diff --git "a/Licensed/Theory_Questions/Year_4/Past_Paper.json" "b/Licensed/Theory_Questions/Year_4/Past_Paper.json" new file mode 100644--- /dev/null +++ "b/Licensed/Theory_Questions/Year_4/Past_Paper.json" @@ -0,0 +1,5540 @@ +[ + { + "question_num": 1, + "query": "中医学整体观念的内涵是", + "options": { + "A": "人体是一个有机的整体", + "B": "自然界是一个整体", + "C": "时令、晨昏与人体阴阳相应", + "D": "五脏与六腑是一个有机整体", + "E": "人体是一个有机整体,人与自然相统一" + }, + "answer": "E", + "reason": "中医学整体观念的内涵:①人与自然界的统一性;②人体是有机的整体。" + }, + { + "question_num": 2, + "query": "外感热病中,正邪相争,提示病变发展转折点的是", + "options": { + "A": "战汗", + "B": "自汗", + "C": "盗汗", + "D": "冷汗", + "E": "热汗" + }, + "answer": "A", + "reason": "战汗指先全身恶寒,战栗,接着大汗出,若汗出热退,脉静身凉,是邪去正复之佳兆,主疾病向愈;若汗出而身热不减,仍烦躁不安,脉来疾急,为邪胜正衰之危候,主病情恶化。" + }, + { + "question_num": 3, + "query": "导致感冒的主因是", + "options": { + "A": "寒邪", + "B": "热邪", + "C": "风邪", + "D": "湿邪", + "E": "暑邪" + }, + "answer": "C", + "reason": "感冒之病因,主要为感受风邪,导致肺卫失和，又名伤风。由于感受四时之邪的特点及禀赋体质的差异,可以表现为风寒、风热、夹暑、夹湿的不同,但总离不开风邪风为百病之长。" + }, + { + "question_num": 4, + "query": "中医外科成为独立专科的年代是", + "options": { + "A": "商代", + "B": "周代", + "C": "秦代", + "D": "汉代", + "E": "明代" + }, + "answer": "B", + "reason": "中医外科成为独立专科是在周代,中医外科到明清时期已较为成熟，外科专著增多。" + }, + { + "question_num": 5, + "query": "中医学的基本特点是", + "options": { + "A": "阴阳五行与藏象经络", + "B": "整体观念与辨证论治", + "C": "以五脏为主的整体观", + "D": "望闻问切与辨证论治", + "E": "辨证求因与审因论治" + }, + "answer": "B", + "reason": "中医学的基本特点如下:①整体观念:人体是有机的整体，人体的各个部分是有机联系的，人和自然相统一;②辨证论浴:项吊染、马的诊新方法，收集患省的症状、体征以及病史有关情况，进行分析、综合,辨明病理变化的性质和部位,判断为何种性质的“证候”,这个过程就是“辨证”“论治”" + }, + { + "question_num": 6, + "query": "下列各项,属痰湿内阻头晕临床表现的是", + "options": { + "A": "头晕胀痛", + "B": "头晕昏沉", + "C": "头晕眼花", + "D": "头晕耳鸣", + "E": "头晕欲仆" + }, + "answer": "B", + "reason": "痰湿内阻证症候胃脘满闷塞不舒,胸膈满闷,纳呆,口淡不渴,或时有恶心呕吐,头晕目眩,头重如裹,小便清,大便溏软;舌淡红,舌体胖大、边有齿痕、苔白厚腻脉沉滑." + }, + { + "question_num": 7, + "query": "风寒感冒兼胸脘痞闷，食少纳呆，脉者,治疗应首选", + "options": { + "A": "荆防败毒散", + "B": "香苏散", + "C": "杏苏散", + "D": "羌活胜湿汤", + "E": "三仁汤" + }, + "answer": "D", + "reason": "风寒感冒治宜辛温解表,宣肺散寒,夹湿者应配以疏风祛湿，方用羌活胜湿汤。" + }, + { + "question_num": 8, + "query": "世界上最早进行死骨别出术和解剖术的外科学家是", + "options": { + "A": "扁鹊", + "B": "郑玄", + "C": "华佗", + "D": "医姁", + "E": "张仲景" + }, + "answer": "C", + "reason": "被称为外科鼻祖的华佗,第一个应用麻沸散作为全身麻醉剂进行剖腹术。" + }, + { + "question_num": 9, + "query": "证候不包括", + "options": { + "A": "四诊检查所得", + "B": "内外致病因素", + "C": "疾病的特征", + "D": "疾病的性质", + "E": "疾病的全过程" + }, + "answer": "E", + "reason": "中医证候以相应的症、舌、脉、形、色、神表现出来,能够不同程度地揭示病因、病位、病性、邪正盛衰、病势等病机内容,为辨证论治提供依据。" + }, + { + "question_num": 10, + "query": "下列除哪项外,均提示病情严重,预后不良", + "options": { + "A": "目暗睛迷", + "B": "舌苔骤剥", + "C": "脉微欲绝", + "D": "抽搐吐沫", + "E": "昏迷烦躁" + }, + "answer": "D", + "reason": "ABCE项均为脏腑精气将绝,形体极度衰弱的表现，此种情况一旦出现多为失神之象,预后不良,D项为神乱意识障碍的主要临床表现，尚未达到病情严重预后不良的程度。" + }, + { + "question_num": 11, + "query": "下列各项,除哪项外,均是内伤咳嗽的常见病因", + "options": { + "A": "情志刺激", + "B": "饮食不节", + "C": "过劳努伤", + "D": "肺脏虚弱", + "E": "久病伤阴" + }, + "answer": "C", + "reason": "内伤为脏腑功能失调,内邪干肺,如肺脏虚弱,情志刺激肝火犯肺,饮食不节痰湿蕴肺,久病伤阴肺肾阴虚。但是过劳努伤不属于内伤咳嗽,应当是外伤咳嗽。" + }, + { + "question_num": 12, + "query": "明代最有成就的中医外科学著作具", + "options": { + "A": "《外科正宗》", + "B": "《疡科心得集》", + "C": "《外科大成》", + "D": "《外科全生集》", + "E": "《霉疮秘录》" + }, + "answer": "A", + "reason": "此期以陈实功的《外科正宗》成就最大，该书广辑病名,详述病因病机、证候、辨证、治疗、预后等,并附医案加以论证,条理清晰,十分完备。" + }, + { + "question_num": 13, + "query": "同病异治的实质是", + "options": { + "A": "证同治异", + "C": "病同治异", + "B": "证异治异", + "D": "证异治同", + "E": "病同治同" + }, + "answer": "B", + "reason": "同病异治,指同一病证,因时、因地、因人不同,或由于病情进展程度、病机变化,以及用药过程中正邪消长等差异，治疗上应相应采取不同治法。" + }, + { + "question_num": 14, + "query": "风痰的特征是", + "options": { + "A": "色黄黏稠", + "B": "白而清稀", + "C": "清稀多泡沫", + "D": "白滑而量多", + "E": "少而黏稠" + }, + "answer": "C", + "reason": "A项为热痰,因热邪内盛,煎熬、浓缩津液成痰。B项为寒痰，因寒邪客肺津凝成痰,或脾虚失运,聚湿为痰。C项为风痰,故选C。D项多为湿痰,因脾失伤肺津,或肺阴虚,肺失润养所致。" + }, + { + "question_num": 15, + "query": "咳嗽痰少,痰中带血或反复略血，而色鲜红,口于咽燥,颧红,潮热盗汗,舌质红,脉细数。治疗应首选", + "options": { + "A": "桑杏汤", + "B": "杏苏散", + "C": "沙参麦冬汤", + "D": "麦门冬汤", + "E": "百合固金汤" + }, + "answer": "C", + "reason": "肺阴亏虚,虚热内灼,肺气上逆,故咳嗽,火伤肺络,故痰中带血或反复咯血,血色鲜红口干咽燥,撷红,潮热盗汗,舌质红,脉细数,俱是阴虚内热的表现,故宜养阴清热,润肺止咳,方用沙参麦冬汤。" + }, + { + "question_num": 16, + "query": "以疾病特性命名的外科疾病是", + "options": { + "A": "背疽", + "B": "肺痈", + "C": "破伤风", + "D": "白驳风", + "E": "流注" + }, + "answer": "E", + "reason": "A项为部位命名,B项为脏腑命名,℃项为病因命名，D项为颜色命名。E项为疾病特性命名。" + }, + { + "question_num": 17, + "query": "事物或现象阴阳属性的征兆是", + "options": { + "A": "寒热", + "B": "上下", + "C": "水火", + "D": "晦明", + "E": "动静" + }, + "answer": "C", + "reason": "素问·阴阳应象大论》:“天地者,万物之上下也;阴阳者,气血之男女也;左右者,阴阳之道路也;水火者，阴阳之征兆也;阴阳者,万物之能始也。”" + }, + { + "question_num": 18, + "query": "舌绛少苔有裂纹,多见于", + "options": { + "A": "热邪内盛", + "B": "气血两虚", + "C": "阴虚火旺", + "D": "瘀血内阻", + "E": "脾虚湿盛" + }, + "answer": "C", + "reason": "绛舌主热人营血，阴虚火旺及瘀血，舌绛而少苔或无苔，或有裂纹。则为阴虚火旺。" + }, + { + "question_num": 19, + "query": "哮病发作期的主要病机是", + "options": { + "A": "外邪侵袭,肺失宣降", + "B": "肺失宣肃,肺气上逆", + "C": "痰气搏结,气道被阻", + "D": "邪袭于肺,肺气不利", + "E": "肺脏虚弱,气失所主" + }, + "answer": "C", + "reason": "哮病的发作期的病机主要是痰气搏结,气道被阻,其他选项也是一些病因,但非病机。" + }, + { + "question_num": 20, + "query": "黄水疮命名的依据是", + "options": { + "A": "部位", + "B": "症状", + "C": "形态", + "D": "疾病特征", + "E": "范围大小" + }, + "answer": "B", + "reason": "以症状命名者,如红丝疗、麻风、黄水疮、疬、乳头破碎。" + }, + { + "question_num": 21, + "query": "言脏腑之阴阳,脾为", + "options": { + "A": "阴中之阳", + "B": "阴中之阴", + "C": "阴中之至阴", + "D": "阳中之阴", + "E": "阳中之阳" + }, + "answer": "C", + "reason": "脾属太阴,太阴所占阴分有三,少阴有二,厥阴只有一,所以太阴为至阴。" + }, + { + "question_num": 22, + "query": "下列哪项不属于听诊内容", + "options": { + "A": "错语", + "B": "呃逆", + "C": "嗳气", + "D": "咳嗽", + "E": "耳鸣" + }, + "answer": "E", + "reason": "耳鸣属于间诊的内容" + }, + { + "question_num": 23, + "query": "治疗哮病缓解期脾虚证,应首选", + "options": { + "A": "理中汤", + "B": "六君子汤", + "C": "黄芪建中汤", + "D": "苏子降气汤", + "E": "补中益气汤" + }, + "answer": "B", + "reason": "哮病在脏腑责之肺脾肾,缓解期多为虚证。脾成用六君子汤;痰涎壅肺、肾虚不纳的可用苏子降气汤，" + }, + { + "question_num": 24, + "query": "“七恶”中,症见“皮肤枯槁,痰多音喑:呼吸喘急,鼻扇动”者,称为", + "options": { + "A": "心恶", + "B": "肝恶", + "C": "脾恶", + "D": "肺恶", + "E": "气血衰竭" + }, + "answer": "D", + "reason": "皮肤枯槁,痰多音喑,呼吸喘急,鼻翼扇动为肺恶。心恶为神志迷糊，心烦舌燥,疮色紫黑,言语呢喃。" + }, + { + "question_num": 25, + "query": "以昼夜分阴阳,后半夜为", + "options": { + "A": "阴中之阳", + "B": "阳中之阴", + "C": "阳中之阳", + "D": "阴中之阴", + "E": "阴中之至阴" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 26, + "query": "唐代以前所称的哕,是指", + "options": { + "A": "呃逆", + "B": "嗳气", + "C": "恶心", + "D": "干呕", + "E": "噫气" + }, + "answer": "A", + "reason": "哕是指呃逆之古称。《灵枢·杂病》:“哕,以草刺鼻,而已。”《证治准绳·杂病》:“呃逆,即《内经》所谓哕也。”" + }, + { + "question_num": 27, + "query": "下列除哪项外,均为喘证的病因", + "options": { + "A": "外邪侵袭", + "B": "饮食不当", + "C": "情志所伤", + "D": "痰热素盛", + "E": "劳欲久病" + }, + "answer": "D", + "reason": "喘证的病因有ABCE项D项痰热素盛属于病理因素,可由多种因素产生,不是最根本的病因，" + }, + { + "question_num": 28, + "query": "下列各项,不属于岩的病因病机的是", + "options": { + "A": "情志郁结", + "B": "六淫之邪", + "C": "脏腑失调", + "D": "饮食不节", + "E": "感受特殊之毒" + }, + "answer": "E", + "reason": "特殊之毒包括虫毒、蛇毒、疯犬毒、毒、药毒、食物毒和疫毒、无名毒。" + }, + { + "question_num": 29, + "query": "“重阴必阳,重阳必阴”说明了阴阳之间的哪种关系", + "options": { + "A": "相互交感", + "B": "对立制约", + "C": "互根互用", + "D": "消长平衡", + "E": "相互转化" + }, + "answer": "E", + "reason": "阴阳的相互转化,如热极生寒,寒极生热。" + }, + { + "question_num": 30, + "query": "按寸口脉分候脏腑,右关脉可候", + "options": { + "A": "心与膻中", + "B": "肾与小腹", + "C": "脾与胃", + "D": "肝、胆与膈", + "E": "肺与胸中" + }, + "answer": "C", + "reason": "右关可候脾与胃,左尺可候肾与小腹。" + }, + { + "question_num": 31, + "query": "下列各项除哪项外,均是虚喘的特有症状", + "options": { + "A": "呼吸浅短难续", + "B": "呼出为快", + "C": "气怯声低", + "D": "深吸为快", + "E": "遇劳加重" + }, + "answer": "B", + "reason": "喘证有虚实之分,实喘病程短、急,症见呼吸深长有余,呼出为快,气粗声高,故选B。" + }, + { + "question_num": 32, + "query": "下列各项,属外科辨别阴证、阳证要点的是", + "options": { + "A": "有无麻木", + "B": "有无脓液", + "C": "有无出血", + "D": "有无灼热", + "E": "有无瘙痒" + }, + "answer": "D", + "reason": "阴和阳属于截然相反的两个对立面,寒凉属阴,温热属阳。" + }, + { + "question_num": 33, + "query": "下列各项,可用阴阳消长来解释的是", + "options": { + "A": "阳虚则寒", + "B": "阳长阴消", + "C": "寒者热之", + "D": "阴损及阳", + "E": "阴盛则阳病" + }, + "answer": "B", + "reason": "阳虚则寒、阴盛则阳病、阴损及阳为阴阳失衡后出现的病理变化。" + }, + { + "question_num": 34, + "query": "下列除哪项外,指下均有脉气紧张之感觉", + "options": { + "A": "弦", + "B": "紧", + "C": "长", + "D": "革", + "E": "牢" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 35, + "query": "下列各项,哪项不属实喘的特点", + "options": { + "A": "深吸为快", + "B": "呼出为快", + "C": "伴有表证", + "D": "痰鸣咳嗽", + "E": "脉实有力" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 36, + "query": "外科辨肿,“肿而皮肉重垂胀急,深则按之如烂棉不起,浅则光亮如水疱,破流黄水”其成因属", + "options": { + "A": "风", + "B": "虚", + "C": "火", + "D": "湿", + "E": "痰" + }, + "answer": "D", + "reason": "湿肿而皮肉重垂胀急，深则按之如烂棉不起,浅则水亮如水疱,搔破流黄水,浸淫皮肤。" + }, + { + "question_num": 37, + "query": "阴中求阳的适应证是", + "options": { + "A": "阴虚", + "B": "阳虚", + "C": "阴盛", + "D": "阳盛", + "E": "阴阳两虚" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 38, + "query": "腹胀满,无压痛,叩之作空声,可见于", + "options": { + "A": "水鼓", + "B": "气胀", + "C": "痰饮", + "D": "积聚", + "E": "内痈" + }, + "answer": "B", + "reason": "B项为腹部胀满,按之有充实感觉,有压痛,叩之做空声的,为气胀,多属虚满。" + }, + { + "question_num": 39, + "query": "确立以滋阴降火为肺痨治疗大法的医家是", + "options": { + "A": "张仲景", + "B": "华佗", + "C": "孙思邈", + "D": "朱丹溪", + "E": "葛可久" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 40, + "query": "辨溃疡,疮面呈翻花或如岩穴属", + "options": { + "A": "瘰疬溃疡", + "B": "麻风溃疡", + "C": "梅毒溃疡", + "D": "岩性溃疡", + "E": "流痰溃疡" + }, + "answer": "D", + "reason": "岩性溃疡,疮面多呈翻花如岩穴,有的在溃疡底部见有珍珠样结节，内有紫黑坏死组织,渗流血水。" + }, + { + "question_num": 41, + "query": "一年季节中,“长夏”所属的是", + "options": { + "A": "木", + "B": "火", + "C": "土", + "D": "金", + "E": "水" + }, + "answer": "C", + "reason": "A项为春,B项为夏,C项为11.C长夏，D项为秋,E项为冬。" + }, + { + "question_num": 42, + "query": "下列哪项不属于八纲辨证的内容", + "options": { + "A": "病性寒热", + "B": "病变吉凶", + "C": "邪正盛衰", + "D": "病变类别", + "E": "病变部位" + }, + "answer": "B", + "reason": "八纲辨证是根据四诊取得的材料,进行综合分析，以探求疾病的性质、病变部位、病势的轻重、机体反应的强弱、正邪双方力量的对比等情况，归纳为阴、阳、表、里、寒、热、虚、实八类证候,是中医辨证的基本方法。" + }, + { + "question_num": 43, + "query": "肺胀发病的主要病理因素是", + "options": { + "A": "气滞、血瘀、水饮", + "B": "气、水饮、痰浊", + "C": "痰浊、水饮、血瘀", + "D": "痰浊、寒邪、血瘀", + "E": "风邪、痰浊、水饮" + }, + "answer": "C", + "reason": "肺胀的病理因素主要为痰花儿即功内。" + }, + { + "question_num": 44, + "query": "中医外科内治法的总则是", + "options": { + "A": "温、托、补", + "B": "清、消、补", + "C": "清、补、托", + "D": "消、通、补", + "E": "消、托、补" + }, + "answer": "E", + "reason": "" + }, + { + "question_num": 45, + "query": "火的特性是", + "options": { + "A": "曲直", + "B": "稼穑", + "C": "从革", + "D": "炎上", + "E": "润下" + }, + "answer": "D", + "reason": "水曰润下;火曰炎上;木曰曲直;金曰从革;土爰稼穑。" + }, + { + "question_num": 46, + "query": "下列除哪项外,均是虚寒证的临床表现", + "options": { + "A": "畏寒喜暧", + "B": "口淡不渴", + "C": "脉沉而紧", + "D": "小便清长", + "E": "大便溏薄" + }, + "answer": "C", + "reason": "虚寒证表现为经常畏冷，四肢不温,嗜睡蜷卧,面色觥白,口淡不渴,或渴喜热饮,或口泛清涎,小便清长，大便溏薄或完谷不化,舌淡胖,苔白滑,脉沉迟或细弱等" + }, + { + "question_num": 47, + "query": "肺胀痰浊壅肺证的治法是", + "options": { + "A": "化痰降气,健脾益肺", + "B": "宣肺化痰,止咳定喘", + "C": "宣肺定喘,健脾益气", + "D": "健脾化痰,宣肺定喘", + "E": "健脾化痰,补土生金" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 48, + "query": "调制箍围药,取其清凉解毒作用的,应选用", + "options": { + "A": "醋", + "B": "葱", + "C": "鸡子清", + "D": "麻油", + "E": "丝瓜叶汁" + }, + "answer": "E", + "reason": "以菊花汁、丝瓜叶汁、银花露调者,取其清凉解毒，而其中用丝瓜叶汁调制的玉露散治疗暑天疖肿效果较好。" + }, + { + "question_num": 49, + "query": "下列不按五行相生顺序排列的是", + "options": { + "A": "呼、笑、歌、哭、呻", + "B": "筋、脉、肉、皮毛、骨", + "C": "青、赤、黄、白、黑", + "D": "角、徵、商、宫、羽", + "E": "酸、苦、甘、辛、咸" + }, + "answer": "D", + "reason": "五音按照相生的顺序排列应:角、徵、宫、商、羽。" + }, + { + "question_num": 50, + "query": "下列哪项不是火淫的临床表现", + "options": { + "A": "壮热口渴", + "B": "面红目赤", + "C": "烦躁不宁", + "D": "舌质红绛", + "E": "脉象濡数" + }, + "answer": "E", + "reason": "火淫的表现:壮热,口渴,面红目赤,心烦,汗出,或烦躁谵妄,衄血,吐血,斑疹,或躁扰发狂，或见痈脓,舌质红绛,脉象洪数或细数" + }, + { + "question_num": 51, + "query": "治疗心悸心阳不振证,应首选", + "options": { + "A": "温胆汤", + "B": "二陈汤", + "C": "苓桂术甘汤", + "D": "金匮肾气丸", + "E": "桂枝甘草龙骨牡蛎汤" + }, + "answer": "E", + "reason": "心悸有多种类型,心阳不振证宜温补心阳，用桂枝甘草龙骨牡蛎汤，故选E。" + }, + { + "question_num": 52, + "query": "下列切开法的注意事项中，错误的是", + "options": { + "A": "在关节部位,宜谨慎开刀,切口应越过关节", + "B": "血瘤、岩肿不宜切开", + "C": "患者体弱应先内服调补药,然后开刀", + "D": "面部疗疮,尤其是口鼻部位，忌早期开刀", + "E": "进刀时,刀头要求向上挑取,不宜向下割划" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 53, + "query": "下列关于五行生克规律的表述,正确的是", + "options": { + "A": "木为土之所胜", + "B": "木为水之子", + "C": "火为土之子", + "D": "水为火之所胜", + "E": "金为木之所胜" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 54, + "query": "情志郁结所致胸痛的表现是", + "options": { + "A": "胸背彻痛", + "B": "胸痛咳嗽", + "C": "憋闷疼痛", + "D": "胀痛走窜", + "E": "刺痛不移" + }, + "answer": "C", + "reason": "情志郁结可致肝失疏泄,气机不畅,而致两胁胀痛,胸闷,善叹息,或见急躁易怒。" + }, + { + "question_num": 55, + "query": "胸痹的病机,总属", + "options": { + "A": "气血失和", + "B": "寒热错杂", + "C": "气血两虚", + "D": "本虚标实", + "E": "上盛下虚" + }, + "answer": "D", + "reason": "胸痹主要表现为胸闷心痛病性为本虚标实,其质在气、血、阴、阳虚,其标为痰浊、血瘀、气滞、火热、寒凝等,可以二者或三者并存,或交互为患,但总属本虚标实，故选D,其余选项都不够全面，" + }, + { + "question_num": 56, + "query": "下列关于切开法切开方向的叙述,错误的是", + "options": { + "A": "一般疮疡,宜循经直开,刀头向上", + "B": "乳部宜放射形切开", + "C": "面部脓肿沿皮肤纹理切开", + "D": "手指脓肿,最好从正面切开,免伤屈伸功能", + "E": "关节附近宜用横切口" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 57, + "query": "下列各项中,属于母病及子的是", + "options": { + "A": "肺病及肾", + "B": "肝病及肾", + "C": "肺病及心", + "D": "心病及肝", + "E": "脾病及肾" + }, + "answer": "A", + "reason": "金生水,肺为母,肾为子,肺病及肾为母病及子。" + }, + { + "question_num": 58, + "query": "下列哪项是燥邪犯肺证与肺阴虚证的鉴别要点", + "options": { + "A": "有无发热恶寒", + "B": "有无胸痛咳血", + "C": "有无口干咽燥", + "D": "痰量的多少", + "E": "咯痰的难易" + }, + "answer": "A", + "reason": "二者的区别为燥邪犯肺为燥邪袭表,肺卫失宜，而见轻微发热恶寒。