疾病都可以使血尿素氮增高，而且常受肾外因素影响，故测定不敏感，也不是肾功能损害的特异性指标。上消化道出血、大面积烧伤时，体内蛋白质分解过剩，血尿素氮升高;严重的肾孟肾炎，血尿素氮升高。" + }, + { + "question_num": 90, + "query": "小儿重舌，多属", + "options": { + "A": "心气不足", + "B": "热盛伤津", + "C": "心经有热", + "D": "心脾火炽", + "E": "气血两虚" + }, + "answer": "D", + "reason": "舌下红肿突出，形如小舌，称为重舌，由心脾积热，火热循经上行所致。" + }, + { + "question_num": 91, + "query": "下列哪项既是症状也是体征", + "options": { + "A": "下肢水肿", + "B": "皮肤瘙痒", + "C": "恶心", + "D": "头痛", + "E": "咳嗽" + }, + "answer": "A", + "reason": "症状是指患者主观感到的不适或痛苦，体征是指医师或其他人能客观检查到的改变，因此下肢��肿既是症状也是体征，而其余四项均为症状。" + }, + { + "question_num": 92, + "query": "培元补肾法常用于治疗的疾病是", + "options": { + "A": "五迟、五软", + "B": "肺炎喘嗽", + "C": "幼儿急疹", + "D": "手足口病", + "E": "脐突" + }, + "answer": "A", + "reason": "小儿五迟、五软的总因为先天肾精不足，后天失于调养，故治法须以补肾为主。" + }, + { + "question_num": 93, + "query": "呕吐与头部位置改变有密切关系的疾病是", + "options": { + "A": "妊娠反应", + "B": "脑炎", + "C": "尿毒症", + "D": "糖尿病酮症酸中毒", + "E": "耳源性眩晕" + }, + "answer": "E", + "reason": "脑炎引起呕吐是因为颅内压增高，呕吐为喷射性，可有剧烈头痛。尿毒症、糖尿病酮症酸中毒、妊娠呕吐是由于呕吐中枢化学感受器受刺激，常伴有恶心。耳源性变动有密切关系。" + }, + { + "question_num": 94, + "query": "产后血性恶露的持续时间为", + "options": { + "A": "1～2天", + "B": "3～4天", + "C": "5～6天", + "D": "7～10天", + "E": "2～3周" + }, + "answer": "B", + "reason": "恶露是产后自子宫排出的余血浊液，先是暗红色的血性恶露，也称红恶露，持续3～4天干净；后渐变淡红，量由多渐少，称为浆液性恶露，7～10天干净；继后渐为不含血色的白恶露，2～3周干净。" + }, + { + "question_num": 95, + "query": "五苓散中桂枝的作用是", + "options": { + "A": "发汗解表", + "B": "温心阳,通心脉", + "C": "温经通脉", + "D": "温阳化气", + "E": "调和营卫" + }, + "answer": "D", + "reason": "五苓散能利水渗湿,温阳化气，适用于治疗蓄水证、水湿内停和痰饮。方中重用泽泻为君，取其甘淡性寒，直达肾与膀胱，利水渗湿。臣以茯苓、猪苓之淡渗，增强利水渗湿之力。佐以白术健脾而运化水湿，转输津液，使水津四布，而不直趋于下。又佐以桂枝，一药二用，既解太阳之表，又内助膀胱气化。解析积实消病丸的功用是行气" + }, + { + "question_num": 96, + "query": "下列病机中，与胎黄无直接联系的是", + "options": { + "A": "脾胃湿热", + "B": "寒湿内蕴", + "C": "肺失通调", + "D": "肝失疏泄", + "E": "气滞血瘀" + }, + "answer": "C", + "reason": "胎黄的主要病机为脾胃湿邪内蕴，肝失疏泄，湿热熏蒸；寒湿阻滞；瘀积发黄。与肺无关。" + }, + { + "question_num": 97, + "query": "枳实消痞丸的功用是", + "options": { + "A": "消食和胃,理气化滞", + "B": "行气导滞,攻积泄热", + "C": "健脾消食,泻热通便", + "D": "消痞除满,健脾和胃", + "E": "消导化积,清热除湿" + }, + "answer": "D", + "reason": "消痞,健脾和胃,适于治疗脾虚气滞，寒热互结证。" + }, + { + "question_num": 98, + "query": "以下属于妇科杂病的是", + "options": { + "A": "癥瘕、盆腔炎、不孕症、带下病", + "B": "癥瘕、盆腔炎、阴痒、子宫脱垂", + "C": "癥瘕、盆腔炎、不孕症、缺乳", + "D": "盆腔炎、阴痒、子宫脱垂、绝经妇女骨质疏松症", + "E": "癥瘕、不孕症、带下病、绝经妇女骨质疏松症" + }, + "answer": "B", + "reason": "妇科杂病的定义：凡不属于经、带、胎、产疾病范围，而又与妇女解剖、生理、病机特点密切相关的各种妇科疾病。" + }, + { + "question_num": 99, + "query": "心肌梗死特征性心电图出现在V1、V2、V3导联,可以确定梗死的部位是", + "options": { + "A": "正后壁", + "B": "前壁", + "C": "侧壁", + "D": "下壁膈面", + "E": "前间壁" + }, + "answer": "E", + "reason": "心肌梗死的心电图定位诊断:V~V:为前间壁梗死;V~V:为前壁梗死;V~Vs为广泛前壁梗死;Ⅱ、Ⅲ、aVF为下壁梗死;V:R~V;R为右室梗死，" + }, + { + "question_num": 100, + "query": "治疗鹅口疮虚火上浮证的首选方剂是", + "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": "治疗虚火上浮证，宜滋阴清火，方选知柏地黄丸。" + }, + { + "question_num": 101, + "query": "高血压性心脏病左心室增大,叩诊其心脏浊音界呈", + "options": { + "A": "烧瓶形", + "B": "梨形", + "C": "靴形", + "D": "普大型", + "E": "心腰部凸出" + }, + "answer": "C", + "reason": "高血压性心脏病左心室增大其心脏浊音界呈靴形;梨形见于二尖瓣狭窄;烧瓶形见于心包积液。" + }, + { + "question_num": 102, + "query": "妊娠足月，胎��下移，腰腹阵痛，有便意或见红者，是", + "options": { + "A": "临产", + "B": "试胎", + "C": "弄胎", + "D": "分娩", + "E": "以上均非" + }, + "answer": "A", + "reason": "临产的征象：见红，离经脉，阵痛。" + }, + { + "question_num": 103, + "query": "下列属于直接灸的是", + "options": { + "A": "隔姜灸", + "B": "隔蒜灸", + "C": "隔盐灸", + "D": "隔附子饼灸", + "E": "无瘢痕灸" + }, + "answer": "E", + "reason": "直接灸包含瘢痕灸和无瘢痕灸。" + }, + { + "question_num": 104, + "query": "治疗疳气证的首选方剂是", + "options": { + "A": "资生健脾丸", + "B": "六君子汤", + "C": "四君子汤", + "D": "肥儿丸", + "E": "八珍汤" + }, + "answer": "A", + "reason": "疳气证，治法为和脾健运，方药选择资生健脾丸。" + }, + { + "question_num": 105, + "query": "在胸部没有穴位的经脉是", + "options": { + "A": "手太阴肺经", + "B": "手少阴心经", + "C": "手厥阴心包经", + "D": "足少阴肾经", + "E": "足阴脾经" + }, + "answer": "B", + "reason": "在胸部没有穴位的经脉:手少阴心经。" + }, + { + "question_num": 106, + "query": "治疗风疹邪入气营证的首选方剂是", + "options": { + "A": "银翘散", + "B": "白虎汤", + "C": "透疹凉解汤", + "D": "清气凉营汤", + "E": "解肌透痧汤" + }, + "answer": "C", + "reason": "治疗风疹邪入气营证，治宜清热解毒，方选透疹凉解汤。" + }, + { + "question_num": 107, + "query": "足阳明胃经在胸部循行距前正中线旁开多少寸", + "options": { + "A": "6寸", + "B": "5寸", + "C": "4寸", + "D": "3寸", + "E": "2寸" + }, + "answer": "C", + "reason": "在胸部经脉距前正中线的分布分别为肾经距前正中线2寸，胃经距前正中线4寸，脾经距前正中线6寸。" + }, + { + "question_num": 108, + "query": "下列哪项不是直接导致冲任损伤的因素", + "options": { + "A": "邪毒感染", + "B": "思虑暗耗", + "C": "房劳多产", + "D": "跌仆闪挫", + "E": "寒湿之邪" + }, + "answer": "B", + "reason": "直接导致冲任损伤的因素：经期产后血室正开，调理不当外邪乘虚而入，直伤冲任胞宫；房劳多产耗伤气血，屡孕屡堕，重伤气血，损伤冲任、胞宫、胞脉、胞络以及耗精伤肾；跌仆闪挫，致使气血紊乱，或瘀阻子宫，损伤冲任。" + }, + { + "question_num": 109, + "query": "用背俞穴治疗耳聋,应首选", + "options": { + "A": "肺俞", + "B": "三焦俞", + "C": "肝俞", + "D": "肾俞", + "E": "脾俞" + }, + "answer": "D", + "reason": "肾俞定位:第2腰椎棘突下，旁开5寸。主治:头晕、耳鸣、耳聋、腰酸痛等肾虚病证;遗尿、遗精、阳痿、早泄、不育等生殖泌尿系疾患;月经不调、带下、不孕等妇科病证。