diff --git "a/Assistant/Theory_Questions/Year_4/Mock.json" "b/Assistant/Theory_Questions/Year_4/Mock.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_4/Mock.json" @@ -0,0 +1,2862 @@ +[ + { + "question_num": 1, + "query": "治疗膏淋实证,应首选", + "options": { + "A": "八正散", + "B": "沉香散", + "C": "小蓟饮子", + "D": "程氏萆薢分清饮", + "E": "无比山药丸" + }, + "answer": "D", + "reason": "骨淋治以清热利湿、分清泻浊，方用程氏革赫分清饮。八正散治疗热淋。沉香散治疗气淋。小蓟伙子治疗血淋。无比山药丸治疗劳淋，" + }, + { + "question_num": 2, + "query": "下列各项除哪项外，均为各种淋证的共同表现", + "options": { + "A": "小便频急", + "B": "腰部酸痛", + "C": "淋漓涩痛", + "D": "尿血而痛", + "E": "小腹拘急" + }, + "answer": "D", + "reason": "淋证是指以小便频数短涩，淋漓刺痛，小腹拘急引痛为主症的病证，尿血只见于血淋或石淋，不见于其他淋证。" + }, + { + "question_num": 3, + "query": "痹证日久,邪痹心脉,瘀阻不通,心血运行不畅,多导致", + "options": { + "A": "痉证", + "B": "厥证", + "C": "心悸", + "D": "痫证", + "E": "癫证" + }, + "answer": "C", + "reason": "风寒湿→人体→痹证→日久不愈复感外邪→内舍于心→心痹→心脉痹阻-血行不畅→心悸《素问·痹论》:“脉不已，复感于邪，内舍于心”“心痹者,脉不通,烦则心下鼓”" + }, + { + "question_num": 4, + "query": "血证的预后与下列哪一项无关", + "options": { + "A": "血证的原因", + "B": "出血量的多少", + "C": "病情的虚实", + "D": "是否伴有发热、咳喘等症状", + "E": "脉象数急与否" + }, + "answer": "C", + "reason": "血证的预后，主要与下述三个因素有关：一是引起血证的原因。一般来说，外感易治，内伤难治，新病易治，久病难治。二是与出血量的多少密切有关。出血量少者病轻，出血量多者病重，甚至形成气随血脱的危急重病。三是与兼见症状有关。出血而伴有发热、咳喘、脉数等症者，一般病情较重。正如《景岳全书・血证》说：“凡失血等证，身热脉大者难治，身凉脉静者易治，若喘咳急而上气逆，脉见弦紧细数，有热不得卧者死。”" + }, + { + "question_num": 5, + "query": "时行感冒与感冒风热证的区别点,关键在于", + "options": { + "A": "恶寒的轻与重", + "B": "发热的轻与重", + "C": "咽喉肿痛与否", + "D": "有无流行性", + "E": "脉数与否" + }, + "answer": "D", + "reason": "时行感冒具有广泛的传染性,流行性，普通风热感冒病情较轻，少有传变，" + }, + { + "question_num": 6, + "query": "身热初按热甚，久按热反轻者多属于", + "options": { + "A": "热在表", + "B": "热在里", + "C": "虚阳外越", + "D": "阴虚证", + "E": "实热证" + }, + "answer": "A", + "reason": "按肌肤可从热的甚微而分表里虚实，身热初按甚热，久按热反转轻的，是热在表；若久按其热反甚，热自内向外蒸发者，为热在里；虚阳外越及阴虚证引起的发热都属于里热，同时还会伴见其他症状，如汗出，脉数无力等。" + }, + { + "question_num": 7, + "query": "瘀血、痰滞、浊气停留于机体组织间产生的结块是", + "options": { + "A": "痰", + "B": "瘤", + "C": "癭", + "D": "岩", + "E": "疽" + }, + "answer": "B", + "reason": "瘤是瘀血、痰滞、浊气停留于人体组织之中而产生的赞生物。" + }, + { + "question_num": 8, + "query": "治疗脾虚湿盛的水肿，宜选用", + "options": { + "A": "泽泻", + "B": "猪苓", + "C": "车前子", + "D": "滑石", + "E": "薏苡仁" + }, + "answer": "E", + "reason": "薏苡仁健脾渗湿、除痹止泻，用于水肿、脚气、小便不利、湿痹拘挛、脾虚泄泻、其他各药虽具有利水作用，但均无健脾之效。" + }, + { + "question_num": 9, + "query": "对全身水液的调节起着主宰作用的是", + "options": { + "A": "胃的游溢精气", + "B": "肺的通调水道", + "C": "脾的运化水液", + "D": "肾的蒸腾汽化", + "E": "肝的疏泄条达" + }, + "answer": "D", + "reason": "肾的蒸腾汽化使肺、脾、膀胱等脏腑在水液代谢中发挥各自的生理作用。被脏腑组织利用后的水液从三焦下行而归于肾，经肾的气化作用分为清、浊两部分。清者再通过三焦上升，归于肺而布散于周身;浊者，变成尿液，下输膀胱,从尿道排出体外,如此循环往复，以维持人体水液代谢的平衡。" + }, + { + "question_num": 10, + "query": "木瓜具有的功效是", + "options": { + "A": "活血通经", + "B": "舒筋活络", + "C": "行气化湿", + "D": "温里散寒", + "E": "软坚散结" + }, + "answer": "B", + "reason": "木瓜舒筋活络、和胃化湿，主要治疗风湿痹证、脚气水肿、吐泻转筋。" + }, + { + "question_num": 11, + "query": "“州都之官”指的是", + "options": { + "A": "胆", + "B": "胃", + "C": "小肠", + "D": "大肠", + "E": "膀胱" + }, + "answer": "E", + "reason": "膀胱的生理功能。" + }, + { + "question_num": 12, + "query": "下列关于哮病的各项叙述中，错误的是", + "options": { + "A": "多有过敏史", + "B": "发时喉中哮鸣有声，呼吸气促困难，甚至喘息不能平卧", + "C": "可见鼻痒、喷嚏、咳嗽、胸闷等先兆症状", + "D": "与先天禀赋有关，全体家族都有哮病史", + "E": "常因气候突变、环境因素、饮食不当、情志失调等诱发" + }, + "answer": "D", + "reason": "哮病多与先天禀赋有关，家族中多有类似患者，但并非全体家族都有哮病。常由气候突变、饮食不当、情志失调、劳累等诱发。多有过敏史，如过敏性鼻炎等。呈反复发作性。常多突然发作，发前可有先兆，如鼻痒、喷嚏、咳嗽、胸闷。喉中哮鸣有声，呼吸气促困难，甚则不能平卧；甚至面色苍白，唇甲青紫。约数分钟、数小时后缓解。可用药或不用药。" + }, + { + "question_num": 13, + "query": "下列不属于瘤、岩疾病常见证候的是", + "options": { + "A": "热盛肉腐证", + "B": "寒痰凝聚证", + "C": "气血瘀滞证", + "D": "毒热蕴结证", + "E": "正虚邪实证" + }, + "answer": "A", + "reason": "本题考查瘤和岩的辨证。不属于瘤、岩疾病常见证候的是热盛肉腐证" + }, + { + "question_num": 14, + "query": "下列关于采用攻逐法治疗水肿的各项叙述中，错误的是", + "options": { + "A": "用于病初水肿严重，正气尚旺者", + "B": "用发汗、利水法无效", + "C": "用十枣汤治疗", + "D": "疗程宜长，用药宜重", + "E": "水肿退后，即行调补脾胃" + }, + "answer": "D", + "reason": "采用攻逐法治疗水肿，时间不宜太长，中病即止，峻下逐水药药性都比较峻猛，容易损耗正气。" + }, + { + "question_num": 15, + "query": "“大实有羸状”指的证候是", + "options": { + "A": "虚实错杂证", + "B": "实中夹虚证", + "C": "真实假虚证", + "D": "真虚假实证", + "E": "由实转虚证" + }, + "answer": "C", + "reason": "一般情况下,现象与本质是一致的，现象是可以反映本质的。但在特殊情况下，现象与本质不一致，往往会出现与疾病本质不符的许多假象，出现虚实真假。“大实有羸状”指的证候是真实假虚证。“至虚有盛候”的证候性质是真虚假实证" + }, + { + "question_num": 16, + "query": "黄疸辨证以何为纲", + "options": { + "A": "阴阳", + "B": "寒热", + "C": "虚实", + "D": "气血", + "E": "表里" + }, + "answer": "A", + "reason": "黄疸辨证当首辨阴阳，阳黄之辨，宜辨湿热轻重。" + }, + { + "question_num": 17, + "query": "联结心和肺两脏使其功能协调平衡的中心环节是", + "options": { + "A": "元气", + "B": "心气", + "C": "肝气", + "D": "肺气", + "E": "宗气" + }, + "answer": "E", + "reason": "宗气聚于胸中,通过上出息道(呼吸道)、贯注心脉及沿三焦下行的方式布散全身。宗气上走息道，推动肺的呼吸。因此,凡是呼吸、语言、发声皆与宗气有关。宗气贯注于心脉之中，促进心脏推动血液运行。凡气血的运行、心搏的力量及节律等皆与宗气有关。宗气是联结心和肺两脏使其功能协调平衡的中心环节，" + }, + { + "question_num": 18, + "query": "臌胀的发生与哪些脏腑有关", + "options": { + "A": "胃、肝、脾", + "B": "胃、脾、肾", + "C": "肝、脾、肾", + "D": "胃、肝、肾", + "E": "脾、胃、心" + }, + "answer": "C", + "reason": "因肝主疏泄，司藏血，肝病则疏泄不行，气滞血瘀，进而横逆乘脾，脾主运化，脾病则运化失健，水湿内聚，进而土壅木郁，以致肝脾俱病。病延日久，累及于肾，肾关开阖不利，水湿不化，则胀满愈甚。" + }, + { + "question_num": 19, + "query": "对关节起润泽和滑利作用的主要是", + "options": { + "A": "精", + "B": "气", + "C": "血", + "D": "津", + "E": "液" + }, + "answer": "E", + "reason": "津与液同属水液。一般地说，性质清稀，流动性大，主要布散于体表皮肤、肌肉和孔窍等部位，并渗入血脉，起滋润作用者，称为津;性质较为稠厚，流动性小，灌注活装人所之为液。" + }, + { + "question_num": 20, + "query": "下列药，善治阳明经头痛的是", + "options": { + "A": "羌活", + "B": "葛根", + "C": "白芷", + "D": "柴胡", + "E": "细辛" + }, + "answer": "C", + "reason": "羌活入膀胱、肾经，主治太阳经头痛；柴胡入肝、胆经，主少阳头痛；葛根主项背疼痛；白芷入肺、胃经，为阳明头痛要药；细辛入肺、肾、心经，主少阴头痛。" + }, + { + "question_num": 21, + "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": "胎黄的病因病机主要为脾胃湿热或寒湿内蕴，肝失疏泄，胆汁外溢而致发黄，日久气滞血瘀。" + }, + { + "question_num": 22, + "query": "支气管哮喘热哮证的首选方剂是", + "options": { + "A": "射干麻黄汤", + "B": "定喘汤", + "C": "玉屏风散", + "D": "六君子汤", + "E": "肾气丸" + }, + "answer": "B", + "reason": "支气管哮喘热哮证的方药是定喘汤加减，治法是清热宣肺，化痰定喘。" + }, + { + "question_num": 23, + "query": "风寒泻与脾虚泻的鉴别诊断,以下各项中最重要的是", + "options": { + "A": "食欲不振", + "B": "大便稀薄", + "C": "大便不臭", + "D": "腹痛较重", + "E": "形体偏瘦" + }, + "answer": "D", + "reason": "本题考查泄泻的辨证。根据题意，风寒泻与脾虚泻的鉴别诊断中最重要的是腹痛较重。" + }, + { + "question_num": 24, + "query": "下列哪一项不是积证的特征", + "options": { + "A": "结块有形", + "B": "结块固定不移", + "C": "痛有定处", + "D": "病在气分", + "E": "是为脏病" + }, + "answer": "D", + "reason": "积属有形，结块固定不移，痛有定处，病在血分，是为脏病；聚属无形包块，聚散无常，痛无定处，病在气分，是为腑病。" + }, + { + "question_num": 25, + "query": "既能泻下逐水,又能去积杀虫的药物是", + "options": { + "A": "槟榔", + "B": "甘遂", + "C": "使君子", + "D": "牵牛子", + "E": "京大戟" + }, + "answer": "D", + "reason": "牵牛子之功效是泻下逐水,去积杀虫。因此既能泻下逐水，又能去积杀虫的药物是牵牛子。槟榔的功效是杀虫消积，行气，利水,截疟,没有泻下之功效。甘遂的功效是泻水逐饮，消肿散结，无去积杀虫之功效，使君子的功效是杀虫消积，无泻下逐水之功效。京大戟的功效是泻水逐饮，消肿散结，也没有去积杀虫之功效。" + }, + { + "question_num": 26, + "query": "痢疾初起，用药当忌", + "options": { + "A": "疏散表邪之品", + "B": "调气行血之品", + "C": "收敛止泻之品", + "D": "清热凉血之品", + "E": "理气化滞之品" + }, + "answer": "C", + "reason": "痢疾初期，多为实证、热证，治宜清热化湿解毒，兼以调气行血导滞，忌用收敛止泻之品，防止闭门留寇。" + }, + { + "question_num": 27, + "query": "燥湿药的性味多是", + "options": { + "A": "辛味", + "B": "酸味", + "C": "甘味", + "D": "苦味", + "E": "咸味" + }, + "answer": "D", + "reason": "苦有泄热、燥湿、坚阴的作用,清热泻火、下气平喘、降逆止呕、通利大便!清热燥湿、苦温燥湿、泻火存阴的药物多具有苦味。" + }, + { + "question_num": 28, + "query": "血淋与尿血的主要鉴别在于", + "options": { + "A": "小便血色明暗", + "B": "小便量的多少", + "C": "小便有无浑浊", + "D": "小便是否通畅", + "E": "小便时有无疼痛" + }, + "answer": "E", + "reason": "不痛者为尿血，痛（滴沥刺痛）者为血淋。" + }, + { + "question_num": 29, + "query": "一般不属于实性病理反应的是", + "options": { + "A": "壮热", + "B": "精神亢奋", + "C": "脉实有力", + "D": "五心烦热", + "E": "二便不通" + }, + "answer": "D", + "reason": "临床上,外感病实证常见壮热、狂躁、声高气粗、腹痛拒按、二便不通、脉实n老工过涎壅盛、食积不化、水湿泛滥、气滞血瘀等各种病变。