diff --git "a/Licensed/Theory_Questions/Year_2/Past_Paper.json" "b/Licensed/Theory_Questions/Year_2/Past_Paper.json" new file mode 100644--- /dev/null +++ "b/Licensed/Theory_Questions/Year_2/Past_Paper.json" @@ -0,0 +1,5332 @@ +[ + { + "question_num": 1, + "query": "中医建立治则治法的主要依据是", + "options": { + "A": "症状", + "B": "证候", + "C": "疾病", + "D": "病因", + "E": "病机" + }, + "answer": "B", + "reason": "辨证论治,是运用中医学理论辨析有关疾病的资料以确立证，论证其治则治法方药并付诸实施的思维和实践过程。" + }, + { + "question_num": 2, + "query": "五轮学说认为,白睛所属的是", + "options": { + "A": "心", + "B": "肺", + "C": "肝", + "D": "肾", + "E": "脾" + }, + "answer": "B", + "reason": "目内眦及外眦的血络属心，称为“血轮”黑珠属肝,称为“风轮”;白睛属肺,称为“气轮”;瞳仁属肾,称为“水轮”;眼胞属脾,称为“肉轮”" + }, + { + "question_num": 3, + "query": "“病时间时甚者”当取的特定穴是", + "options": { + "A": "井穴", + "C": "输穴", + "B": "荣穴", + "D": "经穴", + "E": "合穴" + }, + "answer": "C", + "reason": "《灵枢·顺气一日分为四时》云:“病在脏者,取之井;病变于色者,取之荣:病时间时甚者,取之输;病变于音者,取之经;经满而血者，病在胃及之合。”" + }, + { + "question_num": 4, + "query": "湿邪所致外科疾病多发于人体的部位是", + "options": { + "A": "上部", + "B": "中部", + "C": "胸部", + "D": "背部", + "E": "下部" + }, + "answer": "E", + "reason": "湿性趋下,重浊黏腻,所致外科疾病好发于身体下部。" + }, + { + "question_num": 5, + "query": "天地万物相互联系的中介是", + "options": { + "A": "天气", + "B": "地气", + "C": "精气", + "D": "阴气", + "E": "阳气" + }, + "answer": "C", + "reason": "精气是天地万物生成的本原,天地万物之间又充斥着无形之气，且这无形之气还能渗入有形实体，与已构成有形实体的气进行各种形式的交换活动，因而精气可为天地万物相互联系、相互作用的中介性物质。" + }, + { + "question_num": 6, + "query": "按《素问·刺热》面部分候法,候脾的部位是", + "options": { + "A": "额部", + "B": "鼻部", + "C": "左颊", + "D": "右颊", + "E": "颏部" + }, + "answer": "B", + "reason": "《素问·刺热》分候法中,候脾的部位是鼻部." + }, + { + "question_num": 7, + "query": "股骨大转子至腘横纹间骨度分寸为", + "options": { + "A": "12寸", + "B": "14寸", + "C": "15寸", + "D": "16寸", + "E": "19寸" + }, + "answer": "E", + "reason": "根据骨度分寸,股骨大转子至腘横纹(平髌尖)为19寸。" + }, + { + "question_num": 8, + "query": "“痛无定处,忽彼忽此,走注甚速”,其疼痛的原因是", + "options": { + "A": "风痛", + "B": "湿痛", + "C": "痰痛", + "D": "热痛", + "E": "化脓痛" + }, + "answer": "A", + "reason": "风痛:痛无定处,忽彼忽此,走注甚速,遇风则剧;见于行痹等。" + }, + { + "question_num": 9, + "query": "以四季分阴阳,秋季为", + "options": { + "A": "阴中之阴", + "B": "阴中之阳", + "C": "阴中之至阴", + "D": "阳中之阳", + "E": "阳中之阴" + }, + "answer": "E", + "reason": "肺属金,位西方,通于秋,属阳中之阴的少阴。" + }, + { + "question_num": 10, + "query": "咽喉溃烂处上覆白腐,形如白膜者,称为", + "options": { + "A": "乳蛾", + "B": "喉痈", + "C": "鹅口疮", + "D": "咽喉成脓", + "E": "伪膜" + }, + "answer": "E", + "reason": "咽喉溃烂处上覆白腐,形如白膜者,称为伪膜。" + }, + { + "question_num": 11, + "query": "既可治疗咳嗽气喘,又可治疗头痛齿痛等头面部疾患的腧穴是", + "options": { + "A": "少泽", + "B": "少海", + "C": "曲泽", + "D": "曲池", + "E": "列缺" + }, + "answer": "E", + "reason": "列缺主治:①咳嗽、气喘、咽喉肿痛等肺系病证;②头痛、齿痛、项强、口眼歪斜等头面部疾患;③手腕痛。" + }, + { + "question_num": 12, + "query": "中医外科内治法中,温阳托毒法的代表方是", + "options": { + "A": "透脓散", + "B": "托里消毒散", + "C": "神功内托散", + "D": "右归丸", + "E": "桂附八味丸" + }, + "answer": "C", + "reason": "温阳托毒法代表方神功内托散。" + }, + { + "question_num": 13, + "query": "下列属阳的症状为", + "options": { + "A": "语声低微", + "B": "语声高亢", + "C": "面色苍白", + "D": "脉沉迟", + "E": "畏寒肢冷" + }, + "answer": "B", + "reason": "一般地说,凡是运动的、外向的、上升的、弥散的、温热的、明亮的、兴奋的都属于阳;相对静止的、内守的、下降的、凝聚的、寒冷的、晦暗的、抑制的都属于阴。" + }, + { + "question_num": 14, + "query": "小腿部皮肤突然鲜红成片,色如涂丹，边缘清楚,灼热肿胀者,称为", + "options": { + "A": "抱头火丹", + "B": "麻疹", + "C": "流火", + "D": "瘾疹", + "E": "赤游丹" + }, + "answer": "C", + "reason": "皮肤突然鲜红成片,色如涂丹,边缘清楚,灼热肿胀者,为丹毒。发于头面者,名抱头火丹;发于小腿足部者,名流火。" + }, + { + "question_num": 15, + "query": "人下齿中的经脉是", + "options": { + "A": "手阳明大肠经", + "B": "手少阳三焦经", + "C": "手太阳小肠经", + "D": "足阳明胃经", + "E": "足少阳胆经" + }, + "answer": "A", + "reason": "《灵枢·经脉》:大肠手阳明之脉,起于大指次指之端,循指上廉,出合谷两骨(第1、第2掌骨)之间,上入两筋(拇长伸肌腱与拇短伸肌腱)之中,循臂上廉,人肘外廉,上臑外前廉,上肩,出髃骨(肩胛骨肩峰部)之前廉,上出于柱骨(颈椎骨)之会上,下入缺盆!络肺,下膈,属大肠,其支者,从缺盆上颈,贯颊，人下齿中;还出夹口,交人中--左之右、右之左,上夹鼻孔。" + }, + { + "question_num": 16, + "query": "下列各项,不宜用溻溃法的是", + "options": { + "A": "阳证疮疡初起", + "B": "阳证疡成脓", + "C": "阳证疮疡溃后", + "D": "半阴半阳证疮疡", + "E": "阴证疮疡" + }, + "answer": "B", + "reason": "溻溃法用于阳证疮疡初起溃后;半阴半阳证及阴证疮疡;美容、保健等。" + }, + { + "question_num": 17, + "query": "下列事物五行属性不属于木的是", + "options": { + "A": "肝", + "B": "胆", + "C": "筋", + "D": "春季", + "E": "长夏" + }, + "answer": "E", + "reason": "长夏五行属性属土,不属木," + }, + { + "question_num": 18, + "query": "下列四肢动态异常中,因寒邪凝滞所致的临床表现是", + "options": { + "A": "四肢痿废", + "B": "四肢抽搐", + "C": "手足拘急", + "D": "手足颤动", + "E": "手足蠕动" + }, + "answer": "C", + "reason": "手足拘急为寒邪凝滞,或气血亏虚。" + }, + { + "question_num": 19, + "query": "即可治疗心悸,又可治疗语言謇涩的腧六具", + "options": { + "A": "少泽", + "C": "少冲", + "B": "少海", + "D": "极泉", + "E": "通里" + }, + "answer": "E", + "reason": "通里主治:①心悸、怔忡等心病;②舌强不语;③腕臂痛。" + }, + { + "question_num": 20, + "query": "红丝疔好发部位是", + "options": { + "A": "面部", + "B": "胸腹部", + "C": "四肢后侧", + "D": "四肢内侧", + "E": "四肢外侧" + }, + "answer": "D", + "reason": "红丝疔是发于四肢,皮肤呈红丝显露,迅速向上走窜的急性感染性疾病，其特点是先有手足疔疮或皮肤破损，红肿热痛,继则患肢内侧皮肤出现红丝一条或数条迅速向躯干方向走窜,可伴恶寒发热等症状，邪毒重者可内攻脏腑,发生走黄。" + }, + { + "question_num": 21, + "query": "肺所胜的脏腑为", + "options": { + "A": "肝", + "B": "心", + "C": "脾", + "D": "胆", + "E": "肾" + }, + "answer": "A", + "reason": "“克我”者为“所不胜”,“我克”者为“所胜”。金克木即肺克肝,肺之所胜为肝。" + }, + { + "question_num": 22, + "query": "阴寒内盛,血行瘀滞的舌象表现是", + "options": { + "A": "舌淡红润泽", + "B": "舌红绛少苔", + "C": "舌绛紫而干", + "D": "舌淡白光莹", + "E": "舌淡紫湿润" + }, + "answer": "E", + "reason": "舌淡紫湿润见于阴寒内盛或阳气虚衰所致寒凝血瘀。" + }, + { + "question_num": 23, + "query": "小肠经循行不直接相交的部位是", + "options": { + "A": "口", + "B": "鼻", + "C": "耳", + "D": "目内眦", + "E": "目外眦" + }, + "answer": "A", + "reason": "手太阳小肠经循行:起于手小指尺侧端,沿着手背外侧至腕部,出于尺骨茎突,直上沿着前臂外侧后缘,经尺骨鹰嘴与肱骨内上髁之间,沿上臂外侧后缘,到达肩关节,绕行肩胛部,交会于大椎,向下进入缺盆部,联络心,沿着食管,经过横膈,到达胃部,属于小肠,其支脉,从缺盆分出,沿着颈部,上达面颊,到目外毗,向后进入耳中。另一支脉,从颊部分出,上行目眶下,抵于鼻旁,至目内眦,斜行络于颧骨部。" + }, + { + "question_num": 24, + "query": "治疗锁喉痈初起，应首选的方剂是", + "options": { + "A": "仙方活命饮", + "B": "牛蒡解肌汤", + "C": "普济消毒饮", + "D": "五味消毒饮", + "E": "黄连解毒汤" + }, + "answer": "C", + "reason": "锁喉痈初起(痰热蕴结证)治法散风清热,化痰解毒。代表方:普济消毒饮加减。" + }, + { + "question_num": 25, + "query": "五脏生理特点及临床意义正确的是", + "options": { + "A": "五脏多虚", + "B": "六腑多实", + "C": "主受盛", + "D": "传化水谷", + "E": "传化物而不藏" + }, + "answer": "A", + "reason": "一般说来,病理上“脏病多虚”“腑病多实”;治疗上“五脏宜补”“六腑宜泻”。" + }, + { + "question_num": 26, + "query": "舌体小,有裂纹,舌鲜红少苔,其临床意义是", + "options": { + "A": "虚热证", + "B": "湿热证", + "C": "热极津伤", + "D": "风热表证", + "E": "寒邪人里化热" + }, + "answer": "A", + "reason": "舌体小,舌鲜红而少苔,或有裂纹,或光红无苔,属虚热证" + }, + { + "question_num": 27, + "query": "承扶穴的主治有", + "options": { + "A": "腰腿痛、下肢痿痹、痔疾", + "B": "腹满、小便不利", + "C": "腹痛、急性吐泻等急症", + "D": "咳嗽、气喘、盗汗、肺痨等肺系虚损病证", + "E": "丹毒、皮肤瘙痒、疔疮" + }, + "answer": "A", + "reason": "承扶主治:①腰腿痛,下肢瘘痹;②痔疾。" + }, + { + "question_num": 28, + "query": "乳痈最常见的病因是", + "options": { + "A": "肝郁胃热", + "B": "乳汁郁积", + "C": "阳明积热", + "D": "乳头破损", + "E": "感受外邪" + }, + "answer": "B", + "reason": "乳痈病因:乳汁郁积、肝郁胃热、感受外邪,其中乳汁郁积是最常见的原因。" + }, + { + "question_num": 29, + "query": "心的生理功能说法正确的是", + "options": { + "A": "主情志", + "B": "主水", + "C": "主气", + "D": "主血脉", + "E": "主气血" + }, + "answer": "D", + "reason": "心的生理功能:主血脉,藏神。" + }, + { + "question_num": 30, + "query": "下列各项,属颤动舌临床意义的是", + "options": { + "A": "湿热蕴脾", + "B": "肝阳化风", + "C": "气虚血瘀", + "D": "气滞血瘀", + "E": "阳气虚弱" + }, + "answer": "B", + "reason": "颤动舌为肝风内动的表现可因热盛、阳亢、阴亏、血虚等所致。" + }, + { + "question_num": 31, + "query": "应用合谷穴治疗自汗、盗汗时应配伍", + "options": { + "A": "阳溪穴", + "B": "复溜穴", + "C": "少冲穴", + "D": "极泉穴", + "E": "通里穴" + }, + "answer": "B", + "reason": "复溜主治:①水肿、腹胀、腹泻等胃肠病证;②)水肿、汗证等津液输布失调病证;③腰脊强痛,下肢痿痹。故应用合谷穴治疗自汗、盗汗时应配伍复溜。" + }, + { + "question_num": 32, + "query": "乳房部脓肿切开引流正确的切口选择是", + "options": { + "A": "乳晕旁弧形切口", + "B": "乳晕处放射状切口", + "C": "乳房下缘弧形切口", + "D": "以乳头为中心弧形切口", + "E": "以乳头为中心放射状切口" + }, + "answer": "E", + "reason": "切口应以乳头为中心，放射状切口,按乳络方向并与脓腔基底大小一致。" + }, + { + "question_num": 33, + "query": "被称为“水之上源”的是", + "options": { + "A": "肝", + "B": "心", + "C": "脾", + "D": "肺", + "E": "肾" + }, + "answer": "D", + "reason": "肺位于胸腔,覆盖五脏六腑之上,位置最高,因而有“华盖”之称。肺居高位，又能行水,故称之为“水之上源”" + }, + { + "question_num": 34, + "query": "食滞胃脘呕吐的特点是", + "options": { + "A": "喷射状呕吐", + "B": "饮后即吐出", + "C": "朝食而暮吐", + "D": "呕吐物酸腐", + "E": "吐黏稠之黄水" + }, + "answer": "D", + "reason": "呕吐酸腐味的食糜,多因暴饮暴食,或过食肥甘厚味,以致食滞胃脘,胃失和降,胃气上逆所致。" + }, + { + "question_num": 35, + "query": "劳宫穴的定位为", + "options": { + "A": "在腕前区,腕掌侧远端横纹中,掌长肌腱与桡侧腕屈肌腱之间", + "B": "在前臂前区,腕掌侧远端横纹上2寸,掌长肌腱与桡侧腕屈肌腱之间", + "C": "在前臂区,腕掌侧远端横纹上3寸,掌长肌腱与桡侧腕屈肌腱之间", + "D": "在学区,横平第3掌指关节近端,第2、3堂骨之间偏于第3堂骨", + "E": "在手指,中指末端最高点" + }, + "answer": "D", + "reason": "劳宫穴定位:在掌区,横平第3掌指关节近端,第2、3掌骨之间偏于第3掌骨。" + }, + { + "question_num": 36, + "query": "治疗乳岩冲任失调证,应首选的方剂是", + "options": { + "A": "神效瓜蒌散合开郁散", + "B": "二仙汤合开郁散", + "C": "八珍汤合开郁散", + "D": "人参��荣汤合开郁散", + "E": "参苓白术散合开郁散" + }, + "answer": "B", + "reason": "乳岩冲任失调证代表方:二布老九口。" + }, + { + "question_num": 37, + "query": "关于脾的生理功能正确的是", + "options": { + "A": "主情志", + "B": "主水", + "C": "主升清", + "D": "主血脉", + "E": "主气血" + }, + "answer": "C", + "reason": "脾的生理特性:脾主升清喜燥恶湿,脾为孤脏。" + }, + { + "question_num": 38, + "query": "月经先期的临床意义是", + "options": { + "A": "血海空虚", + "B": "阴寒凝滞", + "C": "瘀血阻滞", + "D": "肝郁化热", + "E": "阳气虚衰" + }, + "answer": "D", + "reason": "月经先期多因脾气亏虚、肾气不足，冲任不固;或因阳盛血热、肝郁化热阴虚火旺,热扰冲任,血海不宁所致。" + }, + { + "question_num": 39, + "query": "在腕前区,腕学侧远端横纹中,掌长肌腱与桡侧腕屈肌腱之间的腧穴是", + "options": { + "A": "阳溪", + "B": "大陵", + "C": "行间", + "D": "极泉", + "E": "劳官" + }, + "answer": "B", + "reason": "大陵穴定位:在腕前区,腕掌侧远端横纹中,掌长肌腱与桡侧腕屈肌腱之间。" + }, + { + "question_num": 40, + "query": "肉瘿可选用的外治法是", + "options": { + "A": "回阳玉龙膏掺黑退消", + "B": "太乙膏掺红灵丹", + "C": "阳和解凝膏掺黑退消", + "D": "太乙膏掺阳毒内消散", + "E": "阳和解凝膏掺阳毒内消散" + }, + "answer": "C", + "reason": "肉瘿外治:阳和解凝膏掺黑退消或桂麝散外敷。" + }, + { + "question_num": 41, + "query": "下列不是肝主疏泄的表现的是", + "options": { + "A": "促进血液与津液的运行输布", + "B": "促进脾胃运化和胆汁的分泌排泄", + "C": "调畅情志", + "D": "促进男子排精与女子排卵行经", + "E": "统摄气血津液" + }, + "answer": "E", + "reason": "肝主疏泄，指肝气具有疏通、畅达全身气机的作用,其包含以下方面:①促进血液与津液的运行输布;②促进脾胃运化和胆汁分泌排泄;③调畅情志;④促进男子排精与女子排卵行经。" + }, + { + "question_num": 42, + "query": "下列各项,属阳明潮热发热特点的是", + "options": { + "A": "低热,食后发作", + "B": "夏季长期低热", + "C": "热势较低,午后或夜间发生", + "D": "身热不扬,午后热甚", + "E": "热势较高,日晡热甚" + }, + "answer": "E", + "reason": "热势较高,日哺热甚,兼见腹胀便秘等,为日晡潮热,属阳明腑实证" + }, + { + "question_num": 43, + "query": "下列不属于胆经腧穴的是", + "options": { + "A": "听会", + "B": "日月", + "C": "环跳", + "D": "阳陵泉", + "E": "角孙" + }, + "answer": "E", + "reason": "角孙为手少阳三焦经穴位其余四项均为胆经腧穴。" + }, + { + "question_num": 44, + "query": "治疗失荣早期气郁痰结证,应首选的方剂是", + "options": { + "A": "和营散坚丸", + "B": "柴胡清肝汤", + "C": "桃红四物汤", + "D": "化痰开郁方", + "E": "二陈汤" + }, + "answer": "D", + "reason": "失荣早期气郁痰结证治法:理气解郁,化痰散结。代表方:化痰开郁方(经验方)。" + }, + { + "question_num": 45, + "query": "肾主四季中的", + "options": { + "A": "春", + "B": "夏", + "C": "秋", + "D": "冬", + "E": "长夏" + }, + "answer": "D", + "reason": "五脏与季节关系:心气通于夏,肺气通于秋,脾气与四时之外的“长夏”相通应,肝气通于春,肾气通于冬," + }, + { + "question_num": 46, + "query": "口中黏腻不爽,其临床意义是", + "options": { + "A": "胃火炽盛", + "B": "湿热蕴脾", + "C": "胆火上炎", + "D": "心火上炎", + "E": "脾胃气虚" + }, + "answer": "B", + "reason": "口黏腻不爽常见于痰热内盛、湿热蕴脾及寒湿困脾之证。" + }, + { + "question_num": 47, + "query": "在足趾,大趾末节内侧,趾甲根角侧后方0.1寸的腧穴是", + "options": { + "A": "隐白", + "B": "太白", + "C": "至阴", + "D": "然谷", + "E": "公孙" + }, + "answer": "A", + "reason": "隐白定位:在足趾,大趾末节内侧,趾甲根角侧后方0.1寸。" + }, + { + "question_num": 48, + "query": "传染性软疣的首选治疗措施是", + "options": { + "A": "内治", + "B": "中药外洗", + "C": "推疣", + "D": "挑治", + "E": "鸦胆子散敷贴" + }, + "answer": "D", + "reason": "传染性软疣外治用挑治法:用消毒针头挑破患处,挤尽白色乳酪样物，再用碘酒点患处。" + }, + { + "question_num": 49, + "query": "��列喜燥恶湿的脏腑是", + "options": { + "A": "肝", + "B": "心", + "C": "脾", + "D": "胃", + "E": "肾" + }, + "answer": "C", + "reason": "脾的生理特性:脾主升清,喜燥恶湿,脾为孤脏，" + }, + { + "question_num": 50, + "query": "消谷善饥的临床意义是", + "options": { + "A": "脾胃虚弱", + "B": "湿热蕴脾", + "C": "肝胆湿热", + "D": "胃阴不足", + "E": "胃强脾弱" + }, + "answer": "E", + "reason": "消谷善饥,兼多饮多尿,形体消瘦者,多见于消渴病;兼大便溏泄者,多属胃强脾弱。" + }, + { + "question_num": 51, + "query": "脐下3寸的腧穴是", + "options": { + "A": "中极", + "B": "关元", + "C": "气海", + "D": "建里", + "E": "下脘" + }, + "answer": "B", + "reason": "关元:在下腹部,脐中下3寸,前正中线上。" + }, + { + "question_num": 52, + "query": "下列各项,常发于多汗体质青年,并可在家庭中相互传染的是", + "options": { + "A": "白秃疮", + "B": "肥疮", + "C": "鹅掌风", + "D": "圆癣", + "E": "花斑癣" + }, + "answer": "E", + "reason": "花斑癣常发于多汗体质青年,可在家庭中互相传染。" + }, + { + "question_num": 53, + "query": "三焦描述正确的是", + "options": { + "A": "主受纳水谷", + "B": "主传化糟粕", + "C": "主受盛化物", + "D": "主腐熟水谷", + "E": "主水液代谢" + }, + "answer": "E", + "reason": "三焦的主要生理机能:疏通水道,运行津液。" + }, + { + "question_num": 54, + "query": "有形实邪闭阻气机所致疼痛的性质是", + "options": { + "A": "胀痛", + "B": "灼痛", + "C": "冷痛", + "D": "绞痛", + "E": "隐痛" + }, + "answer": "D", + "reason": "绞痛多因瘀血、气、结石!虫积等有形实邪阻闭气机，或寒邪凝滞气机所致疼捕。" + }, + { + "question_num": 55, + "query": "下列属于提插法泻法的是", + "options": { + "A": "针下得气后,捻转角度小,用力轻,频率慢,操作时间短", + "B": "针下得气后,先浅后深,重插轻提,提插幅度小,频率慢,操作时间短", + "C": "针下得气后,先深后浅,轻插重提,提插幅度大,频率快,操作时间长", + "D": "进针时徐徐刺人,少捻转,疾速出针者", + "E": "进针得气后,均匀地捻转，提插后即可出针" + }, + "answer": "C", + "reason": "提插法泻法:针下得气后,先深后浅,轻插重提,提插幅度大,频率快,操作时间长者为泻法。" + }, + { + "question_num": 56, + "query": "治疗虫咬皮炎热毒蕴结证,应首选的方剂是", + "options": { + "A": "五味消毒饮合清营汤", + "B": "黄连解毒汤合犀角地黄汤", + "C": "五味消毒饮合黄连解毒汤", + "D": "仙方活命饮合清营汤", + "E": "银翘散合消风散" + }, + "answer": "C", + "reason": "虫咬皮炎热毒蕴结证治法:清热解毒,消肿止痒。