diff --git "a/Assistant/Theory_Questions/Year_4/Past_Paper.json" "b/Assistant/Theory_Questions/Year_4/Past_Paper.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_4/Past_Paper.json" @@ -0,0 +1,2680 @@ +[ + { + "question_num": 1, + "query": "下面属于中医学理论主要特点的是", + "options": { + "A": "同病异治", + "B": "辨病论治", + "C": "标本同治", + "D": "辨证论治", + "E": "审因论治" + }, + "answer": "D", + "reason": "】中医理论体系基本特点:①整体观念包括人体是一个有机的整体和人与自然界具有统一性;②辩证论治就是指四诊(望、闻、问、切)所收集的资料和体征;通过分析综合、辨清疾病的病因、性质、部位以及邪正之间的关系。" + }, + { + "question_num": 2, + "query": "治疗咳嗽，除直接治肺外，还需要注意调治的脏腑是", + "options": { + "A": "心、脾、肾", + "B": "心、肝、肾", + "C": "脾、肝、肾", + "D": "胃、脾、肾", + "E": "脾、胃、肝" + }, + "answer": "C", + "reason": "咳嗽是人体清除呼吸道内的分泌物或异物的保护性呼吸反射动作。咳嗽病变主脏在肺，与肝、脾有关,久则及肾。" + }, + { + "question_num": 3, + "query": "依据阴阳学说昼夜分阴阳，则上午是", + "options": { + "A": "阳中之阴", + "B": "阳中之阳", + "C": "阴中之阴", + "D": "阴中之阳", + "E": "阴中之至阴" + }, + "answer": "B", + "reason": "昼夜夜有阴阳之分,上午为阳中之阳,下午为阳中之阴。" + }, + { + "question_num": 4, + "query": "下列各项中，不属于肺痈逆证表现的是", + "options": { + "A": "脉象缓滑", + "B": "气喘鼻扇", + "C": "爪甲青紫带弯", + "D": "吞咽无力", + "E": "饮食少进" + }, + "answer": "A", + "reason": "溃脓期是肺痈顺与逆的转折点:顺证溃后声音清朗，脓血稀而渐少，腥味转淡，饮食知味,胸胁稍痛，身体不热，坐卧如常!脉象缓滑;逆证则见溃后音嘎无力，脓血如败卤,腥臭异常,气喘鼻扇,胸痛，坐卧不宁,饮食少进,吞咽无力，身热不退，颧红爪甲青紫带弯,脉短涩或弦急，为肺叶腐败之恶候。" + }, + { + "question_num": 5, + "query": "下列各项，适用于“阴虚则热”的是", + "options": { + "A": "热者寒之", + "B": "阴病治阴", + "C": "阳病治阴", + "D": "阴中求阳", + "E": "寒者热之" + }, + "answer": "C", + "reason": "阴虚则热,属阴偏衰,治法：状水之主,以制阳光。体现阳病治阴。" + }, + { + "question_num": 6, + "query": "胸痹的主要病机是", + "options": { + "A": "胸阳不振", + "B": "气滞血瘀", + "C": "心脉痹阻", + "D": "气虚血瘀", + "E": "痰浊闭阻" + }, + "answer": "C", + "reason": "胸痹基本病机为心脉痹阻。病理性质为本虚标实，虚实夹杂" + }, + { + "question_num": 7, + "query": "凡具有收敛、沉降作用的事物和现象，归属的五行是", + "options": { + "A": "木", + "B": "火", + "C": "土", + "D": "金", + "E": "水" + }, + "answer": "D", + "reason": "金的特性包括收效、沉降、清洁、肃降。" + }, + { + "question_num": 8, + "query": "下列各项中，不属于胸痹寒凝心脉证症状的是", + "options": { + "A": "心痛如绞，心痛彻背", + "B": "气候骤冷发病或加重", + "C": "时欲太息，暴怒加重", + "D": "手足不温，冷汗自出", + "E": "舌薄白，脉沉涩" + }, + "answer": "C", + "reason": "时欲太息,暴怒加重为肝气郁结之征,是气滞表现,而不是寒凝。" + }, + { + "question_num": 9, + "query": "五脏关系中，体现先后天相互资生的是", + "options": { + "A": "肝与肾", + "B": "脾与肾", + "C": "心与肾", + "D": "心与脾", + "E": "肺与肾" + }, + "answer": "B", + "reason": "脾为后天之本，肾为先天之本,先后天关系的是脾肾。" + }, + { + "question_num": 10, + "query": "胃痛瘀血停胃的疼痛特点是", + "options": { + "A": "隐痛", + "B": "灼痛", + "C": "暴痛", + "D": "各种痛", + "E": "刺痛" + }, + "answer": "E", + "reason": "瘀血见固定痛,刺痛。" + }, + { + "question_num": 11, + "query": "下列各项，不属肺生理特性的是", + "options": { + "A": "肺为华盖", + "B": "肺为娇脏", + "C": "肺主宜发", + "D": "肺气肃降", + "E": "肺朝百脉" + }, + "answer": "E", + "reason": "ABCD项均为肺的特性，而肺主气、肺朝百脉,主治节均为肺的功能。" + }, + { + "question_num": 12, + "query": "下列各项，与腹痛发病无关的经脉是", + "options": { + "A": "冲任带脉", + "B": "足三阴经", + "C": "足太阳经", + "D": "手少阳经", + "E": "足阳明经" + }, + "answer": "D", + "reason": "腹痛在少腹多属肝经病证为足厥阴、足少阳��主;脐以上大腹疼痛，多为脾胃病证，为足太阴;足阳明所主;脐腹疼痛多为大小肠病变，为手阳明、手太阳经脉所主;脐以下小腹疼痛，多属肾、膀胱及胞宫病证，为足少阴、足太阳及冲任带脉所主。" + }, + { + "question_num": 13, + "query": "下列各项中，称为“孤脏”的是", + "options": { + "A": "三焦", + "B": "脾", + "C": "心", + "D": "肾", + "E": "肝" + }, + "answer": "B", + "reason": "《素问。玉机真脏论》;“脾脉者,土也,孤脏以灌四旁者也。“意思是说脾土居中央,寄旺于四季,故“孤脏”指脾脏。" + }, + { + "question_num": 14, + "query": "治疗泄泻脾虚证应选取的方剂是", + "options": { + "A": "葛根芩连汤", + "B": "参苓白术散", + "C": "理中丸", + "D": "补中益气汤", + "E": "保和丸" + }, + "answer": "B", + "reason": "参苓白术散补脾肾,益肺气,主治脾胃虚弱泄泻，症见大便溏泄，少进油腻则泻,伴神疲乏力。" + }, + { + "question_num": 15, + "query": "具有主液和泌别清浊作用的是", + "options": { + "A": "肝胆", + "B": "脾胃", + "C": "大肠", + "D": "小肠", + "E": "膀胱" + }, + "answer": "D", + "reason": "小肠主液,主受盛、化物和泌别清浊。" + }, + { + "question_num": 16, + "query": "治疗痢疾寒湿证，首选方剂是", + "options": { + "A": "参苓白术散", + "B": "藿香正气散", + "C": "不换金正气散", + "D": "平胃散", + "E": "正气天香散" + }, + "answer": "C", + "reason": "寒湿痢下赤少白多,苔白腻,首选方剂是不换金正气散。" + }, + { + "question_num": 17, + "query": "具有促进女子胞发育成熟的物质是", + "options": { + "A": "精血", + "B": "天癸", + "C": "肾气", + "D": "肝血", + "E": "肾阳" + }, + "answer": "B", + "reason": "天葵,是肾精肾气充盈到一定程度时体内出现的一种精微物质,女子胞的发育成熟.月经按时来潮及其后定时排卵,与天葵的来至和其对胞宫的作用有极其密切的关系。" + }, + { + "question_num": 18, + "query": "便秘冷秘的临床特征是", + "options": { + "A": "大便干结，口干口臭", + "B": "大便干结，欲便不得", + "C": "大便不干，努挣乏力", + "D": "大便艰涩，手足不温", + "E": "大便不干，腰膝酸冷" + }, + "answer": "D", + "reason": "素体阳虚,或病后阳气虚衰,以致阴寒内盛，凝滞肠胃，阳气不运，津液不布，故而形成冷秘。冷秘见寒象，手足不温。" + }, + { + "question_num": 19, + "query": "元神之府指的是", + "options": { + "A": "心", + "B": "肾", + "C": "脑", + "D": "头", + "E": "肝" + }, + "answer": "C", + "reason": "“髓海”“元神之府”指的是脑,是对脑主宰精神.意识`.思维的一种描述。" + }, + { + "question_num": 20, + "query": "下列各项中，不属于黄疸的辨证要点的是", + "options": { + "A": "辨阳黄、阴黄", + "B": "辨黄疸湿热轻重", + "C": "辨黄疸之病因", + "D": "辨黄疸之部位", + "E": "辨黄疸病势轻重" + }, + "answer": "D", + "reason": "黄疸的辨证要点是要首辨阳黄、阴黄，次辨黄疸湿热轻重，三辨黄疸之病因，四辨黄疸病势轻重。" + }, + { + "question_num": 21, + "query": "下列各项，与机体易感外邪的原因密切相关的是", + "options": { + "A": "气推动的功能减弱", + "B": "气温煦的功能减弱", + "C": "气营养的功能减弱", + "D": "气固摄的功能减弱", + "E": "气防御的功能减弱" + }, + "answer": "E", + "reason": "正气对邪气具有防御作用。若正气虚弱,防御作用减弱,则抵抗力下降，易于感受外邪而发病。" + }, + { + "question_num": 22, + "query": "治疗风热头痛，应首选方剂是", + "options": { + "A": "芎芷石膏汤", + "B": "天麻钩藤饮", + "C": "大补元煎", + "D": "龙胆泻肝汤", + "E": "半夏白术天麻汤" + }, + "answer": "A", + "reason": "风热头痛选芎芷石膏汤，风寒头痛选川芎茶调散。" + }, + { + "question_num": 23, + "query": "下列各项，不属于津布散部位的是", + "options": { + "A": "皮肤", + "B": "肌肉", + "C": "孔窍", + "D": "血脉", + "E": "脑髓" + }, + "answer": "E", + "reason": "津和液的区别,①质地稠厚的为液,清稀为津;②流动性小为液,大的为津;③分布在脑髓、筋骨、脏腑的为液,皮肤、孔窍的为津。" + }, + { + "question_num": 24, + "query": "血淋与尿血的鉴别要点是", + "options": { + "A": "有无发热", + "B": "有无尿痛", + "C": "有无腹痛", + "D": "有无排尿困难", + "E": "出血量的多少" + }, + "answer": "B", + "reason": "淋证和尿血、癃闭、尿浊,鉴别点都是尿痛与不痛，有尿痛的为淋，不痛的是尿血、癃闭、尿浊。" + }, + { + "question_num": 25, + "query": "同名手足阳经交接的部位是", + "options": { + "A": "头面部", + "B": "肩项部", + "C": "四肢部", + "D": "颈项部", + "E": "肩胛部" + }, + "answer": "A", + "reason": "所有阳经都在头面交接。