diff --git "a/Assistant/Theory_Questions/Year_3/Past_Paper.json" "b/Assistant/Theory_Questions/Year_3/Past_Paper.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_3/Past_Paper.json" @@ -0,0 +1,2706 @@ +[ + { + "question_num": 1, + "query": "下列各项，不属青色所主病证的是", + "options": { + "A": "寒证", + "B": "惊风", + "C": "血瘀", + "D": "疼痛", + "E": "热证" + }, + "answer": "E", + "reason": "青色主寒证、气滞、血瘀、疼痛和惊风。" + }, + { + "question_num": 2, + "query": "喘证实喘的主要病位在", + "options": { + "A": "心", + "B": "肝", + "C": "肺", + "D": "脾", + "E": "肾" + }, + "answer": "C", + "reason": "实喘在肺,虚喘在肺肾." + }, + { + "question_num": 3, + "query": "症见身热，鼻塞恶风，汗出，脉浮缓，宜选用的方剂是", + "options": { + "A": "桂枝汤", + "B": "麻黄汤", + "C": "桑菊饮", + "D": "小青龙汤", + "E": "九味羌活汤" + }, + "answer": "A", + "reason": "桂枝汤:解肌发表、调和营卫,主治外感风寒表虚证。恶风发热,汗出头痛,鼻鸣干呕,苔白不渴，脉浮缓或浮弱者。" + }, + { + "question_num": 4, + "query": "下列各项，常发于多汗体质青年，并可在家庭中相互传染的是", + "options": { + "A": "白秃疮", + "B": "肥疮", + "C": "鹅掌风", + "D": "圆癣", + "E": "花斑癣" + }, + "answer": "E", + "reason": "花斑癣:本病常发于多汗体质青年，可在家庭中互相传染。皮损好发于颈项、躯干,尤其是多汗部位及四肢近心端，为大小不一、边界清楚的圆形或不规则的无炎症性斑块，色淡褐、灰褐至深褐色，或轻度色素减退，或附少许糠秕状细鳞屑，常融合成片。有轻微痒感,常夏发冬愈，复发率高。" + }, + { + "question_num": 5, + "query": "下列各项，不属于传染病诊治工作道德要求的是", + "options": { + "A": "重视消毒隔离", + "B": "遵守国家相关法律", + "C": "合理使用医疗资源", + "D": "具有无私奉献精神", + "E": "严格疫情报告制度" + }, + "answer": "C", + "reason": "传染科室的道德要求:①热爱本职工作,具有无私素献精神;②坚持预防为主的积极防疫思想;③严格执行消毒喇离制度,防止交叉感染;④遵守国家法律规定,及时上报疫情。" + }, + { + "question_num": 6, + "query": "下列各项，不属于保和丸主治的疾病是", + "options": { + "A": "呕吐", + "B": "痞满", + "C": "泄泻", + "D": "痢疾", + "E": "胃痛" + }, + "answer": "D", + "reason": "保和丸可用于呕吐、痞满、泄泻、胃痛的食滞胃脘证。痢疾无该证型，故不属于保和九主治的疾病。" + }, + { + "question_num": 7, + "query": "下列各项，不属苏合香丸主治证候是", + "options": { + "A": "心腹卒痛", + "B": "高热烦躁", + "C": "牙关紧闭", + "D": "苔白", + "E": "脉迟" + }, + "answer": "B", + "reason": "苏合香九属于温开剂。功用:芳香开穷,行气止痛。主治:寒闭证。突然昏倒,牙关紧闭,不省人事,苔白,脉迟。亦治心腹卒痛,甚则昏厥,属寒凝气滞者。" + }, + { + "question_num": 8, + "query": "小儿风热感冒的治法是", + "options": { + "A": "辛温解表", + "B": "清热利湿", + "C": "清暑解表", + "D": "清热解毒", + "E": "辛凉解表" + }, + "answer": "E", + "reason": "小儿风热感冒证治法:辛凉解表，疏风清热。代表方剂:银翘散。A项为风寒感冒治法，C项为暑邪感冒治法。" + }, + { + "question_num": 9, + "query": "临床诊疗工作的基本道德原则是", + "options": { + "A": "配伍原则", + "B": "及时原则", + "C": "经济原则", + "D": "协作原则", + "E": "最优化原则" + }, + "answer": "E", + "reason": "临床诊疗工作的医学道德原则:最优化原则、知情同意原则、保密原则、生命价值原则。" + }, + { + "question_num": 10, + "query": "肺炎型流感最常见的好发人群是", + "options": { + "A": "2岁以下小儿", + "B": "学龄儿童", + "C": "青壮年", + "D": "孕妇", + "E": "未注射流感疫苗人群" + }, + "answer": "A", + "reason": "肺炎型流感较少见，可以由单纯型转为肺炎型，或直接表现为肺炎型，多发生在2岁以下的小儿，或原有慢性基础疾病者。" + }, + { + "question_num": 11, + "query": "下列各项，属于卫生行政处罚的是", + "options": { + "A": "记大过", + "B": "降级", + "C": "降职", + "D": "撤职", + "E": "罚款" + }, + "answer": "E", + "reason": "行政处罚包括警告、罚款、没收非法财物、没收违法所得、责令停产停业、暂扣或吊销有关许可证等。剩余四项为行政处分。" + }, + { + "question_num": 12, + "query": "内伤头痛的主症特点是", + "options": { + "A": "灼痛", + "B": "胀痛", + "C": "空痛", + "D": "跳痛", + "E": "掣痛" + }, + "answer": "C", + "reason": "内伤头痛以虚证或虚实夹的证多见、表凤为隐痛、空痛、昏痛。" + }, + { + "question_num": 13, + "query": "关系表现在血液生成和血液运行方面的两脏是", + "options": { + "A": "肝与脾", + "B": "脾与肾", + "C": "心与肝", + "D": "心与脾", + "E": "心与肺" + }, + "answer": "D", + "reason": "】脾主运化而为气血生化之源,水谷精微经脾转输至心肺,贯注于心脉而化赤为血。心主血脉,心血养脾以维持其运化机能。血液在脉中正常运行,既有赖于心气的推动,又依靠脾气的统摄,心主行血与脾主统血共同维持着血液的正常运行。" + }, + { + "question_num": 14, + "query": "艾滋病肺部感染最常见的病原体是", + "options": { + "A": "念珠菌", + "B": "隐球菌", + "C": "肺孢子菌", + "D": "结核杆菌", + "E": "疱疹病毒" + }, + "answer": "C", + "reason": "卡氏肺孢子菌肺炎是艾滋病呼吸系统感染最常见的疾病。" + }, + { + "question_num": 15, + "query": "下列各项，属未病先防的预防措施是", + "options": { + "A": "增强正气和慎避邪气", + "B": "增强正气和控制病传", + "C": "早期诊断与早期治疗", + "D": "早期诊治和防止传变", + "E": "先安未受邪之地" + }, + "answer": "A", + "reason": "未病先防的预防措施,养生以增强正气,防止病邪侵害。D项为既病防变。" + }, + { + "question_num": 16, + "query": "洋地黄中毒的主要处理措施是", + "options": { + "A": "立即停药", + "B": "高流量给氧", + "C": "应用利尿剂", + "D": "应用β受体阻滞剂", + "E": "应用血管紧张素转换酶抑制剂" + }, + "answer": "A", + "reason": "洋地黄中毒及其处理:①低血钾、肾功能不全以及与其他药物的相互作用是引起洋地黄中每的常见临床原因:②洋地黄中毒最重要的反应是各类心律失常及加重心力衰蝎，还可出现胃肠道反应，如恶心、呕吐等，以及中枢神经的症状，如视物模糊、黄视、倦怠等;③发生洋地黄中毒后应立即停薪，对症处理。" + }, + { + "question_num": 17, + "query": "乳香具有的功效是", + "options": { + "A": "消肿生肌", + "B": "祛风止痛", + "C": "化瘀止血", + "D": "凉血消痈", + "E": "清利湿热" + }, + "answer": "A", + "reason": "乳香功效:活血行气止痛，消肿生肌。" + }, + { + "question_num": 18, + "query": "治疗淋证气淋，应首选的方剂是", + "options": { + "A": "石韦散", + "B": "通关散", + "C": "沉香散", + "D": "妙香散", + "E": "八正散" + }, + "answer": "C", + "reason": "淋证气淋证候：郁怒之后，小便涩滞,淋沥不宣,少腹胀满疼痛,苔薄白,脉弦。证机概要:气机郁结，膀胱气化不利。治法:理气疏导，通淋利尿。代表方:沉香散加减。" + }, + { + "question_num": 19, + "query": "诊断腰椎间盘突出的最好检查方法是", + "options": { + "A": "平片和透视", + "B": "B超", + "C": "CT检查", + "D": "增强CT检查", + "E": "MRI检查" + }, + "answer": "E", + "reason": "MRI检查:能很好地显示各部位椎间盘突出的图像,是诊断椎间盘突出最好的方法。" + }, + { + "question_num": 20, + "query": "下列各项，属泄泻特点的是", + "options": { + "A": "里急后重", + "B": "便下脓血", + "C": "吐泻并作", + "D": "便稀溏如水", + "E": "便下米泔水" + }, + "answer": "D", + "reason": "泄泻以大便清稀为临床特征，或大便次数增多，粪质清稀;或便次不多但粪质清稀，甚至如水状;或大便清萍，完谷不化，便中无脓血。" + }, + { + "question_num": 21, + "query": "小腿部皮肤突然鲜红成片，色如涂丹，边缘清楚，灼热肿胀者，称为", + "options": { + "A": "抱头火丹", + "B": "麻疹", + "C": "流火", + "D": "瘾疹", + "E": "赤游丹" + }, + "answer": "C", + "reason": "皮肤突然鲜红成片,色如涂丹,边缘清楚,灼热肿胀者,为丹毒。发于头面者,名抱头火丹;发于小腿足部者名流火;发于全身、游走不定者,名赤游丹;发于上部者多由风热化火所致,发于下部者多因温热化火而成,亦有因外伤染毒而引起者。" + }, + { + "question_num": 22, + "query": "治疗噎膈痰气交阻证，应首选的方剂是", + "options": { + "A": "通幽汤", + "B": "涤痰汤", + "C": "启膈散", + "D": "玉枢丹", + "E": "丁香散" + }, + "answer": "C", + "reason": "噎膈痰气交阻证的病机为肝气郁结，痰湿交阻，胃气上逆。治法为开郁化痰,润燥降气，方用启膈散加减。" + }, + { + "question_num": 23, + "query": "下列各项，属心的生理功能的是", + "options": { + "A": "主藏气", + "B": "主藏神", + "C": "主藏血", + "D": "主藏精", + "E": "主藏津" + }, + "answer": "B", + "reason": "】心的主要生理功能是主血脉,主藏神。心主血脉是指心气推动和调控血液在脉道中运行,流注全身发挥营养和滋润作用。心主血脉包括主血和主脉两个方面。心藏神,指心统帅人体生命活动和主宰意识、思维等精神活动的机能。" + }, + { + "question_num": 24, + "query": "与眩晕发病关系密切的脏腑是", + "options": { + "A": "肺、脾、肾", + "B": "心、肝、肾", + "C": "肺、心、肾", + "D": "肝、脾、肾", + "E": "肺、胃、肾" + }, + "answer": "D", + "reason": "眩晕的基本病机主要是脑髓空虚，清窍失养，或痰火上逆，扰动清窍。本病的病位在于头窍，其病变脏腑与肝、脾、肾三脏相关。眩晕的病性以虚者居多，气虚血亏、髓海空虚、肝肾不足所导致的眩晕多属虚证。" + }, + { + "question_num": 25, + "query": "具有疏散风热功效的药物是", + "options": { + "A": "白芷", + "B": "细辛", + "C": "藁本", + "D": "蔓荆子", + "E": "苍耳子" + }, + "answer": "D", + "reason": "蔓荆子:疏散风热,清利头目。白芷:解表散寒,祛风止痛,通鼻窍,燥湿止带,消肿排脓。细辛:解表散寒,祛风止痛，通鼻窍,温肺化饮。藁本:祛风散寒,除湿止痛。苍耳子:发散风寒,通鼻窍,祛风湿,止痛。" + }, + { + "question_num": 26, + "query": "不换金正气散治疗厌食的证候是", + "options": { + "A": "脾失健运证", + "B": "脾胃气虚证", + "C": "脾胃阴虚证", + "D": "脾肾阳虚证", + "E": "脾胃虚寒证" + }, + "answer": "A", + "reason": "脾失健运证证候:食欲不振，厌恶进食，食而乏味，或伴胸脘痞闷，嗳气泛恶，大便不调，偶尔多食后则脘腹饱胀，形体尚可，精神正常，舌质淡红，苔薄白或薄腻，脉尚有力。治法:调和脾胃，运脾开胃。代表方剂:不换金正气散。" + }, + { + "question_num": 27, + "query": "下列各项，决定着个体对某些病因易感性的是", + "options": { + "A": "体质", + "B": "居处", + "C": "气候", + "D": "年龄", + "E": "性别" + }, + "answer": "A", + "reason": "体质,决定个体对某些疾病的易感性。" + }, + { + "question_num": 28, + "query": "直肠癌早期便血的特点是", + "options": { + "A": "便血鲜红，便后停止，呈间歇性", + "B": "无痛性便血，血色鲜红，不与大便相混", + "C": "黏液血便，鲜红或暗红，量不多，呈持续性", + "D": "便血鲜红，量不多，肛门呈周期性疼痛", + "E": "少许黏液或血丝在粪便前流出" + }, + "answer": "C", + "reason": "便血是直肠癌最常见的早期症状。大便带血，血为鲜红或暗红，量不多，常同时伴有黏液、呈持续性，此时份被识认为“痔疮”。