[ { "question_num": 1, "query": "虚里的位置在", "options": { "A": "膻中", "B": "心中", "C": "右胸", "D": "肺中", "E": "心尖搏动部位" }, "answer": "E", "reason": "临床上常以“虚里”处(相当于心尖搏动部位)的搏动情况和脉象变化来测知宗气的盛衰。" }, { "question_num": 2, "query": "胃痞发生的病机关键是", "options": { "A": "胃失和降，膈间气机不利", "B": "脾胃肝肾功能失调，津枯血燥，气痰瘀互结", "C": "胃气阻滞，胃失和降，不通则痛", "D": "胃失和降，胃气上逆", "E": "中焦气机不利，脾胃升降失职" }, "answer": "E", "reason": "中焦气机不利,脾胃升降失职为胃痞发生的病机关键。" }, { "question_num": 3, "query": "水火之宅是指", "options": { "A": "脾", "B": "胃", "C": "肾", "D": "肝", "E": "肺" }, "answer": "C", "reason": "肾脏寄藏命门之火,为元阴、元阳之脏,故有\"水火之宅“”阴阳之根”之称。" }, { "question_num": 4, "query": "下列哪项是治疗呕吐肝气犯胃证的首选方剂", "options": { "A": "理中汤", "B": "黄芪建中汤", "C": "香砂六君子汤", "D": "参苓白术散", "E": "四七汤" }, "answer": "E", "reason": "呕吐之肝气犯胃证,治法:疏肝理气，和胃降逆。代表方:四七汤加减。" }, { "question_num": 5, "query": "下列对《素问·宣明五气》中说法的叙述不正确的是", "options": { "A": "久立伤骨", "B": "久卧伤气", "C": "久行伤筋", "D": "久坐伤精", "E": "久视伤血" }, "answer": "D", "reason": "《素问。宣明五气》说:“久卧伤气,久坐伤肉,久立伤骨,久行伤筋,久视伤血”。" }, { "question_num": 6, "query": "下列不属于腹痛常见病因的是", "options": { "A": "素体阳虚", "B": "胃气上逆", "C": "饮食不节", "D": "外感时邪", "E": "情志失调" }, "answer": "B", "reason": "腹痛病因:外感时邪、饮食不节、情志失调及素体阳虚等可导致本病。此外，跌仆损伤，络脉瘀阻，或腹部术后也可致腹痛。" }, { "question_num": 7, "query": "同病异治的实质是", "options": { "A": "证同治异", "B": "证异治同", "C": "病同治异", "D": "病同治同", "E": "证异治异" }, "answer": "E", "reason": "中医学的基本特点是整体观念与辨证论治。辩证论治即根据辩证的结果确定相应的治疗原则和方法,具体表现为同病异治和异病同治。同病异治,即对同一疾病不同阶段出现的不同证型,采用不同的治法;异病同治,即几种不同的疾病在其发展过程中，由于出现了具有同一性质的证,因而可采用同一治疗方法。可见中医治病主要着眼点在于证,证同则治同,证异则治异。故同病异治的实质是证异治异。" }, { "question_num": 8, "query": "内伤发热血虚发热证，治疗首选的方剂是", "options": { "A": "补中益气汤", "B": "青蒿鳖甲汤", "C": "清营汤", "D": "清骨散", "E": "归脾汤" }, "answer": "E", "reason": "内伤发热之血虚发热证,治法:益气养血。代表方:归脾汤加减。" }, { "question_num": 9, "query": "瘀血引起疼痛的特点是", "options": { "A": "痛处游走不定", "B": "多为胀痛", "C": "病在气分", "D": "夜间痛甚", "E": "遇温痛减" }, "answer": "D", "reason": "瘀血疼痛特点:多为刺痛,痛处国定不移,拒按,夜间痛甚。" }, { "question_num": 10, "query": "下列属于肺胀痰浊壅肺证的治法是", "options": { "A": "补肺纳肾，降气平喘", "B": "温肾健脾，化饮利水", "C": "化痰降气，健脾益肺", "D": "清肺化痰，降逆平喘", "E": "以上均非" }, "answer": "C", "reason": "肺胀痰浊壅肺证,治法:化痰降气，健脾益肺。" }, { "question_num": 11, "query": "在全身气机调节中起着重要作用的脏腑是", "options": { "A": "肺、肝、脾胃", "B": "肝、肾、肺", "C": "脾、肺、肝", "D": "肾、心、肺", "E": "肺、肝、心" }, "answer": "A", "reason": "肝升肺降、脾升胃降,肝主疏泄气机,在调整全身气机中起着极其重要的作用，故脏腑气滞以肺、肝、脾胃为多见。" }, { "question_num": 12, "query": "下列著作，最早开创了妇科外治法先河的是", "options": { "A": "《黄帝内经》", "B": "《金匮要略》", "C": "《脉经》", "D": "《千金要方》", "E": "《景岳全书》" }, "answer": "B", "reason": "汉代名医张仲景《金匮要略》有妇人病三篇，奠定了妇科治疗学基础。产后、杂病多效法《金匮要略》。" }, { "question_num": 13, "query": "“寒从中生”中“寒”的特点是", "options": { "A": "以寒为主", "B": "多为实寒", "C": "恶寒憎热", "D": "虚而有寒", "E": "面色青紫" }, "answer": "D", "reason": "阳虚阴盛之寒从中生;与外感寒邪之外寒的区别：“内寒”的临床特点主要是虚而有寒,以虚为主；”外寒”的临床特点是以寒邪为主,多为实寒。" }, { "question_num": 14, "query": "下列不属于月经先后无定期肾虚证主要症状的是", "options": { "A": "经行或先或后", "B": "月经量少，色淡黯", "C": "小腹冷痛拒按", "D": "头晕，耳鸣，腰痛", "E": "舌淡苔白，脉细弱" }, "answer": "C", "reason": "肾虚证:经行或先或后,量少,色淡黯,质清;或腰骶酸痛,或头晕耳鸣;舌淡，苔白,脉细弱。" }, { "question_num": 15, "query": "五脏主五液，则肾在液为", "options": { "A": "泪", "B": "汗", "C": "涎", "D": "涕", "E": "唾" }, "answer": "E", "reason": "肾在液为唾。" }, { "question_num": 16, "query": "圣愈汤可治疗何种类型的痛经", "options": { "A": "气血虚弱", "B": "肝肾亏损", "C": "心肝血虚", "D": "血虚气滞", "E": "气滞血瘀" }, "answer": "A", "reason": "痛经之气血虚弱证,治法益气养血，调经止痛，方选圣愈汤。" }, { "question_num": 17, "query": "下列选项中，主人体生殖之精的是", "options": { "A": "肾精", "B": "月水", "C": "天癸", "D": "水谷之精", "E": "五脏六腑之精" }, "answer": "A", "reason": "肾精即狭义之精,又称生殖之精,是禀受于父母而贮藏于肾的具有生殖繁衍作用的精微物质。" }, { "question_num": 18, "query": "月经后期之肾虚证，治疗应首选的方剂是", "options": { "A": "大补元煎", "B": "当归地黄饮", "C": "补中益气汤", "D": "艾附暖宫丸", "E": "人参养荣汤" }, "answer": "B", "reason": "月经后期肾虚证的代表方为当归地黄饮。" }, { "question_num": 19, "query": "下列哪项不属于六淫的共同致病特点", "options": { "A": "地域性", "B": "外感性", "C": "传染性", "D": "季节性", "E": "相兼性" }, "answer": "C", "reason": "六淫的共同致病特点：①外感性;②季节性;③地域性;④相兼性。" }, { "question_num": 20, "query": "下列不属于子宫功能的是", "options": { "A": "产生月经", "B": "排出月经", "C": "孕育胎儿", "D": "分娩胎儿", "E": "抵御外邪" }, "answer": "E", "reason": "子宫的主要功能是产生、排出月经;孕育、分娩胎儿。另外，还有排出余血浊液、分泌生理性带下的功能。" }, { "question_num": 21, "query": "以阴阳失调来阐释真寒假热或真热假寒，其病机是", "options": { "A": "阴阳偏衰", "B": "阴阳偏盛", "C": "阴阳格拒", "D": "阴阳互损", "E": "阴阳离决" }, "answer": "C", "reason": "阴阳格拒,是阴阳失调病机中比较特殊的一类病机,主要包括阴盛格阳和阳盛格阴两方面,主要由于某些原因引起阴和阳的一方盛极,因而壅盛于内,将另一方排斥格拒于外,迫使阴阳之间不相维系,从而形成真寒假热或真热假寒等复杂的临床现象。" }, { "question_num": 22, "query": "颈部肿块随喜怒消长属于下列哪种瘿病的特征", "options": { "A": "气瘿", "B": "肉瘿", "C": "石瘿", "D": "瘿痈", "E": "以上均非" }, "answer": "A", "reason": "随喜怒消长是气瘿比较典型的特征。" }, { "question_num": 23, "query": "下列各项中，不属于肝主疏泄的生理功能的是", "options": { "A": "调畅情志", "B": "调畅气机", "C": "促进骨骼发育", "D": "促进脾胃的运化", "E": "促进血液运行" }, "answer": "C", "reason": "肝主疏泄的生理功能:①调畅气机;②通利气血;③促进脾胃的运化;④调畅情志;⑤促进和调节生殖功能,其中,最基本的生理功能是调畅气机。" }, { "question_num": 24, "query": "下列不属于瘿痈特征的是", "options": { "A": "颈中两侧结块", "B": "皮色不变", "C": "微有灼热", "D": "疼痛牵引至耳后枕部", "E": "容易化脓" }, "answer": "B", "reason": "瘿痈是以急性发病、结喉两侧结块、肿胀、色红灼热、疼痛为主要表现的急性炎症性疾病。而皮色不变的只有气瘿和石瘿的前期。" }, { "question_num": 25, "query": "下列属于胃的生理功能的是", "options": { "A": "水液的吸收和转输", "B": "水谷的受纳和腐熟", "C": "水谷精微的转输", "D": "脏器位置的维系", "E": "血液的统摄" }, "answer": "B", "reason": "胃的生理功能是受纳、腐熟水谷;主通降,以降为和。" }, { "question_num": 26, "query": "下列不属于血瘤特点的是", "options": { "A": "触之如海绵状", "B": "边界不清", "C": "柔软而局限", "D": "色泽鲜红或暗紫", "E": "盘曲如蚯蚓状" }, "answer": "E", "reason": "血瘤指体表血络扩张,纵横丛集而形成的肿瘤。可发生于身体任何部位，大多班为先失性、其特众是病变局部色泽鲜红或暗紫、或呈局限性柔软肿块，边界不清，之如海绵状。相当于西医的血管瘤。常见的有毛细血管瘤和海绵状血管瘤。" }, { "question_num": 27, "query": "下列哪项是同司疏泄，共主勇怯的脏腑", "options": { "A": "心与肺", "B": "肺与大肠", "C": "脾与胃", "D": "肝与胆", "E": "肝与心" }, "answer": "D", "reason": "胆附于肝,有经脉互为属络构成表里关系。肝与胆的关系,主要表现在同司疏泄、共主勇怯等方面。" }, { "question_num": 28, "query": "凡发生于颈部或耳之前后的岩肿，伴有面容憔悴、形体消瘦者，称之为", "options": { "A": "石瘿", "B": "失荣", "C": "石疽", "D": "筋瘤", "E": "血瘤" }, "answer": "B", "reason": "失荣是发生于颈部及耳之前后的岩肿，因其晚期气血亏乏，面容憔悴状如树木枝叶发枯，失去荣华而命名。" }, { "question_num": 29, "query": "五脏分阴阳，脾的阴阳属性是", "options": { "A": "阳中之阴", "B": "阳中之阳", "C": "阴中之阴", "D": "阴中之阳", "E": "阴中之至阴" }, "answer": "E", "reason": "脾属土,居中央,主四时,属阴中之至阴。" }, { "question_num": 30, "query": "下列哪项不是急性湿疹的临床表现", "options": { "A": "有糜烂、渗出", "B": "起病急，常对称分布", "C": "有红斑、丘疹", "D": "剧烈瘙痒", "E": "晨僵，关节肿痛" }, "answer": "E", "reason": "皮损对称分布,多形损害,剧烈瘙痒，有渗出倾向，反复发作，易成慢性等。根据病程可分为急性、亚急性、慢性3类。急性湿疮以丘疱疹为主，炎症明显，易渗出;慢性湿疮以苔藓样变为主，易反复发作。" }, { "question_num": 31, "query": "在下列五窍中，脾在窍为", "options": { "A": "口", "B": "耳", "C": "鼻", "D": "目", "E": "舌" }, "answer": "A", "reason": "脾开窍于口。" }, { "question_num": 32, "query": "下列哪项是疥疮的特异性皮损", "options": { "A": "丘疹", "B": "丘疱疹", "C": "小水疱", "D": "隧道", "E": "结节" }, "answer": "D", "reason": "疥疮的临床特点夜间剧痒，在皮损处有灰白色、浅思色或普通皮色的隧道,可找到疥虫。继发感染者，称脓窝疥。" }, { "question_num": 33, "query": "下列气的作用中，失常可导致自汗，多尿，滑精的是", "options": { "A": "推动", "B": "温煦", "C": "防御", "D": "固摄", "E": "气化" }, "answer": "D", "reason": "气的推动作用是指气对于人体的生长发育,以及脏腑经络等组织器官生理活动起推动和激发作用;气的温煦作用是指气是人体热量的来源;气的防御作用是指护卫全身的肌表,防御外邪的入侵;气的固摄作用是指对于血液津液等液态物质具有防止其无故流失的作用;气的气化作用是指通过气的运动而产生的各种变化。" }, { "question_num": 34, "query": "黄水疮的主要治法是", "options": { "A": "健脾除湿", "B": "凉血息风", "C": "益气补血", "D": "清暑利湿", "E": "滋补肝肾" }, "answer": "D", "reason": "黄水疮以清暑利湿为主要治法。" }, { "question_num": 35, "query": "六腑中被称为太仓的是", "options": { "A": "小肠", "B": "三焦", "C": "脾", "D": "大肠", "E": "胃" }, "answer": "E", "reason": "胃主受纳水谷指胃气具有接受和容纳饮食水谷的作用。