diff --git "a/Assistant/Theory_Questions/Year_5/Past_Paper.json" "b/Assistant/Theory_Questions/Year_5/Past_Paper.json" new file mode 100644--- /dev/null +++ "b/Assistant/Theory_Questions/Year_5/Past_Paper.json" @@ -0,0 +1,3096 @@ +[ + { + "question_num": 1, + "query": "肺主通调水道的功能主要依赖于", + "options": { + "A": "肺主一身之气", + "B": "肺可呼吸", + "C": "肺输精于皮毛", + "D": "肺朝百脉", + "E": "肺主宜发和肃降" + }, + "answer": "E", + "reason": "肺气的宣发和肃降贯穿于肺所有的生理功能当中，通调水道也是依赖于宣发和肃降功能来完成的。" + }, + { + "question_num": 2, + "query": "薄荷不具有的功效是", + "options": { + "A": "疏散风热", + "B": "清利头目", + "C": "息风止痉", + "D": "疏肝解郁", + "E": "利咽，透疹" + }, + "answer": "C", + "reason": "薄荷疏散风热——风热表证、风温初起;透疹——风疹瘙痒;麻疹外出不畅等;利咽——风热咽喉肿痛等;清利头目——头痛、目赤、口疮等;疏肝行气——肝郁胸胁胀闷。" + }, + { + "question_num": 3, + "query": "治疗汗出恶风，身重微肿，或肢节疼痛，小便不利，舌淡苔白，脉浮的方剂是", + "options": { + "A": "防己黄芪汤", + "B": "苓桂术甘汤", + "C": "五苓散", + "D": "猪苓汤", + "E": "桂枝汤" + }, + "answer": "A", + "reason": "防已黄芪汤功用：益气祛风，健脾利水。症见：汗出恶风，身重微肿，或肢节疼痛，小便不利，舌淡苔白，脉浮。" + }, + { + "question_num": 4, + "query": "期门穴的定位是", + "options": { + "A": "乳头直下，第5肋间隙，前正中线旁开4寸", + "B": "乳头直下，第6肋间隙，前正中线旁开4寸", + "C": "乳头直下，第7肋间隙，前正中线旁开4寸", + "D": "第11肋游离端下际", + "E": "第12肋游离端下际" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 5, + "query": "痰饮证胸胁支满，宜选方", + "options": { + "A": "苓桂术甘汤", + "B": "真武汤", + "C": "五苓散", + "D": "小青龙汤", + "E": "五皮散" + }, + "answer": "A", + "reason": "痰饮证胸胁支满为脾阳虚弱，饮停于胃，清阳不升所致。治法：温脾化饮。宜选方：苓桂术甘汤合小半夏加茯苓汤加减。" + }, + { + "question_num": 6, + "query": "下列哪项不是糖尿病酮症酸中毒常见诱因", + "options": { + "A": "呕吐", + "B": "感染", + "C": "胰岛素治疗中断", + "D": "创伤", + "E": "妊娠" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 7, + "query": "十二经脉中阴经与阳经的交接部位在", + "options": { + "A": "头面", + "B": "手足", + "C": "胸腹", + "D": "上肢", + "E": "下肢" + }, + "answer": "B", + "reason": "十二经脉的走向与交接规律：手三阴经，从胸走手，交手三阳经；手三阳经，从手走头，交足三阳经；足三阳经，从头走足，交足三阴经；足三阴经，从足走腹上胸，交手三阴经，故阴经与阳经的交接部位是在手足。" + }, + { + "question_num": 8, + "query": "眩晕病机颇为复杂，归纳起来不外下列哪四个方面", + "options": { + "A": "痰、火、风、瘀", + "B": "风、痰、湿、瘀", + "C": "风、痰、瘀、虚", + "D": "痰、湿、虚、瘀", + "E": "风、火、痰、虚" + }, + "answer": "A", + "reason": "眩晕的基本病机主要是脑髓空虚，清窍失养，或痰火上逆，扰动清窍。本病的病位在于头窍，其病变脏腑与肝、脾、肾三脏相关。常见病理因素有风、火、痰、瘀。(此题五版教材认为是风、火、痰、虚、而七版和九版教材则倾向于风、火、痰、瘀。)" + }, + { + "question_num": 9, + "query": "在十二经脉的走向中，足之三阴是", + "options": { + "A": "从脏走手", + "B": "从头走足", + "C": "从足走胸腹", + "D": "从手上头", + "E": "从足上头" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 10, + "query": "水肿的发病病机中，其标在肺，其制在脾，其本在", + "options": { + "A": "三焦", + "B": "膀胱", + "C": "肾", + "D": "心", + "E": "肝" + }, + "answer": "C", + "reason": "水肿的发病病机中,其标在肺、其制在脾，其本在肾、肾虚则水无所主而妄行。" + }, + { + "question_num": 11, + "query": "下列何经循行从耳后，进入耳中，出走耳前", + "options": { + "A": "足太阳膀胱经", + "B": "手太阳小肠经", + "C": "足阳明胃经", + "D": "手阳明大肠经", + "E": "足少阳胆经" + }, + "answer": "E", + "reason": "足少阳胆经循行：耳部分支，从耳后进入耳中，出走耳前到目外眦后方。" + }, + { + "question_num": 12, + "query": "尿浊与淋证的区别关键在于", + "options": { + "A": "小便浑浊的程度", + "B": "有无发热", + "C": "有无腰痛", + "D": "有无排尿疼痛", + "E": "小便中有无砂石" + }, + "answer": "D", + "reason": "尿浊与淋证膏淋均可有小便浑浊，白如泔浆，但淋证排尿时有疼病涩滞，而尿浊无此症状，" + }, + { + "question_num": 13, + "query": "“柱骨之会上”指的是", + "options": { + "A": "迎香", + "B": "合谷", + "C": "曲骨", + "D": "大椎", + "E": "束骨" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 14, + "query": "下列哪项不是头痛的病因病机", + "options": { + "A": "外感六淫", + "B": "气郁化火", + "C": "痰浊内生", + "D": "气血亏虚", + "E": "肺气上逆" + }, + "answer": "E", + "reason": "头痛的病因病机:外感六淫(外感头痛)，内伤所致(气郁化火，痰浊内生，气血亏虚)，不包括肺气上逆，" + }, + { + "question_num": 15, + "query": "常用于治疗腹臭的腧穴是", + "options": { + "A": "极泉", + "B": "少海", + "C": "通里", + "D": "阴郄", + "E": "少府" + }, + "answer": "A", + "reason": "极泉主治心痛、心悸等心疾；肩臂疼痛、胁肋疼痛、上肢不遂等上肢病证；瘰疬，腋臭。" + }, + { + "question_num": 16, + "query": "实热便秘的治法宜", + "options": { + "A": "清热通便", + "B": "清热润肠", + "C": "养血润肠", + "D": "益气润肠", + "E": "增液通便" + }, + "answer": "B", + "reason": "气虚便秘,宜益气润肠,血虚便秘宜养血润肠，热秘宜清热润肠。" + }, + { + "question_num": 17, + "query": "气海穴的定位是前正中线上", + "options": { + "A": "脐下0.5寸", + "B": "脐下1寸", + "C": "脐下1.5寸", + "D": "脐下2寸", + "E": "脐下2.5寸" + }, + "answer": "C", + "reason": "气海在下腹部，脐下1.5寸，前正中线上。" + }, + { + "question_num": 18, + "query": "治疗湿热泄泻的主方为", + "options": { + "A": "藿香正气散", + "B": "胃苓汤", + "C": "葛根芩连汤", + "D": "参苓白术散", + "E": "保和丸" + }, + "answer": "C", + "reason": "湿热泄泻由于感受湿热之邪，由表入里，内陷阳明,肠腑传化失常，而发生泄泻，治疗当清热利湿，方选葛根苓连汤。" + }, + { + "question_num": 19, + "query": "QRS波群代表", + "options": { + "A": "心室肌除极过程", + "B": "心房肌除极过程", + "C": "心室肌复极过程", + "D": "心房肌复极过程", + "E": "房室交界区的兴奋性" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 20, + "query": "女性，不寐多梦，易于惊醒，胆怯心悸，气短倦怠，舌淡脉细者，主方是", + "options": { + "A": "归脾汤", + "B": "养心汤", + "C": "安神定志丸", + "D": "酸枣仁汤", + "E": "枕中丹" + }, + "answer": "C", + "reason": "从症、舌、脉判断为心胆气虚之不寐，治以安神定志丸益气镇惊，安神定志。" + }, + { + "question_num": 21, + "query": "根据藏象理论，肝其华在", + "options": { + "A": "面", + "B": "爪", + "C": "唇", + "D": "毛", + "E": "发" + }, + "answer": "B", + "reason": "心其华在面；肝其华在爪；脾其华在唇；肺其华在毛；肾其华在发。" + }, + { + "question_num": 22, + "query": "被称为“以大寒之剂，易为清补之方”的方剂是", + "options": { + "A": "竹叶石膏汤", + "B": "白虎汤", + "C": "清营汤", + "D": "黄连解毒汤", + "E": "导赤散" + }, + "answer": "A", + "reason": "竹叶石膏汤由清气分热之白虎汤化裁而来，方中清热与益气养阴并用，祛邪扶正兼顾，清而不寒，补而不滞，为清补两顾之剂,故称“以大寒之剂,易为清补之方”。" + }, + { + "question_num": 23, + "query": "阴盛格阳是指下列哪种病理状态", + "options": { + "A": "真虚假实", + "B": "真寒假热", + "C": "真实假虚", + "D": "真热假寒", + "E": "虚实错杂" + }, + "answer": "B", + "reason": "阴盛格阳指阳气极端虚弱，阳不制阴，偏盛之阴盘踞于内，逼迫衰极之阳浮越于外、使阴阳不相维系，相互格拒的一种病理状态。究其本质是很重的虚寒证，但由于阴盛而格阳于外，却表现出假热之象，故称之为真寒假热证。" + }, + { + "question_num": 24, + "query": "中风与厥证的区别在于有无", + "options": { + "A": "神昏", + "B": "肢厥", + "C": "口吐涎沫", + "D": "牙关紧闭", + "E": "后遗症" + }, + "answer": "E", + "reason": "中风以中、老年人为多见，常有素体肝阳亢盛，��中脏腑者，突然昏仆，并伴有口眼歪斜，偏瘫等症，神昏时间较长，苏醒后有偏瘫，口眼歪斜及失语等后遗症。厥证可发生于任何年龄，昏倒时间较短，醒后无后遗症。" + }, + { + "question_num": 25, + "query": "功能甘淡渗泄，利水渗湿，兼能泄热的药物是", + "options": { + "A": "茯苓", + "B": "车前子", + "C": "木通", + "D": "泽泻", + "E": "冬瓜皮" + }, + "answer": "D", + "reason": "泽泻味甘淡，利水渗湿，水湿证常用，性寒，能泄热。" + }, + { + "question_num": 26, + "query": "开鬼门，洁净府的治疗原则是哪部著作提出的", + "options": { + "A": "《金匮要略》", + "B": "《诸病源候论》", + "C": "《内经》", + "D": "《难经》", + "E": "《神农本草经》" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 27, + "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": "白芷入肺胃经善治阳明经头痛。" + }, + { + "question_num": 28, + "query": "血淋与尿血的主要鉴别在于", + "options": { + "A": "小便血色是鲜红还是紫暗", + "B": "小便量的多少", + "C": "小便有无混浊", + "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": "具有止血制酸止痛作用的药物是", + "options": { + "A": "海蛤壳", + "B": "瓦楞子", + "C": "乌贼骨", + "D": "延胡索", + "E": "白芷" + }, + "answer": "C", + "reason": "乌贼骨能收敛止血、制酸止痛。" + }, + { + "question_num": 30, + "query": "治疗鼻衄热邪犯肺证的最佳选方是", + "options": { + "A": "银翘散", + "B": "沙参麦冬汤", + "C": "泻白散", + "D": "桑菊饮", + "E": "清燥救肺汤" + }, + "answer": "D", + "reason": "热邪犯肺证患者的主要表现为鼻燥衄血，口干咽燥,或兼有身热，恶风，头痛，咳嗽，痰少等症,舌质红,苔薄,脉数，治清泄肺热，凉血止血，桑菊饮最为合适，" + }, + { + "question_num": 31, + "query": "治疗痉挛抽搐，将全蝎与蜈蚣同用，其配伍关系是", + "options": { + "A": "相反", + "B": "相恶", + "C": "相须", + "D": "相使", + "E": "相杀" + }, + "answer": "C", + "reason": "全蝎息风解痉，祛风止痛，解毒散结；蜈蚣祛风、解痉、解毒。治疗痉挛抽搐，将全蝎配合蜈蚣来提高息风止痉的功效，此为相须关系。" + }, + { + "question_num": 32, + "query": "便血紫黯，甚则黑色，腹部隐痛，喜热饮，面色不华，神倦懒言，便溏，舌质淡，脉细。治疗应首选", + "options": { + "A": "当归补血汤", + "B": "归脾汤", + "C": "黄土汤", + "D": "无比山药丸", + "E": "黄芪建中汤" + }, + "answer": "C", + "reason": "腹部隐痛,喜热饮,面色不华、神倦懒言,便溏,舌质淡,脉细为脾胃虚寒之证。治以健脾温中，养血止血，用黄土汤。" + }, + { + "question_num": 33, + "query": "入汤剂宜包煎的药物是", + "options": { + "A": "蒲黄", + "B": "麻黄", + "C": "大黄", + "D": "姜黄", + "E": "雄黄" + }, + "answer": "A", + "reason": "蒲黄为粉末状，应该包煎，以免烧焦或使药汁混浊。" + }, + { + "question_num": 34, + "query": "肺痈的常用治法中，有助于痈疡消散的是", + "options": { + "A": "清热", + "B": "解毒", + "C": "排脓", + "D": "化瘀", + "E": "滋阴" + }, + "answer": "D", + "reason": "本病是风热进邪壅滞于肺，热壅血瘀，血败肉腐，以致肺叶生疮形成脓病。血瘀肉腐是其基本的病理，所以常用治法中，化瘀有助于痈疡消散。" + }, + { + "question_num": 35, + "query": "小儿厌食的基本治疗原则是", + "options": { + "A": "开胃运脾", + "B": "健脾益气", + "C": "消食导滞", + "D": "理气醒脾", + "E": "滋养胃阴" + }, + "answer": "A", + "reason": "小儿厌食病位在脾胃。