病情进一步发展、可由现大使次数增多、有里急后重、排使不尽感,便中有血、脓、黏液、并有时殊的臭味，" + }, + { + "question_num": 29, + "query": "下列各项，多表现为下垂性水肿的是", + "options": { + "A": "肾小球肾炎", + "B": "肝硬化", + "C": "低蛋白血症", + "D": "右侧心力衰竭", + "E": "甲状腺功能减退症" + }, + "answer": "D", + "reason": "心源性水肿:特点是下垂性水肿,严重者可出现胸腔积液、腹水等,常伴有呼吸困难,心脏扩大、心率加快、颈静脉怒张、肝颈静脉回流征阳性等表现。" + }, + { + "question_num": 30, + "query": "胃痛胃阴亏耗证的治法是", + "options": { + "A": "滋养阴血，润燥生津", + "B": "养阴益胃，调中消痞", + "C": "养阴益胃，和中止痛", + "D": "滋养胃阴，降逆止呕", + "E": "温中健脾，和胃止痛" + }, + "answer": "C", + "reason": "胃病胃阴亏耗证的病机为胃阴亏耗，胃失濡养。治法为养阴益胃，和中止病、方用一贯煎合芍药甘草汤加减。" + }, + { + "question_num": 31, + "query": "组成药物中含有桂枝、吴茱萸的方剂是", + "options": { + "A": "生化汤", + "B": "温经汤", + "C": "血府逐瘀汤", + "D": "复元活血汤", + "E": "补阳还五汤" + }, + "answer": "B", + "reason": "温经汤组成药物:吴茱萸、当归、芍药、川芎、人参、桂枝、阿胶、牡丹皮、生姜、甘草、半夏、考门冬。生化汤组成药物:当归、川芎、桃仁、炮干姜、炙甘草。血府逐瘀汤组成药物;桃仁、红花、当归、生地黄、川芎、赤芍、牛膝、桔梗、柴胡、枳壳、甘草。复元活血汤组成药物:柴胡、栝楼根、当归、红花、甘草、穿山甲、大黄、桃仁、补阳还五汤组成药物：生黄芪、由归尾、赤芍、地龙(去土）、川芎、红花、桃仁。" + }, + { + "question_num": 32, + "query": "下列各项，不属于远部取穴的是", + "options": { + "A": "目赤肿痛选关冲", + "B": "胃痛选足三里", + "C": "耳聋选中渚", + "D": "牙痛选合谷", + "E": "虚热选太溪" + }, + "answer": "E", + "reason": "远那取穴有胃病选足三里、腰痛选委中、上牙病选内庭、下牙病选合谷等。虚热选太溪、肾俞为辨证取穴。" + }, + { + "question_num": 33, + "query": "具有安神，敛汗功效的药物是", + "options": { + "A": "朱砂", + "B": "磁石", + "C": "远志", + "D": "合欢皮", + "E": "酸枣仁" + }, + "answer": "E", + "reason": "酸枣仁药性甘、酸、平。归肝、胆、心经。功效:养心补肝,宁心安神,敛汗,生津。主治虚烦不眠.惊悖多梦;体虚多汗:津伤口渴。" + }, + { + "question_num": 34, + "query": "黄疸的辨证要点应是", + "options": { + "A": "气血", + "B": "阴阳", + "C": "寒热", + "D": "虚实", + "E": "脏腑" + }, + "answer": "B", + "reason": "黄疸的辨证应首辨阴黄、阳黄。" + }, + { + "question_num": 35, + "query": "主治阴疽的方剂是", + "options": { + "A": "大黄牡丹汤", + "B": "苇茎汤", + "C": "阳和汤", + "D": "半夏厚朴汤", + "E": "仙方活命饮" + }, + "answer": "C", + "reason": "大黄牡丹汤为寒下剂,主治肠痈初起；苇茎汤为清脏腑热剂,主治肺痈;阳和汤为温经散寒剂,主治阴疽;半夏厚朴汤为行气剂,主治梅核气；仙方活命饮为清热解毒剂,主治阳证痈疡肿毒初起。" + }, + { + "question_num": 36, + "query": "红丝疔的好发部位是", + "options": { + "A": "面部", + "B": "胸腹部", + "C": "四肢后侧", + "D": "四肢内侧", + "E": "四肢外侧" + }, + "answer": "D", + "reason": "红丝疔是发于四肢,皮肤呈红丝显露，迅速向上走窜的急性感染性疾病，其特点是先有手足疔疮或皮肤破损，红肿热痛，继则患肢内侧皮肤出现红丝一条或数条，迅速向躯干方向走窜，可伴恶寒发热等症状，邪毒重者可内攻脏腑，发生走黄。" + }, + { + "question_num": 37, + "query": "下列各项，对急性胰腺炎有诊断价值的是", + "options": { + "A": "血清淀粉酶>800U/L", + "B": "血清淀粉酶>1800U/L", + "C": "血清淀粉酶>3000U/L", + "D": "血清淀粉酶>5000U/L", + "E": "血清淀粉酶<800U/L" + }, + "answer": "D", + "reason": "血清淀粉酶:正常值800～1800U/L.如达3500U/L应怀疑急性胰腺炎，超过5000U/L即有诊断价值。" + }, + { + "question_num": 38, + "query": "心悸心阳不振证的主症特点是", + "options": { + "A": "心悸不宁，善惊易恐", + "B": "心悸气短，倦怠乏力", + "C": "心悸不安，面白肢冷", + "D": "心悸气急，胸闷痞满", + "E": "心悸时作，胸闷烦躁" + }, + "answer": "C", + "reason": "心悸心阳不振证的主症为心悸不安,胸闷气短,动则尤甚,面色苍白,形寒肢冷，舌淡苔白,脉虚弱或沉细无力。A项为心虚胆怯证的主症;B项为心血不足证的主症;D项为水饮凌心证的主症;E项为痰火扰心证的主症。" + }, + { + "question_num": 39, + "query": "急性有机磷杀虫药中毒患者呼出的气味是", + "options": { + "A": "酒味", + "B": "烂苹果味", + "C": "刺激性蒜味", + "D": "氨味", + "E": "腥臭味" + }, + "answer": "C", + "reason": "呼气味:浓烈的酒味见于酒后或醉酒,刺激性蒜味见于有机磷农药中毒，烂苹果味见于糖尿病酮症酸中毒,氨味见于尿毒症,腥臭味见于肝性脑病。" + }, + { + "question_num": 40, + "query": "清胃解毒汤治疗水痘的适宜证候是", + "options": { + "A": "邪侵肺卫证", + "B": "邪犯肺胃证", + "C": "邪炽气营证", + "D": "邪入肺脾证", + "E": "湿热蒸盛证" + }, + "answer": "C", + "reason": "水痘邪炽气营证治法:清气凉营,解毒化湿。代表方剂:清胃解毒汤。" + }, + { + "question_num": 41, + "query": "五脏的生理特点是", + "options": { + "A": "受盛和传化水谷", + "B": "化生和贮藏精气", + "C": "传化物而不藏", + "D": "实而不能满", + "E": "中空而贮藏精气" + }, + "answer": "B", + "reason": "五脏内部组织相对充实,共同生理机能是化生和贮藏精气;六腑多呈中空的囊状或管腔形态,共同生理机能是受盛和传化水谷。" + }, + { + "question_num": 42, + "query": "治疗便秘之气秘证，除主穴外，还应选取的配穴是", + "options": { + "A": "合谷、曲池", + "B": "太冲、中脘", + "C": "神阙、关元", + "D": "脾俞、气海", + "E": "照海、太溪" + }, + "answer": "B", + "reason": "便秘的处方主穴:天枢、大肠俞、上巨虚、支沟。配穴:热秘配合谷、曲池;气秘配太冲、中脘;冷秘配种阙、关元;虚秘配足三里、脾俞、气海，兼阴伤津亏者加照海、太溪。" + }, + { + "question_num": 43, + "query": "导致疾病发生的关键因素是", + "options": { + "A": "邪气偏盛", + "B": "正气不足", + "C": "邪胜正衰", + "D": "正胜邪退", + "E": "邪正相持" + }, + "answer": "B", + "reason": "正气不足是疾病发生的内在关键因素，“正气存内，邪不可干。”邪气是发病的重要条件。" + }, + { + "question_num": 44, + "query": "根据骨度分寸，腘横纹（平髌尖）至外踝尖的距离是", + "options": { + "A": "12寸", + "B": "13寸", + "C": "14寸", + "D": "16寸", + "E": "19寸" + }, + "answer": "D", + "reason": "腘横纹(平髌尖)至外踝尖为16寸。" + }, + { + "question_num": 45, + "query": "以四季分阴阳，春季为", + "options": { + "A": "阴中之阴", + "B": "阳中之阳", + "C": "阳中之阴", + "D": "阴中之阳", + "E": "阴中之至阴" + }, + "answer": "D", + "reason": "心属火,位南方,通于夏,属阳中之阳的太阳;肺属金,位西方,通于秋，属阳中之阴的少阴;肝属木,位东方,通于春，属阴中之阳的少阳;肾属水,位北方,通于冬，属阴中之阴的太阴;脾属土,居中央，主四时，属阴中之至阴。" + }, + { + "question_num": 46, + "query": "上消化道出血最常见的病因是", + "options": { + "A": "消化性溃疡", + "B": "食管胃底静脉曲张破裂", + "C": "急性胃黏膜损害", + "D": "胃癌", + "E": "胃息肉" + }, + "answer": "A", + "reason": "消化性溃疡是上消化道出血最常见的病因。" + }, + { + "question_num": 47, + "query": "下列关于室性期前收缩的叙述，正确的是", + "options": { + "A": "提早出现的QRS-T波群，前有异位P'波", + "B": "QRS波群形态宽大畸形", + "C": "QRS波群时间0.08～0.10s", + "D": "T波方向与QRS波群主波方向一致", + "E": "代偿间歇不完全" + }, + "answer": "B", + "reason": "室性期前收缩心电图表现，①提早出现的QRS-T波群,其前无提早出现的异位P'波;②QRS波群形态宽大畸形,时间>0.12s;③T波方向与QRS波群主波方向相反。④有完全性代偿间歇（即期前收缩前后的两个窦性P波间距等于正常PP间距的两倍）。" + }, + { + "question_num": 48, + "query": "根据五输穴的五行配属，足少阳胆经中属“土”的腧穴是", + "options": { + "A": "足临泣", + "B": "阳陵泉", + "C": "足窍阴", + "D": "侠溪", + "E": "阳辅" + }, + "answer": "B", + "reason": "阳经五输穴中合穴属土,足少阳胆经合穴为阳陵泉。A项属木，C项属金，D项属水，E项属火。" + }, + { + "question_num": 49, + "query": "以利益均衡作为价值判断标准来配置卫生资源，体现的卫生法基本原则是", + "options": { + "A": "患者自主原则", + "B": "保护社会健康原则", + "C": "预防为主原则", + "D": "公平原则", + "E": "卫生保护原则" + }, + "answer": "D", + "reason": "公平原则就是以利益均衡作为价值判断标准来配置卫生资源,协调卫生保健活动,以确保每个社会成员都能普遍得到卫生保健" + }, + { + "question_num": 50, + "query": "肉瘿可选用的外治法是", + "options": { + "A": "回阳玉龙膏掺黑退消", + "B": "太乙膏掺红灵丹", + "C": "阳和解凝膏掺黑退消", + "D": "太乙膏掺阳毒内消散", + "E": "阳和解凝膏掺阳毒内消散" + }, + "answer": "C", + "reason": "肉瘿外治:阳和解凝膏掺黑退消或桂腐散外敷。" + }, + { + "question_num": 51, + "query": "下列关于实证和虚证鉴别的描述，错误的是", + "options": { + "A": "实证疼痛拒按，虚证疼痛喜按", + "B": "实证多发热，虚证多恶寒", + "C": "实证声高气粗，虚证声低息微", + "D": "实证舌质老，虚证舌质嫩", + "E": "实证脉有力，虚证脉无力" + }, + "answer": "B", + "reason": "】ACDE项描述均正确，而虚证多为潮热、微热、畏寒,添衣近火得温则减。实证多为高热,恶寒,添衣近火得温不减。" + }, + { + "question_num": 52, + "query": "治疗血栓性浅静脉炎湿热瘀阻证，应首选的方剂是", + "options": { + "A": "五神汤合四妙勇安汤", + "B": "萆薢渗湿汤合五神��", + "C": "二妙散合茵陈赤豆汤", + "D": "四妙散合五神汤", + "E": "六味地黄丸合四妙散" + }, + "answer": "C", + "reason": "血栓性浅静脉炎湿热瘀阻证的证候:患肢肿胀、发热,皮肤发红、胀痛,喜冷恶热，或有条索状物:或微恶寒发热:苔黄腻或厚腻，脉滑数。治法:清热利湿，解毒通络，代表方:二妙散合菌陈赤豆汤加减。" + }, + { + "question_num": 53, + "query": "土不足时，木对土的过度制约，属于", + "options": { + "A": "相克", + "B": "相乘", + "C": "相侮", + "D": "母病及子", + "E": "子病犯母" + }, + "answer": "B", + "reason": "相乘，是相克太过致病。若以肝木和脾土之间的相克关系而言,相来传变就有“木旺乘土”(即肝气乘脾)和\"“土虚木乘”(即脾虚肝乘)两种情况。" + }, + { + "question_num": 54, + "query": "工具避孕指的是", + "options": { + "A": "宫内节育器，阴茎套，阴道隔膜", + "B": "宫内节育器，阴茎套，阴道药环", + "C": "宫内节育器，阴茎套，避孕药物", + "D": "宫内节育器，阴茎套，皮下埋植", + "E": "宫内节育器，阴茎套，避孕药膏" + }, + "answer": "A", + "reason": "工具避孕指的是宫内节育器、阴茎套、阴道隔膜。" + }, + { + "question_num": 55, + "query": "下列气的生理功能，能控制汗液、唾液等液态物质分泌、排泄的是", + "options": { + "A": "推动作用", + "B": "固摄作用", + "C": "防御作用", + "D": "气化作用", + "E": "中介作用" + }, + "answer": "B", + "reason": "气的固摄作用指气对体内的血、津液、精等液态物质的固护、统摄和控制作用。" + }, + { + "question_num": 56, + "query": "治疗口疮心火上炎证，应首选的方剂是", + "options": { + "A": "银翘散", + "B": "凉膈散", + "C": "泻黄散", + "D": "泻心导赤散", + "E": "六味地黄丸加肉桂" + }, + "answer": "D", + "reason": "口疮心火上炎证证候:舌上、舌边溃疡,色赤疼痛,饮食困难,心烦不安，口干欲饮，小便短黄，舌尖红,苔薄黄,脉数,指纹紫。