饮食入口,经过食管(咽)进入胃中,在胃气的通降作用下,由胃接受和容纳,暂存于其中,故胃有“太仓\"和“水谷之海\"之称。" }, { "question_num": 36, "query": "下列属于产后恶露不绝常见病因的是", "options": { "A": "气滞、血热、血瘀", "B": "气虚、血热、血瘀", "C": "气虚、肾虚、脾虚", "D": "气虚、血虚、血瘀", "E": "气虚、寒凝、血瘀" }, "answer": "B", "reason": "产后恶露不绝的常见病因有气虚、血热、血瘀。" }, { "question_num": 37, "query": "肝藏血与脾统血的共同生理功能是", "options": { "A": "贮藏血液", "B": "调节血量", "C": "统摄血液", "D": "防止出血", "E": "化生血液" }, "answer": "D", "reason": "肝藏血,是指肝脏具有贮藏血液、调节血量的生理功能。脾统血,是指脾具有统摄血液在经脉内运行防御其溢出脉外的功能,故肝藏血与脾统血的共同生理功能是防止出血。" }, { "question_num": 38, "query": "月经后期虚寒证的经血特点是", "options": { "A": "色红，质黏稠", "B": "色淡，质黏", "C": "色淡暗，质清稀", "D": "色淡红，质清稀", "E": "色暗红，有血块" }, "answer": "D", "reason": "月经后期虚寒证:月经延后，量少，色淡红，质清稀，小腹隐痛，喜暖喜按;腰酸无力，小便清长，大便稀溏;舌淡，苔白，脉沉迟或细弱。" }, { "question_num": 39, "query": "脏腑中，具有藏而不泻特点的是", "options": { "A": "五官", "B": "五体", "C": "五脏", "D": "六腑", "E": "奇恒之腑" }, "answer": "C", "reason": "五脏者,藏精气而不泻也，故满而不能实。" }, { "question_num": 40, "query": "下列哪项是治疗慢性盆腔炎气滞血瘀证应首选的方剂", "options": { "A": "桃红四物汤", "B": "理冲汤", "C": "膈下逐瘀汤", "D": "少腹逐瘀汤", "E": "大黄牡丹汤" }, "answer": "C", "reason": "慢性盆腔炎气滞血瘀证,治法活血化瘀，理气止痛，方选膈下逐瘀汤。" }, { "question_num": 41, "query": "外邪侵袭致损伤脉络而出血，最为多见的邪气是", "options": { "A": "寒邪", "B": "风邪", "C": "暑邪", "D": "热邪", "E": "燥邪" }, "answer": "D", "reason": "引起出血之因,最主要是热,无论实热、虚热,均可以迫血妄行而致血溢脉外引起出血。" }, { "question_num": 42, "query": "下列哪项是治疗月经过多之血瘀证应首选的方剂", "options": { "A": "失笑散加味", "B": "少腹逐瘀汤", "C": "逐瘀止血汤", "D": "桃红四物汤", "E": "血府逐瘀汤" }, "answer": "A", "reason": "月经过多血瘀证代表方为失笑散。" }, { "question_num": 43, "query": "下列哪项不属于痰饮的致病特点", "options": { "A": "影响水液代谢", "B": "阻滞气血运行", "C": "易于蒙蔽心神", "D": "致病广泛，变幻多端", "E": "病位固定，病证繁多" }, "answer": "E", "reason": "痰饮的致病特点:①阻滞气血远行;②影响水液代谢;③易于蒙蔽心神;④致病广泛,变幻多端。" }, { "question_num": 44, "query": "下列哪项是治疗经期延长血瘀证应首选的方剂", "options": { "A": "失笑散", "B": "桂枝茯苓丸合失笑散", "C": "逐瘀止血汤合失笑散", "D": "桃红四物汤合失笑散", "E": "血府逐瘀汤合失笑散" }, "answer": "D", "reason": "经期延长血瘀证代表方为桃红四物汤合失笑散" }, { "question_num": 45, "query": "利小便而实大便的理论依据源于", "options": { "A": "小肠主化物", "B": "肺主通调水道", "C": "小肠主泌别清浊", "D": "脾主运化", "E": "小肠主受盛" }, "answer": "C", "reason": "临床上治疗泄泻采用利小便而实大便的方法是小肠主泌别清浊理论在临床治疗中的应用。" }, { "question_num": 46, "query": "下列哪项是治疗经间期出血血瘀证应首选的方剂", "options": { "A": "少腹逐瘀汤", "B": "桂枝茯苓丸", "C": "逐瘀止血汤", "D": "桃红四物汤", "E": "血府逐瘀汤" }, "answer": "C", "reason": "经间期出血血瘀证,治法化瘀止血，方选逐瘀止血汤。" }, { "question_num": 47, "query": "消谷善饥，兼大便溏泄者，多属", "options": { "A": "脾胃虚弱", "B": "食滞肠胃", "C": "胃强脾弱", "D": "胃阴不足", "E": "消渴病" }, "answer": "C", "reason": "消谷善饥是指患者食欲过于旺盛,进食量多,食后不久即感觉饥饿的症状。消谷普饥兼多饮多尿,形体消瘦者，多见于消渴病;消谷善饥兼大便溏泄者,多见于胃强脾弱。" }, { "question_num": 48, "query": "下列哪项是治疗崩漏肾气虚证应首选的方剂", "options": { "A": "固阴煎", "B": "当归地黄饮", "C": "大补元煎", "D": "加减苁蓉菟丝子丸", "E": "金匮肾气丸" }, "answer": "D", "reason": "崩漏肾气虚证,治法补肾益气,固冲止血，方选加减苁蓉菟丝子九。" }, { "question_num": 49, "query": "在阴阳关系中，阴中求阳阐述的阴阳关系是", "options": { "A": "阴阳消长", "B": "阴阳交感", "C": "阴阳转化", "D": "阴阳对立", "E": "阴阳互根" }, "answer": "E", "reason": "阴阳互根指一切事物或现象中相互对立的阴阳两个方面,可以相互依存,互为根本的关系。" }, { "question_num": 50, "query": "下列哪项不是喘证的病因", "options": { "A": "外邪侵袭", "B": "饮食不当", "C": "情志失常", "D": "痰热素盛", "E": "劳欲久病" }, "answer": "D", "reason": "喘证的病因:外感为六淫外邪侵袭肺系;内伤为饮食不当、情志失常、劳欲久病等导致肺气上逆，升降失职;或气失所主，肾失摄纳而成。" }, { "question_num": 51, "query": "三因制宜中，少年慎补，老年慎泻，属于", "options": { "A": "因人制宜", "B": "因病制宜", "C": "因时制宜", "D": "因地制宜", "E": "因证制宜" }, "answer": "A", "reason": "根据患者的年龄、性别、体质等不同特点，来制订适宜的治法与方药,这种原则称为“因人制宜”。" }, { "question_num": 52, "query": "下列不属于异位妊娠已破损期不稳定型临床表现的是", "options": { "A": "腹部有压痛及反跳痛", "B": "腹部可触及边界不清的包块", "C": "腹部拒按", "D": "一侧下腹撕裂样疼痛", "E": "阴道少量出血" }, "answer": "D", "reason": "不稳定型的症状是拒按，压痛及反跳痛，但逐渐减轻，边界不清的包块，少量阴道出血，血压平稳" }, { "question_num": 53, "query": "在五行关系中，金为水之", "options": { "A": "相生", "B": "所不胜", "C": "母", "D": "子", "E": "所胜" }, "answer": "C", "reason": "金生水,故金为水之母。" }, { "question_num": 54, "query": "下列医家，确立以滋阴降火为肺痨治疗大法的是", "options": { "A": "张仲景", "B": "华佗", "C": "孙思邈", "D": "朱丹溪", "E": "葛可久" }, "answer": "D", "reason": "朱丹溪倡“痨瘵主乎阴虚”之说，确立了滋阴降火的治疗大法。" }, { "question_num": 55, "query": "气血运行不畅的舌质是", "options": { "A": "淡白舌", "B": "绛舌", "C": "红舌", "D": "淡红舌", "E": "青紫舌" }, "answer": "E", "reason": "青紫舌,主气血运行不畅。" }, { "question_num": 56, "query": "肺胀晚期，病变脏腑主要是", "options": { "A": "肺、脾、肾", "B": "肺、脾、心", "C": "肺、肾、心", "D": "脾、肾、心", "E": "肺、肝、肾" }, "answer": "C", "reason": "肺胀晚期,病变脏腑以肺、肾、心为主，气虚及阳,或阴阳两虚,单纯属阴虚者罕见。" }, { "question_num": 57, "query": "虚寒证患者的卧姿表现是", "options": { "A": "但卧不得坐，坐则晕眩", "B": "蜷卧缩足，喜加衣被", "C": "仰卧伸足，掀去衣被", "D": "卧时喜向内、身重不能转侧", "E": "卧时常向外、身轻能自转侧" }, "answer": "B", "reason": "阳证、热证.实证则卧时常向外,身轻能自转侧;阴证、寒证、虚证则卧时喜向内,身重不能转侧;实热证则仰卧伸足，掀去衣被;虚寒证则蜷卧缩足,喜加衣被。" }, { "question_num": 58, "query": "胸痹寒凝心脉证的胸痛特点是", "options": { "A": "胸部刺痛，入夜尤甚", "B": "胸闷隐痛，时作时止", "C": "胸闷如窒，气短喘促", "D": "胸闷气短，神倦怯寒", "E": "心痛彻背，感寒痛甚" }, "answer": "E", "reason": "胸痹寒凝心脉证:猝然心痛如纹，心痛彻背，喘不得卧，多因气候骤冷或感风寒而发病或加重，伴形寒，其则手足不温，冷汗自出，胸闷气短，心悸，而色苍白,苔白，脉沉紧或沉细。" }, { "question_num": 59, "query": "表现为头晕而胀、面红目赤、烦躁易怒，舌红苔黄，脉弦数者多是", "options": { "A": "痰湿内阻", "B": "肝阳上亢", "C": "胆郁痰扰", "D": "肝火上炎", "E": "气血亏虚" }, "answer": "D", "reason": "头晕而胀,面红目赤,烦躁易怒,舌红苔黄,脉弦数者多为肝火上炎。" }, { "question_num": 60, "query": "治疗吐血胃热壅盛证，应首选的方剂是", "options": { "A": "玉女煎", "B": "龙胆泻肝汤", "C": "加味清胃散合泻心汤", "D": "地榆散合槐角丸", "E": "泻心汤合十灰散" }, "answer": "E", "reason": "吐血胃热壅盛证,治法宜清胃泻火，化瘀止血。方用泻心汤合十灰散。" }, { "question_num": 61, "query": "困倦易睡，伴头目昏沉，胸闷脘痞，肢体困重，苔腻者多属于", "options": { "A": "心肾阳衰", "B": "脾气虚弱", "C": "食滞内停", "D": "胆郁痰扰", "E": "痰湿困脾" }, "answer": "E", "reason": "困倦易睡,伴头目昏沉,胸闷脘痞,肢体困重,苔腻者多为痰湿困脾。" }, { "question_num": 62, "query": "治疗虚劳脾胃阴虚证，应首选的方剂是", "options": { "A": "玉女煎", "B": "益胃汤", "C": "沙参麦冬汤", "D": "麦门冬汤", "E": "一贯煎" }, "answer": "B", "reason": "虚劳脾胃阴虚证治法:养阴和胃。代表方:益胃汤加减。" }, { "question_num": 63, "query": "下列可见口干但欲漱口而不欲咽症状的是", "options": { "A": "阴虚", "B": "湿热", "C": "痰饮", "D": "瘀血", "E": "温病营分证" }, "answer": "D", "reason": "若漱口不欲咽,可见于内有瘀血,系瘀血内阻,气不化津,津不上承,故口燥不欲饮。" }, { "question_num": 64, "query": "治疗腹痛湿热壅滞证，应首选的方剂是", "options": { "A": "大承气汤", "B": "清中汤", "C": "龙胆泻肝汤", "D": "枳实导滞丸", "E": "泻心汤合连朴饮" }, "answer": "A", "reason": "腹痛湿热壅滞肠道,宜通腑泄热，用大承气汤最合适。" }, { "question_num": 65, "query": "矢气酸臭，应属于", "options": { "A": "肝脾不调", "B": "肝胃不和", "C": "脾胃虚弱", "D": "宿食停滞", "E": "寒客于胃" }, "answer": "D", "reason": "矢气酸奥属于宿食停滞。" }, { "question_num": 66, "query": "肾虚腰痛若无明显阴阳偏盛者，治疗可选用的方剂是", "options": { "A": "杜仲丸", "B": "青娥丸", "C": "补髓丹", "D": "虎潜丸", "E": "补血荣筋丸" }, "answer": "B", "reason": "肾虚腰病,偏阳虚者用右归丸;偏阴虚者用左归九;无阴阳偏盛者用青娥丸单纯补肾。" }, { "question_num": 67, "query": "下列为心热下移小肠主要表现的是", "options": { "A": "面赤口渴", "B": "口舌生疮", "C": "小便赤色灼痛", "D": "心烦失眠", "E": "大便秘结" }, "answer": "C", "reason": "心与小肠相为表里,心火内炽,可以下移小肠，热灼津伤而见小便赤色灼痛,故小便赤色灼痛是心热下移小肠的主要表现。" }, { "question_num": 68, "query": "下列不属于便秘病因的是", "options": { "A": "年老体虚", "B": "感受外邪", "C": "饮食不节", "D": "情志失调", "E": "外伤" }, "answer": "E", "reason": "便秘病因:饮食不节、情志失调、年老体虚、感受外邪。" }, { "question_num": 69, "query": "既治风寒表实无汗，又治风寒表虚有汗的药物是", "options": { "A": "紫苏", "B": "桂枝", "C": "香薷", "D": "羌活", "E": "麻黄" }, "answer": "B", "reason": "桂枝应用:风寒感冒。