[ { "question": "对于终末期肝病患者，以下哪种治疗方案被认为是最合适的？", "options": "A. 使用肝细胞生长因子\nB. 人工肝\nC. 肝移植\nD. 保肝药物维持\nE. 中药", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "以下哪些因素可能导致急性胰腺炎的发生？", "options": "A. 大量饮酒\nB. 腹部外伤或手术\nC. 胆道梗阻\nD. 血脂和血钙水平异常\nE. 过度饮食", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，脾脏肿大的主要原因是什么？", "options": "A. 门静脉压力增高\nB. 肝静脉压力增高\nC. 腹水的压迫使脾血液回流障碍\nD. 毒性产物的刺激\nE. 肝动脉压力增高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，有10年慢性乙肝病史，最近4个月出现右上腹隐痛、乏力、食欲减退和体重下降。体检发现皮肤无黄染，右上腹肝区有轻度叩痛，肝脾未触及肿大。B超检查显示肝右叶有一个2cm×3cm×4cm的圆形低密度病灶。为了进一步明确诊断，下列哪项检查最为关键？", "options": "A.乳酸脱氢酶\nB.丙氨酸氨基转移酶\nC.甲胎蛋白\nD.碱性磷酸酶\nE.γ-谷氨酰转肽酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在慢性胰腺炎急性发作期间，以下哪项营养治疗原则最为合适？", "options": "A.禁食24小时\nB.禁食48小时\nC.禁食不少于3天\nD.禁食，待病情缓解后，给予高碳水化合物、低脂半流质膳食\nE.少量多餐", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在解剖学上，胰腺疾病和胆道疾病之间存在关联的主要原因是什么？", "options": "A.胰腺导管和胆总管下端有共同通道、共同开口\nB.胰腺有副胰管和胆总管相通\nC.胰管与胆总管两者解剖位置靠近\nD.胆总管和胰腺导管开口于十二指肠内侧壁\nE.胰腺导管开口于胆总管开口之下", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于胆道蛔虫病的治疗，以下哪种方法不应作为首选？", "options": "A. 解痉治疗\nB. 止痛治疗\nC. 驱虫治疗\nD. 手术治疗\nE. 抗炎治疗", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁女性患者，平时健康状况良好，但近一年来出现上腹隐痛并伴有腹部膨隆，食欲减退，恶心和呕吐。体检发现右上腹可触及一肿块，无明显压痛，且能随呼吸上下移动。关于肝囊肿的描述，以下哪项是错误的？", "options": "A. 囊肿多发生于左叶\nB. 多发性囊肿以40~60岁的女性多见\nC. 小的囊肿并且无症状者，无需特殊处理\nD. 多发性囊肿不主张手术治疗\nE. 囊肿切除术适用于肝边缘部位、带蒂突向腹腔的囊肿", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的发病机制中，哪种学说被认为是中心学说？", "options": "A.氨中毒学说\nB.假性神经递质学说\nC.综合学说\nD.γ-氨基丁酸学说\nE.血浆氨基酸失衡学说", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝破裂出血的肝外伤治疗中，以下哪种做法是不恰当的？", "options": "A.绝对卧床\nB.症状不明显、出血少的应观察\nC.出现出血征象时大量输血\nD.边输血，边手术\nE.控制出血后，立即处理肝损伤，尽快结束手术", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性出血性坏死型胰腺炎的诊断中，以下哪项是最具特征性的实验室检查结果？", "options": "A. 血淀粉酶明显升高\nB. 白细胞计数增高\nC. 血糖升高\nD. 休克\nE. 恶心，呕吐", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在重症病毒性肝炎患者中，导致出血倾向的主要病理机制是什么？", "options": "A. 骨髓造血功能障碍，血小板减少\nB. 凝血因子合成障碍\nC. 毛细血管脆性增加\nD. Ⅹ、Ⅻ因子减少\nE. 维生素K吸收障碍", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁女性患者因持续中上腹痛3小时，伴有恶心和呕吐前来急诊。体检发现腹部柔软，上腹部有轻度压痛，无反跳痛，血淀粉酶水平为300U（Somogyi法）。这种情况下，最可能的诊断是什么？", "options": "A. 急性胃炎\nB. 急性阑尾炎\nC. 消化性溃疡穿孔\nD. 急性胆囊炎\nE. 急性胰腺炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆汁的组成成分中，以下哪一项不属于其正常成分？", "options": "A. 胆色素\nB. 胆酸盐\nC. 脂肪酶\nD. 胆固醇\nE. 电解质", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门腔静脉分流术后，患者出现肝性脑病的主要原因是", "options": "A. 血糖升高\nB. 血清镁升高\nC. 血清钾升高\nD. 血氨升高\nE. 血栓形成", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性硬化性胆管炎的临床特征中，以下哪一项描述是不正确的？", "options": "A. 该疾病在女性中的发病率高于男性\nB. 患者常表现为乏力、瘙痒，随后可能出现黄疸和体重下降\nC. 胆管造影技术是确诊该疾病的最可靠方法\nD. 治疗上，熊去氧胆酸被推荐为首选药物\nE. 该病的发生与遗传和免疫因素密切相关，而感染则作为诱发因素", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位53岁男性患者，长期饮酒21年，平均每日约150ml，现诊断为重度肝硬化伴腹水。主治医生在指导实习医生制定治疗方案时，特别指出应避免使用肥皂水灌肠、不宜使用碱性利尿药，并在必要时采用弱酸性透析液进行结肠透析。这些措施的主要目的是", "options": "A. 避免酸碱失衡\nB. 防止离子紊乱\nC. 降低肝性脑病风险\nD. 减少氨的吸收\nE. 减轻门脉高压", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在特发性门静脉高压的诊断和治疗中，以下哪项描述是错误的？", "options": "A. 该病症主要涉及肝窦前性门静脉压力的增加\nB. 肝细胞再生形成的假小叶对肝窦的压迫是主要原因\nC. 主要临床表现包括脾脏肿大、贫血和出血倾向\nD. 门静脉纤维变性与此病症有关\nE. 首选治疗方法通常是进行分流手术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者出现腹胀症状，经肝胆脾超声检查显示肝硬化并伴有腹水，腹腔游离液体深度为5.1cm。关于肝硬化患者腹水形成的原因，以下哪项描述是不正确的？", "options": "A. 血浆胶体渗透压下降\nB. 门静脉压力增加\nC. 淋巴回流受阻\nD. 醛固酮减少\nE. 有效循环血量减少", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，以下哪种情况通常不需要进行手术治疗？", "options": "A. 胰腺假性囊肿\nB. 胆源性胰腺炎\nC. 继发性胰腺感染、脓肿\nD. 急性水肿性胰腺炎\nE. 多次反复发作胰腺炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎患者中，呕吐后腹痛通常会怎样变化？", "options": "A. 减轻\nB. 缓解\nC. 加重\nD. 消失\nE. 不减轻", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，槟榔肝通常指的是哪种病理状态？", "options": "A. 血吸虫病引起的肝脏病变\nB. 慢性肝炎导致的肝脏变化\nC. 慢性淤血引起的肝脏改变\nD. 胆汁性淤积导致的肝脏异常", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌患者的疼痛管理中，以下哪项护理措施是不恰当的？", "options": "A. 提供心理支持和安慰\nB. 确保环境安静舒适\nC. 使用音乐疗法分散患者注意力\nD. 帮助患者缓解心理压力\nE. 严格控制止痛药物的使用", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，有15年的慢性肝炎病史。超声检查显示肝脏表面不规则，回声增强且分布不均。在右肝前叶发现一个5cm×4cm的低回声结节，结节周围有声晕，边界清晰，内部回声均匀。彩色多普勒显示结节内有高速高阻动脉血流信号。最可能的诊断是什么？", "options": "A. 慢性肝炎\nB. 慢性肝炎合并肝硬化\nC. 肝硬化合并肝癌\nD. 肝硬化合并肝囊肿\nE. 肝硬化合并肝血管瘤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名16岁女性患者，近10个月来出现右上腹疼痛并伴有黄疸，症状逐渐加重，大便呈陶土色。患者曾于出生后6天接受过先天性胆总管囊肿十二指肠吻合术。经过消炎利胆治疗后未见好转。该患者最可能的合并症是什么？", "options": "A. 胆道造影\nB. 吻合口狭窄\nC. 肝硬化\nD. 结石\nE. 癌变", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的治疗中，以下哪种治疗方案是不推荐的？", "options": "A. 肥皂水灌肠+新霉素+精氨酸\nB. 生理盐水灌肠+谷氨酸钠+左旋多巴\nC. 补充葡萄糖+新霉素+精氨酸\nD. 生理盐水+白醋灌肠+左旋多巴\nE. 生理盐水灌肠+中止蛋白质饮食+新霉素", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的诊断和治疗中，以下哪一项说法是不正确的？", "options": "A. 肝区疼痛通常是肝癌的首发症状\nB. 手术切除在早期肝癌治疗中效果最佳\nC. 肝脏肿大是中晚期肝癌的常见体征\nD. AFP检测结果为阴性即可排除原发性肝癌\nE. AFP水平超过400μg/L且影像学支持可确诊肝癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于肝硬化腹水患者，每日的进水量应控制在多少？", "options": "A. 250ml左右\nB. 500ml左右\nC. 750ml左右\nD. 1000ml左右\nE. 1500ml左右", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪项关于血清铁和总铁结合力的描述是正确的？", "options": "A. 血清铁降低，总铁结合力增高\nB. 血清铁增高，总铁结合力降低\nC. 血清铁、总铁结合力均增高\nD. 血清铁、总铁结合力均降低\nE. 血清铁增高，总铁结合力正常", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "急性胰腺炎的发病与以下哪种饮食习惯最为相关？", "options": "A. 持续性腹痛阵发加重\nB. 过食、饮酒后发生\nC. 常发生在进油腻食物后\nD. 腹痛在剧烈活动后发生\nE. 转移性疼痛", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝血管瘤的血管造影检查中，以下哪一项表现不符合典型特征？", "options": "A. 供血动脉轻度增粗，可受压移位\nB. 动脉期可见点状、团状对比剂浓染，成半弧或马蹄形分布\nC. 供血动脉粗细不均、杂乱\nD. 无门静脉异常显影\nE. 静脉期仍见对比剂滞留，呈早出晚归征", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病患者中，哪种情况通常预后最不乐观？", "options": "A. 肝硬化伴有腹水的患者\nB. 肝硬化伴有出血倾向的患者\nC. 由暴发性肝炎引起的患者\nD. 肝硬化伴有黄疸的患者\nE. 诱因明确且易于消除的患者", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病患者的饮食管理中，当开始增加动物蛋白摄入时，以下哪项是正确的？", "options": "A. 选择产氨较多的蛋白质\nB. 不宜供给含植物蛋白质的食品\nC. 应增加含氮多的动物蛋白\nD. 动物性蛋白中牛奶含氮最少\nE. 动物性蛋白中鸡肉含氮最少", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞损害的情况下，凝血因子的异常会随着损害程度的增加而增多。请问，以下哪种维生素依赖性的凝血因子会首先减少？", "options": "A. 维生素A依赖性凝血因子\nB. 维生素C依赖性凝血因子\nC. 维生素D依赖性凝血因子\nD. 维生素E依赖性凝血因子\nE. 维生素K依赖性凝血因子", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者，近10余天出现乏力和食欲不振。体检显示无明显黄疸，肝右肋下1cm可触及，脾未扪及。肝功能检查显示血清ALT为120u/L。2个月前，患者因溃疡病出血接受了1000mL输血，术后恢复顺利。为了进一步明确病原，应首先考虑进行哪项检查？", "options": "A. 抗HAV-IgM\nB. 抗HEV\nC. HAV-RNA\nD. HCV-RNA\nE. HEV-RNA", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁的男性患者，因胆总管结石接受了胆总管切开探查、取石手术，并放置了T管引流。术后T管造影显示仍有0.5cm的残余结石。请问，术后多长时间可以通过T管瘘管取出残余结石？", "options": "A.术后2周\nB.术后4周\nC.术后6周\nD.术后8周", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位67岁的女性患者，有10余年的胆石症病史。2小时前在餐后出现剧烈上腹痛，疼痛向腰背部放射，伴有恶心、呕吐和发热。查体显示：血压120/70mmHg，心率92次/分，巩膜轻度黄染，上腹有明显压痛，伴有反跳痛和肌紧张，移动性浊音阴性。实验室检查显示血清淀粉酶1200U/L，血钙2.0mmol/L，血糖8.0mmol/L。关于该患者的治疗方案，以下哪项是错误的？", "options": "A. 禁食水\nB. 胃肠减压\nC. 抗生素\nD. 抑酸\nE. 及早肠内营养", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位68岁的男性患者，因持续上腹部和腰背部疼痛2个月就诊，疼痛在夜间加重，前倾坐位时有所缓解。患者自述体重减轻10kg。在这种情况下，最合适的初步检查方法是", "options": "A. 腹部平片\nB. 选择性腹腔动脉造影\nC. B超\nD. 穿刺活检术\nE. 十二指肠低张造影", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝海绵状血管瘤的临床管理中，以下哪项并发症的描述是不正确的？", "options": "A. 胆管梗阻\nB. 肿瘤恶性变\nC. 肿瘤破裂导致腹腔内出血\nD. 继发感染导致肝脓肿\nE. 压迫肺部引起呼吸困难", "answer": "ABDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者李某，女，45岁，因持续性上腹部疼痛、体重下降和黄疸2周前来就诊。实验室检查显示血清胆红素显著升高，CEA和CA199水平异常增高，而AFP、CA125、SCC、CA724、CYFRA211、NSE、PSA均在正常范围内。根据这些临床表现和检查结果，最可能的诊断是什么？", "options": "A. 小细胞肺癌\nB. 非小细胞肺癌\nC. 肝癌\nD. 前列腺癌\nE. 胰腺癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科的超声检查中，区分肝囊肿与Caroli病的关键依据是什么？", "options": "A. 病灶的形态差异\nB. 病灶的大小区别\nC. 病灶的数目不同\nD. 囊柱状囊腔是否相互连通\nE. 后方声增强效应的程度", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名15岁男性患者，两周前因自行车把撞击上腹部受伤，近一周出现上腹部隆起，进食后上腹胀满并伴有恶心呕吐。体检发现上腹部可触及18cm×13cm的囊性肿块，钡餐透视显示横结肠下移。最可能的诊断是", "options": "A.腹膜后血肿\nB.胰腺囊腺瘤\nC.假性胰腺囊肿\nD.肠系膜囊肿\nE.脾包膜下血肿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在乙肝患者的实验室检查中，以下哪项指标的阳性结果最能提示患者具有较高的传染性？", "options": "A. HBsAg\nB. HBsAb\nC. HBeAg\nD. 抗-HBe\nE. 抗HBc-IgM", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者因持续上腹部疼痛3天，伴有恶心和呕吐，呕吐物为少量胃内容物。体检发现上腹部压痛，巩膜轻度黄染，体温38.2℃。实验室检查显示血清淀粉酶为58温氏单位，尿淀粉酶为312温氏单位。临床怀疑为急性胰腺炎，为进一步确诊，应首选以下哪项检查？", "options": "A. 腹部立位平片\nB. 肝胆胰脾彩色超声检查\nC. 血、尿淀粉酶测定\nD. 心电图\nE. 动脉造影", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估门静脉高压的临床诊断时，以下哪一项不应被视为诊断依据？", "options": "A.脾脏肿大\nB.腹壁静脉或食管下段静脉曲张\nC.上消化道出血和腹腔积液\nD.肝功能、血常规、凝血功能异常\nE.伴随体重减轻和营养不良", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏代谢过程中，下列哪种物质无法被肝脏直接利用？", "options": "A. 脂肪\nB. 糖类\nC. 酮体\nD. 蛋白质\nE. 胆固醇", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，近一年来在剧烈活动或饱餐后常出现剑突下疼痛，疼痛向咽部放射，通常持续数分钟后自行缓解。最近两周，疼痛发作频率增加，甚至在夜间睡眠中也会发作。两小时前，患者疼痛加剧，无法缓解，疼痛向胸部及后背部放射，伴有憋闷和大汗。该患者最可能的诊断是什么？", "options": "A. 主动脉夹层分离\nB. 自发性气胸\nC. 急性胰腺炎\nD. 急性肺动脉栓塞\nE. 急性心肌梗死", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者主诉在仰卧位时腹痛加重，而在前倾位或俯卧位时疼痛减轻，这种情况最可能提示以下哪种疾病？", "options": "A. 十二指肠淤滞症\nB. 胰体癌\nC. 反流性食管炎\nD. 胃粘膜脱垂\nE. 胃溃疡", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下肝炎病毒中，哪种病毒最可能导致慢性感染？", "options": "A. 甲型肝炎病毒\nB. 乙型肝炎病毒\nC. 丙型肝炎病毒\nD. 丁型肝炎病毒\nE. 戊型肝炎病毒", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位38岁男性患者，因急性胰腺炎入院治疗。在康复期间，患者饮用了一碗肉汤后，再次出现上腹部剧烈疼痛，且注射654-2无效，同时伴有腹胀。此时应采取的处理措施是", "options": "A.禁食+注射吗啡+输液\nB.胃肠减压+输液+哌替啶\nC.注射阿托品+安痛定\nD.胃肠减压+阿托品+输液", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在预防肝癌的研究中，以下哪种维生素被发现能够抑制黄曲霉毒素的合成，从而降低肝癌的发生风险？", "options": "A. 维生素B12\nB. 维生素A\nC. 维生素B6\nD. 维生素B2\nE. 维生素C", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "李某，女，60岁。因乙肝肝硬化并发肝性脑病入院治疗。经过一段时间的治疗后，患者意识恢复清醒，医生建议逐步增加蛋白质摄入量，但强调短期内每日蛋白质摄入量不应超过多少？", "options": "A.40到50g/d\nB.60到70g/d\nC.80到90g/d\nD.100到110g/d\nE.120g/d", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在工业生产中，以下哪种化学物质被证实与肝血管肉瘤的发生有直接关联？", "options": "A. 铬酸盐\nB. 氯甲醚\nC. 氯乙烯\nD. 联苯胺\nE. 多环芳烃", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位70岁男性患者因上消化道大出血急诊入院。手术中发现胃窦部黏膜有一个巨大的火山口状溃疡，切面质硬，呈磁白色，并已侵入肌层。同时，肝内发现数个小结节，手术切除后送病理检查，诊断为胃癌肝转移。这些肝内小结节的病理变化最可能是", "options": "A. 小结节由肝细胞构成\nB. 小结节由印戒细胞构成\nC. 小结节由假小叶构成\nD. 小结节由鳞癌细胞构成", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，腹水的形成与以下哪项因素无关？", "options": "A. 门静脉压力增高\nB. 淋巴液生成过多\nC. 继发性醛固酮和抗利尿激素减少\nD. 低蛋白血症\nE. 水钠潴留", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹部X线检查中，下列哪种类型的胆囊结石通常能够显影？", "options": "A. 胆固醇结石\nB. 胆色素结石\nC. 混合性结石\nD. 泥沙样结石\nE. 黑结石", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的治疗和特征中，以下哪一项描述是不正确的？", "options": "A. 肝切除是首选的治疗方法\nB. 主要通过直接浸润转移\nC. 大多数病例为肝细胞癌\nD. 原发性肝癌常与乙型或丙型肝炎病毒感染相关\nE. 肝细胞癌通常在肝硬化的基础上发展", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者出现血性腹水，但无腹痛及发热症状，最可能的诊断是什么？", "options": "A. 结核性腹膜炎\nB. 原发性肝癌\nC. 门静脉血栓形成\nD. 肝-肾综合征\nE. 自发性腹膜炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者出现腹腔积液时，以下哪种治疗方案最为合适？", "options": "A. 休息，低盐饮食，限制入水量，补充白蛋白，使用利尿剂\nB. 休息，高热量高蛋白饮食，进行保肝治疗\nC. 休息，高热量限制蛋白质饮食，输入支链氨基酸\nD. 休息，禁食，积极补足血容量及采用各种止血措施\nE. 休息，使用保钾利尿剂，纠正电解质紊乱，限制蛋白质", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁的男性患者，身高175cm，体重95kg，有长期饮酒史，每日饮酒量约300ml，持续15年。近期体检发现肝功能异常，怀疑为酒精性肝病。为了确诊并评估病情分期，下列哪项检查最为可靠？", "options": "A.肝脏B超\nB.肝脏CT\nC.肝脏MRI\nD.肝活组织检查\nE.肝脏血管造影", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门脉高压的临床表现中，以下哪一项最具特异性？", "options": "A. 肝掌\nB. 脾功能亢进\nC. 周身水肿\nD. 食管静脉曲张\nE. 腹水", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在棘球蚴病中，最常受到侵害的人体实质器官是哪些？", "options": "A. 肝\nB. 肺\nC. 脑\nD. 脾\nE. 肾", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪种情况最可能导致血氨水平升高？", "options": "A. 胃肠道出血\nB. 胃肠蠕动增强\nC. 肠道内细菌活动减弱\nD. 脂肪摄入减少\nE. 糖类摄入增多", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，以下哪项措施被认为是不恰当的？", "options": "A. 使用迷走神经抑制剂\nB. 使用碳酸酯酶抑制剂\nC. 使用各种抗酸剂\nD. 使用吗啡或哌替啶（杜冷丁）进行镇痛解痉\nE. 使用胰酶活性抑制剂", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝囊肿的诊断和治疗中，以下哪项说法是不正确的？", "options": "A.肝囊肿可分为寄生虫性和非寄生虫性两类\nB.先天性肝囊肿在临床上较为常见\nC.B超检查是诊断肝囊肿的首选方法\nD.无症状的小肝囊肿通常不需要特殊处理\nE.多发性肝囊肿通常建议进行手术治疗", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胆囊炎的CT影像中，以下哪项表现最为典型？", "options": "A.胆囊壁增厚，可钙化\nB.胆囊缩小\nC.胆囊增大\nD.容易穿孔并在肝内形成脓肿\nE.均合并结石", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行胆道T形管造影时，以下哪项操作是不正确的？", "options": "A. 使用30%复方泛影葡胺20ml\nB. 患者采取仰卧位，头高足低位\nC. 抽取10ml胆汁与对比剂混合后注入\nD. 抽取胆管内空气及胆汁以保持负压\nE. 造影过程需在透视下进行", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位67岁的男性患者，近期出现皮肤和巩膜黄染且逐渐加重，大便颜色持续变浅，体重明显下降。最可能的诊断是", "options": "A. 急性病毒性肝炎\nB. 肝硬化\nC. 肝癌\nD. 胰头癌\nE. 胆总管结石", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断不明原因的肝外阻塞性黄疸时，推荐进行哪种手术？", "options": "A. 胆囊造瘘术\nB. 胆道探查及引流术\nC. 胆总管十二指肠吻合术\nD. 肝叶切除术\nE. 胆囊切除", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下关于肝脂肪变性原因的陈述中，哪一项是不正确的？", "options": "A. 化学毒物干扰脂蛋白合成，引起肝脂肪变性\nB. 糖尿病状态下，过量脂肪酸进入肝脏，导致肝脂肪变性\nC. 缺氧环境可诱发肝脂肪变性\nD. 摄入过多脂肪直接导致肝脂肪变性\nE. 白喉杆菌外毒素干扰脂肪酸代谢，引发肝脂肪变性", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在先天性胆总管囊肿的诊断中，以下哪组症状被认为是典型的临床表现？", "options": "A.腹痛、黄疸、发热\nB.腹痛、黄疸、腹块\nC.腹痛、腹块、发热\nD.腹块、黄疸、发热\nE.腹痛、黄疸、呕吐", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆管引流术的操作中，以下哪项描述是不正确的？", "options": "A. 在经皮经肝胆道内-外引流术中，引流管的侧孔部分应跨越狭窄胆道的两侧\nB. 在经皮经肝胆道内-外引流术中，引流管在十二指肠内的头部应卷曲，以减少与十二指肠壁的摩擦\nC. 胆道支架置入后，应进行内-外引流1周，关闭3天以上，若无不良反应再拔管\nD. 在经皮经肝胆道内-外引流术中，引流管的侧孔应位于狭窄胆道的近端胆管内\nE. 在经皮经肝胆道外引流术中，引流管的侧孔应位于狭窄胆道的近端胆管内", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的病理生理过程中，以下哪项描述最全面？", "options": "A. 胰液中的各种酶被激活，对胰腺及其周围组织产生“自身消化”\nB. 弹力蛋白酶破坏血管壁、胰腺导管，使胰腺出血和坏死\nC. 胰舒血管素可使血管扩张、通透性增加，蛋白酶和脂肪酶造成组织细胞坏死\nD. 脂肪酶将脂肪分解成脂肪酸，使钙结合形成脂肪酸钙，血钙降低\nE. 以上都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁男性患者，因右上腹疼痛和黄疸持续3个月就诊。B超检查显示肝脏内有多发性散在性光团，AFP检测结果为阴性。诊断为继发性肝癌，其确诊的关键步骤是什么？", "options": "A. 肝穿刺\nB. 找出原发灶\nC. CT扫描\nD. MRI检查\nE. 肝血管造影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺的解剖结构中，下列哪些大血管与其位置关系最为密切？", "options": "A. 肠系膜上动脉\nB. 肠系膜上静脉\nC. 脾动脉、脾静脉\nD. 腹腔动脉、腹主动脉", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，原发性小肝癌的诊断标准通常是指肿瘤的最大直径不超过多少厘米？", "options": "A. 2cm\nB. 3cm\nC. 4cm\nD. 5cm\nE. 6cm", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝脏肿瘤的转移途径主要包括哪些？", "options": "A. 邻近器官肿瘤的直接侵犯\nB. 经肝门部淋巴路转移\nC. 经门静脉转移\nD. 经肝动脉转移", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位44岁女性患者，有10年乙型肝炎病史，近5个月来反复出现肝区疼痛，伴有间歇性恶心和体重下降。腹部B超检查发现左肝叶有一个直径约3cm的低回声肿块，血AFP水平为545ng/ml。根据这些信息，最可能的诊断是什么？", "options": "A. 活动性肝炎\nB. 早期肝硬化\nC. 生殖腺胚胎肿瘤\nD. 原发性肝癌\nE. 滋养层细胞肿瘤", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估肝硬化患者的皮肤变化时，护士可能会注意到蜘蛛痣的出现。以下哪个部位通常不会出现蜘蛛痣？", "options": "A. 手臂\nB. 胸部\nC. 面颈部\nD. 腹部\nE. 肩背部", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在重症急性胰腺炎的诊断中，以下哪项临床表现最具特异性？", "options": "A.腰肋部皮下瘀斑(Grey-Turner征）或者脐周皮下瘀斑(Cullen征）\nB.突然发病，有时疼痛限于上腹部，血清心肌酶学升高\nC.腹痛为阵发性，肠鸣音亢进，有气过水声\nD.疼痛位于右上腹，Murphy征阳性\nE.腹痛、腹肌紧张、肝浊音界消失、X线透视见膈下游离气体", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在淤血性肝硬化的病因和临床表现中，以下哪项描述是错误的？", "options": "A. 该病可由Budd-Chiari综合征引发\nB. 右心功能衰竭是常见诱因\nC. 肝小叶中心缺氧是主要发病机制\nD. 典型症状包括肝脏肿大和腹水\nE. 患者肝功能检查结果通常正常", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫症患者出现剧烈腹痛时，蛔虫最可能位于哪个部位？", "options": "A. 胆总管口\nB. 胆囊管内\nC. 胆总管内\nD. 胆总管壶腹内\nE. 胆襄内", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种酶是反映肝实质细胞损伤的指标？", "options": "A. ALT\nB. γ-GT\nC. CK\nD. AMY\nE. ChE", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位66岁的女性患者因长期肝区不适、食欲减退、恶心呕吐等症状被诊断为肝癌。家属担心患者无法承受病情真相，要求医生保密。当实习医生被患者询问病情时，应如何回应最为妥当？", "options": "A. 如实告知患者所有病情信息\nB. 坚持患者有权知晓真实病情，不应隐瞒\nC. 出于对患者心理承受能力的考虑，暂时隐瞒真实病情\nD. 建议患者向家属询问病情详情\nE. 以诚实守信为原则，向患者坦白病情", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名40岁男性在常规体检中发现血甲胎蛋白水平显著升高，超过500μg/L，同时血ALT水平为35U/L，体检未发现明显异常。根据这些信息，最可能的初步诊断是什么？", "options": "A. 肝硬化代偿期\nB. 肝硬化失代偿期\nC. 慢性迁延性肝炎\nD. 慢性活动性肝炎\nE. 亚临床肝癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，用于诊断胆管系统疾病的特异性血清酶是以下哪一种？", "options": "A. AST\nB. CK\nC. GGT\nD. ACP\nE. LPS", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于门静脉高压导致的上消化道出血，下列哪项描述是不正确的？", "options": "A. 门静脉压力升高导致门静脉与腔静脉之间的侧支循环扩张，这是出血的基础\nB. 在首次大出血后的1至2年内，再次出血的量通常会比第一次少\nC. 大约25%的患者在首次大出血时会直接导致急性肝衰竭而死亡\nD. 约50%的患者有呕血或黑便的病史，出血量大且迅速\nE. 肝功能损害引起的凝血功能障碍和脾功能亢进导致的血小板减少，使得出血不易自行停止", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名16岁男性患者，因右上腹阵发性绞痛持续12小时前来就诊。体检显示体温37.5℃，脉搏78次/分，血压110/70mmHg，腹部柔软，剑突下有深压痛，无肌紧张及反跳痛，Murphy征阴性，肠鸣音正常。实验室检查显示白细胞计数为11×10^9/L，中性粒细胞比例为75%。根据这些临床表现和检查结果，最可能的诊断是什么？", "options": "A.急性胆囊炎\nB.胃十二指肠溃疡穿孔\nC.急性化脓性胆管炎\nD.胆道蛔虫病\nE.急性胰腺炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝细胞癌的诊断中，以下哪个指标最具临床意义？", "options": "A. ALT\nB. AST\nC. ALP\nD. AFP\nE. MAO", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位成年女性患者，3年前曾患有黄疸型肝炎，近期出现乏力、食欲减退和肝区胀痛症状。体检显示慢性病容，皮肤黄染，但无明显肝掌和蜘蛛痣，肝脾未触及。实验室检查结果显示：ALT 150u/L，白蛋白35g/L，球蛋白31g/L，血清总胆红素16.5umol/L，甲胎蛋白200ug/L。根据这些信息，最可能的诊断是什么？", "options": "A. 慢性肝炎轻度\nB. 慢性肝炎中度\nC. 慢性肝炎重度\nD. 慢性重症肝炎\nE. 肝癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在梗阻性黄疸患者的尿液中，主要存在的胆红素形式是哪种？", "options": "A. 游离胆红素\nB. 葡萄糖醛酸胆红素\nC. 胆红素-清蛋白复合物\nD. 胆红素-Y蛋白", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏功能受损的早期阶段，下列哪种凝血因子的活性会首先降低？", "options": "A. FⅡ：C\nB. FⅤ：C\nC. FⅦ：C\nD. FⅧ：C\nE. FⅩ：C", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性结石性胆囊炎的急诊手术指征中，以下哪一项不是手术的适应症？", "options": "A. 黄疸进行性加重，出现肝功能损害者\nB. 临床症状严重，难以缓解，胆囊肿大且张力高，有穿孔风险者\nC. 腹膜刺激症状明显，在观察治疗过程中腹部体征加重者\nD. 寒战、高热、白细胞计数显著升高者\nE. 发病时间在48至72小时以内者", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断慢性胆囊炎时，以下哪种影像学检查方法是最常用的？", "options": "A. CT\nB. MRI\nC. PET\nD. USG\nE. 内镜活检", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的诊断中，以下哪些影像学表现是典型的？", "options": "A. 上消化道造影检查可出现十二指肠圈扩大，降部内缘出现反“3”字征\nB. CT可出现“双管征”\nC. CT可表现为胰腺的增大或肿块\nD. 血行转移以脾脏最为常见\nE. 增强扫描，病灶强化程度较周围胰腺组织低", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位32岁女性患者，突发右上腹阵发性绞痛，伴有发热和寒战，并出现少量柏油样便。体检显示急性病容，巩膜黄染。最可能的诊断是", "options": "A. 门静脉高压症\nB. 胃十二指肠溃疡\nC. 出血性胃炎\nD. 胆道出血\nE. 应激性溃疡性出血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝炎患者中，以下哪种药物可能诱发肝昏迷？", "options": "A. 地高辛\nB. 洋地黄毒苷\nC. 乙胺丁醇\nD. 异烟肼\nE. 呋塞米", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病患者的护理中，以下哪项措施是不恰当的？", "options": "A. 使用镇静剂处理烦躁患者\nB. 采用弱酸溶液进行灌肠\nC. 确保患者大便通畅\nD. 实施禁蛋白饮食\nE. 密切监测生命体征", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肠阿米巴病的肠外并发症中，以下哪些情况可能发生？", "options": "A.肺脓肿\nB.脑脓肿\nC.肝脓肿\nD.膈下脓肿", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科治疗中，以下哪种药物能够同时发挥利胆、缓解痉挛疼痛以及降低胆固醇的效果？", "options": "A. 熊去氧胆酸\nB. 鹅去氧胆酸\nC. 桂美酸\nD. 去氢胆酸\nE. 硫酸镁", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化早期诊断中，哪种方法被认为是最可靠的？", "options": "A. 肝功能检查\nB. B型超声\nC. 腹腔镜直视下活检\nD. CT\nE. 食管钡餐透视", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，以下哪种结构最可能表现为肝内线状强反射回声？", "options": "A. 血管横断面\nB. 肝窦状隙\nC. 纤维隔\nD. 肝硬化\nE. 非均匀脂肪肝", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的早期转移中，最常见的部位是哪个？", "options": "A. 肺\nB. 胰腺\nC. 胸膜\nD. 肝\nE. 大脑", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，以下哪种药物应避免使用？", "options": "A. 西咪替丁\nB. 吗啡\nC. 生长抑素\nD. 阿托品\nE. 哌替啶", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的昏迷前期，下列哪一项症状通常不会出现？", "options": "A. 定向力减退\nB. 意识模糊\nC. 扑翼样震颤\nD. 肌张力减退\nE. 脑电图异常", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在梗阻性黄疸患者的尿液实验室检查中，以下哪项指标可能会升高？", "options": "A.游离胆红素\nB.葡萄糖醛酸胆红素\nC.结合胆红素-白蛋白复合物\nD.胆红素-Y蛋白\nE.胆红素-Z蛋白", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在晚期血吸虫病的患者中，以下哪两项是最常见的并发症？", "options": "A. 肝脾肿大\nB. 消化道出血\nC. 缺铁性贫血\nD. 肝性昏迷\nE. 异嗜症", "answer": "BD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在妊娠晚期，如果孕妇合并急性病毒性肝炎，需要特别关注和积极治疗的主要原因是什么？", "options": "A. 容易合并妊高征及发生子痫\nB. 容易发展为重症肝炎，孕产妇死亡率增高\nC. 容易发生糖代谢障碍，影响胎儿发育\nD. 容易发生早产，胎儿不易存活\nE. 容易发生宫缩乏力，产程延长", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，以下哪种情况通常不需要外科手术干预？", "options": "A. 胰腺脓肿\nB. 急性呼吸窘迫综合征（ARDS）\nC. 暴发型急性胰腺炎\nD. 腹穿穿刺液为血性或浑浊脓性\nE. 腹痛剧烈，恶心呕吐频繁", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在功能性胰岛细胞瘤的临床特征中，以下哪一项描述是不正确的？", "options": "A. 高胰岛素血症\nB. Whipple三联症\nC. Letterer-Siwe综合征\nD. Zollinger-Ellison综合征\nE. Verner-Morrison综合征", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在CT影像中，观察到“中心点征”通常与胆管囊状扩张的哪种类型相关？", "options": "A. I型胆总管囊肿\nB. Ⅱ型胆总管憩室\nC. Ⅲ型壁内段胆总管囊状膨出\nD. Ⅳ型多发性肝内、外囊肿\nE. V型肝内多发性囊肿", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的发病风险中，除了乙型肝炎病毒（HBV）感染外，以下哪种病毒的感染也会显著增加患病风险？", "options": "A. 甲型肝炎病毒（HAV）\nB. 丙型肝炎病毒（HCV）\nC. 丁型肝炎病毒（HDV）\nD. 戊型肝炎病毒（HEV）\nE. 庚型肝炎病毒（HGV）", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估酒精性肝硬化患者是否适合进行肝移植时，下列哪项说法是不正确的？", "options": "A. 肝移植前应通过Child-Pugh评分或MELD评分判断预后\nB. Maddrey判别函数主要用于判断酒精性肝硬化患者的预后\nC. 酒精性肝病肝移植候选者的评估应谨慎，应由有经验的成瘾行为管理专家参与\nD. 戒酒至少3～6个月后再考虑肝移植\nE. 肝移植后仍需坚持戒酒", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，细菌性肝脓肿的典型临床表现是什么？", "options": "A. 补体结合试验阳性\nB. 甲胎蛋白阳性\nC. 右上腹绞痛及黄疸\nD. 穿刺抽出棕褐色脓液\nE. 突发寒颤高热，肝区疼痛，肝肿大", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎的诊断过程中，最需要与以下哪种疾病进行鉴别？", "options": "A. 胰腺癌\nB. 急性胰腺炎\nC. 胰腺囊肿\nD. 胰腺脓肿\nE. 胆道蛔虫病", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫病的诊断中，以下哪项描述最能概括其典型临床表现？", "options": "A. 中上腹“钻顶样”剧烈绞痛\nB. 突然发病，突然缓解\nC. 可有蛔虫吐出史\nD. 可伴轻度黄疸\nE. 以上都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的早期诊断中，以下哪项检查组合被认为是最有价值的？", "options": "A. AFP+肝动脉造影\nB. AFP+γ-GT\nC. AFP+放射性核素肝扫描\nD. AFP+肝穿刺活组织检查\nE. AFP+超声波检查", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺假性囊肿的手术治疗中，以下哪项描述是不正确的？", "options": "A. 对于持续腹痛无法忍受、影响生活质量或囊肿直径≥6cm并出现压迫症状的患者，应考虑手术治疗\nB. 如果囊肿合并感染或出血，且囊肿壁较薄无法进行内引流时，可采用经皮穿刺置管外引流\nC. 手术的最佳时机是在囊肿形成后的1个月内\nD. 对于位于小网膜囊内的胃后胰腺假性囊肿，可以直接与胃后壁进行吻合\nE. 对于其他部位的囊肿，通常采用囊肿空肠Roux-en-Y吻合术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于淤血性肝硬化的描述，以下哪一项是错误的？", "options": "A. 通常由右心功能衰竭导致\nB. 主要表现为肝脏肿大和腹水\nC. 其主要原因是循环系统障碍\nD. Budd-Chiari综合征也是其诱因之一\nE. 患者通常不会出现肝功能异常", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种疾病的主要临床表现是whipple三联征？", "options": "A.胰岛素瘤\nB.促胃液素瘤\nC.胰高血糖素瘤\nD.胰致腹泻瘤\nE.以上都可以", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪种疾病最常导致肝细胞性黄疸的发生？", "options": "A. 胆总管狭窄\nB. 病毒性肝炎\nC. 肝内泥沙样结石\nD. 原发性胆汁性肝硬化\nE. 毛细胆管型病毒性肝炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁的男性患者，患有肝硬化并伴有腹水，计划进行肠内营养支持。在这种情况下，最合适的肠内营养制剂是哪种？", "options": "A.必需氨基酸配方\nB.高糖配方\nC.低蛋白配方\nD.高支链氨基酸配方\nE.高维生素配方", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的转移过程中，哪个脏器最常受到影响？", "options": "A. 肺\nB. 脑\nC. 肝内\nD. 骨\nE. 胃", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化代偿期患者中，若出现肝细胞坏死，下列哪项实验室检查结果最具有诊断意义？", "options": "A. ALT/AST>1\nB. AST/ALT>1\nC. ALP升高\nD. PT凝血酶原活动度30%\nE. IV型胶原升高", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像中，以下哪个时相是不被包括的？", "options": "A. 血流灌注相\nB. 静脉血池相\nC. 肝实质相\nD. 胆管排泄相\nE. 肠道排泄相", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位37岁男性患者，在饮酒后突然出现上腹部剧烈疼痛，持续20分钟，伴有恶心、呕吐和腹胀。体检发现患者呈强迫体位，上腹部有带状压痛，轻度肌紧张，无反跳痛。最可能的诊断是什么？", "options": "A. 急性胆囊炎\nB. 急性胰腺炎\nC. 消化性溃疡穿孔\nD. 急性胃肠炎\nE. 急性阑尾炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺分泌过程中，缩胆囊素的作用会导致以下哪种情况？", "options": "A. 酶多，碳酸氢钠与水较少\nB. 酶少，碳酸氢钠与水多\nC. 酶、碳酸氢钠与水同样多\nD. 酶与碳酸氢钠均多，水少\nE. 以上均不是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的解剖结构中，哪个结构将尾状叶与左外叶分隔开来？", "options": "A. 肝镰状韧带\nB. 肝圆韧带\nC. 静脉韧带\nD. 肝冠状韧带\nE. 门静脉的分支", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，胆囊沉积状物回声的影像学表现与以下哪种情况最不相关？", "options": "A. 胆总管梗阻患者\nB. 长期禁食的患者\nC. 嗜高脂饮食者\nD. 溶血性黄疸者\nE. 化脓性胆囊炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的早期诊断中，以下哪项实验室检查指标最先出现异常？", "options": "A.血清脂肪酶\nB.血清正铁血清蛋白\nC.血清淀粉酶\nD.尿淀粉酶\nE.血清乳酸脱氢酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝阿米巴病的各种穿破性并发症中，哪一种情况最为危险？", "options": "A. 胸腔和肺\nB. 心包\nC. 腹腔\nD. 胃和十二指肠\nE. 肾脏", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位27岁女性患者，近期出现厌油腻饮食、恶心、呕吐及皮肤黄染症状。入院检查发现肝肿大、压痛，丙氨酸转氨酶水平升高，HBsAg和HbcAg检测呈阳性。以下哪项不属于该患者肝脏的变质性改变？", "options": "A.肝细胞水样变性\nB.肝细胞点灶状坏死\nC.肝细胞气球样变\nD.肝细胞嗜酸性变\nE.淋巴细胞浸润", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断阿米巴肝脓肿时，以下哪项特征最具特异性？", "options": "A. 突发寒战、高热，肝区疼痛，肝肿大\nB. 右上腹绞痛及黄疸\nC. 穿刺抽出棕褐色脓液\nD. 补体结合试验阳性", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁女性患者因不明原因腹水就诊，腹水检查显示比重高于1.018，外观浑浊呈黄色，静置后出现凝固现象，离心涂片镜检发现大量中性粒细胞。根据这些特征，最可能的诊断是", "options": "A.肝硬化\nB.结核性腹膜炎\nC.右心衰竭\nD.结肠癌\nE.隐匿性肠穿孔", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位42岁女性患者，既往健康状况良好，最近两个月出现巩膜和皮肤黄染，且症状逐渐加重。患者没有腹痛，但体重略有下降。体检发现肝脏在肋下可触及，右上腹可扪及肿大的胆囊，但无触痛，也无发热。根据这些临床表现，哪个选项最能排除结石引起的梗阻？", "options": "A. 既往健康状况良好\nB. 无腹痛\nC. 巩膜和皮肤黄染且逐渐加重\nD. 扪及肿大胆囊且无触痛\nE. 无发热", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁的男性患者，因肝硬化并发腹腔积液已持续2个月。最近一周内，他经历了多次呕血和黑便，经过紧急治疗后病情有所稳定。然而，患者最近几天出现嗜睡和认知障碍。在这种情况下，哪种方法最有助于减少肠道中的血氨水平？", "options": "A. 使用弱碱性溶液进行灌肠\nB. 使用弱酸性溶液进行灌肠\nC. 使用中性溶液进行灌肠\nD. 使用肥皂水进行灌肠\nE. 静脉注射精氨酸", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名18岁女性患者，因急性胰腺炎入院治疗5天，目前病情有所好转，血清淀粉酶水平为300U。然而，患者仍偶尔出现上腹部剧烈疼痛。在这种情况下，胰腺炎患者的首选治疗方案是什么？", "options": "A. 山莨菪碱（654-2）肌注\nB. 吗啡肌注\nC. 禁食、补液、继续观察\nD. 肾上腺皮质激素静滴\nE. 抑肽酶静脉滴注", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，以下哪种症状组合最可能提示原发性肝癌的诊断？", "options": "A. 持续性肝区疼痛伴呕血\nB. 轻度上腹部不适\nC. 进行性食欲减退和体重下降\nD. 皮肤和巩膜黄染\nE. 腹部膨隆伴腹水", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在血清检测中发现AFP水平升高，最可能提示患者患有以下哪种肿瘤？", "options": "A. 肺癌\nB. 肾癌\nC. 淋巴细胞白血病\nD. 宫颈癌\nE. 原发性肝癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，为了区分胰岛非β细胞瘤和十二指肠溃疡，医生最常依赖的实验室检查是", "options": "A. 血清胃泌素水平和胃壁细胞数量检测\nB. 观察溃疡的愈合情况\nC. 评估消化道出血风险\nD. 监测腹泻症状\nE. 检查溃疡的数量", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，下列哪种疾病是由变质性炎症引起的？", "options": "A. 白喉\nB. 病毒性肝炎\nC. 伤寒\nD. 绒毛心\nE. 肝脓肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下选项中，哪一项不是ERCP（逆行性胰胆管造影）的常见适应证？", "options": "A. 胆管结石\nB. 急性胰腺炎\nC. 胰腺癌\nD. 胆管癌\nE. 乳头炎性狭窄", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，为了区分肝外阻塞性黄疸和非梗阻性胆汁淤积性黄疸，医生通常会选择哪种药物进行试验性治疗？", "options": "A. 酚妥拉明\nB. 多巴胺\nC. 安体舒通\nD. 泼尼松\nE. 心得安", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位51岁男性患者，出现巩膜黄染并逐渐加重，伴有尿黄3个月，但无腹痛。B超检查显示胆总管扩张，X线钡餐造影发现十二指肠曲扩大。关于该患者黄疸的解释，以下哪项是不正确的？", "options": "A. 黄疸与肿瘤压迫胆总管有关\nB. 如肿瘤转移到肝脏可加重黄疸\nC. 黄疸以间接胆红素增高为主\nD. 黄疸常伴皮肤瘙痒\nE. 黄疸常伴陶土样大便", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科领域，关于假性胰腺囊肿的描述，哪一项是错误的？", "options": "A. 是急慢性胰腺炎的并发症\nB. 形成的纤维包裹内无上皮细胞\nC. 大的假性囊肿可以产生压迫症状\nD. 所有囊肿均可以自行吸收，不需要手术\nE. 继发感染则形成脓肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在Budd-Chiari综合征中，导致肝脏肿大的主要原因是什么？", "options": "A. 肝淤血\nB. 代谢异常\nC. 肿瘤\nD. 血液病\nE. 中毒", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下肿瘤类型中，哪一种被归类为临界性肿瘤？", "options": "A. 肾上腺髓质肿瘤\nB. 胰岛素瘤\nC. 唾液腺混合瘤\nD. 肾母细胞瘤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位男性患者，近半年出现乏力、明显消瘦、消化不良、腹胀、食欲差，以及肝区疼痛并向右肩部放射的症状。查体发现右肋下可触及肿块，移动性浊音（-）。初步诊断为肝癌。以下哪种检查对诊断肝癌的价值最小？", "options": "A. CT\nB. B超\nC. MRI\nD. ERCP\nE. ECT", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名6岁男孩被初步诊断为肝豆状核变性，其主要的脑部病变部位是哪里？", "options": "A. 丘脑黑质\nB. 大脑皮质\nC. 基底神经节\nD. 小脑半球\nE. 脑干网状结构", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊疾病的营养治疗中，以下哪项是最重要的基本原则？", "options": "A. 调控膳食脂肪和胆固醇量\nB. 严格限制蛋白质量\nC. 降低总能量\nD. 严格限制胆固醇量\nE. 严格限制脂肪量", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "李某，女，35岁。午餐后约6小时出现上腹部疼痛，伴有恶心和呕吐。体检显示体温37.6℃，上腹部有压痛，无放射痛，肠鸣音增强。血常规和便常规检查均无异常。根据这些症状，最可能的诊断是什么？", "options": "A.急性胃炎\nB.急性肠炎\nC.急性胆囊炎\nD.急性胰腺炎\nE.胃溃疡", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位58岁女性患者，长期反复出现右上腹疼痛、发热和尿黄症状，最近一次发作伴有右上腹绞痛、发热和黄疸。下列哪项体征对诊断此病情最有帮助？", "options": "A. Murphy征阳性\nB. 季肋点压痛阳性\nC. Courvoisier征阳性\nD. 肝脏肿大\nE. 腹部移动性浊音阳性", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在血吸虫病的晚期阶段，患者最可能出现的临床表现是什么？", "options": "A. 发热、肝肿大和压痛\nB. 门静脉高压、巨脾与腹水\nC. 结肠炎\nD. 慢性腹泻，肝脾肿大\nE. 肺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝实质损害程度时，以下哪个指标最为关键？", "options": "A. ALT\nB. AST\nC. c-AST\nD. m-AST\nE. ALP", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肠外阿米巴病的病例中，哪个器官最常受到影响？", "options": "A. 肺脏\nB. 肝脏\nC. 脑组织\nD. 心脏\nE. 脾脏", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症患者接受脾切除术后，早期应特别关注哪项指标的定期检查？", "options": "A. 生命体征\nB. 腹部体征\nC. 肝、肾功能\nD. 凝血时间\nE. 血小板计数", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位55岁男性患者，饮酒后12小时出现中上腹疼痛，随后呕出200ml鲜红色血液前来急诊。体检发现腹部柔软，中上腹有压痛，肝脏未触及，脾脏在肋下1.5cm处可触及，血压正常。经过初步处理后，出血仍未停止，此时应首先采取以下哪项措施？", "options": "A. 门腔静脉分流术\nB. 凝血酶原复合物静脉滴注\nC. 三腔气囊管压迫止血\nD. 普萘洛尔（心得安）\nE. 反复输血", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，对于疑似肝囊肿的患者，最常采用的初步影像学检查手段是（）。", "options": "A. 腹部X线平片\nB. 超声检查\nC. 磁共振成像\nD. 放射性核素扫描\nE. 计算机断层扫描", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆石症患者中，以下哪一项症状或体征是不可能出现的？", "options": "A. 发热\nB. 黄疸\nC. 呕吐\nD. 贫血\nE. Murphy征", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位67岁的男性患者因急性结石性胆囊炎入院，表现为寒战、高热（体温39.6℃）和白细胞计数升高（WBC 21×10^9/L）。患者心肺功能正常，此时最优先的治疗措施是什么？", "options": "A. 应用抗生素控制感染\nB. 解痉止痛\nC. 禁饮食\nD. 补充营养\nE. 急症手术", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊中，胆汁通常会被浓缩多少倍？", "options": "A. 10倍\nB. 15倍\nC. 20倍\nD. 25倍\nE. 30倍", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆汁分泌的生理过程中，以下哪项描述是不正确的？", "options": "A. 成人每日分泌胆汁800~1200ml\nB. 交感神经的刺激会导致胆汁分泌量减少\nC. 促胰液素能够增加胆汁的分泌量\nD. 蛋白质的分解产物会抑制胆汁的分泌\nE. 成人每日分泌胆汁800~1200ml", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，以下哪类患者被认定为原发性肝癌的高危人群？", "options": "A. 有5年以上肝炎病史，甲型肝炎病毒标记阳性，年龄超过35岁\nB. 有10年以上肝炎病史，戊型肝炎病毒标记阳性，年龄超过35岁\nC. 有5年以上肝炎病史，乙型或丙型肝炎病毒标记阳性，年龄超过35岁\nD. 有10年以上肝炎病史，乙型或丙型肝炎病毒标记阳性，年龄超过35岁\nE. 有5年以上肝炎病史，乙型或丁型肝炎病毒标记阳性，年龄超过35岁", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺的自体消化过程中，以下哪一项不属于该过程？", "options": "A. 脂肪酶使中性脂肪分解\nB. 胶原酶使胶原纤维溶解\nC. 淀粉酶使淀粉水解\nD. 磷脂酶A使卵磷脂变成溶血卵磷脂\nE. 弹力纤维酶使血管壁损害", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的治疗中，由于中枢神经系统的多巴胺合成减少，应选择哪种药物进行治疗？", "options": "A. 多巴胺\nB. 复方氨基酸溶液\nC. 乙酰谷氨酰胺\nD. 左旋多巴\nE. 乳果糖", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的组织结构中，门管区包含以下哪些结构？", "options": "A. 小叶间胆管\nB. 小叶间静脉\nC. 小叶间动脉\nD. 淋巴管和神经纤维\nE. 以上均有", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在比较腹腔镜胆囊切除术与开腹胆囊切除术时，以下哪项不是腹腔镜手术的优势？", "options": "A. 住院时间短\nB. 术后疼痛轻\nC. 可早期恢复正常活动\nD. 腹壁创伤的并发症少\nE. 胆管损伤的风险性小", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，食管静脉曲张破裂导致大出血后，下列哪一项变化是不正确的？", "options": "A. 血尿素氮（BUN）水平升高\nB. 脾脏体积缩小\nC. 腹水量减少\nD. 可能诱发肝性脑病", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，福氏耐格里属阿米巴感染最常导致哪种疾病？", "options": "A. 阿米巴性肝脓肿\nB. 阿米巴性皮肤溃疡\nC. 肉芽肿性阿米巴脑炎\nD. 原发性阿米巴性脑膜脑炎\nE. 继发性阿米巴性脑脓肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名13岁男孩因胆道蛔虫病入院治疗，经过解痉止痛后症状缓解。医生决定给予驱虫药物治疗，请问最佳服药时间是？", "options": "A. 进餐时服用\nB. 餐前半小时\nC. 清晨空腹或晚上临睡前\nD. 餐后1小时\nE. 腹痛时", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，尿淀粉酶水平通常在发病后多长时间开始升高？", "options": "A. 1-2小时\nB. 3-4小时\nC. 12-24小时\nD. 4-16小时\nE. 36-48小时", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊息肉的诊断中，以下哪种特征更倾向于良性息肉的判断？", "options": "A. 单发\nB. 多发\nC. 不规则形状\nD. 直径超过1厘米\nE. 快速生长", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在日本血吸虫病中，最常见的肝硬化类型是", "options": "A.胆汁性肝硬化\nB.门脉性肝硬化\nC.干线型肝硬化\nD.坏死后性肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位26岁男性患者，因酗酒后出现上腹部持续疼痛8小时，疼痛阵发性加剧，伴有恶心和呕吐。根据这些症状，最可能的诊断是什么？", "options": "A. 急性胃炎\nB. 急性肠梗阻\nC. 心肌梗死\nD. 急性胰腺炎\nE. 急性胆囊炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位44岁女性患者，近3年反复出现上腹部疼痛，最近3天出现上腹绞痛，伴有发热、寒战和皮肤巩膜黄染。若患者出现神志淡漠、嗜睡，血压降至90/50mmHg，最有效的治疗措施是", "options": "A. 给予有效足量抗生素\nB. 应用肾上腺皮质激素\nC. 纠正水、电解质和酸碱平衡紊乱\nD. 紧急手术解除胆道梗阻并减压引流\nE. 使用多巴胺等药物维持血压", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆道手术前后，患者每日的脂肪摄入量应控制在多少克以内？", "options": "A. 10g\nB. 20g\nC. 30g\nD. 40g\nE. 50g", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，患者出现血清总胆红素、结合胆红素和非结合胆红素均呈中度升高的现象。这种情况最可能见于以下哪种疾病？", "options": "A. 胆石症\nB. 急性黄疸型肝炎\nC. 蚕豆病\nD. 珠蛋白生成障碍性贫血\nE. 胰头癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下肿瘤中，α-L岩藻糖苷酶可作为特异性标志物的是", "options": "A. 乳腺癌\nB. 前列腺癌\nC. 肝癌\nD. 肺癌\nE. 卵巢癌", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的诊断中，以下哪一项临床表现不符合该疾病的特征？", "options": "A. 患者常表现出明显的全身中毒症状\nB. 影像学检查通常显示肝内存在液性暗区\nC. 血液细菌学培养在某些情况下可能呈阳性\nD. 肝穿刺液呈现咖啡色\nE. 该病常作为胆道感染的并发症出现", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断细菌性肝脓肿时，以下哪项病史或表现不应出现？", "options": "A. 胆管化脓性感染史\nB. 阿米巴原虫感染史\nC. 全身化脓性感染史\nD. 肝大伴疼痛\nE. 可见左膈升高、运动受限", "answer": "BE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，患者出现右上腹剧烈疼痛伴Murphy征阳性，超声检查显示胆囊壁增厚、胆囊体积增大，最可能的诊断是", "options": "A. 急性胆囊炎\nB. 胆囊结石\nC. 胆囊癌\nD. 胰头癌压迫胆总管", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "李某，男，19岁。因疲劳、手部震颤及学业表现显著下滑而就医，经检查诊断为肝豆状核变性。针对该患者的饮食建议，下列哪项是正确的？", "options": "A.高铜高蛋白高热量高维生素饮食\nB.低铜高蛋白高热量高维生素饮食\nC.低铜低蛋白高热量高维生素饮食\nD.低铜高蛋白低热量高维生素饮食\nE.高铜高蛋白低热量高维生素饮食", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床诊断中，A/G（白蛋白/球蛋白）比值主要用于评估哪个器官的疾病严重程度？", "options": "A. 肺脏疾病的严重性\nB. 心脏疾病的严重性\nC. 肝脏疾病的严重性\nD. 肾脏疾病的严重性\nE. 脾脏疾病的严重性", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰岛素瘤的临床表现，下列哪一项描述是不正确的？", "options": "A. 葡萄糖耐量试验显示低平曲线\nB. 饥饿试验可以诱发相关症状\nC. 血液中胰岛素水平增加超过50%\nD. 患者常出现低血糖症状\nE. 确诊后通常建议手术切除肿瘤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者在进行血清免疫学检查时，发现IgM水平显著升高，且血清抗线粒体抗体呈强阳性（1:128）。根据这些检查结果，最可能的诊断是什么？", "options": "A. 肝炎后肝硬化\nB. 原发性胆汁性肝硬化\nC. 酒精性肝硬化\nD. 血吸虫性肝硬化\nE. 血色病所致肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在高度怀疑胰腺癌的情况下，以下哪项检查结果对确诊胰腺癌没有帮助？", "options": "A. 胰周淋巴结肿大\nB. 胃黏膜增粗紊乱\nC. 十二指肠环扩大\nD. 肠系膜上静脉被挤压受侵\nE. 脾静脉被挤压受侵", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，对于肝血管瘤的诊断，以下哪种方法是最为推荐的？", "options": "A. X线\nB. 超声\nC. CT\nD. US\nE. 肝动脉造影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的手术治疗中，主要的手术目标是什么？", "options": "A. 治疗腹水\nB. 改善肝功能\nC. 去除门静脉高压症的病因\nD. 治疗肝性脑病\nE. 预防和控制食管、胃底曲张静脉出血", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断自身免疫性肝病时，以下哪项特征最为关键？", "options": "A. 门管区淋巴样聚集和脂肪变\nB. 高球蛋白血症\nC. 循环自身抗体\nD. 组织学上有界面性肝炎\nE. 汇管区浆细胞浸润", "answer": "BCDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肠阿米巴病和肝阿米巴病时，下列哪种药物是有效的？", "options": "A. 氯喹\nB. 甲硝唑\nC. 吡喹酮\nD. 苯妥英钠\nE. 乙胺嗪", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，导致门静脉高压症的最常见病因是以下哪一种？", "options": "A. 酒精性肝硬化\nB. 血吸虫病肝硬化\nC. 肝炎后肝硬化\nD. 布加综合征\nE. 肝外门静脉血栓形成", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁的男性患者，在参加宴会后的第二天早晨被发现死亡。现场检查发现床上有少量咖啡渣样呕吐物，且左侧腰腹部有大片青紫斑。最可能的死亡原因是", "options": "A.急性心肌梗死\nB.重症急性胰腺炎\nC.胃溃疡出血\nD.高血压脑出血\nE.高血压脑梗死", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名42岁男性患者因胰头癌接受了Whipple手术，术后第一天腹腔引流管中有50ml血液流出，第二天增加到80ml，并出现血压下降、烦躁不安、面色苍白等症状。急诊B超显示腹腔内有大量液体。针对该患者的正确处理措施是", "options": "A. 急查血常规\nB. 快速补液\nC. 剖腹探查\nD. 必要时输血\nE. 以上都对", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位患有肝炎后肝硬化的患者最近出现食欲不振和腹胀症状，体检时发现腹部有移动性浊音，这最可能提示什么？", "options": "A. 腹水\nB. 肠胀气\nC. 腹膜炎\nD. 胆囊结石\nE. 胰管梗塞", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位27岁的经产妇，在妊娠27周时出现皮肤瘙痒和轻微巩膜黄染，持续半个月，无其他不适症状。血压为126/84mmHg，前次妊娠有类似病史，产后黄疸自行消退。实验室检查显示ALT为140U/L。最可能的诊断是什么？", "options": "A. 妊娠期高血压疾病引起肝损害\nB. 急性病毒性肝炎\nC. 妊娠期急性脂肪肝\nD. 妊娠期肝内胆汁淤积症\nE. 药物性肝炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于细菌性肝脓肿的描述，以下哪一项是错误的？", "options": "A. 主要经胆道感染\nB. 右肝发病率高\nC. 单发脓肿居多\nD. 大肠杆菌常见\nE. 一般起病急骤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆囊结石可能引发哪些并发症？", "options": "A. 胰腺炎\nB. 梗阻性黄疸\nC. 胆囊癌\nD. 肠梗阻", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，胆管结石急性发作和急性胆管炎的典型三联症包括哪些症状？", "options": "A.疼痛、发热、胆囊肿大\nB.疼痛、白细胞增高、腹膜炎\nC.发热、淀粉酶增高、黄疸\nD.胆囊结石、胆总管及肝内胆管结石\nE.疼痛、寒战高热、黄疸", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位53岁女性患者，既往有胆囊炎、胆结石和胰腺炎病史。超声检查显示胰腺区域存在一个9.5cm×3.6cm的不均质回声，形态不规则，边界不清。此外，胰头部还发现一个5.0cm×5.5cm的囊性暗区，壁厚薄不均，形态规则，边界尚清。为了确诊，应选择以下哪种检查方法？", "options": "A. CT\nB. MRI\nC. PET\nD. 血常规\nE. 尿常规", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆道蛔虫病的临床表现中，下列哪一项描述是不正确的？", "options": "A. 中上腹“钻顶样”剧烈绞痛\nB. 突然发病，突然缓解\nC. 可能有蛔虫吐出史\nD. 常伴有中上腹部反跳痛及肌紧张\nE. 可能伴有轻度黄疸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁女性患者，2天前在餐后突然出现右上腹阵发性绞痛，伴有恶心，尿液呈浓茶色，既往有类似发作史。查体显示急性病容，巩膜黄染，腹部无肌紧张，右上腹有深压痛。最可能的诊断是什么？", "options": "A. 胆总管结石\nB. 胆道蛔虫病\nC. 胆总管囊肿\nD. 急性胰腺炎\nE. 急性胆囊炎", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断急性胆囊炎时，需要与以下哪些疾病进行鉴别？", "options": "A. 急性病毒性肝炎\nB. 急性胰腺炎\nC. 右下肺炎\nD. 消化性溃疡穿孔\nE. 阑尾炎", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊结石并发急性胆石性胰腺炎的病理机制中，以下哪一项不是其发生的解剖条件？", "options": "A.胆囊多发小结石\nB.胆囊管内径较宽\nC.共同通道较长\nD.出口梗阻\nE.有副胰管存在", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，因右上腹疼痛半年，近1个月加重并发现上腹部包块前来就诊。患者有15年乙型肝炎病史，近期体重下降5公斤。体检发现肝肋下5cm，质韧，有触痛。实验室检查显示AFP显著升高至1000ng/mL，乙肝两对半提示HbsAg阳性。影像学检查显示肝右叶有8cm×7cm的低密度占位性病变。根据这些信息，最可能的诊断是什么？", "options": "A. 肝硬化\nB. 原发性肝癌\nC. 继发性肝癌\nD. 肝血管瘤\nE. 肝脓肿\nF. 肝囊肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在出血性坏死性胰腺炎的病理生理过程中，哪一项是最严重的并发症？", "options": "A. 上消化道出血\nB. 黄疸\nC. 呕吐\nD. 感染性休克，失血性休克\nE. 脓肿形成", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗过程中，如果患者的血清淀粉酶水平在下降后再次上升，这通常意味着什么？", "options": "A. 病情出现反复\nB. 发生了并发症\nC. 病情已经基本得到控制\nD. 胰腺腺泡细胞功能正在恢复\nE. 患者的免疫系统功能增强", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁的男性患者，有6年的肝硬化病史，1天前呕血500ml，出现神志淡漠，吐词不清且较缓慢。以下哪种治疗措施不适合该患者？", "options": "A.用酸性溶液灌肠\nB.硫酸镁导泻\nC.甘露醇导泻\nD.肥皂水导泻\nE.支链氨基酸静脉输注", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，关于甲胎蛋白（AFP）的临床应用，下列哪项描述存在错误？", "options": "A. 健康成年人的AFP正常参考值通常低于20μg/ml\nB. 生殖系统胚胎源性肿瘤患者的血清AFP水平常显著升高\nC. 血清AFP浓度超过500μg/L并持续3周以上即可确诊为原发性肝癌\nD. 血清AFP水平持续8周维持在200μg/L以上可作为原发性肝癌的诊断依据\nE. AFP水平升高可在肝癌临床症状出现前6个月或更早时期提示肿瘤存在", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝外伤的处理中，以下哪种方法是不正确的？", "options": "A. 对于肝包膜下血肿，应进行探查并缝合裂口\nB. 对于边缘整齐的裂伤，可以进行间断缝合，如果缝合效果满意，可以不放置引流\nC. 对于肝脏表浅裂伤，如果出血已经停止，可以不缝合，但需要适当引流\nD. 对于严重的肝裂伤，进行部分肝切除时，通常采用不规则切除\nE. 对于危重的急性肝损伤，可以使用纱布填塞止血，待病情稳定后再进行决定性手术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺囊腺瘤的特征，以下哪几项描述是正确的？", "options": "A. 浆液性囊腺瘤：具有恶性或潜在恶性倾向\nB. 黏液性囊腺瘤：具有恶性或潜在恶性倾向\nC. 黏液性囊腺瘤：通常表现为较大的单房或多房结构\nD. 浆液性囊腺瘤：通常无恶变倾向\nE. 浆液性囊腺瘤：瘤体较小，囊实性，可能伴有钙化", "answer": "BCDE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗湿热黄疸和肝胆结石时，以下哪种中药被认为是最有效的？", "options": "A. 木通\nB. 茵陈\nC. 泽泻\nD. 海金沙\nE. 金钱草", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗阿米巴感染时，以下哪种药物对阿米巴肝脓肿有效，但对肠阿米巴病无效？", "options": "A.甲硝唑\nB.二氯尼特\nC.喹碘方\nD.氯喹\nE.乙酰砷胺", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁女性患者，既往健康状况良好，近一年来出现上腹部隐痛伴腹部膨隆半年，伴有食欲减退、恶心和呕吐。体检发现右上腹可触及一肿块，无明显压痛，且可随呼吸上下移动。关于肝囊肿的描述，以下哪项是不正确的？", "options": "A. 肝囊肿是良性疾病，通常可以无症状\nB. B超是首选的检查方法\nC. 囊肿合并感染时可能出现发热和畏寒\nD. 治疗以抗生素为主\nE. 囊肿增大到一定程度时可能压迫邻近脏器并引起症状", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床诊断中，以下哪些因素被认为是导致胆囊炎发生的主要原因？", "options": "A. 胆囊管梗阻\nB. 胆囊收缩功能减低\nC. 致病菌大多自血循环入侵\nD. 胰液反流", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的临床诊断中，以下哪项表现最具特异性？", "options": "A. 肝区疼痛\nB. 进行性肝大，质硬\nC. 恶病质\nD. 梗阻性黄疸\nE. 肺部转移病灶", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在下列疾病中，哪种疾病最常导致肝细胞性黄疸的发生？", "options": "A. 胆管癌\nB. 急性黄疸性肝炎\nC. 胆管结石\nD. 原发性胆汁性肝硬化\nE. 胰头癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下关于肝脏的描述中，哪一项是不正确的？", "options": "A. 肝脏是消化腺\nB. 肝脏是实质性器官\nC. 肝脏血供丰富\nD. 肝脏的供血血管为肝动脉\nE. 胆汁不在肝脏内生成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆石症的治疗策略中，以下哪些陈述是正确的？", "options": "A. 对于大多数有症状的胆结石患者，开腹手术是首选，尤其适用于有并发症的患者\nB. 腹腔镜胆囊切除术因其并发症少、住院时间短、恢复快以及总死亡率降低而被广泛采用\nC. 对于手术风险较高的胆总管结石患者，内镜乳头切开术和胆管镜取石是可行的选择\nD. 口服胆酸溶石疗法对胆固醇结石患者效果显著\nE. 体外震波碎石技术结合了口服胆酸治疗和结石碎片化两种方法", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝豆状核变性的病理过程中，铜在体内的异常沉积最早发生在哪个年龄段？", "options": "A. 学龄期\nB. 青春期\nC. 婴儿期\nD. 幼儿期\nE. 学龄前期", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断原发性和继发性胆汁性肝硬化时，以下哪项检查方法是最为关键的？", "options": "A. 肝功能检查\nB. 腹部CT扫描\nC. 血胆酸测定\nD. 逆行胰胆管造影\nE. 免疫学检查", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌的CT影像诊断中，以下哪两个管道同时扩张被称为“双管征”？", "options": "A. 胰管\nB. 胆囊管\nC. 胆总管\nD. 肝总管", "answer": "AC", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁女性患者，半年前接受了胃癌根治手术，现因腹水前来就诊。以下哪项是最可能的诊断？", "options": "A.肝硬化\nB.低蛋白血症\nC.手术并发症\nD.种植转移\nE.腹膜炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝豆状核变性的诊断中，以下哪项实验室检查结果最具特征性？", "options": "A. 血清非铜蓝蛋白的铜减少\nB. 血清铜蓝蛋白降低\nC. 血清铜降低\nD. 尿排铜量减少\nE. 肝铜含量减少", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆总管探查的指征中，以下哪一项是不正确的？", "options": "A. 有黄疸病史的患者\nB. 胆总管扩张\nC. 胆总管内有异物或块状物\nD. 胆囊萎缩", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，腹水形成的主要病理生理机制是", "options": "A. 门静脉压力增高\nB. 血清蛋白浓度升高\nC. 脾脏功能减退\nD. 醛固酮分泌增加\nE. 肾小球滤过率降低", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于中等大小的细菌性肝脓肿，以下哪种治疗措施最为主要？", "options": "A. 全身应用抗生素\nB. 输血，应用抗生素\nC. 穿刺抽脓，应用抗生素\nD. 全身支持疗法，应用抗生素\nE. 手术切开引流", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫梗阻的患者中，腹痛的典型表现是什么？", "options": "A. 突发中上腹剧烈刀割样持续性疼痛\nB. 持续性、广泛性剧烈腹痛伴腹肌紧张\nC. 右上腹进行性锐痛\nD. 剑突下钻顶样疼痛\nE. 右上腹阵发性绞痛", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，5小时前出现剧烈上腹部疼痛，疼痛向背部放射，伴有多次恶心、呕吐，呕吐后疼痛未缓解。患者出现休克症状，病史显示7小时前曾参加聚会并暴食、饮酒。在下列药物中，哪种药物不宜使用？", "options": "A.盐酸哌替啶\nB.吗啡\nC.抑肽酶\nD.氟尿嘧啶\nE.阿苯达唑\nF.生长抑素", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名32岁男性患者因黄疸持续加重20天入院。实验室检查结果显示：血清总胆红素427μmol/L，结合胆红素307μmol/L，ALT 380u/L，PTA 70%，Ch 200mg/dl，AKP 620U/L，蛋白电泳显示γ球蛋白占19%。根据这些检查结果，最可能的诊断是什么？", "options": "A. 急性黄疸型肝炎\nB. 慢性肝炎重度\nC. 重型肝炎\nD. 瘀胆型肝炎\nE. 肝炎肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位女性患者，有3年的乙肝病史，最近3天因受凉出现咳嗽、鼻塞、流涕和发热症状。肝功能检查显示ALT为200 U/mL。在这种情况下，应如何选择解热止痛药？", "options": "A. 对乙酰氨基酚\nB. 阿司匹林\nC. 双氯芬酸\nD. 以上都慎用", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏病变的MRI表现中，以下哪项描述是正确的？", "options": "A. Caroli病表现为肝内小胆管显著扩张\nB. 肝血色病在T1加权像上显示肝脏信号普遍降低\nC. 肝腺瘤在T1加权像上呈现低信号包膜\nD. 肝硬化结节在T1加权像上显示稍高信号，在T2加权像上显示低信号\nE. 出血和中央坏死组织在T2加权像上表现为极低信号", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名24岁男性患者，手部外伤后5天出现寒战、发热，经肌内注射青霉素治疗后体温未降，胸部出现猩红热样皮疹，膝关节红肿疼痛，B超检查显示肝区多发性占位，血培养结果显示有细菌生长。根据这些临床表现，最可能的诊断是什么？", "options": "A. 金葡菌脓毒血症\nB. 大肠杆菌菌血症\nC. 厌氧菌败血症\nD. 真菌败血症\nE. 变应性亚败血症", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在妊娠期间，对于合并病毒性肝炎的患者，下列哪项检查通常不作为常规辅助检查？", "options": "A. 肝功检查\nB. 肝炎病毒检测\nC. 凝血功能检查\nD. 胎盘功能评估\nE. 血HCG检查", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺的解剖学特征中，哪一项描述是不正确的？", "options": "A. 纯浆液性腺\nB. 可见泡心细胞\nC. 有较多纹状管\nD. 可见胰岛\nE. 闰管较长", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，为了区分黄疸患者是内科性黄疸还是外科梗阻性黄疸，以下哪种方法最为简便有效？", "options": "A. 详细询问病史\nB. 进行全面的体格检查\nC. 检测血清胆红素水平\nD. 进行B超检查\nE. 评估肝功能指标", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，长期患有肝病，近期出现乏力、腹胀、反复齿龈出血，近一个月下肢水肿，今日呕血后出现神志不清。最可能的诊断是？", "options": "A.脑血栓形成\nB.糖尿病高渗昏迷\nC.内囊出血\nD.尿毒症昏迷\nE.肝性昏迷", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的发病因素中，以下哪一项通常不被认为是主要原因？", "options": "A. 乙型病毒肝炎\nB. 黄曲霉素\nC. 酒精\nD. 淤血性肝硬化\nE. 华支睾吸虫感染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在儿童时期，肝脏中最常见的良性和恶性肿瘤类型是哪些？", "options": "A. 肝血管瘤\nB. 肝腺瘤\nC. 肝胚胎瘤\nD. 肝脂肪瘤\nE. 肝畸胎瘤", "answer": "AC", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症中，以下哪一项不是常见的侧支循环通路？", "options": "A.胃底和食管下端的血管连接\nB.直肠下端的血管连接\nC.腹壁的血管连接\nD.肠系膜血管的血管连接\nE.腹膜后的血管连接", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝细胞癌的诊断中，关于AFP（甲胎蛋白）的标准，以下哪项是正确的？", "options": "A.定性阳性或定量大于500ng/ml一次即可诊断\nB.定性阳性或定量大于500ng/ml持续4周即可诊断\nC.定性阴性或定量小于500ng/ml可否定诊断\nD.定量大于200ng/ml持续8周即可诊断\nE.定量大于200ng/ml持续4周即可诊断", "answer": "BD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁女性患者因反复上腹痛3天入院，疼痛在进食油腻食物后出现，位于中上腹，持续并向左肩背部放射，伴有阵发性加剧。急诊检查显示血淀粉酶1300IU/L，尿淀粉酶815IU/L。该患者禁食禁饮的主要目的是什么？", "options": "A.减少胆汁的分泌\nB.避免胃扩张\nC.减少胃液的分泌\nD.减少胰液的分泌\nE.解除胰管痉挛", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位55岁男性患者因急性肝炎入院，实验室检查显示ALT 500u/L，白蛋白38g/L，球蛋白26g/L，血清总胆红素115umol/L。血清学检测显示甲型肝炎IgG抗体阳性，抗HBs阳性，丙型肝炎抗体阴性，戊型肝炎病毒抗体（IgM和IgG型）阳性。根据这些结果，最可能的诊断是什么？", "options": "A. 急性甲型肝炎\nB. 急性乙型肝炎\nC. 急性丙型肝炎\nD. 急性戊型肝炎\nE. 急性肝炎，甲、乙、戊型肝炎病毒重叠感染所致", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位44岁女性患者，长期出现上腹部无规律的胀痛，症状已持续5年，常在饮食不当时发作，偶尔伴有反酸和嗳气。心血管系统检查未见异常。根据这些症状，最可能的诊断是什么？", "options": "A. 慢性胆囊炎\nB. 心绞痛\nC. 胃溃疡\nD. 胃癌\nE. 慢性胃炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，急性胰腺炎最常见的病因是", "options": "A.胆道梗阻导致胆汁反流\nB.长期酗酒\nC.病毒感染\nD.胃十二指肠穿孔\nE.腹部外伤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝脓肿患者常见的临床表现包括哪些？", "options": "A. 发热\nB. 肝区疼痛\nC. 肝脏肿大\nD. 脾脏肿大\nE. 白细胞升高", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估胆素原排泄的临床因素时，以下哪一项通常不被视为主要影响因素？", "options": "A.胆道梗阻\nB.胆红素生成量\nC.尿pH\nD.肝功能状态\nE.肾功能状态", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，有长期肝炎病史。超声检查发现肝脏表面不规则，肝实质回声不均匀；在左肝发现一个直径约2.5cm的圆形病变，内部呈均匀低回声，边缘清晰光滑，伴有弱回声晕；同时脾脏明显增大。根据这些表现，最可能的诊断是", "options": "A. 慢性肝实质损害\nB. 慢性肝炎合并肝硬化\nC. 肝硬化合并肝囊性占位\nD. 肝硬化合并肝实性占位\nE. 肝硬化合并门静脉高压", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位40岁男性在常规健康检查中，血液检测显示甲胎蛋白水平超过500μg/L，ALT水平为35U/L，体检未发现异常。最可能的初步诊断是什么？", "options": "A. 肝硬化代偿期\nB. 肝硬化失代偿期\nC. 慢性迁延性肝炎\nD. 亚临床肝癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆道感染导致急性休克的情况下，应采取哪种治疗策略？", "options": "A. 紧急手术\nB. 需经抗休克，血压回升后手术\nC. 抗休克同时进行解除胆道梗阻和减压术\nD. 大量抗生素控制感染后手术\nE. 禁忌手术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位38岁男性患者，近一个月出现右上腹疼痛，并向右肩放射。体检发现患者消瘦，肝脾未触及，白细胞计数为7.5×10^9/L，空腹血糖为2.8mmol/L，X线透视显示右膈高位。最可能的诊断是？", "options": "A. 肝硬化\nB. 原发性肝癌\nC. 阿米巴性肝脓肿\nD. 肝结核\nE. 慢性胆囊炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "对于妊娠早期合并重症病毒性肝炎的患者，以下哪种处理方式最为合适？", "options": "A. 立即进行人工流产术\nB. 无需特殊处理，继续妊娠\nC. 积极治疗肝炎，待病情好转后进行人工流产\nD. 肝炎好转后继续妊娠\nE. 立即开始药物治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性梗阻性化脓性胆管炎的治疗中，哪一项措施是最为关键的？", "options": "A. 输液，补充血容量\nB. 胆道减压手术\nC. 静滴大量抗生素\nD. 纠正酸中毒\nE. 营养支持", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能不全的情况下，药物在体内的代谢和效应会发生怎样的变化？", "options": "A. 半衰期缩短，血药浓度降低\nB. 半衰期延长，血药浓度增高\nC. 药物效应不变\nD. 药物效应增强\nE. 药物效应减弱", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的诊断中，以下哪项陈述是不正确的？", "options": "A. 前驱期症状常被误认为精神病\nB. 血氨水平不升高可以排除肝性脑病\nC. 扑翼样震颤、血氨升高和脑电图异常同时出现有助于诊断\nD. 