肺阴虚为肺阴亏损，虚热内生，以干咳无痰或痰少而黏与阴虚见症为辨证要点。" + }, + { + "question_num": 59, + "query": "治疗胸痹心血瘀阻证的代表方剂是", + "options": { + "A": "生脉饮", + "B": "瓜蒌薤白白酒汤", + "C": "血府逐瘀汤", + "D": "瓜蒸薤白半夏汤", + "E": "苏合香丸" + }, + "answer": "C", + "reason": "胸痹心血瘀阻证治宜活血化瘀,通脉止痛,方选血府逐瘀汤。" + }, + { + "question_num": 60, + "query": "下列外治法,可用于治疗白秃疮|肥疮的是", + "options": { + "A": "拔发法", + "B": "挑治法", + "C": "挂线法", + "D": "结扎法", + "E": "熏法" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 61, + "query": "下列哪项在心主血脉中起关键作用", + "options": { + "A": "心血充盈", + "B": "心气充沛", + "C": "心神安宁", + "D": "心搏如常", + "E": "脉道通利" + }, + "answer": "B", + "reason": "所谓心主血脉,是指心脏具有推动血液在脉道内运行的生理功能。在���常生理情况下，心气充足，推动血液运行的生理功能正常。" + }, + { + "question_num": 62, + "query": "饥不欲食可见于", + "options": { + "A": "胃火亢盛", + "B": "胃强脾弱", + "C": "脾胃湿热", + "D": "胃阴不足", + "E": "肝胃蕴热" + }, + "answer": "D", + "reason": "D项临床表现为胃脘隐痛国家执业医师资格考试，中医执业医师饥不欲食,口燥咽干,大便干结,或脘痞不舒,或干呕呃逆,舌红少津,脉细数。" + }, + { + "question_num": 63, + "query": "不寐实证,其病位多在", + "options": { + "A": "心、脾、肝、肾", + "B": "心、肝、小肠", + "C": "心、肝、大肠", + "D": "心、脾、肝、胃", + "E": "肝、胃、大肠" + }, + "answer": "E", + "reason": "不寐的虚证多因脾失健运肾阴不足、心胆气虚,心神失养。实证多因郁怒伤肝、宿食停滞胃肠、痰湿化热，上扰心神故实证病位在肝、胃、大肠。" + }, + { + "question_num": 64, + "query": "适用于乳漏疮口漏乳不止,脓腐已脱尽后的外治法是", + "options": { + "A": "腐蚀法", + "B": "垫棉法", + "C": "切开法", + "D": "挂线法", + "E": "结扎法" + }, + "answer": "B", + "reason": "垫棉法适用于溃疡脓出不畅有袋脓者;或创口窦道形成脓水不易排尽者;或溃疡脓腐已尽,新肉已生,但皮肉一时不能黏合者。" + }, + { + "question_num": 65, + "query": "心主神志最主要的物质基础是", + "options": { + "A": "津液", + "B": "精液", + "C": "血液", + "D": "宗气", + "E": "营气" + }, + "answer": "C", + "reason": "血液是神志活动的物质基础之一,心血充足则能化神、养神而使心神灵敏不惑" + }, + { + "question_num": 66, + "query": "阳明经证与腑证的鉴别要点是", + "options": { + "A": "有无发热", + "B": "有无汗出", + "C": "有无神志改变", + "D": "有无燥屎内结", + "E": "有无舌苔黄燥" + }, + "answer": "D", + "reason": "阳明腑证较经证为重。往往是阳明经证进一步的发展。误用发汗使津液外泄,于是肠中干燥,热与糟粕充斥肠道,结而不通,则脐腹部胀满疼痛,大便秘结。" + }, + { + "question_num": 67, + "query": "治疗狂证火盛伤阴者,应首选", + "options": { + "A": "二至丸", + "B": "六磨汤", + "C": "温胆汤", + "D": "二阴煎", + "E": "养心汤" + }, + "answer": "D", + "reason": "二阴煎滋阴降火,安神定志，用于狂证火盛伤阴证。" + }, + { + "question_num": 68, + "query": "下列哪项不是疖病的临床特点", + "options": { + "A": "好发于项后发际部、臀部", + "B": "好发于冬、春季节", + "C": "好发于消渴患者", + "D": "可发生于身体各处", + "E": "此愈彼起,日久不愈,反复发作" + }, + "answer": "B", + "reason": "疖是一种生于皮肤浅表的急性化脓性疾患,随处可生。此病多见于炎热季节,多发于发际、背部、臀部,但有因治疗或护理不当形成“蝼蛄疖”,或反复发作、日久不愈的“多发性疖病”则不易治愈,消渴病患者或脾虚便溏患者,病久后气阴双亏，容易感染邪毒，而致多发性疖病。" + }, + { + "question_num": 69, + "query": "心的主要生理功能是", + "options": { + "A": "主藏血", + "B": "主神志", + "C": "主运化", + "D": "主统血", + "E": "主疏泄" + }, + "answer": "B", + "reason": "心主血脉,心主藏神" + }, + { + "question_num": 70, + "query": "下列除哪项外，均为阳明腑实证的临床表现", + "options": { + "A": "脉沉迟而实", + "B": "日晡潮热", + "C": "身热不扬", + "D": "腹胀拒按", + "E": "大便秘结" + }, + "answer": "C", + "reason": "阳明腑实证的临床表现为日晡潮热,手足汗出,脐腹胀满疼痛,大便秘结,或腹中转矢气,甚者谵语,狂乱,不得眠,舌苔多厚黄干燥,边尖起芒刺,其至焦黑燥裂，脉沉迟而实或滑数。" + }, + { + "question_num": 71, + "query": "下列哪项与痫证发病无直接关系", + "options": { + "A": "情志失调", + "B": "饮食不节", + "C": "胎气受损", + "D": "脑部外伤", + "E": "先天因素" + }, + "answer": "C", + "reason": "胎气受损只是使得胎儿出生后存在易发痫病的可能性，与发病无直接联系，故选C" + }, + { + "question_num": 72, + "query": "下列疔疮,容易损筋伤骨的是", + "options": { + "A": "烂疔", + "B": "红丝疗", + "C": "颜面疔", + "D": "疫疔", + "E": "手足疔" + }, + "answer": "E", + "reason": "手足疔疮是指发生于手足部的急性化脓性疾病，本病若治疗失误，容易损伤筋骨,继而影响手足功能。" + }, + { + "question_num": 73, + "query": "肺主气的功能取决于", + "options": { + "A": "司呼吸", + "B": "宗气的生成", + "C": "全身气机的调节", + "D": "朝百脉", + "E": "主治节" + }, + "answer": "A", + "reason": "肺主气,主是指主持管理通过肺的呼吸，呼出体内的浊气，吸人自然界的清气,肺不断地吸清呼浊，从而维持人体新陈代谢的顺利进行" + }, + { + "question_num": 74, + "query": "下列哪项属于非感染性发热的疾病", + "options": { + "A": "肺结核", + "B": "肺炎", + "C": "急性肾盂肾炎", + "D": "伤寒", + "E": "血清病" + }, + "answer": "E", + "reason": "非感染性发热见于多种不同的疾病:①结缔组织病;②恶性肿瘤;③无菌性组织坏死;(4沙奖物:扫权神经系统疾病;⑥物理因素;⑦其他,如自主神经功能紊乱影响正常体温调节，可产生功能性发热，包括感染后发热和功能性低热。" + }, + { + "question_num": 75, + "query": "治疗痫病风痰闭阻证,应首选", + "options": { + "A": "定痫丸", + "B": "涤痰汤", + "C": "顺气导痰汤", + "D": "生铁落饮", + "E": "羚角钩藤汤" + }, + "answer": "A", + "reason": "痫病的病因病机为风火触动痰瘀内阻,蒙蔽心窍,壅塞经络，气机逆乱，元神失控。风痰闭阻者应豁痰息风，开窝定痫，用定痫丸合适。" + }, + { + "question_num": 76, + "query": "不属于痈的疾病是", + "options": { + "A": "颈痈", + "B": "脐痈", + "C": "腋痈", + "D": "锁喉痈", + "E": "委中毒" + }, + "answer": "D", + "reason": "颈痈、脐痈、腋痈、委中毒均属于痈的范畴,而锁喉痈属于发的范畴。" + }, + { + "question_num": 77, + "query": "肺主通调水道的功能主要依赖于", + "options": { + "A": "肺主一身之气", + "B": "肺司呼吸", + "C": "肺输精于皮毛", + "D": "肺朝百脉", + "E": "肺主宣发和肃降" + }, + "answer": "E", + "reason": "肺主通调水道的功能主要依赖于:①肺气宣发,调节汗液的排泄;②肺气肃降,促进水液的下行。" + }, + { + "question_num": 78, + "query": "下列除哪项外,均属急腹症", + "options": { + "A": "消化性溃疡病", + "B": "急性胰腺炎伴黄疸", + "C": "胃肠穿孔", + "D": "肠梗阻", + "E": "实质脏器破裂" + }, + "answer": "A", + "reason": "急性胰腺炎伴黄疸、胃肠穿孔、肠梗阻、实质脏器破裂属急腹症:" + }, + { + "question_num": 79, + "query": "治疗气厥虚证,应首选", + "options": { + "A": "安宫牛黄丸", + "B": "补中益气汤", + "C": "四味回阳饮", + "D": "四君子汤", + "E": "通瘀煎" + }, + "answer": "C", + "reason": "厥证病机为气机逆乱,病情危急,当及时救治，醒神回厥为首要职责,气厥为内伤七情诱发，实证用理气开郁，成证用益气回阳的四味回阳汤，血厥实证用理气活血的通瘀煎。" + }, + { + "question_num": 80, + "query": "可能发生髋关节畸形的疾病是", + "options": { + "A": "流火", + "B": "有头疽", + "C": "环跳疽", + "D": "历节风", + "E": "髂窝流注" + }, + "answer": "C", + "reason": "环跳疽愈后常见关节畸形、僵硬、不能活动,或造成关节脱位或硬,而形成残疾,其他均不易发生。" + }, + { + "question_num": 81, + "query": "下列哪项不是脾的生理功能", + "options": { + "A": "水谷的受纳和腐熟", + "B": "水谷精微的转输", + "C": "水液的吸收和转输", + "D": "脏器位置的维系", + "E": "血液的统摄" + }, + "answer": "A", + "reason": "脾的生理功能:①主运化,包括运化水谷和运化水湿;②主升清，包括将水谷精微等营养物质上输于头目和维持内脏位置的相对恒定;③主统血。水谷的受纳和腐熟为胃的功能。" + }, + { + "question_num": 82, + "query": "嘶哑样咳嗽,可见于", + "options": { + "A": "急性喉炎", + "B": "声带疾患", + "C": "百日咳", + "D": "胸膜炎", + "E": "支气管扩张" + }, + "answer": "A", + "reason": "咳嗽声音嘶哑见于声带炎喉炎、喉癌与喉返神经麻痹等。" + }, + { + "question_num": 83, + "query": "治疗胃痛饮食停滞证,应首选", + "options": { + "A": "良附丸", + "B": "理中汤", + "C": "保和丸", + "D": "小建中汤", + "E": "大建中汤" + }, + "answer": "C", + "reason": "胃病有明显的伤食史,吐不消化食物,食积中阻,故脘腹胀满,暖腐吞酸!治宜消食导滞,用保和丸,故选C" + }, + { + "question_num": 84, + "query": "下列哪项不是丹毒的临床特点", + "options": { + "A": "病起缓慢,恶寒发热", + "B": "局部皮肤掀热肿胀,迅速扩大", + "C": "局部皮肤忽然变赤", + "D": "好发于小腿部", + "E": "容易复发" + }, + "answer": "A", + "reason": "丹毒发病急骤,初起往往先有恶寒发热、头痛骨楚、胃纳不香、便秘溲赤等全身症状,好发于小腿,愈后容易复发,常反复发作。局部皮肤掀热肿胀，迅速扩大。" + }, + { + "question_num": 85, + "query": "具有“喜燥恶湿”特性的脏腑是", + "options": { + "A": "肝", + "B": "脾", + "C": "胃", + "D": "肾", + "E": "肺" + }, + "answer": "B", + "reason": "脾喜燥恶湿,否则会产生湿、痰、饮等病理产物,或发为水肿，" + }, + { + "question_num": 86, + "query": "引起吸气性呼吸困难的疾病是", + "options": { + "A": "气管肿瘤", + "B": "慢性阻塞性肺气肿", + "C": "支气管哮喘", + "D": "气胸", + "E": "大面积肺不张" + }, + "answer": "A", + "reason": "吸气性呼吸困难,其病因主要是由气管上段及咽喉部的阻塞性疾病引起如咽后脓肿、喉炎、肿瘤、异物、白喉等" + }, + { + "question_num": 87, + "query": "认为生姜为“呕家圣药”的医家是", + "options": { + "A": "张仲景", + "B": "孙思邈", + "C": "刘完素", + "D": "朱丹溪", + "E": "龚廷贤" + }, + "answer": "B", + "reason": "孙思邈推崇生姜为呕家圣药。" + }, + { + "question_num": 88, + "query": "下列各项,不属下肢丹毒防护要点的是", + "options": { + "A": "患者应卧床休息", + "B": "患者所用敷料、器械须严格消毒", + "C": "积极治疗脚湿气", + "D": "多饮开水,床边隔离", + "E": "保持患肢下垂位,以防热毒上攻" + }, + "answer": "E", + "reason": "患者应卧床休息，多饮开水,床边隔离,流火患者应抬高患肢,有皮肤黏膜破损者，应及时治疗，以免感染毒邪。因脚湿气致下肢复发性丹毒患者，应彻底治愈脚湿气。" + }, + { + "question_num": 89, + "query": "下列各项,不属于肝主疏泄功能的是", + "options": { + "A": "调畅气机", + "B": "调畅情志", + "C": "促进骨骼发育", + "D": "促进脾胃的运化", + "E": "促进血液运行" + }, + "answer": "C", + "reason": "肝主疏泄的生理功能:①调畅气机;②通利气血水;③促进脾胃的运化;④调畅情志;⑤促进和调节生殖功能。其中，最基本的生理功能是调畅气机。" + }, + { + "question_num": 90, + "query": "上消化道出血可单纯表现为呕血或黑便,也可两者兼有,这取决于", + "options": { + "A": "原发病", + "B": "出血部位", + "C": "出血量", + "D": "在胃内停留时间", + "E": "以上均非" + }, + "answer": "C", + "reason": "一般在上消化道大量出血后,均有黑便,但不一定有呕血。只有胃内积血超过300ml可以出现呕血。出血部位在幽门以下者只表现为黑便，幽门以上者常有呕血。" + }, + { + "question_num": 91, + "query": "下列哪项不是痰饮内阻证呕吐的特征", + "options": { + "A": "呕吐清水痰涎", + "B": "院门不适", + "C": "头眩心悸", + "D": "胸胁疼痛", + "E": "脉滑" + }, + "answer": "D", + "reason": "痰饮内阻证的特点,脾不运化,故脘闷不食;胃气不降,故呕吐清水痰涎水饮上犯清阳,故头眩;水气凌心,故心悸;痰饮内盛,故脉滑。但胸胁疼痛一般为气滞血瘀引起,本证无。" + }, + { + "question_num": 92, + "query": "疮口呈空腔或伴瘘管,脓水稀薄,夹有败絮样物,见于", + "options": { + "A": "瘰疬溃疡", + "B": "岩性溃疡", + "C": "附骨疽溃疡", + "D": "压疮溃疡", + "E": "梅毒溃疡" + }, + "answer": "A", + "reason": "瘰疬液化成脓的结块经切开或自行溃破后,脓液稀薄，或来有败絮样坏死组织。疮口呈潜行性空腔,创面肉色灰白:疮口皮色紫暗，久不收敛，可以形成实道空腔或伴有瘘管,其他的不能形成痰管而是形成大面积溃疡。" + }, + { + "question_num": 93, + "query": "五脏中,具有“刚脏”特性的是", + "options": { + "A": "心", + "B": "肺", + "C": "脾", + "D": "肝", + "E": "肾" + }, + "answer": "D", + "reason": "肝气主升主动,具有刚强的生理特性。" + }, + { + "question_num": 94, + "query": "下列除哪项外,常可引起肝细胞性黄疸(", + "options": { + "A": "疟疾", + "B": "急性甲型肝炎", + "C": "中毒性肝炎", + "D": "钩端螺旋体病", + "E": "肝癌" + }, + "answer": "A", + "reason": "能够导致肝细胞广泛损害的疾病均可发生黄疸,如病毒性肝炎、肝硬化:钩端螺旋体病、败血症、中毒性肝炎等" + }, + { + "question_num": 95, + "query": "指出嗜膈的基本病理改变是食道狭窄的医家是", + "options": { + "A": "张仲景", + "B": "李东垣", + "C": "朱丹溪", + "D": "张景岳", + "E": "叶天士" + }, + "answer": "E", + "reason": "叶天士在《临证指南医案》提出“脘管窄隘”,指出了喳膈的基本病理改变是食道狭窄。" + }, + { + "question_num": 96, + "query": "正确的乳房检查方法是", + "options": { + "A": "以手掌放于乳房上轻轻按压", + "B": "四指并拢,用指腹平放于乳房上轻柔按压", + "C": "以食指先触到肿物,并仔细区别与周围组织的关系", + "D": "以食指首先触摸是否有肿物存在，并注意是否活动", + "E": "以手托起乳房,用另一手仔细触摸" + }, + "answer": "B", + "reason": "先检查健侧乳房,再检查患侧，以便对比。将手指并拢平放乳房上轻轻按触,切勿用手指去抓捏，否则会将所抓捏的腺体组织错误地认为乳房肿块。以乳头为中心，将乳房分为4个象限,,依次检查内上一外上一内下→外下。继之,检查乳晕区,注意有无血性液体自乳头溢出，最后触摸腋窝、锁骨下及锁骨上区域淋巴结。" + }, + { + "question_num": 97, + "query": "肾主纳气的主要生理作用是", + "options": { + "A": "使肺之呼吸保持一定的深度", + "B": "有助于元气的固摄", + "C": "有助于精液的固摄", + "D": "有助于元气的生成", + "E": "有助于肺气的宣发" + }, + "answer": "A", + "reason": "肾主纳气,是指肾有摄取肺所吸人的清气的生理功能，所以具体表现为肺吸入的清气必须下达肾，由肾来摄纳之，才能保持呼吸运动的平稳和深度。" + }, + { + "question_num": 98, + "query": "下列哪项不属于意识障碍", + "options": { + "A": "嗜睡", + "B": "抽搐", + "C": "意识模糊", + "D": "谵妄", + "E": "昏迷" + }, + "answer": "B", + "reason": "轻度意识障碍包括意识模糊、嗜睡状态和朦胧状态。中度意识障碍包括混浊状态或精神错乱状态、谵妄状态。重度意识障碍包括昏睡状态或浅昏迷状态、昏迷状态、深昏迷状态和木僵状态，" + }, + { + "question_num": 99, + "query": "呃逆病变的关键脏腑是", + "options": { + "A": "肝", + "B": "脾", + "C": "肺", + "D": "胃", + "E": "胆" + }, + "answer": "D", + "reason": "呃逆的基本病机是胃气上逆,最关键的脏腑是胃。" + }, + { + "question_num": 100, + "query": "乳痈初起,证属肝气不舒,胃热壅潜随治应首选", + "options": { + "A": "逍遥散", + "B": "透脓散", + "C": "四妙汤", + "D": "瓜蒸牛劳汤", + "E": "牛蒡解肌汤" + }, + "answer": "D", + "reason": "情志内伤,肝气郁结,郁久化热,加之产后恣食厚味,胃内积热，以致肝胃蕴热,气血凝滞,乳络阻塞,不通则痛,故乳房肿胀疼痛有块;毒热内蕴，故患侧乳房皮肤微红;邪热内盛,正邪相争,营卫失和,治法应为晚肝疗宵，通乳消肿。万用委午劳边，故达择D。" + }, + { + "question_num": 101, + "query": "肾中精气的主要生理功能是", + "options": { + "A": "促进机体的生长发育", + "B": "促进生殖功能的成熟", + "C": "主生长发育和生殖", + "D": "化生血液的物质基础", + "E": "人体生命活动的根本" + }, + "answer": "C", + "reason": "肾中精气的盛衰决定着人的生长、发育与生殖。" + }, + { + "question_num": 102, + "query": "正常成人腋测法体温应是", + "options": { + "A": "36~37°C", + "B": "36.2~37°C", + "C": "36.2~37.2°C", + "D": "36.4~37.4°C", + "E": "36.5~37.5°C" + }, + "answer": "A", + "reason": "一般成人清晨安静状态下口腔(舌下)温度的正常值为36.3~37.2℃;腋窝温度的正常值为36.0~37.1℃;肛门温度的正常值为36.5~37.7℃" + }, + { + "question_num": 103, + "query": "呃逆与干呕、嗳气在病机上的共同点是", + "options": { + "A": "胃气上逆", + "B": "寒气上逆", + "C": "肝胃气逆", + "D": "肺胃气逆", + "E": "积热上冲" + }, + "answer": "A", + "reason": "呕吐是指胃失和降,气逆于上,迫使胃中之物从口中吐出的一种病证，无物有声谓之干呕;呃逆是指胃气上逆动膈，以气逆上冲,喉间呃呃连声,声短而频,令人不能自制为主要表现的病证;暖气乃胃气阻郁，气逆于上所致,食后多发。" + }, + { + "question_num": 104, + "query": "乳癖的特点是", + "options": { + "A": "乳块肿痛,皮色微红,按后痛甚", + "B": "乳块皮肉相连,溃破脓稀薄如痰", + "C": "乳块呈卵圆形,表面光滑,推之活动", + "D": "乳块质地较软，月经后缩小", + "E": "肿块高低不平,质硬,推之不���" + }, + "answer": "C", + "reason": "乳房内发生多个大小不一的肿块,其形态不规则,或圆或扁,质韧,分散于整个乳房,或局限在乳房的一处。与周围组织分界不清,与皮肤和筋膜无粘连,推之移动，腋下淋巴结不肿大。不发寒热，皮色不变，有时乳头溢出黄绿色、棕色或血性液。" + }, + { + "question_num": 105, + "query": "水火之宅是指", + "options": { + "A": "脾", + "B": "胃", + "C": "肾", + "D": "肝", + "E": "肺" + }, + "answer": "C", + "reason": "肾脏寄藏命门之火，为元阴、元阳之脏,故有“水火之宅”“阴阳之根”之称。" + }, + { + "question_num": 106, + "query": "蜘蛛痣罕见于下列哪个部位", + "options": { + "A": "面颊部", + "B": "手背", + "C": "前胸", + "D": "上臂", + "E": "下肢" + }, + "answer": "E", + "reason": "蜘蛛痣多出现于面部、颈部及胸部,亦有其他部位出现者,痣体有一个中心点，周围有呈辐射形的小血管分支，形态似蜘蛛。是由于体内雌激素分泌相对过多，灭活不足而引起皮肤上的小动脉及其周围分支星辐射状扩张、充血的一种表现。蜘蛛痣的基本结构为小动脉。肝硬化患者在身体上半部经常会看到此种表现，" + }, + { + "question_num": 107, + "query": "呃逆的基本治法是", + "options": { + "A": "理气化瘀降逆", + "B": "疏肝解郁降逆", + "C": "和胃降逆止呃", + "D": "健脾温中止呃", + "E": "清热和胃止呃" + }, + "answer": "C", + "reason": "呃逆一证,总由胃气上逆而成,故理气和胃,降逆止呃为基本治法。" + }, + { + "question_num": 108, + "query": "乳衄的病因是", + "options": { + "A": "心火旺", + "B": "肝火旺", + "C": "肺热上炎", + "D": "肾阴亏", + "E": "阴虚火旺" + }, + "answer": "B", + "reason": "由于情志抑郁,肝气不舒,郁而化火,灼伤血络,迫血妄行，旁走横溢而发;或由于思虑伤脾,统血无权，血流胃经，溢于乳窍而成，其只有肝郁火旺和脾不统血2个证型。" + }, + { + "question_num": 109, + "query": "有主水和纳气功能的脏是", + "options": { + "A": "肝", + "B": "心", + "C": "脾", + "D": "肺", + "E": "肾" + }, + "answer": "E", + "reason": "肾主水和纳气,故选·E。" + }, + { + "question_num": 110, + "query": "方颅可见于", + "options": { + "A": "呆小症", + "B": "先天性梅毒", + "C": "脑膜炎", + "D": "脑积水", + "E": "小儿营养不良" + }, + "answer": "B", + "reason": "呆小症：小颅同时伴有智力障碍(痴呆症)。先天性梅毒:方颅。