代表方:五味消毒饮合黄连解毒汤加地肤子、白鲜皮、紫荆皮。" + }, + { + "question_num": 57, + "query": "脑为", + "options": { + "A": "髓海", + "B": "气海", + "C": "血海", + "D": "刚脏", + "E": "娇脏" + }, + "answer": "A", + "reason": "脑位于头部的颅腔之内,为髓汇聚之处,故《灵枢·海论》说:“脑为髓之海。”" + }, + { + "question_num": 58, + "query": "结脉与代脉的主要区别在于", + "options": { + "A": "节律不同", + "B": "至数不同", + "C": "脉力不同", + "D": "脉位不同", + "E": "流利度不同" + }, + "answer": "A", + "reason": "结脉:脉来缓慢,时有中止止无定数,其脉象特征是脉来迟缓,脉律不齐有不规则的歇止。代脉:脉来一止，止有定数良久方还,其脉象特征是脉律不齐,表现为有规则的歇止，歇止的时间较长，脉势较软弱，至数为脉搏的频率。" + }, + { + "question_num": 59, + "query": "下列关于孕妇针刺注意的描述,错误的是", + "options": { + "A": "妇女怀孕3个月以内者,不宜针刺小腹部的腧穴", + "B": "三阴交、合谷、昆仑、至阴等腧穴,在怀孕期亦应予禁刺", + "C": "习惯性流产的孕妇则应慎用针刺", + "D": "怀孕期需要针刺治疗者,应注意精简针刺穴位", + "E": "可使用强刺激手法" + }, + "answer": "E", + "reason": "怀孕期需要针刺治疗者,应注意精简针刺穴位,不宜使用强刺激手法。" + }, + { + "question_num": 60, + "query": "一期梅毒的主要表现是", + "options": { + "A": "硬下疳", + "B": "杨梅性白斑", + "C": "杨梅疮", + "D": "玫瑰疹", + "E": "杨梅结毒" + }, + "answer": "A", + "reason": "一期梅毒主要表现为疳疮(硬下疳)。" + }, + { + "question_num": 61, + "query": "脏腑之精是指", + "options": { + "A": "一身之精分藏于各脏腑的部分", + "B": "源于肾精的部分", + "C": "禀受于父母精微的部分", + "D": "源于饮食水谷精微的部分", + "E": "精血转化的部分" + }, + "answer": "A", + "reason": "一身之精分藏于脏腑,成为脏腑之精。" + }, + { + "question_num": 62, + "query": "下列各项,称为“合病”的是", + "options": { + "A": "伤寒病初起不从阳经传人，直接邪人三阴者", + "B": "伤寒病按六经的顺序相传者", + "C": "伤寒病不经过传变，两经或三经同时出现病证者", + "D": "伤寒病按隔一经或两经以上相传者", + "E": "伤寒病一经病证未罢,又见他经病证者" + }, + "answer": "C", + "reason": "合病之说,首见于《伤寒论》,指外感病初起时两经同时受邪而发病，如太阳与少阳合病、太阳与阳明合病等。" + }, + { + "question_num": 63, + "query": "下列属于艾条灸的是", + "options": { + "A": "瘢痕灸", + "B": "无瘢痕灸", + "C": "隔姜灸", + "D": "雀啄灸", + "E": "温针灸" + }, + "answer": "D", + "reason": "艾条灸包括悬起灸和实按灸,其中悬起灸分为温和灸、雀啄炎、回旋灸。" + }, + { + "question_num": 64, + "query": "直肠癌早期便血的特点是", + "options": { + "A": "便血鲜红,便后停止,呈间歇性", + "B": "无痛性便血,血色鲜红,不与大便相混", + "C": "黏液血便,鲜红或暗红,量不多,呈持续状", + "D": "便血鲜红,量不多,肛门呈周期性疼痛", + "E": "少许黏液或血丝在粪便前流出" + }, + "answer": "C", + "reason": "便血是直肠癌最常见的早期症状。大便带血，血为鲜红或暗红，量不多常同时伴有黏液,呈持续性。" + }, + { + "question_num": 65, + "query": "血的生化之源为", + "options": { + "A": "营气", + "B": "津液", + "C": "胃气", + "D": "水谷之精", + "E": "肾精" + }, + "answer": "D", + "reason": "由水谷之精化生的营气和津液是化生血液的主要物质，也是血液的主要构成成分。" + }, + { + "question_num": 66, + "query": "切脉时三指沿寸口脉长轴循行,诊察脉之长短，比较寸关尺三部脉象特点的方法是", + "options": { + "A": "循法", + "B": "寻法", + "C": "总按", + "D": "举法", + "E": "按法" + }, + "answer": "A", + "reason": "循法:是指切脉时三指沿寸口脉长轴循行,诊察脉之长短，比较寸关尺三部脉象的特点。" + }, + { + "question_num": 67, + "query": "电针舒波的频次为", + "options": { + "A": "2~5次/秒", + "B": "5~10次/秒", + "C": "10~20次/秒", + "D": "20~50次/秒", + "E": "50~100次/秒" + }, + "answer": "A", + "reason": "频率慢的叫疏波(或叫低频连续波)，一般是2-5次/秒。" + }, + { + "question_num": 68, + "query": "治疗子痰阴虚内热证，应首选的方剂是", + "options": { + "A": "阳和汤合小金丹", + "B": "开郁散合增液汤", + "C": "滋阴除湿汤合透脓散", + "D": "六味地黄丸合透脓散", + "E": "增液汤合知柏地黄丸" + }, + "answer": "C", + "reason": "子痰阴虚内热证:见于中期成脓期,治宜养阴清热、除湿化痰、透脓解毒，方选滋阴除湿汤合透脓散加减" + }, + { + "question_num": 69, + "query": "肺主五神中的", + "options": { + "A": "神", + "B": "魂", + "C": "魄", + "D": "意", + "E": "志" + }, + "answer": "C", + "reason": "《素问·宣明五气》所说:心仲,肿感魄,肝救瑰,胖激息，育激忘。" + }, + { + "question_num": 70, + "query": "主阳虚而寒凝血瘀的脉象是", + "options": { + "A": "沉迟脉", + "B": "沉弦脉", + "C": "沉涩脉", + "D": "弦紧脉", + "E": "沉缓脉" + }, + "answer": "C", + "reason": "沉涩脉多见于血瘀,尤常见于阳虚而寒凝血瘀者。" + }, + { + "question_num": 71, + "query": "枕上正中线主治", + "options": { + "A": "眼病、足癣", + "B": "视力障碍、白内障", + "C": "耳鸣、耳聋", + "D": "平衡障碍", + "E": "后头痛" + }, + "answer": "A", + "reason": "枕上正中线主治:眼病、足癣等。" + }, + { + "question_num": 72, + "query": "下列全身受冻的复温措施,错误的是", + "options": { + "A": "用雪搓、火烤", + "B": "少量饮酒", + "C": "姜汤热饮", + "D": "40℃左右温水中浸泡", + "E": "可将伤者置于救护者怀中" + }, + "answer": "A", + "reason": "全身冻疮的复温方法:对冻僵患者立即施行局部或全身快速复温，用38~42℃恒热温水浸泡伤肢或浸泡全身，局部20分��,全身30分钟内;可给予姜汤、糖水、茶水等温热饮料,亦可少量饮酒及含酒饮料，以促进血液循环,扩张周围血管;早期复温过程中,严禁用雪搓、用火烤或冷水浴等;在急救时,如一时无法获得热水,可将冻肢置于救护者怀中或腋下复温。" + }, + { + "question_num": 73, + "query": "气随津脱说明", + "options": { + "A": "津能生气", + "B": "津能载气", + "C": "气能生津", + "D": "气能摄津", + "E": "气能行津" + }, + "answer": "B", + "reason": "津液是气运行的载体之一,在血脉之外，气的运行必须依附于津液，否则也会使气漂浮失散而无所归，故说津能载气，当大汗、大吐、大泻等津液大量丢失时,气亦随之大量外脱,称之为“气随津脱”" + }, + { + "question_num": 74, + "query": "右少腹作痛拒按,或出现反跳痛的临床意义是", + "options": { + "A": "水鼓", + "B": "气鼓", + "C": "癥积", + "D": "肠痈", + "E": "虫积" + }, + "answer": "D", + "reason": "右少腹作痛而拒按,或出现“反跳痛”,或按之有包块应手者,常见于肠痈等病。" + }, + { + "question_num": 75, + "query": "位于耳屏2区后缘的耳穴是", + "options": { + "A": "外鼻", + "B": "肾上腺", + "C": "咽喉", + "D": "内鼻", + "E": "缘中" + }, + "answer": "B", + "reason": "肾上腺定位:在耳屏游离缘下部尖端,即耳屏2区后缘处。" + }, + { + "question_num": 76, + "query": "治疗血栓性浅静脉炎湿热瘀阻症,应首选的方剂是", + "options": { + "A": "五神汤合四妙勇安汤", + "B": "草癖渗湿汤合五神汤", + "C": "二妙散合茵陈赤豆汤", + "D": "四妙散合五神汤", + "E": "六味地黄丸合四妙散" + }, + "answer": "C", + "reason": "血栓性浅静脉炎湿热瘀阻证治法:清热利湿,解毒通络。代表方:二妙散合茵陈赤豆汤加减。" + }, + { + "question_num": 77, + "query": "一身阴脉之海是", + "options": { + "A": "冲脉", + "B": "任脉", + "C": "督脉", + "D": "带脉", + "E": "阴维脉" + }, + "answer": "B", + "reason": "任脉为“阴脉之海”,冲脉为“十二经脉之海”“五脏六腑之海”,督脉为“阳脉之海”" + }, + { + "question_num": 78, + "query": "下列各项，一般不属于寒证的是", + "options": { + "A": "面色㿠白,大便稀溏", + "B": "口淡不渴,小便清长", + "C": "大便秘结,口臭咽干", + "D": "苔白而润,舌淡胖大", + "E": "脉象沉紧" + }, + "answer": "C", + "reason": "C项为热证的表现" + }, + { + "question_num": 79, + "query": "针灸治疗太阳头痛的配穴是", + "options": { + "A": "印堂、内庭", + "B": "关冲、合谷、少商", + "C": "天柱、后溪、昆仑", + "D": "率谷、外关、足临泣", + "E": "四神聪、太冲、内关" + }, + "answer": "C", + "reason": "太阳头痛:天柱、后溪昆仑。" + }, + { + "question_num": 80, + "query": "下列各项,符合小儿“纯阳”理论的是", + "options": { + "A": "生机蓬勃", + "B": "脏腑娇嫩", + "C": "有阳无阴", + "D": "阳亢阴亏", + "E": "形气未充" + }, + "answer": "A", + "reason": "“纯阳”学说:“纯”指小儿初生，“阳”指以阳为用,即生机。小儿在生长发育过程中,表现出生机旺盛、发育迅速的生理现象。" + }, + { + "question_num": 81, + "query": "六淫中引起疼痛的邪气是", + "options": { + "A": "风邪", + "B": "寒邪", + "C": "暑邪", + "D": "湿邪", + "E": "燥邪" + }, + "answer": "B", + "reason": "寒邪凝滞,易致所伤部位气血津液凝结,经脉阻滞,气血运行不畅,不通则痛,故寒邪为最易导致疼痛的外邪。" + }, + { + "question_num": 82, + "query": "下列关于实证和虚证鉴别的描述,错误的是", + "options": { + "A": "实证疼痛拒按,虚证疼痛喜按", + "B": "实证多发热,虚证多恶寒", + "C": "实证声高气粗,虛证声低息微", + "D": "实证舌质老,虚证舌质嫩", + "E": "实证脉有力，虚证脉无力" + }, + "answer": "B", + "reason": "实证发热为蒸燕壮热，虚证为五心烦热,午后微热;实证恶寒,添衣加被不减,虚证畏寒,得衣近火则减。" + }, + { + "question_num": 83, + "query": "上下颌面痛时辨经络应属", + "options": { + "A": "足太阳经病证", + "B": "手、足阳明和手太阳经病证", + "C": "手、足少阳和足厥阴经病证", + "D": "足太阳、足少阳经病证", + "E": "督脉、手厥阴及足太阴经病证" + }, + "answer": "B", + "reason": "眼部痛为三叉神经第1支即眼支痛,属足太阳经病证;上颌部痛为三叉神经第2支即上颌支痛,��颌部痛为三叉神经第3支即下颌支痛,属手、足阳明和手太阳经病证。" + }, + { + "question_num": 84, + "query": "母乳喂养的原则是", + "options": { + "A": "昼夜均喂", + "B": "定次喂给", + "C": "定量喂给", + "D": "按需喂给", + "E": "按时喂给" + }, + "answer": "D", + "reason": "母乳喂养的方法,以按需喂给为原则。" + }, + { + "question_num": 85, + "query": "下列描述正确的是", + "options": { + "A": "思则气结", + "B": "怒则气下", + "C": "喜则气结", + "D": "恐则气缓", + "E": "恐则气上" + }, + "answer": "A", + "reason": "《素问·举痛论》说:“百病生于气也,怒则气上,喜则气缓,悲则气消,恐则气下……惊则气乱……思则气结。”" + }, + { + "question_num": 86, + "query": "下列表证与里证鉴别的叙述，最恰当的是", + "options": { + "A": "表证多为新病,里证多为久病", + "B": "表证病情较轻,里证病情深重", + "C": "表证寒热并见,里证寒热单见", + "D": "表证起病较急,里证起病较缓", + "E": "表证多为外感,里证皆属内伤" + }, + "answer": "C", + "reason": "外感病中,发热恶寒同时并见者属表证;但热不寒或寒不热者属里证;寒热往来者属半表半里证" + }, + { + "question_num": 87, + "query": "治疗腰痛的主穴是", + "options": { + "A": "肾俞、太溪", + "B": "膈俞、次髎", + "C": "大肠俞、阿是穴、委中", + "D": "命门、腰阳关", + "E": "委中、承山、昆仑" + }, + "answer": "C", + "reason": "治疗腰痛的主穴:大肠俞阿是穴、委中。" + }, + { + "question_num": 88, + "query": "生理性胎黄的特点是", + "options": { + "A": "黄疸常于生后2~3天出现", + "B": "黄疸常于出生后1周内消退", + "C": "早产儿黄疸轻,消退早", + "D": "早产儿24小时内出现黄疽", + "E": "早产儿与足月儿无明显差别" + }, + "answer": "A", + "reason": "生理性黄疸:生后第2~3天出现黄疽,第4~6天达高峰。" + }, + { + "question_num": 89, + "query": "下列不是造成瘀血的成因的是", + "options": { + "A": "气虚", + "B": "血寒", + "C": "血热", + "D": "气滞", + "E": "气逆" + }, + "answer": "E", + "reason": "凡是影响血液正常运行,使血液运行不畅的各种因素,均可致瘀血，如气滞致瘀、因虚致瘀、气虚而推动无力、血寒致瘀、血热致瘀等，" + }, + { + "question_num": 90, + "query": "下列各项,属阳虚证特征表现的是", + "options": { + "A": "少气懒言", + "B": "小便短少", + "C": "神疲乏力", + "D": "舌质淡嫩", + "E": "畏寒肢冷" + }, + "answer": "E", + "reason": "阳虚证特征表现为畏冷,肢凉，口淡不渴" + }, + { + "question_num": 91, + "query": "治疗痹证痛痹的配穴是", + "options": { + "A": "膈俞、血海", + "B": "肾俞、关元", + "C": "阴陵泉、足三里", + "D": "大椎、曲池", + "E": "百会、内关" + }, + "answer": "B", + "reason": "痛痹配肾俞、关元,益火之源,振奋阳气而祛寒邪。" + }, + { + "question_num": 92, + "query": "导致小儿感冒夹痰的生理特点是", + "options": { + "A": "肺常不足", + "B": "脾常不足", + "C": "心常不足", + "D": "肝气未盛", + "E": "肾常虚" + }, + "answer": "A", + "reason": "小儿肺脏娇嫩,感邪之后,失于宣肃,气机不利,津液不得敷布而内生痰液,痰壅气道,则咳嗽加剧,喉间痰鸣,此为感冒夹痰。" + }, + { + "question_num": 93, + "query": "小儿由食积发展为疳积,体现中医发病的", + "options": { + "A": "感邪即发", + "B": "徐发", + "C": "伏而后发", + "D": "继发", + "E": "复发" + }, + "answer": "D", + "reason": "继发指在原发疾病的基础上,继发新的疾病,其特点是新的疾病与原发病在病理上有密切联系,如肝阳上亢所致的中风，小儿食积而致的疳积等" + }, + { + "question_num": 94, + "query": "脘腹痞胀,泛吐清水,肠鸣水声辘辘,舌苔白滑,脉弦,其证候是", + "options": { + "A": "痰证", + "B": "饮证", + "C": "湿证", + "D": "阴水", + "E": "阳水" + }, + "answer": "B", + "reason": "饮证临床表现:脘腹痞胀泛吐清水,脘腹部水声辘辘;肋间饱满,咳唾引痛;胸闷,心悸,息促不得卧;身体、肢节疼重;咳吐清稀痰涎,或喉间哮鸣有声;头目眩晕,舌苔白滑,脉弦或滑等，" + }, + { + "question_num": 95, + "query": "痫病发作期,刺水沟的刺法为", + "options": { + "A": "平泻", + "B": "强刺激", + "C": "点刺出血", + "D": "弱刺激", + "E": "毫针泻法" + }, + "answer": "B", + "reason": "痫病发作期,用毫针泻法水沟宜强刺激。" + }, + { + "question_num": 96, + "query": "治疗风寒咳嗽，应首选的方剂是", + "options": { + "A": "麻黄汤", + "B": "桂枝汤", + "C": "二陈汤", + "D": "金沸草散", + "E": "小青龙汤" + }, + "answer": "D", + "reason": "风寒咳嗽证治法:疏风散寒,宣肺止咳。代表方剂:杏苏散、金沸草散。" + }, + { + "question_num": 97, + "query": "下列与内寒形成关系密切的脏腑是", + "options": { + "A": "心肺脾", + "B": "心肝脾", + "C": "心脾肾", + "D": "肺脾肾", + "E": "肺脾肝" + }, + "answer": "C", + "reason": "“内寒”，指机体阳气虚寒，温煦作用减退,阳不制阴而虚寒内生的病理变化,其多因先天禀赋不足,阳气素虚,或久病伤阳,或外感寒邪,过食生冷,损伤阳气,以致阳气虚衰所致。内寒病机多见于心脾肾。" + }, + { + "question_num": 98, + "query": "下列各项,不属血瘀证临床表现的是", + "options": { + "A": "出血紫暗", + "B": "固定刺痛", + "C": "面色黧黑", + "D": "胸胁胀痛", + "E": "脉象细涩" + }, + "answer": "D", + "reason": "胸胁胀痛是肝气郁滞的表现。" + }, + { + "question_num": 99, + "query": "治疗崩漏实证的主穴是", + "options": { + "A": "三阴交、足三里、血海", + "B": "三阴交、肝俞、气海", + "C": "隐白、血海、阴陵泉、关元", + "D": "关元、隐白、三阴交", + "E": "三阴交、足三里、气海、肾俞" + }, + "answer": "D", + "reason": "崩漏实证主穴:关元、隐白三阴交。" + }, + { + "question_num": 100, + "query": "治疗哮喘风寒束肺证，应首选的方剂是", + "options": { + "A": "玉屏风散合都气丸", + "B": "大青龙汤合定喘丸", + "C": "麻杏石甘汤合苏葶丸", + "D": "射干麻黄汤合二陈汤", + "E": "小青龙汤合三子养亲汤" + }, + "answer": "E", + "reason": "哮喘风寒束肺证治法:温肺散寒,涤痰定喘。代表方剂:小青龙汤合三子养亲汤。" + }, + { + "question_num": 101, + "query": "下列内伤疾病的传变过程不包括", + "options": { + "A": "脏与脏之间的传变", + "B": "脏与腑传变", + "C": "腑与腑传变", + "D": "形脏内外传变", + "E": "卫气营血传变" + }, + "answer": "E", + "reason": "内伤疾病的传变过程:①脏与脏之间的传变;②脏与腑传变;③腑与腑传变;④形脏内外传变。卫气营血传变属于外感病传变。" + }, + { + "question_num": 102, + "query": "以胸胁胃脘胀痛,急躁易怒,嗳气吞酸,不思饮食,舌淡红，脉弦为特征的证候是", + "options": { + "A": "肝胃不和证", + "B": "胃肠气滞证", + "C": "脾气虚证", + "D": "肝郁气滞证", + "E": "肝脾不调证" + }, + "answer": "A", + "reason": "肝胃不和证临床表现:脘胁胀满疼痛,走窜不定,气,呃逆,嘈杂吞酸,不思饮食,情绪抑郁,善太息,或烦躁易怒,舌淡红,苔薄黄,脉弦。" + }, + { + "question_num": 103, + "query": "治疗小儿遗尿的主穴为", + "options": { + "A": "三阴交、足三里、血海", + "B": "肾俞、命门、太溪", + "C": "隐白、血海、阴陵泉、关元", + "D": "肺俞、气海、足三里", + "E": "关元、中极、膀胱俞、三阴交" + }, + "answer": "E", + "reason": "遗尿的主穴:关元、中极、膀胱俞、三阴交。" + }, + { + "question_num": 104, + "query": "银翘散治疗口疮的证候是", + "options": { + "A": "心脾积热证", + "B": "胃火炽盛证", + "C": "心火上炎证", + "D": "肝胆火旺证", + "E": "风热乘脾证" + }, + "answer": "E", + "reason": "口疮风热乘脾证治法:疏风散火,清热解毒。代表方剂:银翘散。" + }, + { + "question_num": 105, + "query": "属防止病邪侵害的是", + "options": { + "A": "顺应自然", + "B": "养性调神", + "C": "调理饮食", + "D": "形体锻炼", + "E": "避其邪气,药物预防" + }, + "answer": "E", + "reason": "在未病先防中,防止病邪侵害的措施:①避其邪气;②药物预防以防止病邪侵害。" + }, + { + "question_num": 106, + "query": "下列各项,属心阴虚证和心血虚证共有症状的是", + "options": { + "A": "心悸心烦", + "B": "失眠多梦", + "C": "口燥咽干", + "D": "面色淡白", + "E": "潮热盗汗" + }, + "answer": "B", + "reason": "心阴虚证和心血虚证共有的症状是心悸、失眠、多梦。" + }, + { + "question_num": 107, + "query": "治疗耳聋实证应选取的经络是", + "options": { + "A": "手、足少阳经", + "B": "手、足厥阴经", + "C": "手太阳经", + "D": "足阳明经", + "E": "足少阴经" + }, + "answer": "A", + "reason": "耳聋实证宜疏风泻火,通络开窍,取局部穴及手、足少阳经穴为主。" + }, + { + "question_num": 108, + "query": "参苓白术散治疗小儿泄泻的证候是", + "options": { + "A": "风寒泻", + "B": "湿热泻", + "C": "伤食泻", + "D": "脾虚泻", + "E": "脾肾阳虚泻" + }, + "answer": "D", + "reason": "小儿泄泻脾虚泻证治法:健脾益气，助运止泻。代表方剂:参苓白术散。" + }, + { + "question_num": 109, + "query": "下列属于温热药作用的是", + "options": { + "A": "引火归原", + "B": "凉血解毒", + "C": "滋阴除蒸", + "D": "清热利尿", + "E": "凉肝息风" + }, + "answer": "A", + "reason": "温热药分别具有温里散寒暧肝散结、补火助阳、温阳利水、温经通络、引火归原、回阳救逆等作用。" + }, + { + "question_num": 110, + "query": "寒滞胃肠证、食滞胃肠证、胃肠气滞证的共同症状是", + "options": { + "A": "胃脘冷痛剧烈", + "B": "脘腹胀痛走窜", + "C": "胃脘疼痛痞胀", + "D": "胃脘隐痛痞胀", + "E": "胃脘疼痛喜按" + }, + "answer": "C", + "reason": "寒滞胃脘证、食滞胃肠证胃肠气滞证共同的症状是胃脘疼痛痞胀。" + }, + { + "question_num": 111, + "query": "近视疲劳的配穴是", + "options": { + "A": "晴明、太阳、风池", + "B": "心俞、脾俞、足空里", + "C": "少商、外关", + "D": "肺俞、气海、足三里", + "E": "肝俞、肾俞、太溪、太冲" + }, + "answer": "B", + "reason": "近视且易疲劳,为心脾两虚证,除主穴晴明、承泣、风池、光明外,还应配心俞、脾俞、足三里。" + }, + { + "question_num": 112, + "query": "疳积证的治法是", + "options": { + "A": "调脾健运", + "B": "消积理脾", + "C": "益气健脾", + "D": "运脾理气", + "E": "补益气血" + }, + "answer": "B", + "reason": "疳积证治法:消积理脾。" + }, + { + "question_num": 113, + "query": "具有疏散风热功效的药物是", + "options": { + "A": "白芷", + "B": "细辛", + "C": "藁本", + "D": "蔓荆子", + "E": "苍耳子" + }, + "answer": "D", + "reason": "感荆子功效:疏散风热,清利头目,其余四项均为发散风寒药。" + }, + { + "question_num": 114, + "query": "诊断肾阳虚证最有意义的临床表现是", + "options": { + "A": "小便频数,滑精早泄", + "B": "大便稀薄,完谷不化", + "C": "下肢水肿,凹陷不起", + "D": "畏寒肢冷,精神萎靡", + "E": "腰膝冷痛,精冷不言" + }, + "answer": "E", + "reason": "肾阳虚证是指肾阳亏虚,机体失却温煦,以腰膝酸冷、性欲减退、夜尿多与虚寒症状共见为辨证的主要依据。