急性肝功能衰竭引起的肝性脑病血氨水平通常正常", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名21岁男性患者因车祸受伤被紧急送往医院，经诊断为肝破裂并伴有开放性气胸。在这种情况下，首先应采取的正确处理原则是什么？", "options": "A. 补液\nB. 输血\nC. 剖腹探查止血\nD. 处理气胸\nE. 应用抗生素", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊结石的临床表现中，以下哪项描述是不正确的？", "options": "A. 所有胆囊结石患者都会出现明显症状\nB. 摄入高脂肪食物后症状通常会加剧\nC. 较大的单发结石较少发生嵌顿\nD. 当结石卡在胆囊颈部时，可能引发急性胆囊炎\nE. 胆绞痛常向右侧肩部放射", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，原发性胆管结石的形成与以下哪一因素最为相关？", "options": "A. 胆盐含量增加\nB. 胆固醇含量增加\nC. 磷脂增加\nD. 胆盐下降\nE. 胆道有感染", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，了解胆总管的血液供应来源至关重要。以下哪条动脉是胆总管的主要供血来源？", "options": "A. 肝固有动脉\nB. 胰十二指肠上动脉\nC. 胃十二指肠动脉\nD. 肝右动脉\nE. 肝左动脉", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪一种可能导致患者出现高血糖和低血钙的症状？", "options": "A. 急性肝炎\nB. 急性胰腺炎\nC. 急性梗阻性化脓性胆管炎\nD. 急性胃炎\nE. 急性阑尾炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，因右上腹疼痛半年，加重伴上腹部包块1个月就诊。患者有乙型肝炎病史15年，近期体重下降5公斤。查体发现肝肋下5cm，边缘钝，质韧，有触痛。实验室检查显示AFP显著升高，B超和CT均提示肝右叶实质性占位性病变。根据患者的病史、体检和检查结果，以下哪些治疗方案最为合适？", "options": "A. 部分肝切除术\nB. 门静脉置泵化疗\nC. 瘤体无水酒精注射\nD. 选择性肝动脉栓塞化疗\nE. 中医中药治疗\nF. B超引导下经皮穿刺肿瘤射频消融", "answer": "ABE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位41岁女性患者，诊断为原发性肝癌晚期，无明显诱因下突然出现右上腹剧烈疼痛，伴有面色苍白和大汗。体检发现腹膜刺激征阳性，最可能的诊断是", "options": "A. 急性胆囊炎\nB. 肝癌结节破裂\nC. 急性胃穿孔\nD. 肝癌腹膜移位\nE. 急性胰腺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，以下哪项不是导致腹水形成的主要机制？", "options": "A. 门静脉高压\nB. 血浆白蛋白水平下降\nC. 醛固酮分泌增多\nD. 抗利尿激素分泌减少\nE. 肝内静脉压力升高", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现胆绞痛、发热和黄疸症状，最可能的诊断是？", "options": "A. 慢性胆囊炎\nB. 急性胰腺炎\nC. 急性化脓性胆管炎\nD. 胰头癌\nE. 急性胆囊炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估重型病毒性肝炎时，以下哪项实验室检查结果最具诊断价值？", "options": "A. 血清胆红素显著上升\nB. 酶胆分离现象\nC. 血清转肽酶活性显著增加\nD. A/G比例反转\nE. 凝血酶原活动度显著下降", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的多种功能中，哪一项描述是不正确的？", "options": "A. 分泌胆汁\nB. 参与代谢过程\nC. 具有解毒功能\nD. 参与免疫反应\nE. 将维生素A转化为凝血酶原", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁男性患者因门静脉高压症接受了门腔静脉分流手术。在术后48小时内，医护人员应特别关注以下哪种并发症的发生？", "options": "A. 肝性脑病\nB. 血管吻合口破裂内出血\nC. 腹腔感染\nD. 肠系膜血管栓塞\nE. 血小板过度增高", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位55岁女性患者，有8年乙肝病史，最近一个月感到明显乏力，并伴有间断性的右上腹疼痛。体检显示血压为115/60mmHg，巩膜出现黄染，结膜无苍白，右上腹饱满且有压痛，无反跳痛及肌紧张，肝区叩痛阳性，移动性浊音阴性，双下肢无水肿。超声检查发现肝内结节呈均匀低回声伴中心点状增强。根据这些信息，最可能的诊断是什么？", "options": "A.肝脓肿\nB.继发性肝癌\nC.活动性肝炎\nD.乙型病毒性肝炎复发\nE.原发性肝癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性轻型胰腺炎的治疗中，以下哪种方法被认为是最合适的？", "options": "A.禁食补液\nB.应用抗生素\nC.Oddi括约肌切开\nD.手术\nE.生长抑素", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔镜胆囊切除术中，以下哪项措施对于预防胆管损伤是不正确的？", "options": "A. 当胆囊壁厚度超过4mm且胆囊功能丧失时，通常表明胆囊管短而粗，胆囊萎缩，应在胆囊壶腹部附近放置钛夹\nB. 如果胆囊管直径超过4mm，应在术中进行胆道造影以排除胆总管结石\nC. 在处理胆囊三角时，应从胆囊管向胆囊方向进行，在未明确胆囊管位置和胆囊管未从胆囊颈部分出之前，不应切断任何管状结构\nD. 当难以确定胆囊管与胆总管的关系时，应仔细解剖肝门部，使胆总管、肝总管、胆囊管“三管骨骼化”，以确定胆囊管\nE. 当术中出现出血或技术困难时，预防胆管损伤的最佳措施是中转开腹手术", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝内胆管结石的临床特征中，以下哪项描述是不正确的？", "options": "A. 右肝管结石发生率高于左肝管\nB. 治疗过程通常较为复杂\nC. 主要成分为胆色素结石或以胆色素为主的混合结石\nD. 属于原发性胆道结石\nE. 部分病例可迁移至肝外胆管形成继发性结石", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在自身免疫性肝炎的病理特征中，以下哪一项描述是不正确的？", "options": "A. 主要表现为慢性肝炎\nB. 肉眼形态与病毒性肝炎相似\nC. 镜下可见界板肝细胞变性和坏死\nD. 坏死细胞周围可见明显的中性粒细胞浸润\nE. 最终可形成肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的手术治疗中，以下哪项描述是不正确的？", "options": "A. 手术主要分为断流术和分流术两大类\nB. 分流术可进一步分为非选择性分流术和选择性分流术\nC. 非选择性分流术可能导致30%-50%的患者发生肝性脑病\nD. 选择性分流术的肝性脑病发生率相对较低\nE. 断流术对患者的肝功能要求较高", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝血吸虫病的病理过程中，以下哪些情况可能发生？", "options": "A. 门静脉高压\nB. 肝纤维化\nC. 门静脉分支虫卵栓塞\nD. 肝细胞功能明显下降", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位46岁女性患者，突发上腹痛14小时，伴有频繁呕吐胃内容物，疼痛阵发性加剧并向右肩放射，2小时后出现发热和腹胀，无寒战或腹泻。患者有5年上腹饱胀病史，曾按“胃痛”治疗，症状偶有缓解。查体显示体温38.5℃，心率101次/分，血压95/40mmHg，呼吸23次/分。心肺检查无异常，腹胀明显，腹部尚软，上腹压痛，肝脾未触及，腹部无移动性浊音。急诊时应优先进行哪些检查？", "options": "A.血电解质检查\nB.血常规\nC.血尿淀粉酶\nD.X线胃肠钡餐检查\nE.胸腹联合透视", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "以下哪种疾病属于常染色体隐性遗传病？", "options": "A. 肝豆状核变性\nB. 苯丙酮尿症\nC. 血友病A\nD. 半乳糖血症\nE. α胱氨酸尿症", "answer": "ABDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科影像学中，靶征是以下哪种病变的典型表现？", "options": "A. 肝囊肿\nB. 转移性肝癌\nC. 肝炎性假瘤\nD. 原发性肝癌\nE. 肝脓肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在中医古籍中，哪一部医书首次明确指出胁痛与肝胆病变之间存在直接关联？", "options": "A.《难经》\nB.《伤寒杂病论》\nC.《景岳全书》\nD.《证治汇补》\nE.以上都不是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，哪种类型的肝炎最常表现为肝细胞碎片状坏死或桥接坏死？", "options": "A.急性重型肝炎\nB.亚急性重型肝炎\nC.中度和重度慢性肝炎\nD.急性较重型肝炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科治疗中，哪种肠内营养制剂特别适用于预防和治疗肝性脑病？", "options": "A.高糖配方\nB.必需氨基酸配方\nC.高维生素配方\nD.高支链氨基酸配方\nE.低蛋白配方", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在Whipple手术中，以下哪种并发症最为常见？", "options": "A. 感染\nB. 功能性胃排空障碍\nC. 胰瘘\nD. 出血\nE. 胆瘘", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科影像学检查中，以下哪种放射性药物无法用于肝脏显影？", "options": "A. 99mTc-SC\nB. 99mTc-PHY\nC. 99mTc-MIBI\nD. 99mTc-DTPA\nE. 99mTc-EHIDA", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者出现黄疸、胆囊增大和肝大的症状，最可能的诊断是什么？", "options": "A. 胆总管结石继发胆管炎\nB. 壶腹部肿瘤\nC. 早期肝癌\nD. 门脉高压症\nE. 病毒性肝炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位62岁男性患者，因无痛性黄疸持续1月余，伴有进行性体重下降，无明显不适。超声检查显示肝内外胆管显著扩张，胆囊增大，胰管未见扩张，胆总管远端发现一实性低回声团块，与胆管壁界限不清，团块内可见动脉血流信号。根据这些超声表现，最可能的诊断是", "options": "A. 胰头部实性占位\nB. 壶腹周围占位\nC. 胆总管下段结石\nD. 十二指肠壁占位\nE. 胆总管上段低回声占位", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位被诊断为原发性肝癌的患者突然感到腹部剧烈疼痛，并伴有腹膜刺激症状，最可能的原因是", "options": "A. 肝癌腹膜转移\nB. 肝癌癌结节破裂\nC. 急性胃穿孔\nD. 急性胆囊炎\nE. 急性胰腺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在细菌性肝脓肿的病例中，病原菌最常通过哪种途径进入肝脏？", "options": "A. 肝门静脉系统\nB. 肝动脉\nC. 淋巴系统\nD. 胆道系统\nE. 腹腔脏器直接蔓延", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰岛素瘤的临床特点，以下哪一项描述是不正确的？", "options": "A.葡萄糖耐量试验显示低平曲线\nB.饥饿试验可以诱发相关症状\nC.血液中胰岛素水平增加超过50%\nD.出现低血糖症状\nE.确诊后通常建议手术治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于胆汁酸盐的功能和特性，以下哪一项描述是不正确的？", "options": "A. 它在肝脏由胆固醇合成\nB. 它在脂类吸收过程中起到乳化剂的作用\nC. 它有助于抑制胆固醇结石的形成\nD. 它是胆色素的代谢产物\nE. 它可以通过肠肝循环被重吸收", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，近2个月来出现食欲减退、全身乏力及右上腹持续性胀痛。体检发现巩膜黄染，肝脏在肋下5cm处可触及，表面呈结节状，脾脏在肋下3cm处可触及。在以下诊断中，最不可能的是", "options": "A. 乙肝后肝硬化\nB. 原发性肝癌\nC. 酒精性肝硬化\nD. 淤血性肝硬化\nE. 原发性胆汁性肝硬化", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的患者中，支链氨基酸与芳香氨基酸的摩尔比值通常会下降到哪个范围？", "options": "A. 5以下\nB. 4以下\nC. 3以下\nD. 2以下\nE. 1以下", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁的男性患者，长期患有肝硬化，最近在右侧肋弓下发现一个质地坚硬的结节。以下哪项体征最可能提示该结节为肝癌？", "options": "A.巩膜明显黄染\nB.肝病面容\nC.肝区可闻及血管杂音\nD.进行性脾大\nE.大量腹水", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性水肿型胰腺炎的治疗中，以下哪项措施是主要的治疗原则？", "options": "A. 大量使用抗生素\nB. 抗休克\nC. 抑制胰液分泌\nD. 手术切除\nE. 用哌替啶（杜冷丁）止痛", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在脂肪肝的发病机制中，以下哪项因素与其形成密切相关？", "options": "A. 脂蛋白合成增多\nB. 肝内形成的甘油三酯增多或氧化减少\nC. 碳水化合物摄入过多\nD. 蛋白质摄入过多\nE. 进入肝脏的脂肪酸过少", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在处理胆道感染性休克时，哪一项措施被认为是至关重要的？", "options": "A. 使用大剂量抗生素控制感染\nB. 使用升压药快速提高血压\nC. 纠正酸中毒防止DIC\nD. 扩充血容量改善休克\nE. 解除胆道梗阻", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胆囊炎的病因中，以下哪一项描述是不正确的？", "options": "A. 胆囊结石阻塞胆囊管\nB. 胆道逆行感染导致细菌入侵\nC. 主要由血行感染引起\nD. 创伤及胆汁淤积导致胆盐浓度升高，产生化学性刺激\nE. 胰液反流引发非结石性胆囊炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性肝病患者中，肝性脑病的最初临床表现通常是什么？", "options": "A. 意识模糊\nB. 定向力障碍\nC. 行为改变和情绪高涨\nD. 肝臭\nE. 昏迷", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，长期接触氯乙烯可能导致哪种法定职业肿瘤的发生？", "options": "A. 肝血管肉瘤\nB. 肺癌\nC. 皮肤癌\nD. 鼻咽癌\nE. 喉癌", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁男性患者，近3个月来出现右上腹胀痛，并伴有半月余的黄疸。体检发现肝脏在肋下3cm，剑突下4cm处可触及，质地坚硬，且有移动性浊音。为了进一步诊断肝癌，以下哪项检查最为关键？", "options": "A. 乙肝五项检查\nB. 腹部X线片\nC. 肝功能检查\nD. AFP升高+B超检查\nE. CT检查", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性化脓性梗阻性胆管炎中，以下哪些病理改变是常见的？", "options": "A.胆管扩张\nB.胆管内脓液\nC.胆管壁广泛性炎症\nD.肝细胞损害", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，长期出现腹胀、下肢浮肿、前胸蜘蛛痣、腹水等症状，体检发现肝未触及，脾脏肿大。最可能的诊断是", "options": "A. 普通型病毒性肝炎\nB. 门脉性肝硬化\nC. 酒精性肝炎\nD. 肝细胞肝癌\nE. 慢性肝淤血", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌患者接受肝叶切除手术后，以下哪项护理措施与预防肝性脑病无关？", "options": "A. 术前使用保肝药物\nB. 术前应用维生素K\nC. 术前使用酸性液体进行灌肠\nD. 术后给予氧气吸入\nE. 保持患者大便通畅", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，进行X线腹部平片检查时，以下哪种类型的胆囊结石最容易被观察到显影？", "options": "A. 胆色素结石\nB. 胆固醇结石\nC. 混合性结石\nD. 黑结石\nE. 泥沙样结石", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪些是常见的继发性病理改变？", "options": "A. 脾脏肿大\nB. 门静脉扩张\nC. 腹腔积液\nD. 食管静脉曲张", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，门脉高压症的主要病因是以下哪种情况？", "options": "A. 肝细胞癌\nB. 门静脉血栓形成\nC. 布加综合征\nD. 慢性肝纤维化\nE. 肝血管畸形", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在正常人的肝脏结构中，胆管的分支系统包括3级分支。请问，以下哪一项属于一级分支？", "options": "A.左、右肝管\nB.左内叶、左外叶\nC.右前叶、右后叶\nD.各肝段胆管\nE.尾状叶", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，近20余天出现持续性黄疸并伴有皮肤瘙痒，症状近日加重。超声检查发现肝内外胆管及胆囊均扩张，胆总管下端呈截断阻塞，局部可见一实性结节。主胰管扩张，内径为0.5cm。最可能的阻塞病因是？", "options": "A.壶腹周围癌\nB.胆总管下段结石\nC.硬化性胆管炎\nD.先天性胆总管囊肿\nE.非特异性胆管炎症", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于WES三联征的描述，以下哪一项是不正确的？", "options": "A.胆囊腔萎缩，内充满结石的声像图\nB.增厚的胆囊壁可呈弱回声\nC.胆囊内结石易与胃肠气体强回声团混淆\nD.合并胆囊癌时较易为超声发现\nE.结石后方声影有助于诊断", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像中，以下哪一项不是不完全性胆总管梗阻的典型表现？", "options": "A. 管腔内充盈缺损\nB. 狭窄部位以上的管腔扩张\nC. 节段性狭窄\nD. 突发或渐变的胆道中断\nE. 胆道至肠道示踪剂转运延迟（大于30分钟）", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁的女性患者，在餐后2小时出现剧烈腹痛，伴有恶心和呕吐，临床怀疑为急性胰腺炎。以下哪项检查对诊断最有意义？", "options": "A.血清脂肪酶检査\nB.尿淀粉酶检查\nC.血常规检查\nD.血清淀粉酶检査\nE.凝血功能检查", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者出现上消化道出血后，为了防止肝性脑病的发生，以下哪项治疗措施最为关键？", "options": "A. 加强保肝治疗\nB. 应用左旋多巴\nC. 弱酸溶液洗肠\nD. 复方氨基酸静点\nE. 纠正酸碱平衡", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "李某，男，60岁，患有慢性胆囊炎，医生建议他调整饮食习惯。以下哪种饮食最适合他的病情？", "options": "A.低盐饮食\nB.低胆固醇饮食\nC.低蛋白饮食\nD.低脂肪饮食\nE.低热量饮食", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在CT增强扫描中，肝局灶性结节增生的典型强化模式是", "options": "A.动脉期均匀高密度强化，静脉期呈等密度或略低密度，延迟扫描病灶呈相对低密度\nB.动脉期明显强化，延迟扫描呈低密度，为快进快出\nC.早期病灶边缘呈高密度强化，增强区域进行性向中心扩展，延迟扫描病灶呈等密度充填\nD.为动脉期明显均匀强化，延迟扫描病灶逐渐变为低密度\nE.晚出晚归", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞内，胆固醇代谢的最终产物是什么？", "options": "A. 7a-胆固醇\nB. 胆酰CoA\nC. 结合胆汁酸\nD. 维生素D3\nE. 胆色素", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性病毒性肝炎的病理学检查中，下列哪项特征最能提示病情较为严重？", "options": "A. 肝细胞广泛变性和点状坏死\nB. 淋巴细胞和单核细胞浸润\nC. 肝细胞点状坏死\nD. 碎片状坏死和界面性肝炎\nE. 肝细胞脂肪变性", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，肝性脑病的主要病因是什么？", "options": "A. 病毒性肝炎\nB. 脂肪肝\nC. 肝癌\nD. 肝硬化\nE. 胆系感染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺组织细胞的功能分类中，以下哪项描述存在错误？", "options": "A. 腺泡细胞分泌碱性液\nB. D1胰岛细胞产生胃泌素\nC. β-胰岛细胞合成胰岛素\nD. 腺泡细胞分泌淀粉酶\nE. α-胰岛细胞分泌胰高血糖素", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，TIPSS手术的主要路径和连接部位是？", "options": "A.经颈静脉途径在肝静脉与肝内门脉之间建立通道\nB.经股静脉途径在下腔静脉与肝动脉之间建立通道\nC.经颈静脉途径在肝动脉与肝内门脉之间建立通道\nD.经股静脉途径在下腔静脉与门脉之间建立通道\nE.经股动脉途径在肝动脉与门脉之间建立通道", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝病患者中，以下哪项不是导致出血的常见原因？", "options": "A. 凝血因子和抗凝蛋白消耗过多\nB. 凝血因子和抗凝蛋白合成减少\nC. 循环抗凝物质和血FDP增多\nD. 类肝素抗凝物质灭活增多\nE. 血小板减少及其功能障碍", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，如果梗阻部位位于壶腹部，以下哪种影像学表现最为典型？", "options": "A.肝内胆管扩张、肝管扩张、胆囊空虚\nB.肝内外胆管扩张、胆囊增大\nC.肝内外胆管扩张、胆囊增大、胰管扩张 (双管征）\nD.肝内胆管不扩张、肝管扩张、胆囊空虚\nE.肝内胆管不扩张、肝管不扩张、胆囊空虚", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者因持续腹胀1个月前来就诊。经B超检查发现：①肝硬化，②脾脏肿大，③中等量腹水。临床诊断为肝硬化腹水。医生开具以下处方：螺内酯40mg tid，氯化钾0.5g tid。关于该治疗方案，以下哪项分析是正确的？", "options": "A. 螺内酯属于排钾利尿剂，是醛固酮的竞争性拮抗剂\nB. 螺内酯属于保钾利尿剂，是醛固酮的竞争性激动剂\nC. 该治疗方案可能导致患者血钾水平升高，严重时可引发心律失常\nD. 该治疗方案可能导致患者血钾水平降低，严重时可引发心律失常", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁的男性患者因急性胰腺炎入院，经过非手术治疗后病情好转，准备出院。以下哪项患者的陈述表明其对自身保健原则的理解存在错误？", "options": "A. 我每天饭量要减少，分四五次吃。\nB. 我要少吃油腻的食物。\nC. 每天一杯红酒有助于我康复。\nD. 我的饮食节律必须规律，食物以蔬菜为主。\nE. 我应当检查一下，有胆道的疾病要尽早治疗。", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位55岁男性患者，饮酒后12小时出现中上腹疼痛，随后呕出200ml鲜红色血液前来急诊。体检发现腹部柔软，中上腹有压痛，肝脏未触及，脾脏在肋下1.5cm处可触及，血压正常。为了明确诊断，首先应进行哪项检查？", "options": "A. 上消化道钡餐检查\nB. 选择性腹腔动脉造影\nC. 内镜检查\nD. BSp\nE. 钡剂灌肠", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在中国，导致肝硬化最常见的病因是以下哪一种？", "options": "A. 慢性酒精中毒\nB. 病毒性肝炎\nC. 胆汁淤积\nD. 非酒精性脂肪性肝炎\nE. 遗传代谢性疾病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝内型门静脉高压症的病因中，以下哪项是最常见的形成因素？", "options": "A. 门静脉畸形\nB. Budd-Chiari综合征\nC. 肝门区肿瘤压迫\nD. 血吸虫病肝硬化\nE. 肝外门静脉血栓形成", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压的择期手术中，主要治疗目标是什么？", "options": "A. 预防肝功能衰竭\nB. 减少腹腔积液\nC. 提高免疫力\nD. 预防上消化道出血\nE. 预防肝癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，因肝硬化导致大量腹腔积液，出现呼吸困难症状。在使用利尿剂治疗后，尿量仍然较少。如果需要进行腹腔穿刺放液，首次单纯放腹腔积液时，一般不应超过多少毫升？", "options": "A. 1500～2000ml\nB. 3000ml\nC. 2500～3500ml\nD. 6000～8000ml\nE. ＜500ml", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性胆汁性肝硬化的治疗中，关于熊去氧胆酸的作用，以下哪项描述是正确的？", "options": "A. 对于降低血清碱性磷酸酶无明显效果\nB. 应小剂量[3～5mg/(kg·d)]间断用药\nC. 可能加重患者的骨质疏松\nD. 晚期患者应用熊去氧胆酸更安全，疗效也更显著\nE. 可改善肝脏生化指标，早期患者长期治疗可以延缓疾病的进展", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，有10年的肝炎肝硬化病史，3年前接受了门腔静脉分流手术。最近2天出现睡眠倒错和计算能力下降的症状。在这种情况下，患者应避免哪种类型的饮食？", "options": "A.高纤维食物\nB.高维生素食物\nC.高蛋白饮食\nD.低脂饮食\nE.淀粉类食物", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在超声检查中，'囊壁-结石-声影三联征（WES）'通常与以下哪种情况相关？", "options": "A. 胆囊壁钙化\nB. 胆囊胆固醇沉着症\nC. 胆囊腺瘤\nD. 胆囊癌\nE. 胆囊内充满结石", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者因突发剧烈上腹痛、腹胀、恶心和呕吐1天前来急诊。患者描述疼痛最初位于剑突下偏右，随后迅速扩散至全腹，并转变为持续性刀割样疼痛，向后背放射。患者伴有恶心、呕吐，且未排便排气。12小时前疼痛加重，出现烦躁不安、憋气和体温升高。患者3年前体检发现胆囊结石，未治疗。查体显示体温38.9℃，血压110/80mmHg，心率110次/分，呼吸32次/分，皮肤及巩膜可疑黄染，全腹膨隆，肌紧张，泛压痛及反跳痛，移动性浊音（±），肠鸣音弱。实验室检查显示Hb 96.1g/L, WBC 18.9×10^9/L, AST 211U/L, BUN 9.9mmol/L, TBIL 30μmol/L, DBIL 12μmol/L, 血钙1.75mmol/L。腹部平片显示肠管充气扩张，肠间隙增宽。B超显示胆囊壁厚0.4cm，内有多发强光团，胆总管直径0.9cm，胰腺形态失常，明显肿大，胰周多量液性暗区，胰管增粗。请问下一步应进行哪些检查？", "options": "A. 静脉肾盂造影\nB. 血尿淀粉酶\nC. 腹腔穿剌，腹水常规及淀粉酶测定\nD. 上消化道造影\nE. 腹部CT\nF. 腹部MRI", "answer": "BCE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位患者在年度健康检查中发现抗HBc阳性，肝脾在肋下未触及，肝功能正常。过去一年中，反复进行的HBV血清学标志物检测也仅显示抗HBc阳性。该患者最可能的诊断是什么？", "options": "A. 慢性HBV携带状态\nB. 慢性乙型肝炎轻度\nC. HBV既往感染\nD. 慢性乙型肝炎重度", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胆道系统疾病时，哪种影像学检查方法是最常用的首选方法？", "options": "A. 经皮肝穿刺胆管造影\nB. 静脉胆囊造影\nC. X线平片\nD. B超\nE. 口服胆囊造影", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位53岁男性患者，近期出现食欲逐渐减退和上腹部不适，伴有下肢水肿。实验室检查显示肝功能正常，但血浆蛋白水平偏低。大便隐血试验持续阳性，尿常规检查未见异常。这些症状最可能的原因是", "options": "A. 慢性胃炎\nB. 肝硬化\nC. 胃癌\nD. 胃溃疡\nE. 十二指肠溃疡", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在阿米巴肝脓肿的临床表现中，哪一项是不正确的？", "options": "A. 继发于阿米巴痢疾后\nB. 病情急骤，中毒症状严重\nC. 部分患者粪中查有阿米巴滋养体\nD. 脓肿较大，多为单发，多见于肝右叶\nE. 外周血白细胞计数增高不明显", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在消化过程中，哪种类型的食物最能促进胆囊收缩素的分泌？", "options": "A. 碳水化合物食物刺激\nB. 脂肪食物刺激\nC. 酸性胃液刺激\nD. 迷走神经兴奋\nE. 蛋白质食物刺激", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化时，以下哪项检查结果最能确诊该疾病？", "options": "A. 腹水\nB. 脾大\nC. 肝掌及蜘蛛痣\nD. 白蛋白/球蛋白比例倒置\nE. 肝穿刺活检显示假小叶形成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆管癌的MRI诊断中，以下哪些表现是正确的？", "options": "A. 胆管局限性狭窄\nB. 病变上方胆管扩张\nC. 扩张的胆管末端胆管突然狭窄\nD. 扩张的胆管末端管壁不规则增厚", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下疾病中，哪一项不适合作为肝脏移植的适应证？", "options": "A. 终末期肝硬化\nB. 肝豆状核变性\nC. 低分化胆管细胞癌\nD. Budd-Chiari综合征\nE. 原发灶已切除但已有多发肝转移的恶性胰岛素瘤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位35岁男性患者，因突发性中上腹痛1天后出现下腹部疼痛，特别是右下腹痛，被诊断为急性阑尾炎入院。患者拒绝手术治疗，接受庆大霉素等抗感染治疗。两天后，患者热不退，突然出现寒战、高热、黄疸等症状，体检发现右上腹压痛明显，伴肝脏肿大，白细胞升高。下列哪种治疗方案不恰当？", "options": "A. 查AFP，CEA排除肝癌可能\nB. 开腹行阑尾切除术\nC. 加强抗炎药物应用及支持疗法\nD. 纠正水，电解质及酸碱失衡\nE. 出现休克时先纠正休克，同时抗感染治疗", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位40岁男性患者，有7年丙肝后肝硬化病史。近3个月来体重明显下降，感到极度疲劳，频繁出现鼻出血，腹部胀满感逐渐加重，尿量减少。2小时前在活动后突然晕倒。根据这些症状，最可能的诊断是什么？", "options": "A. 失血性休克\nB. 原发性肝癌\nC. 肝癌结节破裂出血\nD. 低血糖昏迷\nE. 肝硬化并发消化道出血", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，因持续8天的畏寒发热（体温39~40℃）和肝区持续性胀痛向右肩放射前来就诊。体检发现患者较为软弱，肝区有叩痛与压痛，肝肋下刚触及且有压痛。请问下列哪项检查最有助于诊断？", "options": "A. 血常规检查\nB. 胸部X线透视\nC. 肝功能检查\nD. 乙型肝炎标志测定\nE. B型超声检查", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在中医治疗肝硬化脾肾阳虚证时，下列哪个方剂是首选？", "options": "A.柴胡疏肝散合胃苓汤加减\nB.实脾饮加减\nC.中满分消丸合茵陈蒿汤加减\nD.调营饮加减\nE.附子理中汤合五苓散加减", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位35岁女性患者被诊断为自身免疫性肝炎，实验室检查显示ALT水平为200U/L，肝炎病毒指标为阴性。在这种情况下，首选的治疗方案是什么？", "options": "A. 保肝药物\nB. 胸腺肽\nC. 皮质激素\nD. 综合治疗\nE. 对症治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性胆汁性肝硬化的病理学特征中，哪一项描述最为准确？", "options": "A. 肝内血循环紊乱、血管床缩小、闭塞和扭曲\nB. 汇管区纤维结缔组织增生\nC. 肝内细小胆管慢性非化脓性破坏性炎症\nD. 广泛的肝细胞变性坏死\nE. 汇管区可见程度不等的炎症细胞浸润", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名患者在肝裂伤修复手术后6小时，腹腔内吸出含有胆汁的血液约1500 ml。术后8小时，患者出现逐渐加重的呼吸困难和发绀，即使增加吸氧量也无明显改善。X线胸片显示双肺广泛分布的点状和片状阴影。患者脉搏为110次/分，血压为12.3/9.3 kPa(92/70 mmHg)。此时应考虑患者可能发生了", "options": "A. 肺部感染\nB. 支气管痉挛\nC. 急性心力衰竭\nD. 肺不张\nE. 急性呼吸困难综合症", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位26岁女性患者，2个月前因肝炎住院治疗。最近在门诊复查时，血液化验结果显示：ALT 30U，HAV-IgM阴性，HAV-IgG阳性，抗HBS阳性，抗HBc阳性。根据这些结果，最可能的诊断是什么？", "options": "A. 甲型肝炎恢复期\nB. 乙型肝炎恢复期与甲型肝炎感染后状态\nC. 乙型肝炎急性期与甲型肝炎感染后状态\nD. 甲型肝炎与乙型肝炎混合感染\nE. 非甲非乙型肝炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在鉴别肿块型胆囊癌与肝癌时，以下哪项描述是不正确的？", "options": "A. 胆囊癌常导致胆道明显扩张\nB. 肝癌引起的胆道扩张通常较轻\nC. 肝癌更常见门静脉侵犯和栓塞\nD. 当肿块型胆囊癌累及周围肝实质时，与肝癌的鉴别较为困难\nE. CT和MRI在鉴别这两种疾病时非常容易", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于肝破裂的患者，最适宜采取的手术类型是", "options": "A. 择期手术\nB. 限期手术\nC. 急症手术\nD. 美容手术\nE. 诊断手术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在乙型肝炎的实验室检查中，以下哪个指标通常难以检测到？", "options": "A. HBsAg\nB. 抗-HBs\nC. HBeAg\nD. 抗-HBe\nE. HBcAg", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行经颈静脉肝内门腔静脉分流术之前，以下哪些是必要的术前准备？", "options": "A. 进行血常规、血型及出凝血功能检查\nB. 测定肝、肾功能\nC. 详细了解门静脉与肝静脉的形态及相互位置关系\nD. 术前使用广谱抗生素并进行肠道清洁准备", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，6年前被诊断为肝硬化。近期出现体重明显下降，面色晦暗，皮肤和巩膜黄染，肝区疼痛。体检发现肝剑突下5cm，质地坚硬，表面可触及大结节，伴有腹水和下肢水肿。最可能的诊断是？", "options": "A. 原发性肝癌\nB. 门脉性肝硬化\nC. 坏死后性肝硬化\nD. 肝硬化合并肝癌\nE. 胆汁性肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位36岁男性患者，平时健康状况良好，因淋雨后出现发热和咳嗽2天，随后出现右上腹痛、气急和恶心1天。在体检时，应特别注意检查以下哪一项？", "options": "A. 右上腹肌紧张\nB. 上腹部压痛\nC. 肺肝境界\nD. 肺部呼吸音\nE. 肠鸣音", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术后，患者可能面临哪些并发症？", "options": "A. 肝癌结节破裂出血\nB. 肝性脑病\nC. 上消化道大出血\nD. 继发感染\nE. 以上都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，除原发性肝癌外，哪种疾病可能导致AFP水平超过500μg/L？", "options": "A. 多囊肝\nB. 慢性肝炎\nC. 生殖腺胚胎瘤\nD. 肾脏胚胎瘤\nE. 肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝内胆管结石的主要成分通常是", "options": "A.胆固醇\nB.胆色素结石\nC.泥沙样结石\nD.以胆色素为主的混合结石\nE.以胆固醇为主的混合结石", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者出现无痛性进行性黄疸，最可能的诊断是？", "options": "A.急性胰腺炎\nB.慢性胆囊炎\nC.胰头癌\nD.急性胆囊炎\nE.急性化脓性胆管炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰岛中，胰岛素瘤主要来源于哪种细胞？", "options": "A. D细胞\nB. A细胞\nC. PP细胞\nD. G细胞\nE. B细胞", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断过程中，关于腹部平片检查的作用，以下哪项描述是不正确的？", "options": "A. 有助于排除其他急腹症，如内脏穿孔\nB. 腰大肌边缘模糊可能提示腹水的存在\nC. “哨兵襻”现象是胰腺炎的直接诊断依据\nD. 可以观察到肠麻痹的迹象\nE. 是诊断胰腺炎的重要辅助工具", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆管结石导致感染性休克的紧急情况下，应采取哪种处理措施？", "options": "A. 使用大量抗生素控制感染后再进行手术\nB. 紧急手术\nC. 在抗休克的同时进行手术以解除胆道梗阻\nD. 禁忌手术\nE. 抗休克，待血压回升后再进行手术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，以下哪种生化指标异常提示可能为重症胰腺炎？", "options": "A. 高血糖\nB. 低钙血症\nC. 血、尿淀粉酶显著升高\nD. 代谢性碱中毒\nE. 血小板计数明显下降", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门脉性肝硬化患者中，若出现上消化道出血，下列哪种处理措施可能诱发肝性脑病？", "options": "A. 静脉点滴支链氨基酸\nB. 肥皂水灌肠清除积血\nC. 硫酸镁导泻\nD. 静脉输入止血芳酸", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆囊的解剖结构，以下哪几项描述是正确的？", "options": "A. 胆囊分为底、体、颈、管4个部分\nB. 胆囊底通常突出于肝前缘\nC. 胆囊的主要功能是分泌胆汁\nD. 胆囊位于肝脏下方的胆囊窝内\nE. 胆囊颈和胆囊管内存在螺旋襞", "answer": "ADE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科的超声检查中，发现肝右前叶下段与左内叶交界处有一个低回声不均匀的实性肿块，边缘不清晰，内部可见多个强回声团伴声影，且胆囊腔内无回声区消失。这种情况下，最可能的诊断是什么？", "options": "A.胆囊癌实块型\nB.肝细胞肝癌伴坏死液化\nC.肝内炎性假瘤\nD.胆管细胞肝癌\nE.肝腺瘤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝炎患者中，眼结膜出现黄染的主要原因是", "options": "A. 血中胆固醇水平升高\nB. 血中二氧化碳浓度增加\nC. 血中氧含量上升\nD. 血中胆红素水平升高\nE. 红细胞破坏增加", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者因急性胰腺炎接受保守治疗1个月后病情好转，复查B超显示胰头部出现85mm×92mm的假性囊肿。此时，最合适的处理方案是", "options": "A. 继续保守治疗，3个月后进行内引流术\nB. 继续保守治疗，3个月后进行外引流术\nC. 继续保守治疗，3个月后进行胰腺囊肿切除术\nD. 继续保守治疗，等待囊肿自行吸收\nE. 立即进行急诊引流手术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位52岁女性患者，因反复发作的上腹部剧烈疼痛伴寒战高热3天就诊。患者6个月前曾有类似发作史。体检发现体温39.5℃，心率125次/分，血压135/80mmHg。实验室检查显示白细胞计数13×10^9/L，患者意识清晰，皮肤及巩膜轻度黄染，右上腹可触及压痛性肿大胆囊。若患者病情进展，出现黄疸加重、体温升至40.2℃、心率加快至135次/分、血压下降至85/55mmHg、意识模糊，最可能的诊断是", "options": "A. 细菌性肝脓肿\nB. 急性梗阻性化脓性胆管炎\nC. 肝内胆管结石并胆管炎\nD. 肝外胆管结石并胆管炎\nE. 急性化脓性胆囊炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝局灶性结节性增生（FNH）的影像学特征中，以下哪项描述是正确的？", "options": "A. 病灶周围有完整的包膜\nB. 在T2加权像上，瘢痕区域呈现低信号\nC. 延迟期扫描时，中央瘢痕区域显示为低密度或低信号\nD. 病灶不摄取超顺磁性氧化铁（SPIO）\nE. 病灶内未见出血或钙化", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁女性患者，2天前在餐后突然出现右上腹阵发性绞痛，伴有恶心，尿液呈浓茶色，既往有类似发作史。查体显示急性病容，巩膜黄染，腹部无肌紧张，右上腹有深压痛。最可能的诊断是什么？", "options": "A.胆总管结石\nB.胆道蛔虫病\nC.胆总管囊肿\nD.急性胰腺炎\nE.急性胆囊炎", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胆囊炎的发病机制中，以下哪些因素是最常见的致病原因？", "options": "A.胆道蛔虫阻塞\nB.胆结石嵌顿\nC.酗酒\nD.暴饮暴食", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的临床表现中，以下哪一项描述是不正确的？", "options": "A. 所有患者都会出现昏迷\nB. 病程可分为急性、亚急性和慢性\nC. 可能表现为性格和行为异常\nD. 可能出现理解能力下降\nE. 可能出现神经系统体征", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞性黄疸的诊断中，以下哪一项描述是不正确的？", "options": "A. 血液中结合胆红素和非结合胆红素水平均升高\nB. 血液中结合胆红素的增加幅度通常高于非结合胆红素\nC. 尿液中的胆红素定性测试结果通常为阳性\nD. 尿液中的尿胆原水平通常减少或缺失\nE. 肝功能通常有不同程度的损害", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于患有严重肝病的糖尿病患者，以下哪种降血糖药物是禁用的？", "options": "A. 甲苯磺丁脲\nB. 氯磺丙脲\nC. 甲福明\nD. 胰岛素\nE. 苯乙福明", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗胆绞痛时，为什么吗啡需要与阿托品联合使用？", "options": "A. 减弱吗啡的成瘾性\nB. 对抗吗啡的呼吸抑制作用\nC. 解除吗啡所致的胆道括约肌痉挛\nD. 对抗吗啡引起的瞳孔缩小\nE. 对抗吗啡引起嗜睡的副作用", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝豆状核变性中，哪种矿物质的代谢障碍是主要原因？", "options": "A. 钙\nB. 铜\nC. 铁\nD. 锌\nE. 镁", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁男性患者，近3个月来出现右上腹胀痛，并伴有半月余的黄疸。体检发现肝脏在肋下3cm，剑突下4cm处可触及，质地坚硬，且有移动性浊音。为了进一步诊断肝癌，以下哪项检查最为关键？", "options": "A. 乙肝五项检查\nB. 腹部X线片\nC. 肝功能检查\nD. 甲胎蛋白升高+B超检查\nE. CT检查", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在无结石性胆囊炎的发病机制中，以下哪项被认为是主要原因？", "options": "A. 胆道蛔虫引起感染\nB. 胆汁淤滞\nC. 致病菌随血行扩散\nD. 迷走神经功能亢进\nE. 胆汁中胆固醇含量增加", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科急诊中，患者出现急性腹痛且病情迅速恶化，最可能的原因是以下哪些情况？", "options": "A. 急性出血性坏死性胰腺炎\nB. 空腔脏器穿孔\nC. 梗阻性病变\nD. 实质脏器破裂", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪一项不是导致腹腔积液形成的主要机制？", "options": "A. 门静脉高压\nB. 原发性醛固酮增多症\nC. 血浆白蛋白水平降低\nD. 肝脏淋巴液生成增加\nE. 抗利尿激素分泌增多", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在Couinaud肝脏分段法中，位于肝脏右后下方的区域是哪个段？", "options": "A.左上外侧段\nB.左内侧段\nC.右前下段\nD.右后下段\nE.右前上段", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，关于淀粉酶的检测，以下哪项描述是正确的？", "options": "A. 血淀粉酶具有最高的特异性\nB. 血清淀粉酶的升高持续时间最长\nC. 血清淀粉酶水平与胰腺炎的严重程度呈正相关\nD. 尿淀粉酶在症状出现后24小时内开始上升\nE. 尿淀粉酶水平下降速度较快", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位女性患者，已被诊断为肝癌。近日突然出现剧烈腹痛并伴有休克症状，最可能的并发症是", "options": "A. 原发性腹膜炎\nB. 急性梗阻性化脓性胆管炎\nC. 结核性腹膜炎\nD. 原发性肝癌破裂\nE. 肝性脑病", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在特发性门脉高压的诊断和治疗中，以下哪项描述是错误的？", "options": "A. 患者常表现为脾脏肿大、贫血和出血倾向\nB. 该病症是由于肝细胞再生形成假小叶，进而压迫肝窦所致\nC. 特发性门脉高压是指肝窦前阻塞导致的门静脉压力升高\nD. 该病与门静脉的纤维变性有密切关联\nE. 在治疗上，分流术应作为首选方案", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位58岁男性患者，长期患有乙肝后肝硬化，近期出现腹部膨胀和下肢水肿，并伴有尿量减少。体检显示腹部呈蛙状，液波震颤阳性，下肢有明显凹陷性水肿。实验室检查显示血钠水平为125mmol/L，BUN为20mmol/L。以下哪项不是肝硬化腹腔积液形成的机制？", "options": "A. 门静脉压力增高\nB. 低白蛋白血症\nC. 继发醛固酮增多\nD. 有效循环量不足\nE. 毛细血管通透性增加", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名10岁女孩突然出现剑突下剧烈绞痛，疼痛呈钻顶样，持续1小时，伴有辗转不安。体检发现腹肌柔软，右上腹部有轻微压痛。最可能的诊断是什么？", "options": "A. 急性胆囊炎\nB. 胆总管结石\nC. 胆道蛔虫病\nD. 急性胰腺炎\nE. 急性胃炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在我国，导致门静脉高压症最常见的病因是", "options": "A. 门静脉血栓形成\nB. Budd-Chiari综合征\nC. 肝硬化\nD. 门静脉主干先天性畸形\nE. Banti综合征", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在脾切除手术后的早期阶段，患者应定期进行哪项检查以监测可能的并发症？", "options": "A. 内出血征象\nB. 呼吸功能\nC. 肝、肾功能\nD. 凝血时间\nE. 血小板计数", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的早期阶段，患者最常出现的症状是什么？", "options": "A. 寒战、高热\nB. 肝区疼痛\nC. 肝大\nD. 黄疸\nE. 恶心、呕吐", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "阿米巴肝脓肿的主要感染途径是什么？", "options": "A.阿米巴原虫从胆道上行进入肝脏\nB.阿米巴原虫从结肠溃疡穿入门静脉所属分支进入肝脏\nC.阿米巴原虫从淋巴系统进入肝脏\nD.阿米巴原虫从肝动脉进入肝脏\nE.阿米巴原虫从穿孔的肠腔进入腹腔和肝脏", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者出现呕吐并伴有上腹部节律性、周期性的疼痛，最可能的诊断是？", "options": "A. 肝硬化\nB. 消化性溃疡\nC. 慢性胆囊炎\nD. 急性胃炎\nE. 胆石症", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在下列疾病中，哪一种与幽门螺杆菌感染有密切关联？", "options": "A. 急性胆囊炎\nB. 慢性胆囊炎\nC. 十二指肠溃疡\nD. 急性阑尾炎\nE. 溃疡性结肠炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，以下哪种检查方法具有较高的特异性和诊断价值？", "options": "A. AFP\nB. CEA\nC. ALT\nD. CA199\nE. AST", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁男性患者，因关节疼痛服用吲哚美辛三片后，今晨出现上腹部不适，随后呕吐出咖啡样物并伴有鲜血，总量约500ml。患者既往有胆石症病史。请问其呕血最可能的原因是", "options": "A.胃溃疡并出血\nB.胆道出血\nC.十二指肠球部溃疡并出血\nD.急性胃黏膜损害\nE.胃癌并出血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在乙型肝炎的免疫学检测中，以下哪种抗体具有保护性作用？", "options": "A. 抗-HBs\nB. 抗-HBc\nC. 抗-HBe\nD. 以上都不是\nE. 以上都是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，以下哪种疾病患者常表现为皮肤出现蜘蛛痣、肝掌，并伴有黑便症状？", "options": "A. 胆道梗阻\nB. 肝硬化门静脉高压\nC. 结肠癌\nD. 急性胆囊炎\nE. 胃溃疡", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝外胆道的解剖结构中，以下哪个结构不属于其组成部分？", "options": "A. 肝左管\nB. 肝右管\nC. 肝总管\nD. 胰管\nE. 胆囊", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，哪种病毒与肝癌的发生有密切关联？", "options": "A. HSV\nB. HBV\nC. HPV\nD. EBV", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的CT影像中，以下哪一项是最具诊断价值的特征？", "options": "A. 胰腺表面光滑\nB. 胰腺萎缩\nC. 胰腺边缘锐利\nD. 左肾前筋膜增厚\nE. 胰腺密度均匀", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，以下哪项血清学检查具有最高的诊断价值？", "options": "A. LDH\nB. AKP\nC. AFP\nD. CEA\nE. γ-GT", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胆道疾病时，以下哪种方法被推荐为首选？", "options": "A. 内镜逆行性胰胆管造影\nB. 静脉胆道造影\nC. B超\nD. 口服胆囊造影\nE. 经皮经肝穿刺胆道造影（PTC）", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊癌的CT影像中，以下哪项描述最符合胆囊壁增厚型的特点？", "options": "A.胆囊腔单发或多发乳头状肿块\nB.胆囊壁呈不规则增厚\nC.占41%〜70%\nD.胆囊腔几近全部被肿瘤所占据，形成软组织肿块\nE.肿块基底部胆囊壁增厚", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下因素中，哪一项不是导致肝硬化的常见原因？", "options": "A. 胆汁淤积\nB. 丙型肝炎\nC. 酒精中毒\nD. 乙型肝炎\nE. 甲型肝炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，正常胆总管的直径范围是多少？", "options": "A. 0.4~0.6cm\nB. 0.6~0.8cm\nC. 0.8~1.0cm\nD. 1.0~1.2cm\nE. 1.2~1.4cm", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝血管瘤的超声检查中，以下哪种表现是不正确的？", "options": "A. 高回声型\nB. 低回声型\nC. 血管聚集型\nD. 囊性型\nE. 混合回声型", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门脉高压的临床表现中，下列哪一项最具特异性？", "options": "A. 脾功能亢进\nB. 腹水\nC. 肝掌，蜘蛛痣\nD. 侧支循环开放\nE. 脾肿大", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位54岁女性患者，有19年的乙肝病史，最近3个月出现腹胀、食欲减退和乏力症状。以下哪项检查结果最可能提示肝硬化？", "options": "A. 肝功能检查显示胆红素水平升高\nB. 肝功能检查显示白蛋白水平降低\nC. 肝脏超声检查显示肝脏体积缩小\nD. 血常规检查显示全血细胞减少\nE. 食管吞钡X线检查显示虫蚀样改变", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的病例中，淋巴转移最常发生在哪个部位？", "options": "A. 腹膜后淋巴结\nB. 主动脉旁淋巴结\nC. 锁骨上淋巴结\nD. 肝门淋巴结\nE. 胰周淋巴结", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于早期肝癌患者，目前被认为最有效的治疗方法是（）", "options": "A.放射治疗\nB.肝移植联合综合治疗\nC.化学药物治疗\nD.外科手术切除\nE.免疫疗法", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于患有肝胰疾病的患者，每日脂肪摄入量的上限应该是多少？", "options": "A. 40g\nB. 60g\nC. 80g\nD. 100g\nE. 120g", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在MRI检查中，关于肝脏病变信号强度的描述，以下哪些是正确的？", "options": "A. 等信号：病变区域信号强度与正常肝组织相同\nB. 极低信号：病变区域信号强度与肝内血管信号相同\nC. 稍低信号：病变区域信号强度介于正常肝组织和血管信号之间\nD. 极高信号：病变区域信号强度与脂肪组织相同\nE. 稍高信号：病变区域信号强度介于脂肪组织和正常肝组织之间", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在华支睾吸虫感染人体的情况下，其主要寄生位置是哪个部位？", "options": "A. 肝静脉\nB. 门静脉\nC. 肝动脉\nD. 肝内胆管\nE. 胆总管", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的临床表现中，以下哪一项描述是不正确的？", "options": "A. 肿瘤快速增大，牵拉肝包膜导致疼痛\nB. 门静脉内癌栓形成可引起门静脉高压\nC. 门静脉外癌栓可能导致血管杂音\nD. 肿瘤侵犯肝门部胆管可引发黄疸\nE. 肿瘤生长缓慢，可能无明显疼痛", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在HBsAg阳性患者中，如果抗原持续存在超过多长时间，患者更有可能发展为慢性乙肝或肝硬化？", "options": "A. 1周\nB. 1个月\nC. 2个月\nD. 3个月\nE. 半年", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，Charcot三联症是以下哪种疾病的典型表现？", "options": "A. 急性胆囊炎\nB. 急性胰腺炎\nC. 急性胃炎\nD. 急性胆管炎\nE. 急性十二指肠憩室炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆管狭窄的治疗中，球囊扩张与支架置入术的禁忌证不包括以下哪项？", "options": "A. 胆管良性狭窄\nB. 明显出血倾向\nC. 大量腹水\nD. 肝功能衰竭\nE. 胆管广泛狭窄者", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名年轻男性患者，在发病第8天前来就诊。体检发现患者意识模糊，情绪激动，巩膜呈现中度黄染，牙龈有出血现象，颈部有抵抗感，浅表淋巴结未肿大，肝脏边界明显缩小，无腹水迹象，布-克氏征阴性，未引出病理反射。根据这些临床表现，最可能的诊断是什么？", "options": "A.急性重症肝炎\nB.乙型脑炎\nC.流行性脑脊髓膜炎\nD.肾综合征出血热\nE.钩端螺旋体病，黄疸出血型", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌患者中，十二指肠环的影像学改变可能表现为", "options": "A.降部出现反“3”征\nB.降部充盈缺损\nC.降部双边缘\nD.降部小弯侧黏膜皱襞破坏、消失", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的病程中，血清淀粉酶水平通常在发病后多长时间达到峰值？", "options": "A. 4小时\nB. 8小时\nC. 12～24小时\nD. 48～72小时\nE. 72～96小时", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔镜胆囊切除术中，以下哪种并发症被认为是最具挑战性的术后管理问题？", "options": "A.胆管损伤\nB.术后出血\nC.肠管损伤\nD.胆瘘\nE.血管损伤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏CT增强扫描检查技术中，以下哪项描述是不正确的？", "options": "A. 肝脏增强通常采用三期扫描\nB. 动脉期延迟扫描时间25〜30秒\nC. 门脉期延迟扫描时间60〜70秒\nD. 实质期延迟扫描时间85〜90秒\nE. 怀疑肝血管瘤，则实质期的延迟扫描时间为120秒", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的患者中，以下哪种临床表现通常预示着较差的预后？", "options": "A. 胸腔积液吸收缓慢\nB. 黄疸逐渐加深\nC. 体温持续不降\nD. 肝大触痛明显\nE. 局部皮肤水肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名18岁女性患者，因近期饮食不当，出现右上腹阵发性绞痛，疼痛向右肩放射，发作时疼痛剧烈，间歇期无不适。以下哪项体征对诊断最有帮助？", "options": "A. 黄疸\nB. 腹胀\nC. 腹肌不紧，反跳痛（-）\nD. Murphy征（±）\nE. 胆囊增大", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在某医院对300例肝癌住院患者的回顾性研究中，发现其中75%的患者有丙型肝炎病毒感染史，而无感染者仅占25%。据此，研究者得出丙型肝炎病毒感染者发生肝癌的风险更高的结论。这一结论", "options": "A. 正确\nB. 不正确，因为缺乏统计学显著性检验\nC. 不正确，因为样本仅来自单一医疗机构，代表性不足\nD. 不正确，因为研究仅基于病例组数据，缺乏对照组信息\nE. 丙型肝炎病毒感染者肝癌发生率为不感染者的3倍", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的微观结构中，窦周隙具有以下哪些特征？", "options": "A. 含有血浆成分\nB. 肝细胞的微绒毛延伸至其中\nC. 是肝细胞与血液之间物质交换的主要场所\nD. 位于肝细胞与血窦内皮细胞之间\nE. 含有巨噬细胞", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，胆囊结石患者应考虑进行胆囊切除术？", "options": "A. 无症状的年轻患者\nB. 经常出现右上腹疼痛\nC. 结石直径超过2厘米\nD. 同时患有糖尿病", "answer": "BCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位42岁的女性患者，患有慢性乙肝已有10年，最近一个月病情显著恶化，怀疑为慢性重型肝炎。以下哪一项结果不能作为诊断依据？", "options": "A. 黄疸明显加重\nB. 转氨酶增高\nC. 出现肝性脑病\nD. 肝脏迅速缩小\nE. 血小板明显减少", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的病理过程中，胰管内压力升高可能导致胰小管和胰腺腺泡破裂，进而引发胰腺组织的自身消化。这一过程中起主要作用的酶是", "options": "A. 胰淀粉酶\nB. 胰蛋白酶\nC. 抗胰蛋白酶\nD. 胰脂肪酶\nE. 肠激酶", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者出现上腹部剧烈疼痛，伴有寒战、高热和黄疸症状，最可能诊断为以下哪种疾病？", "options": "A. 胆总管囊肿\nB. 胆道蛔虫病\nC. 急性胆囊炎\nD. 先天性胆道闭锁\nE. 胆总管结石合并感染", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的微观结构中，胆小管的位置是", "options": "A.肝板与血窦间\nB.肝小叶之间\nC.肝板内相邻肝细胞间\nD.窦周隙内\nE.肝板间", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁女性患者，近3年常有夜间上腹部不适。2天前因进食油腻食物后，突然出现右上腹部阵发性绞痛，伴有恶心。入院时体温38℃，巩膜轻度黄染，右上腹肌紧张，压痛明显，肠鸣音减弱。实验室检查显示白细胞计数为16*10^9/L，血清淀粉酶为128温氏单位。根据这些症状和检查结果，最可能的诊断是什么？", "options": "A. 高位急性阑尾炎\nB. 急性胰腺炎\nC. 溃疡病穿孔\nD. 急性化脓性胆囊炎\nE. 胆道蛔虫症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的病理生理过程中，脑组织对神经毒性物质的敏感性增加主要与哪些因素有关？", "options": "A. 脑组织缺氧\nB. 神经毒性物质浓度升高\nC. 继发感染\nD. 电解质平衡失调", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下类型的肝硬化中，哪一种最有可能发展为肝癌？", "options": "A. 胆汁性肝硬化\nB. 坏死后性肝硬化\nC. 门脉性肝硬化\nD. 淤血性肝硬化\nE. 酒精性肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的病理过程中，下列哪项改变最具特征性？", "options": "A. 纤维组织增生\nB. 肝细胞变性坏死\nC. 不同程度的炎性细胞浸润\nD. 再生结节及假小叶形成\nE. 呈小管样结构的新生细胞", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，了解肝外胆道的解剖结构至关重要。以下关于肝外胆道解剖的描述中，哪一项是不正确的？", "options": "A. 胆囊管在解剖上存在多种变异\nB. Oddi括约肌主要由胰胆管部括约肌组成\nC. 胆囊通常分为底部、体部和颈部三个部分\nD. 大多数情况下，胆总管下段与主胰管会汇合\nE. 胆囊动脉是一种终末动脉", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，患者通常需要禁食多长时间？", "options": "A. 不超过12小时\nB. 1到3天\nC. 4到5天\nD. 5到7天\nE. 7天以上", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位64岁男性患者，主诉无痛性黄疸持续加重1个月，伴有体重下降。体检发现巩膜黄染，血清总胆红素水平为70μmol/L，Courvoisier征阳性。根据这些临床表现，最可能的诊断是什么？", "options": "A. 下段胆管癌\nB. 胆囊癌\nC. 肝门部胆管癌\nD. 胆囊结石\nE. 胆总管结石", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在酒精性肝炎的病理变化中，以下哪一组描述是正确的？", "options": "A.肝细胞脂肪变、酒精透明小体和灶状肝细胞坏死伴中性粒细胞浸润\nB.肝细胞脂肪变、酒精透明小体和肝细胞点状坏死伴淋巴细胞浸润\nC.肝细胞脂肪变、酒精透明小体和汇管区的碎片状坏死伴中性粒细胞浸润\nD.肝细胞脂肪变、酒精透明小体和桥接坏死伴淋巴细胞浸润\nE.肝细胞脂肪变、酒精透明小体和肝细胞结节状再生伴小胆管增生", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在完全性阻塞性黄疸的情况下，以下哪项描述是正确的？", "options": "A. 尿胆原阴性，尿胆红素阴性\nB. 尿胆原阳性，尿胆红素阴性\nC. 尿胆原阴性，尿胆红素阳性\nD. 尿胆原阳性，尿胆红素阳性\nE. 粪胆素阳性", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位24岁女性患者，近4个月来出现低热、腹胀症状，伴有体重下降和闭经。体检发现移动性浊音阳性，腹水呈洗肉水样。根据这些临床表现，最可能的诊断是什么？", "options": "A. 肝硬化，失代偿\nB. 原发性肝癌，腹膜转移\nC. 卵巢囊肿\nD. 肝硬化并自发性腹膜炎\nE. 结核性腹膜炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位40岁女性患者，有15年的慢性活动性肝炎病史，1年前被诊断为肝硬化，并反复出现腹水。1周前进行钡餐检查发现球部龛影。3小时前出现呕吐咖啡样物。诊断为上消化道出血，其最可能的原因是", "options": "A.食管胃底静脉曲张破裂\nB.急性胃黏膜病变\nC.十二指肠球部溃疡\nD.胃溃疡\nE.胃癌", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道X线检查中，以下哪项描述是错误的？", "options": "A. 平片胆色素结石一般不显影\nB. 平片胆固醇结石显影\nC. 肝功能不佳造影时不显影\nD. 胃肠功能紊乱，可影响口服法造影\nE. 胆囊功能不正常，造影时可不显影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在考虑肝脏移植的适应证时，以下哪种疾病通常不被包括在内？", "options": "A. Budd-Chiari综合征\nB. 终末期肝硬化\nC. 肝豆状核变性\nD. 低分化胆管细胞癌\nE. 原发灶已切除但已有多发肝转移的恶性胰岛素瘤", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆总管囊性扩张症的分类中，Ⅱ型具体指的是哪种情况？", "options": "A.胆总管扩张呈囊状、柱状或纺锤状\nB.局限于肝内胆管的多发囊状扩张（Caroli病）\nC.胆总管十二指肠壁内段囊状膨出\nD.胆总管单发憩室样扩张\nE.多发性胆管囊肿，位于肝内外或肝外", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在成人中，胆汁酸库的总量约为3~5克，而人体肠道每天所需的胆汁酸总量约为12~32克。为了满足这一需求，人体主要通过哪种机制来维持胆汁酸的生理平衡？", "options": "A. 增加胆汁酸的生物合成\nB. 胆汁酸的肠肝循环\nC. 提高胆汁酸合成限速酶的活性\nD. 增强胆汁酸合成限速酶的表达\nE. 通过激素调节", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的治疗中，以下哪种情况是手术的明确指征？", "options": "A.上消化道出血，内科治疗无效\nB.脾功能亢进\nC.腹腔积液\nD.出血倾向\nE.以上都不是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在MRI检查中，一个病灶在T1加权像上表现为均匀低信号，在T2加权像上随着回波时间（TE）的延长，肿瘤信号强度逐渐增加，呈现出类似灯泡的亮信号。注射Gd-DTPA造影剂后，病灶周边出现结节状强化，延迟扫描时增强范围逐渐扩大。根据这些影像学特征，最可能的诊断是什么？", "options": "A. 肝癌\nB. 肝腺瘤\nC. 肝囊肿\nD. 肝海绵状血管瘤\nE. 胆管癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的诊断和随访过程中，最常用的辅助检查项目是以下哪一项？", "options": "A. 血尿淀粉酶\nB. 糖类抗原19-9\nC. 血清胆红素\nD. 氨基转移酶\nE. 血糖与尿糖值", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患有慢性胆囊炎的男性患者，准备进行胆囊造影检查。在向护士复述检查前的饮食准备时，以下哪项需要纠正？", "options": "A. 检查前一日中午进高脂肪餐\nB. 检查前一日晚餐应无脂肪、低蛋白\nC. 检查前一日晚餐后口服造影剂，禁食\nD. 检查当日早晨应清淡饮食\nE. 首次摄片胆囊显影可进高脂肪餐", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，哪种酶的异常活动最可能导致微循环障碍和休克？", "options": "A. 磷酰酶A2\nB. 弹力蛋白酶\nC. 激肽酶\nD. 胰蛋白酶\nE. 脂肪酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现右上腹剧烈疼痛、寒战高热以及黄疸，最可能的诊断是", "options": "A. 急性化脓性胆管炎\nB. 肝脓肿\nC. 病毒性肝炎\nD. 胆总管癌\nE. 原发性肝癌", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺癌的同步放化疗治疗中，推荐的放疗总剂量（DT）是多少？", "options": "A. 60Gy/30F/6W\nB. 50Gy/25F/5W\nC. 40Gy/20F/4W\nD. 66Gy/33F/7W\nE. 44Gy/22F/5W", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，以下哪项措施是不合适的？", "options": "A.腹部单纯X线照片，在横结肠中部，可见气体充盈影\nB.胰管造影，对诊断是重要的检查方法\nC.血清淀粉酶的高峰值是在发病后48小时以内\nD.对于镇痛，使用盐酸吗啡不合适\nE.常常以胆总管引流术进行治疗", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，以下哪项不是胆道损伤的典型表现？", "options": "A. 术中发现胆汁漏出\nB. 术后早期出现梗阻性黄疸\nC. 检查切除的胆囊标本，发现胆囊管处有1个开口\nD. 术后发生胆汁性腹膜炎\nE. 术中胆道造影显示胆管影像中断、狭窄或造影剂外溢", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者，在劳动过程中突然出现上腹部剧烈疼痛，疼痛迅速扩散至全腹，伴有明显的腹膜刺激症状，肝浊音界消失，肠鸣音减弱。患者腹部呈舟状，无法直立行走。最可能的诊断是？", "options": "A.胆囊穿孔腹膜炎\nB.胃十二指肠溃疡穿孔腹膜炎\nC.肠扭转\nD.阑尾炎穿孔腹膜炎\nE.急性出血性胰腺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝细胞浆内出现的下列病变中，哪一种是变性？", "options": "A. Mallory小体\nB. HbsAg\nC. HbcAg\nD. 巨大病毒包涵体", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名14岁女孩，近10个月来频繁出现右上腹痛并伴有黄疸，症状逐渐加重，大便呈陶土色，经过消炎利胆治疗后未见好转。患儿在出生后6天曾接受过先天性胆总管囊肿十二指肠吻合术。此患儿出现此合并症的最可能原因是", "options": "A.结石\nB.胰液逆流\nC.胆汁淤积\nD.吻合口狭窄\nE.肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，壶腹癌导致的黄疸类型是：", "options": "A. 肝细胞性黄疸\nB. 溶血性黄疸\nC. 梗阻性黄疸\nD. 先天性黄疸\nE. 生理性黄疸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位80岁的女性患者，因急性结石性胆囊炎接受手术后，因伤口疼痛注射了一支哌替啶。半小时后，患者出现昏睡，呼吸频率降至10次/分钟。最可能的原因是__", "options": "A.术后伤口感染\nB.腹腔感染\nC.严重鼓肠\nD.麻醉剂过量\nE.休克", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，大肠腺癌肝转移的超声检查中，最常见的声像图特征是什么？", "options": "A. 高回声型\nB. 强回声型\nC. 低回声型\nD. 弱回声型\nE. 混合回声型", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位41岁男性患者，因右上腹持续疼痛1年就诊。B超检查发现肝左外叶有一10cm的占位性病变，边界模糊，且门静脉左支内存在癌栓。针对此情况，应首选哪种治疗方案？", "options": "A. 全身化学治疗\nB. 肿瘤局部放射治疗\nC. 手术治疗\nD. 介入治疗\nE. 中医治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，原发性肝癌的定义是__", "options": "A. 肝细胞和肝内胆管上皮发生的癌\nB. 胆管上皮发生的癌\nC. 肝细胞发生的癌\nD. 肝细胞和胆管上皮发生的癌\nE. 枯否细胞的恶性肿瘤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位46岁男性患者，有10余年的“慢性肝炎”病史。20小时前因进食烙饼后出现呕血约200ml，排黑便约100ml，2小时前出现意识障碍，无法识别家人。在治疗过程中，以下哪项措施是错误的？", "options": "A.静脉点滴支链氨基酸\nB.肥皂水灌肠清除积血\nC.硫酸镁导泻\nD.静脉输入止血芳酸\nE.限制蛋白饮食", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁男性患者，有30年大量饮酒史，因半天内出现意识不清被送入医院。体检发现患者面色晦暗，且出现扑翼样震颤。请问该患者意识障碍最可能的原因是什么？", "options": "A.肝性脑病\nB.慢性酒精中毒\nC.电解质紊乱\nD.代谢反应\nE.低血糖发作", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的早期阶段，最常见的转移方式是什么？", "options": "A. 通过肝内血管系统扩散\nB. 通过淋巴系统转移至肺部\nC. 通过淋巴系统转移至锁骨上淋巴结\nD. 直接侵入胸腔\nE. 直接扩散到腹腔", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位中年男性患者，近半年出现乏力、明显消瘦、消化不良、腹胀、食欲差，肝区疼痛并向右肩部放射。查体发现右肋下可触及肿块，移动性浊音（-）。临床诊断为肝癌。以下哪项实验室检查对诊断最有意义？", "options": "A. 血常规\nB. 肝炎系列\nC. 肝功能检查\nD. 甲胎蛋白（AFP）\nE. 血浆蛋白测定", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下因素中，哪一个与肝细胞癌的发生没有直接关联？", "options": "A. 乙型肝炎病毒（HBV）感染\nB. 丙型肝炎病毒（HCV）感染\nC. 华支睾吸虫感染\nD. 黄曲霉素暴露\nE. 亚硝胺类化合物摄入", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，以下哪种显像剂是阳性显像剂？", "options": "A. 99mTc-硫胶体\nB. 99mTc-RBC\nC. 99mTc-EHIDA\nD. 99mTc-DTPA\nE. 以上都是", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，Charcot三联征最常与以下哪种疾病相关？", "options": "A. 肝门部胆管癌患者\nB. 胆囊结石患者\nC. 肝内胆管结石患者\nD. 胆总管结石患者\nE. 胰头或乏特壶腹癌患者", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于以腹痛为主要症状的疑似胰腺癌患者，在进一步检查受限的情况下，可以考虑进行剖腹探查，但在此之前必须排除以下哪种情况？", "options": "A.胆石症\nB.胰腺炎\nC.心绞痛等内科疾病\nD.胰腺囊肿\nE.胰腺内分泌肿瘤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，胆总管囊肿的主要病因是什么？", "options": "A. 肝内胆管扩张\nB. 胰胆管合流异常\nC. 胆总管扩张\nD. 病毒性感染\nE. 胆道上皮增生不平衡", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位58岁女性患者因急性上腹痛入院，经诊断为轻症急性胰腺炎。在以下治疗轻症急性胰腺炎的方法中，哪一项是不正确的？", "options": "A. 禁食水\nB. 胃肠减压\nC. 抗生素\nD. 抑酸剂\nE. 胰酶抑制剂", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁的女性患者，长期患有胆结石并接受中药治疗，最近出现右上腹持续性疼痛，疼痛放射至右肩，并伴有黑便。经检查确诊为胆道出血。胆道出血的典型三联征包括以下哪组症状？", "options": "A.腹痛、呕吐、出血\nB.腹痛、黄疸、出血\nC.腹痛、呕吐、黄疸\nD.腹痛、腹胀、黄疸\nE.腹痛、腹胀、呕吐", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "长期服用避孕药可能增加以下哪种肝脏肿瘤的风险？", "options": "A. 肝血管瘤\nB. 肝细胞腺瘤\nC. 肝局灶性结节增生\nD. 肺癌\nE. 结肠癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，Cullen征表现为哪个部位的青紫色瘀斑？", "options": "A. 季肋部青紫色瘀斑\nB. 脐周围青紫色瘀斑\nC. 腰背部青紫色瘀斑\nD. 上腹部青紫色瘀斑\nE. 下腹部青紫色瘀斑", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，经积极保守治疗后，胆道出血患者常出现周期性复发，其复发间隔时间通常为", "options": "A. 1-2周\nB. 3-4周\nC. 5-6周\nD. 7-8周\nE. 9-10周", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的放射介入治疗中，以下哪项描述是不正确的？", "options": "A. 主要方法包括经导管动脉化疗栓塞(TACE)\nB. 适用于肿瘤体积较大或多发且无法手术切除，但肝功能良好的患者\nC. 门静脉分支存在癌栓并非绝对禁忌\nD. 即使患者出现重度黄疸和腹腔积液，仍可采用此方法\nE. 导管应尽可能插入患侧肝动脉，常用药物包括5-FU和阿霉素，常用栓塞剂为碘油和吸收性明胶海绵", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的治疗中，以下哪种情况不适合采用腹腔镜胆囊切除术？", "options": "A.发病时间超过72小时\nB.发病时间少于72小时\nC.右上腹压痛、肌紧张，莫菲氏征阳性\nD.高龄患者伴有糖尿病，发病48小时\nE.肥胖患者", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于无法通过手术治疗的恶性胆管狭窄患者，以下哪种方法被认为是缓解梗阻性黄疸的最佳选择？", "options": "A. 单纯球囊扩张术\nB. 内支架植入术\nC. 内涵管引流术\nD. 外涵管引流术\nE. 永久性涵管引流", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的患者中，以下哪一项症状并不常见？", "options": "A. 脾脏肿大\nB. 肝脏肿大\nC. 食管静脉曲张导致出血\nD. 腹腔积液\nE. 痔疮形成", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位37岁的男性患者，长期患有慢性肝炎并发展为肝硬化，近期出现头晕、恶心、呕吐、呕血和血便症状，出血量约为200ml，经诊断为上消化道出血。在这种情况下，最合适的治疗措施是__", "options": "A.肾上腺素皮下注射\nB.冰盐水+去甲肾上腺素口服\nC.去甲肾上腺素静脉注射\nD.冰盐水+肾上腺素口服\nE.维生素K肌注", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的诊断中，以下哪项是最关键的指标？", "options": "A.放射性核素肝扫描显示占位性病变\nB.右膈肌升高及运动受限\nC.A型超声波检查肝区有束状波\nD.碱性磷酸酶、γ-谷氨酰转肽酶水平升高\nE.甲胎蛋白持续阳性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在阿米巴病的临床并发症中，哪一种最为常见？", "options": "A. 阿米巴脑脓肿\nB. 阿米巴肝脓肿\nC. 阿米巴肺脓肿\nD. 皮肤阿米巴病\nE. 以上都不是", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的临床表现中，下列哪一项不符合其腹痛的特征？", "options": "A. 疼痛性质为刀割样或绞痛\nB. 疼痛位于中上腹部\nC. 疼痛可向腰背部呈带状放射\nD. 疼痛在进食后有所缓解\nE. 疼痛可呈阵发性加剧", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌患者接受肝叶切除手术的护理过程中，以下哪项措施与预防肝性脑病无关？", "options": "A. 术前使用护肝药物\nB. 术前应用维生素K\nC. 术前用酸性液灌肠\nD. 术后吸氧\nE. 保持大便通畅", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，肝硬化病史4年，近期出现胸闷加重和呼吸困难症状。心脏彩超检查显示存在大量心包积液。为缓解患者的呼吸困难，应采取以下哪种体位？", "options": "A. 端坐位\nB. 仰卧位\nC. 半坐卧位\nD. 膝胸卧位\nE. 头低脚高位", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的第三阶段，患者可能会出现哪些临床表现？", "options": "A. 昏迷\nB. 扑翼样震颤\nC. 锥体束征阳性\nD. 腱反射减弱", "answer": "BC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎的发病机制中，最主要的病因是（）。", "options": "A.胰腺组织坏死\nB.胰液引流不畅\nC.胰腺血供障碍\nD.胰液外分泌异常\nE.胰液内分泌异常", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的外科治疗中，最主要的治疗目标是什么？", "options": "A. 预防腹水并发感染\nB. 减轻肝性脑病\nC. 纠正血小板减少\nD. 防治食管胃底静脉破裂出血\nE. 治疗顽固性腹水", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "以下哪种癌症与HBV病毒感染有直接关联？", "options": "A. 肺癌\nB. 结肠癌\nC. 肾癌\nD. 原发性肝癌\nE. 其他组织的癌症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，关于蜘蛛痣的描述，以下哪项是不正确的？", "options": "A. 蜘蛛痣的大小通常不一致\nB. 主要分布在上腔静脉供血区域\nC. 其形成与肝脏对雌激素代谢功能下降有关\nD. 是急慢性肝炎和肝硬化的常见体征\nE. 一旦发现蜘蛛痣即可确诊为肝硬化", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的病例中，最常见的致病菌是哪种？", "options": "A. 梭状芽胞杆菌\nB. 金黄色葡萄球菌\nC. 溶血性链球菌\nD. 铜绿假单胞菌\nE. 大肠埃希菌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，直径约1cm的肝、肾囊肿通常呈现低回声，这一现象的主要原因是", "options": "A. 后壁增强效应\nB. 侧壁回声失落效应\nC. 部分容积效应\nD. 旁瓣效应\nE. 镜像效应", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌患者中，以下哪组症状最为常见？", "options": "A. 腹痛，黄疸，消瘦\nB. 腹痛，休克，黄疸\nC. 腹痛，腹胀，呕吐\nD. 腹痛，寒战高热，呕吐\nE. 消瘦，便秘，呕吐", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名20岁的男性农民，因持续发热和全身肌肉疼痛7天，以及尿液变黄2天，于1998年8月5日入院。体检发现眼球结膜充血，腹股沟淋巴结肿大，巩膜轻度黄染，肝脏在肋下1.5cm可触及，腓肠肌有压痛。该地区近期有类似疾病流行。这些症状最可能由以下哪种疾病引起？", "options": "A. 急性病毒性肝炎\nB. 伤寒并中毒性肝炎\nC. 黄疸出血型钩体病\nD. 败血症致肝损害\nE. 阿米巴肝脓肿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床检查中，发现患者脐周区域出现静脉曲张，最可能提示以下哪种情况？", "options": "A. 心功能不全\nB. 肝门静脉梗阻\nC. 髂血管栓塞\nD. 肾脏疾病\nE. 下肢静脉曲张", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者计划进行胆囊手术，术前测量血压为150/90mmHg。针对这一血压值，以下哪项处理是正确的？", "options": "A. 术后不需要使用降压药\nB. 术前和术后都需要使用降压药\nC. 术前需要使用降压药\nD. 术前不需要使用降压药\nE. 术中需要使用降压药", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，对于疑似脂肪肝的患者，下列哪种影像学检查方法通常作为首选？", "options": "A. 磁共振成像（MRI）\nB. 计算机断层扫描（CT）\nC. 超声检查（B超）\nD. 病理学检查\nE. 体格检查", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在一位患者的肝脏检查中，发现肝脏肿大，弥漫分布着无数直径0.1～0.5cm的小结节，同时散在分布着最大直径达6cm的较大结节。镜下观察显示假小叶形成，大型结节无包膜，由多角形、胞浆丰富、核大深染的细胞组成，呈小梁状或巢状排列，其间有血窦。根据这些病理特征，最可能的诊断是什么？", "options": "A. 结节型肝硬化\nB. 结节型肝癌\nC. 肝细胞癌，结节型肝硬化\nD. 坏死后性肝硬化，肝癌\nE. 胆汁性肝硬化，肝癌", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名外伤后休克患者在接受输液治疗后病情有所改善。X线检查显示第9和第10肋骨骨折。然而，4天后患者再次出现休克，最可能的原因是", "options": "A. 气胸\nB. 肝破裂\nC. 脾破裂\nD. 胃破裂\nE. 结肠破裂", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压患者中，导致出血难以自然止血的主要因素包括哪些？", "options": "A. 脾功能亢进导致血小板减少\nB. 门静脉高压患者的血液黏稠度降低\nC. 肝功能受损导致凝血功能障碍\nD. 曲张的食管静脉位于变薄的黏膜下，缺乏软组织保护\nE. 高压的食管曲张静脉易反复受到进食的机械性刺激", "answer": "ACDE", "answer_format": "MultipleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位59岁男性患者因急性胆囊炎在全麻下接受了胆囊切除术。手术结束后，患者被送入麻醉恢复室，1小时后拔管。随后，患者出现呼吸急促、面部潮红和逐渐加重的意识淡漠。最可能的原因是", "options": "A. 缺氧\nB. 通气不足导致CO2潴留\nC. 低血压\nD. 麻醉药、肌松药延迟作用\nE. 镇痛药过量", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝炎后肝硬化的临床表现中，以下哪一项不属于其特征性表现？", "options": "A. 食管静脉曲张\nB. 睾丸萎缩\nC. 黄斑瘤\nD. 肝掌\nE. 蜘蛛痣", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在布-加综合征的治疗中，支架置入术适用于以下哪些情况？", "options": "A.肝段下腔静脉膜性或节段性狭窄或闭塞，伴血栓形成\nB.PTA疗效不佳或再狭窄病例\nC.下腔静脉长段完全性闭塞\nD.下腔静脉癌性狭窄或闭塞", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位43岁的男性患者，长期患有肝硬化，最近在右侧肋弓下发现一个质地坚硬的结节。以下哪个体征最可能提示肝癌？", "options": "A. 巩膜明显黄染\nB. 肝病面容\nC. 肝区可闻及血管杂音\nD. 进行性脾大\nE. 大量腹水", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在治疗肝硬化引起的腹水时，哪种利尿剂是首选药物？", "options": "A.甘露醇\nB.利尿酸钠\nC.双氢氯噻嗪\nD.安体舒通\nE.速尿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，出现寒战、弛张型高热持续半个月，伴有肝区疼痛，肝左叶肿大且压痛明显。患者有明显的黄疸，白细胞计数为18×10^9/L，AFP检测为阴性。超声波检查显示左肝区有4cm的液性暗区，腹腔内有少量积液。胆囊内有1.0cm×2.0cm的结石，胆囊增大且壁厚。在这种情况下，最有效且简单的治疗方法是", "options": "A. 剖腹探查切开引流\nB. 大量有效抗生素\nC. 经皮肝穿刺脓肿引流\nD. 肝左叶切除术\nE. 以上都不对", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位27岁的经产妇，在妊娠27周时出现皮肤瘙痒和巩膜轻微发黄，持续半个月，无其他不适。血压为126/84mmHg，前次妊娠有类似病史，产后黄疸自行消退。化验结果显示ALT为140U/L。若怀疑是病毒性肝炎，应具备以下哪项症状？", "options": "A. 黄疸\nB. ALT剧烈升高\nC. 胆固醇升高\nD. 食欲缺乏、恶心、呕吐等消化道症状\nE. HBsAg(+)", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在亚急性重型肝炎与急性重型肝炎的病理学鉴别中，最具有诊断价值的形态学特征是", "options": "A. 肝实质体积显著缩小\nB. 肝细胞呈结节状再生\nC. 肝脏表面包膜出现皱缩\nD. 胆管系统出现胆汁淤积\nE. 肝细胞发生大面积坏死", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏CT影像中，关于密度表现的描述，哪一项是不正确的？", "options": "A. 肝弥漫性密度减低通常由肝内脂肪积聚引起，常见于脂肪肝\nB. 在严重的肝细胞脂肪变情况下，肝脏密度可能呈现负CT值\nC. 肝脏实质密度显著下降可能导致肝脏实质密度与血管密度倒置\nD. 对于轻度肝脏密度下降，可以通过比较肝肾密度来确定\nE. 