头为诸阳之会。" + }, + { + "question_num": 26, + "query": "下列各项不属大肠癌与痢疾共同症状的是", + "options": { + "A": "腹痛", + "B": "泄泻", + "C": "里急后重", + "D": "泄泻与便秘交替出现", + "E": "排脓血便" + }, + "answer": "D", + "reason": "痢疾是具有传染性的外感疾病，一般发病较急，常以发热伴有呕吐而开始，继则腹痛腹泻、里急后重,排赤白脓血便为突出的临床特征;肠癌起病较为隐匿，早期症状多较轻或不明显，中晚期伴明显的全身症状，如神疲倦息、消瘦等，腹痛常为持续性隐痛，常见腹泻，但每天次数不多，泄泻与便秘交替出现是其特点。" + }, + { + "question_num": 27, + "query": "所谓得气，体现的经络功能是", + "options": { + "A": "沟通经络作用", + "B": "运输渗灌作用", + "C": "感应传导作用", + "D": "调节平衡作用", + "E": "运行气血作用" + }, + "answer": "C", + "reason": "得气是一种针刺到位后,身体酸麻胀沉的感觉,体现经络感应传导作用。" + }, + { + "question_num": 28, + "query": "呕吐的治疗原则是", + "options": { + "A": "健脾化湿", + "B": "温养脾胃", + "C": "补中益气", + "D": "养阴和胃", + "E": "和胃降逆" + }, + "answer": "E", + "reason": "呕吐以和胃降逆为治疗原则。" + }, + { + "question_num": 29, + "query": "下列各项，不属于六淫共同致病特点的是", + "options": { + "A": "季节性", + "B": "相兼性", + "C": "外感性", + "D": "流行性", + "E": "地域性" + }, + "answer": "D", + "reason": "六邪淫气不具备传染性、流行性,疠气才有此特性。" + }, + { + "question_num": 30, + "query": "着痹的临床特点是", + "options": { + "A": "疼痛游走不定", + "B": "疼痛剧烈、痛有定处", + "C": "关节酸痛、重着，屈伸不利", + "D": "关节肿胀局限", + "E": "关节肿胀，疼痛不甚" + }, + "answer": "C", + "reason": "着痹以感受湿邪为主,湿性重浊，故而患者见关节酸痛、重着，屈伸不利。" + }, + { + "question_num": 31, + "query": "大怒易损伤的脏腑是", + "options": { + "A": "心", + "B": "肺", + "C": "肾", + "D": "肝", + "E": "脾" + }, + "answer": "D", + "reason": "怒伤肝,喜伤心,思伤脾,悲忧伤肺,恐伤肾。" + }, + { + "question_num": 32, + "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": "石瘿的首选治疗措施是早期施行根治性切除术。" + }, + { + "question_num": 33, + "query": "下列各项，易阻遏气机的外邪是", + "options": { + "A": "风邪", + "B": "火邪", + "C": "湿邪", + "D": "寒邪", + "E": "暑邪" + }, + "answer": "C", + "reason": "湿邪停滞于经络,阻塞气机。" + }, + { + "question_num": 34, + "query": "治疗脱疽湿热毒盛证，应首选的方剂是", + "options": { + "A": "阳和汤", + "B": "四妙勇安汤", + "C": "桃红四物汤", + "D": "顾步汤", + "E": "黄芪鳖甲汤" + }, + "answer": "B", + "reason": "脱疽湿热毒盛证,治宜清热利湿，活血化瘀，方选四妙勇安汤加减。" + }, + { + "question_num": 35, + "query": "可用寒因寒用法治疗的证候是", + "options": { + "A": "实寒证", + "B": "虚寒证", + "C": "真热假寒证", + "D": "真寒假热证", + "E": "寒热错杂证" + }, + "answer": "C", + "reason": "寒因寒用属于反治,也叫以寒治寒,用来治疗真热假寒。" + }, + { + "question_num": 36, + "query": "下列各项不宜使用垫棉法的是", + "options": { + "A": "溃疡脓出不畅有脓袋", + "B": "疮孔窦道形成，脓水不易排尽", + "C": "急性炎症红肿热痛", + "D": "溃疡脓腐已尽，皮肉一时不能黏合", + "E": "脓腐疮疡溃后" + }, + "answer": "C", + "reason": "垫棉法适用于:溃疡脓出不畅有脓袋;疮孔窦道形成，脓水不易排尽;溃疡脓腐已尽，皮肉一时不能黏合;脓腐疮疡溃后��但急性炎症红肿热痛时不能使用。" + }, + { + "question_num": 37, + "query": "得神的面色特征是", + "options": { + "A": "面色荣润，含蓄不露", + "B": "面色少华，暗淡不荣", + "C": "面色无华，晦暗暴露", + "D": "面似有华，泛红如妆", + "E": "面色无华，青如草籽" + }, + "answer": "A", + "reason": "得神又称“有神”,提示精气充盈,体健神旺,为健康的表现。中国人正常面色:红黄隐隐,明润含蓄。得神之象的是A项。" + }, + { + "question_num": 38, + "query": "下列疔疮容易损伤筋骨的是", + "options": { + "A": "烂疔", + "B": "红丝疔", + "C": "颜面疔", + "D": "疫毒疔", + "E": "手足疔" + }, + "answer": "E", + "reason": "颜面部疔疮易走黄,手足疔易损伤筋骨，" + }, + { + "question_num": 39, + "query": "肾虚水泛的面色特征是", + "options": { + "A": "面色暗淡", + "B": "面黑干焦", + "C": "眼眶周围色黑", + "D": "面色黧黑", + "E": "面色晦暗如烟熏" + }, + "answer": "C", + "reason": "眼眶周围黑,主肾虚水饮、寒湿带下。面色蜡淡主肾阴虚;面黑干焦主肾阴精亏虚;面色黧黑、肌肤甲错主瘀血久停;面色上晦暗如烟熏,属“阴黄”,多寒湿郁滞所致。" + }, + { + "question_num": 40, + "query": "下列各项，由禀赋不耐而发病的是", + "options": { + "A": "红丝疔", + "B": "疔疮", + "C": "药毒", + "D": "流注", + "E": "脱疽" + }, + "answer": "C", + "reason": "药毒由禀赋不耐,邪毒内侵所致。" + }, + { + "question_num": 41, + "query": "头皮瘙痒，多脂多屑，头发脱落，其临床意义是", + "options": { + "A": "肾精亏损", + "B": "血虚受风", + "C": "肝经风热", + "D": "血热化燥", + "E": "脾胃蕴热" + }, + "answer": "D", + "reason": "】血热化燥会导致头皮瘙痒、多屑、多脂。" + }, + { + "question_num": 42, + "query": "臁疮湿热下注的治法是", + "options": { + "A": "清热解毒，养阴活血", + "B": "清热利湿，活血通络", + "C": "活血化瘀，和营消肿", + "D": "清热利湿，和营解毒", + "E": "益气活血，祛瘀生新" + }, + "answer": "D", + "reason": "臁疮是指发生在小腿下部的慢性溃疡，多因湿热下注，瘀血凝滞经络所致。臁疮湿热下注证，应清热利湿，和营解毒，方选二妙丸合五神汤加减。" + }, + { + "question_num": 43, + "query": "患部形小而圆，红肿热痛不甚的疮疡病变是", + "options": { + "A": "痈", + "B": "疔", + "C": "疖", + "D": "疮", + "E": "疽" + }, + "answer": "C", + "reason": "疔患处顶白形小如粟;疖患部形小而圆,红肿热痛不甚。" + }, + { + "question_num": 44, + "query": "下列各项中，有特殊鼠尿味的是", + "options": { + "A": "白秃疮", + "B": "脚湿气", + "C": "肥疮", + "D": "体癣", + "E": "花斑癣" + }, + "answer": "C", + "reason": "肥疮相当于西医的黄癣,头癣中最常见的一种，好发于儿童，头上黄痂堆积，肥厚，富黏性，质脆易粉碎，有特殊的鼠尿味。" + }, + { + "question_num": 45, + "query": "小儿指纹鲜红，其临床意义是", + "options": { + "A": "外感表证，寒证", + "B": "里热证", + "C": "疼痛惊风", + "D": "脾虚，疳积", + "E": "血络郁闭" + }, + "answer": "A", + "reason": "小儿望指纹:红紫辨寒热，红寒紫热。色鲜红为外感风寒表证;色紫红为热证，" + }, + { + "question_num": 46, + "query": "结块范围约3cm，突起根浅，中心有一脓头，出脓即愈的疾病是", + "options": { + "A": "疖病", + "B": "无头疖", + "C": "蝼蛄疖", + "D": "有头疖", + "E": "有头疽" + }, + "answer": "D", + "reason": "有头疖:患处皮肤上有一红色结块，范围约3cm大小，灼热疼痛，突起根浅，中心有一脓头，出脓即愈。有头疖属于疖病的一种。" + }, + { + "question_num": 47, + "query": "舌苔干燥，扪之无津，甚则干裂的舌象是", + "options": { + "A": "滑苔", + "B": "燥苔", + "C": "糙苔", + "D": "润苔", + "E": "腻苔" + }, + "answer": "B", + "reason": "润苔一一舌面润有津;滑苔一一舌苔水分过多;燥苔一一舌若干燥少津甚则舌苔干裂;糙苔一一舌苔粗糙如沙石，津液全无;苔腻一一苔质颗粒细腻致密,均匀成片,紧贴舌面,中厚边薄,揩之不去，刮之不易脱落。" + }, + { + "question_num": 48, + "query": "发于皮里膜外，由脂肪过度增生而形成，是良性肿瘤的是", + "options": { + "A": "血瘤", + "B": "肉瘤", + "C": "脂瘤", + "D": "脂肪肉瘤", + "E": "失荣" + }, + "answer": "B", + "reason": "肉瘤相当于西医的脂肪瘤，发于皮里膜外，由脂肪过度增生而形成，是良性肿瘤，其特点: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。" + }, + { + "question_num": 49, + "query": "恶寒发热并见，常见的病证是", + "options": { + "A": "虚证", + "B": "实证", + "C": "表证", + "D": "里证", + "E": "寒证" + }, + "answer": "C", + "reason": "恶寒发热并见是诊断表证的重要依据。恶寒重发热轻一一风寒表证;发热轻而恶风一一伤风表证;发热重恶寒轻一一风热表证。" + }, + { + "question_num": 50, + "query": "发于小腿足部的丹毒是", + "options": { + "A": "抱头火丹", + "B": "内发丹毒", + "C": "流火", + "D": "无头疽", + "E": "赤游丹毒" + }, + "answer": "C", + "reason": "生于胸腹腰胯部者,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。多发于骨骼或关节间等深部组织的化脓性疾病称无头疽。" + }, + { + "question_num": 51, + "query": "病势较缓，尚可忍耐，但绵绵不休的症状，称为", + "options": { + "A": "空痛", + "B": "酸痛", + "C": "胀痛", + "D": "重痛", + "E": "隐痛" + }, + "answer": "E", + "reason": "隐痛一一疼痛不剧烈，可以忍耐，但绵绵不休，谓之隐痛。多因阳气精血不足，脏腑经脉失养所致。空病一一疼痛兼有空虚的感觉，谓之空痛。多因气血亏虚，或阴精不足，脏腑经脉失养所致。酸痛一一疼痛兼有酸软的感觉，谓之酸痛。多因湿邪侵袭肌肉关节，气血运行不畅所致。胀痛一一疼痛兼有胀感的症状,是气滞作痛的特点,如胸、胁、脘、腹胀痛,但头目胀痛,则多因肝火上炎或肝阳上亢所致。重痛一一疼痛兼有沉重感的症状，多因湿邪困阻气机所致。" + }, + { + "question_num": 52, + "query": "身体无病，月经定期2个月一潮者，称为", + "options": { + "A": "居经", + "B": "并月", + "C": "暗经", + "D": "激经", + "E": "避年" + }, + "answer": "B", + "reason": "特殊的月经现象。①并月:身体无病，但月经定期2个月来潮一次;②居经:或称季经，身体无病，但月经定期3个月来潮一次;③避年:身体无病，但月经1年行经1次;④暗经:终生不潮但却能受孕者;⑤激经:又称“盛胎”或“垢胎”,若无不适,不影响生育可不作病论。" + }, + { + "question_num": 53, + "query": "下列各项，口苦的临床意义是", + "options": { + "A": "湿热蕴脾", + "B": "痰热内盛", + "C": "心血不足", + "D": "心火上炎", + "E": "胃火炽盛" + }, + "answer": "D", + "reason": "口苦提示肝火或心火旺盛。" + }, + { + "question_num": 54, + "query": "治疗经行头痛肝火证，应首选的方剂是", + "options": { + "A": "通窍活血汤", + "B": "羚角钩藤汤", + "C": "天麻钩藤饮", + "D": "镇肝熄风汤", + "E": "加味逍遥丸" + }, + "answer": "B", + "reason": "经行头痛肝火证治宜清热平肝息风，应首选:羚角钩藤汤。" + }, + { + "question_num": 55, + "query": "大便溏结不调，其临床意义是", + "options": { + "A": "胃肠积热", + "B": "湿热蕴脾", + "C": "气血瘀滞", + "D": "肝郁脾虚", + "E": "食滞胃肠" + }, + "answer": "D", + "reason": "溏结不调,为肝郁脾虚、肝脾不调所致。" + }, + { + "question_num": 56, + "query": "下列各项中，不属于月经后期气滞血瘀证的临床表现是", + "options": { + "A": "月经量少或正常", + "B": "经色黯红或有小血块", + "C": "胸胁乳房胀痛", + "D": "小腹隐痛喜按", + "E": "脉弦数" + }, + "answer": "D", + "reason": "小腹隐痛喜按属虚寒表现,而非气滞血瘀。