病机：损伤脾胃正常纳化功能，致脾胃失和，纳化失职，而成厌食。以运脾开胃为基本原则。" + }, + { + "question_num": 36, + "query": "诊断黄疸最主要的依据是", + "options": { + "A": "目黄", + "B": "身黄", + "C": "尿黄", + "D": "苔黄", + "E": "齿垢黄" + }, + "answer": "A", + "reason": "黄疸是以目黄、身黄、小便黄为主症的一种病证，其中目睛黄染尤为本病的重要特征。" + }, + { + "question_num": 37, + "query": "下列除哪项外均是蒿芩清胆汤的组成药物", + "options": { + "A": "猪苓、枳实", + "B": "青蒿、黄芩", + "C": "竹茹、半夏", + "D": "枳壳、茯苓", + "E": "陈皮、碧玉散" + }, + "answer": "A", + "reason": "蒿芩清胆汤的组成：青蒿、黄芩、竹茹、半夏、茯苓、枳壳、陈皮、碧玉散。" + }, + { + "question_num": 38, + "query": "治疗中风后遗症半身不遂，气虚血瘀证，治疗应选用", + "options": { + "A": "天麻钩藤饮", + "B": "半夏白术天麻汤", + "C": "镇肝熄风汤", + "D": "补阳还五汤", + "E": "局方至宝丹" + }, + "answer": "D", + "reason": "中风后遗症半身不遂,气虚血瘀证，治则宜益气养血，化瘀通络，治疗应选用补阳还五汤。" + }, + { + "question_num": 39, + "query": "不寐心肾不交的主方是", + "options": { + "A": "归脾汤", + "B": "龙胆泻肝汤", + "C": "黄连温胆汤", + "D": "安神定志丸合酸枣仁汤", + "E": "六味地黄丸合交泰丸" + }, + "answer": "E", + "reason": "不寐心肾不交证治法：滋阴降火，交通心肾。主方：六味地黄丸合交泰丸加减。" + }, + { + "question_num": 40, + "query": "排尿突然中断，尿道窘迫疼痛是何种淋证的临床特点", + "options": { + "A": "热淋", + "B": "石淋", + "C": "气淋", + "D": "膏淋", + "E": "血淋" + }, + "answer": "B", + "reason": "淋证石淋的临床表现为尿中夹砂石，排尿涩痛，或排尿时突然中断，尿道窘迫疼痛，少腹拘急，往往突发，一侧腰腹纹痛难忍，甚则牵及外阴，尿中带血，舌红，苔薄黄，脉弦或带数。" + }, + { + "question_num": 41, + "query": "体现“培土生金”治法的方剂是", + "options": { + "A": "参苓白术散", + "B": "四君子汤", + "C": "玉屏风散", + "D": "补中益气汤", + "E": "归脾汤" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 42, + "query": "消渴病并发白内障、耳聋、雀盲，治疗首选", + "options": { + "A": "六味地黄丸", + "B": "石斛夜光丸", + "C": "杞菊地黄丸", + "D": "龙胆泻肝丸", + "E": "镇肝熄风汤" + }, + "answer": "C", + "reason": "消渴病并发白内障、耳聋、雀盲，主要病机为肝肾精血不足，不能上承耳目所致，治疗宜滋补肝肾，益精补血，方选杞菊地黄丸。" + }, + { + "question_num": 43, + "query": "“甘温除热”的代表方是", + "options": { + "A": "参苓白术散", + "B": "四君子汤", + "C": "玉屏风散", + "D": "补中益气汤", + "E": "归脾汤" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 44, + "query": "郁证的主要治法是", + "options": { + "A": "调理阴阳", + "B": "疏通气机", + "C": "滋养气血", + "D": "调和营卫", + "E": "调理气血" + }, + "answer": "B", + "reason": "治疗郁病的基本原则:理气开郁,调畅气机，怡情易性。五个选项中只有B项符合这一原则。" + }, + { + "question_num": 45, + "query": "外感风寒湿邪，症见恶寒发热，无汗，头痛项强，肢体酸楚疼痛，口苦而渴者，治宜选用", + "options": { + "A": "麻黄汤", + "B": "荆防败毒散", + "C": "九味羌活汤", + "D": "藿香正气散", + "E": "羌活胜湿汤" + }, + "answer": "C", + "reason": "九味羌活汤主治外感风寒湿邪，兼里热证，症见恶寒发热，无汗，头痛项强，肢体酸楚疼痛，口苦而渴。" + }, + { + "question_num": 46, + "query": "水湿浸渍证阳水的治法是", + "options": { + "A": "散风清热，宣肺行水", + "B": "宣肺解毒，利湿消肿", + "C": "健脾化湿，通阳利水", + "D": "温运脾阳，以利水湿", + "E": "分利湿热，攻下逐水" + }, + "answer": "C", + "reason": "阳水水湿浸渍证病机:外在水湿之邪浸溃肌肤，壅滞不行，致肢体浮肿不退。内在脾为湿困，阳气不得舒展。由病机得出相应的治法应为健脾化湿，通阳利水。" + }, + { + "question_num": 47, + "query": "导赤散主治心经有热之证，属于下列何种情况者为宜", + "options": { + "A": "气火内郁，暗耗阴血，虚热上炎者", + "B": "气郁化火，心火内炽，循经上炎者", + "C": "气郁化火，炼液为痰，痰火内扰者", + "D": "心火上炎，或下移小肠，水虚火不实者", + "E": "心火亢盛，烦热谵语，口舌生疮，邪实而正不虚者" + }, + "answer": "D", + "reason": "导赤散主治心经火热性、以心火上炎、或下移小肠、水虚火不实者为宜。" + }, + { + "question_num": 48, + "query": "无虚不能作眩出自", + "options": { + "A": "《素问》", + "B": "《灵柩》", + "C": "《丹溪心法》", + "D": "《景岳全书》", + "E": "《古今医统》" + }, + "answer": "D", + "reason": "《景岳全书·眩运》篇中指出:眩运一证，虚者居其八九，而兼火兼痰者，不过十中一二耳。强调无虚不能作眩。" + }, + { + "question_num": 49, + "query": "下列各项，不属于竹叶石膏汤组成药物的是", + "options": { + "A": "半夏", + "B": "麦门冬", + "C": "人参", + "D": "知母", + "E": "甘草" + }, + "answer": "D", + "reason": "竹叶石膏汤的组成为竹叶、石膏、半夏、麦门冬、人参、甘草、粳米。" + }, + { + "question_num": 50, + "query": "头痛牵引项背多属", + "options": { + "A": "太阳经头痛", + "B": "厥阴经头痛", + "C": "少阳经头痛", + "D": "阳明经头痛", + "E": "少阴经头痛" + }, + "answer": "A", + "reason": "根据经络理论:太阳经行于头顶和头后部;足太阳经别:从足太阳经脉的腘窝部分由，其中一条支脉在骶骨下五寸处别行进入肛门，上行归愿膀胱，微布联络肾脏，沿脊柱两旁的肌肉到心脏后散布于心脏内，所以头痛牵引项背多属太阳经头痛，" + }, + { + "question_num": 51, + "query": "止嗽散的组成中不含有", + "options": { + "A": "紫菀", + "B": "白前", + "C": "杏仁", + "D": "荆芥", + "E": "陈皮" + }, + "answer": "C", + "reason": "止嗽散的组成：桔梗、荆芥、紫菀、百部、白前、甘草、陈皮。" + }, + { + "question_num": 52, + "query": "有头疽初起症状多见", + "options": { + "A": "粟粒样脓头", + "B": "蜂窝样脓头", + "C": "肿块坚硬如钉丁之状", + "D": "漫肿无头", + "E": "腐烂疮面" + }, + "answer": "A", + "reason": "有头疽是发生于皮肤间的急性化脓性疾病，特点是初起即有粟粒样脓头。" + }, + { + "question_num": 53, + "query": "治疗昏迷，癫痫，高热，咽喉肿痛，应首选", + "options": { + "A": "四缝", + "B": "十宜", + "C": "八邪", + "D": "合谷", + "E": "曲池" + }, + "answer": "B", + "reason": "十宣主治：①昏迷；②癫痫；③高热、咽喉肿痛；④手指麻木。" + }, + { + "question_num": 54, + "query": "男性不育的病因病机，除了", + "options": { + "A": "肾气虚弱", + "B": "肝郁气滞", + "C": "湿热下注", + "D": "气血两虚", + "E": "肺失宣肃" + }, + "answer": "E", + "reason": "不育症与肾、心、脾、肝有关、其中与肾脏关系最为密切。" + }, + { + "question_num": 55, + "query": "症见寒热如疟，寒轻热重，口苦胸闷，吐酸苦水，或呕黄涎而黏，舌红苔白腻，脉弦滑数。治疗宜首选", + "options": { + "A": "小柴胡汤", + "B": "大柴胡汤", + "C": "逍遥散", + "D": "蒿芩清胆汤", + "E": "半夏泻心汤" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 56, + "query": "疖的特点", + "options": { + "A": "易脓、易溃、易敛", + "B": "易成走黄之势", + "C": "易内陷", + "D": "易溃而不易敛", + "E": "多伴全身症状" + }, + "answer": "A", + "reason": "疖易脓、易溃、易敛,根浅,色红。" + }, + { + "question_num": 57, + "query": "下列药物为麦门冬汤组成部分的是", + "options": { + "A": "人参、生姜、甘草、大枣", + "B": "人参、干姜、甘草、大枣", + "C": "人参、大枣、甘草、粳米", + "D": "人参、干姜、甘草、粳米", + "E": "人参、生姜、甘草、粳米" + }, + "answer": "C", + "reason": "麦门冬汤的药物组成为麦门冬、半夏、人参、甘草、粳米、大枣。" + }, + { + "question_num": 58, + "query": "疔疮脓尽外治用", + "options": { + "A": "九一丹", + "B": "玉露散", + "C": "生肌散", + "D": "八二丹", + "E": "白玉膏" + }, + "answer": "C", + "reason": "丹剂的使用是根据脓腐的多少，确定丹剂的成分多少，脓腐由多到少，丹剂有五五、七三、八二到九一,如果是脓尽宜用生肌散。" + }, + { + "question_num": 59, + "query": "五苓散中桂枝的作用是", + "options": { + "A": "发汗解表", + "B": "温心阳，通心脉", + "C": "温经通脉", + "D": "温阳化气", + "E": "调和营卫" + }, + "answer": "D", + "reason": "五苓散主治膀胱阳气不化而小便不利的蓄水证。桂枝与茯苓、泽泻、猪苓等同用，以助阳化气利水，解表散邪。" + }, + { + "question_num": 60, + "query": "玉茎属肝，马口属小肠，阴囊属肝，肾子属肾，子之系属肝这段记载见于", + "options": { + "A": "��刘涓子鬼遗方》", + "B": "《外科全生集》", + "C": "《外科真诠》", + "D": "《疮疡经验全书》", + "E": "《外科正宗》" + }, + "answer": "C", + "reason": "《外科真诠》是这样划分的:玉茎(阴茎)属肝;马口(尿道)属小肠;阴囊属肝;肾子(附睾、睾丸)属肾;子系(精索)属肝。" + }, + { + "question_num": 61, + "query": "保和丸中连翘的主要作用是", + "options": { + "A": "清热散结", + "B": "清热解毒", + "C": "轻宣透表", + "D": "消痈散结", + "E": "疏风清热" + }, + "answer": "A", + "reason": "保和丸功用消食，导滞，和胃。用于食积停滞，脘腹胀满，嗳腐吞酸，不欲饮食。食积易于化热，连翘清热而散结，为佐药。" + }, + { + "question_num": 62, + "query": "下列除哪项外，均可见于气瘿的临床表现", + "options": { + "A": "呼吸困难", + "B": "吞咽不适", + "C": "颈胸部青丝赤缕", + "D": "面部潮红", + "E": "声音嘶哑" + }, + "answer": "D", + "reason": "气瘿大者可压迫气管影响呼吸;压迫血管可致颈胸静脉扩张;压迫喉返神经可致声音嘶哑;压迫食管可致吞咽不适。" + }, + { + "question_num": 63, + "query": "局部红肿热痛，突起根浅，肿势局限，范围在3cm左右，易脓，易溃，易敛之病是", + "options": { + "A": "痈", + "B": "疔", + "C": "疖", + "D": "有头疽", + "E": "无头疽" + }, + "answer": "C", + "reason": "疖局部红肿热痛，突起根浅，肿势局限，范围3cm左右，易脓、易溃、易敛。" + }, + { + "question_num": 64, + "query": "环跳疽的初期体征下列哪项不符", + "options": { + "A": "不能屈曲", + "B": "不能伸直", + "C": "关节强直", + "D": "臀部外突", + "E": "大腿外翻" + }, + "answer": "C", + "reason": "环跳疽的初期体征有大腿不能伸直，不能屈曲,大腿外翻,臀部外突,髋部隐痛等。" + }, + { + "question_num": 65, + "query": "外感凉燥，头微痛，恶寒无汗，咳嗽稀痰，鼻塞，咽干，苔白，脉弦。宜选用", + "options": { + "A": "清燥救肺汤", + "B": "杏苏散", + "C": "养阴清肺汤", + "D": "桑杏汤", + "E": "增液汤" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 66, + "query": "臁疮的好发部位是", + "options": { + "A": "前臂下1/3", + "B": "小腿下1/3", + "C": "臀部下1/3", + "D": "足部", + "E": "以上都不是" + }, + "answer": "B", + "reason": "臁部是指小腿下1/3内外侧。" + }, + { + "question_num": 67, + "query": "下列各项中，以病因命名的是", + "options": { + "A": "人中疖", + "B": "破伤风", + "C": "湿疮", + "D": "丹毒", + "E": "蛇头疔" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 68, + "query": "失荣的临床特征，以下哪条是错误的", + "options": { + "A": "面容憔悴", + "B": "舌体萎缩", + "C": "形体消瘦", + "D": "状如枯树", + "E": "颈部或耳前后肿块" + }, + "answer": "B", + "reason": "失荣指颈部或耳前后肿块:伴面容憔悴、形体消瘦、状如枯树。" + }, + { + "question_num": 69, + "query": "慢性粒细胞白血病与类白血病反应最主要的区别是", + "options": { + "A": "外周血白细胞计数高", + "B": "外周血可见中幼粒、晚幼粒细胞", + "C": "脾大", + "D": "Ph染色体阳性", + "E": "骨髓检查粒细胞增生活跃" + }, + "answer": "D", + "reason": "在备选答案中，Ph染色体阳性是慢性粒细胞白血病与类白血病反应最主要的区别，后者Ph染色体为阴性，其他干扰答案均不是主要的区别。" + }, + { + "question_num": 70, + "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，其应用应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": 71, + "query": "具有推动呼吸和行血功能的气是", + "options": { + "A": "心气", + "B": "肺气", + "C": "营气", + "D": "宗气", + "E": "卫气" + }, + "answer": "D", + "reason": "宗气上出于肺循喉咙而走息道——推动呼吸——与呼吸、语言、发声有关。