且肾开窍于耳，故治耳聋应首选肾俞。" + }, + { + "question_num": 110, + "query": "中医学女性生殖轴的概念是", + "options": { + "A": "脑－肾－天癸－胞宫", + "B": "肾－天癸－冲任－胞宫", + "C": "肾－天癸－气血－胞宫", + "D": "天癸－冲任－气血－胞宫", + "E": "天癸－肾－冲任－胞宫" + }, + "answer": "B", + "reason": "肾－天癸－冲任－胞宫生殖轴，是中医妇科学有关女性生殖理论的轴心理论，在月经、带下、分娩生理全过程中均发挥着重要的作用。在生殖轴中，肾为主导，肾气、天癸共同主宰，通过冲任二脉的通盛，相资为用，由胞宫具体体现其生殖生理功能。脏腑、天癸、气血、冲任督带与胞宫是月经产生的生理基础，其中肾、天癸、冲任、胞宫是产生月经的中心环节，各环节之间互相联系，称为“肾－天癸－冲任－胞宫”。" + }, + { + "question_num": 111, + "query": "支气管哮喘应用拟肾上腺药物舒张支气管,其主要激动的受体是", + "options": { + "A": "α受体", + "B": "β受体", + "C": "α、β受体", + "D": "β2受体", + "E": "β1受体" + }, + "answer": "D", + "reason": "支气管舒张剂属β受体激动剂。" + }, + { + "question_num": 112, + "query": "胎儿期与新生儿期的分界线是", + "options": { + "A": "妊娠10月", + "B": "孕期满40周", + "C": "胎儿娩出", + "D": "生后脐带结扎", + "E": "孕期28周到生后28天" + }, + "answer": "C", + "reason": "胎儿期指从受孕到分娩断脐，胎儿出生。新生儿期指从出生到生后满28天。两者的分界线是胎儿娩出。" + }, + { + "question_num": 113, + "query": "有助于鉴别再生障碍性贫血与急性白血病的是", + "options": { + "A": "白细胞减少", + "B": "皮肤黏膜出血", + "C": "贫血苍白", + "D": "胸骨压痛", + "E": "感染发热" + }, + "answer": "D", + "reason": "再生障碍性贫血无胸骨压痛，急性白血病有胸骨压痛。" + }, + { + "question_num": 114, + "query": "肝癌肝外血行转移，首先转移到", + "options": { + "A": "盆腔", + "B": "脑", + "C": "肾", + "D": "骨骼", + "E": "肺" + }, + "answer": "E", + "reason": "肝癌肝外血行转移，首先转移到肺，其次是肾上腺、骨、主动脉旁淋巴结、锁骨上淋巴结、肾、脑。" + }, + { + "question_num": 115, + "query": "急性白血病完全缓解的标准，下列哪项是错误的", + "options": { + "A": "症状、体征消失", + "B": "血象恢复正常", + "C": "血红蛋白>100g/L", + "D": "外周血中无幼稚白细胞", + "E": "骨髓中原始细胞加早幼粒细胞<10%" + }, + "answer": "E", + "reason": "急性白血病完全缓解的标准:白血病的症状、体征完全消失，血象Hb>100g/L(男性)或>90g/L(女性、儿童)。中性粒细胞绝对值>1.5x10’/L，血小板>100x10/L，外周血中无白血病细胞;骨髓象原粒细胞加早幼粒细胞<5%，红细胞及巨核细胞正常" + }, + { + "question_num": 116, + "query": "新生儿在上腭中线和齿龈部位有散在黄白色、碎米粒样颗粒，称为", + "options": { + "A": "马牙", + "B": "板牙", + "C": "螳螂子", + "D": "白喉", + "E": "鹅口疮" + }, + "answer": "A", + "reason": "新生儿上腭中线和齿龈部位有散在黄白色、碎米大小隆起颗粒，称为“马牙”，会于数周或数月自行消失，不需挑刮。注：新生儿有几种特殊生理状态，不可误认为病态，如马牙、螳螂子、女婴生后3～5天乳房发育、女婴生后5～7天的假月经、新生儿生理性黄疸等。" + }, + { + "question_num": 117, + "query": "耳尖直上,当入发际1.5寸处的腧穴是", + "options": { + "A": "曲鬓", + "B": "完骨", + "C": "率谷", + "D": "角孙", + "E": "风池" + }, + "answer": "C", + "reason": "曲鬓穴是足少阳胆经的常用腧穴之一，位于耳前鬓角发际后缘的垂线与用在头部，当耳后乳突的后下方凹陷处。率谷穴属足少阳胆经，足太阳、少阳之会，在头部，当耳尖直上入发际1.5寸，角孙直上方。角孙穴属手太阳经，是手、足少阳之会，在头部，折耳郭向前，当耳尖直上入发际处。风池穴在项部，当枕骨之下，与风府相平,胸锁乳突肌与斜方肌上端之间的凹陷处，" + }, + { + "question_num": 118, + "query": "组成药物中均含有干姜的方剂是", + "options": { + "A": "实脾散、归脾汤", + "B": "归脾汤、健脾丸", + "C": "健脾丸、温脾汤", + "D": "温脾汤、实脾散", + "E": "归脾汤、温脾汤" + }, + "answer": "D", + "reason": "组成药物中均含有干姜的方剂是温脾汤、实脾散。实脾散组成药物：厚朴、白术、木瓜、木香、草果仁、大腹子、附子、茯苓、干姜、甘草（生姜、大枣）。温脾汤组成药物：大黄、干姜、当归、附子、人参、芒硝、甘草。" + }, + { + "question_num": 119, + "query": "被称为“阳脉之海”的经脉是", + "options": { + "A": "带脉", + "B": "任脉", + "C": "冲脉", + "D": "督脉", + "E": "阴维脉" + }, + "answer": "D", + "reason": "督脉调节全身阳经经气，称为“阳脉之海”;任脉调节全身阴经经气，称为“阴脉之海”;冲脉含蓄十二经气血,称为“十二经之海”“血海”;带脉约束纵行躯干的诸条经脉;阴维脉主要调节六阴经经气。" + }, + { + "question_num": 120, + "query": "房室结内折返性心动过速发作时先行治疗应选用的是", + "options": { + "A": "静脉注射毛花苷C", + "B": "静脉注射利多卡因", + "C": "给予升压药", + "D": "刺激迷走神经方法", + "E": "胆碱酯酶抑制药" + }, + "answer": "D", + "reason": "房室结内折返性心动过速发作时，如患者心功能与血压正常，可先尝试刺激迷走神经的方法。颈动脉窦按摩（患者取仰卧位，先行右侧，每次5～10秒，切莫双侧同时按摩）、Valsalva动作（深吸气后屏气，再用力做呼气动作）、诱导恶心、将面部浸没于冰水内等方法可使心动过速终止，但停止刺激后，有时又恢复原来心率。初次尝试失败，在应用药物后再次施行仍可望成功。" + }, + { + "question_num": 121, + "query": "下列四肢动态异常中,因寒邪凝滞所致的是", + "options": { + "A": "手足拘急", + "B": "手足颤动", + "C": "手足蠕动", + "D": "四肢抽搐", + "E": "肢体痿废" + }, + "answer": "A", + "reason": "手足拘急见于寒邪凝滞,或气血亏虚;手足颤动见于血虚筋脉失养，或饮酒过度;手足蠕动见于阴虚动风;四肢抽搐见于肝风内动;肢体痿废见于精津亏虚或湿热浸淫，筋脉失养，若双下肢痿废不用，多见于截瘫患者，" + }, + { + "question_num": 122, + "query": "胎儿期易发生先天畸形的是", + "options": { + "A": "妊娠早期4周", + "B": "妊娠早期12周", + "C": "妊娠中期10周", + "D": "妊娠中期15周", + "E": "妊娠晚期13周" + }, + "answer": "B", + "reason": "妊娠早期12周的胚胎期，从受精卵细胞至基本形成胎儿，最易受到各种病理因素，如感染、药物、劳累、物理、营养缺乏以及不良心理因素等伤害，造成流产、死胎或先天畸形。" + }, + { + "question_num": 123, + "query": "在使用辅助检查时应遵循下述要求，但不包括", + "options": { + "A": "严格掌握适应证", + "B": "广泛依赖辅助检查", + "C": "简单的检查先于复杂的检查", + "D": "应从实际需要决定做什么检查", + "E": "结合临床症状应用辅助检查" + }, + "answer": "B", + "reason": "辅助检查的道德要求:①目的明确，诊治需要;②知情同意,尽职尽贵;③综合分析，切忌片面;④密切联系，加强协作。应从实际需要决定做什么检查，而非广泛依赖辅助检查。" + }, + { + "question_num": 124, + "query": "下列属于α受体阻滞药的是", + "options": { + "A": "降压灵", + "B": "普萘洛尔", + "C": "哌唑嗪", + "D": "硝苯地平", + "E": "硝普钠" + }, + "answer": "C", + "reason": "哌唑嗪降压作用的机制包括以下几点：①可舒张小动脉和静脉血管平滑肌；②阻断α1受体；③不引起反射性心率加快。" + }, + { + "question_num": 125, + "query": "八会穴中,治疗脉病的腧穴是", + "options": { + "A": "中脘", + "B": "太渊", + "C": "膻中", + "D": "悬钟", + "E": "章门" + }, + "answer": "B", + "reason": "腑病可取腑会中脘;气病可取气会膻中;脉病可取脉会太渊;脏病可取脏会章门，悬钟为髓会。" + }, + { + "question_num": 126, + "query": "可治疗风热感冒与时邪感冒的方剂是", + "options": { + "A": "银翘散", + "B": "桑菊饮", + "C": "新加香薷饮", + "D": "普济消毒饮", + "E": "仙方活命饮" + }, + "answer": "A", + "reason": "风热感冒治以辛凉解表，方用银翘散加减。