气滞血瘀证见小腹胀痛。" + }, + { + "question_num": 57, + "query": "饭后困倦嗜睡，少气懒言，食量减少的临床意义是", + "options": { + "A": "痰湿困脾", + "B": "脾气不足", + "C": "心肾阳虚", + "D": "邪闭心神", + "E": "热人营血" + }, + "answer": "B", + "reason": "若饭后嗜睡,兼神疲倦怠，食少纳呆者,多由中气不足,脾失健运所致。" + }, + { + "question_num": 58, + "query": "下列各项，不属于月经过少肾虚证临床表现的是", + "options": { + "A": "经量渐少，色暗淡，质稀", + "B": "头晕耳鸣，腰膝酸软", + "C": "头晕目眩，胸胁胀满", + "D": "舌质淡，脉沉弱", + "E": "小腹冷，夜尿多" + }, + "answer": "C", + "reason": "月经过少肾虚证临床表现为腰酸腿软，头晕耳鸣，足跟病而非胸胁胀满" + }, + { + "question_num": 59, + "query": "促、结、代脉的共同特点是", + "options": { + "A": "脉来急救", + "B": "脉来时止", + "C": "脉来迟缓", + "D": "止有定数", + "E": "止无定数" + }, + "answer": "B", + "reason": "促、结、代脉都属于节律失常而有歇止的脉象;促脉是数而歇止,止无定律，歇止时短;结脉是迟而歇止，止无定律，歇止时短；代脉是迟而软止,止有定律,歇止时长。" + }, + { + "question_num": 60, + "query": "治疗闭经肾气亏损证，应选用的方剂是", + "options": { + "A": "加减一阴煎", + "B": "人参养荣汤", + "C": "资血汤", + "D": "一贯煎", + "E": "加减苁蓉菟丝子丸" + }, + "answer": "E", + "reason": "闭经肾气亏损证治宜补肾益气，调理冲任。选方加减苁蓉菟丝子汤加淫羊藿、紫河车。" + }, + { + "question_num": 61, + "query": "沉脉的临床意义是", + "options": { + "A": "寒证", + "B": "表证", + "C": "热证", + "D": "里证", + "E": "实证" + }, + "answer": "D", + "reason": "沉脉的临床意义:里证。常见于下痢、浮肿、呕吐、郁结气滞等。" + }, + { + "question_num": 62, + "query": "治疗绝经前后诸证肾阴阳两虚证，应首选的方剂是", + "options": { + "A": "知柏地黄丸", + "B": "左归丸", + "C": "右归丸", + "D": "二仙汤合二至丸", + "E": "归肾丸" + }, + "answer": "D", + "reason": "绝经前后诸证肾阴阳两虚证，治宜阴阳双补，选方二仙汤合二至丸加菟丝子、何首乌、龙骨、牡蛎。" + }, + { + "question_num": 63, + "query": "下列各项，属于阳虚证特征性临床表现的是", + "options": { + "A": "少气懒言", + "B": "小便短少", + "C": "神疲乏力", + "D": "畏寒肢冷", + "E": "舌质淡嫩" + }, + "answer": "D", + "reason": "阳虚是气虚+寒象,是虚寒证,所以畏寒肢冷最能代表阳虚。" + }, + { + "question_num": 64, + "query": "带下量多热毒蕴结证的带下特点是", + "options": { + "A": "带下如涕如嗜，色淡黄，质稀薄", + "B": "带下色淡黄，有气味", + "C": "带下赤白难闻，质稠，有气味", + "D": "带下色白质黏，呈豆渣样", + "E": "带下黄绿如脓，质黏腻，臭秽难闻" + }, + "answer": "E", + "reason": "带下量多热毒蕴结证见带下量多,黄绿如脓，或赤白相兼,或五色杂下!质黏腻，臭秽难闻，治宜清热解毒。" + }, + { + "question_num": 65, + "query": "痰火扰神证和痰蒙心神证的共有特征是", + "options": { + "A": "狂躁", + "B": "抑郁", + "C": "痴呆", + "D": "神昏", + "E": "妄语" + }, + "answer": "D", + "reason": "痰蒙心神见神志异常(神志抑郁,错乱,痴呆,昏迷)+痰浊证(面色上澡，胸闷呕恶)，舌苔白腻脉滑。痰火扰神见神志异常(神志狂躁,神昏谵语)+痰火内盛证(吐痰黄稠,喉间痰鸣,胸闷不舒),舌红苦黄腻,脉滑数。二者均见神昏,不过痰湿为阴证,而痰火为阳证。" + }, + { + "question_num": 66, + "query": "妊娠期，阴道少量出血，时下时止，而无腰酸腹疼者，称为", + "options": { + "A": "堕胎", + "B": "胎漏", + "C": "胎动不安", + "D": "小产", + "E": "漏下" + }, + "answer": "B", + "reason": "妊娠期间,阴道不时有少量出血，时出时止，或淋漓不断，而无腰酸、腹痛小腹下坠者,称为“胎漏”,也称“胞漏”“漏胎”。" + }, + { + "question_num": 67, + "query": "以干咳无痰或少痰难咯，鼻咽干燥，微有发热恶寒为特征的证候是", + "options": { + "A": "风热犯肺证", + "B": "风寒束肺证", + "C": "燥邪犯肺证", + "D": "肺热炽盛证", + "E": "肺阴亏虚证" + }, + "answer": "C", + "reason": "燥邪犯肺证:干咳+发热恶寒,燥邪伤肺。干燥少津脉浮数(温燥),脉浮紧(凉燥)。" + }, + { + "question_num": 68, + "query": "产后用药，三禁指的是", + "options": { + "A": "禁活血、通便、消导", + "B": "禁大汗、峻下、利小便", + "C": "禁清热、凉血、发汗", + "D": "禁驱寒、破血、通便", + "E": "禁温通、活血、利小便" + }, + "answer": "B", + "reason": "产后用药“三禁”:禁大汗以防亡阳，禁峻下以防亡阴，禁通利小便以防亡津液。" + }, + { + "question_num": 69, + "query": "以神情痴呆，健忘恍惚，两足痿软，动作迟缓，舌淡，脉弱为临床表现的证候是", + "options": { + "A": "心肾不交", + "B": "肾气不固", + "C": "痰蒙心神", + "D": "胆郁痰扰", + "E": "肾精不足" + }, + "answer": "E", + "reason": "肾精不��证:小儿生长发育迟缓一一五迟五软;生殖功能低下一一月经不调、闭经或阳痿精少;成人早衰一一发落齿摇，须发早白，健忘恍惚，申请呆钝，两足萎软，动作迟缓,舌淡，脉弱。" + }, + { + "question_num": 70, + "query": "阴痒肝肾阴虚证的治法是", + "options": { + "A": "滋补肝肾，祛热利湿", + "B": "滋补肝肾，养精益血", + "C": "滋肾益血，清利湿热", + "D": "滋阴补肾，清肝止痒", + "E": "补血益精，活血舒肝" + }, + "answer": "D", + "reason": "阴痒肝肾阴虚证治宜滋阴补肾，清肝止痒。" + }, + { + "question_num": 71, + "query": "下列各项，与心悸并见对诊断心肾阳虚证最有意义的是", + "options": { + "A": "肢体浮肿，畏寒神疲", + "B": "胸闷气喘，唇颊青紫", + "C": "舌质紫青，脉象细涩", + "D": "失眠多梦，面色淡白", + "E": "胸闷气短，腰膝酸软" + }, + "answer": "A", + "reason": "心肾阳虚证:心阳虚证(心悸怔仲)+肾阳虚证(腰膝酸软,水肿)+虚寒证(畏寒肢冷),舌淡紫,苔白滑脉弱。" + }, + { + "question_num": 72, + "query": "按体重公式计算，2周岁幼儿的体重约为", + "options": { + "A": "8kg", + "B": "9kg", + "C": "10kg", + "D": "11kg", + "E": "12kg" + }, + "answer": "E", + "reason": "1~12岁儿童体重(kg)=8十2×年龄。" + }, + { + "question_num": 73, + "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": "升麻和菊花的共同功效是疏散风热、清热解毒。" + }, + { + "question_num": 74, + "query": "小儿惊痫多呈现的面色是", + "options": { + "A": "白", + "B": "红", + "C": "黄", + "D": "青", + "E": "黑" + }, + "answer": "D", + "reason": "小儿面呈青色,多为寒证、痛证、瘀证、惊痫。" + }, + { + "question_num": 75, + "query": "下列选项不属于栀子主治的是", + "options": { + "A": "血淋涩痛", + "B": "骨蒸潮热", + "C": "火毒疮疡", + "D": "湿热黄疸", + "E": "血热吐血" + }, + "answer": "B", + "reason": "栀子主治:火毒疮疡，血淋涩痛,湿热黄疸,血热吐血。但不能清退虚热、治疗骨蒸。" + }, + { + "question_num": 76, + "query": "胎黄湿热郁蒸证面目皮肤发黄特点是", + "options": { + "A": "色泽萎黄", + "B": "色泽晦暗", + "C": "色泽鲜明如橘", + "D": "色泽淡黄无泽", + "E": "色泽深黄无泽" + }, + "answer": "C", + "reason": "胎黄湿热郁蒸证见色泽鲜明如橘，属阳黄;胎黄寒湿阻遏证见色泽晦暗。" + }, + { + "question_num": 77, + "query": "下列选项是砂仁的主治的是", + "options": { + "A": "化湿解表，健脾宁心", + "B": "燥湿健脾，祛风明目", + "C": "燥湿消痞，下气除满", + "D": "化湿行气，温中止泻", + "E": "燥湿温中，除痞截疟" + }, + "answer": "D", + "reason": "砂仁功效是化湿行气,温中止泻,安胎。" + }, + { + "question_num": 78, + "query": "咳嗽痰多，色黄稠黏，难以咳出，喉中痰鸣的证候是", + "options": { + "A": "风寒咳嗽", + "B": "风热咳嗽", + "C": "痰热咳嗽", + "D": "痰湿咳嗽", + "E": "气虚咳嗽" + }, + "answer": "C", + "reason": "痰热咳嗽表现为咳嗽痰多,色黄稠黏难以咳出,喉中痰鸣。" + }, + { + "question_num": 79, + "query": "治疗脾虚泄泻，应首选的药物是", + "options": { + "A": "泽泻", + "B": "猪苓", + "C": "滑石", + "D": "海金沙", + "E": "薏苡仁" + }, + "answer": "E", + "reason": "能够健脾止泻的只有薏苡仁,其余四药不具健脾之功。" + }, + { + "question_num": 80, + "query": "哮喘痰热阻肺证的治法是", + "options": { + "A": "温肺散寒，化痰定喘", + "B": "清热宣肺，止咳化痰", + "C": "清肺涤痰，止咳平喘", + "D": "解表清里，定喘止咳", + "E": "泻肺补肾，标本兼顾" + }, + "answer": "C", + "reason": "哮喘痰热阻肺证，治宜清肺涤痰，止咳平喘。代表方:麻杏石甘汤合苏葶丸。" + }, + { + "question_num": 81, + "query": "治疗亡阳证，寒饮喘咳，应首选的药物是", + "options": { + "A": "附子", + "B": "干姜", + "C": "肉桂", + "D": "吴茱萸", + "E": "小茴香" + }, + "answer": "B", + "reason": "千姜回阳通脉,温肺化饮。" + }, + { + "question_num": 82, + "query": "小儿泄泻的好发年龄是", + "options": { + "A": "2周岁以内", + "B": "2周岁～3周岁", + "C": "4周岁～6周岁", + "D": "7周岁���9周岁", + "E": "9周岁以上" + }, + "answer": "A", + "reason": "小儿泄泻以夏秋季节发病率为高，不同季节发生的泄泻，证候表现有所不同。