如果肝脾密度发生倒置，通常提示肝脏密度减低", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在中医药治疗中，以下哪种药材常用于处理泌尿系统或肝胆系统的结石问题？", "options": "A. 莱菔子\nB. 鸡内金\nC. 谷芽\nD. 山楂\nE. 麦芽", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝脓肿的CT影像特征包括哪些？", "options": "A. 平扫显示低密度占位，中心区域CT值略高于水\nB. 形状多为圆形或椭圆形，部分内部有分隔\nC. 脓肿内部可见小气泡\nD. 脓肿周围出现不同密度的环形带\nE. 增强扫描显示脓肿壁有明显但短暂的强化", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，导致肝硬化最常见的病因是", "options": "A. 胆石症\nB. 病毒性肝炎\nC. 血吸虫病\nD. 胃溃疡\nE. 胆道蛔虫病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断过程中，以下哪项关于实验室检查的描述是不正确的？", "options": "A. 血清淀粉酶超过正常值3倍可确诊\nB. 多有白细胞增多及中性粒细胞核左移\nC. 尿淀粉酶持续存在2〜4周\nD. 血清脂肪酶多在起病后24〜72小时开始上升\nE. CRP有助于评估与监测急性胰腺炎的严重性", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在创伤性胆管损伤的临床处理中，以下哪项描述是正确的？", "options": "A.胆囊损伤是最常见的类型\nB.通常伴有其他腹腔脏器的损伤\nC.胆管挫伤后最常见的长期并发症是胆管狭窄\nD.胆囊损伤最有效的手术治疗方法是胆囊修补术\nE.对于复杂的创伤性胆管损伤，应优先考虑一期原位修复", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，鉴别胆囊息肉与腺瘤时，以下哪项特征最为关键？", "options": "A. 结节的数量（单发或多发）\nB. 结节的回声强度\nC. 结节的发生部位\nD. 结节基底部宽度与结节大小的比例\nE. 结节后方是否存在声影", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者出现右上腹疼痛并伴有呕吐和发热症状，最可能的诊断是？", "options": "A. 急性下壁心肌梗死\nB. 肠梗阻\nC. 急性阑尾炎\nD. 急性胃肠炎\nE. 急性胆囊炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的治疗中，以下哪种药物是禁忌使用的？", "options": "A. 谷氨酸钾\nB. 西咪替丁\nC. 精氨酸钾\nD. 安定\nE. 硫酸镁", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，有5年肝硬化病史，近半年来腹胀症状加重，并伴有双下肢水肿。以下哪项治疗措施是不恰当的？", "options": "A.卧床休息\nB.低盐限水\nC.定期补充白蛋白\nD.低蛋白饮食\nE.快速、大量利尿以加快腹水消退", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断胰高血糖素瘤时，以下哪些检查方法被用于定性诊断？", "options": "A. 血浆胰高血糖素测定\nB. 精氨酸激发试验\nC. 生长抑素敏感试验\nD. 胰岛素C肽水平测定\nE. 皮肤活检", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位37岁男性患者，近2年出现疲乏、心悸和记忆力减退，期间曾有3次癫痫样发作。半月前清晨起床后突然晕倒，神志不清，经静脉注射葡萄糖后恢复。既往无外伤史。体检显示血压为100/70mmHg，无其他明显阳性体征。最可能的诊断是（）。", "options": "A.胃泌素瘤\nB.胰岛素瘤\nC.脑血管疾病\nD.癫痫发作\nE.心血管疾病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名12岁男孩因突发阵发性右上腹绞痛，伴有恶心、呕吐，症状反复发作，持续时间不一。查体显示体温正常，巩膜无黄染，无肌紧张。以下哪种治疗方案不适用于此患者？", "options": "A.胆囊切除术\nB.针刺足三里\nC.解痉利胆驱虫\nD.胆总管探查取虫引流\nE.手术后驱虫治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎患者中，血清淀粉酶水平通常在发病后哪个时间段达到峰值？", "options": "A. 12〜24小时\nB. 24〜48小时\nC. 48〜72小时\nD. 72〜96小时\nE. 96小时以上", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，患有血吸虫性肝硬化，伴有显著的脾肿大和血小板减少，且有上消化道出血的病史。胃镜检查显示食管静脉严重曲张。针对该患者，最适宜的治疗方案是？", "options": "A. 门腔静脉分流术\nB. 脾切除加贲门周围血管离断术\nC. 单纯脾切除术\nD. 脾肾静脉分流术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁女性患者，在进食油腻食物后突然出现右上腹绞痛，并伴有右肩部牵涉痛，持续1小时。为了明确诊断，应首选以下哪项检查？", "options": "A. 静脉胆道造影术\nB. 口服胆囊造影剂造影\nC. B超检查\nD. PTC\nE. ERCP", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门静脉高压症的手术治疗中，主要目标是什么？", "options": "A. 改善肝功能\nB. 治疗腹水\nC. 去除门静脉高压症的病因\nD. 治疗肝性脑病\nE. 预防和控制食管、胃底曲张静脉出血", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁男性患者，有4年肝硬化病史，因突发右上腹剧烈疼痛6小时前来就诊。体检发现血压为9/5kPa，伴有出冷汗，腹水征阳性，诊断性腹穿显示为血性腹水。根据这些临床表现，最可能的诊断是：", "options": "A. 肝癌结节破入腹腔\nB. 结核性腹膜炎\nC. 腹膜转移癌\nD. 自发性腹膜炎\nE. 门静脉血栓形成", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化腹水的治疗中，大量抽水后患者出现内脏充血的主要原因是什么？", "options": "A.血管破裂\nB.减压后充血\nC.血容量增多\nD.引起感染所致\nE.血管通透性增加", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估患者是否患有重症胰腺炎时，以下哪项临床表现最不可能出现？", "options": "A. 四肢厥冷\nB. 腹膜刺激征\nC. 血钙水平低于2mmol/L\nD. 血糖水平超过11.2mmol/L（无糖尿病病史）\nE. 肠鸣音亢进", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在轻症急性胰腺炎的治疗中，以下哪项措施是不推荐的？", "options": "A.胃肠减压\nB.禁食\nC.营养支持治疗\nD.抗生素\nE.抑酸治疗", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，3天前体检时通过B超发现右肝内有一个直径3cm的肿物，血AFP水平为500μg/L。针对这种情况，最有效的治疗方法是什么？", "options": "A.经股动脉插管化疗\nB.经皮肿瘤穿刺注无水酒精\nC.行肝段切除术\nD.放射治疗\nE.全身化疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门静脉高压症的诊断中，以下哪项临床表现最具特异性？", "options": "A. 腹水\nB. 脾大脾亢\nC. 肝功能障碍\nD. 呕血或便血\nE. 食管下段、胃底静脉曲张", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在早期肝癌的筛查中，哪种组合方法被认为是最有效且实用的？", "options": "A.超声波检查＋血清甲胎蛋白测定\nB.肝动脉造影＋血清甲胎蛋白测定\nC.MRI＋γ-谷氨酰转酞酶测定\nD.CT＋碱性磷酸酶测定\nE.肝内肿块B超引导下的活检", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位70岁男性患者，主诉上腹部疼痛已持续1年，进食后症状加重，每日排便10次，粪便中可见脂肪滴。体检发现中腹部有压痛，腹部B超显示胰腺有多发钙化灶。针对此情况，最适宜的治疗药物是", "options": "A. 解痉止痛药物\nB. 胰酶制剂\nC. 消炎利胆药物\nD. 钙化灶阻滞剂\nE. 质子泵抑制剂", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胆囊炎的超声检查中，以下哪些声像图表现是典型的？", "options": "A.胆囊增大、囊壁模糊，外壁线不规则\nB.胆囊壁弥漫性增厚，增厚的壁呈增强回声带\nC.胆囊腔内出现弥漫性低回声或絮状回声等提示胆囊积脓\nD.胆囊窝显示无回声带，提示胆囊周围积液或积脓\nE.胆囊壁内的无回声散在小囊样憩室结构", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，以下哪种血清酶检查具有重要价值？", "options": "A. 谷草转氨酶\nB. 淀粉酶\nC. 碱性磷酸酶\nD. 谷丙转氨酶\nE. 乳酸脱氢酶", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断中，黄疸为主要表现的胰腺癌需要与以下哪些疾病进行鉴别诊断？", "options": "A. 胆管结石\nB. 病毒性肝炎\nC. 急性胰腺炎\nD. 慢性胰腺炎", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的不同类型中，哪一类患者的预后最为不良？", "options": "A.肝功能较好，分流术后由于进食高蛋白质而引起门体分流性脑病者\nB.有黄疸倾向的患者\nC.暴发性肝功能衰竭所致的肝性脑病\nD.有出血倾向的患者\nE.有腹水倾向的患者", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性病毒性肝炎的治疗中，以下哪种药物是有效的？", "options": "A.干扰素\nB.金刚烷胺\nC.两性霉素B\nD.齐多夫定\nE.阿昔洛韦", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，以下哪项检查具有关键作用？", "options": "A. CT扫描\nB. 血尿淀粉酶测定\nC. B型超声波检查\nD. 白细胞计数\nE. 腹腔穿刺", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于原发性肝癌的描述，以下哪一项是错误的？", "options": "A. 原发性肝癌是指起源于肝实质细胞或胆管细胞的恶性肿瘤\nB. 乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）与肝癌的发生密切相关\nC. 纤维板层肝癌是肝细胞癌的常见类型，且多数发生在肝右叶\nD. 根据组织和细胞学特征，原发性肝癌可分为肝细胞癌、胆管细胞癌和混合型三类\nE. 原发性肝癌的形态学分类包括巨块型、结节型和弥漫型", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科的超声检查中，发现胆囊壁上有一个稍强回声的结节，大小约为3mm，没有声影且不移动，如图所示，最可能的诊断是", "options": "A.胆囊结石\nB.胆囊胆汁淤积\nC.胆囊息肉样病变\nD.胆囊癌（隆起型）\nE.胆囊壁胆固醇结晶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者，因急性胰腺炎接受静脉广谱抗生素治疗一周后，症状未见缓解，反而出现腹痛、腹胀加剧和体温再次升高。此时，为了明确诊断，最应优先进行的检查是", "options": "A. 腹部平片以评估肠麻痹情况\nB. 血白细胞计数及分类\nC. CT扫描以检测胰腺坏死\nD. 腹腔穿刺测定渗出液淀粉酶水平\nE. 血脂肪酶检测以评估胰腺炎进展", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆道蛔虫病的早期阶段，下列哪项体征最为典型？", "options": "A.剑突右下方明显压痛，轻度肌紧张和反跳痛\nB.剑突右下方轻压痛，无肌紧张和反跳痛\nC.剑突右下方明显压痛，显著肌紧张和反跳痛\nD.剑突右下方明显压痛，肝区明显叩痛\nE.剑突右下方明显压痛，伴寒热和黄疸", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔内脏损伤中，以下哪种情况可能导致血钙水平下降？", "options": "A. 脾破裂\nB. 肝破裂\nC. 胰腺损伤\nD. 空肠损伤\nE. 结肠损伤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，以下哪种疾病最可能导致脂肪泻的发生？", "options": "A. 慢性胰腺炎\nB. 大肠杆菌感染\nC. 腹腔淋巴瘤\nD. 类癌综合征\nE. 肠结核", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位32岁男性患者因牙龈出血和血小板减少前来就诊。超声检查显示肝脏整体轮廓欠清晰，右叶稍小，形态不规则，边缘不光整，实质回声增粗、增强，分布尚均匀，未见占位病变。血管尚清晰，门静脉内径增宽至1.4cm，其内未见异常回声。最可能的诊断是？", "options": "A. 肝癌\nB. 肝破裂\nC. 肝血管瘤\nD. 弥漫性脂肪肝\nE. 肝硬化并门静脉高压", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行经皮肝穿刺胆道引流术的术前准备中，以下哪项措施是不必要的？", "options": "A. 进行肝功能及B型超声检查\nB. 测定出、凝血时间及部分凝血酶原时间\nC. 术前4小时禁食\nD. 手术前半小时给予镇痛剂和镇静剂\nE. 由于经皮肝穿刺胆道引流术不涉及血管内操作，因此术前必须进行碘过敏试验", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎患者中，以下哪些情况属于可能的并发症？", "options": "A.胆囊穿孔\nB.胆囊内瘘\nC.急性气肿性胆囊炎\nD.胆囊积脓\nE.梗阻性黄疸", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门静脉高压症的临床表现中，以下哪一项最为典型？", "options": "A. 恶心、呕吐\nB. 出血性倾向和贫血\nC. 脾大、侧支循环建立与开放、腹水\nD. 蜘蛛痣和肝掌\nE. 肝病面容", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪一项通常不会导致肝脏体积增大？", "options": "A. 急性病毒性肝炎伴黄疸\nB. 肝硬化伴腹水\nC. 肝癌伴肝性脑病\nD. 肝脓肿伴右侧胸水\nE. 右心衰竭伴下肢水肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿患者中，以下哪种体征的出现通常预示着较差的预后？", "options": "A. 胸腔积液吸收缓慢\nB. 黄疸逐渐加深\nC. 体温持续不降\nD. 肝大触痛明显\nE. 局部皮肤水肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝外胆管癌的超声图像分类中，以下哪种类型是不正确的？", "options": "A. 菜花型\nB. 乳头型\nC. 团块型\nD. 管壁增厚狭窄型\nE. 管腔截断型", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹水的诊断过程中，以下哪项做法是错误的？", "options": "A. 首先确认是否存在腹水，然后区分是渗出液还是漏出液，最后判断是否为良恶性疾病，这是基本的诊断流程\nB. 需要区分腹水是由感染性还是非感染性原因引起的\nC. 对于所有女性腹水患者，应排除妇科肿瘤的可能性\nD. 腹水患者进行食管钡餐透视和X线检查通常没有太大价值\nE. 腹部B超和腹部CT检查对于确定肝胆胰疾病非常有帮助", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝炎患者的蛋白质代谢功能试验中，如果发现持久的明显异常，这通常表明患者处于以下哪种状态？", "options": "A. 急性肝炎黄疸期\nB. 急性肝炎恢复期\nC. 已发展为慢性肝炎\nD. 已转变为重症肝炎\nE. 淤胆型肝炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胆囊炎的患者中，以下哪一项症状通常不会出现？", "options": "A. 嗳气\nB. 腹胀\nC. 胆绞痛\nD. 右腰背部隐痛\nE. 畏寒，高热，黄疸", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性在体检中发现右肝有一个3cm的占位性病变，甲胎蛋白检测结果为阴性。为了进一步明确诊断，以下哪项检查最为关键？", "options": "A. 磁共振成像（MRI）\nB. 超声检查（B-US）\nC. 肝动脉造影\nD. 腹腔镜检查\nE. 肿块穿刺活检或术后病理检查", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌出血且无法进行切除手术的情况下，以下哪种治疗方法是合适的？", "options": "A. 胃大部切除\nB. 肝固有动脉结扎及胆总管引流\nC. 三腔管压迫\nD. 肝叶切除\nE. 肝固有动脉结扎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆固醇结石的形成主要与以下哪一因素相关？", "options": "A. 胆盐浓度\nB. 卵磷脂浓度\nC. 胆盐与卵磷脂的比例\nD. 胆固醇的水溶性\nE. 胆盐的种类", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，关于肝破裂的临床表现，以下哪项描述是正确的？", "options": "A. 在腹部损伤中较为罕见\nB. 腹痛和腹膜刺激征通常较轻\nC. 中央型破裂较少导致肝脓肿\nD. 可能出现呕血或黑便\nE. 被膜下破裂更容易引发肝脓肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "以下哪种疾病与膜转运载体蛋白异常有关？", "options": "A. 半乳糖血症\nB. 血友病A\nC. 肝豆状核变性\nD. α胱氨酸尿症\nE. 苯丙酮尿症", "answer": "CD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎患者中，最常见的腹泻类型是", "options": "A. 感染性腹泻\nB. 渗透性腹泻\nC. 吸收不良性腹泻\nD. 分泌性腹泻\nE. 动力性腹泻", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，阿米巴肝脓肿的典型症状包括哪些？", "options": "A. 发热，贫血，肝肿大\nB. 发热，黄疸，肝痛\nC. 发热，肝肿大，肝区疼痛\nD. 贫血，黄疸，肝肿大\nE. 发热，黄疸，肝肿大", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估疑似急性胰腺炎患者时，以下哪项实验室检查结果最具诊断价值？", "options": "A. 下腹部压痛\nB. 血清脂肪酶显著升高\nC. 腹部CT显示胰腺肿大\nD. 血清淀粉酶超过正常值3倍\nE. 白细胞计数升高", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，导致门脉性肝硬化的最主要病因是什么？", "options": "A. 长期酗酒\nB. 营养摄入不足\nC. 胆管系统梗阻\nD. 血吸虫感染\nE. 肝炎病毒感染", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性胆汁性肝硬化的病理过程中，主要受累的结构是", "options": "A.肝内细小胆管慢性非化脓性破坏性炎症\nB.肝细胞弥漫性混浊肿胀\nC.汇管区炎症\nD.肝细胞碎屑样坏死\nE.小胆管炎症及硬化", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位35岁男性患者，近2年出现乏力、心悸、恍惚和步履不稳，期间有3次精神失常和癫痫样发作。1个月前，因早餐前从事体力劳动后出现四肢抽搐和神志不清，血糖检测为2.0mmol/L，静脉注射50%葡萄糖溶液60ml后症状缓解。患者无头部外伤史，无其他阳性体征。诊断胰岛素瘤的最准确方法是？", "options": "A. Wipple三联征\nB. 血糖空腹时2.2mmol/L以下\nC. 葡萄糖耐量试验\nD. 饥饿试验\nE. 血胰岛素测定", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于妊娠期胆囊功能及胆石病的变化，下列哪项描述是正确的？", "options": "A. 孕激素降低胎囊黏膜对钠的调节，影响胆囊浓缩功能\nB. 妊娠期胆汁中胆固醇成分增多\nC. 在雌激素影响下，胆囊及胆管平滑肌松弛使胆囊排空缓慢\nD. 妊娠期胆结石发病率明显增高\nE. 胆石病多见于妊娠早期", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位34岁女性患者，近一个月来反复出现右上腹阵发性绞痛，疼痛放射至右肩背部。B超检查显示胆囊大小正常，胆汁回声无异常，胆总管轻度扩张，并在其下端发现一枚直径为0.6cm的结石，胰腺未见异常。对于该患者的首次治疗，最合适的方案是？", "options": "A. 排石疗法\nB. 溶石疗法\nC. 碎石疗法\nD. 取石疗法\nE. 外科手术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名53岁男性患者，主诉右季肋部胀痛已持续一个多月。体检显示无黄疸，肝脏在肋缘下可触及3cm，质地坚硬，无腹水迹象。B超检查发现肝右叶有一个约11cm×10cm的低回声病灶，肝左叶也可见多个小低回声区。血清AFP水平超过1000μg/L。针对此情况，最适宜的治疗方案是？", "options": "A. 放射治疗\nB. 抗感染治疗\nC. 肝动脉插管栓塞化疗\nD. 剖腹探查\nE. 中草药治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊结石的形成过程中，以下哪项因素被认为是胆固醇结石形成的最主要原因？", "options": "A.胆道感染\nB.胆汁成分和理化性质改变\nC.胆汁内葡萄糖醛酸酶增加\nD.胆道内蛔虫残体存留\nE.胆道梗阻", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，有5年肝硬化病史，三天前呕血约500ml，今日表现为情绪淡漠、言语减少，脑电图检查结果正常。根据这些症状，最可能的诊断是？", "options": "A. 亚临床肝性脑病\nB. 肝性脑病Ⅰ期\nC. 肝性脑病Ⅱ期\nD. 肝性脑病Ⅲ期\nE. 肝性脑病Ⅳ期", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名2岁儿童，超声检查发现肝脏明显增大，内部可见一个9cm×10cm的高回声团块，边界清晰，内部回声均匀。最可能的诊断是什么？", "options": "A. 畸胎瘤\nB. 错构瘤\nC. 肝脏肉瘤\nD. 肝母细胞瘤\nE. 肝内脓肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性重症胰腺炎的诊断中，以下哪一项不是典型的临床表现？", "options": "A.弥漫性腹膜炎，腹胀明显，肠鸣音弱\nB.血性或脓性腹腔积液\nC.伴有休克\nD.白细胞降低\nE.血糖﹥11.1mmol/L，血钙﹤1.87mmol/L", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，5小时前出现剧烈上腹部疼痛，疼痛向背部放射，伴有多次恶心、呕吐，呕吐后疼痛未缓解。患者还表现出休克症状。进一步询问病史，发现7小时前患者曾参加聚会并暴食、饮酒。根据这些症状和病史，最可能的诊断是什么？", "options": "A. 急性阑尾炎\nB. 急性坏死性胰腺炎\nC. 胃癌伴穿孔\nD. 急性肾绞痛\nE. 急性胆囊炎\nF. 急性胃、十二指肠溃疡穿孔", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，胆管癌患者最常见的症状是什么？", "options": "A. 厌食、恶心、呕吐\nB. 心慌、腹痛、黄疸\nC. 胸闷、黄疸、寒战高热\nD. 无痛性黄疸\nE. 体重明显减轻", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在T1加权成像（T1WI）中，以下哪种病变的信号强度高于正常肝组织？", "options": "A. 肝脓肿\nB. 肝脏血管瘤\nC. 单纯性肝囊肿\nD. 转移性肝癌\nE. 肝脏脂肪瘤", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在Budd-Chiari综合征的临床表现中，以下哪一项体征通常不会出现？", "options": "A. 肝肿大\nB. 脾肿大\nC. 门静脉高压\nD. 肝-颈静脉回流征阳性", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者因上腹持续钝痛、恶寒发热和皮肤黄染入院，诊断为急性胆囊炎和胆石症。上午病情稳定，中午出现休克症状，下午进行了积极治疗，下班时病情未恶化。晚6时夜班医生回家吃晚饭，患者病情突然加重，护士无法联系到夜班医生，直到7时才找到一位门诊医师进行急救，但抢救无效，患者死亡。此时夜班医生才返回病房。此事故的主要责任人是？", "options": "A. 夜班医生\nB. 包括白班医生\nC. 夜班护士\nD. 急救的门诊医师\nE. 夜班医生和护士", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门静脉高压症的治疗中，以下哪项措施是不正确的？", "options": "A. 下腔静脉与门静脉吻合可能导致肝性脑病\nB. 对于食管胃底静脉曲张，非手术治疗首选三腔管压迫止血\nC. 内镜下发现食管静脉呈蓝色曲张时，应立即进行紧急手术\nD. 食管胃底静脉曲张时，可以考虑进行食管内窥镜硬化剂注射治疗\nE. 静脉点滴垂体后叶素是一种治疗方法", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁女性患者，3个月前接受了胆总管十二指肠吻合术。1天前突然出现右上腹疼痛、寒战、高热，并呕吐约1000 ml。入院后立即进行了输血。输血10小时后，患者突然感到心前区压迫感，腰背部酸痛，血压降至8.0/6.0 kPa。针对该患者的最佳治疗方案是什么？", "options": "A.抗休克、碱化尿液\nB.抗休克，碱化尿液、利尿\nC.抗休克\nD.碱化尿液\nE.利尿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位肝硬化腹水患者近期出现低热和腹痛症状，腹水量明显增加。腹水检查结果显示：外观淡黄色，比重1.018，蛋白含量25g/L，李凡他试验阳性，细胞总数为800/μl，其中多核细胞占76%。这些临床表现最可能提示并发哪种疾病？", "options": "A. 结核性腹膜炎\nB. 自发性腹膜炎\nC. 门静脉血栓形成\nD. 功能性肾衰竭\nE. 原发性肝癌结节破裂", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，以下哪种类型的肝硬化最常导致肝性脑病的发生？", "options": "A. 酒精性肝硬化\nB. 原发性胆汁性肝硬化\nC. 淤血性肝硬化\nD. 肝炎后肝硬化\nE. 血吸虫病性肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁的男性患者，因反复发作的上腹部疼痛和呕吐就诊。疼痛在进食后加剧，呕吐后有所缓解，呕吐物中含有胆汁。经过详细检查，诊断为环状胰腺。请问该病最常见的并发症是什么？", "options": "A.急性胰腺炎\nB.胆道梗阻\nC.胃溃疡\nD.十二指肠溃疡\nE.胆结石", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位34岁男性患者因上消化道大出血入院，经过治疗后病情稳定，出血停止。为了确定出血的具体原因，医生应首先考虑进行哪种检查？", "options": "A.纤维胃镜检查\nB.B超检查\nC.肝功能化验\nD.选择性腹腔动脉造影\nE.钡餐透视", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，胆总管的正常压力范围是多少？", "options": "A. 0.49-0.98kPa（5~10cmH2O）\nB. 0.98-1.47kPa（10-15cmH2O）\nC. 1.47-1.96kPa（15~20cmH2O）\nD. 2.45-2.94kPa（25~30cmH2O）\nE. 2.94-3.43kPa（30~35cmH2O）", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男，46岁。长期肝功能异常，近期出现腹胀和尿黄。查体发现面色晦暗，巩膜黄染，肝掌及蜘蛛痣阳性，移动性浊音阳性。实验室检查显示ALT升高至180U/L，TBIL为37μmol/L，PTA为60%。根据这些临床表现和检查结果，肝脏最可能的病理变化是", "options": "A.肝细胞亚大片坏死伴肝细胞增生\nB.肝细胞水肿，纤维结缔组织增生\nC.肝细胞水肿，有大量炎症细胞浸润\nD.肝细胞大片坏死\nE.肝细胞灶状坏死，假小叶形成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道梗阻的介入治疗中，以下哪些是可能发生的并发症？", "options": "A. 术后感染\nB. 胆汁瘘\nC. 引流管的移位、脱落\nD. 出血", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在细菌性肝脓肿的诊断中，以下哪一项不是其典型的临床表现？", "options": "A. 肝穿刺脓液呈现“巧克力”样外观\nB. 通常由胆道感染引发\nC. 患者表现出明显的全身中毒症状\nD. 影像学检查显示肝内存在液性暗区\nE. 血液细菌学培养结果有时呈阳性", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的早期阶段，最常见的转移途径是", "options": "A. 通过淋巴系统扩散\nB. 在腹腔内种植转移\nC. 通过血液循环向肝外器官转移\nD. 在肝脏内部扩散", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在日本血吸虫感染的患者中，以下哪些病变是可能发生的？", "options": "A.肝硬化\nB.胆囊炎\nC.胆结石\nD.肠壁肉芽肿性增殖\nE.胆管炎", "answer": "AD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下肿瘤类型中，哪一种的间质主要由扩张的毛细血管构成？", "options": "A. 肝细胞癌\nB. 海绵状血管瘤\nC. 乳腺髓样癌\nD. 胃硬癌\nE. 宫颈鳞癌", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位36岁男性患者因右上腹腹痛、腹胀和嗳气症状前来就诊，医生建议进行胆囊造影检查。为了确保检查结果的准确性，检查前1天的午餐应选择哪种饮食？", "options": "A. 低蛋白饮食\nB. 无脂肪饮食\nC. 高蛋白饮食\nD. 高脂肪饮食\nE. 低脂肪饮食", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的临床表现中，以下关于腹痛的描述哪一项是不正确的？", "options": "A. 疼痛强度可能有所不同\nB. 通常呈现持续性\nC. 是急性胰腺炎的主要症状和最初表现\nD. 有时会呈现阵发性加重\nE. 山莨菪碱可以有效缓解疼痛", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位59岁男性患者，既往有慢性支气管炎和肝炎病史。最近一周出现精神错乱和尿量减少。体检发现患者处于昏睡状态，口腔有异味，心肺检查无异常，腹部膨隆，腹水征阳性，未引出扑翼样震颤。针对该患者的治疗，以下哪项措施不适宜？", "options": "A. 适量利尿剂\nB. 抗生素\nC. 静滴高渗葡萄糖液\nD. 高蛋白质饮食鼻饲\nE. 精氨酸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在日本血吸虫感染导致的肝硬化中，以下哪种类型最为典型？", "options": "A. 淤血性肝硬化\nB. 坏死后性肝硬化\nC. 干线型肝硬化\nD. 胆汁性肝硬化\nE. 门脉性肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于肝脓肿的描述，以下哪项是正确的？", "options": "A.脓肿壁通常较厚且不规则\nB.脓肿内的液区一般不清晰，有点状回声\nC.常伴有高热\nD.肝脓肿是肝脏穿刺引流的适应症之一\nE.肝脓肿尚未液化时超声显示明显异常", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌的病例中，肿瘤最常侵犯的解剖结构是哪个？", "options": "A. 腹腔动脉\nB. 十二指肠\nC. 肠系膜上动脉\nD. 脾门\nE. 肝脏", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断中，以下哪种检查方法对于区分胰腺炎和胰腺癌具有关键作用？", "options": "A. 超声内镜\nB. 胰腺CT\nC. MRCP\nD. ERCP\nE. 立位腹部平片", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，在肝右下叶发现一个难以定性的肿块，计划进行经皮穿刺活检。在这种情况下，应优先选择哪种导向方法？", "options": "A. X线透视\nB. 超声\nC. CT\nD. MRI\nE. DSA", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在细菌性肝脓肿的临床特征中，以下哪项描述最为准确？", "options": "A. 主要致病菌为革兰氏阳性球菌\nB. 脓液通常呈现棕褐色，且细菌涂片可能为阴性\nC. 溃疡性结肠炎是其主要病因\nD. 胆道系统感染是其主要来源\nE. 外科手术引流是唯一有效的治疗手段", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，慢性胆囊炎的典型表现包括哪些？", "options": "A.胆囊壁常显示增厚\nB.囊内胆汁透声良好\nC.增厚的壁常不光滑\nD.胆囊壁多无异常改变\nE.胆囊萎缩变小或正常", "answer": "ACE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "根据氨中毒学说，血氨水平升高导致肝性脑病的机制主要涉及哪些方面？", "options": "A. 干扰脑细胞的正常能量代谢\nB. 使神经递质发生紊乱\nC. 影响神经细胞膜的功能\nD. 引起脑间质水肿", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种疾病状态下，医生在体检时可能触及到胆囊？", "options": "A. 胆囊癌\nB. 胆囊结石\nC. 急性胆囊炎\nD. 胰头癌", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，关于肝内囊性病变的超声影像特征，以下哪一项描述是错误的？", "options": "A. 肝囊肿的囊壁通常较薄，有时会出现回声失落现象\nB. 多囊肝患者的肝脏体积往往会缩小\nC. 当肝囊肿并发感染时，其影像特征与肝脓肿难以区分\nD. 肝内血肿在超声影像上可能表现为边界清晰的无回声区域\nE. 肝动脉瘤内部可以通过超声检测到动脉血流信号", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，对于胆绞痛的患者，以下哪种药物组合是最合适的缓解方案？", "options": "A. 阿司匹林\nB. 吗啡\nC. 阿托品\nD. 阿司匹林+阿托品\nE. 吗啡+阿托品", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆道X线检查中，以下哪项描述是错误的？", "options": "A. 平片检查中，胆色素结石通常不显影\nB. 平片检查中，胆固醇结石通常显影\nC. 肝功能不佳时，造影检查可能不显影\nD. 胃肠功能紊乱可能影响口服法造影的结果\nE. 胆囊功能异常时，造影检查可能不显影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，哪种疾病特征表现为肝细胞的大片坏死并伴有结节状再生？", "options": "A. 慢性持续性肝炎\nB. 慢性活动性肝炎\nC. 急性普通型肝炎\nD. 急性重型肝炎\nE. 亚急性重型肝炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁的男性患者，患有肝硬化并伴有腹水，因出现眩晕、恶心和耳鸣症状前来就诊。体检结果显示血压为15/9kPa，巩膜黄染，眼球有轻度水平震颤，血氨水平为55μmol/L。在静脉注射山莨菪碱（654-2）后，患者的症状有所缓解。根据这些信息，最可能的诊断是什么？", "options": "A. 肝性脑病\nB. 高血压脑病\nC. 椎-基底动脉供血不足\nD. 肝豆状核变性\nE. 震颤性麻痹", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "李某，女性，38岁。3天前突发右上腹剧痛，经诊断为胆囊结石并发急性胆囊炎，经过禁食和抗生素治疗后症状未见改善，此时最适宜的处理措施是", "options": "A. 增加抗生素剂量\nB. 更换抗生素种类\nC. 进行胃肠减压\nD. 准备传统开腹胆囊切除术\nE. 准备腹腔镜胆囊切除术", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位69岁的女性患者，患有肝硬化已有20年。最近一周被诊断为巨块型肝癌，并进行了手术治疗，但术中发现肿瘤已不适合切除。在这种情况下，应该采取哪种治疗方法？", "options": "A.肝动脉化疗栓塞治疗\nB.物理疗法\nC.放射治疗\nD.超声引导下局部治疗\nE.全身化疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎患者出现剧烈腹痛时，以下哪种药物最适合用于镇痛？", "options": "A. 654-2\nB. 哌替啶\nC. 吗啡\nD. 苯巴比妥纳\nE. 安定", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位38岁男性患者因腹部疼痛4小时入院。患者4小时前在大量饮酒后突然出现剑突下持续性疼痛，休息后未见缓解，疼痛不随体位改变而减轻，伴有呕吐和腹胀。患者无呕血、黑便、发热、咳嗽、气促或心悸等症状。既往有胃、十二指肠溃疡病史，无外伤史或肝炎病史。应考虑患者可能患有以下哪些疾病？", "options": "A.急性胆囊炎\nB.急性阑尾炎\nC.胃、十二指肠穿孔\nD.急性肠梗阻\nE.急性胃肠炎", "answer": "ACDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "李某，女，60岁。患有乙肝肝硬化10年，体检发现胸前有蜘蛛痣，手掌出现肝掌。这些症状的主要原因是", "options": "A.体内雌激素水平升高\nB.体内醛固酮分泌增加\nC.侧支循环的形成\nD.门静脉压力增高\nE.肝脏合成清蛋白能力下降", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，慢性肝炎肝硬化患者出现自发性腹膜炎，这种感染类型属于以下哪一种？", "options": "A. 交叉感染\nB. 自身感染\nC. 医源性感染\nD. 二重感染\nE. 不属于医院感染", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，最需要立即进行急诊手术治疗？", "options": "A. 由盆腔感染引起的腹膜炎\nB. 由败血症继发的腹膜炎\nC. 阑尾穿孔后形成的阑尾周围脓肿\nD. 急性胆囊炎引起的限局性腹膜炎\nE. 急性腹膜炎无局限趋势且原因不明", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位80岁高龄患者被诊断为急性结石性化脓性胆囊炎，以下哪种手术方式最适合该患者？", "options": "A.胆囊切除加胆总管切开探查T管引流术\nB.胆管空肠Roux-en-Y吻合术\nC.胆囊造瘘术\nD.肝叶切除术\nE.胆总管切开探查T管引流术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断中，门脉高压症最常见的病因是以下哪种情况？", "options": "A. 门静脉炎\nB. 肝静脉阻塞\nC. 肝硬化\nD. 门静脉干血栓\nE. 多囊肝", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁的女性患者，3周前被诊断为急性胰腺炎，经过治疗后，现进行超声复查，胰腺影像如图所示，最可能的诊断是", "options": "A. 胰腺假性囊肿\nB. 急性坏死性胰腺炎\nC. 胰腺真性囊肿\nD. 胰腺囊腺癌\nE. 腹膜后肿瘤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下肝脏占位性病变中，哪一种病变的血供最为丰富？", "options": "A.肝囊肿\nB.肝血管瘤\nC.肝硬化结节\nD.肝脓肿\nE.以上都不是", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像中，肝细胞黄疸患者通常不会出现以下哪种情况？", "options": "A. 心前区放射性增高\nB. 肝显影差\nC. 肾脏血池增加\nD. 肝胆系统显影不佳\nE. 肠道持续无放射性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名患者出现严重肝功能异常，临床症状与急性病毒性肝炎相似，怀疑为药物性肝损伤（DILI），在诊断过程中首先需要排除以下哪种情况？", "options": "A.急性戊型肝炎病毒感染\nB.胆系感染\nC.肝脓肿\nD.肝脏占位病变\nE.药物过敏反应", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脓肿的诊断中，以下哪一项临床表现通常不会出现？", "options": "A.膈下有游离气体\nB.寒战、高热、肝区疼痛\nC.右上腹肌紧张和局部明显触痛\nD.有时有贫血", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的Glisson纤维鞘内，以下哪组结构被包裹？", "options": "A. 门静脉、肝静脉、肝胆管\nB. 门静脉、肝动脉、胆总管\nC. 门静脉、肝动脉、肝静脉\nD. 门静脉、肝动脉、肝胆管", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺损伤的临床表现中，以下哪项描述最符合实际情况？", "options": "A.腹膜炎症状迅速出现\nB.腹膜炎症状严重，腹部呈板状\nC.腹膜炎症状出现较晚，但程度较重\nD.腹膜炎症状出现较晚且程度较轻\nE.无明显腹膜刺激征", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能异常的患者中，以下哪种药物应避免使用？", "options": "A. 泼尼松\nB. 泼尼松龙\nC. 氢化可的松\nD. 氟氢松\nE. 甲泼尼龙", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，导致门脉性肝硬化的最常见病因是什么？", "options": "A. 长期酗酒\nB. 营养不良\nC. 病毒性肝炎感染\nD. 药物性肝损伤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌伴梗阻性黄疸的手术中，如果发现肿瘤难以切除，为了缓解黄疸症状，最合适的手术方式是", "options": "A.胆囊十二指肠吻合术\nB.胆总管十二指肠吻合术\nC.胆总管空肠吻合术\nD.胆总管T管引流术\nE.胆囊造瘘术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位54岁女性患者，有19年的乙肝病史，最近3个月出现腹胀、食欲不振和乏力症状。以下哪项检查结果最可能提示肝硬化？", "options": "A. 肝功能检查显示胆红素水平升高\nB. 肝功能检查显示白蛋白水平降低\nC. 肝脏超声检查显示肝脏体积缩小\nD. 血常规检查显示全血细胞减少\nE. 食管吞钡X线检查显示虫蚀样改变", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝包虫病的超声检查中，以下哪一项不是其特征性表现？", "options": "A. 包虫囊震颤征\nB. 囊壁增厚呈双层结构\nC. 大囊内多个大小不等小囊，即囊中囊征\nD. 水上百合花征\nE. 囊内呈脂液分层征", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的超声检查中，以下哪一项描述是不正确的？", "options": "A. 肝癌在超声检查时，多为相对较均匀的低回声\nB. 肿瘤周边多可见低回声的晕环\nC. 肝癌一般可见强回声光团\nD. 肿瘤周边晕环的厚度约为肿瘤的1/10\nE. 如果肿瘤内部有脂肪变性、肝窦扩张、出血、坏死、间质纤维变等，其内部回声可不均匀", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性乙型肝炎的治疗中，以下哪种药物具有抗病毒作用？", "options": "A. 卡介苗\nB. 胎盘肽\nC. 胸腺肽\nD. 左旋咪唑\nE. 拉米夫定", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断和治疗中，以下哪一项陈述是不正确的？", "options": "A. 大约一半的病例与胆道疾病有关\nB. 细菌感染并非主要的发病原因\nC. 如果血、尿淀粉酶水平不高，可以排除急性胰腺炎的诊断\nD. 某些类型的急性胰腺炎可能导致突然死亡\nE. 急性胰腺炎可能引发假性胰腺囊肿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化门脉高压的诊断中，以下哪项B超表现最具特征性？", "options": "A.门静脉直径大于14mm\nB.脾静脉直径小于10mm\nC.食管胃底静脉曲张\nD.腹壁静脉曲张\nE.颈静脉怒张", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估酒精性肝病时，以下哪些步骤是必要的？", "options": "A. 确认是否存在肝病\nB. 确定肝病是否与饮酒有关\nC. 检查是否合并其他类型的肝病\nD. 如诊断为酒精性肝病，需确定其临床病理阶段\nE. 在必要时进行肝穿刺活检以确认诊断", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的非手术治疗中，下列哪种药物不具备抑制胰腺分泌的功能？", "options": "A. 雷尼替丁\nB. 抑肽酶\nC. 生长抑素\nD. 碳酸氢钠\nE. 阿托品", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像中，以下哪些表现可能提示不完全性总胆管梗阻？", "options": "A.胆管节段性狭窄\nB.突然或渐进的胆管显影中断\nC.胆管腔内充盈缺损\nD.胆管狭窄部位上端胆管扩张\nE.胆管动力学异常", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫病的治疗中，以下哪种情况通常不需要立即进行手术治疗？", "options": "A. 患者同时患有急性化脓性胆管炎或胆囊炎\nB. 患者出现肝脓肿、胆道出血、腹膜炎、败血症或中毒性休克\nC. 患者出现重度黄疸\nD. 患者同时患有急性胰腺炎或胆道蛔虫与结石并存\nE. 经过3至5天的非手术治疗后，患者病情恶化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化的病理过程中，哪种细胞类型起着关键作用？", "options": "A. 淋巴细胞\nB. 胆管上皮细胞\nC. 星状细胞\nD. 内皮细胞\nE. Kupffer细胞", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁的孕妇，怀孕28周，被诊断为妊娠合并重症肝炎。在以下诊断要点中，哪一项是不恰当的？", "options": "A. 肾衰竭\nB. 肝性脑病\nC. 实验室检查提示肝衰竭\nD. 恶心、呕吐等胃肠道反应\nE. 凝血功能障碍", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌患者中，以下哪种症状最为常见？", "options": "A. 腹水\nB. 肝区疼痛\nC. 肝脏肿块\nD. 黄疸\nE. 发热", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的发展过程中，导致假小叶形成的关键病理改变是", "options": "A. 肝细胞再生\nB. 纤维结缔组织增生\nC. 肝细胞变性坏死\nD. 小胆管增生", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗过程中，以下哪项描述是不正确的？", "options": "A. 胰腺脓肿和胰腺假性囊肿是常见的局部并发症\nB. 轻症急性胰腺炎患者通常并发症较少\nC. 重症胰腺炎患者可能会出现消化道出血\nD. 早期并发感染主要由革兰阴性杆菌引起\nE. 不恰当的治疗可能导致慢性胰腺炎的发展", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性出血坏死性胰腺炎中，关于出血征象的正确描述是（）。", "options": "A.氧自由基激活弹力蛋白酶损害血管壁\nB.腹部腰部蓝-棕色斑称为Cullen征\nC.为胰蛋白酶激活纤维蛋白溶解系统所致\nD.Grey-Turner征时见到脐周蓝色改变\nE.可以出现呕血和便血", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男，42岁。6小时前在饱餐后出现上腹部剧烈疼痛，伴有恶心和呕吐，呕吐物为胃内容物，呕吐后腹痛加剧，呈刀割样，使用阿托品止痛无效。体检显示脉搏124次/分，血压80/50mmHg，患者表情痛苦，腹部膨胀，全腹肌紧张、压痛、反跳痛，以上腹部最为明显，肠鸣音消失，肝浊音界存在。右下腹穿刺抽出淡红色血性液体。实验室检查显示白细胞12×10^9/L，血清淀粉酶4000U/L，血钙1.5mmol/L。经过3小时的治疗观察，病情未见好转，应考虑诊断为哪种疾病？（）", "options": "A.急性胃炎\nB.胆囊穿孔，弥漫性腹膜炎\nC.溃疡病穿孔，弥漫性腹膜炎\nD.急性出血坏死性胰腺炎\nE.急性绞窄性肠梗阻", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名4岁男孩，自幼生长迟缓，多次在早晨出现惊厥。就诊时发现患儿体型矮胖，肝脏肿大至肋缘下6cm，质地中等硬度。空腹血糖值为2.3mmol/L，注射肾上腺素后血糖升高不明显。肝活检切片显示肝细胞内大量PAS阳性物质积聚并伴有大量脂肪滴。最可能的诊断是", "options": "A. 脑苷脂沉积症\nB. 肝豆状核变性\nC. 半乳糖血症\nD. 糖原累积病\nE. 脂肪肝", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下类型的肝炎中，哪一种最有可能发展为坏死后性肝硬化？", "options": "A.急性重型肝炎\nB.急性普通型肝炎\nC.亚急性重型肝炎\nD.重度慢性肝炎\nE.轻度慢性肝炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行肝穿刺活体组织检查后，患者需要卧床休息多长时间？", "options": "A. 6小时\nB. 12小时\nC. 24小时\nD. 48小时\nE. 72小时", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，溶组织内阿米巴原虫最常见的侵入肝脏的途径是：", "options": "A.经门静脉入肝\nB.穿透结肠壁直接入肝\nC.经胆道逆行入肝\nD.经肝静脉入肝\nE.经局部淋巴管入肝", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位58岁女性患者因急性右上腹阵发性绞痛、寒战高热和黄疸入院，接受了急诊胆囊切除、胆总管探查及T管引流术。术后，医护人员特别关注患者的排便情况，其主要目的是什么？", "options": "A.判断患者胆总管通畅情况\nB.判断患者肠道功能恢复情况\nC.及时发现患者有无胃肠道出血\nD.判断患者术后饮食恢复是否合适\nE.判断患者对脂肪消化和吸收的能力", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌患者中，以下哪个症状是最常见且最主要的？", "options": "A. 肝区疼痛\nB. 低热\nC. 腹胀、乏力\nD. 食欲不振\nE. 消瘦", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于环状胰腺的临床表现，以下哪项描述是正确的？", "options": "A.环状胰腺患者通常会出现黄疸症状\nB.环状胰腺组织通常缺乏正常的腺泡和胰岛结构\nC.部分环状胰腺患者可能没有任何临床症状\nD.环状胰腺是胰腺先天性畸形中最常见的一种\nE.手术治疗环状胰腺时，常通过切断环状组织来缓解十二指肠梗阻", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，以下哪种药物是禁止使用的？", "options": "A.抗胆碱能药物\nB.吗啡止痛\nC.补充血容量\nD.给予钙盐\nE.胃肠减压", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，观察到肝脏呈现“光亮肝”的特征，这通常指示以下哪种疾病？", "options": "A. 脂肪肝\nB. 肝硬化\nC. 弥漫性肝癌\nD. 血吸虫病\nE. 肝脓肿", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位49岁男性患者，平时健康状况良好，无明显不适。最近在医院进行体检时，B超检查发现肝脏内有一个圆形液性暗区，边缘整齐光滑。进一步的CT检查显示液性占位，边界清晰，增强扫描无填充。根据这些检查结果，最可能的诊断是什么？", "options": "A. 肝脓肿\nB. 肝癌\nC. 肝囊肿\nD. 肝棘球囊肿\nE. 多囊肝", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在一位患者的超声检查中，发现右肝前叶有一斑状强回声区域，声影不明显，且不沿肝管走行。根据这些特征，最可能的诊断是什么？", "options": "A. 肝血管瘤\nB. 肝结核\nC. 肝内胆管结石\nD. 肝内钙化灶\nE. 肝内胆管积气", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的发病机制中，以下哪项因素最为关键？", "options": "A.胆囊结石进入胆总管\nB.ERCP\nC.感染伤寒杆菌\nD.环状胰腺\nE.甲状旁腺功能亢进症", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位53岁女性患者，既往有胆囊炎、胆结石及胰腺炎病史。超声检查显示：胰腺区域发现一个9.5cm×3.6cm的不均质回声区，形态不规则，边界不清；同时在胰头部发现一个5.0cm×5.5cm的囊性暗区，囊壁厚薄不均，形态规则，边界尚清。根据患者的病史和超声表现，最可能的诊断是", "options": "A. 胰腺囊腺瘤或癌\nB. 腹腔包裹性脓肿\nC. 小网膜囊肿\nD. 胰腺真性囊肿\nE. 胰腺假性囊肿", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名35岁男性患者，在右上腹部遭受钝性损伤后1小时，出现面色苍白、脉搏加快、血压降至70/45mmHg，伴有腹胀、广泛压痛、肌紧张及反跳痛，血红蛋白水平为8g/dl。在这种情况下，最可能的诊断是什么？", "options": "A. 十二指肠损伤\nB. 肝破裂\nC. 脾破裂\nD. 胰腺损伤\nE. 小肠损伤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在进行肝活检术时，最常用的患者体位是哪种？", "options": "A. 侧卧位\nB. 俯卧位\nC. 斜位\nD. 仰卧位\nE. 侧位", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在妊娠期间，如果患者出现肝昏迷，以下哪种药物最适合用于降低血氨水平？", "options": "A. 新霉素\nB. 精氨酸\nC. 雌激素\nD. 维生素K、维生素C\nE. 青霉素", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化失代偿期的患者中，以下哪项实验室检查结果通常不会出现？", "options": "A. 血清胆红素浓度增高\nB. 球蛋白升高\nC. 白蛋白正常\nD. 血清PⅢP正常", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道T形管造影的临床应用中，以下哪种情况不属于禁忌证？", "options": "A. 甲状腺功能亢进\nB. 严重胆系感染或出血\nC. 肝癌术后\nD. 有胰腺炎病史\nE. 心肾功能严重损害", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位36岁女性患者，1年前因甲亢接受丙基硫氧嘧啶治疗。近1个月来，出现黄疸进行性加重伴皮肤瘙痒，食欲减退和乏力。体检发现皮肤和巩膜深度黄染，无出血点或瘀斑，突眼，甲状腺肿大伴震颤和吹风样血管杂音，心率110次/分、律齐，肝右肋下3cm、质中等，脾未扪及，无腹水。肝功能检查显示ALT 100u/L，白蛋白35g/L，球蛋白32g/L，总胆红素362μmol/L，凝血酶原活动度70%，HBsAg阳性。针对该患者的最佳治疗方案是？", "options": "A. 停用丙基硫氧嘧啶，加强“保肝”支持治疗\nB. 在加强“保肝”支持治疗基础上，继续使用丙基硫氧嘧啶治疗\nC. 加强“保肝”支持治疗，停用丙基硫氧嘧啶，改用心得安治疗\nD. 停用丙基硫氧嘧啶，加强“保肝”支持治疗，创造条件用131I治疗\nE. 停用丙基硫氧嘧啶，加强“保肝”支持治疗，行甲状腺次全手术治疗", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎患者中，出现休克症状通常指示（）。", "options": "A. 血容量不足\nB. 继发细菌感染\nC. 胰腺出血坏死\nD. 并发腹膜炎\nE. 以上都不对", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名3岁男童因上腹部遭受汽车撞击2小时后入院。腹腔诊断性穿刺结果为阴性，初步诊断为腹壁挫伤。8小时后，患儿腹部逐渐膨胀，触诊时哭闹，腹肌紧张，肠鸣音消失，此时应考虑", "options": "A.胃破裂，弥漫性腹膜炎\nB.腹壁挫伤\nC.肝破裂\nD.脾破裂\nE.胰腺破裂", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的临床表现中，以下哪项症状最为突出？", "options": "A. 黄疸\nB. 腹胀\nC. 腹痛\nD. 发热\nE. 恶心、呕吐", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位67岁女性患者，因持续3周的无痛性黄疸入院。剖腹探查发现肝脏右叶有两个直径2cm的硬结节，胆囊大小为12cm×6cm，壁厚，胆总管直径2cm，胰头部有硬肿物，且包绕肠系膜上静脉浸润性生长。请问应选择哪种手术方式？", "options": "A.胰十二指肠切除术\nB.胆总管切开+T管引流术\nC.全胰腺切除术\nD.胆管空肠吻合术\nE.全胰十二指肠切除术", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，对于评估弥漫性肝实质病变，以下哪种影像学检查方法最为简便实用？", "options": "A. 磁共振成像（MRI）\nB. 腹部CT扫描\nC. 选择性肝动脉造影\nD. 单光子发射型计算机断层仪（SPECT）\nE. 腹部超声", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者的营养管理中，关于脂肪摄入的建议是", "options": "A. 脂肪摄入应适量，无需过度限制，但不宜过高\nB. 由于肝功能减退和胆汁合成减少，脂肪消化受影响，建议仅少量使用植物油\nC. 应严格控制脂肪的摄入量\nD. 肝硬化患者应限制中链甘油三酯(MCT)的摄入\nE. 肝硬化患者的脂肪摄入无需特殊要求", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的临床表现中，以下哪一项是不常见的？", "options": "A. 低血糖症\nB. 肝性脑病\nC. 上消化道出血\nD. 红细胞增多症\nE. 嗜酸性粒细胞增多症", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位54岁男性在例行体检中发现胆囊内有一个2.5cm×2.0cm的结石，但没有任何明显症状。在这种情况下，最合适的治疗方法是（）。", "options": "A.胆囊切开取石术\nB.胆囊切除术\nC.口服鹅脱氧胆酸\nD.体外震波碎石\nE.观察", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏显像中，以下哪种放射性药物不适用？", "options": "A. 99mTc-SC\nB. 99mTc-PHY\nC. 99mTc-PMT\nD. 99mTc-DTPA\nE. 99mTc-EHIDA", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在口服胆囊造影检查中，以下哪种情况可能导致胆囊无法显影？", "options": "A. 患者存在胃肠吸收功能障碍，服药后出现腹泻\nB. 胆囊管被结石阻塞\nC. 胆囊因炎症导致收缩功能丧失\nD. 患者未按要求禁食或未遵循低脂肪饮食\nE. 患者存在便秘症状", "answer": "AC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位患有日本血吸虫性肝硬化的患者，无黄疸和蜘蛛痣，肝脏在肋缘下1cm处可触及，质地坚硬，表面无明显结节，脾脏明显肿大，下缘平脐，质地坚硬，经常出现鼻衄及牙龈、皮肤粘膜出血。其出血的主要机制是__", "options": "A. 凝血因子VII合成减少\nB. 纤维蛋白原减少\nC. 脾功能亢进导致血小板破坏增多\nD. 凝血酶原减少\nE. 凝血因子X减少", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，导致肝癌发生的最主要因素是什么？", "options": "A. 乙型肝炎\nB. 丙型肝炎\nC. 黄曲霉毒素\nD. 亚硝胺类化合物\nE. 血吸虫病", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性水肿性胰腺炎的治疗中，以下哪项措施是必要的？", "options": "A. 应用抗生素\nB. 胃肠减压\nC. 给予解痉止痛剂\nD. 静脉补液\nE. 以上都对", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于肝内胆管结石的描述，下列哪一项是不正确的？", "options": "A. 左右肝管汇合部以上的结石多为继发性结石\nB. 可导致严重并发症，是良性胆道疾病死亡的主要原因\nC. 当两侧肝管被结石阻塞时，患者会出现黄疸，严重炎症时可能出现休克及精神症状\nD. 影像学检查通常显示肝内胆管扩张、狭窄、肝内结石以及左右肝管部分不显影\nE. 常用的手术方法包括肝叶切除和胆肠吻合术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊管的解剖学特征中，以下哪一项描述是不正确的？", "options": "A. 比胆囊颈稍细\nB. 长度通常在3至4厘米之间\nC. 直径约为0.2至0.3厘米\nD. 直接延续为胆总管\nE. 与肝总管及其上方的肝下面共同围成胆囊三角", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，主诉右上腹部隐痛持续2周，伴有食欲减退和呕吐。体检发现体温37.6℃，神志清楚，皮肤有轻度黄染，腹部平坦，肝脏在肋下可触及1指，质地柔软。为了进行黄疸的鉴别诊断，应选择以下哪项实验室检查？", "options": "A.血清总胆固醇与胆固醇酯\nB.血清总胆红素与1分钟胆红素\nC.血清白蛋白\nD.血清碱性磷酸酶\nE.血清淀粉酶", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断胆泥或微胆石时，哪种方法被认为是金标准？", "options": "A. 磁共振胰胆管成像（MRCP）\nB. 内镜超声（EUS）\nC. 计算机断层扫描（CT）\nD. 正电子发射断层扫描（PET）\nE. 内镜逆行胰胆管造影+内镜下括约肌切开术（ERCP+EST）", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位55岁男性患者，无明显临床症状和体征。超声检查显示：肝脏回声均匀，肝右后叶发现一28mm×24mm的实质性肿块，边界清晰，中央回声稍高，周边可见细窄低回声晕。彩色多普勒超声（CDFI）显示肿块周边有环状血流信号。最可能的诊断是", "options": "A. 肝转移性癌\nB. 肝腺瘤\nC. 肝脓肿吸收期\nD. 高回声型肝血管瘤\nE. 肝原发性癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胆管炎和胆管结石急性发作时，患者最可能出现的典型症状组合是？", "options": "A. 腹痛、呕吐、寒热\nB. 腹痛、黄疸、腹泻\nC. 腹痛、腹胀、昏迷\nD. 腹痛、呕吐、黄疸\nE. 腹痛、黄疸、寒热", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，以下哪项实验室检查结果最能反映肝纤维化的程度？", "options": "A. 血清乳酸脱氢酶升高\nB. 血清单胺氧化酶升高\nC. 血浆白蛋白降低\nD. 谷-草转氨酶升高\nE. 血清胆固醇升高", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位68岁男性患者，经检查发现肝右叶存在巨大肿瘤，伴有腹腔积液，血清生化结果显示清蛋白水平为20g/L，总胆红素为60μmol/L。血管造影显示门静脉右支闭塞。针对此情况，最适合的治疗方法是", "options": "A. 肝动脉内抗癌药持续注入法\nB. 扩大肝右叶切除术\nC. 肝动脉结扎术\nD. 全身化疗\nE. 放射疗法", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "男，57岁，近3个月出现腹胀和水肿，1周前症状加重并伴有腹痛。20年前曾检测出HBsAg阳性。体检发现肝掌和蜘蛛痣，腹部呈蛙状，肝脏未触及，脾脏肋下4cm，全腹压痛，无反跳痛，移动性浊音阳性。实验室检查显示血清蛋白24g/L，球蛋白31g/L，血钾3.8mmol/L，血钠136mmol/L，血氯98mmol/L。该患者最必要的检查是", "options": "A.腹水常规+细菌培养\nB.腹部B超检查\nC.尿常规及尿钠检测\nD.腹部CT检查\nE.胃镜检查", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位35岁男性患者，近三年来多次在饭前出现昏迷，发作前伴有恐惧感、心悸和出汗。患者食欲良好，体重增加，但记忆力下降。他发现如果在昏迷发作前及时进食，可以预防或缩短昏迷时间。最可能的诊断是？", "options": "A. 胃泌素瘤\nB. 癫痫\nC. 脑血管疾病\nD. 心血管疾病\nE. 胰岛素瘤", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位32岁男性患者，因反复呕血2个月就诊，影像学检查显示肝段下腔静脉阻塞4cm，但肝静脉通畅。针对这种情况，最适宜的手术方案是？", "options": "A. 脾切除、脾肾分流术\nB. 肠系膜上静脉-下腔分流术\nC. 脾切除断流术\nD. 脾切除术\nE. 下腔静脉-右心房搭桥术", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位30岁男性患者，长期ALT水平升高达6年，偶有乏力感和右上腹胀痛。实验室检查显示ALT为160u/L，白蛋白35g/L，球蛋白32g/L，总胆红素16.2umol/L。血清学检测显示甲肝抗体阳性，抗HBc阳性，抗HCV阳性。根据这些信息，最可能的诊断是什么？", "options": "A. 慢性肝炎，由甲、乙、丙型肝炎病毒重叠感染引起\nB. 慢性肝炎，由乙型肝炎病毒感染引起\nC. 慢性肝炎，由丙型肝炎病毒感染引起\nD. 慢性肝炎，由甲、丙型肝炎病毒重叠感染引起\nE. 慢性肝炎，由甲、乙型肝炎病毒重叠感染引起", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断食管静脉曲张时，以下哪些要点是必须考虑的？", "options": "A. 患者是否有肝硬化及门静脉高压史\nB. 患者是否有过呕血的经历\nC. 食管黏膜是否呈现蚯蚓状\nD. 食管壁边缘是否呈现锯齿状", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者出现腹腔积液时，以下哪种治疗措施通常不被推荐？", "options": "A. 限制蛋白饮食\nB. 低盐饮食\nC. 卧床休息\nD. 强烈利尿\nE. 腹腔积液浓缩回输", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位57岁男性患者，有15年的酒精性肝硬化病史。最近1个月出现右上腹胀痛、低热和体重下降的症状。根据这些临床表现，最可能的诊断是什么？", "options": "A. 肝腺肿\nB. 肝血管瘤\nC. 肝囊肿\nD. 原发性肝癌\nE. 胃癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗慢性胰腺炎时，以下哪些手术方式被采用？", "options": "A. 针对胆道疾病的手术，以促进胰液流向肠道\nB. 胰移植术\nC. 胰切除术\nD. 胰管减压及引流术\nE. 迷走神经，腹腔神经节切除术", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在弥漫性肝病患者中，出血倾向是一个常见问题。以下关于该病出血倾向的描述，哪些是正确的？", "options": "A. 维生素K补充通常对纠正出血倾向效果甚微或无效\nB. 患者常伴有血小板数量或功能的异常\nC. 优球蛋白溶解时间（ELT）通常会缩短\nD. 使用维生素K依赖性凝血因子浓缩物是治疗出血倾向的有效方法\nE. 该病不会影响凝血因子的生成", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估急性胰腺炎患者的病情严重程度时，以下哪项血清学指标最为关键？", "options": "A.血清钙\nB.碱性磷酸酶\nC.丙氨酸氨基转移酶\nD.淀粉酶\nE.血清钾", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名45岁男性患者，长期患有慢性乙型肝炎8年，肝硬化4年，近期因饮食不当出现短暂腹泻，未予重视。在社区医院接受甘利欣静脉注射时，突然出现意识丧失和短暂抽搐，随即被送往医院。入院后检测血氨水平为110μg/dl。诊断为肝性脑病、肝硬化失代偿期和慢性乙型肝炎。治疗包括静脉注射谷氨酸钠、谷氨酸钾、六合氨基酸以及补钾。请问在六合氨基酸溶液中，不应包含以下哪种氨基酸？", "options": "A.L-亮氨酸\nB.L-酪氨酸\nC.L-缬氨酸\nD.L-谷氨酸\nE.L-精氨酸", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，有20多年的乙型肝炎病史，今晨突然出现大量呕血，颜色鲜红，总量约1500ml，紧急送医。体检显示血压80/50mmHg，心率106次/分，面色苍白，四肢末端发凉，脾脏在肋缘下5.0cm可触及，移动性浊音阳性，腹壁可见静脉曲张。到达医院后，患者再次呕血约300ml。以下哪种治疗方法不适用于此患者？", "options": "A. 三腔两囊管压迫\nB. 血管加压素静脉注射\nC. 急诊剖腹探查止血\nD. 输血\nE. 纤维胃镜介入治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，哪种情况最适合进行肝叶切除？", "options": "A. 急性单纯性胆囊炎\nB. 胆囊结石经常发作\nC. 胆总管结石感染并休克\nD. 肝内结石局限于左叶\nE. 胆总管扩张不明显，但并发胰腺炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的MRI检查中，以下哪些表现是正确的？", "options": "A.轻度胰腺炎的形态和信号均可无异常改变\nB.胰腺内、外积液T1WI信号减低，T2WI则增高\nC.胰腺局限性或弥漫性增大，轮廓不清\nD.动态增强扫描有助于显示胰腺坏死灶，与增强的正常胰腺相比，坏死灶为高信号\nE.合并出血时T1WI和T2WI胰腺均可表现为高信号", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位48岁的女性患者需要进行胆汁成分的检查。为了刺激胆汁分泌，检查前应建议她食用哪种食物？", "options": "A. 馒头\nB. 油煎鸡蛋\nC. 巧克力\nD. 咖啡\nE. 葡萄酒", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性梗阻性化脓性胆管炎的病因中，以下哪项是最常见的？", "options": "A. 胆总管结石\nB. 胆总管末端狭窄\nC. 胆道出血继发感染\nD. 胆总管癌\nE. 先天性胆总管扩张症", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种疾病中，Charcot三联征是典型的临床表现？", "options": "A. 急性胆囊炎\nB. 急性梗阻性化脓性胆管炎\nC. 急性出血性坏死性胰腺炎\nD. 急性坏死性小肠炎\nE. 绞窄性小肠梗阻", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺炎的影像学检查中，以下哪些X线表现是典型的？", "options": "A. 十二指肠球呈三叶状变形\nB. Vater壶腹肿大\nC. 十二指肠环变形或扩大\nD. 肠管局限性麻痹性肠梗阻\nE. 胰腺结石及钙化", "answer": "BCDE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断出早期原发性肝癌的情况下，以下哪种治疗方法被认为是最有效的？", "options": "A. 化疗\nB. 手术切除\nC. 放疗\nD. 免疫治疗\nE. 肝移植＋综合治疗", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆管癌的相关描述中，以下哪一项是正确的？", "options": "A.胆管癌是胆道系统中最常见的恶性肿瘤\nB.肝外胆管癌中，肝门部是最常见的发病部位\nC.胆管癌在青壮年人群中更为常见\nD.胆管癌的组织学病理类型以鳞癌为主\nE.胆管癌的发病与华支睾吸虫感染无关", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断肝豆状核变性时，以下哪项实验室检查结果最具有特异性？", "options": "A.染色体核型为:46，XX(XY)/47，+21\nB.染色体核型为:45，XO/46，XX\nC.血苯丙氯酸浓度＞0.24mmol/L(4mg/dl)\nD.染色体核型为:48，XXXY\nE.血清铜蓝蛋白值:50mg/L", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名42岁男性患者因胰头癌接受了Whipple手术，术后第一天腹腔引流管中有50ml血液流出，第二天增加到80ml，并出现血压下降、烦躁不安、面色苍白等症状。急诊B超检查显示腹腔内有大量液体。Whipple手术切除的范围包括哪些结构？", "options": "A.胰头、远端胃、十二指肠、上段空肠、胆囊、胆总管、相应区域的淋巴结\nB.胰头、远端十二指肠、上段空肠、胆囊、胆总管、相应区域的淋巴结\nC.胰头、远端十二指肠、下段空肠、胆囊、胆总管、相应区域的淋巴结\nD.胰头、远端胃和近端十二指肠、下段空肠、胆囊、胆总管、相应区域的淋巴结\nE.胰头、远端胃和近端十二指肠、胆囊、胆总管、相应区域的淋巴结", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位46岁男性患者，既往有肝硬化腹水病史，近一周内出现反复呕血和黑便。最近一天表现为白天嗜睡，夜间烦躁不安，且出现定向力障碍。体格检查发现巩膜轻度黄染，双手平举时出现腕下垂和掌腕阵发性震颤。这些临床表现最符合以下哪种诊断？", "options": "A. 肝性脑病\nB. 电解质紊乱\nC. 失血性休克\nD. 氮质血症\nE. 失血性贫血", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性出血性坏死性胰腺炎的病理变化中，下列哪一项描述最为准确？", "options": "A.胰腺组织间质充血水肿，伴有轻度脂肪坏死\nB.胰腺腺泡和胰岛细胞萎缩消失，伴随纤维化\nC.胰腺组织出现大面积出血和坏死，伴有中性粒细胞浸润\nD.胰腺周围脂肪组织形成钙皂\nE.胰腺间质中有炎性细胞浸润", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者李XX，男，因患“肝癌”于3年前接受肝移植手术，术后3年复查中发现肺转移，医生现在要将此消息告知患者及其家属，以下谈话中你认为哪种开场语言最合适：", "options": "A.李先生，您好，今天我想让您明白您已经发生了肝癌的肺转移，我们很有可能要进一步做化疗。\nB.李先生，您好，全身CT扫描发现一些异常的肺部结节，我们虽然不能肯定是不是癌症的转移，但您需要做好充分的准备。\nC.李先生，您好，您对您的病情的关心令我很赞赏，您能及时的来做复查也表明了您对自己身体的关心，但可能今天有些检查情况不像我们开始预期的那么好。\nD.李先生，您好，我仔细看了您的CT结果，应该很像3年前的肝癌发生了转移，所以我要求您配合进一步的治疗。\nE.李先生，您好，我们都知道肝癌并不是做一次肝移植就能根治的，有时候癌症要发生转移，这也是医生最无能为力的地方。", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者，长期有饮酒习惯，因突发呕血和黑便10小时被紧急送往医院。患者否认有胃病或肝炎病史。体检发现腹壁静脉明显，腹部无压痛，有少量腹水，肝脾未能清晰触及，血压为16/10.4kPa(120/78mmHg)。在这种情况下，首先应采取哪种处理措施？", "options": "A. 静脉滴注西咪替丁\nB. 静脉滴注垂体后叶素\nC. 急诊内镜检查\nD. 紧急上消化道钡餐检查\nE. 紧急剖腹探查", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎发病后，血清淀粉酶水平通常在何时开始上升？", "options": "A. 1～2小时\nB. 6～12小时\nC. 13～16小时\nD. 20～24小时\nE. 26～48小时", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，关于甲胎蛋白（AFP）的临床意义，以下哪项陈述是正确的？", "options": "A. 当AFP水平超过200μg/L时，可以确诊为肝细胞癌\nB. 肝转移癌患者的AFP水平通常显著升高\nC. 肝功能异常伴随AFP升高通常提示合并肝癌\nD. 肝细胞癌手术后AFP再次升高提示肿瘤复发", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆总管结石的诊断中，MRCP的主要作用是什么？", "options": "A.观察到低信号的结石及其部位\nB.显示梗阻的胆管扩张程度\nC.显示结石的大小、形态、数目\nD.观察到高信号的结石及其部位", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，以下哪项是导致急性胰腺炎发作的主要诱因？", "options": "A. 长期服用某些药物\nB. 胆囊结石阻塞胆管\nC. 血液中甘油三酯水平异常升高\nD. 暴饮暴食或大量饮酒\nE. 腹部受到严重撞击", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位25岁的初孕妇，在妊娠36周时因急性乙型肝炎入院。以下哪项措施是不恰当的？", "options": "A.卧床休息，加强营养，避免过劳\nB.静滴红霉素预防感染\nC.静滴葡萄糖液内加维生素C\nD.静滴保肝药\nE.肌注维生素K", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰泌素的作用下，胰腺分泌的胰液具有以下哪种特点？", "options": "A. 水和HCO3-含量高，酶含量低\nB. 水和HCO3-含量低，酶含量高\nC. 水含量高，HCO3-和酶含量低\nD. 水、HCO3-和酶含量都低\nE. 水、HCO3-和酶含量都高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在人原发性肝癌中，哪种蛋白激酶的活性显著增强，与细胞的增殖和分化密切相关？", "options": "A. PKA\nB. PKB\nC. PKC\nD. TPK\nE. CEA", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆管癌的诊断中，以下哪种影像学检查方法能够全面评估胆管扩张、梗阻部位、肝实质转移及胆囊状态？", "options": "A. B超检查显示扩张的胆管、梗阻的部位，发现肿块\nB. PTC显示梗阻部位和管腔受累的范围\nC. ERCP可直接观察十二指肠乳头，造影能显示梗阻远端胆管\nD. CT、MRI检查可确定扩张的胆管，梗阻的部位，肝实质有无转移，胆囊是否肿大\nE. 以上都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者在参加完酒宴后突然感到上腹部剧烈疼痛，最可能的诊断包括哪些？", "options": "A.急性胰腺炎\nB.胃、十二指肠溃疡病\nC.急性胆囊炎\nD.肠梗阻\nE.急性病毒性肝炎", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，降氨药物对肝性脑病的治疗效果不佳？", "options": "A. 急性重症病毒性肝炎\nB. 血吸虫病性肝纤维化\nC. 有广泛门腔静脉分流时，服用含氮药物之后\nD. 有广泛门腔静脉分流时，进食高蛋白质饮食所致\nE. 肝炎后肝硬化", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能不全的患者中，以下哪些临床表现是常见的？", "options": "A. 低蛋白血症\nB. 高血糖\nC. 出血倾向\nD. 黄疸\nE. 免疫功能障碍", "answer": "ACDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者出现黄疸、胆囊增大和肝脏肿大，最可能的诊断是什么？", "options": "A. 胆总管结石继发胆管炎\nB. 壶腹部肿瘤\nC. 早期肝癌\nD. 门脉高压症\nE. 病毒性肝炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行胆囊切除术时，以下哪种情况通常不需要进行胆总管探查？", "options": "A. 胆总管扩张\nB. 胆囊内存在多个小结石\nC. 胆囊内积液\nD. 患者有黄疸病史\nE. 患者同时患有胰腺炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎的临床表现中，以下哪项描述最全面？", "options": "A. 持续性腹痛\nB. 脂肪泻\nC. 黄疸\nD. 腹部包块\nE. 以上均包括", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的病理特征中，以下哪项描述是正确的？", "options": "A. 门脉高压症主要表现为脾脏肿大\nB. 主要病理改变包括肝细胞坏死、纤维组织增生和假小叶形成\nC. 亚急性重症肝炎通常发展为胆汁性肝硬化\nD. 肝硬化患者不会发生肝癌\nE. 肝功能不全常表现为出血倾向", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估胰腺炎患者的预后时，以下哪项因素通常不被考虑？", "options": "A. 年龄\nB. 低血压\nC. 贫血\nD. 低氧血症\nE. 低血钙", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位62岁男性患者，出现无痛性黄疸已持续一个多月，体重逐渐下降，但无明显不适。超声检查显示肝内外胆管扩张，胆囊显著增大，胰管未扩张，且在胆总管远段发现一个实性低回声团块，与胆管壁界限不清，团块内可见动脉血流信号。根据这些超声表现，最可能的诊断是", "options": "A. 胰头部占位\nB. 壶腹周围占位\nC. 胆总管下段结石\nD. 十二指肠降部壁占位\nE. 胆总管上段占位", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "对于胆总管末端直径为1.2cm的结石，以下哪种治疗方法是最优选择？", "options": "A. 手术治疗\nB. 口服胆酸溶石\nC. 内镜治疗\nD. 体外震波碎石\nE. 药物灌注溶石", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性病毒性肝炎的早期阶段，下列哪项肝功能指标最先出现异常？", "options": "A.谷丙转氨酶升高\nB.谷草转氨酶升高\nC.γ-GT升高\nD.凝血酶原时间延长\nE.A/G比例倒置", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的多种潜在病因中，目前医学界认为最主要的危险因素是", "options": "A. 长期接触黄曲霉素\nB. 乙型肝炎病毒感染\nC. 肝硬化\nD. 环境污染暴露\nE. 营养不良", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，患有肝硬化并肝功能失代偿已有2年。最近一周出现低热和右侧胸痛，前来就诊。胸腔积液呈微红色，性质介于渗出液和漏出液之间。患者既往有肺结核病史，曾接受正规抗结核治疗并已治愈多年。在以下处理措施中，哪一项是不妥当的？", "options": "A. 试验性抗结核治疗\nB. 同步测定胸腔积液与血清蛋白、乳酸脱氢酶（LDH）、腺苷脱氨酶（ADA）\nC. 胸腔积液细胞学、细菌学检查\nD. 试验性抗生素治疗\nE. 保肝、利尿治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗原发性肝癌时，哪种化疗给药途径被认为是最有效的？", "options": "A. 口服疗法\nB. 全身静脉法注射疗法\nC. 肝动脉插管局部灌注疗法\nD. 门静脉插管灌注疗法\nE. 直肠给药", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的诊断和治疗中，关于肿瘤标志物AFP的临床应用，以下哪项描述是错误的？", "options": "A. AFP是早期诊断肝癌的有效筛查工具\nB. AFP在肝癌的鉴别诊断中具有重要价值\nC. AFP水平的变化可用于评估治疗效果\nD. AFP升高是确诊肝癌的唯一标准\nE. AFP监测有助于发现肝癌的复发和转移", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞再生的研究中，以下哪项陈述是不正确的？", "options": "A. 肝细胞属于不稳定细胞，肝部分切除后可快速再生\nB. 肝脏干细胞具有分化为胆管上皮细胞和肝细胞的双向潜能\nC. 肝细胞广泛变性伴点状坏死时可完全再生修复\nD. 肝细胞坏死，网状支架完整，可通过再生恢复正常结构\nE. 肝细胞大片坏死，网状支架塌陷，则再生肝细胞难以恢复原来小叶结构", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在Couinaud分段法中，主要依据以下哪两个结构进行肝脏的分段？", "options": "A. 肝动脉和胆道\nB. 门静脉和肝静脉\nC. 肝静脉和肝动脉\nD. 门静脉和胆道\nE. 以上都不对", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床检查中，胆囊底的体表投影位置通常位于哪个解剖标志？", "options": "A.胸骨旁线与右肋弓相交处\nB.右腹直肌外缘与右肋弓相交处\nC.右腋前线与肋弓相交处\nD.剑突下2.5cm处\nE.右第10肋软骨尖端", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位癌症患者接受了肝组织穿刺活检，显微镜下观察到癌细胞与正常肝细胞形态相似，具有异型性，并呈现腺管样结构。最可能的诊断是", "options": "A. 肝细胞癌\nB. 肝细胞癌（假腺管型）\nC. 肝细胞癌（索状型）\nD. 胆管上皮癌\nE. 混合性肝癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺腺泡细胞癌的病变特点，以下哪项描述是不正确的？", "options": "A. 多位于胰头部，易引起梗阻性黄疸\nB. 常形成较大结节样肿物，切面分叶状\nC. 瘤细胞呈腺泡状排列，瘤细胞顶端呈PAS染色阳性，黏液染色阴性\nD. 免疫组化染色α1-AAT、α1-AACT、CK8及CK18呈阳性\nE. 起源于胰腺末梢腺泡上皮，不含内分泌细胞", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性坏死性胰腺炎的患者中，以下哪种电解质变化最常见？", "options": "A. 血钾升高\nB. 血钙升高\nC. 血磷降低\nD. 血钙降低\nE. 血钾降低", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，以下哪些疾病可能导致患者出现背部疼痛症状？", "options": "A. 胰腺癌\nB. 十二指肠球后溃疡\nC. 胃幽门梗阻\nD. 穿透性消化性溃疡", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断细菌性肝脓肿时，以下哪项病史不应出现？", "options": "A. 胆道化脓性感染史\nB. 阿米巴原虫感染史\nC. 全身化脓性感染史\nD. 肝肿大伴疼痛\nE. 可见右膈升高、运动受限", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的临床监测中，以下哪项指标的变化最能提示病情恶化？", "options": "A. 血糖水平持续高于200mg/dl，伴有尿糖阳性\nB. 外周血白细胞计数超过15×109/L\nC. 血清脂肪酶活性超过1.5U\nD. 血清钙离子浓度低于1.75mmol/L\nE. 血淀粉酶水平超过256温氏单位", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁女性患者，近5个月来多次出现右上腹阵发性绞痛，伴有恶心和呕吐，症状多在夜间发作，并向右肩部放射。体检显示患者为肥胖体质，血压110/80mmHg，心率90次/min，右上腹有轻度压痛，无腹肌紧张，Murphy征阳性。随着病情进展，患者出现黄疸，此时最可能的诊断是", "options": "A.急性坏死性胰腺炎\nB.胆囊穿孔性腹膜炎\nC.亚急性重型肝炎\nD.胆囊癌侵犯肝总管\nE.胆囊结石进入胆总管并堵塞远端", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化伴有腹水的患者中，水肿的发生主要与肝脏的哪一项生理功能受损有关？", "options": "A.蛋白质合成与分解\nB.激素代谢\nC.防御和免疫功能\nD.再生功能\nE.解毒功能", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗过程中，以下哪种情况最可能导致患者持续高热？", "options": "A. 胰腺假性囊肿的形成\nB. 胰腺脓肿的发生\nC. 急性呼吸窘迫综合征的并发\nD. 黄疸的出现\nE. 出血坏死型胰腺炎的发展", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在酒精性肝炎患者中，以下哪些肝细胞病变是常见的？", "options": "A. 肝细胞内出现大脂肪滴\nB. 肝细胞浆内出现透明小体\nC. 肝细胞气球样变\nD. 肝细胞嗜酸性小体形成", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位胆囊结石患者需要接受血常规检查，以下关于血标本采集的操作中，哪一项是错误的？", "options": "A. 避免从正在输液的针头处采集血标本\nB. 采集后应将血液注入干燥试管内送检\nC. 取下针头后，将血液沿试管壁缓慢注入\nD. 送检过程中应避免剧烈震荡\nE. 不需要特别安排在清晨空腹时采集", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位55岁男性患者，近期出现右上腹胀痛持续1个月，既往有乙型肝炎病史。实验室检查显示：血红蛋白60g/L，白细胞1.8×10^9/L，血小板4.1×10^9/L，胆红素102μmol/L，碱性磷酸酶18U（布氏），甲胎蛋白1320μg/L，大便隐血试验阳性。体检发现肝脏右肋下约5cm，少量腹腔积液，体重下降8kg。根据这些信息，最可能的诊断是什么？", "options": "A.慢性胆囊炎急性发作\nB.慢性肝炎复发\nC.肝脓肿并胆道出血\nD.晚期肝癌\nE.胆石症并胆道感染\nF.肝炎肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于胰腺浆液性囊腺瘤的描述，以下哪项是错误的？", "options": "A. 多见于中老年女性\nB. 通常位于胰腺体尾部\nC. 属于胰腺常见良性肿瘤\nD. 具有恶变倾向\nE. 肿瘤内部常呈多房性结构", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝泡型包虫病的晚期，患者最可能出现的症状是", "options": "A. 上腹隐痛\nB. 肝硬化\nC. 原发性肝癌\nD. 阻塞性黄疸和（或）门脉高压\nE. 肝破裂", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆石症患者出现胆绞痛时，下列哪种药物是禁用的？", "options": "A. 硫酸镁\nB. 阿托品\nC. 东莨菪碱\nD. 吗啡\nE. 安定", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在慢性胰腺炎患者中，以下哪项症状最为常见且具有特征性？", "options": "A. 中上腹部疼痛，饮酒后加重\nB. 体重减轻\nC. 粪便奇臭，量多呈泡沫状，含大量脂肪颗粒\nD. 发热、恶心、呕吐\nE. 低血压和休克", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者有食用生鱼片的习惯，近期检查发现肝功能轻度异常，血象中嗜酸性粒细胞增多，最可能的诊断是？", "options": "A. 钩端螺旋体病\nB. 乙型肝炎\nC. 华支睾吸虫病\nD. 脂肪肝\nE. 胆总管结石", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的治疗策略中，以下哪些措施是推荐的？", "options": "A. 对于代偿期患者，建议采用高热量、高蛋白及丰富维生素的饮食\nB. 同时使用多种保肝药物进行治疗\nC. 针对肝硬化的合并症进行相应治疗\nD. 对于伴有慢性活动性肝炎的患者，可考虑试用肾上腺皮质激素治疗", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的治疗中，以下哪种方法被认为是最有效的？", "options": "A. 放射治疗\nB. 抗癌药物治疗\nC. 手术切除\nD. 