治法:清心凉血，泻火解毒。代表方剂：泻心导赤散。" + }, + { + "question_num": 57, + "query": "手三阳经与足三阴经交接的部位是", + "options": { + "A": "四肢部", + "B": "肩胛部", + "C": "头面部", + "D": "胸部", + "E": "背部" + }, + "answer": "C", + "reason": "阳经与阳经交接:同名的手足三阳经在头面部相交接,如手足阳明经都通于鼻,手足太阳经辟通于目内眦,手足少阳经岁通于目外眦。" + }, + { + "question_num": 58, + "query": "下列关于非甾体抗炎止痛药治疗类风湿关节炎的叙述，错误的是", + "options": { + "A": "有效缓解症状", + "B": "不能控制病情进展", + "C": "不单独使用", + "D": "口服用药", + "E": "长期应用" + }, + "answer": "E", + "reason": "非甾体抗炎药可有效地缓解类风湿关节炎的症状，但不能控制病情进展，不单独使用，不能长期应用。" + }, + { + "question_num": 59, + "query": "导致气管向患侧移位的疾病是", + "options": { + "A": "胸膜粘连", + "B": "大量胸腔积液", + "C": "气胸", + "D": "阻塞性肺气肿", + "E": "纵隔肿瘤" + }, + "answer": "A", + "reason": "气管向串侧移位可见于肺不张、肺硬化.胸膜粘连等。" + }, + { + "question_num": 60, + "query": "下列关于阴道功能的叙述，错误的是", + "options": { + "A": "排出月经", + "B": "分泌带下", + "C": "种子育胎", + "D": "排出恶露", + "E": "阴阳交合" + }, + "answer": "C", + "reason": "阴道是防御外邪入侵的关口，是排出月经、分泌带下的通道和阴阳交合的器官，又是娩出胎儿的路径，故亦称产道。" + }, + { + "question_num": 61, + "query": "以胸胁胃脘胀痛，急躁易怒，嗳气吞酸，不思饮食，舌淡红，脉弦为特征的证候是", + "options": { + "A": "肝胃不和证", + "B": "胃肠气滞证", + "C": "脾气虚证", + "D": "肝郁气滞证", + "E": "肝脾不调证" + }, + "answer": "A", + "reason": "肝胃不和证临床表现为脘胁胀闷疼痛,嗳气呃逆,嘲杂吞酸,不思饮食烦躁易怒,舌红苔薄黄,脉弦或带数象;或颠顶疼痛,遇寒则甚,得温痛减,呕吐涎沫,形寒肢冷，舌淡苦白滑,脉沉弦紧。" + }, + { + "question_num": 62, + "query": "下列各项，不属于休克补液量充分的指标是", + "options": { + "A": "尿量≥30ml/h", + "B": "收缩压接近正常，脉压＞30mmHg", + "C": "中心静脉压升高＞12cmH₂O", + "D": "心率＞60次/分", + "E": "临床症状好转，皮肤黏膜红润温暖" + }, + "answer": "D", + "reason": "判断补液量充分的指标：①收缩压正常或接近正常，脉压>30mmHg;②CVP升高>12cmH20;③尿量>=30ml/h;④临床症状好转，如神志恢复，皮肤、黏膜红润、温暖等。" + }, + { + "question_num": 63, + "query": "结脉与代脉的主要区别在于", + "options": { + "A": "节律不同", + "B": "至数不同", + "C": "脉力不同", + "D": "脉位不同", + "E": "流利度不同" + }, + "answer": "A", + "reason": "结脉:脉来缓慢,时有中止，止无定数,其脉象特征是脉来迟缓,脉律不齐，有不规则的歇止。代脉:脉来一止,止有定数，良久方还,其脉象特征是脉律不齐,表现为有规则的歇止,软止的时间较长,脉势较软弱。至数为脉搏的频率。" + }, + { + "question_num": 64, + "query": "治疗眩晕实证的主穴是", + "options": { + "A": "风池、百会、太阳、列缺", + "B": "风池、头维、太阳、百会", + "C": "风池、百会、内关、太冲", + "D": "风池、百会、肝俞、肾俞", + "E": "百会、内关、后溪、水沟" + }, + "answer": "C", + "reason": "眩晕实证主穴:百会、风池、太冲、内关。眩晕病位在脑，脑为髓海，督脉入络于脑，故选用位于巅顶的百会，清头目、止眩晕;风池亦为近部取穴，疏调头部气机;太冲为肝经之原穴，可平肝潜阳;内关为八脉交会穴通于阴维脉,既可宽胸理气，和胃化痰，又与太冲相配以加强平肝之力。" + }, + { + "question_num": 65, + "query": "下列各项，可出现外周血中性粒细胞减少的是", + "options": { + "A": "糖尿病酮症酸中毒", + "B": "急性心肌梗死", + "C": "急性大出血", + "D": "脾功能亢进", + "E": "恶性肿瘤" + }, + "answer": "D", + "reason": "中性粒细胞病理性减少见于:①感染性疾病，病毒感染最常见，如流行性感冒、病毒性肝炎、麻疹、风疹、水痘等；某些革兰阴性杆茵感染，如伤寒及副伤寒等；某些原虫感染，如恙虫病、疟疾等。②血液病，如再生障碍性贫血、粒细胞减少症、粒细胞缺乏症、非白血性白血病、恶性组织细胞病等。③自身免疫性疾病，如系统性红斑狼疮等。④单核-巨噬细胞系统功能亢进，如脾功能亢进，见于各种原因引起的脾大（如肝硬化等）。⑤药物及理化因素的作用，物理因素如X线、γ射线、放射性核素等；化学物质如苯、铅、汞等；化学药物如氯霉素、磺胺类药、抗肿瘤药、抗糖尿病药物及抗甲状腺药物等，均可引起白细胞及中性粒细胞减少。" + }, + { + "question_num": 66, + "query": "双胍类降糖药的主要适应证是", + "options": { + "A": "1型糖尿病患者", + "B": "肥胖伴高胰岛素血症的2型糖尿病患者", + "C": "餐后高血糖者", + "D": "高脂血症者", + "E": "糖耐量减低患者" + }, + "answer": "B", + "reason": "双胍类降糖药的适应证：①2型糖尿病，尤其是无明显消瘦以及伴血脂异常、高血压或高胰岛素血症的患者;②Ⅰ型糖尿病，与胰岛素联合应用可能减少胰岛素用量和血糖波动。" + }, + { + "question_num": 67, + "query": "具有平肝疏肝，祛风明目功效的药物是", + "options": { + "A": "珍珠母", + "B": "代赭石", + "C": "刺蒺藜", + "D": "钩藤", + "E": "牡蛎" + }, + "answer": "C", + "reason": "刺蒺藜功效:平时暑肝,祛风明目。珍珠母功效,平肝潜阳,清肝明目,镇惊安神。代赭石功效:平肝潜阳,重镇降逆，凉血止血。钓藤功效:清热平肝,息风定惊。牡蛎功效:重镇安神,平肝潜阳,软坚散结,收敛固涩。" + }, + { + "question_num": 68, + "query": "预防流行性乙型脑炎的关键措施是", + "options": { + "A": "管理患者", + "B": "管理猪等家禽", + "C": "注射丙种球蛋白", + "D": "防鼠、灭鼠", + "E": "防蚊、灭蚊和预防接种" + }, + "answer": "E", + "reason": "防蚊、灭蚊和预防接种为预防流行性乙型脑炎的关键。" + }, + { + "question_num": 69, + "query": "下列各项，不属于肝细胞性黄疸特点的是", + "options": { + "A": "尿胆原可增加", + "B": "白陶土色粪便", + "C": "尿胆红素阳性", + "D": "血清结合胆红素增高", + "E": "血清非结合胆红素增高" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 70, + "query": "伤寒患者腹痛的常见部位是", + "options": { + "A": "右上腹", + "B": "右下腹", + "C": "左上腹", + "D": "左下腹", + "E": "脐周部位" + }, + "answer": "B", + "reason": "伤寒主要病变部位在回肠末段的集合淋巴结和孤立淋巴滤泡，故其腹痛以右下腹明显。细菌性痢疾疼病主要在左下腹。" + }, + { + "question_num": 71, + "query": "咽喉溃烂处上覆白腐，形如白膜者，称为", + "options": { + "A": "乳蛾", + "B": "喉痈", + "C": "鹅口疮", + "D": "咽喉成脓", + "E": "伪膜" + }, + "answer": "E", + "reason": "咽喉溃烂处上覆白腐,形如白膜者,称为伪膜。" + }, + { + "question_num": 72, + "query": "治疗感冒，除合谷、列缺、风池外，还应选取的主穴是", + "options": { + "A": "阴陵泉、委中", + "B": "少商、身柱", + "C": "曲池、尺泽", + "D": "风门、肺俞", + "E": "大椎、太阳" + }, + "answer": "E", + "reason": "感冒的处方主穴:列缺、合谷、风池、大椎、太阳。配穴:风寒感冒配风门、肺俞；风热感冒配曲池、尺泽;央湿配阴陵泉;夹暑配委中;体虚感冒配足三里;咽喉疼痛配少商、商阳。" + }, + { + "question_num": 73, + "query": "治疗肝肾阴虚，肝气郁滞证的方剂是", + "options": { + "A": "一贯煎", + "B": "百合固金汤", + "C": "六味地黄丸", + "D": "地黄饮子", + "E": "大补阴丸" + }, + "answer": "A", + "reason": "一贯煎:滋阴疏肝,主治肝肾阴虚,肝气郁滞证。胸脘胁痛,吞酸吐苦,咽干口燥,舌红少津,脉细弱或虚弦,亦治疝气瘕聚。" + }, + { + "question_num": 74, + "query": "应用脓肿一次切开法治肛痈，与分次手术的最主要区别是", + "options": { + "A": "切口呈放射状", + "B": "切口长度与脓肿等长", + "C": "将切口与内口之间的组织切开并搔刮清除", + "D": "分开脓肿的纤维间隔", + "E": "术后常规换药" + }, + "answer": "C", + "reason": "脓肿一次切开法:在麻醉呈放射状，长度应与脓肿等长，使引流通畅，同时寻找齿线处感染的肛隐窝或内口，将切口与内口之间的组织切开，并搔刮清除，以避免形成肛漏。分次手术;适用于体质虚弱或不愿住院治疗的深部脓肿。切口应在压痛或波动明显部位，尽可能靠近肛门，切口呈弧状或放射状，须有足够长度，用红油骨纱条引流，以保持引流通畅。待形成肛漏后，再按肛漏处理。" + }, + { + "question_num": 75, + "query": "下列各项，不属血瘀证临床表现的是", + "options": { + "A": "出血紫暗", + "B": "固定刺痛", + "C": "面色黧黑", + "D": "胸胁胀痛", + "E": "脉象细涩" + }, + "answer": "D", + "reason": "血瘀证疼痛特点为刺痛、痛久拒按、固定不移、常在夜间痛甚。肿块的性状在体表者包块色青紫，腹内者触及质硬而推之不移。出血特征是出血反复不止，色紫暗或夹血块，或大便色黑如柏油状，或妇女血崩、漏血。瘀血色脉征主要有面色黧黑，或唇甲青紫，或皮下紫斑，或肌肤甲错，或腹露青筋，或皮肤出现丝状红缕，或舌有紫色斑点、舌下络脉曲张，脉多细涩或结、代、无脉等。" + }, + { + "question_num": 76, + "query": "妇科温补肾阳法的代表方剂是", + "options": { + "A": "温经汤", + "B": "右归丸", + "C": "金匮肾气丸", + "D": "济生肾气丸", + "E": "举元煎" + }, + "answer": "B", + "reason": "温补肾阳法:肾阳不足,命门火衰，阴寒内盛，治宜温肾暖宫，补益命门之火,所谓“益火之源,以消阴翳”。代表方,如右归丸、右归饮、温胞饮等。" + }, + { + "question_num": 77, + "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方法是", + "options": { + "A": "循法", + "B": "寻法", + "C": "总按", + "D": "举法", + "E": "按法" + }, + "answer": "A", + "reason": "特法:是指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。寻法：是指切脉时指力从轻到重,或从重到轻,左右推寻,调节最适当指力的方法。在寸口三部细细寻找脉动最明显的部位,统称寻法,以捕获最丰富的脉象信息。总按:是指三指同时用力诊脉的方法。举法:是指医生用较轻的指力,按在寸口脉搏跳动部位,以体察脉持部位的方法,亦称“轻取”或“浮取”。按法;是指医生用较重的指力，,甚至按到筋骨，体察脉象的方法,又称“重取“或“沉取”医生手指用力适中,按至肌肉以体察脉象的方法称为“中取”。" + }, + { + "question_num": 78, + "query": "下列各项，不属痿证病因的是", + "options": { + "A": "感受温毒", + "B": "湿热浸淫", + "C": "久病房劳", + "D": "跌仆瘀阻", + "E": "情志所伤" + }, + "answer": "E", + "reason": "痿证的病因为感受温毒、湿热浸淫、饮食毒物所伤、久病房劳、跌仆瘀阻。" + }, + { + "question_num": 79, + "query": "十二指肠球部溃疡的直接X线征象是", + "options": { + "A": "球部充盈缺损", + "B": "球部激惹征", + "C": "球部龛影或变形", + "D": "幽门痉挛，开放延迟", + "E": "黏膜皱襞粗乱" + }, + "answer": "C", + "reason": "十二指肠溃疡:绝大部分发生在球部,溃涡已造成球部变形;球部龛影或球部变形是十二指肠演疡的直接X线征象。闻接征象;①激惹征;②幽门痉挛,开放延迟;③骨分泌增多和胃张力及蠕动方面的改变;④球部固定压痛。" + }, + { + "question_num": 80, + "query": "寿胎丸治疗胎动不安的适应证候是", + "options": { + "A": "肾虚证", + "B": "血热证", + "C": "脾虚证", + "D": "血瘀证", + "E": "气血虚弱证" + }, + "answer": "A", + "reason": "胎动不安肾虚证治法:补肾健脾，益气安胎。代表方:寿胎丸加党参、白术或滋肾育胎丸。" + }, + { + "question_num": 81, + "query": "依据气能生血理论确立的治疗方法是", + "options": { + "A": "治疗血虚常配用补气药", + "B": "治疗津虚常配用补气药", + "C": "治疗出血常配用补气药", + "D": "治疗血瘀常配用补气、行气药", + "E": "治疗痰饮常配用补气、行气药" + }, + "answer": "A", + "reason": "气能生血指气能参与和促进血液的生成。血液的化生以营气、津液和肾精作为物质基础，离不开气作为动力。