2岁以下小儿发病率高。" + }, + { + "question_num": 83, + "query": "治疗肝郁气滞证、久疟瘩块，应首选的药物是", + "options": { + "A": "陈皮", + "B": "木香", + "C": "枳实", + "D": "青皮", + "E": "乌药" + }, + "answer": "D", + "reason": "青皮主治肝郁气滞证、气滞脘腹疼痛、食积腹痛、癥瘕积聚,久疟痞块。" + }, + { + "question_num": 84, + "query": "不属脾虚泄泻粪便特点的是", + "options": { + "A": "大便稀溏", + "B": "大便色淡", + "C": "臭味不甚", + "D": "食后作泻", + "E": "大便中多黏液" + }, + "answer": "E", + "reason": "脾虚泄泻证见大便稀溏,色淡不臭，多于食后作泻，时轻时重，面色萎黄，形体消瘦，神疲倦怠，舌淡苔白，脉缓弱，指纹淡。治宜健脾益气，助运止泻。" + }, + { + "question_num": 85, + "query": "治疗食积气滞、咳喘痰多，应首选的药物是", + "options": { + "A": "山楂", + "B": "神曲", + "C": "麦芽", + "D": "莱菔子", + "E": "鸡内金" + }, + "answer": "D", + "reason": "消食药中菜菔子能行气化妆。" + }, + { + "question_num": 86, + "query": "不属惊风四证的是", + "options": { + "A": "痰", + "B": "瘀", + "C": "热", + "D": "惊", + "E": "风" + }, + "answer": "B", + "reason": "急惊风四证:痰、热、惊、风。" + }, + { + "question_num": 87, + "query": "治疗瘀血证、肠痈、咳嗽气喘，应首选的药物是", + "options": { + "A": "丹参", + "B": "桃仁", + "C": "川芎", + "D": "益母草", + "E": "延胡索" + }, + "answer": "B", + "reason": "桃仁活血散淤，止咳平喘，润肠通便。" + }, + { + "question_num": 88, + "query": "丹痧疹后阴伤证的治法是", + "options": { + "A": "辛凉宣透，清热利咽", + "B": "养阴清热，宣肺止咳", + "C": "清气凉营，泻火解毒", + "D": "益气养阴，润肺止咳", + "E": "养阴生津，清热润喉" + }, + "answer": "E", + "reason": "丹痧疹后阴伤证治宜养阴生津,清热润喉。主方:沙参麦冬汤。" + }, + { + "question_num": 89, + "query": "治疗咳嗽、头虱应首选的药物是", + "options": { + "A": "百部", + "B": "紫菀", + "C": "苦杏仁", + "D": "桑白皮", + "E": "葶苈子" + }, + "answer": "A", + "reason": "百部能够止咳杀虫,其余四药虽能止咳,但不能杀虫。" + }, + { + "question_num": 90, + "query": "治疗痄腮热毒壅盛证应首选的方剂是", + "options": { + "A": "银翘散", + "B": "清瘟败毒散", + "C": "柴胡葛根汤", + "D": "龙胆泻肝汤", + "E": "普济消毒饮" + }, + "answer": "E", + "reason": "痄腮热毒壅盛证治宜清热解毒，软坚散结。首选方剂应为普济消毒饮。" + }, + { + "question_num": 91, + "query": "具有利气散结、通络止痛功效的药物是", + "options": { + "A": "川贝母", + "B": "天南星", + "C": "白芥子", + "D": "天竺黄", + "E": "桑白皮" + }, + "answer": "C", + "reason": "白芥子温肺化饮、利气散结、通络止痛,普治皮里膜外之痰。" + }, + { + "question_num": 92, + "query": "肩髃穴归属的筋脉是", + "options": { + "A": "手阳明大肠经", + "B": "手太阴肺经", + "C": "手太阳小肠经", + "D": "手少阳三焦经", + "E": "手厥阴心包经" + }, + "answer": "A", + "reason": "肩髃穴位于肩峰端下缘,当肩峰与肱骨大结节之间，三角肌上部中央。属手阳明大肠经。" + }, + { + "question_num": 93, + "query": "琥珀具有的功效是", + "options": { + "A": "养血安神", + "B": "润肠通便", + "C": "收敛固涩", + "D": "平肝潜阳", + "E": "活血散瘀" + }, + "answer": "E", + "reason": "琥珀能够镇心安神、活血散瘀、利尿通淋。" + }, + { + "question_num": 94, + "query": "脐下4寸，前正中线旁开2寸是", + "options": { + "A": "水道", + "B": "归来", + "C": "梁门", + "D": "天枢", + "E": "大横" + }, + "answer": "B", + "reason": "归来穴定位脐中下4寸,前正中线旁开2寸。" + }, + { + "question_num": 95, + "query": "治疗心神不安、惊悸失眠、应首选的药物是", + "options": { + "A": "刺蒺藜", + "B": "石决明", + "C": "羚羊角", + "D": "钩藤", + "E": "牡蛎" + }, + "answer": "E", + "reason": "五药都能入肝经,平肝或镇肝,但牡蛎能够镇静安神。" + }, + { + "question_num": 96, + "query": "��太阳小肠经的郄穴是", + "options": { + "A": "会宗", + "B": "梁丘", + "C": "养老", + "D": "阳交", + "E": "金门" + }, + "answer": "C", + "reason": "养老为手太阳小肠经郑穴:会宗为手少阳三焦都穴;梁丘为足阳明胃经郑穴;阳交为阳维脉郑穴经;金门为足太阳膀胱经郄穴。" + }, + { + "question_num": 97, + "query": "治疗血瘀经闭、癥瘕、应首选的药物是", + "options": { + "A": "酸枣仁", + "B": "石菖蒲", + "C": "僵蚕", + "D": "麝香", + "E": "冰片" + }, + "answer": "D", + "reason": "开窍药中能活血化瘀的是麝香,外科跌打损伤、妇人育血经闭都可使用。" + }, + { + "question_num": 98, + "query": "既能治疗肠胃病，又能治疗妇科病的腧穴是", + "options": { + "A": "归来", + "B": "足三里", + "C": "丰隆", + "D": "天枢", + "E": "内庭" + }, + "answer": "D", + "reason": "天枢,大肠之募穴,定位:脐中旁开2寸。主治:腹痛、腹胀、便秘、泄泻、痢疾等肠胃病证;月经不调、病经等妇科疾患。" + }, + { + "question_num": 99, + "query": "治疗四肢拘挛疼痛，应首选的药物是", + "options": { + "A": "人参", + "B": "当归", + "C": "白芍", + "D": "阿胶", + "E": "黄芪" + }, + "answer": "C", + "reason": "白芍配甘草善治四肢拘挛。" + }, + { + "question_num": 100, + "query": "听宫穴的定位是", + "options": { + "A": "在面部，耳屏上切迹与下颌骨髁突之间的凹陷中", + "B": "在面部，耳屏间切迹与下颌骨髁突之间的凹陷中", + "C": "在面部，耳屏正中与下颌切迹之间的凹陷中", + "D": "在面部，颧弓下缘中央与下颌切迹之间的凹陷中", + "E": "在面部，下颌角前上方一横指，按之凹陷中" + }, + "answer": "C", + "reason": "在面部,耳屏正中与下颌骨髁突之间的凹陷中为听宫。在面部，耳屏间切迹与下颌骨髁突之间的凹陷中为听会。" + }, + { + "question_num": 101, + "query": "具有敛肺止咳功效的药物是", + "options": { + "A": "肉豆蔻", + "B": "赤石脂", + "C": "乌梅", + "D": "莲子", + "E": "芡实" + }, + "answer": "C", + "reason": "乌梅能够敛肺止咳,涩肠止泻,安蛔止痛,生津止渴。" + }, + { + "question_num": 102, + "query": "治疗目赤肿痛，除睛明、风池、太阳外，还应选取的主穴是", + "options": { + "A": "少商、外关", + "B": "合谷、太冲", + "C": "行间、侠溪", + "D": "内庭、足临泣", + "E": "关冲、商阳" + }, + "answer": "B", + "reason": "合谷是关穴之一,善治面口疾患。太冲穴是足厥阴肝经输穴、原穴，肝开窍于目，所以太冲穴能够治疗头痛、眩晕、耳鸣、目赤肿痛、口眼喎斜、咽痛等肝经风热病证。" + }, + { + "question_num": 103, + "query": "下列各项，不属麻黄汤功效的是", + "options": { + "A": "解表", + "B": "发汗", + "C": "解肌", + "D": "平喘", + "E": "直肺" + }, + "answer": "C", + "reason": "麻黄汤由麻黄、桂枝、杏仁、炙甘草组成。功用为发汗解表,宣肺平喘。能够解肌的是桂枝汤。" + }, + { + "question_num": 104, + "query": "具有温胃止呕，散寒止痛作用的灸法是", + "options": { + "A": "隔姜灸", + "B": "隔蒜灸", + "C": "隔盐灸", + "D": "隔附子灸", + "E": "无瘢痕灸" + }, + "answer": "A", + "reason": "隔姜灸有解表散寒、温胃止呕的作用。" + }, + { + "question_num": 105, + "query": "下列各项，可增强银翘散辛散透表之功的是", + "options": { + "A": "薄荷", + "B": "牛蒡子", + "C": "连翘", + "D": "荆芥", + "E": "竹叶" + }, + "answer": "D", + "reason": "荆芥穗、淡豆豉辛温发散，开皮毛而逐邪,有助于辛散透表,又不悖辛凉之旨。" + }, + { + "question_num": 106, + "query": "下列各项中，属本经配穴法的是", + "options": { + "A": "太阳头痛取后溪、昆仑", + "B": "失眠取神门、太溪", + "C": "牙痛取颊车、内庭", + "D": "感冒咽痛取曲池、少商", + "E": "肝病取太冲、阳陵泉" + }, + "answer": "C", + "reason": "后溪属手太阳,昆仑属足太阳;神门属手少阴，太溪属足少阴;颊车、内庭均属足阳明;曲池属手阳明,少商属手太阴;太冲属足厥阴，阳陵泉属足少阳。符合本经配穴法的只有C项。" + }, + { + "question_num": 107, + "query": "药物组成中含有柴胡和人参的方剂是", + "options": { + "A": "小柴胡汤", + "B": "半夏泻心汤", + "C": "大柴胡汤", + "D": "四逆散", + "E": "柴胡疏肝散" + }, + "answer": "A", + "reason": "小��胡汤组成药物:柴胡、黄岑、半夏、人参、炙甘草、生姜、大枣。" + }, + { + "question_num": 108, + "query": "治疗厥阴头痛，应选取的配穴是", + "options": { + "A": "印堂、攒竹、合谷", + "B": "率谷、外关、足临泣", + "C": "天柱、后溪、申脉", + "D": "太冲、内关、四神聪", + "E": "血海、膈俞、内关" + }, + "answer": "D", + "reason": "阳明头痛者,加印堂、攒竹、合谷、内庭;少阳头痛者,加率谷、外关、足临泣;太阳头痛者,加天柱、后溪、申脉;厥阴头痛者;加四神聪、太冲、内关。" + }, + { + "question_num": 109, + "query": "主治壮热面赤、汗出恶热的首选方剂是", + "options": { + "A": "竹叶石膏汤", + "B": "犀角地黄汤", + "C": "黄连解毒汤", + "D": "白虎汤", + "E": "清营汤" + }, + "answer": "D", + "reason": "壮热面赤,汗出恶热,表明气分热盛,首选白虎汤(四大证)。" + }, + { + "question_num": 110, + "query": "中风中经络出现语言謇涩，治疗除主穴外，还应选取的配穴是", + "options": { + "A": "金津、玉液", + "B": "合谷、太冲", + "C": "悬钟、太冲", + "D": "合谷、颊车", + "E": "通里、哑门" + }, + "answer": "E", + "reason": "语言謇涩配廉泉、通里、哑门。" + }, + { + "question_num": 111, + "query": "小建中汤组成含有的药物是", + "options": { + "A": "人参，桂枝", + "B": "甘草，干姜", + "C": "生姜，桂枝", + "D": "白术，芍药", + "E": "大枣，人参" + }, + "answer": "C", + "reason": "小建中汤是桂枝汤倍芍药、加饴糖组成的,方中含有桂枝、白芍、生美、饴糖,大枣。" + }, + { + "question_num": 112, + "query": "哮喘实证，治疗除肺俞、中府、定喘外，还应选取的主穴是", + "options": { + "A": "列缺、尺泽", + "B": "风门、合谷", + "C": "丰隆、曲池", + "D": "天突、外关", + "E": "曲池、大椎" + }, + "answer": "A", + "reason": "列缺为手太阴肺经络穴，尺泽为手太阴肺经合穴，均主治咳嗽、气喘、咽喉肿痛等肺系病证。" + }, + { + "question_num": 113, + "query": "炙甘草汤中具有补血作用的药物是", + "options": { + "A": "熟地黄", + "B": "白芍", + "C": "龙眼肉", + "D": "当归", + "E": "阿胶" + }, + "answer": "E", + "reason": "炙甘草汤组成药物:炙甘草、生姜、人参、生地黄、桂枝、阿胶、麦门冬、麻仁,大枣(清酒)。