医学复习资料：八年制总论外科普外题

1、02级八年制总论外科普外题题型:单选1.结肠造瘘术后患者行瘘口关闭手术，手术区皮肤消毒涂擦消毒剂的顺序是A.由手术区中心部向四周涂擦B.由手术区外周涂向瘘口周围C.由手术区的上方涂向下方D.由手术区的一侧涂向另一侧E.无需按一定顺序答案:B难度:12.经高压蒸气灭菌的物品一般可保留A.5天B.7天C.10天D.14天E.21天答案:D难度:13.穿好无菌衣和戴好无菌手套后，下列哪个范围是“无菌地带”A.肩.上肢.胸及腰的前面B.上肢.胸及腹的前面C.肩.上肢.腰部以上的前胸D.肩.上肢.腰部以上的前胸和侧面E.上肢.腰部以上的前胸和侧胸答案:E难度:14.下列无菌操作中，哪项是错误的A.手术者

2、的上肢前臂一旦触及有菌物后，应更换手套B.手套发现破损时应即更换C.无菌手术单湿透时，应加盖无菌单D.禁止越过头部或术者背后传递无菌器械物品E.坠落在手术台边以下的器械物品不准再用答案:A难度:15.高压蒸汽15-20磅/平方英尺，欲杀灭带芽胞细菌，需A.10分钟B.15分钟C.20分钟D.25分钟E.30分钟答案:E难度:16.关于术前准备下列哪项不对A.营养不良病人，术前尽可能给予补充，最好能达到氮正平衡B.血压过高时，术前应使用降血压药物待血压正常后再行手术C.水电解质失调病人术前需纠正D.贫血病人术前应少量多次输血矫正E.对偶发的室性期外收缩，一般不需特别处理答案:B难度:17.评价外

3、科病人的营养状态，最简单而实用的指标是A.近期体重下降程度和三头肌皮皱厚皮B.血清转铁蛋白和视黄醇结合蛋白E.握力和三头肌皮皱厚皮D.近期体重下降程度和血浆白蛋白水平E.氮平衡试验答案:D难度:18.下列有关肠内营养的论证，哪项是不正确的A.肠内营养途径优于肠外营养，因此只要肠道有功能就应行肠内营养B.肠内营养不会发生高血糖高渗性非酮症昏迷C.匀浆膳（一般膳食的匀浆化）渗透压较低较少发生胃肠道及代谢合并症D.要素饮食因渗透压较高，较多发生胃肠道和代谢合并症E.肠内营养防止肠粘膜萎缩和维护胃肠道粘膜的防御系统答案:B难度:19.长期全胃肠外营养最严重的与代谢有关的并发症是A.高血糖B.高氯性代谢

4、性酸中毒C.高渗性非酮性昏迷D.肝脏毒性E.高血压答案:C难度:110.应用要素饮食的主要合并症是腹泻.腹胀.恶心和呕吐，发生这些合并症后，首先应该采取的措施是A.停止TEN,改为TPNB.应用止泻药和抑制肠蠕动药物C.减慢输入速度或减低输入浓度D.胃肠减压E.加温要素饮食至40答案:C难度:111.对没有严重应激的营养不良病人，给予营养支持时，每天每千克体重应给予热量A.1015KcalB.1520KcalC.2025KcalD.2530KcalE.3035Kcal答案:D难度:112.等渗性缺水的主要病理基础是A.细胞外液浓缩B.细胞外液低渗C.细胞外液容量骤减D.细胞内液容量骤减E.细胞

5、内液低渗答案:C难度:113.高渗性缺水早期主要临床表现是口渴，同时还有A.狂燥B.昏迷C.幻觉D.血压下降E.以上都不是答案:E难度:114.下列低钾血症的临床表现中，哪项是错误的A.肌肉软弱无力，甚至四肢软瘫B.腹胀.肠麻痹C.心悸.心率快，甚至心律失常D.尿量明显减少或无尿E.神志淡漠，疲乏答案:D难度:115.浴室内发现一病人人事不醒，动脉血气分析报告为：pH7.16，PO260mmHg，PCO270mmHg，HCO327mEq/L，下列那项最符合病人情况A.严重的低氧血症B.代偿性代谢性酸中毒C.不全代偿性代谢性酸中毒D.代偿性呼吸性酸中毒E.不全代偿性呼吸性酸中毒答案:E难度:11