时邪感冒治以清热解毒，方用银翘散合普济消毒饮加减。" + }, + { + "question_num": 127, + "query": "发热伴有眼结膜充血多见于", + "options": { + "A": "流行性出血热", + "B": "肺炎链球菌肺炎", + "C": "中暑", + "D": "疟疾", + "E": "流行性感冒" + }, + "answer": "A", + "reason": "发热伴有眼结膜充血多见于麻疹、流行性出血热、斑疹伤寒、钩端螺旋体病等。" + }, + { + "question_num": 128, + "query": "疑由胃炎引起上消化道出血，为确诊宜选用的检查是", + "options": { + "A": "吞线试验", + "B": "粪便隐血试验", + "C": "胃镜紧急检查", + "D": "急诊胃肠钡剂检查", + "E": "剖腹探查" + }, + "answer": "C", + "reason": "胃镜检查是目前诊断上消化道出血病因的首选检查方法。胃镜检查在直视下顺序观察食管、胃及十二指肠壶腹部直至降段，从而判断出血病变的部位、病因及出血情况。" + }, + { + "question_num": 129, + "query": "下列可发生胸痛的情况应除外", + "options": { + "A": "带状疱疹", + "B": "食管炎", + "C": "自发性气胸", + "D": "支气管哮喘", + "E": "肋软骨炎" + }, + "answer": "D", + "reason": "胸痛常见于带状疱疹、食管炎、自发性气胸、肋软骨类等，" + }, + { + "question_num": 130, + "query": "上消化道大出血患者，治疗时最首要措施是", + "options": { + "A": "补充血容量", + "B": "静脉滴注止血药", + "C": "抗酸药", + "D": "西咪替丁静脉滴注", + "E": "冰盐水洗胃" + }, + "answer": "A", + "reason": "上消化道大量出血病情急、变化快，严重者可危及生命，应采取积极措施进行抢救。抗休克、迅速补充血容量治疗应放在一切医疗措施的首位。" + }, + { + "question_num": 131, + "query": "肺炎链球菌肺炎痰的特征是", + "options": { + "A": "粉红色泡沫样痰", + "B": "鲜红色痰", + "C": "棕褐色痰", + "D": "铁锈色痰", + "E": "灰黄色痰" + }, + "answer": "D", + "reason": "铁锈色痰是肺炎链球菌肺炎的典型特征。解析，卫生法的基本原则主要有5个方面:①卫生保护原则;②预防为主原则:③公平���则;④保护社会健康原则;⑤患者自主原则。" + }, + { + "question_num": 132, + "query": "白细胞减少症的主要治疗原则是", + "options": { + "A": "病因治疗", + "B": "使用糖皮质激素", + "C": "使用促粒细胞生成药物", + "D": "充分休息", + "E": "增加营养" + }, + "answer": "A", + "reason": "白细胞减少症主要是病因治疗，对可疑的药物或其他致病因素，应立即停止接触。继发性减少者应积极治疗原发病，急性白血病、自身免疫性疾病、感染等经过治疗病情缓解或控制后，白细胞可以恢复正常。脾功能亢进者可考虑脾切除。" + }, + { + "question_num": 133, + "query": "我国卫生法基本原则不包括的内容是", + "options": { + "A": "卫生保护原则", + "B": "预防为主原则", + "C": "公平原则", + "D": "经济效益原则", + "E": "患者自主原则" + }, + "answer": "E", + "reason": "患者有健忘病史,定向力、计算力减退，词不达意，神情呆钝，考虑为痴呆。痴呆髓海不足证证候:智能减退，记忆力、计算力、定向力、判断力明显减退,神情呆钝,词不达意，头晕耳鸣，怠惰思卧,齿枯发焦,腰酸骨软,步履艰难,舌瘦色淡,苔白,脉沉细弱或细数。治宜补肾益髓，填精养神。方药:七福饮加减。" + }, + { + "question_num": 134, + "query": "望诊方法中有五色主病，其中五色是指", + "options": { + "A": "红、黄、青、白、黑", + "B": "红、黄、灰、白、黑", + "C": "红、紫、灰、白、黑", + "D": "红、紫、黄、白、黑", + "E": "红、紫、黄、白、青" + }, + "answer": "A", + "reason": "五色主病按面色红、青、黄、白、黑五种不同颜色的偏向表现来诊察疾病。" + }, + { + "question_num": 135, + "query": "颈部淋巴结肿大,疑为癌肿转移时,应首先考虑的是", + "options": { + "A": "鼻咽癌", + "B": "食管癌", + "C": "结肠癌", + "D": "肺癌", + "E": "肝癌" + }, + "answer": "A", + "reason": "颈部淋巴结肿大常见于鼻咽癌、胃癌、淋巴结炎症等。左锁骨上窝淋巴结肿大常考虑为胸部肿瘤,如肺癌、胃癌等。" + }, + { + "question_num": 136, + "query": "下垂性水肿见于", + "options": { + "A": "肾源性水肿", + "B": "肝源性水肿", + "C": "内分泌源性水肿", + "D": "心源性水肿", + "E": "营养不良性水肿" + }, + "answer": "D", + "reason": "心源性水肿特点是下垂性水肿皮肤张紧发亮，甚至有液体渗出；胸腔、腹腔等浆膜腔内可见积液，外阴部亦可见严重水肿。" + }, + { + "question_num": 137, + "query": "器质性二尖瓣狭窄的杂音性质为", + "options": { + "A": "吹风样", + "B": "叹气样", + "C": "隆隆样", + "D": "乐音样", + "E": "机器样" + }, + "answer": "C", + "reason": "应熟悉心脏听诊杂音,二尖辩狭窄心尖区有低调的舒张中、晚期隆隆样杂音，局限，不传导。" + }, + { + "question_num": 138, + "query": "下列各项，可出现金属样肠蠕动音的是", + "options": { + "A": "麻痹性肠梗阻", + "B": "机械性肠梗阻", + "C": "低血钾", + "D": "急性肠炎", + "E": "败血症" + }, + "answer": "B", + "reason": "肠鸣音次数多，呈高亢、响亮的金属声，称肠鸣音亢进，见于机械性肠梗阻。" + }, + { + "question_num": 139, + "query": "下列各项中,有匙状甲的是", + "options": { + "A": "支气管扩张", + "B": "缺铁性贫血", + "C": "支气管肺癌", + "D": "慢性肺脓肿", + "E": "脓胸" + }, + "answer": "B", + "reason": "又称反甲,特点为指甲中央凹陷,，边缘翘起，指甲变薄，表面粗糙有条纹，常见于缺铁性贫血和高原疾病，偶见于风湿热及甲癣。由此可见，ACDE项均不可引起变态反应性发热。" + }, + { + "question_num": 140, + "query": "用俞募配穴法治疗胃病，应选下列哪组穴位", + "options": { + "A": "脾俞、胃俞", + "B": "胃俞、太白", + "C": "胃俞、足三里", + "D": "脾俞、中脘", + "E": "胃俞、中脘" + }, + "answer": "E", + "reason": "募穴与背俞穴配合使用为“俞募配穴法”。胃俞为胃经背俞穴，中脘为胃经腹募穴。十二募穴歌：天枢大肠中府肺，关元小肠巨阙心，中极膀胱京门肾，日月胆肝期门寻，脾募章门胃中脘，气化三焦石门针，心包募穴何处取，胸前膻中觅浅深。" + }, + { + "question_num": 141, + "query": "不支持流行性脑脊髓膜炎诊断的脑脊液是", + "options": { + "A": "外观浑浊呈脓性", + "B": "蛋白质含量高", + "C": "细胞数<0.5X10°/L,以单核细胞为主", + "D": "糖含量��显减少", + "E": "细胞数>0.5X10°/L,以中性粒细胞为主" + }, + "answer": "C", + "reason": "典型脑膜炎期脑脊液检查外观呈浑浊或脓样，白细胞数大于0.5X10/L,以中性粒细胞为主，蛋白质含量显著增高，而糖含量明显减少，氯化物降低。速记:米汤浑浊是化脑，两白很高糖氯低，" + }, + { + "question_num": 142, + "query": "SARS的首发症状是", + "options": { + "A": "发热", + "B": "咳嗽", + "C": "腹泻", + "D": "胸闷", + "E": "鼻塞" + }, + "answer": "A", + "reason": "急性呼吸窘迫综合征常急性起病，自发病之日起，2～3周病情都可处于进展状态。以发热为首发症状，体温一般高于38℃，常呈持续性高热，可伴有畏寒、肌肉酸痛、关节酸痛、头痛、乏力。" + }, + { + "question_num": 143, + "query": "大便隐血试验持续阳性,常见于", + "options": { + "A": "胃溃疡", + "B": "十二指肠溃疡", + "C": "胃癌", + "D": "胃炎", + "E": "肠道下端炎症" + }, + "answer": "C", + "reason": "隐血试验对消化道出血鉴别诊断有一定意义，消化道溃疡,阳性率为40%~70%，呈间歌阳性;消化道恶性肿瘤，如胃癌、结肠癌，阳性率可达95%,呈持续性阳性，" + }, + { + "question_num": 144, + "query": "流行性脑脊髓膜炎的典型脑脊液外观是", + "options": { + "A": "稍浑浊", + "B": "磨玻璃样", + "C": "绿色脓样", + "D": "米汤样", + "E": "血水样" + }, + "answer": "D", + "reason": "流行性脑脊髓膜炎脑脊液检查：外观浑浊呈米汤样，压力升高，白细胞计数增多，蛋白含量升高，葡萄糖含量降低，氯化物含量降低。" + }, + { + "question_num": 145, + "query": "下列各疾病过程中,可见到玫瑰疹的是", + "options": { + "A": "霍乱", + "B": "流行性乙型脑炎", + "C": "细菌性痢疾", + "D": "伤寒", + "E": "流行性出血热" + }, + "answer": "D", + "reason": "伤寒的极期(病变7~10天)12可见到玫瑰疹" + }, + { + "question_num": 146, + "query": "霍乱的典型症状是", + "options": { + "A": "发热", + "B": "呕吐", + "C": "腹泻", + "D": "腹痛", + "E": "肌痉挛" + }, + "answer": "C", + "reason": "霍乱患者常出现无痛性剧烈腹泻，不伴里急后重。