气能生血还包含营气在血液生成中的作用,营气与津液入脉化血,使血量充足。" + }, + { + "question_num": 82, + "query": "治疗月经先后无定期肾虚证，应首选的方剂是", + "options": { + "A": "逍遥散", + "B": "固阴煎", + "C": "定经汤", + "D": "归肾丸", + "E": "大补元煎" + }, + "answer": "B", + "reason": "月经先后无定期肾虚证治法:补肾调经。方药:固阴煎。" + }, + { + "question_num": 83, + "query": "生成血液的基本物质是", + "options": { + "A": "肺之津", + "B": "肝之阴", + "C": "生殖之精", + "D": "胃之津液", + "E": "水谷之精" + }, + "answer": "E", + "reason": "血液生化之源;水谷之精化血,肾精化血。" + }, + { + "question_num": 84, + "query": "确诊流行性脑脊髓膜炎最重要的实验室检查是", + "options": { + "A": "血白细胞总数增高", + "B": "脑脊液涂片阳性", + "C": "脑脊液呈化脓性改变", + "D": "脑脊液培养阳性", + "E": "咽拭子培养阳性" + }, + "answer": "D", + "reason": "白细胞及中性粒细胞明显升高，脑脊液呈化脓性改变，尤其是细菌培养阳性及流行性脑脊髓膜炎特异性血清免疫检测阳性为确诊的主要依据，" + }, + { + "question_num": 85, + "query": "定喘汤组成中含有的药物是", + "options": { + "A": "苏叶、半夏、杏仁", + "B": "苏子、半夏、甘草", + "C": "苏叶、半夏、生姜", + "D": "苏子、厚朴、杏仁", + "E": "苏子、前胡、半夏" + }, + "answer": "B", + "reason": "定喘汤组成药物:白果、麻黄、苏子、甘草、款冬花、杏仁、桑白皮、炒黄芩、半夏。功用:宣降肺气,清热化痰。主治:风寒外束,痰热内蕴证。" + }, + { + "question_num": 86, + "query": "下列各项，可提示急性黄疸型肝炎发展为急性重型肝炎的是", + "options": { + "A": "肝脏进行性肿大", + "B": "有出血倾向", + "C": "黄疸逐步减轻", + "D": "低氧血症", + "E": "胆酶同步升高" + }, + "answer": "B", + "reason": "丙氨酸氨基转移酶与总胆红素出现分离现象、凝血酶原活动度呈低水平、总胆固醇低水平是判断各种重型病毒肝类的指标，其中凝血酶原时间延长为其诊断的重要指标。凝血酶原时间延长提示有出血倾向。" + }, + { + "question_num": 87, + "query": "下列各项，双肺满布湿啰音的是", + "options": { + "A": "肺炎链球菌肺炎", + "B": "急性肺水肿", + "C": "支气管哮喘", + "D": "肺脓肿", + "E": "支气管扩张症" + }, + "answer": "B", + "reason": "湿啰音散布两肺常见于支气管炎、支气管肺炎、肺水肿、血型播散型肺结模。" + }, + { + "question_num": 88, + "query": "治疗产后身痛肾虚证，应首选的方剂是", + "options": { + "A": "生化汤", + "B": "归肾丸", + "C": "养荣壮肾汤", + "D": "金匮肾气丸", + "E": "右归丸" + }, + "answer": "C", + "reason": "产后身病肾虚证治法:补肾养血，强腰壮骨。方药:养荣壮肾汤加秦艽、熟地黄。" + }, + { + "question_num": 89, + "query": "医学人道主义最根本的思想是", + "options": { + "A": "尊重患者生命", + "B": "尊重患者隐私", + "C": "尊重患者的生命质量", + "D": "尊重患者的生命价值", + "E": "尊重患者平等的医疗权利" + }, + "answer": "A", + "reason": "医学人道主义的核心内容，尊重患者的生命,尊重患者的人格,尊重患者的权利,其中,尊重患者的生命是医学人道主义的根本思想。" + }, + { + "question_num": 90, + "query": "小儿正常舌质的颜色是", + "options": { + "A": "淡白", + "B": "淡红", + "C": "紫绛", + "D": "暗红", + "E": "绛红" + }, + "answer": "B", + "reason": "正常小儿舌体柔软、淡红润泽、伸缩自如，舌面有干湿适中的薄苔。小儿舌质较成人红嫩。新生儿舌红无苔和哺乳婴儿的乳白苔，均属正常舌象。食后或服药后对舌苔有一定影响，应予注意。小儿与成人正常舌象都是淡红舌。" + }, + { + "question_num": 91, + "query": "循行于人体腹面正中线，具有调节阴经气血作用的经脉是", + "options": { + "A": "任脉", + "B": "冲脉", + "C": "督脉", + "D": "带脉", + "E": "阳维脉" + }, + "answer": "A", + "reason": "任脉起于胞中,下出于会阴,经阴阜,沿腹部正中线上行,经咽喉部(天突穴),到达下唇内,左右分行,环绕口唇,交会于督脉之龈交穴，再分别通过鼻翼两穷,上至眼眶下(承泣穴),交于足阳明经。任脉能调节阴经气血,为“阴脉之海\"。" + }, + { + "question_num": 92, + "query": "虚证闭经的治疗原则是", + "options": { + "A": "补益肝肾", + "B": "补而通之", + "C": "健脾益气", + "D": "益气养血", + "E": "调补脾肾" + }, + "answer": "B", + "reason": "闭经的治疗原则应根据病证，虚者补而通之，实者泻而通之。" + }, + { + "question_num": 93, + "query": "能导致瞳孔扩大的疾病是", + "options": { + "A": "有机磷杀虫药中毒", + "B": "吗啡中毒", + "C": "青光眼绝对期", + "D": "毒蕈中毒", + "E": "虹膜炎" + }, + "answer": "C", + "reason": "病理情况下，瞳孔缩小（＜2mm）常见于虹膜炎、有机磷农药中毒、毒蕈中毒，以及吗啡、氯丙嗪、毛果云香碱等药物影响;瞳孔扩大(5mm)见于外伤、青光眼绝对期.视神经萎缩.完全失明、濒死状态、颈交感神经刺激和阿托品可卡因等药物影响。" + }, + { + "question_num": 94, + "query": "下关穴归属的经脉", + "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": "手少阴心经" + }, + "answer": "C", + "reason": "下关穴归属于足阳明胃经。" + }, + { + "question_num": 95, + "query": "医疗机构发现甲类传染病时，应及时采取的措施是", + "options": { + "A": "疑似患者确诊前在指定场所单独隔离治疗", + "B": "医疗机构内病原携带者的密切接触者予以隔离治疗", + "C": "宜布本行政区域为疫区", + "D": "向卫生行政部门提出疫情控制方案", + "E": "封闭被传染病病原体污染的公共饮用水源" + }, + "answer": "A", + "reason": "医疗机构发现甲类传染病时,应当及时采取下列措施:①对患者、病原的携带者,予以隔离治疗,隔离期限根据医学检查结果确定;②对疑似患者,确诊前在指定场所单独隔离治疗;③对医疗机构内的患者.病原携带者、疑似患者的密切接触者,在指定场所进行医学观察和采取其他必要的预防措施。拒绝隔离治疗或者隔离期未满擅自脱离隔离治疗的,可以由公安机关协助医疗机构采取强制隔离治疗措施。" + }, + { + "question_num": 96, + "query": "循行分布于胸中，散络于心包的经脉是", + "options": { + "A": "足太阳膀胱经", + "B": "手太阳小肠经", + "C": "手阳明大肠经", + "D": "手少阳三焦经", + "E": "手厥阴心包经" + }, + "answer": "D", + "reason": "手少阳三焦经，起于无名指尺侧末端，向上经小指与无名指之间、手腕背侧，上达前臂外侧，沿桡骨和尺骨之间，过肘尖，沿上臂外侧上行至肩部，交出足少阳经之后，进入缺盆部，分布于胸中，散络于心包，向下通过横膈,从胸至腹,依次属上、中、下三焦。" + }, + { + "question_num": 97, + "query": "心电图中代表心室除极、复极全过程的时间是", + "options": { + "A": "QRS波群", + "B": "P-R间期", + "C": "Q-T间期", + "D": "S-T段", + "E": "T-P段" + }, + "answer": "C", + "reason": "Q-T间期;代表左、右心室除极与复极所需要的总时间。QRS波群;左、右心室除极波形成,反映左右心室除极过程中的电位和时间变化。P-R间期;为房室传导时间,代表激动从窦房结发出经心房、房室交界、房室束、束支及浦肯野纤维传到心室肌的时间。S-T段,自QRS波群的终点至T波起点间的线段,代表心室缓慢复极过程。" + }, + { + "question_num": 98, + "query": "治疗经行吐衄肺肾阴虚证，应首选的方剂是", + "options": { + "A": "清肝汤", + "B": "调肝汤", + "C": "顺经汤", + "D": "清肝引经汤", + "E": "上下相资汤" + }, + "answer": "C", + "reason": "经行吐衄肺肾阴虚证主要证候:经前或经期吐血、衄血，量少，色黯红，月经每先期、量少;平素可有头晕耳鸣，手足心热，两颧潮红，潮热咳嗽,咽干口渴;舌质红或绛,苔滑剥或无苔,脉细数。治法:滋阴养肺。方药:顺经汤或加味麦门冬汤。" + }, + { + "question_num": 99, + "query": "阴寒内盛，血行瘀滞的舌象表现是", + "options": { + "A": "舌淡红润泽", + "B": "舌红绛少苔", + "C": "舌绛紫而干", + "D": "舌淡白光莹", + "E": "舌淡紫湿润" + }, + "answer": "E", + "reason": "舌淡紫而温润:阴寒内盛，或阳气虚衰所至寒凝血瘀。" + }, + { + "question_num": 100, + "query": "治疗虫咬皮炎热毒蕴结证，应首选的方剂是", + "options": { + "A": "五味消毒饮合清营汤", + "B": "黄连解毒汤合犀角地黄汤", + "C": "五味消毒饮合黄连解毒汤", + "D": "仙方活命饮合清营汤", + "E": "银翘散合消风散" + }, + "answer": "C", + "reason": "虫咬皮炎热毒蕴结证的证候:皮疹较多，成片红肿，水疱较大，瘀斑明显，皮疹附近臖核肿大;伴畏寒，发热，头病，恶心胸闷;舌质红，苔黄,脉数。治法:清热解毒，消肿止痒。方药:五味消毒饮合黄连解毒汤加地肤子、白鲜皮、紫荆皮。" + }, + { + "question_num": 101, + "query": "治疗亡阳证，寒饮喘咳，应选用的药物是", + "options": { + "A": "附子", + "B": "肉桂", + "C": "干姜", + "D": "吴茱萸", + "E": "小茴香" + }, + "answer": "C", + "reason": "干姜主治:腹痛,呕吐,泄泻;亡阳证;寒饮喘咳。附子回阳救逆,补火助阳,散寒止痛,用于亡阳证、阳虚证、寒痹证。肉桂用于阳痿、宫冷、腹痛、寒疝、腰痛、胸痹、阴疽、闭经、痛经、虚阳上浮。吴茱萸用于寒凝疼痛、胃寒呕吐、虚寒泄泻。小茴香用于寒疝腹痛、睾丸偏坠疼痛、少腹冷痛、痛经,中焦虚寒气滞证。" + }, + { + "question_num": 102, + "query": "清热固经汤治疗崩漏的证候是", + "options": { + "A": "湿热证", + "B": "实热证", + "C": "虚热证", + "D": "血瘀证", + "E": "肝郁证" + }, + "answer": "B", + "reason": "崩漏实热证治法:清热凉血，固冲止血。方药:清热固经汤。" + }, + { + "question_num": 103, + "query": "腹部触诊出现反跳痛，提示的病变是", + "options": { + "A": "腹部脏器有炎症", + "B": "胃肠痉挛", + "C": "腹膜壁层有炎症", + "D": "肠系膜动脉栓塞", + "E": "肠梗阻" + }, + "answer": "C", + "reason": "反跳痛表示炎症已波及腹膜壁层,腹肌紧张伴压痛、反跳痛称为腹膜刺激征,是急性腹膜炎的可靠体征。" + }, + { + "question_num": 104, + "query": "下列关于人感染高致病性禽流感的叙述，错误的是", + "options": { + "A": "由禽流感病毒引起", + "B": "属人、禽、畜共患传染病", + "C": "病禽及带毒健康禽为传染源", + "D": "一年四季均可发生", + "E": "应在发病72小时内应用抗流感病毒药物" + }, + "answer": "E", + "reason": "应在发病48小时内应用抗流感病毒药物。" + }, + { + "question_num": 105, + "query": "具有益气健脾、固冲摄血功用的方剂是", + "options": { + "A": "固冲汤", + "B": "归脾汤", + "C": "四物汤", + "D": "黄土汤", + "E": "固经丸" + }, + "answer": "A", + "reason": "固冲汤的功用为益气健脾，固冲摄血;归脾汤的功用为益气补血,健脾养心;四物汤的功用为补血调血;黄土汤的功用为温阳健脾,养血止血;固经九的功用为滋阴清热,固经止带。" + }, + { + "question_num": 106, + "query": "水肿风水相搏证日久，表证已解，身重而水肿，下肢明显，按之没指，小便短少，其治法是", + "options": { + "A": "温肾助阳，化气行水", + "B": "健脾温阳，利水消肿", + "C": "疏风清热，宣肺利水", + "D": "运脾化湿，通阳利水", + "E": "宣肺解毒，利湿消肿" + }, + "answer": "D", + "reason": "该题考察水肿风水相搏证的加减变化。若表证渐解、身重而水肿不退者，可按水湿浸渍证论治，水湿浸渍证治法：运脾化湿，通阳利水。代表方;五皮饮合胃苓汤加减。" + }, + { + "question_num": 107, + "query": "下列各项，最常出现心尖部舒张早期奔马律的是", + "options": { + "A": "心包炎", + "B": "肺源性心脏病", + "C": "左侧心力衰竭", + "D": "高度房室传导阻滞", + "E": "肺动脉瓣狭窄" + }, + "answer": "C", + "reason": "舒张早期奔马律最常见,为病理性第三心音,又称第三心音奔马律或室性奔马律,以左室奔马律占多数,所以在心尖部容易听到。舒张早期奔马律的出现,提示心脏有严重的器质性病变,见于各种原因的心力衰竭、急性心肌梗死,重征心肌炎等。" + }, + { + "question_num": 108, + "query": "急性白血病最常见的感染是", + "options": { + "A": "肺部感染", + "B": "咽峡炎、口腔炎", + "C": "肛周炎", + "D": "皮肤感染", + "E": "尿路感染" + }, + "answer": "B", + "reason": "急性白血病约50%以上患者以发热起病。发热程度不同，多因感染引起。