临床表现:头目眩晕,面色姚白或黧黑,腰膝酸冷疼痛,畏冷肢凉,下肢尤甚,精神萎靡,性欲减退,男子阳痿早泄、滑精精冷,女子官寒不孕,或久泻不止,完谷不化，五更泄泻,或小便频数清长,夜尿频多,舌淡苔白,脉沉细无力,尺脉尤甚。" + }, + { + "question_num": 115, + "query": "虚证晕厥的配穴为", + "options": { + "A": "太阳、风池", + "B": "心俞、脾俞", + "C": "气海、关元", + "D": "合谷、太冲", + "E": "肝俞、肾俞" + }, + "answer": "C", + "reason": "治疗晕厥主穴: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。" + }, + { + "question_num": 116, + "query": "营养性缺铁性贫血治疗后血红蛋白已达正常水平,仍需服用铁剂的疗程是", + "options": { + "A": "2周", + "B": "1个月", + "C": "2个月", + "D": "3个月", + "E": "4个月" + }, + "answer": "C", + "reason": "营养性缺铁性贫血使用铁剂治疗。一般用硫酸亚铁口服，每次5~10mg/kg,每日2~3次，同时口服维生素C有助吸收,服用至血红蛋白达正常水平后2个月左右再停药。" + }, + { + "question_num": 117, + "query": "下列不属于荆芥的功效的是", + "options": { + "A": "祛风解表", + "B": "透疹消疮", + "C": "清热解毒", + "D": "止血", + "E": "发表透疹" + }, + "answer": "C", + "reason": "荆芥功效:祛风解表,透疹消疮，止血。" + }, + { + "question_num": 118, + "query": "温病辨证论治中身热夜甚,心烦躁扰,斑疹隐隐,舌红绛无苔，脉细数者,宜选择的方剂是", + "options": { + "A": "栀子豉汤", + "B": "导赤承气汤", + "C": "清营汤", + "D": "清宫汤", + "E": "犀角地黄汤" + }, + "answer": "C", + "reason": "热灼营阴证临床表现:身热傻甚，心烦踩扰，甚或时有谐语，珍隐隐，呐燥口干而反不甚渴,舌质红绛苔薄或无苔，脉细数。治法:清营泄热;兼表者,佐以透表。代表方剂:清营汤。" + }, + { + "question_num": 119, + "query": "心绞痛寒邪凝滞的配穴为", + "options": { + "A": "太冲、血海", + "B": "心俞、脾俞", + "C": "中脘、丰隆", + "D": "神阙、至阳", + "E": "心俞、至阳" + }, + "answer": "D", + "reason": "心绞痛配穴:气滞血瘀配太冲、血海;寒邪凝滞配神阙、至阳。" + }, + { + "question_num": 120, + "query": "小儿汗证营卫失调证的汗出特点是", + "options": { + "A": "头部、肩背部汗出明显", + "B": "汗出肤热,汗渍色黄", + "C": "汗出遍身而不温", + "D": "头部、手足心汗出明显", + "E": "大汗淋沥,或汗出如油" + }, + "answer": "C", + "reason": "小儿汗证营卫失调证证候以自汗为主,或伴盗汗,汗出遍身而抚之不温，畏寒恶风，不发热,或伴有低热,精神疲倦，胃纳不振,舌质淡红,苔薄白,脉缓。" + }, + { + "question_num": 121, + "query": "下列可治疗内脏脱垂的药物组合是", + "options": { + "A": "葛根、黄芪", + "B": "黄芪、人参", + "C": "桂枝、肉桂", + "D": "升麻、柴胡", + "E": "葛根、玄参" + }, + "answer": "D", + "reason": "升麻功效:解表透疹,清热解毒,升举阳气。柴胡功效:解表退热,疏肝解郁,升举阳气。柴胡、升麻两者均能升阳举陷用治气虚下陷,食少便溏、久泻脱肛、胃下垂肾下垂、子宫脱垂等脏器脱垂。" + }, + { + "question_num": 122, + "query": "主治外感风寒湿邪,内有蕴热证的方剂是", + "options": { + "A": "败毒散", + "B": "九味羌活汤", + "C": "羌活胜湿汤", + "D": "柴葛解肌汤", + "E": "麻黄杏仁甘草石膏汤" + }, + "answer": "B", + "reason": "九味羌活汤主治外感风寒湿邪,内有蕴热证。" + }, + { + "question_num": 123, + "query": "下列哪项不是时行感冒的特征", + "options": { + "A": "传染性强", + "B": "让候相似", + "C": "集中发病", + "D": "老幼易感", + "E": "流行性强" + }, + "answer": "D", + "reason": "时行感冒起病急,具有传染性,证候相似,集中发病;全身症状较重,高热，全身酸痛,退热之后肺系症状始明显。时行冒可见于任何年龄。" + }, + { + "question_num": 124, + "query": "治疗抽动障碍脾虚痰聚证，应首选的方剂是", + "options": { + "A": "逍遥散", + "B": "泻青丸", + "C": "十味温胆汤", + "D": "龙胆泻肝汤", + "E": "柴胡疏肝散" + }, + "answer": "C", + "reason": "抽动障碍脾虚痰聚证治法:健脾化痰,平肝息风。代表方剂:十味温胆汤。" + }, + { + "question_num": 125, + "query": "具有消痈排脓,祛瘀止痛功效的药物是", + "options": { + "A": "金银花", + "B": "败酱草", + "C": "黄连", + "D": "黄芪", + "E": "栀子" + }, + "answer": "B", + "reason": "败酱草功效:洁热解毒,消痈排脓,祛瘀止痛。" + }, + { + "question_num": 126, + "query": "败毒散与参苏饮组成中均含有的药物是", + "options": { + "A": "人参、苏叶", + "B": "人参、羌活", + "C": "半夏、茯苓", + "D": "枳壳、前胡", + "E": "生姜、薄荷" + }, + "answer": "D", + "reason": "败毒散组成:柴胡、前胡、川芎、枳壳、羌活、独活、桔梗、茯苓、人参、甘草(生姜、薄荷)。参苏饮组成:人参、紫苏叶、干葛、半夏、姜汁、前胡、茯苓、枳壳、桔梗、木香、陈皮、炙甘草(生姜、枣)。" + }, + { + "question_num": 127, + "query": "治疗咳嗽之风寒袭肺证,应首选的方剂是", + "options": { + "A": "桑菊饮", + "B": "三拗汤合止嗽散", + "C": "桑杏汤", + "D": "荆防达表汤", + "E": "沙参麦冬汤" + }, + "answer": "B", + "reason": "咳嗽之风寒袭肺证治当疏风散寒,宣肺止咳,方选三拗汤合止嗽散加减。" + }, + { + "question_num": 128, + "query": "治疗小儿慢惊风脾虚肝亢证,应首选的方剂是", + "options": { + "A": "羚角钩藤汤", + "B": "逐寒荡惊汤", + "C": "固真汤", + "D": "缓肝理脾汤", + "E": "大定风珠" + }, + "answer": "D", + "reason": "小儿慢惊风腺虚肝亢证治法:温中健脾,缓肝理脾。代表方剂:缓肝理脾汤。" + }, + { + "question_num": 129, + "query": "下列各选项，不属于玄参主治病证的是", + "options": { + "A": "温毒发斑", + "B": "津伤便秘", + "C": "闭经痛经", + "D": "痈肿疮毒", + "E": "目赤咽痛" + }, + "answer": "C", + "reason": "玄参主治:①温邪人营,内陷心包,温毒发斑;②热病伤阴,津伤便秘,骨蒸劳嗽;③目赤咽痛,瘰疬,白喉,痈肿疮毒" + }, + { + "question_num": 130, + "query": "具有“发中有补,散中有收,邪正兼顾，祛邪扶正，阴阳并调”配伍特点的方剂是", + "options": { + "A": "桂枝汤", + "B": "麻黄汤", + "C": "止咳散", + "D": "小青龙汤", + "E": "九味羌活汤" + }, + "answer": "A", + "reason": "桂枝汤主治外感风寒表虚证。全方发中有补,散中有收,邪正兼顾,祛邪扶正，阴阳并调。" + }, + { + "question_num": 131, + "query": "哮病夙根的形成原因是", + "options": { + "A": "禀赋不足,病后体弱", + "B": "肝气郁结,气机不畅", + "C": "过食生冷,寒饮内停", + "D": "外感风寒或风热之邪", + "E": "津液运化失常,凝聚成痰" + }, + "answer": "E", + "reason": "哮病的病理因素以痰为主。痰的产生主要由于人体津液不归正化,凝聚而成,痰伏藏于肺,成为发病的“夙根”。" + }, + { + "question_num": 132, + "query": "治疗小儿癫痫痰痫证,应首选的方剂是", + "options": { + "A": "涤痰汤", + "B": "固痫丸", + "C": "温胆汤", + "D": "二陈汤", + "E": "菖蒲丸" + }, + "answer": "A", + "reason": "小儿痛证痰痫证治法:豁痰开窍。代表方剂:涤痰汤。" + }, + { + "question_num": 133, + "query": "孕妇禁用的药物是", + "options": { + "A": "玄参", + "B": "牵牛子", + "C": "火麻仁", + "D": "松子仁", + "E": "砂仁" + }, + "answer": "B", + "reason": "妊娠禁用的药物:毒性较强或药性猛烈的药物,如巴豆、牵牛子、大戴等" + }, + { + "question_num": 134, + "query": "体现叶天士“人血就恐耗血动血,直须凉血散血”的方剂是", + "options": { + "A": "清营汤", + "B": "芍药汤", + "C": "白虎汤", + "D": "黄连解毒汤", + "E": "犀角地黄汤" + }, + "answer": "E", + "reason": "犀角地黄汤主治热人血分证。本方证由热毒炽盛于血分所致。此时不清其热则血不宁,不散其血则瘀不去，不滋其阴则火不熄，正如叶天士所谓“人血就恐耗血动血，直须凉血散血”治当以清热解毒、凉血散瘀为法。" + }, + { + "question_num": 135, + "query": "虚喘证的病位在", + "options": { + "A": "肺、脾", + "C": "心、肾", + "B": "肝、肾", + "D": "肺、肾", + "E": "肺、心" + }, + "answer": "D", + "reason": "喘证的病理性质有虚实之分。虚喘责之肺、肾两脏,因阳气不足,阴精亏耗,而致肺肾出纳失常,且尤以气虚为主。" + }, + { + "question_num": 136, + "query": "治疗水肿脾肾阳虚证,应首选的方剂是", + "options": { + "A": "温胆汤", + "B": "真武汤", + "C": "参苓白术散", + "D": "防己黄芪汤", + "E": "已椒苈黄丸合参附汤" + }, + "answer": "B", + "reason": "水肿脾肾阳虚证治法:温肾健脾,利水消肿。代表方剂:真武汤。" + }, + { + "question_num": 137, + "query": "治疗痰饮咳喘，应首选的药物是", + "options": { + "A": "佩兰", + "B": "苍术", + "C": "藿香", + "D": "砂仁", + "E": "厚朴" + }, + "answer": "E", + "reason": "厚朴主治:①湿阻中焦,脘腹胀满;②食积气滞,腹胀便秘;③痰饮咳嗽;④梅核气。" + }, + { + "question_num": 138, + "query": "仙方活命饮中的君药是", + "options": { + "A": "赤芍", + "B": "当归", + "C": "陈皮", + "D": "天花粉", + "E": "金银花" + }, + "answer": "E", + "reason": "仙方活命饮方中金银花性味甘寒,最善清热解毒疗疮,前人称之“疮疡圣药”,故重用为君，" + }, + { + "question_num": 139, + "query": "肺痿的基本病机是", + "options": { + "A": "虚体虫侵,阴虚火旺", + "B": "肺虚,津气失于濡养", + "C": "肺气上逆,宣降失职", + "D": "痰饮瘀血,结于肺间", + "E": "气无所主,肾失摄纳" + }, + "answer": "B", + "reason": "肺痿的基本病机为肺虚,津气大伤,失于濡养,以致肺叶枯萎。" + }, + { + "question_num": 140, + "query": "补中益气汤合缩泉丸加减治疗遗尿的证候是", + "options": { + "A": "肺脾气虚证", + "B": "肾气不足证", + "C": "肾脾气虚证", + "D": "肝经郁热证", + "E": "心肾失交证" + }, + "answer": "A", + "reason": "遗尿肺脾气虚证治法:补肺益脾,固涩膀胱。代表方剂:补中益气汤合缩泉丸。" + }, + { + "question_num": 141, + "query": "治疗血淋的首选药物是", + "options": { + "A": "车前子", + "B": "海金沙", + "C": "草薜", + "D": "石韦", + "E": "滑石" + }, + "answer": "D", + "reason": "石韦功效:利尿通淋,清肺止咳,凉血止血。主治:淋证,肺热咳嗽，血热出血。" + }, + { + "question_num": 142, + "query": "气喘咳嗽,皮肤蒸热,日晡尤甚,舌红苔黄,脉细数,治疗应首选的方剂是", + "options": { + "A": "桑菊饮", + "B": "泻白散", + "C": "桑杏汤", + "D": "清慢救肺汤", + "E": "百合固金丸" + }, + "answer": "B", + "reason": "泻白散主治肺热喘咳证症见气喘咳嗽,皮肤蒸热，日哺尤甚，舌红苔黄,脉细数。" + }, + { + "question_num": 143, + "query": "心悸不论虚实应酌情配伍的治法是", + "options": { + "A": "滋补肝肾", + "B": "培土生金", + "C": "镇心安神", + "D": "补益心脾", + "E": "温补脾肾" + }, + "answer": "C", + "reason": "心悸以心神不宁为其病理特点，且虚实的主次、缓急各有不同,治当相应兼顾。故应酌情配合镇心安神之法。" + }, + { + "question_num": 144, + "query": "麻疹顺证皮疹的首见部位是", + "options": { + "A": "臀部", + "B": "鼻准部", + "C": "胸腹部", + "D": "手足心", + "E": "耳后发际" + }, + "answer": "E", + "reason": "麻疹顺证典型皮疹自耳后发际及颈部开始,渐次延及头面、颈部,而后急速延至胸背腹部、四肢,最后鼻准部及手心、足心。" + }, + { + "question_num": 145, + "query": "治疗亡阳证,寒饮咳喘,应首选的药物是", + "options": { + "A": "附子", + "B": "肉桂", + "C": "千姜", + "D": "吴茱萸", + "E": "小茴香" + }, + "answer": "C", + "reason": "干姜主治:腹痛,呕吐,泄泻;亡阳证;寒饮喘咳。" + }, + { + "question_num": 146, + "query": "主治阴疽的方剂是", + "options": { + "A": "大黄牡丹汤", + "B": "苇茎汤", + "C": "阳和汤", + "D": "半夏厚朴汤", + "E": "仙方活命饮" + }, + "answer": "C", + "reason": "阳和汤功用:温阳补血,散寒通滞。主治:阴疽" + }, + { + "question_num": 147, + "query": "针对胸痹标实的治法是", + "options": { + "A": "益气固脱", + "B": "活血化瘀", + "C": "补气温阳", + "D": "滋阴益肾", + "E": "补益心气" + }, + "answer": "B", + "reason": "标实当泻,针对气滞、血瘀寒凝、痰浊而疏理气机,活血化瘀,辛温通阳泄浊豁痰,尤重活血通脉治法。" + }, + { + "question_num": 148, + "query": "下列关于手足口病的叙述,正确的是", + "options": { + "A": "皮疹呈向心性分布", + "B": "疹退后局部留有瘢痕", + "C": "疱疹壁薄易破,疱浆清亮", + "D": "疹退后在皮疹部位有色素沉着", + "E": "皮疹以口腔、四肢为主,口腔疱疹破溃后形成溃疡" + }, + "answer": "E", + "reason": "手足口病主要表现为口腔及手足部发生疱疹。在口腔疱疹出现后1~2天可见皮肤斑丘疹,呈离心性分布,以手足部多见，并但快恋头流疹拍必具网形龙船网形良九米粒至豌豆大,质地较硬,多不破溃,内有浑浊液体,周围绕以红晕。少数患儿臂、腿、臀等部位也可出现,但躯干及颜面部极少。疱疹一般7~10天消退,疹退后无瘢痕及色素沉着。" + }, + { + "question_num": 149, + "query": "薤白的主治病证为", + "options": { + "A": "肝郁气滞", + "B": "肺热咳嗽", + "C": "虫积腹痛", + "D": "胸痹心痛", + "E": "胃寒呕吐" + }, + "answer": "D", + "reason": "薤白主治:①胸痹证,善散阴寒之凝滞;通胸阳之痹结,为治胸痹之要药;②脘腹痞满胀痛,泻痢里急后重。" + }, + { + "question_num": 150, + "query": "吴茱萸汤中吴茱萸的作用是", + "options": { + "A": "温胃暖肝,降逆止呕", + "B": "温中补虚,和胃止呕", + "C": "温肝解郁,和胃止呕", + "D": "温肾暖肝,降逆止呕", + "E": "温中补虚,疏肝解郁" + }, + "answer": "A", + "reason": "吴茱萸汤方中吴茱萸味辛苦而性热,归肝、脾、胃、肾经,既能温胃暖肝以祛寒,又善和胃降逆以止呕。" + }, + { + "question_num": 151, + "query": "胸痹之气阴两虚证的胸痛类型为", + "options": { + "A": "心胸隐痛", + "B": "心痛憋闷", + "C": "心痛彻背", + "D": "胸闷重而心痛微", + "E": "心痛如绞" + }, + "answer": "A", + "reason": "胸痹之气阴两虚证胸痛的特点是心胸隐痛,时作时休。" + }, + { + "question_num": 152, + "query": "适宜用清热解毒,软坚散结法治疗的流行性腮腺炎的证候是", + "options": { + "A": "邪犯少阳证", + "B": "毒窜睾腹证", + "C": "邪陷厥阴证", + "D": "热毒壅盛证", + "E": "邪陷心肝证" + }, + "answer": "D", + "reason": "流行性腮腺炎热毒壅盛证治法:清热解毒,软坚散结。代表方剂:普济消毒饮。" + }, + { + "question_num": 153, + "query": "下列药物中需要后下的是", + "options": { + "A": "木香", + "B": "檀香", + "C": "小茴香", + "D": "丁香", + "E": "花椒" + }, + "answer": "B", + "reason": "檀香属芳香类药物,煎服宜后下。" + }, + { + "question_num": 154, + "query": "防风通圣散的功用是", + "options": { + "A": "解表散寒,清里消积", + "B": "解肌散邪,清热止痢", + "C": "清热疏风,宣肺止咳", + "D": "辛凉疏表,清肺平喘", + "E": "疏风解表,泻热通便" + }, + "answer": "E", + "reason": "防风通圣散功用:疏风解表,泻热通便。主治:风热盛,表里俱实证。" + }, + { + "question_num": 155, + "query": "治疗真心痛正虚阳脱证，首选的方剂是", + "options": { + "A": "补阳还五汤", + "B": "瓜蒌薤白白酒汤", + "C": "瓜蒌薤白半夏汤", + "D": "当归四逆汤", + "E": "四逆加人参汤" + }, + "answer": "E", + "reason": "真心痛正虚阳脱证,治当回阳救逆,益气固脱，方选四逆加人参汤加减。" + }, + { + "question_num": 156, + "query": "紫癜阴虚火旺证的治法是", + "options": { + "A": "疏风散邪,清热凉血", + "B": "滋阴降火,凉血止血", + "C": "理气化瘀,活血止痛", + "D": "健脾养心,益气摄血", + "E": "清热解毒,凉血止血" + }, + "answer": "B", + "reason": "紫癜阴虚火旺证治法:滋阴降火,凉血止血。" + }, + { + "question_num": 157, + "query": "下列药物中炒用多回乳消胀的是", + "options": { + "A": "山楂", + "B": "神曲", + "C": "麦芽", + "D": "莱菔子", + "E": "鸡内金" + }, + "answer": "C", + "reason": "生麦芽功偏消食健胃,炒麦芽多用于回乳消胀。" + }, + { + "question_num": 158, + "query": "左归丸在补阴之品中配伍补阳药的意义是", + "options": { + "A": "培本清源", + "B": "温补元阳", + "C": "阴中求阳", + "D": "阳中求阴", + "E": "壮水济火" + }, + "answer": "D", + "reason": "左归丸在补阴之品中配伍补阳药,取“阳中求阴”之义。" + }, + { + "question_num": 159, + "query": "内伤头痛的发生,与下列哪些脏腑关系密切", + "options": { + "A": "心、脾、肾", + "B": "肺、胃、肾", + "C": "心、肺、肾", + "D": "心、肝、肾", + "E": "肝、脾、肾" + }, + "answer": "E", + "reason": "脑为髓海,依赖于肝肾精血和脾胃精微物质的充养,故内伤头痛之病机多与肝、脾、肾三脏的功能失调有关。" + }, + { + "question_num": 160, + "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血液传播;②母婴传播;③性接触传播;④其他，如日常生活密切接触传播。" + }, + { + "question_num": 161, + "query": "槟榔不具有的功效是", + "options": { + "A": "消积", + "B": "行气", + "C": "利水", + "D": "截疟", + "E": "止血" + }, + "answer": "E", + "reason": "槟榔功效:杀虫消积,行气利水,截疟。" + }, + { + "question_num": 162, + "query": "参苓白术散主治的病证是", + "options": { + "A": "脾虚湿盛证", + "B": "脾胃气虚证", + "C": "脾虚气陷证", + "D": "心脾两虚证", + "E": "脾肾两虚证" + }, + "answer": "A", + "reason": "参苓白术散:益气健脾,渗湿止泻,主要用于治疗脾虚湿盛证。" + }, + { + "question_num": 163, + "query": "眩晕的辨证中，应首辨的要点是", + "options": { + "A": "病变脏腑", + "B": "寒热虚实", + "C": "标本虚实", + "D": "虚实缓急", + "E": "外感内伤" + }, + "answer": "A", + "reason": "眩晕临证首先应辨明相关脏腑,其次辨标本虚实。" + }, + { + "question_num": 164, + "query": "下列关于慢性重型肝炎临床表现的叙述,错误的是", + "options": { + "A": "腹水", + "B": "脾大", + "C": "蜘蛛痣", + "D": "颅内出血", + "E": "肝掌" + }, + "answer": "D", + "reason": "慢性重型肝炎在慢性肝病的基础上发病。慢性肝病:慢性肝炎或肝硬化病史;②慢性HBV携带史;③无肝病史及无HBSAg携带史,但有慢性肝病体征(如肝学、蜘蛛痣等)影像学改变(如脾大等)及生化检测异常者(如丙种球蛋白升高，A/G比值下降或倒置);④肝穿刺活组织学检查支持慢性肝炎改变。不包括颅内出血。" + }, + { + "question_num": 165, + "query": "活血化瘀药的主治证是", + "options": { + "A": "宿食内停", + "B": "气随血脱", + "C": "痰蒙心窍", + "D": "惊风", + "E": "瘀血阻滞" + }, + "answer": "E", + "reason": "活血化瘀药适用于一切瘀血阻滞证,如内科的胸、腹、头痛,痛如针刺,痛有定处;伤科的跌扑损伤,瘀肿疼痛;外科的疮疡肿痛等。" + }, + { + "question_num": 166, + "query": "治疗肝肾阴虚,肝气郁滞证的方剂是", + "options": { + "A": "一贯煎", + "B": "百合固金汤", + "C": "六味地黄丸", + "D": "地黄饮子", + "E": "大补阴丸" + }, + "answer": "A", + "reason": "一贯煎:滋阴疏肝,主治肝肾阴虚,肝气郁滞证。症见胸脘胁痛，吞酸吐苦,咽干口燥,舌红少津,脉细弱或虚弦,亦治疝气痕聚。" + }, + { + "question_num": 167, + "query": "中风脱证的临床表现除下列哪项外均是", + "options": { + "A": "突然昏仆,不省人事", + "B": "目合口开,汗多不止", + "C": "手撒肢冷，二便自遗", + "D": "口噤不开,牙关紧闭", + "E": "舌痿,脉微欲绝" + }, + "answer": "D", + "reason": "中风脱证属虚,临床可见突然昏仆,不省人事,目合口张,鼻鼾息微,手撒肢冷,汗多,大小便自遗,肢体软瘫,舌痿,脉细弱或脉微欲绝。