黄色水样、米泔样水便或洗肉水样血便，无粪臭。大便量多次频。" + }, + { + "question_num": 147, + "query": "伤寒菌血液培养,阳性率最高的时间是", + "options": { + "A": "第1周", + "B": "第2周", + "C": "第3周", + "D": "第4周", + "E": "第5周" + }, + "answer": "A", + "reason": "伤寒菌进行血液培养时,在病程的第1~2周阳性率高达80%~90%,第3周降到50%。在第1周时病情在初期，症状逐渐明显，这时阳性率逐渐升高，所以在第1周末时会达到高峰，" + }, + { + "question_num": 148, + "query": "既可治疗咳嗽、气喘，又可治疗头项疾患的是", + "options": { + "A": "列缺", + "B": "尺泽", + "C": "中府", + "D": "太渊", + "E": "少商" + }, + "answer": "A", + "reason": "列缺属肺经腧穴，主治：咳嗽、气喘、咽喉肿痛等肺系病证；头痛、牙痛、项部强痛、口眼歪斜等头项部疾患；手腕痛。" + }, + { + "question_num": 149, + "query": "下列各项,不属于急性重型肝炎典型表现的是", + "options": { + "A": "黄疽迅速加深", + "B": "极度乏力", + "C": "肝大", + "D": "出现烦躁、谵妄等神经系统症状", + "E": "无食欲,恶心,频繁呕吐" + }, + "answer": "C", + "reason": "急性重型肝炎亦称暴发型肝炎，以急性黄疸型肝炎起病，2周内出现极度乏力，消化道症状明显(无食欲、恶心、频繁呕吐、鼓肠等),常有高热,迅速出现神经、精神症状(性格改变、行为反常、嗜睡、烦躁不安,甚至昏迷等)，肝浊音界进行性缩小，黄疸急剧加深。" + }, + { + "question_num": 150, + "query": "有关消毒方法的描述，错误的是", + "options": { + "A": "微波消毒属高效消毒法", + "B": "异丙醇属中效消毒法", + "C": "通风换气属低效消毒法", + "D": "高效消毒可杀灭一切微生物", + "E": "病原体及消毒方法相同，在不同的物品上消毒效果相同" + }, + "answer": "E", + "reason": "消毒是用物理、化学或生物方法杀灭或清除所在环境的病原微生物，但不包括芽胞。病原体不同，消毒方法也不同，在不同的物品上消毒效果也是不同的。" + }, + { + "question_num": 151, + "query": "下列传染病中,属于人畜共患病的是", + "options": { + "A": "流行性脑脊髓膜炎", + "B": "流行性乙型脑炎", + "C": "伤寒", + "D": "霍乱", + "E": "病毒性肝炎" + }, + "answer": "B", + "reason": "流行性乙型脑炎是人畜共患的自然疫源性疾病。人和动物感染乙脑病毒后可发生病毒血症，成为传染源。人不是主要的传染源，猪是本病主要传染源。蝙蝠可作为本病的长期储存宿主和传染源" + }, + { + "question_num": 152, + "query": "造成滞针的原因是", + "options": { + "A": "患者体位移动", + "B": "针具质量差", + "C": "留针时间太短", + "D": "外力压迫", + "E": "单一方向捻针太过" + }, + "answer": "E", + "reason": "滞针是指在行针时或留针后医者感觉针下涩滞，捻转、提插、出针均感困难而患者则感觉剧痛的现象。患者精神紧张，当针刺入腧穴后，局部肌肉强烈收缩可造成滞针，或行针手法不当，向单一方向捻针太过，以致肌肉组织缠绕针体可造成滞针。若留针时间过长也可出现滞针。" + }, + { + "question_num": 153, + "query": "腹痛伴里急后重者多见于", + "options": { + "A": "急性细菌性痢疾", + "B": "伤寒", + "C": "副伤寒", + "D": "肠结核", + "E": "Crohn病" + }, + "answer": "A", + "reason": "急性细菌性痢疾表现为高热、寒战;腹痛、腹泻、里急后重;黏液脓血便;左下腹压痛，肠鸣音亢进。解析】多性丙肝病青感染一般临床表现较轻，也可能出现较重的临床表现，但很少出现重型肝炎。" + }, + { + "question_num": 154, + "query": "患者肢体关节疼痛，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": "乌头汤", + "B": "薏苡仁汤", + "C": "防风汤", + "D": "羌活胜湿汤", + "E": "白虎加桂枝汤" + }, + "answer": "C", + "reason": "患者关节疼痛游走不定为行痹，治疗宜祛风通络，散寒除湿，方用防风汤。A项治疗痛痹；B项治疗着痹；E项治疗风湿热痹。" + }, + { + "question_num": 155, + "query": "有关病毒性肝炎的描述下列哪项是错误的", + "options": { + "A": "妊娠后期合并戊肝病死率高", + "B": "急性丙肝易转为慢性肝炎", + "C": "甲型肝炎不转为慢性", + "D": "丙肝病毒感染易致重型肝炎", + "E": "慢性丙型肝炎可演变为肝硬化" + }, + "answer": "E", + "reason": "伤寒杆菌是伤寒的病原菌具有菌体“◎”抗原、鞭毛“H”抗原和表面“Vi’抗原，在机体感染后诱生相应的抗体，做凝集反应检测血清标本中的“◎”与“H”抗体,此即肥达反应，“Vi”抗体效价低，大多数伤寒杆菌带菌者“Vi”抗体阳性。" + }, + { + "question_num": 156, + "query": "患者，男性，50岁。肝硬化腹水。症见：腹膨大，按之坚满，脘闷腹胀纳呆，大便溏泄，小便不利，舌苔白腻，脉弦缓，其治法是", + "options": { + "A": "疏肝理气，利湿除满", + "B": "运脾利湿，化气行水", + "C": "活血化瘀，利水消肿", + "D": "调脾行气，清热利湿", + "E": "温补肾阳，通阳利水" + }, + "answer": "B", + "reason": "本患者出现的症状为脾失健运所致的水湿内停。治宜运脾利湿，化气行水。" + }, + { + "question_num": 157, + "query": "伤寒杆菌的下列特点中哪项是错误的", + "options": { + "A": "沙门菌属D群,Gˉ带鞭毛杆菌", + "B": "在水中存活2~3周,在粪便中存活1个月", + "C": "煮沸立即被杀死", + "D": "消毒饮水余氯达0.2~0.4mg/L时,可迅速致死", + "E": "有菌体和鞭毛2种抗原,且均产生相应的抗体" + }, + "answer": "E", + "reason": "伤寒杆菌是伤寒的病原菌具有菌体“◎”抗原、鞭毛“H”抗原和表面“Vi’抗原，在机体感染后诱生相应的抗体，做凝集反应检测血清标本中的“◎”与“H”抗体,此即肥达反应，“Vi”抗体效价低，大多数伤寒杆菌带菌者“Vi”抗体阳性。" + }, + { + "question_num": 158, + "query": "患者皮肤有青紫点，量多，时发时止。手足烦热，颧红咽干，午后潮热，盗汗，月经过多，色红而稠，伴齿衄，舌红少苔，脉细数。证型是", + "options": { + "A": "阴虚火旺", + "B": "脾不摄血", + "C": "血热伤络", + "D": "肝肾阴虚", + "E": "气滞血瘀" + }, + "answer": "A", + "reason": "本患者出现的症状为虚火内炽，灼伤脉络，血溢肌腠所致的紫斑。治宜滋阴降火，宁络止血。方用茜根散加减。" + }, + { + "question_num": 159, + "query": "下列不属于法定责任疫情报告人的是", + "options": { + "A": "疾病预防控制机构", + "B": "医疗机构", + "C": "采供血机构", + "D": "执行职务的医疗卫生人员", + "E": "社会福利机构" + }, + "answer": "E", + "reason": "《中华人民共和国传染病防治法》第30条规定;疾病预防控制机构、医疗机构和采供血机构及其执行职务的人员发现本法规定的传染病疫情或者发现其他传染病暴发、流行以及突发原因不明的传染病时，应当遵循疫情报告属地管理原则，按照国务院规定的或者国务院卫生行政部门规定的内容、程序、方式和时限报告。" + }, + { + "question_num": 160, + "query": "患者，女性，36岁。突发眼睑及四肢浮肿，肿势迅速，肢体酸重，尿少，恶风寒，舌苔薄白，脉浮。治疗应首选", + "options": { + "A": "麻黄连翘赤小豆汤", + "B": "五苓散合五皮饮", + "C": "越婢加术汤", + "D": "实脾饮", + "E": "苓桂术甘汤" + }, + "answer": "C", + "reason": "患者突发眼睑及四肢浮肿，肿势迅速，此为典型的风水相搏型水肿；又有恶风寒，舌苔薄白，提示偏于风寒。方选越婢加术汤加减。" + }, + { + "question_num": 161, + "query": "作为指导医务人员进行医疗活动的思想和行为准则及医疗单位目标管理重要内容的是", + "options": { + "A": "药品管理的规定", + "B": "实施医师资格考试", + "C": "进行医师技术考核", + "D": "医药卫生体制改革", + "E": "医务人员医德规范" + }, + "answer": "E", + "reason": "医德规范是指导医务人员进行医疗活动的思想和行为准则，《医德规范》要求各医疗单位都必须把医德教育和医德医风建设作为目标管理的重要内容" + }, + { + "question_num": 162, + "query": "患者，男，45岁。