五心烦热属于阴虚的临床表现。" + }, + { + "question_num": 30, + "query": "治疗内伤发热之阴虚发热证,最佳选方为", + "options": { + "A": "一贯煎", + "B": "麦味地黄丸", + "C": "清骨散", + "D": "当归六黄汤", + "E": "左归丸" + }, + "answer": "C", + "reason": "内伤发热之阴虚发热证主症：午后潮热，或夜间发热，不欲近衣，手足心热，烦躁，少寐多梦，盗汗，口干咽燥，舌质红，或有裂纹，苔少甚至���苔，脉细数。治法：滋阴清热。代表方：清骨散加减。" + }, + { + "question_num": 31, + "query": "疾病初期恶寒与发热同时并见,应属", + "options": { + "A": "表邪入里证", + "B": "表热里寒证", + "C": "外感表证", + "D": "半表半里证", + "E": "表寒里热证" + }, + "answer": "C", + "reason": "外感表证包括表寒证和表热证，因卫气受遇，肌表不能得到正常的温煦，故出现恶风寒的症状，六淫邪气客于皮毛肌表，阻遇卫气的正常宣发，郁而发热。" + }, + { + "question_num": 32, + "query": "下列哪一项不是消渴的典型症状", + "options": { + "A": "肟多饮", + "B": "多食", + "C": "多尿", + "D": "雀盲、耳聋", + "E": "身体消瘦" + }, + "answer": "D", + "reason": "消渴病是以多饮、多尿、多食、身体消瘦、尿有甜味为特征的病证，而雀盲耳聋为其变证。" + }, + { + "question_num": 33, + "query": "相当于西医恶性肿瘤颈部淋巴结转移的疾病是", + "options": { + "A": "茧唇", + "B": "舌菌", + "C": "失荣", + "D": "颈痈", + "E": "石瘿" + }, + "answer": "C", + "reason": "相当于西医恶性肿瘤颈部淋巴结转移的疾病是失荣。" + }, + { + "question_num": 34, + "query": "发于躯干部的丹毒称为", + "options": { + "A": "缠腰火丹", + "B": "抱头火丹", + "C": "流火", + "D": "赤游丹", + "E": "内发丹毒" + }, + "answer": "E", + "reason": "发于躯干部的丹毒称为内发丹毒。" + }, + { + "question_num": 35, + "query": "治疗中气下陷,食少便溏,短气乏力,面目浮肿,小便不利者,应首选的药物是", + "options": { + "A": "白术", + "B": "黄芪", + "C": "升麻", + "D": "党参", + "E": "山药" + }, + "answer": "B", + "reason": "黄芪能够补气升阳,利水消肿，固表止汗，托毒生肌。治疗中气下陷，食少便溏，短气乏力，面目浮肿" + }, + { + "question_num": 36, + "query": "治疗胃痛寒邪客胃证,应首选的方剂是", + "options": { + "A": "吴茱萸汤", + "B": "良附丸", + "C": "桂枝人参汤", + "D": "大建中汤", + "E": "当归建中汤" + }, + "answer": "B", + "reason": "胃痛寒邪客胃证治法：温胃散寒，行气止痛。代表方：良附丸加减。" + }, + { + "question_num": 37, + "query": "下列不属于病色的是", + "options": { + "A": "枯槁晦暗", + "B": "鲜明暴露", + "C": "某色独亢", + "D": "红黄隐隐", + "E": "明润而不应时应位" + }, + "answer": "D", + "reason": "我国正常人的面色应是红黄隐隐，明润含蓄。病色是指人体在疾病状态时的面部色泽，除常色(主色和客色)外，其他一切反常的色泽都属病色。" + }, + { + "question_num": 38, + "query": "痫病发生的主要病理基础是", + "options": { + "A": "肺、脾、肾的损伤", + "B": "脾、肺、肝的损伤", + "C": "肺、胃、肾的损伤", + "D": "肝、脾、肾的损伤", + "E": "肺、肾、心的损伤" + }, + "answer": "D", + "reason": "痫病病位在脑，涉及肝、脾、心、肾诸脏，其中肝、脾、肾的损伤是痫病发生的主要病理基础。" + }, + { + "question_num": 39, + "query": "升麻与菊花具有的共同功效是", + "options": { + "A": "透疹", + "B": "解毒", + "C": "消疮", + "D": "止血", + "E": "平肝" + }, + "answer": "B", + "reason": "升麻的功效:解表透疹,清热解毒，升举阳气。菊花的功效:疏散风热，平抑肝阳，清肝明目，清热解毒。" + }, + { + "question_num": 40, + "query": "肺痈病情发生顺逆的转折点是", + "options": { + "A": "初期", + "B": "成痈期", + "C": "溃脓期", + "D": "恢复期", + "E": "消散期" + }, + "answer": "C", + "reason": "溃脓期是肺痈病情发生顺逆的转折点，依据溃脓后的表现，可判断病情顺逆。" + }, + { + "question_num": 41, + "query": "郑声的病因多为", + "options": { + "A": "心气大伤", + "B": "心气不足", + "C": "痰火扰心", + "D": "风痰阻络", + "E": "热扰心神" + }, + "answer": "A", + "reason": "郑声属心气大伤,精神散乱之虚证;“错语”和“独语”均属心气不足,神失所养的虚证;狂证多见于痰火扰心;语言塞涩属风痰阻络或风痰蒙蔽清窍;谵语多属热扰心神之实证。" + }, + { + "question_num": 42, + "query": "治疗噎膈气虚阳微证，应首选", + "options": { + "A": "启膈散", + "B": "五汁安中饮", + "C": "通幽汤", + "D": "补气运脾汤", + "E": "左归丸" + }, + "answer": "D", + "reason": "气虚阳微证，即脾肾阳虚，中阳衰��，温煦失职，气不化津，治当温补脾肾，首选补气运脾汤。" + }, + { + "question_num": 43, + "query": "舌质色紫或青最常见的情形是", + "options": { + "A": "热盛", + "B": "血瘀", + "C": "气虚", + "D": "阴虚", + "E": "痰火" + }, + "answer": "B", + "reason": "A项因血得热则行,热盛则气血沸涌，舌体脉络充盈，故色呈鲜红;C项应苦质淡白，因气虚无力鼓动血脉，血不上营于舌;D项应为舌绛少苔;巨项应舌红苔黄，火为热象，故舌红。" + }, + { + "question_num": 44, + "query": "桑叶、菊花同用的方剂是", + "options": { + "A": "桑杏汤", + "B": "清燥救肺汤", + "C": "银翘散", + "D": "羚角钩藤汤", + "E": "天麻钩藤饮" + }, + "answer": "D", + "reason": "羚角钩藤汤，风盛于内，方中桑叶、菊花既能清热平肝，又兼疏散风热，使肝热从外疏散，共为臣药。" + }, + { + "question_num": 45, + "query": "下列各组药物中,不属于配伍禁忌的是", + "options": { + "A": "水银与砒霜", + "B": "硫黄与厚朴", + "C": "肉桂与赤石脂", + "D": "川贝母与川乌", + "E": "藜芦与赤芍" + }, + "answer": "B", + "reason": "川贝母与川乌、藜芦与赤芍为十八反，肉桂与赤石脂、水银与砒霜为十九畏。十八反歌诀:本草明言十八反，半墓贝及攻鸟，藻戟遂芫俱战草，诸参辛芍叛藜芦，十九畏歌诀:硫黄原是火中精，朴硝一见便相争;水银莫与砒霜见，狼毒最怕密陀僧;巴豆性烈最为上,偏与牵牛不顺情;丁香莫与郁金见,牙硝难合京三棱;川乌草鸟不顺犀，人参最怕五灵脂;官桂善能调冷气，若遇石脂便相欺;大凡修合看顺逆，炮尴炙焯莫相依。" + }, + { + "question_num": 46, + "query": "肾岩的发病部位是", + "options": { + "A": "肾脏", + "B": "睾丸", + "C": "阴茎", + "D": "会阴部", + "E": "阴囊皮肤" + }, + "answer": "C", + "reason": "肾岩是以阴茎龟头出现丘疹、结节状坚硬物，溃后如翻花状，有特异恶臭和脓性分泌物为主要表现的肿瘤性疾病。中医又名肾岩翻花。相当于西医的阴茎癌。" + }, + { + "question_num": 47, + "query": "血府逐瘀汤的组成药物除“桃红四物”和甘草外,其余的是", + "options": { + "A": "柴胡、桔梗、枳壳、牛膝", + "B": "乌药、香附、枳壳、延胡索", + "C": "官桂、干姜、蒲黄、五灵脂", + "D": "香附、牛膝、没药、五灵脂", + "E": "麝香、没药、葱白、鲜生姜" + }, + "answer": "A", + "reason": "血府逐瘀汤方歌:血府当归生地桃,红花甘草壳赤芍，柴胡芎桔牛膝等，血化下行不作劳。桃红四物包括桃仁、红花、生地黄、当归、赤芍、川芎,敌血府逐瘀汤的组成药物除“桃红四物”和甘草外,其余的是柴胡、桔梗、枳壳、牛膝。" + }, + { + "question_num": 48, + "query": "小脑部肿瘤的定位征是", + "options": { + "A": "精神障碍", + "B": "感觉障碍", + "C": "运动失调", + "D": "交叉性偏瘫", + "E": "运动性失语" + }, + "answer": "C", + "reason": "小脑部肿瘤的定位征是运动失调，A项为大脑额叶前部肿瘤的定位征，B项为大脑顶叶部肿瘤的定位征，D项为桥脑部肿瘤的定位征，E项为额下回后部肿瘤的定位征。" + }, + { + "question_num": 49, + "query": "下列各项,不属清燥救肺汤组成的药物是", + "options": { + "A": "石膏", + "B": "石斛", + "C": "桑叶", + "D": "阿胶", + "E": "人参" + }, + "answer": "B", + "reason": "清燥救肺汤组成:桑叶、杏仁、石膏、枇杷叶、胡麻仁、阿胶、麦门冬、人参、甘草。" + }, + { + "question_num": 50, + "query": "《脾胃论》中提出的“甘温除热”的代表方剂是", + "options": { + "A": "小建中汤", + "B": "黄芪建中汤", + "C": "升阳益胃汤", + "D": "六君子汤", + "E": "补中益气汤" + }, + "answer": "E", + "reason": "李东垣在《脾胃论》中论述了甘温除热的方法，并给出了补中益气汤来治疗。" + }, + { + "question_num": 51, + "query": "大出血证的治则是", + "options": { + "A": "扶正兼祛邪", + "B": "祛邪兼扶正", + "C": "急则治标", + "D": "缓则治本", + "E": "标本同治" + }, + "answer": "C", + "reason": "扶正与祛邪兼用适用于正上“实较急重的，应祛邪兼扶正;C项指较急重的症状应当先治疗，大出血属于急症;D项指对于慢性病或急性病恢复期，应当治本;项指标病本病并重的，需标本同治。" + }, + { + "question_num": 52, + "query": "以下哪项不是牛皮癣的症状特点", + "options": { + "A": "易形成苔藓样变", + "B": "扁平丘疹", + "C": "皮损肥厚", + "D": "瘙痒剧烈", + "E": "严重时可见汁水淋漓" + }, + "answer": "E", + "reason": "牛皮癣的皮损特点：皮损多为圆形或多角形的扁平丘疹融合成片，剧烈瘙痒，搔抓后皮损肥厚，皮沟加深，皮嵴隆起，极易形成苔藓样变。" + }, + { + "question_num": 53, + "query": "饥不欲食,舌质光红与下列哪项并见对诊断胃阴虚证最有意义", + "options": { + "A": "口泛清水", + "B": "呕吐酸腐", + "C": "干呕呃逆", + "D": "呕吐鲜血", + "E": "泛恶吞酸" + }, + "answer": "C", + "reason": "A项多属痰饮;B项多属食积;C项阴虚热扰，胃气上逆，故见干呕呃逆;D项多属胃有积热或肝火犯胃，或素有瘀血，血不归经;E项多属胃热，也有胃寒。" + }, + { + "question_num": 54, + "query": "五加皮具有的功效是", + "options": { + "A": "通便", + "B": "利尿", + "C": "凉血", + "D": "安胎", + "E": "和胃" + }, + "answer": "B", + "reason": "五加皮功效：祛风湿，补肝肾，强筋骨，利水。" + }, + { + "question_num": 55, + "query": "三仁汤中有“宣上、畅中、渗下”作用的代表药物是", + "options": { + "A": "杏仁、半夏、桔梗", + "B": "杏仁、厚朴、通草", + "C": "杏仁、白蔻仁、竹叶", + "D": "杏仁、半夏、通草", + "E": "杏仁、白蔻仁、薏苡仁" + }, + "answer": "E", + "reason": "三仁汤中杏仁宣利上焦肺气;白蔻仁芳香化湿，行气宽中;苡仁甘淡，渗利湿热而健脾。三仁“宣上、畅中、渗下”" + }, + { + "question_num": 56, + "query": "气瘿内治通常以疏肝理气，解郁消肿为主，一般选用方剂是", + "options": { + "A": "海藻玉壶汤", + "B": "四海舒郁丸", + "C": "逍遥散", + "D": "桃红四物汤", + "E": "通气散结丸" + }, + "answer": "B", + "reason": "气瘿治法：疏肝解郁，化痰软坚。方药：四海舒郁丸加减。" + }, + { + "question_num": 57, + "query": "易引起肺梗死的疾病是", + "options": { + "A": "臁疮", + "B": "脱疽", + "C": "股肿", + "D": "浅静脉炎", + "E": "压疮" + }, + "answer": "C", + "reason": "股肿好发于下肢髂股静脉和股腘静脉，可并发肺栓塞和肺梗死而危及生命" + }, + { + "question_num": 58, + "query": "疮疡三陷证中，火陷证的治法是", + "options": { + "A": "清热生津，养心安神", + "B": "补益气血，清心安神开窍", + "C": "温补脾肾，清心开窍", + "D": "托毒透邪，养阴清心开窍", + "E": "凉血清热解毒，养阴清心开窍" + }, + "answer": "E", + "reason": "火陷：见于疮疡的成形期或化脓期，疮顶不高，根盘散漫，疮色紫暗，疮口干枯无脓，但灼热剧痛。并有壮热，口渴、便秘尿短，烦躁不安，神昏谵语，舌绛脉数等。多因阴液亏损、火毒炽盛所致。火陷证当以凉血清热解毒为主，并顾护津液。" + }, + { + "question_num": 59, + "query": "气阴不足,症见体倦气短,口渴多汗，舌燥咽干,脉虚细者,治宜选用", + "options": { + "A": "生脉散", + "B": "清暑益气汤", + "C": "八珍汤", + "D": "竹叶石膏汤", + "E": "白虎加人参汤" + }, + "answer": "A", + "reason": "生脉散益气生津,敛阴止汗，是治疗气阴两伤证的代表方剂:" + }, + { + "question_num": 60, + "query": "月经先期阴虚血热证的发病机制是", + "options": { + "A": "阴虚失守，冲任不固", + "B": "肝郁气滞，疏泄失常", + "C": "肾阴不足，封藏失职", + "D": "阴虚阳盛，热扰冲任", + "E": "湿热下注，血热妄行" + }, + "answer": "D", + "reason": "素体阴虚，或失血伤阴，或多产房劳，耗伤精血，或思虑过度，阴血暗耗，阴虚生内热，热扰冲任，冲任不固，经血失于制约，遂致月经提前而至。" + }, + { + "question_num": 61, + "query": "下列药物用法不正确的是", + "options": { + "A": "青黛作散剂冲服或入丸剂服用", + "B": "巴豆榨汁,冷开水调服", + "C": "鸦胆子装胶囊服用", + "D": "芦荟入丸剂服用", + "E": "番泻叶开水泡服,入汤剂后下" + }, + "answer": "B", + "reason": "巴豆辛,热;有大毒。