发汗之力较麻黄温和,风寒感冒表实、表虚均可选用。" }, { "question_num": 70, "query": "不寐的辨证，首辨", "options": { "A": "年龄", "B": "虚实", "C": "寒热", "D": "阴阳", "E": "病程" }, "answer": "B", "reason": "不寐的辨证,首辨虚实。" }, { "question_num": 71, "query": "下列属于心阳虚证和心阳暴脱证鉴别要点的是", "options": { "A": "是否舌质淡白", "B": "有无肢厥脉微", "C": "面白神疲", "D": "有无心悸怔忡", "E": "有无形寒畏冷" }, "answer": "B", "reason": "心阳暴脱证常由心阳虚证进一步发展而来,证候危重,常与亡阳症状状并见,故有无肢厥脉微,具有鉴别意义。" }, { "question_num": 72, "query": "治疗咳血燥热伤肺证，应首选的方剂是", "options": { "A": "沙参麦冬汤", "B": "桑杏汤", "C": "百合固金汤", "D": "麦门冬汤", "E": "清燥救肺汤" }, "answer": "B", "reason": "咳血燥热伤肺证，治法宜清热润肺，宁络止血。方用桑杏汤" }, { "question_num": 73, "query": "下列属于心火上炎的主要临床表现的是", "options": { "A": "神昏谵语", "B": "尿道灼痛", "C": "面赤口渴", "D": "口舌生疮", "E": "心悸失眠" }, "answer": "D", "reason": "舌为心之苗,心火内炽可上炎灼舌,而见口舌生疮。" }, { "question_num": 74, "query": "治疗热淋，应首选的方剂是", "options": { "A": "二妙散", "B": "八正散", "C": "疏凿饮子", "D": "程氏萆薢分清饮", "E": "薏苡仁汤" }, "answer": "B", "reason": "热淋,治法:清热利湿通淋。方选八正散加减。" }, { "question_num": 75, "query": "表现为新起恶寒，头身疼痛，无汗，鼻塞流涕，舌苔白，脉浮紧，此证为", "options": { "A": "伤寒证", "B": "里寒证", "C": "内寒证", "D": "虚寒证", "E": "中寒证" }, "answer": "A", "reason": "伤寒证指寒邪外袭于肌表，阻遏卫阳，阳气抗邪于外所表现的表实寒证，又称外寒证、表寒证、寒邪束表证、太阳表实证,太阳伤寒证等。寒邪袭表,郁闭肌肤,阳气失却温煦,故见恶寒、头身疼痛、无汗、苔白、脉浮紧等症。" }, { "question_num": 76, "query": "治疗痢疾之虚寒痢，应首选的方剂是", "options": { "A": "不换金正气散", "B": "连理汤", "C": "芍药汤", "D": "桃花汤合真人养脏汤", "E": "驻车丸" }, "answer": "D", "reason": "虚寒痢,治法:温补脾肾,收涩固脱。方选:桃花汤合真人养脏汤。" }, { "question_num": 77, "query": "下列哪项不属于肾阴虚证的临床表现", "options": { "A": "潮热盗汗", "B": "五心烦热", "C": "小便清长", "D": "腰膝酸软", "E": "遗精早泄" }, "answer": "C", "reason": "肾阴虚证临床表现:腰膝酸软而痛，头晕,耳鸣,齿松,发脱,男子阳强易举.遗精.早泄,女子经少或经闭、崩漏,失眠，健忘，口咽干燥,形体消瘦,五心烦热,潮热盗汗,骨蒸发热,午后颧红,小便短黄,舌红少津、少苔或无苔,脉细数。小便清长是肾阳虚证的表现。" }, { "question_num": 78, "query": "治疗肺痈咳唾浊痰黄绿而味腥者，应首选的方剂是", "options": { "A": "清金化痰汤", "B": "千金苇茎汤", "C": "加减泻白散", "D": "定喘汤", "E": "加味桔梗汤" }, "answer": "B", "reason": "肺痈症见咳唾浊痰黄绿,味腥者，是病程已进入成痈期，治疗宜清肺化瘀消痈，方应首选千金苇茎汤合如金解毒散加减。" }, { "question_num": 79, "query": "具有散风寒、通鼻窍功效的药物是", "options": { "A": "生姜", "B": "桂枝", "C": "防风", "D": "辛夷", "E": "紫苏" }, "answer": "D", "reason": "桂枝的功效为发汗解肌,温通经脉,助阳化气，平冲降逆。生姜的功效为解表散寒,温中止呕,温肺止咳,解鱼蟹毒。防风的功效为祛风解表,胜湿止痛,止痉。辛夷的功效为发散风寒.通鼻窍。紫苏的功效为解表散寒,行气和胃、解鱼蟹毒、安胎。" }, { "question_num": 80, "query": "治疗小儿尿频脾肾气虚证的方剂是", "options": { "A": "八正散", "B": "知柏地黄丸", "C": "缩泉丸", "D": "理中丸", "E": "以上均非" }, "answer": "C", "reason": "尿频之脾肾气虚证,治法:温补脾肾，升提固摄。代表方:缩泉丸。" }, { "question_num": 81, "query": "郁李仁具有的功效是", "options": { "A": "活血祛瘀", "B": "清肝泻火", "C": "利水消肿", "D": "软坚散结", "E": "凉血解毒" }, "answer": "C", "reason": "郁李仁的功效是润肠通便，下气利水。" }, { "question_num": 82, "query": "小儿脏腑娇嫩，表现突出的脏是", "options": { "A": "肝、脾、肾", "B": "肺、脾、肾", "C": "心、肺、肾", "D": "心、肝、肾", "E": "肺、肝、肾" }, "answer": "B", "reason": "小儿病理特点:“肺常不足”“脾常不足”“肾常虚”。所以,小儿的脏腑娇嫩,肺、脾、肾三脏表现尤为突出。" }, { "question_num": 83, "query": "望小儿食指络脉中，小儿指纹鲜红者多属于", "options": { "A": "疼痛", "B": "实证", "C": "惊风", "D": "里热证", "E": "外感表证" }, "answer": "E", "reason": "指纹鲜红者，多属外感表证。" }, { "question_num": 84, "query": "治疗痄腮毒窜睾腹证，首选的方剂是", "options": { "A": "清瘟败毒饮", "B": "龙胆泻肝汤", "C": "犀角地黄汤", "D": "普济消毒饮", "E": "黄连解毒汤" }, "answer": "B", "reason": "痄腮之毒窜睾腹证,治法:清肝泻火，活血止痛。代表方:龙胆泻肝汤。" }, { "question_num": 85, "query": "下列哪项不是燥邪犯肺证的临床表现", "options": { "A": "咽干鼻燥", "B": "头痛少汗", "C": "咳嗽少痰", "D": "发热恶寒", "E": "舌红脉浮" }, "answer": "E", "reason": "燥邪犯肺证临床表现:发热,微恶风寒、头痛、少汗,咳嗽少痰,咽干鼻燥,口渴,苔白舌红,右脉数大。舌红脉浮是风热犯肺证的表现。" }, { "question_num": 86, "query": "治疗小儿风寒感冒的方剂是", "options": { "A": "麻黄汤", "B": "荆防败毒散", "C": "桑菊饮", "D": "柴葛解肌汤", "E": "桂枝汤" }, "answer": "B", "reason": "小儿风寒感冒治法:辛温解表。主方:荆防败毒散加减。" }, { "question_num": 87, "query": "望舌色中，舌色红绛少苔或无苔者多属于", "options": { "A": "虚热证", "B": "湿热证", "C": "阳虚证", "D": "血虚证", "E": "实热证" }, "answer": "A", "reason": "舌绛少苔或无苔,或有裂纹,属于虚热证，多为热病后期阴液受损，或久病阴虚火旺。" }, { "question_num": 88, "query": "下列关于小儿指纹辨证，说法错误的是", "options": { "A": "浮沉分表里", "B": "色白是惊风", "C": "三关测轻重", "D": "红紫辨寒热", "E": "淡滞定虚实" }, "answer": "B", "reason": "小儿指纹的辨证纲要可以归纳:浮沉分表里，红紫辨寒热，淡滞定虚实，三关测轻重。色白是疳积，色青是惊风。" }, { "question_num": 89, "query": "症见头晕胀痛，头重脚轻，腰酸耳鸣，脉弦细者，辨证是", "options": { "A": "气血亏虚", "B": "痰湿内阻", "C": "胆郁疾扰膏", "D": "肝火上炎", "E": "肝阳上亢" }, "answer": "E", "reason": "头晕胀痛,头重脚轻,腰酸耳鸣,脉弦细者多为肝阳上亢。" }, { "question_num": 90, "query": "下列不宜用三棱针治疗的病证是", "options": { "A": "高热惊厥", "B": "中风脱证", "C": "中暑昏迷", "D": "急性腰扭伤", "E": "乳蛾" }, "answer": "B", "reason": "三棱针主治实证、热证、瘀血、疼病等。常用于急症和慢性病，如昏厥、高热、中风闭证、咽喉肿病、中暑、目赤肿痛、丹毒、扭挫伤等。而B选项为虚证，应以固阳固脱为治疗原则。" }, { "question_num": 91, "query": "上焦热盛或病危虚阳上越所致的异常汗出是", "options": { "A": "头汗", "B": "手足心汗", "C": "热汗", "D": "半身汗", "E": "冷汗" }, "answer": "A", "reason": "头汗多因上焦热盛,或中焦湿热蕴结,或病危虚阳上越所致。" }, { "question_num": 92, "query": "下列穴位配伍，属于原络配穴法的是", "options": { "A": "合谷、偏历", "B": "太溪、大钟", "C": "太渊、列缺", "D": "合谷、列缺", "E": "冲阳、丰隆" }, "answer": "D", "reason": "“原络配穴法”就是把先病经脉的原穴和后病的相表里经脉的络穴相配合，又称“主客原络配穴”。若大肠经先病，则取其经的原穴合谷为“主”肺经后病即取其经的络穴列缺为“客”" }, { "question_num": 93, "query": "补骨脂具有的功效是", "options": { "A": "补气健脾", "B": "温脾止泻", "C": "祛风除湿", "D": "固表止汗", "E": "益气生津" }, "answer": "B", "reason": "补骨脂温肾助阳,温脾止泻,纳气平喘,外用消风祛斑。" }, { "question_num": 94, "query": "十二经脉的命名包含了哪些内容", "options": { "A": "阴阳、五行、脏腑", "B": "五行、手足、阴阳", "C": "手足、阴阳、脏腑", "D": "脏腑、手足、五行", "E": "以上均非" }, "answer": "C", "reason": "十二经脉的命名,由手足、阴阳、脏腑组成。" }, { "question_num": 95, "query": "称生姜为“呕家圣药”的医家是", "options": { "A": "刘完素", "B": "孙思邈", "C": "张仲景", "D": "朱丹溪", "E": "龚延贤" }, "answer": "B", "reason": "孙思邈提出:“凡呕者,多食生姜,此是呕家圣药。”" }, { "question_num": 96, "query": "八脉交会穴中，公孙穴所通的奇经是", "options": { "A": "任脉", "B": "督脉", "C": "冲脉", "D": "阳维脉", "E": "阳跷脉" }, "answer": "C", "reason": "公孙穴通冲脉,任脉与列缺穴相通，督脉与后溪穴相通，阳维脉与外关穴相通，阳跷脉与申脉穴相通。" }, { "question_num": 97, "query": "五加皮具有的功效是", "options": { "A": "通便", "B": "利水", "C": "凉血", "D": "安胎", "E": "和胃" }, "answer": "B", "reason": "五加皮的功效为祛风湿,补肝肾,强筋骨,利水。" }, { "question_num": 98, "query": "定位在头部，眉上1寸，瞳孔直上的腧穴是", "options": { "A": "四白", "B": "隐白", "C": "承泣", "D": "阳白", "E": "睛明" }, "answer": "D", "reason": "阳白:在头部,眉上1寸,瞳孔直上。" }, { "question_num": 99, "query": "辛夷入汤剂煎服时宜", "options": { "A": "冲服", "B": "烊化", "C": "包煎", "D": "先煎", "E": "后下" }, "answer": "C", "reason": "包煎:如蒲黄、海金沙等因药材质地过轻,煎煮时易漂浮在药液面上,或成糊状,不便于煎煮及服用;车前子、葶苈子等药材较细,又含淀粉、黏液质较多的药,煎煮时容易粘锅、糊化、焦化;辛夷、旋覆花等药材有毛,对咽喉有刺激性,这几类药入药时宜用纱布包裹入煎。" }, { "question_num": 100, "query": "下列关于疮疡阴证、阳证的辨别，说法错误的是", "options": { "A": "肿块坚硬如石或柔软如棉者属阴", "B": "疾病发于筋骨者属阴", "C": "皮肤凉或不热者属阴", "D": "肿胀局限，根脚收束者属阴", "E": "肿胀形势平塌下陷者属阴" }, "answer": "D", "reason": "肿胀局限,根脚收束者属阳;肿胀范围不局限，根脚散漫者属阴。" }, { "question_num": 101, "query": "涩味药多治疗的病证是", "options": { "A": "水肿、小便不利", "B": "内热消渴", "C": "胸胁苦满", "D": "恶心呕吐", "E": "虚汗、遗精滑精" }, "answer": "E", "reason": "涩味药：与酸味药的作用相似,有收敛固涩的作用。