病起5日，恶寒发热，鼻塞流涕，少汗身痛，咳嗽气急，痰稠色黄，咽痛声哑，苔薄黄，舌尖红，脉浮数。证属", + "options": { + "A": "风寒束表证", + "B": "风热犯表证", + "C": "暑湿伤表证", + "D": "气虚感冒", + "E": "阴虚感冒" + }, + "answer": "B", + "reason": "患者恶寒发热，鼻塞流涕，脉浮数，诊为感冒。咳嗽气急，痰稠色黄，咽痛声哑，苔薄黄，舌尖红，脉浮数，为外感风热的表现。" + }, + { + "question_num": 163, + "query": "在使用辅助检查手段时,不适宜的是", + "options": { + "A": "认真严格地掌握适应证", + "B": "可以广泛积极地依赖各种辅助检查", + "C": "有利于提高医生诊治疾病的能力", + "D": "必要检查能尽早确定诊断和进行治疗", + "E": "应从患者的利益出发决定该做的项目" + }, + "answer": "B", + "reason": "辅助检查中,临床医生应从诊治世要出发，目的纯正，做到知情同意，尽职尺贵,综合分析，切忌片面，密切联系，加强合作" + }, + { + "question_num": 164, + "query": "患者，女性，54岁。近来时常齿衄，血色淡红，齿摇不坚，舌红少苔，脉细数，其治法是", + "options": { + "A": "益气摄血", + "B": "滋阴润肺", + "C": "清肝泻火", + "D": "清胃泻火", + "E": "滋阴降火" + }, + "answer": "E", + "reason": "患者肾阴不足，虚火上炎，络损血溢则齿衄，舌红少苔，脉细数为肾阴虚。治疗宜滋阴降火。" + }, + { + "question_num": 165, + "query": "下列各项,不符合道德要求的是", + "options": { + "A": "尽量为患者选择安全有效的药物", + "B": "要严格遵守各种抗生素的用药规则,尽可能开患者要求的好药或贵重药物", + "C": "在医疗过程中要为患者保守秘密", + "D": "对婴幼患儿、老年病人的用药应该谨慎防止肾功能损害", + "E": "钻研药理知识,防止粗疏和盲目用药" + }, + "answer": "B", + "reason": "救死扶伤,忠于职守,钻研医术，精益求精，平等交往，一视同仁，举止端庄，语言文明，廉洁行医，遵纪守法，诚实守信，保守医密，互尊互学，团结协作是医德规范的主要内容。" + }, + { + "question_num": 166, + "query": "患者腹大坚满，脘腹绷急，烦热口苦，渴不欲饮，小便短赤，便溏不爽，舌红苔黄腻，脉滑数，其证候是", + "options": { + "A": "气滞湿阻", + "B": "寒湿困脾", + "C": "湿热蕴结", + "D": "脾胃阳虚", + "E": "肝脾血瘀" + }, + "answer": "C", + "reason": "患者由于湿热蕴结影响水液运行出现臌胀，烦热口苦，小便短赤，舌红苔黄，脉数均为热象；渴不欲饮，便溏不爽，苔腻，脉滑均为湿象。辨证分析为臌胀湿热蕴结证。" + }, + { + "question_num": 167, + "query": "患者,女,68岁。有健忘病史多年，如今计算力、定向力明显减退，神情呆钝,词不达意,头晕耳鸣,腰酸骨软,舌瘦色淡,苔薄白,脉沉细弱。治疗应选用的方剂是", + "options": { + "A": "还少丹", + "B": "补阳还五汤", + "C": "人��养荣汤", + "D": "七福饮", + "E": "转呆汤" + }, + "answer": "D", + "reason": "患者有健忘病史,定向力、计算力减退，词不达意，神情呆钝，考虑为痴呆。痴呆髓海不足证证候:智能减退，记忆力、计算力、定向力、判断力明显减退,神情呆钝,词不达意，头晕耳鸣，怠惰思卧,齿枯发焦,腰酸骨软，步履艰难，舌瘦色淡，苔白，脉沉细弱。治宜补肾益髓，填精养神。方药:七福饮加减。" + }, + { + "question_num": 168, + "query": "患者，女，40岁。水肿多年，腰以下为甚，按之不易复起，脘腹胀闷，纳减便溏，面色萎黄，神倦肢冷，小便短少。舌淡胖，边有齿痕，舌苔白腻，脉沉弱。治疗最佳方药是", + "options": { + "A": "实脾饮", + "B": "济生肾气丸合真武汤", + "C": "胃苓汤合五皮饮", + "D": "参苓白术散", + "E": "越婢加术汤" + }, + "answer": "A", + "reason": "阴水脾阳虚衰证证候：身肿日久，腰以下为甚，按之凹陷不易恢复，脘腹胀闷，纳减便溏，面色不华，神疲乏力，四肢倦怠，小便短少，舌质淡，苔白腻或白滑，脉沉缓或沉弱。治法：健脾温阳利水。方药：实脾饮加减。" + }, + { + "question_num": 169, + "query": "患者,男,70岁。痹证日久不愈,关节疼痛时轻时重,疲劳加重,关节屈伸不利,肌肉瘦削,腰膝酸软,畏寒肢冷,阳痿,遗精,舌苔薄白或少津,脉沉细弱或细数。治疗应首选", + "options": { + "A": "独活寄生汤", + "B": "黄芪桂枝五物汤", + "C": "双合汤", + "D": "羌活胜湿汤", + "E": "白虎加桂枝汤" + }, + "answer": "A", + "reason": "痹证肝肾亏虚证证候:痹证日久不愈，关节疼痛时轻时重，疲劳加重，关节屈伸不利，肌肉瘦削，腰膝酸软，或畏寒肢冷，阳痿，遗精，或骨蒸劳热，心烦口干，舌质淡红,舌苔薄白或少津，脉沉细弱或细数。治宜培补肝肾，通络止痛。方选独活寄生汤，" + }, + { + "question_num": 170, + "query": "患者，女，45岁。因胃脘痞闷不适3个月就诊。近3个月来经常脘腹痞闷，重时满闷如塞，但不疼痛，饮食减少，恶心嗳气，大便不爽，喜长叹息，有时心烦易怒，胸胁胀满，每因生气恼怒而使症状加重，苔薄白，脉弦。治疗应首选", + "options": { + "A": "保和丸加减", + "B": "补中益气汤加减", + "C": "泻心汤合连朴饮加减", + "D": "二陈汤加减", + "E": "柴胡疏肝散加减" + }, + "answer": "E", + "reason": "痞满肝胃不和证证候：脘腹痞闷，胸胁胀满，心烦易怒，善太息，呕恶嗳气，或吐苦水，大便不爽，舌质淡红，苔薄白，脉弦。治法：疏肝解郁，和胃消痞。方药：柴胡疏肝散加减。" + }, + { + "question_num": 171, + "query": "患者,男,30岁。饱餐后上腹部持续疼痛1天。查体:下腹部压痛、反跳痛。应首先考虑的是", + "options": { + "A": "肝癌", + "B": "急性胰腺炎", + "C": "急性肝炎", + "D": "右肾结石", + "E": "急性胃炎" + }, + "answer": "B", + "reason": "反跳痛是腹膜壁层已受炎症累及的征象，患者饱餐后上腹部持续疼痛，首选急性胰腺炎。" + }, + { + "question_num": 172, + "query": "患者，男，55岁。3个月前胸胁部撞伤后，出现胁肋刺痛，痛有定处，夜痛甚，舌质紫暗，脉沉涩。治疗应首选", + "options": { + "A": "复元活血汤", + "B": "少腹逐瘀汤", + "C": "膈下逐瘀汤", + "D": "调营饮", + "E": "香附旋覆花汤" + }, + "answer": "A", + "reason": "3个月前因胸胁部撞伤后，而出现胁肋刺痛，提示病属胁痛；病有定处，夜痛甚，舌质紫暗，脉沉涩，提示有血瘀症状。由此可辨证为胁痛瘀血阻络证，治宜祛瘀通络。方药：复元活血汤或血府逐瘀汤加减。" + }, + { + "question_num": 173, + "query": "患者,男,20岁。心悸不安,体弱气短，虚烦眠差,咽干口燥,舌淡少苔,脉结代。治疗应选用", + "options": { + "A": "天王补心丹", + "B": "炙甘草汤", + "C": "归脾汤", + "D": "生脉散", + "E": "朱砂安神丸" + }, + "answer": "B", + "reason": "该患者为阴血阳气虚弱,心脉失养之证。炙甘草汤益气滋阴、通阳复脉临床用于阴血阳气虚弱、心脉失养之证，症见心动悸,脉结代，虚羸少气，舌光少苔,或质干而瘦小;或虚劳肺痿之证，症见干咳无痰，或咳吐涎沫,量少，形瘦气短，虚烦不眠,自汗或盗汗,咽干舌燥,大便干结,脉虚数。" + }, + { + "question_num": 174, + "query": "患者久痢不愈，下痢稀薄，带有白冻，滑脱不禁，腹痛隐隐，口淡不渴，食少神疲，四肢不温，舌淡苔薄白，脉细弱。治疗应首选", + "options": { + "A": "连理汤合参苓白术散", + "B": "桃花汤合真人养脏汤", + "C": "良附丸合温脾汤", + "D": "芍药汤合四君子汤", + "E": "驻车丸合温脾汤" + }, + "answer": "B", + "reason": "题干症状均为阳虚之象，诊断为虚寒痢，治宜温补脾肾，收敛固摄，方用桃花汤合真人养脏汤。而A项治疗休息痢；D项治疗湿热痢；E项治疗阴虚痢。" + }, + { + "question_num": 175, + "query": "患者,女性,29岁。咽喉肿痛1天,咽干,口渴,便秘。治疗应首选", + "options": { + "A": "少泽", + "B": "太溪", + "C": "少商", + "D": "少海", + "E": "太渊" + }, + "answer": "C", + "reason": "此为咽喉肿痛的实热证,取手太阴、阳明经为主。取少商点刺放血可以治户父抽执性定用于此刑明哈曲病景为右动同时配以合谷、尺泽、内庭、陷谷、关冲穴。胃腑热盛加厉兑。" + }, + { + "question_num": 176, + "query": "患者，男性，59岁。平素头晕头痛，耳鸣目眩，突发右半身不遂，肢软无力，口舌喎斜，语言謇涩，不能起床已半年余，舌暗苔薄腻，脉弦细，其治法是", + "options": { + "A": "滋阴潜阳，息风通络", + "B": "益气活血，通经活络", + "C": "辛温开窍，豁痰息风", + "D": "辛凉开窍，清肝息风", + "E": "活血化瘀，化痰通络" + }, + "answer": "A", + "reason": "患者平素肝阳上扰则出现头晕头痛，耳鸣目眩，由于肝阳暴涨，阳化风动，气血逆乱则中风，中风半年则阴不潜阳，易虚风内扰，故治宜滋阴潜阳，息风通络。" + }, + { + "question_num": 177, + "query": "患者,女,47岁。