贯注心脉——推动血行——��气血运行、心搏的力量及节律有关。" + }, + { + "question_num": 72, + "query": "慢性前列腺炎的发病原因以下错误的是", + "options": { + "A": "肾虚", + "B": "饮食不节", + "C": "外来伤害", + "D": "房事不节、不洁", + "E": "起居失常" + }, + "answer": "C", + "reason": "慢性前列腺炎主要由于肾虚加之饮食不节,或房事不节、不洁,或起居失常引起。" + }, + { + "question_num": 73, + "query": "下列病名中哪个是以形态命名的", + "options": { + "A": "蛇头疗", + "B": "发", + "C": "烂疔", + "D": "翻花疮", + "E": "流注" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 74, + "query": "关于圆癣的描述，以下哪项不正确", + "options": { + "A": "好发于长夏高温、潮湿季节", + "B": "好发于面部、躯干及四肢近端", + "C": "皮损为环形，边界清楚，中心消退", + "D": "边缘处可见水疮、鳞屑、结痂", + "E": "愈后常常留有疤痕" + }, + "answer": "E", + "reason": "圆癣好发于长夏高温、潮湿季节;好发于面部、躯干及四肢近端;皮损为环形,边界清楚，中心消退;边缘处可见水疮、鳞屑、结痂;愈后不留疤痕。" + }, + { + "question_num": 75, + "query": "右侧少腹部按之疼痛，重按突然放手后疼痛剧烈的，多见于", + "options": { + "A": "虫积", + "B": "气胀", + "C": "肠痈", + "D": "血瘀", + "E": "燥屎内结" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 76, + "query": "《外科大成》记载：乳房结核，初如梅子，数月不疗，渐大如鸡子，串延胸胁，破流稀脓白汁而内实相同，外见阴虚等证。这段描述的可能是以下哪种疾病", + "options": { + "A": "乳漏", + "B": "乳疬", + "C": "乳痨", + "D": "乳岩", + "E": "乳癖" + }, + "answer": "C", + "reason": "数月不疗,破流稀脓白汁而内实相同,外见阴虚,均为乳痨的典型特征。" + }, + { + "question_num": 77, + "query": "常为外感致病先导的邪气是", + "options": { + "A": "热邪", + "B": "风邪", + "C": "寒邪", + "D": "暑邪", + "E": "燥邪" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 78, + "query": "下列哪项是白秃疮的特点", + "options": { + "A": "灰白色鳞屑斑片", + "B": "特殊的鼠尿臭味", + "C": "愈后留有疤痕", + "D": "毛发永久脱落", + "E": "病发刚出头皮即折断" + }, + "answer": "A", + "reason": "白无疮初起为大小不等红色丘疹，灰白色鳞盾斑片，日久蔓延成片，毛发干枯、易断，易拔脱而不痛，多数在距头皮2~4毫米处头发自行折断，在近头皮的发干上常有灰白色菌鞘围绕。" + }, + { + "question_num": 79, + "query": "患者四肢关节疼痛，酸楚沉重，肌肤不仁，阴雨天加重，其病因主要是", + "options": { + "A": "风邪", + "B": "寒邪", + "C": "暑邪", + "D": "湿邪", + "E": "燥邪" + }, + "answer": "D", + "reason": "肢体困重，肌肤不仁，关节疼痛，阴雨天加重、体现了湿邪重浊的致病特点：故选D。" + }, + { + "question_num": 80, + "query": "下列各项，不属破伤风发作期表现的是", + "options": { + "A": "肌肉强直性痉挛首先从头面部开始", + "B": "面部肌痉挛时，可形成苦笑面容", + "C": "声音、光亮等均可诱发强烈的阵发性抽搐", + "D": "因喉头痉挛，可导致肺炎", + "E": "在发作的间歇期，肌肉可完全松弛" + }, + "answer": "E", + "reason": "破伤风发作期表现:肌肉强直性痉挛首先从头面部开始，进而延伸躯干四肢，面部痉挛呈苦笑面容，声音、光亮等均可诱发强烈的阵发性抽搐，因喉头痉挛，可导致肺炎，在发作的间歇期，肌肉也呈强直状。" + }, + { + "question_num": 81, + "query": "寒邪内阻型腹痛的基本治法是", + "options": { + "A": "散寒温里，理气止痛", + "B": "消食导滞，理气止痛", + "C": "疏肝解郁，理气止痛", + "D": "泄热通腑，行气导滞", + "E": "活血化瘀，和络止痛" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 82, + "query": "下列月经前后诸证中，哪项与血瘀无关", + "options": { + "A": "经行身痛", + "B": "经行吐衄", + "C": "经行头痛", + "D": "经行发热", + "E": "以上均与血瘀有关" + }, + "answer": "B", + "reason": "经行吐衄是由于肝经郁火、肺肾阴虚导致血热冲气上逆，迫血妄行。" + }, + { + "question_num": 83, + "query": "结脉的脉象是", + "options": { + "A": "数而一止，止无定数", + "B": "��而一止，止有定数", + "C": "缓而时止，止无定数", + "D": "缓而时止，止有定数", + "E": "止有定数，良久方来" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 84, + "query": "月经常脉多为", + "options": { + "A": "细数", + "B": "细滑", + "C": "滑利", + "D": "沉缓", + "E": "滑数" + }, + "answer": "C", + "reason": "月经常脉为脉象滑利;妊娠脉为滑有力或滑数，尺脉按之不绝;临产脉为双手中指两旁从中节至末节，均可扪及脉之搏动;产后脉为滑数而重按无力。" + }, + { + "question_num": 85, + "query": "真寒假热的病机是", + "options": { + "A": "阴盛格阳", + "B": "阴盛阳虚", + "C": "阳气暴脱", + "D": "阴阳俱衰", + "E": "以上均不是" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 86, + "query": "下列哪项不是带下病的病因", + "options": { + "A": "感受湿邪", + "B": "脾虚湿注", + "C": "肺阴亏虚", + "D": "湿热下注", + "E": "肾阳虚衰" + }, + "answer": "C", + "reason": "导致带下的主要原因是湿邪，包括内外湿邪，其中，脾肝肾是产生内湿之因。脾虚脾失健运，水湿内生。肾阳虚衰，气化失常，水湿内停。肝郁侮脾，肝火挟脾湿，湿热下注。外湿之因有久居湿地，或涉水淋雨，或不洁性交。" + }, + { + "question_num": 87, + "query": "“壮水之主，以制阳光”是指", + "options": { + "A": "阴病治阳", + "B": "阳病治阴", + "C": "阴中求阳", + "D": "阳中求阴", + "E": "补阴救阳" + }, + "answer": "B", + "reason": "“壮水之主，以制阳光”法是通过滋阴壮水以制约偏盛的阳，也就是《内经》的“阳病治阴”之法。" + }, + { + "question_num": 88, + "query": "胞宫通过胞脉、胞络直接与哪些脏腑相联系", + "options": { + "A": "肝、肾", + "B": "心、脾", + "C": "心、肺", + "D": "脾、肾", + "E": "心、肾" + }, + "answer": "E", + "reason": "《素问》中指出胞络者系于肾;胞脉者,属心而络于胞中。" + }, + { + "question_num": 89, + "query": "触觉语音震颤增强主要见于", + "options": { + "A": "胸腔积液", + "B": "气胸", + "C": "大叶性肺炎", + "D": "胸膜肥厚粘连", + "E": "肺气肿" + }, + "answer": "C", + "reason": "触觉语音震颤增强主要见于：①肺泡炎症浸润肺组织实变使语音传导良好，如大叶性肺炎实变期和肺梗死等；②接近胸膜的肺内巨大空腔，尤其当空腔周围有炎性浸润并与胸壁靠近时，如空洞型肺结核、肺脓肿等；③压迫性肺不张。答案是C项，而其余各项均使触觉语音震颤减弱或消失。" + }, + { + "question_num": 90, + "query": "虚寒月经后期的主要证候，下列哪项是错误的", + "options": { + "A": "经行延后，量少", + "B": "小腹冷痛，拒按", + "C": "经血色淡，质稀", + "D": "小便清长，大便稀溏", + "E": "舌淡苔薄白，脉沉迟无力" + }, + "answer": "B", + "reason": "月经病的辨证主要是根据月经的期、量、色、质辨证,同时也要参考全身症状及舌、脉。量少、经血色淡、质稀、小便清长、大便稀溏、舌淡苔薄白、脉沉迟无力均为虚寒证表现、小服冷痛、拒胺为实证表现。" + }, + { + "question_num": 91, + "query": "无症状柏油便表示消化道出血量约每日", + "options": { + "A": "20ml", + "B": "40ml", + "C": "60ml", + "D": "80ml", + "E": "100ml" + }, + "answer": "C", + "reason": "消化道每日出血量60ml（50~100ml）则出现无症状柏油便。出血5~10ml则粪便隐血试验出现阳性。" + }, + { + "question_num": 92, + "query": "肾阳虚带下过多的主要证候下列哪项是错误的", + "options": { + "A": "带下量多，清稀如水", + "B": "腰酸如折，畏寒肢冷", + "C": "小便清长，夜尿频繁，大便溏薄", + "D": "面色萎黄，四肢倦怠，纳少便溏", + "E": "舌淡苔白润，脉沉迟" + }, + "answer": "D", + "reason": "肾阳虚衰,命门火衰，封藏失职，故带下量多，绵绵不断，清稀如水;腰为肾之府，肾虚而有腰酸如折;肾阳虚，阳气不能外达可有畏寒肢冷;肾阳虚不能上温脾阳，则大便溏薄;不能下暖膀胱，故小便清长，或夜尿频多;舌淡苔白润，脉沉迟亦为肾阳虚之征。面色萎黄，四肢倦怠，纳少便溏为脾虚征象。" + }, + { + "question_num": 93, + "query": "下列为肺下界叩诊的叙述，哪一项错误", + "options": { + "A": "两侧肺下界大致相同", + "B": "平静呼吸时位于锁骨中线上第6肋间", + "C": "平静呼吸时位于腋中线上��8肋间", + "D": "平静呼吸时位于肩胛下角线上第10肋间", + "E": "体型和发育情况不同，肺下界位置无差异" + }, + "answer": "E", + "reason": "正常人两侧肺下界大致相同，即平静呼吸时位于锁骨中线上第6肋间，腋中线上第8肋间，肩胛下角线上第10肋间。但在生理情况下，即体型和发育情况不同，肺下界可有改变，如瘦长体型者的肺下界可低一肋；儿童及矮胖者可升高一肋；妊娠末期，两侧肺下界上升。病理情况下，两侧肺下界下降，常见于肺气肿；两侧肺下界上升，常见于腹内压升高，如高度腹水、气腹、鼓肠及巨大腹腔肿瘤；一侧肺下界上升，见于同侧肺不张、胸腔积液、肝或脾肿大、膈下脓肿等。" + }, + { + "question_num": 94, + "query": "经来先期，量多，色深红或紫红，质黏稠，伴心烦，面红口干，小便黄短，大便干结，舌质红，苔黄，脉滑数，应选用的方剂是", + "options": { + "A": "当归地黄饮", + "B": "大补元煎", + "C": "丹栀逍遥散", + "D": "清经散", + "E": "乌药汤" + }, + "answer": "D", + "reason": "经来先期,为月经先期;月经量多，色深红或紫红，质黏稠，为血热出血的特点;心烦，面红口干，小便黄短，大便干结，舌质红，苔黄，脉滑数，均为热象。综合脉证，为阳盛血热引起的月经先期，治当清热凉血调经，应选用的方剂是清经散。" + }, + { + "question_num": 95, + "query": "下列哪一项属于脑膜刺激征", + "options": { + "A": "巴宾斯基征", + "B": "肱二头肌反射", + "C": "克尼格征", + "D": "霍夫曼征", + "E": "跖反射" + }, + "answer": "C", + "reason": "脑膜刺激征包括克尼格(Kernig)征、布鲁津斯基(Brudzinski)征和颈项强直，故答案是C项，其余各项中，巴宾斯基(Babinski)征和霍夫曼(Hoffmann)征属于病理反射，肱二头肌反射属于深反射，而跖反射和腹壁反射、捉睾反射、肛门反射均属于浅反射。" + }, + { + "question_num": 96, + "query": "治疗肾虚型月经过少的主方是", + "options": { + "A": "滋血汤", + "B": "当归地黄饮", + "C": "八珍汤", + "D": "温经汤", + "E": "圣愈汤" + }, + "answer": "B", + "reason": "肾虚型月经过少的主方是当归地黄饮或归肾丸。" + }, + { + "question_num": 97, + "query": "关于左心房增大的X线表现描述正确的是", + "options": { + "A": "食管向前受压移位", + "B": "心左缘双弧影，心底部双心房影", + "C": "心左缘可见左心耳突出（第三弓）", + "D": "左主支气管受压降低", + "E": "以上都不是" + }, + "answer": "C", + "reason": "左心房增大的X线表现为食管向后受压移位、心右缘双弧影，心底部双心房影，心左缘可见左心耳突出(第三弓)以及左主支气管受压抬高。" + }, + { + "question_num": 98, + "query": "举元煎适宜治疗下列哪组症状", + "options": { + "A": "经行淋漓不净，色红，手足心热，舌红，脉细数", + "B": "经来或先或后，头晕耳鸣，腰痛", + "C": "月经量多，色淡质稀，面色白，气短懒言，小腹空坠", + "D": "经来量少，色淡或点滴即净，面色萎黄，舌淡，脉细弱", + "E": "经来量少，色紫黯有块，小腹胀痛拒按，舌紫黯，脉涩" + }, + "answer": "C", + "reason": "举元煎由人参、黄芪、升麻、白术、甘草组成，具有补气摄血固冲的作用，用于气虚证的出血类疾病。C项为气虚型月经过多的表现。" + }, + { + "question_num": 99, + "query": "破伤风前驱期不应有的症状是", + "options": { + "A": "头痛、头晕", + "B": "乏力、多汗", + "C": "烦躁、打呵欠", + "D": "咀嚼无力", + "E": "张口困难" + }, + "answer": "E", + "reason": "破伤风前驱期：一般1~2天，患者常有头痛、头晕、乏力、多汗、烦躁不安、打呵欠，下颌微感紧张酸胀，咀嚼无力，张口略感不便；伤口往往干陷无脓，周围皮肤暗红、创口疼痛并有紧张牵制感。" + }, + { + "question_num": 100, + "query": "妊娠恶阻肝胃不和证的表现是", + "options": { + "A": "呕吐酸苦水", + "B": "呕吐痰涎", + "C": "呕吐清涎", + "D": "呕吐带血样物", + "E": "呕吐食物残渣" + }, + "answer": "A", + "reason": "妊娠恶阻的辨证主要根据呕吐物的性状和患者的口感，结合全身情况、舌脉而综合分析。呕吐清诞者多为脾胃虚弱，呕吐痰涎者多为脾虚痰湿。呕吐酸水或苦水者多为肝胃不和。