多用于治疗虚汗、泄泻、尿频、遗精、滑精、出血等证。" }, { "question_num": 102, "query": "牛皮癣(中医)的典型皮疹特点是", "options": { "A": "带状分布的成簇水疱", "B": "鲜红或苍白的大小不等的风团", "C": "浅在性脓疱和脓痂", "D": "圆形或多角形扁平丘疹融合成片，易形成苔藓样变", "E": "皮损经搔抓脱屑后基底可见点状出血" }, "answer": "D", "reason": "牛皮癣的皮损特点:皮损多为圆形或多角形的扁平丘疹融合成片，剧烈瘙痒,搔抓后皮损肥厚，皮沟加深，皮隆起,极易形成苔藓样变，" }, { "question_num": 103, "query": "下列哪项属于假神的表现", "options": { "A": "除中", "B": "厌食", "C": "饥不欲食", "D": "消谷善饥", "E": "食欲减退" }, "answer": "A", "reason": "除中指久病或重病患者,本不欲食,甚至不能食,突然欲食或暴食的症状。除中是假神的表现之一，因胃气败绝所致。" }, { "question_num": 104, "query": "下列不属于脱疽局部缺血期临床表现的是", "options": { "A": "静息痛", "B": "患肢发凉", "C": "患肢麻木", "D": "间歇性跛行", "E": "足背动脉搏动减弱" }, "answer": "A", "reason": "脱疽缺血期的临床表现:患肢末端发凉,怕冷,麻木,酸痛,间歌性跛行,患肢肌肉轻度萎缩，皮肤干燥,皮温稍低,足背动脉、胫后动脉搏动减弱。静息痛为营养障碍期的表现。" }, { "question_num": 105, "query": "下列哪项是柴胡与薄荷均具有的功效", "options": { "A": "疏肝解郁", "B": "理气调中", "C": "化湿行气", "D": "消积行气", "E": "发散风寒" }, "answer": "A", "reason": "柴胡:解表退热,疏肝解郁，升举阳气。薄荷：疏散风热，清利头目,利咽透疹,疏肝行气。" }, { "question_num": 106, "query": "滑胎之肾阳亏虚证的主治方剂是", "options": { "A": "育阴汤", "B": "补肾固冲丸", "C": "肾气丸", "D": "安奠二天汤", "E": "以上均不是" }, "answer": "C", "reason": "滑胎之肾阳亏虚证,主要证候:屡孕屡堕;腰膝酸软，甚则腰痛如折，头晕耳鸣，畏寒肢冷，小便清长，夜尿频多，大便溏薄;舌淡，苔薄而润,脉沉迟或沉弱。治法:温补肾阳，固冲安胎。方药:肾气丸去泽泻，加菟丝子、杜仲、白术。" }, { "question_num": 107, "query": "下列哪项是治疗痰火凝结之瘿瘤、瘰疬的药物", "options": { "A": "栀子", "B": "知母", "C": "决明子", "D": "夏枯草", "E": "淡竹叶" }, "answer": "D", "reason": "夏粘草清热泻火,明目,散结消肿。主治：①目赤肿痛，头痛眩晕，目珠夜痛。②瘰疬，瘿瘤。③乳痈肿痛。" }, { "question_num": 108, "query": "足三阴经在内踝上8寸以下的分布是", "options": { "A": "厥阴在前，少阴在中，太阴在后", "B": "太阴在前，厥阴在中，少阴在后", "C": "少阴在前，太阴在中，厥阴在后", "D": "厥阴在前，太阴在中，少阴在后", "E": "太阴在前，少阴在中，厥阴在后" }, "answer": "D", "reason": "足三阴经在内踝上8寸以下的分布是厥阴在前、太阴在中、少阴在后；内踝上8寸以上的分布是太阴在前、厥阴在中、少阴在后。" }, { "question_num": 109, "query": "下列药物中，被称为“回阳救逆第一品药”的是", "options": { "A": "人参", "B": "肉桂", "C": "鹿茸", "D": "附子", "E": "干姜" }, "answer": "D", "reason": "附子:回阳救逆,朴火助阳，散寒止痛,能上助心阳、中温脾阳、下补骨阳，为“回阳救逆第一品药\"。" }, { "question_num": 110, "query": "手太阳小肠经与足太阳膀胱经的交接部位是", "options": { "A": "目中", "B": "目内眦", "C": "目外眦", "D": "鼻旁", "E": "耳前" }, "answer": "B", "reason": "手太阳小肠经与足太阳膀胱经在目内眦交接。手少阳三焦经与足少阳胆经在目外毗交接，" }, { "question_num": 111, "query": "下列不属于木香主治病证的是", "options": { "A": "三焦气滞", "B": "肺气阻滞", "C": "肝胆气郁", "D": "脾胃气滞", "E": "大肠气滞" }, "answer": "B", "reason": "木香归脾、胃、大肠、胆、三焦经。辛行苦泄温通,善通行脾胃之滞气,既为行气止痛之要药;辛行苦降,善行大肠之滞气;味苦主泄,走三焦和胆经,故既能行气健脾又能疏肝利胆。" }, { "question_num": 112, "query": "“阳脉之海”指的是", "options": { "A": "带脉", "B": "阳维脉", "C": "阳跷脉", "D": "督脉", "E": "冲脉" }, "answer": "D", "reason": "督脉循行于背部正中，与人体诸阳经多次交会，总督六阳经，称为“阳脉之海”" }, { "question_num": 113, "query": "消补兼施，主治脾胃虚弱，食少难消，脘腹痞闷，大便溏薄之证的方剂是", "options": { "A": "枳实消痞丸", "B": "健脾丸", "C": "保和丸", "D": "枳实导滞丸", "E": "以上均非" }, "answer": "B", "reason": "健脾丸的功效是健脾开胃，消食止泻,主治脾虚食积证,症见脘腹胀满,食少便溏，倦怠乏力。" }, { "question_num": 114, "query": "提插补泻法中泻法的操作是", "options": { "A": "先深后浅，轻插重提，提插幅度大，频率快", "B": "先深后浅，重插轻提，提插幅度大，频率快", "C": "先浅后深，轻插重提，提插幅度小，频率快", "D": "先深后浅，重插轻提，提插幅度小，频率快", "E": "先浅后深，重插轻提，提插幅度大，频率快" }, "answer": "A", "reason": "提插补泻是针刺补泻手法的一种，针刺得气后，先深后浅，轻插重提，提插幅度大,频率快，操作时间长者为泻法，反之为补法。" }, { "question_num": 115, "query": "平胃散的功效是", "options": { "A": "行气化湿，和胃止呕", "B": "燥湿运脾，和中益气", "C": "化湿和胃，理气健脾", "D": "燥湿运脾，行气和胃", "E": "以上均不是" }, "answer": "D", "reason": "平胃散的功效是燥温运脾，行气和胃;主治湿滞脾胃证。" }, { "question_num": 116, "query": "治疗淋证的基本原则", "options": { "A": "清热利湿通淋", "B": "标本兼顾", "C": "实则清利，虚则补益", "D": "忌汗、忌补", "E": "排石通淋" }, "answer": "C", "reason": "淋证的基本治则是实则清利，虚则补益。实证以膀胱湿热为主者，治宜清热利湿;以热灼血络为主者，治宜凉血止血;以砂石结聚为主者，治宜通淋排石;以气滞不利为主者，治宜利气疏导。虚证以脾虚为主者，治宜健脾益气;以肾虚为主者，治宜补虚益肾。虚实夹杂者,审其主次缓急,通补兼施。" }, { "question_num": 117, "query": "补气养血方中加人适量肉桂，其主要目的是", "options": { "A": "补而不滞", "B": "发汗解表", "C": "引火归元", "D": "鼓舞气血生长", "E": "散寒止痛" }, "answer": "D", "reason": "肉桂应用:①肾阳虚证，为治命门火衰之要药;②脘腹冷痛,寒疝腹痛;③寒痹腰痛,胸痹,阴疽,闭经,痛经;④虚阳上浮。此外,久病体虚气血不足者,在补益气血方中加入少量本品,可鼓舞气血生长。" }, { "question_num": 118, "query": "内痔的主要症状是", "options": { "A": "脱出、便血、疼痛", "B": "便血、便秘、疼痛", "C": "脱出、嵌顿、疼痛", "D": "便血、嵌顿、疼痛", "E": "便血、脱出、坠胀" }, "answer": "E", "reason": "内痔好发于膀胱截石位3、7、11点处,以便血、坠胀、肿块脱出为主要临床表现。外痔以坠胀、疼痛和异物感为主要表现。" }, { "question_num": 119, "query": "既能收敛固涩，益气生津，又能补肾宁心的药物是", "options": { "A": "五倍子", "B": "黄精", "C": "五味子", "D": "补骨脂", "E": "龟甲" }, "answer": "C", "reason": "五味子:收敛固涩,益气生津,补肾宁心。" }, { "question_num": 120, "query": "产后三急指的是", "options": { "A": "尿闭、便难、冷汗", "B": "下血、腹痛、心悸", "C": "呕吐、泄泻、盗汗", "D": "高热、昏迷、自汗", "E": "心悸、气短、抽搐" }, "answer": "C", "reason": "产后常见病和危重症概括为三病、三急、三冲。三病为病痉、病郁冒、大便难;三急为呕吐、泄泻、盗汗;三冲为冲心、冲胃、冲肺。" }, { "question_num": 121, "query": "妇女妊娠期可以服用的药物是", "options": { "A": "三棱、莪术、水蛭", "B": "斑蝥、麝香、虻虫", "C": "当归、阿胶、丹参", "D": "附子、枳实、肉桂", "E": "巴豆、牵牛子、商陆" }, "answer": "C", "reason": "妊娠禁用药指毒性较强或药性猛烈的药物,如巴豆、牵牛子、大戟.商陆、麝香、三棱、莪术、水蛭、斑蝥、雄黄、砒霜等。妊娠慎用药包括通经去瘀、行气破滞及辛热滑利之品,如桃仁、红花、牛膝、大黄、枳实、附子、肉桂、干姜、木通、冬葵子、瞿麦等。" }, { "question_num": 122, "query": "治疗下牙痛，用远部配穴法取", "options": { "A": "合谷", "B": "内庭", "C": "陷谷", "D": "颊车", "E": "下关" }, "answer": "A", "reason": "远部选穴是携选取距离患处较远的腧穴，休现了“经脉所通，主治所及的治疗规律。如胃痛选足三里、腰背病选委中、上牙痛选内庭，下牙痛选合谷。" }, { "question_num": 123, "query": "下列哪项为伤科首选药物", "options": { "A": "三七", "B": "茜草", "C": "白及", "D": "小蓟", "E": "大蓟" }, "answer": "A", "reason": "】三七应用:①出血证,有止血不留瘀、化瘀不伤正的特点;②跌打损伤,瘀滞肿痛,为伤科要药。" }, { "question_num": 124, "query": "痫病的病理因素中最重要的是", "options": { "A": "风", "B": "痰", "C": "火", "D": "虚", "E": "瘀" }, "answer": "B", "reason": "痈病的病理因素主要有风、火、痰、瘀,其中痰最为重要。" }, { "question_num": 125, "query": "下列哪项是朱砂的功效", "options": { "A": "清心镇惊，安神解毒", "B": "镇惊安神，平肝潜阳", "C": "镇惊安神，纳气平喘", "D": "镇惊安神，收敛固涩", "E": "镇惊安神，利尿通淋" }, "answer": "A", "reason": "朱砂:清心镇惊，安神、明目、解毒。" }, { "question_num": 126, "query": "以筋脉色紫、盘曲突起状如蚯蚓、形成团块为主要表现的浅表静脉病变是", "options": { "A": "臁疮", "B": "股肿", "C": "青蛇毒", "D": "筋瘤", "E": "脱疽" }, "answer": "D", "reason": "筋瘤是以筋脉色紫、盘曲突起状如蚯蚓、形成团块为主要表现的浅表静脉病变。" }, { "question_num": 127, "query": "下列属于十八反的是", "options": { "A": "石膏配知母", "B": "硫黄配朴硝", "C": "藜芦配细辛", "D": "人参配黄芪", "E": "丁香配郁金" }, "answer": "C", "reason": "十八反:甘草反甘遂、大戟、海藻、芫花;乌头（川乌、草乌、附子）反贝母、瓜蒌、半夏、白蔹、白芨。黎芦反人参、沙参、丹参、玄参、西洋参、党参、苦参、细辛、芍药。" }, { "question_num": 128, "query": "妇女终生不潮而能受孕者，称为", "options": { "A": "激经", "B": "避年", "C": "季经", "D": "暗经", "E": "居经" }, "answer": "D", "reason": "妇女终生不潮而能受孕者,称为“暗经”" }, { "question_num": 129, "query": "下列属于相杀的药物配伍是", "options": { "A": "人参与莱菔子配伍", "B": "甘草与海藻配伍", "C": "生姜与生半夏配伍", "D": "石膏与知母配伍", "E": "黄芪与茯苓配伍" }, "answer": "C", "reason": "相杀:指一种药物能够减轻或消除另一种药物的毒副作用,如生姜能减轻或消除生半夏和生南星的毒性或副作用，,因此，生姜杀生半夏和生南星的毒。" }, { "question_num": 130, "query": "小儿食指络脉纹色淡红，多为", "options": { "A": "瘀热内结", "B": "内有虚寒", "C": "外感风寒", "D": "邪热郁滞", "E": "气机阻滞" }, "answer": "B", "reason": "正常小儿指纹(食指络脉)大多淡紫隐隐在风关之内。纹色鲜红浮露，多为外感风寒;纹色紫红，多为邪热郁滞;纹色淡红，多为内有虚寒;纹色青紫，多为瘀热内结;纹色深紫;多为瘀滞络闭，病情深重。" }, { "question_num": 131, "query": "诊断慢性阻塞性肺疾病(COPD)的基础条件是", "options": { "A": "FEV1/FVC<40%", "B": "FEV1/FVC<50%", "C": "FEV1/FVC<60%", "D": "FEV1/FVC<70%", "E": "FEV1/FVC<80%" }, "answer": "D", "reason": "COPD诊断的必备条件是不完全可逆的气流受限,吸入支气管扩张剂后FEV1/FVC<70%最有助于诊断。" }, { "question_num": 132, "query": "在传染病的流行期间，为保护易感人群，需进行预防注射，下列预防注射无效的是", "options": { "A": "高效价免疫球蛋白", "B": "丙种球蛋白", "C": "灭活疫(菌)苗", "D": "抗毒素", "E": "类毒素" }, "answer": "D", "reason": "抗毒素的作用是中和游离毒素，但对于病原体已与细胞结合的毒素无效。