6、6.低渗性缺水引起体液容量的变化为A.血浆.组织间液.细胞内液都减少，以血浆减少为主B.血浆.组织间液.细胞内液都减少，以组织间液减少为主；C.血浆.组织间液，细胞内液都减少，以细胞内液减少为主D.只有组织间液减少；E.主要表现为血液浓缩答案:D难度:117.下列关于排斥反应的说法正确的是A.超急性排斥反应是一种细胞介导的免疫反应B.急性排斥反应是由于ABO血型不合.体内有预存抗体存在导致C.急性排斥反应在组织学上主要表现为小淋巴细胞和单核细胞浸润D.急性排斥反应通常发生在移植术后1个月内，免疫抑制剂治疗无效E.慢性排斥反应通常发生在移植术后1个月内，免疫抑制剂治疗有效答案:C难度:118.消

7、化道恶性肿瘤血行转移最早受累的是A.肺B.肾C.肝D.骨E.脑答案:C难度:119.关于清创缝合错误的是A.清除伤口污物和异物，切除失去活力的组织B.清创术最好在伤后6-8小时以内施行C.面部头颈部的伤口超过14小时，清创后应尽可能缝合D.关节.大血管或神经暴露的伤口，清创后不缝合E.污染严重的伤口，清创后不缝合答案:D难度:120.下列哪项不是影响创伤修复的因素A.低蛋白血症B.维生素C缺乏C.铁.铜.锌等微量元素缺乏D.使用皮质激素E.贫血答案:E难度:121.脓性指头尖切开引流的切口应在A.波动最明显处B.患指的掌面C.患指的侧面纵形切口D.鱼口状切口E.患指掌面横切口答案:C难度:12

8、2.抢救重症创伤患者，必须优先处理的是A.抗休克B.止血C.固定骨折D.窒息E.输血输液答案:C难度:123.腹腔脓肿的定位最准确的方法是A.腹平片B.腹部超声检查C.腹部CT检查D.上消化道造影E.静脉肾盂造影答案:C难度:124.破伤风最早出现强烈收缩的肌肉是A.颈项肌B.面肌C.嚼肌D.背肌E.腹肌答案:C难度:125.甲沟炎与脓性指头炎的主要区别是A.指头炎的首选治疗是药物B.甲沟炎涉及指甲C.指头炎有发展为脓肿的趋向D.指头炎可扩散只滑膜间隙E.甲沟炎可发展为侵入性脓毒症答案:B难度:126.关于外科感染分类的叙述哪项是错误的A.丹毒.急性阑尾炎.急性乳腺炎等均属特异性感染B.急性感

9、染指病程在3周以内C.条件性感染指平常为非致病的病原菌乘机体抵抗力下降时乘机而入所引起的感染D.院内感染的主要致病菌为条件致病菌E.病程超过2个月者为慢性感染答案:A难度:127.革兰氏阴性杆菌败血症发热特点是A.有寒战，发热呈间歇热B.有寒战.发热呈稽留热C.无寒战，发热呈间歇热D.无寒战，发热呈稽留热E.无寒战，发热呈弛张热答案:A难度:128.下列肿瘤的主要特点中，哪项是错误的A.不按正常器官的规律生长B.丧失正常细胞的功能C.破坏原来器官结构D.最终将发生转移E.细胞过度增殖答案:D难度:129.根据我国情况,成人头面颈部占人体体表总面积的A.9%B.10%C.15%D.5%E.3%答

10、案:A难度:130.小儿体表面积计算与成人的不同点在于A.头大，躯干小，B.头大，四肢小，躯干相似 C.头大，四肢.躯干相似 D.头大，躯干大，四肢相似 E.头大，下肢小，躯干相似答案:E难度:131.深度烧伤局部损伤的深度达A.真皮浅层，部分生发层健在B.表皮层，生发层健在C.真皮深层，有皮肤附件残留D.脂肪层E.脂肪下层答案:C难度:132.深度烧伤通常愈合时间为A.2-3dB.1周C.2周D.3-4周E.5周以上答案:D难度:133.术后病人呻吟并在床上翻转可能是由于A.伤口有血肿B.缺氧C.脑损害D.缝合过深E.伤口感染答案:B难度:134.一个60kg体重的成人，烧伤面积为60，伤后