感染以咽峡炎、口腔炎最多见，肺部感染、肛周炎及皮肤感染也较常见。严重感染可致菌血症或败血症，是急性白血病最常见的死亡原因之一。" + }, + { + "question_num": 109, + "query": "薤白的主治病证是", + "options": { + "A": "肝郁气滞", + "B": "肺热咳嗽", + "C": "虫积腹痛", + "D": "胸痹心痛", + "E": "胃寒呕吐" + }, + "answer": "D", + "reason": "薤白主治;①胸痹证,善散阴寒之凝滞,通胸阳之痹结,为治胸痹之要药;②脘腹痞满胀痛,泻痢里急后重。" + }, + { + "question_num": 110, + "query": "典型霍乱的首发症状是", + "options": { + "A": "发热", + "B": "呕吐", + "C": "腹泻", + "D": "恶心", + "E": "腹痛" + }, + "answer": "C", + "reason": "霍乱多以剧烈腹泻开始,呕吐多在腹泻数次后出现。" + }, + { + "question_num": 111, + "query": "酸枣仁汤中含有的药物是", + "options": { + "A": "知母、远志", + "B": "川芎、柏子仁", + "C": "茯苓、朱砂", + "D": "知母、川芎", + "E": "甘草、石菖蒲" + }, + "answer": "D", + "reason": "酸枣仁汤的方歌为\"酸枣仁汤治失眠,川芎知草茯苓煎,养血除烦清虚热，安然入睡梦乡甜\",其药物组成为酸吕仁、甘草、知母、茯苓、川芎。" + }, + { + "question_num": 112, + "query": "治疗咯血燥热伤肺证，应首选的方剂是", + "options": { + "A": "黛蛤散", + "B": "泻白散", + "C": "桑杏汤", + "D": "泻心汤", + "E": "玉女煎" + }, + "answer": "C", + "reason": "咳血燥热伤肺证证候:喉痒咳嗽，痰中带血，口干鼻燥,或有身热，舌质红,少津,苔薄黄,脉数。证机概要;燥热伤肺,肺失清肃，肺络受损。治法:清热润肺，宁络止血。代表方:桑杏汤加减。" + }, + { + "question_num": 113, + "query": "下列各项，不属于补中益气汤组成的药物是", + "options": { + "A": "黄芪", + "B": "当归", + "C": "柴胡", + "D": "白术", + "E": "茯苓" + }, + "answer": "E", + "reason": "补中益气汤的方歌\"补中益气芪术陈,升柴参草当归身,虚劳内伤功独擅，亦治阳虚外感因”，,其药物组成为黄芪、炙甘草、人参、当归、陈皮、升麻、柴胡、白术" + }, + { + "question_num": 114, + "query": "乳房部脓肿切开引流正确的切口选择是", + "options": { + "A": "乳晕旁弧形切口", + "B": "乳晕处放射状切口", + "C": "乳房下缘弧形切口", + "D": "以乳头为中心弧形切口", + "E": "以乳头为中心放射状切口" + }, + "answer": "E", + "reason": "乳痈脓肿形成时,应在波动感及压痛最明显处及时切开排脓。切口应以乳头为中心，放射状切口，按乳络方向并与脓腔基底大小一致，切口位置应选择脓肿稍低的部位，使引流通畅而不致袋脓，应避免手术损伤乳络形成乳漏。若脓肿小而浅者，可用针吸穿刺抽脓或用火针刺脓。" + }, + { + "question_num": 115, + "query": "治疗痰饮喘咳，应选用的药物是", + "options": { + "A": "佩兰", + "B": "苍术", + "C": "藿香", + "D": "砂仁", + "E": "厚朴" + }, + "answer": "E", + "reason": "厚朴功效：燥湿消痰、下气除满,主治：①湿阻中焦、脘腹胀满,本品苦燥辛散、温燥湿，又下气除胀满，为消除胀满的要药；②食积气滞、腹胀便秘；③痰饮喘咳,本品能燥湿消痰、下气平喘；④梅核气" + }, + { + "question_num": 116, + "query": "治疗气虚感冒，应首选的方剂是", + "options": { + "A": "银翘散", + "B": "参苏饮", + "C": "新加香薷饮", + "D": "加减葳蕤汤", + "E": "葱豉桔梗汤" + }, + "answer": "B", + "reason": "气虚感冒证证候：恶寒较甚，发热，无汗，头痛身楚,咳嗽,痰白,咳痰无力，平素神疲体弱，气短懒言，反复��感,舌淡苔白，脉浮而无力。证机概要:气虚卫弱，风寒乘袭，气虚无力达邪。治法:益气解表。代表方:参苏饮加减。" + }, + { + "question_num": 117, + "query": "温胆汤组成中含有的药物是", + "options": { + "A": "瓜蒌、杏仁", + "B": "贝母、瓜蒌", + "C": "枳实、竹茹", + "D": "白术、天麻", + "E": "干姜、细辛" + }, + "answer": "C", + "reason": "温胆汤组成药物：半夏、竹茹、枳实、陈皮、炙甘草、茯苓、生姜、大枣。" + }, + { + "question_num": 118, + "query": "流行性腮腺炎毒窜睾腹证的治法是", + "options": { + "A": "疏风清热，散结止痛", + "B": "清热解毒，软坚止痛", + "C": "清热解毒，开窍止痛", + "D": "清肝泻火，活血止痛", + "E": "清肝泻火，理气止痛" + }, + "answer": "D", + "reason": "流行性腮腺炎毒窜睾腹证的证候:腮部肿胀消退后，一侧或双侧睾九肿胀疼痛，或脘腹、少腹疼痛，痛时拒按，舌质红，苔黄,脉数。治法:清肝泻火，活血止痛。代表方剂:龙胆泻肝汤。" + }, + { + "question_num": 119, + "query": "与津液生成关系密切的脏腑是", + "options": { + "A": "脾、胃、小肠、大肠", + "B": "肺、肾、三焦、大肠", + "C": "胃、肾、小肠、大肠", + "D": "心、肺、膀胱、小肠", + "E": "脾、肺、小肠、膀胱" + }, + "answer": "A", + "reason": "津液的生成取决于如下两方面的因素;①充足的水饮类食物,这是生成津液的物质基础:②脏腑功能正常,特别是脾胃、大小肠的功能正常。" + }, + { + "question_num": 120, + "query": "面瘫伴舌麻、味觉减退，除主穴外，还应选取的配穴是", + "options": { + "A": "承浆", + "B": "水沟", + "C": "廉泉", + "D": "翳风", + "E": "风池" + }, + "answer": "C", + "reason": "面瘫配穴:眼睑闭合不全配鱼腰、丝竹空、申脉;鼻唇沟变浅配迎香;人中沟歪斜配水沟;颏唇沟歪斜配承浆;乳突部疼痛配翳风;舌麻、味觉减退配廉泉。" + }, + { + "question_num": 121, + "query": "根据《处方管理办法》,医师开具的普通药品处方一般不得超过的用量限定是", + "options": { + "A": "3日用量", + "B": "5日用量", + "C": "7日用量", + "D": "9日用量", + "E": "12日用量" + }, + "answer": "C", + "reason": "《处方管理办法》第十九条规定,处方一般不得超过7日用量；和急诊处方一般不得超过3日用量:对于某些慢性病,老年病或特殊情况,处方用量可适当延长,但医师应当注明理由。" + }, + { + "question_num": 122, + "query": "溢饮停积的部位是", + "options": { + "A": "胃肠", + "B": "肢体", + "C": "胁下", + "D": "胸肺", + "E": "心膈" + }, + "answer": "B", + "reason": "饮邪具有流动之性,饮留胃肠，则为痰饮;饮流胁下,则为悬饮;饮流肢体:则为溢饮;聚于胸肺,则为支饮。" + }, + { + "question_num": 123, + "query": "右少腹作痛拒按，或出现反跳痛的临床意义是", + "options": { + "A": "水臌", + "B": "气臌", + "C": "癥积", + "D": "肠痈", + "E": "虫积" + }, + "answer": "D", + "reason": "右少腹作痛而拒按,或出现“反跳痛\"(按之局部有压痛,若突然移去手指，腹部疼痛加副),或按之有包块应手者,常见于肠痈等病。" + }, + { + "question_num": 124, + "query": "下列各项，不属感染过程中病原体作用的是", + "options": { + "A": "侵袭力", + "B": "毒力", + "C": "数量", + "D": "抵抗力", + "E": "变异性" + }, + "answer": "D", + "reason": "感染过程中病原体的作用侵袭力、毒力、数量、变异性。" + }, + { + "question_num": 125, + "query": "引起上消化道出血最常见的原因是", + "options": { + "A": "消化性溃疡", + "B": "胆道感染", + "C": "胃癌", + "D": "血小板减少性紫癜", + "E": "肝硬化" + }, + "answer": "A", + "reason": "消化性溃疡是上消化道出血最常见的病因。" + }, + { + "question_num": 126, + "query": "治疗乳岩冲任失调证，应首选的方剂是", + "options": { + "A": "神效瓜蒌散合开郁散", + "B": "二仙汤合开郁散", + "C": "八珍汤合开郁散", + "D": "人参养荣汤合开郁散", + "E": "参苓白术散合开郁散" + }, + "answer": "B", + "reason": "乳岩冲任失调证证候:经事紊乱，素有经前期乳房胀痛。或婚后从未生育，或有多次流产史。乳房结块坚硬。舌质淡，苔薄，脉弦细。治法:调摄冲任，理气散结。方药:二仙汤合开郁散加减。" + }, + { + "question_num": 127, + "query": "在进行人体实验时，首要的道德原则是", + "options": { + "A": "科学性原则", + "B": "医学目的原则", + "C": "知情同意原则", + "D": "维护受试者利益原则", + "E": "有利于社会发展原则" + }, + "answer": "C", + "reason": "人体实验的道德原则:知情同意原则;维护患者利益原则;医学目的原则;科学对照原则。首要的是知情同意原则。" + }, + { + "question_num": 128, + "query": "根据腧穴的分经主治规律，足太阳经腧穴的主治特点是", + "options": { + "A": "后头、肩胛、耳病", + "B": "后头、背腰病、脏腑病", + "C": "侧头、耳病、胁肋病", + "D": "前头、鼻、口、齿病", + "E": "前头、口齿、胃肠病" + }, + "answer": "B", + "reason": "足太阳经腧穴主治后头、背腰(背俞并治脏腑病)，肛肠病，眼病，神志病，热病。" + }, + { + "question_num": 129, + "query": "麻子仁丸主治脾约证的临床表现是", + "options": { + "A": "大便稀溏，小便短少", + "B": "大便干结，小便频数", + "C": "大便黏滞，小便短少", + "D": "大便泄泻，小便频数", + "E": "大便不通，小便清长" + }, + "answer": "B", + "reason": "麻子仁丸主治肠胃燥热，脾津不足,大便干结,小便频数的脾约证。" + }, + { + "question_num": 130, + "query": "善治月经过多、崩漏的腧穴是", + "options": { + "A": "大都", + "B": "太白", + "C": "公孙", + "D": "隐白", + "E": "漏谷" + }, + "answer": "D", + "reason": "隐白主治:①月经过多、崩漏等妇科病;②便血、尿血等出血证;③癫狂，多梦;④惊风;⑤腹满,暴泻。" + }, + { + "question_num": 131, + "query": "下列各项，属于心阴虚证和心血虚证共有症状的是", + "options": { + "A": "心悸心烦", + "B": "失眠多梦", + "C": "口燥咽干", + "D": "面色淡白", + "E": "潮热盗汗" + }, + "answer": "B", + "reason": "心血虚证临床表现:心悸，头晕目眩,失眠,多梦,健忘,面色淡白或萎黄，舌质淡,脉细无力。心阴虚证临床表现:心烦，心悸,失眠,多梦,口燥咽干,形体消疲，或见手足心热,潮热盗汗,两颧潮红，舌红少苔乏津，脉细数。二者共有的症状是心悸、失眠、多梦。" + }, + { + "question_num": 132, + "query": "太乙针灸属于", + "options": { + "A": "艾条灸", + "B": "艾炷灸", + "C": "温针灸", + "D": "温灸器灸", + "E": "天灸" + }, + "answer": "A", + "reason": "艾条灸分为悬起灸和实按灸，其中悬起灸分为温和灸、雀啄灸、回旋负实按灸分为太乙针灸和雷火针灸。" + }, + { + "question_num": 133, + "query": "参苓白术散主治的病证是", + "options": { + "A": "脾虚湿盛证", + "B": "脾胃气虚证", + "C": "脾虚气陷证", + "D": "心脾两虚证", + "E": "脾肾两虚证" + }, + "answer": "A", + "reason": "参苓白术散主治脾虚湿盛证,症见气短乏力,形体消瘦,胸脘痞闷,饮食不化,肠鸣泄渴,面色萎黄，舌质淡苔白白腻，脉虚缓。" + }, + { + "question_num": 134, + "query": "疳证中疳积证的治法是", + "options": { + "A": "和脾健运", + "B": "益气健脾", + "C": "消积理脾", + "D": "运脾理气", + "E": "补益气血" + }, + "answer": "C", + "reason": "疳证疳积证治法:消积理脾。方药:肥儿丸。" + }, + { + "question_num": 135, + "query": "诊断肾阳虚证最有意义的临床表现是", + "options": { + "A": "小便频数，滑精早泄", + "B": "大便稀薄，完谷不化", + "C": "下肢水肿，凹陷不起", + "D": "畏寒肢冷，精神萎靡", + "E": "腰膝冷痛，精冷不育" + }, + "answer": "E", + "reason": "肾虚证，中医病证名。是指肾精、肾气、肾阴、肾阳不足所表现出来的一类病证。根据病变脏腑不同，其证候类型及临床表现多种多样。腰为肾之府、肾的生理功能为促进机体的生长、发育和生殖，上述选项中肾虚证最有意义的诊断指标就是腰膝冷痛、精冷不育。" + }, + { + "question_num": 136, + "query": "下列各项，属带下过多脾虚证主症的是", + "options": { + "A": "带下量多，绵绵不断，质稀如水", + "B": "带下量多，色黄或呈脓性，质黏稠", + "C": "带下量多，色黄", + "D": "带下赤白，质稠，有气味", + "E": "带下量多，色白，质稀" + }, + "answer": "E", + "reason": "带下过多脾虚证的主要证侯：带下量多，色白或淡黄，质稀薄，或如涕如唾，绵绵不断，无臭;面色㿠白或萎黄，四肢倦怠,脘胁不舒，纳少便溏，或四肢水肿;舌淡胖苔白或腻，脉细缓。