主要用于治疗，传染病流行期间接种无效。" }, { "question_num": 133, "query": "下列哪项是玄参的功效", "options": { "A": "清热凉血，泻火解毒，滋阴", "B": "清热凉血，养阴生津", "C": "清热凉血，活血祛瘀", "D": "清热凉血，散瘀止痛", "E": "清热凉血，解毒透疹" }, "answer": "A", "reason": "玄参:清热凉血,泻火解毒，滋阴。" }, { "question_num": 134, "query": "下列使用糖皮质激素治疗SARS，说法正确的是", "options": { "A": "X线胸片示大片阴影并在48小时之内病灶面积增大＜50％，且在正位胸片上病灶面积占双肺总面积的1/4以上", "B": "中毒症状重，持续发热，经对症治疗3日以上，体温仍超过38℃", "C": "目的在于抑制异常的免疫病理反应，减轻局部炎症反应状态", "D": "达到慢性肺损伤的诊断标准", "E": "出现ARDS" }, "answer": "E", "reason": "治疗SARS使用糖皮质激素的目的在于抑制异常的免疫病理反应，减轻全身炎症反应状态。治疗指征:X线胸片示大片阴影并在48小时之内病灶面积增大>50%且在正位胸片上病灶面积占双肺总面积的1/4以上;达到急性肺损伤的诊断标准;出现ARDS。而中毒症状重，持续发热，经对症治疗3日以上，体温仍超过38℃不属于糖皮质激素治疗的指征。" }, { "question_num": 135, "query": "下列哪项为分经论治的方剂", "options": { "A": "柴胡疏肝散", "B": "桂枝汤", "C": "九味羌活汤", "D": "四物汤", "E": "半夏泻心汤" }, "answer": "C", "reason": "九味羌活汤主治外感风寒湿邪,内有蕴热证。以羌活为君,臣以防风、苍术,佐以细辛、白芷、川芎祛风散寒,宣痹止滴，其中,细辛善止少阴头痛,白芷善解阳明头痛，川芎长于止少阳、厥阴头痛,此三味与羌活、苍术合用,为本方“分经论治”的基本结构。" }, { "question_num": 136, "query": "下列哪项是急性乙型肝炎最早出现的血清学标志", "options": { "A": "HBsAg", "B": "抗HBs", "C": "HBeAg", "D": "抗-HBe", "E": "抗-HBc" }, "answer": "A", "reason": "HBsAg是感染HBV后最早出现的血清学标志，最早于感染后1~2周，最迟11~12周出现于周围血中，HBSAg转阴后一段时间，在疾病恢复期，抗-HBs开始出现、至10年内转阴" }, { "question_num": 137, "query": "琥珀具有的功效是", "options": { "A": "安神解郁，祛痰开窍", "B": "定惊安神，敛汗，利尿", "C": "定惊安神，活血，利尿通淋", "D": "宁心安神，消痈肿，活血散瘀", "E": "镇惊安神，活血散瘀，利尿通淋" }, "answer": "E", "reason": "琥珀的功效为镇惊安神，活血散淤,利尿通淋。" }, { "question_num": 138, "query": "下列哪项是可经母婴途径传播的传染性疾病", "options": { "A": "细菌性痢疾", "B": "流行性脑脊髓膜炎", "C": "霍乱", "D": "乙型肝炎", "E": "伤寒" }, "answer": "D", "reason": "乙型肝炎的传播途径:①母婴传播:②经皮传播(血液传播或医源性传播);③性接触传播；④除以上8种传途径外，当口腔黏膜(包括牙龈)破损时有可能经口感染。通过昆虫也可能传播。" }, { "question_num": 139, "query": "大黄牡丹汤的组成药物有", "options": { "A": "麻仁", "B": "枳实", "C": "桃仁", "D": "厚朴", "E": "赤芍" }, "answer": "C", "reason": "大黄牡丹汤组成:大黄、牡丹皮、桃仁、冬瓜仁、芒硝。" }, { "question_num": 140, "query": "下列检查中，为早期诊断甲型肝炎最简便可靠的血清学标志是", "options": { "A": "血清中检出抗HAV-IgM", "B": "ALT明显升高", "C": "血清中检出抗HAV-IgG", "D": "血清中检出抗原-抗体复合物", "E": "分子杂交法检测到HAVRNA" }, "answer": "A", "reason": "抗HAV-IgM是新近感染的证据，是早期诊断甲型肝炎最简便而可靠的血清学指标。" }, { "question_num": 141, "query": "症见面色苍白，头晕目眩，四肢倦怠，气短懒言，心悸怔忡，饮食减少，舌淡苔薄白，脉细弱或虚大无力者，治疗应选用的方剂是", "options": { "A": "八珍汤", "B": "炙甘草汤", "C": "四物汤", "D": "四君子汤", "E": "归脾汤" }, "answer": "A", "reason": "八珍汤主治:气血两虚证。症见面色苍白或萎黄,头晕目眩,四肢倦怠，气短懒言,心悸懒言，饮食减少,舌淡苔薄白,脉细弱或虚大无力。" }, { "question_num": 142, "query": "厉兑穴的定位在", "options": { "A": "足大趾末节内侧，趾甲根角侧后方0.1寸", "B": "足大趾末节外侧，趾甲根角侧后方0.1寸", "C": "第2趾末节外侧，趾甲根角侧后方0.1寸", "D": "第4趾末节外侧，趾甲根角侧后方0.1寸", "E": "小趾末节外侧，趾甲根角侧后方0.1寸" }, "answer": "C", "reason": "厉兑在第2趾末节外侧,趾甲根角侧后方0.1寸(指寸)" }, { "question_num": 143, "query": "感受暑湿六邪，症见身热烦渴、小便不利，治疗应首选的方剂是", "options": { "A": "猪苓汤", "B": "泻白散", "C": "五苓散", "D": "二妙散", "E": "六一散" }, "answer": "E", "reason": "六一散功用:清暑利湿。主治,署湿证。症见身热烦渴,小便不利,或泄泻。" }, { "question_num": 144, "query": "下列可治疗气病的八会穴是", "options": { "A": "章门", "B": "悬钟", "C": "膻中", "D": "中脘", "E": "太渊" }, "answer": "C", "reason": "腑病可取腑会中脘;气病可取气会膻中穴;脉病可取脉会太渊;脏病可取脏会章门。" }, { "question_num": 145, "query": "症见恶寒发热，肌表无汗，头痛项强，肢体酸楚疼痛，口苦微渴，舌苔微黄，脉浮，治疗宜首选的方剂是", "options": { "A": "再造散", "B": "麻黄汤", "C": "银翘散", "D": "败毒散", "E": "九味羌活汤" }, "answer": "E", "reason": "九味羌活汤:发汗祛湿,兼清里热。主治外感风寒湿邪,内有蕴热证,症见恶寒发热,肌表无汗,头痛项强,肢体酸楚疼痛,口苦微渴，舌苦白或微黄,脉浮。" }, { "question_num": 146, "query": "针灸治疗饮食伤胃型胃痛，应加取的配穴是", "options": { "A": "胃俞、肺俞", "B": "下脘、梁门", "C": "三阴交、内庭", "D": "膈俞、胃俞", "E": "气海、命门" }, "answer": "B", "reason": "胃痛的配穴:寒邪客胃配胃俞;饮食伤胃配梁门、下脘;肝气犯胃配期门、太冲;瘀血停胃配膈俞、三阴交;脾胃虚寒配关元、脾俞、胃俞;胃阴不足配胃俞、三阴交、内庭。" }, { "question_num": 147, "query": "下列哪项不是温脾汤的组成药物", "options": { "A": "附子", "B": "人参", "C": "芒硝", "D": "当归", "E": "黄芩" }, "answer": "E", "reason": "温脾汤组成:大黄、当归、干姜、附子、人参、芒研、甘草。" }, { "question_num": 148, "query": "颈椎病，病在太阳经应配的腧穴是", "options": { "A": "大椎", "B": "昆仑", "C": "照海", "D": "申脉", "E": "以上均非" }, "answer": "D", "reason": "颈椎病,病在太阳经配申脉。" }, { "question_num": 149, "query": "甲状腺危象的主要临床表现是", "options": { "A": "发绀、鼻翼扇动、心悸、出汗", "B": "心率>140次/分、体温>39℃、腹泻", "C": "心悸、气促、呕吐、消瘦", "D": "心率降低、血压低、头晕、休克", "E": "面色苍白、四肢厥冷、呼吸困难" }, "answer": "B", "reason": "典型的甲状腺危象:①高热,体温急骤升高,高热常在39°C以上,大汗淋漓,皮肤潮红,继而可出现虚脱.休克、谵妄,皮肤苍白和脱水;②心血管系统,心率显著增快，超过140次/分;③消化系统,食欲极差,恶心、呕吐频繁、腹痛、腹泻明显;④中枢神经系统，精神神经障碍、焦虑、烦躁、哮睡,最后陷入昏迷。" }, { "question_num": 150, "query": "行间的主治病证是", "options": { "A": "咳嗽", "B": "下肢痿痹", "C": "疝气", "D": "头痛眩晕", "E": "阴痒" }, "answer": "D", "reason": "行间主治:①头痛、目眩、目赤肿痛、青盲、口喎等头面五官热性病证;②月经过多、崩漏、痛经、经闭、带下等妇科病证;③阴中痛疝气;④小便不利,癃闭,尿痛;⑤胁涌，黄疸。" }, { "question_num": 151, "query": "类风湿关节炎最早出现的关节表现是", "options": { "A": "疼痛", "B": "肿胀", "C": "晨僵", "D": "关节畸形", "E": "活动障碍" }, "answer": "A", "reason": "晨僵可见于95%以上的类风湿关节炎患者,但关节疼痛是该病出现最早的症状。" }, { "question_num": 152, "query": "内伤发热的病因不包括", "options": { "A": "外伤出血", "B": "情志失调", "C": "感受外邪", "D": "久病体虚", "E": "饮食劳倦" }, "answer": "C", "reason": "内伤发热的病因:久病体虚、饮食劳倦、情志失调及外伤出血。" }, { "question_num": 153, "query": "急性广泛前壁心肌梗死，发病后5小时，首选的治疗措施是", "options": { "A": "口服美托洛尔", "B": "尿激酶溶栓治疗", "C": "口服卡托普利", "D": "静脉注射毛花苷C", "E": "静脉滴注低分子右旋糖酐" }, "answer": "B", "reason": "急性心肌梗死发病12小时内应行再灌注治疗,有条件、无禁忌证者优先考虑介入治疗,不能介入治疗且无溶栓治疗禁忌证者,则行溶栓治疗,常用尿激酶、链激酶等药物。" }, { "question_num": 154, "query": "下列哪项不是肉瘿的特点", "options": { "A": "如肉之团", "B": "发展缓慢", "C": "柔韧而圆", "D": "漫肿质软", "E": "结喉一侧或两侧结块" }, "answer": "D", "reason": "肉瘿是瘿病中较常见的一种，其临床特点是颈前结喉一侧或两侧结块，柔韧而圆，如肉之团，随吞咽动作而上下移动,发展缓慢。好发于青年女性及中年人。相当于西医的甲状腺腺瘤或裳肿，属于甲状腺的良性肿瘤。" }, { "question_num": 155, "query": "下列疾病可引起周围性发绀的是", "options": { "A": "肺炎", "B": "法洛四联症", "C": "气胸", "D": "右心衰竭", "E": "大量胸腔积液" }, "answer": "D", "reason": "周围性发绀:①瘀血性周围性发绀,常见于引起体循环淤血、周围血流缓慢的疾病,如右心衰竭、渗出性心包炎、心包填塞、缩窄性心包炎、血栓性静脉炎、上腔静脉阻塞综合征、下肢静脉曲张等;②缺血性周围性发绀,常见于引起心排出量减少的疾病和局部血流障碍性疾病,如严重休克、暴露于寒冷中和血栓闭塞性脉管炎、雷诺病、肢端发绀症等。" }, { "question_num": 156, "query": "下列不是癌病的基本病理因素的是", "options": { "A": "血瘀", "B": "气郁", "C": "湿阻", "D": "痰浊", "E": "邪热" }, "answer": "E", "reason": "癌病的基本病理因素为气郁、痰浊、湿阻、血瘀、毒聚(热毒、寒毒)。" }, { "question_num": 157, "query": "血脂异常的主要表现是", "options": { "A": "肥胖", "B": "脂肪瘤", "C": "黄色瘤", "D": "眼底血管改变", "E": "主动脉及其分支的粥样硬化" }, "answer": "C", "reason": "血脂异常主要表现为黄色瘤(最常见).早发性角膜环、脂血症眼底改变。" }, { "question_num": 158, "query": "下列哪项不是虚喘的特有症状", "options": { "A": "呼吸浅短难续", "B": "呼出为快", "C": "气怯声低", "D": "深吸为快", "E": "遇劳加重" }, "answer": "B", "reason": "喘证有虚实之分,实喘病程短、急，症见呼吸深长有余,呼出为快,气粗声高。" }, { "question_num": 159, "query": "下列不属锥体束病变病理反射的是", "options": { "A": "巴宾斯基征", "B": "戈登征", "C": "查多克征", "D": "拉塞格征", "E": "奥本海姆征" }, "answer": "D", "reason": "锥体束病变时的病理反射有巴宾斯基征、奥本海姆征、戈登征及查多克征等。" }, { "question_num": 160, "query": "下列哪项是治疗鼻衄气血亏虚证首选的方剂", "options": { "A": "归脾汤", "B": "泻心汤", "C": "桑菊饮", "D": "玉女煎", "E": "清营汤" }, "answer": "A", "reason": "鼻衄气血亏虚证,治法:补气摄血。代表方:归脾汤加减。" }, { "question_num": 161, "query": "咳铁锈色痰最带见的疾病是", "options": { "A": "肺脓肿", "B": "支气管哮喘", "C": "肺炎链球菌肺炎", "D": "慢性支气管炎", "E": "慢性咽炎" }, "answer": "C", "reason": "铁锈色痰是肺类链球菌肺炎的典型特点。" }, { "question_num": 162, "query": "关元穴不能治疗的病证是", "options": { "A": "中风脱证、虚劳羸瘦", "B": "癫狂痫、失眠", "C": "少腹疼痛、疝气", "D": "遗精、阳痿、早泄", "E": "月经不调、痛经" }, "answer": "B", "reason": "关元主治:①中风脱证、虚劳羸瘦、脱肛、阴挺等元气虚损所致病证;②遗精、阳痿、早泄、不育等男科病证;③崩漏、月经不调、痛经、闭经、不孕、带下等妇科病证;④遗尿、癃闭、尿频、尿急等泌尿系病证;⑤腹痛、泄泻、脱肛、便血等肠腑病证;⑥保健要穴。" }, { "question_num": 163, "query": "治疗虚热肺痿宜选用的方剂是", "options": { "A": "一贯煎", "B": "桑杏汤", "C": "玉液汤", "D": "六味地黄丸", "E": "麦门冬汤" }, "answer": "E", "reason": "麦门冬汤主治:①虚热肺瘘;②胃阴不足证。" }, { "question_num": 164, "query": "手足阴经在人体的交接部位是", "options": { "A": "肩胛部", "B": "头面部", "C": "胸部", "D": "背部", "E": "四肢部" }, "answer": "C", "reason": "足手阴经在胸部交接,如足太阴脾经与手少阴心经交接于心中;足少阴肾经与手厥阴心包经交接于胸中;足厥阴肝经与手太阴肺经交接于肺中。" }, { "question_num": 165, "query": "条件致病菌指的是", "options": { "A": "正常菌群中的细菌", "B": "入侵的病原菌", "C": "带菌者排出的病原菌", "D": "患者排出的病原菌", "E": "在某些特定条件下由正常菌群转变成的致病菌" }, "answer": "E", "reason": "条件致病菌又称为机会致病菌,指在某种特定条件下可致病的细菌。