脑积水巨颅。" + }, + { + "question_num": 111, + "query": "提出著名的“治泻九法”的医家是", + "options": { + "A": "张仲景", + "B": "陈无择", + "C": "张景岳", + "D": "李中梓", + "E": "叶天士" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 112, + "query": "乳岩的特点是", + "options": { + "A": "乳块肿痛,皮色微红,按后痛甚", + "B": "乳块皮肉相连,溃破脓稀薄", + "C": "乳块呈卵圆形,表面光滑,推之活动", + "D": "乳块质地较软，月经后缩小", + "E": "肿块高低不平,质硬,推之不动" + }, + "answer": "E", + "reason": "乳岩,多发于40~60岁的妇女,肿块多为单发，边缘不整齐,活动度差常与皮肤粘连,质地坚硬,表面高低不平,病情发展迅速,晚期患部皮肤呈典型橘皮样改变:肿块溃破后呈菜花样,时流血水，其味恶臭，同侧腋窝淋巴结肿大坚硬。" + }, + { + "question_num": 113, + "query": "下列各脏中,其生理特性以升为主的是", + "options": { + "A": "肺与脾", + "B": "肺与肝", + "C": "肝与肾", + "D": "心与肾", + "E": "肝与脾" + }, + "answer": "E", + "reason": "生理特性以升为主的脏腑是肝与脾。" + }, + { + "question_num": 114, + "query": "胸骨明显压痛或叩击痛常见的疾病是", + "options": { + "A": "上呼吸道感染", + "B": "肺炎", + "C": "慢性支气管炎", + "D": "肺结核", + "E": "白血病" + }, + "answer": "E", + "reason": "胸骨明显压痛或叩击痛常见的疾病为白血病，" + }, + { + "question_num": 115, + "query": "疫毒痢的治法是", + "options": { + "A": "清热解毒化湿", + "B": "活血解毒和胃", + "C": "凉血清热利湿", + "D": "清热利湿和胃", + "E": "清热凉血解毒" + }, + "answer": "E", + "reason": "清热凉血解毒适用于疫毒痢,故选E。" + }, + { + "question_num": 116, + "query": "在对瘿病肿块扪诊时，除对其肿块位置、数目、硬度、光滑度、活动度、界限进行检查外,���应注意的是", + "options": { + "A": "颈部活动是否受限", + "B": "颈部皮肤是否肿胀", + "C": "肿块有无震颤,气管是否移位,淋巴结是否肿大", + "D": "下颌活动是否正常", + "E": "颈静脉是否怒张" + }, + "answer": "C", + "reason": "瘿病检查时,应嘱患者端坐，双手放于两膝,显露颈部并使患者头部略为俯下,检查者坐在患者对面,观察颈部两侧是否对称,有无肿块隆起,有无血管怒张,并注意肿块的位置、大小、形态、数目、硬度、光渭度、活动度,有无压痛,边界是否清楚,肿块能否随吞咽而上下移动,有无震颤,气管位置是否受压移位,颈部淋巴结有无肿大,故选C,其他均不属于瘿病的特点。" + }, + { + "question_num": 117, + "query": "肝藏血与脾统血的共同生理功能是", + "options": { + "A": "贮藏血液", + "B": "调节血量", + "C": "统摄血液", + "D": "防止出血", + "E": "化生血液" + }, + "answer": "D", + "reason": "肝藏血与脾统血的共同生理功能是防止出血。" + }, + { + "question_num": 118, + "query": "下列哪项提示左心功能不全", + "options": { + "A": "脉搏强而大", + "B": "舒张早期奔马律", + "C": "奇脉", + "D": "脉搏过缓", + "E": "脉搏绝对不齐" + }, + "answer": "B", + "reason": "舒张早期奔马律见于器质性心脏病。" + }, + { + "question_num": 119, + "query": "治疗便秘气秘证,应首选", + "options": { + "A": "大黄附子汤", + "B": "麻子仁丸", + "C": "大承气汤", + "D": "润肠丸", + "E": "六磨汤" + }, + "answer": "E", + "reason": "便秘不外冷热虚实，气密实证用六磨汤顺气导滞、降逆通便。热秘实证用大承气汤峻下热结，或麻子仁丸泻热导滞，润肠通便。气虚便秘用黄芪汤补气健脾、润肠通便。血虚便秘用润肠丸养血润燥、滋阴通便。阳虚冷秘用大黄附子汤温阳通便。" + }, + { + "question_num": 120, + "query": "气瘿的内治法是", + "options": { + "A": "理气解郁,化痰软坚", + "B": "化痰软坚,开郁行瘀", + "C": "疏肝理气,解郁消肿", + "D": "疏风清热，化痰散结", + "E": "疏肝健脾,化痰散结" + }, + "answer": "C", + "reason": "情志不畅,肝郁气滞,肝失调达,脾失健运,水湿停留,聚而为痰,痰气互凝,结于颈靥,故颈粗瘿肿;气本无形,怒则气长,喜则气消,故肿胀呈弥漫性而边界不清，遂成本病,故首先疏肝然后消肿。" + }, + { + "question_num": 121, + "query": "与血液运行关系最密切的脏腑是", + "options": { + "A": "肝、脾、肾", + "B": "心、肝、脾", + "C": "心、肺、肾", + "D": "心、肝、肾", + "E": "肺、脾、肾" + }, + "answer": "B", + "reason": "心主血脉,心气推动和调控血液在脉管中正常运行,流注全身;肝藏血，具有贮藏血液、调节血量及防止出血的功能;脾统血,可统摄血液在脉内运行，" + }, + { + "question_num": 122, + "query": "肝硬化腹壁静脉曲张时,其血管杂音常可被闻及的部位是", + "options": { + "A": "上腹部", + "B": "下腹部", + "C": "右侧腹部", + "D": "左侧腹部", + "E": "右肋缘下" + }, + "answer": "A", + "reason": "静脉性杂音为连续的嗡鸣声或“潺潺”声,无收缩期与舒张期性质。常出现于脐周或止腹部,尤其是腹壁静脉曲张严重处。此音提示门静脉高压时的侧支循环形成。" + }, + { + "question_num": 123, + "query": "最早指出黄疽有传染性的中医文献是", + "options": { + "A": "《黄帝内经》", + "B": "《伤寒论》", + "C": "《金匮要路》", + "D": "《丹溪心法》", + "E": "《沈氏尊生书》" + }, + "answer": "E", + "reason": "《沈氏尊生书》中言“天行疫疠,以致发黄者,俗称之瘟黄，杀人最急”。对黄疸可有传染性及严重的预后转归有所认识，选项《黄帝内经》中有关于黄疽名称和主要症状的记载。《伤寒论》把黄疽分为黄疸、谷疸、酒疽、女劳疸,黑疸5种,并对黄疸的形成机制症状特点进行了探讨，创制了治疗黄疸的重要方剂一茵陈蒿汤。" + }, + { + "question_num": 124, + "query": "最早设妇科专篇的医著是", + "options": { + "A": "《黄帝内经》", + "B": "《金匮要略》", + "C": "《脉经》", + "D": "《千金要方》", + "E": "《景岳全书》" + }, + "answer": "B", + "reason": "《金匮要略》是现代中医古籍中最早设妇科专篇的医著，开创了妇科辨证论治的先河。" + }, + { + "question_num": 125, + "query": "下列关于五脏外合五体的叙述,错误的是", + "options": { + "A": "心合脉", + "B": "肝合爪", + "C": "脾合肉", + "D": "肺合皮", + "E": "肾合骨" + }, + "answer": "B", + "reason": "心合脉,脾合肉,肺合皮,肾合骨,肝合筋。" + }, + { + "question_num": 126, + "query": "下列疾病除哪项外,均可见到周围血管征", + "options": { + "A": "主动脉瓣关闭不全", + "B": "发热", + "C": "贫血", + "D": "甲亢", + "E": "主动脉瓣狭窄" + }, + "answer": "E", + "reason": "颈动脉搏动增强水冲脉、毛细血管搏动征、枪击音和Duroziez双重音等阳性体征,可统称为周围血管征阳性。主要见于主动脉瓣关闭不全、甲亢、严重贫血脉压增大的疾病。" + }, + { + "question_num": 127, + "query": "黄疸最具特征的表现是", + "options": { + "A": "面黄", + "B": "目黄", + "C": "小便黄", + "D": "恶心纳呆", + "E": "腹胀呕吐" + }, + "answer": "B", + "reason": "黄疸是以身黄、目黄、小便黄为主要临床特征的病证，可以兼见恶心纳呆,腹胀呕吐,但这些不是黄疸独有的症状,故排除DE。身黄、目黄、小便黄中,身黄也可见于脾虚痿病等,小便黄为热证表现之一，只有目黄是黄疸唯一的特征表现，" + }, + { + "question_num": 128, + "query": "下列各项,不属阴道日中医名称的是", + "options": { + "A": "廷孔", + "B": "四边", + "C": "子门", + "D": "龙门", + "E": "胞门" + }, + "answer": "C", + "reason": "子门为子宫颈口。" + }, + { + "question_num": 129, + "query": "五脏主五液,肾之液为", + "options": { + "A": "汗", + "B": "唾", + "C": "涕", + "D": "泪", + "E": "涎" + }, + "answer": "B", + "reason": "肾在液为唾,故选B。" + }, + { + "question_num": 130, + "query": "仰卧位时前腹壁与胸骨下端到耻骨联合的连线大致在同一水平面上,称为", + "options": { + "A": "腹部平坦", + "B": "腹部饱满", + "C": "腹部膨隆", + "D": "腹部低平", + "E": "腹部凹陷" + }, + "answer": "A", + "reason": "腹部平坦:正常成人仰卧时,前腹壁与自肋缘至耻骨联合的连线太致相平或略为低凹。腹部饱满:腹壁紧张度增加，常因病因不同而表现不一。由于腹内容物增加,如肠胀气或人工气腹、腹腔内积液者,触诊腹部张力增大,但无肌痉空,亦不具压痛，应称为腹部饱满。全腹膨隆:平卧时前腹壁明显隆凸于肋缘与耻骨联合的平面，称为全腹膨隆全腹凹陷:仰卧位时见前腹壁明显低于肋缘与耻骨联合的平面称腹部凹陷。" + }, + { + "question_num": 131, + "query": "下列各项,不属积聚病因的是", + "options": { + "A": "情志失调", + "B": "饮食所伤", + "C": "感受寒邪", + "D": "病后所致", + "E": "跌打损伤" + }, + "answer": "E", + "reason": "积聚是因正气亏虚,脏腑失和,气滞、血瘀、痰浊蕴结于腹,引发腹内结块,或胀或痛为主要临床特征的病证,都是内伤。跌打损伤是外伤,不属积聚病因，" + }, + { + "question_num": 132, + "query": "子处又称", + "options": { + "A": "血海", + "B": "血室", + "C": "胞络", + "D": "胞脉", + "E": "天癸" + }, + "answer": "B", + "reason": "胞宫,称子处、女子胞、子宫;子处又称血室。" + }, + { + "question_num": 133, + "query": "具有喜润恶燥特性的脏腑是", + "options": { + "A": "肝", + "B": "肺", + "C": "脾", + "D": "胃", + "E": "大肠" + }, + "answer": "D", + "reason": "脾胃在五行中属土，胃为水谷之海,多气多血,故胃性喜润恶燥" + }, + { + "question_num": 134, + "query": "下列哪项不是腹水的表现", + "options": { + "A": "蛙状腹", + "B": "移动性浊音", + "C": "波动感", + "D": "振水音", + "E": "直立时下腹饱满" + }, + "answer": "D", + "reason": "腹水出现前常有腹胀,大量腹水使腹部膨隆、腹壁绷紧发亮，状如蛙腹，患者行走困难，有时膈显著抬高，出现端坐呼吸和脐疝。直立时下腹饱满有移动性浊音和波动感。" + }, + { + "question_num": 135, + "query": "治疗鼓胀水湿困脾证,应首选", + "options": { + "A": "柴胡疏肝散合胃苓汤", + "B": "实脾饮", + "C": "中满分消丸", + "D": "调营饮", + "E": "附子理苓汤" + }, + "answer": "B", + "reason": "本证水湿困脾,故腹大胀满,按之如裹水,颜面水肿;脾不运化故胸脘胀闷;阳气不足而遇热则舒,精神困倦,怯寒懒动,小便少,大便溏,舌苔白腻,脉缓,治宜温阳健脾,行气利水,用实脾饮。" + }, + { + "question_num": 136, + "query": "与月经产生没有直接关系的脏腑是", + "options": { + "A": "肾", + "B": "肺", + "C": "胆", + "D": "脾", + "E": "胃" + }, + "answer": "C", + "reason": "心主血,肝藏血,脾统血，胃主受纳腐熟,与脾同为生化之源,肾藏精,精化血,肺主一身之气,朝百脉而输布精微。月经的产生与心、脾、胃、肾、肺有关。" + }, + { + "question_num": 137, + "query": "脏腑中有“主津”作用的是", + "options": { + "A": "脾", + "B": "胃", + "C": "大肠", + "D": "小肠", + "E": "三焦" + }, + "answer": "C", + "reason": "胃主受纳、腐熟水谷,大肠主津。" + }, + { + "question_num": 138, + "query": "下列脊椎病变,除哪项外,脊椎叩痛常为阳性", + "options": { + "A": "脊椎结核", + "B": "棘间韧带损伤", + "C": "骨折", + "D": "骨质增生", + "E": "椎间盘脱出" + }, + "answer": "D", + "reason": "在受损部位可产生叩击痛:叩击痛阳性可见于脊椎结核、骨折及椎间盘突出、棘间韧带损伤。" + }, + { + "question_num": 139, + "query": "雷头风发作的病机多是", + "options": { + "A": "风热夹痰上冲", + "B": "湿热夹痰上冲", + "C": "风热夹湿上扰", + "D": "风湿夹火上扰", + "E": "风热夹瘀上扰" + }, + "answer": "B", + "reason": "头风是头痛时发时止,有如风之去来,遇触即发。一般是痰涎风火,郁遏经络,气血壅滞所致。雷头风是头痛而起核块,或痛如雷鸣。特点是湿热夹痰，上冲脑络。风的特点不明显,故排除其他选项。" + }, + { + "question_num": 140, + "query": "主人体生殖的阴精是", + "options": { + "A": "肾精", + "B": "天癸", + "C": "月水", + "D": "水谷之精", + "E": "五脏六腑之精" + }, + "answer": "A", + "reason": "肾主生殖,肾中真阴,逐渐化生、充实,才促成胞宫有经、孕、产、育的生理功能。" + }, + { + "question_num": 141, + "query": "推动人体生长发育及脏腑功能活动的气是", + "options": { + "A": "元气", + "B": "宗气", + "C": "营气", + "D": "卫气", + "E": "中气" + }, + "answer": "A", + "reason": "元气,是人体生命活动的原动力。" + }, + { + "question_num": 142, + "query": "血白细胞总数增多,可见于", + "options": { + "A": "伤寒杆菌感染", + "B": "再生障碍性贫血", + "C": "急性失血", + "D": "使用氯霉素的影响", + "E": "脾功能亢进" + }, + "answer": "C", + "reason": "血白细胞总数增多的意义在于:①急性感染;②严重烧伤、较大手术后、维然预伤3双草度增高时,见于恶性肿瘤、白血病,尤其是慢性白血病;④急性失血;⑤急性化学药物有机磷中毒。" + }, + { + "question_num": 143, + "query": "阳明头痛的“引经药”应首选", + "options": { + "A": "葛根、白芷、知母", + "B": "羌活、川芎、蔓荆子", + "C": "柴胡、黄苓、川芎", + "D": "燕本,吴茱萸、钩藤", + "E": "细辛、白芷、羌活" + }, + "answer": "A", + "reason": "根据头痛部位的不同,参照经络循行部位选用适当的引经药，可提高疗效。太阳经常用羌活、蔓用子阳明经常用葛根、白芷、知母。少阳经常用柴胡、黄芩、川芎。太阴经常用苍术。少阴经常用杜仲、桑寄生、续断。厥阴经常用吴茱萸、燕本，" + }, + { + "question_num": 144, + "query": "下列关于生理性带下的描述,错误的是", + "options": { + "A": "色白或无色透明", + "B": "质地黏稠", + "C": "其量适中", + "D": "无特殊气味", + "E": "从阴道内排出的一种阴液" + }, + "answer": "B", + "reason": "生理性带下指润泽于阴户阴道内无色无臭、黏而不稠的液体。" + }, + { + "question_num": 145, + "query": "下列各项,在血波运行中起关键作用的是", + "options": { + "A": "心血充盈", + "B": "脉道通利", + "C": "心气充沛", + "D": "心神安宁", + "E": "心阳亢盛" + }, + "answer": "C", + "reason": "只有心气充沛,心阴与心阳协调,血液才能在脉管中正常运行,周流不息，营养全身,故选择C" + }, + { + "question_num": 146, + "query": "下列疾病,可以出现凝血时间缩短的是", + "options": { + "A": "先天性凝血酶原缺乏症", + "B": "纤维蛋白原缺乏症", + "C": "DIC早期", + "D": "血小板减少性紫癜", + "E": "严重肝病" + }, + "answer": "C", + "reason": "凝血时间缩短见于妇女口服避孕药、血栓栓塞性疾病及高凝状态等，" + }, + { + "question_num": 147, + "query": "“无痰不作眩”,出自的医著是", + "options": { + "A": "《素问·六元正纪大论》", + "B": "《金匮要略》", + "C": "《丹溪心法》", + "D": "《景岳全书》", + "E": "《医学正传》" + }, + "answer": "C", + "reason": "朱丹溪在《丹溪心法》中提出“无痰不作眩”,倡导痰火致眩学说。" + }, + { + "question_num": 148, + "query": "妊娠八九个月时,或腹中痛,痛定仍然如常者,称为", + "options": { + "A": "试胎", + "B": "弄胎", + "C": "垢胎", + "D": "盛胎", + "E": "滑胎" + }, + "answer": "A", + "reason": "A项指妊娠八九个月时或腹中痛,痛定如常者。B项指若月数已足腹痛或作或止，腰不痛。CD项指孕后仍按月行经而产子者。《本草纲目·论月水》:“有受胎之后，月月行经而产子者，是谓盛胎，俗名垢胎。”E项指凡堕胎或小产发生3次或3次以上者。" + }, + { + "question_num": 149, + "query": "在十二经脉走向中,足之三阴是", + "options": { + "A": "从脏走手", + "B": "从头走足", + "C": "从足走胸", + "D": "从足走腹", + "E": "从手走头" + }, + "answer": "D", + "reason": "足之三阳,从头走足;足之三阴，从足走腹" + }, + { + "question_num": 150, + "query": "下列检查结果中,最能反映慢性肾炎患者肾实质严重损害的是", + "options": { + "A": "尿蛋白明显增多", + "B": "尿中白细胞明显增多", + "C": "尿中红细胞明显增多", + "D": "尿中出现管型", + "E": "尿比重固定于1.010左右" + }, + "answer": "E", + "reason": "慢性肾炎晚期则出现尿比重固定1.010左右的等张尿，表明肾小管重吸收功能很差。" + }, + { + "question_num": 151, + "query": "中风的病理基础是", + "options": { + "A": "风火痰瘀", + "B": "气血逆乱", + "C": "心肝火旺", + "D": "肝阳上亢", + "E": "肝肾阴虚" + }, + "answer": "A", + "reason": "中风的病理基础是风火痰瘀这些病理原因和产物，其余选项都是病因，不是病理因素，" + }, + { + "question_num": 152, + "query": "妊娠月份已足,腹痛或作或止,腰不痛者,称为", + "options": { + "A": "临产", + "B": "盛胎", + "C": "试胎", + "D": "弄胎", + "E": "正产" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 153, + "query": "在奇经八脉中,其循环多次与手足三阳经及阳维脉交会的是", + "options": { + "A": "冲脉", + "B": "任脉", + "C": "督脉", + "D": "阴维脉", + "E": "阳跷脉" + }, + "answer": "C", + "reason": "在奇经八脉中,其循行多次与手、足三阳经及阳维脉交会的是督脉。" + }, + { + "question_num": 154, + "query": "对心肌缺血与心内膜下梗死的鉴别:最有意义的是", + "options": { + "A": "淀粉酶", + "B": "血清转氨酶", + "C": "γ-谷氨酰基转肽酶", + "D": "肌酸磷酸激酶", + "E": "血清碱性磷酸酶" + }, + "answer": "D", + "reason": "肌酸磷酸激酶有3种同工酶,其诊断敏感性和特异性均极高，分别达到100%和99%,它升高的幅度和持续的时间常用于判定梗死的范围和严重性，" + }, + { + "question_num": 155, + "query": "首见“疟疾”病名的医籍是", + "options": { + "A": "《内经》", + "B": "《金匮要略》", + "C": "《神农本草经》", + "D": "《诸病源候论》", + "E": "《瘟疫论》" + }, + "answer": "A", + "reason": "疟疾之名首见于《内经》《素问·疟论》指出疟疾的病因是“疟气”,该篇还描述了疟疾发作的典型症状。" + }, + { + "question_num": 156, + "query": "下列各项,易导致妇产科疾病发生的是", + "options": { + "A": "风、寒、湿", + "B": "风、湿、热", + "C": "寒、热、湿", + "D": "寒、暑、热", + "E": "寒、湿、燥" + }, + "answer": "C", + "reason": "六淫皆导致妇产科疾病，然妇女以血为本,寒热湿邪更易于与血相搏结而导致妇产科疾病。" + }, + { + "question_num": 157, + "query": "下列关于劳逸损伤与疾病发生关系的叙述,错误的是", + "options": { + "A": "久视伤血", + "B": "久坐伤肉", + "C": "久立伤骨", + "D": "久思伤心", + "E": "久行伤筋" + }, + "answer": "D", + "reason": "久视伤血,久卧伤气,久坐伤肉,久立伤骨,久行伤筋,是谓五劳所伤,故选D。" + }, + { + "question_num": 158, + "query": "对诊断系统性红斑狼疮最有意义的检查是", + "options": { + "A": "免疫球蛋白测定", + "B": "抗核抗体", + "C": "总补体溶血活力测定", + "D": "E玫瑰花试验", + "E": "淋巴细胞转化试验" + }, + "answer": "B", + "reason": "抗核抗体常用于弥漫性结缔组织病的诊断,尤其是抗核抗体中的抗双链(天然)DNA抗体对诊断系统性红斑狼疮有较高的特导性:抗10-1抗休对诊断名发性助炎或皮肌炎有特异性;抗Scl-70抗体对诊断硬皮病有特异性;抗Sm抗体是诊断系统性红斑狼特异性抗体，" + }, + { + "question_num": 159, + "query": "与水肿关系最为密切的脏腑是", + "options": { + "A": "肺、脾、肾", + "B": "肺、胃、肾", + "C": "心、脾、肾", + "D": "肝、脾、肾", + "E": "心、肝、肾" + }, + "answer": "A", + "reason": "水肿是由于肺失通调,脾失转输,肾失开合,膀胱气化不利，导致体内水液潴留,泛溢肌肤的一类病证。水肿与肺、脾、肾三脏关系最为密切。" + }, + { + "question_num": 160, + "query": "下列疾病,不会出现妇科血崩证的是", + "options": { + "A": "堕胎", + "B": "崩漏", + "C": "经行吐衄", + "D": "晚期产后出血", + "E": "小产" + }, + "answer": "C", + "reason": "C项是指每逢经行前后或经期,出现周期性的吐血或衄血。" + }, + { + "question_num": 161, + "query": "解表药的味多是", + "options": { + "A": "辛味", + "B": "酸味", + "C": "甘味", + "D": "苦味", + "E": "咸味" + }, + "answer": "A", + "reason": "解表药以辛温发散为主要功能,以辛味居多。" + }, + { + "question_num": 162, + "query": "反映左、右心房电激动过程的是", + "options": { + "A": "P波", + "B": "P-R间期", + "C": "QRS波群", + "D": "ST段", + "E": "T波" + }, + "answer": "A", + "reason": "P波--左右心房的去极化。QRS波--左右两心室的去极化。T波--两心室复极化。P-R间期--房室传导时间。Q-T间期--从QRS波开始到T波结束,反映心室肌除极和复极的总时间。ST段--从QRS波结束到T波开始,反映心室各部分都处于去极化状态" + }, + { + "question_num": 163, + "query": "以小腹胀满疼痛,小便涩滞淋沥不尽为特征的病证是", + "options": { + "A": "热淋", + "B": "血淋", + "C": "石淋", + "D": "气淋", + "E": "劳淋" + }, + "answer": "D", + "reason": "气淋以小腹胀满疼痛为特点。" + }, + { + "question_num": 164, + "query": "下列月经病的治疗,错误的是", + "options": { + "A": "重在治本调经", + "B": "分清先病和后病", + "C": "急则治标,缓则治本", + "D": "顺应不同年龄阶段论治", + "E": "多用辛温暖官之品" + }, + "answer": "E", + "reason": "月经病的3条治疗原则是重在治本调经,分清先病和后病,急则治标,缓则治本。治疗月经病又要顺应和掌握的规律:一是顺应月经周期中阴阳气血的变化规律;二是顺应不同年龄阶段论治的规律;三是掌握虑实补泻规律。" + }, + { + "question_num": 165, + "query": "归经的理论基础是", + "options": { + "A": "阴阳学说", + "B": "五行学说", + "C": "运气学说", + "D": "整体观念", + "E": "脏腑经络理论" + }, + "answer": "E", + "reason": "归经的理论基础是脏腑经络理论。" + }, + { + "question_num": 166, + "query": "对腹部实质性脏器病变,最简便易行的检查方法是", + "options": { + "A": "X线摄片", + "B": "CT扫描", + "C": "同位素扫描", + "D": "B型超声波检查", + "E": "纤维内镜检查" + }, + "answer": "D", + "reason": "B型超声波检查可用于对肝脏、胆爽、胰腺、肾脏、膀胱等脏器病变的诊断,在妇产科常规用于肿瘤等疾病的诊断与鉴别诊断以及胎儿先天性疾病等的产前诊断，" + }, + { + "question_num": 167, + "query": "十二经脉的命名,主要包含了下列哪些内容", + "options": { + "A": "阴阳、五行、脏腑", + "B": "五行、手足、阴阳", + "C": "手足、阴阳、脏腑", + "D": "脏腑、手足、五行", + "E": "以上均非" + }, + "answer": "C", + "reason": "十二经脉的名称是古人根据阴阳消长所衍化的三阴三阳,结合经脉循行于上肢和下肢的特点，以及与脏腑相属络的关系而定的,故十二经脉的命名主要包含了手足、阴阳、脏腑。" + }, + { + "question_num": 168, + "query": "清经散的组成是", + "options": { + "A": "牡丹皮、赤芍、地骨皮、黄芩、黄柏、茯苓、生地黄", + "B": "牡丹皮、地骨皮、青蒿、黄柏、茯苓、黄芩、麦门冬", + "C": "牡丹皮、青蒿、黄芩、黄柏、茯苓、赤芍、地骨皮", + "D": "牡丹皮、地骨皮、白芍、熟地黄、青蒿、黄柏、茯苓", + "E": "牡丹皮、地榆、白芍、生地黄、黄柏、茯苓、青蒿" + }, + "answer": "D", + "reason": "清经散的药物组成为熟地黄、地骨皮、牡丹皮、白芍、青、黄柏:茯苓。" + }, + { + "question_num": 169, + "query": "干姜配伍附子,可降低附子的毒性,属于", + "options": { + "A": "相须", + "B": "相使", + "C": "相畏", + "D": "相杀", + "E": "相反" + }, + "answer": "D", + "reason": "中药���七情”配伍理论:单行、相须、相使、相畏、相杀、相恶、相反。