口噤不开，牙关紧闭为中风闭证的临床表现。" + }, + { + "question_num": 168, + "query": "下列各项,既是重型肝炎的诊断依据,也是判断其预后的敏感指标的是", + "options": { + "A": "血氨", + "B": "胆碱酯酶", + "C": "丙氨酸氨基转移酶", + "D": "天门冬氨酸氨基转移酶", + "E": "凝血酶原活动度" + }, + "answer": "E", + "reason": "凝血酶原活动度<40%是重型肝炎诊断及判断预后的重要指标。" + }, + { + "question_num": 169, + "query": "乳香具有的功效是", + "options": { + "A": "消肿生肌", + "B": "祛风止痛", + "C": "化瘀止血", + "D": "凉血消痈", + "E": "清利湿热" + }, + "answer": "A", + "reason": "乳香功效:活血行气止痛，消肿生肌。" + }, + { + "question_num": 170, + "query": "具有补肾健脾,益气摄血功用的方剂是", + "options": { + "A": "固冲汤", + "B": "归脾汤", + "C": "四物汤", + "D": "黄土汤", + "E": "固经丸" + }, + "answer": "A", + "reason": "固冲汤功用:固冲摄血,益气健脾。主治:脾肾亏虚,冲脉不固证。" + }, + { + "question_num": 171, + "query": "癫狂最重要的病理因素是", + "options": { + "A": "血瘀", + "B": "痰结", + "C": "火郁", + "D": "气郁", + "E": "寒凝" + }, + "answer": "D", + "reason": "癫狂病理因素以气、痰、火瘀为主,四者有因果兼夹的关系,且多以气郁为先。" + }, + { + "question_num": 172, + "query": "下列各项检查,属人感染高致病性禽流感确诊依据的是", + "options": { + "A": "血常规", + "B": "肝功能", + "C": "病毒分离", + "D": "骨髓穿刺", + "E": "胸部X线检查" + }, + "answer": "C", + "reason": "临床诊断病例呼吸道分泌物杯本中分岛出特定病游或采用在测到禽流感病毒基因，且发病初期和恢复期双份血清抗禽流感病毒抗体滴度4倍或以上升高,可确诊人感染高致病性禽流感。" + }, + { + "question_num": 173, + "query": "下列药物中可化瘀止血,敛疮生肌的是", + "options": { + "A": "骨碎补", + "B": "血竭", + "C": "鸡血藤", + "D": "益母草", + "E": "五灵脂" + }, + "answer": "B", + "reason": "血竭勿效:活血定痛，化瘀止血,敛疮生肌。" + }, + { + "question_num": 174, + "query": "酸枣仁汤中含有的药物是", + "options": { + "A": "知母、远志", + "B": "川艺柏子仁", + "C": "茯苓、朱砂", + "D": "知母、川芎", + "E": "甘草、石菖蒲" + }, + "answer": "D", + "reason": "酸枣仁汤组成:炒酸枣仁、甘草、知母、茯苓、芎。" + }, + { + "question_num": 175, + "query": "痴呆的基本病机为", + "options": { + "A": "阴精不足,气血亏虚", + "B": "髓海不足,神机失用", + "C": "脏腑亏虚,痰瘀内阻", + "D": "以虚为本,虚实夹杂", + "E": "气滞血瘀,痰浊内阻" + }, + "answer": "B", + "reason": "痴朵为一种全身性疾病,其基本病机为髓海不足,神机失用。" + }, + { + "question_num": 176, + "query": "下列有关感染的叙述，错误的是", + "options": { + "A": "感染是病原体对人体的一种寄生过程", + "B": "感染过程要有病原体、人体和外环境", + "C": "病原体的致病力包括毒力、侵袭力、病原体数量和变异性", + "D": "机体的免疫应答对感染过程的表现起重要作用", + "E": "病原体侵人人体,只要发病就是感染过程的开始" + }, + "answer": "E", + "reason": "病原体经过不同途径进人人体就开始了感染过程。" + }, + { + "question_num": 177, + "query": "可治疗痰热咳喘,中风痰迷,惊痫癫狂的是", + "options": { + "A": "半夏", + "B": "竹茹", + "C": "竹沥", + "D": "川贝母", + "E": "瓜蒌" + }, + "answer": "C", + "reason": "竹沥功效:清热豁痰,定惊利窍。主治病证:痰热咳喘;中风痰迷,惊痫癫狂。" + }, + { + "question_num": 178, + "query": "下列各项,不属苏合香丸主治证候的是", + "options": { + "A": "心腹卒痛", + "B": "高热烦躁", + "C": "牙关紧闭", + "D": "苔白", + "E": "脉迟" + }, + "answer": "B", + "reason": "苏合香丸属于温开剂。功用:芳香开窍,行气止痛。主治:寒闭证。症见突然昏倒，牙关紧闭，不省人事,苔白,脉迟。亦治心腹卒痛,甚则昏厥,属寒凝气带者。" + }, + { + "question_num": 179, + "query": "胃痛之胃阴亏耗证,治法是", + "options": { + "A": "养阴益胃，和中止痛", + "B": "化瘀通络,理气和胃", + "C": "温中健脾,和胃止痛", + "D": "清化热湿,理气和胃", + "E": "疏肝理气,和胃止痛" + }, + "answer": "A", + "reason": "胃痛之胃阴亏耗证,治法为养阴益胃,和中止痛。" + }, + { + "question_num": 180, + "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": "戌型" + }, + "answer": "B", + "reason": "乙型肝炎病毒属脱氧核糖核酸(DNA)病毒,其余各项均属RNA病毒。" + }, + { + "question_num": 181, + "query": "胃溃疡患者慎用的药物是", + "options": { + "A": "百部", + "B": "瓜蒌", + "C": "海藻", + "D": "桔梗", + "E": "白果" + }, + "answer": "D", + "reason": "桔梗:性升散,凡气机上逆呕吐、呛咳、眩晕、阴虚火旺咯血等不宜用,胃.十二指肠溃疡者慎服。用量过大易致恶心呕吐。" + }, + { + "question_num": 182, + "query": "主治脾胃寒湿气滞证的方剂是", + "options": { + "A": "半夏厚朴汤", + "B": "天台乌药散", + "C": "厚朴温中汤", + "D": "枳实薤白桂枝汤", + "E": "苏子降气汤" + }, + "answer": "C", + "reason": "厚朴温中汤:行气除满,温中燥湿。主治:脾胃寒湿气滞证" + }, + { + "question_num": 183, + "query": "治疗噎膈膈痰气交阻证,应首选", + "options": { + "A": "通幽汤", + "B": "丁香散", + "C": "启膈散", + "D": "通关散", + "E": "四七汤" + }, + "answer": "C", + "reason": "噎膈痰气交阻证,治以开郁化痰,润燥降气,方用启膈散。" + }, + { + "question_num": 184, + "query": "戊型肝炎的潜伏期是", + "options": { + "A": "30天左右", + "B": "60~90天", + "C": "2~9周", + "D": "1~2周", + "E": "1~3天" + }, + "answer": "C", + "reason": "戊型肝炎的潜伏期是2~9周。" + }, + { + "question_num": 185, + "query": "治疗咳喘、水肿，应选用的药物是", + "options": { + "A": "百部", + "B": "紫菀", + "C": "五加皮", + "D": "桑白皮", + "E": "紫苏子" + }, + "answer": "D", + "reason": "桑白皮主治:①肺热咳喘;②水肿。" + }, + { + "question_num": 186, + "query": "定喘汤组成中含有的药物是", + "options": { + "A": "苏叶、半夏、杏仁", + "B": "苏子、半夏、甘草", + "C": "苏叶、半夏、生姜", + "D": "苏子、厚朴、杏仁", + "E": "苏子、前胡、半夏" + }, + "answer": "B", + "reason": "定喘汤组成药物:白果、麻黄、苏子、甘草、款冬花、杏仁、桑白皮、炒黄芩半夏。功用:宣降肺气,清热化痰。主治:风寒外束,痰热内蕴证。" + }, + { + "question_num": 187, + "query": "治疗呃逆胃火上逆证的主方是", + "options": { + "A": "麦门冬汤", + "B": "一贯煎", + "C": "增液汤", + "D": "竹叶石膏汤", + "E": "理中丸" + }, + "answer": "D", + "reason": "呃逆胃火上逆证,治当清胄泄热,降逆止呃,方选竹叶石膏汤加减。" + }, + { + "question_num": 188, + "query": "治疗慢性丙型肝炎的最佳方案是", + "options": { + "A": "聚乙二醇干扰素合拉米夫定", + "B": "聚乙二醇干扰素合利巴韦林", + "C": "聚乙二醇干扰素合恩替卡韦", + "D": "普通干扰素合利巴韦林", + "E": "普通干扰案合拉米夫定" + }, + "answer": "B", + "reason": "聚乙二醇于扰素与利巴韦林联合应用是目前治疗慢性丙型肝炎的最佳方案。" + }, + { + "question_num": 189, + "query": "具有安神,敛汗功效的药物是", + "options": { + "A": "朱砂", + "B": "磁石", + "C": "首乌藤", + "D": "合欢皮", + "E": "酸枣仁" + }, + "answer": "E", + "reason": "酸枣仁功效:养心益肝,安神,敛汗,生津。" + }, + { + "question_num": 190, + "query": "咳血方主治证的病机是", + "options": { + "A": "肝火犯肺,灼热肺络", + "B": "脾阳不足,统血失常", + "C": "阴虚火旺,损伤肺络", + "D": "肺中燥热,损伤肺络", + "E": "心脾两虚,气不摄血" + }, + "answer": "A", + "reason": "咳血方证系肝火犯肺,灼伤肺络所致。" + }, + { + "question_num": 191, + "query": "治疗腹痛中虚脏寒证，首选的方剂是", + "options": { + "A": "枳实导滞丸", + "B": "吴茱萸汤", + "C": "小建中汤", + "D": "少腹逐瘀汤", + "E": "理中丸" + }, + "answer": "C", + "reason": "腹痛中虚脏寒证,治当温中补虚,缓急止痛,方选小建中汤加减。" + }, + { + "question_num": 192, + "query": "引起人感染高致病性禽流感的主要病毒亚型是", + "options": { + "A": "HIN4", + "B": "H5N2", + "C": "H4N1", + "D": "H1N8", + "E": "H5N1" + }, + "answer": "E", + "reason": "目前感染人类的禽流感病毒亚型主要有H5N1、H9N2、H7N7,其中感染H5N1亚型者病情重,死亡率高，可感染人、禽和其他哺乳类动物。" + }, + { + "question_num": 193, + "query": "具有平肝疏肝,祛风明目功效的药物是", + "options": { + "A": "珍珠母", + "B": "代赭石", + "C": "刺蒺藜", + "D": "钩藤", + "E": "牡蛎" + }, + "answer": "C", + "reason": "刺蒺藜功效:平肝疏肝,祛风明目。" + }, + { + "question_num": 194, + "query": "组成药物中含有炮姜、川芎的方剂是", + "options": { + "A": "温经汤", + "B": "生化汤", + "C": "血府逐瘀汤", + "D": "复元活血汤", + "E": "补阳还五汤" + }, + "answer": "B", + "reason": "生化汤组成:当归、川芎、桃仁、炮干姜、炙甘草、黄酒、童便。" + }, + { + "question_num": 195, + "query": "泄泻的治疗大法是", + "options": { + "A": "健脾益气", + "B": "消食导滞", + "C": "运脾化湿", + "D": "清热利湿", + "E": "芳香化湿" + }, + "answer": "C", + "reason": "泄泻的治疗大法为运脾化湿。" + }, + { + "question_num": 196, + "query": "隐性感染病例增加的临床主要意义是", + "options": { + "A": "典型病例增加", + "B": "轻症病例增加", + "C": "潜在感染病例增加", + "D": "病原携带病例增加", + "E": "免疫人群增加" + }, + "answer": "E", + "reason": "隐性感染指病原体只引起特异性免疫应答,不引起或只引起轻微的组织损伤,无临床症状，只能通过免疫学检查发现隐性感染后人群易感性降低,免疫人群增加。" + }, + { + "question_num": 197, + "query": "治疗热闭神昏,湿阻中焦,应选用的药物是", + "options": { + "A": "石菖蒲", + "B": "羚羊角", + "C": "牛黄", + "D": "远志", + "E": "麝香" + }, + "answer": "A", + "reason": "石菖蒲功效:开窍醒神,化湿和胃,宁神益志。主治:①痰蒙清窍,神志昏迷;②湿阻中焦,脘腹痞满,胀闷疼痛;③噤口痢;④健忘、失眠、耳鸣、耳聋。" + }, + { + "question_num": 198, + "query": "主治肝阳偏亢,肝风上扰证的首选方剂是", + "options": { + "A": "大秦艽汤", + "B": "地黄饮子", + "C": "大定风珠", + "D": "羚角钩藤汤", + "E": "天麻钩藤饮" + }, + "answer": "E", + "reason": "天麻钩藤饮主治:肝阳偏亢，肝风上扰证。" + }, + { + "question_num": 199, + "query": "虚寒痢的治法是", + "options": { + "A": "补中益气,健脾升阳", + "B": "温补脾肾,收涩固脱", + "C": "养阴和营,清肠止痢", + "D": "温化寒湿,调气和血", + "E": "温中补虚,清热化湿" + }, + "answer": "B", + "reason": "虚寒痢的治法是温补脾肾收涩固脱。" + }, + { + "question_num": 200, + "query": "下列各项,不属于重症传染性非典型肺炎诊断标准的是", + "options": { + "A": ".低氧血症,氧合指数低于300mmHg", + "B": "呼吸困难,呼吸频率>30次/分", + "C": "X线胸片示多叶病变或病灶总面积范围超过双肺总面积", + "D": "出现休克或多器官功能障碍综合征(MODS)", + "E": "白细胞计数明显升高" + }, + "answer": "E", + "reason": "重症传染性非典型肺炎诊断标准:①呼吸困难,成人休息状态下呼吸频率>30次/分，且伴X线胸片显示多叶病变或病灶总面积在正位胸片上占双肺总面积的1/3以上,病情进展,48小时内病灶面积增大超过50%，且在正位胸片上占双肺总面积的1/4以上;②低氧血症，氧合指数低于3小租从古成乡婴宜功能赔理结”合征(MODS)。" + }, + { + "question_num": 201, + "query": "治疗风寒湿痹,肢体麻木,应选用的药物是", + "options": { + "A": "益智仁", + "B": "沙苑子", + "C": "肉苁蓉", + "D": "紫河车", + "E": "淫羊藿" + }, + "answer": "E", + "reason": "淫羊薇功效:补肾壮阳,祛风除湿。主治:①肾阳虚衰，阳尿频，腰膝无力;②风寒湿痹,肢体麻木。" + }, + { + "question_num": 202, + "query": "下列各项,不属血府逐瘀汤组成的药物是", + "options": { + "A": "牛膝", + "B": "柴胡", + "C": "地黄", + "D": "白芍", + "E": "枳壳" + }, + "answer": "D", + "reason": "血府逐瘀汤组成:桃仁、红花、当归、生地黄、川芎、赤芍、牛膝、桔梗、柴胡、枳壳、甘草。" + }, + { + "question_num": 203, + "query": "便秘热秘,服药后大便不爽者,治疗宜用", + "options": { + "A": "麻子仁丸", + "B": "六磨汤", + "C": "更衣丸", + "D": "青麟丸", + "E": "大承气汤" + }, + "answer": "D", + "reason": "便秘属热秘者,当泻热导滞,润肠通便,方选麻子仁丸。若燥热不甚,或药后大便不爽者,可用青麟丸以通腑缓下。" + }, + { + "question_num": 204, + "query": "鉴别人感染高致病性禽流感与传染性非典型肺炎的主要依据是", + "options": { + "A": "流行病学史", + "B": "高热、咳嗽等临床表现", + "C": "血常规检查", + "D": "X线胸片", + "E": "病原学检查" + }, + "answer": "E", + "reason": "病原学检查是传染病诊断的金指标。" + }, + { + "question_num": 205, + "query": "桑螵蛸的主治病证是", + "options": { + "A": "自汗盗汗", + "B": "遗精滑精", + "C": "中气下陷", + "D": "久咳虚喘", + "E": "久泻久痢" + }, + "answer": "B", + "reason": "桑螵蛸主治病证:①肾虚不固之遗精滑精、遗尿尿频、白浊;②肾虚阳痿," + }, + { + "question_num": 206, + "query": "四逆散配伍中体现“一升一降,升清降浊\"作用的药物是", + "options": { + "A": "柴胡、芍药", + "B": "甘草、枳实", + "C": "枳实、芍药", + "D": "柴胡、甘草", + "E": "柴胡、枳实" + }, + "answer": "E", + "reason": "四逆散中,柴胡与枳实相配,一升一降,以疏理肝脾气机;柴胡与芍药相配,泻木扶土而和肝脾;枳实与芍药相配,理气和血而止腹痛。" + }, + { + "question_num": 207, + "query": "保和丸可用于下列除哪项以外的病证", + "options": { + "A": "饮食停滞型胃痛", + "B": "饮食积滞型腹痛", + "C": "食滞痰阻型积聚", + "D": "食滞肠胃型泄泻", + "E": "饮食停滞型呕吐" + }, + "answer": "C", + "reason": "饮食停滞型胃痛,治当消食导滞,和胃止痛,方选保和丸加减;饮食积滞型腹痛,治当消食导滞,理气止痛,方选枳实导滞丸加减,轻证用保和丸;食滞痰阻型积聚,治当理气化痰,导滞散结,方选六磨汤加减;食滞肠胃型泄泻,治当消食导滞,和中止泻，方选保和丸加减;饮食停滞型呕吐,治当消食化滞,和胃降逆,方选保和丸加减。" + }, + { + "question_num": 208, + "query": "艾滋病可出现持续性全身淋巴结肿大的时间是", + "options": { + "A": "急性HIV感染期", + "B": "无症状感染期", + "C": "艾滋病期", + "D": "恢复期", + "E": "任何时期" + }, + "answer": "C", + "reason": "艾滋病期为感染HIV后的最终阶段。此期主要表现为持续1个月以上的发热、盗汗、腹泻,体重减轻10%以上,部分患者可表现为神经精神症状,如记忆力减退、表情淡漠、性格改变、头痛、疯痫及痴呆等,另外还可出现持续性全身性淋巴结肿大。" + }, + { + "question_num": 209, + "query": "具有截疟功效的药物是", + "options": { + "A": "硼砂", + "B": "升药", + "C": "砒石", + "D": "蜂房", + "E": "蟾酥" + }, + "answer": "C", + "reason": "砒石功效:外用攻毒杀虫，蚀疮去腐;内服祛痰平喘,截疟" + }, + { + "question_num": 210, + "query": "组成中含有白术的方剂是", + "options": { + "A": "保和丸", + "B": "猪苓汤", + "C": "二妙散", + "D": "防己黄芪汤", + "E": "平胃散" + }, + "answer": "D", + "reason": "防已黄芪汤组成:防已、甘草、白术、黄芪、生姜、大枣。" + }, + { + "question_num": 211, + "query": "黄疸最主要的辨证要点是", + "options": { + "A": "急黄之病因", + "B": "黄疸病势轻重", + "C": "辨阳黄、阴黄", + "D": "阳黄湿热之轻重", + "E": "阴黄之病因" + }, + "answer": "C", + "reason": "黄疸的辨证以阴阳为纲,分为阳黄和阴黄。临床应根据黄疽的色泽,结合病史、症状,区别阳黄与阴黄。" + }, + { + "question_num": 212, + "query": "狂犬病麻痹期的典型表现是", + "options": { + "A": "恐风", + "B": "恐水", + "C": "肢��瘫痪", + "D": "呼吸急促", + "E": "心率加快" + }, + "answer": "C", + "reason": "狂犬病麻癌期患者出现迟缓性瘫痪,尤以肢体软瘫为多见。" + }, + { + "question_num": 213, + "query": "脾虚便溏者慎用", + "options": { + "A": "干姜", + "B": "桂枝", + "C": "知母", + "D": "天花粉", + "E": "黄芩" + }, + "answer": "C", + "reason": "知母性寒质润,有滑肠作用,故脾求便溏者不宜用" + }, + { + "question_num": 214, + "query": "三仁汤主治证中，身热的特点是", + "options": { + "A": "身热夜甚", + "B": "身热不扬", + "C": "皮肤蒸热", + "D": "壮热不休", + "E": "往来寒热" + }, + "answer": "B", + "reason": "三仁汤主治湿温初起及暑温夹湿之湿重于热证。湿热证的身热特点为身热不扬。" + }, + { + "question_num": 215, + "query": "下列各项,不属于积证瘀血内结证的表现的是", + "options": { + "A": "腹部积块质软不坚,胀痛并见", + "B": "腹部积块大,质地较硬", + "C": "积块固定不移，隐痛或刺痛", + "D": "面暗消瘦,时有寒热", + "E": "纳谷减少,体倦乏力" + }, + "answer": "A", + "reason": "积证瘀血内结证可见腹部积块明显，质地较硬，固定不移,隐痛或刺痛,形体消瘦，纳谷减少，面色附暗奥黑，面钡领脑或有血痣赤缕等。" + }, + { + "question_num": 216, + "query": "下列关于流行性乙型脑炎的临床分型的叙述正确的是", + "options": { + "A": "轻型、普通型、重型、极重型", + "B": "轻型、普通型、危重型", + "C": "轻型、中型、重型", + "D": "不典型、典型、暴发型", + "E": "不典型、典型、重型" + }, + "answer": "A", + "reason": "流行性乙型脑炎的临床分型:轻型、普通型、重型、极重型(暴发型)。" + }, + { + "question_num": 217, + "query": "慢性肺源性心脏病最多见的并发症是", + "options": { + "A": "肺性脑病", + "B": "心律失常", + "C": "酸碱失衡", + "D": "消化道出血", + "E": "肾衰竭" + }, + "answer": "C", + "reason": "酸碱平衡失调和电解质紊乱是因为二氧化碳潴留可导致呼吸性酸中毒，严重缺氧可导致代谢性酸中毒,低钾、低氯血症可导致代谢性碱中毒。这是本病最常见并发症。" + }, + { + "question_num": 218, + "query": "八正散的主治证是", + "options": { + "A": "湿热外感", + "B": "暑温夹湿", + "C": "湿热黄疸", + "D": "湿热淋证", + "E": "湿温初起" + }, + "answer": "D", + "reason": "八正散:清热泻火,利水通淋，主治失热淋症" + }, + { + "question_num": 219, + "query": "疟疾的治疗原则是", + "options": { + "A": "祛邪截疟", + "B": "解毒除瘴", + "C": "扶正截疟", + "D": "祛瘀化痰软坚", + "E": "灭蚊截疟" + }, + "answer": "A", + "reason": "疟疾的治疗以祛邪截疟为基本治则。" + }, + { + "question_num": 220, + "query": "流行性乙型脑炎患者出现瞳孔不等大,呼吸不规则,应首先采取的措施是", + "options": { + "A": "糖皮质激素静脉滴注", + "B": "吸痰", + "C": "20%甘露醇快速静脉滴注", + "D": "吸氧", + "E": "镇静" + }, + "answer": "C", + "reason": "流行性乙型脑炎患者出现瞳孔不等大,呼吸不规则,说明颅内压增高,出现脑疝,应立即应用20%甘露醇快速静脉滴注,降低颅内压。" + }, + { + "question_num": 221, + "query": "肺癌发病的最重要因素是", + "options": { + "A": "室内空气污染", + "B": "室外空气污染", + "C": "吸烟", + "D": "长期接触石棉", + "E": "电离辐射" + }, + "answer": "C", + "reason": "吸烟是公认的肺癌发病的最重要危险因素。" + }, + { + "question_num": 222, + "query": "二陈汤与半夏白术天麻汤二方中均含有的药物是", + "options": { + "A": "半夏、杏仁", + "B": "枳实、橘皮", + "C": "半夏、茯苓", + "D": "白术、半夏", + "E": "橘红、乌梅" + }, + "answer": "C", + "reason": "二陈汤组成:半夏、橘红、茯苓、炙甘草、生姜、乌梅。