可入丸、散服,每次0.1~0.3g,大多数制成巴豆霜用，以减低毒性，外用适量，" + }, + { + "question_num": 62, + "query": "石瘿的首选治疗措施是", + "options": { + "A": "早期中药外敷", + "B": "早期中药内治", + "C": "早期手术切除", + "D": "早期化学治疗", + "E": "早期放射治疗" + }, + "answer": "C", + "reason": "石瘿为恶性肿瘤，一旦确诊，应早期手术切除。" + }, + { + "question_num": 63, + "query": "苦寒有小毒,不宜持续及过量服用的药物是", + "options": { + "A": "全蝎", + "B": "苦参", + "C": "花椒", + "D": "吴茱萸", + "E": "川棟子" + }, + "answer": "E", + "reason": "全蝎辛,平,有毒、用量不宜过大，孕妇慎用。苦参苦,寒，无毒。花椒辛、天朱哭2、7式2毒，故不宜多用、久服,阴虚有热者忌用。川楝子苦,寒，有小毒，不宜过量或持续服用，以免中毒，又因性寒,脾胃虚寒者慎用" + }, + { + "question_num": 64, + "query": "具有泻水逐饮，消肿散结功效的药物是", + "options": { + "A": "大黄", + "B": "芒硝", + "C": "巴豆", + "D": "牵牛子", + "E": "甘遂" + }, + "answer": "E", + "reason": "大黄泻下攻积，清热泻火，止血，解毒，活血祛瘀。芒硝泻下，软坚，清热。巴豆峻下冷积，逐水退肿，祛痰利咽，蚀疮。牵牛子泻下，逐水，去积，杀虫。甘遂泻水逐饮，消肿散结。" + }, + { + "question_num": 65, + "query": "治疗血热所致之痔血、便血,宜首选", + "options": { + "A": "小蓟", + "B": "艾叶", + "C": "地榆", + "D": "灶心土", + "E": "白及" + }, + "answer": "C", + "reason": "地榆凉血止血,解毒敛疮其味苦寒入血分，长于泄热而凉血止血;味兼酸涩，又能收敛止血，可用治多种血热出血之证。又因其性下降，故尤宜于下焦之下血，如痔血、便血。" + }, + { + "question_num": 66, + "query": "治疗风湿痹证，腰膝酸痛，下肢痿软无力，遇劳甚者，应首选", + "options": { + "A": "防己", + "B": "秦艽", + "C": "五加皮", + "D": "豨莶草", + "E": "蕲蛇" + }, + "answer": "C", + "reason": "防己祛风湿，止痛，利水消肿。秦艽祛风湿，止痹痛，退虚热，清湿热。五加皮祛风湿，强筋骨，利尿。豨莶草祛风湿，通经活络，清热解毒。蕲蛇祛风通络，定惊止痉。" + }, + { + "question_num": 67, + "query": "具有利水消肿功效的药物是", + "options": { + "A": "益母草", + "B": "鸡血藤", + "C": "丹参", + "D": "川芎", + "E": "郁金" + }, + "answer": "A", + "reason": "以上选项均为活血化瘀药。益母草可活血调经，利水消肿，清热解毒。鸡血藤可行血补血，调经，舒筋活络。丹参可活血调经，祛瘀止痛，凉血消痈，除烦安神。川芎可活血行气，祛风止痛。郁金可活血止痛，行气解郁，凉血清心，利胆退黄。" + }, + { + "question_num": 68, + "query": "下列关于内治法应用的叙述，错误的是", + "options": { + "A": "治疗外科疾病都应严格遵循消、托、补法的顺序", + "B": "治疗肿疡早期用消法", + "C": "治疗肿疡中期用托法", + "D": "治疗溃疡后期用补法", + "E": "托法中应用黄芪主要是透脓而不是补气" + }, + "answer": "A", + "reason": "消、托、补法是外科内治总的治则，是根据临床中疾病的发生发展过程，特别是三个发展阶段，所确立的治疗原则。但绝不是每种外科病的内治严格遵循消、托、补法的顺序。" + }, + { + "question_num": 69, + "query": "下列各项,具有大补元气功效的药物是", + "options": { + "A": "人参", + "B": "党参", + "C": "黄芪", + "D": "甘草", + "E": "太子参" + }, + "answer": "A", + "reason": "人参可大补元气,补脾益肺，生津，安神益智。党参可补脾、肺之气，补血，生津。黄芪可健脾补中，升阳举陷，益卫固表,利尿，托毒生肌。甘草可补脾益气，祛止咳,缓急止痛，清热解毒,调和诸药。太子参可补气健脾,生津润肺，" + }, + { + "question_num": 70, + "query": "治疗产后血瘀发热的最佳选方是", + "options": { + "A": "解毒活血汤", + "B": "生化汤", + "C": "桃红四物汤", + "D": "少腹逐瘀汤", + "E": "失笑散" + }, + "answer": "B", + "reason": "产后血瘀发热是由于产后血室正开，感受寒邪，或情志不遂，瘀血内停，瘀阻冲任，恶露不下，败血停滞，阻碍气机，营卫不通，而致发热。此证治法为活血祛瘀，和营除热。" + }, + { + "question_num": 71, + "query": "具有益卫固表,利尿功效的药物是", + "options": { + "A": "山药", + "B": "党参", + "C": "浮小麦", + "D": "麻黄根", + "E": "黄芪" + }, + "answer": "E", + "reason": "山药有补脾养胃,生津益肺，补肾涩精的功效。党参有补脾肺气，补血生津的功效。浮小麦有固表止汗，益气，除热的功效。麻黄根可固表止汗。黄芪可健脾补中，井阳举陷，益卫固表,利尿,托毒生肌。" + }, + { + "question_num": 72, + "query": "治疗肾虚型子肿的代表方剂是", + "options": { + "A": "白术散", + "B": "肾气丸", + "C": "五苓散", + "D": "真武汤", + "E": "健固汤" + }, + "answer": "D", + "reason": "肾虚型子肿是由于素体肾虚，或房事不节，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。此证治法为补肾温阳，化气行水。方用真武汤。" + }, + { + "question_num": 73, + "query": "下列各药,常用于治疗肝气郁结所致月经不调的是", + "options": { + "A": "香附", + "B": "木香", + "C": "枳实", + "D": "橘皮", + "E": "川楝子" + }, + "answer": "A", + "reason": "香附可疏肝解郁,调经止痛，理气调中，可用于治疗肝气郁结所致月经不调。木香可行气止痛，健脾消食。枳实可破气除痞，化痰消积。橘皮可理气健脾，燥湿化痰。川楝子可行气止痛，杀虫。" + }, + { + "question_num": 74, + "query": "容易损筋伤骨的疔疮是", + "options": { + "A": "手足疔", + "B": "红丝疔", + "C": "颜面疔", + "D": "疫疔", + "E": "烂疔" + }, + "answer": "A", + "reason": "发于颜面部的疔疮很容易走黄而有生命危险；发于手足部的疔疮则易损筋伤骨。" + }, + { + "question_num": 75, + "query": "腰部冷痛沉重,阴雨天加重,属", + "options": { + "A": "阴虚", + "B": "瘀血", + "C": "寒湿", + "D": "阳虚", + "E": "肾虚" + }, + "answer": "C", + "reason": "冷痛属于寒的特点,沉重属于湿的特点，阴雨天加重也与寒湿有关。" + }, + { + "question_num": 76, + "query": "顾步汤适用的脱疽证候是", + "options": { + "A": "寒湿阻络", + "B": "血脉瘀阻", + "C": "湿热毒盛", + "D": "热毒伤阴", + "E": "肝郁气滞" + }, + "answer": "D", + "reason": "顾步汤以益气活血合以清热解毒为其配伍特点，治疗脱疽之热毒伤阴证。寒湿阻络证方用阳和汤。血脉瘀阻证方用桃红四物汤。湿热毒盛证方用四妙勇安汤。气阴两虚证方用黄芪鳖甲汤。" + }, + { + "question_num": 77, + "query": "止嗽散的组成中不舍有", + "options": { + "A": "紫菀", + "B": "白前", + "C": "杏仁", + "D": "荆芥", + "E": "陈皮" + }, + "answer": "C", + "reason": "止嗽散组成为桔梗、荆芥紫菀、百部、白前、甘草、陈皮,其功用是宣利肺气，疏风止咳，适用于治疗风邪犯肺证。" + }, + { + "question_num": 78, + "query": "治疗产后腹痛气血两虚证，应首选的方剂是", + "options": { + "A": "肠宁汤", + "B": "八珍汤", + "C": "生化汤", + "D": "四君子汤", + "E": "人参养荣汤" + }, + "answer": "A", + "reason": "治疗产后腹痛气血两虚证，治宜养血益气，方选肠宁汤。" + }, + { + "question_num": 79, + "query": "乌梅丸适用于", + "options": { + "A": "寒热错杂,痰热互结。症见心下疼痛，按之石硬者", + "B": "胃虚痰阻,气机阻滞。症见心下痞硬，噫气不除者", + "C": "寒热错杂,虚实夹杂,肠道失固。症见久泻久痢者", + "D": "寒热错杂,痰湿交阻。症见心下痞满，恶食懒倦者", + "E": "寒热错杂,气机阻滞。症见心下痞满，呕吐下利者" + }, + "answer": "C", + "reason": "乌梅丸主治蛔厥证,亦主治久泻久痢。方中黄连、干姜同用，所以治法中寒热并施。" + }, + { + "question_num": 80, + "query": "妇人癥瘕的主症是", + "options": { + "A": "下腹部胀满", + "B": "下腹部疼痛", + "C": "腰腹部疼痛", + "D": "下腹部结块", + "E": "月经过多" + }, + "answer": "D", + "reason": "妇女下腹有结块，或胀，或满，或痛者，称为癥瘕。" + }, + { + "question_num": 81, + "query": "逍遥散与一贯煎相同的功用是", + "options": { + "A": "和营", + "B": "益气", + "C": "滋阴", + "D": "疏肝", + "E": "补脾" + }, + "answer": "D", + "reason": "逍遥散:疏肝解郁,养血健脾，主治肝郁血虚脾弱证。表现:两胁作痛，寒热往来，头痛目眩，口燥咽干，神疲食少，月经不调,乳房作胀，脉弦而虚。一贯煎:滋阴疏肝，主治阴虚肝郁证。表现:胸脘胁痛，吞酸吐苦,咽干口燥,舌红少津,脉细弱或虚弦，亦治疝气疲聚。相同功用为疏肝，" + }, + { + "question_num": 82, + "query": "浸淫四窜，黄水淋漓，最易沿表皮蚀烂，越腐越痒者，其病因是", + "options": { + "A": "湿胜", + "B": "风胜", + "C": "热胜", + "D": "虫淫", + "E": "血虚" + }, + "answer": "A", + "reason": "皮肤病以外湿居多，但有时外湿与内湿相合致病。湿邪侵入肌肤，郁结不散，与气血相��，多发生疱疹、瘙痒、渗液、糜烂等。湿邪所致的皮肤病，其皮肤损害为水疱，或为多形性，或皮肤糜烂，常患病于下部，或浸淫四窜，滋水淋漓，病程缠绵，难以速愈。若与内湿相合，则常伴有胸闷，纳差，肢体沉重，苔白腻，脉濡缓等症状；若湿邪与寒邪相合，则伴有四肢乏力，一身肌肉疼痛，四肢受凉则肢端发冷、苍白或紫暗，苔薄白，脉迟缓等症状。" + }, + { + "question_num": 83, + "query": "头发成斑片状脱落的临床意义是", + "options": { + "A": "血热化燥", + "B": "肾精亏损", + "C": "久病体弱", + "D": "血虚受风", + "E": "气血两虚" + }, + "answer": "D", + "reason": "突然片状脱发,脱落处显露圆形或椭圆形光亮头皮而无自觉症状，称为斑秃，多为血虚受风所致。" + }, + { + "question_num": 84, + "query": "治疗阴痒湿热下注证，应首选的方剂是", + "options": { + "A": "易黄汤", + "B": "止带方", + "C": "萆薢渗湿汤", + "D": "托里消毒散", + "E": "蛇床子汤" + }, + "answer": "C", + "reason": "治疗阴痒湿热下注证，治宜清热利湿，解毒杀虫，方选萆薢渗湿汤。" + }, + { + "question_num": 85, + "query": "循行于上肢外侧前缘的经脉是", + "options": { + "A": "肺经", + "B": "大肠经", + "C": "三焦经", + "D": "小肠经", + "E": "心经" + }, + "answer": "B", + "reason": "阳经行于外侧,阴经行于内侧。上肢外侧为手阳明大肠经在前，手少阳三焦经在中，手太阳小肠经在后，AE项行于上肢内侧。" + }, + { + "question_num": 86, + "query": "月经后期虚寒证首选的方剂为", + "options": { + "A": "当归地黄饮", + "B": "大补元煎", + "C": "温经汤", + "D": "乌药汤", + "E": "芎归二陈汤" + }, + "answer": "C", + "reason": "月经后期虚寒证治疗当扶阳驱寒调经，方选温经汤（《金匮要略》）或艾附暖宫丸。" + }, + { + "question_num": 87, + "query": "在胸骨左缘第3、第4肋间触及收缩期震颤,应考虑为", + "options": { + "A": "肺动脉瓣狭窄", + "B": "二尖瓣狭窄", + "C": "室间隔缺损", + "D": "三尖瓣狭窄", + "E": "主动脉瓣关闭不全" + }, + "answer": "C", + "reason": "在胸骨右缘第2肋间触及收缩期震颤，应考虑为主动脉瓣狭窄;在胸骨左缘第2肋间触及收缩期震额，应考虑为肺动脉辩狭窄;在胸骨左缘第3、第4.肋间触及收缩期震颤:应考虑为室间隔缺损;在胸骨左缘第2肋间触及连续性震颤，应考虑为动脉导管未闭;在心尖区触及舒张期震颤，应考虑为二尖瓣狭窄" + }, + { + "question_num": 88, + "query": "随着小儿年龄增长，其脉搏、血压变动规律是", + "options": { + "A": "同步增加", + "B": "同步减低", + "C": "基本不变", + "D": "脉搏增加，血压减低", + "E": "脉搏减低，血压增加" + }, + "answer": "E", + "reason": "小儿年龄越小，脉搏越快。" + }, + { + "question_num": 89, + "query": "下列方剂中含有石膏与知母的是", + "options": { + "A": "大定风珠", + "B": "消风散", + "C": "大秦艽汤", + "D": "竹叶石膏汤", + "E": "羚角钩藤汤" + }, + "answer": "B", + "reason": "大定风珠鸡子黄,麦地麻芍牡草方，龟甲整甲胶五味，滋阴息风最相当。消风散内有荆防,蝉蜕胡麻苦参苍，石知旁通归地草，风疹湿疹服之康。大秦艽汤羌独防，芎芷辛芩二地黄，石膏归芍芩甘术，风邪散见可通尝。竹叶石脊参麦冬，半夏粳米甘草从:清补气津又和胃，余热耗伤气津用。