干呕或呕吐血性物者多为气阴两虚。" + }, + { + "question_num": 101, + "query": "流行性脑脊髓膜炎出现昏迷、潮式呼吸和瞳孔不等大时最主��的抢救措施为", + "options": { + "A": "肌内注射苯巴比妥", + "B": "使用人工呼吸机", + "C": "注射山莨菪碱（654-2）", + "D": "立即气管切开", + "E": "20%甘露醇静脉快速注射" + }, + "answer": "E", + "reason": "此症状说明颅内压增高，出现脑疝，应立即脱水降颅压。" + }, + { + "question_num": 102, + "query": "产后恶露不绝分为", + "options": { + "A": "气虚型、血瘀型、邪毒型", + "B": "气虚型、血虚型、血瘀型", + "C": "气虚型、血瘀型", + "D": "血瘀型、血热型", + "E": "气虚型、血热型、血瘀型" + }, + "answer": "E", + "reason": "产后恶露不绝多由气虚、血热,血瘀而致冲任失固，气血运行失常，常分为气虚型、血热型、血瘀型。" + }, + { + "question_num": 103, + "query": "对于传染性非典型肺炎要做到“三早”，“三早”是指", + "options": { + "A": "早发现、早隔离、早治疗", + "B": "早发现、早诊断、早治疗", + "C": "早发现、早隔离、早诊断", + "D": "早诊断、早隔离、早降温", + "E": "早诊断、早降温、早治疗" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 104, + "query": "异位妊娠已破损期的包块型选用下列哪方治疗", + "options": { + "A": "宫外孕Ⅰ号方", + "B": "宫外孕Ⅱ号方", + "C": "宫外孕Ⅰ号方加党参、黄芪", + "D": "宫外孕Ⅱ号方加蜈蚣、全蝎、紫草", + "E": "桂枝茯苓丸" + }, + "answer": "B", + "reason": "异位妊娠已破损期的包块型是输卵管妊娠破损时间较长，腹腔内血液已形成血肿包块者。治宜活血化瘀，消癥杀胚。方用官外孕Ⅱ号方。" + }, + { + "question_num": 105, + "query": "上星穴的定位是", + "options": { + "A": "前发际正中", + "B": "前发际正中直上0.5寸", + "C": "前发际正中直上1寸", + "D": "前发际正中直上1.5寸", + "E": "前发际正中直上2寸" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 106, + "query": "流行性乙型脑炎邪犯卫气偏卫分证，治疗应首选", + "options": { + "A": "清瘟败毒饮", + "B": "新加香薷饮", + "C": "银翘白虎汤", + "D": "犀角地黄汤", + "E": "凉膈散" + }, + "answer": "B", + "reason": "流行性乙型脑炎邪犯卫气偏卫分证，治以辛凉解表、清暑化湿，首选方为新加香薷饮。" + }, + { + "question_num": 107, + "query": "下列各组腧穴中，相距不是1寸的是", + "options": { + "A": "中极、关元", + "B": "下腕、上腕", + "C": "中腕、上腕", + "D": "内关、间使", + "E": "外关、支沟" + }, + "answer": "B", + "reason": "下脘在上腹部，脐中上2寸，前正中线上。上脘在上腹部，脐中上5寸，前正中线上。二者相距3寸。" + }, + { + "question_num": 108, + "query": "疳证患儿，见小便短少，全身浮肿，以腰以下为著，四肢不温。治疗宜选方", + "options": { + "A": "五苓散", + "B": "真武汤", + "C": "防己黄芪汤", + "D": "金匮肾气丸", + "E": "五苓散合五皮饮" + }, + "answer": "B", + "reason": "本证为疳肿胀,症状偏于肾阳虚，故当用真武汤加减治疗。" + }, + { + "question_num": 109, + "query": "治疗血瘀证时，常配补气、行气药物的理论依据是", + "options": { + "A": "气能生血", + "B": "气能行血", + "C": "气能摄血", + "D": "血能载气", + "E": "血能生气" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 110, + "query": "五迟、五软的病因中，最重要的是", + "options": { + "A": "禀赋不足", + "B": "喂养不当", + "C": "护理不当", + "D": "瘀血阻络", + "E": "痰浊阻窍" + }, + "answer": "A", + "reason": "五迟、五软的主要病因责之于先天禀赋不足。" + }, + { + "question_num": 111, + "query": "关于切开引流的切口方向，下列哪项是错误的", + "options": { + "A": "循经切开，刀头向上", + "B": "乳房部呈放射状切开", + "C": "面部沿皮纹切开", + "D": "手指宜侧面切开", + "E": "关节区宜纵行切开" + }, + "answer": "E", + "reason": "关节区脓肿，一般施行横切口、弧形切口或“S”形切口。" + }, + { + "question_num": 112, + "query": "疳气的发病机制是", + "options": { + "A": "脾胃虚损，积滞内停", + "B": "脾胃失和，纳化失健", + "C": "脾胃虚衰，津液消亡", + "D": "脾胃阴虚，津液内耗", + "E": "脾失健运，精微不布" + }, + "answer": "B", + "reason": "疳气为疳症的初起阶段,由脾胃失和,纳化失健所致。以体略瘦，食欲不振为特征;疳积多由疳气发展而来，属脾胃虚损，积滞内停，虚实夹杂之证，病情较为复杂，腹大肢细是本证的典型体征;干疳为疳证的后期表现，由脾胃虚衰，津液消亡，气血两败所致，以形体极度消瘦,精神萎靡为特征，常病涉五脏而出现种种兼证。" + }, + { + "question_num": 113, + "query": "关于皮肉之间的急性化脓性疾患，局部光软无头，红肿热痛（少数初起皮色不变），范围在6~9cm，发病迅速，易肿，易溃，易脓，易敛。应诊断为", + "options": { + "A": "疖", + "B": "有头疽", + "C": "疔", + "D": "附骨疽", + "E": "痈" + }, + "answer": "E", + "reason": "痈为发于皮肉之间的急性化脓性疾患，局部光软无头，红肿热痛(少数初起皮色不变)，范围在6~9cm，发病迅速，易肿、易溃、易脓、易敛。" + }, + { + "question_num": 114, + "query": "夏季热的主要临床特征为", + "options": { + "A": "发热，口渴，便秘，尿少", + "B": "长期发热，口渴多饮，多尿，汗闭", + "C": "大热，大渴，大汗，脉洪大", + "D": "发热，口渴多饮，多尿，多汗", + "E": "发热，多食多饮，多尿，消瘦" + }, + "answer": "B", + "reason": "夏季热是暑天发生的季节性疾病，临床以长期发热、口渴多饮、多尿、少汗或汗闭为特征。" + }, + { + "question_num": 115, + "query": "关于慢性支气管炎的发病因素，以下哪一项是错误的", + "options": { + "A": "呼吸道局部防御功能和免疫功能低下", + "B": "自主神经功能失调", + "C": "呼吸道黏液分泌功能减退", + "D": "呼吸道黏液分泌功能亢进", + "E": "遗传易感性" + }, + "answer": "C", + "reason": "慢性支气管炎的发病因素包括内因和外因。外因包括吸烟、大气污染、寒冷等因素使副交感神经兴奋性增加，支气管痉挛，支气管黏膜杯状细胞增生，呼吸道黏液分泌功能亢进，气道净化能力减退，支气管黏膜充血水肿等。内因包括呼吸道局部防御功能和免疫功能低下和自主神经功能失调。同时，喘息型支气管炎患者常常有过敏史，提示有一定的遗传易感性。C项呼吸道黏液分泌功能减退不是慢性支气管炎的发病因素。" + }, + { + "question_num": 116, + "query": "小儿厌食的主要病机为", + "options": { + "A": "脾胃虚弱，纳化无权", + "B": "脾失健运，乳食不化", + "C": "暑湿内伤，脾为湿困", + "D": "脾胃不和，纳化失职", + "E": "肝郁气滞，乘脾犯胃" + }, + "answer": "D", + "reason": "脾主运化,胃司受纳,脾胃调和则口能知五味。若脾胃不和，纳化失职:则成厌食。" + }, + { + "question_num": 117, + "query": "急性水肿型胰腺炎的临床表现不包括", + "options": { + "A": "上腹部持续疼痛", + "B": "中等程度发热", + "C": "恶心、呕吐", + "D": "轻度黄疸", + "E": "上腹部有压痛、反跳痛与肌紧张" + }, + "answer": "E", + "reason": "上腹部有压痛，反跳痛与肌紧张提示有局限性腹膜炎、不应在水肿型胰腺炎中出现。" + }, + { + "question_num": 118, + "query": "2岁以内小儿反复呼吸道感染指一年内呼吸道感染超过", + "options": { + "A": "3次", + "B": "5次", + "C": "7次", + "D": "8次", + "E": "10次" + }, + "answer": "E", + "reason": "0~2岁小儿反复呼吸道感染的诊断标准是一年内呼吸道感染超过10次以上，其中下呼吸道感染3次以上。" + }, + { + "question_num": 119, + "query": "慢性肺源性心脏病发病的主要因素，下列哪项不正确", + "options": { + "A": "肺血管阻力增加", + "B": "气道梗阻", + "C": "肺动脉高压", + "D": "低氧血症及高碳酸血症", + "E": "血黏度增加" + }, + "answer": "B", + "reason": "肺心病的发病先决条件是肺血管阻力增加所致的肺动脉高压，使右心负荷加重，引起右室肥厚、扩大，导致肺心病、血黏度增加亦可加重肺动脉高压。长期的低氧血症和高碳酸血症可直接使心肌功能受损，加重右心功能衰竭。但气道梗阻不是诱发肺心病的直接因素。" + }, + { + "question_num": 120, + "query": "以下除哪项外，均是紫癜风热伤络证的症状", + "options": { + "A": "紫癜反复发作", + "B": "小腿及臀部较多", + "C": "颜色较鲜明", + "D": "关节肿痛，尿血", + "E": "起病缓慢，病程较长" + }, + "answer": "E", + "reason": "风伤热络证以起病较急,紫癜色泽鲜红，且伴风热表证为其特点。" + }, + { + "question_num": 121, + "query": "急性和慢性白血病的最主要区别是哪项", + "options": { + "A": "出血程度", + "B": "病程长短", + "C": "贫血程度", + "D": "WBC数目", + "E": "白血病细胞分化程度" + }, + "answer": "E", + "reason": "区别急、慢性白血病的主要根据是白血病细胞的分化程度，急性白血病的细胞分化停滞在较早阶段，多为原始细胞和早期幼稚细胞；慢性白血病的细胞停滞在较晚的阶段，多为较成熟幼稚细胞和成熟细胞。" + }, + { + "question_num": 122, + "query": "急惊风最多见的病因为", + "options": { + "A": "外感时邪", + "B": "内蕴痰热", + "C": "暴受惊恐", + "D": "饮食积滞", + "E": "热病伤阴" + }, + "answer": "A", + "reason": "急惊风多见于5岁以下儿童，多由外感时邪引发。" + }, + { + "question_num": 123, + "query": "下列哪一项不符合缺铁性贫血", + "options": { + "A": "血清铁蛋白减低", + "B": "血清铁减低", + "C": "总铁结合力减低", + "D": "转铁蛋白饱和度减低", + "E": "骨髓有核红细胞内铁减低" + }, + "answer": "C", + "reason": "缺铁性贫血时总铁结合力应该升高，C项不符合，其余各项均正确。" + }, + { + "question_num": 124, + "query": "百日咳的临床特征是", + "options": { + "A": "阵发性痉挛性咳嗽，咳末伴有较长的鸡鸣样吸气性吼声，最后倾吐痰沫", + "B": "连声干咳，咳声高亢，无痰", + "C": "阵发性咳嗽，咳声重浊，痰液黏稠", + "D": "呛咳不已，咽痛无痰", + "E": "喉间哮鸣气促，呼气延长" + }, + "answer": "A", + "reason": "百日咳又名顿咳、鸣咳,临床以阵发痉咳和鸡鸣样吼声为特征。" + }, + { + "question_num": 125, + "query": "下列哪项对诊断原发性肝癌有较高特异性", + "options": { + "A": "B超检查", + "B": "甲胎蛋白测定", + "C": "碱性磷酸酶", + "D": "核素显像", + "E": "乙肝病毒感染标志" + }, + "answer": "B", + "reason": "甲胎蛋白(AFP)测定对原发性肝癌有较高特异性。若放射免疫测定AFP＞400μg/L，并能除外妊娠、活动性肝病、生殖腺胚胎性肿瘤等，即可诊断为原发性肝癌。" + }, + { + "question_num": 126, + "query": "四缝穴的位置在", + "options": { + "A": "手1～5指间，指蹼缘后方赤白肉际处", + "B": "手1～4指掌侧，指骨关节横纹中点处", + "C": "手2～5指掌侧，近端指骨关节横纹中点处", + "D": "手1～4指掌侧，近端指骨关节横纹中点处", + "E": "手2～5指掌侧，掌指关节横纹中点处" + }, + "answer": "C", + "reason": "四缝:第2、第3、第4、第5指掌面，近端指间关节的中央，左右共8穴。" + }, + { + "question_num": 127, + "query": "肝硬化腹水患者，应首选的利尿剂为", + "options": { + "A": "甘露醇", + "B": "依他尼酸", + "C": "氢氯噻嗪", + "D": "螺内酯", + "E": "呋塞米" + }, + "answer": "D", + "reason": "肝硬化腹水的形成原因之一是继发性醛固酮增多，而螺内酯有抗醛固酮作用，临床实践证明螺内酯对肝硬化腹水病人有明显利尿效果，因此首选。" + }, + { + "question_num": 128, + "query": "骨度分寸规定，髀枢至膝中是", + "options": { + "A": "13寸", + "B": "14寸", + "C": "16寸", + "D": "18寸", + "E": "19寸" + }, + "answer": "E", + "reason": "髀枢至膝中是19寸。" + }, + { + "question_num": 129, + "query": "关于医德良心，下述提法中错误的是", + "options": { + "A": "医德良心是对道德情感的深化", + "B": "医德良心是对道德责任的自觉认识", + "C": "医德良心是一种自我评价能力", + "D": "医德良心是一种强烈的道德责任感", + "E": "医德良心因其不可见而很难确定其行为的作用" + }, + "answer": "E", + "reason": "良心是非常重要的伦理学范畴。由于同样生活在一个环境中，客观上说，仍然存在一些共享的道德标准和评价依据，它对行为的作用非常大，它的作用表现在行为前的选择，行为中的监督和行为后的评价。