肝动脉插管局部化疗\nE. 肝动脉结扎或门静脉分支结扎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者李女士，45岁，因乳腺癌接受手术治疗后恢复良好，但一年后的腹部增强CT显示肝脏出现一个约5×7cm的实性占位病灶，医生怀疑为肝癌。当李女士得知这一消息时，表现出明显的情绪麻木，既没有哭泣也没有表现出悲伤。作为主治医生，您认为此时最合适的做法是", "options": "A.立即对李女士表示深切的同情\nB.告知李女士此时即便肝脏发现占位病变也不能代表就是肝癌\nC.马上鼓励李女士接受事实并努力战胜疾病\nD.保持安静，暂停一切对话，用肢体语言表示关切和安慰\nE.告知李女士，检查报告也可能有误，这种情况在医疗中也时常发生", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺癌的治疗中，动脉灌注化疗适用于以下哪些情况？", "options": "A. 胰腺癌合并梗阻性黄疸\nB. 不能手术切除的中晚期胰腺癌\nC. 胰腺癌伴肝转移\nD. 严重肝、肾功能不全\nE. 不能纠正的凝血功能障碍", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在阑尾炎导致肝脓肿的病例中，感染物质最可能通过哪条途径到达肝脏？", "options": "A. 阑尾静脉—肠系膜下静脉—下腔静脉—肝脏\nB. 阑尾静脉—肠系膜下静脉—上腔静脉—肝脏\nC. 阑尾静脉—肠系膜上静脉—门静脉—肝脏\nD. 阑尾静脉—肠系膜上静脉—下腔静脉—肝脏\nE. 阑尾静脉—肠系膜上静脉—肝静脉—肝脏", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "李某，女，45岁。因乙肝肝硬化失代偿期入院治疗。在进行食管X线钡餐检查时，发现钡剂在食管黏膜上呈现不均匀分布，伴有虫蚀样或蚯蚓状充盈缺损。针对该患者的饮食管理，应特别注意避免以下哪种食物？", "options": "A. 富含钾的食物\nB. 谷类食物\nC. 粗糙坚硬的食物\nD. 植物性蛋白\nE. 动物性蛋白", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在比较两种不同治疗方法对胆结石患者的疗效时，中药治疗组19例中有15人治愈，西药治疗组18例中有12人治愈。为了比较两组的治疗效果，应采用哪种统计方法？", "options": "A.Σ（o-E）2/E\nB.Σ（|o-E|-1）2/E\nC.Σ（|o-E|-0.5）2/E\nD.（|o-E|-1）2/E\nE.Fisher确切检验", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的治疗中，乳果糖的主要作用机制是什么？", "options": "A. 抑制肠内细菌生长，促进乳酸杆菌繁殖\nB. 与游离氨结合，从而降低血氨\nC. 与氨合成尿素和鸟氨酸，从而降低血氨\nD. 被细菌分解成乳酸和醋酸，使肠内呈酸性\nE. 纠正氨基酸代谢不平衡，抑制假神经递质形成", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的诊断中，以下哪种肿瘤标志物最为关键？", "options": "A. CEA（癌胚抗原）\nB. PSA（前列腺特异抗原）\nC. AFP（甲胎蛋白）\nD. HCG（绒毛膜促性腺激素）\nE. AKP（碱性磷酸酶）", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，患者最可能发展为急性重型肝炎？", "options": "A. T细胞功能正常，但感染的病毒量少且毒力弱\nB. T细胞功能不足，只能杀死部分病毒\nC. T细胞功能正常，但感染的病毒量多且毒力强\nD. 机体免疫功能缺陷，缺乏有效免疫反应\nE. 机体状态极差", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病患者中，以下哪些因素可能导致氨清除不足？", "options": "A.鸟氨酸循环障碍\nB.谷氨酰胺合成障碍\nC.门体分流\nD.三羧酸循环障碍", "answer": "AC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺分泌的胰液中，以下哪种物质是不存在的？", "options": "A.碳酸氢根\nB.胰淀粉酶\nC.胰脂肪酶\nD.胰蛋白酶\nE.糜蛋白酶原", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者在进行B超检查时发现肝脏内存在多个结节病变，血液中的甲胎蛋白水平正常。通过肝内结节穿刺镜检，发现结节内细胞呈柱状，细胞核多形，核质比例大，细胞排列成腺腔样结构。根据这些发现，该患者最可能的诊断是什么？", "options": "A. 肝细胞癌\nB. 肺癌肝转移\nC. 结肠癌肝转移\nD. 食管癌肝转移\nE. 膀胱癌肝转移", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺导管癌的病理特征中，以下哪一项描述是不正确的？", "options": "A. 肿瘤质地较硬，切面可能呈现黄白色\nB. 癌组织中含有不同量的黏液\nC. 间质通常较少\nD. 常侵犯神经\nE. 可能出现破骨细胞样巨细胞", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于APT的以下陈述，哪一项是不正确的？", "options": "A. 慢性肝炎患者中APT水平可能升高\nB. 转移性肝癌患者的APT水平通常高于肝细胞癌患者\nC. APT是肝细胞癌的一种标志物\nD. APT在维生素K缺乏时由肝脏合成\nE. 联合检测APT和AFP可提高肝癌诊断的准确性", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，观察到肝脏内出现一个边界清晰、内部无回声的圆形结构，最可能的诊断是", "options": "A. 转移性肝癌\nB. 肝血管瘤低回声型\nC. 慢性肝脓肿\nD. 肝囊肿\nE. 肝内胆管囊状扩张", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆固醇结石的形成过程中，以下哪项因素起主要作用？", "options": "A.胆汁中钙离子浓度升高\nB.胆盐与磷脂的微胶粒不足\nC.胆固醇绝对含量增加\nD.大肠杆菌产生的β葡萄糖醛酸酶过量\nE.胆汁酸分泌量增加", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性肝衰竭的治疗中，以下哪种药物应避免使用？", "options": "A. 支链氨基酸\nB. 葡萄糖注射液\nC. 谷氨酸钠\nD. 脂肪乳剂\nE. 乳果糖", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的发病机制中，以下哪项是关键的初始步骤？", "options": "A.胰蛋白酶原转化成胰蛋白酶\nB.胰酶在胰腺管内被激活\nC.磷脂酶A2分解细胞膜的磷脂产生溶血卵磷脂\nD.弹力蛋白酶水解血管壁的弹力纤维\nE.激肽酶原水解为缓激肽", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者因肝脏疾病出现昏睡和精神错乱症状，此时最可能处于肝性脑病的哪个阶段？", "options": "A.肝性脑病前驱期\nB.肝性脑病昏迷前期\nC.肝性脑病昏睡期\nD.肝性脑病昏迷期\nE.亚临床肝性脑病", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胃癌患者中，肝转移最常见的途径是以下哪一种？", "options": "A. 邻近器官直接侵犯\nB. 经肝门部淋巴结转移\nC. 经门静脉转移\nD. 经肝动脉转移\nE. 经下腔静脉转移", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁的女性患者，过去3年中多次发生胰腺炎，每次发作前均无明显诱因，且无胰腺功能不全的表现。请问导致其胰腺炎复发的最常见原因可能是？", "options": "A. 药物影响\nB. 胆道疾患\nC. 内分泌与代谢障碍\nD. 家族性高脂血症\nE. 遗传因素", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者李某，女性，45岁，诊断为原发性肝癌，计划进行肝动脉化疗栓塞治疗。关于该患者的护理措施，下列哪项是不正确的？", "options": "A. 术前需进行碘过敏和普鲁卡因过敏试验\nB. 术前6小时需禁食禁水\nC. 术后需禁食2到3天，之后逐渐过渡到流质饮食\nD. 穿刺部位包扎后无需压迫，以免影响穿刺肢体血液循环\nE. 术后应保持穿刺侧肢体伸直24小时", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者因持续上腹部疼痛3天，伴有恶心和呕吐，呕吐物为少量胃内容物。体检发现上腹部压痛，巩膜黄染，体温38.2℃。实验室检查显示血清淀粉酶为58温氏单位，尿淀粉酶为310温氏单位。初步诊断为急性胰腺炎。关于胰腺的解剖结构，以下哪项描述是不正确的？", "options": "A. 胰腺位于第3~4腰椎前方\nB. 胰腺固定在腹膜后，无法移动\nC. 胰管与胰腺的长轴平行\nD. 胰腺的主要血液供应来自胰十二指肠上动脉\nE. 胰腺的前面被胃、胃结肠韧带和横结肠及其系膜覆盖", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在国际抗癌联盟（UICC）的肝癌TNM分期系统中，以下哪一项描述是错误的？", "options": "A.Ⅰ期：T1N0M0\nB.Ⅱ期：T2N0M0\nC.Ⅲ期：T1N1M0，T2N1M0，T3N1~2M0\nD.ⅣA期：T3N0M0\nE.ⅣB期：T1~4N0~1M1", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断原发性胆汁性肝硬化时，以下哪些实验室检查结果具有重要参考价值？", "options": "A. 血清胆固醇升高\nB. 血清ALP升高\nC. 凝血酶原时间延长\nD. 抗核抗体阳性", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的治疗中，以下哪项原则是不正确的？", "options": "A. 保证充足的休息\nB. 采用高热量高蛋白饮食\nC. 针对肝炎引起的肝硬化进行抗肝炎治疗\nD. 增加高维生素饮食\nE. 避免使用对肝脏有损害的药物", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估慢性肝细胞损伤时，以下哪项指标最为敏感？", "options": "A. ALT\nB. γ-GT\nC. AST\nD. AMY\nE. ChE", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝功能不全患者时，以下哪种药物选择原则最为合适？", "options": "A.采用联合用药的方式\nB.合用肝药酶诱导剂\nC.选用代谢物经肾脏排泄的药物\nD.选用血浆蛋白结合率低的药物\nE.选用以原形经肾脏直接排泄的药物", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，以下哪项指标具有重要的诊断价值？", "options": "A.血清脂肪酶测定\nB.血清钙测定\nC.血、尿淀粉酶测定\nD.X-线检查\nE.CT检查", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏病理学中，'气球'样变通常指的是哪种类型的细胞变化？", "options": "A. 水样变性\nB. 脂肪变性\nC. 玻璃样变性\nD. 淀粉样变性\nE. 纤维素样变性", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁的男性患者，患有肝硬化已有6年，体检发现存在少量腹水。如果该患者需要使用利尿剂进行治疗，以下哪种药物应作为首选？", "options": "A. 氢氯噻嗪\nB. 螺内酯（安体舒通）\nC. 乙酰唑胺\nD. 甘露醇\nE. 呋塞米", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压的并发症中，哪一种情况需要立即紧急处理？", "options": "A. 脾功能亢进\nB. 腹腔积液\nC. 食管胃底曲张静脉破裂出血\nD. 肝功能异常\nE. 血细胞减少", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的分类中，以下哪种类型最为罕见？", "options": "A. 巨块型\nB. 结节型\nC. 弥漫型\nD. 混合型\nE. 卫星型", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，5小时前出现剧烈上腹部疼痛，疼痛向背部放射，伴有多次恶心、呕吐，呕吐后疼痛未缓解。患者出现休克症状，病史显示7小时前曾参加聚会并暴食饮酒。在治疗急性胰腺炎时，以下哪种药物应禁用？", "options": "A. 抗胆碱药物\nB. 吗啡止痛\nC. 5-氟尿嘧啶\nD. 钙剂\nE. 抗生素", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性梗阻性化脓性胆管炎（AOSC）的手术治疗中，以下哪项处理原则最为关键？", "options": "A. 首要任务是迅速解除胆道梗阻并建立引流\nB. 若胆囊存在明显炎症反应，应同时进行胆囊切除术\nC. 对于无明显炎症的胆囊，可仅行胆囊造瘘术\nD. 在处理胆管结石时，应优先取出位于胆管下段的结石\nE. 若发现胆管下段完全狭窄，应立即实施胆-肠内引流术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在解剖学中，胆总管下段与胰头的关系是（）。", "options": "A. 前方\nB. 后方\nC. 外侧\nD. 内侧\nE. 实质内", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位47岁男性患者，主诉右上腹疼痛并伴有显著黄疸。超声检查显示肝外胆管和肝内胆管均未见扩张。为了明确诊断，应选择以下哪项检查？", "options": "A. 核素肝扫描\nB. 十二指肠低张造影\nC. PTC\nD. ERCP\nE. MRI", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者，有10年慢性肝炎病史，近期出现腹胀、皮肤和巩膜黄染，并在右上腹触及一个拳头大小、质地坚硬的包块。最可能的诊断是什么？", "options": "A. 转移性肝癌\nB. 原发性肝癌\nC. 慢性肝炎活动\nD. 肝脓肿\nE. 肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆超声检查中，以下哪种病变在声像图上表现为强回声团伴彗星尾征，并且会随体位改变而移动？", "options": "A.胆道结石\nB.肝内钙化灶\nC.胆道气体\nD.胆囊息肉\nE.胆道沉渣", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝细胞癌的介入化疗栓塞治疗中，以下哪种药物通常不被使用？", "options": "A. MMC\nB. CDDP\nC. MTX\nD. ADM\nE. 5-FU", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，哪种检测方法被认为是确诊胰岛素瘤的金标准？", "options": "A. 监测空腹血糖水平低于2.2mmol/L\nB. 进行Wipple三联征评估\nC. 实施葡萄糖耐量试验\nD. 开展饥饿试验\nE. 测定血液中胰岛素水平", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在酒精性肝病的治疗中，哪一项措施最为关键？", "options": "A. 营养支持\nB. 戒酒\nC. 肝移植\nD. 给予保肝药\nE. 给予利胆药", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "李先生，70岁，患有晚期肝癌，身体状况极差，对其护理的主要目标是什么？", "options": "A.让患者有尊严地度过余生\nB.延长生命过程\nC.提供根治疗法\nD.放弃特殊治疗\nE.实施安乐死", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性肝功能衰竭的治疗中，以下哪项是需要严格限制的？", "options": "A. 脂肪\nB. 蛋白质\nC. 热量\nD. 牛奶\nE. 糖", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁女性患者，近5个月来出现不规则发热并伴有右上腹持续性胀痛。体检发现肝脏在肋下3cm处可触及，质地坚硬，肝区听诊可闻及吹风样血管杂音，脾脏在肋下4cm处可触及。实验室检查显示HBsAg阳性。根据这些临床表现，最可能的诊断是", "options": "A.急性肝炎\nB.肝硬化\nC.原发性肝癌\nD.肝脓肿\nE.肝囊肿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者，男，48岁，有15年乙型肝炎病史，近期出现右上腹疼痛并伴有上腹部包块，体重下降5公斤。体检发现肝肋下5cm，边缘钝，质韧，有触痛。实验室检查显示AFP显著升高，B超和CT均提示肝右叶有实质性占位性病变。为进一步确诊，应进行以下哪些辅助检查？", "options": "A. 上腹部B超\nB. ERCP\nC. 肝功能、乙肝两对半\nD. AFP\nE. 上腹部CT\nF. 纤维胃镜", "answer": "ACDEF", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断非典型胆囊结石时，以下哪种情况不应被考虑？", "options": "A. 胆囊颈部结石\nB. 胆囊壁黏膜下小结石\nC. 胆囊内单个大结石\nD. 胆囊泥沙样结石\nE. 胆囊结石充满型", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在我国，导致肝硬化形成的最主要病因是下列哪一种？", "options": "A. 酒精中毒\nB. 乙型病毒性肝炎\nC. 甲型病毒性肝炎\nD. 药物中毒\nE. 日本血吸虫病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎患者中，血钙浓度的变化规律是怎样的？", "options": "A. 起病后6〜12小时升高，48小时下降，持续3〜5天\nB. 起病后12〜14小时升高，下降缓慢，持续1〜2周\nC. 起病后24〜72小时上升，持续7〜10天\nD. 降低程度与临床症状平行\nE. 起病后3〜4小时上升，12小时高峰，24小时下降", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的淋巴结转移中，哪个区域的淋巴结最常受到影响？", "options": "A.腹腔动脉周围淋巴结\nB.肝门区淋巴结\nC.腹主动脉旁淋巴结\nD.下腔静脉周围淋巴结\nE.胃周淋巴结", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性期及肝功能明显受损的情况下，以下哪种药物应避免使用？", "options": "A. 山药\nB. 六味地黄丸\nC. 砒石\nD. 山楂\nE. 牛黄", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位54岁男性患者，平时健康状况良好，最近两周出现巩膜和皮肤黄染，无腹痛，黄疸持续且无波动，体重略有下降。体检发现明显黄疸，肝脏在肋下可触及，右上腹可扪及无触痛的肿大胆囊，无发热。根据这些临床表现，排除梗阻性结石的主要依据是", "options": "A. 患者为男性\nB. 无伴随腹痛\nC. 扪及肿大胆囊，无触痛\nD. 黄疸无波动\nE. 无发热", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁的男性患者，被诊断为肝癌晚期，身体状况极度衰弱。在这种情况下，医护人员应采取的主要措施是什么？", "options": "A.以对症照料为主\nB.尽量延长患者的生存时间\nC.以治疗疾病为主\nD.放弃一切治疗\nE.实施安乐死", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位47岁女性患者，因怀疑胆管结石进行了ERCP检查。检查后4小时，她出现剑突下偏左的持续性疼痛并伴有呕吐。体检显示体温37.8℃，剑突下偏左有轻压痛，无反跳痛和肌紧张。根据这些症状，最可能的诊断是什么？", "options": "A. 胃炎\nB. 胰腺炎\nC. 胆囊炎\nD. 胆管炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位35岁男性患者，因酗酒后出现上腹部持续疼痛3小时，疼痛阵发加剧并向腰背部呈带状放射。关于其腹痛的产生机制，下列哪项描述是错误的？", "options": "A.胰腺炎症累及肠道，导致肠胀气和肠麻痹\nB.胰管阻塞或胆囊炎引起疼痛\nC.胰腺炎性渗出液刺激腹膜\nD.胆汁刺激肠道\nE.炎症刺激和牵拉胰腺包膜上的神经末梢", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位58岁男性患者，近半年出现进行性贫血、消瘦和乏力，偶尔感到右腹隐痛，但无腹泻。体检发现右中腹部可触及肿块，肠鸣音活跃。若需进行手术治疗，术前最重要的准备工作是", "options": "A. 纠正营养\nB. 肠道准备\nC. 心肺功能检查\nD. 肝肾功能检查\nE. 心理准备", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位48岁女性患者，近两年出现右上腹疼痛，偶有低热，并伴有脓血便。体检发现右肝增大，有轻度压痛，X线显示右膈肌抬高，右胸腔有较多积液。B超检查显示肝右叶有巨大液平，放射性核素扫描提示占位性病变。根据这些临床表现和检查结果，最可能的诊断是？", "options": "A. 肝癌\nB. 阿米巴性肝脓肿\nC. 细菌性肝脓肿\nD. 急性肝炎\nE. 肝包囊虫病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在当前的医疗实践中，输血后肝炎的主要病原体是以下哪种病毒？", "options": "A. 甲型肝炎病毒\nB. 丙型肝炎病毒\nC. 戊型肝炎病毒\nD. 乙型肝炎病毒\nE. 丁型肝炎病毒", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪些可能导致门静脉高压性腹水的发生？", "options": "A. 结核性腹膜炎\nB. 急性胰腺炎\nC. 缩窄性心包炎\nD. 肝硬化\nE. 门静脉血栓形成", "answer": "CDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名26岁男性患者，因突发性腹部疼痛2小时就诊。体检发现肝右肋下2cm，质地韧，触痛明显，肝区扣痛阳性。腹部弥漫性压痛，腹水征阳性。为明确诊断，首先应采取哪种诊断方法？", "options": "A. 胸片\nB. B超\nC. 肝功分析\nD. 胃肠钡餐透视\nE. 腹水抽液检查", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆道感染的严重并发症中，以下哪一项不属于常见并发症？", "options": "A. 胆道出血\nB. 急性坏死性胰腺炎\nC. 硬化性胆管炎\nD. 感染性休克\nE. 肝脓肿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在进行十二指肠引流液检查时，如果发现胆囊液（B胆汁）的流出量显著增加，这可能与以下哪种情况有关？", "options": "A.胆总管上段梗阻\nB.胆囊收缩不良\nC.胆囊摘除术后\nD.Oddi括约肌松弛\nE.慢性胰腺炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在阿米巴肝脓肿的临床过程中，以下哪一项并发症通常不会发生？", "options": "A. 继发细菌感染\nB. 脓肿破溃\nC. 肝脏出血\nD. 脓胸\nE. 心包积液", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，在劳累后突然呕出大量咖啡色胃内容物。体检发现患者面色苍白，巩膜轻度黄染，四肢湿冷，脉搏细速，但血压正常。根据这些临床表现，最可能的出血原因是", "options": "A. 胃、十二指肠溃疡病\nB. 门静脉高压症\nC. 出血性胃炎\nD. 胆道出血\nE. 胃癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝细胞性黄疸患者的血液和尿液中，以下哪项化学物质的变化描述是不正确的？", "options": "A. 血清间接胆红素含量升高\nB. 血清总胆红素含量升高\nC. 血清直接胆红素含量升高\nD. 血清直接胆红素/总胆红素比值大于0.5\nE. 尿胆红素检测结果为阴性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化患者的Child-Pugh分级时，以下哪一项指标不被考虑？", "options": "A. 腹水\nB. 凝血酶原时间\nC. 总胆红素\nD. 转氨酶\nE. 白蛋白", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，关于淀粉酶的变化，以下哪项描述是不正确的？", "options": "A.尿淀粉酶的升高通常比血淀粉酶晚\nB.尿淀粉酶的降低通常比血淀粉酶晚\nC.当尿淀粉酶水平超过128温氏单位时，具有诊断意义\nD.在坏死性胰腺炎患者中，尿淀粉酶水平可能不会升高\nE.尿淀粉酶的水平与病情的严重程度不一定成正比", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者两个月前被诊断出腹水，昨天突然出现剧烈腹痛，伴有呕吐和发热，腹水迅速增加，并排出少量暗红色血便。这种情况最可能的原因是", "options": "A.急性胰腺炎\nB.食管静脉曲张破裂出血\nC.合并肝癌破裂\nD.门静脉血栓形成\nE.合并脾破裂出血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺癌的早期临床表现中，最常见的初始症状是__", "options": "A. 黄疸\nB. 体重明显下降\nC. 腹部持续性疼痛\nD. 食欲减退\nE. 排便次数增多", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患有慢性乙型肝炎3年的女性患者，近期因感冒出现咳嗽、鼻塞、流涕及发热症状。实验室检查显示ALT为200 U/mL。在这种情况下，应如何选择解热止痛药物？", "options": "A. 对乙酰氨基酚\nB. 阿司匹林\nC. 双氯芬酸\nD. 以上都可用\nE. 以上都慎用", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏病理学中，以下哪些变化可能发生在肝细胞中？", "options": "A. 液化性坏死\nB. 纤维素样坏死\nC. 脂肪变性\nD. 玻璃样变性", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于肝病患者，在使用大环内酯类酯化物进行抗感染治疗时，应采取何种策略？", "options": "A. 短期口服或静脉给药\nB. 长期用药应减量\nC. 尽可能避免使用\nD. 属于禁忌证\nE. 谨慎使用", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的早期治疗中，以下哪种药物是禁用的？", "options": "A. 碳酸氢钠\nB. 多潘立酮\nC. 胰酶\nD. 六味安消散\nE. 复合乳酸菌胶囊", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化腹水的形成机制中，以下哪一项因素不相关？", "options": "A. 心房利钠肽过度分泌\nB. 门静脉压力升高\nC. 血浆胶体渗透压下降\nD. 醛固酮及抗利尿激素增多\nE. 有效循环血容量不足", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位62岁的男性患者，因持续性右上腹疼痛入院。既往有慢性乙型肝炎病史，近期体重明显下降。影像学检查显示肝脏多发占位性病变，血清甲胎蛋白显著升高。患者疼痛逐渐加重，伴有夜间盗汗、食欲减退和轻度黄疸。为缓解患者的癌性疼痛，下列哪种药物最为适宜？", "options": "A. 吗啡\nB. 对乙酰氨基酚\nC. 卡马西平\nD. 吲哚美辛\nE. 氟哌啶醇", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在继发性肝癌的诊断和治疗中，以下哪一项描述是不准确的？", "options": "A. 血清AFP水平通常为阴性\nB. 常见的原发癌灶包括胃癌、结肠癌和胰腺癌\nC. 通常表现为单个结节，而非多发结节\nD. 主要症状通常由肝外原发癌肿引起\nE. 诊断的核心在于确定原发癌灶的位置", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化失代偿期的诊断中，以下哪项是最主要的依据？", "options": "A. 乏力，食欲不振\nB. 消瘦\nC. 腹胀、腹泻\nD. 腹水\nE. 肝掌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，饮酒后12小时出现中上腹疼痛，随后呕出鲜红色血液约200ml，前来急诊。体检发现腹部柔软，中上腹有压痛，肝脏未触及，脾脏在肋下1.5cm处可触及，血压正常。在急诊室期间，患者持续呕血，伴有烦躁和冷汗。此时，最优先的处理措施是", "options": "A. 快速输血\nB. 口服去甲肾上腺素\nC. 静滴止血敏\nD. 静滴垂体后叶素\nE. 手术治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科诊断中，以下哪种标本最有可能检测到溶组织内阿米巴包囊？", "options": "A. 肝脓肿穿刺液\nB. 黏液脓血便\nC. 脓血痰液\nD. 成形粪便\nE. 肺脓肿穿刺液", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压的临床表现中，以下哪一项通常不会出现？", "options": "A. 食管胃底静脉曲张\nB. 痔核形成\nC. 腹水\nD. 脾功能亢进\nE. 肝大", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝病患者中，以下哪项是导致出血倾向的主要原因？", "options": "A. 血管壁变态反应\nB. 某些凝血因子合成减少\nC. 消耗性凝血障碍\nD. 抗凝物质合成增多\nE. Ⅷ因子缺乏", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位65岁的男性患者，长期患有慢性乙型病毒性肝炎，最近因腹部不适就诊。超声检查显示肝硬化和脾脏肿大。请问患者脾脏肿大的主要原因是什么？", "options": "A.肝静脉压力升高\nB.肝动脉压力升高\nC.门静脉压力升高\nD.腹壁静脉曲张\nE.淋巴回流障碍", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位47岁女性患者因餐后上腹痛伴恶心、呕吐2小时入院。查体显示体温38℃，呼吸23次/分，脉搏98次/分，右上腹墨菲氏征阳性。B超检查发现胆囊腔内有一2.3cm的强回声光团，随体位改变而移动，胆总管直径为1.2cm，其他未见明显异常。在手术中剥离胆囊时，发现胆囊壁增厚并与周围组织粘连，此时应采取哪种处理措施？", "options": "A. 无菌盐水浸泡冲洗\nB. 浆膜下注射0.25%普鲁卡因\nC. 胆囊壁注射去甲肾上腺素\nD. 生理盐水稀释肝素冲洗\nE. 血管钳钝性分离", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆系统的动态显像中，以下哪种放射性药物是常用的显像剂？", "options": "A. 99mTc-HIDA\nB. 99mTc-EDTMP\nC. 99mTc-PMT\nD. 99mTc-DISIDA\nE. 99mTc-植酸盐", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝硬化患者时，为了有效清除肠道内的积血，应选择哪种液体进行灌肠？", "options": "A. 温开水\nB. 生理盐水\nC. 稀醋溶液\nD. 碳酸氢钠溶液\nE. 肥皂水", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，有10年慢性肝炎病史，近期出现腹胀、乏力、食欲减退。体检发现肝脏未触及肿大，脾脏在肋下4.5cm处可触及，同时观察到肝掌和蜘蛛痣。这些症状中，肝掌和蜘蛛痣的出现主要是由于：", "options": "A. 甲基硫醇、二甲基硫化物增多\nB. 继发性醛固酮增多症\nC. 雌激素增多\nD. 黑色素细胞刺激素作用增加\nE. 大脑基底节受假性神经递质的干扰", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下患者中，哪一类患者需要遵循低脂肪饮食？", "options": "A. 甲状腺功能亢进患者\nB. 烧伤患者\nC. 大手术后患者\nD. 急性肾炎患者\nE. 肝胆胰疾病患者", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在西方国家，导致慢性胰腺炎最常见的原因是什么？", "options": "A. 药物\nB. 外伤\nC. 高甘油三酯血症\nD. 酒精\nE. 感染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的病理分类中，以下哪种类型不属于其肉眼形态学表现？", "options": "A. 块状型\nB. 周围型\nC. 结节型\nD. 小癌型\nE. 弥漫型", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名35岁的男性司机，在车祸中因方向盘挤压受伤，3小时后到医院就诊。患者主诉上腹部疼痛，并向右肩及腰部放射。腹部平片显示腹膜后花斑状改变。最可能的诊断是", "options": "A. 肝破裂\nB. 十二指肠破裂\nC. 胰腺断裂\nD. 右肾损伤\nE. 胆囊破裂", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位肝硬化腹水患者在接受护肝和利尿治疗后，昨晚出现乏力和腹胀症状，今晨突然意识不清。为了确定原因，首先应进行哪项检查？", "options": "A. 血常规\nB. 血氨\nC. 血电解质\nD. 肾功能\nE. 肝功能", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，对于无症状的胆囊结石患者，医生通常会建议观察随诊而非立即进行胆囊切除手术？", "options": "A.结石直径小于1cm\nB.合并糖尿病且糖尿病已控制时\nC.伴有胆囊息肉\nD.合并瓷化胆囊\nE.口服胆囊造影，胆囊不显影", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位38岁的女性患者，患有肝硬化并伴有腹水。近一周来，她出现畏寒发热，体温维持在38℃左右，全腹疼痛，腹部明显膨隆，尿量减少至500ml/d。在体检时，以下哪个体征应特别引起注意？", "options": "A.蜘蛛痣及肝掌\nB.腹壁静脉曲张\nC.脾大\nD.腹部移动性浊音\nE.全腹压痛及反跳痛", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，以下哪种情况适合进行胆道梗阻支架置入术？", "options": "A. 胆管结石\nB. 胆管癌\nC. 胰头癌压迫引起的胆管梗阻\nD. 胆道蛔虫引起的胆管梗阻\nE. 胆管炎性狭窄", "answer": "BC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，半年前因上消化道出血就诊，胃镜检查显示食管胃底静脉曲张。患者有乙肝病史，且多次出现血清谷丙转氨酶（SGPT）升高。体检发现肝脏刚触及肋下，质地硬，临床诊断为门静脉高压症。以下哪项不是导致该患者门静脉高压症的原因？", "options": "A.肝小叶间汇管区肝动脉与门静脉间交通支开放\nB.脐静脉阻塞\nC.肝小静脉阻塞\nD.肝窦阻塞\nE.肝外门静脉血栓形成", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位48岁男性患者，有10年乙型肝炎病史，近期出现乏力、低热、腹胀和少尿症状。体检发现巩膜黄染，腹部明显膨隆，存在大量腹腔积液。超声检查显示肝脏略缩小，脾脏增大，肝内纤维增殖，肝硬化结节形成，门静脉和脾静脉增宽。诊断为肝炎后肝硬化伴门脉高压症。若不及时治疗，最可能出现的并发症是", "options": "A. 上消化道出血\nB. 低蛋白血症\nC. 肝性脑病\nD. 代谢性酸中毒\nE. 高钾血症", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断胰岛素瘤时，Whipple三联征的典型表现包括哪些？", "options": "A.癫痫样发作，空腹血糖＜50mg/dL，用葡萄糖后症状缓解\nB.腹痛，血清胰岛素值高于正常，用葡萄糖后症状缓解\nC.腹痛，空腹血糖＜50mg/dL，用葡萄糖后症状缓解\nD.癫痫样发作，空腹血糖＜50mg/dL，静注胰高血糖素后症状缓解\nE.空腹恶心呕吐，甲苯磺丁脲激发试验阳性，静注胰高血糖素后症状缓解", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位34岁男性患者，因高热和右上腹疼痛5天入院，B超检查显示肝脓肿，且有胆道感染病史。针对该患者的饮食指导，以下哪项最为合适？", "options": "A. 高蛋白质、低热量、低脂肪\nB. 低蛋白质、高热量、高脂肪\nC. 低蛋白质、高糖、低脂肪\nD. 低蛋白质、低糖、高脂肪\nE. 高蛋白质、高热量、低脂肪", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗阿米巴性肝脓肿时，以下哪种方法应作为首选？", "options": "A. 手术切开引流\nB. 抗阿米巴药物\nC. 穿刺引流\nD. 反复穿刺吸脓", "answer": "BD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性出血性胰腺炎中，导致DIC发生的主要机制是什么？", "options": "A.大量胰蛋白酶入血激活凝血酶原\nB.大量组织因子入血\nC.引起广泛的内皮细胞损伤\nD.发热和粒细胞破坏\nE.单核吞噬细胞系统功能受损", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，下列哪项是肝功能不全的典型表现？", "options": "A. 出血倾向\nB. 脾功能亢进\nC. 胃肠道淤血\nD. 食管下段静脉曲张及破裂出血\nE. 腹水", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在巴德-吉亚利综合征的影像学检查和血管造影表现中，以下哪种临床类型是不正确的？", "options": "A. 肝静脉开口以下下腔静脉阻塞\nB. 下腔静脉弥漫性狭窄或阻塞\nC. 肝静脉阻塞\nD. 肝静脉加下腔静脉阻塞\nE. 以下腔静脉隔膜为主的局限性狭窄或阻塞", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在暴发型肝炎的临床表现中，以下哪一项不符合其特征？", "options": "A.肝脏持续增大\nB.肝性脑病\nC.深度黄疸\nD.肝肾综合征\nE.出血倾向", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者因胆囊结石需要进行B型超声检查，检查前一晚最适合进食的食物是", "options": "A. 油煎鸡蛋\nB. 牛奶\nC. 红烧牛肉\nD. 清汤面\nE. 炖豆腐", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名35岁男性患者因车祸导致上腹部受伤4小时，出现呼吸困难、呕吐，血压为90/70mmHg。体检发现全腹压痛、肌紧张及反跳痛，腹部无明显移动性浊音，肠鸣音减弱。X线检查显示右侧膈肌升高且活动受限，同时伴有右7、8、9肋骨骨折。该患者最可能的诊断是？", "options": "A. 胃破裂\nB. 肠破裂\nC. 脾破裂\nD. 肝破裂\nE. 损伤性气胸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的不同阶段，下列哪一项描述与实际情况不符？", "options": "A. 患者可能出现轻度性格改变和行为异常，但脑电图显示正常\nB. 患者可能出现意识错乱和行为异常，脑电图显示异常\nC. 患者可能出现嗜睡和行为异常，但脑电图显示正常\nD. 患者可能出现昏睡或精神错乱，脑电图显示异常\nE. 患者可能出现神志完全丧失，无法唤醒，脑电图显示异常", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位34岁的男性患者，职业为公司经理，近1个月出现低热、乏力、食欲缺乏等症状，因工作繁忙未及时就医。近1周症状加重，出现不思饮食、食后即吐。查体显示重病面容，皮肤重度黄染，多处淤斑，腹水征阳性，诊断为“亚急型重型肝炎”。请问导致该患者发展为重型肝炎的最可能原因是？", "options": "A.原有肝病\nB.过度劳累\nC.服用对肝有损害的药物\nD.肝炎病毒的重叠感染\nE.肝炎病毒的变异", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名26岁男性患者，在夜间饮用了约500mL高度白酒后出现神志不清、呼吸困难和口唇发绀的症状，被紧急送往医院。体检显示体温36.9℃，心率141次/分，呼吸频率38次/分，血压95/72mmHg；患者处于嗜睡状态，半卧位，呼吸急促；腹部有轻微压痛，但无肌紧张。根据这些症状，分诊护士最可能判断该患者患有", "options": "A.急性胰腺炎\nB.癔症\nC.癫痫发作\nD.脑疝\nE.酒精中毒", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位34岁的女性患者，初次怀孕，目前孕34周，被确诊为乙型肝炎并入院。针对该患者，最合适的处理措施是什么？", "options": "A. 继续妊娠\nB. 立即隔离并实施引产术以终止妊娠\nC. 立即进行剖宫产术\nD. 在积极治疗肝炎的同时终止妊娠\nE. 进行隔离和保肝治疗，若病情恶化则考虑终止妊娠", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝豆状核变性的临床表现中，以下哪一项描述是错误的？", "options": "A. 角膜可见K-F环\nB. 铜蓝蛋白水平升高并在组织中积聚\nC. 可能出现溶血性贫血\nD. 神经系统症状主要表现为锥体外系症状\nE. 属于常染色体隐性遗传病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝脏合成功能时，以下哪组血清酶学指标最为关键？", "options": "A. ALT和ALP\nB. AST和γ-GT\nC. CHE和LCAT\nD. MAO和AST\nE. LD和CK", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于肝脓肿的超声表现，以下哪一项描述是不正确的？", "options": "A. 细菌性肝脓肿\nB. 阿米巴性肝脓肿\nC. 多数囊壁较厚\nD. 囊腔内可出现气体回声\nE. 肝脓肿均为囊性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化失代偿期，腹水的形成机制中，以下哪一项是不正确的？", "options": "A. 门静脉高压\nB. 低蛋白血症\nC. 肝淋巴液生成过多\nD. 有效循环血容量不足\nE. 继发性醛固酮减少", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝囊肿的超声检查中，以下哪一项描述是不正确的？", "options": "A. 囊壁薄且表面光滑\nB. 囊壁较厚，表面光滑，呈现双层结构\nC. 囊肿侧壁出现回声失落现象\nD. 囊肿后方回声增强\nE. 彩色多普勒血流成像显示囊壁处有短条状血流信号", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，急性胰腺炎最常见的发病机制是什么？", "options": "A. 细菌感染\nB. 病毒感染\nC. 自身消化\nD. 免疫反应\nE. 霉菌感染", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，腹水的性质通常属于以下哪种类型？", "options": "A.漏出液\nB.渗出液\nC.血性\nD.脓性\nE.乳糜性", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者因突发寒战、高热持续4天，伴有右上腹剧烈疼痛就诊。体检发现体温高达39.5℃，心率110次/分，巩膜无黄染，右季肋区明显隆起，肝脏肿大，右上腹压痛伴肌卫，血常规显示白细胞显著升高并伴有核左移。关于细菌性肝脓肿的病原菌入侵途径，下列哪项描述是不正确的？", "options": "A. 胆道系统\nB. 门静脉系统\nC. 肝动脉系统\nD. 呼吸系统\nE. 淋巴系统", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估肝硬化患者病情严重程度时，以下哪项指标最能提示失代偿期的发生？", "options": "A. 血清白蛋白/球蛋白比值降低\nB. 皮肤出现肝掌和蜘蛛痣\nC. 脾脏体积增大\nD. 食管下端静脉曲张\nE. 巩膜和皮肤黄染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名43岁男性患者，体检时发现AFP水平超过500μg/L，肝肾功能正常，且有6年HbsAg阳性病史。最可能的诊断是什么？", "options": "A. 慢性乙型肝炎，活动期\nB. HbsAg携带者\nC. 乙肝病毒感染者\nD. 原发性肝癌\nE. 转移性肝癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，以下哪种胰腺疾病的发病率最高？", "options": "A. 胰岛细胞瘤\nB. 胰腺囊腺瘤\nC. 胰腺囊肿\nD. 胰腺癌\nE. 急性胰腺炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，导致肝硬化最常见的病因是什么？", "options": "A. 长期酗酒\nB. 病毒性肝炎感染\nC. 肝脏寄生虫感染\nD. 营养不良\nE. 化学物质中毒", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝细胞癌的诊断中，以下哪种肿瘤标记物的测定被认为是最具参考价值的？", "options": "A. 铁蛋白\nB. 甲胎蛋白\nC. PSA\nD. CA19-9\nE. β2-mg", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，放射性核素肝胆动态显像技术可用于以下哪些情况？", "options": "A. 急性胆囊炎的诊断\nB. 肝外胆道梗阻与肝内胆汁淤积的鉴别诊断\nC. 先天性胆道闭锁与新生儿肝炎的鉴别诊断\nD. 胆总管囊肿等先天性胆道异常的诊断\nE. 肝胆系统术后疗效评估及胆汁漏的诊断", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在我国，导致肝硬化最常见的病因是什么？", "options": "A. 长期酗酒\nB. 药物或化学物质引起的肝炎\nC. 病毒性肝炎\nD. 长期营养不良\nE. 慢性肠道炎症性疾病", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位64岁男性患者，在散步时突然感到腹部不适，伴有恶心、头晕、出虚汗、心率加快和心慌，紧急就诊。查体显示：脉搏118次/分，血压100/60mmHg，心率整齐，面色苍白，腹部广泛压痛，尤其右侧腹明显，轻度肌紧张。患者有肝炎后肝硬化病史，但无出血史，也未进行进一步检查。最可能的诊断是？", "options": "A. 脾破裂\nB. 肝癌破裂\nC. 溃疡病穿孔\nD. 急性坏死性胰腺炎\nE. 急性化脓性胆囊炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名成年患者在接受肝脏超声检查时，图像显示如图，最可能的诊断是", "options": "A. 肝血管瘤\nB. 原发性肝癌\nC. 肝囊肿\nD. 阿米巴肝脓肿\nE. 肝内胆管囊状扩张", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者被诊断为直肠癌，B超检查发现肝左叶有一个孤立的转移结节，其他部位未见异常。在这种情况下，最适宜的治疗方案是？", "options": "A. 单纯放疗\nB. 直肠癌根治术联合肝左叶切除\nC. 乙状结肠造口\nD. 单纯化疗\nE. Miles手术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者，有3年肝硬化病史，近期因摄入高蛋白饮食后出现认知功能下降、睡眠紊乱及脑电图异常。针对该患者的治疗，以下哪项措施是不恰当的？", "options": "A. 减少蛋白质摄入\nB. 使用硫酸镁进行导泻\nC. 采用弱碱性溶液进行灌肠\nD. 口服乳果糖\nE. 静脉滴注精氨酸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的多种发病机制中，哪一种学说被研究得最为广泛？", "options": "A.氨中毒学说\nB.假性神经递质学说\nC.GABA/BZ复合体学说\nD.氮基酸代谢失衡学说\nE.以上都不是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁女性患者因持续乏力、食欲减退、对油腻食物反感、恶心已持续5天，且尿液呈现黄色3天前来就诊。体检显示血压为100/70 mmHg，皮肤和眼白部分出现黄疸，肝脏和脾脏在肋下未能触及，但肝区有叩击痛。在治疗过程中，以下哪项检查是不必要的？", "options": "A. anti-HAV-IgG\nB. HBV DNA\nC. 肝功能\nD. 肝纤维化指标\nE. 血清AFP", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估肝外伤时，关于诊断性腹腔穿刺的应用，以下哪项描述是不正确的？", "options": "A. 对于闭合性肝损伤，腹腔穿刺灌洗法能有效提高检测阳性率\nB. 该方法的阳性率仅为50%\nC. 这是一种操作简便且安全性高的诊断手段\nD. 若灌洗液呈现澄清状态，可能表明腹腔内无出血\nE. 灌洗液中红细胞计数超过100×10^9/L，胆红素水平高于0.16mg/dl，提示肝脏损伤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位49岁女性患者，近半年多次出现右上腹疼痛，伴有恶心呕吐，疼痛多在夜间发作并向右肩放射。患者体型肥胖，血压110/80mmHg，心率90次/分，右上腹有轻度压痛，无腹肌紧张。经过治疗后症状未缓解，反而出现持续性疼痛加重，右上腹压痛、反跳痛、腹肌紧张，体温升至38.5℃。随后病情进一步恶化，出现黄疸。此时应首先考虑的诊断是", "options": "A. 急性坏死性胰腺炎\nB. 胆囊穿孔性腹膜炎\nC. 亚急性肝坏死\nD. 胆囊癌侵犯肝总管\nE. 胆囊结石进入胆总管并堵塞远端", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，急性胰腺炎最常见的病因是（）。", "options": "A.酒精摄入\nB.胰胆管梗阻导致胆汁反流\nC.胰腺外伤\nD.流行性腮腺炎\nE.穿透性胃溃疡", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在右肝肋缘下向上扫查时，常可见到镜面伪像。以下关于镜面伪像的描述中，哪一项是错误的？", "options": "A. 正常肝脏：膈下是肝脏实像，膈上是肝脏伪像\nB. 近膈肌处肝内肿瘤，膈上见相同的肿瘤，前者为实像，后者是伪像\nC. 近膈肌处肝内囊肿，膈上见相同的囊肿，前者为实像，后者是伪像\nD. 右侧胸腔积液时，以上镜面伪像更明显\nE. 右侧胸腔积液时，以上镜面伪像消失", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，近两个月来出现肝区疼痛、乏力、体重明显下降、消化不良、腹胀和食欲减退，但无黄疸症状。体检发现肝脏在右肋下可触及3.0cm，移动性浊音阴性，初步诊断为肝癌。请问以下哪项实验室检查对确诊肝癌最为关键？", "options": "A.血常规\nB.肝炎系列\nC.肝功能\nD.AFP\nE.血浆蛋白测定", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在自身免疫性肝炎的诊断中，下列哪一项病理学改变最具特征性？", "options": "A. 小胆管增生\nB. 可见Mallory小体\nC. 界面性肝炎、浆细胞浸润、玫瑰花结\nD. 汇管区淋巴滤泡形成、胆管损伤、小叶内肝细胞脂肪变性\nE. 肝细胞内铁颗粒沉积", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于患有肝硬化并伴有腹水的患者，每日的液体摄入量应控制在多少？", "options": "A. 1500ml\nB. 1000ml\nC. 800ml\nD. 500ml\nE. 300ml", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的病例中，最常见的淋巴转移部位是哪个？", "options": "A. 主动脉旁\nB. 胰周\nC. 腹膜后\nD. 锁骨上\nE. 肝门", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断不明原因的肝外阻塞性黄疸时，推荐进行的手术方式是（）。", "options": "A.胆囊造瘘术\nB.胆道探查及引流术\nC.胆总管十二指肠吻合术\nD.肝叶切除术\nE.胆囊切除", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝细胞腺瘤时，以下哪些手术方法是常用的？", "options": "A. 肝叶切除术\nB. 囊内剜除术\nC. 肿瘤捆扎术\nD. 肝动脉结扎或栓塞术\nE. 内囊摘除术", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性重症肝炎的诊断中，以下哪项临床表现最具诊断意义？", "options": "A. 黄疸进行性加深\nB. 出血倾向\nC. 中枢神经系统症状\nD. 腹水鼓胀\nE. 肝浊音界缩小", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于阿米巴肝脓肿的发病机制，以下哪一项描述是不正确的？", "options": "A. 阿米巴大滋养体能够穿透肠壁直接进入肝脏\nB. 大滋养体可以通过淋巴系统迁移至肝脏\nC. 肠腔中的大滋养体能够利用其侵袭能力通过门静脉系统进入肝脏\nD. 所有肝脓肿患者之前必定经历过急性阿米巴痢疾\nE. 到达肝脏的阿米巴原虫大多数会被消灭，只有少数能够在肝脏中存活并繁殖", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁男性患者被诊断为肝性脑病，医生开具了乳果糖口服治疗。乳果糖的主要作用机制是", "options": "A. 促进肠道蠕动\nB. 降低肠道pH值\nC. 抑制肠道细菌繁殖\nD. 提供额外热量\nE. 增强肝脏功能", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在特发性门脉高压的诊断和治疗中，以下哪项描述是错误的？", "options": "A. 该病症主要涉及肝窦前性门静脉压力的异常升高\nB. 肝细胞再生形成的假小叶对肝窦的压迫是主要原因\nC. 患者常表现为脾脏肿大、贫血和出血倾向\nD. 首选治疗方法通常是进行分流手术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位38岁男性患者，出现右上腹疼痛、寒战、高热和黄疸症状已持续1天。体检显示体温高达39.6℃，血压为83/60mmHg，皮肤和巩膜明显黄染，右上腹及剑突下区域有压痛，并可触及肿大的胆囊。血常规检查显示白细胞计数为26×109/L。根据这些临床表现，最可能的诊断是（）。", "options": "A.急性坏死性胰腺炎\nB.胆囊穿孔\nC.急性化脓性胆囊炎\nD.急性梗阻性化脓性胆管炎\nE.肝内胆管结石并发胆道感染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，了解胰腺主胰管的正常直径对于手术规划至关重要。请问胰腺主胰管的正常直径是多少？", "options": "A. 1.0mm\nB. 2.5mm\nC. 3.5mm\nD. 4.0mm\nE. 5.0mm", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在壶腹周围癌的分类中，以下哪种癌症不属于该范畴？", "options": "A. 胰头癌\nB. 胰体癌\nC. 十二指肠癌\nD. 胆总管下端癌\nE. 壶腹癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的发展过程中，哪种病理变化被认为是其最具特征性的表现？", "options": "A. 肝细胞增生\nB. 小胆管增生\nC. 纤维组织增生\nD. 肝细胞坏死\nE. 假小叶形成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位47岁男性患者，在食用油炸食品后出现右上腹剧烈疼痛，疼痛放射至右肩胛区，伴有寒战和发热，最可能的诊断是__", "options": "A.急性胆囊炎\nB.急性胃肠炎\nC.急性心肌梗死\nD.急性胰腺炎\nE.十二指肠球部溃疡", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在阿米巴肝脓肿的诊断中，以下哪一项不符合其典型特征？", "options": "A. 患者通常有阿米巴痢疾的病史\nB. 疾病进展缓慢，病程较长，症状较轻\nC. 肝穿刺获得的脓液通常呈现棕褐色\nD. 结肠镜检查可发现结肠黏膜存在慢性溃疡\nE. 脓肿通常为多发性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺癌的诊断和特点，以下哪项描述是不正确的？", "options": "A. 胰腺癌是一种恶性程度高、进展迅速且预后不良的肿瘤\nB. 胰腺癌在早期阶段症状不明显，缺乏特异性，导致早期诊断困难\nC. 当胰腺癌出现典型症状时，通常已进入晚期，治疗效果不佳，死亡率高\nD. 研究表明，18F-FDG PET在诊断胰腺癌时的灵敏度为94%，特异性为84%\nE. CT在检测胰腺癌的原发灶、转移淋巴结及肝转移方面的检出率高于18F-FDG PET", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在某城市，如果自来水供应系统被一家传染病医院的污水污染，最可能引发以下哪两种病毒性肝炎的流行？", "options": "A. 甲型肝炎和乙型肝炎\nB. 乙型肝炎和丙型肝炎\nC. 乙型肝炎和丁型肝炎\nD. 乙型肝炎和戊型肝炎\nE. 甲型肝炎和戊型肝炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫症的临床表现中，以下哪一项描述是不正确的？", "options": "A. 常有呕吐蛔虫病史\nB. 上腹“钻顶样”疼痛\nC. 突然患病突然缓解\nD. 伴反跳痛与肌紧张\nE. 可伴有轻度黄疸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肠阿米巴感染中，最常见的并发症是以下哪一种？", "options": "A. 肺脓肿\nB. 脑脓肿\nC. 肝脓肿\nD. 心包炎\nE. 脓胸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位25岁女性，G3P0，宫内孕34周，主诉皮肤瘙痒和黄疸4天。产科检查未发现明显异常。她的姐姐在怀孕期间也有类似症状，并在孕35周时早产。根据这些信息，最可能的诊断是什么？", "options": "A. 急性肝炎\nB. 药物性肝损害\nC. 妊娠期肝内胆汁淤积症\nD. 妊娠期急性脂肪肝\nE. 妊娠期肝损害", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名40岁男性患者从4米高处跌落2小时后出现腹痛，腹肌紧张，伴有压痛和反跳痛，肠鸣音减弱。血压为104/70mmHg，脉搏120次/分。血红蛋白水平为80g/L。X线检查显示右侧第9和第10肋骨骨折，右侧膈肌升高。最可能的诊断是什么？", "options": "A. 肝破裂\nB. 胃破裂\nC. 脾破裂\nD. 横结肠破裂\nE. 胰腺断裂", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位40岁女性患者因反复右上腹痛2年入院。体检显示皮肤和巩膜无黄染，右上腹有深压痛，Murphy征阴性。B超检查发现胆囊壁无增厚，大小正常，胆囊内有多发小结石。胆总管直径为1.0cm，下端显示不清。患者有胰腺炎病史。在这种情况下，首先需要排除的疾病是（）。", "options": "A.胆总管结石\nB.肝内胆管结石\nC.胆囊炎\nD.胆管炎\nE.胆囊结石\nF.以上都不是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断原发性硬化性胆管炎时，以下哪项是最关键的诊断方法？", "options": "A. 胆管造影\nB. 缓慢波动性进行性的胆管梗阻及胆管炎\nC. 抗线粒体抗体\nD. ANCA\nE. 肝穿刺活检", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的格利森纤维(Glisson)鞘内，以下哪组管道被包裹？", "options": "A. 门静脉、肝静脉、肝胆管\nB. 肝动脉，门静脉，胆总管\nC. 肝动脉，门静脉，肝静脉\nD. 肝动脉，肝胆管，门静脉\nE. 肝动脉，肝胆管，肝静脉", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位外伤性肝破裂患者需进行急症手术，术前血压为82/58mmHg，脉搏为130次/分。以下哪项麻醉处理原则是不正确的？", "options": "A.立即开放静脉，加快输血输液\nB.纠正电解质、酸碱紊乱\nC.待休克纠正后马上手术\nD.首选气管内全麻\nE.加强呼吸循环功能监测", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在18F-FDG PET显像中，除了SUV指标外，靶/非靶(T/NT)比值也常用于判断病灶的良恶性。对于鉴别分化型肝细胞癌和肝良性病变，通常采用的T/NT值是多少？", "options": "A.大于1.0\nB.大于等于1.3\nC.大于等于1.5\nD.大于等于2.0\nE.大于等于2.5", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男，45岁。因呕血和黑便2天入院，有长期肝硬化病史。体检发现患者面色苍白，巩膜轻度黄染，腹部明显膨隆，脾脏在肋下可触及约7cm，腹水征阳性。在紧急处理措施中，哪一项是不必要的？", "options": "A.静脉注射血管加压素\nB.静脉注射生长抑素\nC.立即进行胃镜检查并止血\nD.进行开腹手术止血\nE.给予输血和补液", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在治疗肝性脑病患者时，以下哪种方法是不推荐的？", "options": "A. 口服25%硫酸镁\nB. 口服抗生素\nC. 口服乳果糖\nD. 肥皂水灌肠\nE. 生理盐水灌肠", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断中，关于腹水的描述，以下哪一项是不正确的？", "options": "A. 当腹部移动性浊音呈阳性时，通常表明腹水量在1000至1500毫升之间\nB. 肝脏疾病是导致腹水的最常见原因\nC. 肾脏疾病是引起腹水的最常见原因\nD. 低蛋白血症也是导致腹水生成的一个因素\nE. 腹膜肿瘤通常会引起血性腹水", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，在饮酒及高脂饮食后突然出现上腹疼痛4小时，疼痛向背部放射，伴有呕吐、大汗和尿色黄。为了明确诊断，最应该进行的辅助检查是", "options": "A. 上消化道X线钡剂造影\nB. 腹部CT\nC. 肝胆核素扫描\nD. 立位腹部X线平片\nE. 胃镜", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位30岁男性患者，近3个月来感到乏力，并伴有左上腹饱胀感。体检发现浅表淋巴结未触及，肝脏未触及，脾脏肋下5cm。实验室检查显示Hb 90g/L，白细胞170×10^9/L，血小板300×10^9/L，原粒0.01，晚幼粒0.4，杆粒0.34，分叶粒0.1，嗜碱粒细胞0.02，NAP(-)。为进一步明确诊断，应进行以下哪项检查？", "options": "A. 51铬红细胞半寿命期\nB. 染色体分析\nC. MRI\nD. 同位素骨扫描\nE. 淋巴管造影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在阻塞性黄疸的临床表现中，以下哪一项是不正确的？", "options": "A. 胆总管结石伴有发热\nB. 胰头癌伴有胆囊肿大\nC. 血中结合胆红素显著升高\nD. 胆总管结石黄疸呈波动性\nE. 尿中胆红素阴性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的早期阶段，患者最常出现的症状是什么？", "options": "A. 寒战、高热\nB. 右上腹肌紧张，局部触痛明显\nC. 黄疸\nD. 贫血\nE. 恶心", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，以下哪种化学物质与肝血管肉瘤的发生有直接关联？", "options": "A. 聚乙烯\nB. 联苯胺\nC. 苯\nD. 氯乙烯\nE. 铬酸盐", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，肝脾肿大的主要病理生理机制是什么？", "options": "A. 胎儿性造血\nB. 代谢物质的沉着\nC. 充血性增大\nD. 网状内皮细胞数量增多\nE. 异常细胞浸润", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男性，48岁，有10年乙型肝炎病史，近期出现乏力、低热、腹胀和少尿症状。体检发现巩膜黄染，腹部膨隆，有大量腹腔积液。超声检查显示肝内纤维增殖，肝硬化结节形成，门静脉和脾静脉增宽。诊断为肝炎后肝硬化，门脉高压症。下列哪项指标不能提示肝功能严重损害？", "options": "A. 清蛋白明显降低\nB. 转氨酶明显提高\nC. 重度黄疸\nD. 大量腹腔积液\nE. 扑翼样震颤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏病理学中，肝细胞气球样变性主要指的是哪种细胞变化？", "options": "A.细胞水肿\nB.脂肪变性\nC.萎缩\nD.纤维素样坏死\nE.包裹钙化", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌的早期临床表现中，以下哪种症状最为常见？", "options": "A. 皮肤瘙痒\nB. 上腹隐痛\nC. 贫血\nD. 黄疸\nE. 稀便", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁的男性患者，因原发性肝癌接受了手术治疗并已出院。在门诊复查时，以下哪项检查不是常规必需的？", "options": "A. 甲胎球蛋白\nB. 肝脏B超\nC. 癌胚抗原（CEA）\nD. 胸部X线片", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位58岁男性患者，患有肝炎已有10余年，最近因感到无力、食欲不振和腹胀20天，被诊断为乙肝后肝硬化（失代偿期）并入院。肝功能测试显示显著异常，特别是白蛋白水平降低，球蛋白水平升高，白蛋白与球蛋白比率倒置。为了治疗其低蛋白血症，应首选哪种血液制品？", "options": "A. 全血\nB. 新鲜冰冻血浆\nC. 普通冰冻血浆\nD. 低分子右旋糖酐\nE. 白蛋白", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的早期阶段，哪一条侧支血管最先受到影响？", "options": "A. 脐静脉\nB. 胃冠状静脉\nC. 直肠上静脉\nD. 腹膜后静脉\nE. 腹壁上静脉", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞肝癌的早期筛查中，以下哪种方法最为关键？", "options": "A. 甲胎蛋白升高+B超检査\nB. 有慢性肝炎或肝硬化病史\nC. 有脂肪肝病史\nD. 肝功能检查\nE. 肝脏肿大伴压痛", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名12岁男孩突然出现阵发性右上腹绞痛，伴有恶心和呕吐，症状在短时间内缓解，但可能反复发作。体检显示体温正常，巩膜无黄染，无肌紧张。诊断胆道蛔虫病的主要依据是什么？", "options": "A.典型症状和特征\nB.内镜逆行胆管检查\nC.X线钡餐造影\nD.静脉胆道造影\nE.大便找虫卵", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名28岁的男性建筑工人在工作中不慎被重物挤压腹部，导致严重腹痛。急诊CT显示胰头部横断损伤。在紧急剖腹探查术中，确认了胰头部的横断伤。在这种情况下，最合适的手术方式是", "options": "A. 胰头两断端分别缝合术\nB. 胰十二指肠切除术\nC. 胰头侧断端缝合，远端断端与空肠行端端吻合，空肠空肠端侧吻合术\nD. 腹腔引流术\nE. 胰头两断端作对端吻合术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在细菌性肝脓肿的治疗中，下列哪项措施是不推荐的？", "options": "A.对于合并胆道感染的患者，应进行胆道引流\nB.如果脓肿穿破进入胸腔，应进行胸腔引流\nC.血源性肝脓肿应针对原发病灶进行治疗\nD.对于脓肿壁较厚且难以治愈的患者，可考虑肝叶或肝段切除\nE.一旦确诊肝脓肿，应立即进行手术治疗", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现右上腹痛、发热、黄疸并伴有呕吐，最可能的诊断是以下哪种疾病？", "options": "A. 急性胃炎\nB. 急性胰腺炎\nC. 急性腹膜炎\nD. 急性胆囊炎\nE. 急性肾盂肾炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎患者中，休克的出现通常指示以下哪种情况？", "options": "A. 血容量不足\nB. 继发细菌感染\nC. 胰腺出血坏死\nD. 并发腹膜炎\nE. 以上都不对", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝门部胆管癌的诊断中，以下哪项检查结果是不典型的？", "options": "A. 超声检查显示胰腺增大\nB. 血液检查显示总胆红素和直接胆红素水平显著升高\nC. 超声检查显示肝内胆管扩张\nD. 经皮经肝胆管造影显示单侧肝内胆管扩张，另一侧不显影\nE. CT扫描显示肝内胆管扩张，肝门部有肿块", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下疾病中，哪种疾病最常导致肝细胞性黄疸的发生？", "options": "A. 胆总管结石\nB. 中毒性肝炎\nC. 新生儿溶血\nD. 蚕豆病\nE. 原发性胆汁性肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者李某，女性，50岁，因肝性脑病住院治疗。医生建议进行灌肠以清除肠道内的含氮物质。在灌肠液的选择上，以下哪种溶液是不适宜的？", "options": "A. 生理盐水\nB. 弱酸性溶液\nC. 肥皂水\nD. 新霉素液\nE. 清水", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊切除术后，以下哪种引流方式最为常用？", "options": "A. 烟卷式引流\nB. 纱条引流\nC. 管状引流\nD. 橡皮条引流\nE. 负压吸引瓶引流", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁女性患者因持续腹胀2个月前来就诊。体检发现：巩膜无黄染，腹壁静脉曲张明显，脐疝可见，脾脏肿大至脐水平，伴有腹水。根据这些临床表现，以下哪种疾病最可能导致门静脉高压？", "options": "A. 原发性胆汁性肝硬化\nB. 酒精性肝硬化\nC. 结节性肝硬化\nD. 血吸虫病肝硬化\nE. 营养不良性肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌的早期阶段，哪种治疗方法被认为是首选？", "options": "A. 放射疗法\nB. 化学疗法\nC. 手术切除\nD. 中医中药\nE. 免疫疗法", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊炎的发病机制中，以下哪项不是其常见病因？", "options": "A. 胆囊管阻塞导致胆汁滞留\nB. 病原体通过淋巴系统传播\nC. 病原体通过血液循环传播\nD. 肝炎直接侵犯胆囊\nE. 胆管炎症蔓延至胆囊", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位47岁女性患者因餐后上腹痛伴恶心、呕吐2小时入院。体检显示体温38℃，呼吸23次/分，脉搏98次/分，右上腹墨菲氏征阳性。B超检查发现胆囊腔内有一2.3cm的强回声光团，随体位改变而移动，胆总管直径为1.2cm，其他未见明显异常。初步治疗方案应考虑", "options": "A. 腹腔镜胆囊切除\nB. 开腹胆囊切除\nC. 胆总管切开取石\nD. 保守治疗\nE. 中药治疗", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，哪种影像学检查方法被认为是诊断肝癌和微小肝癌的金标准？", "options": "A. 超声检查\nB. 甲胎蛋白检查\nC. 腹腔镜检查\nD. CT扫描\nE. 肝穿刺活检", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下选项中，哪一项不是ERCP（逆行性胰胆管造影）的适应证？", "options": "A. 胰腺癌\nB. 急性胰腺炎\nC. 胆管癌\nD. 胆管结石\nE. 乳头炎性狭窄", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种情况最可能导致槟榔肝的发生？", "options": "A. 酒精性肝硬化\nB. 胆汁性肝硬化\nC. 门脉性肝硬化\nD. 慢性肝淤血\nE. 坏死性肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎患者的饮食管理中，每日蛋白质摄入量应控制在什么范围内？", "options": "A. 10～20g\nB. 20～50g\nC. 50～70g\nD. 70～100g\nE. 100～150g", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名20岁男性患者，近一周出现发热、食欲减退、厌油、恶心、呕吐、尿黄，黄疸急剧加深，凝血酶原活动度为35％。近两天出现嗜睡、烦躁不安，伴有牙龈出血和皮下瘀斑。肝脾未扪及。血清学标志物检测显示HBV感染标志，且HBV-DNA阳性。除其他治疗外，可进行抗病毒治疗，首选的抗病毒药物是", "options": "A. 干扰素\nB. 拉米呋啶\nC. 病毒唑\nD. 阿昔洛韦\nE. 强的松", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰源性溃疡的诊断和治疗，以下哪项陈述是不正确的？", "options": "A. 胰源性溃疡通常与胰腺非B细胞瘤相关\nB. 该病症有时由胰岛和胃窦部G细胞增生引起\nC. 大多数胰岛细胞瘤为恶性\nD. 患者的基础酸分泌量（BAO）通常超过15mmol/h，且BAO与最大酸分泌量（MAO）的差异减小\nE. 夜间胃液量超过1升且酸量超过100mmol具有诊断意义", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脓肿的治疗中，以下哪种情况不是肝叶切除术的适应症？", "options": "A. 肝脓肿切开引流后脓壁不塌陷者\nB. 慢性厚壁肝脓肿者\nC. 留有无效腔或窦道长期流脓不愈者\nD. 脓肿腔内脓液特别黏稠者\nE. 肝内胆管结石合并左外叶多发性脓肿，肝组织已破坏失去功能者", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性重症胆管炎的治疗中，以下哪项措施是首要的？", "options": "A. 急症手术行胆总管引流\nB. 急症手术行腹腔引流\nC. 胆囊切除\nD. 胆囊造瘘\nE. 给予解痉止痛", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名42岁男性患者，HBsAg阳性已有8年，ALT水平时有升高。近3周出现食欲减退、明显乏力、尿色深黄及齿龈出血。近2周尿量减少，查体发现神志清楚，扑翼样震颤阳性。实验室检查显示ALT为170U/L，血清总胆红素为431μmol/L，PT为38秒（对照13秒）。最可能的诊断是？", "options": "A. 病毒性肝炎乙型亚急性重型\nB. 病毒性肝炎乙型慢性重型\nC. 病毒性肝炎乙型慢性重度\nD. 乙肝后肝硬化\nE. 病毒性肝炎乙型慢性中度", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的治疗中，哪种分流术式在显著降低门静脉压力的同时，也导致肝性脑病的发生率最高？", "options": "A.脾肾静脉分流术\nB.门腔静脉分流术\nC.脾腔静脉分流术\nD.肠系膜上，下腔静脉分流术\nE.下腔静脉与肠系膜上静脉之间'桥式'吻合术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，有20年的慢性肝炎病史。5年前被诊断为食管黏膜下静脉曲张，3个月前在肝右叶发现一个拳头大小的肿物，且甲胎蛋白检测呈阳性。根据这些信息，最可能的诊断是__", "options": "A. 慢性肝炎\nB. 慢性肝炎伴肝硬化\nC. 慢性肝炎伴胆管上皮癌\nD. 慢性肝炎伴食管静脉曲张\nE. 肝硬化伴肝细胞性肝癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位46岁男性患者，长期患有慢性肝病，在常规体检中发现甲胎蛋白（AFP）水平高达800μg/L。为了进一步诊断，首先应进行哪项检查？", "options": "A. 选择性肝动脉造影\nB. 肝脏核素扫描\nC. 腹部平片\nD. 腹部（肝脏）B超或CT\nE. 腹腔镜探查术", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位31岁男性患者因发热和肝区疼痛前来就诊。超声检查显示肝脏肿大，右肝内发现一个6.0cm×5.5cm的椭圆形占位性病变，边界清晰、光滑，内部呈现低回声，肿物后方回声显著增强，并可见侧边声影。根据这些超声特征，最可能的诊断是什么？", "options": "A. 肝囊肿\nB. 肝实质性肿瘤\nC. 肝囊肿合并出血\nD. 肝囊肿合并感染\nE. 肝囊腺瘤", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝豆状核变性患者中，起病较早者主要受累的器官是哪个？", "options": "A. 神经系统损害\nB. 肝脏损害为主\nC. 急性溶血病\nD. 裂隙灯下可见角膜边缘的K-F环\nE. 肾小管性酸中毒", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位29岁男性患者因肝脓肿破裂导致弥漫性腹膜炎，表现为面色苍白、肢体湿冷、脉搏122次/分、血压80/60mmHg、尿量减少、血pH7.29。在以下治疗措施中，哪一项是不正确的？", "options": "A. 输液补充血容量\nB. 联合应用抗菌药物\nC. 纠正酸中毒\nD. 手术引流感染灶\nE. 大量多次应用氢化可的松", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性坏死性胰腺炎的诊断中，以下哪些实验室检查结果通常会显示异常？", "options": "A. 空腹血糖升高\nB. 血、尿淀粉酶均升高\nC. 血钙升高\nD. 血钾增高\nE. 血清脂肪酶早期升高", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，用于诊断肝细胞癌的特定生物标志物是哪个？", "options": "A. CEA\nB. AFP\nC. PSA\nD. CA19-9", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位38岁女性患者，近3年来反复出现右上腹疼痛。1天前因摄入油腻食物后腹痛加剧，伴有高热39.2℃，疼痛向右肩背部放射，无黄疸，急诊入院。体检发现右上腹压痛及反跳痛。该患者最可能的诊断是什么？", "options": "A.急性胰腺炎\nB.肝脓肿\nC.急性胆囊炎、胆囊结石\nD.急性梗阻性化脓性胆管炎\nE.壶腹部肿瘤\nF.十二指肠溃疡", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化门静脉高压的患者中，以下哪项症状通常不会出现？", "options": "A. 脾脏肿大\nB. 腹部积液\nC. 胸腔积液\nD. 腹壁静脉扩张\nE. 下肢水肿", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断过程中，以下哪项关于实验室检查的描述是不正确的？", "options": "A. 血清脂肪酶测定对于延迟就诊的患者具有重要的诊断意义\nB. 血清淀粉酶水平的高低直接反映了病情的严重程度\nC. 低血钙的程度与临床病情的严重程度呈正相关\nD. CRP（C反应蛋白）是组织损伤和炎症的非特异性标志物\nE. 淀粉酶在胰源性腹水和胸腔积液中的水平也会显著升高", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺的自体消化过程中，以下哪一项不属于该过程？", "options": "A. 脂肪酶分解中性脂肪\nB. 胶原酶溶解胶原纤维\nC. 淀粉酶水解淀粉\nD. 磷脂酶A将卵磷脂转化为溶血卵磷脂\nE. 弹力纤维酶损害血管壁", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁女性患者，有胆囊炎、胆结石及胰腺炎病史。超声检查显示胰腺区有一约9.2cm×3.6cm的不均质回声，形态不规则，边界可见，并在胰头部发现一个5.0cm×5.5cm的囊性暗区，形态规则，边界尚清，壁厚薄不均。为了确诊，应选择哪种检查方法？", "options": "A. CT\nB. MRI\nC. PET\nD. 血常规\nE. 尿常规", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脓肿的超声检查中，以下哪种表现最为罕见？", "options": "A.病变呈不均匀的低至中等回声区，边界模糊，似肝脏恶性肿瘤\nB.囊壁厚而不光滑\nC.囊壁薄而光滑\nD.囊内不规则低回声，可随体位改变出现光点漂浮现象\nE.囊壁可有钙化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的临床过程中，以下哪些并发症可能发生？", "options": "A. 腹膜炎\nB. 肝脓肿\nC. 中毒性休克\nD. 盆腔脓肿\nE. 胆道出血", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位女性患者被诊断为肝硬化失代偿期，伴有大量腹水。以下哪个体征与腹水无关？", "options": "A. 脐疝\nB. 振水音\nC. 移动性浊音\nD. 蛙腹状\nE. 液波震颤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在佐林格-埃利森综合征的诊断中，以下哪项生化指标通常会显著升高？", "options": "A. 胰酶\nB. 胰岛素\nC. 胃泌素\nD. 胰高血糖素\nE. 生长抑素", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位46岁女性患者，突发上腹痛14小时，伴有频繁呕吐胃内容物，疼痛呈阵发性加剧并向右肩放射，2小时后出现发热和腹胀，无寒战或腹泻。患者有5年的上腹饱胀史，曾按“胃痛”治疗，症状偶有缓解。体检显示体温38.5℃，心率101次/分，血压95/40mmHg，呼吸23次/分。心肺检查无异常，腹部明显膨胀，上腹有压痛，肝脾未触及，腹部无移动性浊音。根据这些信息，最可能的诊断是什么？", "options": "A.急性心肌梗死\nB.急性胃肠炎\nC.食管裂孔疝\nD.急性胰腺炎\nE.胆石症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位70岁男性患者，主诉上腹部疼痛已持续1年，进食后症状加重，每日排便次数达10次，且粪便中可见脂肪滴。体检发现上腹中部有压痛。腹部B超显示胰腺存在多发钙化灶。针对此情况，应给予的药物是", "options": "A.胰酶制剂\nB.质子泵抑制剂\nC.钙通道阻滞剂\nD.H2受体拮抗剂\nE.抗胆碱药物", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，诊断胆道蛔虫病的关键依据是什么？", "options": "A.上腹部阵发性“钻顶样”剧痛与体征不符合\nB.十二指肠引流液镜检有虫卵\nC.钡餐检查十二指肠内有条带状虫影\nD.静脉胆道造影术胆总管内显示虫体阴影\nE.胃液引流查到蛔虫卵", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的影像学检查中，增强扫描的主要目的是什么？", "options": "A.观察胰腺与脾静脉的关系\nB.判断有无胰腺坏死灶及其范围，推断病变的程度\nC.观察胰腺与结肠肝曲及脾曲的关系\nD.观察胰腺与肾前筋膜的关系\nE.观察胰腺与十二指肠的关系", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌患者中，以下哪组症状最为常见？", "options": "A.腹痛、黄疸和消瘦\nB.黄疸、消瘦和腹胀\nC.腹痛、黄疸和上腹包块\nD.黄疸、消瘦和上腹包块\nE.腹痛、黄疸和呕吐", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪些临床表现与肝功能不全相关？", "options": "A. 蜘蛛痣\nB. 海蛇头\nC. 肝细胞性黄疸\nD. 男性乳房发育\nE. 出血倾向", "answer": "ACDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化患者的实验室检查结果时，以下哪项指标最能反映肝功能的损害程度？", "options": "A. ALT升高\nB. 白蛋白下降及A/G比值倒置\nC. 胆红素增高\nD. ALP升高", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位26岁男性患者，右上腹反复发作性疼痛已有10年。最初按胃炎治疗，钡餐检查未见异常。ERCP检查显示胰管无扩张、无结石、无充盈缺损，但胆总管及左肝管扩张，并可见多个充盈缺损。最可能的诊断是什么？", "options": "A. 慢性胰腺炎\nB. 胰腺结石\nC. 胰腺癌\nD. 胆管癌\nE. 胆总管及左肝管结石", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊切除手术中，以下哪种情况不适合进行胆总管探查？", "options": "A. 胆总管有扩张\nB. 曾有梗阻性黄疸史\nC. 胆囊水肿\nD. 术中胆管造影示胆管结石\nE. 胆总管触到结石", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，在饱餐后出现上腹部剧烈疼痛6小时，伴有恶心和呕吐，呕吐物为胃内容物，呕吐后腹痛加剧，呈刀割样。体检显示体温37.8℃，脉搏124次/分钟，血压80/50mmHg，患者表情痛苦，腹部膨胀，全腹肌紧张，压痛和反跳痛明显，以上腹部最为显著，肠鸣音消失，肝浊音区存在，右下腹穿刺得到淡红色血性液体。实验室检查显示白细胞计数为12×10^9/L，血淀粉酶320温氏单位，血钙1.5mmol/L。最可能的诊断是什么？", "options": "A.胆囊穿孔，弥漫性腹膜炎\nB.急性胃炎\nC.急性出血性坏死性胰腺炎\nD.溃疡病穿孔，弥漫性腹膜炎\nE.急性绞窄性肠梗阻", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位中年女性患者，出现明显黄疸和皮肤瘙痒症状已持续1个月，无明显腹胀和食欲减退，但感到轻度乏力。实验室检查显示血清ALT为80u/L，ALP为1600u/L，r-GT为600u/L。肝胆超声波检查结果显示肝内外胆管未见明显扩张，肝脏大小正常。根据这些信息，最可能的诊断是什么？", "options": "A. 急性黄疸型肝炎\nB. 原发性肝癌\nC. 淤胆型肝炎\nD. 胆汁性肝硬化\nE. 肝外阻塞性黄疸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位32岁的女性农民在劳动中突然出现上腹部剧烈疼痛，疼痛迅速扩散至整个腹部，伴有腹膜刺激症状，肝浊音界消失，腹部呈舟状。最可能的诊断是", "options": "A. 阑尾炎穿孔，弥漫性腹膜炎\nB. 宫外孕破裂\nC. 绞窄性肠梗阻\nD. 溃疡病穿孔\nE. 急性出血性胰腺炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下关于胆汁酸的描述中，哪一项是不正确的？", "options": "A. 在肝脏中由胆固醇合成\nB. 作为乳化剂促进脂类的吸收\nC. 抑制胆固醇结石的形成\nD. 可代谢转变为胆色素\nE. 通过肠肝循环被重吸收", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，Mirizzi综合征的主要病理机制是什么？", "options": "A.胆囊结石排入小肠引起肠梗阻\nB.胆囊结石进入胆总管嵌顿于壶腹部引起胰腺炎\nC.胆囊结石压迫导致胆囊十二指肠瘘\nD.胆囊结石引起肝总管狭窄或胆囊胆管瘘\nE.胆囊结石引起胆囊癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，若门静脉内发现栓子，最需要排除的肝癌类型是", "options": "A. 巨块型肝癌\nB. 结节型肝癌\nC. 弥漫型肝癌\nD. 原发性小肝癌\nE. 转移性肝肿瘤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估患者是否患有重症胰腺炎时，以下哪项临床表现最不可能出现？", "options": "A. 四肢厥冷\nB. 腹膜刺激征\nC. 血钙水平低于2mmol/L\nD. 血糖水平超过11.2mmol/L（无糖尿病病史）\nE. 肠鸣音亢进", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎患者的营养支持疗法中，以下哪项是不正确的？", "options": "A.选择回肠内喂养要素膳最好\nB.选择以游离氨基酸为氮源的要素膳\nC.选择以短肽为氮源的要素膳\nD.膳食中脂肪含量应该较低\nE.选择含中链甘油三酯的配方", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "李某，女，45岁。因长期慢性肝炎导致肝硬化入院治疗。下列哪一项体征与肝硬化引起的肝功能减退无关？", "options": "A. 肝掌\nB. 腹水\nC. 杵状指\nD. 蜘蛛痣\nE. 皮下出血", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁女性患者，长期患有乙肝超过10年，并在2年前被诊断为肝硬化。她经常出现牙龈出血和鼻出血的症状。这些出血症状的主要原因是什么？", "options": "A. 维生素K缺乏\nB. 血小板功能不良\nC. 凝血因子合成障碍\nD. 毛细血管脆性增加\nE. 毒素破坏血小板功能", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，夏科(Charcot)三联症是以下哪种疾病的典型表现？", "options": "A. 急性胰腺炎\nB. 急性胆管炎\nC. 急性十二指肠憩室炎\nD. 急性胃炎\nE. 急性胆囊炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性重型病毒性肝炎中，主要的肝细胞坏死类型是哪种？", "options": "A.点状坏死\nB.桥接坏死\nC.碎片状坏死\nD.大片坏死\nE.灶性坏死", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者，晚餐后突然出现上腹部剧烈疼痛，迅速扩散至全腹，无法直立行走，2小时后急诊就诊。患者呈急性痛苦面容，腹式呼吸消失，腹肌紧张，腹膜刺激征阳性，肝浊音界消失，肠鸣音消失。最可能的诊断是什么？", "options": "A. 阑尾炎穿孔\nB. 溃疡病穿孔\nC. 胆囊穿孔\nD. 绞窄性肠梗阻\nE. 急性胰腺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性坏死性胰腺炎患者中，以下哪些因素可能导致休克的发生？", "options": "A.体液丧失\nB.心肌抑制因子\nC.胰蛋白酶\nD.血小板破坏、组织坏死或感染毒素\nE.肾功能衰竭", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在治疗肝性脑病患者时，为何不推荐使用肥皂水进行灌肠？", "options": "A. 可以减少氨的产生和吸收\nB. 肥皂水易引起腹胀\nC. 可以防止发生酸中毒\nD. 肥皂水易造成肠穿孔\nE. 可以防止发生水肿", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名50岁女性患者因车祸导致腹部外伤，2小时后就诊。查体显示患者意识清醒，血压为95/65mmHg，上腹部有轻度压痛，但无反跳痛和肌紧张。左右下腹诊断性腹腔穿刺结果均为阴性。腹部X线检查发现腰大肌轮廓模糊，腹膜后呈现花斑状改变。根据这些信息，最可能的诊断是", "options": "A. 肝脏损伤\nB. 胃损伤\nC. 横结肠损伤\nD. 小肠破裂\nE. 肾脏损伤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在腹部平片中，胆囊结石的显示率通常为多少？", "options": "A. 0.1\nB. 0.15\nC. 0.2\nD. 0.5\nE. 0.8", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断和监测中，血清淀粉酶水平是一个关键指标。请问，血清淀粉酶水平通常在发病后多长时间达到高峰？", "options": "A. 4小时\nB. 8小时\nC. 12小时\nD. 24小时\nE. 48小时", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆总管囊性扩张症的分类中，Ⅲ型具体指的是哪种情况？", "options": "A.胆总管扩张呈囊状、柱状或纺锤状\nB.局限于肝内胆管的多发囊状扩张（Caroli病）\nC.胆总管十二指肠壁内段囊状膨出\nD.胆总管单发憩室样扩张\nE.多发性胆管囊肿，位于肝内外或肝外", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者，过去5年反复出现乏力、食欲减退和肝脾肿大，多次检测HBsAg阳性，血清ALT水平在50～300u/L之间波动。最近10天因劳累后感到极度乏力、食欲不振、腹胀，皮肤黄染明显加深。血总胆红素为342umol/L，血清ALT为90u/L，凝血酶原活动度为40%。入院后出现出血倾向和腹水。此例最可能的诊断是？", "options": "A.急性重症肝炎\nB.亚急性重症肝炎\nC.慢性重症肝炎\nD.瘀胆型肝炎\nE.肝炎后肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁男性患者，近3个月来出现进行性黄疸，伴有中上腹持续性胀痛，夜间平卧时疼痛加重，体重明显下降。体检发现患者呈慢性消耗性面容，皮肤和巩膜黄染，腹部平坦，Courvoisier征阳性。最可能的诊断是", "options": "A. 肝门部胆管癌\nB. 壶腹癌\nC. 原发性肝癌\nD. 胃癌\nE. 胰头癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估慢性胰腺炎时，以下哪种影像学检查方法被认为是最具诊断价值的？", "options": "A. 腹部X线平片\nB. 计算机断层扫描（CT）\nC. 磁共振胰胆管成像（MRCP）\nD. 内镜逆行胰胆管造影（ERCP）\nE. 