中南大学医学影像学考试真题.(1).doc

中南大学考试试卷20062007学年 二学期 2004级五年制临床专业 课程 时间120分钟姓名: 学号:题 号一二三四合 计得 分评卷人合分人复查人登分人一.名词解释(please answer in English)(20分)1.Artificial contrast:2. Destruction of bone:3.Air bronchogram sign:4. Double contour :5. Stirlin sign:二简答题(please answer in English)(20分)1. How to distinuish benign ulcer from maligan ulcer In the stomach？2. Please writte down the differentiate between benign and malignant pulmonary tumor三阅片(48分)1. 25岁男性,高热,咳嗽,痰为铁锈色 What is the diagnosis?2. 男,40岁,腰痛十余年。WhatWhat is the diagnosis?3. 男，8岁,一月前麻疹后，一直咳嗽，低烧。体查：颈内淋巴结肿大。 What is the diagnosis?4 56岁男性,咳嗽,痰中带血3月. What is the diagnosis?5 反复上腹部痛3月,以夜间痛明显.What is the diagnosis?6 腹痛,肛门停止排气排便1天.What is the diagnosis? 7 右腰痛半年,加重1天.体查:右肾区扣痛.What is the diagnosis? 8 右碗外伤,活动受限. What is the diagnosis?9 60岁男性,突发晕厥,意识障碍.What is the diagnosis? 10 头颅外伤半小时. What is the diagnosis?11 女，47岁病史：咳嗽、胸闷20天 .What is the diagnosis? 12 男,81岁,高血压病史十年余，现感心悸、气促。What is the diagnosis?四.病例分析题(please answer in English)(12分)1. A 76-year-old man presents to the emergency department with sudden-onset abdominal pain of 4 hours duration. The pain is present in the upper abdomen, centered in the epigastrium, and described as deep and burning. The patient has a medical history of coronary artery disease and hypertension. He also reports having indigestion, which caused pain similar to todays episode in his upper abdomen. In the past, food did not relieve this symptom.On physical examination, the patient is pale and in obvious discomfort. His heart rate is 122 beats per minute, and his blood pressure is 110/65 mm Hg. Cardiovascular and respiratory findings are unremarkable, but he has tenderness in the epigastric region of his abdomen. His stool is brown and guaiac positive. Hyperactive bowel sounds are heard on auscultation. Laboratory investigations show a mild anemia with hemoglobin concentration of 127 g/L (12.7 g/dL) and BUN and creatinine values of 17.1 mmol/L (48 mg/dL) and 106 mol/L (1.2 mg/dL), respectively.What is the diagnosis?2. A 29-year-old, previously healthy white female was seen 3 times by her primary care provider for upper respiratory symptoms 2 weeks after competing in an outdoor obstacle course that involved crawling on the dirt in the California San Joaquin Valley. The patient denies any recent sick contacts or travel outside of the local area. She was given 3 separate courses of antibiotics, over the course of 6-8 weeks, for the diagnosis of community-acquired pneumonia without improvement. Eventually, she presented to the urgent care clinic with worsening cough, production of malodorous sputum, anorexia, fevers, chills, sweats, nausea, vomiting, and malaise. She has lost 20 lbs since the onset of symptoms.On physical examination, the patient is mildly ill-appearing with a temperature of 102.4F, a heart rate of 106 beats per minute, a respiratory rate of 22 breaths per minute, a blood pressure of 118/64 mm Hg, and an oxygen saturation of 95% on room air. Lung auscultation revealed coarse rhonchi in the left upper lung field. Her heart rate is rapid, but no murmurs are appreciated. The remainder of her physical examination is unremarkable.Laboratory tests performed in urgent care showed a mild leukocytosis of 13.4 WBC count with otherwise normal results. Chest radiograph shows a 4.2-cm diameter cavitary lesion with an air fluid level in the left upper lobe, along with mediastinal lymphadenopathy (see Images 1-2).What is the diagnosis? 答案一. 名词解释(20分)1.Artificial contrast: Those organs or spaces lack of natural contrast, can be renderde to be visible by means of contrast agents to create an artificial contrast. 2.Destruction of bone: Bone tissue elimination caused by sclerotin partly substituted with pathologic organism.Roentgenologically,it shows osteolytic bone areas of decreased density and loss of bone structures.3.Air bronchogram sign: Because the air in the alveoli is replaced by exudates, while the air in the bronchus is not displaced and remain patent.This produces contrast between the air in the bronchial tree and the surrounding airless parenchyma.4.Double contour ：On PA film ,the right border of an enlarged left atrium may produce an extra shadow superimposed on the right cardiac border,giving a double contour.5.Stirlin sign： There is a lack of barium retention in a diseased segment of ileum and caecum but with a column of barium remains on either side of the affected area. This phemonenon may result from spasm,organic constracture of a combination of both.It is suggestive of tuberculosis of intestine. 二简答题(20分)1.Benign gastric ulcerMalignant gastric ulcerLocation Penetration beyond lumen Intraluminal craterShape Round,sharply circumscribed crater Irregular shaped ulcer Mucosal Membrance Mucosal folds radiate to crater edge,Edematous tissue surrounding an ulcer produce ulcer mound or collar Amputation of mucosal folds nodularity of surrounding mucosal Gastric wall pliable,presence of peistalsis Rigidity of wall 2.Benign tumorMalignant tumorShapeGlobularIrregularityPeplos or notYesNoMarginSharp、smooth and glossyNo sharp, short and fine sentus,sublobe or hilum notchNeoplasm necrosisNoYes，part may form cavityGrowthSlowly,no periphery infiltratingFast ，infiltrative growthContrast CT scanning Light or no potentializeObviously otentialize，CT value added more than 20HU。三阅片(48分)1. Right middle lobe lobar pneumonia2.Tuberculosis of the 3、4lumbar veterbra3.Primary complex tuberculosis4.Right upper lobe central carcino