相杀指一种药物能减轻或消除另一种药物的毒性" + }, + { + "question_num": 170, + "query": "气管向患侧移位,可见于", + "options": { + "A": "胸腔积液", + "B": "气胸", + "C": "肺气肿", + "D": "肺不张", + "E": "肺实变" + }, + "answer": "D", + "reason": "肺不张的X线间接征象①叶间裂向不张的患侧移位;②肺门影缩小和消失，向不张的患侧移位,或与肺不张的致密影融合;③纵隔、心脏、气管向患侧移位,有时健侧的肺组织移向患侧;④病变邻近的肺组织生膨胀，病发侧使腐才尚，胸外循刀间隙变窄。" + }, + { + "question_num": 171, + "query": "足三阴经从起始部至内踝上8寸段的分布是", + "options": { + "A": "厥阴在前,太阴在中,少阴在后", + "B": "厥阴在前,少阴在中,太阴在后", + "C": "少阴在前,太阴在中,厥阴在后", + "D": "太阴在前,厥阴在中,少阴在后", + "E": "太阴在前,少阴在中,厥阴在后" + }, + "answer": "A", + "reason": "足三阴经在足内踝上8寸以下为厥阴在前、太阴在中、少阴在后,至内踝上8寸以上，太阴经交出厥阴之前,故选A。" + }, + { + "question_num": 172, + "query": "治疗月经先期阳盛血热证，应首选", + "options": { + "A": "清经散", + "B": "逍遥散", + "C": "当归芍药散", + "D": "导赤散", + "E": "柴胡疏肝散" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 173, + "query": "下列各组药物中,不属于配伍禁忌的是", + "options": { + "A": "川贝母与川乌", + "B": "藜芦与赤芍", + "C": "肉桂与赤石脂", + "D": "水银与砒霜", + "E": "硫黄与厚朴" + }, + "answer": "E", + "reason": "硫黄与矿物药朴硝禁忌,而不是与皮类药厚朴禁忌。" + }, + { + "question_num": 174, + "query": "肺结核早期诊断最主要的办法是", + "options": { + "A": "痰结核菌检查", + "B": "X线检查", + "C": "结核菌素试验", + "D": "红细胞沉降率", + "E": "白细胞计数和分类" + }, + "answer": "B", + "reason": "X线对各类结核病变的透过度不同,通过X线检查大致能估计结核病灶的病理性质,并能早期发现肺结核，以及判断病情发展及治疗效果，有助于决定治疗方案必须指出,不同病因引起的肺内病变,可能呈现相似的X线影像,故亦不能仅凭X线检查轻易确定肺结核的诊断，" + }, + { + "question_num": 175, + "query": "三焦经在上肢的循行部位是", + "options": { + "A": "外侧前缘", + "B": "内侧中线", + "C": "外侧后缘", + "D": "内侧前缘", + "E": "外侧中线" + }, + "answer": "E", + "reason": "" + }, + { + "question_num": 176, + "query": "大补元煎的组成是", + "options": { + "A": "人参、熟地黄、山药、山萸肉、菟丝子、炙甘草、远志、五味子", + "B": "人参、熟地黄、山药、山茱萸:枸杞子、炙甘草、杜仲、当归", + "C": "人参、熟地黄、黄芪、白术、茯神、远志酸枣仁、当归", + "D": "人参、熟地黄、黄芪、白术、茯苓、甘草、白芍、当归", + "E": "人参、熟地黄、黄芪、白术、陈皮、柴胡、升麻、当归" + }, + "answer": "B", + "reason": "大补元煎的组成:人参、山药(炒)、熟地黄、杜仲、当归、山茱萸(如畏酸吞酸者去之)、枸杞子、炙甘草。" + }, + { + "question_num": 177, + "query": "“十九畏”中,人参“畏”的是", + "options": { + "A": "三棱", + "B": "朴硝", + "C": "硫黄", + "D": "五灵脂", + "E": "密陀僧" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 178, + "query": "下列关于胸肺部X线检查临:床应用的叙述,错误的是", + "options": { + "A": "诊断呼吸系统疾病", + "B": "检测呼吸功能", + "C": "防癌", + "D": "防痨", + "E": "防职业病" + }, + "answer": "B", + "reason": "胸肺部X线检查可以诊断出肺炎、肿瘤、硅肺、肺结核、肺肿等等,所以能用于诊断呼吸系统疾病、防癌、防职业病。" + }, + { + "question_num": 179, + "query": "经络系统中，具有维持人体正常运动功能的是", + "options": { + "A": "十二经脉", + "B": "十五络脉", + "C": "十二经别", + "D": "十二经筋", + "E": "十二皮部" + }, + "answer": "D", + "reason": "十二经筋具有约束骨骼,屈伸关节,维持人体正常运动功能的作用。" + }, + { + "question_num": 180, + "query": "与月经后期和月经过少的发病均有关的是", + "options": { + "A": "血热", + "B": "血虚", + "C": "血瘀", + "D": "血寒", + "E": "湿热" + }, + "answer": "B", + "reason": "月经后期的病因为肾虚、血虚、血寒、气滞。月经过少的病因为肾、血虚、血瘀、痰湿,故血虚为共同病因。" + }, + { + "question_num": 181, + "query": "龟甲人汤剂应当", + "options": { + "A": "包煎", + "B": "先煎", + "C": "后下", + "D": "另煎", + "E": "烊化" + }, + "answer": "B", + "reason": "煎煮方法需要特殊处理的有矿石类、贝壳类、动物甲壳类、某些有毒中药需先煎;龟甲属于动物甲壳类,质地坚硬,有效成分不易煎出，入汤剂宜先煎。" + }, + { + "question_num": 182, + "query": "对脾大与腹腔肿块的鉴别,最有意义的是", + "options": { + "A": "质地", + "B": "活动度", + "C": "有无压痛", + "D": "有无切迹", + "E": "叩诊音的差异" + }, + "answer": "D", + "reason": "脾脏肿大与腹腔肿块的鉴别最有意义的是有无切迹" + }, + { + "question_num": 183, + "query": "手三阳经的走向为", + "options": { + "A": "从头走足", + "B": "从足走腹", + "C": "从胸走手", + "D": "从手走头", + "E": "从手走足" + }, + "answer": "D", + "reason": "手三阴经从胸走手,手三阳经从手走头，足三阳经从头走足，足三阴经从足走胸腹,故选D" + }, + { + "question_num": 184, + "query": "月经先后不定期的主要发病机制是", + "options": { + "A": "肝郁气滞,疏泄失调", + "B": "肾气不足,封藏失职", + "C": "脾气虚弱,统摄无权", + "D": "湿热下注,任带不固", + "E": "气血失调,血海蓄溢失常" + }, + "answer": "E", + "reason": "月经先后不定期的主要发病机制是肝肾功能失调，冲任功能系乱，血海昔溢失常。" + }, + { + "question_num": 185, + "query": "麻黄具有的功效是", + "options": { + "A": "解鱼蟹毒", + "B": "平喘利水", + "C": "祛风胜湿", + "D": "行气宽中", + "E": "温经通阳" + }, + "answer": "B", + "reason": "麻黄发汗解表,宣肺平喘利水消肿。" + }, + { + "question_num": 186, + "query": "下列除哪项外,均是采录主诉所要求的内容", + "options": { + "A": "主诉是迫使患者就医的最主要的症状", + "B": "一般不超过20个字", + "C": "确切的主诉常可作为诊断的向导", + "D": "主诉的记录,尽量使用诊断术语", + "E": "症状不突出者,可把就医的主要目的作为主诉" + }, + "answer": "D", + "reason": "主诉应记录患者就诊的主要原因及其发生的时间，其原因通常为患者自诉的主要(成悬癌苦)症快及甘性质因此能是“尽量使用诊断性术语”。为了使主要原因症状突出、扼要,要求字数精炼简洁;症状不突出者,可把就医主要目的作为主诉。疾病的诊断通常依据其症状、体征和辅助检查结果，所以,确切的主诉可作为诊断的向导。" + }, + { + "question_num": 187, + "query": "十二经之海是指", + "options": { + "A": "督脉", + "B": "任脉", + "C": "冲脉", + "D": "带脉", + "E": "阴维脉" + }, + "answer": "C", + "reason": "A项督脉调节全身阳经经气,称“阳脉之海”故排除。B项任脉调节全身阴经经气,称“阴脉之海”,故排除。C项冲脉含蓄十二经气血,称“十二经之海”或“血海”,故选C" + }, + { + "question_num": 188, + "query": "下列除哪项外,均属月经过少血虚证的临床表现", + "options": { + "A": "月经量少,色淡无块", + "B": "胸闷泛恶,纳呆", + "C": "头晕眼花", + "D": "舌淡红", + "E": "脉细" + }, + "answer": "B", + "reason": "B项是痰湿致病的特点。" + }, + { + "question_num": 189, + "query": "下列解表药中兼有化湿和中的功效的是", + "options": { + "A": "紫苏", + "B": "香薷", + "C": "生姜", + "D": "白芷", + "E": "防风" + }, + "answer": "B", + "reason": "香薷发汗解表,化湿和中,利水消肿。" + }, + { + "question_num": 190, + "query": "下列除哪项外,均属于现病史的内容", + "options": { + "A": "起病情况", + "B": "主要症状及伴随症状", + "C": "诊疗经过", + "D": "病程中的一般情况", + "E": "家族成员患同样疾病的情况" + }, + "answer": "E", + "reason": "现病史的内容主要:①起病国家执业医师资格考试，中医执业医师时间、缓急,可能的病因和诱因(必要时包括起病前的一些情况);②主要症状(或体征)出现的时间、部位、性质、程度及其演变过程;③伴随症状的特点及变化，对具有监别诊断意义的重要阳性和阴性症状(或体征)亦应加以说明;④对患有与本病有关的慢性病者或旧病复发者,应着重了解其初发时的情况和重大变化以及���近复发的情况;⑤发病以来曾在何处做何种诊疗(包括诊疗日期，检查结果，用药名称及其剂量、用法,手术方式,疗效等);⑥与本科疾病无关的未愈仍需诊治的其他科重要伤病，应另段叙述;⑦发病以来的一般情况,如精神、食欲、食量、睡眠、大小便、体力和体重的变化等。" + }, + { + "question_num": 191, + "query": "起于足跟内侧的经脉是", + "options": { + "A": "阳跷脉", + "B": "阴跷脉", + "C": "阴维脉", + "D": "阳维脉", + "E": "冲脉" + }, + "answer": "B", + "reason": "B项阴跷脉起于足跟内侧" + }, + { + "question_num": 192, + "query": "经期延长阴虚血热证的发病机制是", + "options": { + "A": "阴虚失守,冲任不固", + "B": "肝郁气滞,疏泄失常", + "C": "肾阴不足,封藏失职", + "D": "阴虚内热,热扰冲任", + "E": "湿热下注,血热妄行" + }, + "answer": "D", + "reason": "经期延长阴虚血热证的发病机制是阴虚内热，热扰冲任。" + }, + { + "question_num": 193, + "query": "下列药物中,长于清利头目的是", + "options": { + "A": "葛根", + "B": "柴胡", + "C": "升麻", + "D": "蔓荆子", + "E": "淡豆豉" + }, + "answer": "D", + "reason": "芟荆子长于清利头目,故选D。" + }, + { + "question_num": 194, + "query": "对急性支气管炎与流行性感冒的鉴别，最有意义的是", + "options": { + "A": "发热", + "B": "咳痰", + "C": "肺部啰音", + "D": "白细胞计数", + "E": "流行病学史" + }, + "answer": "E", + "reason": "发热，咳痰等为急性支气管炎和流行性感冒都可具有的临床表现，急性支气管炎和流行性感冒若无合并并发症的话基本没有肺部啰音，" + }, + { + "question_num": 195, + "query": "外邪由皮毛传人脏腑的途径,依次是", + "options": { + "A": "络脉→孙脉→经脉", + "B": "孙脉→经脉→络脉", + "C": "经脉-孙脉→>络脉", + "D": "络脉→>经脉->孙脉", + "E": "孙脉一>" + }, + "answer": "E", + "reason": "外邪侵犯人体由表及里,先从皮毛开始，卫气充实于络脉,络脉散布于全身,密布于皮部,当外邪侵犯机体时,卫气首当其冲发挥其抗御外邪、保卫机体的屏障作用人体最小的是孙脉,其次是络脉,最大的是经脉,故外邪由皮毛传人脏腑的途径依次为孙脉->络脉→经脉。" + }, + { + "question_num": 196, + "query": "下列哪项不是经期延长阴虚血热证的主症", + "options": { + "A": "月经持续八九日,量少、色红、质稠", + "B": "小腹疼痛拒按", + "C": "咽干口燥", + "D": "手足心热", + "E": "舌红少苔,脉细数" + }, + "answer": "B", + "reason": "经期延长阴虚血热证是虚证,B项是实证表现,故选B,其余皆是。" + }, + { + "question_num": 197, + "query": "治疗外感风热,发热,微恶寒,头痛,咽喉肿痛,兼胸闷胁肋胀痛,应首选", + "options": { + "A": "升麻", + "B": "薄荷", + "C": "葛根", + "D": "蝉蜕", + "E": "牛蒡子" + }, + "answer": "B", + "reason": "患者外感风热,发热,微恶寒,治宜疏散风热。有头痛，治宜清利头目，咽喉肿痛,治宜清热利咽。胸闷胁肋胀痛，治宜疏肝行气。薄荷疏散风热，清利头目，利咽透疹,疏肝行气，" + }, + { + "question_num": 198, + "query": "肺心病肺动脉高压形成的主要原因是", + "options": { + "A": "肺细小动脉痉挛", + "B": "肺血管玻璃样改变", + "C": "血容量增加", + "D": "右心室肥大", + "E": "左心衰竭" + }, + "answer": "A", + "reason": "肺心病最常见的病因是COPD,COPD可引起缺氧，缺氧又可导致肺部细小动脉痉挛，促使肺血管构型改建，肺小动脉中膜增生肥厚,导致肺部循环阻为升高，使肺动脉压升高,最终导致右心室肥大、扩张，其中,肺细小动脉痉蛮起了关键性作用。" + }, + { + "question_num": 199, + "query": "脾之大络,名为", + "options": { + "A": "天池", + "B": "俞府", + "C": "鸠尾", + "D": "大包", + "E": "虚里" + }, + "answer": "D", + "reason": "鸠尾是任脉的络穴，大包是脾之大络。" + }, + { + "question_num": 200, + "query": "治疗经期出血肾阴虚证,应首选", + "options": { + "A": "清肝止淋汤", + "B": "左归丸", + "C": "两地汤合二至丸", + "D": "逐瘀止血汤", + "E": "调肝汤" + }, + "answer": "C", + "reason": "治疗经间期出血肾阴虚证,应首选两地汤合二至丸。" + }, + { + "question_num": 201, + "query": "治疗热病伤津,烦热口渴,呕逆时作舌燥少津者,应首选", + "options": { + "A": "石膏", + "B": "知母", + "C": "天花粉", + "D": "芦根", + "E": "栀子" + }, + "answer": "D", + "reason": "针对本题所述症状,应选择兼具清热泻火、生津止渴、除烦止呕功效的药物,芦根清热泻火、生津止渴,除烦止呕、利尿。" + }, + { + "question_num": 202, + "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最早出现和最重要的症状。" + }, + { + "question_num": 203, + "query": "脾经的郄穴是", + "options": { + "A": "外丘", + "B": "梁丘", + "C": "中都", + "D": "地机", + "E": "金门" + }, + "answer": "D", + "reason": "外丘是胆经的都穴,梁丘是胃经的郄穴，中都是肝经的郄穴，地机是脾经的都穴，金门是膀胱经的都穴，" + }, + { + "question_num": 204, + "query": "下列哪项是固本止崩汤的组成药物", + "options": { + "A": "人参、黄芪、白术、熟地黄、当归、干姜", + "B": "人参、黄芪、白术,熟地黄、当归、生姜", + "C": "人参、黄芪、白术、生地黄、当归、干姜", + "D": "人参、黄芪、白术、熟地黄、当归、黑姜", + "E": "人参、黄芪、白术、生地黄、当归、黑姜" + }, + "answer": "D", + "reason": "固本止崩汤由熟地、白术,黄芪、当归、黑姜、人参组成。" + }, + { + "question_num": 205, + "query": "黄苓具有而黄柏不具有的功效是", + "options": { + "A": "燥湿", + "B": "泻火", + "C": "解毒", + "D": "清肺热", + "E": "退虚热" + }, + "answer": "D", + "reason": "黄芩、黄连、黄柏三药均能清热燥湿，泻火解毒，常用于多种湿热与热毒病证。但黄芩善清上焦热邪，并善清肺热，用于肺热咳嗽证,兼能凉血、止血、清热安胎，可用于血热出血与胎动不安等证，" + }, + { + "question_num": 206, + "query": "风心病最常见的并发症是", + "options": { + "A": "呼吸道感染", + "B": "心力衰竭", + "C": "心律不齐", + "D": "亚急性感染性心内膜炎", + "E": "栓塞" + }, + "answer": "B", + "reason": "风心病是指由于风湿热活动,累及心脏瓣膜而造成的心脏病变。患病初期常常无明显症状，后期则表现为心慌气短乏力、咳嗽、肢体水肿、咳粉红色泡沫痰,直至心力衰竭而死亡" + }, + { + "question_num": 207, + "query": "膀胱经的合穴是", + "options": { + "A": "上巨虚", + "B": "下巨虚", + "C": "足三里", + "D": "委阳", + "E": "委中" + }, + "answer": "E", + "reason": "" + }, + { + "question_num": 208, + "query": "崩漏的治疗原则是", + "options": { + "A": "塞流与澄源结合", + "B": "澄源与复旧结合", + "C": "复旧与塞流结合", + "D": "固本与澄源结合", + "E": "急则治标,缓则治本" + }, + "answer": "E", + "reason": "治崩三法是“塞流”“澄源”复旧”。这3条要灵活运用,急则治标,缓则治本。" + }, + { + "question_num": 209, + "query": "治疗咽喉红肿疼痛,兼有肺热咳嗽痰多者,应首选", + "options": { + "A": "射干", + "B": "鱼腥草", + "C": "马勃", + "D": "板蓝根", + "E": "山豆根" + }, + "answer": "A", + "reason": "“咽喉红肿疼痛”治宜利咽“肺热咳嗽痰多”治宜清肺热止咳化痰。射干清热解毒,消痰,利咽,故选A。" + }, + { + "question_num": 210, + "query": "下列哪项不是自发性心绞痛的特点", + "options": { + "A": "休息或夜间发作", + "B": "可持续15~30分钟", + "C": "含服硝酸甘油片不易缓解", + "D": "心电图出现异常Q波", + "E": "血清酶一般正常" + }, + "answer": "D", + "reason": "自发性心绞痛可于非体力活动时发作,病情加重则含服硝酸甘油不缓解,持续时间较稳定型心绞痛长，但血清酶一般正常,此点与心肌梗死区别。" + }, + { + "question_num": 211, + "query": "髀枢至膝中的骨度分寸是", + "options": { + "A": "14寸", + "B": "15寸", + "C": "16寸", + "D": "18寸", + "E": "19寸" + }, + "answer": "E", + "reason": "髀枢至膝中,即股骨大转子至明楷纹，其骨度分十具19北" + }, + { + "question_num": 212, + "query": "崩漏的主要病机是", + "options": { + "A": "阴虚欠旺,经血失约", + "B": "气虚不摄,经血失约", + "C": "瘀血内阻,血不归经", + "D": "冲任损伤,经血失约", + "E": "阳盛血热,迫血妄行" + }, + "answer": "D", + "reason": "崩漏的主要病机是冲任不固,不能制约经血,使子官藏泻失常。" + }, + { + "question_num": 213, + "query": "具有凉血解毒功效的药物是", + "options": { + "A": "大黄", + "B": "芒硝", + "C": "芦荟", + "D": "火麻仁", + "E": "桃仁" + }, + "answer": "A", + "reason": "大黄、芒硝、芦荟、火麻仁、桃仁均有泻下或润下的功效，大黄兼能清热凉血解毒。" + }, + { + "question_num": 214, + "query": "萎缩性胃炎，胃黏膜的病理改变是", + "options": { + "A": "充血,水肿", + "B": "糜烂，出血", + "C": "肥厚,粗糙", + "D": "灰暗,变薄", + "E": "渗出" + }, + "answer": "D", + "reason": "萎缩性胃炎的胃黏膜表面反复受到损害后导致黏膜固有腺体萎缩，甚至消失,故胃黏膜有不同程度的变薄,颜色灰暗，" + }, + { + "question_num": 215, + "query": "下列经脉循行除哪项外,都经过心", + "options": { + "A": "手厥阴经", + "B": "手少阳经", + "C": "手太阳经", + "D": "手阳明经", + "E": "足少阴经" + }, + "answer": "D", + "reason": "手厥阴心经起于心中;手少阳三焦经经脉散络于心包;手太阳小肠经交会于大椎,向下进人缺盆部,联络心脏;足少阴肾经其支脉从肺出来络心,注入胸中，只有手阳明大肠经未经过心。" + }, + { + "question_num": 216, + "query": "下列哪项不是闭经与痛经的共同病机", + "options": { + "A": "气血虚弱", + "B": "气滞血瘀", + "C": "肺肾阴虚", + "D": "肝肾不足", + "E": "寒凝血瘀" + }, + "answer": "C", + "reason": "闭经的病因有气血虚弱、气滞血瘀、肾气亏虚、阴虚血燥、痰湿阻滞、寒凝血瘀。痛经的病因有气滞血瘀、寒凝血瘀、湿热瘀阻、气血虚弱、肾气亏损。" + }, + { + "question_num": 217, + "query": "既能泻下逐水,又能去积杀虫的药物是", + "options": { + "A": "槟榔", + "B": "甘遂", + "C": "使君子", + "D": "牵牛子", + "E": "京大戟" + }, + "answer": "D", + "reason": "牵牛子泻下逐水,去积杀虫,故选D。" + }, + { + "question_num": 218, + "query": "肝硬化出血倾向的主要原因是", + "options": { + "A": "维生素缺乏", + "B": "血小板功能不良", + "C": "凝血因子减少", + "D": "毛细血管脆性增加", + "E": "肝脏解毒功能下降" + }, + "answer": "C", + "reason": "肝硬化出血倾向的原因按照由主到次:①凝血因子生成减少;②血小板数量减少及功能异常;③抗凝物质增多;④纤维蛋白溶解增加;⑤血管损伤;⑥弥散性血管内凝血。" + }, + { + "question_num": 219, + "query": "迎香穴位于", + "options": { + "A": "鼻孔外缘,旁开0.5寸", + "B": "鼻翼外缘,旁开0.5寸", + "C": "鼻翼外缘中点,旁开0.5寸", + "D": "鼻翼上缘中点,旁开0.5寸", + "E": "平鼻孔,当鼻唇沟中" + }, + "answer": "C", + "reason": "迎香穴位于鼻翼外缘中点旁,旁开0.5寸,当鼻唇沟中。" + }, + { + "question_num": 220, + "query": "闭经虚证的发病机制是", + "options": { + "A": "多产房劳或久病伤肾", + "B": "血海空虚,无血可下", + "C": "脾胃虚弱,化源不足", + "D": "思虑过度,损伤心脾", + "E": "素体阴虚或久病伤血" + }, + "answer": "B", + "reason": "闭经虚证主要是因为肾气不足,或肝肾亏损,或脾胃虚弱,或阴虚血燥,导致精亏血少,冲任血海空虚,源断其流,无血可下。" + }, + { + "question_num": 221, + "query": "独活具有的功效是", + "options": { + "A": "活血", + "B": "行气", + "C": "化痰", + "D": "泻下", + "E": "解表" + }, + "answer": "E", + "reason": "独活能够祛风湿、止痛、解表,故选E。" + }, + { + "question_num": 222, + "query": "慢性肾小球肾炎的主要发病机制是", + "options": { + "A": "链球菌感染", + "B": "病毒感染", + "C": "感染后免疫损害", + "D": "毛细血管脆性增加", + "E": "肝脏解毒功能下降" + }, + "answer": "C", + "reason": "各种不同病理类型的慢性肾炎的发病机制起始因素多，为免疫介导炎症反应,故选C。" + }, + { + "question_num": 223, + "query": "循行于腹中线旁开2寸,胸中线旁开4寸的经脉是", + "options": { + "A": "手太阴肺经", + "B": "足阳明胃经", + "C": "足少阴肾经", + "D": "足太阴脾经", + "E": "足厥阴肝经" + }, + "answer": "B", + "reason": "循行于腹中线旁开2寸,胸中线旁开4寸的经脉是足阳明胃经。" + }, + { + "question_num": 224, + "query": "痛经之所以随月经周期而发作，与下列哪项有关", + "options": { + "A": "寒凝胞中", + "B": "经期胞中血虚邪盛", + "C": "经期冲任气血变化急骤", + "D": "冲任血虚、胞宫失养", + "E": "湿热蕴结胞中" + }, + "answer": "C", + "reason": "痛经之所以随月经周期而发作,又与经期及经期前后特殊生理状态有关,未行经期间,由于冲任气血平和,致病因素尚不足以引起冲任、子宫气血瘀滞或不足，故平时不发生疼痛。