内镜超声", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在中医治疗中，针对肝硬化湿热蕴脾证，下列哪个方剂组合是最具代表性的？", "options": "A.柴胡疏肝散合胃苓汤加减\nB.实脾饮加减\nC.中满分消丸合茵陈蒿汤加减\nD.调营饮加减\nE.附子理中汤合五苓散加减", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆囊癌的描述，以下哪一项是错误的？", "options": "A.胆囊癌是胆道系统中最常见的恶性肿瘤\nB.早期通常无症状，多见于中老年人群\nC.男性发病率显著高于女性，男女比例约为3:1\nD.肿瘤多发生于胆囊底部或颈部\nE.70%至90%的病例为腺癌，少数为鳞癌，其中80%呈浸润性生长，20%呈乳头状生长", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位长期在牧区生活的患者，通过超声检查发现肝右叶有一个8cm×10cm的无回声包块，囊壁厚且外壁光滑整齐，囊内可见多个大小不等的圆形无回声小囊。根据这些表现，最可能的诊断是什么？", "options": "A. 阿米巴肝脓肿\nB. 肝包虫囊肿\nC. Caroli病\nD. 肝血肿\nE. 肝囊肿分隔型", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名10岁男孩突然出现剑突下剧烈绞痛，疼痛呈钻顶样，持续1小时，伴有辗转不安。体检发现腹肌柔软，右上腹部有轻微压痛。最可能的诊断是", "options": "A.急性胆囊炎\nB.胆道蛔虫病\nC.胆总管结石\nD.急性胰腺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏的解剖结构中，尾状叶的具体位置是哪里？", "options": "A. 肝前的下面\nB. 肝后的下面\nC. 肝前的上面\nD. 肝后的上面\nE. 肝右叶内", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，67Ga肿瘤显像技术常用于诊断哪些类型的肿瘤？", "options": "A. 恶性黑色素瘤\nB. 淋巴瘤\nC. 肝细胞癌\nD. 肺癌\nE. 肾癌", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者因腹腔积液就诊，体检发现腹壁稍紧张，轻压痛，肝脾未触及，无颈静脉怒张，心界不大，心率90次/分，律齐，无杂音，血压15/9kPa，呼吸音正常。实验室检查显示Hb为100g/L，白细胞9.8×10^9/L，中性70%，GPT50U。血总蛋白52g/L，清/球蛋白23/30。腹腔积液常规检查显示浅黄色，比重1.018，Rivalta试验阳性，细胞数为560×10^6/L，淋巴细胞占74%。最可能的诊断是？", "options": "A.肝硬化并肝癌\nB.肝硬化并结核性腹膜炎\nC.肝硬化并自发性腹膜炎\nD.原发性肝癌腹膜转移\nE.腹膜恶性肿瘤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门静脉高压症的外科治疗中，主要目的是什么？", "options": "A. 紧急制止食管胃底曲张静脉破裂的大出血\nB. 改善肝功能，提高血浆蛋白\nC. 缓解脾功能亢进\nD. 消除腹水\nE. 以上都是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者因大量腹水入院，开始接受利尿治疗。以下哪项指标最能敏感地反映治疗效果？", "options": "A. 血钾\nB. 腹围\nC. 体重变化\nD. 尿量\nE. 血钠", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下选项中，哪一项是导致肝内型门静脉高压的主要原因？", "options": "A. 门静脉畸形\nB. Budd-Chiari综合征\nC. 肝门区肿瘤压迫\nD. 血吸虫病性肝硬化\nE. 肝外门静脉血栓形成", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，以下哪种病毒感染与肝癌的发生密切相关？", "options": "A. HPV\nB. EB病毒\nC. HBV\nD. 腺病毒\nE. 疱疹病毒", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的治疗中，以下哪项措施是不正确的？", "options": "A. 禁止蛋白质饮食的摄入\nB. 躁动不安时禁用吗啡类药物\nC. 口服甲硝唑\nD. 肥皂水灌肠\nE. 给予支链氨基酸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病患者中，血浆支链氨基酸水平下降的主要原因是什么？", "options": "A.肝脏对胰高血糖素的灭活能力下降\nB.肝脏对糖皮质激素的灭活能力下降\nC.肝脏对胰岛素的灭活能力下降\nD.肝脏对肾上腺素的灭活能力下降\nE.肝脏对甲状旁腺激素的灭活能力下降", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名12岁患者，近两个月出现书写困难和构音障碍。体检发现表情呆板、流涎、肢体震颤，双上肢肌张力增高，角膜可见K-F环，肝功能异常，尿蛋白阳性。针对此情况，最重要的治疗措施是什么？", "options": "A. 限制铜的摄入\nB. 护肝治疗\nC. 青霉胺、硫酸锌等药物治疗\nD. 输注白蛋白\nE. 左旋多巴减轻震颤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于疑似胆石症的患者，以下哪种影像学检查方法应作为首选？", "options": "A. 腹部CT\nB. 腹部超声\nC. 腹部平片\nD. 腹部MRI\nE. ERCP", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下选项中，哪一项不被认为是急性胰腺炎的诱因或易感因素？", "options": "A. 中年\nB. 男性\nC. 胆道疾病\nD. 暴饮暴食\nE. 吸烟", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床检查中，Murphy征阳性最常提示以下哪种疾病？", "options": "A. 急性胃炎\nB. 急性胰腺炎\nC. 急性胆囊炎\nD. 急性阑尾炎\nE. 急性胃穿孔", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在出血坏死性胰腺炎的病理变化中，以下哪项不属于其典型特征？", "options": "A. 胰腺间质充血和水肿\nB. 胰腺间质单核细胞浸润\nC. 胰腺组织大面积坏死\nD. 胰腺腺泡和胰腺组织萎缩、消失，伴有纤维化", "answer": "AD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "以下哪种病毒与肝细胞癌的发生有直接关联？", "options": "A. 人乳头瘤病毒\nB. 幽门螺旋杆菌\nC. 乙肝病毒\nD. EB病毒\nE. 丙肝病毒", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝脏疾病患者时，下列哪种抗菌药物应避免使用？", "options": "A. 林可霉素\nB. 氯霉素\nC. 庆大霉素\nD. 美洛西林\nE. 阿托品", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在CT影像中，胰腺癌最直接和主要的特征表现是什么？", "options": "A. 胰腺局部增大、肿块形成\nB. 胰管阻塞\nC. 胆总管阻塞\nD. 肿瘤侵犯胰腺周围脏器\nE. 肿瘤侵犯胰腺周围血管", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于甲胎蛋白（AFP）与肝癌的关系，以下哪种说法是正确的？", "options": "A. 甲胎蛋白阴性可以排除原发性肝细胞癌\nB. 甲胎蛋白阳性可以确诊为原发性肝细胞癌\nC. 原发性胆管细胞癌患者通常甲胎蛋白阳性\nD. 继发性肝癌患者血清甲胎蛋白通常为阴性\nE. 肝炎后肝硬化、酒精性肝硬化和胆汁性肝硬化患者都容易发展为肝癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，为了区分阿米巴性肝脓肿和细菌性肝脓肿，哪项检查方法被认为是最具诊断价值的？", "options": "A. 血液学检查\nB. 脓肿穿刺\nC. CT扫描\nD. B超检查", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在全胰切除术后，患者最可能面临以下哪种健康问题？", "options": "A. 糖尿病\nB. 高钙血症\nC. 高磷血症\nD. 便秘\nE. 体重增加", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的临床表现中，哪一项描述是不正确的？", "options": "A. 进食高脂肪食物后易诱发症状\nB. 右上腹出现持续性疼痛，并伴有阵发性加剧\nC. 疼痛通常向右侧肩部或背部放射\nD. 检查时墨菲征呈阳性反应\nE. 大多数患者会出现黄疸症状", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，突然出现寒战、高热，右上腹疼痛，体温在39～40℃之间，呈弛张热。体检发现肝脏肿大，右上腹有触痛并伴有肌紧张。实验室检查显示白细胞增高，核左移。胸腹部透视显示右膈升高，运动受限。超声检查发现液平，放射性核素扫描显示肝占位病变，穿刺得到黄白色脓液。若需与阿米巴肝脓肿进行鉴别，以下哪项描述是正确的？", "options": "A. 细菌性肝脓肿通常为单发，体积较大\nB. 阿米巴肝脓肿起病急骤，伴有寒战和高热\nC. 阿米巴肝脓肿较少见，多为多发性\nD. 阿米巴肝脓肿的脓液呈褐色，无臭味\nE. 阿米巴肝脓肿患者的粪便中可检测到阿米巴原虫", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝棘球蚴病的诊断中，以下哪一项不是其典型的临床表现？", "options": "A. 患者多为男性，且以青壮年为主\nB. 患者常有牧区工作或与牛羊接触的历史\nC. 病变通常为多发性，且常侵犯两肝\nD. 超声波检查显示包块为囊性\nE. 皮内过敏试验结果通常为阳性", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者在与朋友聚会时过量饮食并饮酒，随后出现剧烈腹痛、恶心和呕吐症状，被紧急送往医院后诊断为急性胰腺炎。请问导致该病最可能的原因是什么？", "options": "A. 大肠埃希菌\nB. 免疫反应\nC. 结核分枝杆菌\nD. 幽门螺杆菌\nE. 自体消化", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "对于肝硬化并发严重腹水的患者，在制定饮食方案时应特别注意以下哪项？", "options": "A. 限制钠盐摄入\nB. 控制脂肪摄入\nC. 减少蛋白质摄入\nD. 增加蛋白质摄入\nE. 提高热量摄入", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位35岁男性患者，在饮酒后出现上腹疼痛，伴有恶心和腹胀症状。实验室检查显示血、尿淀粉酶水平均超过1000U，且疼痛向腰背部放射。根据这些临床表现，最可能的诊断是什么？", "options": "A. 慢性阑尾炎\nB. 急性阑尾炎\nC. 慢性胰腺炎\nD. 急性胰腺炎\nE. 急性肠梗阻", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名42岁男性患者，主诉右季肋区隐痛、食欲减退3个月，伴有间歇性低热和体重减轻约3kg。体检发现肝肋下2cm可触及，质地中等，无结节。影像学检查显示右膈外侧抬高且运动受限，B超发现右肝有5cm×3cm的实质性暗区。实验室检查显示HBsAg阳性，AFP水平升高至400μg/ml，ALT为50U/L。根据这些信息，确诊后应首选哪种治疗方案？", "options": "A. 内科保守治疗\nB. 放射介入治疗\nC. 及时手术治疗\nD. 足量放疗\nE. 积极化疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌的诊断中，以下哪种肿瘤标志物最为重要？", "options": "A. CEA\nB. AFP\nC. TSA\nD. CTA\nE. PSA", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者出现血性腹水，但没有腹痛和发热的症状，最可能的诊断是什么？", "options": "A. 结核性腹膜炎\nB. 原发性肝癌\nC. 门静脉血栓形成\nD. 肝-肾综合征\nE. 自发性腹膜炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的病因中，高三酰甘油血症的诊断标准是血三酰甘油水平应达到多少？", "options": "A.大于2.3mmol/L\nB.达到正常上限的3倍\nC.大于11.0mmol/L\nD.大于20.0mmol/L\nE.达到正常上限的3倍，伴血胆固醇升高", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于隐性肝性脑病病人的临床特点，以下哪项描述最准确？", "options": "A. 轻度性格改变\nB. 轻度行为改变\nC. 应答尚准确，但吐字稍缓慢\nD. 可有扑翼样震颤\nE. 无任何临床表现", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性梗阻性化脓性胆管炎的诊断中，以下哪项是最具特征性的临床表现？", "options": "A. 右上腹阵发性绞痛\nB. 胆囊肿大压痛\nC. 墨菲征阳性\nD. 雷诺五联征阳性\nE. 夏柯三联症阳性", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝昏迷患者时，若患者出现抽搐症状，下列哪种药物是最佳选择？", "options": "A. 氯丙嗪\nB. 吗啡\nC. 副醛\nD. 安定\nE. 硫喷妥钠", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的发病机制中，以下哪项因素通常不被认为是主要风险因素？", "options": "A. 乙型病毒肝炎\nB. 游血性肝硬化\nC. 酒精\nD. 黄曲霉素\nE. 华支睾吸虫感染", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，用于确诊细菌性肝脓肿的首选影像学检查方法是", "options": "A. 腹部X线平片\nB. 超声检查\nC. 计算机断层扫描\nD. 血常规分析\nE. 血液细菌培养", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在血清蛋白质醋酸纤维素薄膜电泳中，观察到β-γ桥现象，这最常与以下哪种疾病相关？", "options": "A. 急性肝炎\nB. 胆囊炎\nC. 肾病综合征\nD. 肝硬化\nE. 急性肾小球肾炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的病例中，最常见的致病菌侵入途径是哪个？", "options": "A. 门静脉\nB. 肝总动脉\nC. 肝静脉\nD. 肝血管\nE. 胆道系统", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，胆总管损伤后，T管的放置时间应满足以下哪项要求？", "options": "A. 放置T管时间至少2周\nB. 放置T管时间至少2个月\nC. 放置T管时间至少半年\nD. 无时间限制\nE. 以上都不正确", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌患者的介入栓塞化疗术中，哪种栓塞剂是最常用的？", "options": "A. NBCA胶\nB. 38%碘化油\nC. 40%碘苯酯\nD. 60%泛影葡胺\nE. 40%Gd-DTPA", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性肝功能衰竭的患儿中，营养支持策略应如何调整？", "options": "A.以碳水化合物为主提供足够热卡，限制脂肪摄入和减少蛋白质的供给\nB.以碳水化合物为主提供足够热卡，限制脂肪摄入和增加蛋白质的供给\nC.若患儿能进食，可以牛奶喂养以增加热卡\nD.静脉中应减少蛋白质的输入，增加支链氨基酸的输入\nE.每天的热卡不低于60kJ/kg", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞癌的治疗中，以下哪种介入方式是不正确的？", "options": "A. 经动脉栓塞术（TAE）\nB. 经皮腔内血管成形术（PTA）\nC. 经动脉灌注化疗（TAI）\nD. 微波消融治疗\nE. 门静脉化疗栓塞", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行静脉胆道造影术时，胆管显影达到最清晰状态的时间点是（）。", "options": "A. 30分钟\nB. 60分钟\nC. 90分钟\nD. 120分钟\nE. 150分钟", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在多发性内分泌综合征中，若患者被怀疑为MENI型，以下哪个腺体最可能受到影响？", "options": "A. 胰腺\nB. 甲状腺\nC. 甲状旁腺\nD. 垂体\nE. 肾上腺", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于胆囊的功能和结构，以下哪项描述是不正确的？", "options": "A. 可贮存、浓缩和分泌胆汁\nB. 位于胆囊窝内\nC. 分底、体、颈、管四个部分\nD. 胆囊底的体表投影在右锁骨中线与右肋弓相交处\nE. 胆囊管、肝总管和肝的脏面围成胆囊三角", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化患者的肝功能损害时，以下哪项指标最能反映肝实质的损害程度？", "options": "A. 胆固醇降低\nB. 血清胆红素增加\nC. 白蛋白合成减少或(及)凝血酶原时间延长\nD. BSP潴留大于10%(45分钟)\nE. 血氨升高", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种胆汁酸属于次级胆汁酸？", "options": "A. 甘氨石胆酸\nB. 牛磺石胆酸\nC. 鹅脱氧胆酸\nD. 牛磺脱氧胆酸", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位46岁男性患者，有10余年的“慢性肝炎”病史。20小时前因进食烙饼后出现呕血约200ml，随后排黑便约100ml，2小时前出现意识障碍，无法识别家人。在治疗过程中，以下哪项措施是错误的？", "options": "A.静脉点滴支链氨基酸\nB.肥皂水灌肠清除积血\nC.硫酸镁导泻\nD.静脉输入止血芳酸\nE.限制蛋白饮食", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名12岁男孩突然出现阵发性右上腹剧烈疼痛，伴有恶心和呕吐，症状有时会突然缓解，但可能反复发作，持续时间不定。体检显示体温正常，巩膜无黄染，腹部无肌紧张。根据这些症状，最可能的诊断是什么？", "options": "A. 急性胆囊炎\nB. 急性胰腺炎\nC. 肝脓肿\nD. 胆道蛔虫病\nE. 胆道出血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床实践中，异位胰腺最常被发现的位置是哪个部位？", "options": "A. 胃\nB. 十二指肠\nC. 空肠\nD. 回肠\nE. 食管", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胆囊炎的临床表现中，以下哪一项不属于典型症状？", "options": "A. 右腰背部隐痛\nB. 腹胀\nC. 胆绞痛病史\nD. 嗳气\nE. 畏寒高热，黄疸", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位35岁的女性患者，G1P1，诊断为肝硬化，建议她采用哪种避孕方法？", "options": "A. 口服避孕药\nB. 男用避孕套\nC. 放置宫内节育器\nD. 避孕贴剂\nE. 使用长效避孕针", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰岛细胞瘤的病理特征中，以下哪一项描述是不正确的？", "options": "A. 通常表现为单发性结节\nB. 可能具有包膜\nC. 肿瘤细胞排列成岛状、条索状或腺泡状\nD. 间质中富含血窦\nE. 根据HE染色细胞的形态特点，可将其分为6种不同类型", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁男性患者，患有乙肝小三阳2年，近期出现乏力、食欲减退、腹胀、水肿及尿黄症状1个月，入院后被诊断为肝炎后肝硬化。实验室检查显示肝功能显著异常，表现为白蛋白水平降低，球蛋白水平升高，白/球蛋白比例倒置，凝血功能指标正常。为纠正患者的低蛋白血症，应首选哪种血液制品进行治疗？", "options": "A. 全血\nB. 新鲜冰冻血浆\nC. 普通冰冻血浆\nD. 冷沉淀\nE. 白蛋白制剂", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎的患者中，以下哪一项症状通常不会出现？", "options": "A. 高脂饮食后上腹部疼痛，常向腰背部放射，呈束带状\nB. 食欲减退和体重减轻\nC. 脂肪泻\nD. 恶心和呕吐\nE. 胰岛素依赖性糖尿病", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于胆汁酸盐的功能和来源，以下哪项描述是正确的？", "options": "A. 它能够抑制胆固醇结石的形成\nB. 它在肝脏中由胆固醇转化而来\nC. 它作为一种乳化剂发挥作用\nD. 它可以通过肠肝循环被重吸收", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断中，以下哪项是区分水肿型胰腺炎和出血坏死型胰腺炎的关键指标？", "options": "A. 上腹剧痛向左腰背部放射\nB. 黄疸\nC. 发热\nD. Cullen征\nE. 呕吐", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁女性患者，因右上腹疼痛和黄疸就诊。CT平扫显示肝左内叶及右前叶密度减低，肝内胆管轻度扩张，胆囊未显影，局部可见与肝密度相似的软组织肿块影。根据这些影像学表现，最可能的诊断是", "options": "A. 急性胆囊炎\nB. 慢性胆囊炎\nC. 胆囊结石\nD. 肝癌\nE. 胆囊癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名14岁男性患儿，因身材矮小、长期面色苍白和乏力就诊。体检发现巩膜轻度黄染，脾脏在肋下5cm处可触及。该患者最可能出现的实验室检查异常是", "options": "A. 血清结合珠蛋白增高\nB. CD59阳性\nC. 血红蛋白尿\nD. 尿胆原排出增多\nE. 血红蛋白血症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，关于先天性胆总管囊肿的病因，以下哪些因素被广泛认为是主要原因？", "options": "A. 胆胰管连接部异常\nB. 胆总管远端神经节细胞发育异常\nC. 肝内胆管闭锁\nD. 胆道上皮增生不平衡\nE. 病毒感染", "answer": "ABDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在阿米巴肝脓肿的临床管理中，以下哪项并发症需要特别关注？", "options": "A. 继发细菌感染\nB. 脓肿破溃\nC. 肝脏出血\nD. 脓胸\nE. 心包积液", "answer": "ABDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在排除其他疾病后，以下哪项是诊断原发性肝癌的标准？", "options": "A. AFP大于500μg/L持续2周\nB. AFP大于500μg/L持续4周\nC. AFP大于200μg/L持续2周\nD. AFP大于200μg/L持续4周\nE. AFP大于200μg/L持续6周", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊炎的病因中，以下哪一项不应被包括？", "options": "A. 胆囊管梗阻，胆汁淤积\nB. 胆囊功能异常，排出障碍\nC. 致病菌经血行传播\nD. 肝炎累及胆囊\nE. 胆管炎症累及胆囊", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在病毒性肝炎的病理变化中，哪种类型的肝炎会表现出明显的碎片状坏死和桥接坏死？", "options": "A. 急性黄疸型肝炎\nB. 亚急性重型肝炎\nC. 慢性持续性肝炎\nD. 慢性活动性肝炎\nE. 急性重型肝炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于乙型肝炎患者的病情发展，以下哪项描述是不正确的？", "options": "A. 同时感染HDV等其他肝炎病毒会加重病情\nB. 重型肝炎患者常伴有细菌感染\nC. 乙型肝炎是导致肝细胞癌的主要原因\nD. 急性淤胆型肝炎容易发展为胆汁性肝硬化\nE. 成年人感染HBV后不易发展为慢性肝炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "根据以下超声图像，最可能的诊断是什么？", "options": "A. 肝硬化\nB. 肝转移癌\nC. 小肝癌\nD. 多发性肝囊肿\nE. 多发肝血管瘤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位22岁女性患者，有10年肝硬化病史。最近两天出现嗜睡症状，今晨测量体温时无法唤醒，无自主运动，对声音和光线刺激无反应。该患者的意识状态属于以下哪种？", "options": "A.嗜睡\nB.意识模糊\nC.昏睡\nD.定向力障碍\nE.昏迷", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的治疗中，酸化肠道的主要目的是什么？", "options": "A. 增加氨的排泄\nB. 减少氨的吸收\nC. 减少假性神经介质的释放\nD. 促进氨的转化\nE. 清除肠道感染", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪种情况需要患者采用低蛋白饮食？", "options": "A. 肝硬化腹水\nB. 急性肾炎\nC. 肾病综合征\nD. 心脏病\nE. 高热", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道系统的生理功能中，以下哪几项描述是正确的？", "options": "A. 胆囊每日可储存和浓缩胆汁约500ml\nB. 促胰液素是促进胆汁分泌的主要激素\nC. 毛细胆管在胆汁的流量和成分调节中发挥重要作用\nD. 肝细胞是胆汁的唯一来源", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，以下哪种疾病最常导致细菌性肝脓肿的发生？", "options": "A. 胆囊结石并发胆囊炎\nB. 坏疽性阑尾炎\nC. 胆结石并发化脓性胆管炎\nD. 下肢化脓性骨髓炎\nE. 开放性肝脏损伤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化失代偿期的患者中，以下哪种临床表现最为典型？", "options": "A. 水肿质地柔软且易于移动\nB. 水肿首先出现在眼睑，随后扩散至全身\nC. 主要由于水钠潴留引起\nD. 腹水是主要表现\nE. 常伴有淋巴回流障碍", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在增强CT扫描中，典型肝脓肿的壁呈现三层环状结构，其中哪一层在增强扫描时显示最明显的强化？", "options": "A. 水肿带\nB. 炎性坏死组织\nC. 纤维肉芽组织\nD. 脓肿内分隔\nE. 尚未坏死的肝组织", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病患者出现躁动不安症状时，以下哪种药物应避免使用？", "options": "A. 苯巴比妥钠\nB. 副醛\nC. 东莨菪碱\nD. 苯海拉明\nE. 地西泮（安定）", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于肾功能正常的肝病患者，在使用阿米卡星进行抗感染治疗时，应采取何种措施？", "options": "A. 属于禁忌证\nB. 谨慎使用\nC. 减量应用\nD. 尽可能避免使用\nE. 短期口服或静脉给药", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的不同类型中，哪一种主要表现为门静脉高压症状，而肝功能损害相对较轻？", "options": "A. 大结节性肝硬化\nB. 小结节性肝硬化\nC. 混合性肝硬化\nD. 不完全分隔性肝硬化（如血吸虫肝纤维化）\nE. 胆汁性肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者突然出现中上腹部剧烈的刀割样疼痛，最可能的诊断是什么？", "options": "A. 急性胃炎\nB. 急性胰腺炎\nC. 消化性溃疡穿孔\nD. 胆石症\nE. 急性弥漫性腹膜炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下肿瘤标志物中，与肝癌和骨肉瘤最相关的是", "options": "A. CEA（癌胚抗原）\nB. PSA（前列腺特异抗原）\nC. AKP（碱性磷酸酶）\nD. AFP（甲胎蛋白）\nE. HCG（绒毛膜促性腺激素）", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病症状显现之前，哪种检测方法能够早期发现该疾病？", "options": "A. 血氨\nB. 脑电图\nC. 诱发电位\nD. 空腹血糖\nE. 肝功能测试", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪项描述符合慢性肝炎的特征？", "options": "A. 病程持续半年以上\nB. 肝细胞碎片状坏死\nC. 肝细胞桥接坏死\nD. 肝细胞大片坏死", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性硬化性胆管炎的外科治疗中，以下哪项措施是不正确的？", "options": "A. 目的是引流胆汁，减轻肝脏损害\nB. 手术探查胆道时，需做活检\nC. 局限性狭窄者可行狭窄处扩张，放入支撑管引流\nD. 左或右半肝切除，引流胆汁\nE. 肝移植", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔镜胆囊切除术中，关于胆管损伤的描述，以下哪一项是错误的？", "options": "A. 将胆总管误认为胆囊管是一种常见的“典型”损伤\nB. 在肝右动脉周围进行电切、电凝或分离操作可能导致胆总管损伤\nC. 胆管撕裂伤后，通常可以进行单纯修补\nD. 胆管电热损伤后，胆瘘的发生率较高，且通常能及早发现\nE. 肝外胆管的解剖变异也是导致肝外胆管损伤的原因之一", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，大出血后易诱发肝性脑病，其主要机制是", "options": "A.失血导致脑组织缺氧\nB.失血引起脑出血\nC.失血造成休克\nD.肠道积血导致氨生成增加\nE.失血干扰脑代谢", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁的女性患者在胆道手术后进行了T管引流，计划在2周后拔管。在拔管前，医生建议先试行夹管1～2天。在此期间，医生应特别注意观察患者的哪些症状？", "options": "A. 饮食、睡眠\nB. 腹痛、发热、黄疸\nC. 大便的颜色\nD. 引流口有无渗液\nE. 神志、血压和脉搏", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性坏死型胰腺炎的患者中，以下哪种电解质变化最常见？", "options": "A. 血钙升高\nB. 血钙降低\nC. 血钾升高\nD. 血钾降低\nE. 血磷降低", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道出血的诊断中，以下哪一项描述是不正确的？", "options": "A. 通常由肝门静脉支的破裂引起\nB. 患者常伴有右上腹疼痛\nC. 可能出现呕血或黑便\nD. 可能有胆道蛔虫的病史\nE. 并非所有病例都需要手术治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，发现一个边界尚清、有类似包膜回声且较糙的病变，周边钙化显示为强回声并伴声影，最可能的诊断是？", "options": "A. 炎性假瘤\nB. 肝结核\nC. 肝细胞腺瘤\nD. 肝海绵状血管瘤\nE. 小肝癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位59岁男性患者，因酒后突发左上腹痛并放射至背部，伴有发热、恶心和呕吐症状。患者无高血压和冠心病病史，入院后被诊断为急性重症胰腺炎。在静吸复合全麻下完成手术后，患者被带管送至ICU。在ICU中，患者的气道压力逐渐升高，吸入纯氧时脉搏氧饱和度为95%。此时，患者的氧合指数最可能为多少？", "options": "A. 200 < PaO2/FiO2 ≤ 300\nB. 150 < PaO2/FiO2 ≤ 250\nC. 100 < PaO2/FiO2 ≤ 200\nD. 100 < PaO2/FiO2 ≤ 150\nE. 50 < PaO2/FiO2 ≤ 100", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在梗阻性黄疸患者的尿液中，主要存在的胆红素类型是", "options": "A.游离胆红素\nB.葡萄糖醛酸胆红素\nC.结合胆红素\nD.胆红素-Y蛋白\nE.胆红素-Z蛋白", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的不同类型中，哪种检查项目在水肿型中会升高，而在出血坏死型中可能保持正常？", "options": "A.血清淀粉酶\nB.血钙\nC.血清脂肪酶\nD.血清淀粉酶肌酐清除率比率\nE.C反应蛋白", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁女性患者因急性胰腺炎入院，计划进行胰腺减压与坏死组织清除术。术前检查显示Hb为86g/L，PLT为34×109/L，APTT为42秒。关于该患者的输血策略，以下哪项是正确的？", "options": "A.该患者不需要输注血小板\nB.立即给予输注血小板\nC.为防止血小板下降，使用小分子肝素\nD.可不使用冷沉淀\nE.患者贫血，术前应输红细胞悬液2单位", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，以下哪种寄生虫感染可能导致肝脏出现占位性病变？", "options": "A. 蠕形住肠线虫\nB. 华支睾吸虫\nC. 刚地弓形虫\nD. 溶组织内阿米巴\nE. 细粒棘球绦虫", "answer": "DE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊积脓穿孔并伴有感染性休克的紧急情况下，最适宜的手术方式是什么？", "options": "A.胆囊切除术\nB.胆囊造瘘术\nC.Oddi括约肌切开成形术\nD.胆囊切除加胆管空肠吻合\nE.胆囊切除加胆总管探查引流术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，尿淀粉酶和血清淀粉酶的变化模式是怎样的？", "options": "A. 两者同时升高\nB. 尿淀粉酶升高早于血清淀粉酶\nC. 尿淀粉酶升高晚于血清淀粉酶\nD. 尿淀粉酶不升高，血清淀粉酶升高\nE. 尿淀粉酶持续升高，血清淀粉酶先升高后降低", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝内胆管结石的手术治疗中，以下哪项原则最为重要？", "options": "A. 解除胆道狭窄与梗阻\nB. 尽可能取净结石\nC. 去除肝内感染性病灶\nD. 建立与恢复通畅的胆汁引流\nE. 预防复发", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆管阻塞的患者通常会出现哪种颜色的大便？", "options": "A. 黑色\nB. 黄褐色\nC. 陶土色\nD. 暗红色\nE. 鲜红色", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于小结节性肝硬化的描述，以下哪一项是不正确的？", "options": "A. 起病多隐匿\nB. 进展较缓慢\nC. 多由血吸虫病引起\nD. 症状不明显\nE. 结节大小均匀，最大不超过1.0cm", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，血清脂肪酶水平在发病后24小时内显著升高的是", "options": "A. 胆管结石\nB. 急性胰腺炎\nC. 胰腺囊肿\nD. 慢性胰腺炎\nE. 壶腹部癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝细胞肝癌的诊断中，以下哪种肿瘤标记物被认为是最理想的？", "options": "A. AFP\nB. GGT2\nC. CA19-9\nD. CA125\nE. CEA", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种原发癌最常发生肝转移？", "options": "A. 肺癌\nB. 胰腺癌\nC. 结直肠癌\nD. 胃癌\nE. 以上均是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝海绵状血管瘤的临床管理中，以下哪种并发症被认为是最具威胁性的？", "options": "A. 肿瘤破裂导致腹腔内急性大出血\nB. 压迫十二指肠引发上消化道梗阻\nC. 肝功能衰竭\nD. 上消化道大出血\nE. 肝性脑病", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆汁的生理功能中，以下哪项描述是不正确的？", "options": "A. 胆盐、胆固醇和卵磷脂共同作用以乳化脂肪\nB. 胆盐有助于脂肪的吸收\nC. 肝胆汁在十二指肠中能够中和部分胃酸\nD. 胆囊胆汁在十二指肠中能够中和部分胃酸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名35岁男性患者因车祸导致上腹部受伤4小时，出现呼吸困难、呕吐，血压为90/70mmHg。体检发现全腹压痛、肌紧张及反跳痛，腹部无明显移动性浊音，肠鸣音减弱。X线检查显示右侧膈肌升高且活动受限，右7、8、9肋骨骨折。在诊断腹部闭合性损伤时，最关键的是确定是否存在", "options": "A. 休克\nB. 内脏损伤\nC. 腹壁损伤\nD. 腹膜后血肿\nE. 颅脑损伤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者，因突发剧烈上腹部疼痛并放射至背部，伴有恶心、呕吐，呕吐后疼痛未见缓解，且出现休克症状。患者自述在症状出现前8小时曾参加聚会并大量进食和饮酒。根据这些临床表现，最可能的诊断是什么？", "options": "A. 急性阑尾炎\nB. 急性坏死性胰腺炎\nC. 胃癌伴穿孔\nD. 急性肾绞痛\nE. 急性胆囊炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位70岁男性患者，被诊断为肝右叶巨块性肝癌，同时有10年的老年性慢性支气管炎病史，肝肾功能基本正常。在这种情况下，最合适的治疗方案是什么？", "options": "A. 全身化学治疗\nB. 肿瘤局部放射治疗\nC. 手术切除\nD. 介入治疗\nE. 中医治疗", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁男性患者，近半年来反复出现上腹部隐痛，伴有食欲减退和体重下降。最近两个月出现黄疸和皮肤瘙痒，大便呈陶土色，尿液深黄，体检发现胆囊增大。最可能的诊断是？", "options": "A. 胆总管结石\nB. 胆囊结石\nC. 胰头癌\nD. 壶腹部癌\nE. 胆总管癌", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，当面对一位新确诊的肝癌患者时，医务人员应采取的最恰当做法是", "options": "A. 向患者本人及家属详细说明病情严重程度\nB. 与患者沟通时完全回避病情相关话题\nC. 与家属充分沟通，尊重患者知情权，向家属如实告知病情\nD. 立即向患者本人直接告知全部真实病情\nE. 提供虚假诊断报告，对患者隐瞒真实病情", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者因上腹部疼痛1天前来就诊，血淀粉酶水平为600U（Somogyi法），诊断为急性胰腺炎。经过治疗后痊愈，为了防止疾病复发，以下哪项措施是不合适的？", "options": "A.避免暴饮暴食\nB.避免酗酒\nC.忌食油腻食物\nD.积极治疗胆石症\nE.定期预防性应用抑肽酶", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科诊断中，以下哪种放射性药物最常用于肝胆系统的显像？", "options": "A. 99mTc-EHIDA\nB. 99mTc-SC\nC. 99mTc-MAA\nD. 99mTc-GH\nE. 99mTc-PYP", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名24岁男性患者，因急性化脓性阑尾炎合并穿孔和弥漫性腹膜炎，在当地医院进行了阑尾切除术。术后三天，患者自行要求转院至市医院。术后第四天起，患者出现持续发热、偶尔呃逆和右上腹痛。查体发现右肺底呼吸音减弱，X线透视显示右膈活动受限，肋膈角有少量积液，血白细胞计数为20×109/L。首先应考虑的诊断是？", "options": "A.右下肺炎\nB.右侧胸膜炎\nC.肺不张\nD.膈下脓肿\nE.门静脉炎、肝脓肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，蛋白质代谢障碍会导致以下哪种情况？", "options": "A.血浆中芳香族氨基酸的浓度明显降低\nB.血浆中支链氨基酸浓度明显升高\nC.芳香族氨基酸与支链氨基酸水平均下降\nD.血中芳香族氨基酸和支链氨基酸的比例下降\nE.血浆中芳香族氨基酸的浓度明显升高", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁的女性患者，有10年的乙肝病史，2年前被诊断为肝硬化。她经常出现牙龈出血和鼻出血。这些出血症状的最主要原因是", "options": "A. 毛细血管脆性增加\nB. 维生素K缺乏\nC. 凝血因子合成障碍\nD. 血小板功能不良\nE. 肝脏解毒功能不良而致毒性反应", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胰岛素瘤时，以下哪项实验室检查结果通常会出现异常？", "options": "A. 血浆胰岛素原与总胰岛素的比值超过20%\nB. C肽水平升高\nC. 血浆胰岛素浓度增加\nD. 胰岛素原水平上升\nE. 胰岛素分泌功能下降", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于门静脉高压引起的腹腔积液，下列哪项描述是错误的？", "options": "A. 肝内型门静脉高压的晚期约1/3患者会出现腹腔积液\nB. 呕血后常导致或加重腹腔积液的形成，部分患者可能出现难以消退的“顽固性腹腔积液”\nC. 肝外型门脉梗阻由于肝功能损害严重，腹腔积液通常难以消退\nD. 腹腔积液的出现是肝功能失代偿的标志\nE. 腹腔积液的原因包括低蛋白血症、门静脉压升高和肝功能损害", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪一种通常不会导致梗阻性黄疸的发生？", "options": "A. 胰头癌\nB. 胆总管结石\nC. 壶腹癌\nD. 原发性硬化性胆管炎\nE. 左肝内胆管结石", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔镜胆囊切除术中，以下哪种并发症的术后处理最为复杂和困难？", "options": "A.胆管损伤\nB.胆瘘\nC.肠管损伤\nD.血管损伤\nE.术后出血", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，哪种类型的肝硬化会导致肝细胞出现羽毛状或网状坏死？", "options": "A. 门脉性肝硬化\nB. 坏死后性肝硬化\nC. 胆汁性肝硬化\nD. 淤血性肝硬化\nE. 血吸虫性肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌与慢性胰腺炎的超声鉴别诊断中，以下哪一项描述是不正确的？", "options": "A. 胰腺癌通常表现为局限性肿大\nB. 肿瘤后方回声通常衰减\nC. 胰腺癌的胰管通常呈现不均匀串珠样轻度增宽\nD. 慢性胰腺炎的胰腺体积通常轻度肿大或萎缩\nE. 胰腺癌可能伴有淋巴结肿大及腹水", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁女性患者，近1个月来出现上腹部逐渐隆起，伴有腹痛但无发热，进食后感到腹胀。半年前曾患有急性胰腺炎。体检发现上腹部可触及一个拳头大小的肿物，表面光滑，B超检查显示为囊性肿物。最可能的诊断是？", "options": "A. 胰腺囊腺瘤\nB. 胰腺假性囊肿\nC. 胰腺脓肿\nD. 胃癌\nE. 胰腺癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在终宿主体内，肝片形吸虫成虫通常寄生于哪个部位？", "options": "A. 小肠\nB. 静脉血管\nC. 肺\nD. 肝胆管内\nE. 盲肠", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在重症胰腺炎的临床表现中，以下哪一项不属于典型体征？", "options": "A. 上腹或全腹压痛明显\nB. 肠鸣音增加\nC. Grey-Turner征\nD. Cullen征\nE. 腹肌紧张、反跳痛明显", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男性，59岁，长期饮酒史，反复左上腹持续性隐痛伴腹胀、消瘦、脂肪泻4年，腹痛发作时加剧并向腰背部放射，呈束腰带状。查体：皮肤巩膜无黄染。实验室检查：尿淀粉酶450U/L，空腹血糖11.5mmol/L。最可能的诊断是？", "options": "A. 胃溃疡\nB. 慢性结肠炎\nC. 慢性胰腺炎\nD. 胰头癌\nE. 十二指肠溃疡", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏的生物转化过程中，哪种酶的作用最为关键？", "options": "A. 细胞色素P450\nB. 过氧化氢酶\nC. 需氧脱氢酶\nD. 过氧化物酶\nE. 氧原子", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的病理过程中，哪种脑细胞类型最常受到影响？", "options": "A. 神经元细胞\nB. 小胶质细胞\nC. 星形胶质细胞\nD. 少突胶质细胞\nE. 室管膜细胞", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胰腺主胰管的正常直径是多少？", "options": "A. 1mm\nB. 2.0mm\nC. 3.5mm\nD. 4.0mm\nE. 5.0mm", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脓肿的治疗中，以下哪种情况不是进行肝叶切除术的适应症？", "options": "A. 脓肿腔内脓液特别黏稠\nB. 切开引流后脓壁不塌陷\nC. 有明显的无效腔\nD. 慢性厚壁肝脓肿\nE. 有肝内胆管结石，肝组织已破坏失去功能", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "根据NCCN指南，对于晚期胰腺癌患者，推荐的一线标准治疗药物是以下哪种？", "options": "A. 吉西他滨\nB. 培美曲塞\nC. 紫杉醇\nD. 多西紫杉醇\nE. 长春瑞滨", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在华支睾吸虫感染的患者中，最主要的病理改变发生在哪个器官？", "options": "A. 肝脏的次级胆管\nB. 十二指肠\nC. 胰腺\nD. 脾脏\nE. 小肠", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位62岁女性患者，主诉剑突下持续性胀痛已持续10余小时，伴有恶心、呕吐、寒战和发热。患者有类似发作史，并曾伴有黄疸，既往诊断为传染性肝炎。体检显示患者神志淡漠，体温高达39.8℃，血压为10/7kPa(75/55mmHg)，脉搏120次/分，剑突下压痛，肝区叩击痛。实验室检查显示白细胞计数为28×109/L，中性粒细胞比例为0.92，血清淀粉酶为160苏氏单位。根据这些临床表现和检查结果，最可能的诊断是什么？", "options": "A.急性胰腺炎\nB.胆道蛔虫病\nC.急性胆囊炎，胆石症\nD.急性梗阻性化脓性胆管炎\nE.溃疡病穿孔", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位女性患者，长期有上腹部隐痛史，最近几天出现剧烈腹痛、高热和皮肤黄染，伴有寒战和呕吐，尿液颜色加深。若患者出现神志淡漠、嗜睡，血压降至90/50mmHg，此时最有效的治疗措施是什么？", "options": "A. 给予有效足量抗生素\nB. 应用肾上腺皮质激素\nC. 纠正水、电解质和酸碱平衡紊乱\nD. 紧急手术解除胆道梗阻并减压\nE. 使用多巴胺等药物维持血压", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在放射性核素肝胆动态显像中，为了更准确地诊断先天性胆道闭锁，应选择以下哪种药物？", "options": "A. 促胆囊收缩素\nB. 辛卡利特（sincalid）\nC. 吗啡\nD. 苯巴比妥\nE. 阿司匹林", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的临床过程中，以下哪种并发症最为严重且危及生命？", "options": "A. 胆囊十二指肠内瘘\nB. 胆囊积脓\nC. 胆囊坏疽穿孔引起胆汁性腹膜炎\nD. 细菌性肝脓肿\nE. 并发急性胰腺炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，因急性重症胰腺炎并发休克36小时，经过抗休克治疗后进行了胰腺及周围坏死组织清除和腹腔引流术。术后患者心率106次/分，血压12.8/8kPa(96/60mmHg)，中心静脉压10cmH2O，呼吸频率22次/分，动脉血氧分压11.5kPa(86mmHg)，尿量10ml/小时，尿比重1.002。请问该患者目前最紧急的并发症是什么？", "options": "A. 心功能不全\nB. 肺功能衰竭\nC. 肾功能衰竭\nD. 血容量不足\nE. 体内抗利尿激素分泌过多", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位44岁男性患者，无肝炎病史，突然发病。实验室检查显示ALT为1350U/L，总胆红素（T-BIL）为120μmol/L，直接胆红素（D-BIL）为75μmol/L，凝血酶原活动度（PTA）为80%。患者大便呈灰白色，B超检查显示肝内外胆管无扩张，胰头部和胰管也无扩张。经过两周的保肝和退黄治疗后，ALT降至200U/L，T-BIL降至43μmol/L。最可能的诊断是什么？", "options": "A.急性黄疸型肝炎\nB.溶血性黄疸\nC.外科梗阻性黄疸\nD.先天性黄疸\nE.自身免疫性肝炎", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估肝损伤的严重程度时，以下哪项指标通常不被用作评估标准？", "options": "A. 胆红素\nB. 白蛋白\nC. 凝血酶原活动度\nD. ALT\nE. AST", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名20岁男性，在体检中发现HBsAg阳性，当时无症状且肝功能正常。一年后，因突然出现乏力、恶心、厌食和尿黄入院。实验室检查显示ALT 500U，血清总胆红素85μmol/L，抗-HAVIgM阳性。该患者最可能的诊断是什么？", "options": "A. 乙型肝炎、慢性迁延型、既往感染过甲型肝炎\nB. 乙型肝炎、慢性活动型、既往感染过甲型肝炎\nC. 急性甲型黄疸型肝炎、乙型肝炎病毒携带者\nD. 急性乙型肝炎、合并甲型肝炎\nE. 急性黄疸型肝炎、甲、乙型肝炎病毒混合感染", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在男性肝硬化患者中，常见的症状包括性欲减退、睾丸萎缩、乳房发育和蜘蛛痣。这些症状主要是由于什么原因引起的？", "options": "A. 垂体功能减低\nB. 雌激素过多\nC. 雄激素过多\nD. 肾上腺皮质激素过多\nE. 以上均不是", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在MRI检查中，肝门区胆管癌最典型的影像学特征是什么？", "options": "A. 肝门区胆管腔内出现充盈缺损\nB. 肝内胆管扩张，但肝总管及胆总管未见扩张\nC. 胆囊体积显著缩小\nD. 肝内及周围淋巴结出现转移病灶\nE. 肝门区周围多个淋巴结肿大", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊癌的相关描述中，哪一项是不正确的？", "options": "A. 上段胆管癌的发病率高于下段\nB. 大多数病例的病理组织类型为腺癌\nC. 局限性生长在胆囊癌中较为常见\nD. 血行转移是胆囊癌的主要转移方式\nE. 先天性胆管扩张症患者发生癌变的风险较高", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在下列病毒中，哪一种DNA病毒是引起肝硬化的主要原因？", "options": "A. HAV\nB. HBV\nC. HCV\nD. HDV\nE. HEV", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的治疗中，以下哪些介入治疗方法被广泛应用？", "options": "A. 射频消融治疗\nB. 肝动脉化疗栓塞术\nC. 冷冻消融治疗\nD. 微波凝固治疗\nE. 经皮穿刺药物注射治疗", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下药物中，哪一种不会导致急性胰腺炎的发生？", "options": "A.氢氧化铝\nB.乙醇（酒精）\nC.硫唑嘌呤\nD.氢氯噻嗪\nE.促肾上腺皮质激素", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断梗阻性黄疸时，以下哪项检查的临床价值相对较低？", "options": "A. 经皮经肝穿刺胆道造影\nB. B型超声\nC. 静脉法胆道造影\nD. 经内窥镜逆行胰胆管造影\nE. 低张十二指肠钡餐检查", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肠阿米巴病的肠外并发症中，哪一种最为常见？", "options": "A.阿米巴肝脓肿\nB.阿米巴肺脓肿\nC.阿米巴脑脓肿\nD.阿米巴胸腔积液\nE.阿米巴腹腔积液", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在人体解剖学中，胰作为第二大消化腺，其具体位置位于", "options": "A.腹膜后方，第3、4腰椎的高处横贴于腹后壁\nB.肝的后方，第1、2腰椎的高处横贴于腹后壁\nC.脾的后方，第1、2腰椎的高处横贴于腹后壁\nD.胃的后方，第1、2腰椎的高处横贴于腹后壁\nE.十二指肠横部上方，第3、4腰椎的高处横贴于腹后壁", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下哪种情况下，肝脏穿刺活检不推荐作为诊断手段？", "options": "A. 肝粟粒状结核\nB. 肝硬化\nC. 慢性肝炎\nD. 血吸虫肝病\nE. 肝包虫病", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患有肝硬化15年的患者，为了排除肝癌的可能性，以下哪项检查是不必要的？", "options": "A. AFP\nB. 肝脏MRI\nC. 胃镜\nD. 肝脏增强CT\nE. 肝胆脾B超", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆总管的解剖分段中，以下哪一段不属于其标准分段？", "options": "A. 十二指肠上段\nB. 胰腺段\nC. 十二指肠后段\nD. 十二指肠壁内段\nE. 十二指肠下段", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床病理学中，以下哪项特征最能体现坏死后性肝硬化的典型表现？", "options": "A. 肝脏体积显著缩小\nB. 肝内结节呈现均匀一致的大小\nC. 出现典型的假小叶结构\nD. 具有较高的癌变风险", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的血液供应中，以下哪一项描述是正确的？", "options": "A. 肝动脉提供30%的血液，门静脉提供70%\nB. 肝动脉提供20%的血液，门静脉提供80%\nC. 肝动脉提供40%的血液，门静脉提供60%\nD. 肝动脉提供70%的血液，门静脉提供30%\nE. 肝动脉提供80%的血液，门静脉提供20%", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于胆道结石并发胰腺炎的患者，最合适的治疗方案是什么？", "options": "A. 手术治疗\nB. 抗感染，对症处理\nC. 激素治疗\nD. 透析治疗\nE. 中西医结合治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症患者的手术前准备中，以下哪项措施是不正确的？", "options": "A. 进行保肝治疗\nB. 提供无渣高糖饮食\nC. 输注新鲜血液\nD. 肌肉注射维生素K\nE. 手术当天留置胃管", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位无症状的胆囊结石胆囊炎患者，B超显示胆囊壁厚0.4cm，结石周围未见胆囊腔，胆囊肿胀，内回声不均匀，胆囊大小超过13cm×4cm，结石直径大于2.0cm，总胆管直径为0.9cm。下一步最合适的治疗选择是（）。", "options": "A. 保守治疗\nB. 内镜胆囊切除\nC. 腹腔镜胆囊切除，切除困难时中转开腹\nD. 开腹手术胆囊切除\nE. 做ERCP或胆道造影检查", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "1-患者入院后检测结果显示抗-HAV-IgM阳性，乙肝五项检查中仅抗-HBs阳性，其余均为阴性。对于这一检查结果的正确解释是", "options": "A.既往曾经感染过甲型肝炎\nB.目前感染的是甲型肝炎\nC.目前感染的是乙型肝炎\nD.可除外甲型、乙型肝炎感染\nE.为乙型肝炎病毒携带者", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的18F-FDG PET/CT显像中，以下哪项描述是错误的？", "options": "A. 肝细胞癌的分化程度越低，其对FDG的摄取通常越高\nB. 增强CT的使用可以提升单独FDG PET对高分化肝细胞癌的诊断灵敏度\nC. 肝细胞结节性增生可能导致假阳性的结果\nD. 对于胆管细胞癌的探测灵敏度高于肝细胞癌\nE. 结合使用FDG和11C-acetate可以提高对中、高分化肝细胞癌的探测灵敏度", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，因右上腹胀痛持续1个月就诊。患者有乙型肝炎病史，近期体重下降8kg。实验室检查显示：血红蛋白60g/L，白细胞1.8×10^9/L，血小板4.1×10^9/L，胆红素102μmol/L，碱性磷酸酶18U（布氏），甲胎蛋白1320μg/L，大便隐血试验阳性。体检发现肝脏右肋下约5cm，伴有少量腹腔积液。为明确诊断，最直接的检查方法是？", "options": "A. 肝脏B超\nB. 腹部X线\nC. CT\nD. B超下穿刺活检\nE. MRI\nF. 肝动脉造影", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，以下哪种情况最常导致门静脉高压症的发生？", "options": "A. 门静脉血栓形成\nB. 肝炎后肝硬化\nC. 门静脉海绵窦样变\nD. 门静脉狭窄\nE. 营养不良性肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行胆囊切除手术时，哪个解剖结构是外科医生需要特别关注的关键部位？", "options": "A. Vater壶腹\nB. Oddi括约肌\nC. Hartmann袋\nD. Heister瓣\nE. Calot三角", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，因肝硬化导致腹水、尿量减少、下肢水肿以及端坐呼吸。在这种情况下，应立即采取以下哪种措施？", "options": "A. 口服呋塞米片\nB. 洋地黄静推\nC. 毛花苷C静推\nD. 口服硫酸镁导泻\nE. 呋塞米静推", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝脏储备功能时，以下哪项试验最为关键？", "options": "A. 血胆红素测定\nB. 血清白蛋白测定\nC. 吲哚菁绿清除试验\nD. ALT测定\nE. 免疫球蛋白测定", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名30岁男性因从10米高处坠落，导致右胸2~5肋骨骨折、血气胸、肝脾破裂、T12~L1爆裂骨折以及右股骨粉碎性骨折。根据这些损伤，该伤者应被归类为", "options": "A.多处伤\nB.多部位伤\nC.多发伤\nD.复合伤\nE.胸腹联合伤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估胰腺病变的CT影像时，以下哪项表现最符合胰腺癌的诊断？", "options": "A. 胰周及腹腔渗出，胰腺实质内有不规则低密度区，强化后低密度区增强不明显\nB. 胰头有3cmx4cm不均匀低密度区，强化后有不均匀增强\nC. 胰头部增大，密度与其他部位胰腺组织密度一致，胰周界限模糊\nD. 胰头均匀低密度区，CT值10 Hu，不被强化，胰体尾萎缩，胰管扩张\nE. 胆管扩张明显，胆总管下端可见2 cmxlcm的极强密度区", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的病理变化中，假小叶的哪一项特征是不正确的？", "options": "A. 假小叶内肝细胞索排列紊乱\nB. 假小叶内可见到门管区\nC. 假小叶内静脉偏位或有两个以上的中央静脉\nD. 假小叶内可无中央静脉\nE. 假小叶内肝细胞异型明显", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的患者中，以下哪种并发症被认为是最严重的？", "options": "A. 原发性腹膜炎\nB. 肝性脑病\nC. 上消化道出血\nD. 电解质紊乱\nE. 肝肾综合征", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的治疗中，以下哪些措施属于对症治疗？", "options": "A. 预防脑水肿\nB. 纠正水、电解质和酸碱平衡失调\nC. 保护脑细胞功能\nD. 保持呼吸道通畅\nE. 强化心肌功能", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估重型肝炎的严重程度时，以下哪项指标最为关键？", "options": "A. 总胆红素大于171μmol/L\nB. ALT大于500U/L\nC. PTA小于40%\nD. WBC15×109/L\nE. 电解质紊乱", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，尿淀粉酶水平通常在症状出现后多久开始上升？", "options": "A. 3~5日\nB. 12~14小时\nC. 1~2周\nD. 6~12小时\nE. 48小时", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位71岁男性患者，近3个月出现右上腹不适、食欲减退和体重下降。最近3天出现皮肤瘙痒、尿色深黄和粪便呈陶土色。体检发现患者消瘦，皮肤呈暗黄色。腹部超声检查显示肝内胆管结石。该患者黄疸的原因最可能是", "options": "A. 溶血性黄疸\nB. 肝细胞性黄疸\nC. 胆汁淤积性黄疸\nD. 先天性非溶血性黄疸\nE. 药物性黄疸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁的女性患者，因进食后右上腹胀痛并向后背部放射，伴有恶心持续2周而入院。患者描述疼痛在空腹时有所缓解，同时伴有消化不良和食欲减退。体检显示右上腹部有压痛，但无腹肌紧张和反跳痛。腹部B超检查发现胰腺肿物，生化检测显示多项肿瘤标记物升高。该患者后背部疼痛的可能原因是", "options": "A.胰腺炎症痛\nB.胰腺肿瘤压迫痛\nC.胰腺病变的牵涉痛\nD.后背脊柱痛\nE.后背炎症痛", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者出现发热和肝痛症状，阿米巴血清学检查结果为阴性，最可能的诊断是什么？", "options": "A. 确诊阿米巴肝病\nB. 排除阿米巴肝病\nC. 阿米巴原虫携带者\nD. 肠阿米巴病普通型\nE. 肠阿米巴病普通型", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位38岁男性，平时健康状况良好，饮酒后4小时开始感到上腹部疼痛，14小时后出现呼吸困难，呼吸频率达到40次/分。最可能的诊断是__", "options": "A.急性胃炎\nB.右叶性肺炎\nC.急性肠梗阻\nD.急性水肿型胰腺炎\nE.急性出血坏死型胰腺炎合并成人呼吸窘迫综合征", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在慢性胰腺炎患者中，转化为胰腺癌的比例大约是多少？", "options": "A. 3.6％～5％\nB. 36％～50％\nC. 16％-20％\nD. 0.6％～3.0％\nE. 0.6％～2.6％", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺的结构和功能，下列哪一项描述是不正确的？", "options": "A. 胰腺由内分泌和外分泌两部分组成\nB. 胰液无法分解脂肪\nC. 胰岛素在糖代谢调节中起重要作用\nD. 胰头位于十二指肠的弯曲处\nE. 胰尾靠近脾脏的门部", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的影像学诊断中，以下哪项描述是不正确的？", "options": "A. 血糖水平升高可能降低FDG PET的检测灵敏度\nB. 胰头癌可能导致胆管和胰管同时扩张，形成“双管征”\nC. 慢性胰腺炎在FDG PET显像中可能出现假阳性结果\nD. CT灌注成像显示病灶通常为富血供\nE. 黏液腺癌在影像学检查中可能产生假阴性结果", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的初期管理中，哪项措施被认为是最关键的？", "options": "A. 使用抗生素静脉滴注\nB. 应用吗啡等止痛药物\nC. 使用H2受体阻滞剂\nD. 进行充分的液体补充\nE. 紧急进行剖腹手术引流", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌患者中，以下哪项是最常见的临床表现？", "options": "A.进行性无痛性黄疸\nB.肝脏肿大\nC.胆囊肿大\nD.上腹部隐痛\nE.厌食、消瘦、乏力", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位49岁的女性患者，近半年来多次出现右上腹疼痛，伴有恶心和呕吐，症状多在夜间睡眠时发作，并向右肩部放射。体检显示患者为肥胖体质，血压110/80mmHg，心率90次/分，右上腹有轻度压痛，无腹肌紧张。随着病情进展，患者出现了黄疸。根据这些症状和体征，最可能的诊断是什么？", "options": "A. 高位急性阑尾炎\nB. 胆囊腺瘤性息肉\nC. 十二指肠溃疡穿孔\nD. 急性胰腺炎\nE. 胆囊结石", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的大体形态分型中，以下哪一项描述是不正确的？", "options": "A. 块状型：肿块直径大于5cm\nB. 结节型：多个癌结节，直径多大于5cm\nC. 弥漫型：米粒至黄豆大小的癌结节，弥漫散布全肝\nD. 小癌型：孤立癌结节，直径小于3cm\nE. 混合型：肿块大小不等，多伴有肝硬化", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，血脂肪酶水平通常在发病后何时开始显著升高？", "options": "A. 6~8小时\nB. 10~12小时\nC. 12~24小时\nD. 24~72小时\nE. 72小时以后", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性重型肝炎的治疗中，以下哪项措施对于预防肝性脑病是不正确的？", "options": "A. 高蛋白饮食\nB. 口服乳果糖\nC. 给予六合氨基酸\nD. 脱水治疗\nE. 给予左旋多巴治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在解剖学上，胆道系统与胰腺之间存在密切联系的主要原因是？", "options": "A. 两个器官的血供相互联系\nB. 胆总管与主胰管有共同通道或开口\nC. 副胰管的存在\nD. 两个器官同属迷走神经支配\nE. 两个器官相邻", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位35岁女性患者，因胆囊结石反复发作急性胆囊炎，B超显示胆总管直径为6mm，口服胆囊造影检查胆囊未显影。此时，最合适的治疗方案是？", "options": "A. 胆囊造瘘术\nB. 胆囊切除术\nC. 胆囊切开取石术\nD. 胆总管探查术II体外碎石\nE. 胆囊切除", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下类型的肝硬化中，哪一种通常导致门脉高压症最为严重？", "options": "A. 病毒性肝炎肝硬化\nB. 酒精性肝硬化\nC. 血吸虫病性肝纤维化\nD. 淤血性肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位62岁男性患者出现腹痛、寒战发热、呕吐和黄疸症状，最可能的诊断是？", "options": "A. 急性胰腺炎\nB. 急性胃炎\nC. 急性胆囊炎\nD. 急性腹膜炎\nE. 急性肾炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，有30年的乙型肝炎病史，最近一个月出现腹胀、乏力、双下肢水肿和尿少。B超检查显示肝脏回声增粗且不均匀，伴有中等量腹水。根据这些临床表现和检查结果，该患者肝脏病理最可能的表现是什么？", "options": "A. 肝细胞脂肪变性\nB. 假小叶形成\nC. 淤血性改变\nD. 淋巴细胞浸润\nE. 小胆管普遍淤胆", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门腔分流术后的前48小时内，医护人员应特别关注以下哪种并发症的发生？", "options": "A. 血管吻合口破裂出血\nB. 肝性脑病\nC. 血小板增高\nD. 肠系膜血管栓塞\nE. 腹腔感染", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝炎肝硬化患者中，蜘蛛痣和男性乳房发育的主要原因是", "options": "A. 肝脏对血管活性物质和雌激素的灭活功能降低\nB. 肝脏合成激素能力降低\nC. 肝脏对从肠道吸收的有毒物质解毒功能降低\nD. 门静脉高压\nE. 肾素-血管紧张素-醛固酮系统紊乱", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于患有慢性胰腺炎的患者，以下哪种饮食建议是最合适的？", "options": "A. 高脂肪食物\nB. 油炸食品\nC. 少量多餐\nD. 少量饮酒\nE. 化学性和机械性刺激的食物", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种疾病以夏科(Charcot)三联征为典型表现？", "options": "A.急性憩室炎\nB.急性出血性胰腺炎\nC.急性胆管炎\nD.急性胆囊炎\nE.先天性胆管扩张症", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，关于淀粉酶水平的描述，以下哪项是不正确的？", "options": "A. 重症胰腺炎患者的淀粉酶水平可能正常或低于正常\nB. 大多数急腹症患者的淀粉酶水平通常不超过正常值的两倍\nC. 血液中淀粉酶的水平直接反映了病情的严重程度\nD. 尿液中淀粉酶的水平会受到患者尿量的影响\nE. 胰源性胸腔积液和腹水中的淀粉酶水平也会显著升高", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "李某，男，62岁。因长期酒精性肝硬化入院，主诉近期出现鼻衄和皮肤瘀斑。以下哪项不是由肝功能减退导致的出血原因？", "options": "A. 凝血酶原时间延长\nB. 纤维蛋白原减少\nC. 血小板减少\nD. 凝血功能障碍\nE. 维生素K缺乏", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，以下哪种吸虫感染可能导致肝脏疾病？", "options": "A. Clonorchi sinensis\nB. Paragonimus westermani\nC. Schistosoma japonicum\nD. Pagumogonimus skrjabini\nE. Fasciolopis buski", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位62岁男性患者因右上腹阵发性绞痛、恶心、呕吐20小时急诊入院。患者神志淡漠，伴有寒战高热和明显黄疸。体检发现巩膜及全身皮肤黄染，心率120次/分，体温40℃，血压90/60mmHg，剑突下压痛，腹肌紧张。白细胞计数20×10^9/L。急诊剖腹探查术中见胆总管直径为1.8cm，穿刺有脓性胆汁。术中患者心率130次/分，血压70/40mmHg。针对此病例，最合适的治疗原则是", "options": "A. 胃肠减压，维持水电解质平衡\nB. 解除痉挛，镇痛\nC. 服用大量中药利胆\nD. 大量使用抗生素\nE. 胆道减压引流，解除梗阻", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的治疗中，以下哪种药物主要用于抑制胰酶的活性？", "options": "A. 抑肽酶\nB. 胰升糖素\nC. 降钙素\nD. 生长抑素\nE. 奥曲肽", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的单纯型中，以下哪项描述最符合其特征？", "options": "A. 患者可能伴有肝硬化，且出现持续性发热及谷丙转氨酶增高\nB. 患者出现迅速肿大的压痛性肿块，并突然出现腹膜刺激征\nC. 患者无肝硬化的表现，且肝功能试验基本正常\nD. 患者出现颈静脉充盈，肝大，肝颈静脉回流征阳性\nE. 患者有肝硬化表现，且肝功能改变符合肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞发生气球样变时，下列哪一项改变通常不会出现？", "options": "A. 细胞内水分增多\nB. 内质网扩张，囊泡变\nC. 粗面内质网核蛋白颗粒脱失\nD. 线粒体肿胀，嵴消失\nE. 细胞内糖原增多", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在重症急性胰腺炎患者中，以下哪些并发症是可能发生的？", "options": "A. 腹腔间隔室综合征\nB. 胰腺假性囊肿\nC. 胰腺脓肿\nD. 腹腔出血", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位28岁男性患者出现乏力、厌油、食欲减退、畏寒高热3天，体温达39℃，巩膜黄染，临床拟诊为急性病毒性肝炎。在下列实验室指标中，最能敏感反映急性肝细胞损伤的是", "options": "A. 丙氨酸氨基转移酶（ALT）\nB. 天冬氨酸氨基转移酶（AST）\nC. 乳酸脱氢酶（LDH）\nD. γ-谷氨酰转移酶（GGT）\nE. 碱性磷酸酶（ALP）", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，以下哪项指标的出现提示病情可能为重症？", "options": "A. 血淀粉酶显著上升\nB. 血钙水平降低\nC. 血糖水平升高\nD. 白细胞计数显著增加", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于无功能胰岛细胞瘤的描述，以下哪项是正确的？", "options": "A. 是胰腺最常见的隐性内分泌肿瘤\nB. 无功能胰岛细胞瘤常为多发\nC. 属于胰岛的非B细胞产生的肿瘤\nD. 偶见空腹或非劳累时的发作性低血糖反应\nE. 瘤体较小时即易出现液化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位51岁男性患者，有4年肝硬化病史，近2天出现呕血和黑便，半天前开始意识模糊和躁动，被紧急送往医院。为了清除患者肠道内的积血，下列哪种灌肠液最为适宜？", "options": "A.弱酸性液\nB.温开水\nC.肥皂水\nD.弱碱性液", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断小肝癌时，哪种影像学技术被认为是最准确的定位方法？", "options": "A.数字减影肝动脉造影\nB.CT\nC.B超\nD.放射性核素扫描\nE.腹腔镜检查", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆石的形成与以下哪项因素有关？", "options": "A.胆汁中胆固醇含量增加\nB.胆汁中游离胆红素水平升高\nC.胆汁中胆汁酸盐浓度降低\nD.胆汁中存在异物如蛔虫卵\nE.以上所有因素", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断慢性胰腺炎时，以下哪些检查方法可以提供辅助信息？", "options": "A. 胰腺内分泌测定\nB. 吸收功能试验\nC. 淀粉酶测定\nD. X线腹部平片\nE. 胰腺外分泌功能测定", "answer": "ABDE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁男性患者，近3个月来出现上腹部隐痛，伴有食欲减退和乏力。体检发现腹部平坦，无压痛，未触及肿块，移动性浊音阴性。B超检查显示肝左叶有一个1.5cm的光团，胃镜检查发现胃窦部有溃疡病变，组织学检查确认为高分化腺癌。请问最合适的治疗方案是什么？", "options": "A. 化疗\nB. 肝动脉插管化疗\nC. 胃大部切除加肝左叶切除\nD. 免疫治疗\nE. 放疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，若出现血性腹水，最可能的原因是", "options": "A. 结核性腹膜炎\nB. 原发性腹膜炎\nC. 肝硬化癌变\nD. 门静脉血栓形成\nE. 功能性肾衰竭（肝肾综合征）", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的超声检查中，以下哪项表现具有特异性？", "options": "A.胆囊壁增厚\nB.胆囊增大\nC.胆汁内出现细点状或絮状回声\nD.胆囊腔内结石\nE.胆囊壁增厚合并超声Murphy征阳性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位60岁男性患者，有30年饮酒史，最近出现上腹部疼痛并向腰背部放射，进食油腻食物后腹痛加重，大便中发现油珠。超声检查显示主胰管直径为4mm。最可能的诊断是什么？", "options": "A. 慢性胃炎\nB. 慢性胆囊炎\nC. 胃癌\nD. 慢性胰腺炎\nE. 消化性溃疡", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，以下哪种腹水类型属于渗出液？", "options": "A. 门静脉高压引起的腹水\nB. 恶性肿瘤导致的腹水\nC. 急性胰腺炎并发症引起的腹水\nD. 肝硬化失代偿期产生的腹水", "answer": "BC", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名24岁女性患者，因1天前进食不洁食物后出现阵发性腹痛，伴有恶心、呕吐和腹泻。查体显示体温为38℃。该患者最可能的诊断是什么？", "options": "A.急性菌痢\nB.急性阑尾炎\nC.急性胰腺炎\nD.急性胆囊炎\nE.早孕", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位62岁的男性患者，因急性重症胰腺炎正在接受保守治疗。最近两天尿量逐渐减少，现已无尿。患者出现气促、全身水肿，血压为180/92mmHg，心率为120次/分。听诊发现双下肺布满细湿啰音，血钾水平为6.9mmol/L，BUN为25.2mmol/L，肌酐为577μmol/L。此时，最有效的治疗措施是什么？", "options": "A. 静脉注射袢利尿剂\nB. 静脉滴注甘露醇以利尿\nC. 口服甘露醇或硫酸镁进行导泻\nD. 控制液体摄入量，停止补钾\nE. 立即进行紧急透析", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁的男性患者，患有慢性乙型肝炎已有8年，最近一个月病情显著恶化，怀疑为慢性重型肝炎。以下哪项结果不能作为诊断依据？", "options": "A. 肝脏迅速缩小\nB. PTA明显减少\nC. 出现肝性脑病\nD. 黄疸明显加重\nE. 转氨酶增高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现阵发性剑突下钻顶样疼痛，最可能的诊断是什么？", "options": "A. 急性胰腺炎\nB. 胆道蛔虫症\nC. 胃溃疡\nD. 十二指肠球部溃疡\nE. 急性胆囊炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆汁淤积性黄疸的实验室检查中，以下哪项通常不会出现异常？", "options": "A. 结合胆红素增多\nB. 尿胆红素（++），尿胆原（-）\nC. ALT可增高\nD. PT延长\nE. 胆固醇降低", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的临床表现中，以下哪一项描述是不正确的？", "options": "A. 肝肿大并有触压痛\nB. 寒战、高热\nC. 肝区胀痛\nD. 胆囊肿大\nE. 起病急", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝外胆管癌的发病部位中，哪个部位的发生率最高？", "options": "A. 左肝管\nB. 下段胆管\nC. 中段胆管\nD. 上段胆管\nE. 胆囊管", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在进行口服胆囊造影检查时，患者服用造影剂后，胆囊最清晰显影的时间段是（）。", "options": "A. 6小时\nB. 6～8小时\nC. 8～10小时\nD. 12～14小时\nE. 24小时", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔镜胆囊切除术中，以下哪项措施对于预防胆管损伤是不恰当的？", "options": "A. 当胆囊管较粗（大于4mm）时，术中应进行胆道造影以排除胆总管结石\nB. 如果胆囊壁厚（大于4mm）且胆囊无功能，通常提示胆囊管短粗和胆囊萎缩，此时应靠近胆囊壶腹部上钛夹\nC. 在处理胆囊三角时，应从胆囊管延伸至胆囊，在未明确胆囊管之前和胆囊管未从胆囊颈部分出时，不应切断任何管状结构\nD. 当确定胆囊管与胆总管关系困难时，应仔细解剖肝门部，使胆总管、肝总管、胆囊管“三管骨骼化”，以确定胆囊管\nE. 术中出现出血或技术困难时，预防胆管损伤的最佳措施是中转开腹", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌的诊断中，以下哪项实验室检查项目具有最高的诊断价值？", "options": "A. 癌胚抗原\nB. γ—谷氨酰转肽酶\nC. 甲胎蛋白\nD. 碱性磷酸酶\nE. 乳酸脱氢酶同工酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁男性患者，患有慢性胆囊炎和胆囊结石，计划进行手术治疗。该患者曾有心肌梗死病史。请问，手术治疗至少应在心肌梗死后多长时间进行？", "options": "A.1周以后\nB.2周以后\nC.4周以后\nD.12周以后\nE.24周以后", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科领域，关于肝炎的预后和转归，以下哪一项陈述是不正确的？", "options": "A. 妊娠晚期合并戊型肝炎的患者死亡率较高\nB. 急性丙型肝炎患者容易发展为慢性肝炎\nC. 慢性迁延性肝炎通常预后良好\nD. 丙型肝炎病毒感染容易导致重型肝炎的发生\nE. 慢性淤胆型肝炎可能进展为胆汁性肝硬化", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝血管瘤介入治疗的适应证有哪些？", "options": "A. 瘤体直径大于等于5cm\nB. 肿瘤位于肝脏表面或破裂出血者\nC. 伴腹胀、疼痛\nD. 瘤体直径小于5cm，但影响患者工作、学习、生活者", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位63岁的女性患者，近3年来在冬季反复出现上腹部疼痛，疼痛通常在餐后半小时开始，餐前缓解。最近一周症状复发。体检显示患者神志清醒，无贫血表现，剑突下有压痛，肝脾未触及。根据这些症状和体征，最可能的诊断是什么？", "options": "A. 胃癌\nB. 慢性胃炎\nC. 十二指肠溃疡\nD. 慢性胆囊炎\nE. 胃溃疡", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的治疗中，以下哪种情况通常不需要进行手术治疗？", "options": "A. 病情在积极抢救后持续恶化\nB. 出现腹肌紧张和反跳痛\nC. 胰腺坏死并伴有感染\nD. 合并胆道疾病\nE. 无法排除其他外科急腹症", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位49岁的女性患者，近半年来多次出现右上腹疼痛，伴有恶心和呕吐，症状多在夜间睡眠时发作，并向右肩部放射。患者体型肥胖，血压110/80mmHg，心率90次/分，右上腹有轻度压痛，无腹肌紧张。随着病情进展，患者出现黄疸，尽管接受了治疗，但疼痛持续加重，右上腹压痛、反跳痛和腹肌紧张明显，体温升至38.5℃。此时最可能的诊断是什么？", "options": "A.急性坏死性胰腺炎\nB.十二指肠溃疡穿孔并弥漫性腹膜炎\nC.胆总管结石\nD.结石性急性坏疽性胆囊炎\nE.急性化脓性胆管炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下病因中，哪一个与肝硬化的发生关系不大？", "options": "A. 长期饮酒和不良饮食习惯\nB. 情绪波动和心理压力\nC. 血吸虫感染\nD. 长期黄疸和肝内积聚\nE. 外感风寒或风热", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的诊断中，以下哪项实验室检查结果最具有特异性？", "options": "A. 血氨升高\nB. 血清促胃液素升高\nC. 血清淀粉酶升高\nD. 血清酸性磷酸酶升高\nE. 血清肌酸激酶升高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的超声介入治疗中，以下哪项描述是不正确的？", "options": "A. 超声引导下的微创介入治疗是可行的\nB. 瘤体内无水乙醇注射术(PEI)是一种常用的超声介入治疗方法\nC. 对于无明显出血倾向、严重黄疸或腹腔积液的患者，均可采用超声介入治疗\nD. 对于小肝癌及直径小于3cm的复发性肝癌，超声介入治疗效果更佳\nE. 对于不适合手术治疗的大肝癌或复发灶，可以采用多点注射法", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁女性患者，有10年的肝炎肝硬化病史，最近3个月腹围显著增加，近1周出现少尿症状。AFP和血常规检查结果均正常。根据这些信息，最可能的诊断是什么？", "options": "A. 肝病合并慢性肾炎\nB. 急性肾小管坏死\nC. 肾前性氮质血症\nD. 肝肾综合征\nE. 慢性肾小球肾炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位38岁男性患者，在餐后2小时突然出现腹痛、恶心、呕吐，并伴有发热。第二天出现黄疸，血液检查显示淀粉酶和胆红素水平显著升高。请问导致黄疸的最可能原因是什么？", "options": "A. 肝细胞性黄疸\nB. 胆结石并胰腺炎\nC. 肿大的胰腺压迫胆管所致\nD. 胆囊炎所致\nE. 胆总管下端狭窄", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的早期阶段，患者最可能出现的初始症状是什么？", "options": "A. 扑翼样震颤\nB. 性格改变\nC. 脑电图异常\nD. 定向力、理解力障碍\nE. 以上均不是", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "张某，妊娠39周，因恶心、食欲不振和呕吐症状被诊断为急性病毒性肝炎，现已入院待产。以下哪项处理措施是不正确的？", "options": "A.立即终止妊娠\nB.新生儿注射乙肝疫苗\nC.胎儿娩出后注射缩宫素\nD.缩短第二产程\nE.新生儿注射免疫球蛋白", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆石症的非手术治疗中，有一种药物属于钙通道阻滞剂，使用时需注意不可掰开或嚼碎，且应避免卧位服用。这种药物是：", "options": "A. 熊去氧胆酸片\nB. 鹅去氧胆酸片\nC. 匹维溴铵片\nD. 山莨菪碱片\nE. 消炎利胆片", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌患者接受肝移植手术后的第三天，为了评估移植肝脏的血流情况，应该优先选择哪种影像学检查方法？", "options": "A. CT\nB. B超\nC. MRI\nD. PET/CT\nE. 肝脏血池显像", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在描述假小叶病变时，以下哪一项不符合其特点？", "options": "A. 肝细胞索围绕中央静脉呈放射状排列\nB. 缺少中央静脉\nC. 中央静脉偏位或有2个以上\nD. 肝细胞排列紊乱\nE. 出现汇管区", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，导致胆囊憩室形成的最主要病因是", "options": "A. 胆囊内胆汁排出受阻\nB. 胆囊恶性肿瘤\nC. 胆囊手术后的创伤\nD. 胆囊受到外部压迫\nE. 胆囊结石的存在", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，过量服用对乙酰氨基酚可能导致严重的肝毒性反应。在这种情况下，以下哪种药物应作为首选解毒剂？", "options": "A. 乙酰半胱氨酸\nB. 半胱氨酸\nC. 谷氨酸\nD. 谷胱甘肽\nE. 酰甘氨酸", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于肝性脑病患者，在治疗后神志恢复时，哪种蛋白质饮食是最合适的？", "options": "A.动物蛋白质\nB.蔬菜、水果\nC.碳水化合物\nD.蛋白质在60g/d以上\nE.植物蛋白质", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名10岁男孩，居住在山区，有生食蛎蛄的历史，近一年来发现肝脏肿大，血液中嗜酸粒细胞水平升高，肺吸虫抗原皮试结果呈强阳性。这些症状最可能提示的肝脏肿大原因是", "options": "A. 病毒性肝炎\nB. 肝血吸虫病\nC. 丝虫病\nD. 肝蛔虫病\nE. 肝肺吸虫病", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁女性患者，无重大疾病史，近期出现皮肤和巩膜黄染，症状逐渐加重，无腹痛，体重略有下降。体检发现肝脏可触及，右上腹可触及无痛性胆囊肿大，无发热。手术中发现胰头部有一不规则肿块，边界清晰，未侵犯门静脉和肠系膜上静脉。此时最适宜的手术方式是（）。", "options": "A.Whipple胰头十二指肠切除术\nB.扩大切除术\nC.全胰切除术\nD.胆囊十二指肠吻合术\nE.胆总管十二指肠吻合术\nF.PPPD保留幽门的胰头十二指肠切除术", "answer": "AF", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位肝硬化患者在进行血清免疫学检查时，发现IgM水平显著升高，且血清抗线粒体抗体呈强阳性（1：128）。根据这些检查结果，最可能的诊断是？", "options": "A. 肝炎后肝硬化\nB. 原发性胆汁性肝硬化\nC. 酒精性肝硬化\nD. 血吸虫性肝硬化\nE. 血色病所致肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下外科急腹症中，哪一种最常导致难以纠正的休克？", "options": "A. 急性胰腺炎\nB. 急性梗阻性化脓性胆管炎\nC. 机械性肠梗阻\nD. 消化性溃疡急性穿孔\nE. 急性化脓性阑尾炎穿孔", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的CT影像中，以下哪一项表现不符合该疾病的典型特征？", "options": "A. 胰腺肿大\nB. 肾前筋膜增厚\nC. 蜂窝织炎和假囊肿形成\nD. 胰腺及胰管钙化\nE. 可合并脓肿、出血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆石症的描述，以下哪项是正确的？", "options": "A. 肝内胆管结石，右肝管多于左肝管\nB. 胆囊结石多为胆固醇结石或混合性结石\nC. 胆道蛔虫所致的结石多为混合性结石\nD. 胆色素结石的剖面，中心是放射状而外周呈层状\nE. 肝外胆管结石占全部胆石的10%，多位于肝总管或胆管上段", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化门静脉高压症患者中，脾切除联合贲门周围血管离断术用于治疗食管静脉曲张破裂出血。关于该手术的优点，以下哪项说法尚未得到广泛认同？", "options": "A. 手术创伤相对较小\nB. 止血效果较为理想\nC. 术后肝性脑病发生率较低\nD. 术后肝功能得到改善", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性重症胰腺炎的病理变化中，以下哪一项是最具特征性的表现？", "options": "A.钙皂斑\nB.脓肿、假性囊肿或瘘管形成\nC.腺泡细胞及脂肪坏死、血管出血\nD.坏死灶外周有炎性细胞包绕\nE.静脉炎、淋巴管炎和血栓形成", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在进行肝胆显像检查前，患者需要禁食多长时间？", "options": "A. 4～12小时\nB. 8～24小时\nC. 6～24小时\nD. 12～24小时\nE. 8～12小时", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝性脑病时，医生可能会给患者开新霉素口服，其主要目的是什么？", "options": "A. 抑制肠道细菌生长\nB. 预防肠道感染\nC. 减少尿素酶的产生\nD. 预防原发性腹膜炎", "answer": "AC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，B超检查发现肝右叶有一个约2cm的实性占位病变，甲胎蛋白水平为500 ug/L，肝功能正常，且有8年的肝炎病史。