羚角钓藤菊花桑，地芍贝茹茯草襄。" + }, + { + "question_num": 90, + "query": "孕妇月数已足，腹痛或作或止，腰不痛者称作", + "options": { + "A": "滑胎", + "B": "弄胎", + "C": "垢胎", + "D": "盛胎", + "E": "试胎" + }, + "answer": "B", + "reason": "若月数已足，腹痛或作或止，腰不痛者，此名“弄胎”。" + }, + { + "question_num": 91, + "query": "下列除哪项外,常可出现红细胞沉降率明显增快", + "options": { + "A": "风湿病的病情趋于静止时", + "B": "亚急性细菌性(感染性)心内膜炎", + "C": "重度贫血", + "D": "心肌梗死", + "E": "多发性骨髓瘤" + }, + "answer": "A", + "reason": "红细胞沉降率病理性增快见于以下几种原因:①各种炎症，如细菌性急性类症、风湿热和结核病活动期;②损伤及坏死、心肌梗死等;③恶性肿瘤;④各种原因导致的高球蛋白血症，如多发性骨髓瘤、感染性心内膜炎、系统性红斑狼疮、肾炎、肝硬化等:⑤贫血和高胆固醇血症，故风湿病的病情趋于静��时不会出现红细胞沉降率明显增快" + }, + { + "question_num": 92, + "query": "刺四缝疗法，常用于治疗的小儿病证是", + "options": { + "A": "泄泻", + "B": "呕吐", + "C": "腹痛", + "D": "疳证", + "E": "积滞" + }, + "answer": "D", + "reason": "四缝是经外奇穴，位置在食指、中指、环指及小指四指中节，是手三阴经所过之处。针刺四缝可以解热除烦、通畅百脉、调和脏腑，常用于治疗疳证和小儿厌食症。" + }, + { + "question_num": 93, + "query": "对捻转补泻中泻法的叙述,不正确的是", + "options": { + "A": "捻转角度大", + "B": "用力轻", + "C": "频率快", + "D": "操作时间长", + "E": "拇指向后、食指向前(右转用力为主)" + }, + "answer": "B", + "reason": "捻转补泻法中捻转角度大,用力重，频率快,操作时间长，结合拇指向后，食指向前(右转用力为主)者为泻法，" + }, + { + "question_num": 94, + "query": "下列疾病，不会出现妇科血崩证的是", + "options": { + "A": "经行吐衄", + "B": "崩漏", + "C": "堕胎", + "D": "晚期产后出血", + "E": "小产" + }, + "answer": "A", + "reason": "血崩证是指以阴道急剧而大量出血为主症者。可由崩漏、功能失调性子宫出血类月经病，或堕胎、小产、滋养细胞疾病、前置胎盘等妊娠病，或产后血崩、晚期产后出血，或子宫肌瘤尤其是子宫黏膜下肌瘤、子宫颈癌等多种中、西医妇科疾病引起。" + }, + { + "question_num": 95, + "query": "望神的重点是", + "options": { + "A": "目光", + "B": "面色", + "C": "体态", + "D": "意识", + "E": "语言" + }, + "answer": "A", + "reason": "望神就是观察人体生命活动的外在表现，即观察人的精神状态和机能状态。神是以精气为物质基础的一种机能，是五脏所生之外荣，尤应重视眼神的变化。" + }, + { + "question_num": 96, + "query": "下列不属于头汗临床意义的是", + "options": { + "A": "虚阳上越", + "B": "上焦热盛", + "C": "中焦湿热", + "D": "卫阳不足", + "E": "进食辛辣" + }, + "answer": "D", + "reason": "头汗指患者近头部或头颈部出汗较多，多因上焦热盛、中焦湿热、虚阳上越所致，或进食辛辣、热汤、饮酒，使阳气旺盛，热蒸于头。" + }, + { + "question_num": 97, + "query": "邪热挟酒毒上壅的舌象是", + "options": { + "A": "舌色青紫", + "B": "舌色晦暗", + "C": "舌红肿胀", + "D": "舌脉粗长", + "E": "舌多瘀斑" + }, + "answer": "C", + "reason": "舌红肿胀多属邪热挟酒毒上壅，ABDE项均属血行瘀滞" + }, + { + "question_num": 98, + "query": "久病、重病呃逆不止，声低气怯者属", + "options": { + "A": "胃气衰败", + "B": "脾胃气虚", + "C": "脾胃阳虚", + "D": "寒邪客胃", + "E": "热邪客胃" + }, + "answer": "A", + "reason": "久病、重病呃逆不止，声低气怯无力者属胃气衰败之危候。" + }, + { + "question_num": 99, + "query": "毛细血管搏动征最常见于下列何种疾病", + "options": { + "A": "主动脉瓣关闭不全", + "B": "主动脉瓣狭窄", + "C": "肺动脉瓣狭窄", + "D": "肺动脉瓣关闭不全", + "E": "二尖瓣狭窄" + }, + "answer": "A", + "reason": "毛细血管搏动征与水冲脉:枪击音、Duroziez双重音一样,均为周围血管征。当用手指轻压患者指甲末端或以玻片轻压患者口唇黏膜，若见随心脏搏动而有规律地出现红白交替的节律性微血管搏动现象，称为毛细血管搏动征，见于主动脉瓣关闭不全、甲状腺功能亢进症、重度贫血及其他有脉压增大的情况。除A项外，其余各项均不引起脉压增大，故均不会出现毛细血管搏动征。" + }, + { + "question_num": 100, + "query": "治疗大失血、大吐泻所致体虚欲脱、脉微欲绝之证，急需益气固脱，宜首选", + "options": { + "A": "苦参", + "B": "太子参", + "C": "人参", + "D": "党参", + "E": "西洋参" + }, + "answer": "C", + "reason": "人参大补元气，用于气虚欲脱，脉微欲绝。" + }, + { + "question_num": 101, + "query": "理中丸与四君子汤中相同的药物是", + "options": { + "A": "人参、白术、茯苓", + "B": "人参、白术、甘草", + "C": "人参、茯苓、干姜", + "D": "人参、干姜、甘草", + "E": "人参、茯苓、甘草" + }, + "answer": "B", + "reason": "理中九的组成是甘草、人参、白术、干姜。四君子汤的组成是人参、白术、茯苓、甘草,故两个方剂中共同的药物是人参、白米、甘草。" + }, + { + "question_num": 102, + "query": "用于治血不养心引起的虚烦不眠、惊悸怔忡之证，宜选用的药物是", + "options": { + "A": "酸枣仁、柏子仁", + "B": "石菖蒲、远志", + "C": "合欢皮、龙骨", + "D": "朱砂、磁石", + "E": "珍珠母、琥珀" + }, + "answer": "A", + "reason": "酸枣仁与柏子仁二药均为养心安神之品，常相须为用，治疗阴血不足、心神失养的心神不宁病证。" + }, + { + "question_num": 103, + "query": "正常人两上肢血压的差别一般是", + "options": { + "A": "5~10mmHg", + "B": "11~15mmHg", + "C": "16~20mmHg", + "D": "21~25mmHg", + "E": "26~30mmHg" + }, + "answer": "A", + "reason": "正常人两上肢血压可有5~10mmHg的差别,下肢血压较上肢高20~40mmHg." + }, + { + "question_num": 104, + "query": "常用于治疗五更泄泻的药物是", + "options": { + "A": "丁香", + "B": "附子", + "C": "干姜", + "D": "吴茱萸", + "E": "小茴香" + }, + "answer": "D", + "reason": "吴茱萸用于治疗虚寒泄泻。为治脾肾阳虚，五更泄泻之常用药，如四神丸。" + }, + { + "question_num": 105, + "query": "所有不同病因的肺心病,共同的机制是", + "options": { + "A": "肺循环阻力增高→肺动脉高压→右心负荷增加→右心肥大", + "B": "慢性支气管炎→阻塞性肺气肿→肺心病", + "C": "慢性支气管炎→肺纤维化→肺心病", + "D": "原发性肺动脉高压→右心室负荷过重→右心衰竭", + "E": "二尖瓣狭窄→肺淤血→右心室肥大→右心衰竭" + }, + "answer": "A", + "reason": "肺心病病机:慢性炎症刺激引起肺间质纤维增生，排气量下降，残气量增加，同时,慢性缺氧导致血管收缩，炎症刺激导致血管增生增厚，管腔狭窄，使得肺循环阻力增高,肺动脉高压，右心室后负荷增大，右心室肥大。" + }, + { + "question_num": 106, + "query": "下列各项中，不属于麻疹顺证表现的是", + "options": { + "A": "发热恶寒，咳嗽痰多", + "B": "呛咳气急，声音嘶哑", + "C": "壮热持续，疹点渐密", + "D": "疹色红活，依次隐退", + "E": "手心、足心均见疹点" + }, + "answer": "B", + "reason": "顺证患者常表现为身热不甚，常有微汗，神气清爽，咳嗽而不气促。3～4天后开始出疹，先见于耳后发际，渐次延及头面、颈部、耳后蔓延及胸背腹部、四肢，最后鼻准部及手心、足心均见疹点，疹点色泽红活，分布均匀，无其他合并证候。疹点约在3天内透发完毕，之后依次消退，热退咳减，胃纳渐增，渐趋康复。" + }, + { + "question_num": 107, + "query": "根据骨度分寸,除哪项外,两者间距都是9寸", + "options": { + "A": "两完骨间", + "B": "天突至歧骨", + "C": "剑突联合至脐中", + "D": "腋前、后纹头至肘横纹(平肘尖)", + "E": "前两额角发际(头维)之间" + }, + "answer": "C", + "reason": "两完骨间,天突至歧骨,腋前、后纹头至肘横纹(平肘尖)，前两额角发际(头维)之间的间距均为9寸，剑突联合至脐中为8寸。" + }, + { + "question_num": 108, + "query": "肝肾不足所致之胎动不安，应首选", + "options": { + "A": "紫苏", + "B": "狗脊", + "C": "黄芩", + "D": "桑寄生", + "E": "五加皮" + }, + "answer": "D", + "reason": "桑寄生：补肝肾，除风湿，强筋骨，安胎，治肝肾不足所致之胎动不安。" + }, + { + "question_num": 109, + "query": "慢性肾盂肾炎早期肾功能减退的主要表现是", + "options": { + "A": "代谢性酸中毒", + "B": "血肌酐浓度升高", + "C": "内生肌酐清除率下降", + "D": "肾小管功能受损", + "E": "血尿素氮升高" + }, + "answer": "D", + "reason": "慢性肾孟肾炎后期肾小管功能受损，可出现多尿、夜尿增多、肾小管性酸中毒等，最终可致肾小球功能受损而导致肾衰竭。" + }, + { + "question_num": 110, + "query": "心源性哮喘最主要的临床表现是", + "options": { + "A": "胸闷", + "B": "气促", + "C": "紫绀", + "D": "心率加快", + "E": "夜间阵发性呼吸困难" + }, + "answer": "E", + "reason": "心源性哮喘常见于左心衰竭，常伴有高血压、冠心病、风湿性心脏病和二尖瓣狭窄等病史和体征。发作时往往表现为夜间睡眠中突然因发憋醒来，被迫坐起。轻者常于端坐数分钟后自行缓解，重者则可在一夜之间反复发作数次。伴有阵发性咳嗽，常咳出粉红色泡沫痰，左心界增大，心率加快，心尖部可闻及奔马律。" + }, + { + "question_num": 111, + "query": "经脉循行联系上齿的为", + "options": { + "A": "足少阴肾经", + "B": "手阳明大肠经", + "C": "足少阳胆经", + "D": "足阳明胃经", + "E": "足太阳膀胱经" + }, + "answer": "D", + "reason": "足少阴肾经是“循喉呢,挟舌本”;手阳明大肠经是“贯颊,入下齿中”;足阳明胃经是“下循鼻外，入上齿中”;足少阳胆经是“其支者,别目锐眦，下大迎，下颊车”;足中店脱空在面额,交巅,其支者,从巅至耳上角”" + }, + { + "question_num": 112, + "query": "溃疡病最常见的并发症是", + "options": { + "A": "上消化道出血", + "B": "胃、肠穿孔", + "C": "幽门梗阻", + "D": "胃溃疡恶变", + "E": "溃疡病急性穿孔" + }, + "answer": "A", + "reason": "溃疡病的并发症为出血、穿孔、幽门梗阻及癌变。出血，尤其是上消化道出血是溃疡病最常见的并发症。" + }, + { + "question_num": 113, + "query": "胸骨明显压痛或叩击痛常见的疾病是", + "options": { + "A": "上呼吸道感染", + "B": "肺炎", + "C": "慢性支气管炎", + "D": "肺结核", + "E": "白血病" + }, + "answer": "E", + "reason": "有胸骨压痛或叩击痛首先考虑白血病。" + }, + { + "question_num": 114, + "query": "关于出血坏死性急性胰腺炎的诊断，错误的是", + "options": { + "A": "血钙显著升高", + "B": "无糖尿病史而血糖升高", + "C": "血清淀粉酶突然下降", + "D": "烦躁不安，四肢厥冷，有休克表现", + "E": "范围广泛的剧烈腹痛伴高热与腹膜刺激征象" + }, + "answer": "A", + "reason": "出血坏死型急性胰腺炎，有以下表现时应拟诊断：①全腹剧痛及出现腹肌强直、腹膜刺激征时；②烦躁不安、四肢厥冷、皮肤呈斑点状等休克时；③血钙显著下降到2mmol/L以下；④腹腔诊断性穿刺有高淀粉酶活性的腹水；⑤血、尿淀粉酶突然下降；⑥肠鸣音显著降低、肠胀气等麻痹性肠梗阻；⑦Grey-Turner征或Cullen征；正铁血白蛋白阳性；⑧肢体出现脂肪坏死，消化道大量出血；⑨低氧血症；⑩白细胞＞18×10⁹/L，血尿素氮＞14.3mmol/L，血糖＞11.2mmol/L（无糖尿病史）。" + }, + { + "question_num": 115, + "query": "具有极细极软,似有似无特征的脉象是", + "options": { + "A": "微脉", + "B": "细脉", + "C": "弱脉", + "D": "虚脉", + "E": "濡脉" + }, + "answer": "A", + "reason": "微脉为脉形极细小,脉势极软弱，以致轻取不见，重按起落不明显，似有似无。" + }, + { + "question_num": 116, + "query": "下列属于非感染性发热的疾病是", + "options": { + "A": "肺结核", + "B": "肺炎", + "C": "急性肾盂肾炎", + "D": "伤寒", + "E": "血清病" + }, + "answer": "E", + "reason": "感染性发热是由各种病原体，如病毒、细菌、支原体、立克次体、螺旋体、真菌、寄生虫等引起的感染；非感染性发热，主要是由于无菌性坏死物质吸收、抗原－抗体反应、内分泌与代谢疾病、皮肤散热减少、体温调节中枢功能失常及自主神经功能紊乱引起的。