半夏白术天麻汤组成:半夏、天麻、茯苓、橘红、白术、甘草、生姜、大枣。" + }, + { + "question_num": 223, + "query": "尿血与尿淋的家别要点是", + "options": { + "A": "尿色的深浅", + "B": "尿量的多少", + "C": "尿味的情况", + "D": "有无尿痛", + "E": "以上均非" + }, + "answer": "D", + "reason": "血淋与尿血都有小便出血的表现,但血淋是溺血而痛，尿血无尿痛的表现。" + }, + { + "question_num": 224, + "query": "伤寒杆菌菌体裂解产生的毒素是", + "options": { + "A": "���毒素", + "B": "外毒素", + "C": "神经毒素", + "D": "细胞毒素", + "E": "溶血毒素" + }, + "answer": "A", + "reason": "伤寒杆菌菌体裂解产生内毒素，是伤寒发病的重要因素。" + }, + { + "question_num": 225, + "query": "对化疗最敏感的肺癌组织学类型是", + "options": { + "A": "鳞状上皮癌", + "B": "类癌", + "C": "腺癌", + "D": "小细胞肺癌", + "E": "大细胞肺癌" + }, + "answer": "D", + "reason": "小细胞肺癌对化疗最敏感" + }, + { + "question_num": 226, + "query": "主治痰热咳嗽的方剂是", + "options": { + "A": "桑杏汤", + "B": "温胆汤", + "C": "清气化痰丸", + "D": "清燥救肺汤", + "E": "贝母瓜蒌散" + }, + "answer": "C", + "reason": "清气化痰丸主治:痰热咳嗽。" + }, + { + "question_num": 227, + "query": "治疗淋证之气淋,应首选的方剂是", + "options": { + "A": "小蓟饮子", + "B": "补中益气汤", + "C": "八正散", + "D": "沉香散", + "E": "程氏草薜分清饮" + }, + "answer": "D", + "reason": "淋证之气淋病机为气机郁结,膀胱气化不利,治宜理气疏导,通淋利尿,方用沉香散。" + }, + { + "question_num": 228, + "query": "下列关于阴道功能的叙述,错误的是", + "options": { + "A": "排出月经", + "B": "分泌带下", + "C": "种子育胎", + "D": "排出恶露", + "E": "阴阳交合" + }, + "answer": "C", + "reason": "阴道,又称产道,意指胎儿分娩时所经之道路,位于子宫与阴户之间。阴道是防御外邪人侵的关口，是排出月经、分泌带下的通道,是阴阳交合的器官，又是娩出胎儿、排出恶路的路俭，故小杯食胎是胞宫的功能。" + }, + { + "question_num": 229, + "query": "治疗洋地黄中毒引起的频发室性期前收缩,应首选的药物是", + "options": { + "A": "奎尼丁", + "B": "利多卡因", + "C": "阿托品", + "D": "美托洛尔", + "E": "苯妥英锁" + }, + "answer": "E", + "reason": "洋地黄中淼引起的频发室性期前收缩,应立即停用洋地黄,给予苯妥英钠或氯化钾等治疗" + }, + { + "question_num": 230, + "query": "常引起弛张热的疾病是", + "options": { + "A": "结核病", + "B": "肺炎链球菌肺炎", + "C": "伤寒", + "D": "霍奇金病", + "E": "风湿热" + }, + "answer": "E", + "reason": "弛张热常见于败血症、风湿热、重症肺结核、化脓性炎症等。" + }, + { + "question_num": 231, + "query": "不属于郁证常见证型的是", + "options": { + "A": "痰气郁结证", + "B": "心神失养证", + "C": "津液亏虚证", + "D": "肝气郁结证", + "E": "气郁化火证" + }, + "answer": "C", + "reason": "郁证临床可见肝气郁结证气郁化火证,痰气郁结证,心神失养证,心脾两虚证,心肾阴虚证。" + }, + { + "question_num": 232, + "query": "下列各项,不属妊娠期生理现象的是", + "options": { + "A": "脉滑", + "B": "月经停闭", + "C": "头痛", + "D": "乳晕加大变黑", + "E": "恶心欲呕,择食" + }, + "answer": "C", + "reason": "妊娠初期出现饮食偏嗜、恶心作呕、晨起头晕等现象。早期孕妇可自觉乳房胀大。妊娠2~3个月后，六脉平和滑利,按之不绝,尺脉尤甚。妊娠3个月后，白带稍增多,乳头、乳晕的颜色加深。妊娠4~5个月后，孕妇可自觉胎动,胎体逐渐增大,小腹部逐渐膨隆。妊娠6个月后，可出现轻度肿胀。妊娠末期,可见小便频数、大便秘结。" + }, + { + "question_num": 233, + "query": "主动脉瓣狭窄的典型三联征是", + "options": { + "A": "呼吸困难一心绞痛一晕厥", + "B": "心力衰竭一心绞痛一晕厥", + "C": "呼吸困难一心律失常一晕厥", + "D": "心力衰竭-心律失常一晕厥", + "E": "心绞痛一心律失常一晕厥" + }, + "answer": "A", + "reason": "主动脉瓣狭窄出现症状较晚,轻度和中度主动脉瓣狭窄者可多年无症状,严重者典型表现为呼吸困难一心绞痛一号厥,称为主动脉瓣狭窄三联征，个别患者会猝死。" + }, + { + "question_num": 234, + "query": "引起上消化道出血最常见的原因是", + "options": { + "A": "消化性溃疡", + "B": "胆道感染", + "C": "胃癌", + "D": "血小板减少性紫癜", + "E": "肝硬化" + }, + "answer": "A", + "reason": "消化性溃疡是上消化道出血最常见的病因，" + }, + { + "question_num": 235, + "query": "治疗郁证之痰气郁结证，应首选", + "options": { + "A": "甘麦大参汤", + "B": "半夏厚朴汤", + "C": "柴胡疏肝散", + "D": "丹栀逍遥散", + "E": "小陷胸汤" + }, + "answer": "B", + "reason": "郁证痰气郁结证的病机为气郁痰凝,阻滞胸咽,治宜行气开郁,化痰散结，方选半夏厚朴汤加减。" + }, + { + "question_num": 236, + "query": "下列各项,属寒邪导致的妇科疾病是", + "options": { + "A": "子淋", + "B": "痛经", + "C": "经行吐衄", + "D": "崩漏", + "E": "月经先期" + }, + "answer": "B", + "reason": "若机体阳气不足,寒自内生,脏腑机能失常,影响冲任、胞宫的功能,可出现痛经、带下病、妊娠腹痛、宫寒不孕等。A.C、D、E项为热邪所致。" + }, + { + "question_num": 237, + "query": "急性心肌梗死引起急性左心衰竭，主要的治疗措施是", + "options": { + "A": "扩充血容量", + "B": "强心", + "C": "应用吗啡和利尿剂", + "D": "抗感染", + "E": "升血压" + }, + "answer": "C", + "reason": "急性心肌梗死引起急性左心衰竭,以应用吗啡(或哌替啶)和利尿剂为主,亦可选用血管扩张剂减轻左心室的负荷，或用短效血管紧张素转换酶抑制剂从小剂量开始等治疗。梗死发生后24小时内应避免使用洋地黄制剂。" + }, + { + "question_num": 238, + "query": "下列各项,多表现为下垂性水肿的是", + "options": { + "A": "肾小球肾炎", + "B": "肝硬化", + "C": "低蛋白血症", + "D": "右心衰竭", + "E": "甲状腺功能减退症" + }, + "answer": "D", + "reason": "心源性水肿的特点:下垂性水肿,严重者可出现胸水、腹水等,常伴有呼吸困难、心脏扩大、心率加快、颈静脉怒张、肝颈静脉回流征阳性等表现。" + }, + { + "question_num": 239, + "query": "脏躁的代表方是", + "options": { + "A": "柴胡疏肝散", + "B": "滋水清肝饮", + "C": "丹栀逍遥散", + "D": "甘麦大枣汤", + "E": "半夏厚朴汤" + }, + "answer": "D", + "reason": "脏躁为营阴暗耗,心神失养之郁证。治宜甘润缓急,养心安神，方选甘麦大枣汤加减。" + }, + { + "question_num": 240, + "query": "中医妇科内治法中,温补肾阳法的代表方是", + "options": { + "A": "温经汤", + "B": "左归丸", + "C": "金匮肾气丸", + "D": "参附汤", + "E": "举元煎" + }, + "answer": "C", + "reason": "肾阳虚,命门火衰,冲任失于温煦,导致经、带、胎、产等病,治疗以温肾助阳、温养冲任为主,常用的代表方剂为金医肾气丸、温胞饮、右归丸等。" + }, + { + "question_num": 241, + "query": "高血压伴糖尿病肾病的治疗药物是", + "options": { + "A": "利尿剂", + "B": "β受体阻滞剂", + "C": "CCB", + "D": "ACEI", + "E": "ARB" + }, + "answer": "D", + "reason": "目前ACEI主要用于各种类型尚血压及各种在度的尚血压对作有衰竭、左心室肥大、心肌梗死、糖耐最降低或糖尿病肾病蛋白尿等尤为适宜。" + }, + { + "question_num": 242, + "query": "胸痛常表现为呼吸时加重,屏气时消失的疾病是", + "options": { + "A": "肋间神经炎", + "B": "支气管肺癌", + "C": "食管癌", + "D": "急性心肌梗死", + "E": "干性胸膜炎" + }, + "answer": "E", + "reason": "干性胸膜炎常呈尖锐刺痛或撕裂痛,呼吸时加重,屏气时消失。" + }, + { + "question_num": 243, + "query": "治疗紫斑阴虚火旺证,应首选", + "options": { + "A": "知柏地黄丸", + "B": "无比山药丸", + "C": "犀角地黄丸", + "D": "茜根散", + "E": "归脾汤" + }, + "answer": "D", + "reason": "紫斑阴虚火旺证为虚火内炽,灼伤脉络,血溢肌腠,治宜滋阴降火,宁络止血，方选茜根散加减。" + }, + { + "question_num": 244, + "query": "下列各项,属月经先期阳盛血热证中主症的是", + "options": { + "A": "经色暗淡,质清稀", + "B": "经色淡红,质清稀", + "C": "经色深红,质黏稠", + "D": "经色暗红,有血块", + "E": "经色淡红，质黏稠" + }, + "answer": "C", + "reason": "阳盛血热证的主症为经来先期,量多,色深红或紫红,质黏稠;或伴心烦:面红口干,小便短黄,大便燥结;舌质红,苔黄脉数或滑数。" + }, + { + "question_num": 245, + "query": "肝癌常见的淋巴结转移部位是", + "options": { + "A": "颈前淋巴结", + "B": "肝门淋巴结", + "C": "腋窝淋巴结", + "D": "颌下淋巴结", + "E": "颏下淋巴结" + }, + "answer": "B", + "reason": "肝癌的转移途径:①血行转移,分肝内转移和肝外转移，肝内血行转移发生最早、最常见;②淋巴转移,转移至肝门淋巴结最多,也可转移到主动脉旁、脾、胰及锁骨上淋巴结;③种植转移,较少见，如果种植在腹膜,可形成血性腹水。" + }, + { + "question_num": 246, + "query": "表现为持续��睡眠,可被唤醒,醒后能正确回答问题,刺激停止后迅速入睡的是", + "options": { + "A": "嗜睡", + "B": "昏睡", + "C": "昏迷", + "D": "谵妄", + "E": "意识模糊" + }, + "answer": "A", + "reason": "嗜睡:最轻的意识障碍,为病理性倦怠，可被唤醒，并能作出各种不同的反应。" + }, + { + "question_num": 247, + "query": "按痰饮停积的部位分类,饮流胁下的是", + "options": { + "A": "痰饮", + "C": "溢饮", + "B": "支饮", + "D": "悬饮", + "E": "伏饮" + }, + "answer": "D", + "reason": "饮邪具有流动之性,饮流胁下,则为悬饮。" + }, + { + "question_num": 248, + "query": "实证闭经的主要机制是", + "options": { + "A": "寒凝其滞", + "B": "血海空虚", + "C": "气血阻滞", + "D": "肝肾亏损", + "E": "湿热瘀阻" + }, + "answer": "C", + "reason": "实证闭经多因气血阻滞,或痰湿流注下焦,使血流不通，冲任受阻,血海阻隔,经血不得下行而成闭经。" + }, + { + "question_num": 249, + "query": "原发性蛛网膜下隙出血最常见的病因是", + "options": { + "A": "脑动脉炎", + "B": "高血压性动脉硬化", + "C": "血液病", + "D": "脑底囊性动脉瘤破裂", + "E": "脑血管畸形" + }, + "answer": "D", + "reason": "导致原发性蛛网膜下隙出血最多见的病因是脑底囊性动脉瘤破裂(85%)，其次是脑动静脉畸形，" + }, + { + "question_num": 250, + "query": "下列各项,不属于肝细胞性黄疸特点的是", + "options": { + "A": "尿胆原可增加", + "B": "白陶土色粪便", + "C": "尿胆红素阳性", + "D": "血清结合胆红素增高", + "E": "血清非结合胆红素增高" + }, + "answer": "B", + "reason": "肝细胞性黄疸类便颜色为颜色变浅或正常。" + }, + { + "question_num": 251, + "query": "治疗支饮寒饮伏肺证,应首选的方剂是", + "options": { + "A": "柴积半夏汤", + "B": "小青龙汤", + "C": "香附旋覆花汤", + "D": "甘遂半夏汤", + "E": "金匮肾气丸" + }, + "answer": "B", + "reason": "支饮寒饮伏肺证的病机为寒饮伏肺,肺失宣降,治宜宣肺化饮,方选小青龙汤加减。" + }, + { + "question_num": 252, + "query": "下列各项,不属于痛经气血虚弱证主症的是", + "options": { + "A": "月经量少、色淡、质稀", + "B": "腹痛出现在行经之后", + "C": "神疲乏力,面色无华", + "D": "头晕眼花,腰痛如折", + "E": "下腹隐隐作痛,喜按" + }, + "answer": "D", + "reason": "痛经气血虚弱证的主症为经期或经后小腹隐隐作痛，喜按或小腹及阴部空坠不适;月经量少,色淡,质清稀;面色无华,头晕心悸,神疲乏力;舌质淡,脉细无力。" + }, + { + "question_num": 253, + "query": "溃疡性结肠炎活动期的重要表现是", + "options": { + "A": "发热", + "B": "腹痛", + "C": "腹部压痛", + "D": "黏液血便", + "E": "贫血" + }, + "answer": "D", + "reason": "腹泻为本病的主要症状,腹泻主要与炎症导致大肠黏膜对水钠吸收障碍以及结肠运动功能失常有关，粪便性状为稀便、水样便、黏液便、血便、黏液脓血便等。黏液脓血便是本病活动期的重要表现，大便次数及便血的程度反映病情轻重。" + }, + { + "question_num": 254, + "query": "急性有机磷杀虫药中毒患者呼出的气味是", + "options": { + "A": "酒味", + "B": "烂苹果味", + "C": "刺激性蒜味", + "D": "氨味", + "E": "腥臭味" + }, + "answer": "C", + "reason": "呼气味:浓烈的酒味见于酒后或醉酒,刺激性蒜味见于有机磷农药中毒，烂苹果味见于糖尿病酮症酸中毒，氨味见于尿毒症,腥臭味见于肝性脑病。" + }, + { + "question_num": 255, + "query": "治疗消渴胃热炽盛证,应首选", + "options": { + "A": "七味白术散", + "B": "消渴方", + "C": "玉女煎", + "D": "茜根散", + "E": "清中汤" + }, + "answer": "C", + "reason": "胃热炽盛证为胃火内炽,胃热消谷,耗伤津液所致。治宜清胃泻火，养阴增液,方用玉女煎加减。" + }, + { + "question_num": 256, + "query": "经行乳房胀痛肝肾亏虚证的治法是", + "options": { + "A": "疏肝养血,和胃通络", + "B": "温肾养阴,和胃通络", + "C": "疏肝理气,和胃通络", + "D": "滋肾养肝,和胃通络", + "E": "补肾健脾,和胃通络" + }, + "answer": "D", + "reason": "经行乳房胀痛肝肾亏虚证症见经行或经后两乳作胀作痛，乳房按之柔软无块,月经量少,色淡;两目干涩,咽干口燥,五心烦热;舌淡或舌红,少苔,脉细数。治法为滋肾养肝,和胃通络。" + }, + { + "question_num": 257, + "query": "缺铁性贫血治疗后首先升高的是", + "options": { + "A": "嗜酸性粒细胞", + "B": "中性粒细胞", + "C": "白细胞", + "D": "全血细胞", + "E": "网织红细胞" + }, + "answer": "E", + "reason": "缺铁性贫血在服用铁剂治疗后最早发生的治疗反应是自觉症状的迅速改善,短时期网织红细胞计数明显升高，常于用药后5~10天达高峰" + }, + { + "question_num": 258, + "query": "下列各项，可出现脉压减小的是", + "options": { + "A": "主动脉瓣关闭不全", + "B": "缩窄性心包炎", + "C": "动脉导管未闭", + "D": "甲状腺功能亢进症", + "E": "严重贫血" + }, + "answer": "B", + "reason": "脉压<30mmHg称为脉压减小,见于主动脉瓣狭窄、心力衰竭、低血压休克、心包积液、缩窄性心包炎等。" + }, + { + "question_num": 259, + "query": "阳虚发热的首选方剂是", + "options": { + "A": "金匮肾气丸", + "B": "右归丸", + "C": "中和汤", + "D": "清骨散", + "E": "归脾汤" + }, + "answer": "A", + "reason": "阳虚发热的病机为肾阳虚衰,火不归原。治宜温补阳气,引火归原,方选金匮肾气丸加减" + }, + { + "question_num": 260, + "query": "经行头痛血瘀证的主症是", + "options": { + "A": "经前头痛,甚或巅顶掣痛", + "B": "经期头痛,甚或顶掣痛", + "C": "经期头痛,痛如锥刺", + "D": "经后头晕,绵绵作痛", + "E": "经后头痛,痛如锥刺" + }, + "answer": "C", + "reason": "经行头痛血瘀证症见每逢经前、经期头痛剧烈,痛如锥刺，经色紫暗有块;伴小腹疼痛拒按,胸闷不舒;舌暗或尖边有瘀点，脉细涩或弦涩。" + }, + { + "question_num": 261, + "query": "对1型与2型糖尿病的监别最有意义的是", + "options": { + "A": "年龄", + "B": "体重", + "C": "有无自发性酮症倾向", + "D": "有无明显“三多一少”症状", + "E": "并发症的多少与严重程度" + }, + "answer": "C", + "reason": "糖尿病酮症酸中毒是由于胰岛素不足以及升血糖激素不适当升高引起的临床综合征，是最为常见的糖尿病急症:a1型糖尿病患者有自发酮症倾向，2型糖尿病患者在一定诱因下也可发生,如感染、胰岛素治疗中断或不活当减母，饮食不当，各种应激等,有时也可无明显诱因" + }, + { + "question_num": 262, + "query": "能导致瞳孔扩大的疾病是", + "options": { + "A": "有机磷杀虫药中毒", + "B": "吗啡中毒", + "C": "青光眼绝对期", + "D": "毒蕈碱中毒", + "E": "虹膜炎" + }, + "answer": "C", + "reason": "病理情况下,瞳孔缩小(<2mm)常见于虹膜炎、有机磷农药中毒、毒蕈碱中毒,以及吗啡、氯丙嗪、毛果芸香碱等药物影响;瞳孔扩大(>5mm)见于外伤、青光眼绝对期、视神经萎缩、完全失明、死状态、颈交感神经刺激和阿托品、可卡因等药物影响。" + }, + { + "question_num": 263, + "query": "喘证之正虚喘脱证，治疗应首选", + "options": { + "A": "可山尚鱼", + "B": "参蛤散", + "C": "金匮肾气丸", + "D": "生脉散", + "E": "参附汤" + }, + "answer": "E", + "reason": "喘证之正虚喘脱证当扶阳固脱,镇摄肾气,方选参附汤加减。" + }, + { + "question_num": 264, + "query": "治疗经行吐衄肺肾阴虚证,应首选的方剂是", + "options": { + "A": "清肝汤", + "B": "调肝汤", + "C": "顺经汤", + "D": "清肝引经汤", + "E": "上下相资汤" + }, + "answer": "C", + "reason": "经行吐衄肺肾阴虚证的治法为滋阴养肺,方用顺经汤或加味麦门冬汤。" + }, + { + "question_num": 265, + "query": "消化性溃疡的典型表现是", + "options": { + "A": "反复呕血,黑便", + "B": "慢性、周期性、节律性上腹痛", + "C": "反复上腹饱胀不适", + "D": "周期性发作的无节律性上腹痛", + "E": "反复、节律性的消化不良" + }, + "answer": "B", + "reason": "消化性溃疡具有典型的临床特点:慢性过程，周期性发作,节律性疼痛，可被抑酸或抗酸剂缓解。" + }, + { + "question_num": 266, + "query": "导致气管向患侧移位的疾病是", + "options": { + "A": "胸膜黏连", + "B": "大量胸腔积液", + "C": "气胸", + "D": "阻塞性肺气肿", + "E": "纵隔肿瘤" + }, + "answer": "A", + "reason": "气管向患侧移位可见于肺不张、胸膜黏连等，" + }, + { + "question_num": 267, + "query": "肺痨的辨证,应首辨的要点是", + "options": { + "A": "脏腑", + "B": "表里", + "C": "寒热", + "D": "虚实", + "E": "外感内伤" + }, + "answer": "A", + "reason": "肺痨应首辨病��之脏器,次辨虚实之性质,三辨夹火、夹痰、夹瘀之不同。" + }, + { + "question_num": 268, + "query": "经断复来脾虚肝郁证的出血表现是", + "options": { + "A": "经血色淡,质稀", + "B": "经色鲜红,质稠", + "C": "经色红,夹白带", + "D": "经色暗,质稀", + "E": "经色暗,恶臭" + }, + "answer": "A", + "reason": "经断复来脾虚肝郁证症见经断后阴道出血，量少,色淡,质稀,气短懒言,神疲肢倦,食少腹胀,胁肋胀满;舌苔薄白,脉弦无力。" + }, + { + "question_num": 269, + "query": "提示严重大出血的征象是", + "options": { + "A": "收缩压<100mmHg,血红蛋白<90g/L", + "B": "收缩压<90mmHg,血红蛋白<80g/L", + "C": "收缩压<80mmHg,血红蛋白<70g/L", + "D": "收缩压<60mmHg,血红蛋白<60g/L", + "E": "收缩压<40mmHg,血红蛋白<30g/L" + }, + "answer": "C", + "reason": "提示严重大出血的征象:收缩压<80mmHg或较基础血压降低>25%。心率>120次/分，血红蛋白<70g/L。" + }, + { + "question_num": 270, + "query": "下列各项，双肺满布湿啰音的是", + "options": { + "A": "肺炎链球菌肺炎", + "B": "急性肺水肿", + "C": "支气管哮喘", + "D": "肺脓肿", + "E": "支气管扩张症" + }, + "answer": "B", + "reason": "湿啰音散布两肺常见于支气管炎、支气管肺炎、肺水肿、血型播散型肺结核。" + }, + { + "question_num": 271, + "query": "肺胀偏实者早期的病理因素主要是", + "options": { + "A": "瘀血", + "B": "痰浊", + "C": "水饮", + "D": "外邪", + "E": "本虚" + }, + "answer": "B", + "reason": "肺胀偏实者的病理因素主要为痰浊、水饮与血瘀互为影响，兼见同病。早期以痰浊为主,渐而痰瘀并重,并可兼见气滞、水饮错杂为患。" + }, + { + "question_num": 272, + "query": "带下病的主要发病机制是", + "options": { + "A": "外感湿邪,损及任、带,约固无力", + "B": "肾气不足,封藏失职,阴液滑脱而下", + "C": "湿邪影响任、带二脉,任脉不固,带脉失约", + "D": "脾虚生湿,流注下焦,伤及任、带", + "E": "肝经湿热,流注下焦,伤及任、带" + }, + "answer": "C", + "reason": "带下病的主要病机是湿邪伤及任、带二脉,使任脉不固,带脉失约。" + }, + { + "question_num": 273, + "query": "尿路感染最主要的感染途径是", + "options": { + "A": "直接感染", + "B": "上行感染", + "C": "淋巴道感染", + "D": "血行感染", + "E": "局部浸润" + }, + "answer": "B", + "reason": "上行感染约占尿路感染的95%,是由细菌经尿道上行至膀胱，甚至肾盂引起感染。" + }, + { + "question_num": 274, + "query": "下列各项,最常出现心尖部舒张早期奔马律的是", + "options": { + "A": "心包炎", + "B": "肺源性心脏病", + "C": "左心衰竭", + "D": "高度房室传导阻滞", + "E": "肺动脉瓣狭窄" + }, + "answer": "C", + "reason": "舒张早期奔马律最常见，为病理性第三心音,又称第三心音奔马律或室性奔马律,以左室奔马律占多数,所以,在心尖部容易听到。舒张早期奔马律的出现,提示心脏有严重的器质性病变，见于各种原因的心力衰竭、急性心肌梗死、重症心肌炎等。" + }, + { + "question_num": 275, + "query": "不寐的病机总属", + "options": { + "A": "阴虚火旺,心肾不交", + "B": "脾虚不运,心神失养", + "C": "阳盛阴衰,阴阳失交", + "D": "邪扰心神,心神不宁", + "E": "气血阴阳亏虚,心失所养" + }, + "answer": "C", + "reason": "不寐的病因虽多,但其病理变化,总属阳盛阴衰,阴阳失交。" + }, + { + "question_num": 276, + "query": "下列各项,不属胎动不安常见证型的是", + "options": { + "A": "肾虚证", + "B": "湿热证", + "C": "血热证", + "D": "血瘀证", + "E": "气血虚弱证" + }, + "answer": "B", + "reason": "胎漏、胎动不安的主要病机是冲任损伤、胎元不固。常见的病因有肾成血热、气血虚弱、血瘀。常见证型有肾虚证、血热证、气血虚弱证、血瘀证。" + }, + { + "question_num": 277, + "query": "类风湿关节炎最常检查的部位是", + "options": { + "A": "双侧腕、掌指关节", + "B": "双侧踝关节", + "C": "双侧膝关节", + "D": "双侧肘关节", + "E": "双侧肩关节" + }, + "answer": "A", + "reason": "疼痛是类风湿关节炎最早的表现。