A项见于肾阳虚证，B项见于湿热下注证，C项见于热毒蕴结证，D项见于阴虚夹湿证，" + }, + { + "question_num": 137, + "query": "具有消痈排脓，祛瘀止痛功效的药物是", + "options": { + "A": "金银花", + "B": "败酱草", + "C": "黄连", + "D": "黄芩", + "E": "栀子" + }, + "answer": "B", + "reason": "败酱草的功效:清热解禁，消痈排脓,祛瘀止痛。金银花的功效:清热解毒,疏散风热。黄连的功效,清热燥湿,泻火解毒。黄岑的功效:清热燥湿,泻火解毒,止血，安胎。栀子的功效:泻火除顷,清热利湿,凉血解毒,外用消肿止痛。" + }, + { + "question_num": 138, + "query": "下列腧穴中，治疗足心热的是", + "options": { + "A": "太冲", + "B": "行间", + "C": "大敦", + "D": "侠溪", + "E": "涌泉" + }, + "answer": "E", + "reason": "涌泉穴主治:①昏厥、中暑、小儿惊风、癫狂痫、头痛、头晕、目眩、失眠等急症及神志病证;②咯血、咽喉肿痛、喉痹、失声等肺系病证;③大便难，小便不利;④奔豚气;⑤足心热。肉紧执亚医师资始书快，中医执业助理医狮" + }, + { + "question_num": 139, + "query": "下列各项，属胃的生理功能的是", + "options": { + "A": "主运化水谷", + "B": "主受纳腐熟", + "C": "主受盛化物", + "D": "主泌别清浊", + "E": "主传输降浊" + }, + "answer": "B", + "reason": "胃的生理功能:主受纳水谷,主腐熟水谷。" + }, + { + "question_num": 140, + "query": "商阳穴的定位是", + "options": { + "A": "拇指末节桡侧，指甲根角侧上方0.1寸", + "B": "食指末节桡侧，指甲根角侧上方0.1寸", + "C": "无名指末节桡侧，指甲根角侧上方0.1寸", + "D": "小指末节桡侧，指甲根角侧上方0.1寸", + "E": "小指末节尺侧，指甲根角侧上方0.1寸" + }, + "answer": "B", + "reason": "商阳穴定位:在手指,食指末节桡侧，指甲根角侧上方0.1寸。A项为少商穴，D项为少冲穴,E项为少泽穴。" + }, + { + "question_num": 141, + "query": "口中黏腻不爽，其临床意义是", + "options": { + "A": "胃火炽盛", + "B": "湿热蕴脾", + "C": "胆火上炎", + "D": "心火上炎", + "E": "脾胃气虚" + }, + "answer": "B", + "reason": "口黏腻,是指病人自觉口中黏腻不网的症状,多见于痰热内盛、湿热蕴脾及寒湿困脾之证。" + }, + { + "question_num": 142, + "query": "按体重计算，3周岁幼儿的体重约为", + "options": { + "A": "10kg", + "B": "11kg", + "C": "12kg", + "D": "13kg", + "E": "14kg" + }, + "answer": "E", + "reason": "1岁以上儿童体重(kg)=8+2×年龄。" + }, + { + "question_num": 143, + "query": "下列各项，属温热药的作用是", + "options": { + "A": "引火归原", + "B": "凉血解毒", + "C": "滋阴除蒸", + "D": "清热利尿", + "E": "凉肝息风" + }, + "answer": "A", + "reason": "温热药分别具有温里散寒、暖肝散结、补火助阳、温阳利水.温经通络、引火归原,回阳救逆等作用。余四项为寒凉药作用。" + }, + { + "question_num": 144, + "query": "乳痈最常见的病因是", + "options": { + "A": "肝郁胃热", + "B": "乳汁郁积", + "C": "阳明积热", + "D": "乳头破损", + "E": "感受外邪" + }, + "answer": "B", + "reason": "乳痈的病因:乳汁郁积、肝郁胃热、感受外邪。乳汁郁积是最常见的原因。初产妇乳头破碎,或乳头畸形、凹陷,影响充分哺乳;或哺乳方法不当，或乳汁多而少饮或断乳不当,均可导致乳汁郁积，乳络阻塞结块,郁久化热酿脓而成痈肿。" + }, + { + "question_num": 145, + "query": "正常成人血小板计数的正常参考值是", + "options": { + "A": "(4～10)×10^9/L", + "B": "(50～90)×10^9/L", + "C": "(50～90)×10^12/L", + "D": "(100～300)×10^9/L", + "E": "(400～600)×10^9/L" + }, + "answer": "D", + "reason": "血小板参考值:(100一300)X10^9/L。" + }, + { + "question_num": 146, + "query": "常用敷贴法治疗的小儿疾病是", + "options": { + "A": "水肿", + "B": "哮喘", + "C": "紫癜", + "D": "惊厥", + "E": "癫痫" + }, + "answer": "B", + "reason": "敷贴法是将药物制成软膏、药饼、或研粉撒于普通膏药上，敷贴于局部的一种外治法。可用于治疗肺炎后期湿性啰音经久不消、婴儿泄泻、寒性哮喘等," + }, + { + "question_num": 147, + "query": "消谷善饥的临床意义是", + "options": { + "A": "脾胃虚弱", + "B": "湿热蕴脾", + "C": "肝胆湿热", + "D": "胃阴不足", + "E": "胃强脾弱" + }, + "answer": "E", + "reason": "消谷善饥指患者食欲亢进，食量较多,食后不久即感饥饿的汪状,多由胃热炽盛，腐熟太过所致。消谷善饥���兼多饮多尿，身体消疲者,多见于消渴病。多食易饥,兼见大便溏泄者,为胃强脾弱。" + }, + { + "question_num": 148, + "query": "治呕吐，除胃募穴外，还应选取的经穴是", + "options": { + "A": "手厥阴、手阳明经穴", + "B": "手太阴、手阳明经穴", + "C": "手少阴、手阳明经穴", + "D": "手厥阴、足阳明经穴", + "E": "手少阴、足阳明经穴" + }, + "answer": "D", + "reason": "呕吐的治法:和胃理气,降逆止呕。取胃的募穴及足阳明、手厥阴经穴为主。" + }, + { + "question_num": 149, + "query": "用于判断远端肾小管稀释—浓缩功能的实验室检查是", + "options": { + "A": "内生肌酐清除率", + "B": "血肌酐", + "C": "血清尿素氮", + "D": "血β2-微球蛋白测定", + "E": "昼夜尿比密试验" + }, + "answer": "E", + "reason": "昼夜尿比密试验(莫氏试验),可了解肾脏的稀释-浓缩功能,是反映远端肾小管和集合管功能状态的敏感试验。" + }, + { + "question_num": 150, + "query": "胎黄寒湿阻滞证的特点是", + "options": { + "A": "面目皮肤发黄，色泽鲜明", + "B": "面目皮肤发黄，色泽晦暗", + "C": "面目皮肤发黄，颜色迅速加深无华", + "D": "面目皮肤萎黄", + "E": "面目皮肤发黄如橘色" + }, + "answer": "B", + "reason": "胎黄寒湿阻滞证证候:面目皮肤发黄，色泽晦暗，持久不退，精神萎靡，四肢欠温，纳呆，大便溏薄色灰白，小便短少，舌质淡，苔白腻。AE项为湿热郁蒸证，C项为气滞血瘀证。" + }, + { + "question_num": 151, + "query": "脉象特征形细而行迟，往来不畅，脉势不匀，如轻刀刮竹，其临床意义是", + "options": { + "A": "气血两虚", + "B": "阳气虚衰", + "C": "气滞血瘀", + "D": "痰湿内停", + "E": "阴盛气结" + }, + "answer": "C", + "reason": "汲脉形细而行迟,往来艰涩不畅,脉势不匀。脉象特征是脉形较细,脉势滞汲不申,如\"轻刀刮竹\";至数较缓而不匀，脉力大小亦不均，显三五不调之状，涩脉多见于气滞、血瘀和精伤,血少。" + }, + { + "question_num": 152, + "query": "慢性心力衰竭肺淤血表现中最严重的状态是", + "options": { + "A": "劳力型呼吸困难", + "B": "端坐呼吸", + "C": "夜间阵发性呼吸困难", + "D": "心源性哮喘", + "E": "运动后哮喘" + }, + "answer": "D", + "reason": "肺淤血的表现:表现为程度不同的呼吸困难，呼吸困难程度及表现与心力衰竭程度有关。①劳力性呼吸困难:左侧心力衰竭最早出现的症状，呼吸困难发生在重体力活动时，休息后可缓解;②夜间阵发性呼吸困难:与平卧睡眠后回心血量增加、副交感神经呼吸;④急性肺水肿(心源性哮喘):是呼吸困难最严重的状态。除呼吸困难外，常有咳嗽、咳痰、咯血等。" + }, + { + "question_num": 153, + "query": "常引起弛张热的疾病是", + "options": { + "A": "结核病", + "B": "肺炎链球菌肺炎", + "C": "伤寒", + "D": "霍奇金病", + "E": "风湿热" + }, + "answer": "E", + "reason": "弛张热常见于败血症、风湿热.重症肺结核、化脓性炎症等。" + }, + { + "question_num": 154, + "query": "患者，男，49岁。因夜卧受凉致颈、项部疼痛，伴左上肢手指麻木发凉，遇寒即发，肩臂酸楚，舌苔薄白，脉弦涩，其针灸处方除颈夹脊、风池、阿是穴外，还应选取的腧穴是", + "options": { + "A": "天柱、曲池、列缺、合谷", + "B": "天柱、膈俞、三阴交、合谷", + "C": "肩井、外关、肝俞、肾俞", + "D": "大椎、后溪、太溪、太冲", + "E": "风门、肺俞、曲池、内关" + }, + "answer": "A", + "reason": "患者项部疼痛,伴左上肢手指发麻，诊为颈椎病。因夜卧受凉而诱发，为外邪侵袭。颈椎病主穴:颈夹脊、天柱、风池、曲池、悬钟、阿是穴。外邪内侵配合谷、列缺。" + }, + { + "question_num": 155, + "query": "仙方活命饮中的君药是", + "options": { + "A": "赤芍", + "B": "当归", + "C": "陈皮", + "D": "天花粉", + "E": "金银花" + }, + "answer": "E", + "reason": "仙方活命饮——清热解毒,消肿溃坚,活血止痛——阳证痈疡肿毒初起。其中,金银花性味甘寒,最善清热解毒疗疮,前人称之谓“疮疡圣药”,故重用为君。" + }, + { + "question_num": 156, + "query": "患者平时头晕耳鸣，腰酸，突然发生口眼歪斜，语言不利，口角流涎，手指瞤动，半身不遂，舌质红，苔腻，脉弦细数，其证候是", + "options": { + "A": "阴虚风动证", + "B": "风阳上扰证", + "C": "风痰入络证", + "D": "痰浊瘀闭证", + "E": "痰火瘀闭证" + }, + "answer": "A", + "reason": "根据患者症状可诊断为中风之阴虚风动证。肝肾阴虚，清窍及经脉失养,故头晕耳鸣,腰酸,舌质红,脉细;风阳内动，风痰闭阻经络，故突然发生口眼歪斜，语言不利，口角流涎,手指动,半身不遂,苔腻,脉弦数。" + }, + { + "question_num": 157, + "query": "下列各项，不属玄参主治病证的是", + "options": { + "A": "温毒发斑", + "B": "津伤便秘", + "C": "经闭痛经", + "D": "痈肿疮毒", + "E": "目赤咽痛" + }, + "answer": "C", + "reason": "玄参的功效:清热凉血,滋阴降火,解毒疏结。主治热入营血,温毒发班热病伤阴,舌绛烦渴,津伤便秘,骨蒸劳嗽；目赤肿痛,咽喉肿病、白喉,瘰疬,痈肿疮毒。药性:甘、苦、咸,微寒。归肺、胃、符经。" + }, + { + "question_num": 158, + "query": "患儿，5岁。不思进食2个月余。食少饮多，皮肤失润，大便偏干，小便短黄，舌红少津，苔花剥，脉细数。治疗应首选的方剂是", + "options": { + "A": "生脉汤", + "B": "养胃增液汤", + "C": "六味地黄汤", + "D": "增液承气汤", + "E": "养阴清肺汤" + }, + "answer": "B", + "reason": "厌食脾胃阴虚证证候:不思进食，食少饮多，皮肤失润，大便偏干，小便短黄，甚或烦踩少寐，手足心热，舌质红少津，苔少或花剥，脉细数。治法:滋脾养胃，佐以助运。代表方剂:养胃增液汤、益胃汤。" + }, + { + "question_num": 159, + "query": "有形实邪闭阻气机所致疼痛的性质是", + "options": { + "A": "胀痛", + "B": "灼痛", + "C": "冷痛", + "D": "绞痛", + "E": "隐痛" + }, + "answer": "D", + "reason": "绞痛指疼痛剧烈如刀绞一般而难于忍受的症状,多因瘀血、气滞、结石、虫积等有形实泻阻闭气机,或寒泻凝滞气机所致。" + }, + { + "question_num": 160, + "query": "患者1周前因外伤出现右手食指红肿热痛，肿胀呈圆柱状，皮色光亮，关节轻度屈曲，不能伸展，现局部跳痛明显，拟切开排肿。应选择的切口部位是", + "options": { + "A": "指掌侧面", + "B": "指掌正中", + "C": "手指侧面", + "D": "手指正中", + "E": "食指关节处" + }, + "answer": "C", + "reason": "蛇肚疔宜在手指侧面做纵行切口，切口长度不得超过上下指关节面。" + }, + { + "question_num": 161, + "query": "治疗咳喘，水肿，应选用的药物是", + "options": { + "A": "百部", + "B": "紫菀", + "C": "五加皮", + "D": "桑白皮", + "E": "紫苏子" + }, + "answer": "D", + "reason": "桑白皮药性甘,寒。归肺经。功效:泻肺平喘,利水消肿。主治肺热喘咳;水肿胀满尿少,面目肌肤浮肿。" + }, + { + "question_num": 162, + "query": "患儿，4岁。咳嗽痰多，色黄黏稠，难以咯出，喉间痰鸣，发热口渴，烦躁不宁，舌红苔黄，脉滑数。治疗应首选的方剂是", + "options": { + "A": "二陈汤", + "B": "桑菊饮", + "C": "桑杏汤", + "D": "清金化痰汤", + "E": "麻杏石甘汤" + }, + "answer": "D", + "reason": "内伤咳嗽之痰热咳嗽证证候:咳嗽痰多，色黄黏稠,难以咳出,甚则喉间痰鸣，或伴发热口渴,烦躁不安，小便黄少，大便干结，舌质红，苔黄腻，脉滑数或指纹青紫治法:清热化痰，宣肺止咳。代表方剂:清金化痰汤、清气化痰汤。" + }, + { + "question_num": 163, + "query": "八正散的主治证候是", + "options": { + "A": "湿热外感", + "B": "暑温夹湿", + "C": "湿热黄疸", + "D": "湿热淋证", + "E": "湿温初起" + }, + "answer": "D", + "reason": "八正散:清热洱火,利水通淋。