血清病是一种典型的Ⅲ型变态反应。" + }, + { + "question_num": 117, + "query": "既可治疗口苦、胁肋疼痛,又善于治疗筋脉失养病证的穴位为", + "options": { + "A": "阳陵泉", + "B": "支沟", + "C": "丘墟", + "D": "光明", + "E": "间使" + }, + "answer": "A", + "reason": "阳陵泉为足少阳胆经的合穴，胆下合穴、八会穴之筋会，故其具有疏肝利胆、清热利湿、疏经活络的功效，可用于治疗胁痛、口苦、呕吐及筋脉失养病证的半身不遂、下肢痿痹等。" + }, + { + "question_num": 118, + "query": "风湿性心脏病并发心律失常最多见的是", + "options": { + "A": "期前收缩", + "B": "阵发性心动过速", + "C": "心房颤动", + "D": "心动过缓", + "E": "房室传导阻滞" + }, + "answer": "C", + "reason": "心房额动可见于主常人，可在情浩激动、手末后、违动表头量役酒发生，心房搦动常发生于旅有心血奢疾病者、常见于风湿性心推病、无心病、再血压心胜病、甲获腺场能亢进症、审性心也类、心肌病、感染性心内联炎及慢性肺珠性心脏病，最多见的是风湿性心脏病" + }, + { + "question_num": 119, + "query": "急性糜烂出血性胃炎的治疗中,错误的是", + "options": { + "A": "使用H2受体拮抗剂", + "B": "服用制酸药", + "C": "服用硫糖铝", + "D": "服用凝血酶", + "E": "服用水杨酸类抗炎药" + }, + "answer": "E", + "reason": "水杨酸类药是引起急性胃黏膜病变的主要原因，其他各项均为急性糜烂出血性胃炎的治疗措施，" + }, + { + "question_num": 120, + "query": "治疗痰热咳嗽证��应首选的方剂是", + "options": { + "A": "清金化痰汤", + "B": "三拗汤", + "C": "百合固金汤", + "D": "沙参麦冬汤", + "E": "金沸草散" + }, + "answer": "A", + "reason": "清金化瘐汤清热化痰，三拗尚宣肺土，二陈汤燥湿化瘐，沙参麦冬汤清肺润烨、全沸草散疏风散寒,宣肺止咳。" + }, + { + "question_num": 121, + "query": "下列符合药物治疗中的道德要求是", + "options": { + "A": "对症下药、合理配伍", + "B": "联合用药、尽量周全", + "C": "知情同意、免担风险", + "D": "不惜费用、专选贵药", + "E": "少用药物、减少费用" + }, + "answer": "A", + "reason": "用药道德要求是对症下药、合理配伍，不滥用药，节约费用，同时保证患者安全。" + }, + { + "question_num": 122, + "query": "结核病可出现的热型是", + "options": { + "A": "消耗热", + "B": "不规则热", + "C": "回归热", + "D": "稽留热", + "E": "弛张热" + }, + "answer": "B", + "reason": "不规则热可见于结核病、风湿热等。四归热可见于回归热、霍奇金病、周期病。稍留热见于肺类球菌肺炎、伤寒、斑疹伤对。弛张热见于败血症、风湿热等" + }, + { + "question_num": 123, + "query": "脏腑之气汇集于胸腹部的腧穴是", + "options": { + "A": "原穴", + "B": "络穴", + "C": "俞穴", + "D": "郄穴", + "E": "募穴" + }, + "answer": "E", + "reason": "原穴是脏腑的原气输注经过留止的部位，其分布均位于腕、踩部附近。络穴是络脉由经脉别由部位的腧穴，皆位于肘、膝关节以下。俞穴是脏腑之气输注之处，均位于节腰部都穴是指经脉之气深浆部位的腧穴。募穴是脏腑之气汇集之处，均位于胸腹部。" + }, + { + "question_num": 124, + "query": "小儿“纯阳”之体的含义是", + "options": { + "A": "纯阳无阴", + "B": "阳常有余", + "C": "阴亏阳亢", + "D": "肝常有余", + "E": "发育迅速" + }, + "answer": "E", + "reason": "“纯”指小儿先天所禀的元阴元阳米曾耗散，“阳”指小儿的生命活力，犹如旭日之初生，草木之方萌，蒸蒸日上，欣欣向荣。“纯阳”之体特指小儿生长发育迅速。" + }, + { + "question_num": 125, + "query": "可治疗气病的八会穴是", + "options": { + "A": "中脘", + "B": "太渊", + "C": "膻中", + "D": "悬钟", + "E": "章门" + }, + "answer": "C", + "reason": "八会穴属于不同的经脉,但均对各自对应的脏腑、组织等病证具有特殊治疗作用，如腑病可取腑会中脘;气病可取气会膻中;脉病可取脉会太渊;脏病可取脏会章门。" + }, + { + "question_num": 126, + "query": "铅管样肌张力增高的病变部位在", + "options": { + "A": "锥体外系", + "B": "锥体束", + "C": "小脑", + "D": "脊髓灰质前角", + "E": "以上都不是" + }, + "answer": "A", + "reason": "肌张力过低或缺失见于周围神经、脊髓灰质前角及小脑病变。折刀样肌张力过高见于锥体束损害;铅管样肌张力增高及齿轮样肌张力过高见于锥体外系损害" + }, + { + "question_num": 127, + "query": "医学伦理学关于尊重原则的叙述，错误的是", + "options": { + "A": "实现尊重原则是保障患者根本权益的必要条件", + "B": "医务人员应该尊重患者自主决定权", + "C": "尊重原则的关键是医方对患方的尊重", + "D": "尊重原则不包括尊重患者的姓名权、荣誉权", + "E": "医患双方应该真诚地尊重对方的人格" + }, + "answer": "C", + "reason": "医患双方应该真诚地尊重对方的人格，医方对患方的尊重是片面的。尊重原则包括尊重患者的人格，尊重患者的自主决定权，尊重患者的隐私权。" + }, + { + "question_num": 128, + "query": "与慢性胃炎发病密切相关的细菌是", + "options": { + "A": "沙门菌", + "B": "副溶血弧菌", + "C": "大肠埃希菌", + "D": "金黄色葡萄球菌", + "E": "幽门螺杆菌" + }, + "answer": "E", + "reason": "幽门螺杆菌作为慢性胃炎主要病因的确立其于如下证据，绝大多数慢性活动性胃炎患者胃黏膜中可检出幽门螺杆菌;②幽门螺杆菌在胃内的分布与胃内炎症分布一致;③根除幽门螺杆菌可使胃黏膜炎症消退;④从志愿者和动物模型中可复制幽门螺杆菌感染引起的慢性胃炎。" + }, + { + "question_num": 129, + "query": "下列不会引起腹痛的情况是", + "options": { + "A": "肺下叶炎症", + "B": "肺结核", + "C": "自发性气胸", + "D": "心绞痛", + "E": "心肌梗死" + }, + "answer": "B", + "reason": "急性腹痛胸腔���病所致的腹部牵涉性痛所包含的疾病有肺炎、肺梗死、气胸、心绞痛、心肌梗死、急性心包炎、食管裂孔疝。" + }, + { + "question_num": 130, + "query": "不属急惊风四证的是", + "options": { + "A": "痰", + "B": "瘀", + "C": "热", + "D": "惊", + "E": "风" + }, + "answer": "B", + "reason": "急惊风为痰、热、惊、风四证俱备，临床以高热、抽风、神昏为主要表现，多由外感时邪、内蕴湿热和暴受惊恐而引发。" + }, + { + "question_num": 131, + "query": "表现为吸气性呼吸困难的疾病是", + "options": { + "A": "支气管哮喘", + "B": "慢性支气管炎", + "C": "慢性阻塞性肺气肿", + "D": "广泛肺纤维化", + "E": "气管内异物" + }, + "answer": "E", + "reason": "吸气性呼吸困难见于各种原因引起的喉、气管、大支气管的狭窄与阻塞，如急性喉炎、喉水肿、气管肿瘤、气管异物等," + }, + { + "question_num": 132, + "query": "下列各项，诊断尿路感染最有意义的是", + "options": { + "A": "畏寒、高热、白细胞增高", + "B": "尿中大量红细胞", + "C": "尿中白细胞＞5/HP", + "D": "尿培养菌落计数＞10/ml", + "E": "肾区叩击痛" + }, + "answer": "C", + "reason": "尿沉渣镜检白细胞>5/HP称为白细胞尿，对尿路感染诊断意义较大" + }, + { + "question_num": 133, + "query": "下列哪项属于《中华人民共和国传染病防治法》规定的乙类传染病", + "options": { + "A": "黑热病", + "B": "麻风病", + "C": "流行性感冒", + "D": "人感染高致病性禽流感", + "E": "风疹" + }, + "answer": "D", + "reason": "乙类传染病是指传染性非典型肺炎、艾滋病、病毒性肝炎、脊髓灰质炎、人感染高致病性禽流感、麻疹、流行性出血热:狂犬病、流行性乙型脑炎、登革热、炭疽、细菌性和阿米巴性痢疾、肺结核、伤寒和副伤寒、流行性脑脊髓膜炎、百日咳、白喉、新生儿破伤风、狸红热、布鲁氏菌病、淋病、梅毒、钩端螺旋体病、血吸虫病、疟疾。ABCE项均为丙类传染病。" + }, + { + "question_num": 134, + "query": "为了排除继发性癫痫，首选的检查是", + "options": { + "A": "腰椎穿刺", + "B": "经颅多普勒", + "C": "颅脑CT或MRI", + "D": "颅骨摄片", + "E": "血糖测定" + }, + "answer": "C", + "reason": "继发性癫痫以反复突然发作感觉障碍、肢体抽搐、意识丧失、行为障碍和自主神经功能异常为主症。可有过度劳累、精神刺激、暴饮暴食、月经来潮等诱因存在。脑电图常规检查或诱发试验可见癫痫波型。经抗癫痫药物医治可控制发作。详细询问病史、查体及颅脑CT或MRI检查常可发现原发疾病。" + }, + { + "question_num": 135, + "query": "下列不出现语颤减弱或消失的疾病是", + "options": { + "A": "支气管阻塞", + "B": "胸壁与肺组织距离加大", + "C": "体质衰弱", + "D": "语调低", + "E": "肺泡内含气量增多" + }, + "answer": "D", + "reason": "语音震颤减弱或消失常见于哮喘、慢性阻塞性肺疾病、肺气肿、胸腔积液、胸壁与肺组织距离加大、肺泡内含气量增多及年老体弱呼吸功能减退等。" + }, + { + "question_num": 136, + "query": "下面所列络穴错误的是", + "options": { + "A": "心经—通里", + "B": "胆经—光明", + "C": "胃经—丰隆", + "D": "大肠经—偏历", + "E": "肝经—太冲" + }, + "answer": "E", + "reason": "肝经络穴是蠡沟穴，心经络穴是通里穴，胆经络穴是光明穴，胃经络穴是丰隆穴，大肠经络穴是偏历穴。太冲穴是足厥阴经的原穴。" + }, + { + "question_num": 137, + "query": "治疗普通型流脑的首选抗菌药物是", + "options": { + "A": "青霉素", + "B": "庆大霉素", + "C": "氨苄西林", + "D": "链霉素", + "E": "磺胺药" + }, + "answer": "A", + "reason": "治疗普通型流脑应尽早足量应用细菌敏感且能透过血脑屏障的抗菌药物，青霉素对脑膜炎球菌高度敏感，在脑脊液中的浓度为血液浓度的10%~30%，大剂量注射可使脑脊液内达到有效浓度，故为首选药物。" + }, + { + "question_num": 138, + "query": "下列不属于右心衰竭体征的是", + "options": { + "A": "舒张期奔马律", + "B": "反流性杂音", + "C": "肝大、紫绀、水肿", + "D": "肝颈静脉回流征阳性", + "E": "颈静脉怒张" + }, + "answer": "A", + "reason": "右心衰竭主要以体循环淤血为主。体征：①颈静脉搏动增强、充盈、怒张，肝颈静脉回流征阳性；②肝大；③水肿；④心脏可出现因三尖瓣关闭不全的反��性杂音；⑤紫绀。" + }, + { + "question_num": 139, + "query": "以鼠类为主要传染源的传染性疾病是", + "options": { + "A": "流行性脑脊髓膜炎", + "B": "流行性乙型脑炎", + "C": "流行性出血热", + "D": "霍乱", + "E": "细菌性痢疾" + }, + "answer": "C", + "reason": "流行性脑脊髓膜炎以带菌者和患者为传染源，病原菌借咳嗽、喷啶、说话等由飞沫直接从空气中传播。流行性出血热在我国黑线姬鼠为野鼠型出血热的主要宿主和传染源,褐家鼠为城市型或家庭型出血热的主要传染源。传播途径:接触传播,呼吸道传播，消化道感染，虫媒传播，垂直传播。霍乱以患者和带菌者为传染源，经粪一口途径传播。细菌性痢疾以患者和带菌者为传染源，经粪一口途径传播。" + }, + { + "question_num": 140, + "query": "AIDS的传播途径不包括", + "options": { + "A": "性接触", + "B": "输血", + "C": "母婴传播", + "D": "器官移植", + "E": "蚊虫叮咬" + }, + "answer": "E", + "reason": "艾滋病的传播途径：①性接触传播；②输血注射传播；③母婴传播；④其他传播途径：器官移植、人工授精。一般接触不会传播艾滋病。" + }, + { + "question_num": 141, + "query": "患者不能被叫醒,但压其眶上孔尚有反应,此种意识障碍称为", + "options": { + "A": "浅昏迷", + "B": "深昏迷", + "C": "嗜睡", + "D": "意识模糊", + "E": "昏睡" + }, + "answer": "A", + "reason": "患者意识大部分丧失,不能被叫醒，暗孔对光反射尚存在，此意识陪碍为浅昏迷。" + }, + { + "question_num": 142, + "query": "下列各项中，被称为“一源三歧”的是", + "options": { + "A": "任脉、督脉、带脉", + "B": "任脉、督脉、冲脉", + "C": "任脉、冲脉、带脉", + "D": "任脉、督脉，阴跷脉", + "E": "任脉、督脉、阴维脉" + }, + "answer": "B", + "reason": "一源三歧指任脉、督脉、冲脉，同起于胞宫，但循行各不同。" + }, + { + "question_num": 143, + "query": "急性乙型肝炎最早出现的血清学标志是", + "options": { + "A": "HBsAg", + "B": "抗-HBs", + "C": "HBeAg", + "D": "抗-HBe", + "E": "抗-HBc" + }, + "answer": "A", + "reason": "HBsAg是感染HBV后最早出现的血清学标志，HBsAg转阴后一段时间，在疾病恢复期，抗一HBs开始出现，至10年内转阴。