在这种情况下，最佳的治疗方案是什么？", "options": "A. 放疗\nB. 化疗\nC. 肝动脉栓塞\nD. 手术\nE. 观察随访", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性重症胰腺炎的患者中，以下哪种症状通常不会出现？", "options": "A. 休克\nB. 呼吸衰竭\nC. 发热\nD. 腹泻\nE. 消化道出血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床检查中，发现患者肝脏逐渐增大，触诊质地坚硬如石，表面可触及结节，这种情况最可能提示的疾病是", "options": "A. 肝淤血\nB. 慢性肝炎\nC. 肝癌\nD. 急性肝炎\nE. 脂肪肝", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化腹水患者最近一周出现发热、腹痛、腹胀加重以及呼吸困难，心率达到120次/分钟。最可能的诊断是什么？", "options": "A. 心力衰竭\nB. 自发性腹膜炎\nC. 肝癌腹膜转移\nD. 肾衰竭\nE. 肝肺综合征", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道梗阻伴感染的情况下，以下哪种并发症通常不会发生？", "options": "A.硬化性胆管炎\nB.胆道出血\nC.胆源性休克\nD.肝脓肿\nE.坏死性胰腺炎", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位60岁男性患者，长期上腹痛，疼痛向腰背部放射，弯腰时疼痛减轻。CT检查显示胰腺缩小，尿PAB排出减少，血糖水平正常，但葡萄糖耐量试验异常。根据这些症状和检查结果，最可能的诊断是什么？", "options": "A. 慢性胆囊炎\nB. 胰腺癌\nC. 隐性糖尿病\nD. 慢性胰腺炎\nE. 慢性胰腺炎并隐性糖尿病", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝囊肿继发感染和出血的情况下，以下哪种处理方式是不推荐的？", "options": "A. 应用广谱抗生素\nB. 囊肿开窗引流术\nC. 囊肿内放置双套管，术后冲洗引流\nD. 肝叶切除术\nE. 囊肿穿刺抽液", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位58岁的男性患者，既往有肝硬化病史，因大量呕血1天后出现神志恍惚、淡漠少言、口齿不清、嗜睡及昼睡夜醒等症状。护士应警惕患者可能出现了以下哪种并发症？", "options": "A. 肺性脑病\nB. 肝性脑病\nC. 呼吸衰竭\nD. 肝癌\nE. 急性胰腺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，有5年肝硬化病史，近半年来腹胀症状加重，并伴有双下肢水肿。以下哪项治疗措施是不恰当的？", "options": "A. 卧床休息\nB. 低蛋白质饮食\nC. 低盐限水\nD. 定期补充白蛋白\nE. 快速、大量利尿以加快腹水消退", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下关于肝脏的描述中，哪一项是不正确的？", "options": "A. 是人体最大的腺体\nB. 在膈面借鎌状韧带分为左、右叶\nC. 在脏面借“H”形沟分为4个叶\nD. 横沟前方是方叶\nE. 胆囊窝位于右纵沟后部", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位51岁男性患者，近10年间歇性上腹痛，近1年症状持续并加重，伴有食欲不振、腹胀和每日1～3次糊状便。体重下降5kg。体检显示血压和心肺功能正常。实验室检查：尿糖阴性，尿淀粉酶正常，大便苏丹Ⅲ染色阳性。B超显示胆囊多发结石，胰腺回声不均，胰实质有0.5cm×0.3cm强回声光团伴声影，肝脾未见异常。我国慢性胰腺炎的主要病因是什么？", "options": "A.长期嗜酒\nB.胆道疾病\nC.暴饮暴食\nD.外伤\nE.急性胰腺炎迁延", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，Calot三角的边界由以下哪些结构组成？", "options": "A. 肝下缘\nB. 胆总管\nC. 肝总管\nD. 胆囊管", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下疾病中，哪种疾病的患者需要采用低蛋白饮食？", "options": "A. 尿毒症\nB. 糖尿病\nC. 慢性肝炎\nD. 冠心病\nE. 肥胖病", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁女性患者，因持续9个月的巩膜及皮肤黄染伴皮肤瘙痒前来就诊。体检发现巩膜及皮肤明显黄染，肝脾显著肿大，初步怀疑为原发性胆汁性肝硬化。请问下列哪项检查结果最有助于确诊该疾病？", "options": "A. 血清总胆红素、结合胆红素增高\nB. 尿三胆阳性\nC. 血清白蛋白与球蛋白比例倒置\nD. 血清线粒体抗体强阳性\nE. 血清IgG显著升高", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰头肿瘤伴梗阻性黄疸的手术中，若发现肿瘤难以切除，为有效缓解黄疸症状，应选择哪种手术方式？", "options": "A.胆囊十二指肠吻合术\nB.胆总管十二指肠吻合术\nC.胆总管空肠吻合术\nD.胆总管T形管引流术\nE.胆囊造瘘术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症患者接受脾切除术后的第二周，应特别关注哪项指标的定期检查？", "options": "A. 生命体征\nB. 腹部体征\nC. 肝肾功能\nD. 凝血时间\nE. 血小板计数", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁男性患者，有4年肝硬化病史，因突发右上腹剧烈疼痛6小时前来就诊。体检发现血压为9/5kPa，伴有出冷汗，腹水征阳性，诊断性腹穿显示为血性腹水。根据这些临床表现，最可能的诊断是：", "options": "A. 肝癌结节破入腹腔\nB. 结核性腹膜炎\nC. 腹膜转移癌\nD. 自发性腹膜炎\nE. 门静脉血栓形成", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化腹水的治疗中，以下哪项原则是不正确的？", "options": "A. 患者应严格限制钠和水的摄入\nB. 应同时使用留钾利尿剂和排钠利尿剂\nC. 使用呋塞米利尿时需补充氯化钾\nD. 腹水消退后，仍需限制钠的摄入\nE. 快速利尿以迅速消退腹水有助于病情缓解", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位58岁女性患者，出现进行性黄疸15天，伴有恶心、厌食和腹胀，但无腹痛。近5天来，患者的大便呈陶土样，尿液呈浓茶色。体检发现巩膜和皮肤黄染，可触及肿大的胆囊，但无压痛。在这种情况下，首选的影像学检查是什么？", "options": "A. 内镜逆行性胰胆管造影\nB. 经皮肝穿刺胆道造影\nC. 腹部B超\nD. 磁共振胰胆管成像\nE. 静脉法胆道造影", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者，因上腹痛伴恶心呕吐12小时就诊，呕吐后疼痛未缓解。体检显示体温38℃，上腹部压痛。实验室检查结果显示白细胞计数为15×10^9/L，血淀粉酶560U/dl，尿淀粉酶378U/dl（Somogyi法）。以下哪些实验室检查结果提示患者可能出现多器官功能衰竭和严重代谢紊乱？", "options": "A. 白细胞增多\nB. 血糖3.9mmol/L\nC. 血糖14.5mmol/L\nD. 血钙3.4mmol/L\nE. 血钙1.67mmol/L\nF. 尿素氮8.1mmol/L\nG. pH7.29\nH. PaO2＜57mmHg", "answer": "ACEFGH", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁的男性患者，有长期丙型肝炎病史，已发展为肝硬化。近期出现体重显著下降、持续疲劳、频繁鼻出血、腹部膨胀加剧及尿量减少。在一次轻度活动后突然晕倒，最可能的诊断是什么？", "options": "A. 失血性休克\nB. 原发性肝癌\nC. 肝癌结节破裂出血\nD. 低血糖昏迷\nE. 肝硬化并发消化道出血", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆道系统的生理功能，以下哪一项描述是正确的？", "options": "A.胆囊每日分泌胆汁200ml\nB.肝细胞每日分泌胆汁400ml\nC.胆囊的排空收缩主要受缩胆囊素的影响\nD.胆盐和磷脂相对增多可形成胆固醇结石\nE.肝脏分泌胆汁后，在胆囊内被浓缩2倍", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫的治疗中，以下哪种情况不是手术的明确指征？", "options": "A. 合并急性胰腺炎或胆道蛔虫与结石并存者\nB. 非手术治疗3～5天，病情恶化者\nC. 合并急性化脓性胆管炎、胆囊炎者\nD. 合并肝脓肿、胆道出血、腹膜炎、败血症、中毒性休克者\nE. 合并重度黄疸者", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性肝衰竭的治疗方案中，以下哪项措施是不推荐的？", "options": "A. 使用甘露醇以降低颅内压\nB. 进行腹膜透析\nC. 实施抗感染治疗\nD. 控制水分摄入并调整电解质和酸碱平衡\nE. 使用泻剂或乳果糖并限制蛋白质摄入", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁男性患者在常规体检中发现肝左叶有一个3cm×3cm的占位性病变，体检无阳性体征，肝肾功能正常。为了进一步诊断原发性肝癌，以下哪项检查最为关键？", "options": "A. AFP（+）\nB. 胸片\nC. r-GT\nD. CT\nE. CEA（-）", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病患者的饮食管理中，以下哪种饮食成分是不推荐的？", "options": "A. 高热量\nB. 高碳水化合物\nC. 高维生素\nD. 高蛋白质\nE. 对于不能进食的患者，可以使用鼻饲或静脉滴注葡萄糖", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝癌患者的AFP水平时，以下哪项陈述是错误的？", "options": "A. 肝炎和肝硬化患者的AFP检测结果可能为阳性\nB. 肝癌患者的AFP水平可能不会升高\nC. AFP的浓度与肝癌的肿瘤大小无关\nD. 肝癌患者中，LCA结合型AFP的比例通常超过25%\nE. 在活动性肝病中，AFP和ALT的水平变化趋势通常是平行或同步的", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，为了减少肝脏缺血损伤，常温下阻断入肝血流的安全时间上限通常是多少？", "options": "A. 5～10分钟\nB. 15～20分钟\nC. 20～25分钟\nD. 25～30分钟\nE. 30～35分钟", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝内、外胆管结石形成的主要机制是什么？", "options": "A. 胆汁中大肠埃希菌产生葡萄糖醛酸酶的水解作用\nB. 磷脂增加\nC. 胆盐增加\nD. 血胆固醇增加\nE. 胆盐下降", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性重型肝炎的病理变化中，以下哪一项描述是不正确的？", "options": "A. 肝细胞广泛坏死\nB. 肝窦扩张充血及出血\nC. 网状支架塌陷\nD. 淋巴细胞及巨噬细胞浸润\nE. 可见明显的肝细胞再生结节", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下肝硬化的临床类型中，哪些类型通常伴有肝脏肿大的表现？", "options": "A. 肝炎后肝硬化\nB. 淤血性肝硬化\nC. 酒精性肝硬化\nD. 原发性胆汁性肝硬化", "answer": "BCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能受损的情况下，下列哪种代谢异常通常不会发生？", "options": "A. 血糖水平下降\nB. 蛋白质水平降低\nC. 血钾水平升高\nD. 血钠水平降低\nE. 血浆渗透压下降", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺疾病伴发的精神障碍，下列哪项描述是错误的？", "options": "A. 急性胰腺炎所致精神障碍主要表现为抑郁状态、幻觉妄想状态、意识障碍\nB. 急性胰腺炎幻觉妄想状态以被害妄想、评论性幻听为主\nC. 慢性胰腺炎精神障碍与胆道疾病和饮酒有关\nD. 急性胰腺炎意识障碍时，慎重抗精神病药\nE. 胰腺癌所致精神障碍以妄想障碍为主", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，血清淀粉酶水平的峰值通常出现在症状发作后的哪个时间段？", "options": "A. 4小时\nB. 8小时\nC. 12小时\nD. 24小时\nE. 48小时", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪项因素最可能诱发肝性脑病？", "options": "A. 上消化道出血\nB. 吃甜食\nC. 饮浓茶\nD. 摄入低蛋白食物\nE. 3天排便1次", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在2009年秋季，广西某县城居民因长期以玉米为主食，突然有10余人出现发烧、呕吐、厌食、黄疸等症状，随后发展为腹水和水肿。经医生诊断排除了传染性肝炎的可能性，最可能的原因是", "options": "A.玉米种有农药残留\nB.玉米被AF污染\nC.污水灌田引起玉米中镉超标\nD.玉米晾晒过程被多环芳烃污染\nE.玉米种混进了有毒植物种子", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁男性患者，有6年慢性乙型肝炎病史，最近1个月出现皮肤呈现金黄色。体检发现肝掌和蜘蛛痣。以下哪项实验室检查结果不符合该患者的病情？", "options": "A.尿中胆红素阳性\nB.血中结合胆红素和非结合胆红素均增加\nC.尿中尿胆原增加\nD.血中胆红素增加，以结合胆红素为主\nE.血清转氨酶明显升高", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆囊结石症的错误描述是", "options": "A. 可能引发急性胆囊炎\nB. 可能导致胆囊积脓\nC. 可能引起急性化脓性胆管炎和全身感染\nD. 大结石比小结石更容易引起症状\nE. 无症状的胆囊结石通常不需要治疗", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，导致胰腺炎发生的最主要病因是以下哪一项？", "options": "A. 长期酗酒\nB. 胆道系统疾病\nC. 使用噻嗪类降压药物\nD. 血液中脂肪含量过高\nE. Oddi括约肌功能异常", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，阿托品作为一种解痉药物，最适合用于缓解以下哪种疼痛？", "options": "A. 支气管痉挛\nB. 心绞痛\nC. 胆绞痛\nD. 肾绞痛\nE. 胃肠绞痛", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆总管的正常压力范围是多少？", "options": "A. 6～9cmH2O\nB. ＜6cmH2O\nC. 9～15cmH2O\nD. 20～25cmH2O\nE. 15～20cmH2O", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位33岁女性患者，有8年乙型肝炎病史，近5个月来反复出现肝区疼痛，伴有间歇性恶心和体重下降。B超检查发现左肝叶有一个3cm的低回声肿块，血清AFP水平为530ng/ml。根据这些信息，最可能的诊断是什么？", "options": "A. 早期肝硬化\nB. 活动性肝炎\nC. 生殖腺胚胎肿瘤\nD. 原发性肝癌\nE. 滋养层细胞肿瘤", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位38岁女性患者，长期服用避孕药，近期出现上腹不适和食欲减退，体检发现上腹部有一表面光滑、质硬、无压痛且随呼吸移动的包块。进一步检查诊断为肝腺瘤。关于该患者的治疗原则，以下哪项是错误的？", "options": "A. 不论其有无症状，均应争取尽早手术治疗\nB. 肿瘤破裂时必须急诊手术，可先夹闭肝动脉以止血\nC. 肿瘤侵犯肝的一叶或半肝，可作局部、肝叶或半肝切除\nD. 腺瘤紧邻大血管，不能将肿瘤完整切除时，应行局部化疗药物灌注\nE. 可沿包膜切除肿瘤", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌的初步诊断中，最推荐的首选检查方法是什么？", "options": "A. CT扫描\nB. 磁共振成像（MRI）\nC. 超声检查\nD. 肝动脉造影\nE. 超声检查联合甲胎蛋白（AFP）定量测定", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的临床表现中，以下哪一项最典型？", "options": "A. 突发剑突下剧烈疼痛、阵发性伴钻顶感，间歇期不痛\nB. 右上腹部阵发性绞痛\nC. 突发左上腹剧痛可伴左肩、腰背放射\nD. 食后上腹胀痛、伴呕吐\nE. 与饮食有关的慢性周期性节律性上腹痛", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，10年前曾患无黄疸型肝炎，半年前开始出现腹胀，腹部逐渐增大，近日出现嗜睡和晚间烦躁不安前来就诊。体检发现患者神志模糊，皮肤有轻度黄染，腹水征阳性，肝脾未满意扪及。随后患者神志不清进入昏迷状态，此时应选用哪种药物治疗？", "options": "A.谷氨酸钠（钾）\nB.胰岛素\nC.葡萄糖\nD.阿托品\nE.甲氯芬酯（氯酯醒）", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在口服法胆囊造影中，以下哪项因素不会导致胆囊不显影？", "options": "A.胆囊管阻塞\nB.肝功能不良\nC.胃肠吸收不全\nD.胆囊无收缩功能\nE.肾功能不良", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现右上腹疼痛、高热寒战，随后出现黄疸，最可能的诊断是以下哪种疾病？", "options": "A. 急性肝炎\nB. 慢性肝炎\nC. 急性胆囊炎\nD. 急性梗阻性化脓性胆管炎\nE. 急性阑尾炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科治疗中，以下哪种药物组合可以有效抑制胰酶活性？", "options": "A. 加贝酯\nB. 氟尿嘧啶\nC. 抑肽酶\nD. 生长抑素\nE. 奥曲肽", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，近3个月来持续感到肝区疼痛，肝脏逐渐增大，频繁出现低血糖症状，且外周血中红细胞计数明显升高。根据这些症状，最可能的诊断是：", "options": "A. 真性红细胞增多症\nB. 重症肝炎\nC. 肺源性心脏病\nD. 原发性肝癌\nE. 继发性红细胞增多症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下选项中，哪一种情况与静脉血管杂音相关？", "options": "A. 甲亢时甲状腺侧叶的血管杂音\nB. 多发性大动脉狭窄局部的血管杂音\nC. 肝硬化门脉高压上腹部血管杂音\nD. 冠状动静脉瘘\nE. 动脉导管未闭", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在解剖学中，胆总管下段与胰头的关系是？", "options": "A. 前方\nB. 后方\nC. 外侧\nD. 内侧\nE. 实质内", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，关于胆管细胞癌的特征描述，以下哪几项是正确的？", "options": "A. 起源于肝内胆管的上皮细胞\nB. 在CT平扫中，胆管细胞癌与肝细胞癌的鉴别较为困难\nC. 在CT平扫中，胆管细胞癌通常表现为低密度实性病灶，部分病例可见不规则钙化\nD. 在某些情况下，末梢胆管的局限性扩张可能是胆管细胞癌的唯一表现\nE. 增强扫描后，胆管细胞癌的病灶显示更为清晰，可能呈现多结节状", "answer": "ACDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的发病机制中，以下哪项是最主要的诱因？", "options": "A. 胆石症和胆道疾病\nB. 感染\nC. 胰管梗阻\nD. 腹部外伤\nE. 暴饮暴食", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的诊断中，以下哪种肿瘤标记物最为常用？", "options": "A. AFP\nB. CA19-9\nC. CA125\nD. CA15-3\nE. PSA", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的病理变化和临床表现中，以下哪项描述是不正确的？", "options": "A. 水肿型病变通常局限于胰尾\nB. 水肿型病变可能伴有局限性脂肪坏死\nC. 出血型病变表现为大片凝固性坏死\nD. 血清碱性磷酸酶活性显著增加\nE. 血清和尿中的淀粉酶水平升高", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝内胆管结石的分布中，哪个部位更为常见？", "options": "A.右肝管多于左肝管\nB.左右肝管相同\nC.左肝管多于右肝管\nD.完全在左肝管\nE.完全在右肝管", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位患者在体检时发现肝右后叶上段有一个0.7cm的强回声斑块，后方伴有清晰的声影，斑块周围未见门静脉分支，肝内外胆管未见扩张，最可能的诊断是", "options": "A. 肝内胆管结石\nB. 肝内钙化灶\nC. 肝内胆管积气\nD. 肝圆韧带横断面\nE. 肝内高回声型血管瘤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位59岁的女性患者因持续黄疸1个月入院，初步诊断为阻塞性黄疸。以下哪项临床表现和辅助检查结果最支持这一诊断？", "options": "A. 皮肤瘙痒\nB. 血清碱性磷酸酶显著升高\nC. 影像学检查显示肝内胆管扩张\nD. 大便颜色加深\nE. 血清结合胆红素高于非结合胆红素", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性化脓性胆管炎的治疗策略中，以下哪项描述是不正确的？", "options": "A.胆管梗阻和胆管化脓性感染并存\nB.致病菌主要有大肠埃希菌、变形杆菌、产气杆菌等以及厌氧菌\nC.起病急骤，可发生感染性休克、并发急性肝肺肾衰竭\nD.白细胞计数、中性粒细胞及胆红素均升高，代谢性酸中毒，PaO2下降\nE.先保守治疗，病情稳定后择期手术", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁女性患者，3个月前接受了乳腺癌根治术，术中输血800mL。近期肝功能检查显示ALT升高至150u，进一步检测发现甲肝抗体阳性，抗HBs阳性，抗HCV阳性，丁肝和戊肝抗体均为阴性。针对此情况，最佳的治疗方案是", "options": "A. 以“保肝”治疗为主\nB. “保肝”治疗+阿昔洛韦\nC. “保肝”治疗+猪苓多糖\nD. “保肝”治疗+α干扰素\nE. “保肝”治疗+强的松", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆总管梗阻的情况下，以下哪项描述最符合影像学表现？", "options": "A. 肝内胆管扩张、肝管扩张、胆囊空虚\nB. 肝内外胆管扩张、胆囊增大\nC. 肝内外胆管扩张、胆囊增大、胰管扩张(双管征）\nD. 肝内胆管不扩张、肝管扩张、胆囊空虚\nE. 肝内胆管不扩张、肝管不扩张、胆囊空虚", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位53岁男性患者，因右上腹痛2天，伴有皮肤和黏膜黄染1天，体温高达40℃，并出现寒战。体检发现右上腹有压痛和反跳痛。在这种情况下，首选的影像学检查是什么？", "options": "A. 血常规\nB. 血清胆红素\nC. 肝胆CT\nD. 肝胆脾彩超\nE. 立体腹平片", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位26岁女性患者，半年前进行了人工流产手术，近期出现阴道不规则出血，并伴有厌食、恶心和肝区疼痛。肝脏超声检查显示多个异常回声，血hCG水平显著升高，最终诊断为绒癌肝转移。根据这些临床表现和检查结果，该患者的分期应为？", "options": "A.Ⅰ期\nB.Ⅱa期\nC.Ⅱb期\nD.Ⅲ期\nE.Ⅳ期", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道探查取石手术后，何时可以拔除“T”形管？", "options": "A.术后1周，切口拆线\nB.术后1周，引流减少\nC.术后1周，体温正常，白细胞下降\nD.术后2周，黄疸消退，肝功能正常\nE.术后2周，引流减少，造影通畅", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，以下哪种疾病最适合进行穿刺检查？", "options": "A. 肝细胞癌\nB. 肝管细胞癌\nC. 继发性肝癌\nD. 阿米巴肝脓肿\nE. 肝包囊虫病", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎的患者中，以下哪一项症状通常不会出现？", "options": "A. 黄疸\nB. 食欲缺乏、腹泻\nC. 反复发作腹痛\nD. 恶心、呕吐\nE. 腹胀", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的治疗中，以下哪项原则是不正确的？", "options": "A. 保证充足的休息\nB. 采用高维生素饮食\nC. 对于由肝炎引起的肝硬化，进行抗肝炎治疗\nD. 避免使用对肝脏有损害的药物\nE. 采用高热量高蛋白质饮食", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床检查中，患者出现胆囊肿大且无压痛，同时伴有明显的皮肤和巩膜黄染，最可能的诊断是", "options": "A. 胰头癌\nB. 急性胆囊炎\nC. 急性胆管炎\nD. 胰体癌\nE. 急性黄疸型肝炎", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "根据国际自身免疫性肝炎研究小组的标准，治疗前评分达到多少分可以确诊自身免疫性肝炎（AIH）？", "options": "A. 10分\nB. 11分\nC. 12分\nD. 13分\nE. 15分", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，急性胰腺炎患者最常见的症状表现是什么？", "options": "A. 上腹部烧灼感，进食后症状减轻\nB. 上腹部持续剧烈疼痛，疼痛向腰背部放射\nC. 阵发性上腹部钻顶样疼痛，患者常辗转反侧\nD. 脐周阵发性绞痛，伴有停止排便排气\nE. 上腹部剧烈疼痛，疼痛向左上臂内侧放射", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的并发症中，以下哪一项是不常见的？", "options": "A. 假性囊肿\nB. 糖尿病\nC. 痢疾样大便\nD. 血性腹水", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，3年前接受了胆总管切开取石手术，目前出现持续黄疸已一个月，肝脏肿大至肋下3cm，血清胆红素水平为70μmol/L，超声检查显示胆总管直径为2cm。在这种情况下，以下哪种检查方法最为适宜？", "options": "A.口服法胆囊造影术\nB.静脉法胆道造影术\nC.低张性十二指肠造影\nD.CT\nE.PTC", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名4个月大的女婴，已被诊断为先天性胆总管囊肿。近两周来，她出现了严重的黄疸、持续高热，并且凝血酶原时间延长。在这种情况下，最合适的治疗方法是", "options": "A.囊肿外引流术\nB.静脉输液加抗生素\nC.囊肿切除Roux-Y手术\nD.囊肿切除空肠间置代胆道术\nE.行囊肿十二指肠吻合术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在进行MRCP检查以诊断胆道结石时，以下哪些因素可能导致误诊？", "options": "A.胆道内的气泡\nB.胆道内的血凝块\nC.右肝动脉或胃十二指肠动脉外压造成的充盈缺损\nD.胆囊窝内的金属夹\nE.以上各项均不正确", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "胆总管的行程可以分为哪几个部分？", "options": "A. 十二指肠上段、胰腺段、十二指肠壁内段\nB. 十二指肠上段、胰腺段、十二指肠壁后段\nC. 十二指肠上段、十二指肠后段、胰腺段、十二指肠壁内段\nD. 十二指肠上段、胰腺段、十二指肠后段、十二指肠壁内段\nE. 十二指肠上段、十二指肠壁内段、十二指肠后段", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，胆管梗阻的定位通常分为哪几个关键区域？", "options": "A.肝门段\nB.胰腺段\nC.胰上段\nD.壶腹段", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位28岁男性患者，因胃溃疡接受了胃切除手术。术后半年，他出现了明显的上腹部疼痛和频繁腹泻。尽管使用了制酸药物和诺氟沙星（氟哌酸）治疗，症状未见改善，反而加重。请问最可能的诊断是什么？", "options": "A. 功能性消化不良\nB. 胃空肠吻合口溃疡\nC. 慢性胰腺炎\nD. 胃泌素瘤\nE. 癌性溃疡", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，以下哪项陈述是正确的？", "options": "A. 血清淀粉酶水平超过正常值的两倍即可确诊急性胰腺炎\nB. 尿淀粉酶水平升高可以持续2至4周\nC. 血清淀粉酶水平在发病后8小时达到峰值\nD. 淀粉酶水平的高低并不总是与病情的严重程度相关\nE. 只有血和尿淀粉酶水平升高才能诊断急性胰腺炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于肝损伤导致胆汁分泌减少的影响，以下哪项说法是不正确的？", "options": "A. 影响脂肪的消化分解\nB. 影响脂肪的吸收\nC. 脂溶性维生素吸收\nD. 影响胃酸的中和\nE. 不影响水溶性维生素的吸收", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，患有肝硬化并伴有腹水，腹部胀大且坚硬，胃脘部闷胀，食欲不振，大便稀溏，小便不畅，舌苔白腻，脉象弦缓。请问其最合适的治疗方法是？", "options": "A.运脾利湿，化气行水\nB.疏肝理气，攻下逐水\nC.活血化痰，利水消肿\nD.调脾行气，清热利湿\nE.温补肾阳，通络利水", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位46岁男性在健康体检中通过B超发现右肝有一个1.5cm×2cm的占位性病变，接下来应首选哪种检查？", "options": "A. ALP\nB. GGT\nC. AFP\nD. AFα（α-岩藻糖苷酶）\nE. CA19-9", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性出血坏死型胰腺炎中，以下哪项描述最能概括其严重的临床表现？", "options": "A. 上腹剧痛，高热持续l周以上\nB. 常伴有休克\nC. 腹胀显著，腹壁紧张与上腹肿块，可并发胰腺脓肿\nD. 血尿淀粉酶不增高\nE. 以上各点都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在妊娠期胆石性胆囊炎的治疗中，以下哪种方法是最为推荐的？", "options": "A.首选内科药物治疗\nB.首选外科治疗尽可能切除胆囊\nC.首选外科治疗行胆囊造口引流术\nD.首选外科治疗尽可能切除胆囊并行胆管探查术\nE.首选内科药物治疗，病情缓解后行胆囊切除术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的早期阶段，患者可能出现哪些症状？", "options": "A. 定向力减退，计算能力差\nB. 表情欣快，行为异常\nC. 脑电图异常\nD. 肌张力增强", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，长期HBsAg阳性，血ALT水平为28g/L，体检发现肝脏体积增大，但巩膜无明显黄染。该患者肝脏最可能的病理变化是", "options": "A. 气球样变\nB. 脂肪变性\nC. 嗜酸性坏死\nD. 碎片状坏死\nE. 桥接坏死", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位65岁男性患者因上腹部不适和食欲减退前来就诊。影像学检查显示右上腹平片有石榴籽样致密阴影，侧位片显示该致密影位于前方并与肋骨相连，且位置固定。最可能的诊断是什么？", "options": "A. 右肾结石\nB. 肠系膜淋巴结钙化\nC. 肝癌\nD. 肋软骨钙化\nE. 胆囊结石", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌肝叶切除术后，以下哪些措施有助于预防肝昏迷的发生？", "options": "A. 术前使用护肝药物\nB. 术后吸氧\nC. 术前用酸性液灌肠\nD. 保持大便通畅\nE. 术前应用维生素K", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性普通型病毒性肝炎的病理变化中，下列哪一项描述是正确的？", "options": "A. 汇管区炎症并突破界板\nB. 桥接坏死伴小叶结构破坏\nC. 肝细胞广泛脂肪变性伴嗜酸性粒细胞浸润\nD. 肝细胞广泛水肿伴点状坏死", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者近期发现肝脏体积逐渐增大，作为主治医生，您首先应该考虑以下哪种可能性？", "options": "A. 肝癌的发生\nB. 肝炎活动加剧\nC. 门静脉压力升高\nD. 肝淤血加重\nE. 肝硬化进展", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆管结石和胆管炎急性发作时，患者最可能出现的典型症状组合是？", "options": "A. 腹痛、呕吐、寒热\nB. 腹痛、黄疸、腹泻\nC. 腹痛、腹胀、昏迷\nD. 腹痛、呕吐、黄疸\nE. 腹痛、黄疸、寒热", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在酗酒和丙型肝炎患者中，以下哪项描述是正确的？", "options": "A. 会增加肝细胞癌的风险性\nB. 降低肝细胞癌的风险性\nC. 无变化\nD. 取决于丙型肝炎病毒的基因型\nE. 不明确", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位18岁女性患者，一周前突然出现黄疸，伴有面色发黄、胸胁部胀痛、恶心呕吐以及小便黄赤等症状，中医辨证为肝胆湿热证。针对此证型，下列哪种中成药最为适宜？", "options": "A. 香连丸\nB. 排石颗粒\nC. 消炎利胆片\nD. 沉香化滞丸\nE. 茵栀黄口服液", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "对于肝硬化合并腹水的患者，医生通常会建议严格控制每日的钠盐摄入量。请问以下哪个选项最符合这类患者的每日氯化钠摄入量建议？", "options": "A. 1.2～2.0g\nB. 4.5～5.0g\nC. 3.5～4.0g\nD. 2.5～3.0g\nE. 5.0～7.5g", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位43岁女性患者，因突发右上腹剧烈疼痛并伴有阵发性加重3天，伴随寒战、高热、恶心和呕吐。体检发现全身黄疸，体温高达39℃，脉搏120次/分，血压降至80/60mmHg，出现谵妄和神志不清。剑突偏左腹肌紧张，肝肋下可触及2cm，白细胞计数15×10^9/L，中性粒细胞占80%，血清总胆红素50μmol/L。针对此病例，最重要的治疗措施是什么？", "options": "A. 胆囊切除，腹腔引流术\nB. 抗休克，抗感染治疗\nC. 胆总管减压引流\nD. 胆囊造口术\nE. 溃疡病穿孔缝合", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在重症胰腺炎的临床表现中，以下哪一项不属于其典型体征？", "options": "A. 上腹或全腹压痛明显\nB. 肠鸣音增加\nC. Grey-Turner征\nD. Cullen征\nE. 腹肌紧张、反跳痛明显", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性胰腺炎的临床特征中，下列哪一项描述是不准确的？", "options": "A. 患者群体主要集中在30至60岁的女性\nB. 大多数患者会经历不同程度的腹部疼痛\nC. 黄疸是该疾病可能出现的症状之一\nD. X线检查可能显示胰腺区域有钙化或结石\nE. 超声检查可能发现胰腺体积增大或缩小", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗急性胰腺炎并伴有脂质代谢紊乱的患者时，以下哪种药物应避免通过静脉途径给予？", "options": "A.胰岛素注射液\nB.生长抑素注射液\nC.葡萄糖注射液\nD.乌司他丁注射液\nE.脂肪乳注射液", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能障碍导致的高胆红素血症中，以下哪一项不是其原因？", "options": "A. 肝脏摄取胆红素障碍\nB. 肝脏合成胆红素障碍\nC. 肝脏酯化胆红素障碍\nD. 肝脏运载胆红素障碍\nE. 肝脏排泄胆红素障碍", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的诊断中，以下哪一项体征最为关键？", "options": "A. 上腹部压痛\nB. 黄疸\nC. 营养不良\nD. 腹部包块\nE. Courvoisier征", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆汁淤积性黄疸的病例中，以下哪项描述是正确的？", "options": "A.尿胆原减少，尿胆红素（-）\nB.尿胆原增加，尿胆红素（-）\nC.尿胆原减少，尿胆红素（-）\nD.尿胆原增加，尿胆红素（-）\nE.粪胆素（-）", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的发病机制中，以下哪一项因素与其关联性较弱？", "options": "A. 乙型肝炎病毒感染\nB. 酒精性肝病\nC. 门静脉高压性肝硬化\nD. 黄曲霉毒素暴露\nE. 华支睾吸虫感染", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估慢性肝细胞损伤时，以下哪项指标被认为是最敏感的？", "options": "A. ALT\nB. γ-GT\nC. AST\nD. AMY\nE. ChE", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位34岁男性患者，主诉肝区疼痛并伴有间歇性发热。影像学检查（B超、CT）显示左肝外叶胆管扩张伴结石，胆囊肿大，胆总管增粗且内有泥沙样结石。术中证实胆总管远端明显狭窄，F9号导尿管无法通过。请问以下哪些手术方式适用于该患者？", "options": "A. 胆囊切除术\nB. 胆肠吻合术\nC. 胆总管探查术\nD. 左肝外叶切除术\nE. Oddi括约肌成形术", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝昏迷的早期阶段，下列哪项症状最为显著？", "options": "A. 精神错乱\nB. 肌张力增高\nC. 行为异常、吐词不清\nD. 表情欣快，昼睡夜醒\nE. 意识模糊、扑翼震颤", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断由结石、胰头癌或胆管癌引起的梗阻性黄疸时，以下哪几项因素最为关键？", "options": "A. 胆管及胰管的扩张程度\nB. 胆管及胰管的扩张平面\nC. 胆管的形态及管壁厚度\nD. 肝脏的大小及密度\nE. 是否存在结石和软组织肿块", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏中，胆红素主要与哪种基团结合？", "options": "A. 硫酸银\nB. 乙酰基\nC. 葡萄糖醛酸基\nD. 甲基\nE. 以上都不是", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆道感染的并发症中，以下哪一项不属于其常见并发症？", "options": "A. 胆道出血\nB. 急性胰腺炎\nC. 硬化性胆管炎\nD. 感染性休克\nE. 肝脓肿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝外伤后肝动脉栓塞的适应证包括哪些情况？", "options": "A. 肝动脉破裂\nB. 动脉门脉瘘\nC. 创伤性胆道出血\nD. 肝修补术后仍出血\nE. 假性动脉瘤形成", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者李某，男性，60岁，一年前因肝细胞癌接受了左半肝切除术。术后需定期随访，以下哪种检查方法对早期发现肿瘤复发最为敏感？", "options": "A. 定期进行ALT水平监测\nB. 定期进行GGT水平监测\nC. 定期进行腹部超声检查\nD. 定期进行甲胎蛋白（AFP）检测\nE. 选择性进行肝动脉造影", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，哪种手术方法既能有效降低门静脉压力，又能确保肝门静脉血流的持续供应？", "options": "A.脾肾静脉分流术\nB.门腔静脉分流术\nC.脾腔静脉分流术\nD.贲门周围静脉离断术\nE.肠系膜上、下腔静脉分流术", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，关于尿淀粉酶水平的变化，下列哪项描述是正确的？", "options": "A. 发病后3-12小时开始升高\nB. 与血淀粉酶同时升高\nC. 24-48小时达到峰值\nD. 2-5天后恢复正常\nE. 发病12小时后开始升高", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胰岛素瘤时，以下哪种试验被认为是最有意义的？", "options": "A.高渗盐水试验\nB.水利尿试验\nC.螺内酯试验\nD.饥饿试验\nE.酚妥拉明试验", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病伴有肾功能损害的患者中，下列哪种口服抗生素是合适的选择？", "options": "A. 新霉素\nB. 卡那霉素\nC. 氨苄西林(氨苄青霉素）\nD. 甲硝唑（灭滴灵）\nE. 庆大霉素", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆总管探查T管引流术后，关于拔除T管的注意事项中，下列哪项是错误的？", "options": "A. 拔除T管前常规行T管造影\nB. 造影后保持T管开放12小时后再夹闭\nC. 对低蛋白血症或营养不良的患者应适当推迟拔管时间\nD. 拔管时切忌使用暴力\nE. 如果造影发现结石残留，则需保留T管6周以上", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，5小时前出现剧烈上腹部疼痛，疼痛向背部放射，伴有多次恶心、呕吐，呕吐后疼痛未缓解。患者出现休克症状，病史显示7小时前曾参加聚会并暴食、饮酒。此时，最有价值的检查是（）。", "options": "A.血白细胞计数\nB.尿淀粉酶测定\nC.血淀粉酶测定\nD.血小板计数\nE.血电解质测定\nF.尿常规检查", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝功能不全的情况下，药物的代谢和排泄通常会受到影响。以下哪项描述最准确地反映了肝功能不全患者服药后的药动学变化？", "options": "A. 半衰期缩短，血药浓度降低\nB. 半衰期延长，血药浓度增高\nC. 药物效应不变\nD. 药物效应增强\nE. 药物效应减弱", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者进入肝功能失代偿期时，下列哪项临床表现最为显著？", "options": "A. 食欲减退\nB. 恶心、呕吐\nC. 疲劳、黄疸\nD. 肝脏体积增大\nE. 腹水", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在重症肝炎患者中，最常见的致命并发症是以下哪一项？", "options": "A. 肝性脑病\nB. 严重感染\nC. 心力衰竭\nD. 弥散性血管内凝血（DIC）\nE. 酮症酸中毒", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像中，以下哪种药物不用于显像？", "options": "A. 99mTc-IDAS\nB. 99mTc-PAA\nC. 99mTc-EHIDA\nD. 99mTc-Mebrofenin\nE. 99mTc-MIBI", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下肝外伤类型中，哪一种最不可能导致肝内或腹腔脓肿的形成？", "options": "A. 肝包膜下血肿\nB. 肝真性破裂\nC. 肝中央破裂\nD. 开放型肝损伤\nE. 肝脏被膜挫裂", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁的女性患者因肝癌破裂导致大出血被紧急送往医院，随即开始输血。在输注50 ml血液后，患者出现烦躁不安、心前区压迫感、腰背酸痛，尿液呈酱油色，血压降至70/40 mmHg。除了立即停止输血外，还应采取哪些措施？", "options": "A.抗休克\nB.抗休克，碱化尿液\nC.抗休克，碱化尿液，利尿\nD.利尿\nE.碱化尿液", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的病例中，淋巴转移最常发生在哪个部位？", "options": "A. 腹膜后淋巴结\nB. 主动脉旁淋巴结\nC. 锁骨上淋巴结\nD. 肝门淋巴结\nE. 胰周淋巴结", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌患者的健康教育计划中，哪种评价方法贯穿整个计划的实施过程？", "options": "A. 效应评价\nB. 目的评价\nC. 总结评价\nD. 结局评价\nE. 过程评价", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在解剖学中，胆总管的末端通常位于胰头的哪个位置？", "options": "A. 前方\nB. 后方\nC. 内侧\nD. 实质中\nE. 外侧", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名25岁男性患者因乏力、食欲减退、尿色深黄3天，神志欠清1天入院。体检显示体温36.7℃，脉搏80次/分，患者烦躁不安，检查不合作，巩膜中度黄染，肝浊音界明显缩小。以下哪项处理措施是不正确的？", "options": "A. 氯丙嗪25mg肌注\nB. 肝脑清500mL静滴\nC. 谷氨酸钠23g+10％ 葡萄糖500mL静滴\nD. 20％甘露醇100mL静注\nE. 左旋多巴400mg静滴", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，了解血管解剖至关重要。以下哪支动脉的起源与肠系膜上动脉无关？", "options": "A. 胰十二指肠上动脉\nB. 结肠中动脉\nC. 回结肠动脉\nD. 胰十二指肠下动脉\nE. 结肠右动脉", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断中，血清中甲胎蛋白水平的显著升高最常与以下哪种疾病相关？", "options": "A. 胃肠道肿瘤\nB. 乳腺肿瘤\nC. 肝癌\nD. 血细胞恶性肿瘤\nE. 肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在长期慢性溶血的患者中，最常见的并发症是什么？", "options": "A.胆道结石或炎症\nB.吞咽异物感\nC.肾功能不全\nD.出血性膀胱炎\nE.尿铅增高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝破裂的诊断中，以下哪一项陈述是不正确的？", "options": "A. 患者通常有明确的外伤史\nB. 肝破裂可能并发肝脓肿\nC. 左肝破裂的发生率高于右肝破裂\nD. 患者常表现出明显的腹膜刺激征\nE. 肝破裂可能导致呕血和黑便", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在先天性胆管扩张症的患者中，以下哪些临床表现是可能出现的？", "options": "A. 右上腹肿块\nB. 黄疸\nC. 发热、上腹痛\nD. 右上腹阵发性绞痛\nE. 症状出现的时间范围广泛，从新生儿到成年均可", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁女性患者，既往健康状况良好，最近两个月出现巩膜和皮肤黄染，且症状逐渐加重。患者无腹痛，但体重略有下降。体检发现肝脏在肋下可触及，右上腹可扪及肿大的胆囊，无触痛，无发热。为了明确黄疸的性质，以下哪项检查最有意义？", "options": "A. B超检查\nB. CT检查\nC. MRI检查\nD. 肝功能检查\nE. ERCP", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位肝硬化腹水患者最近一周出现发热、腹痛、腹胀加重以及呼吸困难，心率达到120次/分钟。这些症状最可能提示的并发症是什么？", "options": "A. 心力衰竭\nB. 自发性腹膜炎\nC. 肝癌腹膜转移\nD. 肾衰竭\nE. 肝肺综合征", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脾破裂出血引发低血容量性休克的情况下，根据医疗指导，应迅速给予哪种类型的液体？", "options": "A. 营养液\nB. 利尿剂\nC. 镇静剂\nD. 强心剂\nE. 晶体胶体液", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪种内分泌变化是不正确的？", "options": "A. 醛固酮水平升高\nB. 血管升压素水平升高\nC. 雌激素水平升高\nD. 肾上腺皮质激素水平升高\nE. 垂体前叶分泌功能受到抑制", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的病理特征中，以下哪一项描述是正确的？", "options": "A. 胰腺癌可发生于胰腺的任何部位，胰头癌约占70%\nB. 胰腺癌大多起源于胰腺腺泡细胞，约占90%\nC. 胰腺癌少数起源于腺管上皮细胞，约占10%\nD. 胰腺腺泡细胞癌又称为髓样癌，易出血\nE. 胰腺腺泡包膜完整，血运丰富，易发生早期转移", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，要素膳的使用是不合适的？", "options": "A. 胰腺炎\nB. 短肠综合征\nC. 大面积烧伤\nD. 胃肠功能衰竭\nE. 营养不良术前营养", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝门静脉高压导致食管静脉丛曲张的情况下，肝门静脉血液通过哪些途径回流至上腔静脉？", "options": "A. 肠系膜下静脉\nB. 肝静脉\nC. 脾静脉\nD. 奇静脉\nE. 附脐静脉", "answer": "DE", "answer_format": "MultipleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断中，如何区分肝硬化引起的水肿和右心衰竭引起的水肿？", "options": "A. 是否存在肝脏肿大\nB. 是否存在肝功能异常\nC. 是否存在腹部积液\nD. 是否存在颈静脉扩张\nE. 是否存在下肢水肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化患者是否并发原发性肝癌时，以下哪项检查最具诊断价值？", "options": "A. 胃镜检查显示食管下段及胃底静脉曲张\nB. 腹水分析\nC. 白蛋白与球蛋白比例显著倒置\nD. 靛青绿清除试验\nE. 肝脾超声检查", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的TACE治疗中，以下哪一项陈述是不正确的？", "options": "A. 肝癌的血供95%以上来自肝动脉\nB. 正常肝组织的血供70%～75%来自肝动脉\nC. 带有化疗药物的碘油可趋向性沉积在肿瘤局部\nD. TACE能使肝癌组织坏死\nE. TACE能诱导肿瘤细胞凋亡", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，突然出现寒战、高热，体温在39℃至40℃之间，呈弛张热型。患者主诉右上腹胀痛，体检发现右上腹肌紧张、压痛，肝脏肿大。实验室检查显示白细胞计数为21×10^9/L，伴有核左移。影像学检查中，X线显示右膈肌升高且运动受限，B超提示肝内存在液平，同位素扫描显示肝脏有占位性病变。根据这些临床表现和检查结果，最可能的诊断是什么？", "options": "A. 肝癌\nB. 细菌性肝脓肿\nC. 阿米巴肝脓肿\nD. 急性肝炎\nE. 急性化脓性肝胆管炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，患有肝硬化并伴有腹水，表现为腹部膨大且触感坚硬，胃脘部闷胀，食欲不振，大便稀溏，小便不畅，舌苔白腻，脉象弦缓。针对此症状，最适宜的治疗方法是", "options": "A.疏肝理气，利湿散满\nB.运脾利湿，化气行水\nC.活血化瘀，利水消肿\nD.调脾行气，清热利湿\nE.温补肾阳，通阳利水", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科诊断中，甲胎蛋白（AFP）水平的升高最常与以下哪种疾病相关？", "options": "A. 肝内胆管细胞癌\nB. 原发性肝癌\nC. 慢性活动性乙型肝炎\nD. 转移性肝癌\nE. 肝硬化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种肝病中，患者最有可能发展为原发性肝癌？", "options": "A. 酒精性肝硬化\nB. 病毒性肝炎后肝硬化\nC. 原发性胆汁性肝硬化\nD. 淤血性肝硬化\nE. 血吸虫病肝纤维化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在中医药理论中，茯苓被用于治疗肝硬化，其主要的有效成分是", "options": "A. 茯苓醇\nB. 泽泻素\nC. 茯苓多糖\nD. 泽泻醇\nE. 茯苓素", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者，半年前上腹部曾遭受钝挫伤。近2个月来，上腹部出现肿物，并伴有呕吐，但无腹痛及发热。体检发现上腹部有一巨大囊性肿物，无压痛，诊断为假性胰腺囊肿。请问以下哪种治疗方法最为适宜？", "options": "A. 继续观察\nB. 囊肿内引流术\nC. 穿刺抽吸囊肿内容物\nD. 手术切除囊肿\nE. 囊肿外引流术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估急性胰腺炎患者的实验室检查结果时，以下哪项描述是正确的？", "options": "A. 白细胞增多及中性粒细胞核右移是常见现象\nB. 血清淀粉酶水平超过正常值的4倍即可确诊\nC. 尿淀粉酶水平通常持续升高2至4周\nD. 血清淀粉酶水平多在发病后24至72小时内开始上升\nE. C反应蛋白（CRP）有助于评估和监测急性胰腺炎的严重程度", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，关于肝破裂的描述，以下哪一项是不正确的？", "options": "A. 肝损伤常合并胆汁性腹膜炎\nB. 肝破裂右肝较左肝多\nC. 肝破裂如肝静脉主干有损伤，有并发空气栓塞的可能\nD. 肝破裂应行肝叶切除术\nE. 肝破裂常有胆道出血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的诊断中，以下哪个体征最具特异性？", "options": "A. 上腹部有压痛和反跳痛\nB. Grey-Turner征阳性\nC. McBurney点有压痛和反跳痛\nD. 肝浊音界缩小\nE. Murphy征阳性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰源性腹水或胸水的诊断中，淀粉酶水平的测定结果通常表现为", "options": "A.与正常人血清淀粉酶水平相当\nB.略高于正常人血清淀粉酶水平\nC.显著高于正常人血清淀粉酶水平\nD.低于正常人血清淀粉酶水平\nE.以上所有选项均正确", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺功能受损的情况下，下列哪种胃肠道症状最能提示胰腺的弥漫性破坏？", "options": "A. 腹痛\nB. 腹胀\nC. 呕吐\nD. 脂肪泻", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的急性期，患者应采取哪种饮食管理措施？", "options": "A. 禁食24小时\nB. 禁食48小时\nC. 禁食不少于3天\nD. 流质饮食\nE. 少量多餐", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪种类型的黄疸是由于胆红素代谢障碍引起的？", "options": "A. 胆红素性脑病\nB. 肝细胞性黄疸\nC. 阻塞性黄疸\nD. 溶血性黄疸\nE. 体质性黄疸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在新生儿梗阻性黄疸的诊断中，以下哪一项不是其典型特征？", "options": "A. 黄疸逐渐加重\nB. 粪便颜色逐渐变浅\nC. 尿液中尿胆素阳性\nD. 肝脏体积增大\nE. 伴随营养和发育障碍", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名15岁男性患者，表现为轻度乏力和腹胀，实验室检查显示ALT水平为350U/L，总胆红素为14.8μmol/L，抗HAV IgM阳性，抗HBc阳性，胆红素定量正常。根据这些信息，最可能的诊断是什么？", "options": "A. 急性乙型肝炎\nB. 急性黄疸型肝炎，甲型\nC. 急性无黄疸型肝炎，甲型\nD. 甲肝病毒携带者\nE. 乙肝病毒携带者", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名8岁女孩，右侧腹部发现一肿块，表面光滑，触诊有囊性感。进一步询问病史发现肿块的大小和张力有变化。最可能的诊断是", "options": "A. 肠系膜囊肿\nB. 肾积水\nC. 胆总管囊肿\nD. 肾母细胞瘤\nE. 卵巢囊肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的治疗中，以下哪种药物是禁忌使用的？", "options": "A. 雷尼替丁\nB. 吗啡\nC. 生长抑素\nD. 阿托品\nE. 抑肽酶", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，超声检查是评估胆囊大小的重要手段。根据最新临床指南，正常成人胆囊的长径测量值通常应控制在什么范围内？", "options": "A. 不超过8.0cm\nB. 不超过9.0cm\nC. 不超过10.0cm\nD. 不超过11.0cm\nE. 超过12.0cm", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门脉高压症的临床表现中，以下哪一项通常不被视为主要特征？", "options": "A. 腹水\nB. 肝大\nC. 脾大\nD. 静脉侧支循环", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性酒精中毒导致的胰腺炎中，以下哪项机制是正确的？", "options": "A. 脂肪分泌过多导致胰管梗阻\nB. 酒精及其代谢产物直接减少胰液中脂质微粒体酶的分泌\nC. 脂肪酶的降解作用减弱\nD. 乙醇通过间接刺激胰液分泌，降低胰腺对缩胆囊素的敏感性\nE. 胰液中蛋白质分泌增加，钙离子浓度升高", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能不全的患者中，由于雌激素的灭活作用减弱，可能会出现以下哪些症状？", "options": "A. 蜘蛛痣\nB. 肝掌\nC. 男子乳房发育\nD. 女子月经失调", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性坏死性胰腺炎中，以下哪项不是导致休克的原因？", "options": "A. 胰液外溢\nB. 腹腔内出血\nC. 持续性呕吐\nD. 组织坏死\nE. 血钙浓度迅速降低", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，医生通过肝穿刺获取了典型的棕褐色脓液，并在显微镜下观察到阿米巴滋养体。这一发现最可能意味着什么？", "options": "A. 确诊阿米巴肝病\nB. 排除阿米巴肝病\nC. 阿米巴原虫携带者\nD. 肠阿米巴病普通型\nE. 肠阿米巴病慢性型", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估急性肝细胞损伤时，以下哪种血清酶学检查指标最为敏感？", "options": "A.丙氨酸转氨酶(ALT)\nB.天门冬氨酸转氨酶(AST)\nC.乳酸脱氢酶(LDH)\nD.腺苷脱氨酶(ADA)\nE.胆碱酯酶(ChE)", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断代偿期肝硬化时，以下哪种检查方法最为准确？", "options": "A. 腹腔积液\nB. 脾大\nC. 肝掌及蜘蛛痣\nD. 白蛋白与球蛋白比值倒置\nE. 肝穿刺活检见有假小叶形成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在中医治疗急性胰腺炎时，针对肝郁气滞证的治疗原则是什么？", "options": "A.疏肝利胆，行气止痛\nB.清利肝胆湿热\nC.通腑泻热，行气止痛\nD.疏肝理气，健脾利湿\nE.疏肝理气，行气止痛", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁女性患者因胰头癌入院，接受了胰头十二指肠切除术后出现高血糖。在出院时，以下哪种饮食指导原则最适合她？", "options": "A. 低脂、低糖、低蛋白\nB. 高脂、低糖、高蛋白\nC. 高脂、低糖、低蛋白\nD. 低脂、低糖、高维生素\nE. 低脂、高糖、高维生素", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在讨论瘀血性肝硬化的病因时，以下哪一项描述是不准确的？", "options": "A. 通常与右心功能衰竭相关\nB. Budd-Chiari综合征也是其成因之一\nC. 主要由于肝小叶中心区域缺氧所致\nD. 患者通常不会出现肝功能异常", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁男性患者，出现无痛性黄疸已持续一个多月，体重逐渐下降，但无明显不适。超声检查显示肝内外胆管和胆囊明显扩张，胰管未扩张，胆总管下段发现低回声团块，与胆管壁界限不清，彩色多普勒超声显示团块内有血流信号，脉冲多普勒检测到动脉频谱。以下哪种疾病不需要与该病进行鉴别？", "options": "A. 胰头部实性占位\nB. 壶腹周围实性占位\nC. 胆总管下段结石\nD. 十二指肠壁占位\nE. 胆总管上段实性占位", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脓肿的经皮穿刺引流治疗中，以下哪项操作是不正确的？", "options": "A. 穿刺点的确定应依赖于正位观察\nB. 对比剂注射和脓腔冲洗应采用低压力、低流量的方式\nC. 插管引流过程中应同时进行抗炎和对症治疗\nD. 当脓腔在短期内缩小，引流管后退时，由于窦道尚未完全形成，应及时更换具有较少侧孔的引流管\nE. 在脓腔未完全闭合前，不应过早移除引流管", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，因肝硬化（失代偿期）入院。1天前出现明显呼吸困难。查体：体温正常，双肺呼吸音清，血气分析显示低氧血症。抗感染治疗无效。最可能发生的并发症是", "options": "A.肺炎\nB.急性左心衰\nC.肝肺综合征\nD.支气管哮喘\nE.肝肾综合征", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位56岁男性患者，有20年的慢性肝炎病史，最近两周出现右上腹隐痛，无呕吐、发热等症状。B超检查发现肝脏内有一低回声占位性病变，回声不均匀且边界不清。为了进一步明确诊断，应优先选择以下哪种影像学检查？", "options": "A. CT检查\nB. 选择性肝动脉造影\nC. 经脐静脉肝脏造影\nD. 同位素肝血池扫描", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌的临床特征中，以下哪一项描述是不正确的？", "options": "A. 常与肝硬化同时存在\nB. 容易在肝内扩散\nC. 可能导致严重的腹腔内出血\nD. 中晚期患者的预后通常较差\nE. 不会通过淋巴系统转移", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化腹水的治疗中，哪项措施是最基本且需要优先考虑的？", "options": "A. 补充白蛋白\nB. 改善肝功能\nC. 限水钠\nD. 放腹水\nE. 利尿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁男性患者被诊断为肝性脑病，医生决定给予乳果糖口服治疗。这种治疗的主要目的是什么？", "options": "A. 促进肠道蠕动\nB. 降低肠道pH值\nC. 减少肠道细菌数量\nD. 提供额外热量\nE. 增强肝功能", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于急性化脓性胆管炎的描述，下列哪一项是错误的？", "options": "A. 主要致病菌包括大肠埃希菌、克雷白杆菌、粪链球菌和厌氧菌\nB. 胆管梗阻与胆管化脓性感染同时存在\nC. 可能导致感染性休克、肝肾功能衰竭或DIC\nD. 表现为Charcot三联征或Reynolds五联征\nE. 以上所有描述均正确", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位70岁男性在健康体检中通过B超发现胆囊内有一个直径约0.8cm的结石，结石随体位活动，口服法胆囊造影显示胆囊显影，充盈缺损不明显。患者既往无胃病史，无胆囊炎发作史，无心脏病、糖尿病史。针对此情况，目前的治疗建议是", "options": "A. 观察、随诊\nB. 溶石疗法\nC. 中药排石\nD. 择期行胆囊切除术\nE. 择期行腹腔镜胆囊切除术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位患者因腹部明显膨隆且呈球形前来就诊，体检发现转动体位时腹部形状改变不明显。这种情况下，最可能的诊断是", "options": "A. 肝硬化\nB. 右心功能不全\nC. 缩窄性心包炎\nD. 肾病综合征\nE. 肠麻痹", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝性脑病患者时，如果患者出现便秘，下列哪种灌肠液是禁用的？", "options": "A. 生理盐水\nB. 肥皂水\nC. 新霉素液\nD. 弱酸性溶液\nE. 液状石蜡", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎患者中，尿淀粉酶水平通常在什么时间开始升高？", "options": "A. 发病后立即\nB. 发病后4小时\nC. 血清淀粉酶升高后2小时\nD. 血清淀粉酶升高的同时\nE. 与血清淀粉酶同步升高", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断丙型肝炎时，以下哪项实验室检测项目是必要的？", "options": "A. HCV-Ag\nB. HCV-Ab\nC. HCV RNA\nD. 以上都是\nE. 以上都不是", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的相关描述中，以下哪一项是错误的？", "options": "A. 肝癌可以起源于肝细胞\nB. 乙型肝炎病毒是肝癌的直接致病因素\nC. 胆汁性肝硬化与肝癌的发生没有关联\nD. 肝癌也可以起源于肝内胆管细胞\nE. 黄曲霉毒素的暴露可能与肝癌的发病有关", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的临床表现中，以下哪一项描述是不正确的？", "options": "A. 上腹部可触及包块\nB. 腹部可有压痛反跳痛\nC. 腹痛向腰背部放散\nD. 腹部体征与病理轻重相平行\nE. 腹部体征与腹痛轻重相平行", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，早期肝癌的诊断标准是什么？", "options": "A. 癌结节直径不超过3cm\nB. 癌结节数量不超过两个\nC. 癌结节与周围组织界限清晰\nD. 癌结节直径不超过3cm且数量不超过两个", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁女性患者，因急性胆囊炎接受非手术治疗已5天，现症状加重，表现为剧烈疼痛、高热（39℃），右上腹广泛压痛、反跳痛、腹肌紧张，肠鸣音减弱，白细胞计数升高至18×10^9/L。此时应采取的手术方式是？", "options": "A. 胆囊切除术\nB. 胆囊切除及胆总管引流\nC. 胆囊造瘘及腹腔引流术\nD. 胆囊切除及腹腔引流术\nE. 胆总管十二指肠引流术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于原发性肝癌的描述，以下哪一项是不正确的？", "options": "A. 在我国，大多数肝癌患者伴有肝硬化\nB. 肝癌可分为巨块型、结节型和弥散型\nC. 黄曲霉素的摄入与肝癌的发生有关\nD. 乙型和丙型肝炎病毒感染者的肝癌发病率显著增加\nE. 所有肝癌患者的甲胎蛋白（AFP）水平都会升高", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于慢性胰腺炎患者，每日推荐的碳水化合物摄入量是多少？", "options": "A. 每日可供200g以上\nB. 每日可供300g以上\nC. 每日可供400g以上\nD. 每日可供500g以上\nE. 每日可供600g以上", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行胆道手术时，以下哪一项不应作为胆总管探查的依据？", "options": "A. 胆总管、肝总管、肝胆管结石\nB. 黄疸或曾有黄疸病史\nC. 胰头肿大且质地变硬\nD. 胆总管壁增厚且直径增大\nE. 胆囊内积液", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝炎和肝硬化患者的手术耐受力时，以下哪项陈述是错误的？", "options": "A. 肝功能轻度受损，通常不会影响手术耐受力\nB. 对于肝功能严重受损或接近失代偿的患者，必须经过长时间的严格准备后才能进行择期手术\nC. 肝功能严重受损，伴有营养不良、腹水或黄疸的患者，通常不适合进行任何手术\nD. 急性肝炎患者，不应进行包括急诊抢救在内的任何手术", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名8岁男孩的血清学检查显示抗HBs、抗HBe、抗HBc阳性，而其他乙型肝炎血清学指标均为阴性。这种情况下，最可能的诊断是什么？", "options": "A. 急性乙型肝炎\nB. 慢性乙型肝炎\nC. 重型乙型肝炎\nD. 急性乙型肝炎潜伏期\nE. 急性乙型肝炎恢复期", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，哪种疾病最常导致肝细胞弥漫性细胞水肿？", "options": "A. 酒精性肝炎\nB. 急性普通型肝炎\nC. 慢性肝炎\nD. 急性重型肝炎\nE. 亚急性重型肝炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的分子生物学研究中，以下哪个基因的第12号染色体突变与其发病机制相关？", "options": "A. Bcl-2基因\nB. Bax基因\nC. K-ras基因\nD. Ki-67基因\nE. Survivin基因", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在病毒性肝炎的病理变化中，以下哪些是肝细胞常见的形态学改变？", "options": "A. 胞浆疏松化\nB. 气球样变\nC. 嗜酸性坏死\nD. 溶解坏死", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的病因中，以下哪一项不是常见的致病因素？", "options": "A. 甲型肝炎病毒\nB. 乙型肝炎病毒\nC. 非甲非乙型肝炎病毒\nD. 酒精中毒\nE. 抗胰蛋白酶缺乏", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的诊断和治疗中，以下哪项陈述是正确的？", "options": "A. 黄疸是大多数胰腺癌患者的主要症状\nB. 影像学检查如CT和血管造影对评估肿瘤可切除性无益\nC. 出现黄疸的患者手术切除率通常低于5%\nD. 确诊时，多数胰腺癌患者已发生远处转移\nE. Whipple手术后，胰腺癌患者的5年生存率在30%至40%之间", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科影像学检查中，以下哪项是诊断肝外胆管癌的直接影像学特征？", "options": "A. 肝脏体积增大\nB. 胆管系统广泛扩张\nC. 远端胆管壁增厚\nD. 胰腺导管扩张\nE. 肝门区淋巴结肿大", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男性，45岁，因持续发热10天伴右上腹及右腰部疼痛5天入院。查体发现右上腹饱满，肝下缘在肋下2.5cm处可触及，伴有明显叩击痛和压痛。超声检查显示肝右叶下部有一4.5cm×5cm的液性暗区。患者2周前有慢性腹泻病史，临床诊断为阿米巴肝脓肿。以下治疗方案中，哪一项是不恰当的？", "options": "A.卧床休息\nB.静脉滴注甲硝唑\nC.肾上腺皮质激素\nD.脓肿穿刺引流\nE.外科手术引流", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在解剖学中，胆总管上段相对于门静脉的位置是？", "options": "A. 右前方\nB. 左前方\nC. 左方\nD. 右后方", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胰腺癌时，以下哪些体征是典型的？", "options": "A. 黄疸\nB. 上腹压痛\nC. 消瘦\nD. Cullen征\nE. 手足搐搦", "answer": "BCE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位胆管结石患者主诉右上腹剧烈疼痛，最可能的原因是", "options": "A. Oddi括约肌痉挛\nB. 胆管炎症\nC. 胆管损伤\nD. 腹腔感染\nE. 胆汁逆流", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎中，导致DIC（弥散性血管内凝血）的主要机制是什么？", "options": "A. 通过钙与组织因子形成复合物\nB. 激活凝血酶原，促进凝血酶生成\nC. 导致血管内皮广泛损伤\nD. 促使大量组织因子入血\nE. 引起激肽释放酶原激活", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌患者中，以下哪些情况可能作为并发症出现？", "options": "A. 门静脉癌栓\nB. 肝动脉-门静脉或肝动脉-肝静脉瘘及肝静脉癌栓\nC. 下腔静脉癌栓\nD. 梗阻性黄疸", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，胰腺癌的发病年龄高峰通常出现在哪个年龄段？", "options": "A. 30岁左右\nB. 40岁左右\nC. 50岁左右\nD. 60岁左右\nE. 70岁左右", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的病理变化中，以下哪一项最能代表其特征性改变？", "options": "A. 肝细胞坏死\nB. 肝纤维化\nC. 肝脏体积缩小\nD. 假小叶形成\nE. 中央静脉缺如", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，关于淀粉酶变化的描述，哪一项是不正确的？", "options": "A.尿淀粉酶升高时间晚于血清淀粉酶\nB.尿淀粉酶下降时间晚于血清淀粉酶\nC.尿淀粉酶超过300索氏单位即可确诊\nD.淀粉酶水平越高，诊断准确性越高\nE.淀粉酶水平与疾病严重程度不一定相关", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆管炎的诊断中，Reynolds五联征包括以下哪组症状？", "options": "A. 发热、腹痛、呕吐、黄疸加深、肝功受损\nB. 腹痛、发热、黄疸、尿量减少、血压下降\nC. 腹痛、发热、黄疸、血压下降、意识改变\nD. 腹胀、发热、黄疸、疼痛休克、烦躁不安\nE. 腹泻、发热、腹痛、呼吸深快、尿量减少", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位51岁男性患者，体检发现肝脏在肋下9cm处可触及，质地坚硬如触前额，边缘不规则，表面不光滑，呈不均匀的结节状。该患者最可能的诊断是", "options": "A. 肝癌\nB. 肝炎\nC. 脂肪肝\nD. 肝淤血\nE. 肝硬化", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，近期出现上腹部闷胀感，黄疸逐渐加重，并伴有体重下降，持续2个月。体检发现患者消瘦，巩膜和皮肤明显黄染，腹部柔软，肝脏在肋下可触及2指，伴有触痛和轻叩痛，胆囊未触及肿大。患者既往无胆道疾病史。实验室检查显示尿胆红素显著升高（+++），而尿胆原未见增加。为明确诊断，应优先考虑进行哪项检查？", "options": "A.静脉胆道造影\nB.口服法胆囊造影\nC.MRCP\nD.上消化道钡餐检查\nE.胃、十二指肠液检查", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁女性患者，因皮肤和巩膜黄染30天，伴有皮肤瘙痒、厌食、乏力、消瘦、小便黄、大便发白等症状就诊。既往无特殊病史。体检发现皮肤和巩膜黄染，腹部无压痛和反跳痛，肝区无叩击痛，可触及肿大的胆囊，腹水征阴性。实验室检查显示TBIL:25mg/dl、DBIL：20mg/dl、CA199：12U/ml，CA50：8U/ml。影像学检查显示B超和CT均提示低位胆道梗阻、肝内外胆管扩张，胰头不大，胰管扩张（双管征），胰腺未见明显占位；十二指肠低张造影显示十二指肠曲不大、降部黏膜紊乱，未见明确的充盈缺损。在明确诊断并排除远处转移的情况下，最积极的治疗手段是？", "options": "A.胰十二指肠切除\nB.剖腹探查\nC.胆囊切除\nD.胆总管切除\nE.肝癌根治术", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在乙肝病毒感染的患者中，以下哪一组血清学标志物组合最能提示病毒复制活跃？", "options": "A. HBsAg(+)，HBeAg(-)，抗-HBc(+)\nB. HBsAg(+)，HBeAg(-)，抗-HBe(+)\nC. HBsAg(+)，HBeAg(+)\nD. 抗-HBc(+)\nE. 抗-HBs(+)", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位64岁男性患者，近4个月来感到乏力、体重下降，并伴有大便次数增多。体检发现患者面色苍白，腹部平坦柔软，右侧腹部可触及一个直径约5cm的包块。实验室检查显示血红蛋白为80g/L，粪便隐血试验阳性。根据这些症状和检查结果，最可能的诊断是什么？", "options": "A. 十二指肠癌\nB. 胆囊癌\nC. 阑尾类癌\nD. 升结肠癌\nE. 胰头癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的病例中，细菌最常通过哪种途径进入肝脏？", "options": "A. 肝动脉\nB. 胆道\nC. 门静脉\nD. 淋巴系统", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化的早期阶段，患者最可能首先出现的症状是什么？", "options": "A. 恶心、呕吐\nB. 乏力和食欲不振\nC. 肝区疼痛\nD. 皮肤出血\nE. 腹泻", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在中医治疗肝硬化寒湿困脾证时，应首选哪种方剂？", "options": "A.柴胡疏肝散\nB.实脾饮\nC.中满分消丸\nD.茵陈蒿汤\nE.以贯煎合膈下逐瘀汤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位29岁男性患者，半年前上腹部曾遭受钝挫伤。近2个月来，上腹部出现肿物，伴有呕吐，但无腹痛及发热。体检发现上腹部有一巨大囊性肿物，无压痛，诊断为假性胰腺囊肿。针对此情况，最佳的治疗方案是？", "options": "A.继续观察\nB.穿刺抽吸囊肿内容物\nC.手术切除囊肿\nD.囊肿外引流术\nE.囊肿内引流术", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位42岁的男性患者因突发右上腹剧烈疼痛伴发热（体温38.9℃）和恶心呕吐就诊，疼痛放射至右肩胛区。查体发现Murphy征阳性，初步怀疑急性胆囊炎。为明确诊断，首选的影像学检查是", "options": "A. 腹部CT扫描\nB. 腹部超声检查\nC. 磁共振胰胆管成像（MRCP）\nD. 经皮经肝胆管造影（PTC）\nE. 内镜逆行胰胆管造影（ERCP）", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在酒精性肝病中，肝细胞最常出现的病理改变是", "options": "A. 脂肪沉积\nB. 细胞水肿\nC. 细胞内玻璃样变\nD. 结缔组织玻璃样变\nE. 血管壁玻璃样变", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位75岁男性患者，长期患有慢性支气管炎和乙型肝炎。最近两个月出现下肢水肿、尿量减少和气短症状。体检显示颈静脉怒张，肝脏在肋下2cm可触及，有少量腹水和下肢水肿。实验室检查显示转氨酶轻度升高。请问以下哪项临床表现最能帮助区分右心衰竭和肝硬化？", "options": "A. 肝脏肿大\nB. 下肢水肿\nC. 腹腔积液\nD. 颈静脉怒张\nE. 转氨酶增高", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位35岁的男性患者被诊断为急性胆囊炎，此时他应采取哪种体位？", "options": "A. 自主体位\nB. 强迫俯卧位\nC. 强迫停立位\nD. 强迫坐位\nE. 辗转体位", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在人体内，氨的主要产生部位是哪里？", "options": "A. 肾脏\nB. 肠道\nC. 肝脏\nD. 大脑\nE. 骨骼肌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的诊断和治疗中，以下哪项陈述是正确的？", "options": "A. 黄疸是大多数胰腺癌患者的主要症状\nB. 影像学检查如CT和血管造影对评估肿瘤可切除性无益\nC. 出现黄疸的患者手术切除率通常低于5%\nD. 确诊时，多数胰腺癌患者已发生远处转移\nE. Whipple手术后，胰腺癌患者的5年生存率可达30%至40%", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位38岁女性患者因右上腹剧烈疼痛、寒战、高热以及呕血约200ml急诊入院。体检发现皮肤和巩膜黄染，肝脏在肋下1cm处可触及且触痛明显，Murphy征阳性。根据这些症状和体征，最可能的诊断是什么？", "options": "A. 胃息肉出血\nB. 十二指肠溃疡出血\nC. 胆道出血\nD. 食管静脉曲张破裂大出血\nE. 胃癌出血", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，胆管结石急性发作和急性胆管炎的典型三联征是什么？", "options": "A. 突发右上腹剧痛、黄疸、休克\nB. 突发右上腹绞痛、高热、昏迷\nC. 突发右上腹绞痛、休克、昏迷\nD. 突发右上腹绞痛、畏寒发热、胆囊肿大\nE. 突发右上腹绞痛、寒战高热、黄疸", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于胆管结石的描述，以下哪一项是错误的？", "options": "A. 根据结石的形态分为原发性胆管结石和继发性胆管结石\nB. 原发性胆管结石大多为胆色素性结石或混合性结石\nC. 继发性胆管结石是胆囊结石排入胆总管的胆固醇结石\nD. 肝外胆管结石多位于胆总管下端\nE. 肝内胆管结石分布于左右肝内胆管，以左外叶和右后叶居多", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在解剖学中，胆总管根据其走行路径可以被划分为几个部分？", "options": "A. 二段\nB. 三段\nC. 四段\nD. 五段\nE. 六段", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于壶腹部癌的描述，下列哪一项是不正确的？", "options": "A. 壶腹部癌患者可能出现间断性黄疸\nB. 壶腹部癌的症状通常较早出现，治疗效果优于胰头癌\nC. 患者可能表现出消化道症状\nD. 患者可能表现出胰腺炎症状，伴有淀粉酶升高\nE. 患者可能出现贫血和消瘦", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科检查中，肝胶体显像显示肝内存在巨块型缺损区，随后进行的67Ga显像显示该缺损区的放射性浓聚程度与邻近正常组织相似。这种情况下，最可能的占位性病变是什么？", "options": "A. 囊肿\nB. 肝血管瘤\nC. 癌\nD. 肝硬化结节\nE. 肝脓肿", "answer": "CE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于胆总管的解剖结构，以下哪一项描述是不正确的？", "options": "A. 长度通常在7至9厘米之间\nB. 直径大约为0.6至0.8厘米\nC. 十二指肠上段位于肝动脉的右侧\nD. 十二指肠后段的后方是门静脉\nE. 胰腺段位于胰头的实质中", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，近3个月来持续感到肝区疼痛，肝脏逐渐增大，频繁出现低血糖症状，且外周血中红细胞计数明显升高。根据这些症状，最可能的诊断是：", "options": "A. 真性红细胞增多症\nB. 重症肝炎\nC. 肺源性心脏病\nD. 原发性肝癌\nE. 继发性红细胞增多症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在妊娠期间，如果患者出现急性胆囊炎，以下哪种治疗方法是不推荐的？", "options": "A. 控制饮食\nB. 纠正水、电解质紊乱和酸碱失衡\nC. 抗感染\nD. 解痉镇痛\nE. 终止妊娠", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，肝内最常见的良性实性占位病变是以下哪一种？", "options": "A.肝腺瘤\nB.肝错构瘤\nC.肝血管瘤\nD.脂肪瘤\nE.炎性假瘤", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能减退的情况下，由于尿素合成能力下降，下列哪种物质在血液中的浓度会显著升高？", "options": "A. 血糖\nB. 血脂\nC. 血氨\nD. 血胆固醇\nE. 血胆红素", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝豆状核变性患者中，以下哪种血浆蛋白的水平通常会发生变化？", "options": "A. 结合珠蛋白\nB. 铜蓝蛋白\nC. 运铁蛋白\nD. γ-球蛋白\nE. 清蛋白", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁的男性患者因酒精性肝硬化入院，护士在指导其生活方式和行为时，哪一项最为关键？", "options": "A. 避免过度劳累\nB. 适量饮酒\nC. 戒酒\nD. 服用解酒护肝药\nE. 低脂饮食", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者，男，48岁，有15年乙型肝炎病史，近期出现右上腹疼痛并伴有上腹部包块，体重下降5公斤。查体显示肝肋下5cm，边缘钝，质韧，有触痛。实验室检查显示AFP显著升高，B超和CT均显示肝右叶有实质性占位性病变。根据这些信息，以下哪项诊断最不可能？", "options": "A. 肝硬化\nB. 肝脏恶性肿瘤\nC. 胆囊结石伴慢性胆囊炎\nD. 肝血管瘤\nE. 肝脓肿\nF. 胆管结石", "answer": "CF", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在门静脉高压的临床表现中，以下哪一项最具特异性？", "options": "A. 腹水\nB. 脾大\nC. 脾功能亢进\nD. 侧支循环开放\nE. 肝掌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的临床过程中，以下哪种并发症最为严重？", "options": "A. 胆囊十二指肠内瘘\nB. 胆囊积脓\nC. 胆囊坏疽穿孔引起胆汁性腹膜炎\nD. 细菌性肝脓肿\nE. 并发急性胰腺炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，以下哪些表现提示胆囊内可能存在结石？", "options": "A. 胆囊内出现强回声团并伴有声影\nB. 胆囊内出现强回声团但不伴有声影\nC. 胆囊内充满强回声\nD. 胆囊内出现实性团块\nE. 胆囊壁出现强回声团", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位男性肝硬化患者出现性欲减退、睾丸萎缩和肝掌症状，这些症状最可能的原因是", "options": "A. 雄激素过多\nB. 肾上腺皮质激素过多\nC. 雌激素过多\nD. 甲状腺激素过多\nE. 醛固酮过多", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，了解胰腺的动脉供血来源至关重要。以下哪条动脉是胰腺的主要供血血管？", "options": "A. 肠系膜上动脉\nB. 肝固有动脉\nC. 脾动脉\nD. 胃左动脉\nE. 肠系膜下动脉", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位38岁男性患者，有6年肝硬化病史，因上消化道出血不止接受了TIPS治疗。治疗后，患者出现睡眠障碍。在这种情况下，以下哪种检查方法最不适用？", "options": "A. 血氨\nB. 脑电\nC. 诱发电位\nD. 脑CT\nE. 智力测验", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝棘球蚴病的并发症中，以下哪一项是不正确的？", "options": "A.囊肿继发感染\nB.囊肿破裂\nC.囊肿支气管瘘\nD.过敏性休克\nE.脑部转移", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在TIPSS手术中，以下哪项操作是错误的？", "options": "A. 在扩张肝内通道前，常规栓塞胃冠状静脉和胃短静脉，以巩固疗效并预防术后分流通道和肝性脑病\nB. 选择至胃冠状静脉后需再次造影，以显示其走行和大小，从而估计栓塞剂用量并尽可能彻底栓塞\nC. 由于胃底食管静脉曲张的供血血管常有多支参与，因此主张尽可能栓塞全部胃冠状静脉、胃短静脉及胃后静脉，若无法做到，则应将胃冠状静脉作为常规栓塞血管\nD. 当支架植入位置不理想时，不能同时放置两个内支架\nE. 除使用Cobra导管栓塞胃冠状静脉外，导丝应始终注意不要拖出门静脉，以确保整个操作顺利完成", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的病理组织学检查中，以下哪些变化是常见的？", "options": "A. 纤维组织增生\nB. 假小叶形成\nC. 淋巴细胞浸润\nD. 肝细胞弥漫大片坏死", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者张某，因胆囊炎需要进行胆囊造影检查。在第一次摄片后，胆囊显影良好，此时患者可以进食以下哪种食物？", "options": "A. 水 500ml\nB. 馒头 1个\nC. 苹果 2个\nD. 面条 1碗\nE. 油煎荷包蛋2个", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的治疗中，如果患者出现抽搐症状，下列哪种药物是首选？", "options": "A. 吗啡\nB. 氯苯那敏\nC. 地西泮\nD. 阿片\nE. 布桂嗪", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，因急性胰腺炎接受静脉广谱抗生素治疗一周后，症状加重，出现腹痛、腹胀和体温再次升高。腹腔穿刺涂片检查发现大肠杆菌，此时应采取的治疗措施是", "options": "A. 增加甲硝唑静脉点滴\nB. 甲硝唑和广谱抗生素腹腔灌洗\nC. 急诊行剖腹外引流手术\nD. 急诊行剖腹内引流手术\nE. 西药静脉点滴结合中药胃管内滴注", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰岛细胞瘤的免疫组化染色中，以下哪项标记物的阳性结果对诊断无意义？", "options": "A. INS阳性\nB. GLU阳性\nC. GAS阳性\nD. SS阳性\nE. PSA阳性", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位35岁的女性患者，患有甲状旁腺功能亢进症并伴有急性胰腺炎，其发病机制可能与高血钙有关。关于钙离子与急性胰腺炎的关系，以下哪项描述是错误的？", "options": "A. 高血钙可能导致胰管内结石形成，引起梗阻\nB. 钙离子与胰蛋白酶原的激活过程无关\nC. 高血钙可促进胃液分泌\nD. 钙离子与胰淀粉酶的激活过程无关\nE. 高血钙可刺激胃泌素分泌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在评估低血糖患者是否存在胰岛素和C肽分泌过多时，应同时进行哪些检测？", "options": "A. 血浆葡萄糖\nB. C肽水平\nC. 胰岛素\nD. T3、T4\nE. 血常规", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者出现上消化道出血的情况下，下列哪种血液制品应避免使用？", "options": "A. 血小板\nB. 血浆\nC. 白蛋白\nD. 新鲜血\nE. 