因情志不畅而致咽中如有物梗阻,咳吐不出,吞咽不下,胸胁满闷。治疗应首选", + "options": { + "A": "越鞠丸", + "B": "厚朴温中汤", + "C": "半夏厚朴汤", + "D": "天台乌药散", + "E": "苏子降气汤" + }, + "answer": "C", + "reason": "根据题干主症“因情志不畅而致咽中如有物梗阻”，故知此为梅核气。半夏厚朴汤行气散结、降逆化痰，主治梅核气。症见咽中如有物阻，咳吐不出，吞咽不下,胸膈满闷或咳或呕,苔白润或白滑,脉弦滑或弦缓。" + }, + { + "question_num": 178, + "query": "患者，男，45岁。呃逆频作，声音洪亮有力，冲逆而出，口臭烦渴，多喜冷饮，脘腹满闷，大便秘结，舌苔黄燥，脉滑数。治疗应首选", + "options": { + "A": "竹叶石膏汤", + "B": "橘皮竹茹汤", + "C": "丁香柿蒂散", + "D": "小承气汤", + "E": "泻心汤" + }, + "answer": "A", + "reason": "依据患者表现诊为呃逆胃炎上逆证，方选竹叶石膏汤。" + }, + { + "question_num": 179, + "query": "患者,女性,36岁。1周来头晕目眩伴胸胁胀闷,舌红,脉弦。治疗应首选", + "options": { + "A": "脾俞、足三里、气海、百会", + "B": "丰隆、中脘、内关、头维", + "C": "胃俞、丰隆、太冲、期门", + "D": "风池、肝俞、行间、侠溪", + "E": "百会、肾俞、悬钟、太溪" + }, + "answer": "D", + "reason": "本例患者辨证为肝阳上亢型眩晕。肝、胆两经，同为风木所寄，取风池行间、侠溪清泻肝胆上亢之阳，肝俞平肝潜阳。A项治疗气血虚弱型眩晕;B项治疗痰湿中阻型眩晕;C项治疗肝胃不和型疾病;E项治疗肾精亏损型眩晕。" + }, + { + "question_num": 180, + "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": "理气解郁，化痰开窍", + "D": "镇心涤痰，安神定志", + "E": "化痰健脾，养心宁神" + }, + "answer": "C", + "reason": "肝郁乘脾，脾失健运，输布失司，聚液成痰，阻于心窍则见精神抑郁，表情淡漠，沉默痴呆，妄见妄闻；痰迷心窍则喃喃自语，多疑多虑，喜怒无常，秽浊不分；肝郁不舒，肝气乘脾，脾失健运则时时太息，不思饮食；舌红苔腻而白，脉弦滑为气滞痰结之象，故辨证分析为癫证之痰气郁结证。治宜理气解郁，化痰开窍。" + }, + { + "question_num": 181, + "query": "患者,男,62岁。腹胀大如鼓，按之如囊裹水,有波动感。应首先考虑的是", + "options": { + "A": "水鼓", + "B": "痞满", + "C": "积聚", + "D": "水饮", + "E": "内痈" + }, + "answer": "A", + "reason": "痞满为无形之邪,仅自觉腹胀;积聚多为有形之邪，按之固定不移，无波动感;水饮虽也可见腹胀大如鼓,但无如囊裹水，有波动感症状;内痈一般无腹胀大如鼓的表现，" + }, + { + "question_num": 182, + "query": "患者突然昏倒��地，神志不清，牙关紧闭，两目上视，手足抽搐，口吐涎沫，不久渐醒，醒后疲乏无力，舌苔白腻，其治法是", + "options": { + "A": "豁痰开窍，息风定痫", + "B": "理气化痰，活血化瘀", + "C": "镇心祛痰，安神定志", + "D": "清肝泻火，养血安冲", + "E": "清肝泻火，化痰开窍" + }, + "answer": "A", + "reason": "患者突然跌倒，神志不清，抽搐吐涎，是由于肝风痰浊蒙神；短暂神志不清，为痰浊阻滞；苔白腻，脉弦滑有力为痰浊或痰热内盛之象，故辨证分析为痰浊素盛，肝阳化风，痰随风动，风痰闭阻，上干清窍所致的痫证风痰闭阻证。治法当以豁痰开窍，息风定痫。" + }, + { + "question_num": 183, + "query": "患者,男,48岁。长期感腰膝酸软，听力减退,尿频,夜尿多,滑精,舌质淡,脉弱,其临床意义是", + "options": { + "A": "肾不纳气", + "B": "肾阴虚", + "C": "肾气不固", + "D": "肾精不足", + "E": "肺肾气虚" + }, + "answer": "C", + "reason": "患者出现腰膝酸软,表明肾虚，结合尿频，夜尿多，滑精等气不摄津症状，是为肾气不固。" + }, + { + "question_num": 184, + "query": "患者，男，25岁。肢体关节疼痛较剧，痛有定处，得热痛减，遇寒痛增，疼痛局部皮色不红，触之不热，舌苔薄白，脉弦紧。治疗应首选", + "options": { + "A": "独活寄生汤", + "B": "蠲痹汤", + "C": "薏苡仁汤", + "D": "乌头汤", + "E": "白虎加桂枝汤" + }, + "answer": "D", + "reason": "病势较甚,痛有定处,遇寒加重者为痛痹，属寒邪盛，治以温经散寒，祛风除湿为法，方选鸟头汤。" + }, + { + "question_num": 185, + "query": "患者,女,25岁,已婚。月经周期或先或后,经量或多或少,色黯有小块,经行不畅，乳房作胀,舌苔薄白,脉弦,其证型是", + "options": { + "A": "肝郁化热", + "B": "肝郁", + "C": "肾虚", + "D": "脾虚肝郁", + "E": "肝郁血虚" + }, + "answer": "B", + "reason": "月经先后不定期,伴随乳房作胀，舌苔薄白，脉弦。病机是肝郁气滞。脉弦也为肝气郁滞之象。" + }, + { + "question_num": 186, + "query": "患者,女,36岁。产后抑郁多年,长期自觉咽中如有物梗阻,但无咽痛及吞咽困难在心情愉快时,症状可减轻或消失,而当心情抑郁或注意力集中于咽部时,则梗阻感觉加重,苔白腻，脉弦滑。本证候的证机概要是", + "options": { + "A": "肝郁化火,上扰心神", + "B": "肝郁气滞,脾胃失和", + "C": "肝郁化火，横逆犯胃", + "D": "气郁痰凝，阻滞胸咽", + "E": "肝郁不舒,气机上逆" + }, + "answer": "D", + "reason": "证属郁证痰气交阻证,属中医“梅核气”。产后抑郁多年,咽中不适随情绪增减,脉弦,都提示气郁。苔白腻，脉滑，为痰湿的表现。因此该证病机应为气郁痰凝，阻滞胸咽。" + }, + { + "question_num": 187, + "query": "患者,女,20岁。日晡潮热，口臭,脘腹胀满,大便秘结,舌红苔黄,脉沉而有力。此证的发热属于", + "options": { + "A": "阴虚潮热", + "B": "阳明潮热", + "C": "湿温潮热", + "D": "气虚发热", + "E": "阳明经热" + }, + "answer": "B", + "reason": "阳明潮热、汉下午3~5时(即申时)热势妆高、这种发热有明显的时间限定、并且常件有使秘、种春、黄或黑起制、沉有力的表现、" + }, + { + "question_num": 188, + "query": "患者因劳累后唇缘、口角处见群集的小水疱,灼热痒痛,周身不适,心烦郁闷,大便干,小便黄,舌红,苔黄,脉弦数。治疗应首选的方剂是", + "options": { + "A": "龙胆泻肝汤", + "B": "五味消毒饮", + "C": "黄连解毒汤", + "D": "导赤散", + "E": "辛夷清肺饮合竹叶石膏汤" + }, + "answer": "E", + "reason": "患者唇缘、口角处见群集的小水疱，此为热疮的典型表现，根据其余临床表现辨证为脾胃热盛型，治宜疏风清热解毒方用辛夷清肺饮合竹叶石膏汤。" + }, + { + "question_num": 189, + "query": "患者食欲和记忆力减退,检查见眼睑苍白，血红细胞、白细胞和血小板均减少。应首先考虑的是", + "options": { + "A": "再生障碍性贫血", + "B": "缺铁性贫血", + "C": "溶血性贫血", + "D": "失血性贫血", + "E": "白细胞减少及粒细胞缺乏症" + }, + "answer": "A", + "reason": "三系减少结合贫血表现者先考虑再生障碍性贫血。" + }, + { + "question_num": 190, + "query": "患者,女,55岁。2个月来关节肿大窜痛,屈伸不利,恶风怕冷,虽已治疗,症无改善，又增关节局部灼热,口干便燥,脉滑稍数,舌苔薄黄。主方选用", + "options": { + "A": "白虎桂枝汤", + "B": "薏苡仁汤", + "C": "防风汤", + "D": "桂枝芍雩〟掬锏的优佺樾匠榖掲璇母汤", + "E": "犀角散" + }, + "answer": "D", + "reason": "据其主症、舌脉分析,此为痹证之行痹。由风寒湿邪留滞经络，阻滞气血所引起，且邪有化热之象。治疗当首选寒热并用的桂枝芍药知母汤，祛风通络，散寒除湿清热。" + }, + { + "question_num": 191, + "query": "患者,女,43岁。经来量多，色淡红,质清稀，面色白,气短懒言,肢软无力,小腹空坠，舌淡,脉细弱。妇科检查:子宫正常大小,双附件正常，血红蛋白90g/L。诊断为月经过多。治疗应首选", + "options": { + "A": "补中益气汤", + "B": "安冲汤", + "C": "保阴煎", + "D": "失笑散", + "E": "八珍汤" + }, + "answer": "B", + "reason": "患者月怒过多、血红蛋白90g/L，出现轻度贫血。据而色白，气短懒言，小坡空业等症、辨征为气鹿征。月经过多气盛证，治宜补气摄血固冲方药:举元瓜或安冲汤。" + }, + { + "question_num": 192, + "query": "患者,男,55岁。胁肋胀痛或灼热疼痛,触痛较甚,口苦口黏,胸闷纳呆,恶心呕吐,小便黄赤,大便不爽,或兼有身热恶寒,身目发黄,舌2红苔黄腻,脉弦滑数。治疗应首选", + "options": { + "A": "龙胆泻肝汤", + "B": "少腹逐瘀汤", + "C": "膈下逐瘀汤", + "D": "调营饮", + "E": "香附旋覆花汤" + }, + "answer": "A", + "reason": "口苦口黏,胸闷纳呆,恶心呕吐，小便黄赤，大便不爽，或兼有身热恶寒，身目发黄，舌红苔黄腻，都是肝胆湿热表现，治疗当清热利湿。