主治湿热淋证。尿频尿急,溺时涩痛,淋沥不畅,尿色混赤,甚则癃闭不通,小腹急满，口燥咽干，舌苦黄腻,脉滑数。" + }, + { + "question_num": 164, + "query": "患者，女，49岁。反复低热、尿急1年余。近3个月出现夜尿增多，尿沉渣镜检白细胞50个/HP，可见白细胞管型，血尿素氮10.8mmol/L，B超深探双肾凹凸不平且大小不等，中段尿培养有大肠埃希菌生长。应首先考虑的诊断是", + "options": { + "A": "急性肾盂肾炎", + "B": "慢性肾小球肾炎", + "C": "慢性肾盂肾炎", + "D": "急性肾结核", + "E": "慢性肾衰竭" + }, + "answer": "C", + "reason": "慢性肾盂肾炎诊断要点:①反复发作的尿路感染病史;②影像学显示肾外形凹凸不平且双肾大小不等，或静脉肾孟造影见肾孟肾益变形、缩窄;③合并持续性肾小管功能损害。" + }, + { + "question_num": 165, + "query": "炒用多用于回乳消胀的药物是", + "options": { + "A": "山楂", + "B": "神曲", + "C": "麦芽", + "D": "莱菔子", + "E": "鸡内金" + }, + "answer": "C", + "reason": "生麦芽健腺和胃，疏肝行气,用于脾虚食少,乳汁郁积;炒麦芽行气消食回乳,用于食积不消,妇女断乳;焦麦芽消食化滞，用于食积不消，脘腹胀痛。" + }, + { + "question_num": 166, + "query": "患者鼻燥衄血，口干咽燥，兼有身热，恶风，头痛，咳嗽，痰少，舌质红，苔薄，脉数。治疗应首选的方剂是", + "options": { + "A": "玉女煎", + "B": "桑菊饮", + "C": "清胃散", + "D": "十灰散", + "E": "泻心汤" + }, + "answer": "B", + "reason": "鼻衄热邪犯肺证的证候:鼻燥衄血，口干咽燥,或兼有身热，恶风，头痛，咳嗽，痰少，舌质红,苔薄,脉数。证机概要:燥热伤肺，血热妄行，上溢清窍。治法:清泄肺热，凉血止血。代表方:桑菊饮加减，" + }, + { + "question_num": 167, + "query": "治疗闭证神昏，湿阻中焦，应选用的药物是", + "options": { + "A": "石菖蒲", + "B": "羚羊角", + "C": "牛黄", + "D": "远志", + "E": "麝香" + }, + "answer": "A", + "reason": "石菖蒲功效:开穷醒神,化湿和胃，,宁神益志。主治:①痰蒙清穷,神志昏迷;②湿阻中焦,脘腹痞满,胀闷疼痛;③噤口痢;④健忘、失眠、耳鸣、耳聋。" + }, + { + "question_num": 168, + "query": "患者大便并不干硬，虽有便意，但排便困难，用力努挣则汗出短气，便后乏力，面白神疲，肢倦懒言，舌淡苔白，脉弱，其治法是", + "options": { + "A": "温阳通便", + "B": "滋阴通便", + "C": "养血润燥", + "D": "益气润肠", + "E": "温里散寒" + }, + "answer": "D", + "reason": "根据患者症状可诊断为便秘之气虚秘。大肠传导无力，故大便并不硬，虽有便意，但排便困难，其人肺脾气虚，故用力努挣则汗出短气，便后乏力，面白神疲，肢倦懒言，舌淡苔白，脉弱。治法为益气润肠，方用黄芪汤加减。" + }, + { + "question_num": 169, + "query": "下列各项，不属槟榔功效的是", + "options": { + "A": "消积", + "B": "行气", + "C": "利水", + "D": "截疟", + "E": "止血" + }, + "answer": "E", + "reason": "槟榔药性苦、辛,温。归胃、大肠经。功效:杀虫,消积,行气,利水,截疟。" + }, + { + "question_num": 170, + "query": "患者停经56天，呕吐酸水，胸满胁痛，嗳气叹息，烦渴口苦，舌质淡红，苔微黄，脉弦滑，查尿妊娠试验阳性，其治法是", + "options": { + "A": "健脾和胃，降逆止呕", + "B": "疏肝解郁，降逆止呕", + "C": "清肝和胃，降逆止呕", + "D": "健脾和胃，清热止呕", + "E": "清肝和胃，健脾止呕" + }, + "answer": "C", + "reason": "妊娠恶阻肝胃不和证证候:妊娠早期，恶心，呕吐酸水或苦水，恶闻油腻;烦渴、口干口苦,头胀而晕、胸痛胁疬、嗳气叹息:舌质淡红、苔微黄、脉弦滑。治法:清肝和胃、降逆止呕。方药:橘皮竹茹汤或苏叶黄连沸加美半夏、枇耙叶、竹茹、乌梅" + }, + { + "question_num": 171, + "query": "表证与里证的鉴别要点是", + "options": { + "A": "表证多为新病，里证多为久病", + "B": "表证病较轻浅，里证病较深重", + "C": "表证恶寒发热，里证或寒或热", + "D": "表证起病较急，里证起病较缓", + "E": "表证多为外感，里证皆属内伤" + }, + "answer": "C", + "reason": "外感病中,发热恶寒同时并见者属表证;但热不寒或但寒不热者属里证;寒热往来者属半表半里证。" + }, + { + "question_num": 172, + "query": "患者关节游走性疼痛，活动不便，局部灼热红肿，痛不可触，得冷则舒，伴有发热，恶风，汗出，口渴，舌质红，苔黄腻，脉浮数。治疗应首选的方剂是", + "options": { + "A": "薏苡仁汤或蠲痹汤", + "B": "乌头汤合五味消毒饮", + "C": "双合汤合羌活胜湿汤", + "D": "白虎加桂枝汤", + "E": "防风汤合桂枝芍药知母汤" + }, + "answer": "D", + "reason": "根据患者症状可辨病为痹证、感受风湿热邪，袭于肌腠则发热，恶风，汗出、口渴；热邪盛则局部灼热红肿，病不可触，得冷则舒;风邪善行而数变故关节游走性疼痛、活动不便;苔黄腻则为湿热之象。辨证为风湿麻痹，治法为清热通络，祛风除湿，方用白虎加桂枝汤或宣痹汤加减。" + }, + { + "question_num": 173, + "query": "中医学建立治则治法的主要依据是", + "options": { + "A": "证候", + "B": "症状", + "C": "疾病", + "D": "病因", + "E": "病机" + }, + "answer": "A", + "reason": "中医学的主要特点是辩证论治,即运���中医学理论辨析有关羔痪的资料以确立证,在证的基础上确立相应的治疗原则和方法，" + }, + { + "question_num": 174, + "query": "患者喉中痰涎壅盛，声如哨笛，喘急胸满，但坐不得卧，咳痰不利，无明显寒热倾向，面色青黯，发病急，常倏忽来去，发作前自觉目、耳、咽痒，喷嚏，流涕，舌苔厚浊，脉滑实。治疗应首选的方剂是", + "options": { + "A": "射干麻黄汤", + "B": "定喘汤", + "C": "三子养亲汤", + "D": "六君子汤", + "E": "平喘固本汤" + }, + "answer": "C", + "reason": "痰浊伏肺,故喉中痰涎壅盛;肺气郁闭，升降失司，故声如哨笛,喘急胸满、但坐不得卧，咳痰不利，无明显寒热倾向,发病急，常倏忽来去，发作前自觉目、耳、咽痒,喷嚏,流涕;舌苔厚浊,脉滑实均为痰浊内盛之象。治法为祛风涤痰，降气平喘，方用三子养亲汤加减。射干麻黄汤治疗冷哮证，定喘汤治疗热哮证，六君子汤适用于缓解期的肺脾气虚证，平喘固本汤治疗虚哮证。" + }, + { + "question_num": 175, + "query": "生理病理统归于心而分属于五脏的奇恒之腑是", + "options": { + "A": "脑", + "B": "髓", + "C": "骨", + "D": "脉", + "E": "胆" + }, + "answer": "A", + "reason": "脑为奇桓之腑，其生理病理统归于心而分属于五脏。" + }, + { + "question_num": 176, + "query": "患儿，3岁。面目浮肿，尿黄，有血尿，烦热口渴，皮肤有脓疱疮，舌质红，苔黄腻，其证候是", + "options": { + "A": "风水相搏证", + "B": "湿热内侵证", + "C": "脾肾阳虚证", + "D": "水毒内闭证", + "E": "脾虚湿困证" + }, + "answer": "B", + "reason": "水肿湿热内侵证证候:浮肿或轻或重，小便黄赤短少或见尿血，伴脓疱疮、疖肿、丹毒,发热口渴,烦躁,头痛头晕,大便干结，舌质红,苔黄腻，脉滑数。治法:清热解毒，利水消肿。方药:五味消毒饮合五皮饮。" + }, + { + "question_num": 177, + "query": "“孤阴不生、独阳不长”主要说明了阴", + "options": { + "A": "对立", + "B": "互根", + "C": "消长", + "D": "转化", + "E": "动态平衡" + }, + "answer": "B", + "reason": "阳阳互根,是指一切事物或现象中相互对立着的阴阳两个方面.具有相互依存,互为根本的关系。如果由于某些原因，阴和阳之间的互根关系遭到破坏,就会导政“孤阴不生,独阳不长\",甚则\"阴阳离决,精气乃绝\"(《素问·生气通天论))而死亡。" + }, + { + "question_num": 178, + "query": "患者经常不易入睡，或寐而易醒，甚则彻夜不眠，伴见心悸多梦，易惊恐，舌质淡，脉弦细。治疗除主穴外，还应选取的配穴是", + "options": { + "A": "内关、曲池", + "B": "行间、侠溪", + "C": "心俞、胆俞", + "D": "太溪、肾俞", + "E": "心俞、脾俞" + }, + "answer": "C", + "reason": "患者经常不易入睡,或寐则易醒，甚则彻夜不眠,诊为不寐。伴心悸多梦易惊恐，舌淡，脉弦细，为心胆气虚证。除主穴百会、安眠、神门、三阴交、照海、申脉外,还应配心俞、胆俞。" + }, + { + "question_num": 179, + "query": "桑螵蛸的主治病证是", + "options": { + "A": "自汗盗汗", + "B": "遗精滑精", + "C": "中气下陷", + "D": "久咳虚喘", + "E": "久泻久痢" + }, + "answer": "B", + "reason": "桑螵蛸主治病证:①肾虚不固之遗精滑精、遗尿尿频、白浊;②贤虚阳瘘。" + }, + { + "question_num": 180, + "query": "患者，女，55岁。带下量少，阴部干涩，头晕耳鸣，腰膝酸软，烘热汗出，夜寐不安，小便黄，大便干结，舌质红，少苔，脉细数。治疗应首选的方剂是", + "options": { + "A": "小营煎", + "B": "归肾丸", + "C": "左归丸", + "D": "知柏地黄丸", + "E": "桃红四物汤" + }, + "answer": "C", + "reason": "带下过少肝肾亏损证证候带下过少，甚至全无，阴部干涩灼痛，或伴阴痒，阴部萎缩，性交疼痛，甚则性交干涩困难头晕耳鸣，腰膝酸软,烘热汗出，烦热胸闷，夜寐不安，小便黄，大便干结;舌质红,少苔,脉细数或沉弦细。治法:滋补肝肾，养精益血。代表方:左归丸加知母、肉苁蓉、紫河车、麦门冬。" + }, + { + "question_num": 181, + "query": "主治肝阳偏亢、肝风上抗证的首选方剂是", + "options": { + "A": "大秦艽汤", + "B": "地黄饮子", + "C": "大定风珠", + "D": "羚角钩藤汤", + "E": "天麻钩藤饮" + }, + "answer": "E", + "reason": "天麻钓藤饮:平肝息风，,清热活血,补益肝肾。主治肝阳偏亢.肝风上扰证。头痛,眩紧,失眠多梦,或口苦面红,舌红苦黄,脉弦或数。" + }, + { + "question_num": 182, + "query": "患者脘腹痞闷，胸胁胀满，心烦易怒，善太息，呕恶嗳气，大便不爽，舌质淡红，苔薄白，脉弦。治疗应首选的方剂是", + "options": { + "A": "益胃汤", + "B": "保和丸", + "C": "泻心汤合左金丸", + "D": "柴胡疏肝散", + "E": "平胃散合逍遥丸" + }, + "answer": "D", + "reason": "根据患者症状可诊断为痞满之肝胃不和证。肝主条达，肝郁气滞，胸胁胀满,心烦易怒,善太息,脉弦;肝气横犯脾胃,致胃气阻滞，脾失健运，故脘腹痞闷，呕恶嗳气，大便不爽。治法为疏肝解郁，和胃消痞，方用柴胡疏肝散加减。" + }, + { + "question_num": 183, + "query": "五轮学说认为，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:目内毗及外眦的血络属心,称为“血轮\";黑珠属肝,称为“风轮“;白睛属肺,称为“气轮\";瞳仁属肾,称为“水轮”;眼胞属脾,称为“肉轮”。" + }, + { + "question_num": 184, + "query": "患儿，5岁。每晚尿床2次，小便清长，神疲乏力，肢冷畏寒，舌质淡，苔白滑，其治法是", + "options": { + "A": "补肺益脾，固涩膀胱", + "B": "温补肾阳，固涩膀胱", + "C": "清心滋肾，安神固脬", + "D": "健脾温肾，助运止遗", + "E": "清热利湿，缓急止遗" + }, + "answer": "B", + "reason": "遗尿肾气不足证证侯：寐中多遗，可达数次，小便清长，而白少华，种疲乏力，智力较同龄儿稍差，肢冷畏寒，舌质淡，苔白滑，脉沉无力。治法:温补肾阳，固涩膀胱。代表方剂:兔丝子散。" + }, + { + "question_num": 185, + "query": "患者身目俱黄，黄色晦暗，腹胀纳少，神疲畏寒，大便不实，口淡不渴，舌淡苔腻，脉濡缓，其证候是", + "options": { + "A": "阴黄寒湿阻遏证", + "B": "急黄疫毒炽盛证", + "C": "阴黄脾虚湿盛证", + "D": "阳黄热重于湿证", + "E": "阳黄湿重于热证" + }, + "answer": "A", + "reason": "根据患者症状可诊断为黄痘。中阳不振，则腹胀纳少，神疲畏寒;寒湿滞留，脾失健运，则大便不实，口淡不渴，舌淡苔腻,脉濡缓,皮肤晦暗;肝胆失于疏泄、胆汁外溢则身目俱黄。辨证为阴黄寒湿阻遏证。" + }, + { + "question_num": 186, + "query": "患者感受风寒后出现喉中哮鸣如水鸡声，痰多色白，稀薄有泡沫，恶寒发热，舌苔薄白，脉浮紧。治疗除主穴外，还应选取的配穴是", + "options": { + "A": "丰隆、曲池", + "B": "风门、合谷", + "C": "风池、太渊", + "D": "关元、气海", + "E": "肾俞、太溪" + }, + "answer": "B", + "reason": "根据题干判断为哮喘风寒外袭。风寒外袭配风门、合谷;痰热阻肺配丰隆、曲池;喘甚者配天突。" + }, + { + "question_num": 187, + "query": "患者胃脘灼热隐痛，饥不欲食，咽干口燥，大便干结，舌质红少津，脉弦细。治疗除主穴外，还应选取的配穴是", + "options": { + "A": "下脘、梁门、天枢", + "B": "膈俞、三阴交、内关", + "C": "胃俞、内庭、三阴交", + "D": "期门、太冲、合谷", + "E": "胃俞、脾俞、关元" + }, + "answer": "C", + "reason": "患者胃脘灼热隐痛,诊为胃痛。胃痛治疗的主穴:中脘、足三里、内关。