条件致病菌是人体的正常菌群,当其集聚部位改变、机体抵抗力降低或菌群失调时可致病,如变形杆菌。" }, { "question_num": 166, "query": "定位在前臂后区，腕背横纹上1寸，尺骨头桡侧凹陷中的腧穴是", "options": { "A": "养老", "B": "支沟", "C": "后溪", "D": "支正", "E": "外关" }, "answer": "A", "reason": "养老:在前臂后区,腕背横纹上1寸，尺骨头桡侧凹陷中" }, { "question_num": 167, "query": "病毒性肝炎的临床类型不包括", "options": { "A": "急性肝炎", "B": "慢性肝炎", "C": "重型肝炎", "D": "淤胆型肝炎", "E": "药物性肝损害" }, "answer": "E", "reason": "病毒性肝炎的临床类型有和急性肝炎、慢性肝炎、重型肝炎、淤胆型肝炎、肝炎后肝硬化。" }, { "question_num": 168, "query": "下列经脉中，循行于腹中线旁开2寸，胸中线旁开4寸的是", "options": { "A": "足阳明胃经", "B": "足太阴脾经", "C": "足厥阴肝经", "D": "手太阴肺经", "E": "手少阴心经" }, "answer": "A", "reason": "足阳明胃经的循行线路是其直者,从缺盆下乳内廉，下挟脐，入气街中。即胸部距前正中线4寸，从缺盆穴到乳根穴，腹部距前正中线2寸。" }, { "question_num": 169, "query": "抢救霍乱休克患者首要的措施是", "options": { "A": "升压药", "B": "纠正水与电解质丢失", "C": "抗菌治疗", "D": "激素应用", "E": "输血" }, "answer": "B", "reason": "大量吐泻引起水和电解质严重丢失是霍乱的主要病理生理改变,因此及时补计液体和电解质是治疗本病的关键。" }, { "question_num": 170, "query": "治疗咽喉肿痛肺胃实热型，应加用哪组腧穴", "options": { "A": "风池、外关", "B": "太渊、曲池", "C": "列缺、照海", "D": "内庭、鱼际", "E": "中渚、风池" }, "answer": "D", "reason": "咽喉肿痛实证处方主穴:少商、合谷、尺泽、关冲。配穴:外感风热配风池、外关;肺胃热盛配内庭、鱼际。" }, { "question_num": 171, "query": "下列关于哮喘持续状态的紧急处理，说法错误的是", "options": { "A": "静脉注射地塞米松", "B": "补充水、电解质", "C": "纠正酸中毒", "D": "吸氧", "E": "口服氨茶碱" }, "answer": "E", "reason": "哮喘持续状态的治疗方法。①吸氧;②迅速缓解气道痉挛,常用琥珀酸氢化可的松、甲基泼尼松龙或地塞米松静脉滴注或注射;③及时进行人工通气;④注意并发症，包括预防和控制感染;补充足够液体量,避免痰液粘稠;纠正严重酸中毒和调整水电解质平衡等。哮喘持续状态服用氨茶碱可能会加重支气管的痉挛。" }, { "question_num": 172, "query": "治疗骨蒸潮热的背俞穴是", "options": { "A": "肺俞", "B": "脾俞", "C": "三焦俞", "D": "心俞", "E": "肝俞" }, "answer": "A", "reason": "肺俞主冶:①鼻塞、咳嗽、气喘、咯血等肺系病证;②骨蒸潮热、盗汗等阴虚病证;③背痛;④皮肤瘙痒，瘾疹。" }, { "question_num": 173, "query": "甲亢患者，给予甲巯咪唑20mg，一日3次。半个月后应到医院复查", "options": { "A": "心率、心律", "B": "心电图", "C": "甲状腺大小", "D": "白细胞计数", "E": "突眼程度" }, "answer": "D", "reason": "甲硫咪唑的重要副作用为粒细胞减少,故复查须监测白细胞。" }, { "question_num": 174, "query": "下列腧穴中，属于足少阴肾经的络穴是", "options": { "A": "复溜", "B": "大钟", "C": "涌泉", "D": "然谷", "E": "太溪" }, "answer": "B", "reason": "大钟为足少阴肾经的络穴。" }, { "question_num": 175, "query": "年轻女性，月经增多，疑有缺铁性贫血，下列检查最有诊断意义的是", "options": { "A": "血清铁降低", "B": "钴盐吸收降低", "C": "血清铁蛋白降低", "D": "游离原卟啉降低", "E": "总铁结合力增高" }, "answer": "C", "reason": "血清铁蛋白浓度稳定,与体内贮铁量相关性好,与骨髓可染铁一起,是缺铁性贫血最可靠、最有诊断价值的实验室指标。" }, { "question_num": 176, "query": "下列哪项是经母婴途径传播的传染病", "options": { "A": "伤寒", "B": "霍乱", "C": "艾滋病", "D": "鼠疫", "E": "细菌性痢疾" }, "answer": "C", "reason": "艾滋病的传播途径:①性传播;②血液或血液制品传播;③母婴传播。" }, { "question_num": 177, "query": "腹部叩诊出现移动性浊音，应首先考虑是", "options": { "A": "尿潴留", "B": "幽门梗阻", "C": "右心衰竭", "D": "急性胃炎", "E": "巨大卵巢囊肿" }, "answer": "C", "reason": "尿潴留呈圆形浊音区,则可能为胀大的膀胱。幽门梗阻出现振水音。右心衰竭出现移动性浊音。急性胃炎在胃泡鼓音区的上界,再做水平方向叩诊鼓音区变大。巨大卵巢囊肿为实音。" }, { "question_num": 178, "query": "针刺头顶、项部以及上背部的腧穴，患者应采取的体位为", "options": { "A": "仰卧位", "B": "侧卧位", "C": "俯卧位", "D": "仰靠坐位", "E": "侧伏坐位" }, "answer": "C", "reason": "俯卧位:后身部,头顶,背腰,臀，下肢背侧。" }, { "question_num": 179, "query": "下列选项中，不会引起血清钾增高的是", "options": { "A": "急、慢性肾衰竭少尿期", "B": "静脉滴注大量钾盐", "C": "严重溶血", "D": "代谢性酸中毒", "E": "代谢性碱中毒" }, "answer": "E", "reason": "血清钾增高的原因:①肾脏排钾减少,如急、慢性肾衰竭少尿期及肯上腺皮质功能减退等;②摄入或注射大量钾盐,超过肾脏排钾能力;③严重溶血或组织损伤,红细胞或组织的钾大量释放入细胞外液;④组织缺氧或代谢性酸中毒时大量细胞内的钾转移至细胞外。" }, { "question_num": 180, "query": "下列不属于传染病基本特征的是", "options": { "A": "有病原体", "B": "有感染后免疫性", "C": "有流行病学特征", "D": "有发热", "E": "有传染性" }, "answer": "D", "reason": "传染病基本特征:有病原体,有传染性、有流行病学特征、有感染后免疫性。而发热则是多种疾病的一种临床表现。" }, { "question_num": 181, "query": "下列关于丙型肝炎病毒的叙述，不正确的是", "options": { "A": "为单股正链RNA病毒", "B": "可应用血源疫苗免疫以预防感染", "C": "抗-HCV阳性是感染的标志", "D": "血清中可检测病毒RNA", "E": "绝大多数为血源传播" }, "answer": "B", "reason": "丙型肝炎病毒,为单股正链RNA病毒。两型肝炎的传染源主要为急性临床型患者和无注状的亚临床患者,慢性患者和病毒携带者。一般患者发病前其血液即有感染性;并可带毒数年。HCV主要为血源传播，还可通过其他方式如母婴重直传播,家庭日常接触和性传播等。抗一HCV阳性是感染的标志(包括现症感染和有既往感染)。" }, { "question_num": 182, "query": "在传染病的管理中，传染性非典型肺炎的管理归属是", "options": { "A": "甲类传染病", "B": "乙类传染病", "C": "丙类传染病", "D": "肠道传染病", "E": "虫媒传染病" }, "answer": "A", "reason": "传染性非典型肺炎(严重急性呼吸综合征)分类属于乙类传染病，但按照甲类传染病管理。另外，炭疽中的肺炭疽、人感染高致病性禽流感与之一样，必须采取甲类传染病的报告、控制措施。" }, { "question_num": 183, "query": "下列有关医院感染的概念，错误的是", "options": { "A": "在医院内获得的感染称为医院感染", "B": "入院时处于潜伏期的感染不是医院感染", "C": "出院之后的感染有可能是医院感染", "D": "与上次住院有关的感染是医院感染", "E": "婴幼儿经胎盘获得的感染属医院感染" }, "answer": "E", "reason": "医院感染的内涵:①明确了医院感染必须发生在医院范围内,包括在医院内感染出院后发病的,但不包括在入院时处于感染潜伏期者;②感染与发病是在不同阶段产生的,其顺序是感染一潜伏期一发病。因此,潜伏期是判断感染发生时间与地点的重要依据。③感染对象包括一切在医院内活动的人群,即患者(住院、门诊)、医院工作人员、访客、陪客和探视者等。不属于医院感染的情况:①皮肤黏膜开放性伤口只有细菌定殖而无炎症表现。②由于创伤或非生物性因子刺激而产生的炎症表现。③新生儿经胎盘获得(出生后48小时内发病)的感染如单纯疱疹、弓形体病、水痘等。;④患者原有的慢性感染在医院内急性发作。" }, { "question_num": 184, "query": "病原体侵入人体后能否引起疾病，主要取决于何种因素", "options": { "A": "机体保护性免疫", "B": "病原体侵入途径与特异性", "C": "病原体毒力与数量", "D": "机体天然屏障作用", "E": "病原体的致病力与机体免疫机能" }, "answer": "E", "reason": "病原体侵入人体后能否引起疾病，取决于病原体的致病力、机体的免疫功能和外环境三个因素。病原体的致病力包括侵袭力、毒力、数量和变异性。" }, { "question_num": 185, "query": "大咯血指每日咯血量", "options": { "A": ">100mL", "B": ">200mL", "C": ">300mL", "D": ">400mL", "E": ">500mL" }, "answer": "E", "reason": "每日咯血量超过500mL者属于大量咯血。大咯血是一种危及患者生命的急症。" }, { "question_num": 186, "query": "下列哪项是典型流行性脑脊髓膜炎脑脊液的改变", "options": { "A": "白细胞增多，蛋白升高，糖含量低", "B": "白细胞减少，蛋白升高，糖含量高", "C": "白细胞减少，蛋白正常，糖含量正常", "D": "白细胞增多，蛋白降低，糖含量高", "E": "白细胞增多，蛋白升高，糖含量正常" }, "answer": "A", "reason": "脑脊液检查是流行性脑脊髓膜炎明确诊断的重要方法:颅内压增高，脑脊液外观混浊，白细胞明显增多,蛋白升高,糖及氯化物含量明显降低。" }, { "question_num": 187, "query": "下列哪项是引起咯血最常见的疾病", "options": { "A": "肺结核", "B": "肺淤血", "C": "肺部恶性肿瘤", "D": "肺炎球菌性肺炎", "E": "肺梗死" }, "answer": "A", "reason": "肺结核为我国最常见的咯血原因。" }, { "question_num": 188, "query": "下列哪项是暴发型流脑脑膜脑炎型对症治疗的关键", "options": { "A": "退热、止惊", "B": "脱水、降低颅内压", "C": "补充血容量", "D": "吸氧", "E": "使用糖皮质激素" }, "answer": "B", "reason": "暴发型流脑脑膜脑炎型以脑实质严重损害为特征，所以应防治脑水肿脑疝。治疗的关键是及早发现脑水肿，积极脱水治疗，降低颅内压预防脑癌。可用甘露醇治疗，还可使用白蛋白、甘油果糖、呋塞米和激素等药物治疗。" }, { "question_num": 189, "query": "夜间阵发性呼吸困难，可见于哪种疾病", "options": { "A": "急性脑血管疾病", "B": "癔病", "C": "急性感染所致的毒血症", "D": "慢性阻塞性肺气肿", "E": "急性左心功能不全" }, "answer": "E", "reason": "急性左心功能不全时，因急性肺淤血,常出现阵发性呼吸困难,多在夜间睡眠中发作,突感气闷或气急而惊醒,被迫坐起,这种情况称为夜间阵发性呼吸困难。" }, { "question_num": 190, "query": "感染的类型不包括", "options": { "A": "原发感染", "B": "继发感染", "C": "重复感染", "D": "混合感染", "E": "重叠感染" }, "answer": "B", "reason": "根据病原体感染的次数、时间先后和种数，感染可分为原发感染、重复感染、混合感染、重叠感染4种。" }, { "question_num": 191, "query": "下列属于个人史问诊内容的是", "options": { "A": "曾经患过的疾病", "B": "外伤手术", "C": "预防接种", "D": "习惯与嗜好", "E": "过敏史" }, "answer": "D", "reason": "个人史包括社会经历、职业和工作条件、习惯和嗜好、治游史。" }, { "question_num": 192, "query": "下列哪项是治疗乙型肝炎和丙型肝炎主要的抗病毒药物", "options": { "A": "干扰素", "B": "阿糖腺苷", "C": "阿昔洛韦", "D": "利巴韦林", "E": "核苷类似物" }, "answer": "A", "reason": "抗病毒治疗方法。