而抗-HBc出现于HBsAg出现后:HBeAg一般仅见于HBsAg阳性血清,出现稍晚于HBsAg而消失较早,抗一HBe在HBeAg阴转后出现。" + }, + { + "question_num": 144, + "query": "有关SARS病原学检查的叙述，错误的是", + "options": { + "A": "血清SARS-CoV抗体由阴性转变为阳性提示为近期感染", + "B": "急性期到恢复期血清SARS-CoV抗体滴度升高4倍及以上，提示为近期感染", + "C": "SARS-CoVPCR测定结果阴性可除外SARS", + "D": "SARS-CoVPCR测定结果阳性可确诊SARS", + "E": "SARS-CoV分离培养阳性结果可确诊SARS" + }, + "answer": "C", + "reason": "SARS-CoV是一种单股正链RNA病毒，特异性IgM和IgG抗体在起病后7-14天出现，因此SARS-CoVPCR测定结果阴性也不能除外SARS。" + }, + { + "question_num": 145, + "query": "传染源是指", + "options": { + "A": "病原体已在体内繁殖并能将其排出体外的人和动物", + "B": "被病原体污染的食物和水", + "C": "带有病原体的节肢动物", + "D": "带有病原体的血液、体液和血制品", + "E": "被病原体污染的土壤" + }, + "answer": "A", + "reason": "传染源是指病原体已在体内生长繁殖并能将其排出体外的人和动物，包括患者、隐性感染者、病原携带者和受感染的动物。" + }, + { + "question_num": 146, + "query": "诊断急性菌痢必做的检查是", + "options": { + "A": "血常规", + "B": "粪便常规", + "C": "直肠镜", + "D": "血培养", + "E": "悬滴检查" + }, + "answer": "B", + "reason": "急性菌痢的诊断依据：①夏秋季，有进食不洁食物或与菌痢病人接触史；②临床表现发热、腹痛、腹泻、里急后重及黏液脓血便，左下腹明显压痛；③粪便常规示黏液脓血便，WBC≥15/HP。" + }, + { + "question_num": 147, + "query": "晚期肝硬化患者肝浊音区可出现的变化是", + "options": { + "A": "缩小", + "B": "扩大", + "C": "上升", + "D": "消失", + "E": "下移" + }, + "answer": "A", + "reason": "肝浊音界扩大见于肝癌、肝脓肿、肝炎、肝淤血和多囊肝等;肝浊音界缩小见于急性重型肝炎、肝硬化和胃肠胀气等。" + }, + { + "question_num": 148, + "query": "急性细菌性痢疾的典型表现不包括", + "options": { + "A": "里急后重", + "B": "发热", + "C": "呕吐", + "D": "腹痛", + "E": "黏液便" + }, + "answer": "C", + "reason": "急性菌痢典型表现为发热、腹痛、腹泻、里急后重及黏液脓血便，左下腹明显压痛，而胃肠道症状轻微甚至无呕吐。" + }, + { + "question_num": 149, + "query": "流行性出血热治疗原则中的“三早一少”不包括", + "options": { + "A": "少搬动", + "B": "早休息", + "C": "早诊断", + "D": "早治疗", + "E": "早发现" + }, + "answer": "C", + "reason": "流行性出血热治疗原则中的“三早一少”分别是早发现、早休息、早治疗及少搬动。" + }, + { + "question_num": 150, + "query": "与目赤肿痛的发生密切相关的经脉是", + "options": { + "A": "足厥阴、足少阳经", + "B": "足太阴、足阳明经", + "C": "手厥阴、手少阳经", + "D": "足少阴、足太阳经", + "E": "手太阴、手阳明经" + }, + "answer": "A", + "reason": "肝开窍于目，与胆相表里。所以和目赤肿痛的发生密切相关的经脉是足厥阴肝经、足少阳胆经。" + }, + { + "question_num": 151, + "query": "下列可引起中性粒细胞减少的疾病是", + "options": { + "A": "脾功能亢进", + "B": "急性心肌梗死后1~2天", + "C": "急性溶血", + "D": "肺吸虫病", + "E": "急性细菌性肺炎" + }, + "answer": "A", + "reason": "引起中性粒细胞减少的原因有感染，血液系统疾病，物理、化学因素造成的损伤，单核吞噬细胞系统功能亢进，如各种原因引起的脾大及其功能亢进，自身免疫性疾病等。" + }, + { + "question_num": 152, + "query": "下列哪项不是足厥阴肝经的循行", + "options": { + "A": "上腘内廉,下股内后廉", + "B": "上循足跗上廉,去内踝1寸", + "C": "循喉咙之后，上人颃颡", + "D": "循股阴,人毛中,环阴器", + "E": "起于大趾丛毛之际" + }, + "answer": "A", + "reason": "足厥阴肝经是“上腘内廉，循股阴，入毛中，环阴器，抵小腹”，而不是“下股内后廉”。" + }, + { + "question_num": 153, + "query": "下列可引起姿势性脊柱侧凸的是", + "options": { + "A": "佝偻病", + "B": "先天性倾斜", + "C": "胸膜肥厚", + "D": "一侧腰肌瘫痪", + "E": "儿童发育期坐或立姿势不良" + }, + "answer": "E", + "reason": "姿势性脊柱侧凸多见于儿童发育期坐立位姿势不良、椎间盘突出症、脊髓灰质炎等。器质性脊柱侧凸多见于向偻病、脊椎损伤、胸膜肥厚等。" + }, + { + "question_num": 154, + "query": "患者肢体痿软,麻木微肿,足胫热气上腾,身体困重,胸脘痞闷,溲短涩痛,舌苔黄腻,脉滑数,其证候是", + "options": { + "A": "肺热津伤", + "B": "脾胃虚弱", + "C": "肝肾亏损", + "D": "湿热浸淫", + "E": "阴损及阳" + }, + "answer": "D", + "reason": "由于湿热浸淫经脉，营卫运行受阻，或郁遏生热，或痰热内停，蕴湿积热，导致湿热相蒸，浸淫筋脉，气血运行不畅，致筋脉失于滋养而成痿证。经辨证分析为湿热浸淫证（身体困重，胸脘痞闷，溲短涩痛，舌苔黄腻，脉滑数）。治宜清热利湿，通利经脉。" + }, + { + "question_num": 155, + "query": "下列关于蜘蛛痣的叙述,正确的是", + "options": { + "A": "皮肤小动脉扩张所致", + "B": "皮肤毛细血管扩张所致", + "C": "多分布于下腔静脉回流区", + "D": "体内雌激素相对增多所致", + "E": "皮肤小静脉扩张所致" + }, + "answer": "D", + "reason": "蜘蛛痣是皮肤小动脉末端分支性扩张所形成的血管痣，因形似蜘蛛而得名。出现部住多在上腔静脉分布区，如面、颈、手背、上臂、前胸和肩部等处。蜘蛛痣的发生一般认为与雌激素增多有关。常见于慢性肝炎、肝硬化病人，健康妇女在妊娠期间、月经前或月经期偶尔也可出现蜘蛛痣。" + }, + { + "question_num": 156, + "query": "患者烦渴多饮,口干舌燥,兼见小便频多,舌边、尖红,苔薄黄,脉洪数,其治法是", + "options": { + "A": "清胃泻火,养阴增液", + "B": "清热润肺,生津止渴", + "C": "滋补肾阴,固摄肾气", + "D": "温阳滋肾,固摄肾气", + "E": "养阴清热,镇肝潜阳" + }, + "answer": "B", + "reason": "患者以烦渴多饮、口干舌燥为主，故诊断为上消，治宜清热润肺，生津止渴。方用消渴方。A项适用于中消；C项适用于肾消。" + }, + { + "question_num": 157, + "query": "下列有关乙脑极期瘫痪患者的叙述，错误的是", + "options": { + "A": "常呈截瘫", + "B": "病理征阳性", + "C": "肌张力增高", + "D": "必有意识障碍", + "E": "深反射先亢进后消失" + }, + "answer": "A", + "reason": "乙脑极期昏迷者可有肢体强直性瘫痪、偏瘫或全瘫，而非截瘫。" + }, + { + "question_num": 158, + "query": "患者多食易饥,形体消瘦,口渴引饮,大便干燥,舌苔黄燥,脉滑实有力。治疗应首选", + "options": { + "A": "白虎汤", + "B": "二冬汤", + "C": "玉女煎", + "D": "益胃汤", + "E": "消渴方" + }, + "answer": "C", + "reason": "患者多食易饥，形体消瘦，口渴引饮可以判断其为中消；多食易饥则说明患者胃火亢盛，故辨证为胃热炽盛，治宜清胃泻火、养阴增液，方选玉女煎加减。" + }, + { + "question_num": 159, + "query": "必须按照国务院卫生行政部门的有关规定,严格执行消毒隔离制度,防止发生医院内感染和医源性感染的机构是", + "options": { + "A": "疾病控制中心", + "B": "卫生监督所", + "C": "预防保健机构", + "D": "医疗保健机构", + "E": "卫生行政管理机构" + }, + "answer": "D", + "reason": "《中华人民共和国传染病防治法》第二十一条规定，医疗机构应当确定专门的部门或者人员，承担传染病疫情报告、本单位的传染病预防、控制及责任区域内传染病的预防工作;承担医疗活动中与医院感染有关的危险因素监测、安全防护、消毒、隔离和医疗废物处置工作" + }, + { + "question_num": 160, + "query": "患者经常出现发作性眩晕,头痛,一过性肢体麻木及一时性语言容涩,其最易引发的是", + "options": { + "A": "痫证", + "B": "消渴", + "C": "痹证", + "D": "中风", + "E": "痉证" + }, + "answer": "D", + "reason": "患者经常出现发作性眩晕，且一过性肢体麻木及一时性语言謇涩，多为虚风内动或肝阳上亢，这是中风的先兆。而A项以突然昏仆，不省人事，发作时有叫号、抽搐、口吐涎沫、两目上视、小便失禁等为主症。" + }, + { + "question_num": 161, + "query": "传染性非典型肺炎防治工作应坚持的原则是", + "options": { + "A": "预防为主,防治结合,分级负责,依靠科学,依法管理", + "B": "预防为主,及时隔离,依靠科学,防治结合,加强监督", + "C": "有效预防,宣传教育,加强监测,防治结合,科学管理", + "D": "预防控制,分级负责,依靠科学,防治结合,及时隔离", + "E": "预防为主,及时控制,科学治疗,统一监测,防治结合" + }, + "answer": "A", + "reason": "SARS患者是最主要的传染源，在发病后2周左右传染性最强，所以要预防为主，且防治结合。由于人群普遍易感，所以还要分级负贵，依靠科学，依法管理。" + }, + { + "question_num": 162, + "query": "患者症见腹中结块柔软,时聚时散,攻窜胀痛,脘腹胀闷,舌淡苔薄白,脉弦,其诊断是", + "options": { + "A": "胃痛", + "B": "腹痛", + "C": "痞满", + "D": "积证", + "E": "聚证" + }, + "answer": "E", + "reason": "积聚是腹内结块，或痛或胀的病证。分别言之，积属有形，结块固定不移，痛有定处，病在血分，是为脏病。聚属无形，包块聚散无常，痛无定处，病在气分，是为腑病。根据该患者症状，应诊为聚证肝气郁结证。" + }, + { + "question_num": 163, + "query": "某中医内科医师经执业医师注册后，在医疗机构执业。以后,该医师进修放射专业知识与技能,并被原医疗机构安排至放射科工作,对其改变执业范围的行为", + "options": { + "A": "医疗机构允许即可", + "B": "应到准予注册的卫生健康主管部门办理变更注册手续", + "C": "应到准予注册的上级卫生行政部门办理变更注册手续", + "D": "任何组织和个人无权干涉", + "E": "只要其医术高明,就不受限制" + }, + "answer": "B", + "reason": "《中华人民共和国医师法》规定，国家实行医师执业注册制度。取得医师资格的，可以向所在地县级以上人民政府卫生健康主管部门申请注册。因此，当其改变执业范围时，还应到准予注册的卫生健康主管部门办理变更注册手续。" + }, + { + "question_num": 164, + "query": "患者,女,67岁。平素体弱消瘦,近目外感,出现身热,微恶风,少汗,头昏,心烦,口干咽痛。舌红少苔,脉细数,其证候是", + "options": { + "A": "风寒感冒", + "B": "时邪感冒", + "C": "阴虚感冒", + "D": "暑湿感冒", + "E": "气虚感冒" + }, + "answer": "C", + "reason": "身热，微恶风是外感的主要表现。口干咽痛，舌红少苔，脉细数是阴虚的表现。辨为阴虚感冒，方选加减葳蕤汤。" + }, + { + "question_num": 165, + "query": "对不伤害原则的解释,正确的是", + "options": { + "A": "不伤害原则就是消除任何医疗伤害", + "B": "不伤害原则就是要求医生对患者丝毫不能伤害", + "C": "因绝大多数医疗行为都存在着不同程度的伤害,所以不伤害原则是做不到的", + "D": "不伤害原则要求对医学行为进行受益与伤害的权衡,把可控伤害控制在最低限度之内", + "E": "对肿瘤患者进行化疗意味着绝对伤害" + }, + "answer": "D", + "reason": "不伤害原则强调培养为病人高度负责、保护病人健康和生命的医学伦理理念和作风，正确对待医疗伤害现象，在实践中努力使病人免受不应有的医疗伤害，把不可避免但可控的伤害控制在最低限度之内。" + }, + { + "question_num": 166, + "query": "患者,男,30岁。腹痛,里急后重,赤多白少,肛门灼热,小便短赤,舌红苔黄,脉滑数,其证候是", + "options": { + "A": "疫毒痢", + "B": "湿热痢", + "C": "阴虚痢", + "D": "休息痢", + "E": "寒湿痢" + }, + "answer": "B", + "reason": "根据题干描述，可以明确诊断为痢疾，证型为湿热痢。痢疾的主症是大便次数增多，腹痛，里急后重，痢下赤白黏冻。A项项疫毒痢为疫毒内侵，毒盛于里，熏灼肠道，耗伤气血，下痢鲜紫脓血，壮热口渴；B项湿热痢为外感湿热或内生湿热，壅滞腑气，则成下痢赤白，肛门灼热之症；C项阴虚痢多为疫毒热盛伤津或湿热内郁不清，日久则伤阴伤气，已由素体阴虚感邪，常表现为痢下赤白，日久不愈，脓血黏稠，其下灼痛，虚坐怒责，心烦口渴，舌红少津，脉细数等症；D项休息痢多由于痢疾失治或治疗不当引起，常表现为下痢时发时止，日久难愈；E项寒湿痢多因寒湿阴邪，内困脾土，脾失健运，邪留肠中，气机阻滞，则为下痢白多赤少之征。" + }, + { + "question_num": 167, + "query": "患儿,6岁。发热39.5℃,咽喉肿痛,咳嗽,鼻塞流涕,面部和耳后有针头大小的丘疹，部分融合呈砖红色,或片状斑丘疹。诊断为麻疹初起。宜首选的药物是", + "options": { + "A": "柴胡、升麻、葛根", + "B": "防风、桑叶、菊花", + "C": "薄荷、牛蒡子、蝉蜕", + "D": "葛根、桑叶、蔓荆子", + "E": "荆芥、防风、桂枝" + }, + "answer": "C", + "reason": "薄荷、牛蒡子、蝉蜕都能透疹，可用于麻疹初起。" + }, + { + "question_num": 168, + "query": "患者，女，42岁。肢体浮肿，按之没指，小便短少，身体困重，胸闷泛恶，舌苔白腻，脉沉缓其治法是", + "options": { + "A": "宣肺利水", + "B": "温脾行水", + "C": "通阳利水", + "D": "温肾行水", + "E": "解毒消肿" + }, + "answer": "C", + "reason": "根据题干描述，可以明确诊断为水肿，证型为水湿浸渍证。水湿内停，脾气受困，脾阳不振，故可出现上述症状。治疗宜选用通阳利水之法。A项宣肺利水适应于风水相搏证。B项温脾行水适应于脾阳虚衰证。D项温肾行水适应于肾阳衰微证。E项解毒消肿适应于湿毒侵淫证。" + }, + { + "question_num": 169, + "query": "患者,女,60岁。素有高血压病史，猝然昏厥,不省人事,两手握紧,牙关紧闭,右侧肢体偏瘫。拟用麝香开窍醒神,药量是", + "options": { + "A": "0.03~0.1g", + "B": "0.3~0.5g", + "C": "1~3g", + "D": "5~10g", + "E": "15~30g" + }, + "answer": "A", + "reason": "麝香入九散,用量为0.03~0.1g。" + }, + { + "question_num": 170, + "query": "患者吐血量多，面色苍白，四肢厥冷，汗出，脉微。治疗首选方为", + "options": { + "A": "回阳救急汤", + "B": "生脉饮", + "C": "附子理中丸", + "D": "大补元煎", + "E": "独参汤" + }, + "answer": "E", + "reason": "若吐血过多，导致气随血脱，表现为面色苍白、四肢厥冷、汗出、脉微等症者，当用独参汤等益气固脱，并结合西医方法积极救治。" + }, + { + "question_num": 171, + "query": "患者,女,36岁。发热胸痛5天,咳吐腥臭脓血痰,舌红苔腻。