库存血", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性腹水的形成过程中，以下哪些全身性因素可能起到重要作用？", "options": "A.门静脉压力升高\nB.血浆胶体渗透压下降\nC.淋巴回流受阻\nD.肾小球滤过率降低且肾小管重吸收增加", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位62岁女性患者被诊断为急性化脓性胆管炎，目前血压为75/60 mmHg，心率为132次/分，每小时尿量少于20毫升。在这种情况下，应首选哪种心血管药物进行治疗？", "options": "A. 异丙肾上腺素\nB. 去甲肾上腺素\nC. 苯肾上腺素\nD. 间羟胺（阿拉明）\nE. 多巴胺", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在腹部外伤中，哪种损伤可能在受伤初期无明显症状，但数天后突然发生危及生命的急性大出血？", "options": "A. 小肠穿孔\nB. 肝脾破裂\nC. 大肠破裂\nD. 十二指肠破裂\nE. 胆囊穿孔", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的发病机制中，以下哪个因素被认为是最主要的诱因？", "options": "A. 饮用水污染\nB. 病毒性肝炎\nC. 黄曲霉毒素\nD. 肝硬化\nE. 寄生虫", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的非手术治疗中，哪种方法被广泛认为是最有效的首选方案？", "options": "A. 肝动脉栓塞化疗\nB. 放射治疗\nC. 抗肿瘤化学药物治疗\nD. 生物和免疫治疗\nE. 中医治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁女性患者，出现黄疸和食欲减退已持续2个月。体检发现全身黄染，肝脏肿大，胆囊可触及肿大。实验室检查显示血胆红素为171μmol/L，碱性磷酸酶为30U/L，其他肝功能指标正常。根据这些临床表现和检查结果，最可能的诊断是什么？", "options": "A. 胆道蛔虫症\nB. 急性病毒性肝炎\nC. 先天性溶血性黄疸\nD. 胆总管囊肿\nE. 壶腹周围肿瘤", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，突然出现剧烈上腹痛，伴有腹胀、恶心和呕吐。疼痛最初位于剑突下偏右，随后迅速扩散至全腹，并转变为持续性、刀割样疼痛，向后背放射。患者还出现烦躁不安、憋气和体温升高。既往有胆囊结石病史。体检显示体温38.9℃，血压110/80mmHg，心率110次/分，呼吸32次/分。皮肤和巩膜可疑黄染，全腹膨隆，肌紧张，广泛压痛和反跳痛，移动性浊音（±），肠鸣音弱。实验室检查显示Hb 96.1g/L，WBC 18.9×10^9/L，AST 211U/L，BUN 9.9mmol/L，TBIL 30μmol/L，DBIL 12μmol/L，血钙1.75mmol/L。腹部平片显示肠管充气扩张，肠间隙增宽。B超显示胆囊壁增厚，内有强光团，胰腺形态失常，明显肿大，胰周多量液性暗区，胰管增粗。该病人的诊断应为（）。", "options": "A.急性弥漫性腹膜炎\nB.上消化道穿孔\nC.急性胰腺炎\nD.胆囊炎\nE.胆石症\nF.肾结石", "answer": "ACDE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位47岁女性患者在常规体检中通过超声检查发现肝右叶存在占位性病变。进一步的CT平扫显示肝右叶肿块呈低密度，增强多期扫描中动脉期表现为边缘明显强化，门静脉及平衡期持续强化且密度高于肝脏。这种情况下，最可能的诊断是：", "options": "A. 肝细胞癌（HCC）\nB. 海绵状血管瘤\nC. 肝脓肿\nD. 肝转移瘤\nE. 肝囊肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在比较门脉性肝硬化和坏死后性肝硬化时，以下哪一项不是两者的主要区别？", "options": "A. 假小叶的大小\nB. 纤维间隔的宽窄\nC. 纤维间隔内炎细胞浸润的轻重\nD. 小胆管增生的程度\nE. 肝细胞坏死的多少", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在初步怀疑患者可能患有早期原发性肝癌时，以下哪种检查方法应优先考虑？", "options": "A. 同位素肝扫描\nB. 血清甲胎蛋白动态观察检查\nC. 肝区超声波检查\nD. 血清Y-谷氨酰转肽酶\nE. 选择性肝动脉造影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的病例中，致病菌最常见的侵入途径是以下哪一项？", "options": "A. 肝动脉\nB. 门静脉\nC. 胆管上行感染\nD. 新生儿脐带\nE. 肝损伤处", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于肝炎的叙述，下列哪一项是正确的？", "options": "A. 甲型肝炎不会发展为慢性病毒携带状态\nB. 轻度慢性肝炎患者大多会进展为肝硬化\nC. 戊型肝炎病毒感染是原发性肝癌的主要病因\nD. 丙型肝炎感染不会导致肝硬化\nE. 重度慢性肝炎都是由乙型肝炎病毒引起的", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名60岁男性患者，持续右上腹痛并伴有低热已超过一个月。超声检查显示肝左叶有一低回声占位，直径约4厘米。CT平扫显示该占位为多房状，内部呈低密度，增强扫描时呈现环形强化。最可能的诊断是？", "options": "A. 转移瘤\nB. 肝囊肿\nC. 肝细胞癌\nD. 血管瘤\nE. 肝脓肿", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在治疗慢性肝病患者时，以下哪种药物需要特别谨慎使用？", "options": "A. 辅酶A\nB. 异烟肼\nC. 法莫替丁\nD. 硝苯地平\nE. 地高辛", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺癌的描述，以下哪一项是不正确的？", "options": "A. 胰头是胰腺癌最常见的发生部位\nB. 吸烟是导致胰腺癌风险增加的主要环境因素\nC. 胰腺癌患者中90%存在C-myc基因点突变\nD. 胰腺癌与慢性胰腺炎在临床上有时难以区分\nE. 胰腺癌患者多为老年人群", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "长期酗酒可能导致的最严重的肝脏疾病是", "options": "A. 脂肪肝\nB. 酒精性肝炎\nC. 肝萎缩\nD. 酒精性肝硬化\nE. 合并病毒性肝炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位43岁男性患者因胆道中毒性休克急诊接受全麻下胆总管探查术，术后转入监护室并使用呼吸机辅助通气。患者神志清醒，但呼吸急促且烦躁，呼吸机显示气道高压报警。以下哪项处理措施是不恰当的？", "options": "A. 适当应用镇静药物\nB. 调整呼吸机参数和模式\nC. 上调高压报警界限\nD. 吸痰\nE. 检查呼吸机管路是否扭曲", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，哪种类型的肝硬化更容易导致肝性脑病的发生？", "options": "A. 弥漫性肝硬化\nB. 中结节性肝硬化\nC. 大结节性肝硬化\nD. 混合结节性肝硬化\nE. 小结节性肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者因腹痛前来就诊，超声检查显示胆石症。该患者的腹痛最可能表现为哪种性质？", "options": "A. 烧灼样\nB. 阵发性绞痛\nC. 剑突下钻顶样痛\nD. 隐痛\nE. 胀痛", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名新生儿出现大便颜色变白和肝脏明显肿大的症状，最可能的诊断是什么？", "options": "A. 生理性黄疸\nB. 母乳性黄疸\nC. 新生儿溶血病\nD. 胆道闭锁\nE. 新生儿败血症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位65岁的男性患者，长期患有肝硬化并伴有轻度腹水，正在服用利尿剂治疗。最近，为了增强营养，他开始服用高蛋白补充剂。家属注意到他最近显得反应迟钝，言语含糊，并出现双手扑翼样震颤。医生初步诊断为肝性脑病，请问最可能的诱因是什么？", "options": "A. 上消化道出血\nB. 高蛋白饮食\nC. 感染\nD. 大量排钾利尿\nE. 放腹水", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，医生需要准确识别肝脏的各个叶段。附图中直线所指部位的解剖名称为", "options": "A. 肝脏右前叶\nB. 肝脏左外叶下段\nC. 肝脏左内叶\nD. 肝脏右后叶\nE. 肝脏左外叶上段", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆系统的动态显像过程中，以下哪个阶段不属于标准流程？", "options": "A. 血流灌注相\nB. 肝血池相\nC. 肝实质相\nD. 胆管排泄相\nE. 肠道排泄相", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位53岁的女性患者，因终末期肝病接受了肝移植手术。术后出现进行性少尿，最终无尿，伴有氮质血症和代谢性酸中毒。针对这一紧急情况，首先应采取哪项治疗措施？", "options": "A. 严格限制入量，宁少勿多\nB. 应用蛋白合成激素\nC. 静脉营养支持，高蛋白、高热量、高维生素\nD. 大剂量利尿药物冲击利尿\nE. 防止并及时纠正高钾血症", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病患者中，血液中芳香族氨基酸含量的增加会导致脑内哪种物质的增多？", "options": "A. γ-氨基丁酸增多\nB. 羟苯乙醇胺增多\nC. 乙酰胆碱增多\nD. 去甲肾上腺素增多\nE. 多巴胺增多", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊炎的CT影像学表现中，以下哪一项描述是不准确的？", "options": "A. 胆囊壁呈现均匀性增厚，厚度超过3mm\nB. 胆囊周围组织出现水肿，胆囊壁周围可见环状低密度带\nC. CT扫描是诊断急性胆囊炎的首选检查方法\nD. 胆囊体积增大，直径超过5cm\nE. 增厚的胆囊壁在增强扫描中呈现均匀强化，并具有延迟效应", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位30岁的女性患者，在妊娠期间被诊断出合并病毒性肝炎。关于她在产褥期的处理措施，下列哪一项是不正确的？", "options": "A. 产后不宜哺乳\nB. 雌激素回奶\nC. 新生儿必须隔离\nD. 预防感染\nE. 宜用器械避孕", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性肝淤血的病理变化中，以下哪一项通常不会发生？", "options": "A. 肝细胞脂肪变性\nB. 纤维组织增生\nC. 肝细胞萎缩\nD. 肝小叶结构严重破坏\nE. 中央静脉和肝血窦扩张淤血", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁女性在体检时通过B超发现胆囊内有多枚结石，最大结石直径为1.2cm。胆囊壁光滑且不厚，患者平时无明显症状，且不愿意接受胆囊切除手术。在这种情况下，最合适的处理措施是什么？", "options": "A.观察\nB.保胆取石术\nC.体外碎石术\nD.药物排石", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者出现右上腹疼痛并伴有发热症状，最可能的原因是以下哪种疾病？", "options": "A. 胰腺炎\nB. 肠道感染\nC. 溃疡病发作\nD. 肝、胆系统感染\nE. 肠系膜淋巴结感染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆道梗阻的影像学表现中，哪些征象提示恶性病变的可能性较大？", "options": "A. 肝外胆管扩张，肝内胆管不扩张\nB. 肝内外胆管扩张，呈“软藤”征\nC. 扩张的胆管自上而下逐渐缩小\nD. 肝外胆管扩张，肝内胆管轻度扩张，呈“枯枝”征\nE. 扩张的胆管突然中断", "answer": "BE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在解剖学中，肝脏的正中裂将其分为左右两部分，这两部分的比例大约是多少？", "options": "A. 5：5\nB. 4：6\nC. 3：7\nD. 2：8\nE. 6：4", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胰头癌与壶腹周围癌时，以下哪项检查结果最能区分两者？", "options": "A. 大便潜血试验（+），黄疸进行性加重\nB. 血管造影提示门静脉受浸润\nC. PTCD显示胆管下端梗阻\nD. 血淀粉酶高于正常\nE. 大便苏丹染色阳性，显示脂肪颗粒", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆道蛔虫症患者出现剧烈腹痛时，蛔虫最常位于哪个部位？", "options": "A. 胆囊内\nB. 胰腺管内\nC. 胆总管内\nD. 十二指肠内\nE. 胆囊管内", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断恶性胰岛细胞瘤时，以下哪项是最可靠的指征？", "options": "A. 病理性核分裂象\nB. 侵犯包膜\nC. 淋巴结转移\nD. Ki-67高表达\nE. 出现大片坏死", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症患者中，导致腹水形成的主要病理生理机制是", "options": "A. 门静脉系统毛细血管床的滤过压升高\nB. 肝脏表面淋巴液大量渗漏进入腹腔\nC. 肝脏功能减退\nD. 醛固酮分泌增加\nE. 抗利尿激素水平升高", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在妊娠合并急性病毒性肝炎的治疗中，口服新霉素在昏迷前期的主要目的是什么？", "options": "A. 减少游离氨及其他毒素的形成\nB. 抑制厌氧菌\nC. 控制重症肝炎进展\nD. 预防感染\nE. 消除体内感染灶", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫病的临床并发症中，以下哪一项是不正确的？", "options": "A. 中毒性休克\nB. 败血症\nC. 肝脓肿\nD. 膈下感染\nE. 肠梗阻", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者因突发上腹痛、恶心和呕吐1天前来就诊。超声检查显示胰腺增大增厚，边缘模糊不清，回声减弱且较均匀，胰腺周围未见无回声区。根据这些表现，最可能的诊断是什么？", "options": "A. 急性出血坏死型胰腺炎\nB. 急性水肿型胰腺炎\nC. 慢性胰腺炎\nD. 胰腺癌\nE. 胰腺假性囊肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位长期患有肝硬化的患者，最近两周出现发热和腹痛症状，腹围从85cm增加到90cm。血沉检测结果为40mm/h，腹水常规检查显示蛋白定量为25g/L，细胞总数为1100/μl，其中分叶核细胞占14%，淋巴细胞占86%。这些症状和检查结果最可能提示患者并发了哪种疾病？", "options": "A. 自发性腹膜炎\nB. 肝癌结节破裂\nC. 结核性腹膜炎\nD. 门静脉血栓形成\nE. 化脓性腹膜炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，长期HBsAg阳性，伴有间断性ALT升高。近两年出现乏力及双下肢水肿。体检发现肝掌阳性，胸前有多个蜘蛛痣，血清白蛋白（ALB）为28g/L。请问该患者最可能的肝脏组织学病理改变是什么？", "options": "A. 肝细胞气球样变\nB. 桥接坏死\nC. 肝细胞碎片状坏死\nD. 肝细胞脂肪样变\nE. 假小叶形成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，胆固醇结石最常见的发生部位是哪里？", "options": "A. 总胆管\nB. 左肝管\nC. 右肝管\nD. 胆囊内\nE. 以上都不是", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺炎的病理变化中，以下哪一项不是其基本特征？", "options": "A. 梗阻\nB. 坏死\nC. 出血\nD. 充血\nE. 水肿", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的早期筛查中，以下哪种组合检查方法最具临床价值？", "options": "A. AFP联合肝动脉造影\nB. AFP联合γ-谷氨酰转移酶检测\nC. AFP联合放射性核素肝扫描\nD. AFP联合超声检查", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在细菌性肝脓肿的临床特征中，以下哪项描述是正确的？", "options": "A. 脓肿多发生于肝脏右叶\nB. 主要致病菌为革兰阳性杆菌\nC. 脓液通常呈现黄绿色，细菌培养常为阳性\nD. 多数病例与胆道系统感染无关\nE. 抗生素治疗无效，必须进行手术干预", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现无痛性进行性黄疸，最可能的诊断是？", "options": "A.胰头癌\nB.急性胰腺炎\nC.慢性胆囊炎\nD.急性胆囊炎\nE.急性化脓性胆管炎", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的解剖结构中，哪一结构负责将左内叶与左外叶分隔开来？", "options": "A. 肝镰状韧带\nB. 肝圆韧带\nC. 静脉韧带\nD. 肝冠状韧带\nE. 门静脉的分支", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者突然呕出300ml暗红色血液，并伴有两次黑便。体检发现蜘蛛痣阳性，肝脏在肋下1cm处可触及且质地坚硬，脾脏在肋下3cm处可触及，并有少量腹腔积液。在这种情况下，最合适的治疗方法是？", "options": "A. 服用胃黏膜保护剂\nB. 输白蛋白\nC. 静脉注射维生素K\nD. 静脉注射止吐药\nE. 静脉滴注垂体后叶素", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下选项中，哪一项不是胆汁淤积性黄疸的病因？", "options": "A. 肝内胆管泥沙样结石\nB. 胆石症\nC. 胰头癌\nD. 肝硬化\nE. 壶腹癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化失代偿期，以下哪项临床表现最为突出？", "options": "A. 食管、胃底静脉曲张\nB. 全血细胞减少\nC. 腹腔内出现漏出液\nD. 皮肤色泽变黑\nE. 消瘦贫血营养不良", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆石症的描述，以下哪一项是不正确的？", "options": "A. 胆石症包括胆囊结石和胆管结石\nB. 在我国，胆固醇结石的发生率目前高于胆色素结石\nC. 在我国，胆管结石的发生率目前高于胆囊结石\nD. 混合性结石中有60%发生在胆囊内\nE. 胆固醇结石也可能发生在胆管内", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位孕24周的女性，初次怀孕，被诊断为妊娠期胆囊炎，首次发作且症状较轻。在内科药物治疗有效但病情反复发作的情况下，若选择外科治疗，术中应特别注意以下哪项措施？", "options": "A. 禁食无脂肪食物\nB. 继续内科药物治疗，包括解痉、镇痛、抗炎\nC. 尽可能切除胆囊\nD. 进行胆囊造口引流术\nE. 尽可能切除胆囊并行胆管探查术，内科药物治疗，病情缓解后行胆囊切除术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名15岁男性患者，出现轻度乏力和腹胀症状，实验室检查显示ALT水平为350U/L，抗HAVIgM阳性，抗HBs阳性，胆红素定量正常。根据这些信息，最可能的诊断是？", "options": "A. 急性乙型肝炎\nB. 急性黄疸型肝炎，甲型\nC. 急性无黄疸型肝炎，甲型\nD. 甲肝病毒携带者\nE. 急性戊型肝炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，肝门层面的解剖特征是什么？", "options": "A.约平第10、11胸椎水平\nB.可见门静脉、肝动脉及胆管由肝门进入肝\nC.增强扫描门静脉、胆管表现为高密度分支状阴影，肝动脉呈低密度影\nD.三个管道以肝动脉最粗、较明显\nE.正常的胆管、门静脉进入肝后的小分支一般不能清楚显示", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在重症胰腺炎患者中，若出现肠麻痹症状，下列哪种药物应避免使用？", "options": "A. 抗生素\nB. 抗酸药\nC. 抑酸药\nD. 抗胆碱药\nE. 抑制胰酶活性药", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位28岁的男性患者，因剧烈上腹痛8小时入院，伴有恶心、呕吐和发热。体检发现上腹部压痛、反跳痛和肌紧张，Cullen征阳性。实验室检查显示血清淀粉酶显著升高。在以下哪种并发症出现时，可考虑短期使用肾上腺皮质激素治疗？", "options": "A. 腹水\nB. 急性呼吸窘迫综合征（ARDS）\nC. 严重低钙血症\nD. 持续性高血糖\nE. 进行性氮质血症", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，以下哪种情况可能导致单侧肝管阻塞而不引起黄疸？", "options": "A.胆囊结石\nB.胆总管结石\nC.肝管结石\nD.左、右肝管分支处结石\nE.胆总管胰腺段结石", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胆囊炎的临床过程中，以下哪两种并发症最为常见？", "options": "A. 胆囊积脓\nB. 胆囊穿孔\nC. 胆石症\nD. 胰腺炎\nE. 急性肝炎", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺假性囊肿的成熟时间，以下哪项描述是正确的？", "options": "A. 包膜由上皮细胞形成\nB. 4~6周可成熟\nC. 不可能自行吸收\nD. 常表现为急腹症\nE. 常需外科手术切除", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁的男性患者因突发剧烈腹痛6小时前来就诊。患者自述6小时前在朋友聚会中饮用了大量酒精饮料后出现上腹部持续性剧痛，疼痛位于剑突下区域，改变体位无法缓解。伴随症状包括恶心、呕吐和腹部胀满感，但无呕血、黑便、发热或呼吸困难。既往有消化性溃疡病史，无肝炎或腹部外伤史。为明确诊断，应进行哪些检查？", "options": "A. 腹部超声检查\nB. 全血细胞计数\nC. 凝血功能检测\nD. 胸部X线检查\nE. 肾功能检查\nF. 血清淀粉酶测定", "answer": "ABCDEF", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化肝功能代偿期，患者可能出现以下哪些临床表现？", "options": "A.肝大\nB.皮肤紫癜、贫血\nC.乏力，食欲不振\nD.不规则低热\nE.上腹隐痛，腹胀不适", "answer": "ACE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，有慢性肝炎病史，近两个月出现右上腹持续闷痛，伴有低热和明显消瘦。体检发现患者呈贫血貌，肝在右肋弓下可触及边缘，质地硬，有轻度压痛。实验室检查显示Hb为80g/L，AFP阳性，便潜血试验阳性。最可能的诊断是？", "options": "A. 慢性胆囊炎急性发作\nB. 肝脓肿并胆道出血\nC. 阿米巴性肝脓肿\nD. 慢性肝炎，肝硬变\nE. 晚期肝癌", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床诊断中，下列哪项特征是区分肝硬化腹水与右心衰伴大量腹水的关键指标？", "options": "A. 颈静脉怒张\nB. 下肢浮肿\nC. 呈现蛙腹\nD. 肝大质硬\nE. 伴黄疸", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝细胞癌的早期筛查中，以下哪项检查最为关键？", "options": "A. 超声检查\nB. 甲胎蛋白检查\nC. 酶学检查\nD. 肝血管造影\nE. 腹部X光检查", "answer": "BD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位男性患者在体检中发现肝脏呈现弥漫性肿大，以下哪种疾病最可能是其原因？", "options": "A.脂肪肝\nB.肝囊肿\nC.肝脓肿\nD.肝脏肿瘤\nE.肝包虫病", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性水肿型胰腺炎的治疗过程中，以下哪项指标恢复正常是恢复肠内营养的关键指征？", "options": "A.血清淀粉酶恢复正常\nB.尿淀粉酶恢复正常\nC.腹胀消失\nD.腹痛消失\nE.血清脂肪酶恢复正常", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，以下哪项指标是首选的？", "options": "A. ALT、AST\nB. AFP\nC. STB、CB、UCB\nD. AMA\nE. TP、ALB、GLB、A／G比值", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的诊断中，以下哪个体征被认为是典型的阳性表现？", "options": "A. Cullen征\nB. Charcot征\nC. RovSing征\nD. Murphy征\nE. Reynolds征", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁女性患者，长期携带乙型肝炎病毒20年，最近半年出现体重下降、黄疸、腹部肿胀和水肿症状。实验室检查显示ALT 400U/L，AST 350U/L，初步诊断为慢性肝炎。在以下检查结果中，哪一项最不可能出现？", "options": "A. 血清清蛋白60g/L\nB. 血清球蛋白20g/L\nC. 血清总蛋白40g/L\nD. 血清清蛋白/球蛋白比值（A/G）为1\nE. 血清清蛋白20g/L", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在脂类代谢过程中，以下关于肝脏功能的描述，哪一项是不正确的？", "options": "A. 肝脏是合成酮体的主要场所\nB. 肝脏是脂肪代谢的主要器官\nC. 肝脏是合成磷脂的主要场所\nD. 肝脏是合成分泌胆汁酸的主要器官\nE. 肝脏是合成4种血浆脂蛋白的主要场所", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺炎的诊断中，以下哪项实验室检查的描述是正确的？", "options": "A. 白细胞计数通常保持在正常范围内\nB. 血淀粉酶水平在症状出现后5小时内上升，并在48小时后开始下降\nC. 尿淀粉酶水平上升较晚，通常在症状出现后12至14小时开始升高，并持续1至2周\nD. 淀粉酶的检测具有很高的特异性，其他消化道疾病通常不会引起淀粉酶水平升高\nE. 淀粉酶水平的高低与病情的严重程度成正比", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，转移性肝癌最常呈现的特征性表现是什么？", "options": "A. 牛眼征\nB. 低回声病灶\nC. 囊性病灶\nD. 高回声病灶\nE. 后方伴声影", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下因素中，哪一项不会促进胆汁的分泌？", "options": "A.迷走神经兴奋\nB.促胃液素释放\nC.交感神经兴奋\nD.胆盐的肠-肝循环", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位58岁男性患者，体检时B超发现肝脏肿块，血检显示癌胚抗原水平升高，被诊断为早期肝癌。患者最初出现右肋胁部间歇性钝痛，随着时间的推移，疼痛逐渐加重且持续时间延长，原有药物无法有效缓解疼痛。在这种情况下，最佳选择的镇痛药物是", "options": "A. 哌替啶\nB. 可待因\nC. 苯妥英钠\nD. 布洛芬\nE. 氯丙嗪", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估胆囊功能时，口服胆囊造影主要用于以下哪项？", "options": "A.了解胆囊浓缩和吸收功能\nB.明确肝内病变的范围和性质\nC.了解梗阻性黄疸的部位\nD.可显示胆道系统和胰管\nE.了解胆道术后胆道系统的情况", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位56岁女性患者，主诉胃脘部剧烈疼痛，疼痛有时放射至背部，疼痛位置固定且拒按。体检发现上腹部可触及肿块，皮肤干燥如鳞，眼眶周围呈现暗黑色，舌质紫暗伴有瘀斑，舌下脉络紫胀，脉象弦涩。根据这些症状，最适宜的治疗方剂是？", "options": "A. 柴胡疏肝散加减\nB. 海藻玉壶汤加减\nC. 开郁二陈汤加减\nD. 膈下逐瘀汤加减\nE. 血府逐瘀汤加减", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊息肉的各种类型中，哪一种是最为常见的？", "options": "A. 炎症息肉\nB. 腺瘤性息肉\nC. 胆固醇性息肉\nD. 胆囊上皮来源息肉\nE. 胆囊间叶来源息肉", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者因食管-胃底静脉曲张破裂导致大量呕血入院，以下哪种止血方法最为简便且有效？", "options": "A. 静滴垂体后叶素\nB. 口服去甲肾上腺素溶液\nC. 应用三腔两囊\nD. 盐水洗胃\nE. 静滴酚磺乙胺", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，长期有吸烟和饮酒习惯，并有胆道结石病史。昨晚在大量饮酒和暴食后，突然感到左上腹剧烈疼痛。根据这些症状，最可能的诊断是什么？", "options": "A. 胆囊穿孔\nB. 胆道阻塞\nC. 肝硬化\nD. 急性胰腺炎\nE. 原发性肝癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化腹水合并功能性肾衰竭的患者中，以下哪一项不是常见的临床表现？", "options": "A.少尿或无尿\nB.尿钠低\nC.自发性氮质血症\nD.稀释性低钠血症\nE.肾小管缺血性坏死", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰液分泌不足但其他消化液分泌正常的情况下，患者可能会出现以下哪种症状？", "options": "A. 血糖降低\nB. 脂肪泻\nC. 胰腺炎\nD. 恶性贫血", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名35岁女性，既往无肝病史，2个月前因手术输血800ml，近日出现腹胀、乏力，ALT升高至200U/L。实验室检查显示甲肝抗体(-)，HBsAg(-)，抗HBc(-)，抗HBs(+)，抗HCV(+)。最可能的诊断是什么？", "options": "A. 术后引起中毒性肝炎\nB. 甲型肝炎\nC. 乙型肝炎\nD. 输血后肝炎\nE. 急性丙型肝炎，输血所致", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位47岁女性患者，因精神障碍长期服用氯丙嗪，最近出现全身皮肤黄染、尿液颜色加深并伴有皮肤瘙痒症状，最可能的诊断是", "options": "A. 肝细胞性黄疸\nB. 中毒性肝炎\nC. 肝外阻塞性黄疸\nD. 肝内胆汁淤积\nE. 自身免疫性溶血性黄疸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，有18年的慢性活动性肝炎病史，2年前被诊断为肝硬化，并反复出现腹水。1周前进行钡餐检查发现球部龛影。3小时前出现呕吐咖啡样物。诊断为上消化道出血，其最可能的原因是", "options": "A.急性胃黏膜病变\nB.食管胃底静脉曲张破裂\nC.胃溃疡\nD.十二指肠球部溃疡\nE.胃癌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，以下哪些是常见的临床并发症？", "options": "A. 肝性脑病\nB. 上消化道出血\nC. 功能性肾衰竭\nD. 感染\nE. 电解质紊乱及酸碱平衡失调", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于晚期血吸虫病肝硬化患者，伴有脾大和脾功能亢进，哪种外科手术方式最为适宜？", "options": "A. 脾切除联合门腔静脉吻合术\nB. 脾切除联合脾肾静脉吻合术\nC. 脾切除联合贲门周围血管离断术\nD. 脾切除联合胃冠状静脉栓塞术\nE. 单纯脾切除术", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆囊癌的流行病学和病理特征，以下哪项描述是正确的？", "options": "A. 发病高峰年龄在50-70岁之间\nB. 以血行转移为主要扩散途径\nC. 肿瘤好发于胆囊体部和底部\nD. 女性发病率显著高于男性", "answer": "AC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现上消化道出血症状，同时伴有发热和右上腹疼痛，最可能的诊断是？", "options": "A. 胃、十二指肠溃疡病\nB. 门静脉高压症\nC. 出血性胃炎\nD. 胃癌\nE. 胆道出血", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位42岁男性患者突然出现上腹部疼痛并伴有腹胀症状。超声检查结果显示胰腺弥漫性增大，胰腺实质回声减低，主胰管未扩张，且胃内有潴留液。根据这些临床表现和检查结果，最可能的诊断是什么？", "options": "A. 急性肠梗阻\nB. 急性胃潴留\nC. 急性胰腺炎\nD. 胰腺肿瘤\nE. 急性胆囊炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在早期肝癌的诊断中，以下哪一项描述最符合其病理特征？", "options": "A.癌肿直径在5cm以内\nB.高级别上皮内瘤变\nC.癌结节直径不超过3cm\nD.无明显症状，癌组织未侵及肌层，无淋巴结转移\nE.癌组织未侵及肌层，可有或无淋巴结转移", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位33岁女性患者因持续乏力、面色苍白及排浓茶色尿2周入院，伴有脱发和关节酸痛。体检显示贫血貌，皮肤黄染，无皮疹和出血点，全身浅表淋巴结未触及，肝未触及，脾肋下1cm。针对此情况，首选的治疗方案是什么？", "options": "A. 脾切除\nB. 免疫抑制剂\nC. 输血\nD. 丙酸睾酮\nE. 糖皮质激素", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺癌的超声检查中，以下哪一项描述是不正确的？", "options": "A. 胰腺实性肿块，多呈分叶状，边界不清，边缘伪足或尖角状，短期内增大明显\nB. 胰腺肿块随瘤体积增大回声逐渐不均匀，易出现坏死液化显示为无回声区\nC. 为较规则结节状，周边见弱回声晕环，血供丰富\nD. 肿瘤好发于胰头部，远端胰管扩张\nE. 多数后方回声衰减，黏液腺癌后方回声可增强", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位56岁女性患者，近3年来反复出现右上腹疼痛，最近2天伴有皮肤和巩膜黄染、发热及寒战。在这种情况下，首选的诊断检查是什么？", "options": "A. 内镜逆行胆胰管造影\nB. 腹部B超\nC. 静脉胆囊造影\nD. 磁共振胆胰管成像\nE. 经皮肝穿刺胆管造影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的鉴别诊断中，以下哪种情况需要被考虑？", "options": "A.急性胆囊炎和胆石症\nB.急性心肌梗死\nC.急性肠梗阻\nD.消化性溃疡并发穿孔\nE.以上都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在MRI影像中，观察到“灯泡征”这一特征，最可能提示以下哪种肝脏病变？", "options": "A. 肝脓肿\nB. 肝转移瘤\nC. 肝硬化\nD. 肝血管瘤\nE. 肝囊肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性胆汁性肝硬化的诊断中，以下哪项免疫学检查结果最具诊断价值？", "options": "A.抗线粒体抗体阳性+IgM阳性\nB.抗核抗体阳性\nC.抗平滑肌抗体阳性\nD.类风湿因子阳性\nE.抗线粒体抗体阳性+IgA阳性", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁女性患者，因甲亢每日口服PTU 6片，持续一个半月。既往无肝肾疾病史。实验室检查显示ALT 180U/L，AST 67U/L，AKP 203U/L，T3、T4水平仍未恢复正常，TSH为0.1mU/L。请问其肝功能异常最可能的原因是？", "options": "A. 甲亢引起的肝损害\nB. PTU引起的肝损害\nC. 合并急性肝炎\nD. 实验室检查误差\nE. 合并慢性肝炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者在进行肝脏超声检查时，发现肝右叶有一个较大的高回声肿块，肿块内部有不规则的无回声区域，周围有低回声晕环绕。彩色多普勒超声显示肿块内部及周边有多条状和簇状彩色血流分布，频谱分析显示为动脉波形，最大流速为68cm/s。最可能的诊断是", "options": "A.原发性肝细胞癌\nB.原发性胆管细胞癌\nC.转移性肝癌\nD.肝血管瘤\nE.以上都不是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位44岁男性患者，长期患有肝病，近期随访发现肝右叶有一个8cm的占位性病变，周围有多个卫星灶，但肝肾功能正常。在这种情况下，首选的治疗方案是什么？", "options": "A. 全身化学治疗\nB. 肿瘤局部放射治疗\nC. 手术切除\nD. 介入治疗\nE. 肿瘤局部无水酒精注射", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏中，胆汁的排出路径按照以下哪个顺序进行？", "options": "A.胆小管、黑林管、小叶间胆管、肝管\nB.胆小管、小叶间胆管、肝管\nC.肝管、小叶间胆管、黑林管、胆小管\nD.黑林管、小叶间胆管、肝管\nE.小叶间胆管、黑林管、胆小管", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "以下哪些因素被认为是胰腺癌的高危因素？", "options": "A. 慢性胰腺炎，特别是慢性家族性胰腺炎\nB. 2型糖尿病\nC. 年龄大于40岁，近期出现餐后上腹不适，伴轻度腹泻\nD. 家族性腺瘤息肉病者\nE. 高脂血症", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名35岁男性患者，近期出现恶心、呕吐和尿色加深的症状，持续2天。患者有肝炎感染史。根据这些症状和病史，最可能的诊断是什么？", "options": "A. 急性胆囊炎\nB. 肝癌\nC. 肝硬化\nD. 慢性乙型肝炎\nE. 急性肾炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下肝炎病毒中，哪些通常不会导致慢性肝炎的发生？", "options": "A. 丁型肝炎病毒\nB. 甲型肝炎病毒\nC. 乙型肝炎病毒\nD. 丙型肝炎病毒\nE. 戊型肝炎病毒", "answer": "BE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝功能不全的患者在接受特殊口腔护理时，护理人员注意到患者口腔散发出明显的肝臭味。这一症状最可能提示以下哪种情况？", "options": "A. 肝功能逐渐好转\nB. 患者出现消化不良\nC. 病情无变化\nD. 肝性脑病前兆\nE. 合并其他腹腔疾病", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝门静脉高压的患者中，以下哪条静脉最可能出现扩张？", "options": "A.右结肠静脉\nB.腹壁下静脉\nC.肾上腺静脉\nD.膈下静脉\nE.卵巢静脉", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门脉高压症患者中，食管静脉曲张手术治疗的主要目标是什么？", "options": "A. 预防曲张静脉破裂出血\nB. 减少腹水\nC. 提高机体免疫力\nD. 防止肝癌发生\nE. 改善肝功能", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，近3个月来持续感到上腹部隐痛，食欲减退前来就诊。患者既往无胃病史，大便外观呈黄色，隐血试验结果时阴时阳。体检发现上腹部有压痛，未触及包块，肝脾未触及。请问下列哪项检查对确诊最有帮助？", "options": "A. 胃镜检查\nB. B型超声波检查\nC. 胃酸测定\nD. 血清胃泌素测定\nE. 腹部CT检查", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在以下疾病中，哪一种通常会导致慢性腹泻？", "options": "A. 急性肠道缺血\nB. 慢性胰腺炎\nC. 过敏性紫癜\nD. 败血症\nE. 砷中毒", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，体检时发现血清AFP水平显著升高至650μg/L，但无任何临床症状。腹部检查显示腹壁柔软，肝脏未触及。关于早期肝癌的临床特征，以下哪几项是正确的？", "options": "A. 早期肝癌的转移主要发生在肺部\nB. 早期肝癌也可能发生转移\nC. 患者通常有病毒性肝炎的病史\nD. 腺瘤样增生可能通过不典型腺瘤样增生发展为早期肝细胞癌\nE. 胆管细胞癌的转移主要通过血道进行\nF. 早期小肝癌通常表现为膨胀性生长，并具有完整的肿瘤包膜\nG. 病理学上，小肝癌定义为单个癌结节直径小于3cm或两个癌结节直径总和不超过3cm", "answer": "BCDG", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝血管瘤的MRI影像中，以下哪种表现最为典型？", "options": "A.灯泡征\nB.快进慢出\nC.牛眼征\nD.爆米花状染色\nE.快进快出", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆石症患者中，急性重症胆管炎的典型临床表现是什么？", "options": "A. 高热、寒战\nB. 上腹绞痛\nC. 胆囊肿大\nD. 黄疸明显\nE. 血压下降伴意识不清", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，以下哪些因素可能诱发肝性脑病？", "options": "A. 上消化道出血\nB. 大量利尿\nC. 静脉输注冷冻血浆\nD. 休克", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "胰腺癌患者预后较差的主要原因是什么？", "options": "A. 黄疸对肝功能影响较大\nB. 早期症状不明显，发现和确诊晚\nC. 患者消化不良，营养状况差\nD. 胰，十二指肠切除术，对患者创伤大\nE. 肿瘤细胞胰管浸润", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌的发展过程中，最常受到影响的血管是哪一个？", "options": "A. 腔静脉\nB. 主动脉\nC. 门静脉\nD. 肠系膜下静脉\nE. 腹腔静脉", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌的临床表现中，以下哪一项描述是不正确的？", "options": "A. 肝癌患者通常不会出现急腹症的症状\nB. 肝癌患者可能完全没有疼痛感或仅感到轻微钝痛\nC. 肝癌有时会导致膈肌抬高的现象\nD. 位于肋弓下的肝癌结节最容易通过触诊发现\nE. 肝癌患者有时在腹壁上可以听到吹风样的血管杂音", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的手术治疗中，以下哪项描述是正确的？", "options": "A. 门腔静脉吻合术相比脾肾静脉吻合术，肝性脑病的发生率更高\nB. 脾肾静脉吻合术的吻合口栓塞率低于门腔静脉吻合术\nC. 经腹门奇静脉断流术必须切断胃左静脉的食管支\nD. 胃左静脉与下腔静脉吻合术会导致肝血流显著减少\nE. 脾肾静脉吻合术需要先切断脾再进行吻合", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断肝脏含液性病变时，以下哪种影像学检查方法能够提供最清晰的图像？", "options": "A. 放射性核素扫描\nB. 逆行胰胆管造影\nC. B超\nD. 腹部X线检查\nE. CT扫描", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者因突发上腹部剧烈疼痛入院，伴有高热（体温39℃）、巩膜黄染及剑突下压痛。在观察期间，患者多次出现寒战，脉搏加快至110次/分，血压升高至22/14kPa(165/105mmHg)。根据这些症状，最可能的诊断是什么？", "options": "A.急性胰腺炎\nB.慢性胆囊炎合并胆囊结石\nC.急性梗阻性化脓性胆管炎\nD.急性化脓性胆囊炎\nE.胆道蛔虫病", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊结石患者中，以下哪项描述不符合其疼痛特征？", "options": "A. 疼痛通常表现为轻微隐痛\nB. 可能出现剧烈的胆绞痛\nC. 疼痛常在夜间发作\nD. 疼痛向腹背呈束带状放射\nE. 疼痛与体位变化有关", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者因胆道砂石阻塞出现黄疸、右胁疼痛并放射至肩背，伴有寒热交替及大便呈灰白色，应选用哪种治疗方案？", "options": "A.茵陈蒿汤\nB.麻黄连翘赤小豆汤\nC.栀子柏皮汤\nD.大柴胡汤", "answer": "AD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在解剖学中，肝外胆管的位置通常是在", "options": "A.门静脉主干的前内侧\nB.门静脉主干的前外侧\nC.门静脉主干的后内侧\nD.门静脉主干的后外侧\nE.门静脉主干的后侧", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞肝癌的诊断中，以下哪项血液检查具有较高的特异性？", "options": "A. 血甲胎蛋白\nB. 血碱性磷酸酶\nC. 血胆红素\nD. 血尿素氮\nE. 胰岛素", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁男性患者，出现无痛性黄疸已持续一个多月，体重逐渐下降，但无明显不适。超声检查显示肝内外胆管和胆囊明显扩张，胰管未见扩张，胆总管下段发现低回声团块，与胆管壁界限不清，彩色多普勒超声显示团块内有血流信号，脉冲多普勒检测到动脉频谱。根据这些超声表现，最可能的诊断是", "options": "A. 胰头部实性占位\nB. 壶腹周围实性占位\nC. 胆总管下段结石\nD. 十二指肠壁占位\nE. 胆总管上段实性占位", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆超声检查中，正常肝总管及胆总管上段的内径通常小于伴行门静脉的多少？", "options": "A.1/2\nB.2/3\nC.3/4\nD.1/3\nE.二者内径相等", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化患者的肝功能时，以下哪项指标最具参考价值？", "options": "A. 血清转氨酶\nB. 碱性磷酸酶\nC. 单胺氧化酶\nD. 血清A/G比值\nE. 血清总胆红素", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰源性胰腺炎中，导致休克的主要病理生理机制是", "options": "A.胰酶外溢-脂肪酶-脂肪坏死\nB.胰蛋白酶-磷脂酶A-组织坏死\nC.胰蛋白酶-胰舒血管素-激肽原-激肽\nD.大量胰消化酶被激活\nE.胰酶-弹力纤维酶-血管损害出血", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断小肝癌时，哪种方法被认为是最优的定位诊断技术？", "options": "A. 超声检查\nB. 放射学核素肝扫描\nC. 选择性腹腔动脉造影检查\nD. CT检查", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胆道系统疾病时，下列哪种影像学检查方法通常作为首选？", "options": "A. 超声检查（B超）\nB. 计算机断层扫描（CT）\nC. 磁共振成像（MRI）\nD. 经皮经肝胆管造影（PTC）\nE. 内镜逆行胰胆管造影（ERCP）", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺手术后出现出血情况时，以下哪种药物是最合适的治疗选择？", "options": "A. 维生素K\nB. 硫酸鱼精蛋白\nC. 氨甲环酸\nD. 硫酸亚铁\nE. 右旋糖酐铁", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化代偿期，患者最早出现的临床症状通常是", "options": "A. 腹胀\nB. 乏力和食欲不振\nC. 恶心、厌油腻\nD. 上腹不适或隐痛\nE. 腹泻", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科领域，氯喹的临床应用主要涉及以下哪些疾病？", "options": "A. 阿米巴肝脓肿\nB. 室上性心动过速\nC. 类风湿关节炎\nD. 阿米巴痢疾\nE. 控制间日疟的症状发作", "answer": "ACE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位癌症患者接受了肝组织穿刺活检，显微镜下观察到癌细胞与正常肝细胞形态相似，具有异型性，并呈现腺管样结构。最可能的诊断是", "options": "A. 肝细胞癌\nB. 肝细胞癌(假腺管型）\nC. 肝细胞癌(索状型）\nD. 胆管上皮癌\nE. 混合性肝癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在慢性肝炎患者中，毛玻璃样肝细胞的出现主要与以下哪种细胞器内的物质积累有关？", "options": "A.滑面内质网内有大量HBsAg颗粒\nB.高尔基复合体内有大量HBsAg颗粒\nC.粗面内质网内有大量HBsAg颗粒\nD.线粒体肿胀\nE.核糖体增多", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在出血坏死型胰腺炎中，导致休克的主要因素与以下哪种酶最相关？", "options": "A. 弹力纤维酶\nB. 胰血管舒缓素\nC. 磷脂酶A\nD. 胰蛋白酶\nE. 以上都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，关于酶学检查的描述，哪一项是正确的？", "options": "A. 血清淀粉酶水平通常在症状出现后1-2小时内开始上升\nB. 尿淀粉酶水平通常在症状出现后3-4小时内开始增加\nC. 当胰腺发生广泛坏死时，尿淀粉酶水平可能不会显著增加\nD. 尿淀粉酶的增加通常早于血清淀粉酶的增加\nE. 尿淀粉酶和血清淀粉酶的水平通常同时开始增加", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的病理过程中，导致细胞水肿的主要原因是以下哪种物质水平升高？", "options": "A. 谷氨酸↑\nB. 谷氨酰胺↑\nC. 乙酰胆碱↑\nD. γ-氨基丁酸↑\nE. 去甲肾上腺素↑", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞癌的发病机制中，以下哪项因素与其发生关系不大？", "options": "A. 病毒性肝炎\nB. 肝硬化\nC. 食物中黄曲霉素污染\nD. 炎性肠道疾病\nE. 食物中亚硝酸盐污染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种类型的脓肿属于化脓性炎症？", "options": "A.嗜酸性脓肿\nB.阿米巴肝脓肿\nC.冷脓肿\nD.转移性脓肿\nE.炎性肉芽肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，多发胆固醇结石通常呈现多面形，这些结石最常见于哪个部位？", "options": "A.胆囊内\nB.肝内胆管内\nC.胆总管壶腹内\nD.肝外胆管内\nE.肝内、肝外胆管内", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，了解肝尾叶的静脉引流至关重要。请问肝尾叶的静脉主要引流入以下哪条静脉？", "options": "A.肝右静脉\nB.门静脉\nC.肝中静脉\nD.下腔静脉\nE.肝左静脉", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化患者的代偿状态时，以下哪一项通常不被视为代偿性肝硬化的特征？", "options": "A. 门脉高压症\nB. 轻度食管静脉曲张\nC. 无明显肝功能衰竭表现\nD. 临床症状轻\nE. 腹水", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在血清蛋白醋酸纤维素薄膜电泳图谱中，如果观察到清蛋白减少并且β-γ区带融合，这最可能提示以下哪种疾病？", "options": "A. 正常人\nB. 肾病综合征\nC. 肝硬化\nD. 多发性骨髓瘤\nE. 低蛋白血症", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科的放射性动态显像检查中，以下哪项不属于其适应症？", "options": "A. 异位胆囊的定位\nB. 肝血管瘤的诊断\nC. 慢性胆囊炎的诊断\nD. 肝胆手术后疗效的评估和随访\nE. 肝功能的检测", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊结石患者中，以下哪种并发症最为常见？", "options": "A. 肝脓肿\nB. 急性化脓性胆囊炎\nC. 胆道蛔虫病\nD. 急性水肿性胰腺炎\nE. 化脓性梗阻性胆管炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝硬化患者近期频繁出现意识障碍和昏迷症状，最可能的诊断是什么？", "options": "A. 脑血管意外\nB. 低血糖\nC. 肝性脑病\nD. 尿毒症\nE. 糖尿病", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在我国，导致门静脉高压症最常见的病因是", "options": "A. 肝炎后肝硬化\nB. 血吸虫病性肝硬化\nC. Budd-Chiari 综合征\nD. 门静脉主干血栓形成", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病昏迷期患者的饮食管理中，以下哪项建议是不正确的？", "options": "A.应禁食蛋白质，待病情好转后，可逐渐增加其摄入量\nB.显著腹水者，摄入钠应限制在500〜800mg/d\nC.清醒后可逐步增加蛋白质饮食，应以植物蛋白为宜，如豆制品\nD.清醒后可逐步增加蛋白质饮食，应以动物蛋白为宜，如牛奶、瘦肉\nE.提供足够的热量，以减少组织蛋白分解产氨", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，胃肠减压的主要目的是什么？", "options": "A. 减轻腹胀\nB. 减少胆囊收缩素的分泌\nC. 吸出胃液，减少其对促胰液素的刺激作用\nD. 减少胰腺的分泌\nE. 以上均正确", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脾胶体显像中，晚期肝硬化的患者通常会出现以下哪些典型表现？", "options": "A. 肝形态异常\nB. 弥漫性斑点稀疏\nC. 脾脏肿大\nD. 肝形态正常\nE. 骨髓摄取增加", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道蛔虫症的治疗方案中，以下哪种方法被认为是不恰当的？", "options": "A. 胆囊切除术\nB. 针刺足三里\nC. 解痉利胆驱虫\nD. 胆总管探查取虫引流\nE. 手术后驱虫治疗", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位46岁女性患者，主诉右上腹疼痛，伴有低热和反复血便。实验室检查显示白细胞计数轻度升高。超声检查发现肝右叶有一个直径约6cm的无回声区，边界清晰，呈类圆形，液区不清晰；同时右侧胸腔有少量积液。根据这些临床表现和检查结果，最可能的诊断是？", "options": "A. 肝囊肿\nB. 肝包虫病\nC. 细菌性肝脓肿\nD. 原发性肝癌\nE. 阿米巴肝脓肿", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝性脑病时，以下哪种药物通过酸化肠道环境来减少氨的吸收？", "options": "A.乳果糖\nB.新霉素\nC.左旋多巴\nD.溴隐亭\nE.肾上腺皮质激素", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁女性患者，有15年慢性活动性肝炎病史，1年前确诊为肝硬化，并反复出现腹水。1周前进行钡餐检查发现球部龛影。3小时前出现呕吐咖啡样物。诊断为上消化道出血，其最可能的原因是", "options": "A.食管胃底静脉曲张破裂\nB.急性胃黏膜病变\nC.胃溃疡\nD.胃癌\nE.十二指肠球部溃疡", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎患者中，血钙水平的下降主要与以下哪种酶的活性相关？", "options": "A. 血淀粉酶\nB. 弹性蛋白酶\nC. 脂肪酶\nD. 磷脂酶\nE. 胰酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的早期阶段，最常见的转移方式是什么？", "options": "A. 通过肝内血管系统扩散\nB. 通过淋巴系统转移至肺部\nC. 通过淋巴系统转移至锁骨上淋巴结\nD. 直接侵入胸腔\nE. 直接扩散至腹腔", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，对于严重的胆绞痛患者，最合适的治疗方案是", "options": "A. 阿托品\nB. 哌替啶\nC. 阿司匹林\nD. 普鲁本辛\nE. 阿托品+哌替啶", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位57岁男性患者，主诉右胁疼痛并伴有发热已持续3个月。体检发现肝脏在肋下3cm处可触及，质地坚硬，并可闻及血管杂音。实验室检查显示ALT为45U/L，γ-GT为400U/L。尽管接受了多种治疗，症状未见改善。首先应考虑的诊断是？", "options": "A. 慢性活动性肝炎\nB. 肝硬化并糖尿病\nC. 原发性肝癌\nD. 肝脓肿\nE. 肝性脑病", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位肝硬化腹水患者的24小时尿钠为110mmol（正常范围130～261mmol），24小时尿钾为117mmol（正常范围51～102mmol）。在这种情况下，最合适的利尿剂选择是", "options": "A. 氢氯噻嗪（双氢克尿塞）\nB. 螺内酯(安体舒通）\nC. 呋塞米（速尿）\nD. 依他尼酸钠（利尿酸钠)\nE. 氯噻酮", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的临床表现中，下列哪一项体征最具特异性？", "options": "A. 腱反射亢进\nB. 肌张力增加\nC. 扑翼样震颤\nD. 裸阵挛\nE. 巴宾斯基征阳性", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝内窦前型门静脉高压的病例中，以下哪种病因最为常见？", "options": "A. 肝炎后肝硬化\nB. 门静脉血栓形成\nC. 血吸虫性肝硬化\nD. 缩窄性心包炎\nE. 肝静脉血栓形成", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位肝癌患者接受了右肝部分切除手术，术后出现了血压下降、意识模糊以及皮肤出现出血斑的症状，这些症状最可能提示什么并发症？", "options": "A.急性心功能不全\nB.急性肾衰\nC.弥散性血管内凝血\nD.急性呼吸窘迫综合征\nE.急性肝功能不全", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，如果梗阻部位位于肝总管或以上，以下哪项描述最符合影像学表现？", "options": "A. 肝内胆管扩张、肝管扩张、胆囊空虚\nB. 肝内外胆管扩张、胆囊增大\nC. 肝内外胆管扩张、胆囊增大、胰管扩张 (双管征）\nD. 肝内胆管不扩张、肝管扩张、胆囊空虚\nE. 肝内胆管不扩张、肝管不扩张、胆囊空虚", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁女性患者，近两天出现右上腹疼痛，伴有寒战，体温升至38.8℃，随后发现巩膜和皮肤出现黄染。这些症状最可能提示的疾病是", "options": "A.急性胆囊炎\nB.急性胃穿孔\nC.总胆管结石\nD.急性病毒性肝炎\nE.急性胰腺炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，近期出现巩膜和皮肤黄染逐渐加重，伴有上腹部胀痛不适已持续近一个月。超声检查显示肝内胆管扩张（如图）。根据超声图像，最可能的诊断是", "options": "A. 壶腹部癌\nB. 肝门部胆管癌\nC. 胆总管远段癌\nD. 胰头癌\nE. 肝外胆管下段结石", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，自发性腹膜炎的发生主要与以下哪个因素有关？", "options": "A. 脾功能亢进、白细胞减少\nB. 肝内库普弗细胞功能减低\nC. 肠道黏膜屏障作用减弱\nD. 产生抗体的功能低下\nE. 侧支循环的建立与开放", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在弥漫性肝脏疾病患者中，餐后血糖水平可能高于正常范围，但与糖尿病的关键区别在于什么？", "options": "A. 胰岛B细胞功能同样存在缺陷\nB. 长期来看，也会发展出糖尿病的微血管并发症\nC. 餐后2至3小时血糖水平恢复正常或低于正常\nD. 空腹血糖水平保持正常\nE. 不需要使用降糖药物", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性肝衰竭患者出现肝性脑病的情况下，以下哪种治疗方法是不推荐的？", "options": "A. 使用硫喷妥钠\nB. 进行过度换气\nC. 将体温降低至32℃-33℃\nD. 实施腹膜透析", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺的先天性疾病中，哪一种最为常见？", "options": "A. 环状胰腺\nB. 异位胰腺\nC. 胰腺钙化\nD. 先天性胰腺憩室\nE. 先天性胰瘘", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，胆囊息肉的特征性表现是", "options": "A. 强回声团\nB. 随体位改变而移动\nC. 两者均有\nD. 两者均无", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科治疗中，以下哪种类型的肝脏肿瘤适合进行栓塞治疗？", "options": "A. 肝转移瘤\nB. 原发性肝癌\nC. 原发性肝癌门静脉完全阻塞\nD. 巨块型肝癌体积超过肝脏体积80%\nE. 10cm以下的血管瘤", "answer": "ABE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于肝硬化腹水患者，每日的液体摄入量应控制在什么范围内？", "options": "A. 1000-1500ml\nB. 500-1000ml\nC. 小于500ml\nD. 1500-2000ml\nE. 2000-2500ml", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆道感染的典型症状包括以下哪一项？", "options": "A.寒战、发热、呕血\nB.肝脾大、腹水\nC.剧烈呕吐后呕血\nD.上腹痛、反酸、烧心\nE.肝明显肿大、质硬伴结节，腹水，AFP增高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位56岁女性患者因水肿、腹胀和气促前来就诊，查体发现波动感阳性。为了区分肝性腹水和心源性腹水，应首选以下哪项检查？", "options": "A. 肝颈静脉回流征\nB. 心电图检查\nC. 腹部B超检查\nD. 胸片\nE. 腹腔穿刺", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脓肿的X线平片检查中，以下哪些表现是常见的？", "options": "A.膈肌升高\nB.肝向下增大\nC.右下肺盘状不张\nD.结肠肝曲上移\nE.右侧胸腔积液", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断肝癌与良性活动性肝病时，以下哪项指标的变化趋势最具鉴别价值？", "options": "A. HBsAg阳性\nB. AFP阳性\nC. AFP阴性\nD. 肝功能明显损害\nE. AFP和ALT动态曲线", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊结石的临床表现中，以下哪项描述是不正确的？", "options": "A. 所有胆囊结石患者都会出现明显症状\nB. 摄入高脂肪食物后症状会加剧\nC. 较大的单发结石较少发生嵌顿\nD. 结石卡在胆囊颈部时，可能引发急性胆囊炎\nE. 胆绞痛常向右侧肩部放射", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在CT扫描中，如果发现肝内胆管和肝门区近段胆管均出现扩张，以下哪种情况最可能是其原因？", "options": "A. 胆总管下段结石\nB. 原发性肝癌\nC. 胰头癌\nD. 肝门区淋巴结压迫\nE. 壶腹癌", "answer": "BD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，关于淀粉酶的变化，以下哪项描述是错误的？", "options": "A. 尿淀粉酶的升高通常比血清淀粉酶晚\nB. 血清脂肪酶的升高比血清淀粉酶更早\nC. 尿淀粉酶水平超过300U（索氏法）具有诊断意义\nD. 在急性坏死性胰腺炎中，尿淀粉酶可能不会升高\nE. 尿淀粉酶的水平与病情的严重程度不一定成正比", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁女性患者因出现黄疸、腹胀和乏力症状2天而入院。体检发现肝脏在肋下可触及两指宽度，巩膜和皮肤有轻度黄染。实验室检查显示转氨酶水平显著升高，且HBsAb检测为阳性。患者无输血史，但在2周前曾外出与同乡聚会并食用海鲜。基于这些信息，你认为下一步最应该进行的检查是什么？", "options": "A. HBV和HCV的抗原抗体检测\nB. HAV和HEV的抗原抗体检测\nC. HBV和HDV的抗原抗体检测\nD. HAV和HCV的抗原抗体检测\nE. HDV和HEV的抗原抗体检测", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，以下哪种药物被认为不会导致急性胰腺炎的发生？", "options": "A. 硫唑嘌呤\nB. 促肾上腺皮质激素\nC. 氢氧化铝\nD. 双氢克尿噻", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，了解胆总管的长度对于手术规划至关重要。根据解剖学研究，胆总管的平均长度是多少？", "options": "A. 5~7cm\nB. 7~9cm\nC. 9~11cm\nD. 12~14cm\nE. 15~17cm", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断典型疟疾时，需要与以下哪些疾病进行鉴别诊断？", "options": "A. 伤寒\nB. 胆道感染\nC. 败血症\nD. 钩端螺旋体病\nE. 恙虫病", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科诊断中，超声检查对于以下哪种疾病的诊断作用有限？", "options": "A. 胆囊炎\nB. 胆结石\nC. 胆囊积液\nD. 胃肠炎\nE. 阻塞性黄疸", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位39岁男性患者，因右上腹隐痛持续2个月就诊。影像学检查（B超及CT）显示肝脏多发占位病变，高度怀疑为原发性肝癌。实验室检查显示AFP水平显著升高至6250U/L，肝功能指标ALT为68U/L，AST为96U/L，总胆红素（T-BIL）、直接胆红素（D-BIL）和白蛋白（ALB）均在正常范围内。若该患者的肝脏病变不适合手术治疗，应首选哪种治疗方法？", "options": "A.化疗\nB.放疗\nC.索拉非尼治疗\nD.贝伐单抗治疗\nE.免疫治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏的病理变化中，以下哪种病变是不可能发生的？", "options": "A. 血管瘤\nB. 血管肉瘤\nC. 囊肿\nD. 绿色瘤\nE. 脓肿", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊胆固醇息肉的超声检查中，以下哪一项描述是不正确的？", "options": "A. 胆囊的大小和形态通常保持正常\nB. 呈现小于1.0厘米的球状或桑椹状略强回声\nC. 息肉样病变通常是多发的，体积较小\nD. 较少出现有蒂或基底窄的乳头状略强回声\nE. 桑椹状或类圆形略强回声结节，通常大于1.0厘米", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性梗阻性化脓性胆管炎的治疗中，哪一项措施最为关键？", "options": "A. 输液、输血维持有效血容量\nB. 纠正代谢性酸中毒\nC. 静脉输入大量抗生素\nD. 胆道减压引流解除梗阻\nE. 急诊行胆囊切除术", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的早期诊断中，以下哪项指标最为敏感？", "options": "A.血淀粉酶\nB.尿淀粉酶\nC.血脂肪酶\nD.尿淀粉酶肌酐清除率\nE.血钙", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位53岁男性患者，因皮肤和巩膜黄染及食欲减退1个月入院，有6年酒精性肝硬化病史。入院后接受护肝治疗，治疗期间出现腹腔积液，加用利尿剂治疗1周后，出现淡漠少言、吐字不清。查体显示皮肤巩膜黄染，肝掌阳性，心肺无异常，扑翼样震颤可疑。实验室检查显示ALT 125U/L, AST 167U/L, TB 183 μmol/L, K+ 3.7 mmol/L, 血氨133 μmol/L。患者意识障碍的最可能原因是", "options": "A. 肝硬化并发肝肾综合征\nB. 肝硬化并发电解质紊乱\nC. 肝硬化并发肝性脑病\nD. 肝硬化并发中毒性脑病\nE. 肝硬化并发脑血管意外", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺假性囊肿的描述，以下哪项是正确的？", "options": "A. 包膜由上皮细胞形成\nB. 4～6周可成熟\nC. 不可能自行吸收\nD. 常表现为急腹症\nE. 常需外科手术切除", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪一种疾病导致的出血属于漏出性出血？", "options": "A. 肝硬化\nB. 子宫颈癌\nC. 支气管扩张\nD. 胃溃疡\nE. 血小板减少性紫癜", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在华支睾吸虫感染的患者中，以下哪些病理变化是最常见的？", "options": "A. 胆管炎\nB. 胆道结石\nC. 胆囊炎\nD. 阻塞性黄疸\nE. 门静脉高压", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化门静脉高压症的诊断中，以下哪项表现最具特异性？", "options": "A. 腹水\nB. 食管下段、胃底静脉曲张\nC. 腹壁静脉曲张\nD. 脾大，脾功能亢进\nE. 黄疸", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "患者李某，男性，52岁，因右上腹持续性疼痛2天入院。既往有慢性胆囊炎病史。在护理评估中，以下哪项内容不属于护士需要重点关注的方面？", "options": "A. 疼痛的诱发因素\nB. 疼痛的具体位置、性质和强度\nC. 患者的日常饮食习惯\nD. 患者的体位变化\nE. 是否伴有其他不适症状", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科手术中，关于医源性胆管损伤的描述，以下哪一项是不正确的？", "options": "A. 胆管损伤可能是完全横断或部分损伤\nB. 胆管被横断结扎后，通常都会伴有胆管感染症状\nC. 超过90%的胆管损伤发生在胆囊切除术中\nD. 损伤常见于胆囊管、肝总管和胆总管的汇合部\nE. 如果是损伤性胆管狭窄，术后早期可能没有明显的临床表现", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌患者中，以下哪一体征最为显著？", "options": "A. 黄疸\nB. 肝区疼痛\nC. 肝脏进行性肿大\nD. 腹壁静脉曲张\nE. 脾功能亢进", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者出现右上腹疼痛、发热和白细胞升高已持续一周，超声检查显示胆囊显著增大，内部可见粗斑点状不均匀非沉积性回声，最可能的诊断是", "options": "A. 胆囊癌\nB. 胆囊积脓\nC. 胆囊水肿\nD. 陶瓷胆囊\nE. 胆囊积血", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在腹部X线平片中，以下哪项征象最可能提示慢性胰腺炎？", "options": "A.胰腺区多发性小结石和钙化\nB.胸腔积液\nC.十二指肠圈增大、淤积、充气\nD.结肠充气，结肠截断征\nE.十二指肠黏膜皱襞增粗，降段内缘受压", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在坏疽性阑尾炎患者出现高热、寒战和黄疸症状时，应特别警惕以下哪种并发症？", "options": "A.门静脉炎\nB.急性梗阻性化脓性胆管炎\nC.膈下脓肿\nD.急性溶血反应\nE.阑尾周围脓肿", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺导管腺癌的以下描述，哪些是正确的？", "options": "A. 放射治疗对该病敏感\nB. 长春新碱是其主要化疗药物\nC. 5年总体生存率不足10%\nD. CA19-9是其主要的血清标记物", "answer": "ACD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位患者出现腹水，一周前有呕血和黑便病史。最近表现出烦躁不安和动作不协调的症状，伴有轻度黄疸，且在双手举起时出现腕部阵发性颤抖。最可能的诊断是？", "options": "A.震颤麻痹\nB.氮质血症\nC.肝性脑病\nD.脑缺血\nE.安眠药过量", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝外伤的手术处理中，以下哪项原则是不正确的？", "options": "A. 清除坏死肝组织\nB. 确切止血\nC. 阻止胆汁外溢\nD. 充分引流\nE. 肝包膜下血肿均无需切开清创", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的初步诊断中，哪种无创性检查方法被推荐为首选？", "options": "A.超声检查\nB.X线钡餐造影\nC.CT\nD.MRI\nE.肿瘤标记物CA199", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者因突发呕血300ml，呈暗红色，并伴有两次黑便就诊。体检发现患者有蜘蛛痣，肝脏在肋下1.5cm处可触及，质地坚硬，脾脏在肋下3cm处可触及，质地韧，伴有少量腹水。针对此情况，首选的治疗方法是什么？", "options": "A. 静注维生素K\nB. 输白蛋白\nC. 法莫替丁静滴\nD. 服用氢氧化铝凝胶\nE. 静滴垂体后叶素", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "对于一位患有肝硬化门脉高压症并伴有肝癌的患者，在接受肝移植手术后，以下哪些益处是可以预期的？", "options": "A. 消除肝硬化\nB. 解除脾功能亢进\nC. 降低食管静脉破裂出血的风险\nD. 不再发生肝癌", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，近半个月出现寒战、弛张型高热，伴有肝区疼痛，肝左叶肿大且压痛明显。患者有明显的黄疸，白细胞计数为18×10^9/L，AFP检测为阴性。超声波检查显示左肝区有4cm的液性暗区，腹腔内有少量积液。胆囊内有1.0cm×2.0cm的结石，胆囊增大且壁厚。患者出现黄疸和腹水最可能提示", "options": "A. 病人有广泛的肝功能损害\nB. 病人有溶血\nC. 病人有肝硬化\nD. 病人有肝内外胆道的梗阻\nE. 病人有低蛋白血症", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断肝外胆管阻塞与肝内胆汁淤积性黄疸时，以下哪种检查方法最为有效？", "options": "A. X线检查\nB. B型超声\nC. CT\nD. 经皮肝穿刺胆管造影（PTC）\nE. 经十二指肠镜逆行胰胆管造影（ERCP）", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断中下段胆管结石时，哪种影像学检查方法具有更高的诊断价值？", "options": "A. 腹部超声\nB. 腹部CT扫描\nC. 腹部磁共振成像\nD. 放射性核素显像\nE. X线平片", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脏的微结构中，肝巨噬细胞主要分布在哪个部位？", "options": "A. 门管区内\nB. 肝血窦中\nC. 胆小管中\nD. 肝细胞索中\nE. 窦周隙内", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰岛细胞瘤中，哪种类型最为常见？", "options": "A.胰岛素瘤\nB.胰高血糖素瘤\nC.胃泌素瘤\nD.生长抑素瘤\nE.VIP瘤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "对于先天性胆道闭锁的患者，最佳的手术干预时间通常是在出生后的哪个阶段？", "options": "A. 2岁以后\nB. 2个月内\nC. 10岁以内\nD. 不需要手术，仅需药物治疗\nE. 以上都不对", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺小导管细胞中，哪种激素主要负责刺激大量水和碳酸氢盐的分泌？", "options": "A. 血管活性肠肽\nB. 去甲肾上腺素\nC. 胆囊收缩素\nD. 促胃液素\nE. 促胰液素", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化门静脉高压症的诊断中，以下哪项表现最具诊断价值？", "options": "A. 脾肿大，脾功能亢进\nB. 腹壁静脉曲张\nC. 食管下段、胃底静脉曲张\nD. 腹腔积液\nE. 黄疸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名6岁男孩被诊断为胆道蛔虫病，以下哪项病史或体征最不符合该诊断？", "options": "A. 发病12～24小时常有明显黄疸\nB. 曾有粪便中排出蛔虫的病史\nC. 腹痛呈间歇性发作\nD. 病情严重时可出现急性胆管炎症状\nE. 伴有恶心、呕吐症状", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位肝硬化患者突然出现剧烈腹痛和大量血性腹水，体温正常，最可能的并发症是什么？", "options": "A. 结核性腹膜炎\nB. 门静脉血栓形成\nC. 继发性肝癌\nD. 原发性腹膜炎\nE. 肝肾综合症", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁男性患者，有10年慢性乙肝病史，最近4个月出现右上腹隐痛、乏力、食欲减退和体重下降。体检发现皮肤无黄染，右上腹肝区有轻度叩痛，肝脾未触及肿大。B超检查显示肝右叶有一个2cm×3cm×4cm的圆形低密度病灶。关于该患者的预后判断，以下哪项是错误的？", "options": "A. 年老预后较差\nB. OT试验阴性预后差\nC. 有并发症者预后差\nD. ALT升高者预后差\nE. 有重度黄疸者预后差", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位52岁男性患者在接受胰十二指肠切除术后，开始进行肠内营养支持。在营养支持期间，患者出现了腹泻症状。以下哪项因素与患者腹泻的发生最不相关？", "options": "A. 肠内营养制剂被微生物污染\nB. 肠内营养制剂渗透压过高\nD. 患者对营养制剂存在不耐受\nE. 术后使用广谱抗生素导致肠道菌群失调\nC. 肠内营养制剂以40-50ml/h的速度输注", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断早期肝硬化时，哪项检查具有确诊意义？", "options": "A. 血清蛋白电泳\nB. 食道钡餐造影\nC. B型超声波\nD. CT\nE. 肝穿刺活体组织学检查", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性坏疽性胆囊炎并发胆囊穿孔的危重情况下，最优先考虑的治疗措施是", "options": "A. 立即进行胆囊切除术\nB. 立即进行腹腔引流术\nC. 实施胆总管引流术\nD. 进行胆囊造瘘术\nE. 给予解痉止痛药物", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的治疗中，以下哪种措施被认为是不起作用的？", "options": "A. 使用醋酸进行灌肠\nB. 口服乳果糖以促进肠道健康\nC. 口服新霉素以减少肠道细菌\nD. 限制患者饮食中的蛋白质摄入\nE. 静脉注射多巴胺以改善脑功能", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗顽固性腹水时，以下哪种方法效果不佳？", "options": "A. 大量排放腹水并补充白蛋白\nB. 将患者自身腹水浓缩后回输\nC. 增加利尿剂的剂量\nD. 实施经颈静脉肝内门体分流术\nE. 进行肝移植", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名20岁男性患者，近一周出现发热、食欲减退、厌油、恶心呕吐、尿黄等症状，黄疸迅速加重，血清总胆红素达到170μmo/L，凝血酶原活动度降至35%。最近两天出现嗜睡、烦躁不安，并伴有牙龈出血和皮下瘀斑。体检发现肝肋下未触及。该患者最可能的诊断是什么？", "options": "A.急性肝炎\nB.中毒肝炎\nC.急性重症肝炎\nD.淤胆肝炎\nE.慢性肝炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝外是否存在分流时，肝动脉灌注显像通常使用哪种显像剂？", "options": "A. 99mTc-RBC\nB. 99mTc-MAA\nC. 99mTc-IDA\nD. 99mTc-PAA\nE. 99mTc-GH", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，腹腔镜胆囊切除术适用于以下哪些情况？", "options": "A. 胆囊息肉\nB. 慢性胆囊炎、胆囊结石\nC. 急性胆囊炎\nD. 胆管结石", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，体检时发现血清AFP水平显著升高至800μg/L，但无任何临床症状。腹部CT扫描显示肝脏存在占位性病变。关于甲胎蛋白（AFP）的相关知识，以下哪几项是正确的？", "options": "A. AFP水平升高可见于睾丸或卵巢畸胎瘤患者\nB. AFP水平可用于监测肝癌治疗效果\nC. AFP是一种糖蛋白，正常情况下在出生后两年内逐渐消失\nD. 妊娠期妇女和慢性肝炎患者可能出现AFP水平升高\nE. 胃癌和肺癌患者也可能出现AFP水平升高\nF. AFP在体内的半衰期约为3至9.5天\nG. AFP水平升高可能在肝癌临床症状出现前6至12个月即可检测到", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化患者中，大量腹水通常不会伴随以下哪种腹部体征？", "options": "A. 腹部膨隆\nB. 液波震颤阳性\nC. 振水音阳性\nD. 移动性浊音阳性\nE. 蛙状腹", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔镜手术中，如果发生胆管损伤，以下哪一项描述是不正确的？", "options": "A. 胆汁流入腹腔，引起腹痛，继发性腹膜炎\nB. 胆管损伤后形成环行瘢痕，管壁增厚，胆道梗阻\nC. 胆管损伤，无胆汁外渗时，常在术后2周出现进行性黄疸\nD. 胆管破裂伴胆汁外渗，在术后10日内出现肠梗阻、弥漫性腹痛和胆汁性腹水\nE. 出现胆汁性腹膜炎，是胆管损伤后的早期表现", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在全胰切除术后，患者通常需要补充多种药物以维持正常生理功能。以下哪种药物在这种情况下是不必要的？", "options": "A. 胰岛素\nB. 多酶片\nC. 胰高血糖素\nD. 脂溶性维生素\nE. 水溶性维生素", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，微小肝癌的直径标准是（）。", "options": "A. ≤1cm\nB. ＜1cm\nC. ≤2cm\nD. ＜5cm\nE. ≤5cm", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的病理变化中，以下哪一项描述不符合假小叶的特征？", "options": "A.假小叶内肝细胞排列规整\nB.小叶中央静脉缺如、偏位或多个\nC.肝细胞团内出现汇管区\nD.增生的纤维组织分隔包绕肝细胞团\nE.增生的纤维间隔中可见新生的小胆管", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断过程中，以下哪项描述是不准确的？", "options": "A. 血清淀粉酶水平在症状出现后2至12小时内开始上升\nB. 血清脂肪酶水平在症状出现后24至72小时内开始上升\nC. 淀粉酶水平可能不会升高\nD. 血清淀粉酶水平的高低与病情的严重程度成正比\nE. 尿淀粉酶水平在症状出现24小时后开始上升", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝炎后肝硬化的诊断中，以下哪项检查结果最具诊断价值？", "options": "A. 脾脏肿大\nB. 皮肤出现蜘蛛痣\nC. 肝功能指标异常\nD. 超声波检查显示肝脏回声不均匀\nE. 食管钡餐检查显示下段有蚯蚓样充盈缺损", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在慢性肝胆炎症的病理变化中，以下哪项描述最为准确？", "options": "A.组织中大量中性粒细胞浸润，形成脓肿\nB.间质弥漫纤维化，有时可见结石和假性囊肿\nC.间质内有小胆管增生\nD.残存细胞呈结节状再生\nE.细胞有明显的脂肪变性", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名27岁男性在地震中腹部受压1小时，随后出现持续性腹痛、休克和腹膜刺激征。剖腹探查发现肝脾破裂，腹腔内积血达3000ml。术后第3天，患者突然出现烦躁不安、惊恐、呼吸频率增快，进行性呼吸困难，口唇发绀。肺部听诊无异常发现。首先考虑的诊断是", "options": "A. ARDS\nB. MODS\nC. SIRS\nD. 毒血症\nE. 菌血症", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位28岁的患者因暴饮暴食和大量饮酒后出现上腹正中剧烈刀割样疼痛，伴有恶心和呕吐，被诊断为急性胰腺炎。在病情稳定后，医生决定采用鼻饲连续滴入要素饮食来提供营养。在实施要素饮食的过程中，以下哪项做法是正确的？", "options": "A.配制时应严格执行无菌原则\nB.溶液温度应保持在30〜35℃\nC.应用时由高浓度、大剂量、慢滴入开始\nD.停用要素饮食时无须逐渐减量\nE.长期使用时无须监测电解质、尿素氮等指标", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁的男性肝硬化患者，近期出现尿量减少，实验室检查显示BUN为26mmol/L，BCr为400μmol/L。在治疗过程中，应避免采取以下哪项措施？", "options": "A.输注右旋糖酐\nB.静滴多巴胺\nC.严格控制输液量\nD.首先要加强利尿\nE.补充血浆白蛋白", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床诊断急性胰腺炎时，以下哪项实验室检查应作为首选？", "options": "A. 血钾\nB. 血肌酐\nC. 血淀粉酶\nD. 血尿酸\nE. 血白细胞计数", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺中，胰岛素瘤主要起源于哪种细胞类型？", "options": "A. A细胞\nB. B细胞\nC. D细胞\nD. G细胞\nE. D1细胞", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者被诊断为胃窦部肿块型胃癌，肿瘤大小约为6cm×4cm，已侵犯至浆膜层。CT扫描显示左肝外叶有一个3cm的转移灶，胰腺未见异常。针对该患者的最佳治疗方案是？", "options": "A. 已无法手术，行全身化学疗法\nB. 根治性胃大部切除术\nC. 根治性胃大部切除+左肝动脉栓塞术\nD. 根治性胃大部切除+左肝外叶切除术\nE. 胃空肠吻合术", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝移植手术后，如果患者继发巨细胞病毒感染，下列哪种药物是首选治疗方案？", "options": "A.膦甲酸钠\nB.干扰素\nC.核苷（酸)类似物\nD.阿昔洛韦\nE.更昔洛韦", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝炎患者的实验室检查中，如果发现白蛋白水平降低而球蛋白水平升高，这通常提示什么情况？", "options": "A. 急性肝炎黄疸期\nB. 急性肝炎恢复期\nC. 慢性肝炎\nD. 肝硬化\nE. 已转变为重症肝炎", "answer": "CD", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆汁的成分中，哪一种物质具有促进胆汁分泌的作用？", "options": "A. 胆固醇\nB. 胆色素\nC. 胆盐\nD. 胆绿素\nE. 卵磷脂", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位47岁的女性患者被诊断为细菌性肝脓肿，并接受了脓肿穿刺引流术。在术后护理中，最主要的护理目标是什么？", "options": "A. 防止引流管脱落\nB. 确保脓液完全排出\nC. 减少脓液的渗出\nD. 控制感染\nE. 监测病情变化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断出阿米巴性肝脓肿后，医生通常会优先选择哪种治疗方法？", "options": "A.抗阿米巴药物\nB.穿刺引流\nC.切开引流\nD.手术切除\nE.手术内引流", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位33岁女性患者，10天前出现发热和食欲减退，随后8天出现尿黄，5天前眼黄逐渐加深并伴有恶心、呕吐，1天前出现躁动不安和扑翼样震颤阳性。该患者的肝组织活检最可能显示的病理改变是？", "options": "A. 肝细胞普遍水肿、变性及点状坏死\nB. 肝细胞碎片状坏死\nC. 大量肝细胞坏死、肝小叶纤维支架遭破坏\nD. 汇管区严重炎症反应\nE. 肝细胞严重嗜酸性变", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆汁中，胆固醇能够保持溶解状态的主要依赖因素是", "options": "A.胆盐\nB.胆汁酸与卵磷脂\nC.黏蛋白\nD.β-葡萄糖醛酸酶\nE.胆碱酯酶", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胰腺分泌HCO-3的功能，下列哪项描述是错误的？", "options": "A.由胰腺内小导管上皮细胞分泌\nB.为胰酶提供适宜的作用环境\nC.防止盐酸对十二指肠黏膜的侵蚀\nD.缩胆囊素可引起HCO-3大量分泌\nE.胃酸进入十二指肠后可间接刺激HCO-3的分泌", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病症状显现之前，哪种检测方法能够早期发现病情？", "options": "A.空腹血糖\nB.脑电图\nC.肝功能全套\nD.视觉诱发电位\nE.血氨", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在下列哪种疾病中，Reynolds征最为典型？", "options": "A. 急性化脓性胆囊炎\nB. 急性梗阻性化脓性胆管炎\nC. 急性出血性坏死性胰腺炎\nD. 急性坏死性小肠炎\nE. 绞窄性小肠梗阻", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰高血糖素瘤的临床表现中，以下哪一项是不常见的？", "options": "A. 肺栓塞\nB. 坏死松解性游走性红斑\nC. 抑郁症\nD. 多发性神经根炎\nE. 1型糖尿病", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在临床实践中，对于疑似早期胰腺癌的患者，下列哪种影像学检查方法具有最高的诊断准确性？", "options": "A. 腹部超声检查\nB. 常规CT扫描\nC. 动态增强薄层CT扫描\nD. 磁共振胰胆管成像（MRCP）\nE. 内镜逆行胰胆管造影（ERCP）", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性硬化性胆管炎的相关描述中，哪一项是不正确的？", "options": "A.约50%～70%患者合并有溃疡性结肠炎\nB.病变可累及整个胆道系统，以肝外胆管病变明显\nC.患者常死于肝衰竭\nD.胆囊多受侵犯\nE.ERCP或MRCP具有一定诊断价值", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的治疗中，患者预后不佳的主要因素是什么？", "options": "A.病情发展迅速\nB.较早发生转移\nC.早期症状不明显，发现和确诊较晚\nD.肝功能损害严重\nE.手术对患者创伤大", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位患者因持续腹痛6小时被紧急送往医院，目前意识模糊、面色苍白、脉搏细弱，初步诊断为急性胰腺炎伴休克，已被送入重症监护室。家属焦急地询问护士关于患者的状况和预后，护士应如何回应？", "options": "A. 