经期前后，血海由满盈而泻溢,气血盛实而骤虚,子宫、冲任气血变化较平时急剧,易受致病因素干扰，加之体质因素的影响,导致子宫、冲任气血运行不畅或失于煦濡,不通或不荣而痛。" + }, + { + "question_num": 225, + "query": "具有燥湿健脾,祛风湿,发汗,明目功效的药物是", + "options": { + "A": "苍术", + "B": "厚朴", + "C": "藿香", + "D": "佩兰", + "E": "砂仁" + }, + "answer": "A", + "reason": "苍术燥湿健脾,祛风湿,发汗,明目。" + }, + { + "question_num": 226, + "query": "治疗慢性再生障碍性贫血应首选", + "options": { + "A": "叶酸", + "B": "维生素B₁₂", + "C": "硫酸亚铁", + "D": "雄激素", + "E": "白消安" + }, + "answer": "D", + "reason": "雄激素为再生障碍性贫血的首选用药。" + }, + { + "question_num": 227, + "query": "下列穴位与关元相平的是", + "options": { + "A": "归来", + "B": "大赫", + "C": "大横", + "D": "外陵", + "E": "水道" + }, + "answer": "E", + "reason": "水道穴的定位:在下腹部当脐中下3寸，距脐正中线2寸，与关元穴相平,故选E,归来穴在脐中下4寸,与中极穴相平,故排除A。" + }, + { + "question_num": 228, + "query": "治疗痛经湿热下注证,应首选", + "options": { + "A": "清热调血汤", + "B": "龙胆泻肝汤", + "C": "知柏地黄汤", + "D": "血府逐瘀汤", + "E": "加味逍遥散" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 229, + "query": "泽泻具有的功效是", + "options": { + "A": "泄热", + "B": "清肝", + "C": "健脾", + "D": "清肺", + "E": "解暑" + }, + "answer": "A", + "reason": "泽泻是利水消肿药,除利水消肿外,还能渗湿，泄热。" + }, + { + "question_num": 230, + "query": "粒细胞缺乏症可出现的临床表现是", + "options": { + "A": "进行性贫血", + "B": "皮肤、鼻腔等处发生坏死性溃疡", + "C": "皮肤、黏膜出血", + "D": "频繁性呕吐", + "E": "胸骨压痛" + }, + "answer": "B", + "reason": "粒细胞缺乏症体检时可见员疡及脓肿,有肝脾大及淋巴结增大，颌下和颈淋巴结尤其明显。" + }, + { + "question_num": 231, + "query": "下列哪项不属足太阴经的主治范围", + "options": { + "A": "妇科病", + "B": "口舌痛", + "C": "前阴病", + "D": "胸胁痛", + "E": "脾胃病" + }, + "answer": "B", + "reason": "足太阴脾经腧穴主治脾胃病、妇科病、前阴病和经脉循行部位的其他痛证如下肢痿痹、胸胁痛等" + }, + { + "question_num": 232, + "query": "痛经寒湿凝滞证的治法是", + "options": { + "A": "理气化瘀止痛", + "B": "温经暖宫止痛", + "C": "温经活血，调经止痛", + "D": "温经除湿,调经止痛", + "E": "温经化痰,利湿止痛" + }, + "answer": "D", + "reason": "痛经寒湿凝滞证的治法是温经除湿,化瘀止痛,使寒散湿除,气血运行通畅,而痛经自止。" + }, + { + "question_num": 233, + "query": "具有散寒止痛,疏肝下气,燥湿,助阳止泻功效的药物是", + "options": { + "A": "附子", + "B": "肉桂", + "C": "千姜", + "D": "吴茱萸", + "E": "高良姜" + }, + "answer": "D", + "reason": "吴茱萸散寒止痛,疏肝下气,燥湿,助阳止泻;高良姜散寒止痛、温中止呕，" + }, + { + "question_num": 234, + "query": "下列关于感染过程的描述,错误的是", + "options": { + "A": "病原体与人体相互作用,相互斗争的过程称为感染过程", + "B": "感染过程的构成必须具备病原体、人体和外环境三个因素", + "C": "病原体侵人人体,临床上出现相应的症状、体征则意味着感染过程的开始", + "D": "病原体侵人的数量越大，出现显性感染的危险也越大", + "E": "病原体的致病力包括毒力、侵袭力、病原体数量和变异性" + }, + "answer": "C", + "reason": "病原体通过各种途径进人人体就意味着感染过程的开始，而临床上是否出现相应的症状、体征,则取决于病原体的致病力和机体的免疫功能。" + }, + { + "question_num": 235, + "query": "下列穴位归经,错误的是", + "options": { + "A": "太白一肝经", + "B": "列缺一肺经", + "C": "合谷一大肠经", + "D": "阳陵泉一胆经", + "E": "阴陵泉一脾经" + }, + "answer": "A", + "reason": "太白穴是脾经的输穴、原穴,故选A。" + }, + { + "question_num": 236, + "query": "圣愈汤治疗痛经的适应证是", + "options": { + "A": "气血虚弱", + "B": "肝肾亏损", + "C": "心肝血虚", + "D": "血虚气滞", + "E": "气滞血瘀" + }, + "answer": "A", + "reason": "圣愈汤的组成是人参、黄芪合四物汤,方中药物气血同补。" + }, + { + "question_num": 237, + "query": "性微寒的行气药是", + "options": { + "A": "木香", + "B": "香附", + "C": "沉香", + "D": "薤白", + "E": "枳实" + }, + "answer": "E", + "reason": "行气药性多温,木香、沉香,薤白性温,香附甘平,枳实性微寒。" + }, + { + "question_num": 238, + "query": "甲类传染病指的是", + "options": { + "A": "SARS、狂犬病", + "B": "黑热病、炭疽", + "C": "高致病禽流感、天花", + "D": "鼠疫、霍乱", + "E": "伤寒、流行性出血热" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 239, + "query": "腕横纹尺侧端,尺侧腕屈肌腱桡侧凹陷中的腧穴是", + "options": { + "A": "神门", + "B": "大陵", + "C": "列缺", + "D": "太渊", + "E": "内关" + }, + "answer": "A", + "reason": "神门穴的定位:在腕部,腕草夜纹人侧端，侧腕屈肌腱的税侧口陷处" + }, + { + "question_num": 240, + "query": "肝火引起经行头痛的特点是", + "options": { + "A": "头晕,头部绵绵作痛", + "B": "巅顶掣痛,头晕目眩", + "C": "头痛剧烈,痛如锥刺", + "D": "头部胀痛重着", + "E": "头痛如裹,头晕目眩" + }, + "answer": "B", + "reason": "肝火引起经行头痛的特点是引起肝经循行部位疼痛,故选B。" + }, + { + "question_num": 241, + "query": "既能消食化积,又能降气化痰的药物是", + "options": { + "A": "山楂", + "B": "神曲", + "C": "莱菔子", + "D": "麦芽", + "E": "谷芽" + }, + "answer": "C", + "reason": "莱菔子降气化痰,麦芽回乳消胀,谷芽健脾开胃。" + }, + { + "question_num": 242, + "query": "下列各项,不属传染病基本特征的是", + "options": { + "A": "有病原体", + "B": "有感染后免疫性", + "C": "有流行病学特征", + "D": "有发热", + "E": "有传染性" + }, + "answer": "D", + "reason": "传染病与其他疾病相区别的基本特征有4个:有病原体、有传染性、有流行病学特征和有感染后免疫。" + }, + { + "question_num": 243, + "query": "治疗胎位不正最常用的腧穴是", + "options": { + "A": "合谷", + "B": "至阴", + "C": "三阴交", + "D": "太冲", + "E": "足三里" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 244, + "query": "最早把“疳”列为脾胃病的儿科医家是", + "options": { + "A": "万全", + "B": "薛铠", + "C": "刘昉", + "D": "董汲", + "E": "钱乙" + }, + "answer": "E", + "reason": "钱乙重视小儿脾胃病的调理,提出“疳皆脾胃病”的著名论断。" + }, + { + "question_num": 245, + "query": "驱虫药的服用时间是", + "options": { + "A": "饭前服", + "B": "空腹服", + "C": "饭后服", + "D": "定时服", + "E": "睡前服" + }, + "answer": "B", + "reason": "驱虫药一般应在空腹时服用,使药物充分作用于虫体而保证疗效。" + }, + { + "question_num": 246, + "query": "下列不属于急性重型肝炎典型表现的是", + "options": { + "A": "黄疸迅速加深", + "B": "出血倾向明显", + "C": "肝大", + "D": "出现烦躁、谵妄等神经系统症状", + "E": "急性肾功能不全" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 247, + "query": "下列腧穴中,归经错误的是", + "options": { + "A": "合谷-大肠经", + "B": "太溪一肝经", + "C": "列缺-肺经", + "D": "阳陵泉一胆经", + "E": "阴陵泉一脾经" + }, + "answer": "B", + "reason": "太溪穴属于足少阴肾经的腧穴,故选B。" + }, + { + "question_num": 248, + "query": "创立儿科“五脏证治法则”的专著是", + "options": { + "A": "《颅囟经》", + "B": "《幼科发挥》", + "C": "《幼幼集成》", + "D": "《小儿药证直诀》", + "E": "《小儿卫生总微论方》" + }, + "answer": "D", + "reason": "创立儿科“五脏证治法则”的专著是《小儿药证直诀》。" + }, + { + "question_num": 249, + "query": "善治血热便血、痔血及肝热目赤头痛的药物是", + "options": { + "A": "虎杖", + "B": "槐花", + "C": "小蓟", + "D": "地榆", + "E": "大蓟" + }, + "answer": "B", + "reason": "槐花凉血止血,清肝泻火,控长治疗血热便血、痔血及肝热目赤头痛。" + }, + { + "question_num": 250, + "query": "下列各项,不符合淤胆型肝炎临床表现的是", + "options": { + "A": "黄疸深", + "B": "自觉症状重", + "C": "皮肤瘙痒", + "D": "大便颜色变浅", + "E": "血清胆固醇升高" + }, + "answer": "B", + "reason": "淤胆型肝炎主要表现为急性病毒性肝炎较长时期的肝内梗阻性黄疸，临床自觉症状轻微，常表现有皮肤瘙痒、粪便颜色变浅,肝功能检查血清胆红素明显升高，以直接胆红素为主。" + }, + { + "question_num": 251, + "query": "腕横纹中央,掌长肌腱与桡侧腕屈肌腱之间的穴位是", + "options": { + "A": "阳溪", + "B": "太渊", + "C": "大陵", + "D": "神门", + "E": "腕骨" + }, + "answer": "C", + "reason": "大陵穴的定位:在腕学横纹的中点处,当学长肌腱与桡侧腕屈肌腱之间。" + }, + { + "question_num": 252, + "query": "小儿营养不良是指体重低于正常均值的", + "options": { + "A": "60%", + "B": "70%", + "C": "85%", + "D": "95%", + "E": "90%" + }, + "answer": "C", + "reason": "小儿营养不良是指体重低于正常均值的85%。" + }, + { + "question_num": 253, + "query": "治疗血瘀气滞,经行腹痛,兼风湿肩臂疼痛者，应选用", + "options": { + "A": "桃仁", + "B": "丹参", + "C": "红花", + "D": "姜黄", + "E": "益母草" + }, + "answer": "D", + "reason": "患者“血瘀气滞”,治宜活血痹痛。姜黄活血行气,通经止痛,故选D。" + }, + { + "question_num": 254, + "query": "下列有关流行性出血热的描述,正确的是", + "options": { + "A": "发病以青少年为主", + "B": "一般不经呼吸道传播", + "C": "无明显季节性", + "D": "所有患者均有5期经过", + "E": "可有母婴传播" + }, + "answer": "E", + "reason": "流行性出血热的传播途径包括呼吸道传播、消化道传播、接触传播、母婴传播和虫媒传播等5种方式。" + }, + { + "question_num": 255, + "query": "“循喉咙之后,上人颃颡”的经脉是", + "options": { + "A": "足厥阴肝经", + "B": "足少阴肾经", + "C": "足少阳胆经", + "D": "足太阴脾经", + "E": "足阳明胃经" + }, + "answer": "A", + "reason": "足厥阴肝经的走行:起于大趾丛毛之际，上循足跗上廉,去内踝一寸，上踩八寸,交出太阴之后,上内廉,循股阴，人毛中过阴器,抵小腹,挟胃属肝络胆，上贯,布胁肋,循喉咙之后,上人颃颡,连目系,上出额,与督脉会于巅,其支者，从目系下颊里,环唇内，其支者,复从肝,别贯膈,上注肺。" + }, + { + "question_num": 256, + "query": "小儿出齐20颗乳牙的时间是", + "options": { + "A": "8~10个月", + "B": "11~12个月", + "C": "13~15个月", + "D": "16~19个月", + "E": "20~30个月" + }, + "answer": "E", + "reason": "小儿生后4~10个月乳牙开始萌出,在2~2.5岁出齐。" + }, + { + "question_num": 257, + "query": "半夏、天南星均具有的功效是", + "options": { + "A": "祛风止痉", + "B": "消痞散结", + "C": "降逆止呕", + "D": "燥湿化痰", + "E": "利气通络" + }, + "answer": "D", + "reason": "半夏与天南星内服均能燥湿化痰,半夏兼有降逆止呕、消痞散结之功。天南星兼有息风解痉之功。" + }, + { + "question_num": 258, + "query": "HIV造成机体免疫功能损害主要侵犯的细胞是", + "options": { + "A": "CD4⁺T细胞", + "B": "CD8⁺T细胞", + "C": "B淋巴细胞", + "D": "NK细胞", + "E": "浆细胞" + }, + "answer": "A", + "reason": "CD4+T淋巴细胞在HIV直接和间接作用下，细胞功能受损和大量破坏,导致细胞免疫缺陷。" + }, + { + "question_num": 259, + "query": "四缝穴的位置在", + "options": { + "A": "手第一至五指间,指蹼缘后方赤白肉际处", + "B": "手第一至四指掌侧,指骨关节横纹中点处", + "C": "手第二指学测,近端指骨关节横纹中点", + "D": "手第一至四指学侧,近端指骨关节横纹中点处", + "E": "手第二至五指学侧,掌指关节横纹中点处" + }, + "answer": "E", + "reason": "四缝穴的定位:手第二至五指掌侧,近端指骨关节横纹中点处，一手4穴:左右共8穴。" + }, + { + "question_num": 260, + "query": "小儿能独走的时间一般是", + "options": { + "A": "8个月", + "B": "10个月", + "C": "12个月", + "D": "16个月", + "E": "18个月" + }, + "answer": "C", + "reason": "新生儿仅有反射性活动(如吮吸、吞咽等)和不自主的活动;8个月会爬;10个月可扶走;小儿12个月会独走。" + }, + { + "question_num": 261, + "query": "桔梗具有的功效是", + "options": { + "A": "温肺祛痰", + "B": "降气止呕", + "C": "开宣肺气", + "D": "燥湿化痰", + "E": "利气宽胸" + }, + "answer": "C", + "reason": "桔梗宣肺,祛痰,利咽,排脓,故选C。" + }, + { + "question_num": 262, + "query": "下列各项,不支持流行性脑脊髓膜炎诊断的脑脊液检查是", + "options": { + "A": "外观混浊呈脓性", + "B": "蛋白质含量高", + "C": "细胞数<0.5x10^6/L,以单核细胞为主", + "D": "糖含量明显减少", + "E": "氯化物含量减少" + }, + "answer": "C", + "reason": "脑脊液检查是流行性脑脊髓膜炎明确诊断的重要依据。发病过程中，脑脊液压力升高,外观浑浊呈脓性,故A项正确;蛋白质含量增高,糖及氯化物含量均减少，故BDE项正确" + }, + { + "question_num": 263, + "query": "针刺肌肉浅溥部位的脑八，常用的进针法是", + "options": { + "A": "指切", + "B": "挟持", + "C": "舒张", + "D": "提捏", + "E": "套管" + }, + "answer": "D", + "reason": "A项指切适用于短针的进针,B项挟持适用于长针的进针,C项舒张适用于皮肤松弛部位腧穴的进针，D项提捏适用于皮肉浅薄部位的进针,E项套管可以代替押手但是不常用,均排除,故选D。" + }, + { + "question_num": 264, + "query": "新生儿在上腭中线和齿龈部位有散在黄白色、碎米粒样颗粒,称为", + "options": { + "A": "马牙", + "B": "板牙", + "C": "螳螂子", + "D": "口疮", + "E": "鹅口疮" + }, + "answer": "A", + "reason": "大多数婴儿在出生后4~6周时,口腔上腭中线两侧和齿龈边缘出现一些黄白色的小点,很像是长出来的牙齿,俗称“马牙”,医学上称为上皮珠。" + }, + { + "question_num": 265, + "query": "既能息风止痉,又能祛风湿,止痹痛的药物是", + "options": { + "A": "羚羊角", + "B": "石决明", + "C": "决明子", + "D": "天麻", + "E": "珍珠" + }, + "answer": "D", + "reason": "天麻兼能祛风通络、止痹痛。" + }, + { + "question_num": 266, + "query": "高热、头痛、呕吐,全身皮肤散在瘀点颈项强直，最可能的诊断是", + "options": { + "A": "结核性脑膜炎", + "B": "流行性脑脊髓膜炎", + "C": "流行性乙型脑炎", + "D": "伤寒", + "E": "中毒性细菌性痢疾" + }, + "answer": "B", + "reason": "高热、头痛、呕吐,全身皮肤散在瘀点,颈项强直等均为流行性脑脊髓膜炎的典型症状,首先考虑流行性脑脊髓膜炎;结核性脑膜炎,结核中毒症状之一是低热，排除A;流行性乙型脑炎皮肤一般无瘀点,排除C伤寒常有中毒性脑病的表现，无脑膜刺激征，皮疹的典型特征为玫瑰疹，排除D;中毒性细菌性痢疾一般无脑膜刺激征,排除E。" + }, + { + "question_num": 267, + "query": "提插补泻法中,泻法的操作手法是", + "options": { + "A": "重插轻提,幅度大,频率快", + "B": "重插轻提,幅度小,频率快", + "C": "重插轻提,幅度小,频率慢", + "D": "轻插重提,幅度小,频率快", + "E": "轻插重提,幅度大,频率快" + }, + "answer": "E", + "reason": "提插补泻中先深后浅,轻插重提,幅度大,频率快,操作时间长者为泻法故选E。" + }, + { + "question_num": 268, + "query": "小儿疾病谱中最为多见的是", + "options": { + "A": "肺肾系病证", + "B": "心肺系病证", + "C": "肺脾系病证", + "D": "心肝系病证", + "E": "肝肾系病证" + }, + "answer": "C", + "reason": "小儿肺脏娇嫩、卫表未固,易为邪气所感,使肺系疾病成为儿科发病率最高的一类疾病。小儿“脾常不足”,其脾胃之体成而未全、脾胃之气全而未壮,因而易于因家长喂养不当、小儿饮食失节,出现受纳、腐熟、精微化生转输等方面的异常,使脾系疾病的发病率在儿科仅次于肺系病证而居第二位,故选C。" + }, + { + "question_num": 269, + "query": "在使用注意方面,宜从小量开始,缓缓增加,以免阳升风动,头晕目赤的药物是", + "options": { + "A": "冬虫夏草", + "B": "石斛", + "C": "鳖甲", + "D": "白术", + "E": "鹿茸" + }, + "answer": "E", + "reason": "服用鹿茸宜从小量开始,缓缓增加,不可骤用大是，以免阳升风动、头晕目赤,或伤阴动血。凡发热者均当忌用，故选E" + }, + { + "question_num": 270, + "query": "目前认为志贺菌致病必须具备的条件是", + "options": { + "A": "过度劳累", + "B": "暴饮暴食", + "C": "细菌变异性", + "D": "痢疾杆菌对肠黏膜上皮细胞的侵袭力", + "E": "发病季节" + }, + "answer": "D", + "reason": "目��认为志贺菌致病必须具备3个条件:①具有介导细菌吸附的光滑性脂多糖“O”抗原;②具侵袭上皮细胞并在其中繁殖的能力;③侵袭、繁殖后可产生毒素。" + }, + { + "question_num": 271, + "query": "治疗丹毒首选的拔罐法是", + "options": { + "A": "留罐法", + "B": "走罐法", + "C": "留针拔罐法", + "D": "刺血拔罐法", + "E": "闪罐法" + }, + "answer": "D", + "reason": "丹毒属于毒血瘀积于皮肤，应该用刺血拔罐法,故选D。" + }, + { + "question_num": 272, + "query": "小儿面呈红色,证候多属", + "options": { + "A": "热", + "B": "湿", + "C": "燥", + "D": "虚", + "E": "实" + }, + "answer": "A", + "reason": "面呈红色多为热证,故选择A。" + }, + { + "question_num": 273, + "query": "浮小麦具有的功效是", + "options": { + "A": "收敛止血", + "B": "益气止汗", + "C": "涩精止带", + "D": "涩肠敛汗", + "E": "止血止汗" + }, + "answer": "B", + "reason": "浮小麦的功效:固表止汗:益气除热。" + }, + { + "question_num": 274, + "query": "下列各项,医学道德所具有的特点不包括", + "options": { + "A": "具有全人类性", + "B": "具有实践性", + "C": "具有稳定性", + "D": "具有天然性", + "E": "具有继承性" + }, + "answer": "D", + "reason": "医学道德的特征:科学性:服务性、继承性、实践性、时代性,医学道德属于医务人员及服务对象的行为准则，具有全人类性及稳定性的特点。" + }, + { + "question_num": 275, + "query": "下列不属于原络配穴法的是", + "options": { + "A": "合谷、偏历", + "B": "太溪、大钟", + "C": "太渊、列缺", + "D": "合谷、列缺", + "E": "冲阳、丰隆" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 276, + "query": "小儿指纹色紫主证为", + "options": { + "A": "燥", + "B": "热", + "C": "寒", + "D": "滞", + "E": "瘀" + }, + "answer": "B", + "reason": "指纹的辨证纲要可归纳为“浮沉分表里,红紫辨寒热,淡定虚实,三关测轻重”。小儿指纹色紫主证为热。" + }, + { + "question_num": 277, + "query": "治疗蛔虫引起蛔厥腹痛呕吐,肺虚久咳,宜首选", + "options": { + "A": "槟榔", + "B": "花椒", + "C": "乌梅", + "D": "使君子", + "E": "苦楝皮" + }, + "answer": "C", + "reason": "乌梅敛肺止咳,涩肠止泻安蛔止痛,生津止渴。" + }, + { + "question_num": 278, + "query": "撰写\"医家五戒十要\"的医家是", + "options": { + "A": "李时珍", + "B": "陈实功", + "C": "孙思邈", + "D": "张仲景", + "E": "华佗" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 279, + "query": "在五输穴中,合穴主要治疗", + "options": { + "A": "心下满", + "B": "身热", + "C": "体重节痛", + "D": "喘咳寒热", + "E": "逆气而泄" + }, + "answer": "E", + "reason": "五输穴中,井主心下满,荥主身热,输主体重节痛,经主喘咳寒热,合主逆气而泄,故选E。" + }, + { + "question_num": 280, + "query": "小儿断奶时间应在", + "options": { + "A": "2~3个月", + "B": "4~5个月", + "C": "6~7个月", + "D": "8~12个月", + "E": "13~18个月" + }, + "answer": "D", + "reason": "加时问祖丹婴情而宁一般可在小儿10~12个月时断奶。