需注意良心是自己对自己的评价，不是自己对他人的评价。" + }, + { + "question_num": 130, + "query": "十二经脉的命名主要是结合了哪几方面的内容", + "options": { + "A": "阴阳、五行、脏腑", + "B": "五行、手足、阴阳", + "C": "手足、阴阳、五行", + "D": "脏腑、手足、阴阳", + "E": "脏腑、手足、五行" + }, + "answer": "D", + "reason": "十二经脉的名称由手足,阴阳、脏腑三部分组成。" + }, + { + "question_num": 131, + "query": "在社会主义市场经济条件下，加强医学伦理学教育的意义，不包括", + "options": { + "A": "防止和限制市场经济对医学实践的负面��响", + "B": "为医疗体制改革奠定基础", + "C": "解决医疗单位与人民群众的矛盾", + "D": "进一步提高医务人员的社会待遇", + "E": "提高医务人员的整体素质" + }, + "answer": "D", + "reason": "医学伦理道德教育，可以：①保障市场经济对医学实践促进作用的发挥，防止和最大限度地限制市场经济对医学实践的负面影响；②为医疗体制改革奠定基础、引导方向；③可以解决医疗单位内部以及医疗单位与人民群众的矛盾；④有利于提高医务人员的整体素质。" + }, + { + "question_num": 132, + "query": "手三里穴位于阳溪穴与曲池穴连线上，当", + "options": { + "A": "曲池穴下2寸处", + "B": "曲池穴下3寸处", + "C": "曲池穴下4寸处", + "D": "阳溪穴上8寸处", + "E": "阳溪穴上9寸处" + }, + "answer": "A", + "reason": "手三里:在阳溪穴与曲池穴连线上，肘横纹下2寸处。" + }, + { + "question_num": 133, + "query": "选择辅助检查时医生应遵循的道德要求不包括", + "options": { + "A": "综合考虑，确定检查项目", + "B": "知情同意，尽职尽责", + "C": "向病人解释清楚检查的危害性", + "D": "综合分析，避免片面性", + "E": "病情的需要是唯一的" + }, + "answer": "C", + "reason": "从诊疗需要出发，合理选择检查项目；告知检查目的，征得患者或家属同意；全面综合分析病情、尽量避免片面性。还要多考虑病人的需要和接受情况，从病人的切身利益出发是符合道德的。" + }, + { + "question_num": 134, + "query": "下合穴中可治疗肠痈、痢疾的是", + "options": { + "A": "足三里", + "B": "上巨虚", + "C": "下巨虚", + "D": "委中", + "E": "阳陵泉" + }, + "answer": "B", + "reason": "肠痈、痢疾的病变部位在大肠，应取大肠的下合穴治疗大肠的病变，大肠的下合穴是上巨虚。" + }, + { + "question_num": 135, + "query": "下列哪项不是月经先期的病因", + "options": { + "A": "脾气虚", + "B": "肾气虚", + "C": "阳盛血热", + "D": "肝郁血热", + "E": "血瘀" + }, + "answer": "E", + "reason": "月经先期的病因分为气虚和血热，气虚包含脾气虚和肾气虚，血热分为阳盛血热、阴虚血热和肝郁血热。" + }, + { + "question_num": 136, + "query": "具有强壮保健作用，主治咳喘，肺痨，诸虚百损的腧穴是", + "options": { + "A": "膏肓俞", + "B": "脾俞", + "C": "肾俞", + "D": "肺俞", + "E": "中府" + }, + "answer": "A", + "reason": "膏肓可主治：咳嗽、气喘、肺痨等肺之虚损证。" + }, + { + "question_num": 137, + "query": "小儿易患感冒、咳嗽等是因为", + "options": { + "A": "肺常不足", + "B": "脾常不足", + "C": "肾常虚", + "D": "纯阳之体", + "E": "稚阴稚阳" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 138, + "query": "百会穴在头正中线上，其具体位置在", + "options": { + "A": "人前发际7寸", + "B": "人前发际5寸", + "C": "人后发际6寸", + "D": "头顶旋毛中", + "E": "两耳连线上" + }, + "answer": "B", + "reason": "百会:价发际正中直上5寸处。或两耳尖直上、头正中线上。" + }, + { + "question_num": 139, + "query": "对急性脑梗死患者，下列哪种情况不适于溶栓治疗", + "options": { + "A": "发病6小时以内", + "B": "CT证实无出血灶", + "C": "病人无出血素质", + "D": "出凝血时间正常", + "E": "头部CT出现低密度灶" + }, + "answer": "E", + "reason": "头颅CT出现低密度灶说明该处神经细胞已经坏死，水肿，属溶栓禁忌证。" + }, + { + "question_num": 140, + "query": "脾经中用于治疗妇科疾病的常用穴位是", + "options": { + "A": "阴陵泉", + "B": "地机", + "C": "公孙", + "D": "商丘", + "E": "大横" + }, + "answer": "B", + "reason": "脾经腧穴中有不少用来治疗妇科疾病，但在所给5个选择中，地机最为常用。" + }, + { + "question_num": 141, + "query": "益智仁具有的功效是", + "options": { + "A": "补肾阳，益肾精", + "B": "温脾开胃摄唾", + "C": "养血益气", + "D": "益卫固表", + "E": "养肝明目" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 142, + "query": "下列何经绕肩胛", + "options": { + "A": "手阳明大肠经", + "B": "手厥阴心包经", + "C": "手太阳小肠经", + "D": "手少阴心经", + "E": "手太阴肺经" + }, + "answer": "C", + "reason": "手太阳小肠经沿上臂外侧后缘、出于肩关节、绕行肩胛部，交会于大椎(督脉)，向下进入缺盆部，联络心脏，沿着食管、通过横隔,到达胃部,属于小肠。" + }, + { + "question_num": 143, + "query": "流行性出血热治疗原则中的三早一就不包括", + "options": { + "A": "早发现", + "B": "早休息", + "C": "早诊断", + "D": "早治疗", + "E": "就近治疗" + }, + "answer": "C", + "reason": "流行性出血热治疗原则中的三早一就分别：早发现、早休息、早治疗及就近治疗。" + }, + { + "question_num": 144, + "query": "八脉交会穴中，主治心、胸、胃部疾患的是", + "options": { + "A": "内关、公孙", + "B": "列缺、照海", + "C": "外关、足临泣", + "D": "后溪、申脉", + "E": "以上均可" + }, + "answer": "A", + "reason": "内关配公孙可治疗胃、心、胸的疾病。" + }, + { + "question_num": 145, + "query": "传染性非典型肺炎潜伏期为", + "options": { + "A": "1～14天，通常在2～10天", + "B": "8～20天，通常在8～10天", + "C": "15～30天，通常在10～18天", + "D": "15～20天，通常在10～15天", + "E": "1～30天，通常在10～15天" + }, + "answer": "A", + "reason": "传染性非典型肺炎的潜伏期为1~14天，通常在2~10天。" + }, + { + "question_num": 146, + "query": "电针仪最大输出电压为40伏以上时，最大输出电流应限制在", + "options": { + "A": "1.5mA以内", + "B": "2mA以内", + "C": "1mA以内", + "D": "10mA以内", + "E": "10mA以上" + }, + "answer": "C", + "reason": "电针仪器最大输出血压在40伏以上者,最大输出电流应限制在1mA以内，防止触电。" + }, + { + "question_num": 147, + "query": "指出下列哪种是戊型肝炎病毒的主要传播途径", + "options": { + "A": "注射、输血", + "B": "蚊虫叮咬传播", + "C": "唾液传播", + "D": "垂直传播", + "E": "粪-口传播" + }, + "answer": "E", + "reason": "戊型肝炎病毒与甲型肝炎病毒一样，粪—口传播是其主要传播途径，特别是饮用水污染可引起戊型肝炎病毒暴发流行，其他途径均不是戊型肝炎病毒的传播途径。" + }, + { + "question_num": 148, + "query": "在下列特定穴中治疗腑病一般多用", + "options": { + "A": "五输穴", + "B": "络穴", + "C": "合穴", + "D": "俞穴", + "E": "募穴" + }, + "answer": "E", + "reason": "背俞穴、募穴主要用于治疗相关脏腑的病变。临床上腑病多选其募穴，脏病多选其背俞穴。" + }, + { + "question_num": 149, + "query": "传染病流行过程的基本条件", + "options": { + "A": "病原体，人体和他们所处的环境", + "B": "病原体，带菌动物，易感人群", + "C": "传染源，传播途径，易感人群", + "D": "传染源，传播途径", + "E": "社会环节，自然环节" + }, + "answer": "C", + "reason": "传染病流行过程的三个基本条件是传染源、传播途径和易感人群。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；传播途径是指病原体离开传染源后，到达另一个易感者的途径；易感人群是指对某一种传染病缺乏特异性免疫力的人群。" + }, + { + "question_num": 150, + "query": "患者，男，40岁。咳嗽，痰稠带血，咯吐不爽，心烦易怒，胸胁刺痛，颊赤，便秘，舌红苔黄，脉弦数。治疗应首选", + "options": { + "A": "十灰散", + "B": "四生丸", + "C": "咯血方", + "D": "百合固金汤", + "E": "养阴清肺汤" + }, + "answer": "C", + "reason": "咳嗽,痰稠带血,咳吐不爽，心烦易怒,胸胁刺痛，颊赤，便秘,舌红苔黄,脉弦数。治疗应首选咳血方。本题为肝火灼肺之咳血。" + }, + { + "question_num": 151, + "query": "发生霍乱时，对疫区接触者的检疫期是", + "options": { + "A": "3天", + "B": "5天", + "C": "7天", + "D": "9天", + "E": "12天" + }, + "answer": "B", + "reason": "对接触者应严密检疫5d，在检疫期应留观培养并服药预防。" + }, + { + "question_num": 152, + "query": "患者，女，36岁。数日大便不解，胸胁苦满，呕吐不止，郁郁微烦，往来寒热，心下痞硬，舌苔黄，脉弦而有力。治疗应首选", + "options": { + "A": "小承气汤", + "B": "大柴胡汤", + "C": "防风通圣散", + "D": "调胃承气汤", + "E": "麻子仁丸" + }, + "answer": "B", + "reason": "数日大便不解,胸胁苦满，呕吐不止，郁郁微烦,往来寒热,心下痞硬，舌苔黄，脉弦而有力。少阳阳明合病，用大柴胡汤。" + }, + { + "question_num": 153, + "query": "典型细菌性痢疾的粪便星", + "options": { + "A": "稀水样", + "B": "米泔水样", + "C": "鲜血便", + "D": "黏液脓血便", + "E": "灰白色便" + }, + "answer": "D", + "reason": "痢疾杆菌侵袭肠道，导致肠道局部小血管循环障碍，上皮细胞变性坏死、脱落、浅表溃疡形成，出现黏液脓血便。非感染性腹泻呈稀水便。霍乱可为米泔水样便。肛门病变可为鲜血便。淤胆型肝炎呈灰白色便。" + }, + { + "question_num": 154, + "query": "患者平时情绪急躁，心烦失眠，咳痰不爽，口苦而干，便秘。发作时昏仆，抽搐吐涎，两目上视，如作猪羊叫声，舌红苔黄腻，脉弦滑数，其治法是", + "options": { + "A": "涤痰息风，开窍定痫", + "B": "清肝泻火，化痰开窍", + "C": "豁痰开窍，清心定痫", + "D": "理气解郁，化痰开窍", + "E": "化痰息风，安神定志" + }, + "answer": "B", + "reason": "患者平时情绪急躁,心烦失眠,咳痰不爽，口苦而干，便秘。发作时昏仆，抽搞吐延，两目上视，如作猪羊叫声，舌红苔黄腻，脉弦滑数。治法是清肝泻火，化痰开窍，此病为痫病的休止期，舌红苔黄腻、脉弦滑数、心烦口苦、便秘,辨证为痰火扰心之证。" + }, + { + "question_num": 155, + "query": "HIV造成机体免疫功能损害主要侵犯的细胞是", + "options": { + "A": "CD4+T淋巴细胞", + "B": "CD8+T淋巴细胞", + "C": "B淋巴细胞", + "D": "NK细胞", + "E": "浆细胞" + }, + "answer": "A", + "reason": "CDT淋巴细胞在HIV直接和间接作用下，细胞功能受损和大量破坏，导致细胞免疫缺陷。虽然同时还侵犯其他类型免疫细胞：单核吞噬细胞、B淋巴细胞、NK细胞损伤及HIV感染后的免疫应答异常。最主要的还是CD4+T淋巴细胞。" + }, + { + "question_num": 156, + "query": "患者心烦不寐，心悸，头晕，耳鸣，腰酸梦遗，五心烦热，口干，舌红，脉细数，其治法是", + "options": { + "A": "化痰清热，和中安神", + "B": "益气镇惊，安神定志", + "C": "疏肝泄热，镇静安神", + "D": "滋阴降火，养心安神", + "E": "补养心脾，益气生血" + }, + "answer": "D", + "reason": "患者心烦不寐,心悸,头晕,耳鸣，腰酸梦遗，五心烦热，口干，舌红，脉细数。符合阴虚火旺之不寐，其治法是滋阴降火，养心安神。" + }, + { + "question_num": 157, + "query": "可经母婴途径传播的疾病是", + "options": { + "A": "细菌性痢疾", + "B": "流行性脑脊髓膜炎", + "C": "霍乱", + "D": "乙型肝炎", + "E": "伤寒" + }, + "answer": "D", + "reason": "乙型肝炎的传播途径：①母婴传播；②经皮传播(血液传播或医源性传播)；③性接触传播；④除以上3种传播途径外，当口腔黏膜(包括牙龈)破损时，有可能经口感染。通过昆虫也可能传播。" + }, + { + "question_num": 158, + "query": "患者发热恶风，汗出，脉浮缓，其证候是", + "options": { + "A": "表寒", + "B": "表虚", + "C": "表热", + "D": "表实", + "E": "虚寒" + }, + "answer": "B", + "reason": "发热恶风,汗出,脉浮缓,其证候符合表虚。易错选A项。" + }, + { + "question_num": 159, + "query": "下列关于霍乱临床表现的叙述，错误的是", + "options": { + "A": "典型大便为米泔水样", + "B": "成人一般无发热", + "C": "泻吐期主要为无痛性剧烈呕吐", + "D": "严重脱水出现烦躁不安", + "E": "恢复期所有患者出现反应性发热" + }, + "answer": "E", + "reason": "恢复期(反应期)患者脱水得到及时纠正后，大多数症状可迅速消失而恢复正常。此期约有部分患者出现发热，可能由于循环改善后，大量毒素吸收所致，一般持续1~3d，可不治自愈。无并发症者一般3~5d恢复。" + }, + { + "question_num": 160, + "query": "患者，男，32岁。发热微恶寒，咳嗽，咳白色黏沫痰，痰量渐多，胸痛，咳时痛甚，呼吸不利，口干鼻燥，舌苔薄黄，脉浮滑数。诊断为肺痈，其病期是", + "options": { + "A": "初期", + "B": "成痈期", + "C": "溃脓期", + "D": "恢复期", + "E": "晚期" + }, + "answer": "A", + "reason": "发热微恶寒,咳嗽、咳白色黏沫痰，痰量渐多，胸痛，咳时痛甚，呼吸不利，口干鼻燥,舌苔薄黄,脉浮滑数。诊断为肺痈，其病期是初期。" + }, + { + "question_num": 161, + "query": "患者，男，19岁。手足心热，夜眠多梦，时有遗精，舌质红，脉细数。用药宜首选", + "options": { + "A": "黄芩、黄连", + "B": "黄连、黄柏", + "C": "黄芩、黄柏", + "D": "黄柏、知母", + "E": "白果、莲子" + }, + "answer": "D", + "reason": "黄柏长于清相火，退虚热，常与知母相须为用，用于阴虚发热，盗汗遗精，如知柏地黄丸。此为阴虚发热证。" + }, + { + "question_num": 162, + "query": "患者心悸不宁，心烦少寐，头晕目眩，手足心热，耳鸣腰酸，舌红少苔，脉细数，其治法是", + "options": { + "A": "滋养肝肾，镇惊安神", + "B": "滋阴清火，养心安神", + "C": "滋阴益肾，定志安神", + "D": "益肾养心，镇惊安神", + "E": "滋阴养心，定志宁神" + }, + "answer": "B", + "reason": "手足心热,耳鸣腰酸,舌红少苔，脉细数，为阴虚火旺之候。