宜首选的药物是", + "options": { + "A": "桔梗、薏苡仁、鱼腥草", + "B": "紫菀、款冬花、百部", + "C": "桑叶、苦杏仁、枇杷叶", + "D": "麻黄、苦杏仁、石膏", + "E": "白果、川贝母、苦杏仁" + }, + "answer": "A", + "reason": "患者发热胸痛,咳吐腥臭脓血痰，诊为肺痈，善治肺痈的是鱼腥草、桔梗和薏苡仁。" + }, + { + "question_num": 172, + "query": "患者久患胁痛，痛势隐隐，绵绵不休，口干咽燥，心烦少寐，头晕目眩，舌红少苔，脉弦细，其治法是", + "options": { + "A": "养血通络", + "B": "养阴柔肝", + "C": "滋阴养血", + "D": "滋养肝肾", + "E": "养阴润燥" + }, + "answer": "B", + "reason": "患者久患胁痛则肝肾阴亏，精血耗伤，肝络失养。经辨证分析痛势隐隐，绵绵不休，口干咽燥，心烦少寐，头晕目眩，舌红少苔，脉弦细均阴虚之象。治疗宜养阴柔肝止痛。方用一贯煎加减。" + }, + { + "question_num": 173, + "query": "患者,女,32岁。自述于半年前行人工流产,术后阴道出血,淋漓不断,持续半月余。从此每次月经来潮,前两天量多,继而淋漓,血色暗淡,四肢不温,面色萎黄,舌淡苔白,脉沉细无力。治宜选用", + "options": { + "A": "固经丸", + "B": "固冲汤", + "C": "四物汤", + "D": "温经汤", + "E": "黄土汤" + }, + "answer": "E", + "reason": "该患者为脾阳不足,脾不统血证。黄土汤温阳健脾，养血止血。主治脾阳不足，脾不统血证。症见大便下血，先便后血，以及吐血、衄血、妇人崩漏,血色暗淡,四肢不温，面色萎黄,舌淡苔白,脉沉细无力。" + }, + { + "question_num": 174, + "query": "患者呕吐清水痰涎，脘闷食少，时有头晕心悸，舌苔白腻，脉滑，其治法是", + "options": { + "A": "疏邪解表，和胃降逆", + "B": "消食化滞，和胃降逆", + "C": "温中化饮，和胃降逆", + "D": "疏肝理气，和胃降逆", + "E": "温中健脾，和胃降逆" + }, + "answer": "C", + "reason": "脾不运化，痰饮内停，胃气上逆则呕吐清水痰涎，脘闷不食；水饮上犯，清阳之气不展则头眩；水饮凌心则心悸；苔白腻，脉滑为痰饮停留之证，故诊断为呕吐痰饮内阻证，治宜温中化饮，和胃降逆。" + }, + { + "question_num": 175, + "query": "患者,男性,60岁。两耳听力下降5年余,伴耳鸣如蝉,腰膝酸软、脉沉细。治疗应选取", + "options": { + "A": "手、足厥阴经穴为主,兼取手少阳经穴", + "B": "手、足少阴经穴为主,兼取手少阳经穴", + "C": "手、足太阳经穴为主.兼取足少阴经穴", + "D": "手、足少阳经穴为主、兼取足少阴经穴", + "E": "足厥阴、足少阴经穴为主，兼取手少阳经六" + }, + "answer": "D", + "reason": "耳为胆经所辖,手、足少阳经脉循耳之前后，故耳鸣、耳聋可取手、足少阳经的腧穴以疏导少阳经气，患者伴腰膝酸软，脉沉细，是因肾气耗损、髓海空虚所致，因此，治疗时兼取足少阴经穴，" + }, + { + "question_num": 176, + "query": "患者，男，30岁。素日嗜酒，外出受寒后，始见时时阵寒，发热。继而壮热汗出，烦躁不宁，咳嗽气急，咯吐腥臭浊痰，胸满作痛，口干苦，便秘，舌红苔黄腻，脉滑数。治疗应首选", + "options": { + "A": "桔梗杏仁煎", + "B": "济生桔梗汤", + "C": "桑白皮汤", + "D": "加味泻白散", + "E": "如金解毒散" + }, + "answer": "E", + "reason": "题中症状都是肺痈成痈期的典型表现，是由于热毒蕴肺，热壅血瘀，酝酿成痈。应当清肺解毒，化瘀消痈，方选《千金》苇茎汤合如金解毒散加减。" + }, + { + "question_num": 177, + "query": "患者、女,45岁。咳嗽1周,咳嗽时胸背痛、咳吐大量脓痰,素有便秘,舌苔黄,脉滑数。用药宜首选", + "options": { + "A": "柴胡、桔梗", + "B": "柴胡、枳壳", + "C": "瓜蒌仁、鱼腥草", + "D": "浙贝母、桃仁", + "E": "薏苡仁、冬瓜仁" + }, + "answer": "C", + "reason": "瓜蒌仁能消肿散结,治疗肺痈咳吐脓血，常配伍鱼腥草同用，此外瓜婆仁有通便润肠之功。该患者为肺痈，伴有便秘。" + }, + { + "question_num": 178, + "query": "患者大便时溏时泻，水谷不化，稍进油腻之物，则大便次数增多，饮食减少，脘腹胀闷不舒，面色萎黄，舌淡苔白，脉缓弱。治疗应首选", + "options": { + "A": "藿香正气散", + "B": "黄芪汤", + "C": "参苓白术散", + "D": "枳实导滞丸", + "E": "附子理中丸" + }, + "answer": "C", + "reason": "脾胃虚弱，运化无权，清浊不分则大便时溏时泻，完谷不化，迁延反复；脾失健运，胃不受纳则食少，食后脘闷不适，稍进油腻之物则便次明显增多；脾胃虚弱，气血生化不足则面色萎黄，神疲倦怠；舌质淡，苔薄白，脉细弱为脾胃虚弱之象，故辨证分析为泄泻脾胃虚弱证，治疗宜健脾益气，化湿止泻，方用参苓白术散。A项治疗呕吐外邪犯胃证；B项治疗气虚便秘；D项治疗胃脘胀痛而便秘者；E项治疗呕吐脾胃阳虚证。" + }, + { + "question_num": 179, + "query": "患者,男,51岁。脘腹胀满,不思饮食，口淡无味,恶心呕吐,嗳气吞酸,常多自利,肢体沉重,怠惰嗜卧,舌苔白厚腻,脉缓。治疗应首选", + "options": { + "A": "枳实消痞丸", + "B": "厚朴温中汤", + "C": "保和丸", + "D": "平胃散", + "E": "越鞠丸" + }, + "answer": "D", + "reason": "肢体沉重,急惰啫卧,苔腻脉缓，为明显的湿邪表现，可排除ACE项，因患者无寒象，可排除B项，故治疗应首选平胃散。平胃散燥湿运脾、行气和胃，用于湿滞脾胃证，症见脘腹胀满，不思饮食，口淡无味，呕吐恶心，嗳气吞酸,肢体沉重，急惰嗜卧,常多自利，舌苔白腻而厚,脉缓。" + }, + { + "question_num": 180, + "query": "患者，男，56岁。眩晕，动则加剧，劳累即发，不寐心悸，神疲懒言，倦怠食少，唇甲不华，舌质淡，脉细弱，其治法是", + "options": { + "A": "补养气血，健运脾胃", + "B": "补中益气，调和肝胃", + "C": "益气养血，调理心肾", + "D": "养血柔肝，补益脾肺", + "E": "养血安神，滋补肝肾" + }, + "answer": "A", + "reason": "本题考查眩晕气血亏虚证的治疗。病位非肝、胃、肾、肺，排除BCDE项。辨证属气血亏虚证，治以补养气血，健运脾胃。" + }, + { + "question_num": 181, + "query": "患者身目发黄,黄色鲜明,腹部痞满，肢体困重,便溏尿黄,身热不扬,舌红苔黄腻，脉濡数,其证候是", + "options": { + "A": "肝胆湿热", + "B": "大肠湿热", + "C": "肝火上炎", + "D": "湿热蕴脾", + "E": "寒湿困脾" + }, + "answer": "D", + "reason": "腹部痞满,使溏而知病在脾。身目发黄，黄色鲜明，肢体困重，身热不扬，舌红苔黄腻,脉濡数为湿热之象，故选湿热蕴脾。湿热阻滞中焦,纳运失健,升降失常，气机阻滞，则腹部病满;湿热交结，热蒸于内，湿泛肌肤，阻碍经气，气化不利，则肢体困重，小便短黄;湿热蕴结脾胃，熏蒸肝胆，疏泄失权，胆汁泛溢肌肤，则身目发黄，黄色鲜明:舌红苔黄腻，脉濡数均为湿热内蕴之证，" + }, + { + "question_num": 182, + "query": "患者腹痛拘急，得温痛减，遇冷更甚，饮食减少，口不渴，小便清利，舌苔白腻，脉沉紧，其证候是", + "options": { + "A": "气滞", + "B": "实寒", + "C": "血瘀", + "D": "实热", + "E": "虚寒" + }, + "answer": "B", + "reason": "寒为阴邪，其性收引，寒邪内侵，阳气不运，气机郁滞则腹痛拘急，得温痛减，遇寒痛甚；阴寒凝滞，中阳受伤则小便清长；舌质淡，苔白腻，脉沉紧是里寒之证，故辨证分析为腹痛寒邪内阻证。A项为胀痛；C项为刺痛；D项为得冷痛减，遇热更甚；E项为疼痛隐隐，且喜按。" + }, + { + "question_num": 183, + "query": "感冒患者,恶寒发热轻微,但以脘腹冷痛、呕吐腹泻为主要症状,舌苔薄，脉紧,其病机是", + "options": { + "A": "寒邪伤及太阳", + "B": "寒邪伤及太阴", + "C": "寒邪直中少阴", + "D": "寒邪直中脾胃", + "E": "寒邪伤及厥阴" + }, + "answer": "D", + "reason": "患者以脘腹冷痛、呕吐、腹泻为主要症状，此为脾胃病变的表现，故为寒邪直中脾胃。太阴范围较大，即指手太阴肺经，也指足太阴脾经。但患者没有肺的表现故优先选D项。" + }, + { + "question_num": 184, + "query": "患者，男，35岁。数月来干咳少痰，痰中带血，潮热盗汗，胸闷隐痛，身体逐渐消瘦，口燥咽干，舌红少苔，脉细数，其诊断是", + "options": { + "A": "肺痨", + "B": "肺痿", + "C": "咳血", + "D": "虚劳", + "E": "肺胀" + }, + "answer": "A", + "reason": "肺痨以咳嗽、咯血、潮热、盗汗及身体逐渐消瘦为主要临床表现，据此可以诊断。" + }, + { + "question_num": 185, + "query": "患者,女,65岁。1年来表现为间断性胸闷胸疼,每次持续3~5分钟,服用硝酸甘油后能缓解。可能的诊断为", + "options": { + "A": "急性阑尾炎", + "B": "心绞痛", + "C": "心肌梗死", + "D": "急性胃炎", + "E": "慢性胃炎" + }, + "answer": "B", + "reason": "间断性胸闷胸疼持续时间小于15分钟,服硝酸甘油能够缓解,诊断为心绞痛。" + }, + { + "question_num": 186, + "query": "患者，女性，40岁。无意中发现背部肿块，无自觉症状。查：局部皮色不变，肿块触之柔软，呈分叶状，推之可移动，无压痛。该患者最可能的诊断是", + "options": { + "A": "痈", + "B": "背疽", + "C": "血瘤", + "D": "脂瘤", + "E": "肉瘤" + }, + "answer": "E", + "reason": "肉瘤的特点为皮下肉中生肿块，大如桃、拳，按之稍软，皮色不变，无痛。多因湿痰凝结所致，相当于西医的脂肪瘤。" + }, + { + "question_num": 187, + "query": "患者,男,58岁。近两日来出现头晕，胸闷,心脏X线表现为左心室肥厚、增大,主动脉增宽、延长、迂曲,有肺淤血和肺水肿征象。考虑最可能的诊断是", + "options": { + "A": "心包积液", + "B": "慢性肺源性心脏病", + "C": "风湿性心脏病", + "D": "高血压心脏病", + "E": "以上都不是" + }, + "answer": "D", + "reason": "左心室肥厚、增大,主动脉增宽、延长、迂曲,有肺淤血和肺水肿征象，均为高血压心脏病X线的特征性表现。" + }, + { + "question_num": 188, + "query": "患者，男，42岁。呃声沉缓有力，胸膈及胃脘不舒，得热则减，遇寒更甚，进食减少，恶食冷凉，喜热饮，口淡不渴，舌苔白润，脉迟缓。治疗应首选", + "options": { + "A": "竹叶石膏汤", + "B": "橘皮竹茹汤", + "C": "凉膈散", + "D": "小承气汤", + "E": "丁香散" + }, + "answer": "E", + "reason": "依据患者表现，证属呃逆胃中寒冷证，治当温中散寒，降逆止呃。代表方：丁香散加减。" + }, + { + "question_num": 189, + "query": "患者,男,28岁。高度水肿近1年，血压140/90mmHg。检查:尿蛋白(++++)，镜检红细胞0~8个/高倍视野。白蛋白/球蛋白为2.2/2.0，酚红排泄率42%，血胆固醇7mmol/L,其诊断是", + "options": { + "A": "慢性肾炎普通型", + "B": "慢性肾炎肾病型", + "C": "慢性肾炎高血压型", + "D": "慢性肾炎急性发作型", + "E": "慢性肾盂肾炎" + }, + "answer": "B", + "reason": "慢性肾炎普通型一般症状不严重，血压可正常或轻度升高，肾功能正常或轻度受损;慢性肾炎高血压型血压(特别是舒张压)持续中等以上程度增高，患者可有眼底出血、渗出，甚至视盘水肿;慢性肾炎急性发作型常因感染、劳累呈急性发作，病情急剧恶化;再由蛋白尿、血尿、高血压、水肿、酚红排泄率下降和血胆固醇的升高可诊断为慢性肾炎肾病型。" + }, + { + "question_num": 190, + "query": "患者，女，35岁。乳房胀痛半年，经前加重，经后痛减，伴情绪抑郁，心烦易怒，失眠多梦，胸胁胀满；舌质淡红苔薄白，脉细涩，其证型是", + "options": { + "A": "痰瘀凝结证", + "B": "肝郁气滞证", + "C": "气滞血瘀证", + "D": "冲任失调证", + "E": "毒热蕴结证" + }, + "answer": "B", + "reason": "乳腺增生病之肝郁气滞证证候：乳房胀痛或有肿块，一般月经来潮前乳痛加重和肿块稍肿大，行经后好转；常伴有情绪抑郁，心烦易怒，失眠多梦，胸胁胀满等；舌质淡红，苔薄白，脉细涩。治法：疏肝理气，散结止痛。方药：逍遥散加减。" + }, + { + "question_num": 191, + "query": "患者,男,65岁。皮肤、巩膜黄染进行性加重,大便持续变白,消瘦明显。应首先考虑的是", + "options": { + "A": "急性病毒性肝炎", + "B": "肝硬化", + "C": "肝癌", + "D": "胰头癌", + "E": "胆总管结石" + }, + "answer": "D", + "reason": "胰头癌是胰腺癌中最常见的一种，腹痛、黄疸和消瘦是最常见的临床表现，上腹痛和上腹饱胀不适是常见的首发症状，黄疸是胰头癌的最主要的症状和体征。黄疸呈进行性加重，大便呈陶土色，体格检查可见巩膜黄染、肝大，大部分病人胆囊肿大。" + }, + { + "question_num": 192, + "query": "患者，男性，50岁，高位复杂性肛瘘切开挂线术后11天。检查局部创面肉芽新鲜，橡皮筋松弛。此时的最佳处理方法是", + "options": { + "A": "熏洗坐浴", + "B": "拆除橡皮筋", + "C": "剪开挂线处", + "D": "外用中药生肌长肉", + "E": "紧线" + }, + "answer": "E", + "reason": "挂线术后一般2-3天拉紧橡皮筋重新结扎一次。本次检查局部无异常，橡皮筋松弛，故应继续紧线，等待漏管被挂断。" + }, + { + "question_num": 193, + "query": "患者,女,26岁。被人发现时躺在房间地上，呈昏迷状态。查体:神志不清，两瞳孔针尖大小，口角流涎,口唇紫绀，两肺满布水泡音,心率60次/分,肌肉震颤,其诊断是", + "options": { + "A": "癫痫大发作", + "B": "右心衰竭", + "C": "左心衰竭", + "D": "有机磷农药中毒", + "E": "安眠药中毒" + }, + "answer": "D", + "reason": "有机磷农药中毒会有神志不清，两瞳孔针尖大小(为主要诊断依据)，口角流涎，口唇紫绀，两肺满布水泡音，肌肉震颜。" + }, + { + "question_num": 194, + "query": "患者，男性，35岁。左足怕冷、疼痛、间歇性跛行，1年余。1个月来足痛转为持续性静止痛，夜间痛剧，不能入睡，足背动脉搏动消失，其诊断是", + "options": { + "A": "痹证", + "B": "脱疽", + "C": "糖尿病坏疽", + "D": "闭塞性动脉硬化症", + "E": "雷诺现象(肢端动脉痉挛症)" + }, + "answer": "B", + "reason": "足背动脉搏动消失为脱疽典型的临床表现。" + }, + { + "question_num": 195, + "query": "患者,男,50岁。慢性支气管炎病史5年。近2~3个月咳嗽加重,痰中持续带血,伴胸闷，气急,胸痛。X线检查见肺门阴影增大。应首先考虑的是", + "options": { + "A": "慢性支气管炎", + "B": "原发性支气管肺癌", + "C": "肺炎", + "D": "肺结核", + "E": "肺脓肿" + }, + "answer": "B", + "reason": "近2~3个月咳嗽加重,痰中持续带血，伴胸闷，气急，胸痛。X线检查见肺门阴影增大。