D项最接近,故选D。" + }, + { + "question_num": 281, + "query": "适宜用开窍剂治疗的证候是", + "options": { + "A": "阳明腑实,神昏谵语", + "B": "阴虚风动,神倦瘛疭", + "C": "瘀热扰神,谵语如狂", + "D": "热陷心包,窍闭神昏", + "E": "火毒扰神,错语不眠" + }, + "answer": "D", + "reason": "A项宜用泻下剂,B项宜用滋阴剂,C项宜用清热化痰之剂，D项宜用开窍剂,E项宜用清热解毒之剂:" + }, + { + "question_num": 282, + "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“脑死亡”诊断标准:①对外部刺激和内部刺激无接受性、反应性;②自主肌肉运动、自主呼吸消失;③诱导反射消失;④脑电图平直或等电位，同时规定凡符合以上4条标准,持续24小时测定,每次不少于10分钟,反复检查多次结果一致者,就可宣告死亡" + }, + { + "question_num": 283, + "query": "下列腧穴在五行配属中,��“金”的是", + "options": { + "A": "少府", + "B": "大陵", + "C": "阳溪", + "D": "后溪", + "E": "经渠" + }, + "answer": "E", + "reason": "阴经的井荣输经合属木火土金水，阳经的井荥输经合属金水木火土。经渠是肺经的经穴属金,故选E。" + }, + { + "question_num": 284, + "query": "可治疗风热感冒与时邪感冒的方剂是", + "options": { + "A": "银翘散", + "B": "桑菊饮", + "C": "新加香薷饮", + "D": "普济消毒饮", + "E": "杏苏散" + }, + "answer": "A", + "reason": "风热感冒证的方剂为银翘散加减,时邪感冒证的方剂为银翘散合普济消毒饮加减。" + }, + { + "question_num": 285, + "query": "败毒散的组成药物中不包括", + "options": { + "A": "柴胡、前胡", + "B": "羌活、独活", + "C": "桔梗、枳壳", + "D": "人参、甘草", + "E": "当归、芍药" + }, + "answer": "E", + "reason": "败毒散的组成药物有柴胡前胡、川芎、枳壳、羌活、独活、茯苓、桔梗、人参、甘草。" + }, + { + "question_num": 286, + "query": "对不伤害原则的解释,正确的是", + "options": { + "A": "不伤害原则就是消除任何医疗伤害", + "B": "不伤害原则就是要求医生对患者丝亳不能伤害", + "C": "因绝大多数医疗行为都存在着不同程度的伤害，所以不伤害原则是做不到的", + "D": "不伤害原则要求对医学行为进行受益与伤害的权衡，把可控伤害控制在最低限度之内", + "E": "对肿瘤患者进行化疗意味着绝对伤害" + }, + "answer": "D", + "reason": "不伤害原则的解释：不伤害原则要求对医学行为进行受益与伤害的权衡，把可控伤害控制在最低限度内。" + }, + { + "question_num": 287, + "query": "下列各项五输穴中属“水”的是", + "options": { + "A": "少府", + "B": "大陵", + "C": "后溪", + "D": "曲泉", + "E": "经渠" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 288, + "query": "哮喘与肺炎喘嗽的主要区别是", + "options": { + "A": "咳嗽气喘", + "B": "痰壅", + "C": "气急", + "D": "鼻扇", + "E": "哮鸣,呼气延长" + }, + "answer": "E", + "reason": "哮病与肺炎喘嗽的主要区别是哮鸣,呼气延长。" + }, + { + "question_num": 289, + "query": "不属于济川煎组成药物的是", + "options": { + "A": "芍药", + "B": "牛膝", + "C": "泽泻", + "D": "升麻", + "E": "枳壳" + }, + "answer": "A", + "reason": "济川煎的组成:当归、牛膝,肉苁蓉、泽泻、升麻、枳壳，" + }, + { + "question_num": 290, + "query": "1976年美国学者提出的医患关系基本模式是", + "options": { + "A": "主动一被动型,互相一合作型,平等参与型", + "B": "主动一合作型,相互一指导型,共同参与型", + "C": "主动一配合型,指导一合作型,共同参与型", + "D": "主动一被动型,指导一合作型,共同参与型", + "E": "主动一被动型,共同参与型,父权主义型" + }, + "answer": "D", + "reason": "1976年美国学者提出的医患之间技术性关系基本模式为主动-被动型，指导一合作型,共同参与型。" + }, + { + "question_num": 291, + "query": "五输穴中所行为", + "options": { + "A": "井", + "B": "荥", + "C": "输", + "D": "经", + "E": "合" + }, + "answer": "D", + "reason": "灵枢·九针十二原》所载所出为井,所溜为荣,所注为输,所行为经,所从行" + }, + { + "question_num": 292, + "query": "治疗鹅口疮心脾积热证,应首选", + "options": { + "A": "凉膈散", + "B": "泻黄散", + "C": "清热泻脾散", + "D": "泻心导赤散", + "E": "知柏地黄丸" + }, + "answer": "C", + "reason": "鹅口疮心脾积热证,选清热泻脾散;而虚火上浮证,选知柏地黄丸。" + }, + { + "question_num": 293, + "query": "下列具有疏风散邪,清热解毒功用的方剂是", + "options": { + "A": "黄连解毒汤", + "B": "普济消毒饮", + "C": "清瘟败毒饮", + "D": "青蒿鉴甲汤", + "E": "龙胆泻肝汤" + }, + "answer": "B", + "reason": "普济消毒饮清热解毒,疏风散邪。" + }, + { + "question_num": 294, + "query": "尊重患者知情同意权，其正确的做法是", + "options": { + "A": "婴幼患儿可以由监护人决定其诊疗方案", + "B": "家属无承诺,即使患者本人知情同意也不得给予手术", + "C": "对特殊急诊患者的抢救都同样对待", + "D": "无须做到患者完全知情", + "E": "只经患者同意即可手术" + }, + "answer": "A", + "reason": "知情同意权的主体,一是成年患者本人:具有完全民事行为能力的患者应是知情同意权的主体。二是法定代理人:对于未成年人患者,知情同意权的主体是其父母;对于精神病患者、神志不明的患者,知情同意权的主体是配偶、父母、成年子女和其他近亲属等。" + }, + { + "question_num": 295, + "query": "患者,女,40岁。精神抑郁,表情淡漠神志痴呆,语无伦次,不思饮食,舌苔腻,脉弦滑,其治法是", + "options": { + "A": "疏肝理气,活血化瘀", + "B": "清肝泻火,解郁和胃", + "C": "理气解郁,化痰开窍", + "D": "理气活血,宁心定志", + "E": "顺气化痰,清肝泄热" + }, + "answer": "C", + "reason": "痴呆之痰浊蒙窍证表现精神抑郁,表情淡漠,神志痴呆,语无伦次,不思饮食,舌苔腻,脉弦滑,应用涤痰汤理气解郁化痰开窍,故选C。" + }, + { + "question_num": 296, + "query": "小儿厌食脾失健运证的治法是", + "options": { + "A": "调和脾胃,运脾开胃", + "B": "健脾益气,佐以温中", + "C": "滋脾养胃,佐以助运", + "D": "运脾化湿,消积开胃", + "E": "补脾开胃,消食助运" + }, + "answer": "A", + "reason": "小儿厌食脾失健运证的治法是调和脾胃,运脾开胃。" + }, + { + "question_num": 297, + "query": "具有解毒消痈，化痰散结，活血祛瘀功效的方剂是", + "options": { + "A": "四妙勇安汤", + "B": "犀黄丸", + "C": "仙方活命饮", + "D": "大黄牡丹汤", + "E": "苇茎汤" + }, + "answer": "B", + "reason": "犀黄丸有解毒消痈,化痰散结,活血祛瘀的功用。" + }, + { + "question_num": 298, + "query": "在使用辅助检查手段时,不适宜的是", + "options": { + "A": "认真严格地掌握适应证", + "B": "可以广泛积极地依赖各种辅助检查", + "C": "有利于提高医生诊治疾病的能力", + "D": "必要检查能尽早确定诊断和进行治疗", + "E": "应从患者的利益出发决定该做的项目" + }, + "answer": "B", + "reason": "使用辅助检查手段时认真严格地掌握适应证是必须首先要遵守的;必要检查能尽早确定诊断和进行治疗并且有利于提高医生诊治疾病的能力;医生应从患者的利益出发决定该做的项目。" + }, + { + "question_num": 299, + "query": "患者,男,45岁。自觉心慌,时息时作,健忘失眠。治疗应首选", + "options": { + "A": "三阴交", + "B": "神门", + "C": "足三里", + "D": "太溪", + "E": "合谷" + }, + "answer": "B", + "reason": "神门穴的主治要点为心痛心烦、健忘失眠、惊悸怔忡、痴呆、疯狂、痫证目黄胁痛、掌中热、呕血、吐血、头痛、眩晕、失声等病证,且神门是治疗健忘失眠的要穴。" + }, + { + "question_num": 300, + "query": "“疳者甘也”的含义是指", + "options": { + "A": "病证", + "B": "病位", + "C": "病情", + "D": "病因", + "E": "症状" + }, + "answer": "D", + "reason": "“疳者甘也”是指小儿恣食肥甘厚腻,损伤脾胃,形成疳证。" + }, + { + "question_num": 301, + "query": "青蒿鳖甲汤主治证的热型是", + "options": { + "A": "骨蒸潮热", + "B": "夜热早凉", + "C": "日晡潮热", + "D": "身热夜甚", + "E": "皮肤蒸热" + }, + "answer": "B", + "reason": "青蒿整甲汤适用于温热病后期，余热未尽而阴液不足之虚热证。临床应用以夜热早凉,热退无汗，舌红少苔,脉细数为辨证要点,其余选项均不符合。" + }, + { + "question_num": 302, + "query": "安乐死的定义", + "options": { + "A": "自然死亡", + "B": "他人干预死亡", + "C": "无痛苦死亡", + "D": "脑死亡", + "E": "自己结束生命" + }, + "answer": "C", + "reason": "安乐死来源于希腊文,意思是无痛苦的、幸福的死亡。" + }, + { + "question_num": 303, + "query": "患者,女,67岁。平素体弱消瘦,近日外感，出现身执微亚风小江师干咽痛,舌红少苔,脉细数,其证候是", + "options": { + "A": "风寒感冒", + "B": "风热感冒", + "C": "阴虚感冒", + "D": "暑湿感冒", + "E": "气虚感冒" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 304, + "query": "患者,女,45岁,已婚。月经提前,量多、色淡、质稀,纳少便溏,气短懒言,舌淡苔白,脉缓弱,其治法是", + "options": { + "A": "健脾和胃", + "B": "补气摄血调经", + "C": "养血调经", + "D": "益气活血", + "E": "补血止血" + }, + "answer": "B", + "reason": "月经先期脾气虚治宜补脾益气,摄血调经。" + }, + { + "question_num": 305, + "query": "患者感受暑湿,症见身热烦渴,小便不利。治疗应首选", + "options": { + "A": "六一散", + "B": "猪苓汤", + "C": "泻白散", + "D": "五苓散", + "E": "二妙散" + }, + "answer": "A", + "reason": "六一散功能清暑利湿,用于治疗暑湿证，主症为身热烦渴，小便不利泄泻。" + }, + { + "question_num": 306, + "query": "卫生法的立法宗旨和最终目的是", + "options": { + "A": "预防为主", + "B": "中西医并重", + "C": "保护公民健康", + "D": "动员全社会参与", + "E": "卫生工作法制化" + }, + "answer": "C", + "reason": "卫生法的立法宗旨和最终目的是保护公民健康。" + }, + { + "question_num": 307, + "query": "患者项背强直,头痛,恶寒发热,肢体酸重,舌苔白腻,脉浮紧,其治法是", + "options": { + "A": "疏散风寒,调和气血", + "B": "散寒祛风,解肌发汗", + "C": "祛风散寒,和营燥湿", + "D": "辛温解表,散寒止痛", + "E": "疏风散寒,化痰通络" + }, + "answer": "C", + "reason": "风寒束表,故头痛,恶寒发热,湿阻经络,故肢体酸重,舌苔白腻,脉浮紧为寒湿在表之象,营卫不和,风寒束表,治宜祛风散寒,和营燥湿。" + }, + { + "question_num": 308, + "query": "患者,女,19岁,未婚。经来先期,量少,色红,质稠;手足心热,咽干口燥;舌质红,苔少,脉细数。治疗应首选", + "options": { + "A": "清经散", + "B": "丹栀逍遥散", + "C": "两地汤", + "D": "固阴煎", + "E": "归肾丸" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 309, + "query": "理中丸除温中祛寒外,还具有的功用是", + "options": { + "A": "和中缓急", + "B": "和胃止呕", + "C": "降逆止痛", + "D": "养血通脉", + "E": "补气健脾" + }, + "answer": "E", + "reason": "理中丸温中祛寒、补气健，" + }, + { + "question_num": 310, + "query": "我国卫生法律是由哪一级机构制定和颁布的", + "options": { + "A": "卫健委", + "B": "国务院", + "C": "最高人民法院", + "D": "全国人大及其常委会", + "E": "地方人民政府" + }, + "answer": "D", + "reason": "卫生法属于基本法律。全国人大及其常委会是宪法和基本法律的制定和颁布机构。" + }, + { + "question_num": 311, + "query": "患者,男,40岁。咳嗽气促,咳痰量多,痰质黏稠而黄，咳吐不爽，胸胁胀满，面赤身热,口干,舌红苔黄腻,脉滑数。治疗应首选", + "options": { + "A": "止嗽散", + "B": "桑菊饮", + "C": "二陈汤", + "D": "清金化痰汤", + "E": "加减泻白散" + }, + "answer": "D", + "reason": "痰热壅阻肺气,肺失清肃故见咳嗽气促,咳痰最多,痰质黏稠而黄,咳吐不爽,胸胁胀满,面赤身热,口干,舌红苔黄腻脉滑数,俱是痰热郁肺的表现，治宜清热化痰肃肺止咳。" + }, + { + "question_num": 312, + "query": "患者,女,28岁,已婚。月经50天一行,量少、色淡、质稀,小腹隐痛,喜热喜按,腰酸无力,大便溏薄,小便清长,舌淡苔白,脉沉细而迟。治疗应首选。", + "options": { + "A": "温经汤(《金匮要略》)", + "B": "艾附暖宫丸", + "C": "温胞饮", + "D": "大补元煎", + "E": "人参养荣汤" + }, + "answer": "A", + "reason": "由主症和兼症可知此病为月经后期的血虚寒证，治法为扶阳祛寒调经，主方为温经汤。" + }, + { + "question_num": 313, + "query": "黄芪桂枝五物汤与当归四逆汤组成中均含有的药物是", + "options": { + "A": "生姜、芍药、桂枝", + "B": "大麦、桂枝、生姜", + "C": "黄芪、桂枝、芍药", + "D": "芍药、生姜、大枣", + "E": "桂枝、芍药、大枣" + }, + "answer": "E", + "reason": "黄芪桂枝五物汤组成:黄芪、桂枝、芍药、生姜、大枣。当归四逆汤的组成:当归、桂枝、芍药、细辛、通草、大枣、炙甘草。" + }, + { + "question_num": 314, + "query": "下列不属于我国卫生法规中所涉及的民事责任的承担方式的是", + "options": { + "A": "恢复原状", + "B": "解决争议", + "C": "停止侵害", + "D": "消除危险", + "E": "支付违约金" + }, + "answer": "B", + "reason": "民事责任的承担方式有停止侵害、排除妨碍、消除危险、返还财产、恢复原状、修理、重作、更换、继续行、赔偿损失、支付违约金、消除影响、恢复名誉、赔礼道歉，" + }, + { + "question_num": 315, + "query": "患者,女,20岁。每遇生气后即咳逆阵作,口苦咽干,胸胁胀痛,咳时面赤,舌红苔薄黄,脉弦数,其证候是古·", + "options": { + "A": "痰热郁肺", + "B": "肝肺气逆", + "C": "肝火犯肺", + "D": "阴虚火旺", + "E": "肺热津伤" + }, + "answer": "C", + "reason": "每遇生气后即咳逆阵作,口苦咽干胸胁胀痛,咳时面赤,舌红���薄黄,脉弦数,为咳嗽之肝火犯肺证,故选C" + }, + { + "question_num": 316, + "query": "患者,女,29岁,已婚。近半年来月经后期,经量少,现已停经4个月,伴五心烦热,潮热颧红,舌红少苔脉细数，尿妊娠试验阴性，其治法是", + "options": { + "A": "养阴清热调经", + "B": "理气活血通经", + "C": "豁痰活血通经", + "D": "益气养血调经", + "E": "补肾养肝调经" + }, + "answer": "A", + "reason": "由题干五心烦热,潮热颧红,舌红少苔,脉细数辨证为阴虚有热,治宜养阴清热调经。" + }, + { + "question_num": 317, + "query": "下列除哪项外,均是补中益气汤主治病证的临床表现", + "options": { + "A": "胸脘闷胀", + "B": "发热汗出", + "C": "渴喜热饮", + "D": "体倦肢软", + "E": "脉洪而虚" + }, + "answer": "A", + "reason": "补中益气汤主治:①治烦劳内伤,身热心烦,头痛恶寒,懒言恶食,脉洪大而虚;②或喘或渴,或阳虚自汗,或气虚不能摄血;③或疟痢脾虚，久不能愈;④一切清阳下陷，中气不足之证。" + }, + { + "question_num": 318, + "query": "国家实行医师资格考试制度,目的是检查评价申请医师资格者是否具备", + "options": { + "A": "医学专业学历", + "B": "取得医学专业技术职务的条件", + "C": "从事医学专业教学科研的资格", + "D": "开办医疗机构的条件", + "E": "从事医学实践必需的基本专业知识与能力" + }, + "answer": "E", + "reason": "国家实行医师资格考试制度，目的是检查评价申请医师资格者是否具备从事医学实践必需的基本专业知识与能力，故选E。" + }, + { + "question_num": 319, + "query": "患者呼吸急促,喉中哮鸣有声,胸膈满闷,咳嗽痰少,形寒畏冷,舌苔白滑,脉弦紧,其治法是", + "options": { + "A": "温肺化痰,纳气平喘写", + "B": "温肺散寒,化痰平喘", + "C": "温肺散寒,止咳化痰", + "D": "温肺化痰,散寒解表", + "E": "散寒温脾,化痰平喘" + }, + "answer": "B", + "reason": "证属寒哮,寒痰伏肺,遇感触发,痰升气阻,以致呼吸急促,喉中哮鸣有声,寒痰郁闭,故胸膈满闷,咳嗽痰少,形寒畏冷,舌苔白滑,脉弦紧。治宜温肺散寒,化痰平喘,故选B。" + }, + { + "question_num": 320, + "query": "患者,女,34岁,已婚。经行先后不定,经量多、色红、质稠,少腹胀痛,乳房胀痛,舌暗红、苔薄黄,脉弦。治疗应首选", + "options": { + "A": "逍遥散", + "B": "小柴胡汤", + "C": "加味道遥散", + "D": "血府逐瘀汤", + "E": "当归芍药散" + }, + "answer": "A", + "reason": "该患者为月经先后不定期肝郁证,代表方药为逍遥散。" + }, + { + "question_num": 321, + "query": "大补阴丸的组成药物中含有", + "options": { + "A": "黄精", + "B": "黄芩", + "C": "黄连", + "D": "黄柏", + "E": "黄芪" + }, + "answer": "D", + "reason": "大补阴丸的组成药物有熟地黄、知母、黄柏、龟甲、猪脊髓" + }, + { + "question_num": 322, + "query": "王某1997年于中医药大学毕业分配到市级中医院工作，并于1998年取得了中医师执业资格，《中华人民共和国执业医师法》施行当年，其依照有关开办医疗机构的规定申请个体开业。依据我国《中华人民共和国执业医师法》的规定，卫生行政部门应", + "options": { + "A": "批准其个体行医资格申请", + "B": "要求其应具备主治医师资格", + "C": "要求其参加国家临床中医专业技术资格考试", + "D": "要求其能保证个体行医质量,才能予以受理申请", + "E": "要求其经执业医师注册后在医疗机构中执业满5年" + }, + "answer": "E", + "reason": "《中华人民共和国医师法》规定:申请个体开业的执业医师要求其经执业医师注册后在医疗机构中执业满5年按照有关" + }, + { + "question_num": 323, + "query": "患者,男,70岁。喘促气短,声低气怯咳声低弱,咳痰稀白,自汗畏风,舌淡红苔薄白,脉弱无力,其治疗应首选", + "options": { + "A": "三子养亲汤合二陈汤", + "B": "生脉散合补肺汤", + "C": "七味都气丸合生脉散", + "D": "参蛤散合金匮肾气丸", + "E": "苏子降气汤合二陈汤" + }, + "answer": "B", + "reason": "肺虚气失所主,故喘促气短,声低气怯,咳声低弱,气不化津故咳痰稀白,肺虚卫外不固,自汗畏风,舌淡红苔薄白脉弱无力,治宜益气补肺,用生脉散合补肺汤故选择B。痰浊阻肺用三子养亲汤合二陈汤。" + }, + { + "question_num": 324, + "query": "患者,女,27岁,已婚。经来量多,周期23天,经期7天,妇科检查示子宫前位,如鸡蛋大小,质中,双侧附件(一)。应首先考虑的是", + "options": { + "A": "血崩", + "B": "经乱", + "C": "月经先期", + "D": "癥痕出血", + "E": "月经过多" + }, + "answer": "E", + "reason": "月经过多的定义是月经量较正常明显增多,而周期基本正常。由题干经来量多,周期23天,经期7天,妇科检查无异常可判断为月经过多。" + }, + { + "question_num": 325, + "query": "组成药物中含有熟地黄、肉桂的方剂是", + "options": { + "A": "一贯煎", + "B": "暧肝煎", + "C": "肾气丸", + "D": "炙甘草汤", + "E": "地黄饮子" + }, + "answer": "E", + "reason": "地黄饮子的药物组成:熟地黄、巴戟天、山茱萸、石斛、肉苁蓉、附子、五味子、肉桂、白茯苓、麦门冬、石菖蒲、远志。" + }, + { + "question_num": 326, + "query": "除特殊需要外,第一类精神药品的处方,每次不得超过多少日的常用量", + "options": { + "A": "1日", + "B": "3日", + "C": "5日", + "D": "7日", + "E": "14日" + }, + "answer": "B", + "reason": "除特殊需要外,第一类精神药品的处方,每次不得超过3日的常用量，故选B。(此法已废止)" + }, + { + "question_num": 327, + "query": "肺痈患者,咳吐大量脓血痰,气味腥臭异常,舌红苔黄腻,脉滑数,其病期是", + "options": { + "A": "初期", + "B": "成痈期", + "C": "溃脓期", + "D": "恢复期", + "E": "慢性期" + }, + "answer": "C", + "reason": "肺痈分初期、成脓期、溃脓期、恢复期。溃脓期的特点是咳吐大量脓血痰,气味腥臭异常,故选C。" + }, + { + "question_num": 328, + "query": "患者,女,28岁。近2个月经量渐减:点滴即止,胸闷呕恶,带下量多,形体肥胖,舌淡苔白腻,脉滑,其诊断是", + "options": { + "A": "月经过少血瘀证", + "B": "带下病脾虚证", + "C": "月经过少痰湿证", + "D": "月经过少阴虚证", + "E": "月经过少血虚证" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 329, + "query": "玉屏风散与牡蛎散相同的功用是", + "options": { + "A": "固表", + "B": "涩肠", + "C": "止遗", + "D": "固冲", + "E": "补肾" + }, + "answer": "A", + "reason": "玉屏风散益气固表止汗牡蛎散益气固表,敛阴止汗" + }, + { + "question_num": 330, + "query": "某药店经营者为贪图利益而违法销售超过有效期的药品，依据《中华人民共和国药品管理法》的规定，其所在地的药品监督管理行政执法机构应给予的处罚是,没收违销售药品和违法所得，并", + "options": { + "A": "处以非法所得1倍以上3倍以下的罚款", + "B": "处以非法所得2倍以上5倍以下罚款", + "C": "处以2000元以上5000元以下的罚款", + "D": "处以违法销售药品货值金额十倍以上二十倍以下的罚款", + "E": "处以违法销售药品货值金额1倍以上3倍以下的罚款" + }, + "answer": "D", + "reason": "《中华人民共和国药品管理法》规定,违法销售超过有效期的药品，其所在地的药品监督管理行政执法机构应给予的处罚:没收违法销售药品和违法所得，并处以违法销售药品货值金额十倍以上二十倍以下的罚款。" + }, + { + "question_num": 331, + "query": "患者,女,32岁。咳嗽3个月,咳声无力,气短声低,痰中带血,血色淡红,潮热,热度不高,盗汗,面色觥白,舌质嫩红,边有齿痕,脉细弱,其诊断是", + "options": { + "A": "虚痨肺阴虚证", + "B": "喘证肺阴虚证", + "C": "喘证肾阴虚证", + "D": "肺痨气阴耗伤证", + "E": "咳嗽肺阴亏耗证" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 332, + "query": "患者,女,36岁,已婚。两次月经中间阴道少量出血,色鲜红,头晕腰酸,夜寐不宁五心烦热。舌质红，苔薄，脉细数，其治法是", + "options": { + "A": "益气补肾,因冲止血", + "B": "滋肾养阴,固冲止血", + "C": "养阴清热,固冲止血", + "D": "补肾养肝,固冲止血", + "E": "益气养阴,凉血清热" + }, + "answer": "B", + "reason": "由题干两次月经中间,阴道少量出血判断为经间期出血，由色鲜红，头晕腰酸,夜寐不宁,五心烦热,舌质红,苔薄,脉细数辨证为肾阴虚证。