治以滋阴清火，养心安神，" + }, + { + "question_num": 163, + "query": "患者，女，63岁。近3天痰多，胸闷，慢性咳嗽30年，喘息不得卧，一身面目浮肿，舌暗胖，苔白腻略黄，用药宜首选", + "options": { + "A": "葶苈子", + "B": "麻黄", + "C": "地龙", + "D": "旋覆花", + "E": "杏仁" + }, + "answer": "A", + "reason": "葶苈子的功效为泻肺平喘，利水消肿，用于痰涎壅盛，喘咳不得平卧之证。" + }, + { + "question_num": 164, + "query": "患者，女，45岁。不寐多梦，易惊，胆怯心悸，遇事善惊，舌淡苔白，脉虚弦，其治法是", + "options": { + "A": "交通心肾", + "B": "养血安神", + "C": "安神定志", + "D": "清心安神", + "E": "育阴潜阳" + }, + "answer": "C", + "reason": "易惊,胆怯心悸,遇事善惊,舌淡苔白,脉虚弦，为心胆气虚之表现，治以益气镇惊，安神定志。" + }, + { + "question_num": 165, + "query": "患者，女，50岁。体弱多病，形体消瘦，气短乏力，纳食不香，头晕心慌，面色苍白，时嗳气，腹胀，经查诊断为胃下垂。应选用哪一类药物", + "options": { + "A": "味辛，升浮药", + "B": "味甘，沉降药", + "C": "味甘，升浮药", + "D": "味酸，沉降药", + "E": "味苦，沉降药" + }, + "answer": "C", + "reason": "甘：能补、能缓、能和，即有补益、缓急止痛、调和药性、和中的作用，该证属于虚证，故用甘缓以补之。升浮之药能上行，提升气机，该病诊断为胃下垂，故用升浮之药以升阳举陷。" + }, + { + "question_num": 166, + "query": "患者突然昏倒仆地，神志不清，牙关紧闭，两目上视，手足抽搐，口吐涎沫，不久渐醒，醒后疲乏无力，舌苔白腻，脉弦滑，其证候是", + "options": { + "A": "痰火扰神", + "B": "心肾亏虚", + "C": "风痰闭阻", + "D": "瘀阻脑络", + "E": "心脾两虚" + }, + "answer": "C", + "reason": "昏倒仆地,舌苔白腻,脉弦滑，为肝风挟痰浊之象,辨证属风痰闭阻。" + }, + { + "question_num": 167, + "query": "患者，男，89岁。久病卧床，近日来冷汗自出，四肢厥逆，面色苍白，舌淡苔白，脉微欲绝。用药宜首选", + "options": { + "A": "肉桂、桂枝", + "B": "干姜、高良姜", + "C": "附子、干姜", + "D": "细辛、小茴香", + "E": "吴茱萸、丁香" + }, + "answer": "C", + "reason": "附子能上助心阳、中温脾阳、下补肾阳，为回阳救逆第一品药。用于久病体虚，阳气衰微，阴寒内盛，或大汗、大吐、大泻所致亡阳证，多与干姜、甘草同用，此为亡阳证。" + }, + { + "question_num": 168, + "query": "患者胃脘刺痛，痛有定处而拒按，食后痛甚，舌质紫暗，脉涩，其证候是", + "options": { + "A": "气机阻滞", + "B": "食积气阻", + "C": "瘀血停滞", + "D": "血瘀血虚", + "E": "气虚血瘀" + }, + "answer": "C", + "reason": "胃脘刺痛,痛有定处而拒按，为血瘀内停之表现。食后则触动其瘀，故食后痛甚。舌质紫暗，脉涩，为血瘀血行不通之表现。辨证属瘀血停滞，" + }, + { + "question_num": 169, + "query": "患者，女，28岁。月经提前1周，经量多，色鲜红，腰膝酸痛，五心烦热，舌质红，脉细数。除哪组药外均可选用", + "options": { + "A": "生地黄、牡丹皮", + "B": "牡丹皮、地骨皮", + "C": "茜草、蒲黄", + "D": "小蓟、旱莲草", + "E": "艾叶、炮姜" + }, + "answer": "E", + "reason": "凉血止血药、药性寒凉、能清血分之热而止血、适用于血热妄行之出血证。ABCD项均为凉血止血药，而E组为温经止血药、本证为阴虚血热证。" + }, + { + "question_num": 170, + "query": "患者，男，20岁。胃痛暴作，疼痛较剧，喜热敷，口不渴，舌苔薄白，脉弦紧。治疗应首选", + "options": { + "A": "理中丸", + "B": "良附丸", + "C": "藿香正气散", + "D": "人参健脾丸", + "E": "黄芪建中汤" + }, + "answer": "B", + "reason": "寒凝胃脘,阳气被遏,气��阻滞，不通则痛，故胃痛暴作,疼痛较剧;寒邪得温则散,故喜热敷;舌苔薄白，脉弦紧为寒邪入体之征,故辨证属寒邪客胃，治以温中散寒、理气止痛，方药选良附丸。理中汤、人参健脾九、黄芪建中汤有温中健脾之功效，主要用于脾胃虚寒证，排除ADE项。藿香正气散具有解表化湿之功效,排除C项。" + }, + { + "question_num": 171, + "query": "患者，男，40岁。右侧面神经麻痹一周，右眼闭合露睛，饮水外漏，体质尚可，用药首选", + "options": { + "A": "全蝎、蜈蚣", + "B": "全蝎、白僵蚕", + "C": "全蝎、地龙", + "D": "地龙、白僵蚕", + "E": "羌活、防风" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 172, + "query": "患者，女，65岁。身体素弱，饮食稍有不慎即呕吐未消化食物，面色白，倦怠乏力，四肢不温，便溏，舌淡苔白，脉濡弱。治疗应首选", + "options": { + "A": "吴茱萸汤", + "B": "理中丸", + "C": "黄芪建中汤", + "D": "苓桂术甘汤", + "E": "四君子汤" + }, + "answer": "B", + "reason": "脾胃虚寒,失于温煦,腐熟无力，运化失职，故呕吐未消化食物;脾为后天之本，化源不足，则面色白,倦怠乏力;脾主四肢肌肉，脾胃阳虚则四肢不温;舌淡苔白，脉濡弱均为脾胃阳虚之证，故辨证胃阳虚证，治以温中使脾、和胃降逆，方用理中九。吴茱萸汤主治胃中虚寒，黄芪建中汤主治虚劳里急。苓桂术甘汤主治痰饮内阻。四君子汤主治脾胃气虚。" + }, + { + "question_num": 173, + "query": "患者，女，35岁。哮喘咳嗽，痰多气急，咳吐黄稠痰，微恶风寒，舌苔黄腻，脉滑数。治疗应选用", + "options": { + "A": "止嗽散", + "B": "贝母瓜蒌散", + "C": "清气化痰丸", + "D": "麻杏石甘汤", + "E": "定喘汤" + }, + "answer": "E", + "reason": "定喘汤主治风寒外束，痰热内蕴证。症见咳嗽、痰多气急，咳吐黄稠痰，微恶风寒、舌苔黄腻，脉滑数。" + }, + { + "question_num": 174, + "query": "患者腹部刺痛较剧，痛处不移，触之痛甚，舌质紫暗，脉弦涩，其治法是", + "options": { + "A": "理气和胃", + "B": "理气活血", + "C": "活血化瘀", + "D": "化瘀散结", + "E": "化痰祛瘀" + }, + "answer": "C", + "reason": "刺痛为血瘀特点,患者腹部刺痛较剧，痛处不移，触之痛甚,舌质紫暗,脉弦涩，为瘀血表现。治以活血化瘀，" + }, + { + "question_num": 175, + "query": "患者，男，23岁。6月23日就诊。近来天气炎热，大量食用冷饮，昨夜通宵在空调低温下休息，早起感发热恶寒，头痛，胸膈满闷，恶心，呕吐1次，腹泻3次，舌苔白腻，脉濡或缓。治疗最佳选方是", + "options": { + "A": "九味羌活汤", + "B": "麻黄汤", + "C": "三仁汤", + "D": "平胃散", + "E": "藿香正气散" + }, + "answer": "E", + "reason": "藿香正气散主治内伤湿滞，外感风寒之证。本例患者发病季节、诱因和病变证候十分典型，辨证不难。麻黄汤主治无汗而喘；三仁汤主治湿温证；九味羌活汤主治外寒内热；平胃散主治脾胃湿滞，而无外感之证。" + }, + { + "question_num": 176, + "query": "患者久痢不愈，下痢稀薄，带有白冻，滑脱不禁，腹痛隐隐，口淡不渴，食少神疲，四肢不温，舌淡苔薄白，脉细弱。治疗应首选", + "options": { + "A": "连理汤合参苓白术散", + "B": "桃花汤合真人养脏汤", + "C": "良附丸合温脾汤", + "D": "芍药汤合四君子汤", + "E": "驻车丸合温脾汤" + }, + "answer": "B", + "reason": "久痢不愈,下痢稀薄,带有白冻,滑脱不禁，食少神疲，四肢不温为脾肾阳虚之表现。舌淡苔薄白，脉细弱，皆为虚寒征象。辨证为虚寒痢。治以温补脾肾，收涩固脱，方用桃花汤合真人养脏汤。连理汤合参苓白术散温中清肠，治疗寒热夹杂之休息痢，排除A项。良附丸散寒止痛，温脾汤治疗脾阳虚寒，驻车丸治疗阴虚痢，无温肾之功，排除CE项。芍药汤清热解毒，排除D项。" + }, + { + "question_num": 177, + "query": "患者自觉身微热，干咳无痰，心烦。咽干口渴，舌红，苔黄少津，右脉浮数，治方宜选", + "options": { + "A": "泻白散", + "B": "桑菊饮", + "C": "杏苏散", + "D": "桑杏汤", + "E": "清燥救肺汤" + }, + "answer": "D", + "reason": "桑杏汤主治外感温燥证。身热不甚，口渴，咽干鼻燥，干咳无痰或痰少而粘，舌红，苔薄白而干，脉浮数而右脉大者。" + }, + { + "question_num": 178, + "query": "患者眩晕，动则加剧，劳累即发，心悸少寐，面色苍白，���疲懒言，饮食减少，舌淡，脉细弱。治疗应首选", + "options": { + "A": "左归丸", + "B": "大定风珠", + "C": "温胆汤", + "D": "天麻钩藤饮", + "E": "归脾汤" + }, + "answer": "E", + "reason": "气血不足,清阳不展,脑失所养，则眩晕;气血不能荣心，则心悸少寐;清阳不升，则神疲懒言,饮食减少;舌淡，脉细弱，为气血亏虚之征。辨证属气血亏虚证，治以补养气血，健运脾胃，方用归脾汤。左归丸、大定风珠主治阴虚，排除AB项。温胆汤主治痰热，天麻钩藤饮主治肝阳上扰，排除CD项。" + }, + { + "question_num": 179, + "query": "患者，男，32岁。小便频数，白如米泔，凝如膏糊，舌淡苔白，脉沉。治宜选用", + "options": { + "A": "金锁固精丸", + "B": "缩泉丸", + "C": "桑螵蛸散", + "D": "天台乌药散", + "E": "草薢分清饮" + }, + "answer": "E", + "reason": "草薢分清饮功能温肾利湿，分清化浊。主治下焦虚寒之膏淋、白浊。" + }, + { + "question_num": 180, + "query": "患者，男，43岁。尿道中有白色分泌物滴出3年，劳累后更为明显，伴腰膝酸冷，放射至会阴部。形寒肢冷，精神不振，头晕。治疗应首选", + "options": { + "A": "龙胆泻肝丸", + "B": "知柏地黄丸", + "C": "左归丸", + "D": "济生肾气丸", + "E": "独活寄生汤" + }, + "answer": "D", + "reason": "辨证为慢性前列腺炎之肾阳虚损证，治宜:补肾助阳，故选方济生肾气丸。" + }, + { + "question_num": 181, + "query": "患者，男，40岁。胸膈痞闷，脘腹胀痛，嗳腐吞酸，恶心呕吐，饮食不消，脉弦滑，治疗应选用", + "options": { + "A": "左金丸", + "B": "越鞠丸", + "C": "枳实消痞丸", + "D": "厚朴温中汤", + "E": "保和丸" + }, + "answer": "B", + "reason": "越鞠丸主治六郁证。六郁之中以气郁为主，故气滞疼痛是主要证候。左金丸主治肝气犯胃，以胃脘热痛，吞酸嘈杂为主；枳实消痞丸所主为心下痞满，满而不痛，或疼痛不明显；厚朴温中汤有寒湿气滞；保和丸主治是食积，以食物不消为主症，气滞为次要证候。" + }, + { + "question_num": 182, + "query": "患者，男，60岁。双下肢发凉麻木已有2年。时有小腿部抽痛及间歇性跛行，近1月余足痛转为持续性静息痛，夜间痛剧，不能入睡，双足背动脉搏动消失，其诊断是", + "options": { + "A": "痛风", + "B": "雷诺氏病", + "C": "糖尿病足", + "D": "动脉硬化性闭塞症", + "E": "血栓闭塞性脉管炎" + }, + "answer": "D", + "reason": "辨证为脱疽之动脉硬化性闭塞症，而血栓闭塞性脉管炎的发病年龄多为20~40岁。雷诺氏病患者患肢动脉搏动正常。糖尿病足有多饮、多食、多尿等症状。" + }, + { + "question_num": 183, + "query": "患者症见骨蒸盗汗，心烦易怒，消渴多食，遗精尿赤，足膝热痛，舌红少苔，脉细数。治宜选用的方剂是", + "options": { + "A": "大补阴丸", + "B": "清骨散", + "C": "六味地黄丸", + "D": "右归饮", + "E": "当归六黄汤" + }, + "answer": "A", + "reason": "大补阴丸在补阴之中有强劲的清热泻火之力，所用药物是知母、黄柏，实为补泻同施。清骨散纯为清虚热之品组成，无补；六味地黄丸的主治与大补阴丸的主治十分接近，也是有补有泻，但是虚热不是十分亢进，就是骨蒸潮热还不是很突出；右归饮补阳，完全不能使用；当归六黄汤治疗表虚而内有实火之证。" + }, + { + "question_num": 184, + "query": "患者，女，21岁。因喉炎而服用磺胺药物，继见皮肤红斑及血疱，口腔、阴部黏膜糜烂，伴有口干，便秘，溲赤，舌红苔薄，脉细数。诊断为固定性红斑型药疹，内治应首选", + "options": { + "A": "消风散合黄连解毒汤", + "B": "萆薢渗湿汤合黄连解毒汤", + "C": "犀角地黄汤合黄连解毒汤", + "D": "清营汤", + "E": "普济消毒饮" + }, + "answer": "B", + "reason": "辨证为湿毒蕴肤;治宜:清热利湿解毒，故选方萆薢渗湿汤合黄连解毒汤。" + }, + { + "question_num": 185, + "query": "患者，男，60岁。3天前受凉，突然恶寒发热，无汗，咳嗽，夜间加剧，痰稀色白，舌苔薄白腻，脉浮紧，其证候是", + "options": { + "A": "寒邪客肺证", + "B": "风寒犯肺证", + "C": "外感风寒证", + "D": "风邪袭卫证", + "E": "饮邪停肺证" + }, + "answer": "B", + "reason": "咳嗽，夜间加剧，痰稀色白。说明病位在肺。恶寒发热，无汗，舌苔薄白腻，脉浮紧，说明感受了风寒之邪，故为风寒犯肺证。" + }, + { + "question_num": 186, + "query": "患者，女，46岁。半年来头皮，四肢出现皮损，色焮红，瘙痒，鳞屑增多，有筛状出血点，喜凉怕热，便干尿黄，舌红苔黄，脉滑数，其证候是", + "options": { + "A": "血虚肝旺", + "B": "火毒炽盛", + "C": "湿热蕴积", + "D": "血热", + "E": "风热" + }, + "answer": "D", + "reason": "辨证为白疕,相当于西医的银屑病，血热证，治宜:清热解毒凉血。选用方:犀角地黄汤或凉血地黄场加减。" + }, + { + "question_num": 187, + "query": "患者，女，58岁。心悸胸闷已2年，近日心悸加剧，且胸部闷痛，入夜加重，伴畏寒肢冷，舌淡胖，苔白滑，脉沉弦迟。临床诊断最可能是", + "options": { + "A": "心气虚证", + "B": "心阳虚证", + "C": "心脉痹阻证", + "D": "气虚血瘀证", + "E": "肾阳虚证" + }, + "answer": "B", + "reason": "心悸病用。其病位在心，畏寒肢冷、舌淡胖、苔白滑。脉沉弦迟，说明病性为阳虚、辩证为心阳虚证。" + }, + { + "question_num": 188, + "query": "患者，女，42岁。肛门部肿物，异物感明显，时肿痛。经查可见截石位3、7、11点为静脉曲张性外痔。应首选的治疗措施是", + "options": { + "A": "注射法", + "B": "枯痔法", + "C": "结手法", + "D": "切除法", + "E": "外剥内手法" + }, + "answer": "D", + "reason": "外痔首选切除法取侧卧位或截石位，用组织钳提起外痔组织，在痔中心自下缘至齿线作一纵行V宇形切口，再用剪刀分离皮下曲张的静脉丛，将皮肤及皮下组织一并切除，用凡士林纱条纳敷创面引流无菌纱布包扎。" + }, + { + "question_num": 189, + "query": "患者，男，50岁。