最常出现的部位为腕、学指关节，其次是趾、膝、踝、肘、肩等关节。" + }, + { + "question_num": 278, + "query": "腹部触诊出现反跳痛,提示的病变是", + "options": { + "A": "腹部脏器有炎症", + "B": "胃肠痉挛", + "C": "腹膜壁层有炎症", + "D": "肠系膜动脉栓塞", + "E": "肠梗阻" + }, + "answer": "C", + "reason": "反跳痛表示炎症已波及腹膜壁层,腹肌紧张伴压痛、反跳痛称为腹膜刺激征,是急性腹膜炎的可靠体征。" + }, + { + "question_num": 279, + "query": "眩晕症的证候分类中不包括", + "options": { + "A": "肝阳上亢证", + "B": "肝火上炎证", + "C": "气血两虚证", + "D": "瘀血阻窍证", + "E": "肾精不足证" + }, + "answer": "B", + "reason": "眩晕的证候可分为肝阳上亢证、气血亏虚证、肾精不足证、痰湿中阻证、瘀血阻窍证，" + }, + { + "question_num": 280, + "query": "胎萎不长的病因病机是", + "options": { + "A": "气血虚弱、脾肾不足、血寒宫冷", + "B": "气血虚弱、肝肾精亏、脾肾阳虚", + "C": "气血虚弱、脾肾不足、寒凝血瘀", + "D": "脾肾不足、血寒官冷、肝郁脾虚", + "E": "血热扰胎、气血虚弱、脾肾不足" + }, + "answer": "A", + "reason": "胎袭不长的主要病机是气血不足以荣养其胎，而致胎儿生长迟缓。主要病因有气血虚弱、脾肾不足、血寒宫冷。" + }, + { + "question_num": 281, + "query": "左心衰竭时,最早出现和最重要的症状是", + "options": { + "A": "咳嗽", + "B": "咳痰", + "C": "咯血", + "D": "乏力", + "E": "呼吸困难" + }, + "answer": "E", + "reason": "左心衰竭以肺淤血及心排血量降低表现为主，其中呼吸困难是左心衰竭最早出现和最重要的症状。" + }, + { + "question_num": 282, + "query": "下列各项,符合中枢性瘫痪表现特点的是", + "options": { + "A": "瘫痪范围较局限，以肌群为主", + "B": "肌张力增高", + "C": "深反射减弱或消失", + "D": "无病理反射", + "E": "肌萎缩明显" + }, + "answer": "B", + "reason": "中枢性瘫痪范围较广,可表现为单瘫、偏瘫、截瘫。肌张力增强,肌萎缩不明显，膝腱反射几进，有病埋及，无肌界颤动。" + }, + { + "question_num": 283, + "query": "治疗疯证痰气郁结证,应首选的方剂是", + "options": { + "A": "逍遥散合顺气导痰汤", + "B": "半夏厚朴汤", + "C": "养心汤合越鞠丸", + "D": "苏合香丸", + "E": "控涎丹" + }, + "answer": "A", + "reason": "癫症痰气郁结证，治当理气解郁,化痰醒神，方用逍遥散合顺气导痰汤加减。" + }, + { + "question_num": 284, + "query": "治疗产后身痛肾虚证,应首选的方剂是", + "options": { + "A": "黄芪桂枝五物汤", + "B": "归肾丸", + "C": "养荣壮肾汤", + "D": "独活寄生汤", + "E": "身痛逐瘀汤" + }, + "answer": "C", + "reason": "产后身痛肾虚证治宜补肾养血,强腰壮骨，方选养荣壮肾汤加秦艽、熟地黄。" + }, + { + "question_num": 285, + "query": "典型心绞痛胸部疼痛的部位是", + "options": { + "A": "心尖部", + "B": "左肩背部", + "C": "胸部左侧", + "D": "胸骨体上段或中段的之后", + "E": "胸部右侧" + }, + "answer": "D", + "reason": "心绞痛以发作性胸痛为主要临床表现,疼痛部位主要在胸骨体上段或中段之后,可波及心前区,有手掌大小范围。" + }, + { + "question_num": 286, + "query": "正常成年人血小板计数的正常参考值是", + "options": { + "A": "(4~10)X10^9/L", + "B": "(50~90)x10^9/L", + "C": "(60~90)X10^9/L", + "D": "(100~300)x10^9/L", + "E": "(400~600)x10^9/L" + }, + "answer": "D", + "reason": "血小板参考值:(100~300)x10°/L." + }, + { + "question_num": 287, + "query": "中风、厥证、痫病的共同症状是", + "options": { + "A": "昏不知人", + "B": "四肢抽搐", + "C": "角弓反张", + "D": "喉中有声", + "E": "布李强古" + }, + "answer": "A", + "reason": "中风、厥证、痫病发作均可出现突然仆倒，昏不知人。" + }, + { + "question_num": 288, + "query": "治疗阴痒肝经湿热证，应首选的方剂是", + "options": { + "A": "易黄汤", + "B": "内补丸", + "C": "柴胡疏肝散", + "D": "龙胆泻肝汤", + "E": "清肝利湿汤" + }, + "answer": "D", + "reason": "阴痒肝经湿热证治宜清热利湿,杀虫止痒,方用龙胆泻肝汤或草渗湿汤,外用蛇床子散。" + }, + { + "question_num": 289, + "query": "消化性溃疡最常见的并发症是", + "options": { + "A": "上消化道出血", + "B": "胃肠穿孔", + "C": "幽门梗阻", + "D": "癌变", + "E": "休克" + }, + "answer": "A", + "reason": "消化性溃疡主要指发生在胃和十二指肠的慢性溃疡。出血是消化性溃疡最常见的并发症，也是上消化道大出血��常见的病因。" + }, + { + "question_num": 290, + "query": "下列各项,可出现外周血中性粒细胞减少的是", + "options": { + "A": "糖尿病酮症酸中毒", + "B": "急性心肌梗死", + "C": "急性大出血", + "D": "脾功能亢进", + "E": "恶性肿瘤" + }, + "answer": "D", + "reason": "中性粒细胞病理性减少见于:①感染性疾病,病毒感染最常见;②血液病,如再生障碍性贫血、粒细胞减少症、粒细胞缺乏症、非白血性白血病、恶性组织细胞病等;自身免疫性疾病，如系统性红斑狼疮等;3④单核一巨噬细胞系统功能亢进，如脾功能亢进,见于各种原因引起的脾大(如肝硬化等);⑤药物及理化因素的作用。" + }, + { + "question_num": 291, + "query": "下列哪项不是噎膈初期的治法", + "options": { + "A": "降火", + "B": "消瘀", + "C": "化痰", + "D": "散寒", + "E": "理气" + }, + "answer": "D", + "reason": "喳膈初期重在治标,宜理气、化痰、消瘀、降火为主。" + }, + { + "question_num": 292, + "query": "工具避孕指的是", + "options": { + "A": "宫内节育器,阴茎套,阴道隔膜", + "B": "宫内节育器,阴茎套,阴道药环", + "C": "宫内节育器,阴茎套,避孕药物", + "D": "宫内节育器,阴茎套,皮下埋植", + "E": "宫内节育器,阴茎套,避孕药膏" + }, + "answer": "A", + "reason": "工具避孕是利用器具防止精液泄人阴道,阻止泄人阴道内的精子进人子宫腔,或改变子宫腔内的环境，以实现避孕目的的方法。目前常用的避孕工具有官内节育器、阴道隔膜、阴基套。" + }, + { + "question_num": 293, + "query": "瞳孔缩小,呼出气为蒜臭味,全血胆碱酯酶活力不同程度降低的诊断是", + "options": { + "A": "溶血反应", + "B": "休克", + "C": "中暑", + "D": "急性有机磷杀虫药中毒", + "E": "急性一氧化碳中毒" + }, + "answer": "D", + "reason": "急性有机磷杀虫药中毒时瞳孔针尖样缩小,呼出气为蒜臭味,大汗淋漓，腺体分泌增加，肌纤维颤动和意识障碍等。全血胆碱酯酶活力不同程度降低为确诊依据。" + }, + { + "question_num": 294, + "query": "上消化道大出血时,粪便的特点是", + "options": { + "A": "水样稀便", + "B": "黏液脓血便", + "C": "米泔样便", + "D": "柏油样便", + "E": "鲜血便" + }, + "answer": "D", + "reason": "柏油样便:见于各种原因引起的上消化道出血。" + }, + { + "question_num": 295, + "query": "便秘的基本病机是", + "options": { + "A": "肝气郁结", + "B": "肺失肃降", + "C": "肝胃不和", + "D": "大肠传导失常", + "E": "脾失运化" + }, + "answer": "D", + "reason": "便秘的基本病机属大肠传导失常,气机不畅,糟粕内停。" + }, + { + "question_num": 296, + "query": "子宫内膜增生早期,其内膜厚度为", + "options": { + "A": "1~2mm", + "B": "3~4mm", + "C": "5~6mm", + "D": "7~8mm", + "E": "9~10mm" + }, + "answer": "A", + "reason": "子宫内膜增生早期,内膜的增生与修复在月经期即已开始。在月经周期的5~7日,此期内膜较,为1~2mm。" + }, + { + "question_num": 297, + "query": "脑梗死患者出现典型的“三偏征”,其闭塞的脑动脉是", + "options": { + "A": "大脑中动脉", + "B": "大脑前动脉", + "C": "大脑后动脉", + "D": "椎一基底动脉", + "E": "小脑后下动脉" + }, + "answer": "A", + "reason": "大脑中动脉闭塞时有三偏征,即病变对侧偏瘫、偏身感觉障碍和同向偏盲,优势半球病变伴失语。" + }, + { + "question_num": 298, + "query": "下列各项,肾病综合征可出现的是", + "options": { + "A": "肾小球性蛋白尿", + "B": "肾小管性蛋白尿", + "C": "混合性蛋白尿", + "D": "溢出性蛋白尿", + "E": "假性蛋白尿" + }, + "answer": "A", + "reason": "肾小球性蛋白尿:见于原发性肾小球疾病,如急性肾小球肾炎、急进性肾小球肾炎、隐匿性肾小球肾炎、慢性肾小球肾炎、肾病综合征，以及某些继发性肾小球疾病:如糖尿病肾病及系统性红斑狼疮肾病等。" + }, + { + "question_num": 299, + "query": "治疗黄疸胆腑郁热证，首选的方剂是", + "options": { + "A": "茵陈术附汤", + "B": "大柴胡汤", + "C": "茵陈五苓散", + "D": "茵陈蒿汤", + "E": "龙胆泻肝汤" + }, + "answer": "B", + "reason": "黄疸胆腑郁热证是由湿热砂石郁滞,脾胃不和,肝胆失疏所致,治应疏肝泄热,利胆退黄,方用大柴胡汤加减。" + }, + { + "question_num": 300, + "query": "治疗月经后期实寒证,应首选的方剂是", + "options": { + "A": "少腹逐瘀汤", + "B": "温经汤(《妇人大全良方》)", + "C": "乌药汤", + "D": "艾附暧宫丸", + "E": "温经汤(《金匮要略》)" + }, + "answer": "B", + "reason": "月经后期实寒证的治法为温经散寒调经，方用温经汤(《妇人大全良方》)。温经汤(《金匮要略》)用于月经后期虚寒证。" + }, + { + "question_num": 301, + "query": "下列各项,不属支气管哮喘诊断标准的是", + "options": { + "A": "反复发作喘息", + "B": "发作时可闻及以呼气相为主的哮鸡音", + "C": "症状可缓解", + "D": "残气量增加", + "E": "支气管舒张试验呈阳性" + }, + "answer": "D", + "reason": "支气管哮喘的诊断标准:①反复发作喘息、胸闷;②发作时可闻及以呼气相为主的哮鸣音,呼气相延长;③症状可自行缓解或治疗后缓解;④支气管舒张试验呈阳性,或支气管激发试验或运动试验阳性。" + }, + { + "question_num": 302, + "query": "下列各项,对急性胰腺炎有诊断价值的是", + "options": { + "A": "血清淀粉酶>800U/L", + "B": "血清淀粉酶>1800U/L", + "C": "血清淀粉酶>3000U/L", + "D": "血清淀粉酶>5000U/L", + "E": "血清淀粉酶<800U/L" + }, + "answer": "D", + "reason": "血清淀粉酶:正常值800~1800U/L,若达到3500U/L应怀疑急性胰腺炎，超过5000U/L即有诊断价值。" + }, + { + "question_num": 303, + "query": "水肿风水相搏证的表现，下列哪项除外", + "options": { + "A": "伴恶寒、发热", + "B": "肢节酸楚,小便不利", + "C": "伴咽喉红肿疼痛", + "D": "皮肤光亮,尿少色赤,身发疮痍", + "E": "眼睑浮肿，波及四肢" + }, + "answer": "D", + "reason": "水肿风水相搏证因风邪袭表,肺气闭塞,通调失职,风遏水阻表现为眼睑浮肿,进而四肢及全身皆肿,来势迅速,多有恶寒,发热,肢节酸楚,小便不利等症。偏于风热于者,伴咽喉红肿疼痛,舌质红,脉浮滑数。偏风寒者,兼恶寒,咳喘,舌苔薄白,脉浮滑或浮紧。皮肤光亮,尿少色赤,身发疮痰,见于水肿湿毒浸淫证。" + }, + { + "question_num": 304, + "query": "治疗经行头痛血瘀证，应首选的方剂是", + "options": { + "A": "失笑散合四物汤", + "B": "桃红四物汤", + "C": "少腹逐瘀汤", + "D": "通窍活血汤", + "E": "血府逐瘀汤" + }, + "answer": "D", + "reason": "经行头痛血瘀证症见每逢经前、经期头痛剧烈,痛如锥刺，经色紫暗有块;伴小腹疼痛拒按，胸闷不舒;舌暗或尖边有瘀点,脉细涩或弦涩。治宜化瘀通络，方用通窍活血汤。" + }, + { + "question_num": 305, + "query": "肺动脉高压早期的X线表现是", + "options": { + "A": "双肺纹理增多", + "B": "双肺透亮度增加", + "C": "右下肺动脉干扩张", + "D": "右心房肥大", + "E": "右心室肥厚、扩张" + }, + "answer": "C", + "reason": "肺动脉高压早期的X线表现为右下肺动脉干扩张。" + }, + { + "question_num": 306, + "query": "心电图中代表心室除极、复极全过程的时间是", + "options": { + "A": "QRS波群", + "B": "PR间期", + "C": "QT间期", + "D": "ST段", + "E": "TP段" + }, + "answer": "C", + "reason": "QT间期:代表左、右心室除极与复极所需要的总时间。" + }, + { + "question_num": 307, + "query": "石淋的治法是", + "options": { + "A": "健脾益气,升清固摄", + "B": "清热利湿,分清泄浊", + "C": "清热利湿,排石通淋", + "D": "清热通淋,凉血止血", + "E": "理气疏导,通淋利尿" + }, + "answer": "C", + "reason": "石淋的病机为湿热蕴结下焦,尿液煎熬成石,膀胱气化失司。治宜清热利湿,排石通淋。" + }, + { + "question_num": 308, + "query": "下列各项,不属于绝经前后诸证临床表现的是", + "options": { + "A": "烘热汗出,烦躁易怒", + "B": "潮热面红,眩晕耳鸣", + "C": "心悸失眠,腰背酸楚", + "D": "面浮肢肿,情志不宁", + "E": "精神萎靡,面色晦暗" + }, + "answer": "E", + "reason": "妇女在绝经期前后,围绕月经系乱或绝经出现明显不适证候，如烘热汗00腰背酸楚、面浮肢肿、情志不宁等症状,称为绝经前后诸证。" + }, + { + "question_num": 309, + "query": "风湿性心脏瓣膜病并发栓塞,最常见于", + "options": { + "A": "二尖瓣狭窄合并心力衰竭", + "B": "二尖瓣狭窄合并心房颤动", + "C": "二尖瓣关闭不全合并心力衰竭", + "D": "二尖瓣关闭不全合并主动脉瓣关闭不全", + "E": "二尖瓣狭窄合并关闭不全" + }, + "answer": "B", + "reason": "风湿性心脏瓣膜病并发栓塞,最常见于二尖瓣狭窄合并心房颤动。" + }, + { + "question_num": 310, + "query": "下列心电图表现,不符合房性期前收缩的是", + "options": { + "A": "P波提前出现,与窦性P波不同", + "B": "QRS波群形态多正常", + "C": "代偿间歇完全", + "D": "PR间期≥0.12秒", + "E": "P波后可以没有QRS波群" + }, + "answer": "C", + "reason": "房性期前收缩心电图表现P'波提早出现，其形态与窦性P波不同，PR间期大于.0.12秒,通常下传的·QRS波群形态与正常窦性心律的QRS波群形态相同，少数无QRS波群发生(阻滞的或未下传的房性期前收缩),或出现宽大、畸形的QRS波群(室内差异性传导)。期前收缩后多见不完全代偿间歇" + }, + { + "question_num": 311, + "query": "下列不属于关格病因的是", + "options": { + "A": "水肿", + "B": "淋证", + "C": "癃闭", + "D": "消渴", + "E": "痰饮" + }, + "answer": "E", + "reason": "关格多由水肿，淋症，窿闭，消渴等病证反复不愈,迁延日久，以致脾肾阴阳衰惫,气化不利,湿浊毒邪内蕴而发。" + }, + { + "question_num": 312, + "query": "妊娠腹痛血虚证的中医治法是", + "options": { + "A": "养血活血,补肾安胎", + "B": "暖宫止痛,养血安胎", + "C": "疏肝解郁,养血安胎", + "D": "养血安胎止痛", + "E": "补肾益气,养血安胎" + }, + "answer": "D", + "reason": "血虚以致胞脉、胞络阻滞或失养,气血运行不畅，“不通则痛”或“不荣则痛”。治法为养血安胎止痛，方用当归芍药散加首乌、桑寄生。" + }, + { + "question_num": 313, + "query": "下列哪项不是高血压病的并发症", + "options": { + "A": "短暂性脑缺血发作", + "B": "脑血栓形成", + "C": "脑出血", + "D": "脑栓塞", + "E": "高血压脑病" + }, + "answer": "D", + "reason": "短暂性脑缺血发作、脑血栓形成、脑出血、高血压脑病均是高血压的并发症,而脑栓塞是指因异常的固态、液态、气态物体(被称作栓子)沿血循环进人脑动脉系统，引起动脉管腔闭塞，导致该动脉供血区局部脑组织的坏死。" + }, + { + "question_num": 314, + "query": "心肌梗死特征性心电图出现在Ⅱ、Ⅲ、aVF导联,提示梗死的部位是", + "options": { + "A": "前间壁", + "B": "前壁", + "C": "侧壁", + "D": "正后壁", + "E": "下壁" + }, + "answer": "E", + "reason": "下壁心肌梗死特征性心电图改变表现在Ⅱ、Ⅲ、aVF导联。" + }, + { + "question_num": 315, + "query": "消渴的病变胜腑主要是", + "options": { + "A": "肝、脾、肾", + "B": "脾、胃、肾", + "C": "心、肝、肾", + "D": "脾、肺、肾", + "E": "肺、胃、肾" + }, + "answer": "E", + "reason": "消渴病变的脏腑主要在肺、胃、肾,尤以肾为关键。" + }, + { + "question_num": 316, + "query": "患者月经先后无定期,量少,色淡暗，质清;腰骶酸痛,头晕耳鸣,舌淡,苔白,脉细弱。治疗应首选的方剂是", + "options": { + "A": "肾气丸", + "B": "六味地黄丸", + "C": "大补元煎", + "D": "固阴煎", + "E": "归肾丸" + }, + "answer": "D", + "reason": "月经量少,色淡暗,质清,辨证为虚证。腰骶酸痛,头晕耳鸣,腰为肾之府，肾开窍于耳,其脉内通于脑,结合舌脉,可辨证为肾虚证。肾气虚弱,封藏失司，冲任失调，血海蓄溢无常,治宜补肾调经,方用固阴煎。" + }, + { + "question_num": 317, + "query": "早期胃癌是指病变局限在", + "options": { + "A": "黏膜层", + "B": "黏膜层和黏膜下层", + "C": "黏膜层和肌层", + "D": "肌层", + "E": "胃全层,未发生远处转移" + }, + "answer": "B", + "reason": "早期胃癌是指病变仅限于黏膜层或黏膜下层，中晚期胃癌病变可侵及肌层或全层。" + }, + { + "question_num": 318, + "query": "X线片见Codman三角,应首先考虑的是", + "options": { + "A": "恶性骨髓瘤", + "B": "良性骨髓瘤", + "C": "化脓性骨髓炎", + "D": "骨关节结核", + "E": "长骨骨折" + }, + "answer": "A", + "reason": "恶性骨肿瘤常有骨膜增生并且骨膜新生骨可被肿瘤破坏,形成恶性骨肿瘤的特征性X线表现(Codman三角)。" + }, + { + "question_num": 319, + "query": "患者,女,56岁。咳喘10余年。一月前感受风寒后见胸膺满闷,短气喘息,咳嗽痰多,色白黏腻或呈泡沫,肢体浮肿,恶寒,无汗,干呕,脘痞纳少,舌苔白腻,脉紧。治疗宜用", + "options": { + "A": "苏子降气汤", + "B": "越婢加半夏汤", + "C": "小青龙汤", + "D": "二陈平胃散", + "E": "清金化痰汤" + }, + "answer": "C", + "reason": "该患者为外感风寒诱发,痰从寒化为饮所致的肺胀表寒里饮证，用小青龙汤温肺散寒,降逆涤痰。" + }, + { + "question_num": 320, + "query": "患者月经停闭半年,神疲肢倦,头晕眼花,心悸气短,面色萎黄;舌淡,苔薄,脉沉缓。治疗应首选的方剂是", + "options": { + "A": "参苓白术散", + "B": "归肾丸", + "C": "参芪四物汤", + "D": "人参养荣汤", + "E": "大补元煎" + }, + "answer": "D", + "reason": "屡伤脾胃,生化之源不足,或久病大病，营血亏虚，血虚气弱,冲任不充，不能按时满溢,故月经周期延迟、量少、色淡红质薄。脏腑气血进一步损伤，血海空虚，无血可下而月经停闭。患者为气血虚弱之症，治宜益气养血调经,方用人参养荣汤。" + }, + { + "question_num": 321, + "query": "发现不明原因的群体性疾病的，医疗机构向所在地县级人民政府卫生行政主管部门报告的时限要求在", + "options": { + "A": "12小时内", + "B": "10小时内", + "C": "6小时内", + "D": "2小时内", + "E": "1小时内" + }, + "answer": "D", + "reason": "突发事件监测机构、医疗卫生机构和有关单位发现突发公共卫生事件应当在2小时内向所在地且级人民政府工生行政主管部门报告;接到报告的卫生行政主管部门应当在2小时内向本级人民政府报告，并同时向上级人民政府卫生行政主管部门和国务院卫生行政主管部门报告。" + }, + { + "question_num": 322, + "query": "下列各项,不属肾结石X线征象的是", + "options": { + "A": "主要位于肾盂或肾盏内", + "B": "圆形或卵圆形高密度影", + "C": "可有肾盂、肾盏积水", + "D": "造形可见充盈缺损", + "E": "肾轮廓局限性外突" + }, + "answer": "E", + "reason": "E项为肾癌X线表现。" + }, + { + "question_num": 323, + "query": "患者不寐多梦,甚则彻夜不眠,急躁易怒,伴头晕头胀,目赤耳鸣,口干而苦,不思饮地上史，必小蚁。行疗川目选", + "options": { + "A": "归脾汤", + "B": "龙胆泻肝汤", + "C": "朱砂安神丸", + "D": "天王补心丹", + "E": "安神定志丸" + }, + "answer": "B", + "reason": "患者不寐多梦,其则彻夜不眠,诊断为不寐。肝郁化火,可见急躁易怒,伴头晕头胀,目赤耳鸣,口干而苦,不思饮食,便秘赤溲,结合舌脉,辨证属肝火扰心证,治当疏肝泻火,镇心安神,方选龙胆泻肝汤加减。" + }, + { + "question_num": 324, + "query": "患者,女,35岁,已婚。经前或经期大便泄泻,脘腹胀满,神疲肢倦,经行量多,色淡质稀,平时带下量多,色白质黏,无臭气,或面浮肢肿,舌淡胖,脉濡缓。治疗应首选", + "options": { + "A": "小建中汤", + "B": "健固汤", + "C": "参苓白术散", + "D": "真人养脏汤", + "E": "补中益气汤" + }, + "answer": "C", + "reason": "由患者症状可诊断为经行泄泻之脾虚证。治法为健脾渗湿，理气调经，方用参苓白术散。" + }, + { + "question_num": 325, + "query": "根据对患者人身造成的损害程度，医疗事故分为四级，四级医疗事故是指", + "options": { + "A": "抢救重危患者生命而采取紧急医疗措施造成不良后果", + "B": "造成患者轻度残疾、器官组织损伤导致一般功能障碍", + "C": "造成患者中度残疾、器官组织损伤导致严重功能障碍", + "D": "造成患者明显人身损害的其他后果", + "E": "造成患者死亡、重度残疾" + }, + "answer": "D", + "reason": "医疗事故分为四级:①一级医疗事故,造成患者死亡、重度残疾的;②二级医疗事故,造成患者中度残疾、器官组织损伤导致严重功能障碍的;③三级医疗事故,造成患者轻度残疾、器官组织损伤导致一般功能障碍的;④四级医疗事故，造成患者明显人身损害的其他后果的。" + }, + { + "question_num": 326, + "query": "十二指肠球部溃疡的直接X线征象是", + "options": { + "A": "球部充盈缺损", + "B": "球部激惹征", + "C": "球部龛影或变形", + "D": "幽门痉挛,开放延迟", + "E": "黏膜皱襞粗乱" + }, + "answer": "C", + "reason": "十二指肠溃疡:绝大部分发生在球部,溃疡已造成球部变形;球部龛影或变形是十二指肠溃疡的直接X线征象。" + }, + { + "question_num": 327, + "query": "王某,男,58岁。近年来心烦不寐,人睡困难,心悸多梦,腰膝酸软,潮热盗汗,咽干少津,舌红少苔,脉细数。