功用:益气补血,滋阴复脉。方中生地黄、麦门冬、阿胶、麻仁滋阴补血，养心充脉。" + }, + { + "question_num": 114, + "query": "治疗呕吐热邪内蕴者，宜点刺出血的是", + "options": { + "A": "金津、玉液", + "B": "中脘、关元", + "C": "厉兑、内庭", + "D": "公孙、合谷", + "E": "厉兑、商阳" + }, + "answer": "A", + "reason": "呕吐寒气客胃或脾胃虚寒者宜配合灸法，热邪内蕴者选金津、玉液点刺出血。" + }, + { + "question_num": 115, + "query": "朱砂安神丸组成中不含有的药物是", + "options": { + "A": "黄连", + "B": "生地黄", + "C": "白芍", + "D": "当归", + "E": "甘草" + }, + "answer": "C", + "reason": "朱砂安神丸组成药物:朱砂、黄连、炙甘草、生地黄、当归。" + }, + { + "question_num": 116, + "query": "治疗瘾疹可采用拔罐法，常用的腧穴是", + "options": { + "A": "血海", + "B": "膈俞", + "C": "神阙", + "D": "风门", + "E": "大椎" + }, + "answer": "C", + "reason": "瘾疹可宜用拔罐法,取神阙穴，用大号玻璃罐，先留罐5分钟,起罐后再拔罐5分钟,如此反复三次。" + }, + { + "question_num": 117, + "query": "具有行气散结、降逆化痰功用的方剂是", + "options": { + "A": "定喘汤", + "B": "瓜蒌薤白白酒汤", + "C": "半夏厚朴汤", + "D": "苏子降气汤", + "E": "柴胡疏肝散" + }, + "answer": "C", + "reason": "半夏厚朴汤由半夏、厚朴、茯苓、生姜、苏叶组成。功用:行气散结,降逆化痰,主治痰气交阻的梅核气。" + }, + { + "question_num": 118, + "query": "治疗血热型崩漏，除了选用关元、隐白穴外，还应该选取的穴位是", + "options": { + "A": "肾俞、血海、膈俞", + "B": "然谷、地机、太冲", + "C": "中极、血海、三阴交", + "D": "血海、胃俞、脾俞", + "E": "气海、肾俞、三阴交" + }, + "answer": "C", + "reason": "崩漏实证选穴,主穴:关元、三阴交、隐白。配穴:血热配中极、血海;血瘀配血海、膈俞;湿热配中极、阴陵泉;气郁配膻中、太冲。" + }, + { + "question_num": 119, + "query": "藿香正气���组成中含有的药物是", + "options": { + "A": "白术，陈皮", + "B": "苍术，半夏", + "C": "大腹皮，人参", + "D": "桔梗，山药", + "E": "猪苓，白芷" + }, + "answer": "A", + "reason": "藿香正气散组成药物:大腹皮、白芷、紫苏、茯苓、半夏曲、白术、陈皮、厚朴、桔梗、藿香、甘草、生姜、大枣。功用:解表化湿,理气和中。" + }, + { + "question_num": 120, + "query": "可治疗小儿惊风的腧穴是", + "options": { + "A": "悬钟", + "B": "风疹", + "C": "阳陵泉", + "D": "环跳", + "E": "足临泣" + }, + "answer": "C", + "reason": "尺泽、涌泉、中冲、阳陵泉、太冲、大椎、印堂可治疗小儿惊风的腧穴。" + }, + { + "question_num": 121, + "query": "药物组成中含有白术、茯苓的方剂是", + "options": { + "A": "五苓散", + "B": "补中益气汤", + "C": "小建中汤", + "D": "真人养脏汤", + "E": "猪苓汤" + }, + "answer": "A", + "reason": "五苓散组成药物:猪苓、泽泻、白术、茯苓、桂枝。" + }, + { + "question_num": 122, + "query": "尿路感染最常见的致病菌是", + "options": { + "A": "副大肠埃希菌", + "B": "大肠埃希菌", + "C": "粪链球菌", + "D": "变形杆菌", + "E": "克雷白杆菌" + }, + "answer": "B", + "reason": "尿路感染95%以上是由单一细菌引起的，其中，90%的门诊患者和50%左右的住院患者，其病原菌是大肠埃希菌。" + }, + { + "question_num": 123, + "query": "具有温肺化饮功用的方剂是", + "options": { + "A": "半夏白术天麻汤", + "B": "苏子降气汤", + "C": "半夏厚朴汤", + "D": "苓甘五味姜辛汤", + "E": "二陈汤" + }, + "answer": "D", + "reason": "苓甘五味姜辛汤组成药物，茯苓、甘草、干姜、细辛、五味子。功用:温肺化饮。" + }, + { + "question_num": 124, + "query": "原发性支气管肺癌对化疗最敏感的病理类型是", + "options": { + "A": "腺癌", + "B": "类癌", + "C": "鳞状上皮细胞癌", + "D": "大细胞癌", + "E": "小细胞肺癌" + }, + "answer": "E", + "reason": "小细胞未分化癌(简称小细胞癌)多发于肺门附近的大支气管，倾向于黏膜下层生长,常侵犯管外肺实质，易与肺门、纵隔淋巴结融合成团块。癌细胞生长快，侵袭力强，远处转移早，手术时发现60%~100%血管受侵犯，尸检证明80%~100%有淋巴结转移，常转移至脑、肝、骨、肾上腺等脏器。本型对放疗和化疗比较敏感。" + }, + { + "question_num": 125, + "query": "乌梅丸可出现的临床表现是", + "options": { + "A": "久泻久痢", + "B": "渴欲饮冷", + "C": "赤多白少", + "D": "里急后重", + "E": "肛门灼热" + }, + "answer": "A", + "reason": "乌梅丸主脏寒蛔厥证,亦可治久痢、久泻。" + }, + { + "question_num": 126, + "query": "可反应类风湿关节炎活动性及严重性的实验室检查是", + "options": { + "A": "C反应蛋白检测", + "B": "血液一般检查", + "C": "类风湿因子测定", + "D": "抗核抗体测定", + "E": "免疫蛋白抗体测定" + }, + "answer": "C", + "reason": "类风湿关节炎患者血沉和C反应蛋白(CRP)常升高，但仅和疾病的活动度相关。而类风湿因子滴度一般与类风湿关节炎的活动性和严重性呈比例。" + }, + { + "question_num": 127, + "query": "下列各项，不属消法适应证的是", + "options": { + "A": "行气", + "B": "活血", + "C": "止血", + "D": "化痰", + "E": "利水" + }, + "answer": "C", + "reason": "消法是授过消食导滞、软坚散结,全体内气、血、痰、水、食、虫等积聚而成的有形实结缓消渐散的一种治疗方闫,并不包括止血。" + }, + { + "question_num": 128, + "query": "急性心肌梗死发病早期伴急性左心衰竭时，应慎用药物是", + "options": { + "A": "毛花苷C", + "B": "吗啡", + "C": "呋塞米", + "D": "硝酸甘油", + "E": "多巴胺丁酸" + }, + "answer": "A", + "reason": "急性心肌梗死早期,应用普萘洛尔或美托洛尔可减轻心脏负荷。若合并心力衰竭，以应用吗啡(或哌替啶)和利尿剂为主，也可应用血管扩张剂。梗死后24小时尽量避免使用洋地黄制剂。右心室梗死患者应慎用利尿剂。" + }, + { + "question_num": 129, + "query": "下列各项，不属于清燥救肺汤的组成药物是", + "options": { + "A": "石膏", + "B": "石斛", + "C": "桑叶", + "D": "阿胶", + "E": "人参" + }, + "answer": "B", + "reason": "清燥救肺汤组成药物:桑叶、石膏、人参、甘草、胡麻仁、阿胶、麦门冬、杏仁、枇杷叶。���包括石斛。" + }, + { + "question_num": 130, + "query": "增加外周组织对胰岛素的敏感性、减轻胰岛素抵抗的降糖药是", + "options": { + "A": "二甲双胍", + "B": "格列苯脲", + "C": "阿卡波糖", + "D": "吡格列酮", + "E": "瑞格列奈" + }, + "answer": "D", + "reason": "噻唑烷二酮类药物(TZDs):降糖作用主要提高胰岛素的敏感性，减轻胰岛素抵抗，降糖效果良好，不增加胰岛素的分泌，保护胰岛β细胞，另外还具有调脂作用，用于2型糖尿病。常用的药物有罗格列酮和吡格列酮。" + }, + { + "question_num": 131, + "query": "下列各项，可出现间歇热的是", + "options": { + "A": "肺炎链球菌肺炎", + "B": "肺结核", + "C": "伤寒", + "D": "疟疾", + "E": "风湿热" + }, + "answer": "D", + "reason": "疟疾、肾盂肾炎可出现间歇热。肺炎链球菌肺炎、伤案见稽留热;肺结核、风湿热见不规则热，" + }, + { + "question_num": 132, + "query": "慢性左心衰竭最早出现的症状是", + "options": { + "A": "咳嗽、咳痰、咳血", + "B": "夜间阵发性呼吸困难", + "C": "劳力性呼吸困难", + "D": "端坐呼吸", + "E": "心悸、乏力" + }, + "answer": "C", + "reason": "劳力性呼吸困难可为慢性左心衰竭首发症状(最早出现)。" + }, + { + "question_num": 133, + "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": "正常双侧上肢血压差别达5～10mmHg,下肢较上肢高20～40mmHg。" + }, + { + "question_num": 134, + "query": "完全性脑卒中发病后达到最高峰的时间一般是", + "options": { + "A": "＜2小时", + "B": "＜6小时", + "C": "＜12小时", + "D": "＜24小时", + "E": "＜36小时" + }, + "answer": "B", + "reason": "完全性卒中发病后常有完全性瘫痪及昏迷，于数小时内(<6小时)达到高峰。" + }, + { + "question_num": 135, + "query": "我国最常见的咯血原因是", + "options": { + "A": "支气管肺癌", + "B": "肺结核", + "C": "支气管炎", + "D": "支气管扩张症", + "E": "肺炎" + }, + "answer": "B", + "reason": "咳血一般多见于肺部,支气管和心血管疾患,我国最常见的咳血原因是肺结核。" + }, + { + "question_num": 136, + "query": "下列各型肝炎病毒，属脱氧核糖核酸(DNA)病毒的是", + "options": { + "A": "甲型", + "B": "乙型", + "C": "丙型", + "D": "丁型", + "E": "戊型" + }, + "answer": "B", + "reason": "肝炎病毒中属DNA的只有乙肝。" + }, + { + "question_num": 137, + "query": "下列各项，可出现黏液性水肿面容的是", + "options": { + "A": "破伤风", + "B": "恶性肿瘤", + "C": "库欣综合征", + "D": "伤寒", + "E": "甲状腺功能减退" + }, + "answer": "E", + "reason": "内分泌源性水肿多见于甲状腺功能减退、垂体前叶功能减退症等黏液性水肿。" + }, + { + "question_num": 138, + "query": "可经母婴途径传播的疾病是", + "options": { + "A": "细菌性痢疾", + "B": "流行性脑脊髓炎", + "C": "霍乱", + "D": "艾滋病", + "E": "伤寒" + }, + "answer": "D", + "reason": "可经母婴途径传播的疾病:乙型病毒性肝炎、丙型病毒性肝炎、丁型病毒性肝炎、流行性出血热、艾滋病。" + }, + { + "question_num": 139, + "query": "腹痛伴有呕吐、腹胀、停止排便排气的疾病是", + "options": { + "A": "肠梗阻", + "B": "急性菌痢", + "C": "急性胆囊炎", + "D": "结核性腹膜炎", + "E": "急性腹腔内出血" + }, + "answer": "A", + "reason": "痛、呕、胀、闭提示肠梗阻。" + }, + { + "question_num": 140, + "query": "判断重型肝炎预后的敏感指标是", + "options": { + "A": "丙氨酸氨基转移酶", + "B": "天门冬氨酸氨基转移酶", + "C": "乳酸脱氢酶", + "D": "碱性硝酸酶", + "E": "凝血酶原活动度" + }, + "answer": "E", + "reason": "凝血酶原活动度PTA≤40%为肝细胞大量坏死的肯定界限，为重型肝炎诊断及判断预后的重要指标。" + }, + { + "question_num": 141, + "query": "可引起高度脾大的疾病是", + "options": { + "A": "慢性粒细胞性白血病", + "B": "系统性红斑狼疮", + "C": "败血症", + "D": "慢性肝炎", + "E": "肝硬化" + }, + "answer": "A", + "reason": "高度脾大,表面光滑者见于慢性粒细胞性白血病，慢性疟疾和骨髓纤维化。" + }, + { + "question_num": 142, + "query": "下列关于人感染��致病性禽流感的叙述，错误的是", + "options": { + "A": "传染源主要为病禽", + "B": "传播途径主要经呼吸道", + "C": "人类普遍缺乏免疫力", + "D": "夏季发病少", + "E": "爆发流行多在秋季" + }, + "answer": "E", + "reason": "人感染高致病性禽流发病季节：禽流感一年四季均可发生,但冬、春季节多暴发流行，夏季发病较少，呈散发，症状也较轻。" + }, + { + "question_num": 143, + "query": "下列各项，可引起心尖搏动增强的是", + "options": { + "A": "心包积液", + "B": "甲状腺功能亢进症", + "C": "心肌炎", + "D": "左侧气胸", + "E": "左侧胸腔积液" + }, + "answer": "B", + "reason": "病理情况下,如发热.