患慢性支气管炎15年。近因受寒，使咳喘加重，并见胸闷痰多，痰稀白滑易咯出，舌苔白腻，脉滑，其证候是", + "options": { + "A": "寒邪客肺证", + "B": "风寒犯肺证", + "C": "痰湿阻肺证", + "D": "饮停于肺证", + "E": "肺气虚证" + }, + "answer": "C", + "reason": "咳喘、胸闷、痰多说明病位在肺；痰稀白滑易咳出，舌苔白腻、脉滑说明痰湿内盛，辩证为痰湿阻肺证。" + }, + { + "question_num": 190, + "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": "血瘤可发生于身体任何部位，但以四肢、躯干、面颈部多见。常在出生后即发现，随着年龄增长而长大，长到某种程度后，可停止进展。瘤体外观呈暗红色或紫蓝色，亦可为正常皮色，小如豆粒，大如举头，质地柔软，状如海绵，压之可缩小，肢体活动时胀大。" + }, + { + "question_num": 191, + "query": "患者，女，55岁。心悸、胸闷、气短，活动后加剧已3年。面色淡白，神疲乏力，语言低微，入夜不能安睡，舌淡苔白，脉弱，其证候是", + "options": { + "A": "心气虚证", + "B": "心阳虚证", + "C": "心血虚证", + "D": "肺气虚证", + "E": "肺阳虚证" + }, + "answer": "A", + "reason": "心悸、胸闷，其病位在心。气短，神疲乏力、语声低微、其病性为气虚，辨证为心气虚证。" + }, + { + "question_num": 192, + "query": "患者，女，18岁。两小腿皮肤炎症在急性阶段，大量渗液且红肿。外治剂宜用", + "options": { + "A": "洗剂", + "B": "粉剂", + "C": "溶液湿敷", + "D": "油剂", + "E": "软膏" + }, + "answer": "C", + "reason": "溶液适用于急性皮肤病,渗出较多或脓性分泌物多的皮损;粉剂和洗剂适用于无渗液的急性或亚急性皮炎类皮肤病;油剂适用于亚急性皮肤病中有糜烂、渗出、鳞屑、脓疱、溃疡的皮损;软膏适用于一切慢性皮肤病具有结痂、皲裂、苔藓样变等皮损。" + }, + { + "question_num": 193, + "query": "患者，女，78岁。大便干结难解，5日一行，口燥咽干，并伴有头晕，口臭，腹胀，舌红少津苔黄燥，脉细涩，其辨证是", + "options": { + "A": "上焦热盛", + "B": "肠燥津亏", + "C": "脾经湿热", + "D": "下焦湿热", + "E": "胃经湿热" + }, + "answer": "B", + "reason": "大使干结难解，5日一行，腹胀，说明病位在大肠；口燥咽干，舌红少津苔黄燥，脉细涩说明津液亏虚。头晕，口臭，为浊气上犯，也是大便秘结所致，故辩证为肠燥津亏证。" + }, + { + "question_num": 194, + "query": "患者，女，19岁。经期前后不定，经量或多或少，经行不畅，有血块，胸胁���乳房、少腹胀痛，精神抑郁，舌苔薄白，脉弦。治疗应首选", + "options": { + "A": "香棱丸", + "B": "丹栀逍遥散", + "C": "逍遥散", + "D": "乌药汤", + "E": "柴胡疏肝散" + }, + "answer": "C", + "reason": "经行不畅,有血块,胸胁、乳房、少腹胀痛,精神抑郁,舌苔薄白,脉弦,为肝郁之表现。治以疏肝解郁、和血调经，方用逍遥散。无肝郁化热之候,排除B项。" + }, + { + "question_num": 195, + "query": "患者，女，38岁。慢性腹泻已5年余，大便每日2～3次，稀便不成形，纳呆，腹胀，周身乏力，气短懒言，消瘦，舌淡苔白，脉缓，其证候是", + "options": { + "A": "脾阳虚证", + "B": "脾气虚证", + "C": "大肠虚寒证", + "D": "寒湿困脾证", + "E": "肺气虚证" + }, + "answer": "B", + "reason": "慢性腹泻已5年余，说明病程较久，多为虚证。周身乏力，气短懒言，说明是气虚，大便每日2~3次，稀便不成形、纳呆，腹胀，说明病位在脾，辨证为脾气虚证。" + }, + { + "question_num": 196, + "query": "患者，女，34岁，已婚。阴道出血40天不止，量多，色淡，质稀，神倦乏力，面浮肢肿，不思饮食，手足不温，舌淡苔白，脉沉弱。治疗应首选", + "options": { + "A": "归脾汤", + "B": "补中益气汤", + "C": "固本止崩汤", + "D": "举元煎", + "E": "大补元煎" + }, + "answer": "C", + "reason": "气血两虚崩漏反复发作,气随血去，导致气血两虚，故阴道出血40天不止，量多,色淡，质稀,神倦乏力，面浮肢肿,不思饮食，手足不温，舌淡苔白,脉沉弱。辨证属气血两虚，治以补血益气止血，方选固本止崩汤。归脾汤、补中益气汤无固冲止血之功。举元煎益气升提。大补元煎主治肾虚证。" + }, + { + "question_num": 197, + "query": "一患者，女，67岁，素有心脏病病史，常规体检时出现剑突下心脏搏动，吸气时加强，应考虑", + "options": { + "A": "左心房扩大", + "B": "右心房扩大", + "C": "左心室扩大", + "D": "右心室扩大", + "E": "脉压增大" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 198, + "query": "患者，女，40岁，已婚。每值经前1天出现大便溏泻。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": "健固汤", + "B": "香砂六君子汤", + "C": "补中益气汤", + "D": "白术散", + "E": "参苓白术散" + }, + "answer": "E", + "reason": "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，脉濡缓为脾气虚之表现。治以补脾益气，除湿止泻，方用参苓白术散。健固汤补脾渗湿，合四神丸治肾虚型经行泄泻。香砂六君子汤、补中益气汤、白术散无除湿止泻之功。" + }, + { + "question_num": 199, + "query": "女性，40岁。既往有风湿性心脏病史，近一周出现咳嗽、咳痰，双下肢浮肿，不能平卧。该患者还可能出现下列哪项体征", + "options": { + "A": "呼吸过缓", + "B": "深大呼吸", + "C": "潮式呼吸", + "D": "呼吸过速", + "E": "叹息样呼吸" + }, + "answer": "D", + "reason": "该例中年女性病人因患风湿性心脏病，近一周出现心力衰竭，表现为全心衰竭(左心衰竭——不能平卧；右心衰竭——下肢浮肿)，因而可能会出现呼吸过速。呼吸过速是指呼吸频率大于24次/分，见于心力衰竭、发热、疼痛、贫血和甲状腺功能亢进症等。呼吸过缓是指呼吸频率小于12次/分，见于麻醉剂或镇静剂过量和颅内压增高等；深大呼吸见于代谢性酸中毒时，如糖尿病酮症酸中毒和尿毒症酸中毒等；潮式呼吸多见于中枢神经系统疾病，如脑炎、脑血栓等，也可见于巴比妥中毒和尿毒症、糖尿病酮症酸中毒等；叹息样呼吸多为功能改变、见于神经衰弱、精神紧张或抑郁症。" + }, + { + "question_num": 200, + "query": "患者，女，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": "A", + "reason": "肾虚无力系胎,封藏失司。以致冲任不固，出现腰酸腿软，阴道少量出血，色暗淡,头晕耳鸣、小便清长等。辨证属肾虚，治以补肾固冲、止血安胎。方药为寿胎九。圣愈汤补气养血，主治血虚。胎元饮主治气虚。举元煎益气升提。保阴煎清热凉血。" + }, + { + "question_num": 201, + "query": "患者，男，26岁。心悸，���促1年。查体：两颊暗红，颈静脉明显怒张，下肢浮肿，心浊音界向左扩大，心尖区可闻及舒张期隆隆样杂音，肝右肋下4cm，质软，有压痛肝颈静脉回流征阳性。应首先考虑的是", + "options": { + "A": "二尖瓣狭窄并发右心衰竭", + "B": "二尖瓣关闭不全后期所致右心衰竭", + "C": "主动脉瓣狭窄并发左心衰竭", + "D": "主动脉瓣关闭不全并发左心衰竭", + "E": "肺源性心脏病致右心衰竭" + }, + "answer": "A", + "reason": "患者为青年男性、无慢性支气管炎病史、所以肺源性心脏病致右心衰竭可除外。心尖区可闻及舒张期隆隆样杂音、提示二尖瓣狭窄、所以二尖瓣关闭不全后期所致右心衰竭、主动脉瓣狭窄并发左心衰竭、主动脉瓣关闭不全并发左心衰竭可除外。颈静脉明显怒张，下肢水肿、心浊音界向左扩大，肝右肋下4cm、有压痛、肝颈静脉回流征阳性，提示右心衰竭表现。" + }, + { + "question_num": 202, + "query": "患者，女，36岁，已婚。带下量多，色白，质黏，无味，纳少便溏，神疲肢倦，舌淡苔白腻，脉缓弱。治疗应首选", + "options": { + "A": "完带汤", + "B": "止带方", + "C": "萆薢渗湿汤", + "D": "参苓白术散", + "E": "香砂六君子汤" + }, + "answer": "A", + "reason": "脾虚运化失职,内湿流注下焦，出现白带量多、无味、色白、质黏，纳少便溏、神疲肢倦，舌淡苔白腻,脉缓弱。辨证属脾阳虚，治以健脾益气，升阳除湿。止带方、萆薢渗湿汤主治湿热下注。参苓白术散主治脾虚挟湿。香砂六君子汤健脾止呕。" + }, + { + "question_num": 203, + "query": "患者，女，40岁。仰卧时腹部呈蛙状，侧卧时下侧腹部明显膨出。应首先考虑的是", + "options": { + "A": "胃肠胀气", + "B": "腹腔积液", + "C": "巨大卵巢囊肿", + "D": "肥胖", + "E": "子宫肌瘤" + }, + "answer": "B", + "reason": "仰卧位时腹部呈蛙状，侧卧位时下侧腹部明显膨出，移动性浊音阳性，提示腹腔积液。" + }, + { + "question_num": 204, + "query": "患者，女，18岁，未婚。每逢经期鼻衄，量中等，经行量少，色鲜，伴心烦易怒，两胁胀痛，舌红，苔黄，脉弦数。治疗应首选", + "options": { + "A": "加味逍遥散", + "B": "清肝引经汤", + "C": "顺经汤", + "D": "清经散", + "E": "清热固经汤" + }, + "answer": "B", + "reason": "肝经都火,伏于冲任,经期冲气偏盛，冲气挟肝火循经上逆，肝脉过亢，损伤阳络，则经行衄血，色深红;经不下行而由口鼻溢出，冲任气血因而不足，血海满溢不多甚或无血可下，则经量减少;肝气郁结,则烦踩易怒，两胁胀痛;舌红,苔黄,脉弦数,也为郁火之证。辨证属肝经郁火证，治以疏肝泻火，降逆止血。加味逍遥散疏肝泻火。顺经汤主治阴虚肺燥证。清经散治疗阳盛血热证。清热固经汤主治实热血热证，" + }, + { + "question_num": 205, + "query": "患者多食，大便每日2～3次。查体，血压140/60mmHg(18.62/7.98kPa)，双眼突出，心律不齐，脉搏短绌。应首先考虑的是", + "options": { + "A": "糖尿病合并缺血性心脏病", + "B": "风心病伴心房纤颤", + "C": "高血压性心脏病伴心房纤颤", + "D": "肺心病伴心房纤颤", + "E": "甲状腺功能亢进症伴心房纤颤" + }, + "answer": "E", + "reason": "患者多食，大便次数增多，双眼突出符合甲亢的特点，脉搏短绌、心律不齐为房颤特点。" + }, + { + "question_num": 206, + "query": "患者，女，20岁。经来量少，1天即净，现已停经半年，平时带下量多，色白，形体肥胖，胸脘满闷，时欲呕恶，舌苔腻，脉滑。治疗应首选", + "options": { + "A": "苍附导痰丸", + "B": "芎归二陈汤", + "C": "启宫丸", + "D": "归肾丸", + "E": "温胆汤" + }, + "answer": "A", + "reason": "带下量多,色白,形体肥胖,胸脘满闷,时欲呕恶,舌苔腻,脉滑,为痰湿阻滞之表现。治以豁痰除湿，活血通经，方用苍附导痰丸。芎归二陈汤主治痰湿犯肺，病位不同。启宫九主治妇人体肥痰盛，子宫脂满，不能孕育者。归肾丸主治肾阴不足。温胆汤主治痰热证。" + }, + { + "question_num": 207, + "query": "患者饱餐后上腹部持续疼痛1天。查体：上腹部压痛、反跳痛。应首先考虑的是", + "options": { + "A": "急性胃炎", + "B": "急性胰腺炎", + "C": "急性肝炎", + "D": "右肾结石", + "E": "肝癌" + }, + "answer": "B", + "reason": "本题考察上述几种疾病疼痛的鉴别诊断，其中急性胰腺炎多因饱餐后诱发，呈持续疼痛，有压痛、反跳痛。急性���炎有恶心，呕吐，上腹部压痛，无反跳痛；急性肝炎有发热，黄疸，恶心，呕吐，右上腹压痛；右肾结石见右上腹剧烈疼痛，右肾区叩击痛；肝癌见右上腹间断疼痛，有压痛，无反跳痛。" + }, + { + "question_num": 208, + "query": "患者，女，38岁，已婚。近半年来，月经40～45天一行，量少、色暗、时有血块，小腹及乳房作胀，舌略暗苔薄，脉弦。应首先考虑的是", + "options": { + "A": "月经后期", + "B": "月经过少", + "C": "痛经", + "D": "行经乳房胀痛", + "E": "以上均非" + }, + "answer": "A", + "reason": "月经后期是指月经周期延后7日以上，甚至3~5个月一行者;月经过少是指月经周期基本正常，经量明显减少，甚或点滴即净，或经期缩短不足两天，经量也少;痛经是指以经期、经行前后，由现周期性腹病、病引腰骶，甚至剧痛晕厥为主要表现的月经病；经行乳房胀病是指以行经前乳房胀满疼痛，按之有块为主要表现的月经病。" + }, + { + "question_num": 209, + "query": "男性，65岁。慢性喘息型支气管炎病史20余年，近5年来间断出现下肢浮肿，7天前受凉后咳、痰、喘加重，难以入睡，时有躁动，以下治疗错误的是", + "options": { + "A": "抗感染", + "B": "化痰", + "C": "利尿", + "D": "营养支持", + "E": "安眠药镇静" + }, + "answer": "E", + "reason": "患者老年男性，有慢性肺疾病，近5年来间断出现下肢浮肿，考虑慢性肺源性心脏病可能性大。现因感染诱发病情加重，应给予抗感染、化痰、解痉平喘、营养支持和改善右心功能等治疗。但应避免给予镇静剂，以免出现呼吸中枢受抑制，加重通气功能障碍，甚至诱发肺性脑病。" + }, + { + "question_num": 210, + "query": "患者，女，23岁，已婚。妊娠7个月，面浮肢肿，下肢尤甚，心悸气短，腰酸无力，舌淡苔薄润，脉沉细，其诊断是", + "options": { + "A": "妊娠肿胀脾虚证", + "B": "妊娠肿胀肾虚证", + "C": "妊娠肿胀气滞证", + "D": "胎动不安肾虚证", + "E": "以上均非" + }, + "answer": "B", + "reason": "患者主症为妊娠中晚期面浮肢肿。腰酸无力，舌淡苔薄润,脉沉细——肾气虚弱。面浮肢肿，下肢尤甚——子肿肾虚证典型表现。因此，此为子肿之肾虚证。治宜补肾温阳，化气行水。方用真武汤或肾气丸。" + }, + { + "question_num": 211, + "query": "男性，45岁。呕血400ml，黑便400g。查体：巩膜轻度黄染，肝脏未触及，脾肋下及边，肠鸣音活跃，移动性浊音阳性。诊断可能为", + "options": { + "A": "胃癌出血", + "B": "消化性溃疡出血", + "C": "食管胃底静脉曲张破裂出血", + "D": "肝癌破裂出血", + "E": "胆道出血" + }, + "answer": "C", + "reason": "呕血加黑便，结合体检发现巩膜黄染，提示肝病不能除外，又存在移动性浊音，可能系出血后白蛋白过低所致，因此，该患者最可能为食管胃底静脉曲张破裂出血。" + }, + { + "question_num": 212, + "query": "患儿，11个月。早产，生后一直人工喂养，经常泄泻。近四个月来食欲不振，面色㿠白，唇舌爪甲苍白，毛发稀黄，精神萎靡，手足欠温，舌淡苔白，指纹淡。检查：血红蛋白60g/L。治疗应首选", + "options": { + "A": "金匮肾气丸", + "B": "六味地黄丸", + "C": "右归丸", + "D": "理中丸", + "E": "小建中汤" + }, + "answer": "C", + "reason": "诊断为营养性缺铁性贫血。病在脾肾，为脾肾阳虚，当温补脾肾，益阴养血，选用右归丸加减。" + }, + { + "question_num": 213, + "query": "女性，21岁。患慢性肾小球肾炎4年，两天来发热咳嗽，查体：T38℃，重症贫血貌，心界向左下扩大，心率130次/分，右肺满布湿性啰音，肝在肋下1cm，无明显水肿，肾功能严重损害，胸透右肺炎症，应选下列哪种抗生素", + "options": { + "A": "多黏菌素", + "B": "卡那霉素", + "C": "青霉素", + "D": "庆大霉素", + "E": "四环素" + }, + "answer": "C", + "reason": "患者肾炎4年，两日来发热、咳嗽、心界扩大、右肺炎症，应选青霉素治疗。