治疗此病证首选的方剂是", + "options": { + "A": "左归丸合酸枣仁汤", + "B": "六味地黄丸合交泰丸", + "C": "安神定志丸合酸枣仁汤", + "D": "六味地黄丸合安神定志丸", + "E": "右归丸合酸枣仁汤" + }, + "answer": "B", + "reason": "患者心烦不寐,人睡困难心悸多梦,诊断为不寐。肾水亏虚，不能上济于��,心火炽盛,不能下交于肾,可见心烦不寐,心悸多梦,腰酸膝软,潮热盗汗,咽干少津，结合舌脉,辨证属心肾不交证。治当滋阴降火,交通心肾,方选六味地黄丸合交泰丸加减" + }, + { + "question_num": 328, + "query": "患者,女,29岁,未婚。妊娠小腹胀痛:烦躁易怒,伴胸胁胀满,舌红,苔薄,脉弦滑。治疗应首选", + "options": { + "A": "胶艾汤", + "B": "当归芍药散", + "C": "小柴胡汤", + "D": "逍遥散", + "E": "桂枝茯苓丸合寿胎丸" + }, + "answer": "D", + "reason": "主症为妊娠小腹胀痛,伴烦躁易怒,胸胁胀满,辨证为妊娠腹痛之气滞证。治宜疏肝解郁,养血安胎,方用逍遥散。" + }, + { + "question_num": 329, + "query": "某药业公司将其他药品冒充感冒药销售,该药属于", + "options": { + "A": "劣药", + "B": "假药", + "C": "特殊管理药品", + "D": "非处方药", + "E": "失效药品" + }, + "answer": "B", + "reason": "有下列情形之一的为假药:①药品所含成分与国家药品标准规定的成分不符的;②以非药品冒充药品或者以他种药品冒充此种药品的;③变质的药品;④药品所标明的适应证或者功能主治超出规定范围。" + }, + { + "question_num": 330, + "query": "“上以疗君亲之疾，下以救贫贱之厄，中可保身长全”体现的医疗活动的原则是", + "options": { + "A": "尊重原则", + "B": "保密原则", + "C": "公益原则", + "D": "审慎原则", + "E": "公正原则" + }, + "answer": "E", + "reason": "公正原则是指以形式公正与内容公正的有机统一为依据分配和实现医疗和健康利益的伦理原则,即具有同样医疗需要以及同等社会贡献和条件的患者应得到同样的医疗待遇。" + }, + { + "question_num": 331, + "query": "患者头痛而胀,甚则头胀如裂,面红目赤,口渴喜饮,大便便秘,溲赤,舌尖红,苔薄黄,脉浮数。治疗首选", + "options": { + "A": "天麻钩藤饮", + "B": "加味四物汤", + "C": "羌活胜湿汤", + "D": "川芎茶调散", + "E": "芎芷石膏汤" + }, + "answer": "E", + "reason": "患者头痛而胀,其则头胀如裂,诊断为头痛。风热外袭,上扰清空,窍络失和,可见头痛而胀,甚则头胀如裂,恶风;面红目赤,口渴喜饮，大便便秘,溲赤均为实热之症;结合舌脉,辨证为风热头痛。治法为疏风清热和络。方选芎芷石膏汤加减" + }, + { + "question_num": 332, + "query": "患者,女,27岁,已婚。妊娠70天,阴道下血,色鲜红,腰腹坠胀作痛,手足心热，口干心烦,小便黄,大便秘结,舌红苔黄,脉滑数。治疗应首选", + "options": { + "A": "清经散", + "B": "两地汤", + "C": "寿胎丸", + "D": "保阴煎", + "E": "胎元饮" + }, + "answer": "D", + "reason": "患者妊娠期间阴道下血,腰腹坠胀作痛，可诊为胎动不安。血色鲜红，手足心热，口干心烦，小便黄,大便秘结,舌红苔黄,脉滑数,是邪热内扰所致,辨证为血热证。治宜清热凉血,养血安胎,方用保阴煎。" + }, + { + "question_num": 333, + "query": "医师签署有关医学证明文件，必须亲自诊查、调查,并按照规定及时填写医学文书:对医学文书及有关资料，不得", + "options": { + "A": "与同行讨论", + "B": "用电脑打印", + "C": "随身携带", + "D": "向主管医生报告", + "E": "隐匿、伪造或者销毁" + }, + "answer": "E", + "reason": "医师签署有关医学证明文件,必须亲自诊查、调查,并按照规定及时填写医学文书,对医学文书及有关资料不得隐匿、伪造或者销毁。" + }, + { + "question_num": 334, + "query": "下列各项,不属医患冲突原因的是", + "options": { + "A": "医疗服务态度", + "B": "医疗事故", + "C": "无法满足患者需求", + "D": "患者不愿支付医疗费用", + "E": "医疗管理方面因素" + }, + "answer": "D", + "reason": "形响医患关系的主要因素:①服务态度问题;②医疗事故与医疗过失的原因;③满足患者需求方面的因素;④医疗体制与医院管理方面的因素。" + }, + { + "question_num": 335, + "query": "患者眩晕,头重昏蒙,或伴视物旋转,胸闷恶心,呕吐痰涎,食少多寐,舌苔白腻,脉濡滑。治疗首选的方剂是", + "options": { + "A": "三子养亲汤", + "B": "贝母瓜萎散", + "C": "半夏白术天麻汤", + "D": "小陷胸汤", + "E": "黄连温胆汤" + }, + "answer": "C", + "reason": "患者眩晕,头重昏蒙,或伴视物旋转,为眩晕。痰浊中阻，上蒙清窍,清阳不升,可见眩晕,头重昏蒙,或伴视物旋转,胸闷恶心，呕吐痰涎，食少多寐，舌苔白腻，脉濡滑均为痰湿中阻之症，辨证为眩晕痰湿中阻证。治当化痰祛湿���,健脾和胃，方选半夏白术天麻汤加减。" + }, + { + "question_num": 336, + "query": "患者,女,31岁,已婚。曾孕3次,均自然流产,平日头晕耳鸣,腰膝酸软,精神萎靡现又妊娠33天，夜尿频多，面色晦暗,舌淡苔白,脉沉弱。治疗应首选", + "options": { + "A": "加味阿胶汤", + "B": "补肾安胎饮", + "C": "泰山磐石散", + "D": "补肾固冲丸", + "E": "以上均非" + }, + "answer": "D", + "reason": "患者曾自然流产3次,可诊为滑胎。头晕耳鸣,腰膝酸软,精神萎靡,夜尿频多,属肾气不足证。治宜补肾健脾，固冲安胎,方用补肾固冲丸。" + }, + { + "question_num": 337, + "query": "制定《药品管理法》的目的不包括", + "options": { + "A": "保证药品质量", + "B": "增进药品疗效", + "C": "维护用药者的经济利益", + "D": "保障用药安全", + "E": "维护人体健康" + }, + "answer": "B", + "reason": "制定《药品管理法》的目的是为了加强药品管理,保证药品质量，保障公众用药安全和合法权益，保护和促进公众健康。" + }, + { + "question_num": 338, + "query": "在选择诊断方法、治疗药物时,应考虑患者的经济负担和社会医疗资源，这反映的是", + "options": { + "A": "知情同意原则", + "B": "保护隐私原则", + "C": "医疗公正原则", + "D": "医疗最优化原则", + "E": "效益最大化原则" + }, + "answer": "D", + "reason": "医疗最优化原则指在临床诊疗中诊疗方案要以最小的代价获得最大效刀打汉取生，文王加舌，痛苦最小,耗费最少，" + }, + { + "question_num": 339, + "query": "患者肌肤不仁,手足麻木,突然发生口眼喁斜,语言不利,口角流涎,舌强语容,甚则半身不遂,或兼见手足拘挛、关节酸痛等症,舌苔薄白,脉浮数，其治法是", + "options": { + "A": "息风化痰", + "B": "祛风化痰通络", + "C": "利湿化饮", + "D": "镇肝息风", + "E": "清肝息风潜阳" + }, + "answer": "B", + "reason": "患者突然发生口眼斜,语言不利，甚则半身不遂,诊断为中风。脉络空虚,风痰乘虚人中,气血闭阻,可见肌肤不仁,手足麻木;风邪侵袭,可见手足拘挛,关节酸痛等症,辨证为风痰人络证,治当祛风化痰通络。" + }, + { + "question_num": 340, + "query": "患者,女,24岁,已婚。妊娠6个半月,面目四肢浮肿，皮薄光亮，按之没指，纳呆便溏,舌胖嫩,苔薄腻,脉滑缓无力。治疗应首选", + "options": { + "A": "茯苓导水汤", + "B": "真武汤", + "C": "天仙藤散", + "D": "猪苓汤", + "E": "白术散" + }, + "answer": "E", + "reason": "患者妊娠期间面目四肢浮肿,可诊为子肿。浮肿部位皮薄光亮，按之没指,纳呆便溏,是脾虚不运所致,应为脾虚证。治法为健脾利水，首选方剂为白术散加砂仁或健脾利水汤。" + }, + { + "question_num": 341, + "query": "已经通过执业医师考核,但未经注册取得执业证书的", + "options": { + "A": "不得从事医师执业活动", + "B": "可在预防机构从事医师执业活动", + "C": "可在保健机构从事医师执业活动", + "D": "可在执业医师指导下,在预防、保健机构从事医师执业活动", + "E": "可在执业医师指导下，从事医师执业活动" + }, + "answer": "A", + "reason": "已经通过执业医师考核,但未经注册取得执业证书的不可从事医师执业活动。" + }, + { + "question_num": 342, + "query": "下列各项，属中医四诊的道德要求的是", + "options": { + "A": "全面系统", + "B": "安神定志", + "C": "认真细致", + "D": "加强联系", + "E": "切忌片面" + }, + "answer": "B", + "reason": "中医四诊的道德要求:①安神定志;②实事求是。" + }, + { + "question_num": 343, + "query": "患者表情呆滞,沉默寡言,记忆减退失认失算，口齿含糊,词不达意,伴腰膝酸软肌肉萎缩,食少纳呆,气短懒言,口涎外溢,腹痛喜按,鸡鸣泄泻,舌质淡白,舌体胖大,苔少脉沉细弱，双尺尤其，治疗应首涉的方剂是", + "options": { + "A": "七福饮", + "B": "归脾汤", + "C": "洗心汤", + "D": "还少丹", + "E": "天王补心丹" + }, + "answer": "D", + "reason": "患者表情呆滞,沉默寡言,记忆减退,失认失算,口齿含糊,词不达意,诊断为痴呆。脾肾两虚,可见腰膝酸软，肌肉萎缩,食少纳呆,气短懒言,口涎外溢;腹痛喜按,鸡鸣泄泻,舌质淡白,舌体胖大,苔少,脉沉细弱,双尺尤甚均为脾肾阳虚之症，辨证为脾肾两虚证。治当补肾健脾，益气生精，方选还少丹加减。" + }, + { + "question_num": 344, + "query": "患者,女,30岁,已婚。产后乍寒乍热:恶露虽下甚少,色紫暗有块,���腹疼痛拒按，舌紫暗，有瘀斑，脉弦涩有力。治疗应首选", + "options": { + "A": "少腹逐瘀汤", + "B": "八珍汤", + "C": "保阴煎", + "D": "生化汤", + "E": "血府逐瘀汤" + }, + "answer": "D", + "reason": "患者主症为产后乍寒乍热伴恶露虽下甚少,色紫暗有块,小腹疼痛拒按舌紫暗,有瘀斑,脉弦涩有力,辨证为产后发热之血瘀证。治宜活血化瘀，和营退热，方用生化汤加味或桃红消瘀汤。" + }, + { + "question_num": 345, + "query": "患者,女,21岁。四肢关节痛6个月，近2个月出现面颊部对称性红斑，口腔溃疡反复发作。检查:白细胞2.7x10/L,红细胞沉降率67mm/h，ANA()。该患者最可能的诊断是", + "options": { + "A": "类风湿关节炎", + "B": "系统性红斑狼疮", + "C": "干燥综合征", + "D": "白塞病", + "E": "风湿性关节炎" + }, + "answer": "B", + "reason": "系统性红斑狼疮(SLE)的症状一般为面颊部蝴蝶形红斑或盘状红斑，口腔黏膜点状出血、糜烂或溃疡,关节肿胀、酸痛等。一般检查血常规可见白细胞减少,狼疮活动时红细胞沉降率增快等。ANA(十)且伴有特征性狼疮症状支持系统性红斑狼疮的诊断" + }, + { + "question_num": 346, + "query": "下列各项,符合体格检查道德要求的是", + "options": { + "A": "尊重患者,心正无私", + "B": "全神贯注,语言得当", + "C": "客观求实,科学探索", + "D": "安全保密,谨慎行事", + "E": "综合分析,合理运用" + }, + "answer": "A", + "reason": "体格检查的道德要求:①全面系统，认真细致;②关心体贴,减少痛苦;③尊重患者,心正无私。" + }, + { + "question_num": 347, + "query": "患者脘腹痞闷,胸胁胀满,心烦易怒善太息,呕恶嗳气,或吐苦水,大便不爽,舌质淡红,苔薄白,脉弦。首选的方剂是", + "options": { + "A": "保和丸", + "B": "龙胆泻肝汤", + "C": "柴胡疏肝散", + "D": "补中益气汤", + "E": "泻心汤合连朴饮" + }, + "answer": "C", + "reason": "患者脘腹痞闷,胸胁胀满诊断为痞满。肝气犯胃,胃气郁滞,可见心烦易怒,普太息,呕恶嗳气,或吐苦水，大便不爽:舌质淡红,苔薄白,脉弦均为肝郁气滞之症,辨证为肝胃不和证,当疏肝解郁,和胃消痞,方选柴胡疏肝散加减:" + }, + { + "question_num": 348, + "query": "患者1周前因外伤出现右手示指红肿热痛,肿胀呈圆柱状,皮色发亮,关节轻度扭曲,不能伸展,先局部跳痛明显,拟切开排脓。应选择的切口部位是", + "options": { + "A": "指掌侧面", + "B": "指掌正中", + "C": "手指侧面", + "D": "手指正中", + "E": "示指关节处" + }, + "answer": "C", + "reason": "蛇肚疔宜在手指侧面作纵形切口,切口长度不得超过上下指关节面。" + }, + { + "question_num": 349, + "query": "患者,女,34岁。皮肤反复出血半年检查:血红蛋白90g/L，血白细胞5.0X10°/L血小板46X10”/L,骨髓增生活跃,颗粒型巨核细胞增多。应首先考虑的是", + "options": { + "A": "再生障碍性贫血", + "B": "急性白血病", + "C": "特发性血小板减少性紫癜", + "D": "脾功能亢进", + "E": "过敏性紫癜" + }, + "answer": "C", + "reason": "皮肤反复出血,外周血小板减少,骨髓增生活跃,颗粒型巨核细胞增多,可推断巨核细胞产板不良,故首选诊断为特发性血小板减少性紫癜。检查结果未见红细胞及白细胞减少,骨髓未见增生低下,排除A项;脾功能亢进及过敏性紫癜不出现该患者的骨髓变化，排除D、E项;患者病程半年,除巨细胞外其他系均正常，骨髓增生活跃而不是极度活跃,排除B项。" + }, + { + "question_num": 350, + "query": "根据美国哈佛医学院提出的“脑死亡”概念,不能确诊“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知觉和反应", + "C": "体温低于32.2°C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": "哈佛大学医学院提出的脑死亡有四条具体标准(简称哈佛标准):①对外部刺激和内部需要无接受性和反应性，即患者处于不可逆的深度昏迷,完全丧失了对外界刺激和内部需要的所有感受能力，以及由此引起的反应性全部消失;②自主的肌肉运动和自主呼吸消失;③诱导反射消失;④脑电图示脑电波平直,对以上四条标准还要持续24小时观察,反复测试其结果无变化,并排除体温过低(<32.2℃)或刚服用过巴比妥类药物等中枢神经系统抑制剂的病例,即可宣布患者死亡。" + }, + { + "question_num": 351, + "query": "患者恶心呕吐,食���不振,食人难化,脘部痞闷,大便不畅,舌淡胖,苔薄,脉细。首选的方剂是", + "options": { + "A": "小半夏汤", + "B": "四七汤", + "C": "麦门冬汤", + "D": "香砂六君子汤", + "E": "理中汤" + }, + "answer": "D", + "reason": "患者恶心呕吐，食欲不振。诊断为呕吐。脾胃气虚,纳运无力,胃虚气逆，可见恶心呕吐,食欲不振，食人难化,脘部痞闷,大便不畅;舌淡胖,苔薄,脉细均为气虚之症,辨证属脾胃气虚证。治当健脾益气，和胃降逆,方选香砂六君子汤加减。" + }, + { + "question_num": 352, + "query": "患者行注射治疗后，出现臀部结块坚硬,漫肿不红,病情进展缓慢,无全身症状,舌苔白腻,脉缓,其诊断是", + "options": { + "A": "痈", + "C": "流痰", + "B": "肉瘤", + "D": "内陷", + "E": "无头疽" + }, + "answer": "A", + "reason": "痈是发生于臀部肌肉丰厚处范围较大的急性化脓性疾病。" + }, + { + "question_num": 353, + "query": "患者,男,40岁。乙肝病史6年,近半月肝区持续性疼痛，胃纳差，黄疸,消瘦。查贝便,衣用/，压拥。川自元考虑的是", + "options": { + "A": "慢性肝炎", + "B": "肝脓肿", + "C": "肝硬化", + "D": "继发性肝癌", + "E": "原发性肝癌" + }, + "answer": "E", + "reason": "原发性肝癌的症状:肝痛乏力、纳差、消瘦是最具特征性的临床症状体征:进行性肝大为最常见的特征性体征之一。肝质地坚硬，表面及边缘不规则，常呈结节状,少数肿瘤深埋于肝实质内者则肝表面光滑,伴或不伴明显压痛。肝右叶膈面癌肿可使右侧膈肌明显抬高。脾大，腹水，黄疸，肝区血管杂音,肝区摩擦音。" + }, + { + "question_num": 354, + "query": "患者呃逆,呃声沉缓有力,胸膈及胃脘不舒,得热则减,遇寒更甚,进食减少,喜食热饮，口淡不渴,舌淡白润,脉迟缓。首选的方剂是", + "options": { + "A": "补中益气汤", + "B": "吴茱萸汤", + "C": "理中丸", + "D": "丁香散", + "E": "竹叶石膏汤" + }, + "answer": "D", + "reason": "寒蓄中焦,气机不利,胃气上逆,可见呃声沉缓有力,胸膈及胃脘不舒;得热则减,遇寒更甚,舌苔白润,脉沉缓等为寒邪内停之症，辨证属胃中寒冷证。治当温中散寒,降逆止呃,方选丁香散加减" + }, + { + "question_num": 355, + "query": "患者,女,45岁。乳房肿块月经前加重,经后缓解,伴有腰酸乏力,神疲倦息,月经失调,量少色淡,舌淡苔白，脉沉细,其治法是", + "options": { + "A": "疏肝散结", + "B": "化痰散结", + "C": "调摄冲任", + "D": "调补气血", + "E": "行气活血" + }, + "answer": "C", + "reason": "该患者乳房肿块月经前加重,经后缓解,伴有腰酸乏力,神疲倦息,月经失调,量少色淡，舌淡苔白，脉沉细,为乳癖冲任失调证。治法:调摄冲任。代表方剂:二仙汤合四物汤加减。" + }, + { + "question_num": 356, + "query": "患者,女,30岁。反复上腹痛6年,饥饿时加重,进食后减轻。近1周来进食后上腹部胀痛加重,但大量呕吐后减轻。查体:轻度脱水，上腹部膨隆,有振水音。应首先考虑的是", + "options": { + "A": "多发性溃疡病", + "B": "复合性溃疡病", + "C": "胃溃癌恶变", + "D": "十二指肠溃疡伴幽门梗阻", + "E": "胃窦部溃疡伴急性穿孔" + }, + "answer": "D", + "reason": "结合患者上腹痛，饥饿痛且进食后减轻的临床表现可初步诊断为十二指肠溃疡。近来腹胀加剧,呕吐后减轻，上腹部振水音，因食物无法从幽门口向小肠运动，应考虑为十二指肠溃疡导致的幽门梗阻所致，" + }, + { + "question_num": 357, + "query": "患者脘腹胀满疼痛,拒按,嗳腐吞酸厌食呕恶,痛而欲泻,泻后痛减,舌苔厚腻,脉滑实,其首选的方剂是", + "options": { + "A": "大承气汤", + "B": "丁香散", + "C": "益胃汤", + "D": "保和丸", + "E": "枳实导滞丸" + }, + "answer": "E", + "reason": "患者脘腹胀满疼痛明显,诊断为腹痛。食滞内停,运化失司,胃肠不和,可见腹痛拒按,吸腐吞酸,厌食呕恶等症,结合舌脉,证属饮食积滞证,治当消食导滞,理气止痛。方选积实导滞丸加减" + }, + { + "question_num": 358, + "query": "患者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。应首先考虑的诊断是", + "options": { + "A": "气瘤", + "B": "筋瘤", + "C": "血瘤", + "D": "血瘤", + "E": "肉瘤" + }, + "answer": "D", + "reason": "血瘤可发生于身体任何部位，大多数为先天性，其特点是病变局部色泽鲜红或暗紫,或呈局限性柔软肿块，边界不清，触之如海绵状。" + }, + { + "question_num": 359, + "query": "惠者,男,50岁。高血压病史10年,今目剧烈头痛，眩晕,恶心,呕吐。查体:无肢体活动障碍,血压200/120mmHg。为快速降压，应选择下列哪种药物", + "options": { + "A": "硝普钠", + "B": "普萘洛尔", + "C": "硝苯地平", + "D": "利血平", + "E": "复方降压片" + }, + "answer": "A", + "reason": "患者有长期高血压病史，此次发病时血压200/120mmHg,结合发作时临床表现;可诊断为高血压危重症。此时为快速降压首选能直接扩张动静脉的硝普钠，降压迅速、效果显著。" + }, + { + "question_num": 360, + "query": "患者泄泻清稀,脘闷食少,腹痛肠鸣恶寒,发热,头痛,肢体酸痛,舌苔白或白腻,脉濡缓。首选的方剂是", + "options": { + "A": "四袖古", + "B": "藿香正气散", + "C": "胃苓汤", + "D": "参苓白术散", + "E": "补中益气汤" + }, + "answer": "B", + "reason": "寒湿内盛,脾失健运,清浊不分,可见泄泻清稀,脘闷食少,腹痛肠鸣;兼有外感风寒,可见恶寒,发热,头痛,肢体酸痛，结合舌脉,辨证属寒湿内盛证,治当散寒化湿方选蓥香正气散加减。" + }, + { + "question_num": 361, + "query": "患者因牙痛服去痛片,7天后四肢出现豌豆至蚕豆大圆形或椭圆形水肿性红斑，有些部位中央有水疱,其药毒的类型是", + "options": { + "A": "多形红斑样型", + "B": "湿疹皮炎样型", + "C": "固定红斑型", + "D": "大疱性表皮松解型", + "E": "剥脱性皮炎型" + }, + "answer": "A", + "reason": "药毒多形红斑型:临床与多形红斑相似，皮损为豌豆至蚕豆大圆形或椭圆形水肿性红斑、丘疹,红斑中心呈紫色或有水疱,有虹膜样或靶样损害,境界清楚。" + }, + { + "question_num": 362, + "query": "患者,男,42岁。既往脾大,HBSAg阳性。今晨排油样便约200ml。应首先考虑的是", + "options": { + "A": "糜烂性胃炎", + "B": "消化性溃疡", + "C": "肝硬化", + "D": "白血病", + "E": "胃癌" + }, + "answer": "C", + "reason": "患者有乙肝病史,且已出现肝硬化门脉高压的临床表现(脾大)。柏油样便应考虑食管一胃底侧支循环内压力过高破裂出血的结果。" + }, + { + "question_num": 363, + "query": "患者痢下赤白清稀,无腥臭,滑脱不禁,肛门坠胀,便后更甚,腹部隐痛,缠绵不已,喜温喜按,形寒畏冷,四肢不温,食少神疲,腰膝酸软,舌淡苔薄白,脉沉细弱,其证型为", + "options": { + "A": "虚寒痢", + "B": "湿热痢", + "C": "疫毒痢疾", + "D": "阴虚痢", + "E": "休息痢" + }, + "answer": "A", + "reason": "脾肾阳虚,寒湿内生,阻滞肠腑,可见痢下赤白清稀,滑脱不禁,肛门坠胀;喜温喜按,形寒畏冷,四肢不温,舌淡苔薄白,脉沉细弱等表现均为虚寒之症,辨证属寒痢。" + }, + { + "question_num": 364, + "query": "男性患者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,能自行流出。应首先考虑", + "options": { + "A": "慢性前列腺炎", + "B": "急性淋病", + "C": "前列腺增生", + "D": "梅毒", + "E": "尖锐湿疣" + }, + "answer": "B", + "reason": "急性淋病: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,以后逐渐变稠出现黄色黏稠的脓性分泌物,特别是清晨起床后分泌物量较多。当病变上行慈延至后尿道时，可出现终末血尿、血精、会阴部轻度坠胀等现象。" + }, + { + "question_num": 365, + "query": "患者,女,32岁。近两年间断发生尿路刺激症状,不发热，尿液检查可见白细胞与颗粒管型。应首先考虑的是", + "options": { + "A": "急性肾炎", + "B": "慢性肾炎", + "C": "急性肾孟肾炎", + "D": "慢性肾盂肾炎", + "E": "急性膀胱炎" + }, + "answer": "D", + "reason": "肾盂肾炎常见于女性,致病菌可经短而直的尿道日逆行性感染，临床表现为尿路刺激征,尿液检查见炎症细胞与颗粒管型。患者病程2年，间断发作,故考虑为慢性肾盂肾炎。" + }, + { + "question_num": 366, + "query": "患者大便并不干硬,虽有便意,但排便困难,用力努挣则汗出短气,便后乏力，面白神疲,肢倦懒言，舌淡苔白，脉弱，其治法是", + "options": { + "A": "养血滋阴,润燥通便", + "B": "补脾益肺,润肠通便", + "C": "滋阴增液,润肠通便", + "D": "补肾温阳,润肠通便", + "E": "顺气导滞,润肠通便" + }, + "answer": "B", + "reason": "患者排便困难,诊断为便秘。脾肺气虚,传送无力,可见大便并不干硬，虽有便意但排便困难，气虚可见汗出短气，便后乏力,面白神疲,肢倦懒育,舌淡苔白,脉弱,辨证属气虚秘。治当补脾益肺,润肠通便，方选黄芪汤加减。" + }, + { + "question_num": 367, + "query": "梅毒患者周身起杨梅疮,色如玫瑰,不痛不痒,或见丘疹、脓疱、鳞屑;兼见口干咽燥口舌生疮，大便秘结;舌质红绛,苔薄黄或少苔,脉细滑。应首选方剂", + "options": { + "A": "龙胆泻肝汤", + "B": "清营汤合桃红四物汤", + "C": "清瘟败毒饮", + "D": "地黄饮子", + "E": "五虎汤" + }, + "answer": "B", + "reason": "梅毒血热蕴毒证证候:多见于二期梅毒。周身起杨梅疮，色如玫瑰，不痛不痒,或见丘疹、脓疱、鳞屑;兼见口千咽燥,口舌生疮，大便秘结;舌质红绛,苔黄或少苔脉细滑或细数。治法:凉血解毒，泻热散瘀，代表方剂:清营汤合桃红四物汤加减。" + }, + { + "question_num": 368, + "query": "患儿,男,12岁。2年前诊断为1型糖尿病。今日在家中用胰岛素治疗后，突然发生昏迷。