配穴:寒邪客胃配胃俞;饮食伤胃配梁门、下脘;肝气犯胃配期门、太冲;瘀血停胃配膈俞、三阴交;脾胃虚寒配关元、脾俞、胃俞;胃阴不足胃俞、三阴交、内廷。" + }, + { + "question_num": 188, + "query": "患儿，出生后28天，面目皮肤发黄，色泽鲜明如橘，不欲吮乳，大便秘结，小便深黄，舌质红，苔黄腻，其治法是", + "options": { + "A": "健脾利湿", + "B": "温中化湿", + "C": "温阳固脱", + "D": "化瘀消积", + "E": "清热利湿" + }, + "answer": "E", + "reason": "胎黄湿热郁蒸证的证候:面目皮肤发黄，色泽鲜明如橘,哭声响亮,不欲吮乳，口渴唇干，或有发热，大便秘结，小便深黄!舌质红，苔黄腻。治法:清热利湿退黄。代表方剂:茵陈蒿汤。" + }, + { + "question_num": 189, + "query": "患者左股骨颈骨折7天，左下肢肿胀粗2天，皮温升高，皮色红，胀痛，浅表静脉扩张，活动不利，舌质红，苔黄腻，脉弦滑。治疗应首选的方剂是", + "options": { + "A": "活血通脉汤", + "B": "参苓白术散", + "C": "补阳还五汤", + "D": "龙胆泻肝汤", + "E": "四妙勇安汤" + }, + "answer": "E", + "reason": "股肿发病特点为肢体肿胀疼痛、局部皮温升高及��静脉怒张。股肿湿热下注证的证候:发病较急，表现为下肢粗肿，局部发红、发热，疼痛，活动受限，舌质红，苔黄腻，脉弦滑。治疗:清热利湿，活血化瘀。方用四妙勇安汤加味。" + }, + { + "question_num": 190, + "query": "患者，男。突发右侧胁肋疼痛，呈持续性，阵发性加剧，放射到右肩胛区，恶心、呕吐，苔黄腻，脉滑数。治疗应选取的主穴是", + "options": { + "A": "内关、郄门、阴郄、膻中", + "B": "中脘、内关、足三里、内庭", + "C": "期门、外关、阴陵泉、足三里", + "D": "胆囊穴、阳陵泉、胆俞、日月", + "E": "肾俞、中极、三阴交、阴陵泉" + }, + "answer": "D", + "reason": "胆绞痛主穴:胆囊穴、阳陵泉、胆俞、日月。配穴:肝胆湿热配内庭、阴陵泉;肝胆气滞配太冲、丘墟;蛔虫妄动配迎香透四白。记忆口诀:二胆日月阳。" + }, + { + "question_num": 191, + "query": "患者，女，24岁。已婚。妊娠4个月，肢体肿胀，肿势从足部渐发展到腿部，皮色不变，随按随起，胸闷胁胀，头晕胀痛，舌苔薄腻，脉弦滑。治疗应首选的方剂是", + "options": { + "A": "健脾利水汤", + "B": "真武汤", + "C": "天仙藤散", + "D": "猪苓汤", + "E": "白术散" + }, + "answer": "C", + "reason": "子肿气滞证主要证候:妊娠3~4个月后，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。方药:天仙藤散或正气天香散。" + }, + { + "question_num": 192, + "query": "患者，男，23岁。劳累受凉感冒3天后出现寒战、高热、胸痛，呼吸困难。体格检查：右下胸部叩诊呈浊音，听诊呼吸音减低，出现支气管呼吸音。血白细胞计数14.5×10⁹/L。胸部X线示肺叶见密度均匀阴影。应首选考虑的诊断是", + "options": { + "A": "肺炎链球菌肺炎", + "B": "肺结核", + "C": "金黄色葡萄球菌肺炎", + "D": "克雷伯杆菌肺炎", + "E": "支原体肺炎" + }, + "answer": "A", + "reason": "肺炎链球菌肺炎:典型症状寒战、高热、咳嗽、铁锈色疚伴患侧胸病,患侧呼吸运动减弱、触觉语颤增强、叩诊呈浊音或实音听诊呼吸音减弱或消失，并可出现支气管呼吸音。胸部X线早期可见肺纹理增粗、紊乱，实变期呈肺叶、肺段分布的密度均匀阴影。" + }, + { + "question_num": 193, + "query": "患者皮肤突然出现块、片状风团，异常瘙痒，舌质红，脉浮。治疗除合谷、血海、三阴交外，还应选取的主穴是", + "options": { + "A": "外关、风门", + "B": "膈俞、曲池", + "C": "曲池、内庭", + "D": "天枢、足三里", + "E": "脾俞、足三里" + }, + "answer": "B", + "reason": "瘾疹起病急骤,皮肤突发瘙痒不止，可见大小不等、形状各异的风团，融合成片或孤立散在，淡红或白色，边界清楚，此起彼伏。针灸治疗主穴为曲池、合谷、血海、膈俞、三阴交。" + }, + { + "question_num": 194, + "query": "患者，女，29岁。每次经行期间，发热，恶寒，无汗，鼻塞流涕，咽喉痒痛，咳嗽痰稀，头痛身痛，舌淡红，苔薄白，脉浮紧，经净诸证渐愈，其治法是", + "options": { + "A": "疏风解表，调和营卫", + "B": "疏风清热，和血调经", + "C": "和解表里，调和营卫", + "D": "解表散寒，和血调经", + "E": "疏肝理气，调和营卫" + }, + "answer": "D", + "reason": "患者每次经行期间，发热恶寒，无汗,鼻塞流涕,咽喉痒病,咳嗽痰稀，头痛身痛，舌淡红，苔薄白，脉浮紧，经净诸证渐愈，为经行感冒风寒证。治法:解表散寒，和血调经。代表方:荆穗四物汤。" + }, + { + "question_num": 195, + "query": "患者行注射治疗后，出现臀部结块坚硬，漫肿不红，病情进展缓慢，无全身症状，舌苔白腻，脉缓，其诊断是", + "options": { + "A": "臀痈", + "B": "肉瘤", + "C": "流痰", + "D": "内陷", + "E": "无头疽" + }, + "answer": "A", + "reason": "臀痈是发生于臀部肌肉丰厚处范围较大的急性化脓性疾病。由于肌内注射引起者，俗称针毒结块。湿痰凝滞证的证候:漫肿不红，结块坚硬，病情进展缓慢，多无全身症状。舌苔薄白或白腻，脉缓。" + }, + { + "question_num": 196, + "query": "患者腰痛遇劳而发，腰部强直僵硬，痛处固定不移，转侧偏身不利，腘中络脉瘀血，舌质暗，脉涩。治疗选取阿是穴、大肠俞、委中穴，其操作方法是", + "options": { + "A": "温和灸", + "B": "温针灸", + "C": "耳针法", + "D": "刺络拔罐法", + "E": "毫针补法" + }, + "answer": "D", + "reason": "腰痛基本刺灸方法:毫针虚补实泻法。寒湿腰痛或肾虚腰痛加灸法;瘀血腰病阿是穴用刺络拔罐;痛势较急者委中点刺放血。患者腰痛，痛处固定不移，转侧偏身不利，腘中络脉瘀血，舌质暗，脉涩，为瘀血腰痛，选择刺络拔罐法。" + }, + { + "question_num": 197, + "query": "患者因流产而失血过多，导致月经不调，久不怀孕，其病在哪经", + "options": { + "A": "阴跷脉、阳跷脉", + "B": "阴维脉、阳维脉", + "C": "督脉、任脉", + "D": "冲脉、任脉", + "E": "阴跷脉、阴维脉" + }, + "answer": "D", + "reason": "任脉可调节全身阴经脉气，故称“阴脉之海”;冲脉可含蓄调节十二经周家执亚医师资格者状中质执亚助搜医帅泉、胆俞、日月。穴:肝胆湿热配内庭、阴陂泉:肝胆气沸配太冲、在墟:如虫妄动配迎香透四白、记忆口诀:一胆日月附。" + }, + { + "question_num": 198, + "query": "患者产后2周，恶露过期不尽，量多，色紫红，质黏稠，有臭秽气，面色潮红，舌红，脉细数，其证候是", + "options": { + "A": "气虚证", + "B": "血热证", + "C": "阴虚证", + "D": "血瘀证", + "E": "肝郁证" + }, + "answer": "B", + "reason": "产后恶露不绝血热证证候:产后恶露过期不止，量较多，色紫红，质黏稠、有臭秽气，而色潮红,口燥咽干，舌质红,脉细数。治法:养阴清热止血。方药:保阴煎加益母草、七叶一枝花、贯众。" + }, + { + "question_num": 199, + "query": "患者牙痛隐隐，时作时止，牙齿浮动，口不臭，脉细数。治疗除取主穴外，还应选取的配穴是", + "options": { + "A": "外关、风池", + "B": "二间、曲池", + "C": "太冲、劳宫", + "D": "二间、内庭", + "E": "太溪、行间" + }, + "answer": "E", + "reason": "牙痛隐隐,时作时止，牙齿浮动，口不臭，舌红少苔,脉细数，为虚火牙痛。针灸治疗主穴为合谷、颊车、下关，虚火牙痛配太溪、行间。" + }, + { + "question_num": 200, + "query": "患者，女，19岁。乳房肿块月经前加重，经后缓解，伴有腰酸乏力，神疲倦怠，月经失调，量少色淡，舌淡苔白，脉沉细，其治法是", + "options": { + "A": "疏肝散结", + "B": "化痰散结", + "C": "调摄冲任", + "D": "调补气血", + "E": "补益气血" + }, + "answer": "C", + "reason": "该患者乳房肿块月经前加重，经后缓解，伴有腰酸乏力，神疲倦怠，月经失调，量少色淡，舌质淡苔白，脉沉细，为乳癖冲任失调证。治法:调摄冲任。代表方:二仙汤合四物汤加减。" + }, + { + "question_num": 201, + "query": "患者尿频量多，混浊如脂膏，头晕耳鸣，口干唇燥，皮肤干燥，瘙痒，腰膝酸软，乏力，舌红少苔，脉细数，其证候是", + "options": { + "A": "肺热津伤证", + "B": "胃热炽盛证", + "C": "气阴亏虚证", + "D": "阴阳两虚证", + "E": "肾阴亏虚证" + }, + "answer": "E", + "reason": "消渴下消肾阴亏虚证的证候:尿频量多，混浊如脂膏,或尿甜,腰膝酸软,乏力，头晕耳鸣，口干唇燥,皮肤干燥,瘙痒,舌质红苔少，脉细数。证机概要:肾阴亏虚，肾失固摄。治法:滋阴固肾。代表方:六味地黄丸加减。" + }, + { + "question_num": 202, + "query": "患者，男，53岁。1天前因“十二指肠球部溃疡并出血”急诊入院，静脉输注奥美拉唑及输血1000ml后，血压80/50mmHg，还自觉头晕、心慌，2小时排黑便3次。进一步处理最佳选择措施是", + "options": { + "A": "口服奥美拉唑", + "B": "静脉点滴垂体加压素", + "C": "继续快速输血", + "D": "气囊压迫止血", + "E": "手术治疗" + }, + "answer": "E", + "reason": "患者输血后血压80/50mmHg,自觉头晕、心慌,2小时排黑便3次，提示患者仍继续出血。消化性溃疡并出血经积极内科治疗仍有活动性出血者，应掌握时机进行手术治疗，手术指征:①年龄>50岁并伴动脉硬化、经治疗24小时后出血不止;②严重出血经内科积极治疗后仍出血不止;③近期曾反复多次出血;④合并幽门梗阻、胃穿孔或疑有癌变者。" + }, + { + "question_num": 203, + "query": "患者，女，27岁。多次发生经间期出血，此次出血量稍多，色深红，质黏腻，无血块，平时带下量多色黄，时现异味，小腹时痛，神疲乏力，胸闷烦躁，纳呆腹胀，小便短赤，舌质红，苔黄腻，脉滑数，其证型是", + "options": { + "A": "肾阴虚证", + "B": "脾气虚证", + "C": "血瘀证", + "D": "痰饮证", + "E": "湿热证" + }, + "answer": "E", + "reason": "经间期出血湿热证证候:两次月经中间，阴道出血量稍多，色深红，质黏腻，无血块，平时带下量多色黄，小腹时痛，神疲乏力,骨节酸楚,胸闷烦躁,口苦咽干，纳呆腹胀，小便短赤，舌质红，苔黄腻,脉滑数。治法:清利湿热、固冲止血。方药:清肝止淋汤去阿胶、红枣、加小蓟、茯苓。" + }, + { + "question_num": 204, + "query": "患者因牙痛服用索米痛片，7天后四肢出现豌豆至蚕豆大圆形或椭圆形水肿性红斑，有些部位中央有水疱，其诊断是", + "options": { + "A": "药毒", + "B": "瘾疹", + "C": "湿疹", + "D": "接触性皮炎", + "E": "麻疹" + }, + "answer": "A", + "reason": "药毒发病前有服药史,有一定的潜伏期、第一次常于用药后5~20天内出现。突然发病、自觉灼热瘙痒、皮损形态多样、颜色鲜艳、全身性或对称性或局部性分布。" + }, + { + "question_num": 205, + "query": "患儿，2岁。起病1天，大便如蛋花汤样，日行10余次，泻下急迫，气味臭秽，恶心，呕吐，小便短黄，舌质红，苔黄腻，其证候是", + "options": { + "A": "伤食泻", + "B": "湿热泻", + "C": "风寒泻", + "D": "脾虚泻", + "E": "脾肾阳虚泻" + }, + "answer": "B", + "reason": "患者大便如蛋花汤样，日行10余次,诊为泄泻。泻下急迫，气味秽臭，恶心.呕吐，小便短黄、舌质红,苔黄腻,均为湿热泄泻的表现，故诊为湿热泻。" + }, + { + "question_num": 206, + "query": "患者便血伴肛门疼痛反复3年，肛门截石位6点处肛管皮肤裂开，伴结缔组织外痔，肛乳头肥大。治疗应选用的手术方法是", + "options": { + "A": "扩肛法", + "B": "切开法", + "C": "挂线法", + "D": "结扎法", + "E": "纵切横缝法" + }, + "answer": "B", + "reason": "肛裂手术治疗的不同方法及其适应证如下。①扩肛法:适用于早期肛裂、无结缔组织外痔、肛乳头肥大等并发症者:②切开疗法:适用于陈旧性肛裂，伴有结缔组织外痔、肛乳头肥大等;③肛裂侧切术:适用于不伴有结缔组织外痔、皮下瘘等的陈旧性肛裂;④纵切横缝法:适用于陈旧性肛裂伴有肛管狭窄者。" + }, + { + "question_num": 207, + "query": "患者胸闷重而心痛微，痰多气短，肢体沉重，形体肥胖，倦怠无力，纳呆便溏，舌体胖大，苔白腻，脉滑，其治法是", + "options": { + "A": "温补阳气，振奋心阳", + "B": "疏肝理气，活血通络", + "C": "通阳泄浊，豁痰宣痹", + "D": "辛温散寒，宣通心阳", + "E": "益气养阴，活血通脉" + }, + "answer": "C", + "reason": "胸痹痰浊闭阻证的证候: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，伴有倦怠乏力，纳呆便溏，咳吐痰涎，舌体胖大且边有齿痕，苔浊腻或白滑，脉滑。证机概要:痰浊盘踞，胸阳豁痰宣痹。代表方:栝蒌薤白半夏汤合涤痰汤加减。" + }, + { + "question_num": 208, + "query": "患者，男，60岁。高血压、冠心病病史8年。1天前起床时出现右半身瘫痪，感觉障碍，失语，逐渐加重。今天头颅CT示左侧大脑有低密度病变区。应首选考虑的诊断是", + "options": { + "A": "腔隙性脑梗死", + "B": "短暂性脑缺血发作", + "C": "脑出血", + "D": "动脉血栓性脑梗死", + "E": "脑栓塞" + }, + "answer": "D", + "reason": "患者CT查大脑低密度病变区，排除脑出血。短暂性脑缺血发作最常见表现为眩晕、平衡障碍、眼球运动异常及复视，CT或MRI检查大多正常。脑栓塞然起病数秒至数分钟达到高峰。腔隙性脑梗死突然起病或逐渐起病，出现偏瘫或偏身感觉障碍等局灶症状，症状较轻、体征单一。患者右身偏瘫,感觉障碍，失语，呈逐渐加重状态，左侧大脑低密度病变，符合血栓性脑梗死特征，" + } +] \ No newline at end of file