庆大霉素、卡那霉素具肾毒性，不宜使用。" + }, + { + "question_num": 214, + "query": "患儿，7岁。发热1天，恶寒，无汗，头痛，鼻塞流清涕，喷嚏咳嗽，口不渴，咽不红，舌苔薄白，脉浮紧，其证候是", + "options": { + "A": "风寒感冒", + "B": "风热感冒", + "C": "暑邪感冒", + "D": "感冒挟滞", + "E": "感冒挟痰" + }, + "answer": "A", + "reason": "该患者的临床表现符合风寒束表证。" + }, + { + "question_num": 215, + "query": "患者突然意识丧失，全身抽搐，面色紫绀，口吐白沫，小便失禁，5~6分钟后意识逐渐清醒。可能是", + "options": { + "A": "癔症", + "B": "舞蹈病", + "C": "癫痫", + "D": "帕金森病", + "E": "手足搐搦症" + }, + "answer": "C", + "reason": "该患者呈现典型的癫痫发作过程：突然意识丧失，全身抽搐，面色紫绀，口吐白沫，小便失禁，短时间内停止发作，并且意识逐渐恢复。答案是C项，其他均不可能，因为均不会有意识丧失。" + }, + { + "question_num": 216, + "query": "患儿，2岁。面色苍白、唇淡甲白、发黄稀疏、神疲乏力、形体消瘦3个月，诊断为营养性缺铁性贫血，西药选用铁剂治疗后，正确的停药时间为血红蛋白", + "options": { + "A": "开始升高时", + "B": "达正常时", + "C": "达正常后2个月左右", + "D": "达正常后4个月左右", + "E": "达正常后6个月左右" + }, + "answer": "C", + "reason": "营养性缺铁性贫血西药选用铁剂治疗，服用时间要血红蛋白达到正常水平后2个月左右再停药。" + }, + { + "question_num": 217, + "query": "男性，60岁。心前区阵发性疼痛1个月，多在夜间发作。与活动无关。每次发作15分钟，发作时心电图Ⅱ、Ⅲ、aVF导联ST段抬高。首选治疗的药物是", + "options": { + "A": "硝酸酯类", + "B": "β受体阻滞剂", + "C": "钙离子拮抗剂", + "D": "洋地黄类", + "E": "胺碘酮" + }, + "answer": "C", + "reason": "该老年男性病人心前区疼痛的特点是多在夜间发作，与活动无关，疼痛呈发作性，且发作时心电图相关导联ST段抬高，符合典型的变异型心绞痛，是由于冠状动脉痉挛所致，该类心绞痛的首选治疗药物是钙离子拮抗剂，可以扩张冠状动脉，解除冠状动脉痉挛，改善心肌血液供应。" + }, + { + "question_num": 218, + "query": "患儿，3岁。面色少华，不思纳食，形体偏瘦，舌淡苔薄白，其治法是", + "options": { + "A": "健脾化湿", + "B": "健脾和胃", + "C": "疏肝和胃", + "D": "消食导滞", + "E": "和脾助运" + }, + "answer": "E", + "reason": "辨证为脾失健运证。舌苔薄白未见湿象，无弦脉、胁肋、口苦等肝证症状，无饮食积滞症状，无胃脘不舒适的症状。治法应和脾助运。" + }, + { + "question_num": 219, + "query": "男性，64岁。反复咳嗽、咳痰、痰中带血2周。体温38.3℃，WBC12×10^9/L，胸片见右肺门肿块影，伴远端大片状阴影，抗感染治疗阴影不吸收。最有可能的诊断是", + "options": { + "A": "肺炎", + "B": "肺化脓症", + "C": "肺癌", + "D": "肺结核", + "E": "支气管扩张" + }, + "answer": "C", + "reason": "该老年男性病人近期发生咳嗽和痰中带血，胸片有肺门肿块影和片状阴影，虽有发热和血白细胞增高，但抗感染治疗阴影不吸收，所以最有可能的诊断是肺癌，有助于尽快明确诊断的检查首选纤支镜，不仅可直接观察病变情况，还可取组织进行病理学检查。" + }, + { + "question_num": 220, + "query": "患儿，2岁。持续壮热5天，起伏如潮，肤有微汗，烦躁不安，目赤眵多，皮疹布发，疹点由细小稀少而逐渐稠密，疹色先红后暗，皮疹凸起，触之碍手，压之褪色，大便干结，小便短少，舌质红赤，舌苔黄腻，脉数有力。治疗应首选", + "options": { + "A": "宣毒发表汤", + "B": "清解透表汤", + "C": "沙参麦冬汤", + "D": "麻杏石甘汤", + "E": "羚角钩藤汤" + }, + "answer": "B", + "reason": "患儿壮热5天,疹点由细小稀少而逐渐稠密,为出疹期，又大便干结，小便短少，舌质红赤，舌苔黄腻,脉数有力，毒象明显，当清解透表，解毒。选用清解透表汤。" + }, + { + "question_num": 221, + "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": "应到准予注册的上一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》第十八条规定：医师变更执业地点、执业类别、执业范围等注册事项的，应当依照本法规定到准予注册的卫生健康主管部门办理变更注册手续。" + }, + { + "question_num": 222, + "query": "患儿，男，6岁。皱眉眨眼，���头耸肩，嘴角抽动，时伴异常发声，病情时轻时重。抽动时能受意志遏制，可暂时不发作。查脑电图未见异常，其诊断是", + "options": { + "A": "习惯性抽搐", + "B": "多发性抽搐", + "C": "癫痫", + "D": "注意力缺陷多动症", + "E": "风湿性舞蹈病" + }, + "answer": "B", + "reason": "A项多无意志改变。B项多发性抽搐或称进行性抽搐，又称抽动—秽语综合征，是一种以运动、言语和抽搐为特点的综合征或行为障碍，起病在2~12岁之间，男童发病较女童多。抽动为一种不自主、突发、快速、反复发生、无节律、方式固定的运动或发声。C项半数有先兆，如头昏、精神错乱、上腹部不适、视听和嗅觉障碍，本患者无此表现。D项是以与年龄不相称的活动过多、注意力不集中、任性、易冲动为主要特征的行为障碍。智力基本正常。E项由风湿性感染所致，具有相应的症状和化验结果(如ESR、ASO、CRP等)，很少有发声抽动或秽语、强迫障碍等表现。" + }, + { + "question_num": 223, + "query": "黄某2001年10月因医疗事故受到吊销医师执业证书的行政处罚，2002年9月向当地卫生健康主管部门申请重新注册。卫生健康主管部门经过审查决定对黄某不予注册，理由是黄某被吊销医师执业证书不满", + "options": { + "A": "1年", + "B": "2年", + "C": "3年", + "D": "4年", + "E": "5年" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 224, + "query": "患儿，女，8岁。遗尿3个月余，每隔3、5夜1次，面色萎黄，纳食不多，舌淡苔薄，脉细弱。治疗应首选", + "options": { + "A": "中极、关元、三阴交、膀胱俞", + "B": "中极、天枢、足三里、阴陵泉、太冲", + "C": "关元、太溪、三阴交、至阴", + "D": "气海、太冲、行间、昆仑、曲池", + "E": "曲骨、内庭、太溪、肾俞、气海" + }, + "answer": "A", + "reason": "进尿,而色萎黄,纳食不多，舌淡营薄，脉细弱。治疗应首选中极、关元、三阴交、膀胱俞。关元充益肾气，固摄下元、三阴交为三阴经交会穴可调补脾胃，本病为膀胱失约，故取膀胱募穴中极和膀胱俞，振奋膀胱机能。" + }, + { + "question_num": 225, + "query": "患者，男，18岁。突然出现无痛性腹泻，米泔水样便，量多，大便频繁，继之出现喷射状呕吐，呕吐物为米泔水样。查体：神志淡漠，声音嘶哑，眼窝深凹，口唇干燥。应首先考虑的是", + "options": { + "A": "霍乱", + "B": "急性细菌性痢疾", + "C": "急性胃肠炎", + "D": "伤寒", + "E": "副伤寒" + }, + "answer": "A", + "reason": "霍乱多突然发病，以剧烈腹泻开始，继之呕吐。多无腹痛、里急后重，大便日数次至数十次，开始为稀便，后为水样，少数为米泔水样。腹泻1~2次后出现喷射状呕吐，与大便性质相似，常无恶心。严重吐泻后，可迅速出现脱水虚脱。细菌性痢疾的特点为里急后重，黏液脓血便。伤寒、副伤寒会伴有皮疹或皮下出血点。出现腹泻、呕吐症状、但不是米泔样。" + }, + { + "question_num": 226, + "query": "患者，男，48岁。耳中胀痛，鸣声不断，按之不减，烦躁易怒，胸胁胀痛，口苦咽干，舌苔黄，脉弦数。治疗除取翳风、听会、侠溪、中渚外，还应加", + "options": { + "A": "外关、合谷", + "B": "听宫、足三里", + "C": "太冲、丘墟", + "D": "肾俞、关元", + "E": "耳门、太溪" + }, + "answer": "C", + "reason": "肝胆火盛之耳鸣，太冲配胆经原穴丘墟，用泻法清泻肝胆之火，取病在上,取之下和盛则泻之之意。" + }, + { + "question_num": 227, + "query": "患者，男，20岁。近2周自觉乏力，食欲不振，厌油，腹胀。检查：巩膜无黄染，肝肋缘下2cm，有压痛，谷丙转氨酶升高。应首先考虑的是", + "options": { + "A": "急性肝炎", + "B": "慢性肝炎", + "C": "重型肝炎", + "D": "淤胆型肝炎", + "E": "肝炎肝硬化" + }, + "answer": "A", + "reason": "患者属急性无黄疸型肝炎。本病主要表现为乏力、食欲不振，腹胀，肝区疼痛，谷丙转氨酶升高有助诊断。急性肝炎病程超过半年，为慢性肝炎。重型肝炎症状较重。淤胆型肝炎、自觉症状较轻，皮肤瘙痒，大便灰白。肝炎肝硬化为慢性肝炎，有门脉高压证据，出现肝脏缩小等。" + }, + { + "question_num": 228, + "query": "患者，女，36岁。1周来头晕目眩，伴胸胁胀闷，舌红，脉弦。治疗应首选", + "options": { + "A": "脾俞、足三里、气海、百会", + "B": "丰隆、中脘、内关、头维", + "C": "胃俞、丰隆、太冲、期门", + "D": "风池、肝俞、行间、侠溪", + "E": "百会、胆俞、外关、侠溪" + }, + "answer": "D", + "reason": "为肾阴不足而肝阳上亢，故取胆经风池、侠溪，肝经行间以清泻肝胆上亢之阳,取肝俞而实肝肾之阴。" + }, + { + "question_num": 229, + "query": "某患者由印尼入境后2天。频繁腹泻，无腹痛及里急后重，伴有呕吐。最重要的检查是", + "options": { + "A": "血常规", + "B": "尿常规", + "C": "电解质", + "D": "泻吐物悬滴检查", + "E": "以上均非" + }, + "answer": "D", + "reason": "频繁腹泻，无腹痛及里急后重，伴有呕吐，考虑为霍乱，最重要的检查是泻、吐物悬滴检查。" + }, + { + "question_num": 230, + "query": "患者，男，32岁。两年前因高处跌落致腰疼，至今未愈，腰部僵硬，刺痛明显，治疗除选取主穴外，应加用", + "options": { + "A": "志室、太溪", + "B": "次髎、膈俞", + "C": "风池、腰阳关", + "D": "命门、太冲", + "E": "太溪、肝俞" + }, + "answer": "B", + "reason": "因高处跌落致腰痛，至今未愈,腰部僵硬，刺痛明显。治疗除选取主穴外,应加用次髎、膈俞。此症为瘀血腰痛，膈俞为血之会，合次髎以疏利膀胱经气，消络中瘀滞。" + }, + { + "question_num": 231, + "query": "男，16岁。乏力，食欲减退，黄疸进行性加深10d，神志不清1d。查体：明显黄疸，烦躁不安，皮肤瘀斑，肝右肋下未扪及，肝浊音界7~8肋，扑击样震颤阳性，血清总胆红素255μmol/L，ALT200U/L，凝血酶原活动度28%，诊断应考虑", + "options": { + "A": "急性黄疸型肝炎", + "B": "急性重症肝炎", + "C": "亚急性重症肝炎", + "D": "慢性重症肝炎", + "E": "淤胆型肝炎" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 232, + "query": "患者，女，18岁。头痛1天，以后头部为重，痛如锥刺，舌淡。治疗除用阿是穴外，应选取", + "options": { + "A": "天柱、后顶、昆仑", + "B": "上星、头维、合谷", + "C": "百会、通天、行间", + "D": "率谷、太阳、悬钟", + "E": "血海、合谷、申脉" + }, + "answer": "A", + "reason": "头痛根据病位可分为前头痛、后头痛、侧头痛、巅顶痛、全头痛几种，其中前头病与阳明经有关，后头痛与太阳经有关，巅顶痛与厥阴经有关，侧头痛与少阳经有关，全头痛与少阴经有关。本症中的后头痛与太阳经有关，所以答案应在AE项中选取。但是E项中的血海与本症没有关系，故本题选A项。" + }, + { + "question_num": 233, + "query": "患者腹痛、腹泻3天，大便呈黏液脓血便，伴发热。应首先考虑的是", + "options": { + "A": "细菌性痢疾", + "B": "阿米巴痢疾", + "C": "急性胃肠炎", + "D": "血吸虫病", + "E": "霍乱" + }, + "answer": "A", + "reason": "细菌性痢疾多为黏液脓血便、恶寒发热，BCDE项少见脓血便。" + }, + { + "question_num": 234, + "query": "患者牙痛剧烈，伴口臭，口渴，便秘，舌苔黄，脉洪。治疗应首选", + "options": { + "A": "风池", + "B": "外关", + "C": "足三里", + "D": "地仓", + "E": "内庭" + }, + "answer": "E", + "reason": "牙痛除循经取穴外，还要根据症状取穴，本症见口臭、口渴等症状，一派胃热之象。最善于泻胃热的是胃经的荥穴内庭，因为荥主身热。" + }, + { + "question_num": 235, + "query": "患儿，5岁。高热3d，伴呕吐。查体：全身皮肤散在出血点，颈项强直，克氏征阳性。应首先考虑的是", + "options": { + "A": "结核性脑膜炎", + "B": "流行性脑脊髓膜炎", + "C": "流行性乙型脑炎", + "D": "伤寒", + "E": "中毒性菌痢" + }, + "answer": "B", + "reason": "流行性脑脊髓膜炎主要临床表现是突发高热，剧烈头疼，频繁呕吐，皮肤黏膜瘀点、瘀斑及脑膜刺激征，严重者可有败血症休克和脑实质损害，脑脊液呈化脓性改变，儿童易患。流行性乙型脑炎临床上以高热、意识障碍、抽搐、病理反射及脑膜刺激征为特征。结核性脑膜炎起病慢、病程长，有低热、盗汗、消瘦等症状，神经系统症状出现晚，无瘀点、瘀斑。" + }, + { + "question_num": 236, + "query": "患儿，男，10岁。睡梦中遗尿，每夜1次，精神不振，脉细弱。治疗应首选", + "options": { + "A": "中极、三阴交、脾俞、肺俞", + "B": "关元、三阴交、肾俞、膀胱俞", + "C": "中极、足三里、胃俞、肾俞", + "D": "关元、足三里、肺俞、膀胱俞", + "E": "中极、三阴交、肺俞、三焦俞" + }, + "answer": "B", + "reason": "小儿遗尿主要因为肾气不固，膀胱失约造成，所以治疗上当以补肾气，固膀胱为主。穴取肾俞、膀胱俞，针用朴法。另取关元，用炙法，取三阴交，用朴法，其他选项中的肺俞、胃俞、三焦俞与小儿遗尿的治疗关系不大。" + }, + { + "question_num": 237, + "query": "患者，女，50岁。因恼怒致胃脘胀痛，嗳气，呕酸，舌苔薄白，脉弦。依据近部取穴的原则，治疗应首选", + "options": { + "A": "足三里", + "B": "膻中", + "C": "太冲", + "D": "天枢", + "E": "中脘" + }, + "answer": "E", + "reason": "嗳腐吞酸,主要病位在胃。选用下合穴足三里或者胃的募穴中腕均可，但是题干提示近部取穴。" + }, + { + "question_num": 238, + "query": "患者，男，45岁。自觉心慌心烦，时息时作，健忘失眠。治疗应首选", + "options": { + "A": "三阴交", + "B": "神门", + "C": "足三里", + "D": "太溪", + "E": "合谷" + }, + "answer": "B", + "reason": "此患者为心悸，首选心经原穴神门宁心安神。" + } +] \ No newline at end of file