临床应用较多的有干扰素(治疗乙型肝炎和丙型肝炎)阿糖腺苷、阿昔洛韦（治疗疱疹病毒感染)、利巴韦林(治疗流行性出血热)、核苷类似物(治疗AIDS或乙型肝炎)" }, { "question_num": 193, "query": "触诊肠管或条索状包块，下列最适用的触诊法是", "options": { "A": "深压触诊法", "B": "浅部滑行触诊法", "C": "深部滑行触诊法", "D": "双手触诊法", "E": "冲击触诊法" }, "answer": "C", "reason": "深部滑行触诊:医师以并拢的四指末端逐渐加压到腹腔的脏器或包块上，做上、下、左、右滑动触摸。滑动触诊主要适用于腹腔深部包块和脏器的检查。" }, { "question_num": 194, "query": "下列哪项是传染病病原学诊断的“金指标”", "options": { "A": "血常规检查", "B": "大便常规检查", "C": "分子杂交技术", "D": "聚合酶链反应", "E": "病原体分离培养" }, "answer": "E", "reason": "病原体的直接检出或分离培养是传染病病原学诊断的“金指标”" }, { "question_num": 195, "query": "下列意识障碍的表现中，属于浅昏迷的主要特点是", "options": { "A": "对声、光刺激仍有反应", "B": "对强烈疼痛刺激无反应", "C": "意识大部分丧失", "D": "角膜、对光反射消失", "E": "吞咽反射消失" }, "answer": "C", "reason": "根据程度分:①浅昏迷,对强烈痛刺激有反应,意识大部分丧失，基本生理反应存在,生命体征正常;②中度昏迷,对痛刺激反应消失,生理反应存在,生命体征正常;③深昏迷,除生命休征存在外,其他均消失。" }, { "question_num": 196, "query": "治疗耳鸣、耳聋、腰酸痛的背俞穴是", "options": { "A": "肾俞", "B": "脾俞", "C": "肺俞", "D": "三焦俞", "E": "肝俞" }, "answer": "A", "reason": "肾俞为肾之背俞穴，主治：①头晕、耳鸣、耳聋、慢性腹泻、气喘、腰酸痛、遗精、阳痿、不育等肾虚病证;②遗尿、癃闭等前阴病证;③月经不调、带下、不孕等妇科病证;④消渴。" }, { "question_num": 197, "query": "下列为肺动脉高压早期X线表现的是", "options": { "A": "双肺纹理增多", "B": "双肺透亮度增加", "C": "右下肺动脉干扩张", "D": "右心房肥大", "E": "右心室肥厚、扩张" }, "answer": "C", "reason": "肺动脉高压表现:右下肺动脉干扩张,肺动脉段中度凸出或其高度≥3mm,中心肺动脉扩张和外周分支纤细。" }, { "question_num": 198, "query": "某种传染病在某一地区近几年发病率的一般水平称为", "options": { "A": "散发", "B": "暴发", "C": "流行", "D": "流行性", "E": "大流行" }, "answer": "A", "reason": "散发:某种传染病在某一地区近几年发病率的一般水平。" }, { "question_num": 199, "query": "下列疾病中，呕吐物呈咖啡色的是", "options": { "A": "幽门梗阻", "B": "上消化道出血", "C": "溃疡性结肠炎", "D": "食物中毒", "E": "空肠梗阻" }, "answer": "B", "reason": "上消化道出血可引起呕血,呕吐物的颜色与出血量及在胃中存留时间有关，若出血量大,在胃中停留时间短,呕吐物可呈鲜红色、暗红色或混有凝血块;若出血量少或在胃中停留时间长,则因血红有蛋白与胃酸作用而形成酸化正铁血红素,呕吐物呈咖啡色。" }, { "question_num": 200, "query": "卫生法的概念指", "options": { "A": "国家立法机关颁布的卫生法律", "B": "国家行政机关颁布的卫生法规", "C": "国务院卫生行政部门颁布的规章", "D": "卫生行政部门颁布的技术规范", "E": "调整在卫生活动过程中所发生的社会关系的法律规范的总称" }, "answer": "E", "reason": "卫生法是调整在卫生活动过程中所发生的社会关系的法律规范的总称。" }, { "question_num": 201, "query": "下列哪项疾病可出现胆囊显著肿大无压痛、伴黄疸进行性加重", "options": { "A": "急性胆囊炎", "B": "慢性胆囊炎", "C": "胆结石", "D": "胆囊癌", "E": "胰头癌" }, "answer": "E", "reason": "黄疸伴有胆囊肿大者提示有胆总管梗阻,出现黄疸提示胆总管梗阻后胆汁淤积性黄疸,常见于胰头癌、壶腹癌、胆总管癌等,选项A、B、C、D中胆囊炎、胆结石有压痛,胆囊癌为胆囊病变,均不会引起胆囊的显著增大及黄疸进行性加重。" }, { "question_num": 202, "query": "患者恶寒较甚，发热，无汗，身楚倦怠，咳嗽，咳痰无力，舌淡苔薄白，脉浮无力，其治法是", "options": { "A": "辛温解表", "B": "辛凉解表", "C": "祛湿解表", "D": "益气解表", "E": "以上均非" }, "answer": "D", "reason": "气虚感冒:恶寒较甚,发热,无汗,头痛身楚，咳嗽,痰白,咳痰无力,平素神疲体弱，气短懒言,反复易感,舌淡苔白脉浮而无力。治法:益气解表。" }, { "question_num": 203, "query": "出现“三偏”征，提示病变部位在", "options": { "A": "内囊", "B": "深皮质", "C": "脑干", "D": "脊髓", "E": "基底节" }, "answer": "A", "reason": "所谓的“三偏“即为偏瘫、偏深感觉障碍及偏盲,此为内囊损伤的典型表现。" }, { "question_num": 204, "query": "患者，男，73岁。常感头晕头痛，耳鸣目眩，突然发生口舌歪斜，舌强语謇，手足重滞，舌质红苔黄，脉弦。治疗应首选的方剂是", "options": { "A": "镇肝熄风汤", "B": "桃仁承气汤", "C": "羚角钩藤汤", "D": "涤痰汤", "E": "天麻钩藤饮" }, "answer": "E", "reason": "中风中经络风阳上扰证治法:平肝潜阳，活血通络。代表方:天麻钩藤饮加减。忙，其" }, { "question_num": 205, "query": "COPD稳定期常规选用的药物是", "options": { "A": "抗生素", "B": "利尿剂", "C": "皮下免疫调节剂", "D": "支气管扩张药", "E": "高流量吸氧" }, "answer": "D", "reason": "支气管扩张药可缓解气短症状,提高生活质量,是COPD稳定期最主要的治疗药物。" }, { "question_num": 206, "query": "患者，女，46岁。不喜运动，近2年出现腰部酸痛，右侧痛重，腰部肌肉僵硬，久坐加重，舌质淡暗，边有瘀点。针灸治疗除主穴外，应加取的配穴是", "options": { "A": "腰阳关", "B": "足三里", "C": "肾俞", "D": "膈俞", "E": "太冲" }, "answer": "D", "reason": "瘀血腰痛配膈俞、次髎。" }, { "question_num": 207, "query": "下列为肺心病心功能失代偿期表现的是", "options": { "A": "以右心衰竭为主", "B": "低氧血症", "C": "二氧化碳潴留", "D": "全心衰竭", "E": "肺水肿" }, "answer": "A", "reason": "肺心病的主要表现为颈静脉怒张、肝大、下肢水肿等,发生机制为COPD时因肺小动脉收缩导致肺动脉高压,长期肺动脉高压将导致右室负荷增加,右心室扩大及肥大，右心失代偿则体循环淤血,出现上述临床表现。" }, { "question_num": 208, "query": "患者，女，47岁。眩晕半年，加重1周，伴神疲乏力，面色㿠白，时有心悸，夜寐欠安，舌淡，脉细。治疗应选取的配穴是", "options": { "A": "百会、太阳、印堂", "B": "气海、脾俞、胃俞", "C": "风池、肝俞、肾俞", "D": "中脘、内关、解溪", "E": "百会、上星、风池" }, "answer": "B", "reason": "眩晕虚证主穴:百会、风池、肝俞、肾俞、足三里。气血两虚配气海、脾俞、胃俞。天雨目" }, { "question_num": 209, "query": "最易发生膀胱炎的人群是", "options": { "A": "女性婴幼儿", "B": "50岁以上男性", "C": "育龄妇女", "D": "老年妇女", "E": "青年女性" }, "answer": "E", "reason": "膀胱炎属于下屎路感染，女性尿道特点为宽、短,直。此解剖特点可以使细菌喝客易通过尿道进入下尿路甚至上尿路,常见于年轻女性。" }, { "question_num": 210, "query": "患者，女，46岁。乳房肿块，月经前加重，经后缓解，伴有腰酸乏力，神疲倦怠，月经失调，量少色淡，舌淡苔白，脉沉细，辨证其治法是", "options": { "A": "疏肝散结", "B": "化痰散结", "C": "调摄冲任", "D": "调补气血", "E": "行气活血" }, "answer": "C", "reason": "患者乳房有肿块,为乳癖，腰酸乏力,神疲倦息,月经失调,可辨为冲任失调证,治法:调摄冲任。" }, { "question_num": 211, "query": "用于治疗急性心肌梗死合并心源性休克的血管扩张剂是", "options": { "A": "间羟胺", "B": "异丙肾上腺素", "C": "去甲肾上腺素", "D": "硝普钠", "E": "肾上腺素" }, "answer": "D", "reason": "硝普钠是用于治疗急性心肌梗死合并心源性休克的血管扩张剂。" }, { "question_num": 212, "query": "患者，女，32岁，已婚。有盆腔炎病史，下腹部疼痛结块，缠绵日久，痛连腰骶，经行加重，经血量多有块，带下量多，精神不振，纳少乏力，舌质紫黯有瘀点，苔白，脉弦涩无力。治疗应首选的方剂是", "options": { "A": "理冲汤", "B": "膈下逐瘀汤", "C": "少腹逐瘀汤", "D": "血府逐瘀汤", "E": "银甲丸" }, "answer": "A", "reason": "慢性盆腔炎气虚血瘀证，治法:益气健脾，化瘀散结。方选:理冲汤。" }, { "question_num": 213, "query": "下列为再生障碍性贫血的血象特点是", "options": { "A": "小细胞低色素性贫血", "B": "正细胞正色素性贫血", "C": "小细胞正色素性贫血", "D": "大细胞低色素性贫血", "E": "大细胞正色素性贫血" }, "answer": "B", "reason": "再生障碍性贫血多呈全血细胞减少,为正细胞正色素性贫血。" }, { "question_num": 214, "query": "患儿，男，5岁。气喘，喉间哮鸣，咳嗽，痰稀色白有泡沫，流清涕，唇青，形寒肢凉，无汗，口不渴，小便清长，大便溏薄，咽不红，舌淡红，苔薄白，脉浮紧，其证候是", "options": { "A": "寒性哮喘", "B": "热性哮喘", "C": "外寒内热证", "D": "肺实肾虚证", "E": "肺脾气虚证" }, "answer": "A", "reason": "哮喘之寒性哮喘:气喘,喉间哮鸣,咳嗽,胸闷,痰稀色白有泡沫,喷嚏鼻塞,流清涕，唇青,形寒肢凉,无汗,口不渴，小便清长，大便溏薄，咽不红，舌质淡红，苔薄白或白滑,脉浮紧，指纹红。" }, { "question_num": 215, "query": "道德是在人们社会生活实践中形成的、由下列哪项决定的", "options": { "A": "文化发展", "B": "意识形态", "C": "科技发展", "D": "经济基础", "E": "社会进步" }, "answer": "D", "reason": "道德是人们在社会生活实践中形成的,并由经济基础决定的,用善恶标准去评价,依靠社会舆论、内心信念和传统习俗为指导的,调节人与人、人与自然之间关系的行为原则和规范的总和。" }, { "question_num": 216, "query": "患者，男，34岁。肩背皮肤浅层肿块，与皮肤无粘连，瘤体表面中心有青黑色毛孔，挤压后有臭味的粉渣样内容物溢出，其诊断是", "options": { "A": "脂瘤", "B": "肉瘤", "C": "流痰", "D": "血瘤", "E": "筋瘤" }, "answer": "A", "reason": "脂瘤多见于头面部、臀部、背部等皮脂腺、汗腺丰富的部位,生长缓慢，一般无明显自觉症状。肿块呈圆形或椭圆形，边界清楚，与皮肤无粘连，表皮紧张，中央导管开口处呈青黑色小孔，挤压后可有粉渣样内容物溢出，有臭味。" }, { "question_num": 217, "query": "下列属于生命伦理学的基本原则是", "options": { "A": "不伤害原则", "B": "行善原则", "C": "公正原则", "D": "尊重原则", "E": "以上皆是" }, "answer": "E", "reason": "美国学者比彻姆和邱卓斯在《生物医学伦理学原则}》一书中提出“不伤害原则、行善原则、公正原则、尊重原则”,在国际上被普遍接受为生命伦理学的基本原则。" }, { "question_num": 218, "query": "患者每至经行期间，发热，恶寒，无汗，鼻塞流涕，咽喉痒痛，咳嗽痰稀，头痛身痛，舌淡红，苔薄白，脉浮紧。经血净后，诸证渐愈。治疗应首选的方剂是", "options": { "A": "桑菊饮", "B": "银翘散", "C": "荆穗四物汤", "D": "小柴胡汤", "E": "麻黄汤" }, "answer": "C", "reason": "经行感冒风寒证,治法:解表散寒，和血调经。方选:荆穗四物汤。" }, { "question_num": 219, "query": "患者、男、27岁。于3天前进食后受凉，腹泻不止、日行5~8次，水样便，微感腹痛，恶心，纳呆、小便短少，舌苔白厚腻，脉缓，其证候是", "options": { "A": "外感寒湿证", "B": "寒湿困脾证", "C": "寒湿犯胃证", "D": "脾阳虚证", "E": "胃阴虚证" }, "answer": "B", "reason": "本病以腹泻为主诉,考虑病位在脾或肠,胃病多以胃痛、痞满、呕吐等为主诉。脾阳虚多伴畏寒怕冷.四肢不温等阳虚表现;寒湿困脾多伴头身困重.呕恶纳采等湿困表现。" }, { "question_num": 220, "query": "患儿，女，3岁。发热日久不退，朝盛暮衰，虚烦不安，面色苍白，下肢清冷，小便清长，频数无度，大便稀溏，口渴多饮，舌质淡，苔薄黄，脉细数无力。治疗首选的方剂为", "options": { "A": "养阴清肺汤", "B": "温下清上汤", "C": "大补阴丸", "D": "增液汤", "E": "生脉散" }, "answer": "B", "reason": "夏季热之上盛下虚证，治法:温补肾阳，清心护阴。代表方:温下清上汤。" }, { "question_num": 221, "query": "患者，女，27岁。