代表方:龙胆泻肝汤加减。" + }, + { + "question_num": 193, + "query": "患者,女,32岁,已婚。婚后4年未孕，月经3~5月一行。经量甚少,形体肥胖,头晕心悸,带下量多、质稠,面色?白,舌苔白腻,脉滑。治疗应首选", + "options": { + "A": "毓麟珠", + "B": "温胞饮", + "C": "养精种玉汤", + "D": "开郁种玉汤", + "E": "苍附导痰丸" + }, + "answer": "E", + "reason": "女子婚后未进孕,有正常性生活，同居2车，而未受孕者;或曾有过妊娠，而后未进孕，又连续2年朱再受孕者，称“不孕症”、题中患者已婚，婚后4车米孕即可诊断为不孕症。患者又现为经3~5月一行，经量甚少,形体肥胖,头晕心悸,带下量多、质稠,面色觥白,舌苔白腻,脉滑,为痰湿阻滞。辨证为不孕症之痰湿内阻证。治宜燥湿化痰，行滞调经。方选苍附导痰丸。" + }, + { + "question_num": 194, + "query": "患者,男性,32岁。右下肢麻木、发凉泊冷2年,每行走约1000m须停下休息。体检查:右下肢皮温较对侧低,色泽苍白,右足背动脉搏动减弱,其诊断是", + "options": { + "A": "血栓闭塞性脉管炎", + "B": "大动脉炎", + "C": "右下肢动脉硬化性闭塞症", + "D": "右下肢深静脉血栓形成", + "E": "右下肢血栓性浅静脉炎" + }, + "answer": "A", + "reason": "右下肢皮温较对侧低,右足背动脉搏动减弱，此为脱疽的典型表现，脱疽相当于西医的血栓闭塞性脉管炎。" + }, + { + "question_num": 195, + "query": "患者,男,55岁。因急性广泛前壁心肌梗死入院,现突然出现频发室性期前收缩，其治疗首选静脉注射", + "options": { + "A": "阿托品", + "B": "毛花苷", + "C": "普罗帕酮", + "D": "苯妥英钠", + "E": "利多卡因" + }, + "answer": "E", + "reason": "室性心律失常首选利多卡室上性考虑维拉帕米。因。" + }, + { + "question_num": 196, + "query": "患者大便秘结,欲便不得,暖气频作,胸胁痞满,重则腹中胀痛,纳食减少,舌苔薄腻,脉弦。治疗应首选", + "options": { + "A": "四磨汤", + "B": "四逆散", + "C": "六磨汤", + "D": "四七汤", + "E": "柴胡疏肝散" + }, + "answer": "C", + "reason": "大便秘结,诊为便秘;嗳气频作，胸胁痞满，重则腹中胀痛,诊为气滞，故诊断为便秘之气滞证，治当顺气导滞，方用六磨汤。" + }, + { + "question_num": 197, + "query": "患者,女,26岁。头昏、乏力半年，近2年每次月经经期持续7~8天,有血块。红细胞3.0X10/L,血红蛋白65g/L,血清铁蛋白10μg/L,血清叶酸16ng/ml，网织红细胞0.015。该患者最可能的诊断是", + "options": { + "A": "营养性巨幼细胞性贫血", + "B": "缺铁性贫血", + "C": "溶血性贫血", + "D": "再生障碍性贫血", + "E": "珠蛋白生成障碍性贫血" + }, + "answer": "B", + "reason": "患者慢性失血病史，血红蛋白小于110g/L,血清铁蛋白<12μg/L,诊为缺铁性贫血。" + }, + { + "question_num": 198, + "query": "惠儿,足月生,25天。出生后2周出现身黄,目黄,其色晦暗,持续不退,��神差,四肢欠温,大便溏薄,舌苔白腻,指纹色淡。治疗应首选", + "options": { + "A": "茵陈蒿汤加减", + "B": "茵陈理中汤加减", + "C": "血府逐瘀汤加减", + "D": "羚角钩藤汤加减", + "E": "茵陈四苓散加减" + }, + "answer": "B", + "reason": "新生儿黄疸寒湿阻滞证证候:面目皮肤发黄，色泽晦暗，黄疸持久不退，精神萎靡，四肢欠温，大便溏薄，或便色灰白，小便短少，舌质偏淡，苔白腻。治法:温中化湿退黄。方药:茵陈理中汤。" + }, + { + "question_num": 199, + "query": "患者,男,50岁。反复上腹痛15年，腹痛常在饭后,持续1~2小时。近半年疼痛加剧,食欲减退,体重减轻。检查:贫血貌,左锁骨上触及肿大淋巴结,红细胞沉降率46mm/h，大便隐血试验持续阳性。应首先考虑的是", + "options": { + "A": "慢性胆囊炎发作", + "B": "十二指肠溃疡发作", + "C": "胃溃疡伴幽门梗阻", + "D": "胃溃疡恶变", + "E": "复合性溃疡病" + }, + "answer": "D", + "reason": "胃溃疡的特点是反复规律的餐后痛，发生恶变时体重下降，淋巴结肿大;红细胞沉降率增快。胃溃疡伴幽门梗阻会有呕吐、腹胀痛等表现，十二指肠溃疡的特点是反复的饥饿痛。" + }, + { + "question_num": 200, + "query": "患者,女性,34岁,已婚。月经50多天一行,量少,色暗,少腹胀闷,胸胁乳房作胀舌苔薄白,脉弦。治疗应首选", + "options": { + "A": "逍遥散", + "B": "丹栀逍遥散", + "C": "乌药汤", + "D": "香棱丸", + "E": "小柴胡汤" + }, + "answer": "C", + "reason": "月经后期气滞证的特征性证候是小腹胀痛或乳房胀痛，代表方为乌药汤。月经后期肾虚证的特征性证候是头晕耳鸣、腰膝酸软，代表方为当归地黄饮，月经后期血虚证的特征性证候是心悸少寐、头晕眼花、面色苍白，代表方为大补元煎。月经后期血寒证的代表方为温经汤。月经后期痰湿证的代表方为芎归二陈汤。" + }, + { + "question_num": 201, + "query": "患者，女性，27岁，未婚。经间期出血，色红，无血块，无腹痛，头晕腰酸，大便坚，溲黄，舌红，脉细弦数。治疗应首选", + "options": { + "A": "六味地黄丸", + "B": "清肝止淋汤", + "C": "逐瘀止血汤", + "D": "两地汤", + "E": "清肝引经汤" + }, + "answer": "D", + "reason": "肾阴不足，热伏冲任，于氤氲期，阳气内动，阳气乘阴，迫血妄行，故发生出血；阴虚内热，故色红；肾阴虚，脑髓及外府失养，故头晕腰酸；阴虚生内热，热伤津，故大便艰，溲黄；舌红，脉细弦数为阴虚内热之证，其治法为养阴清热，固冲止血。" + }, + { + "question_num": 202, + "query": "患者，女，21岁，未婚。近4个月经提前8～10天，量多、色淡、质稀，神疲肢倦，小腹空坠，舌淡，脉缓弱，诊为月经先期，其证候是", + "options": { + "A": "阴虚", + "B": "实热", + "C": "气虚", + "D": "肝郁血热", + "E": "阳盛血热" + }, + "answer": "C", + "reason": "“近4个月经提前8-10天”，诊为月经先期；“量多、色淡、质稀，神疲肢倦，小腹空坠，舌淡，脉缓弱”，诊为脾气虚。因此，此为月经先期之脾气虚证，统属于气虚证。" + }, + { + "question_num": 203, + "query": "患者，女性，34岁，已婚。患痛经2年，经前或经期小腹冷痛，痛甚则呕恶，经色紫黯、有块，块下痛减，形寒肢冷，面色苍白，舌紫黯有瘀点，其证型是", + "options": { + "A": "气滞血瘀", + "B": "寒凝血瘀", + "C": "气虚血瘀", + "D": "肾虚血瘀", + "E": "热郁血瘀" + }, + "answer": "B", + "reason": "寒客冲任，血为寒凝，瘀滞冲任，气血运行不畅，经行之际，气血下注冲任，胞脉气血壅滞，“不通则痛”，故痛经发作；寒客冲任，血为寒凝，可见周期延长，经色紫暗、有块，块下痛减；寒伤阳气，故形寒肢冷，面色苍白；舌紫暗有瘀点亦为寒凝血瘀之证，其治疗原则为温经散寒，祛瘀止痛。" + }, + { + "question_num": 204, + "query": "患者，女性，40岁，已婚。每值经前1天出现大便溏泄，脘腹胀满，面浮肢肿，神疲肢软，经净渐止，舌淡苔白，脉濡缓。治疗应首选", + "options": { + "A": "健固汤", + "B": "香砂六君子汤", + "C": "补中益气汤", + "D": "白术散", + "E": "参苓白术散" + }, + "answer": "E", + "reason": "脾气本虚，经前或经期，气血下注冲任，脾气益虚，运化失司，水湿下走大肠，故有泄泻，脘腹胀满；脾主四肢，脾气虚弱，故神疲肢软；水湿泛溢肌肤，故面浮肢肿；舌淡苔白，脉濡缓亦为脾虚之证，���治疗原则为补脾益气，除湿止泻。方选参苓白术散。" + }, + { + "question_num": 205, + "query": "患者，女性，36岁，已婚。带下量多，色黄白，质黏，无味，纳少便溏，舌淡，苔白腻，脉缓弱。治疗应首选", + "options": { + "A": "完带汤", + "B": "止带方", + "C": "萆薢渗湿汤", + "D": "参苓白术散", + "E": "内补丸" + }, + "answer": "A", + "reason": "脾阳虚弱，运化失职，水湿内停，湿浊下注，损伤任带二脉，约束无力，故带下量多，色白或淡黄，质稀薄，无臭气，绵绵不断；脾虚中阳不振，则神疲倦怠，四肢不温；脾虚运化失职，则纳少便溏；湿浊内盛，则两足跗肿；脾虚清阳不升，则面色㿠白。舌淡，苔白腻，脉缓弱，为脾阳不足之证。治疗原则为健脾益气，升阳除湿。" + }, + { + "question_num": 206, + "query": "患者，男，23岁。一个月前左上肢突然疼痛，检查局部光软无头，红、肿、热、痛，范围在6～9cm，易肿、易溃、易脓、易敛。应诊断为", + "options": { + "A": "疖", + "B": "疔", + "C": "痈", + "D": "发", + "E": "有头疽" + }, + "answer": "C", + "reason": "痈是指发生于体表皮肉之间的急性化脓性疾病，其特点是局部光软无头，红肿疼痛（少数初起皮色不变），结块范围多在6-9cm左右，发病迅速，易肿、易脓、易溃、易敛，或伴恶寒、发热、口渴等症状。该患者表现符合痈的诊断。" + }, + { + "question_num": 207, + "query": "患者，女性，33岁，已婚。