应首选的抢救措施是", + "options": { + "A": "小剂量胰岛素静脉滴注", + "B": "静脉补充氯化钾", + "C": "快速补充生理盐水", + "D": "静脉补充高渗葡萄糖", + "E": "静脉补充碳酸氢钠" + }, + "answer": "D", + "reason": "1型糖尿病应用胰岛素治疗的常见并发症为胰岛素应用过最导致低血糖:进而昏迷,其治疗应首先提高血糖浓度。" + }, + { + "question_num": 369, + "query": "患者突发黄疸,迅速加深,其色如金皮肤瘙痒,高热口渴,胁痛胀满,神昏谵语,烦躁抽搐,或见衄血、便血,肌肤瘀斑,舌质红绛:舌黄而燥,脉弦滑,其治法为", + "options": { + "A": "清热解毒,凉血开窍", + "B": "利湿化浊运脾,佐以清热", + "C": "清热通腑,利湿退黄", + "D": "疏肝泄热,利胆退黄", + "E": "利湿清热,以除余邪" + }, + "answer": "A", + "reason": "根据患者临床表现,诊断为黄疸疫毒炽盛证。治法:清热解毒,凉血开窍。" + }, + { + "question_num": 370, + "query": "患者便血伴肛门疼痛反复发作3年。肛门截石位6点处肛管皮肤裂开,伴结缔组织外痔，肛乳头肥大。治疗应首选用的手术方法是", + "options": { + "A": "扩肛法", + "B": "切开法", + "C": "挂线法", + "D": "结扎法", + "E": "纵切横缝法" + }, + "answer": "B", + "reason": "切开疗法适用于陈旧性肛裂,伴有结缔组织外痔、肛乳头肥大等。" + }, + { + "question_num": 371, + "query": "患者,男,30岁。十二指肠溃疡史5年。今日突然呕血伴休克。应首先采取的抢救措施是", + "options": { + "A": "补充血容量", + "B": "口服去甲肾上腺素", + "C": "静脉滴注止血敏", + "D": "静滴甲氛咪胍", + "E": "冰水洗胃" + }, + "answer": "A", + "reason": "休克的本质为有效循环血容量的不足,故首选补充血容量。待病情稳定后,再针对病因进行其他治疗，" + }, + { + "question_num": 372, + "query": "患者面目及肌肤淡黄,甚则晦暗不泽肢软乏力，心悸气短,大便溏薄。舌质淡，苔薄,脉濡细,其证候是", + "options": { + "A": "中脏虚寒证", + "B": "湿热留恋证", + "C": "阴黄脾虚湿滞证", + "D": "阳黄湿重于热证", + "E": "阴黄寒湿阻遏证" + }, + "answer": "C", + "reason": "患者面目及肌肤淡黄,其则晦暗不泽,辨病为黄疽。黄疽日久，脾血亏虚:湿滞残留,则见面目及肌肤淡黄,甚则晦暗不泽,肢软乏力,心悸气短,大便溏薄,舌质淡,苔薄,脉细。" + }, + { + "question_num": 373, + "query": "孕期36周早产,新生儿出生10天。体短形瘦,头大囟张,头发稀黄,耳壳软,哭声低微,肌肤不温,指甲软短,骨弱肢柔,指纹淡,其证候是", + "options": { + "A": "肾精薄弱证", + "B": "脾胃气虚证", + "C": "脾胃阴虚证", + "D": "脾肾两虚证", + "E": "脾胃虚寒证" + }, + "answer": "A", + "reason": "肾精薄弱证证候:体短形瘦,头大囟张,头发稀黄,耳壳软,哭声低微,肌肤不温,指甲软短,骨弱肢柔,或有先天性缺损畸形,指纹淡。" + }, + { + "question_num": 374, + "query": "患者,女,25岁。患风心病二尖瓣狭窄。近来感冒后病情加重,心悸,胸闷,气短，心率110次/分。此外，还可能出现的症状是", + "options": { + "A": "呼吸困难,咳嗽,咯血", + "B": "低热,气急,心尖搏动向左下移动", + "C": "胸痛,晕厥,水冲脉", + "D": "枪击音,毛细血管搏动", + "E": "收缩压高,脉压增大" + }, + "answer": "A", + "reason": "二尖瓣狭窄使左心房压升高,左心房压力升高导致肺静脉和肺毛细血管压力升高,继而导致肺毛细血管扩张和淤血产生肺间质水肿。心率增快时，心脏舒张期缩短，左心房压更高,进一步增加肺毛细血管压力。当超过30mmHg时致肺泡水肿，出现呼吸困难、咳嗽、发绀等临床表现。早期肺静脉压增高,支气管静脉破裂会出现大咯血。痰中带血,粉红色泡沫痰由肺充血、肺毛细血管破裂所致。" + }, + { + "question_num": 375, + "query": "患者胁下结块,隐痛、刺痛不适,胸胁胀闷,面颈部见有赤丝红纹，舌有紫斑或紫点脉涩。治疗宜首选", + "options": { + "A": "茵陈术附汤", + "B": "黄芪建中汤", + "C": "大柴胡汤", + "D": "膈下逐瘀汤合六君子汤加减", + "E": "千金犀角散" + }, + "answer": "D", + "reason": "患者胁下结块,隐痛、刺痛不适,诊断为积聚。瘀血内结,故见胁下结块:隐痛、刺痛不适;肝病日久,则见胸胁胀闷,面颈部见赤丝红纹，舌有紫斑或紫点，脉涩,辨证属积证之瘀血内结证。方选膈下逐瘀汤合六君子汤加减" + }, + { + "question_num": 376, + "query": "2岁幼儿,咳嗽频作、声重,咽痒,痰白清稀,鼻塞流涕,恶寒无汗,发热头痛,全身酸痛,舌苔薄白,脉浮紧。治法是", + "options": { + "A": "疏风清热,散结止痛", + "B": "清热解毒,软坚止痛", + "C": "清热解毒,开窍止痛", + "D": "疏风散寒,宣肺止咳", + "E": "清热解毒,息风开窍" + }, + "answer": "D", + "reason": "风寒咳嗽证证候:咳嗽频作、声重,咽痒,痰白清,鼻塞流涕,恶寒无汗,发热头痛,全身酸痛,舌苔薄白,脉浮紧或指纹浮红。治法:疏风散寒,宣肺止咳。代表方剂:杏苏散、金沸草散。" + }, + { + "question_num": 377, + "query": "患者眼睑浮肿,继则四肢及全身皆肿多有恶寒,发热,肢节酸楚,小便不利,咳喘。若经治疗后表证渐解,但仍见身重而水肿不退，其治法为", + "options": { + "A": "疏风清热,宣肺利水", + "B": "运脾化湿,通阳利水", + "C": "宣肺解毒,利湿消肿", + "D": "健脾温阳利水", + "E": "温肾助阳,行气利水" + }, + "answer": "B", + "reason": "恶寒,发热，肢节酸楚,小便不利,咳喘,辨证为风邪袭表,肺气闭塞,通调失职,风遏水阻所致的风水相搏证。治宜疏风清热,宣肺行水。若表证渐解，身重而水肿不退者,则属水湿内侵,脾气受困,脾阳不振,治宜运脾化湿,通阳利水。" + }, + { + "question_num": 378, + "query": "患儿,2岁。起病1天,大便如蛋花汤样,日行10余次,泻下急迫,气味秽臭,恶心。呕吐,腹痛时作,小便短黄,舌质红,苔黄腻,其证候是", + "options": { + "A": "伤食泻", + "B": "湿热泻", + "C": "风寒泻", + "D": "脾虚泻", + "E": "脾肾阳虚泻" + }, + "answer": "B", + "reason": "湿热泻证候:大便水样,或如蛋花汤样,泻下急迫，量多次频,气味秽臭，或见少许黏液,腹痛时作，食欲不振，或伴呕恶,神疲乏力,或发热烦躁,口渴,小便短黄,舌质红,苔黄腻,脉滑数,指纹紫。" + }, + { + "question_num": 379, + "query": "患者遍体浮肿,皮肤绷急光亮,胸脘痞闷,烦热口渴,小便短赤,大便干结,舌红,苔黄腻，脉沉数，其治法是", + "options": { + "A": "温肾助阳,化气行水", + "B": "疏风清热,宣肺利水", + "C": "运脾化湿,利湿消肿", + "D": "健脾温阳利水", + "E": "分利湿热" + }, + "answer": "E", + "reason": "水湿之邪，郁而化热，或湿热之邪壅于肌肤经髓之间,故见遍体浮肿，皮肤绷急光亮。由于湿热壅滞三焦，气机通降失常,故见胸脘痞闷;若热邪偏重者,津液被耗，故见烦热口渴，小便短赤，大便干结。苔黄腻脉沉数均为湿热之症，辨证属湿热壅盛证。治宜分利湿热。" + }, + { + "question_num": 380, + "query": "患儿,5岁。不思进食2月余,食少饮多,皮肤失润,大便偏干,小便短黄。舌红少津，苔薄，脉细数。治疗应首选的方剂是", + "options": { + "A": "生脉散", + "B": "养胃增液汤", + "C": "六味地黄汤", + "D": "增液承气汤", + "E": "养阴清胃汤" + }, + "answer": "B", + "reason": "患儿为脾胃阴虚证的表现治法:滋脾养胃,佐以助运。代表方剂:养胃增液汤、益胃汤。" + }, + { + "question_num": 381, + "query": "患者小便频效知涩，灼热刺痛，尿色黄赤,少腹拘急胀痛,口苦、呕恶,大便秘结,苔黄腻,脉滑数。首选的方剂是", + "options": { + "A": "程氏草游分清饮", + "B": "石韦散", + "C": "归脾汤", + "D": "小蓟饮子", + "E": "八正散" + }, + "answer": "E", + "reason": "患者小便频数短涩,诊断为淋证。湿热蕴结下焦,膀胱气化失司，故见小便频数短涩，灼热刺痛，尿色黄赤;若湿热内蕴,邪正相争,可见口苦、呕恶,热甚波及大肠,则见大便秘结;苔黄腻,脉滑数，均为湿热之症。故辨证为热淋。治宜清热利湿通淋，方选八正散加减。" + }, + { + "question_num": 382, + "query": "患儿长期纳呆,形体消瘦,面色苍白,唇淡甲白，舌淡苔白，脉细无力，指纹淡红，Hb90g/L。治法是", + "options": { + "A": "疏风清热,散结止痛", + "B": "温补脾肾,益阴养血", + "C": "健运脾胃,益气养血", + "D": "补脾养心,养气生血", + "E": "滋养肝肾,益精生血" + }, + "answer": "C", + "reason": "贫血脾胃虚弱证证候:长期纳食不振,神疲乏力,形体消瘦,面色苍黄,唇淡甲白,大便不调,舌淡苔白,脉细无力，指纹淡红。治法:健运脾胃,益气养血。代表方剂:六君子汤。" + }, + { + "question_num": 383, + "query": "患者情绪不宁,急躁易怒,胸胁胀满:口苦而干,头痛、目赤、耳鸣,嘈杂吞酸,大便秘结,舌质红,苔黄,脉弦数,其证型是", + "options": { + "A": "痰气郁结证", + "B": "气滞血瘀证", + "C": "气郁化火证", + "D": "肝气郁结证", + "E": "心肾阴虚证" + }, + "answer": "C", + "reason": "患者情绪不宁,急躁易怒诊断为郁证。肝气郁结疏泄不利，可见胸胁胀满。肝郁日久化火,故见情绪不宁,急躁易怒口苦而干。若肝火上炎，扰乱清空，则见头痛目赤、耳鸣。肝火犯胃则见嘈杂吞酸。舌质红,苔黄,脉弦数均为气郁化火之象。故辨证为气郁化火证。" + }, + { + "question_num": 384, + "query": "患儿水肿5个月。面色无华,神疲乏力,口干咽燥,舌稍红,苔少,脉细数,其证候是", + "options": { + "A": "风水相搏证", + "B": "气阴两虚证", + "C": "脾肾阳虚证", + "D": "水毒内闭证", + "E": "脾虚湿困证" + }, + "answer": "B", + "reason": "水肿气阴两虚证证候:面色无华,腰膝酸软,或有水肿,耳鸣目眩,咽干口燥,舌稍红,苔少,脉细弱。" + }, + { + "question_num": 385, + "query": "患者烦渴多饮,口干舌燥,尿频量多,舌边尖红,苔薄黄,脉洪数。首选的方剂是", + "options": { + "A": "金匮肾气丸", + "B": "二冬汤", + "C": "玉泉丸", + "D": "消渴方", + "E": "六味地黄丸" + }, + "answer": "D", + "reason": "患者烦渴多饮,尿频量多诊断为消渴。肺胃津伤，燥热内生，故烦渴多饮,口干舌燥。肺失宣降则治节失司，水不化津,肾关不固,故尿频是多。舌边尖红,苔燕黄,脉洪数均为肺热之症。故辨证属肺热津伤证,方选消渴方加减。" + }, + { + "question_num": 386, + "query": "患儿,女,6岁。小便短赤频数,起病急,尿道灼热刺痛,尿液浑浊,伴发热,烦躁口渴,舌质红,苔黄腻,脉滑数。治法是", + "options": { + "A": "疏风清热,散结止痛", + "B": "清热解毒,软坚止痛", + "C": "清热解毒,开窍止痛", + "D": "清热利湿,通利膀胱", + "E": "清热解毒,息风开窍" + }, + "answer": "D", + "reason": "尿频湿热下注证证候:起病较急,小便频数短赤,尿道灼热疼痛,尿液林沥混浊,小腹坠胀,腰部酸痛,常伴有发热、烦躁口渴、头痛身痛、恶心呕吐,舌质红,苔薄腻微黄或黄腻,脉数有力。治法:清热利湿,通利膀胱。代表方剂:八正散。" + }, + { + "question_num": 387, + "query": "由老而名茶苦飞力,少气懒言,大便溏薄,肠呜腹痛,每因受寒或饮食不慎而加剧，其诊断为", + "options": { + "A": "积聚之正虚瘀结证", + "B": "黄疸之肝脾不调证", + "C": "黄疸之脾虚湿滞证", + "D": "虚劳之脾气虚证", + "E": "虚劳之脾阳虚证" + }, + "answer": "E", + "reason": "患者总体表现为一派虚-”大““,A2c产元懒言为气血不足。气虚日久伤阳,脾阳不足,温煦失职则形寒,肠鸣腹痛，每因受寒或饮食不慎而加剧。阳虚运化无权则见食少便溏,故辨证为脾阳虚证。" + }, + { + "question_num": 388, + "query": "2岁幼儿,语迟,智力低下,头发生长迟缓,发稀萎黄,四肢萎软,肌肉松弛，口角流涎,纳食欠佳,舌淡胖,苔少。治法是", + "options": { + "A": "疏风清热,散结止痛", + "B": "温补脾肾,益阴养血", + "C": "健运脾胃,益气养血", + "D": "健脾养心,补益气血", + "E": "滋养肝肾,益精生血" + }, + "answer": "D", + "reason": "五迟、五软心脾两虚证证候:语言发育迟滞,精神呆滞,智力低下,头发生长迟缓,发稀萎黄,四肢癌软，肌肉松弛，口角流涎,纳食欠佳,大便秘结,舌淡胖,苔少,脉细缓,指纹色淡。治法:健脾养心，补益气血。代表方剂:调元散。" + }, + { + "question_num": 389, + "query": "患者游走性关节疼��,活动不便,局部灼热红肿,痛不可触,得冷则舒,伴有发热恶风、汗出、口渴、烦躁不安等全身症状,舌质红,舌苔黄,脉滑数。首选的方剂为", + "options": { + "A": "白虎加桂枝汤或宣痹汤", + "B": "白虎汤", + "C": "蠲痹汤", + "D": "犀角散", + "E": "桂枝芍药知母汤" + }, + "answer": "A", + "reason": "患者游走性关节疼痛,活动不便,诊断为痹证。感受风湿热邪，或风寒湿邪郁而化热，湿热壅滞经络,流注肢节，气血瘀滞不通致活动不便,局部灼热红肿，痛不可触。湿热壅盛，营卫郁滞失和,故见发热、恶风,湿热久郁,化燥伤津,故汗出、口渴、烦躁不安。辨证为风湿热痹证，治宜清热通络，祛风除湿,方选白虎加桂枝汤或宣痹汤加减。" + }, + { + "question_num": 390, + "query": "患儿发热8天。遍身多形红斑，球结膜充血，草莓舌和颈淋巴结肿大，手足硬肿。应首先考虑的是", + "options": { + "A": "紫癜", + "B": "皮肤黏膜淋巴结综合征", + "C": "麻疹", + "D": "丹痧", + "E": "风痧" + }, + "answer": "B", + "reason": "皮肤黏膜淋巴结综合征又称川崎病,临床以持续发热、多形红斑、球结膜充血、草莓舌、颈淋巴结肿大、手足硬肿为特征,好发于婴幼儿。" + }, + { + "question_num": 391, + "query": "患者腰部冷痛,缠绵不愈，局部发凉喜温喜按,遇劳更甚,卧则减轻,常反复发作，少腹拘急,面色白,肢冷畏寒,舌质淡,脉沉细九力，具治法为", + "options": { + "A": "培补肝肾,通络止痛", + "B": "散寒行湿,温经通络", + "C": "滋补肾阴,濡养筋脉", + "D": "清热利湿,疏筋止痛", + "E": "补肾壮阳,温煦经脉" + }, + "answer": "E", + "reason": "患者腰部冷痛,诊断为腰痛。肾为腰府,充养腰部,肾中精气亏虚,元阳虚衰,腰脊失养,可见腰部冷痛,缠绵不愈，局部发凉,喜温喜按,遇劳更甚,卧则减轻,常反复发作。肾阳不振，不能温胞则见少腹拘急，肢冷畏寒,面色眺白。舌质淡,脉沉细无力为阳虚有寒之象。故辨证为肾阳虚腰痛，治宜补肾壮阳,温煦经脉。" + }, + { + "question_num": 392, + "query": "患儿发热恶风、喷流涕,皮疹起于头面、躯干,随即遍及四肢,疹点稀疏,疹色淡红,耳后及枕部界核肿大，舌质偏红,苔薄白，脉浮数，其证候是", + "options": { + "A": "风水相搏证", + "B": "邪犯肺卫证", + "C": "脾肾阳虚证", + "D": "水毒内闭证", + "E": "脾虚湿困证" + }, + "answer": "B", + "reason": "邪犯肺卫证证候:发热恶风,喷流涕,轻微咳嗽,精神倦怠,饮食欠佳，皮疹先起于头面、躯干,随即遍及四肢,,分布均匀,疹点稀疏细小,疹色淡红,耳后及枕部界核肿大触痛,舌质偏红,苔薄白或薄黄,脉浮数。" + }, + { + "question_num": 393, + "query": "患者，男，39岁。阳痿,单纯食欲不振,神疲,腹胀,面色少华,舌质淡苔薄,脉细无力。针刺应配", + "options": { + "A": "内关、神门、心俞", + "B": "太冲、内关", + "C": "曲骨、阴陵泉", + "D": "心俞、脾俞、足三里", + "E": "命门、太溪" + }, + "answer": "D", + "reason": "患者阳痿,单纯食欲不振神疲,腹胀,面色少华,舌质淡苔薄,脉细无力，此为心脾两虚，治疗宜补益肾气，除主穴外配伍心脾之背俞穴心俞、脾俞,培补心肾;足三里为胃经腧穴，可健运脾胃。" + }, + { + "question_num": 394, + "query": "患儿轻微发热,口腔内疱疹,破溃后形成小溃疡,疼痛;足跖部出现疱疹,分布稀疏,疱液清亮,舌质红,苔薄黄腻,脉浮数,其证候是", + "options": { + "A": "风水相搏证", + "B": "邪犯肺脾证", + "C": "脾肾阳虚证", + "D": "水毒内闭证", + "E": "脾虚湿困证" + }, + "answer": "B", + "reason": "邪犯肺脾证证候:发热轻微,或无发热,或流涕咳嗽、纳差恶心、呕吐泄泻,1~2天后或同时出现口腔内疱疹,破溃后形成小的溃疡,疼痛流涎,不欲进食。随病情进展,手掌、足跖部出现米粒至豌豆大斑丘疹，并迅速转为疱疹,分布稀疏,疹色红润，根盘红晕不著,疱液清亮,舌质红,苔薄黄腻,脉浮数。" + }, + { + "question_num": 395, + "query": "患者因冒雨受寒而致腰痛放射至小腿后侧，其治疗主穴是", + "options": { + "A": "申脉、解溪、丘墟", + "B": "大肠俞、腰痛点、委中", + "C": "肾俞、膀胱俞、中极、三阴交、阴陵泉", + "D": "腰夹脊、秩边、委中、承山、昆仑", + "E": "腰夹脊、环跳、阳陵泉、悬钟、丘墟" + }, + "answer": "D", + "reason": "腰痛放射至小腿后侧,为坐骨神经痛足太阳经证，治疗主穴为腰夹脊，、秩边、委中、承山、昆仑。" + }, + { + "question_num": 396, + "query": "患儿发热轻微,鼻塞流涕，喷，咳嗽,1天后出皮疹,疹色红润,疱浆清亮,皮疹瘙痒,分布稀疏,以躯干为多,舌苔薄白,脉浮数。治疗应首选的方剂是", + "options": { + "A": "生脉散", + "B": "银翘散", + "C": "六味地黄汤", + "D": "增液承气汤", + "E": "养阴清胃汤" + }, + "answer": "B", + "reason": "邪伤肺卫证证候:发热轻微,或无发热,鼻塞流涕,喷,咳嗽,起病后1~2天出皮疹,疹色红润,疱浆清亮,根盘红晕:皮疹瘙痒,分布稀疏，此起彼伏，以躯干为多舌苔薄白，脉浮数。治法:疏风清热，利湿解毒。代表方剂:银翘散。" + }, + { + "question_num": 397, + "query": "患者头重如裹,视物旋转,舌淡,苔白腻,脉弦滑。针刺配穴为", + "options": { + "A": "行间他语大深", + "B": "气海、脾俞、胃俞", + "C": "太溪、悬钟、三阴交电", + "D": "阴陵泉、内庭", + "E": "头维、中脘、丰隆" + }, + "answer": "E", + "reason": "患者头重如裹,视物旋转舌淡,苔白腻，脉弦滑,辨证为眩晕痰湿中阻证。痰湿中阻配头维、中脘、丰隆。" + }, + { + "question_num": 398, + "query": "患者睡眠醒来时发现一侧面部肌肉板滞、麻木、瘫痪、额纹消失。针刺起远治作用的主穴是", + "options": { + "A": "合谷、太冲", + "B": "风池、风府", + "C": "鱼腰、丝竹空", + "D": "翳风、承浆", + "E": "头维、颊车" + }, + "answer": "A", + "reason": "患者睡眠醒来时发现一侧面部肌肉板滞、麻木、瘫痪、额纹消失,为面瘫。面瘫主穴:攒竹、阳白、四白、髎、颊车、地仓,合谷、太冲。" + }, + { + "question_num": 399, + "query": "患者心烦不寐,时寐时醒,手足心热瓶红潮热，舌红，苔少,脉细数。针刺治疗应取的经脉为", + "options": { + "A": "手阳明大肠经", + "B": "手少阴心经", + "C": "手太阳小肠经", + "D": "足阳明胃经", + "E": "足少阳胆经" + }, + "answer": "B", + "reason": "患者心烦不寐,时寐时醒,手足心热,颧红潮热，舌红,苔少,脉细数,辨证为不寐心肾不交证。不寐的治疗取督脉、手少阴穴为主。" + }, + { + "question_num": 400, + "query": "患者精神抑郁善忧，易怒易哭,咽部异物硬塞感,兼胸胁胀痛,舌苔薄白,脉弦。针刺配穴为", + "options": { + "A": "膻中、期门", + "B": "行间、侠溪", + "C": "天突、照海", + "D": "通里、心俞、三阴交", + "E": "肝俞、肾俞、太溪、三阴交" + }, + "answer": "A", + "reason": "患者精神抑郁善忧，易怒易哭,咽部异物硬塞感,诊为郁证。兼胸胁胀痛,舌苔薄白,脉弦,为肝气郁滞证。治疗主穴为百会、印堂、水沟、内关、神门、太冲。配穴肝气郁结配膻中、期门。" + }, + { + "question_num": 401, + "query": "患者神志淡漠,寡言少语,反应迟钝,记忆减退,头晕耳鸣,腰酸骨软,舌质红,苔薄白,脉沉细。针刺配穴为", + "options": { + "A": "足三里、气海、血海", + "B": "丰隆、中脘", + "C": "天突、照海", + "D": "膈俞、太冲", + "E": "肝俞、肾俞" + }, + "answer": "E", + "reason": "患者辨证为肝肾阴虚证。肝肾亏虚配肝俞、肾俞。" + }, + { + "question_num": 402, + "query": "患者大便时溏时泻，迁延反复,稍食油腻食物则便次增多，面黄神疲,舌淡苔白，脉细弱。针刺配穴为", + "options": { + "A": "脾俞、太白", + "B": "内庭、曲池", + "C": "肾俞、关元", + "D": "膈俞、太冲", + "E": "肝俞、肾俞" + }, + "answer": "A", + "reason": "大便时溏时泻,迁延反复，稍进油腻食物则便次增多，面黄神疲,舌淡苔白,脉细弱,为泄泻脾气虚弱。应在主穴神阙、天枢、足三里、公孙的基础上配用脾俞、太白。" + }, + { + "question_num": 403, + "query": "患者多饮,多食,多尿,形体消瘦。针刺治疗主穴除胃脘下俞外还有", + "options": { + "A": "中极、膀胱俞、秩边、阴陵泉、三阴交", + "B": "肺俞、脾俞、肾俞、太溪、三阴交", + "C": "关元、脾俞、肾俞、三焦俞、秩边", + "D": "肩髃、曲池、合谷", + "E": "风池、曲池、血海" + }, + "answer": "B", + "reason": "患者多饮，多食，多尿，形体消瘦,诊为消渴。消渴针刺治疗主穴:胃脘下俞、肺俞、脾俞、肾俞、太溪、三阴交。" + }, + { + "question_num": 404, + "query": "患者月经先期量多，色淡质稀,神疲肢倦，心悸气短，舌淡，脉细弱。针刺配穴为", + "options": { + "A": "足三里、血海", + "B": "足三里、脾俞", + "C": "关元、命门", + "D": "肾俞、太溪", + "E": "期门、太冲" + }, + "answer": "B", + "reason": "��者月经先期量多,色淡质稀,神疲肢倦,心悸气短,舌淡,脉细弱,诊为月经先期气虚证。气虚配足三里、脾俞。" + }, + { + "question_num": 405, + "query": "患者经血非时暴下,量多势急,经血色红质稠。针刺主穴为", + "options": { + "A": "三阴交、足三里、血海", + "B": "三阴交、肝俞、气海", + "C": "隐白、血海、阴陵泉、关元", + "D": "关元、隐白、三阴交", + "E": "三阴交、足三里、气海、肾俞" + }, + "answer": "D", + "reason": "经血非时暴下,诊为崩漏。量多势急,经血色红质稠，为血热证。崩漏实证主穴:关元、三阴交、隐白。" + }, + { + "question_num": 406, + "query": "患者胁下皮肤灼热刺痛、发红,继而出现簇集性粟粒大小丘状疱疹，呈带状排列，皮损鲜红,疱壁紧张,灼热刺痛,兼口苦,烦躁易怒,苔黄,脉弦滑数。针刺配穴为", + "options": { + "A": "足三里、血海", + "B": "肝俞、气海", + "C": "行间、侠溪", + "D": "阴陵泉、内庭", + "E": "血海、三阴交" + }, + "answer": "C", + "reason": "患者辨证为肝胆火盛证，肝胆火盛配行间、侠溪。" + }, + { + "question_num": 407, + "query": "患者乳房肿块和疼痛在月经前加重，兼腰酸乏力，月经失调,色淡量少,舌淡,脉沉细。针刺配穴为", + "options": { + "A": "丰隆、中脘", + "B": "肝俞、气海", + "C": "行间、侠溪", + "D": "肝俞、内关", + "E": "关元、肝俞、肾俞" + }, + "answer": "E", + "reason": "患者乳房肿块和疼痛在月经前加重,诊为乳癖。兼腰酸乏力，月经失调色淡量少，舌淡,脉沉细,辨证为冲任失调证。冲任失调配关元、肝俞、肾俞。" + }, + { + "question_num": 408, + "query": "患者感受风寒,肩部疼痛以肩前外部为主。针刺选经为", + "options": { + "A": "手阳明经", + "B": "手少阳经", + "C": "手太阳经", + "D": "手太阴经", + "E": "手少阴经" + }, + "answer": "A", + "reason": "患者感受风寒,肩部疼痛为漏肩风。疼痛以肩前外部为主者为手阳明经证。" + }, + { + "question_num": 409, + "query": "患者,女,46岁。咽喉微感疼痛,稍肿,色暗红，人夜尤甚,舌红,脉细数。针刺主穴为", + "options": { + "A": "尺泽、合谷、少商", + "B": "关冲、合谷、少商", + "C": "太溪、照海、鱼际", + "D": "关冲、厉兑、鱼际", + "E": "太溪、曲池、少商" + }, + "answer": "C", + "reason": "患者咽喉微感疼痛,稍肿色暗红，人夜尤甚，舌红，脉细数，为阴虚火旺型咽喉肿痛。咽喉肿痛虚证主穴:太溪、照海列缺、鱼际。" + }, + { + "question_num": 410, + "query": "患者形体肥胖兼消谷善饥，大便干燥,舌质红，苔黄腻，脉滑数。针刺配穴为", + "options": { + "A": "脾俞、足三里", + "B": "上巨虚、内庭", + "C": "肾俞、关元", + "D": "神门、内关", + "E": "照海、申脉" + }, + "answer": "B", + "reason": "患者形体肥胖,诊为肥胖症。兼消谷善饥，大便干燥,舌质红,苔黄腻,，脉滑效，为胃肠积热。胃肠积热配上巨虚、内庭。" + } +] \ No newline at end of file