治法为滋肾养阴，固冲止血。" + }, + { + "question_num": 333, + "query": "朱砂安神丸组成中含有的药物是", + "options": { + "A": "栀子", + "B": "黄连", + "C": "石膏", + "D": "竹叶", + "E": "知母" + }, + "answer": "B", + "reason": "朱砂安神丸药物组成:朱砂、黄连、当归、生地黄、炙甘草。" + }, + { + "question_num": 334, + "query": "传染性非典型肺炎防治工作应坚持的原则是", + "options": { + "A": "预防为主、防治结合、分类管理、依靠科学、依靠群众", + "B": "预防为主、及时隔离、依靠科学、防治结合、加强监督", + "C": "有效预防、宣传教育、加强监测、防治结合、科学管理", + "D": "预防控制、分级负责、依靠科学、防治结合、及时隔离", + "E": "预防为主、及时控制、科学治疗、统一监测、防治结合" + }, + "answer": "A", + "reason": "传染性非典型肺炎防治工作应坚持的原则是预防为主、防治结合、分类管理、依靠科学、依靠群众。" + }, + { + "question_num": 335, + "query": "肺胀患者,神志恍惚,烦躁不宁,咳逆喘促,咯痰不爽,舌暗苔淡黄而腻,脉滑数。治疗应首选", + "options": { + "A": "涤痰汤合苏合香丸", + "B": "涤痰汤合至宝丹", + "C": "玉枢丹", + "D": "菖蒲郁金汤", + "E": "通窍活血汤" + }, + "answer": "B", + "reason": "痰蒙神窍,故神志异常。痰热阻肺故咳逆喘促,咳痰不爽,舌暗苔淡黄而腻,脉滑数都是痰热之象。治宜涤痰开窍息风。用涤痰汤涤痰，至宝丹开窍息风清热。" + }, + { + "question_num": 336, + "query": "患者,女,25岁,已婚。月经周期先后不定,量多如注,持续十余日不净,婚后1.年半未避孕未孕。可诊断为", + "options": { + "A": "月经先后无定期", + "B": "崩漏", + "C": "月经过多", + "D": "经期延长", + "E": "不孕症" + }, + "answer": "B", + "reason": "月经先后无定期只有周期不定,但是不涉及经量的变化,故A项错误。月经过多是经量增多，经期延长是经期的延长,两者都不涉及周期的变化,故CD项错误。婚后2年未避孕而未孕者称为不孕症,故E项错误。崩漏是指经期、周期、经量均发生异常改变的病变,故选B。" + }, + { + "question_num": 337, + "query": "天王补心丹中敛心气而安神的药物是", + "options": { + "A": "丹参、五味子", + "B": "茯苓、五味子", + "C": "远志、五味子", + "D": "人参、五味子", + "E": "酸枣仁、五味子" + }, + "answer": "E", + "reason": "天王补心丹的配伍。天门冬、麦门冬滋阴清热,酸枣仁、柏子仁养心安神,当归补血润燥,共助生地黄滋阴补血,并养心安神,俱为臣药。五味子之酸敛心气，安心神;丹参清心活血,合补血药使补而不滞,则心血易生。" + }, + { + "question_num": 338, + "query": "《中华人民共和国传染病防治法》规定应予以隔离治疗的是", + "options": { + "A": "疑似传染病患者", + "B": "甲类传染病患者", + "C": "甲类传染病患者和病原携带者", + "D": "乙类传染病患者和病原携带者", + "E": "除艾滋病患者、炭疽中的肺炭疽以外的乙类传染病患者" + }, + "answer": "C", + "reason": "甲类传染病患者和病原携带者以及乙类传染病中的艾滋病、淋病、梅毒患者的密切接触者必须按照有关规定接受检疫、医学检查和防治措施。甲类传染病患者和病原携带者予以隔离治疗,疑似病人确诊前在指定场所单独隔离治疗。" + }, + { + "question_num": 339, + "query": "患者,男,35岁。心悸不宁,头晕目眩,手足心热,耳鸣腰酸,舌红少苔,脉细数,其证候是", + "options": { + "A": "心血不足", + "B": "心虚胆怯", + "C": "心阴亏虚", + "D": "阴虚火旺", + "E": "心火内盛" + }, + "answer": "D", + "reason": "肝肾阴虚,水不济火,心火偏亢,心神不宁,故心悸眩晕。手足心热,耳鸣腰酸,舌红少苔,脉细数,都是肝肾阴虚心火旺之证，故选D。" + }, + { + "question_num": 340, + "query": "患者,女,20岁,未婚。月事非时而小量多如崩,色鲜,质稠,伴心烦,口渴欲饮,便干溲黄,面部痤疮,舌红苔薄黄,脉细数。根据治崩三法,应首选的是", + "options": { + "A": "塞流", + "B": "澄源", + "C": "复旧", + "D": "调经为本", + "E": "塞流,澄源并进" + }, + "answer": "E", + "reason": "由题干量多如崩,色鲜,质稠,伴心烦,口渴欲饮,便干溲黄,面部痤疮,舌红苔薄黄,脉细数,辨证为实热证,故应澄源。又量多如崩,故应塞流。" + }, + { + "question_num": 341, + "query": "下列除哪项外，均是至宝丹的功用", + "options": { + "A": "清热", + "B": "开窍", + "C": "通便", + "D": "化浊", + "E": "解毒" + }, + "answer": "C", + "reason": "至宝丹的功用清热开窍、化浊解毒。" + }, + { + "question_num": 342, + "query": "必须按照国务院卫生行政部门的有关规定，严格执行消毒隔离制度，防止发生院内感染和医源性感染的机构是", + "options": { + "A": "疾病控制中心", + "B": "卫生监督所", + "C": "预防保健机构", + "D": "医疗保健机构", + "E": "卫生行政管理机构" + }, + "answer": "D", + "reason": "《中华人民共和国传染病防治法实施办法》第十四条:医疗保健机构必须按照国务院卫生行政部门的有关规定，严格执行消毒隔离制度，防止医院内感染和医源性感染。" + }, + { + "question_num": 343, + "query": "患者心悸,气短,劳则尤甚,神疲体倦自汗。治疗应首选", + "options": { + "A": "补肺汤", + "B": "七福饮", + "C": "加味四君子汤", + "D": "大补元煎", + "E": "金匮肾气丸" + }, + "answer": "C", + "reason": "心为气舍,心气不足则神浮不敛,故心悸气短,劳则尤甚,神疲体倦,自汗都是心脾气虚表现,治以补心脾益气为主，方用加味四君子汤。" + }, + { + "question_num": 344, + "query": "患者,女,24岁,已婚。闭经7个月,形体肥胖,胸胁满闷,呕恶痰多,面浮足肿,舌淡苔白腻,脉沉滑,其证候是", + "options": { + "A": "肝肾不足", + "B": "气血虚弱", + "C": "痰湿阻滞", + "D": "肝血不足", + "E": "肺肾阴虚" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 345, + "query": "属于天台乌药散组成药物的是", + "options": { + "A": "川楝子", + "B": "陈皮", + "C": "草豆蔻", + "D": "肉桂", + "E": "厚朴" + }, + "answer": "A", + "reason": "天台乌药散的组成:乌药木香、小茴香、青皮、高良姜、槟榔、川棟子、巴豆。" + }, + { + "question_num": 346, + "query": "大肠津亏证的主症是", + "options": { + "A": "口干咽燥", + "B": "口臭头晕", + "C": "便于难以排出", + "D": "舌红苔白干", + "E": "脉象细涩" + }, + "answer": "C", + "reason": "大便秘结干燥,难以排出常数日一行，口干咽燥,或伴见口臭，头晕等症,舌红少津,脉细涩。本证以大便干燥难于排出为辨证要点" + }, + { + "question_num": 347, + "query": "患者,男,42岁。胸闷且痛,心悸盗汗,头晕目眩,心烦不寐,腰酸膝软,舌红少津,脉细数,其治法是", + "options": { + "A": "益气养血,宁心和络", + "B": "补气活血,通络止痛", + "C": "益气温阳,活血通络", + "D": "滋阴益肾,养心安神", + "E": "行气活血,温经止痛" + }, + "answer": "D", + "reason": "心肾阴虚,血瘀凝滞痹阻心脉,故见胸闷且痛,后面证候俱为阴虚火旺之象，治宜滋阴益肾,养心安神,方用左归饮。" + }, + { + "question_num": 348, + "query": "患者,女,28岁,已婚。每于经行小腹冷痛,得热痛减,月经量少,持续2~3天,色暗质稀,腰腿酸软,舌淡苔白,脉沉细尺弱,其治法是", + "options": { + "A": "散寒除湿止痛", + "B": "温经暖宫止痛", + "C": "行气活血止痛", + "D": "利湿活血止痛", + "E": "益肾养肝止痛" + }, + "answer": "B", + "reason": "痛经,由得热痛减,月经量少,持续2~3天,色暗、质稀,腰腿酸软,舌淡苔白,脉沉细尺弱,辨证为寒凝血瘀证，故治法是温经暖宫止痛。" + }, + { + "question_num": 349, + "query": "组成药物中含有蒲黄、五灵脂的方剂是", + "options": { + "A": "血府逐瘀汤", + "B": "通窍活血汤", + "C": "膈下逐瘀汤", + "D": "少腹逐瘀汤", + "E": "身痛逐瘀汤" + }, + "answer": "D", + "reason": "少腹逐瘀汤的组成:小茴香、干姜、延胡索、没药、当归、川芎、肉桂、赤芍、蒲黄、五灵脂。" + }, + { + "question_num": 350, + "query": "患者,男,60岁。形寒便溏,完谷不化，夜尿频多清长，下肢不温，舌质淡白,脉沉细，其舌苔应是", + "options": { + "A": "透明苔", + "B": "白干苔", + "C": "黄苔", + "D": "黄腻苔", + "E": "灰苔" + }, + "answer": "A", + "reason": "由题目中描述的诸症可判定患者为脾肾阳虚证,B项常见于风热表证，不符合题意,可排除;C项主热证、里证;D项主湿热内蕴、痰饮化热或食积化热，因此也要排除E项主热极或寒盛,故排除。通过排除法可确定答案为A。" + }, + { + "question_num": 351, + "query": "患者,男,60岁。胸闷疼痛,痰多气短1-uH浊腻,脉滑。治疗应首选", + "options": { + "A": "瓜蒌薤白半夏汤合涤痰汤", + "B": "枳实薤白桂枝汤", + "C": "血府逐瘀汤", + "D": "瓜蒌薤白白酒汤", + "E": "柴胡疏肝散" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 352, + "query": "患者,女,36岁,已婚。经行时肢体疼痛麻木,肢软无力，月经量少，色淡质薄，面色无华,舌淡,苔白,脉细弱。治疗应首选", + "options": { + "A": "八珍汤", + "B": "当归补血汤", + "C": "血府逐瘀汤", + "D": "趁痛丸", + "E": "圣愈汤" + }, + "answer": "B", + "reason": "经行身痛。由肢��无力，月经量少,色淡质薄,面色无华,舌淡,苔白,脉细弱,辨证为血虚证,代表方剂是当归补血汤。" + }, + { + "question_num": 353, + "query": "大秦艽汤的功用是", + "options": { + "A": "祛风清热,养血活血", + "B": "疏风养血,清热除湿", + "C": "疏风止血", + "D": "祛风化痰止痉", + "E": "祛风除湿,化痰通络" + }, + "answer": "A", + "reason": "大秦艽汤祛风清热,养血活血。主治手足不能运动，舌强不能育语，故选A。" + }, + { + "question_num": 354, + "query": "患者,男,70岁。神志痴呆,表情淡漠，举止失常，面色晦滞,胸闷泛恶，舌苔白腻,脉滑,其病机是", + "options": { + "A": "痰迷心窍", + "B": "痰火扰心", + "C": "心血瘀阻", + "D": "肾精亏虚", + "E": "心脾两虚" + }, + "answer": "A", + "reason": "表情淡漠，神志痴呆，举止失常多由肝气郁结，气郁生痰，痰浊上蒙心窍所致，属于损证。面色晦滞为外感湿浊之邪，湿浊郁遏中焦，清阳不升，浊气上泛。脘闷作恶为胃失和降，胃气上逆，舌苔白腻，脉滑是痰浊内盛之象。。" + }, + { + "question_num": 355, + "query": "患者心烦不寐,心悸不安,头晕,耳鸣健忘,腰酸梦遗,五心烦热,口干津少,舌红,脉细数，其治法是", + "options": { + "A": "清心宁神,养阴除烦", + "B": "养阴生津,除烦宁神", + "C": "清火除烦,宁心安神", + "D": "滋阴降火,养心安神", + "E": "滋阴宁心,镇惊安神" + }, + "answer": "D", + "reason": "肾阴不足,心肾不交,心火上炎,故见心烦不寐，心悸不安,头晕,耳鸣健忘,腰酸梦遗,五心烦热,口干津少,舌红,脉细数。治宜滋阴降火,养心安神。" + }, + { + "question_num": 356, + "query": "患者,女,20岁,未婚。每于经期鼻衄,是多、色深红,心烦易怒,口苦咽干,尿黄便结近3个月来,月经提前7天,量少、色红,舌红苔黄,脉弦数,其诊断是", + "options": { + "A": "逆经肺肾阴虚证", + "B": "月经先期血热证", + "C": "逆经肝经郁火证", + "D": "月经先期肝郁化热证", + "E": "月经过少血虚证" + }, + "answer": "C", + "reason": "由题干每于经期鼻衄,辨病为逆经，由心烦易怒，口苦咽干，尿黄便结，辨证为肝经郁火证。" + }, + { + "question_num": 357, + "query": "平胃散与藿香正气散组成中均含有的药物是", + "options": { + "A": "陈皮、白术", + "B": "陈皮、厚朴", + "C": "陈皮、苍术", + "D": "厚朴、苍术", + "E": "白术、厚朴" + }, + "answer": "B", + "reason": "平胃散：苍术、厚补、陈皮、甘草。藿香正气散:藿香、白芷、紫苏、茯苓、半夏曲、陈皮、白术、厚朴、姜汁、苦桔梗、炙甘草。" + }, + { + "question_num": 358, + "query": "患者,女,70岁。冠心病史5年。今日突然心悸气短,不能平卧,咳嗽,咳粉红色泡沫样痰。应首先考虑的是", + "options": { + "A": "肺癌", + "B": "肺脓肿", + "C": "肺结核", + "D": "急性肺水肿", + "E": "支气管扩张" + }, + "answer": "D", + "reason": "肺癌剧烈干咳,痰中带血丝。肺脓肿咯脓痰。肺结核痰中带血丝,伴低热,盗汗。急性肺水肿为粉红色泡沫样痰。支气管扩张痰量较多，为湿性咳嗽，" + }, + { + "question_num": 359, + "query": "患者突然仆倒，昏不知事，口吐白沫四肢抽搐，口中喊叫，无口眼歪斜及半身不遂，老伞诊断龙", + "options": { + "A": "中风", + "B": "痉证", + "C": "痫证", + "D": "厥证", + "E": "眩晕" + }, + "answer": "C", + "reason": "痫病的特点“一昏二抽三无后遗症”,痉证不昏迷,厥证、眩晕不抽搐,中风有口眼喁斜、半身不遂的后遗症。" + }, + { + "question_num": 360, + "query": "患者,女,51岁。月经不规律,精神萎靡,头晕耳鸣,腰痛如折,腹冷阴坠;形寒肢冷淡苔白滑,脉沉细而迟，其治法是", + "options": { + "A": "滋肾益阴", + "B": "滋阴潜阳", + "C": "益肾清肝", + "D": "补肾扶阳,益养冲任", + "E": "温肾壮阳,填精养血" + }, + "answer": "E", + "reason": "" + }, + { + "question_num": 361, + "query": "患者,男，18岁。突然出现无痛性腹泻,米泔水样便，量多,大便频繁,继之出现喷射状呕吐，呕吐物为米泔水样。查体：神志淡漠,声音嘶哑,眼窝深凹,口唇干燥。应首先考虑的是", + "options": { + "A": "霍乱", + "B": "急性细菌性痢疾", + "C": "急性胃肠炎", + "D": "伤寒", + "E": "副伤寒" + }, + "answer": "A", + "reason": "霍乱的腹泻,为无痛性,无里急后重感,每日大便数次甚至难以计数，多,每天2000~4000ml,严重者8000ml以上初为黄水样，不久转为米��水样便，少数患者有血性水样便或柏油样便,腹泻后出现喷射性呕吐;初为胃内容物继而水样、米泔样,由于剧烈泻吐，体内大量液体及电解质丢失而出现脱水表现。轻者口渴,眼窝稍陷,唇舌干燥;重者烦躁不安,眼窝下陷,两颊深凹,精神呆滞,皮肤于而皱缩失去弹性，声音嘶哑，四肢冰凉体温下降。因血液浓缩,脉搏细弱,心音低钝，血压下降。" + }, + { + "question_num": 362, + "query": "患者,男,50岁。昏仆抽搐吐涎,两目上视,口中如作猪羊叫,平时情绪急躁,心烦失眠,咯痰不爽,口苦而干,舌红苔黄腻,脉弦滑数。治疗应首选", + "options": { + "A": "知柏地黄丸合定痫丸", + "B": "天王补心丹合定痫丸", + "C": "顺气导痰汤合二阴煎", + "D": "龙胆泻肝汤合涤痰汤", + "E": "滋水清肝饮合定痈丸" + }, + "answer": "D", + "reason": "患者昏仆抽搐吐涎,两目上视,口中如作猪羊叫,此为痫病;见“心烦失眠。咳痰不爽,口苦而干,舌红苔黄腻,脉弦滑数这类痰火扰神证,应用“龙胆泻肝汤合涤痰汤清肝泻火,化痰开窍。" + }, + { + "question_num": 363, + "query": "患者,女,40岁。带下量多,色黄或白,质黏稠,有臭气,小腹作痛,或阴痒,便秘溺赤，舌红苔黄厚腻,脉滑数。治疗应首选", + "options": { + "A": "五味消毒饮", + "B": "龙胆泻肝汤", + "C": "草游渗湿汤", + "D": "止带方", + "E": "易黄汤" + }, + "answer": "D", + "reason": "诊断为带下过多湿热下注证,代表方剂止带方。" + }, + { + "question_num": 364, + "query": "患者,女,18岁。2周前患扁桃体炎，近日心悸，气短，发热，出汗,踝、膝关节游走性疼痛。查体:心率110次/分,第一心音减弱,上肢内侧皮肤有环形红斑。应首先考虑的是", + "options": { + "A": "病毒性心肌炎", + "B": "类风湿关节炎", + "C": "风湿热", + "D": "亚急性感染性心内膜炎", + "E": "系统性红斑狼疮" + }, + "answer": "C", + "reason": "风湿热的临床表现:皮肤环形红斑，多见于躯干及四肢屈侧，呈环形或半环形,边缘稍隆起,早淡红色,环内皮肤颜色正常。此种红斑常于摩擦后表现明显，1天之内可时隐时现,消退后不遗留脱屑及色素沉着。" + }, + { + "question_num": 365, + "query": "患者暴饮过食之后,突然昏厥,气息窒塞,脘腹胀满,舌苔厚腻,脉滑实。经探吐治疗后应首选", + "options": { + "A": "藿香正气散", + "B": "藿朴夏苓汤", + "C": "大分已涨七", + "D": "神术散合保和丸", + "E": "越鞠丸" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 366, + "query": "患者,女,40岁,已婚。月经规律,平时带下量多,色黄,黏稠,无臭气,纳呆,大便黏腻不爽,苔黄腻,脉濡数。治疗应首选", + "options": { + "A": "止带方", + "B": "内补丸", + "C": "易黄汤", + "D": "参苓白术散", + "E": "草邢渗湿汤" + }, + "answer": "A", + "reason": "为湿热下注,代表方剂止带方。" + }, + { + "question_num": 367, + "query": "患者,男,60岁。慢性支气管炎病史20年,近半年活动后心悸,气短。查体：有肺气肿体征,两肺散在干、湿啰音、剑突下可见心尖搏动,肺动脉瓣区第二心音亢进。应首先考虑的是", + "options": { + "A": "冠心病", + "B": "肺心病", + "C": "风心病", + "D": "高血压性心脏病", + "E": "心肌炎" + }, + "answer": "B", + "reason": "肺心病的临床表现有原发病的症状(两肺散在干、湿啰音)，体检有肺动脉瓣区第二心音亢进(为右心室肥大的表现)" + }, + { + "question_num": 368, + "query": "患者,女,59岁。胃痛时作,喜温喜按空腹痛甚,得食痛减,纳差,大便溏薄,舌淡苔白,脉虚弱。治疗应首选", + "options": { + "A": "贯煎", + "B": "左归丸", + "C": "化肝煎", + "D": "黄芪建中汤", + "E": "龙胆泻肝汤" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 369, + "query": "患者,女,32岁,已婚。妊娠2个月，近日因恶阻而恶心、呕吐,呕吐酸苦水,不能进食胸满胁痛,舌红苔黄,脉弦滑,其证候是", + "options": { + "A": "肝胃不和", + "B": "胃虚", + "C": "胃热", + "D": "痰滞", + "E": "以上均非" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 370, + "query": "患者,40岁。高热寒战3天,伴咳嗽，胸痛，痰中带血。为确诊，应首选的检查方法是", + "options": { + "A": "肺部听诊", + "B": "血常规检查", + "C": "X线检查", + "D": "痰结核菌检查", + "E": "血培养" + }, + "answer": "C", + "reason": "高热寒战3天,伴咳嗽,胸痛,痰中带血提示肺部可能出现疾病，��此应选择既经济又能检查肺部大部分疾病的筛查性检查方法X线。" + }, + { + "question_num": 371, + "query": "患者以胃脘痞塞,满闷不舒为主,按之柔软,压之不痛,望无胀形。发病缓慢,时轻时重,反复发作,病程漫长。多因饮食、情志、起居、寒温等因素诱发,其诊断是", + "options": { + "A": "胃痛", + "B": "鼓胀", + "C": "治狮", + "D": "胸痹", + "E": "结胸" + }, + "answer": "C", + "reason": "痞满的特点是胃脘痞塞,满闷不舒,按之柔软,压之不痛,望无胀形。" + }, + { + "question_num": 372, + "query": "患者,女,29岁。已婚2年一直未孕既往月经周期26~28天,行经期4~6天。现停经45天,突然左下腹撕裂样剧痛,并伴头晕恶心,面色苍白。不应采取的措施是", + "options": { + "A": "妊娠试验", + "B": "腹部叩诊", + "C": "后穹隆穿刺", + "D": "立即转院", + "E": "妇科检查" + }, + "answer": "D", + "reason": "符合异位妊娠破裂的临床表现，应采取的处理是患者平卧，采用妊娠试验、腹部叩诊、后穹隆穿刺、妇科检查,以明确诊断,而不应转院，以免途中发生生命危险。" + }, + { + "question_num": 373, + "query": "患者,女,40岁。3年前发现患有风湿性心脏病,近半年来，体力活动明显受限,轻度活动即出现心悸,气短,其心功能为", + "options": { + "A": "I级", + "B": "Ⅱ级", + "C": "Ⅲ级", + "D": "Ⅳ级", + "E": "以上均非" + }, + "answer": "C", + "reason": "美国纽约心脏病学会(NY-HA)1928年发布的心功能分级。工级:患者患有心脏病但活动量不受限制，平时一般活动不引起疲乏、心悸、呼吸困难或心绞痛。工级:心北注由长的人太门AArE华小无自觉症状，但平时一般活动下可出现疲乏、心悸、呼吸困难或心绞痛。Ⅲ级:心脏病患者体力活动明显受限，小于平时一般活动即引起上述的症状。Ⅳ级:心脏病患者不能从事任何体力活动。休息状态下也出现心衰的症状，体力活动后加重。" + }, + { + "question_num": 374, + "query": "患者呕吐多为清水痰涎,脘闷不食,头晕心悸,舌苔白腻,脉滑,其证候为", + "options": { + "A": "饮食积滞", + "B": "痰饮内阻", + "C": "脾胃虚弱", + "D": "脾阳虚衰", + "E": "气滞痰阻" + }, + "answer": "B", + "reason": "脾不运化,痰饮内阻,胃气不降,故见呕吐清水痰涎,脘闷不食。水饮上犯清阳,故头晕心悸。" + }, + { + "question_num": 375, + "query": "患者,女,23岁,已婚。孕后心烦少寐渴喜冷饮,腰酸腹痛,伴阴道少量出血，舌红苔黄,脉滑数。治疗应首选", + "options": { + "A": "清热固经汤", + "B": "保阴煎", + "C": "加味阿胶汤", + "D": "加味圣愈汤", + "E": "以上均非" + }, + "answer": "B", + "reason": "诊断为胎动不安血热证,方剂首选保阴煎。" + }, + { + "question_num": 376, + "query": "患者,男,50岁。半年来经常突发胸骨后疼痛,有窒息感,持续1~5分钟,休息后迅速缓解，心电图示ST段下移及T波倒置。应首先考虑的是", + "options": { + "A": "稳定型劳累性心绞痛", + "B": "初发劳累性心绞痛", + "C": "恶化型劳累性心绞痛", + "D": "自发性心绞痛", + "E": "急性心肌梗死" + }, + "answer": "A", + "reason": "稳定型心绞痛指劳力型心绞痛,每次发作频率和诱因相同,疼痛性质和部位无改变,疼痛时限相仿(3~5分钟),休息或自服硝酸甘油后相同时间内产生疗效。发作时心电图可见ST段下移及T波倒置,故选A。B项定义为最近1个月内初次发生劳力型心绞痛;C项恶化型指3个月内疼痛的频率、程度、时限、诱因经常变动,进行性恶化,可发作于安静或熟睡时，ST段可压低或拾高;E项发作时疼痛时间超过30分钟，且休息或硝酸甘油不缓解,心电图亦不符合,故排除，" + }, + { + "question_num": 377, + "query": "患者吞咽梗阻,胸膈痞闷,情志舒畅时可稍减轻,口干咽燥,舌偏红苔薄腻,脉弦滑。治疗应首选", + "options": { + "A": "通幽汤", + "B": "涤痰汤", + "C": "温胆汤", + "D": "玉枢丹", + "E": "启膈散" + }, + "answer": "E", + "reason": "痰气交阻用启膈散开郁化痰,润燥降气,故选E,瘀血内结用通幽汤。" + }, + { + "question_num": 378, + "query": "患者,男,23岁。右前臂内侧有红丝一条,向上走窜,停于肘部。用砭镰疗法的操作要点是", + "options": { + "A": "沿红线两头,针刺出血", + "B": "梅花针沿红线叩刺,微微出血", + "C": "用三棱针沿红线寸寸挑断,并微微出血", + "D": "用三棱针点刺出血", + "E": "梅花针沿红线打刺,微微出血,并加神灯照法" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 379, + "query": "患者,男,40岁。乙肝病史10年,近2个月来右上腹胀痛加重,检查:面部有蜘蛛痣，右上腹压痛，肝肋缘下3cm。质硬，ALT40U，HBsAg(+)，AFP500μg/L。应首先考虑的是", + "options": { + "A": "慢性乙肝活动期", + "B": "乙肝合并肝硬化", + "C": "乙肝合并胆囊炎", + "D": "原发性肝癌", + "E": "继发性肝瘤" + }, + "answer": "D", + "reason": "患者有10年乙肝病史,且HBSAg(+);体检发现蜘蛛痣、右上腹压痛、肝大、质硬,为肝硬化表现;查AFP升高,故首先考虑为乙肝→肝硬化→原发性肝癌这三阶梯，目前已达第三阶段,故选C。HBV是我国原发性肝癌的重要致病因素之一" + }, + { + "question_num": 380, + "query": "患者呃声洪亮,冲逆而出,口臭烦渴喜冷饮,小便短赤,大便秘结,舌苔黄,脉滑数,其治法是", + "options": { + "A": "清胃化痰止呃", + "B": "清热化湿降逆", + "C": "清热化瘀止呃", + "D": "清胃平肝降逆", + "E": "清降泻热止呃" + }, + "answer": "E", + "reason": "阳明热盛,胃火上冲,故见呃声洪亮,冲逆而出,热灼伤津故见口臭烦渴喜冷饮,小便短赤,大便秘结,舌苔黄,脉滑数。治宜清热泻火,降逆止呃。" + }, + { + "question_num": 381, + "query": "患者,男,38岁。