需进行排癌检查。" + }, + { + "question_num": 196, + "query": "患者，女.61岁。左小腿焮红灼热疼痛伴高热3天。症见小腿皮肤鲜红一片，稍高出皮面，色如丹涂，扪之灼热，疮周色红，边界清楚，按压时红色稍退，放手后立即恢复。体温39℃,伴胃纳不佳，大便2日未行，其诊断是", + "options": { + "A": "烂疔", + "B": "足发背", + "C": "痈", + "D": "类丹毒", + "E": "丹毒" + }, + "answer": "E", + "reason": "丹毒是患部皮肤突然发红成片、色如涂丹的急性感染性疾病。生于躯干部者，称内发丹毒；发于头面部者，称抱头火丹；发于小腿足部者，称流火；新生儿多生于臀部，称赤游丹毒。特点是病起突然，恶寒发热，局部皮肤忽然变赤，色如丹涂脂染，焮热肿胀，边界清楚，迅速扩大，数日内可逐渐痊愈，但容易复发。" + }, + { + "question_num": 197, + "query": "患者,男,42岁。因反复机会性感染人院，检查发现患者伴发卡波西肉瘤。诊断应首先考虑", + "options": { + "A": "艾滋病", + "B": "腺苷脱氨酶缺乏症", + "C": "X性连锁低丙球血症", + "D": "先天性胸腺发育不全", + "E": "选择性IgA缺乏症" + }, + "answer": "A", + "reason": "反复机会性感染加之卡波西肉瘤，诊断为艾滋病。" + }, + { + "question_num": 198, + "query": "患者，女性，35岁，已婚。月经提前，量多，色淡，质稀，纳少便溏，气短懒言，舌淡，苔白，脉缓弱，其治法是", + "options": { + "A": "健脾和胃", + "B": "补气摄血", + "C": "养血调经", + "D": "益气养血", + "E": "补血止血" + }, + "answer": "B", + "reason": "脾主中气而统血，脾气虚弱，统血无权，冲任不固，故月经提前而至，量多；气虚血失温煦，则经色淡而质稀；脾虚中气不足，故神疲肢倦，气短懒言，小腹空坠；运化失职，则纳少便溏。舌淡，苔白，脉缓弱为脾虚之证。" + }, + { + "question_num": 199, + "query": "患者,男,27岁,农民。突起发热,伴头痛、眼眶痛、腰痛。病程第4日就诊时热已退,血压偏低,球结膜水肿、出血,腰背部可见条索状出血点。前1日24小时尿量300ml。该病例最可能的诊断是", + "options": { + "A": "败血症", + "B": "流行性出血热", + "C": "免疫性血小板减少症", + "D": "钩端螺旋体病", + "E": "流行性感冒" + }, + "answer": "B", + "reason": "歌诀:三红三痛症,流行性出血热。" + }, + { + "question_num": 200, + "query": "患者，男，45岁。左上臂内侧有一肿块，呈半球形。暗红色，质地柔软，状如海绵，压之可缩小。应首先考虑的是", + "options": { + "A": "气瘤", + "B": "筋瘤", + "C": "脂瘤", + "D": "血瘤", + "E": "肉瘤" + }, + "answer": "D", + "reason": "肿块质地柔软，状如海绵，压之可缩小为血瘤特征，即西医血管瘤。" + }, + { + "question_num": 201, + "query": "患者，女性，25岁，已婚。月经周期或先或后，经量或多或少，色暗有小块，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": "肾虚肝郁" + }, + "answer": "B", + "reason": "肝郁气结，气机逆乱，冲任失司，血海蓄溢失常，故月经周期或先或后，经量或多或少；肝气郁滞，气机不畅，经脉不利，故经行不畅，色暗有小块；肝郁气滞，经脉涩滞，故乳房作胀；舌苔薄白，脉弦正是肝郁之证。" + }, + { + "question_num": 202, + "query": "患者，男，38岁。两手出现皮下小水疱，疱壁破裂，叠起白皮，中心已愈，四周续起疱疹。诊断为鹅掌风，外治应首选", + "options": { + "A": "雄黄膏", + "B": "皮脂膏", + "C": "疯油膏", + "D": "青黛膏", + "E": "复方土槿皮酊" + }, + "answer": "E", + "reason": "以水疱为主的鹅掌风可选用1号癣药水、2号癣药水、复方土槿皮酊外搽。" + }, + { + "question_num": 203, + "query": "患者，女性，30岁，���婚。每逢经行小腹冷痛喜按，经量少，色暗淡，腰酸腿软，小便清长，舌苔润，脉沉。治疗应首选", + "options": { + "A": "温经汤(《金匮要略》)", + "B": "温经汤(《妇人大全良方》)", + "C": "艾附暖宫丸", + "D": "膈下逐瘀汤", + "E": "少腹逐瘀汤" + }, + "answer": "A", + "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天出现大便泄泻，脘腹胀满，面浮肢肿，神疲肢软，经净渐止，舌淡红，苔白，脉濡缓。治疗应首选", + "options": { + "A": "人参健脾丸", + "B": "香砂六君子汤", + "C": "补中益气汤", + "D": "痛泻要方", + "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，故神疲肢倦；水湿泛溢肌肤，故面浮肢肿；脾气虚失于统摄，冲任不固，故经行量多，色淡质稀；脾虚生湿，湿注下焦，损伤带脉，带脉失约，故带下量多，色白质黏。舌淡胖，苔白腻，脉濡缓，也为脾虚之证。治疗原则为补脾益气，除湿止泻。应选参苓白术散。" + }, + { + "question_num": 205, + "query": "患者，女性，35岁，已婚。患带下病3年，带下清冷、量多、质稀，腰酸腿软，少腹发凉，大便溏，舌淡苔薄白，脉沉迟，其证候是", + "options": { + "A": "肾阳虚", + "B": "肾阴虚", + "C": "湿热", + "D": "脾虚", + "E": "热毒" + }, + "answer": "A", + "reason": "肾阳不足，命门火衰，气化失常，寒湿内盛，致带脉失约，任脉不固，故带下量多，色白清冷，质稀；肾阳虚胞络失于温煦，故少腹发凉；肾阳虚外府失容，故腰膝酸软；火不温土，则大便溏；舌淡苔薄白，脉沉迟为肾阳虚之证。" + }, + { + "question_num": 206, + "query": "患者，女，35岁。因双乳胀痛伴肿块数年而就诊，检查时发现双乳可扪及多个大小不等之结节，质韧，腋窝淋巴结无明显肿大，挤压乳头时有少量淡黄色液体溢出，细胞学检查无异常发现。最可能的诊断是", + "options": { + "A": "乳岩", + "B": "乳核", + "C": "乳漏", + "D": "乳痨", + "E": "乳癖" + }, + "answer": "E", + "reason": "乳癖的特点是双乳胀痛伴肿块，双乳可扪及多个大小不等之结节。" + }, + { + "question_num": 207, + "query": "患者，女性，28岁，已婚。孕50天。腰酸腹痛，阴道少量出血，色淡暗，头晕耳鸣，小便清长，舌淡苔白，脉细缓滑。治疗应首选", + "options": { + "A": "寿胎丸", + "B": "圣愈汤", + "C": "胎元饮", + "D": "举元煎", + "E": "保阴煎" + }, + "answer": "C", + "reason": "气血虚弱，则冲任不固，胎失摄载，故孕后腰酸腹痛，阴道少量出血；气虚不化，则出血色淡质稀；气虚中阳不振，清阳不升，则神疲肢倦，面色白；舌淡，苔白，脉细缓滑为气血虚弱之证。" + }, + { + "question_num": 208, + "query": "患者产后血性恶露13天不尽，量多、色淡、质稀，无气味，神疲懒言，小腹空坠，食少便溏，舌淡苔薄白，脉细弱，其证候是", + "options": { + "A": "肾虚证", + "B": "气虚证", + "C": "血虚证", + "D": "血瘀证", + "E": "气滞证" + }, + "answer": "B", + "reason": "肾虚患者常有隐痛、空痛；血虚患者多见面色无华；血瘀患者恶露多有血块，舌紫暗或有瘀点；气滞患者常见小腹疼痛拒按。量多、质稀、色淡、神疲懒言为气虚证的典型症状。" + }, + { + "question_num": 209, + "query": "患者，女，30岁。下腹部肿块，疼痛2月余，伴低热，经行量多，赤白带下。妇检盆腔右侧触及鸭卵大包块，形不整，触压痛(+)；舌红，苔黄厚，脉弦滑数。治疗应首选", + "options": { + "A": "大黄牡丹汤", + "B": "益肾调经汤", + "C": "桂枝茯苓丸", + "D": "香棱丸", + "E": "银甲丸" + }, + "answer": "A", + "reason": "该患者诊为癥瘕湿热瘀阻证，治宜清热利湿，化瘀消癥，方选大黄牡丹汤。" + }, + { + "question_num": 210, + "query": "患儿，5岁。近1周内常有头面、肢体浮肿，时轻时重，小便短赤，头身困重，脘闷纳呆，口苦口黏，大便不爽，���红，苔黄腻，脉滑数。1个月前曾有皮肤感染病史。治疗应首选的方剂是", + "options": { + "A": "麻黄连翘赤小豆汤合五苓散", + "B": "五味消毒饮合小蓟饮子", + "C": "苓桂术甘汤合小蓟饮子", + "D": "甘露消毒丹合五苓散", + "E": "甘露消毒丹合小蓟饮子" + }, + "answer": "B", + "reason": "根据题干“曾有皮肤感染病史，小便短赤，舌红苔黄腻”可知证属湿热内侵，方剂当选五味消毒饮合小蓟饮子。" + }, + { + "question_num": 211, + "query": "患儿，4岁半。面色潮红，身热消瘦，手足心热，肢体拘挛或强直，时或抽搐，大便干结，舌光无苔，质绛少津，脉象细数。治疗应首选的方剂是", + "options": { + "A": "大定风珠", + "B": "镇肝熄风汤", + "C": "天麻钩藤饮", + "D": "地黄饮子", + "E": "四逆汤" + }, + "answer": "A", + "reason": "该患儿的临床表现符合慢惊风阴虚风动证，故应育阴潜阳，滋肾养肝。代表方剂为大定风珠。" + }, + { + "question_num": 212, + "query": "患儿，男，2岁，纳差2个月，腹泻1周。平素食欲不振，挑食偏食，近日大便日行3～4次，食后作泻，面色萎黄，舌淡苔白，指纹淡红。治疗应首选", + "options": { + "A": "熏洗法", + "B": "擦拭法", + "C": "割治疗法", + "D": "推拿疗法", + "E": "拔罐疗法" + }, + "answer": "D", + "reason": "AB项多用于外科病证，C项常用以治疗疳证和哮喘等病证，E项常用于肺炎喘嗽，哮喘，腹痛，遗尿等病证。" + }, + { + "question_num": 213, + "query": "患儿，22天。面目皮肤发黄22天，色泽鲜明如橘皮，精神疲倦，不欲吮乳，尿黄便秘，舌红苔黄腻，其证候是", + "options": { + "A": "脾失健运", + "B": "瘀积发黄", + "C": "寒湿阻滞", + "D": "湿热熏蒸", + "E": "胆道不利" + }, + "answer": "D", + "reason": "“患儿，22天”—新生儿；“面目皮肤发黄、尿黄”—黄疸；“色泽鲜明如橘皮”—阳黄；“尿黄便秘，舌红苔黄腻”—湿热郁蒸之证。综合分析作出诊断：胎黄（新生儿黄疸）之湿热熏蒸证，治宜清热利湿，方用茵陈蒿汤加味。胎黄的辨证论治主要分为三型：湿热熏蒸证，黄色鲜明如橘皮，同时伴有内热症状；寒湿阻滞证，黄色淡而晦暗，大便灰白，有寒象；瘀积发黄证，发黄深而晦暗，右胁有痞块坚硬。AE项一般不作为胎黄的辨证分型，因肝胆在胎黄中必然不通利，无法对病性进行确切的概括和描述。" + }, + { + "question_num": 214, + "query": "患儿，女，9个月。发热，微汗，鼻塞流涕，咽红，夜间体温升高，又见惊惕啼叫，夜卧不安，舌质红，苔薄白，指纹泛紫，其诊断是", + "options": { + "A": "夜啼", + "B": "感冒夹痰", + "C": "感冒夹惊", + "D": "急惊风", + "E": "小儿暑温" + }, + "answer": "C", + "reason": "患者有发热症状，A项不正确，B项多无精神方面的症状，D项多症见壮热神昏，手足抽搐，唇口撮动，牙关紧闭，两眼直视，颈项强直，甚至角弓反张等，本患者尚没有这方面症状。E项多有烦躁或萎靡、虚烦等精神见症。" + }, + { + "question_num": 215, + "query": "患儿，8岁。发热2天，左侧腮部肿胀、疼痛，边缘不清，触之痛甚，咀嚼不便。伴头痛，咽痛，纳少。舌红，苔薄黄，脉浮数，其治法是", + "options": { + "A": "清热解毒，软坚散结", + "B": "疏风清热，散结消肿", + "C": "疏风清热，解毒化痰", + "D": "清热化痰，通络散瘀", + "E": "滋阴降火，活血消肿" + }, + "answer": "B", + "reason": "据患儿左侧腮部肿胀、疼痛。边缘不清，触之痛甚，咀嚼不便，诊断为痄腮。据“舌红苔薄黄，脉浮数”，为风热在表之象，辨证为邪犯少阳证。治宜疏风清热，散结消肿，方选柴胡葛根汤、银翘散。" + }, + { + "question_num": 216, + "query": "患者，男性，50岁。高血压病史15年，未坚持服药。2小时前因情绪激动突然意识不清，双侧瞳孔不等大。应首先考虑的是", + "options": { + "A": "酒精中毒", + "B": "药物中毒", + "C": "高血压性脑出血", + "D": "脑血栓", + "E": "心功能不全" + }, + "answer": "C", + "reason": "高血压病史，未坚持服药，情绪激动诱发，排除ABE项，D项脑血栓，安静休息时发病，多数病人意识清楚，症状和体征与闭塞血管供应区的脑功能损伤一致，如瘫痪、感觉障碍、失语、甚至意识障碍等、脑膜刺激征阴性、排除。" + }, + { + "question_num": 217, + "query": "患者，男，30岁。口角歪向右侧，左眼不能闭合2天，左侧额纹消���。治疗应选取何经穴为主", + "options": { + "A": "手、足少阳经", + "B": "手、足太阴经", + "C": "手、足少阴经", + "D": "手、足厥阴经", + "E": "手、足阳明经" + }, + "answer": "E", + "reason": "面瘫治宜祛风通络、疏调经筋。取局部穴、手足阳明经穴为主。" + }, + { + "question_num": 218, + "query": "患者，男性，42岁。反复上腹痛6年，今日突发上腹剧痛，迅速扩散到右下腹及全腹。查体：面色苍白，脉搏细弱，腹直肌强直，肝浊音界消失。应首先考虑的是", + "options": { + "A": "胃溃疡出血", + "B": "溃疡病合并幽门梗阻", + "C": "溃疡病急性穿孔", + "D": "胃溃疡恶变", + "E": "急性心肌梗死" + }, + "answer": "C", + "reason": "溃疡病急性穿孔主要表现为突发剧烈腹痛，持续而加剧，先出现于上腹，再逐步延及全腹，腹壁呈板样僵直，有压痛和反跳痛，半数有气腹征，肝浊音界消失，部分出现休克症状。" + }, + { + "question_num": 219, + "query": "患者，男，68岁。家属代诉：患者于今日下午外出散步，突然昏仆，不省人事，半身不遂，目合口张，鼻鼾息微，遗尿，汗出，四肢厥冷，脉细弱。治疗应首选", + "options": { + "A": "督脉经穴，灸法", + "B": "任脉经穴，灸法", + "C": "背俞穴，灸法", + "D": "足阳明经穴，灸法", + "E": "足厥阴经穴，针刺用泻法" + }, + "answer": "B", + "reason": "中风脱证宜回阳固脱，取任脉经穴灸法。任脉为阴脉之海，用大艾炷重灸，以回垂绝之阳，治疗中风脱证。" + }, + { + "question_num": 220, + "query": "患者，男性，65岁。皮肤、巩膜黄染进行性加重，大便持续变白，消瘦明显。应首先考虑的是", + "options": { + "A": "急性病毒性肝炎", + "B": "肝硬化", + "C": "肝癌", + "D": "胰头癌", + "E": "胆总管结石" + }, + "answer": "D", + "reason": "以上几种疾病都会出现黄疸，但只有胰头癌出现大便变白。" + } +] \ No newline at end of file