孕5个月，面浮肢肿，肿处皮薄而光亮，按之凹陷不起，腰酸无力，下肢逆冷，舌淡苔白润，脉沉迟。诊断为子肿，其证候是", + "options": { + "A": "脾虚", + "B": "肾虚", + "C": "气滞", + "D": "血瘀", + "E": "血虚" + }, + "answer": "B", + "reason": "肾虚型子肿是由于素体肾虚，或房事不节所致。孕后阴血下聚冲任养胎，阻碍肾阳输布，不能化气行水，以致水湿内停，水湿泛溢肌肤而为肿胀；肾虚髓海不足，外府失荣，故腰酸无力，下肢逆冷；舌淡苔白润，脉沉迟为肾阳不足之证。" + }, + { + "question_num": 208, + "query": "患者，女，32岁。小腹部有一包块，坚硬，固定不移，疼痛拒按，面色晦暗，月经量多或少，经色紫黯有块，腰膝酸软，头晕耳鸣。舌边有瘀点，脉沉涩。宜选用", + "options": { + "A": "桂枝茯苓丸", + "B": "补肾祛瘀方", + "C": "香棱丸", + "D": "大黄牡丹皮汤", + "E": "开郁二陈汤" + }, + "answer": "B", + "reason": "小腹部有一包块，坚硬，固定不移，疼痛拒按，考虑癥瘕。面色晦暗，月经量多或少，经色紫黯有块，腰膝酸软，头晕耳鸣，舌边有瘀点，脉沉涩，诊为肾虚血瘀证。治法：补肾活血，消癥散结。代表方：补肾祛瘀汤或益肾调经汤。" + }, + { + "question_num": 209, + "query": "患儿，1岁。刚会用拇指、食指去拾东西。他的这项功能比正常儿童延迟的时间是", + "options": { + "A": "2～3个月", + "B": "4～5个月", + "C": "6～7个月", + "D": "8～9个月", + "E": "10～11个月" + }, + "answer": "A", + "reason": "小儿在9个月左右时，可扶栏杆站立，会爬，会用拇指、食指去拾东西。" + }, + { + "question_num": 210, + "query": "患儿，3岁。体重11kg。以下诊断中可能性最大的是", + "options": { + "A": "佝偻病", + "B": "营养不良", + "C": "侏儒症", + "D": "解颅", + "E": "肥胖症" + }, + "answer": "B", + "reason": "2岁以上小儿体重计算公式：体重（kg）=8+2×年龄。按照计算公式，3岁小儿体重应为14kg，体重小于正常均值的85％考虑营养不良。" + }, + { + "question_num": 211, + "query": "患儿，7个月。病起1天，发热，泄泻9次，大便稀薄如水，泻下急迫，恶心呕吐，阵阵啼哭，小便短黄。治疗应首选的方剂是", + "options": { + "A": "保和丸", + "B": "平胃散", + "C": "参苓白术散", + "D": "藿香正气散", + "E": "葛根黄芩黄连汤" + }, + "answer": "E", + "reason": "A项治疗伤食泻，粪便酸臭，嗳气酸馊。C项用于脾虚泻，食后作泻，色淡不臭，时轻时重。D项用于风寒泻，泄泻清稀，有泡沫。E项用于湿热泻，泻下稀薄，或如水注。" + }, + { + "question_num": 212, + "query": "患者，女，29岁。月经周期先后不定，量多如注，持续十余日不净，婚后半年，未避孕未孕。可诊断为", + "options": { + "A": "月经先后无定期", + "B": "月经过多", + "C": "经期延长", + "D": "崩漏", + "E": "不孕症" + }, + "answer": "D", + "reason": "崩漏指经血���时而至，或暴下不止，或淋漓不尽；前者称崩中，后者称漏下，其特点是周期、经期、经量均发生严重紊乱。月经周期基本正常，行经时间超过7天以上，甚或淋漓半月方净者，称为经期延长。月经量较正常明显增多，而周期基本正常者，称为月经过多。月经周期时或提前时或延后7天以上，连续3个周期以上者，称为月经先后无定期。凡女子婚后未避孕，有正常性生活，同居1年，而未受孕者；或曾有的妊娠，而后未避孕，又连续1年未再受孕者，称为不孕症。前者称为原发性不孕，后者称为继发性不孕。" + }, + { + "question_num": 213, + "query": "患者，男性，60岁。反复咳嗽、咳痰10年，近3年每当秋冬发病，大气变暖后逐渐减轻。检查：两肺闻及散在干啰音。X线显示肺纹理增多，其诊断是", + "options": { + "A": "肺结核", + "B": "肺癌", + "C": "支气管扩张", + "D": "支气管哮喘", + "E": "慢性支气管炎" + }, + "answer": "E", + "reason": "肺结核表现为午后低热、乏力、食欲减退、消瘦、盗汗，干咳或伴咯血。X线示密度较高、边缘清晰的斑点、条索或结节或云雾状阴影或空洞。咳嗽后偶可闻及湿啰音。肺癌表现为咳嗽、气促，痰中带血，多为血丝痰，胸闷、胸痛，晚期患者可出现较明显的恶病质。支气管扩张具有咳嗽、咳痰反复发作的特点，合并感染时有大量脓痰，或反复和多少不等的咯血史。支气管哮喘表现为反复发作性的喘息、呼气性呼吸困难、胸闷或咳嗽等；慢性支气管炎主要表现为咳嗽、咳痰或伴喘息。" + }, + { + "question_num": 214, + "query": "患者，女，35岁。有十二指肠溃疡病史3年余，近日劳累后频发上腹疼痛，食欲缺乏，乏力，2小时前因上消化道出血急诊，经治疗未再呕血。提示患者仍有继续出血的表现是", + "options": { + "A": "心率106次/分", + "B": "肠鸣音5次/分", + "C": "血压105/65mmHg", + "D": "红细胞计数增加", + "E": "体液与尿量足够的情况下，血尿素氮持续或再次增高" + }, + "answer": "E", + "reason": "临床上出现下列情况应考虑继续出血：①反复呕血，或黑便次数增多，甚至呕血转为鲜红色，黑便转为暗红色，伴肠鸣音亢进；②虽经补液、输血，周围循环衰竭表现未见明显改善，或暂时好转后又恶化；③红细胞计数与血细胞比容继续下降，网织细胞计数持续升高；④在体液与尿量足够的情况下，血尿素氮持续或再次增高。" + }, + { + "question_num": 215, + "query": "患者因夜吹风扇，晨起出现右颈项痛，转动受限，并向同侧肩部放射。针灸治疗除主穴外，宜选取", + "options": { + "A": "血海、膈俞、肩髃", + "B": "合谷、曲池、大椎", + "C": "风池、内关、肩井", + "D": "风池、合谷、肩髃", + "E": "大椎、束骨、天宗" + }, + "answer": "D", + "reason": "该患者为落枕风寒袭络证。落枕治疗主穴：外劳宫、天柱、阿是穴、后溪、悬钟。配穴：病在督脉、太阳经者配大椎、束骨；病在少阳经配风池、肩井。风寒袭络配风池、合谷；气滞血瘀配内关、合谷。肩痛配肩髃；背痛配天宗。" + }, + { + "question_num": 216, + "query": "风湿性心脏病心力衰竭服用地高辛13天，出现恶心、呕吐，室性期前收缩二联律，除停用洋地黄外，治疗应首选", + "options": { + "A": "美西律", + "B": "普萘洛尔", + "C": "钾盐", + "D": "普罗帕酮", + "E": "胺碘酮" + }, + "answer": "C", + "reason": "洋地黄的中毒反应包括各类心律失常和胃肠道反应，如恶心、呕吐，以及中枢神经系统的症状，如视物模糊、倦怠等。发生洋地黄中毒应立即停止用药，可使用钾盐纠正钾低。" + }, + { + "question_num": 217, + "query": "患者，男，24岁。发热，咽痛，皮肤紫斑1个月余。查体：胸骨压痛明显，肝脾大，骨髓象中原始细胞占38％，血象呈全血细胞减少，其诊断是", + "options": { + "A": "再生障碍性贫血", + "B": "粒细胞缺乏症", + "C": "特发性血小板减少性紫癜", + "D": "急性白血病", + "E": "过敏性紫癜" + }, + "answer": "D", + "reason": "急性白血病：临床有发热、感染、贫血等症状，体检有淋巴结、肝脾肿大及胸骨压痛，外周血片有原始细胞，骨髓细胞形态学及细胞化学染色显示某一系列原始细胞≥30％即可诊断。" + }, + { + "question_num": 218, + "query": "患者，男性，53岁。有乙肝病史，近1个月右上腹胀痛加重，时有牙龈出血。查体：有肝掌，胸部有蜘蛛痣，肝肋缘下3cm，质硬，有压痛，脾大，腹水征阳性，腹���静脉曲张，应首先考虑的是", + "options": { + "A": "慢性乙肝活动期", + "B": "原发性肝癌", + "C": "肝硬化", + "D": "疟疾", + "E": "肝脓肿" + }, + "answer": "C", + "reason": "肝硬化主要表现为肝功能减退和肝硬化门静脉高压症，出现上腹部胀满不适，恶心呕吐、黄疸、鼻出血、牙龈出血、皮肤紫癜、蜘蛛痣、肝掌；脾大、静脉曲张和腹水。" + }, + { + "question_num": 219, + "query": "患者，男，46岁。5年来，胃脘部经常反复发作性疼痛。表现为隐隐作痛，喜温喜按，纳差神疲，大便溏，苔白，脉弱。针灸取穴为", + "options": { + "A": "中脘、足三里、脾俞、胃俞、关元", + "B": "中脘、内关、足三里、梁门、建里", + "C": "中脘、足三里、膈俞、公孙、三阴交", + "D": "中脘、内关、足三里、太冲、合谷", + "E": "中脘、足三里、脾俞、胃俞、内庭" + }, + "answer": "A", + "reason": "从本患者的症状可诊断为胃痛（脾胃虚寒型），治疗应健脾胃、温中散寒，A项中的脾俞、胃俞、关元能健脾胃、助阳散寒，故为正确答案。" + }, + { + "question_num": 220, + "query": "患者，女，63岁。长期咽喉不适感，隐痛，咽喉稍肿，色暗红，舌淡红，苔薄白，脉沉细。欲用针灸配合治疗，可取腧穴", + "options": { + "A": "少商、合谷、尺泽、关冲", + "B": "少商、合谷、列缺、外关", + "C": "太溪、照海、鱼际、列缺", + "D": "太渊、丰隆、列缺、合谷", + "E": "以上都不可" + }, + "answer": "C", + "reason": "从患者的症状可诊断为咽喉肿痛（肾阴不足型），针灸治疗应滋补肾阴，清虚火。太溪为肾经原穴，有滋阴降火作用；照海亦属肾经，又通阴跷脉，列缺属手太阴肺经，通任脉，二穴相配，为八脉交会组穴，治疗咽喉疾患；鱼际为手太阴经的荥穴，可清肺热、利咽喉。" + } +] \ No newline at end of file