我们正在全力抢救其他病人，稍后医生会向您详细说明情况。\nB. 请先签署知情同意书并完成入院手续，我们才能开始治疗。\nC. 医生正在积极治疗您的家人，请配合我们，谢谢。\nD. 我们处理过许多类似病例，病情并不严重，请放心。\nE. 由于家属送医较晚，我们无法保证治疗结果。", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位40岁男性患者，患有肝硬化并伴有腹腔积液已1个月。6天前因反复呕血和黑便接受抢救治疗后病情稳定，但最近出现嗜睡和认人不清的症状。以下哪项检查对诊断最无帮助？", "options": "A. 脑电图\nB. 扑翼震颤\nC. 血氨\nD. 诱发电位\nE. 脑CT", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏的解剖结构中，以下哪一项描述是不正确的？", "options": "A. 肝胃韧带和十二指肠韧带固定肝脏脏面\nB. 肝脏通过左右三角韧带、冠状韧带、链状韧带和肝圆韧带固定在膈肌及腹壁上\nC. 门静脉、肝动脉和胆管进入肝脏的部位被称为第一肝门\nD. 肝右、肝中和肝左静脉在肝后上缘汇入下腔静脉，称为第二肝门\nE. 少量血液通过数支肝短静脉汇入下腔静脉的部位，称为第三肝门", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在中医治疗肝硬化肝肾阴虚证时，下列哪个方剂是最佳选择？", "options": "A. 柴胡疏肝散\nB. 实脾饮\nC. 中满分消丸\nD. 茵陈蒿汤\nE. 一贯煎合膈下逐瘀汤", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，长期上腹疼痛，症状在平卧时加剧，弯腰时有所缓解。体检发现上腹有轻度压痛，X线腹部摄片显示胰区有钙化。根据这些症状和检查结果，最可能的诊断是什么？", "options": "A. 慢性浅表性胃炎\nB. 慢性萎缩性胃炎\nC. 慢性胆囊炎\nD. 慢性胰腺炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位49岁的女性患者，近半年来多次出现右上腹疼痛，伴有恶心和呕吐，症状多在夜间睡眠后发作，并向右肩部放射。体检显示患者为肥胖体质，血压110/80mmHg，心率90次/分，右上腹有轻度压痛，无腹肌紧张。随着病情进展，患者出现黄疸，尽管接受了治疗，但疼痛持续加重，右上腹压痛、反跳痛和腹肌紧张明显，体温升至38.5℃。此时最可能的诊断是？", "options": "A.急性坏死性胰腺炎\nB.十二指肠溃疡穿孔并弥漫性腹膜炎\nC.胆总管结石\nD.结石性急性坏疽性胆囊炎\nE.急性化脓性胆管炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性水肿型胰腺炎的治疗中，以下哪项措施是必要的？", "options": "A. 应用抗生素\nB. 胃肠减压\nC. 静脉补液\nD. 给解痉止痛剂\nE. 以上都对", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，血清淀粉酶（AMS）水平的显著升高通常提示以下哪种疾病？", "options": "A. 病毒性心肌炎\nB. 慢性胆囊炎\nC. 急性胰腺炎\nD. 急性肠胃炎\nE. 病毒性肝炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断阿米巴肝脓肿时，以下哪项是其典型特征？", "options": "A. 患者通常有阿米巴痢疾的病史\nB. 病情发展缓慢，病程较长，症状较轻\nC. 肝穿刺时脓液常呈现棕褐色\nD. 脓肿通常为多发性", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗胆绞痛时，吗啡通常与哪种药物联合使用以增强疗效并减少副作用？", "options": "A. 阿司匹林\nB. 阿托品\nC. 芬太尼\nD. 纳洛酮\nE. 地西泮", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，肝脏各叶比例发生改变，其中尾叶与右叶的横径比通常超过多少？", "options": "A. 0.5\nB. 0.55\nC. 0.6\nD. 0.65\nE. 0.7", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁男性患者，出现寒战和弛张型高热持续半个月，伴有肝区疼痛，肝左叶肿大且压痛明显。患者有明显的黄疸，白细胞计数为18×10^9/L，AFP检测为阴性。超声波检查显示左肝区有4cm的液性暗区，腹腔内有少量积液。胆囊内有1.0cm×2.0cm的结石，胆囊增大且壁厚。如果不及时治疗，以下哪项并发症是不正确的？", "options": "A. 支气管胆道瘘\nB. 消化道出血\nC. 肺炎\nD. 脓胸\nE. 支气管胸膜瘘", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名5岁男童因发热服用了解热镇痛药。由于该药物未引起胃肠道不适，家长误以为可以增加剂量，导致药物过量中毒。两天后，患儿出现食欲不振、恶心、呕吐、腹痛和腹泻，随后出现肝区疼痛、肝肿大、黄疸，并迅速进展为急性肝衰竭。请问该患儿可能服用了以下哪种药物？", "options": "A. 对乙酰氨基酚\nB. 布洛芬\nC. 阿司匹林\nD. 双氯芬酸\nE. 吲哚美辛", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在出血坏死型急性胰腺炎中，胸水或腹水的形成主要是由于什么原因？", "options": "A.胰腺体积增大压迫淋巴组织所致淋巴液回流受阻\nB.胰酶刺激腹膜或胸膜所致\nC.肝细胞重度受损\nD.胸、腹腔内静脉炎及血栓发生\nE.禁食不严格或输液速度过快", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行肝血流灌注和肝血池显像时，以下哪项注意事项是错误的？", "options": "A. 根据标记红细胞方法的不同，其标记率须达到各方法的质控要求\nB. 需进行肝胶体和肝血流灌注与血池显像时，二者检查时间间隔不宜少于24小时\nC. 由于肝血管瘤血流缓慢，血池显像开始采集时间一般不早于30分钟\nD. 可疑占位病变越大，开始采集时间越要后延。必要时要延迟采集\nE. 肝血池显像可以用99mTcO4-", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位孕妇在怀孕期间服用了数天的红霉素，随后出现了黄疸、ALT水平升高、皮疹以及嗜酸性粒细胞增多。这些症状最可能的原因是什么？", "options": "A. 妊娠合并重症肝炎\nB. 妊娠期药物性肝损害\nC. 妊娠期高血压疾病引起的肝损害\nD. 妊娠期肝脏的生理变化\nE. 妊娠期胆汁淤积症", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆道梗阻患儿的大便通常呈现什么颜色？", "options": "A. 大便干结\nB. 大便呈黑色\nC. 大便带血丝\nD. 大便呈黄绿色\nE. 大便呈陶土色", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位68岁的男性患者因持续上腹部疼痛2个月前来就诊，疼痛主要集中在腹部和背部，夜间尤为严重。患者发现前倾坐位时疼痛有所缓解，且自发病以来体重减轻了10公斤。这种疼痛最可能的原因是", "options": "A. 腹腔神经丛受到侵犯或压迫\nB. 膈肌受到炎症刺激\nC. 后腹膜受到炎症刺激\nD. 腹前壁受损\nE. 胃肠道浆膜受到侵犯", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位48岁男性患者，有10年乙型肝炎病史，因乏力、低热、腹胀和少尿前来就诊。体检发现巩膜黄染，腹部膨隆，存在大量腹腔积液。肝脏略缩小，脾脏增大，超声检查显示肝内纤维增殖，肝硬化结节形成，门静脉和脾静脉增宽。诊断为肝炎后肝硬化伴门脉高压症。以下哪项治疗措施对该患者不适当？", "options": "A. 卧床休息\nB. 忌盐饮食\nC. 精氨酸静脉滴注\nD. 合并应用保钾和排钾利尿剂\nE. 反复多次抽放腹腔积液", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝硬化失代偿期的患者中，以下哪一项临床表现通常不会出现？", "options": "A. 食管胃底静脉曲张\nB. 血小板减少\nC. 肝病面容\nD. 糖尿病发生率增加\nE. 双颊盘状红斑", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，腹水的主要形成机制是__", "options": "A.门静脉压升高\nB.肝功能障碍\nC.侧支循环形成\nD.低蛋白血症\nE.醛固酮、抗利尿激素增多", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种疾病中，患者需要遵循低铜膳食？", "options": "A.肝硬化患者\nB.糖尿病患者\nC.腹泻患者\nD.肝豆状核变性患者\nE.脑梗死吞咽困难患者", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，哪种酶的作用会导致血管扩张和血管壁通透性增加？", "options": "A. 磷酰酶A2\nB. 弹力蛋白酶\nC. 激肽酶\nD. 胰蛋白酶\nE. 脂肪酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在比较壶腹周围癌与胰头癌的预后时，壶腹周围癌的预后较好，主要原因是什么？", "options": "A.肿瘤位于十二指肠乳头，容易发生坏死脱落\nB.肿瘤位于后腹膜，位置较深\nC.症状出现较早，较易早就医，早发现，早治疗\nD.肿瘤的恶性程度较低\nE.不易向淋巴结及肝脏转移", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的发病机制中，以下哪项因素与其发生无直接关联？", "options": "A. 胆道疾病\nB. 酒精中毒\nC. 暴饮暴食\nD. 低钙血症，上消化道出血\nE. 病毒感染", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的治疗中，手术切除率较低的主要原因是什么？", "options": "A. 癌直接浸润和转移\nB. 癌的恶性程度高\nC. 并发胆道疾病\nD. 年老，体弱\nE. 手术复杂", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，导致上消化道出血的常见原因包括哪些？", "options": "A.食管静脉曲张破裂\nB.消化道溃疡\nC.胃底静脉曲张破裂\nD.糜烂出血性胃炎\nE.以上均是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝豆状核变性（Wilson病）时，青霉胺的作用机制属于以下哪种方法？", "options": "A.螯合剂应用\nB.基因治疗法\nC.代谢抑制剂利用\nD.平衡清除法\nE.促排泄剂应用", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男，46岁，近2年出现右季肋部不适和食欲减退，最近1个月出现腹胀和下肢浮肿，近4天来症状加重，伴有腹痛和发热。体检发现脾脏肿大至肋下2.0cm，移动性浊音阳性，血红蛋白72g/L，白蛋白26g/L。腹水检查显示淡黄色，比重1.017，蛋白25g/L，细胞总数6.0×10^9/L，白细胞5.6×10^9/L，中性粒细胞占80%。最可能的诊断是", "options": "A.肝硬化合并结核性腹膜炎\nB.肝硬化合并自发性腹膜炎\nC.肝硬化门静脉血栓形成\nD.肝硬化合并原发性肝癌\nE.肝肾综合征", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，以下哪些非感染性因素可能导致全身炎性反应综合征(SIRS)的发生？", "options": "A. 严重创伤\nB. 烧伤\nC. 组织缺血\nD. 胰腺炎\nE. 失血性休克", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在阿米巴肝脓肿的诊断中，以下哪一项描述是不正确的？", "options": "A. 大多数阿米巴肝脓肿发生在肝脏的右叶\nB. 脓肿通常是单个的，但也可能是多个的\nC. 脓液中除了细胞、脂肪和夏科-雷登结晶外，还可以发现阿米巴滋养体\nD. 在慢性脓肿中，脓液中很少发现滋养体，但可能会发现包囊\nE. 大约10%的肝脓肿位于左叶", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在进行PTC和ERCP检查时，胆总管扩张的诊断标准通常是指其直径达到：", "options": "A.大于0.8cm\nB.大于0.9cm\nC.大于1.0cm\nD.大于1.1cm\nE.大于1.2cm", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在晚期肝硬化患者中，最常见的酸碱平衡紊乱类型是？", "options": "A. 代谢性酸中毒\nB. 呼吸性碱中毒\nC. 代谢性碱中毒\nD. 呼吸性酸中毒\nE. 呼吸性碱中毒、代谢性酸中毒", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝脓肿的发病机制中，细菌最常见的入侵途径是（）。", "options": "A.胆道\nB.肝动脉\nC.门静脉\nD.淋巴系统\nE.直接经伤口侵入", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，导致胆红素结石形成的最主要因素是什么？", "options": "A. 代谢异常\nB. 反复胆道感染\nC. 胆囊功能异常\nD. 致石基因\nE. 环境因素", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，肝脏转移性肿瘤最常见的原发部位是哪个？", "options": "A. 甲状腺癌\nB. 肺癌\nC. 胃癌和大肠癌\nD. 前列腺癌和乳腺癌\nE. 皮肤和食管鳞癌", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰头癌患者中，若伴有梗阻性黄疸，查体时胆囊的表现通常是怎样的？", "options": "A.胆囊表面光滑，伴局部肌紧张\nB.胆囊表面不平，压痛明显\nC.Murphy征阳性\nD.胆囊表面不平，无压痛\nE.胆囊表面光滑，无压痛", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像检查中，注射促胆囊收缩素（CCK）的主要临床应用包括", "options": "A. 评估胆囊排空功能\nB. 诊断急性非结石性胆囊炎\nC. 鉴别胆总管梗阻类型\nD. 诊断急性结石性胆囊炎\nE. 确诊慢性胆囊炎", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪项是肝癌的典型临床表现？", "options": "A. 寒战、发热、呕血\nB. 肝明显肿大、质硬伴结节，腹水，AFP增高\nC. 肝脾大、腹水\nD. 剧烈呕吐后呕血\nE. 上腹痛、反酸、烧心", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁女性患者，因肝硬化合并腹水入院。近日突发呕血约1000ml，随后出现嗜睡、精神错乱、幻觉，并伴有扑翼样震颤，脑电图显示异常。根据这些症状，患者最可能处于肝性脑病的哪个阶段？", "options": "A. 前驱期\nB. 昏迷前期\nC. 昏睡期\nD. 浅昏迷期\nE. 深昏迷期", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝功能障碍患者中，以下哪种电解质紊乱最为常见？", "options": "A. 低钠血症\nB. 低钾血症\nC. 高钙血症\nD. 高磷血症", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆色素结石的形成过程中，以下哪一项因素不参与其中？", "options": "A. 双葡萄糖醛酸胆红素\nB. β-葡萄糖醛酸胆红素\nC. 葡萄糖醛酸-1，4-内酯\nD. 胆道蛔虫病\nE. 肝胆管狭窄", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝性脑病的患者中，哪种情况通常预后最差？", "options": "A. 肝硬化伴腹腔积液者\nB. 暴发性肝炎所致者\nC. 诱因明确，且易消除者\nD. 肝硬化伴黄疸者\nE. 肝硬化伴自发性腹膜炎者", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性出血坏死性胰腺炎的患者中，以下哪种并发症最为常见？", "options": "A. 急性呼吸窘迫综合征 (ARDS)\nB. 休克\nC. 急性肾衰竭\nD. 胰腺周围脓肿\nE. 胰腺假性囊肿", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男，57岁，近3个月出现腹胀和水肿，1周前症状加重并伴有腹痛。20年前曾检测出HBsAg阳性。体检发现肝掌和蜘蛛痣，腹部呈蛙状，肝脏未触及，脾脏在肋下4cm处可触及，全腹有压痛但无反跳痛，移动性浊音阳性。实验室检查显示血清蛋白24g/L，球蛋白31g/L，血钾3.8mmol/L，血钠136mmol/L，血氯98mmol/L。该患者最可能的基本诊断是什么？", "options": "A. 原发性肝癌\nB. 乙肝肝硬化\nC. 慢性乙型肝炎\nD. 原发性肾病综合征\nE. 结核性腹膜炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病的发病机制中，以下哪种物质不属于神经毒质？", "options": "A. 硫醇\nB. 多巴胺\nC. 胺类\nD. 短链脂肪酸\nE. 酚类", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆道感染中，以下哪种情况不属于常见的严重并发症？", "options": "A. 急性胰腺炎\nB. 硬化性胆管炎\nC. 胆道出血\nD. 感染性休克", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胆囊三角的解剖结构中，下列哪一项不属于其组成部分？", "options": "A. 胆囊动脉\nB. 肝右动脉\nC. 肝总管\nD. 副右肝管\nE. 胆囊淋巴结", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位65岁男性患者因急性胰腺炎入院，随后发展为多器官功能不全综合征。在分析其发病机制时，以下哪项不属于主要的损害因子？", "options": "A. 细胞因子\nB. 炎性介质\nC. 生长因子\nD. 全身炎性反应\nE. 组织缺血—再灌注过程", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在临床检查中，若发现黄疸患者伴有胆囊肿大且无触痛，最可能的诊断是？", "options": "A. 急性胆囊炎\nB. 慢性胆囊炎、胆囊积水\nC. 胆囊颈部结石嵌顿\nD. 中下段胆管癌\nE. 胆总管下段结石", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，以下哪种化学物质与肝血管肉瘤的发生有关？", "options": "A. 苯\nB. 聚乙烯\nC. 联苯胺\nD. 氯乙烯\nE. 铬酸盐", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊穿孔的病例中，穿孔最常发生在胆囊颈部，这主要是因为", "options": "A. 该部位结石易嵌顿\nB. 局部血供差\nC. 该部位张力低\nD. 该部位肌肉运动差\nE. 该部位黏膜抵抗力弱", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，有30年的大量饮酒史，1年前被诊断为肝硬化失代偿期。以下哪项临床表现最不可能出现在该患者身上？", "options": "A.高磷血症\nB.低血糖\nC.肝性胸腔积液\nD.贫血\nE.低血钾", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在放射性核素肝脾胶体显像中，显像剂的主要作用机制是什么？", "options": "A. 显像剂通过胆管排泄\nB. 显像剂被肝脏内的星状细胞吞噬\nC. 显像剂能够进入肝囊肿\nD. 脓肿组织特异性摄取显像剂\nE. 显像剂滞留在肝血管瘤中", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种疾病中，严格禁止进行诊断性穿刺？", "options": "A. 细菌性肝脓肿\nB. 肝癌\nC. 肝包虫病\nD. 阿米巴性肝脓肿", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位48岁男性患者，因右上腹疼痛半年，近期加重并发现上腹部包块1个月前来就诊。患者半年前开始出现右上腹持续性钝痛，有时疼痛向右肩背部放射。近1个月来，疼痛加重，伴有腹胀、食欲减退、恶心和偶发低热（最高体温38.1℃）。患者自述睡眠不佳，有腹泻，但小便正常，体重下降约5kg。患者有15年乙型肝炎病史，无疫区接触史，无烟酒嗜好，无药物过敏史，家族中无类似疾病。查体显示：体温36.7℃，脉搏78次/分，呼吸12次/分，血压110/70mmHg。患者发育正常，营养一般，神志清楚，合作。皮肤无黄染，巩膜轻度黄染，双锁骨上窝未触及肿大淋巴结。心肺检查无异常。右上腹明显饱满，无腹壁静脉曲张，腹软，右上腹压痛，无反跳痛和肌紧张，右肋缘下3cm触及肝脏，边缘钝，质韧，有触痛，脾未触及，腹部叩诊呈鼓音，无移动性浊音，肝上界于右锁骨中线第5肋间叩出，肝区叩痛，肠鸣音8次/分。肛门指诊无异常。请问，诊断本病最特异性的检查是？", "options": "A.补体结合试验\nB.肝核素扫描\nC.CT\nD.卡松尼试验\nE.间接血凝试验", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁男性患者，因突发右上腹剧烈疼痛伴恶心、呕吐12小时入院，伴有寒战、高热及明显黄疸。体检发现剑突下压痛和腹肌紧张，诊断为急性梗阻性化脓性胆管炎。请问该患者急性梗阻性化脓性胆管炎的最常见原因是什么？", "options": "A.胆总管狭窄\nB.胆总管结石\nC.肿大胆囊压迫胆总管\nD.胆总管肿瘤合并梗阻\nE.肝脓肿合并出血，阻塞胆管", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位30岁女性患者，近2年多来反复出现右上腹疼痛，并伴有肩背部放射痛。根据超声检查结果，最可能的诊断是", "options": "A. 胆囊息肉\nB. 胆囊腺瘤\nC. 胆囊结石\nD. 胆囊蛔虫\nE. 胆囊癌", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位50岁男性患者，2个月前因饮酒后出现剧烈腹痛，住院治疗30天后症状有所缓解。最近在上腹部左侧发现一个包块，伴有轻度压痛。根据这些症状，最可能的诊断是什么？", "options": "A.胰腺假性囊肿\nB.脾脏肿瘤\nC.胰腺炎性包块\nD.胰腺恶性肿瘤", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎炎症扩散至全胰和腹腔的情况下，患者最可能出现的症状是什么？", "options": "A. 腹部压痛\nB. 呕吐\nC. 一般情况差\nD. 剧烈全上腹痛，并呈柬带状向两侧腰背部放射\nE. 腹胀和肠鸣音稍减弱", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位55岁女性患者，出现寒战、发热和右上腹疼痛已持续15天，每日体温高达39.8℃。CT扫描显示肝内有两个脓肿，最大直径达6cm。针对此情况，首选的治疗方法是什么？", "options": "A. 全身大剂量应用抗生素\nB. 右半肝切除术\nC. 经皮穿刺置管引流术\nD. 脓腔内注入抗生素\nE. 支持治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像的临床应用中，以下哪项不属于其适应症？", "options": "A. 诊断急性胆囊炎\nB. 诊断胆囊结石\nC. 诊断慢性胆囊炎\nD. 胆管先天性囊状扩张症\nE. 先天性胆管闭锁", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，Charcot三联症是以下哪种疾病的典型表现？", "options": "A. 急性胰腺炎\nB. 急性十二指肠憩室炎\nC. 急性胃炎\nD. 急性胆管炎\nE. 急性胆囊炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在治疗阿米巴感染时，有一种药物对肠阿米巴病无效，但对阿米巴肝脓肿有效。这种药物是", "options": "A. 二氯尼特\nB. 氯喹\nC. 喹碘方\nD. 甲硝唑\nE. 乙酰胂胺", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胆汁淤积性黄疸时，以下哪项实验室检查结果最具特征性？", "options": "A. 血清碱性磷酸酶水平升高\nB. 尿胆红素检测呈阳性\nC. 血清谷氨酰转肽酶活性增加\nD. 尿胆原排泄增多\nE. 粪便中胆原含量上升", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在CT影像中，肝硬化的特征性表现有哪些？", "options": "A. 肝脏右叶体积缩小，尾状叶代偿性增大\nB. 肝叶间裂间隙明显增宽\nC. 肝脏实质可呈现不同程度的脂肪浸润\nD. 平扫时肝脏密度分布不均匀\nE. 门静脉主干直径超过正常范围", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝硬化引起的顽固性腹腔积液时，以下哪些方法是正确的？", "options": "A. 经颈静脉肝内门体分流术\nB. 系列的治疗性放腹腔积液与补充白蛋白\nC. 腹腔静脉分流术\nD. 腹腔积液超滤浓缩回输\nE. 肝移植", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名10岁儿童，近3个月来出现言语不清、书写障碍和肢体震颤，头颅CT显示基底节区有低密度影。该患儿有肝炎病史，最可能的诊断是什么？", "options": "A. 脑梗死\nB. 肝豆状核变性\nC. 小舞蹈病\nD. 脑炎\nE. 瑞氏综合征", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在治疗肝衰竭患者时，哪种血液净化技术是最为推荐的？", "options": "A. 血液透析\nB. 血液滤过\nC. 血液灌流\nD. 血浆置换\nE. 单纯超滤", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，凝血功能障碍的主要原因是什么？", "options": "A. 某些凝血因子缺乏\nB. 血小板减少\nC. 血液中抗凝物质增多\nD. 维生素K缺乏\nE. 组织因子缺乏", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝血吸虫病慢性期的超声检查中，以下哪项描述是正确的？", "options": "A. 肝脏整体缩小，门静脉肝内分支增宽，多普勒显示血流速度下降\nB. 肝脏弥漫性增大，实质回声细密增强，后方出现衰减\nC. 肝脏增大，实质回声致密，肝静脉增宽，血流频谱呈现连续性\nD. 左肝缩小，右肝增大，肝内回声增粗不均，呈现地图样改变\nE. 右肝缩小，左肝增大，门静脉壁增厚，回声增强，形成高回声网状结构", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，以下哪些辅助检查具有重要的参考价值？", "options": "A. 谷草转氨酶\nB. 甲胎蛋白\nC. γ-谷氨酰转肽酶\nD. 放射性核素肝扫描\nE. 甲胎蛋白异质体", "answer": "BCDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在CT影像中，以下哪项是慢性胆囊炎的典型表现？", "options": "A.胆囊增大\nB.胆囊缩小\nC.胆囊壁增厚，可能伴有钙化\nD.伴有胆结石\nE.胆管扩张", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，关于胆总管直径的正常范围及其扩张标准，以下哪项描述最为准确：", "options": "A.正常胆总管直径小于5mm，大于8mm为扩张\nB.正常胆总管直径小于8mm，大于10mm为扩张\nC.正常胆总管直径小于10mm，大于15mm为扩张\nD.正常胆总管直径小于15mm，大于20mm为扩张\nE.正常胆总管直径小于15mm，大于25mm为扩张", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "关于壶腹癌的描述，以下哪一项是不正确的？", "options": "A. 肿瘤通常呈现低回声\nB. 早期症状常包括胆管梗阻\nC. 肿瘤形态多为圆形或轻度分叶状\nD. 常见于十二指肠乳头后胆总管壶腹区\nE. 胆总管和胰管通常同时扩张", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的病理生理过程中，以下哪项关于腹痛产生机制的描述是不正确的？", "options": "A.胰腺炎症累及肠道，导致肠胀气和肠麻痹\nB.胰管阻塞或胆囊炎引起疼痛\nC.胰腺炎性渗出液刺激腹膜\nD.胆汁刺激肠道\nE.炎症刺激和牵拉胰腺包膜上的神经末梢", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下类型的肝硬化中，哪一种会导致门脉高压症最为严重？", "options": "A. 病毒性肝炎肝硬化\nB. 酒精性肝硬化\nC. 血吸虫病性肝纤维化\nD. 原发性胆汁性肝硬化\nE. 淤血性肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位32岁男性患者，已有肝脾肿大病史3年。10天前帮助同事搬家后，出现极度乏力、食欲减退、恶心、厌油、腹胀以及深度巩膜黄染。体检发现肝右肋下未触及，实验室检查显示血清ALT为60u/L，总胆红素324umol/L，凝血酶原活动度30%，一分钟胆红素188.6umol/L。根据这些信息，最可能的诊断是什么？", "options": "A. 慢性肝炎重度\nB. 淤胆型肝炎\nC. 急性重症肝炎\nD. 亚急性重症肝炎\nE. 慢性重症肝炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺的先天性疾病中，以下哪两种是最常见的？", "options": "A.环状胰腺和异位胰腺\nB.先天性胰瘘和环状胰腺\nC.异位胰腺和先天性胰瘘\nD.先天性胰腺憩室和先天性胰瘘\nE.胰腺钙化和异位胰腺", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性化脓性胆囊炎的情况下，胆囊的哪个部位最容易发生穿孔？", "options": "A. 胆囊颈部\nB. 胆囊壶腹部\nC. 胆囊前壁\nD. 胆囊底部\nE. 胆囊后壁", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者并发自发性细菌性腹膜炎的情况下，选择抗生素治疗的主要原则是什么？", "options": "A.针对革兰氏阴性杆菌，同时考虑革兰氏阳性球菌\nB.针对革兰氏阳性球菌，同时考虑厌氧菌\nC.针对革兰氏阳性杆菌，联合使用抗真菌药物\nD.针对革兰氏阴性球菌，同时考虑厌氧菌\nE.针对革兰氏阴性杆菌，联合使用抗真菌药物", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者的CT影像中，以下哪些描述是正确的？", "options": "A. 肝左叶及尾状叶增大较为常见\nB. 肝实质密度一般与正常肝无明显变化\nC. 肝表面凹凸不平，肝缘变钝\nD. 肝硬化再生结节CT动态增强扫描无强化\nE. 胃底部可见小球形或扭曲的绦虫样影", "answer": "ABCE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下寄生虫感染中，哪一种主要通过化学性损害影响宿主？", "options": "A. 华支睾吸虫引起的阻塞性黄疸\nB. 胆道蛔虫症\nC. 脑囊虫病引起的癫痫\nD. 黑热病引起的脾肿大\nE. 疟原虫红内期成熟裂殖体对红细胞的破坏", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，尿淀粉酶的变化特点是", "options": "A. 最早出现增高\nB. 稍晚出现增高\nC. 最晚出现增高\nD. 不会出现增高\nE. 持续增高", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎患者中，Grey-Turner征表现为", "options": "A. 上腹部可触及肿块，伴有肌紧张和反跳痛\nB. 腹部明显膨胀，肠鸣音减弱\nC. 胁腹部皮肤出现灰紫色斑\nD. 脐周皮肤呈现青紫色\nE. 胆总管或壶腹部结石嵌顿导致黄疸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的MRI检查中，以下哪些表现是常见的？", "options": "A.胰腺肿大，出现形态学改变\nB.T1WI为低信号\nC.T2WI为高信号\nD.胰周常出现炎症性改变\nE.以上各项均不正确", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位52岁男性患者，近两年来一直感到上腹部不适。经过超声检查，图像显示如下，最可能的诊断是", "options": "A. 胆囊腺瘤\nB. 胆囊息肉样病变\nC. 胆囊癌隆起型\nD. 胆囊结石\nE. 胆囊腺肌增生症", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位55岁的女性患者，因慢性阻塞性肺疾病导致活动能力严重受限，无法上楼梯和做家务。此次因腹痛和黄疸1天入院，初步诊断为急性化脓性胆管炎，需进行急诊手术。在APACHEⅡ评分中，急性生理学评分为40分，年龄评分为3分。请问APACHEⅡ评分的总分是多少？", "options": "A.43分\nB.45分\nC.46分\nD.47分\nE.48分", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝性脑病患者出现抽搐症状时，以下哪种药物是最佳选择？", "options": "A. 氯丙嗪\nB. 吗啡\nC. 副醛\nD. 哌替啶（度冷丁）\nE. 地西泮（安定）", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科影像学检查中，以下哪一项不是门静脉瘤栓的典型影像学特征？", "options": "A. 门静脉管径增宽或形态不规则\nB. 平扫CT显示瘤栓密度与门静脉相近\nC. 平扫CT上门静脉呈现高密度影\nD. 增强扫描时瘤栓表现为低密度充盈缺损\nE. 瘤栓可能向肝内和/或肠系膜上静脉延伸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁男性患者，突然出现剑突下上腹部持续性刀割样剧烈疼痛，伴有恶心和呕吐。体检发现皮肤和巩膜无黄染，患者表情痛苦，腹部平坦，全腹压痛，腹肌强直，反跳痛明显，以上腹部压痛最为显著。血压为11/8kPa，脉搏124次/分。最可能的诊断是", "options": "A.胆总管结石嵌顿\nB.消化性溃疡穿孔\nC.胆道蛔虫病\nD.急性出血性胰腺炎\nE.泌尿系结石", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位60岁男性患者，主诉腹胀、腹痛和体重减轻已持续2个月。患者无发热或午后潮热，但有多汗和盗汗现象，大便呈糊状，每日3~4次。腹部B超和CT检查显示中量腹水，肝、胆、胰、脾及双肾均正常。胃镜和肠镜检查未发现异常。腹水分析显示为渗出性，以淋巴细胞为主，普通细菌培养阴性，未发现肿瘤细胞。为了进一步明确诊断，建议患者进行以下哪项检查？", "options": "A. MRI检查\nB. 粪便细菌培养\nC. 腹腔镜检查\nD. X线钡餐检查\nE. PPD试验", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的病理类型中，哪种类型占据了绝大多数病例？", "options": "A. 男性患者\nB. 导管细胞癌\nC. 可完全治愈\nD. 恶性未分化癌\nE. 髓样癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝海绵状血管瘤的MRI检查中，T2加权像显示肿瘤信号强度随TE延长而递增，通常TE值为", "options": "A. 60ms以上\nB. 90ms以上\nC. 100ms以上\nD. 120ms以上\nE. 180ms以上", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性肝衰竭的治疗方案中，以下哪项措施被认为是不恰当的？", "options": "A. 使用乳果糖进行口服治疗\nB. 提供肠道抗菌药物\nC. 补充支链氨基酸\nD. 使用脂肪乳剂来提供热量\nE. 通过活性炭吸附和半透膜透析清除血液中的有害物质", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断出血坏死型胰腺炎时，以下哪项检查结果最具特异性？", "options": "A. 血清正铁白蛋白阳性\nB. 血液浓缩，血细胞比容增高\nC. 血、尿淀粉酶活性明显增高\nD. 白细胞增多，粒细胞核左移\nE. 淀粉酶、肌酐清除率比值明显增高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎发作期间，患者应采取哪种饮食方式？", "options": "A. 低脂膳食\nB. 流质膳食\nC. 禁食\nD. 低胆固醇膳食\nE. 低盐膳食", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，B型超声（BUS）对以下哪种结石的诊断准确率最高？", "options": "A. 胆囊结石\nB. 肝内胆管结石\nC. 胆总管结石\nD. 肾结石\nE. 胰腺结石", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估慢性肝炎的严重程度时，以下哪项描述符合轻度慢性肝炎的特征？", "options": "A. 病程持续时间超过半年\nB. 肝细胞出现碎片状坏死\nC. 汇管区纤维组织显著增生\nD. 汇管区有慢性炎细胞浸润", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在门静脉高压症的诊断中，以下哪项表现最具特异性？", "options": "A. 腹水\nB. 脾大、脾功能亢进\nC. 肝功能障碍\nD. 呕血或便血\nE. 胃底、食管静脉曲张", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，5小时前出现剧烈上腹部疼痛，疼痛向背部放射，伴有多次恶心、呕吐，呕吐后疼痛未缓解。患者出现休克症状，病史显示7小时前曾参加聚会并暴食饮酒。最可能的诊断是什么？", "options": "A. 急性肾绞痛\nB. 急性胆囊炎\nC. 急性阑尾炎\nD. 急性坏死性胰腺炎\nE. 胃癌伴穿孔", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的发病机制中，以下哪项因素被确认为主要的促进因素？", "options": "A. 长期大量饮酒\nB. 乙型肝炎病毒感染\nC. 亚硝胺类化学物质的暴露\nD. 肝硬化的存在\nE. 饮用水中的污染物", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，胆囊动脉的主要来源是以下哪条动脉？", "options": "A. 肝固有动脉\nB. 胰十二指肠上动脉\nC. 胃十二指肠动脉\nD. 肝右动脉\nE. 肝左动脉", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断肝癌与良性活动性肝病时，以下哪项指标的组合最能提供鉴别依据？", "options": "A. HBsAg阳性\nB. AFP阳性\nC. AFP阴性\nD. 肝功能明显损害\nE. AFP和ALT动态曲线", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝细胞碎片样坏死的病理学观察中，下列哪一项最能描述其特征性改变？", "options": "A. 肝细胞核发生碎裂现象\nB. 肝小叶内出现广泛的点状坏死\nC. 坏死区域突破界板向肝小叶内部扩散\nD. 超过1/3的肝细胞坏死导致小叶结构破坏", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名10岁男孩，突发剑突下阵发性剧烈绞痛3小时，疼痛发作时辗转不安，呻吟不止，伴有恶心和呕吐，疼痛缓解后如常人。体检显示无发热、无黄疸，腹部平软无明显压痛，白细胞计数正常。最可能的诊断是什么？", "options": "A. 急性胃炎\nB. 急性胆囊炎\nC. 肠套叠\nD. 胆道蛔虫症\nE. 胃溃疡穿孔", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位64岁女性患者，在进食硬质食物后突然出现大量呕血，量约800～1000ml，血色鲜红，呈喷射状。当时心率为110次/分，血压为13/6.5kPa(90/50mmHg)。患者有慢性肝病史，平时常有肝区疼痛并伴有腹胀。该患者消化道出血的最可能病因是什么？", "options": "A.急性胃炎出血\nB.食管静脉曲张破裂出血\nC.反流性食管炎出血\nD.食管贲门粘膜撕裂综合征\nE.消化性溃疡出血", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在关于乙型肝炎的讨论中，以下哪一项陈述是不正确的？", "options": "A. 人群对HBV普遍易感\nB. HBV感染后抗-HBs阳转者可在一定时期内维持免疫力\nC. 抗-HBs与其他类型肝炎病毒存在交叉免疫\nD. 人群易感性一般随年龄的增高而降低\nE. 接种乙肝疫苗是降低人群HBV易感性的有效措施", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，导致死亡的最常见原因是什么？", "options": "A. 上消化道出血\nB. 原发性肝癌\nC. 感染\nD. 肝肾综合征\nE. 肝性脑病", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，识别胆囊动脉的来源至关重要。请问胆囊动脉主要源自哪条动脉？", "options": "A.肝右动脉\nB.胃、十二指肠动脉\nC.肝左动脉\nD.胰十二指肠上动脉\nE.肝固有动脉", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名30岁男性患者，两天前在骑自行车时不慎撞伤左胸，X光检查显示左7、8肋骨骨折，其他未见异常。今日上午下楼梯时突然出现剧烈腹痛，面色苍白，被紧急送往医院。查体发现血压50/30mmHg，心率140次/分，呈现弥漫性腹膜炎症状，腹腔穿刺抽出1ml不凝血。最可能的诊断是什么？", "options": "A. 上消化道出血\nB. 外伤后腹膜后血肿破裂\nC. 迟发性脾破裂\nD. 虚脱\nE. 肝被膜下血肿破裂", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位52岁的女性患者因反复发作的胆源性胰腺炎入院，经内镜逆行胰胆管造影（ERCP）检查发现Oddi括约肌功能障碍。Oddi括约肌的解剖结构包括以下哪些组成部分？", "options": "A.胆总管括约肌\nB.胰管括约肌\nC.十二指肠乳头\nD.壶腹部括约肌\nE.胰胆管腹括约肌", "answer": "ABD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝血管瘤的肝血池显像中，血管瘤区域的放射性强度与周围肝组织相比如何？", "options": "A. 增高\nB. 明显增高\nC. 稍低\nD. 明显减低\nE. 相似", "answer": "AB", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名53岁男性患者，主诉右季肋部胀痛持续1个月。体检发现无黄疸，肝脏在肋缘下可触及3cm，质地坚硬，无腹水迹象。B超检查显示肝右叶有一个约11cm×10cm的低回声病灶，肝左叶可见多个小低回声区。血清AFP水平超过1000ug/L。针对此患者，最适宜的治疗方案是？", "options": "A.放射治疗\nB.抗感染治疗\nC.肝动脉插管栓塞化疗\nD.剖腹探查术\nE.中草药治疗", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位53岁男性患者，患有肝硬化并伴有腹腔积液，最近一周出现发热、腹胀和轻度呼吸困难，腹腔积液量有所增加，心率为96次/分。在使用利尿药治疗2天后，患者表现出沉默寡言和性格改变。在这种情况下，下列哪项检查结果最可能正常？", "options": "A. 血钾钠离子测定\nB. 血氨\nC. 脑电图\nD. 扑翼样震颤\nE. 腹腔积液常规", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在诊断肝豆状核变性时，以下哪项实验室检查结果最具有特异性？", "options": "A. 染色体核型为:46，XX(XY)/47，+21\nB. 染色体核型为:45，XO/46，XX\nC. 血苯丙氯酸浓度＞0.24mmol/L(4mg/dl)\nD. 染色体核型为:48，XXXY\nE. 血清铜蓝蛋白值:50mg/L", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，以下哪项不是甲胎蛋白（AFP）的典型表现？", "options": "A. 甲胎蛋白水平持续上升，且不下降\nB. 甲胎蛋白与谷丙转氨酶（ALT）同时升高\nC. 甲胎蛋白升高，但谷丙转氨酶保持正常\nD. 甲胎蛋白水平超过500μg/L，持续4周以上\nE. 甲胎蛋白水平超过200μg/L，并在8周内逐步上升", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的早期筛查中，以下哪种方法被认为是最简便且有效的？", "options": "A. CT扫描\nB. 甲胎蛋白（AFP）检测\nC. 选择性肝动脉造影\nD. 磁共振成像（MRI）\nE. 放射性核素扫描", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位67岁的男性患者，通过B超检查发现肝脏存在实性肿块。为了进一步明确诊断，医生建议进行肝动脉造影检查。在检查前，以下哪项准备工作是不必要的？", "options": "A. 碘过敏试验\nB. 普鲁卡因皮试\nC. 会阴部备皮\nD. 抽血查凝血功能\nE. 向患者介绍检查的目的", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科的超声检查中，如果观察到肝脏呈现如图所示的声像图特征，最可能的诊断是什么？", "options": "A. 肝血吸虫病\nB. 原发性结节型肝癌\nC. 结节性肝硬化\nD. 多囊肝\nE. 不均匀性脂肪肝", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在考虑肝细胞癌患者的治疗方案时，以下哪种情况适合采用化疗栓塞？", "options": "A. 恶病质\nB. 严重肝肾功能不良\nC. 肝肿瘤体积占全肝的70%以上\nD. 伴肝海绵状血管瘤\nE. 凝血酶原时间延长", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现明显梗阻性黄疸症状，但B超检查显示胆总管及肝内胆管未见扩张，此时应选择哪种检查方法进一步诊断？", "options": "A.十二指肠低张造影\nB.放射性核素胰腺扫描\nC.经皮肝穿刺胆管造影术\nD.逆行胰胆管造影\nE.腹腔镜检查", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性坏死性胰腺炎的临床表现中，以下哪一项最具特征性？", "options": "A. 上腹部持续性刀割样疼痛\nB. 恶心、呕吐\nC. 黄疸\nD. 中等程度发热\nE. 脐周或肋腹部皮肤青紫色", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，自发性腹膜炎最常见的病原体是__", "options": "A. 大肠杆菌\nB. 链球菌\nC. 金黄色葡萄球菌\nD. 肠球菌\nE. 幽门螺杆菌", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，测量脾脏大小的正确方法是", "options": "A. 通过肋间斜切，显示脾门和脾静脉，测量其厚度及最大长径\nB. 通过肋间斜切，显示脾门和胰尾，测量其厚度及长径\nC. 通过肋间斜切，显示腹腔动脉，测量其厚度及长径\nD. 通过肋下斜切，显示腹主动脉，测量其长径\nE. 通过肋下斜切，显示下腔静脉，测量其长径", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现上腹部剧烈疼痛、寒战高热以及黄疸症状，最可能的诊断是", "options": "A. 胆总管囊肿\nB. 胆道蛔虫病\nC. 急性胆囊炎\nD. 先天性胆道闭锁\nE. 胆总管结石合并感染", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，细菌进入肝脏的主要途径是哪个？", "options": "A. 肝动脉\nB. 胆道\nC. 门静脉\nD. 外伤伤口\nE. 淋巴系统", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，为了准确区分胆色素结石、胆固醇结石、混合性结石和黑结石，以下哪种影像学检查方法最为有效？", "options": "A. B超\nB. X线平片\nC. CT\nD. ERCP\nE. 口服造影", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科临床实践中，下列哪种疾病最可能同时出现呕吐和黄疸症状？", "options": "A. 急性胃炎\nB. 幽门梗阻\nC. 胆石症\nD. 急性肾盂肾炎\nE. 急性阑尾炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的诊断中，以下哪项实验室检查结果最具有特异性？", "options": "A. 甲胎蛋白（AFP）阳性\nB. 癌胚抗原（CEA）阳性\nC. 尿中本-周（Bence-Jones）蛋白定性试验阳性\nD. 降钙素升高\nE. 尿中17-羟类固醇明显升高", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的诊断中，以下哪一项症状通常不会出现？", "options": "A. 持续不规则发热\nB. 低胆固醇血症\nC. 肝硬化表现\nD. 低血糖症\nE. 门静脉血栓形成", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺炎中，哪种酶的主要作用是导致血管壁的破坏和坏死？", "options": "A. 胰蛋白酶\nB. 糜蛋白酶\nC. 弹力蛋白酶\nD. 磷脂酶A\nE. 激肽酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在阻塞性黄疸患者的尿液中，主要存在的胆红素形式是哪种？", "options": "A. 游离胆红素\nB. 胆红素-Y蛋白\nC. 葡萄糖醛酸胆红素\nD. 胆红素-清蛋白复合物\nE. 胆红素-Z蛋白", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝功能不全的患者中，以下哪种血液成分通常不会出现减少？", "options": "A. 血浆白蛋白\nB. 纤维蛋白原\nC. 球蛋白\nD. 凝血酶原\nE. 凝血因子", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者，晚餐后突然出现上腹部剧烈疼痛，疼痛迅速扩散至全腹，无法直立行走。2小时后急诊就诊。查体显示患者呈痛苦面容，腹式呼吸消失，腹肌紧张，腹膜刺激征阳性，肝浊音界消失，肠鸣音消失。最可能的诊断是", "options": "A. 阑尾炎穿孔\nB. 溃疡病穿孔\nC. 胆囊穿孔\nD. 绞窄性肠梗阻\nE. 急性胰腺炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在治疗肝豆状核变性（Wilson病）时，医生通常会使用一种药物与铜离子形成螯合物，以帮助患者排出体内过量的铜。以下哪种药物是用于此目的的首选？", "options": "A.青霉素\nB.青霉胺\nC.维生素B12\nD.硫酸镁\nE.去铁胺B", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，因上腹部不适持续3年就诊。胃镜检查确诊为胃窦癌。手术探查发现胃窦癌约4cm×4cm，活动性良好，同时左肝外叶发现一约2cm的转移结节。针对此情况，最合适的手术方案是", "options": "A. 仅进行腹腔关闭，不进行其他处理\nB. 实施胃与空肠吻合术\nC. 进行姑息性胃大部切除，并在腹腔内放置化疗药物\nD. 进行姑息性胃大部切除，并在胃网膜行动脉置管进行化疗\nE. 进行姑息性胃大部切除，并同时切除左肝外叶的转移结节", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在先天性胆管扩张症的患者中，以下哪种症状通常不会出现？", "options": "A. 右上腹肿块\nB. 黄疸\nC. 发热、上腹痛\nD. 右上腹阵发性绞痛\nE. 出现症状时间可由新生儿、儿童至成年", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位65岁的男性患者，有胆囊结石病史，因持续上腹痛4小时被家属紧急送医。查体发现患者意识模糊，血压为90/50mmHg，右上腹部有明显肌紧张。根据这些症状，最可能的诊断是什么？", "options": "A.急性胆囊炎\nB.急性胆管炎\nC.急性胰腺炎\nD.感染性休克\nE.急性胆原性胰腺炎", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，以下哪种血清酶的水平会显著升高？", "options": "A. 淀粉酶\nB. 胆碱酯酶\nC. GPT\nD. 酸性磷酸酶\nE. 碱性磷酸酶", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆汁性肝硬化的病理特征中，以下哪一项不属于其典型表现？", "options": "A. 肝脏表面结节细小或不明显\nB. 假小叶不完全\nC. 肝细胞淤胆明显\nD. 可见羽毛状坏死\nE. 可见碎片状坏死", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁男性患者，5小时前出现剧烈上腹部疼痛，疼痛向背部放射，伴有多次恶心、呕吐，呕吐后疼痛未缓解。患者出现休克症状，病史显示7小时前曾参加聚会并暴食饮酒。在治疗急性胰腺炎时，以下哪种药物应禁用？", "options": "A. 钙剂\nB. 抗生素\nC. 抗胆碱药物\nD. 吗啡止痛\nE. 5-氟尿嘧啶", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名新生儿出现黄疸症状，黄疸消退后又再次出现，伴有反应迟钝、拒乳和体温偏低。最可能的诊断是什么？", "options": "A. 生理性黄疸\nB. 母乳性黄疸\nC. 新生儿溶血病\nD. 胆道闭锁\nE. 新生儿败血症", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种疾病与体内铜的异常积聚有关？", "options": "A.苯丙酮尿症\nB.肝豆状核变性\nC.黏多糖病\nD.半乳糖血症\nE.有机酸代谢病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "男性，48岁，有15年乙型肝炎病史，近期出现右上腹持续性钝痛，伴有上腹部包块、腹胀、食欲减退、恶心和偶发低热。体检发现巩膜轻度黄染，右上腹压痛，肝脏肿大且触痛明显。根据这些症状和体征，最可能的诊断是哪些？", "options": "A. 肝炎后肝硬化\nB. 肝脏恶性肿瘤\nC. 慢性结石性胆囊炎\nD. 肝血管瘤\nE. 肝脓肿\nF. 原发性肝胆管结石", "answer": "ABDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位67岁的男性患者，近两个月来出现中上腹持续性隐痛，并伴有腰背部疼痛，前倾位或俯卧位时疼痛有所减轻，最可能的诊断是__", "options": "A. 消化性溃疡\nB. 胃黏膜脱垂\nC. 胰体癌\nD. 胆囊炎\nE. 慢性胃炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性水肿性胰腺炎的治疗中，以下哪项措施是正确的？", "options": "A. 应用抗生素\nB. 胃肠减压\nC. 静脉补液\nD. 给予解痉止痛剂\nE. 以上都对", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位60岁女性患者，近1个月出现腹胀和食欲减退，体重减轻10公斤。检查发现腹水呈血性，腹水ADA水平为20U。最可能的诊断是：", "options": "A. 结核性腹膜炎\nB. 肝癌结节破入腹腔\nC. 腹膜转移癌\nD. 自发性腹膜炎\nE. 门静脉血栓形成", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在国内，肝癌患者进行肝动脉栓塞治疗时，常用的栓塞剂包括哪些？", "options": "A. 微球\nB. 无水酒精\nC. 不锈钢圈\nD. 碘化油\nE. 明胶海绵", "answer": "ADE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆总管探查术后，关于T形引流管的拔除指征，以下哪一项是不正确的？", "options": "A.术后一周\nB.血胆红素水平恢复正常\nC.患者体温稳定\nD.患者无腹痛、腹胀等不适症状\nE.T管造影显示肝内外胆管显影正常", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断细菌性肝脓肿时，以下哪种检查方法能够提供确诊依据？", "options": "A. 血常规\nB. B超\nC. CT\nD. 放射线核素扫描\nE. 诊断性肝穿刺", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的治疗方案中，哪种方法被普遍认为是最有效的首选治疗手段？", "options": "A.化疗\nB.手术治疗\nC.免疫治疗\nD.放疗\nE.支持治疗", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名患者在车祸中上腹部受到车轮压伤，1小时后出现休克和明显贫血症状。最可能的诊断是什么？", "options": "A.创伤性胰腺损伤\nB.创伤性肝脾破裂\nC.创伤性脾破裂\nD.创伤性小肠损伤\nE.创伤性结肠损伤", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在原发性肝癌的早期诊断中，以下哪项检查最具诊断价值？", "options": "A. 血清转氨酶\nB. 癌胚抗原\nC. 甲胎蛋白\nD. 凝血酶原\nE. 酸性同工铁蛋白", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化的临床管理中，以下哪项不属于其常见并发症？", "options": "A. 上消化道出血\nB. 肝性脑病\nC. 肝肾综合征\nD. 高血压\nE. 自发性腹膜炎", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患有门脉肝硬化并伴有腹水的患者，最近两天出现腹泻、恶寒发热、腹痛，全腹压痛及反跳痛，最可能的诊断是什么？", "options": "A. 肝癌破裂\nB. 自发性腹膜炎\nC. 门静脉血栓形成\nD. 结核性腹膜炎\nE. 腹腔转移癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估肝硬化患者的肝功能损害程度时，下列哪项血清学指标最具参考价值？", "options": "A. 谷丙转氨酶\nB. 谷草转氨酶\nC. 碱性磷酸酶\nD. 白蛋白/球蛋白比例", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种疾病可能导致右肩部放射痛？", "options": "A. 肝阿米巴病\nB. 肠阿米巴病\nC. 二者均是\nD. 二者均不是", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一名30岁男性患者，因乏力、食欲不振10余天就诊。体检显示无明显黄疸，肝右肋下1cm可触及，脾未扪及。肝功能检查显示血清ALT为120u/L。患者2个月前因溃疡病出血，接受了1000mL输血，术后恢复顺利。若HCV-RNA检测为阳性，确诊为急性输血后丙型肝炎，最佳治疗方案是", "options": "A. '保肝'治疗加用强的松\nB. '保肝'治疗加用干扰素\nC. '保肝'治疗加用病毒唑\nD. '保肝'治疗加用胸腺素\nE. '保肝'治疗加用阿昔洛韦", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，乳腺、胰腺等腺癌转移至肝脏的转移性肿瘤，其常见的超声影像特征是什么？", "options": "A. 高回声型\nB. 强回声型\nC. 低回声型\nD. 弱回声型\nE. 混合回声型", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在HE染色切片中，观察到肝细胞体积增大，胞浆呈现淡染且空泡状。为了进一步确定这些空泡的性质，最常用的染色方法是？", "options": "A.苏丹Ⅲ染色\nB.普鲁士兰染色\nC.嗜银染色\nD.免疫组化\nE.电镜检查", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性肝衰竭的治疗中，以下哪项措施是不推荐的？", "options": "A. 腹膜透析\nB. 抗感染治疗\nC. 使用甘露醇以降低颅内压\nD. 限制水分摄入并调整电解质和酸碱平衡\nE. 使用泻剂或乳果糖并限制蛋白质摄入", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在阿米巴肝脓肿的治疗中，以下哪种情况通常需要手术引流？", "options": "A.左叶肝脓肿\nB.右叶肝脓肿\nC.经抗阿米巴药物治疗无效及穿刺引流失败者\nD.多发性脓肿穿刺引流失败者\nE.继发细菌感染者或穿破入腹者", "answer": "ACDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，如果仅进行脾切除术而不进行门奇静脉断流，可能会增加哪种并发症的风险？", "options": "A. 感染加重\nB. 血栓形成\nC. 消化道出血加重\nD. 胃扩张\nE. 其他", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断门脉性肝硬化时，以下哪种腹水类型最具有特征性？", "options": "A. 血性腹水\nB. 腹水为渗出液\nC. 腹水为漏出液\nD. 腹水为脓型\nE. 腹水介于漏出液与渗出液之间", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性巨块型肝癌的超声检查中，以下哪一项表现是不常见的？", "options": "A.肝内巨大的实质性肿块，呈分叶状或类圆球状\nB.肿块边界清楚，多见丰富血流信号\nC.肿块内部回声可呈结节融合状，即块中块表现\nD.肿块坏死时，中心可见不规则高回声区\nE.肿块向外浸润时，与周围肝组织界线不清", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在磁共振成像（MRI）的T2加权像（T2WI）中，肝转移瘤常表现为'灯泡征'，这种特征性表现最常见于以下哪种原发肿瘤？", "options": "A. 乳腺癌\nB. 平滑肌肉瘤\nC. 胃肠道癌\nD. 内分泌肿瘤\nE. 肺癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "原发性胆汁性肝硬化的主要病因是", "options": "A. 细菌感染引起\nB. 自身免疫性疾病\nC. 慢性化脓性胆管炎\nD. 结石造成的胆道阻塞引起\nE. 中华分枝睾吸虫引起", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位来自牧区的男性患者，近三个月来感到右上腹饱胀，并伴有间歇性隐痛。体检发现肝脏增大，触诊有囊性感，进一步检查确诊为肝包虫病。关于该病的治疗原则，以下哪项是正确的？", "options": "A. 优先考虑内科保守治疗\nB. 口服甲苯咪唑400mg能杀灭幼虫\nC. 局部注射甲醛溶液3~4个疗程可达临床治愈\nD. 手术治疗易致病灶扩散\nE. 一律考虑手术治疗为主", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在慢性胰腺炎患者中，胰腺功能不全的临床表现通常在疾病持续多长时间后出现？", "options": "A. 持续5周以上时出现\nB. 持续2年以上时出现\nC. 持续5年以上时出现\nD. 持续10年以上时出现\nE. 持续5个月以上时出现", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下关于胆汁的描述中，哪一项是不正确的？", "options": "A.胆汁呈金黄色，pH7.8〜8.6\nB.胆汁中除97%是水外，还有胆盐等有机物及Na+等无机物\nC.正常人每天分泌胆汁600〜1200ml\nD.在胆囊中贮存胆汁，因被浓缩而颜色加深\nE.消化期时，胆汁进入胆囊储存", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁的男性患者，患有肝硬化已有3年，体检发现少量腹水。在考虑使用利尿剂治疗时，以下哪种药物应作为首选？", "options": "A.甘露醇\nB.螺内酯（安体舒通）\nC.依他尼酸钠（利尿酸钠）\nD.氢氯噻嗪(双氢克尿塞）\nE.呋塞米（速尿）", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，关于胆总管囊肿的描述，以下哪项是正确的？", "options": "A.肝门部闭锁，肝外胆道有或无腔隙\nB.肝管闭锁，肝外胆道呈一纤维索带\nC.胆总管闭锁，肝外胆管呈一盲袋，内含胆汁\nD.胆总管正常，肝内胆管扩张\nE.胆总管呈囊状扩张", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，细菌性肝脓肿的最常见病因是什么？", "options": "A.胆道化脓性感染\nB.肝包虫病\nC.开放性肝损伤\nD.坏疽性阑尾炎\nE.右侧膈下脓肿", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，如果发现胆总管呈现梭形或圆形扩张，医生首先应该怀疑的疾病是？", "options": "A.胆总管结石\nB.胆总管癌\nC.胰头癌\nD.胆总管炎\nE.胆总管囊肿", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科的诊断中，下列哪项不是肝胆动态显像的常见适应证？", "options": "A. 诊断急性胆囊炎\nB. 诊断胆囊结石\nC. 诊断慢性胆囊炎\nD. 胆管先天性囊状扩张症\nE. 先天性胆管闭锁", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，门静脉高压症最常见的原因是什么？", "options": "A. 门静脉主干先天性畸形\nB. 肝静脉血栓形成、狭窄\nC. 肝段下腔静脉阻塞\nD. 肝硬化\nE. 各种原因致脾静脉血流量过大", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在腹腔镜胆囊切除术中，关于胆管损伤的描述，哪一项是不正确的？", "options": "A. 在肝右动脉周围进行电切、电凝、分离，可能导致胆管损伤\nB. 典型损伤是将胆总管误认为胆囊管\nC. 胆管撕裂伤，即可进行单纯修补\nD. 胆管电热损伤后多出现胆瘘，可及早发现\nE. 肝外胆管解剖变异也是导致肝外胆管损伤的原因", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，亚临床肝癌的定义是什么？", "options": "A. 肝细胞DNA代谢异常\nB. AFP检出而无任何症状和体征的肝癌\nC. B超检出＜2cm的肝癌\nD. CT检出＜2cm的肝癌\nE. 患者仅有肝区疼痛的肝癌", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的诊断中，关于淀粉酶的变化，以下哪项描述是错误的？", "options": "A.尿淀粉酶升高时间晚于血淀粉酶\nB.尿淀粉酶下降时间晚于血淀粉酶\nC.尿淀粉酶水平超过200U/dl（索氏单位）具有诊断意义\nD.在坏死性胰腺炎中，尿淀粉酶水平不一定升高\nE.淀粉酶水平的高低与病情的严重程度不一定成正比", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断出血坏死型胰腺炎时，以下哪项指标最具特异性？", "options": "A. 血脂肪酶增高\nB. 血淀粉酶增高\nC. 血钙降低\nD. 血胆红素增高\nE. B超检查胰腺增大", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的治疗中，以下哪些方法属于经肝动脉的介入治疗？", "options": "A. 肝动脉灌注化疗\nB. 肝动脉栓塞\nC. 肝动脉化疗栓塞\nD. 肝动脉球囊成形\nE. 射频消融治疗", "answer": "ABC", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科手术中，Calot三角是由哪些结构组成的解剖区域？", "options": "A.胆囊管，脾静脉，肝下缘\nB.胆囊管，肝总管，肝下缘\nC.主胰管，肝总管，肝下缘\nD.胆囊管，肝总管，肝上缘\nE.胆囊底，胆总管，肝上缘", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位42岁的女性患者，主诉右上腹疼痛已持续1年，通常在摄入高脂肪食物后发作。昨晚在食用炖猪蹄后1小时，她出现了右上腹疼痛，并向右肩部放射，伴有两次呕吐。在进行腹部检查时，最可能发现压痛的部位是哪个？", "options": "A. 肋脊点\nB. McBurney点\nC. 上输尿管点\nD. 季肋点\nE. 胆囊点", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在解剖学中，胆囊的具体位置是？", "options": "A.肝脏面肝门右纵沟的前部\nB.肝脏面肝门左纵沟的前部\nC.方叶的前方\nD.第2肝门的前方\nE.肝的裸区", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在评估门静脉高压时，以下哪项发现最具诊断价值？", "options": "A. 肝功能异常\nB. 脾大和脾功能亢进\nC. 食管胃底静脉曲张\nD. 腹水征阳性\nE. 肝掌阳性", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PortalHypertension", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的病因中，以下哪一项是不正确的？", "options": "A.胆石症\nB.胆囊炎\nC.暴饮暴食\nD.酗酒\nE.低钙血症", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在原发性肝癌的临床诊断中，以下哪项方法是错误的？", "options": "A. 对于有肝病病史、HBsAg阳性、肝硬化或慢性肝炎，年龄在40~60岁的患者，应定期进行AFP和B超检查\nB. 如果AFP水平大于400μg/L，且影像学检查显示肝内实质性占位，可以明确诊断\nC. 如果AFP水平小于400μg/L，但影像学检查显示肝内实质性占位，且AFP异质体阳性，可以明确诊断\nD. 如果AFP阴性，但B超或CT显示肝内实质性占位，可以进行肝动脉造影或B超引导下细针经皮肝穿刺细胞学检查\nE. 如果AFP水平大于400μg/L，但B超或CT未发现肝内明确占位，可以排除肝癌诊断", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，对于无症状的胆囊结石患者，医生通常会建议观察随诊而非立即进行胆囊切除手术？", "options": "A.结石直径小于1cm\nB.合并糖尿病且糖尿病已控制时\nC.伴有胆囊息肉\nD.合并瓷化胆囊\nE.口服胆囊造影，胆囊不显影", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "患者出现深黄色大便且粪胆原水平升高，最可能的原因是", "options": "A. 胆管部分梗阻\nB. 肝细胞性黄疸\nC. 溶血性黄疸\nD. 胆管完全梗死\nE. 阻塞性黄疸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在解剖学上，胰腺疾病与胆道疾病之间存在密切关联，这种关联的基础是什么？", "options": "A. 胰管与胆总管在解剖位置上非常接近\nB. 胰腺导管和胆总管下端共享一个共同的通路并共同开口\nC. 胰腺的副胰管与胆总管直接相通\nD. 胆总管和胰腺导管均开口于十二指肠的内侧壁\nE. 胰腺导管的开口位于胆总管开口的下方", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝癌的介入治疗中，以下哪种情况通常不被视为适应证？", "options": "A. 小肝癌\nB. 术后复发病灶\nC. 伴有肝动脉门静脉瘘\nD. 肝功能Child C级\nE. 肝内多发病灶", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患有肝硬化的患者因消化道出血入院，同时伴有高血压和冠心病。在考虑止血措施时，下列哪种方法应避免使用？", "options": "A. 冰生理盐水洗胃\nB. 三腔二囊管压迫\nC. 去甲肾上腺素胃管滴注\nD. 垂体后叶素静脉滴注\nE. 6-氨基己酸静脉滴注", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胰腺癌的治疗中，哪种手术方法被广泛认为是根治性的首选？", "options": "A.Whipple手术\nB.胆肠吻合\nC.ERCP\nD.放置支架\nE.PTCD", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于胆总管的解剖结构，以下哪项描述是正确的？", "options": "A. 直径0.3～0.5cm\nB. 位于肝固有动脉的左侧\nC. 位于肝胃韧带内\nD. 由左、右肝管汇合形成\nE. 由肝总管和胆囊管汇合形成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎的诊断中，以下哪项实验室检查结果提示可能为出血坏死型胰腺炎？", "options": "A. 血清淀粉酶显著升高\nB. 低血钙\nC. 血糖水平升高\nD. 血磷水平降低\nE. 白细胞计数显著增加", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的早期临床表现中，以下哪项症状最为典型？", "options": "A. 体重明显下降\nB. 持续性上腹部剧烈疼痛\nC. 反复恶心呕吐\nD. 体温升高\nE. 食欲明显减退", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患有高血压和冠心病的肝硬化患者出现消化道出血，以下哪种止血措施不推荐使用？", "options": "A. 三腔二囊管压迫\nB. 去甲肾上腺素胃管滴注\nC. 垂体后叶素静脉滴注\nD. 生长抑素静脉滴注\nE. 冰生理盐水洗胃", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位患者被诊断为多发性内分泌综合征，伴有多个内分泌腺的功能亢进。如果该患者出现粘膜多发性神经瘤，最可能的分型是？", "options": "A. MENⅠ型\nB. MENⅡ型\nC. MENⅡA型\nD. MENⅡB型\nE. MENⅢB型", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科临床实践中，如果发现患者的AFP和ALT指标同时升高，最可能提示以下哪种疾病？", "options": "A. 肝脓肿\nB. 肝血管瘤\nC. 肝囊肿\nD. 肝癌\nE. 活动性肝炎", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝棘球蚴病的CT影像中，以下哪项描述是正确的？", "options": "A.肝实质内单发或多发、大小不等、圆形或类圆形的低密度囊性病灶\nB.可见环状、半环状、条索状或结节状钙化\nC.囊壁强化\nD.于母囊内有大小不一、数目不等的子囊、形成多房或蜂窝状", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者，因右中上腹疼痛伴恶心、呕吐1天，症状加重并伴有腹胀12小时前来就诊。患者体型肥胖，体温38.9℃，呼吸频率30次/分，心率120次/分，血压110/80mmHg。体检发现全腹胀，伴有压痛、反跳痛及肌紧张，移动性浊音阳性。实验室检查显示血淀粉酶1000索氏单位，白细胞计数20×10^9/L，血钙水平降低。根据这些临床表现和检查结果，最可能的诊断是（）。", "options": "A.急性水肿性胰腺炎\nB.急性腹膜炎\nC.急性胃肠炎\nD.出血坏死性胰腺炎\nE.胃溃疡穿孔", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位53岁男性患者，患有肝硬化并伴有腹腔积液。最近一周出现发热、腹胀和轻度呼吸困难，腹腔积液有所增加，心率为96次/分。在使用速尿治疗2天后，患者出现沉默寡言和性格改变。以下哪种治疗方案最不合适？", "options": "A. 静脉补钾\nB. 早期、足量联合应用抗生素\nC. 口服乳果糖\nD. 静脉滴注精氨酸\nE. 静脉滴注复方氨基酸", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位45岁的男性患者，体重超标，过去五年每周有超过五天的应酬，饮酒量较大，但没有厌油、食欲不振等症状。患者有两年高脂血症病史，最近半年在服用降脂药物。体检发现右锁骨中线肋缘下2厘米处可触及肝脏。实验室检查显示ALT为60U/L，胆红素水平正常，HBsAg阴性。患者转氨酶升高的最可能原因是？", "options": "A. 病毒性肝炎\nB. 药物性肝炎\nC. 酒精性肝病\nD. 非酒精性脂肪性肝病\nE. 自身免疫性肝炎", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在日本血吸虫病导致的肝脏病变中，最常见的肝硬化类型是", "options": "A. 胆汁性肝硬化\nB. 门脉性肝硬化\nC. 干线型肝硬化\nD. 游血性肝硬化\nE. 坏死后性肝硬化", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下哪种情况下，肝穿刺检查是合适的？", "options": "A. 肝功能异常伴有血友病\nB. 肝血管瘤\nC. 大量腹水\nD. 阿米巴肝脓肿\nE. 肝昏迷", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝硬化患者中，以下哪种并发症被认为是最严重的？", "options": "A. 食管胃底静脉曲张破裂出血\nB. 肝性脑病\nC. 低钾血症\nD. 原发性肝癌\nE. 自发性腹膜炎", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位45岁的女性患者，患有肝硬化并伴有腹水，在使用大剂量呋塞米后出现乏力、少尿、食欲不振和行为异常。实验室检查显示血清肌酐为10mg/dl，血钾为3.2mmol/L，血钠为130mmol/L。脑电图结果正常。根据这些信息，最可能的诊断是什么？", "options": "A. 尿毒症\nB. 肝性脑病\nC. 肝肾综合征\nD. 代谢性酸中毒\nE. 继发性醛固酮增多症", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "华支睾吸虫成虫在人体内的主要寄生部位是", "options": "A. 肝\nB. 肠系膜静脉\nC. 腹腔\nD. 肝胆管\nE. 肺", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎（水肿型）的治疗中，以下哪项措施最为关键？", "options": "A. 应用肾上腺皮质激素\nB. 抑制或减少胰腺分泌\nC. 手术\nD. 应用抗生素\nE. 应用吗啡镇痛", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胆囊炎的超声检查中，以下哪些表现是典型的？", "options": "A.胆囊增大、胆囊壁轮廓线模糊，外壁线不规则\nB.胆囊壁弥漫性增厚，增厚的胆囊壁呈增强回声带\nC.胆囊内可见结石强回声后方伴声影\nD.脂肪餐试验胆囊收缩功能差或丧失\nE.超声Murphy征阴性", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在筛查原发性肝癌时，以下哪种方法被认为是最简便且有效的？", "options": "A. B超\nB. AFP\nC. 腹部CT\nD. 肝MRI\nE. 同位素肝扫描", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，以下哪种情况最符合弥漫性肝癌的典型表现？", "options": "A. 患者有肝硬化病史，伴有持续高热和转氨酶升高\nB. 患者无肝硬化病史，肝功能基本正常\nC. 患者有肝硬化病史，伴有肝功能异常、腹水和黄疸\nD. 肝脏内遍布米粒大小的癌结节\nE. 肝癌由胆管上皮细胞发展而来", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在乙型肝炎的不同类型中，哪一类型的发病机制表现为细胞免疫功能严重缺损，导致病毒持续繁殖而肝细胞几乎不受损伤？", "options": "A.细胞免疫功能正常，病毒数量多，毒力强，较多肝细胞损害\nB.细胞免疫功能低下，病毒不能彻底清除，肝细胞不断受损\nC.细胞免疫功能过强，大量肝细胞破坏或自溶\nD.细胞免疫功能严重缺损，病毒持续繁殖，肝细胞几无损伤\nE.体液免疫反应过强，短时间内形成大量免疫复合物", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆外科中，胆道大出血的患者通常会出现哪些典型症状？", "options": "A. 剧烈的上腹部绞痛\nB. 畏寒发热\nC. 黄疸\nD. 呕血、便血\nE. 以上都是", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在胰腺病变引起的腹痛中，疼痛常向左背部呈带状放射，这种现象的主要原因是什么？", "options": "A. 胰腺位于腹后壁，是腹膜外器官\nB. 胰腺炎症和水肿压迫邻近器官及组织\nC. 胰腺病变累及腹腔神经丛\nD. 胰液逆流进入胆管及胆囊，引起反射性疼痛\nE. 以上都不是", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝癌患者中，以下哪项症状和体征最为常见且具有重要临床意义？", "options": "A. 黄疸\nB. 上消化道出血\nC. 发热\nD. 肝脏进行性肿大与疼痛\nE. 血性腹水", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在以下疾病中，哪种疾病同时存在细胞凋亡不足和过度的情况？", "options": "A. 心力衰竭\nB. 动脉粥样硬化\nC. 艾滋病\nD. 肝癌\nE. 胰岛素依赖性糖尿病", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在超声检查中，发现肝内多个部位出现囊状回声，且这些囊状回声的壁与胆管相连，最可能的诊断是", "options": "A.肝包虫囊肿\nB.肝内胆管扩张症Caroli病\nC.多囊肝\nD.肝多发性囊肿\nE.转移性肝癌液化", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在乙型肝炎后肝硬化的患者中，以下哪一项不是常见的合并症？", "options": "A. 肝癌\nB. 门静脉高压症\nC. 急性肠系膜上静脉血栓形成\nD. 肝功能衰竭\nE. 急性肝静脉血栓形成", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断急性梗阻性化脓性胆管炎（AOSC）时，以下哪项不是关键的临床依据？", "options": "A. 胆绞痛\nB. 寒战、高热\nC. 剧烈呕吐\nD. 白细胞显著升高\nE. 血小板显著减少", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位47岁男性患者突然出现右上腹剧烈疼痛，呈钻顶样，超声检查显示胆道内有蠕动条状物。最可能的诊断是？", "options": "A. 急性胰腺炎\nB. 肠系膜血栓形成\nC. 肠道蛔虫症\nD. 急性胃肠炎\nE. 急性心肌梗死", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在细菌性肝脓肿的诊断和治疗中，以下哪项描述是不正确的？", "options": "A. 大多数病例与胆道系统感染有关\nB. 主要致病菌通常是革兰氏阳性球菌\nC. 脓液常呈棕褐色，且细菌涂片可能为阴性\nD. 脓肿通常位于肝脏右叶且为单发\nE. 手术引流是唯一有效的治疗方法", "answer": "A", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在急性胰腺炎的治疗中，以下哪种情况通常不需要进行手术治疗？", "options": "A. 胰腺坏死合并感染\nB. 肠道感染\nC. 胰腺脓肿\nD. 胰腺假性囊肿\nE. 胆道梗阻", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊结石症的相关描述中，哪一项是不正确的？", "options": "A. 可能导致胆囊积脓\nB. 可能继发感染，引发急性胆囊炎\nC. 可能导致急性化脓性胆管炎和全身感染\nD. 较大的结石比小结石更容易引起临床症状\nE. 静止性胆囊结石可能无需处理", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆囊收缩的调节过程中，以下哪种体液因素起着关键作用？", "options": "A. 促胃液素\nB. 促胰液素\nC. 胆囊收缩素\nD. 胆盐\nE. 盐酸", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在肝胆动态显像中，以下哪种显像剂对胆红素具有较好的拮抗作用？", "options": "A. 99mTc-PMT\nB. 99mTc-EHIDA\nC. 99mTc-BIDA\nD. 99mTc-DISIDA\nE. 99mTc-HIDA", "answer": "BCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "KnowledgeQA" }, { "question": "关于原发性肝癌的描述，以下哪一项是不正确的？", "options": "A. 在我国，大多数肝癌患者伴有肝硬化\nB. 肝癌可分为巨块型、结节型和弥散型\nC. 黄曲霉素的摄入与肝癌的发生有关\nD. 乙型和丙型肝炎病毒感染者的肝癌发病率显著增加\nE. 所有肝癌患者的甲胎蛋白（AFP）水平都会升高", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位30岁男性患者因持续寒战高热和右上腹胀痛20天入院。体检显示体温39℃，呈现消耗病容，右季肋区有叩痛，右肋缘下3cm可触及肝下缘并伴有触痛。实验室检查显示Hb为80g/L，WBC为10.6×109/L，中性粒细胞占92%。B超检查发现肝右叶有一个10cm×8cm的液性暗区。请问这种严重感染的致病菌最可能来源于以下哪种病灶？", "options": "A. 破伤风之伤口\nB. 疖病\nC. 细菌性痢疾\nD. 化脓性胆管炎\nE. 血栓性外痔", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性出血坏死型胰腺炎并发肠麻痹的情况下，下列哪种药物应避免使用？", "options": "A. 奥曲肽\nB. 抗生素\nC. H2受体拮抗剂\nD. 质子泵阻滞剂\nE. 抗胆碱能药物", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在诊断胃泌素瘤、胰岛细胞瘤和胰高血糖素瘤等神经内分泌肿瘤时，术前定位的首选显像技术是", "options": "A. 99mTc-MDP显像\nB. 18F-FDG代谢显像\nC. 99mTc-octreotide显像\nD. 67Ga-枸橼酸显像\nE. 18F-FENP显像", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位50岁男性患者因突发剧烈上腹痛、腹胀、恶心和呕吐1天前来急诊。患者无明确诱因突然发作剧烈腹痛，最初位于剑突下偏右，随后迅速扩散至全腹，并转为持续性刀割样疼痛，向后背放射。患者伴有恶心、呕吐，且未排便排气。12小时前腹痛加重，出现烦躁不安、憋气和体温升高。既往有胆囊结石病史，无溃疡病史。查体显示体温38.9℃，血压110/80mmHg，心率110次/分，呼吸32次/分，皮肤及巩膜可疑黄染，全腹膨隆，肌紧张，广泛压痛及反跳痛，移动性浊音（±），肠鸣音弱。实验室检查显示Hb 96.1g/L，WBC 18.9×10^9/L，AST 211U/L，BUN 9.9mmol/L，TBIL 30μmol/L，DBIL 12μmol/L，血钙1.75mmol/L。腹平片显示肠管充气扩张，肠间隙增宽。B超显示胆囊壁增厚，内有强光团，胆总管直径0.9cm，胰腺肿大，胰周液性暗区，胰管增粗。为明确诊断，下一步应进行的检查是（）。", "options": "A.静脉肾盂造影\nB.血尿淀粉酶\nC.腹腔穿刺，腹水常规及淀粉酶测定\nD.上消化道造影\nE.腹部CT\nF.腹部MRI", "answer": "BCE", "answer_format": "MultipleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝脏触诊的临床实践中，以下哪项描述是不正确的？", "options": "A. 触诊过程中需要与患者的呼吸动作密切配合\nB. 单手触诊法是临床上较为常用的触诊方法\nC. 当肝脏位置较深时，应采用浮沉触诊法（冲击触诊法）\nD. 正常肝脏在肋缘下的触诊范围通常不超过1厘米\nE. 正常肝脏在剑突下的触诊范围通常在3至5厘米之间", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位63岁的女性患者，近3年来每到冬季就会出现上腹部疼痛，疼痛通常在餐后半小时开始，餐前会有所缓解。最近一周症状复发。体检显示患者意识清醒，无贫血表现，剑突下有压痛，肝脾未触及。根据这些症状，最可能的诊断是什么？", "options": "A. 胃癌\nB. 慢性胃炎\nC. 十二指肠溃疡\nD. 慢性胆囊炎\nE. 胃溃疡", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆动态显像检查中，为什么需要患者进食脂肪餐？", "options": "A. 提高胆道影像的清晰度\nB. 避免泌尿系统在影像中显现\nC. 评估胆囊的收缩能力\nD. 帮助诊断黄疸的原因\nE. 减少肝脏对放射性物质的吸收，以免影响胆道显影", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科中，以下哪些因素可能诱发肝性脑病？", "options": "A. 上消化道出血\nB. 感染\nC. 大量抽取腹腔积液\nD. 进食较多蛋白质\nE. 使用镇静剂", "answer": "ABCDE", "answer_format": "MultipleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在核医学影像中，肝脏海绵状血管瘤的典型表现是什么？", "options": "A. 肝血池显像呈部分填充\nB. 肝血池显像未见填充\nC. 肝血池显像呈过度填充\nD. 肝脾胶体显像呈放射性分布浓聚\nE. 肝脏肿瘤阳性显像呈放射性浓聚", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位男性患者出现皮肤黄染，肝脏质地硬且肿大。实验室检查显示清蛋白显著降低，α1球蛋白和α2球蛋白水平正常，而β球蛋白和γ球蛋白均升高。该患者最可能的诊断是", "options": "A.急性肝炎\nB.慢性乙型肝炎\nC.肝硬化\nD.肾病综合征\nE.急性肾衰", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名27天大的男婴，足月出生，母乳喂养，皮肤黄疸持续23天。最近两天因呛奶和低热前来就诊。体检发现头面部及躯干有黄染，双肺呼吸音粗糙，腹部膨胀，肝脏在肋下2cm处可触及，质地柔软，边缘锐利。以下哪项最不可能是导致黄疸不退的原因？", "options": "A. 母乳性黄疸\nB. 新生儿肺炎\nC. 新生儿肝炎综合征\nD. 生理性黄疸\nE. 新生儿败血症", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一名42岁男性患者，因胰头癌接受了Whipple手术。术后第一天腹腔引流管中有50ml血液流出，第二天增加到80ml，并出现血压下降、烦躁不安、面色苍白等症状。急诊B超检查显示腹腔内有大量液体。该患者最可能出现了什么问题？", "options": "A. 止血不彻底或血管结扎欠妥\nB. 血管结扎处缺血坏死\nC. 结扎线脱落\nD. 局部感染后组织坏死\nE. 内出血和休克", "answer": "E", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在急性胰腺炎发病后的最初12小时内，哪项实验室检查最能准确诊断该疾病？", "options": "A. 血钙\nB. 血糖\nC. 血淀粉酶\nD. 血脂肪酶\nE. 尿淀粉酶", "answer": "C", "answer_format": "SingleChoice", "disease_domain": "PancreaticDisease", "inquiry_type": "KnowledgeQA" }, { "question": "一位40岁的男性患者被诊断为直肠癌，B超检查发现肝左叶有一个孤立的转移结节，其他部位未见异常。请问最适合的治疗方案是？", "options": "A. 乙状结肠造口术\nB. 根治术+肝左叶切除\nC. 单纯放疗\nD. 单纯化疗\nE. Miles手术", "answer": "B", "answer_format": "SingleChoice", "disease_domain": "LiverDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "一位61岁的女性患者，患有肝硬化失代偿期，伴有大量腹水。在使用利尿剂治疗后，腹水未见明显减少，诊断为难治性腹水。关于难治性腹水的治疗，以下哪种利尿剂的最大剂量是正确的？", "options": "A.螺内酯100mg，呋塞米40mg\nB.螺内酯200mg，呋塞米80mg\nC.螺内酯200mg，呋塞米100mg\nD.螺内酯400mg，呋塞米160mg\nE.螺内酯500mg，呋塞米200mg", "answer": "D", "answer_format": "SingleChoice", "disease_domain": "OtherDisease", "inquiry_type": "KnowledgeQA" }, { "question": "在胆道系统的MRI成像中，以下哪些信号特征是正确的：", "options": "A. T1加权成像中肝管呈现低信号\nB. T2加权成像中肝管呈现高信号\nC. 胆囊在T1加权成像中呈现低信号\nD. 胆囊在T2加权成像中呈现高信号\nE. 胆囊在T1加权成像中呈现高信号", "answer": "ABCD", "answer_format": "MultipleChoice", "disease_domain": "BiliaryDisease", "inquiry_type": "ClinicalDiagnosis" }, { "question": "在肝胆外科治疗中，肝癌消融术适用于以下哪些情况？", "options": "A. 单发肝癌\nB. 直径小于3cm的原发或转移性肝癌\nC. 肝包膜下肝癌\nD. 严重肝、肾功能不全而无法栓塞治疗\nE. 栓塞治疗不满意者", "answer": "ABDE", "answer_format": "MultipleChoice", "disease_domain": "LiverDisease", "inquiry_type": "KnowledgeQA" } ]