严重贫血、甲状腺功能亢进、左心室肥大时,心尖搏动增强。心肌炎、重度心力衰竭时,心尖搏动可减弱并弥散。心包积液、左侧气胸、胸腔积液或肺气肿时,心脏与前胸壁的距离增加，心尖持动常减弱,甚至消失。" + }, + { + "question_num": 144, + "query": "下列各项，不属流感治疗原则的是", + "options": { + "A": "隔离患者", + "B": "及早应用抗流感病毒药物", + "C": "加强支持治疗和防治并发症", + "D": "合理应用对症治疗药物", + "E": "常规应用抗生素" + }, + "answer": "E", + "reason": "流感属病毒感染,抗生素并不能发挥治疗作用。" + }, + { + "question_num": 145, + "query": "中腹壁反射的反射中枢位于", + "options": { + "A": "胸椎7~8节段", + "B": "胸椎9~10节段", + "C": "胸椎11~12节段", + "D": "腰椎1~2节段", + "E": "腰椎3~4节段" + }, + "answer": "B", + "reason": "浅反射中枢:上腹壁反射胸7~8节段,中腹壁反射胸9～10节段,下腹壁反射胸11～12节段,提睾反射腰1～2节段。" + }, + { + "question_num": 146, + "query": "下列关于流行性出血热少尿期治疗原则的叙述，错误的是", + "options": { + "A": "稳定内环境", + "B": "扩充血容量", + "C": "促进利尿", + "D": "放血疗法", + "E": "透析疗法" + }, + "answer": "B", + "reason": "流行性出血热少尿期,防治肾衰竭及其并发症是此期治疗的关键:①稳定内环境平衡，严格限制入液量，注意维持水、电解质和酸碱平衡;②促进利尿;③导泻疗法，常用甘露醇粉或中药大黄、芒硝等(重度恶心、呕吐、消化道大出血者禁用);④透析疗法，有明显氮质血症、高血钾或高血容量综合征时可进行血液或腹膜透析。" + }, + { + "question_num": 147, + "query": "下列贫血原因中，属红细胞破坏过多的是", + "options": { + "A": "阵发性睡眠性血红蛋白尿", + "B": "慢性感染", + "C": "恶性肿瘤", + "D": "巨幼细胞性贫血", + "E": "上消化道出血" + }, + "answer": "A", + "reason": "红细胞减少原因中破坏过多多见于溶血性贫血,包括异常血红蛋白病、阵发性睡眠性血红蛋白尿、珠蛋白生成障碍性贫血、免疫性溶血性贫血、脾功能亢进。" + }, + { + "question_num": 148, + "query": "感染HIV后，临床无明显症状，但血中可检出病毒和抗体，此期的持续时间一般是", + "options": { + "A": "1～2年", + "B": "3～4年", + "C": "4～5年", + "D": "6～8年", + "E": "12～15年" + }, + "answer": "D", + "reason": "该题所述为感染HIV后的无症状感染期，此期病毒处于低水平复制状态，患者无任何临床症状，但血清中可检出病毒及抗体，有传染性，可持续6~8年，长可达15年。" + }, + { + "question_num": 149, + "query": "下列疾病，一般不会引起出血时间延长的是", + "options": { + "A": "维生素C缺乏症", + "B": "血小板无力症", + "C": "血管性血友病", + "D": "缺铁性贫血", + "E": "弥散性血管内凝血" + }, + "answer": "D", + "reason": "缺铁性贫血是由于人体对铁的摄入量不足,影响血红蛋白的合成,使红细胞中血红蛋白的含量显著减少,随之红细胞减少,但自身并不主要是凝血因子缺乏，而是血红蛋白.血清铁减少,ABCE项均能导致出血时间延长。" + }, + { + "question_num": 150, + "query": "下列关于暴发型流脑的叙述，错误的是", + "options": { + "A": "败血症休克型常短期内出现广泛皮肤黏膜瘀斑", + "B": "败血症休克型的特征是循环衰竭", + "C": "败血症休克型患者脑膜刺激征大多缺如", + "D": "脑膜脑炎型患者锥体束征阴性", + "E": "败血症型患者易并发DIC" + }, + "answer": "D", + "reason": "暴发型流脑可分为3型。①败血症休克型:为败血症引起，高热寒战或体温不升,伴严重中毒症状，精神萎靡、烦躁不循坏花晒农现，皮肤���片从饮业冲瘀斑伴中央坏死，并有休克表现，易发生DIC，脑膜刺激征常缺如;②脑膜脑炎型:为脑实质损害，高热、昏迷抽搞,锥体束征阳性，血压持续升高，有脑水肿，可发生脑疝而死亡;③混合型:上二型表现同时或先后出现，治疗困难，病死率常高达80%。" + }, + { + "question_num": 151, + "query": "下列各项，不属“既往史”的内容是", + "options": { + "A": "冶游史", + "B": "手术史", + "C": "预防接种情况", + "D": "传染病史", + "E": "过敏史" + }, + "answer": "A", + "reason": "冶游史属于个人史。" + }, + { + "question_num": 152, + "query": "霍乱治疗的关键环节是", + "options": { + "A": "补液治疗", + "B": "抗菌治疗", + "C": "纠正酸中毒", + "D": "应用血管活性药物", + "E": "抗肠毒素治疗" + }, + "answer": "A", + "reason": "补液治疗指及时适当地补充液体和电解质，是治疗霍乱的关键环节。" + }, + { + "question_num": 153, + "query": "下列各项，一般不会引起血糖升高的是", + "options": { + "A": "肢端肥大症", + "B": "甲状腺功能亢进症", + "C": "急性酒精中毒", + "D": "颅脑外伤", + "E": "急性脑血管病" + }, + "answer": "C", + "reason": "急性酒精中毒血糖降低，而不是升高。" + }, + { + "question_num": 154, + "query": "患者心悸气短，头晕目眩，失眠健忘，面色无华，倦怠乏力，纳呆食少，舌淡红，脉细弱。治疗应首选的方剂是", + "options": { + "A": "安神定志丸", + "B": "归脾汤", + "C": "天王补心丹", + "D": "桂枝甘草龙骨牡蛎汤", + "E": "黄连温胆汤" + }, + "answer": "B", + "reason": "心悸气短伴面色无华,纳呆食少,诊为心血不足证,方选归脾汤。" + }, + { + "question_num": 155, + "query": "酒精性肝病时，血清氨基转移酶的变化是", + "options": { + "A": "ALT和AST均显著增高", + "B": "ALT增高明显，AST基本正常", + "C": "ALT基本正常，AST增高明显", + "D": "ALT和AST均增高不明显", + "E": "ALT/AST>1" + }, + "answer": "C", + "reason": "消精性肝病ALT基本正常,AST增高明显,ALT/AST<1。" + }, + { + "question_num": 156, + "query": "患者突然昏倒扑地，意识不清，牙关紧闭，两目上视，手足抽搐，口吐涎沫，不久渐醒，醒后疲乏无力，舌苔白腻，脉滑，其治法是", + "options": { + "A": "涤痰息风，开窍定痫", + "B": "理气化痰，活血化瘀", + "C": "镇心祛痰，安神定痫", + "D": "清肝泻火，养血安神", + "E": "清肝泻火，化痰开窍" + }, + "answer": "A", + "reason": "依据患者表现,诊为痫病。见两目上视,肝风指征，舌苔白腻,脉滑痰浊之象，辨为风痰闭阻证，治法:涤痰息风，开窍定痛。" + }, + { + "question_num": 157, + "query": "诊断陈旧性心肌梗死的心电图特征是", + "options": { + "A": "坏死型Q波", + "B": "T波倒置", + "C": "ST段水平下降", + "D": "T波高尖", + "E": "ST段抬高与T波融合成单项曲线" + }, + "answer": "A", + "reason": "陈旧性心肌梗死ST段和T波不再变化,遗留坏死型Q波。" + }, + { + "question_num": 158, + "query": "患者胃脘疼痛反复发作，隐痛为主，喜温喜按，劳累、受凉后加重，空腹痛甚，进食后缓解，神疲乏力，四肢倦怠，手足不温，大便溏薄，舌淡苔白，脉虚弱。治疗应首选的方剂是", + "options": { + "A": "藿香正气丸", + "B": "黄芪建中汤", + "C": "芍药甘草汤", + "D": "附子理中丸", + "E": "香砂六君子汤" + }, + "answer": "B", + "reason": "喜温喜按,虚寒之象,诊为胃痛脾胃虚寒证。治法:温中健脾，和胃止痛。代表方:黄芪建中汤加减。" + }, + { + "question_num": 159, + "query": "下列关于胆囊点的叙述，正确的是", + "options": { + "A": "右髂前上棘与脐连线中、外1/3交界处", + "B": "右侧腹直肌外缘与肋弓交界处", + "C": "右侧第10肋骨前端", + "D": "右侧脐水平与腹直肌外缘交界处", + "E": "右侧箭前上棘水平与腹直肌外缘交界处" + }, + "answer": "B", + "reason": "胆囊点位于右侧腹直肌外缘与肋弓交界处。" + }, + { + "question_num": 160, + "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。积与聚的鉴别: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": 161, + "query": "窦性P波的方向应该是", + "options": { + "A": "I、II、aVF、aVR、V1~V6直立", + "B": "I、II、III、V1~V6直立，aVR倒置", + "C": "I、II、aVF、V3~V6直立，aVR倒置", + "D": "II、III、aVF倒置", + "E": "I、II、aVR、V3~V6直立" + }, + "answer": "C", + "reason": "窦性P波I、II、aVF、V3～V6直立,aVR倒置,V1、V2、aVL可以低平.双向或倒置。" + }, + { + "question_num": 162, + "query": "患者，男，63岁。痢下赤白清稀，无腥臭，滑脱不禁，肛门坠胀，腹部隐痛，形寒畏冷，腰膝酸软，舌淡苔薄白，脉沉细。治疗应首选的方剂是", + "options": { + "A": "连理汤合四神丸", + "B": "驻车丸", + "C": "白头翁汤", + "D": "桃花汤合真人养脏汤", + "E": "不换金正气散" + }, + "answer": "D", + "reason": "腹部隐痛,为虚寒之象,结合病症，诊为痢疾，虚寒痢。治法:温补脾肾，收涩固脱。代表方:桃花汤合真人养脏汤加减。" + }, + { + "question_num": 163, + "query": "立位腹部平片可见脂下游离气体影，首先考虑的是", + "options": { + "A": "肺炎", + "B": "急性胃肠穿孔", + "C": "肠炎", + "D": "胰腺炎", + "E": "肠梗阻" + }, + "answer": "B", + "reason": "胃肠道穿孔最常见于胃或十二指肠穿孔,主位X线透视可见两侧膈下弧形或半月形透亮气体影，" + }, + { + "question_num": 164, + "query": "患者突然昏仆，不省人事，目合口开，鼻鼾息微，汗多，大小便自遗，脉微欲绝。