近日频繁出现尿急、尿频等症状，入院初步诊断为尿路感染，引起该病的病原体最常见的是", "options": { "A": "链球菌", "B": "变形杆菌", "C": "葡萄球菌", "D": "大肠埃希菌", "E": "副大肠杆菌" }, "answer": "D", "reason": "尿路感染最多见的病原体是大肠埃希菌,其次有副大肠杆菌、变形杆菌、克雷白杆菌.产气杆菌等。" }, { "question_num": 222, "query": "患者，男，65岁。有健忘病史多年，如今计算力、定向力明显减退，神情呆钝，词不达意，头晕耳鸣，腰酸骨软，舌瘦色淡，苔薄白，脉沉细弱，其治法是", "options": { "A": "填精补髓，育阴息风", "B": "豁痰开窍，健脾化浊", "C": "补肾健脾，益气生精", "D": "活血化瘀，开窍醒脑", "E": "以上均非" }, "answer": "A", "reason": "痴呆髓海不足证:智能减退，记忆力、计算力、定向力、判断力明显减退,神情呆钝,词不达意,头晕耳鸣,怠惰思卧,齿枯发焦，腰酸骨软、步履艰难、舌瘦色淡，苔薄白，脉沉细弱。治法:填精补髓，育阴息风。" }, { "question_num": 223, "query": "患者，男，56岁。既往有慢性阻塞性肺疾病病史，控制不佳，症状反复发作并加重，近期出现下肢水肿，检查可见颈静脉怒张、肝大。患者最可能的诊断是", "options": { "A": "慢性阻塞性肺疾病伴急性加重", "B": "慢性肺源性心脏病失代偿期", "C": "慢性阻塞性肺气肿", "D": "慢性肺源性心脏病代偿期", "E": "肺性脑病" }, "answer": "B", "reason": "患者有慢性阻塞性肺疾病病史，且反复发作伴加重,近期出现下肢水肿，检查可见颈静脉怒张、肝大;下肢水肿、颈静脉怒张、肝大均为右心功能宫竭的典型表现，故考虑为慢性肺源性心脏病失代偿期。" }, { "question_num": 224, "query": "患者，女，40岁。患者近1周来喘逆上气，息粗鼻扇，咳而不爽，痰吐稠黏，形寒身热，无汗，口渴，苔薄黄，舌质红，脉浮数。治疗应首选的方剂是", "options": { "A": "麻黄汤", "B": "小青龙汤", "C": "麻杏石甘汤", "D": "桑白皮汤", "E": "三子养亲汤" }, "answer": "C", "reason": "患者喘逆上气,息粗,痰吐稠黏，形寒身热，身病无汗辨证为实喘表肺热证，方选麻杏石甘汤加减。" }, { "question_num": 225, "query": "患者，女，43岁。既往有蛛网膜下腔出血病史，现行DSA检查，提示大脑中动脉瘤，考虑为出血病灶。患者想防止再出血，则应选择的最好方法是", "options": { "A": "应用止血药物", "B": "严格控制血压", "C": "手术干预", "D": "绝对卧床4～6周", "E": "控制情绪、避免剧烈运动" }, "answer": "C", "reason": "蛛网膜下腔出血的最常见原因为颅内动脉瘤或血管畸形,因此防止患者再出血最有效的方法是去除病因，即手术切除动脉瘤或血管畸形。严格控制血压、绝对卧床4~6周、保持大便通畅、控制情绪、避免剧烈运动,也是控制诱因、减少再出血发生的重要手段。" }, { "question_num": 226, "query": "患者，女，38岁。干咳少痰，咳声短促，痰中带血，五心烦热，时有盗汗，形体消瘦，胸部闷痛隐隐，舌红少苔，脉细数。治疗宜选用的方剂是", "options": { "A": "月华丸", "B": "参苓白术散", "C": "百合固金汤", "D": "秦艽鳖甲散", "E": "以上均非" }, "answer": "A", "reason": "肺痨肺阴亏损证,治法:滋阴润肺。代表方:月华丸加减。" }, { "question_num": 227, "query": "患者，女，30岁。无明显诱因反复鼻出血。检查：眼睑苍白，血红细胞、白细胞和血小板均减少。该患者诊断应首先考虑", "options": { "A": "再生障碍性贫血", "B": "缺铁性贫血", "C": "溶血性贫血", "D": "失血性贫血", "E": "巨幼红细胞性贫血" }, "answer": "A", "reason": "再生障碍性贫血患者的检查可见全血细胞(红细胞、白细胞和血小板)均减少。" }, { "question_num": 228, "query": "患者，女，32岁。大便秘结不通，排便艰难，伴腹胀痛，身热，口干口臭，喜冷饮，舌红，苔黄，脉滑数。治疗应选取的配穴是", "options": { "A": "中脘、太冲", "B": "足三里、三阴交", "C": "神阙、关元", "D": "合谷、曲池", "E": "气海、脾俞" }, "answer": "D", "reason": "便秘处方,主穴:天枢、大肠俞、上巨虚、支沟。配穴:热秘配合谷、曲池;气秘配太冲、中脘;冷秘配神阙、关元;虚秘配足三里、脾俞、气海，兼阴伤津亏者加照海、太溪。" }, { "question_num": 229, "query": "患者，男，65岁。血压210/100mmHg，伴心力衰竭，心率110次/分。首选的治疗药物是", "options": { "A": "卡托普利", "B": "美托洛尔", "C": "氢氯噻嗪", "D": "硝苯地平", "E": "哌唑嗪" }, "answer": "A", "reason": "卡托普刊属于血管紧张素转换酶抑制剂,尤其适用于伴有心力衰竭、心肌梗死、糖耐量异常或在糖尿病肾病的高血压患者，" }, { "question_num": 230, "query": "患者，女，52岁。头晕头痛，心悸耳鸣，失眠多梦，急躁易怒，脉细弦。治疗应首选的腧穴是", "options": { "A": "百会、脾俞、气海、足三里", "B": "风池、百会、太冲、行间、侠溪", "C": "头维、中脘、内关、丰隆、解溪", "D": "脾俞、胃俞、合谷、足三里", "E": "四神聪、印堂、太阳、外关" }, "answer": "B", "reason": "根据该患者表现可诊断为眩晕实证肝阳上亢证。治疗处方主穴:风池、百会、内关、太冲。肝阳上亢配行间、侠溪、太溪。" }, { "question_num": 231, "query": "患者，男，45岁。1个月前畏寒、腹痛、腹泻，大便带脓血，每天10次左右，伴里急后重，诊断为菌痢，服用甲𫫇唑、黄连素，1周后好转，近1周来又腹泻、腹痛，大便每天10余次，大便常规：RBC+/HP，WBC+++/HP，PC+/HP，吞噬细胞3~4/HP，既往无腹泻史。应诊断为", "options": { "A": "慢性菌痢迁延型", "B": "慢性菌痢隐匿型", "C": "慢性菌痢急性发作", "D": "急性菌痢典型", "E": "急性菌痢轻型" }, "answer": "E", "reason": "慢性菌痢须病程在2月以上,患者病程1个月,主诉无明显全身症状,故为急性菌痢轻型。" }, { "question_num": 232, "query": "患儿、男、4岁。因畏寒、发热1天，精神萎靡6小时入院。查体：体温40℃，脉搏126次/分、血压68/45mmHg，浅昏迷，面色苍白，全身可见瘀斑、瘀点，腌孔等大，颈软，克氏征(-)、布氏征(-)、病理征(-)，血常规WBC20×10^9/L，N0.90，L0.10。对本病例有较大意义的快速确诊实验室检查是", "options": { "A": "皮肤瘀斑、瘀点涂片找细菌", "B": "脑脊液常规和生化检查", "C": "血培养", "D": "脑脊液培养", "E": "头部CT检查" }, "answer": "A", "reason": "患者考虑为流行性脑脊髓膜炎,瘀点或脑脊液涂片寻找病原体是早期确诊的重要方法,脑脊液检查早期可不典型。" }, { "question_num": 233, "query": "患者，男，50岁。突然意识不清1小时。头颅CT显示右侧大脑半球3cm×4cm×5cm高密度影。最可能的诊断是()", "options": { "A": "昏厥", "B": "脑出血", "C": "脑栓塞", "D": "脑血栓形成", "E": "高血压脑病" }, "answer": "B", "reason": "CT高密度影提示出血性脑血管疾病,故考虑为脑出血。" }, { "question_num": 234, "query": "患者，女，59岁。反复上腹部饭后痛10年，每次约持续1～2小时。近半年疼痛加剧，食欲减退，体重减轻。检查：贫血貌，左锁骨上触及肿大淋巴结，红细胞沉降率47mm/h，大便隐血试验持续阳性。该患者诊断应首先考虑是", "options": { "A": "胃溃疡", "B": "十二指肠溃疡发作", "C": "胃溃疡伴幽门梗阻", "D": "复合性溃疡病", "E": "胃癌" }, "answer": "E", "reason": "患者节律性饭后腹痛,提示为胃溃疡,而近期的疼痛突然加剧,食欲减退,体重减轻均提示癌变,检查中又见贫血貌和肿大的淋巴结,提示胃癌可能已发生转移，故诊断为胃癌。" }, { "question_num": 235, "query": "患者，女，26岁。尿痛、尿频、尿急3天。检查：肾区无叩击痛，尿中白细胞(++)，中段尿细菌培养为大肠埃希菌，其诊断是", "options": { "A": "急性肾盂肾炎", "B": "肾结核", "C": "膀胱炎", "D": "肾结石", "E": "慢性肾盂肾炎，" }, "answer": "C", "reason": "患者有典型膀胱刺激征，且尿中白细胞和细菌均提示尿路感染,无肾区叩击痛提示为膀胱炎。" }, { "question_num": 236, "query": "患者，男，32岁。近2年来餐后3～4小时反复上腹痛，持续至下次进餐后才缓解。应首先考虑的诊断是", "options": { "A": "消化性溃疡", "B": "慢性胃炎", "C": "胃癌", "D": "胃肠神经官能症", "E": "胆囊炎" }, "answer": "A", "reason": "十二指肠溃疡疼常于饭后2～4小时发作,持续至下次进食后才缓解，其规律为进食一一舒适一一疼痛,常在夜间痛醒。餐后痛可能由于胃部肿瘤所致,但胃部肿瘤患者一般年龄较大;胆囊炎或胆石症发作前常有进油腻食物史。" }, { "question_num": 237, "query": "患者，男，34岁。注射青霉素后突发意识丧失，查体，心率122次/分，血压80/50mmHg。已静脉注射肾上腺素。进一步治疗应选择的措施是", "options": { "A": "高压氧舱", "B": "增强心肌收缩力", "C": "纠正酸碱失衡", "D": "应用血管活性药物", "E": "迅速补充血容量" }, "answer": "E", "reason": "休克的本质为有效循环血容量的不足,故首选补充血容量。待病情稳定后,再针对病因进行其他治疗。" }, { "question_num": 238, "query": "患者，男，60岁。因急性一氧化碳中毒急诊入院。查体：浅昏迷状态，呼吸节律整齐，血压110/70mmHg，为了加快一氧化碳排出，应采用的最有效的治疗方法是", "options": { "A": "高压氧舱治疗", "B": "持续低流量吸氧", "C": "静脉滴注能量合剂", "D": "使用呼吸机", "E": "注射呼吸兴奋剂" }, "answer": "A", "reason": "高压氧舱治疗可增加血液中溶解氧,提高动脉血氧分压,促进氧气向组织弥散,从而迅速纠正缺氧,为最有效的治疗方法。" }, { "question_num": 239, "query": "患者突发呼吸困难，吸气时胸骨上窝、锁骨上窝和肋间隙明显凹陷，临床诊断可能为", "options": { "A": "左心功能不全", "B": "右心功能不全", "C": "肺气肿", "D": "气管异物", "E": "大块肺梗死" }, "answer": "D", "reason": "患者突发呼吸困难,并表现出三凹征,为典型的吸气性呼吸困难,主要由于喉、气管.大支气管的炎症、水肿、肿瘤或异物等引起狭窄或梗阻所致。" }, { "question_num": 240, "query": "患者，女，62岁。反复咳嗽咯痰10年，气短3年，受凉后加重，心悸，查体：T38.3℃，P105次/分，R24次/分，神清，口唇发绀，桶状胸，P2>A2，HR104次/分，肝肋下1cm，双下肢可凹性水肿，最关键的治疗措施是", "options": { "A": "保持呼吸道通畅", "B": "控制感染", "C": "应用利尿剂", "D": "应用强心剂", "E": "抗凝" }, "answer": "B", "reason": "患者有慢性咳嗽咳痰病史，现气短,肺气肿体征以及低氧血症、右心衰体征，属于慢性肺心病失代偿期,多由急性呼吸道感染所诱发,而呼吸道感染是发生呼吸衰竭和心力衰竭的最常见诱因,故需积极应用药物予以控制。" }, { "question_num": 241, "query": "患者，男，30岁。因气急伴呼气性呼吸困难1日入院。查体：气管居中，两侧胸部饱满，呼吸动度减弱，两肺叩诊过清音，呼气时间延长，可闻及哮鸣音，首先考虑的诊断是", "options": { "A": "支气管哮喘", "B": "胸腔积液", "C": "肺炎链球菌肺炎", "D": "自发性气胸", "E": "肺不张" }, "answer": "A", "reason": "支气管哮喘的诊断:①反复发作的喘息、气急、胸闷或咳嗽;②发作时在双肺可闻及散在或弥漫性、以呼气相为主的哮鸣音,呼气相延长。" }, { "question_num": 242, "query": "患者尿频、尿急、尿痛，并见肉眼血尿，舌质红，舌苔薄黄，脉弦数。治疗应首选的药物是", "options": { "A": "车前子", "B": "泽泻", "C": "石韦", "D": "木通", "E": "金钱草" }, "answer": "C", "reason": "石韦:利尿通淋,清肺止咳,凉血止血。用于淋证,肺热咳嗽,血热出血。" }, { "question_num": 243, "query": "患者腹部膨隆呈球形，转动体位时形状改变不明显。应首先考虑的诊断是", "options": { "A": "肝硬化", "B": "右心功能不全", "C": "缩窄性心包炎", "D": "肾病综合征", "E": "肠麻痹" }, "answer": "E", "reason": "肠麻痹患者腹部大量积气呈球形,两侧腰部膨出不明显,转动体位时其形状无明显改变。肝硬化、右心功能不全、缩窄性心包炎、肾病综合征患者表现为腹水,腹部膨隆随体位改变。" }, { "question_num": 244, "query": "患者，女，69岁。慢性支气管炎及高血压病史15年，近半年活动后自觉气短。检查：血压160/95mmHg，心脏听诊未闻及器质性杂音，两肺听诊无异常，心电图及X线显示左心室增大。应首先考虑的诊断是", "options": { "A": "冠心病", "B": "高血压性心脏病", "C": "风心病", "D": "肺心病", "E": "病毒性心肌炎" }, "answer": "B", "reason": "患者有长期高血压病史，左心室增大,为长期后负荷增加所致。此患者亦有长期慢性支气管炎史，但肺心病常导致右心室肥大、右心衰。" }, { "question_num": 245, "query": "患者，女，32岁。乏力纳差半年，恶心呕吐3日，高血压10年，BP180/100mmHg，Hb58g/L，血尿素氮26.5mmol/L，肌酐936μmol/L，血磷2.72mmol/L，CO2结合力13.2mmol/L。纠正贫血首选", "options": { "A": "口服铁剂", "B": "口服叶酸", "C": "注射铁剂", "D": "皮下注射促红细胞生成素", "E": "口服泼尼松" }, "answer": "D", "reason": "诊断为慢性肾衰竭，纠正贫血首选促红细胞生成素。" } ]