左瓶面部疔疮,根深坚硬,形如钉丁状,红肿灼痛,伴发热、恶寒、头痛等全身症状,舌红苔腻,脉滑数,其治法是", + "options": { + "A": "清热消肿", + "B": "和营消肿", + "C": "清热凉血", + "D": "清热解毒", + "E": "和营托毒" + }, + "answer": "D", + "reason": "" + }, + { + "question_num": 382, + "query": "患者,男,20岁。近2周自觉乏力，食欲不振，厌油,腹胀。检查:巩膜无黄染，肝肋缘下2cm,有压痛,谷丙转氨酶升高。应首先考虑的是", + "options": { + "A": "急性肝炎", + "B": "慢性肝炎", + "C": "重型肝炎", + "D": "淤胆型肝炎", + "E": "急性心肌梗死" + }, + "answer": "A", + "reason": "患者有乏力,食欲不振,厌油的症状说明肝脏出现问题，而体检发现肝大并且有压痛,谷丙转氨酶升高，而没有消瘦的症状,并且发病较急,考虑急性肝炎。" + }, + { + "question_num": 383, + "query": "患者胸胁胀闷,嗳气食少,每因抑郁恼怒之时，发生腹痛泄泻,舌淡红，脉弦,其治法是", + "options": { + "A": "调理脾胃", + "B": "疏肝理气", + "C": "抑肝扶脾", + "D": "泻肝和胃", + "E": "疏肝和胃" + }, + "answer": "C", + "reason": "肝气郁滞,乘犯脾胃,故胸胁胀闷,嗳气食少,并于抑郁恼怒之时加重,气滞于中则腹痛,脾运无权,水谷下趋则泄泻,俱是肝气乘脾之象,治应抑肝扶脾。" + }, + { + "question_num": 384, + "query": "患者,女,28岁。右口角疔疮2天,根深坚硬,形如钉丁状,热红肿,疼痛,张口不便,伴恶寒发热，古音腻,脉滑数。治疗应首选", + "options": { + "A": "五味消毒饮", + "B": "清暑汤", + "C": "防风通圣散", + "D": "普济消毒饮", + "E": "银翘散" + }, + "answer": "A", + "reason": "生在口角的,称为锁口疔。感受火热之邪,热毒蕴于肌肤,以致营卫不和，经络阻隔，气血凝滞;气不通则肿，血不通则痛;火为阳邪,性热而色赤,故皮色红而灼热;毒邪炽盛,与正气相搏,属于热毒蕴结。应清热解毒,用五味消毒饮。" + }, + { + "question_num": 385, + "query": "患者大便时溏时泻,水谷不化,稍进油腻之物,则大便次数增多,食少,脘腹胀闷,面黄,肢倦乏力,舌淡苔白,脉细弱。治疗应首选", + "options": { + "A": "四君子汤", + "B": "大建中汤", + "C": "参苓白术散", + "D": "小建中汤", + "E": "补气运脾汤" + }, + "answer": "C", + "reason": "泄泻有虚实之分,此为脾胃虚弱导致的泄泻,应用\"参苓白术散”健脾益气,化湿止泻,故选C。" + }, + { + "question_num": 386, + "query": "患者,男,50岁。1周前项后发际处突发一肿块,红肿热痛,渐渐加剧,其后出现多个粟米样脓头,部分溃破、溢脓,其治法是", + "options": { + "A": "凉血祛风,行瘀通络", + "B": "凉血清热,解毒利湿", + "C": "和营托毒,清热利湿", + "D": "清热解毒,活血通络", + "E": "养阴清热,托毒透邪" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 387, + "query": "患者腹痛,里急后重,下痢赤白相杂，肛门灼热,小使短赤,舌苔微黄,脉滑数,其治法是", + "options": { + "A": "清热解毒,调气行血", + "B": "清热化湿,理气止痛", + "C": "清热凉血,和胃利湿", + "D": "清肠和胃,利湿解毒", + "E": "清胃利湿,和胃通降" + }, + "answer": "A", + "reason": "湿热之邪毒积滞肠中,气血被阻,传导失司,故腹痛、里急后重,湿热游邪伤肠破血,故下痢赤白相间。治宜清热解毒,调气行血。" + }, + { + "question_num": 388, + "query": "患者,男,78岁。患背部有头疽月余:局部疮形平塌,根盘散漫,疮色紫滞,溃后脓水稀少,伴有唇燥口干,便艰溲短,舌质红,脉细数。内治应首选", + "options": { + "A": "仙方活命饮", + "B": "竹叶黄芪汤", + "C": "托里消毒散", + "D": "知柏地黄汤", + "E": "清骨散" + }, + "answer": "B", + "reason": "阴液亏虚,虚火内生,复感湿热毒邪,阴虚无水制火热之邪,而使毒蕴更甚,故疮色紫滞,疼痛剧烈;属于阴虚火炽。治法:滋阴生津,清热解毒。方药:竹叶黄芪汤加减。" + }, + { + "question_num": 389, + "query": "患者发病急骤,痢下鲜紫脓血,腹痛剧烈,里急后重较甚,壮热口渴，舌红绛苔黄燥,脉滑数,其诊断是", + "options": { + "A": "湿热痢", + "B": "疫毒痢", + "C": "休息痢", + "D": "寒湿痢", + "E": "以上均非" + }, + "answer": "B", + "reason": "患者发病急骤,痢下鲜紫脓血,腹痛剧烈,可诊断为“疫毒痢”应“清热解毒,凉血除积”,用白头翁汤,故选B。" + }, + { + "question_num": 390, + "query": "患者,男,48岁。因鼻部破损引起头额红肿,两目肿胀不能外视,伴形寒发热，舌红苔黄腻,脉滑数。治疗应首选(", + "options": { + "A": "化斑解毒汤", + "B": "普济消毒饮", + "C": "龙胆泻肝汤", + "D": "五神汤", + "E": "仙方活命饮" + }, + "answer": "B", + "reason": "舌红、苔薄黄、脉滑数为邪热尚在表之象。治法:疏风清热解毒。方药:普济消毒饮加减。龙胆泻肝汤泻肝胆之火，仙方活命饮治疗痈证。" + }, + { + "question_num": 391, + "query": "患者大便不干硬,虽有便意，临厕努挣无力，挣则汗出短气，便后疲乏，面色白，舌淡嫩苔薄,脉虚,其治法是", + "options": { + "A": "补脾和胃", + "B": "温阳通便", + "C": "益气补肺", + "D": "温中健脾", + "E": "益气润肠" + }, + "answer": "E", + "reason": "肺脾气虚,运化失职,大肠传导无力,故虽有便意,临厕努挣无力,汗出短气,便后疲乏,面色觥白,舌淡嫩苔薄,脉虚,均为气虚之征,治宜益气,便秘都要润肠。" + }, + { + "question_num": 392, + "query": "患儿,男,12岁。患流痰3年,溃口位于左腰部,脓水稀薄,夹有败絮样物,伴有午后潮热,夜间盗汗,口燥咽干,咳嗽痰血,舌红少苔,脉细数。治疗应首选", + "options": { + "A": "阳和汤", + "B": "知柏地黄丸", + "C": "清骨散", + "D": "人参养荣汤", + "E": "六味地黄丸" + }, + "answer": "C", + "reason": "患者属于阴虚火旺之象治法为养阴除蒸。以上方药能养阴除蒸的只有清骨散。" + }, + { + "question_num": 393, + "query": "患者,男,60岁。久患胁痛,悠悠不休,遇劳加重,头晕目眩,口千舌燥,舌红少苔,脉弦细。治疗应首选", + "options": { + "A": "柴胡疏肝散", + "B": "逍遥散", + "C": "杞菊地黄丸", + "D": "一贯煎", + "E": "二阴煎" + }, + "answer": "D", + "reason": "肝阴不足,阴血难以养肝络,故见胁痛悠悠不休,劳则耗气,故遇劳加重,精血亏虚故头晕目眩，口干咽燥，舌红少苔,脉弦细。证属肝阴不足，治宜养阴柔肝，方用一贯煎。" + }, + { + "question_num": 394, + "query": "患者,女,28岁。产后乳房胀痛,位于乳房外上方皮肤掀红，肿块形似鸡卵，压痛明显,按之中软,有波动感,伴壮热口渴。切开引流的部位及切口是", + "options": { + "A": "循乳络方向做放射状切口", + "B": "乳晕旁弧形切口", + "C": "脓肿处作任意切口", + "D": "以乳头为中心的弧形切日", + "E": "脓肿波动明显处作切口" + }, + "answer": "A", + "reason": "一般采用与乳头方向呈放射状的切口，切口位置选择脓肿稍低的部位:切口长度与脓腔基底的大小一致，使引流通畅不致袋脓,但需避免手术损伤乳络形成乳瘘，因为乳腺每一腺叶有单独的腺管(乳管)呈放射状聚向乳头，并分别开口于乳头。" + }, + { + "question_num": 395, + "query": "患者黄疽日久，黄色晦暗如烟熏,纳少脘闷,大便溏,神疲畏寒,舌淡不渴,舌淡苔腻,脉沉迟。治疗应首选", + "options": { + "A": "茵陈酱汤", + "B": "茵陈五苓散", + "C": "甘露消毒丹", + "D": "黄连温胆汤", + "E": "茵陈术附汤" + }, + "answer": "E", + "reason": "黄疽日久,损伤脾阳,脾气失司,寒湿内盛,故纳少脘闷,大便溏,神疲畏寒,口淡不渴,黄色晦暗如烟露,证属两黄的寒湿内盛证型,治宜温化寒湿、健脾退黄，方用茵陈术附汤。" + }, + { + "question_num": 396, + "query": "患者,女,40岁。双乳肿胀疼痛,月经前加重,经后减轻,肿块大小不等,形态不一伴乳头溢液,月经不调,腰酸乏力,舌淡苔白,脉弦细,其证候是", + "options": { + "A": "肝郁痰凝", + "B": "肝气郁结", + "C": "冲任失调", + "D": "肝郁火旺", + "E": "肝郁脾虚" + }, + "answer": "C", + "reason": "冲任失调,上则乳房痰浊凝结,故乳房肿块伴胀痛;下则经水逆乱，故月经周期紊乱，最少色淡，甚或闭经;脾失健运气血亏虚,故神疲乏力,头晕;冲为血海,隶属肝肾,冲任失调,肝气不舒,故经前加重,经水一行,肝气得舒,故经后缓减;肝肾不足,故腰酸乏力;舌淡、脉沉细为冲任失调之象。" + }, + { + "question_num": 397, + "query": "患者,女,53岁。腹中可及积块,软而不坚,固着不移,胀痛并见,舌苔薄,脉弦,其证候是", + "options": { + "A": "肝气郁滞", + "B": "瘀血内结", + "C": "气滞血阻", + "D": "气滞痰阻", + "E": "气虚血瘀" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 398, + "query": "患者,女,50岁,未婚。右乳内上方可及2cm×2cm×2cm肿物,无疼痛,质地韧，不光滑,界限不清,基底不粘连,推之可移动。应首先考虑的是", + "options": { + "A": "乳癖", + "B": "乳疬", + "C": "乳痨", + "D": "乳岩", + "E": "乳腺增生病" + }, + "answer": "C", + "reason": "乳痨是以乳房结块如梅李,不痛,边界不清,皮肉相连,肿块化脓,溃后脓出稀薄,疮口不易收敛,病程缓慢为主要表现的结核性疾病。" + }, + { + "question_num": 399, + "query": "患者因肺肾阴虚，虚火妄动，脉络受伤而致咳血。治疗应首选", + "options": { + "A": "孔最", + "B": "梁丘", + "C": "隐白", + "D": "曲泽", + "E": "定喘" + }, + "answer": "A", + "reason": "孔最主治:咯血、咳嗽、气喘、咽喉肿痛等肺系病证及肘臂挛痛" + }, + { + "question_num": 400, + "query": "患者,女,42岁。乳头溢出血性液体1周,同时伴有急躁易怒,胸胁胀痛，口苦咽干,舌红苔黄,脉弦数,其证候是", + "options": { + "A": "阴虚火旺", + "B": "肝郁脾虚", + "C": "肝郁火旺", + "D": "脾虚失摄", + "E": "气血两阴" + }, + "answer": "C", + "reason": "乳衄是以乳窍溢出血性液体,乳头或乳晕部触及可活动的质软、不痛肿块为主要表现的乳房肿瘤。由于情志抑郁,肝气不舒,郁而化火,灼伤血络,迫血妄行,旁走横溢而发;或由于思虑伤脾,统血无权，血流胃经,溢于乳窍而成,其只有肝郁火旺和脾不统血2个证型，所以与情志有关的只有肝郁火旺。" + }, + { + "question_num": 401, + "query": "患者,男,23岁。右前臂内侧有红丝一条，向上走窜,停于肘部。用砭镰疗法的操作要点是", + "options": { + "A": "沿红线两头,针刺出血", + "B": "梅花针沿红线叩刺,微微出血", + "C": "用三棱针沿红线寸寸挑断,并微微出血", + "D": "用三棱针点刺出血", + "E": "梅花针沿红线叩刺,微微出血,并加神灯照法" + }, + "answer": "C", + "reason": "" + }, + { + "question_num": 402, + "query": "患者,女,28岁,已婚。颈前肿物10余年,渐渐增大,边缘不清,皮色如常,无疼痛可触及肿物表面结节,随吞咽上下移动，其诊断是", + "options": { + "A": "肉瘿", + "B": "石瘿", + "C": "瘿痈", + "D": "气瘿", + "E": "血瘿" + }, + "answer": "A", + "reason": "石瘿多见于40岁以上患者,多年存在的颈部肿块,突然迅速增大，坚硬如石,表面凹凸不平,随吞咽动作而上下的移动度减少,或固定不移。而气瘿边界不清,故排除。瘿痈有压痛。" + }, + { + "question_num": 403, + "query": "患儿，女,10岁。阵发性右上腹绞痛伴恶心、呕吐,腹部平软。用特定穴治疗，应首选", + "options": { + "A": "原穴", + "B": "络穴", + "C": "背俞穴", + "D": "八会穴", + "E": "下合穴" + }, + "answer": "E", + "reason": "治疗六腑病证均可选用各相应的下合穴。此患者所患疾病应与腑病相关,故应选用下合穴" + }, + { + "question_num": 404, + "query": "患者,女,52岁。颈前结喉右侧肿物3cm×3cm×2cm,质地较硬,表面不光,不能随吞咽而上下移动,同时伴有局部疼痛,音哑，临床考虑为石瘳。行同位素\"扫描,其结果多是", + "options": { + "A": "温结节", + "B": "热结节", + "C": "冷结节", + "D": "无改变", + "E": "中性结节" + }, + "answer": "C", + "reason": "甲状腺同位素”1扫描,多显示为凉结节(或冷结节)。" + }, + { + "question_num": 405, + "query": "患者,男,50岁。肩关节疼痛,痛有定处,抬举困难,夜间痛甚,劳���加剧,治疗应首选", + "options": { + "A": "手太阳经穴", + "B": "近部取穴为主", + "C": "近部取穴与远部取穴相结合", + "D": "循经取穴", + "E": "手少阳经穴" + }, + "answer": "C", + "reason": "此患者所患之证为痹证:其取穴原则应近部取穴与远部取穴相结合。" + }, + { + "question_num": 406, + "query": "患者,男,48岁。肩背皮肤浅层肿块与皮肤粘连,瘤体表面中心有黑色粗大毛孔挤压时有臭脂浆溢出，其诊断是", + "options": { + "A": "脂瘤", + "B": "肉瘤", + "C": "流痰", + "D": "血瘤", + "E": "筋瘤" + }, + "answer": "A", + "reason": "" + }, + { + "question_num": 407, + "query": "患者,男,24岁。颈项强痛,活动受限,头向患侧倾斜,项背牵拉痛，颈项部压痛明显,兼见恶风畏寒。治疗除取主众外，还应选用的穴位是", + "options": { + "A": "内关、外关", + "B": "肩井、后溪", + "C": "风池、合谷", + "D": "血海、阴陵泉", + "E": "肾俞、关元" + }, + "answer": "C", + "reason": "由本病患者的症状可以得出所患疾病为颈椎病,兼见恶风畏寒，所以治疗上应该兼顾颈椎病和疏风散寒，故选取疏风散寒的风池穴和合谷穴。" + }, + { + "question_num": 408, + "query": "患者,女,58岁。左侧腰周出现绿豆大水疱,簇集成群,累累如串珠,排列成带状,疼痛较重,舌苔薄黄,脉弦数,其诊断是", + "options": { + "A": "接触性皮炎", + "B": "药物性皮炎", + "C": "蛇串疮", + "D": "热疮", + "E": "湿疮" + }, + "answer": "C", + "reason": "蛇串疮是一种皮肤上出现成簇水疱,呈带状分布,痛如火燎的急性疱疹性皮肤病。皮疹多发生于身体一侧,不超过正中线,但有时在患部对侧,亦可出现少数皮疹，皮损好发于腰胁、胸部、头面、颈部,亦可见于四肢、阴部及眼、鼻、曰等处,故可判断为C。" + }, + { + "question_num": 409, + "query": "患者，男，55岁。1年来每日黎明之前腹微痛,痛即泄泻,或肠鸣而不痛,腹部和下肢畏寒,舌淡苍白,脉沉细。治疗除取主穴外，还应加", + "options": { + "A": "胃俞、合谷", + "B": "肝俞、内关", + "C": "三焦俞、公孙", + "D": "命门、关元", + "E": "关元俞、三阴交" + }, + "answer": "D", + "reason": "由本患者的症状可知本病为泄泻之肾虚泄泻，故治疗上要配肾俞穴、命门、关元等补肾虚的腧穴。" + }, + { + "question_num": 410, + "query": "患儿,3岁。体重14kg,身长86cm。该患儿的生长发育状况为", + "options": { + "A": "体重正常,身长偏高", + "B": "体重正常,身长偏低", + "C": "体重偏高,身长正常", + "D": "体重偏高,身长偏低", + "E": "体重偏低,身长正常" + }, + "answer": "B", + "reason": "临床可用以下公式推算小儿体重:1岁以上体重(kg)=8+2x年龄。2岁后至12岁儿童的身高(身长):身高(cm)=70+7x年龄,将患儿的年龄代人计算,其理想体重应该为14kg,理想身长为91cm。对比后可知体重正常,身长偏低。" + }, + { + "question_num": 411, + "query": "患者,男,22岁。发热恶寒,寒重热轻,头痛身痛,鼻塞流涕,咳,咳清稀,舌苔薄白,脉浮紧。治疗应首选", + "options": { + "A": "手太阴、手阳明、足太阳经穴", + "B": "手少阴、手太阳、手太阴经穴", + "C": "手太阴、足太阳、手少阳经穴", + "D": "手太阴、手少阳、足少阳经穴", + "E": "手阳明、足阳明、手太阴经穴" + }, + "answer": "A", + "reason": "由本患者的症状可知本病为感冒之风寒感冒,所以应首选手太阴肺经疏风散寒;手阳明大肠经与肺经相表里，故选足太阳膀胱经的脑穴以解表宣肺，" + }, + { + "question_num": 412, + "query": "患儿,22天。面目皮肤发黄，色泽鲜明如橘皮,精神疲倦,不欲吮乳,尿黄便秘,舌红苔黄,其证候是", + "options": { + "A": "肝失疏泄", + "B": "瘀积发黄", + "C": "寒湿阻滞", + "D": "湿热熏蒸", + "E": "胆道不利" + }, + "answer": "D", + "reason": "湿热熏蒸是由于孕母素体湿盛或内蕴湿热之毒,遗于胎儿，或因胎产之时、出生之后,婴儿感受湿热邪毒所致。热为阳邪,故黄色鲜明如橘皮。" + }, + { + "question_num": 413, + "query": "患者,男,22岁。左眼不能闭合2天,左侧额纹消失。治疗应选取何经穴为主", + "options": { + "A": "手、足少阳经", + "B": "手、足太阴经", + "C": "手、足太阳经", + "D": "手、足厥阴经", + "E": "手、足阳明经" + }, + "answer": "E", + "reason": "由本患者的症状可知本病为中风，因风病多犯阳明，分别选取手足阳明经穴位,以达调和经脉,疏通气血的作用，" + }, + { + "question_num": 414, + "query": "患儿,2岁。咳嗽2天,咳声不爽,痰黄黏稠,口渴咽痛,鼻流浊涕,伴发热、恶心、头痛、微汗出，舌红苔薄黄,脉浮数,其证候是", + "options": { + "A": "风寒咳嗽", + "B": "风热咳嗽", + "C": "痰热咳嗽", + "D": "痰湿咳嗽", + "E": "阴虚燥咳" + }, + "answer": "B", + "reason": "" + }, + { + "question_num": 415, + "query": "患者,男,45岁。大便秘结不通,排便艰难,伴腹胀痛，身热,口干口臭,喜冷饮,舌红,苔黄,脉滑数。治疗除取主穴外，还应选用的穴位是", + "options": { + "A": "足三里、三阴交", + "B": "中脘、太冲", + "C": "神阙、关元", + "D": "合谷、内庭", + "E": "气海、脾俞" + }, + "answer": "D", + "reason": "由本患者的症状可知本病为便秘之实证,故治疗应清热理气、通导肠腑故应选用内庭和合谷穴，内庭乃胃经荣穴，宣散肠胃积热，合谷穴亦可以清热:" + }, + { + "question_num": 416, + "query": "患儿,10岁。昨天受凉后,见喷、鼻塞、流清涕,今晨起喘咳,咳痰稠黄,口渴欲饮大便干燥。查体:鼻扇，口周紫绀,咽红,双肺满布哮鸣音,舌质红,苔薄白,脉滑数,其证候是", + "options": { + "A": "寒性哮喘", + "B": "热性哮喘", + "C": "外寒内热", + "D": "肺实肾虚", + "E": "肺肾阴虚" + }, + "answer": "C", + "reason": "本证之外寒多由外感风寒所致,其内热一则常因外邪入里化热或素蕴之痰饮郁遏而化热，一则常为平素体内有热邪蕴积,被外邪引动而诱发。临床辨证以外有风寒之表证,内有痰热之里证为要点。" + }, + { + "question_num": 417, + "query": "患者,女,41岁。精神抑郁善忧,情绪不宁,伴胸胁胀满,脘闷嗳气,不思饮食,大便不调,脉弦。治疗除取主穴外，还应选用的穴位是", + "options": { + "A": "曲泉、膻中、期门", + "B": "行间、侠溪、外关", + "C": "通里、心俞、三阴交、太溪", + "D": "太溪、三阴交、肝俞、肾俞", + "E": "心俞、脾俞、足三里、三阴交" + }, + "answer": "E", + "reason": "由本患者的症状可知本病为抑郁症。抑郁从心而得，故选用心俞以宁心安神;又其不思饮食,故选用脾俞,调理脾胃;三阴交可以调整其心肾不交之证，足王里促进身体的恢复。" + }, + { + "question_num": 418, + "query": "患儿,7岁。曾咳喘反复发作。现面色眺白,气短懒言,倦怠乏力,自汗怕冷,舌淡苔薄,脉细无力。治疗应首选", + "options": { + "A": "玉屏风散", + "B": "六君子汤", + "C": "金匮肾气丸", + "D": "二陈汤", + "E": "参苓白术散" + }, + "answer": "A", + "reason": "“曾咳喘反复发作”此为交代病史,所给信息不足以作出诊断,但此与解题关系不大，不需理会。自汗怕冷,说明肺气虚而卫表不固。面色白，气短懒言,倦怠乏力,自汗怕冷,舌淡苔薄均为气虚表现。由此可诊断为肺气虚。治宜补肺固表，方用玉屏风散:故选A。六君子汤主治脾胃气虚兼有痰湿;金匮肾气丸主治肾阳不足;二陈汤主治痰湿咳嗽;参苓白术散主治脾胃气虚夹湿。" + }, + { + "question_num": 419, + "query": "患者,女,23岁。痛经9个月,经行不畅,小腹胀痛,拒按,经色紫红,夹有血块,血块下后痛即缓解,脉沉涩。治疗应首选", + "options": { + "A": "足三里、太冲、三阴交", + "B": "中极、次髎、地机", + "C": "合谷、三阴交", + "D": "曲池、内庭", + "E": "合谷、归来" + }, + "answer": "B", + "reason": "由本患者的症状可知本病为实证选用散寒逐瘀,通经止痛的中极、次髎地机。中极为任脉经穴，可通调冲任脉之气散寒行气;次髎为治疗痛经之经验穴;地机为脾经郄穴，可疏调脾经经气而止痛。三穴合用，以达通经散寒、温经止痛之功效,故选B。" + }, + { + "question_num": 420, + "query": "患儿,6岁。泄泻1天,泻下稀薄如水注,粪色深黄臭秽,夹有少量黏液。腹部时感疼痛,食欲减退,恶心欲吐,口渴引饮,舌红苔黄腻,其证候是", + "options": { + "A": "脾肾阳虚泻", + "B": "伤食泻", + "C": "风寒泻", + "D": "湿热泻", + "E": "脾虚泻" + }, + "answer": "D", + "reason": "泄泻辨病容易,重在辨证“粪色深黄臭秽”“口渴引饮”“舌红苔黄腻”为关键症状,表明内有湿热,所以辨其证候为湿热泻。" + }, + { + "question_num": 421, + "query": "患者,女,22岁。月经不调,常提前7天以上,甚至10余日一行。治疗应首选", + "options": { + "A": "足三里、脾俞、太冲", + "B": "命门、三阴交、足三里", + "C": "关元、三阴交、血海", + "D": "气海、三阴交、归来", + "E": "关元、三阴交���肝俞" + }, + "answer": "C", + "reason": "由本患者的症状可知本病为月经先期。应选用清热调经的关元、血海、三阴交,关元为任脉经穴，足三阴经之交会，故为调理冲任之要穴;血海调理血分;三阴交为妇科疾病的要穴。" + }, + { + "question_num": 422, + "query": "患儿,3岁。面色少华,不思纳食,形体偏瘦,舌淡苔薄白,其治法是", + "options": { + "A": "健脾化湿", + "B": "健脾和胃", + "C": "疏肝和胃", + "D": "消食导滞", + "E": "和脾助运" + }, + "answer": "E", + "reason": "患儿主症为不思纳食,诊断为厌食。除厌食外其他症状不著,精神正常,所以为厌食症。初期脾失健运证，治宜调和脾胃,运脾开胃。" + }, + { + "question_num": 423, + "query": "患者,女,21岁。食鱼虾后皮肤出现片状风团,瘙痒异常。治疗取神阙穴，所用的方法是", + "options": { + "A": "针刺", + "C": "拔罐", + "B": "隔盐灸", + "D": "隔姜灸", + "E": "艾条灸" + }, + "answer": "C", + "reason": "患者食鱼虾后皮肤出现片状风团,癌痒异常,为食物过敏的现象，属中医瘾疹。瘾疹可用拔罐法治疗，在神阙穴拔火罐,留罐5分钟,取下再拔罐留5分钟,如此3次为1次治疗。神阙穴一般不针。瘾疹治宜疏风和营,病在营血。隔盐灸有回阳、救逆、固脱的功效。隔姜灸有温胃止呕，散寒止痛的功效。艾条灸有温经散寒,扶阳固脱,消瘀散结的功效。" + }, + { + "question_num": 424, + "query": "患儿,2岁。形体极度消瘦,面呈老人貌,皮包骨头,腹凹如舟,精神萎靡,大便溏薄舌淡苔薄腻,其证候是", + "options": { + "A": "疳肿胀", + "C": "疳积", + "B": "疳气", + "D": "干疳", + "E": "心疳" + }, + "answer": "D", + "reason": "干疳,亦称“疳极”,临床表现为极度消瘦,貌似老人,腹凹如舟,精神萎靡。" + }, + { + "question_num": 425, + "query": "患儿,6岁。2个月来胃纳不振,精神疲倦,伴有低热,遍身汗出,微恶风寒。治疗应首选", + "options": { + "A": "玉屏风散", + "B": "牡蛎散", + "C": "生脉散", + "D": "黄芪桂枝五物汤", + "E": "当归六黄汤" + }, + "answer": "D", + "reason": "患儿主症是遍身汗出2个月,诊为汗证。遍身汗出可见于营养失调和气阴亏虚,但气阴亏虚以盗汗为主，此患儿为自调。治宜调和营卫，方用黄芪桂枝五物汤。" + }, + { + "question_num": 426, + "query": "患儿,男,6岁。皱眉眨眼,摇头耸肩,嘴角抽动,时伴异常发声,病情时轻时重。抽动能受意志遏制,可暂时不发作。查脑电图未见异常,其诊断是", + "options": { + "A": "习惯性抽搐", + "B": "多发性抽搐症", + "C": "癫痫", + "D": "注意力缺陷多动症", + "E": "风湿性舞蹈病" + }, + "answer": "B", + "reason": "由皱眉眨眼,摇头耸肩,嘴角抽动,时伴异常发声可诊为多发性抽搐症。" + } +] \ No newline at end of file