治疗应首选的方剂是", + "options": { + "A": "镇肝熄风汤", + "B": "桃仁承气汤", + "C": "羚角钩藤汤合至宝丹", + "D": "涤痰汤", + "E": "参附汤合生脉散" + }, + "answer": "E", + "reason": "根据题干患者可诊为中风脱证(阴竭阳亡)治法:回阳救阴，益气固脱。方药:参附汤合生脉散加味。" + }, + { + "question_num": 165, + "query": "下列各项，不属于人体实验应遵循的道德原则是", + "options": { + "A": "科学性原则", + "B": "医学目的原则", + "C": "知情同意原则", + "D": "生命价值原则", + "E": "维护受试者原则" + }, + "answer": "D", + "reason": "人体实验的四大道德原则：①知情同意原则；②维护病人利益原则；③医学目的原则；④科学对照原则，" + }, + { + "question_num": 166, + "query": "患者水肿反复消长不已，面浮肢肿，腰以下为甚，按之凹陷不起，心悸，气短，腰部冷痛，尿少，四肢冷，舌质淡胖，苔薄白，脉沉细，其证候是", + "options": { + "A": "脾阳虚衰证", + "B": "水湿浸渍证", + "C": "湿毒浸淫证", + "D": "湿热壅盛证", + "E": "肾阳虚衰证" + }, + "answer": "E", + "reason": "患者水肿反复消长不已,面浮肢肿,腰以下为甚,腰部冷痛,肾阳虚之象。" + }, + { + "question_num": 167, + "query": "下列各项，属医患关系基本内容的是", + "options": { + "A": "契约关系与人道主义", + "B": "技术关系和非技术关系", + "C": "技术操作和服务态度", + "D": "技术方面和法律方面", + "E": "法律方面和伦理方面" + }, + "answer": "B", + "reason": "医患关系是医务人员与病人在医疗过程中产生的特定医治关系。内容可分为技本方面的关系和非技术方面的关系两部分。" + }, + { + "question_num": 168, + "query": "患者吐血量多，面色苍白，四肢厥冷，汗出，脉微。治疗首选方是", + "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": "题干所述为气随血脱表现,独参汤益气固脱可治疗元气虚脱，肢冷汗出，脉微细等症。" + }, + { + "question_num": 169, + "query": "医德形成的基础是", + "options": { + "A": "医德认识", + "B": "医德情感", + "C": "医德意志", + "D": "医德信念", + "E": "医德行为" + }, + "answer": "E", + "reason": "医德是在医德行为的基础上产生的。" + }, + { + "question_num": 170, + "query": "患者午后潮热，不欲近衣，手足心热，烦躁，少寐多梦，盗汗，口干咽燥，舌红少苔，脉细数。治法是", + "options": { + "A": "活血化瘀", + "B": "解郁泄热", + "C": "益气养血", + "D": "滋阴清热", + "E": "和中清热" + }, + "answer": "D", + "reason": "手足心热,午后潮热,盗汗均提示内伤发热之阴虚发热。治法:滋阴清热。代表方:清骨散加减。" + }, + { + "question_num": 171, + "query": "根据1948年美国哈佛大学医学��提出的“脑死亡”概念，不能诊断脑死亡的条件是", + "options": { + "A": "自主运动和自主呼吸消失", + "B": "对外部刺激和内部需求毫无自觉和反应", + "C": "体温低于32.2℃或服用中枢抑制药物者", + "D": "脑电波平直或等电位", + "E": "诱导反射消失" + }, + "answer": "C", + "reason": "“脑死亡”诊断标准:①对外部的刺激和内部的需要无接受性、无反应性;②自主的肌肉运动和自主呼吸消失;③诱导反射消失；④脑电波平直或等电位。同时规定，凡符合以上4条标准,持续24小时测定,每次不少于10分钟,反复检查多次结果一致者,就可宣告死亡。" + }, + { + "question_num": 172, + "query": "患者，女，28岁。左乳胀痛10天，局部红、肿、热、痛，中软应指，伴壮热不退，口渴喜饮，舌红苔黄，脉弦数。治疗首选的外治法是", + "options": { + "A": "乳房按摩，并用黄金散外敷", + "B": "切开引流，行弧形切口", + "C": "切开引流、行放射切口", + "D": "切开引流、行十字切口", + "E": "应用砭镰法" + }, + "answer": "C", + "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。切口应按乳络方向，切口位置应选择脓肿稍低的部位，乳房部切口，应以乳头为中心，放射状切开。" + }, + { + "question_num": 173, + "query": "具有高等学校医学专科学历，报考执业助理医师资格考试的，必须在医疗卫生机构中", + "options": { + "A": "参加医学专业工作实践满一年", + "B": "工作满二年", + "C": "工作满三年", + "D": "工作满五年", + "E": "经多年实践，医术确有专长" + }, + "answer": "A", + "reason": "具有高等学校相关医学专业专科以上学历,在执业医师指导下,在医疗卫生机构中参加医学专业工作实践满一年的，可以参加执业助理医师资格考试。" + }, + { + "question_num": 174, + "query": "患者，男，38岁。右侧脚趾发麻，皮肤干燥，毫毛脱落，趾甲增厚变形，呈干性坏疽，口干欲饮，便秘溲赤，舌红苔黄，脉弦细数，其证候是", + "options": { + "A": "血脉瘀阻证", + "B": "湿热壅盛证", + "C": "营血两伤证", + "D": "热毒伤阴证", + "E": "邪毒内陷证" + }, + "answer": "D", + "reason": "口干欲饮,便秘溲赤，结合干性坏疽，诊为脱疽热毒伤阴证。" + }, + { + "question_num": 175, + "query": "对生产、销售假药和劣药在追究法律责任时，法律规定的不同处理形式是", + "options": { + "A": "没收违法生产、销售的药品和违法所得", + "B": "罚款金额", + "C": "吊销许可证", + "D": "追究刑事责任", + "E": "停产，停业整顿" + }, + "answer": "B", + "reason": "生产、销售假药的,没收违法生产、销售的药品和违法所得,并处违法生产、销售药品货值金额十互倍以上三十倍以下的罚款；生产、销售劣药的，没收违法生产、销售的药品和违法所得,并处违法生产、销售药品货值金额十倍以上二十倍以下的罚款。" + }, + { + "question_num": 176, + "query": "患者素有足癣史，1周前左第1、第2趾缝间作痒，糜烂流脓加重，2天前左大趾至小腿内侧出现红丝1条，宽约3mm，色红灼热，边界清楚，压痛明显，并伴有左腹股沟结块疼痛。诊断是", + "options": { + "A": "丹毒", + "B": "烂疔", + "C": "类丹毒", + "D": "红丝疔", + "E": "附骨疽" + }, + "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。可伴恶寒发热等全身症状，邪毒重者者可内攻脏腑，发生走黄。" + }, + { + "question_num": 177, + "query": "属于乙类传染病，依法采取甲类传染病防控措施的是", + "options": { + "A": "艾滋病", + "B": "流行性出血热", + "C": "肺炭疽", + "D": "流行性乙型脑炎", + "E": "疟疾" + }, + "answer": "C", + "reason": "对乙类传米病中采取甲类传染病防控措施的有传染性非典型肺炎、炭疽中的肺炭疽和人感染高致病性禽流感。" + }, + { + "question_num": 178, + "query": "患者项部皮损为多角形皮疹融合成片，剧烈瘙痒，搔抓后皮损增厚，皮沟加深，皮嵴隆起，形成苔藓样变。诊断是", + "options": { + "A": "白疕", + "B": "圆癣", + "C": "白秃疮", + "D": "红蝴蝶疮", + "E": "牛皮癣" + }, + "answer": "E", + "reason": "牛皮癣是一种常见的具有特征性皮损的慢性易于复发的炎症性皮肤病。特点:皮损多呈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，极易形成苔藓化。" + }, + { + "question_num": 179, + "query": "下列各项，不属于全国突发事件应急预案内容的是", + "options": { + "A": "突发事件应急处理技术和监测机构及其任务", + "B": "突发事件应急处理专业队伍的建设和培训", + "C": "突发事件信息的收集、分析、报告、通报制度", + "D": "突发事件的立法规划方案", + "E": "突发事件的分级和应急处理工作方案" + }, + "answer": "D", + "reason": "全国突发事件应和急预案应包括的主要内容:①突发事件应和急处理指挥部的组成和相关部门的职责;②突发事件的监测与预警;③突发事件信息的收集分析、报告、通报制度;④突发事件应急处理技术和监测机构及其任务;⑤突发事件的分级和应和急处理工作方案;⑥突发事件预防、现场控制,应急设施、设备、救治药品和医疗器械以及其他物资和技术的储备与调度；⑦突发事件应急处理专业队伍的建设和培训。" + }, + { + "question_num": 180, + "query": "患者急性子痈2天，恶寒发热，左侧附睾肿大疼痛。疼痛引及子系(精索)，舌红苔黄腻，脉滑数。治疗应首选的方剂是", + "options": { + "A": "透脓散", + "B": "滋阴除湿汤", + "C": "萆薢化毒汤", + "D": "五味消毒饮", + "E": "枸橘汤" + }, + "answer": "E", + "reason": "患者见舌红苔黄腻,脉滑数，湿热之证，诊为湿热下注证。治法:清热利湿，解毒消肿。方药:枸橘汤或龙胆泻肝汤加减。" + }, + { + "question_num": 181, + "query": "患者，男，35岁。先有尿道红肿，轻度刺痛排尿不适，1天后症状加剧，尿道口溢脓，逐渐出现黏稠脓性分泌物，其诊断是", + "options": { + "A": "慢性尿路感染", + "B": "尖锐湿疣", + "C": "慢性淋病", + "D": "急性淋病", + "E": "前列腺炎" + }, + "answer": "D", + "reason": "急性淋病表现为尿道口红肿发痒及轻度刺痛，继而有稀薄黏液流出，引起排尿不适，24小时后症状加剧。排尿开始时尿道外口刺痛或灼热痛，排尿后疼痛减轻。尿道口溢脓，开始为浆液性分泌物，以后逐渐出现黄色黏稠的脓性分泌物。" + }, + { + "question_num": 182, + "query": "患者经血非时而下，出血量时多时少、时出时止已月余，经色紫暗，有血块，小腹疼痛，舌质紫暗，边有瘀点，脉弦涩。治疗应首选的方剂是", + "options": { + "A": "逐瘀止血汤", + "B": "桃红四物汤", + "C": "失笑散", + "D": "少腹逐瘀汤", + "E": "血府逐瘀汤" + }, + "answer": "A", + "reason": "患者经血非时而下诊为崩漏，经色紫暗,有血块，小腹疼病，舌质紫暗，边有瘀点，辨为崩漏血瘀证，治法:活血化瘀，固冲止血。代表方:逐瘀止血汤或将军斩关散。" + }, + { + "question_num": 183, + "query": "患者妊娠70天，阴道少量下血，色鲜红，腰酸，口干心烦，小便黄，大便秘结，舌红，苔黄，脉滑数。治疗应首选的方剂是", + "options": { + "A": "清经散", + "B": "两地汤", + "C": "寿胎丸", + "D": "保阴煎", + "E": "胎元饮" + }, + "answer": "D", + "reason": "结合下血色鲜红或深红,质稠，口苦咽干，心烦不安,便结溺黄，舌红苔黄，脉滑数,辨为胎漏、胎动不安血热证。治法:清热凉血，养血安胎。代表方剂:保阴煎或当归散。" + }, + { + "question_num": 184, + "query": "患者月经每月提前8～9天来潮，量多，色深红，质黏稠，伴心烦，面红口干，小便短黄，大便燥结，舌红，苔黄，脉数，其治法是", + "options": { + "A": "清热凉血调经", + "B": "养阴清热调经", + "C": "舒肝清热调经", + "D": "清热利湿调经", + "E": "补肾固冲调经" + }, + "answer": "A", + "reason": "经期提前,量多，色深红质稠，心胸烦闷,渴喜冷饮，大便燥结，小便短赤面色红赤，舌红，苔黄，脉滑数。诊为阳盛血热。治法:清热凉血调经。代表方:清经散。" + }, + { + "question_num": 185, + "query": "患者怀孕3次，均为自然流产，平素头晕目眩，神疲乏力，心悸气短，舌质淡，苔薄白，脉细弱。治疗首选的方剂是", + "options": { + "A": "泰山磐石散", + "B": "寿胎丸", + "C": "肾气丸", + "D": "安奠二天汤", + "E": "补肾固冲丸" + }, + "answer": "A", + "reason": "根据题干可诊为气血两虚证。治法:益气养血，固冲安胎。代表方:泰山磐石散。" + }, + { + "question_num": 186, + "query": "患者产后32天恶露不止，量多，色淡，神疲倦怠。小腹空坠，舌质淡，脉细弱，其证候是", + "options": { + "A": "血热证", + "B": "气虚证", + "C": "血瘀证", + "D": "湿热��", + "E": "肾虚证" + }, + "answer": "B", + "reason": "患者产后恶露不绝,色淡,神疲倦怠，小腹空坠，为气虚表现。