220_5372533_2014年医师定期考核试题及答案(全科B卷试题).doc

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2014年北京市医师定期考核业务水平测评（全科医师专业试卷-b卷）单位：_ 姓名：_ 性别：_身份证号：_ 分数：a1型题：每道试题由1个题干和5个供选择的备选答案组成 每题1分，请将正确答案填写在答题卡上1.诊断肺炎球菌性肺炎哪一项症状价值最大 ( )a.寒战 b.持续高热 c.咳嗽呼吸困难 d.胸痛 e.咯铁锈色痰2.支气管哮喘发作期禁用( )a.麻黄素b.肾上腺素c.吗啡d.氨茶碱e.舒喘灵3.关于肺炎球菌性肺炎，下列哪项是正确的( )a.大多数发生于老年人、慢性阻塞性肺部疾病、营养不良、全身衰弱的病人b.有突发寒战，发热，咳嗽，胸痛，肺部疾病、营养不良、全身衰弱的病人c.血白细胞计数及淋巴细胞均明显增多d.x线胸片有大征密度不均匀的阴影，常有空洞形成e.常因分泌物堵塞支气管导致肺叶或肺段的不张4.诊断早期肺炎球菌性肺炎下列哪一项最有价值( )a.白细胞总数及中性粒细胞均增高b.痰培养肺炎球菌阳性c.肺实变体征d.x线见大片状阴影呈肺叶或肺段分布e.肺部湿罗音5.普通型肺炎球菌性肺炎的治疗，最主要的是( )a.卧床休息补液b.鼻导管给氧c.退热止痛d.祛痰止咳e.选用敏感抗生素6.慢性阻塞性肺疾病健康管理的康复锻炼，哪项是错误的( )a.止咳化痰b.胸式呼吸c.腹式呼吸d.根据患者的体力状况，选择扩胸、步行、骑车等运动e.缩唇呼吸7.肺癌增大引起支气管狭窄时，可出现阻塞性咳嗽，其特征是( )a.刺激性干咳，痰多b.持续性、高调金属音样咳嗽c.间歇性咳嗽伴脓性痰d.夜间阵发性咳嗽伴脓性痰e.间歇性低调鼾音样咳嗽8.慢性阻塞性肺气肿分两型, 下列哪项符合紫肿型( )a.多见于老年b.红细胞压积为3545%c.右心衰竭发生较晚d.肺内湿罗音稀少e.心排出量多接近正常9.诊断早期肺心病的主要依据是( )a.长期肺及支气管病史b.发绀c.两肺干湿罗音及肺气肿体征d.肺动脉高压及右心室增大征象e.高碳酸血症10.初诊病人，胸透发现右下肺炎性改变，为排除肺癌，首先用哪种方法检查( )a.支气管镜检查b.支气管造影检查c. x线肺断层片d.剖胸肺活检e.痰脱落细胞检查11.肺炎的转诊指征：( )a.患者体温38b.心率100次/分c.经抗炎治疗48小时症状无改善d.当患者出现重症肺炎e. 经抗炎治疗24小时症状无改善12.哪种肺炎最易并发肺脓肿( )a.肺炎球菌性肺炎b.支原体肺炎c.葡萄球菌性肺炎d.克雷白杆菌肺炎e.病毒性肺炎13.高血压定义为：( )a.凡高于正常均为高血压b.收缩压130mmhg，舒张压80mmhgc.收缩压120mmhg，舒张压90mmhgd.收缩压140mmhg和（或）舒张压90mmhge.收缩压130mmhg和（或）舒张压90mmhg14.哪项不是影响高血压患者分层的重要因素：( )a.腹型肥胖b.男性65岁，女性55岁c.伴有糖尿病d.伴有心脏疾病e.吸烟15.关于心肌梗死的下列哪种说法正确？( ) a.是心肌缺血性坏死，为在冠状动脉病变 的基础上，发生冠状动脉血供急剧减少或中断，使相应的心肌严重而持久地急性缺血导致心肌坏死。b.持续病毒感染是其重要原因。c.是心肌的自身的炎症病变。d.与遗传因素有关。e.查体时可闻及心脏杂音。16. 急性心梗时缓解疼痛宜用：( )a.休息和吸氧b.硝酸甘油c.消心痛 d.吗啡 e.以上都不是17.患者男性45岁, 冠心病五年, 稍活动即心悸、气短, 因而体力活动明显受限, 可诊为: ( )a.心功能级b.心功能级c.心功能级d.心功能级e.心功能级伴老年性肺气肿18.对诊断慢性左心衰最有价值的表现是( )a.肺动脉瓣区第二心音亢进b.睡眠中出现阵发性呼吸困难c.咳嗽d.左房增大e.肺动脉段突出19.高血压患者发生心力衰竭的最早症状是( )a.咳嗽、咳痰b.夜间心绞痛c.咯血d.下肢水肿及肝肿大e.劳力性呼吸困难20.诊断右心衰时, 最可靠的体征是( )a.颈静脉怒张, 肝颈静脉回流征阳性b.肝肿大c.下肢浮肿d.腹水e.胸水21.女性, 60岁, 冠心病患者, 重度体力活动时, 有心悸、气短, 可诊为( )a.心功能级b.心功能级c.心功能级d.心功能级e.以上都不是22.用刺激迷走神经的方法可以纠正的心律 失常是( )a.窦性心律不齐b.房颤c.房扑d.阵发性室上性心动过速e.室性心动过速23.急性心肌梗死发生心律失常的处理, 下列哪组不正确( )a.室性早搏利多卡因b.室颤非同步直流电除颤c.室速洋地黄d.窦性心动过缓阿托品e.房室传导阻滞安装心脏起搏器24.诊断室速最有力的心电图证据是( )a.心率140200次/分b.r-rp-p(房室分离)c.qrs波群增宽0.12d.出现心室夺获或室性融合波e.节律整齐或轻度不齐25.下列哪项符合典型心绞痛( )a.呼吸困难伴典型心电图t波改变b.劳累后心尖部针刺样疼痛c.劳力时历时数分钟胸骨后压榨感d.心前区痛含硝酸甘油5分钟后缓解e.胸痛伴心电图胸导联st段抬高而无衍变26.急性心肌梗死最早期的心电图改变是( )a.st段明显抬高, 呈弓背向上的单向曲线b.出现异常q波和st段抬高c.出现异常q波, st段抬高或t波倒置d.t波高耸e.以r波为主的导联st段呈水平型下降27.急性心肌梗死时, 下列哪种酶最先恢复正常( )a.sgotb.ldhc.一羟丁酸脱氢酶d.sgpte.cpk28.关于慢性萎缩性胃炎，以下哪项正确( )a.b型胃炎常与多种自身免疫性疾病相并发b.b型胃炎常可检出血清抗壁细胞抗体c.b型胃炎不易发生胃癌或消化不良症状d.b型胃炎血清胃泌素正常e.b型胃炎常可合并恶性贫血29.慢性萎缩性胃炎通常不宜选用下述哪一种药物( )a.甲硝唑b.呋喃唑酮c.胶体铋剂d.吗丁啉e.奥美拉唑