治法:补气摄血固冲。代表方:补中益气汤加艾叶、阿胶、益母草。" + }, + { + "question_num": 187, + "query": "患者孕6月，尿频、尿急、尿痛，尿意不尽，欲解不能，小腹坠胀，胸闷纳少，带下量多黄稠，舌红，苔黄腻，脉弦滑数，其治法是", + "options": { + "A": "滋阴清热，润燥通淋", + "B": "清热泻火，利湿通淋", + "C": "清热利湿，润燥通淋", + "D": "清热利湿，泻火通淋", + "E": "清心泻火，润燥通淋" + }, + "answer": "C", + "reason": "患者孕6月,尿频、尿急、尿痛，诊为妊娠小便淋痛。带下量多黄稠，舌红，苔黄腻，脉弦滑数，辨为湿热下注证。治法:清热利湿,润燥通淋。代表方:加味五苓散。" + }, + { + "question_num": 188, + "query": "患儿，2岁。易发腹泻，现体重9.5kg，面色少华，毛发稀疏，不欲饮食，急躁易怒，大便糖稀，舌淡红，苔薄白，指纹淡红，其诊断是", + "options": { + "A": "厌食，脾胃气虚证", + "B": "积滞，脾虚夹积证", + "C": "疳证，疳气证", + "D": "积证，疳积证", + "E": "疳证，干疳证" + }, + "answer": "C", + "reason": "腹泻引发小儿体重减轻,伴随面色少华，毛发稀疏，不欲饮食，诊为疳证。急躁易怒，大便溏稀，舌淡红，苔薄白，指纹淡红,辨为疳气。" + }, + { + "question_num": 189, + "query": "患儿，5岁。突发脐周剧痛，频繁呕吐，呕吐物中可见1条蛔虫，腹部可扪及柔软可移动团块，大便干结，舌质红，苔黄腻，脉弦数。治疗应首选的方剂是", + "options": { + "A": "乌梅汤", + "B": "使君子汤", + "C": "附子理中汤", + "D": "驱蛔承气汤", + "E": "宣白承气汤" + }, + "answer": "D", + "reason": "脐周剧痛,频繁呕吐,呕吐物中可见1条蛔虫，腹部可扪及柔软可移动团块，诊为虫瘕证。治法:行气通腑，散蛔驱虫。代表方剂:驱蛔承气汤" + }, + { + "question_num": 190, + "query": "患儿，9岁。尿频1天，小便频数短赤，尿急尿痛，尿液淋漓浑浊，小腹坠胀，舌红，苔微腻，脉数有力。治疗应首选的方剂是", + "options": { + "A": "八正散", + "B": "缩泉丸", + "C": "菟丝子散", + "D": "小蓟饮子", + "E": "知柏地黄丸" + }, + "answer": "A", + "reason": "小便频数短赤，尿急尿痛尿液浑浊，小腹坠胀，舌红，舌苔微腻,诊为尿频湿热下注证。治法:清热利湿，通利膀胱。主方:八正散。" + }, + { + "question_num": 191, + "query": "患儿，4岁。发热2天，低热，恶寒，无汗，鼻塞流涕，咳嗽较剧，痰多，痰白较稀，舌红，苔薄白，其治疗在疏风解表的基础上应加用的方剂是", + "options": { + "A": "桑菊饮", + "B": "三拗汤", + "C": "桑杏汤", + "D": "桑白皮汤", + "E": "麻杏石甘汤" + }, + "answer": "B", + "reason": "该患儿为小儿风寒感冒夹痰，用药在疏风解表的基础上加用三拗汤、二陈汤,常用麻黄、杏仁、半夏、陈皮等宣肺化痰。" + }, + { + "question_num": 192, + "query": "患儿，5岁。盗汗明显，伴自汗，形体消瘦，心烦少寐，口干，手足心灼热，舌淡苔花剥，其治法是", + "options": { + "A": "益气固表", + "B": "调和营卫", + "C": "益气养阴", + "D": "清热泻脾", + "E": "养血补心" + }, + "answer": "C", + "reason": "小儿汗证,见盗汗明显,伴自汗，形体消瘦，心烦少寐，口干，手足心灼热舌淡苔花剥，辨为气阴两虚证。治法:益气养阴。" + }, + { + "question_num": 193, + "query": "患儿，4岁。眼睑浮肿，按之凹陷即起，尿少色赤，伴发热咽痛，舌淡苔薄白，脉浮。治疗应首选的方剂是", + "options": { + "A": "银翘散", + "B": "五苓散", + "C": "五皮饮", + "D": "五味消毒饮", + "E": "麻黄连翘赤小豆汤" + }, + "answer": "E", + "reason": "水肿,伴有发热、脉浮,诊为风水相搏证，应首选麻黄连翘赤小豆汤。" + }, + { + "question_num": 194, + "query": "患者头晕目眩，伴颧红目赤，目胀耳鸣，烦躁易怒，口苦，善太息，舌红苔白，脉弦数。治疗除了督脉穴位外，还应该选取的经穴是", + "options": { + "A": "足少阴、足少阳经穴", + "B": "足太阴、足阳明经穴", + "C": "足厥阴、足太阴经穴", + "D": "足厥阴、足少阳经穴", + "E": "足太阴、足太阴经穴" + }, + "answer": "D", + "reason": "该患者应为眩晕肝阳上亢证,除主穴百会、风池、太冲、内关外,配穴行间、侠溪、太溪。行间属足厥阴��经，侠溪足少阳胆，太溪足少阴肾经。实证眩军应平肝潜阳，化痰定眩,取足少阳、足厥阴经穴及督脉穴为主。" + }, + { + "question_num": 195, + "query": "患者月经周期提前10余天，月经量少色淡，伴神疲气短，舌淡，脉细弱。治疗除主穴外，还应选取的配穴是", + "options": { + "A": "脾俞、足三里", + "B": "肾俞、太溪", + "C": "气海、肾俞", + "D": "肾俞、命门", + "E": "太冲、期门" + }, + "answer": "A", + "reason": "月经先期选穴，主穴:关元、三阴交、血海。配穴:实热配行间;虚热配太溪;气虚配足三里、脾俞,月经过多配隐白。" + }, + { + "question_num": 196, + "query": "患者腰痛隐隐，酸多痛少，绵绵不已，腰腿酸软无力，劳则更甚，反复发作，舌淡红，脉细。治疗除主穴外，还应选取的配穴是", + "options": { + "A": "后溪、申脉", + "B": "肾俞、太溪", + "C": "肾俞、腰阳关", + "D": "命门、腰阳关", + "E": "太溪、申脉" + }, + "answer": "B", + "reason": "患者腰痛隐隐,酸多痛少,绵绵不已，腰腿酸软无力，为肾虚表现。肾虚腰痛配肾俞、太溪。" + }, + { + "question_num": 197, + "query": "患者因恼怒而突发昏仆，不省人事，呼吸急促，牙关紧闭，舌淡，苔薄白，脉沉弦。治疗除主穴外，还应该选择的穴位是", + "options": { + "A": "合谷、太冲", + "B": "气海、关元", + "C": "印堂、合谷", + "D": "足三里、照海", + "E": "太溪、照海" + }, + "answer": "A", + "reason": "晕厥处方,主穴:水沟、百会、内关、足三里。配穴;虚证配气海、关元;实证配合谷、太冲。患者呼吸急促，牙关紧闭，舌淡,苔薄白,脉沉弦,病属实证。" + }, + { + "question_num": 198, + "query": "患者因受寒而致颈项疼痛、重着，以项背部疼痛为主，有明显压痛，低头加重，伴恶寒、头痛，舌淡红、苔薄白，脉弦紧。治疗除主穴外，还应选取的配穴是", + "options": { + "A": "申脉、外关", + "B": "肩髃、天宗", + "C": "内关、肩井", + "D": "风池、合谷", + "E": "大椎、束骨" + }, + "answer": "D", + "reason": "落枕处方,主穴:外劳宫、天柱、阿是穴、后溪、悬钟。配穴:病在督脉、太阳经者配大椎、束骨;病在少阳经配风池、肩井。风寒袭络配风池、合谷;气滞血瘀配内关、合谷。肩痛配肩髃;背痛配天宗。患者恶寒，头痛;舌淡红,苔薄白,脉弦紧,属风寒袭络。" + }, + { + "question_num": 199, + "query": "患者恶寒重，发热轻，无汗，鼻塞流涕，喷嚏不断，咳嗽白痰，舌淡红、苔薄白，脉浮紧。治疗除主穴外，还应选取的配穴是", + "options": { + "A": "脾俞、足三里", + "B": "委中、曲泽", + "C": "阴陵泉、外关", + "D": "曲池、尺泽", + "E": "风门、肺俞" + }, + "answer": "E", + "reason": "患者恶寒重,发热轻，无汗,鼻塞流涕,喷嚏不断,咳嗽白痰,舌淡红,苔薄白,脉浮紧,诊为风寒感冒。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;夹湿配阴陵泉;央暑配委中;体虚感冒配足三里;咽喉疼病配少商、商阳。" + }, + { + "question_num": 200, + "query": "患者咽干微肿，疼痛以午后、入夜尤甚，伴手足心热，舌红，少苔，脉细数。治疗应选取的主穴是", + "options": { + "A": "风池、外关、内庭、鱼际", + "B": "少商、合谷、尺泽、天冲", + "C": "太溪、照海、列缺、鱼际", + "D": "少商、商阳、照海、列缺", + "E": "商阳、关冲、照海、太溪" + }, + "answer": "C", + "reason": "患者咽干微肿,疼痛以午后、入夜尤甚，伴手足心热，舌红，少苔，脉细数，为阴虚之象。实证治以清热利咽，消肿止痛，取手太阴、手阳明经穴为主。虚证治以滋阴降火，利咽止痛，取足少阴经穴为主，虚证主穴:太溪、照海、列缺、鱼际。" + }, + { + "question_num": 201, + "query": "患者大便干结，腹胀腹痛，口干口臭，舌红，苔黄燥，脉滑实。治疗首选的主穴是", + "options": { + "A": "天枢、大肠俞、上巨虚、支沟", + "B": "合谷、曲池、天枢、公孙", + "C": "太冲、足三里、中脘、支沟", + "D": "神阙、关元、足三里、中脘", + "E": "公孙、气海、三阴交、内关" + }, + "answer": "A", + "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;冷秘配神阙、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": 202, + "query": "患者左耳听力减退，兼见畏寒，发热，舌红，苔薄，脉浮数。治疗除听会、翳风穴外，还应选取的主穴是", + "options": { + "A": "气海、足三里", + "B": "中渚、侠溪", + "C": "行间、丘墟", + "D": "丰隆、阴陵泉", + "E": "太溪、肾俞" + }, + "answer": "B", + "reason": "患者左耳听力减退，兼见畏寒,发热，舌红，苔薄,脉浮数。皆表证之象属新病实证。实证主穴:听会、翳风、中渚、侠溪。配穴:外感风邪配外关、合谷;肝胆火盛配行间、丘墟;痰火郁结配丰隆、阴陵泉。" + }, + { + "question_num": 203, + "query": "患者，男，20岁。突发胸闷，带哮鸣音的呼气性呼吸困难，咳嗽。听诊两肺布满哮鸣音。应首先考虑的诊断是", + "options": { + "A": "急性支气管炎", + "B": "支气管哮喘", + "C": "喘息性慢性支气管炎", + "D": "心源性哮喘", + "E": "自发性气胸" + }, + "answer": "B", + "reason": "患者为青少年,结合呼气性呼吸困难，满肺哮鸣音，首先考虑支气管哮喘。" + }, + { + "question_num": 204, + "query": "患者因上腹疼痛、消瘦、贫血8个月来诊，体重减轻约10kg。查体：左锁骨淋巴结肿大，质硬，无触痛。应首先考虑的诊断是", + "options": { + "A": "胃溃疡", + "B": "胃癌", + "C": "反流性食管炎", + "D": "慢性萎缩性胃炎", + "E": "十二指肠球部溃疡" + }, + "answer": "B", + "reason": "上腹疼痛、消瘦、贫血，恶病质，考虑癌病。" + }, + { + "question_num": 205, + "query": "患者既往有冠心病病史，近1周心绞痛发作，2小时前心前区疼痛，伴大汗，面色苍白，含服硝酸甘油未缓解，遂急诊。查心电图示：I、aVL、V₄、V₅导联ST段抬高，并与T波、U波融合，血cTnT显著增高，其诊断是", + "options": { + "A": "急性下壁心肌梗死", + "B": "急性前壁心肌梗死", + "C": "急性局限前壁心肌梗死", + "D": "急性高侧壁心肌梗死", + "E": "急性广泛前壁心肌梗死" + }, + "answer": "D", + "reason": "患者2小时内心前区疼痛，伴大汗，面色苍白，首行含服硝酸甘油未缓解,考虑心肌梗死，心肌梗死定位:①V1~V6导联改变示广泛前壁心肌梗死;②V1~V3:导联改变示前间壁心肌梗死;③V3~V5导联改变示局限前壁心肌梗死;④Ⅱ、Ⅲ、aVF导联改变示下壁心肌梗死;⑤Ⅰ、aVL导联改变示高侧壁心肌梗死;⑥V7~V8导联改变示正后壁心肌梗死;⑦Ⅱ、Ⅲ、aVF导联伴V3R~V5R导联ST段抬高，可作为下壁心肌梗死并发右室梗死的参考指标，" + }, + { + "question_num": 206, + "query": "患者，女，30岁。月经量过多史12年，近1年出现乏力，活动后心悸，气促，查血常规：血红蛋白85g/L。血涂片：成熟红细胞体积小且大小不等，血清铁80μmol/L，血清铁蛋白10μg/L。应首选的医疗措施是", + "options": { + "A": "肌内注射维生素B₁₂", + "B": "口服硫酸亚铁", + "C": "肌内注射右旋糖酐铁", + "D": "输注红细胞悬液", + "E": "皮下注射促红细胞生成素" + }, + "answer": "B", + "reason": "缺铁性贫血首选二价铁治疗，如有慢性失血史、血红蛋白、血清铁、铁蛋白减少，均可选用。" + } +] \ No newline at end of file