11、第一个24小时所需补充液体量为A.2000mlB.3700mlC.3000mlD.3400mlE.7400ml答案:E难度:135.78岁男性患者，胆囊切除术后第二天自觉憋气，痰多.发烧.腹痛，查心率100次/分。心电图无特殊发现，白细胞计数为7000/mm3，最可能的诊断是什么A.心肌梗阻B.肺部感染C.胸腔积液D.胆瘘E.心力衰竭答案:B难度:136.休克时最能反应组织细胞是否缺氧，缺氧程度，休克是否好转与恶化的主要实验室检查是A.动脉血CO2结合力B.动脉血PH值C.动脉血乳酸含量D.血清钾离子浓度E.血清乳酸脱氢酶含量答案:C难度:137.判断休克患者微循环效能较可靠的依据是A.血压B

12、.脉搏C.呼吸D.神志E.尿量答案:E难度:138.失液性休克补充血容量首选的液体是A.全血B.10%葡萄糖溶液C.50%葡萄糖溶液D.复方氨基酸E.复方氯化钠答案:E难度:139.急性出血而致病人明显休克时，提示失血已达总血容量的A.10%B.1020%C.2040%D.40%E.以上都不对答案:C难度:140.发生感染性休克的主要原因是A.低血容量B.对细菌的过敏C.细菌的内毒素D.感染组织的炎性产物E.心功能失代偿答案:C难度:141.Five days after an uneventful cholecystectomy, an a symptomatic middle-aged w

13、omen is found to have a serum sodium level of 120 Meq/L.Proper management would beA.Administration of hypertonic saline solutionB.Restriction of free waterC.Plasma ultrafiltrationD.HemodialysisE.Aggressive diuresis with furosemide答案:B难度:142.Which of the following is an appropriate definition of the

14、shock state?A.Low blood pressure B.Low cardiac outputC.Low circulating volumesD.Inadequate tissue perfusionE.Abnormal vascular resistance答案:D难度:143.In cases of hemorrhagic shock, what initial alteration in blood pressure is seen?A.An increase in the systolic pressureB.A decrease in the systolic pres

15、sureC.An increase in the diastolic pressureD.A decrease in the diastolic pressureE.A decrease in the both systolic and diastolic pressure答案:C难度:144.The response to shock includes which of the following metabolic effectsA.Increase in sodium and water excretionB.Increase in renal perfusionC.Decrease i

16、n cortisol levelsD.HyperkalemiaE.Hypoglycemia答案:D难度:145.Which of the following is appropriate times to begin the administration of prophylactic antibiotic therapy for abdominal surgery?A.Two days before the operationB.Immediately before the operationC.As the incision is being closedD.After closure o

17、f the abdomenE.Two days after the operation答案:D难度:146.With regard to the systemic inflammatory response syndrome, which of the following statements is not true?A.Invariably associated with infectionB.Body temperature above 38 or under 36C.Tachypnea (20 breaths/minute) or hyperventilation (PaCO212x10

18、9/L) or leucopoenia (4x109/L)E.Heart rate greater than 90 beats/minute答案:A难度:147.Five days after a sigmoid colectomy for cancer, a patients skin staples are removed and a large gush of serosanguineous fluid emerges.Examination of the wound reveals an extensive fascial dehiscence.The most appropriate

19、 management isA.Wide opening of the wound to assure adequate drainage B.Smear and culture of the fluid and appropriate antibiotics after the smear is reviewedC.Careful reapproximation of the wound edges with tape D.Immediate return to the operating roomE.Application of a Scultetus binder答案:D难度:148.W

20、hich is the major barrier to successful transplantation across animal species（xenotransplantation）？A.Acute rejectionB.Chronic rejectionC.Hyperacute rejectionD.InfectionE.ABO incompatibility答案:C难度:149.Which of the following is absolute contraindications to orthotopic liver transplantation?A.History o

21、f alcohol abuseB.Age greater than 60 yearsC.Portal vein thrombosisD.HIV-positiveE.Chronic hepatitis C infection答案:D难度:150.Which of the following chemotherapy agents causes hemorrhagic cystitis?A.BleomycinB.5-fluorouracilC.CisplatinD.VincristineE.Cyclophosphamide答案:E难度:151.Which of the following fact

22、ors is not important in determining the likelihood of the development of a clinical infection and the severity of the infection?A.Size of bacterial inoculumB.Bacterial virulenceC.Bacterial capacity to invade tissueD.Bacterial capacity to produce toxinE.None of above答案:E难度:152.Which one of the follow

23、ing cases is considered a clean-contaminated wound?A.Open cholecystectomy for cholelithiasisB.Herniorrhaphy with mesh repairC.Lumpectomy with axillary node dissectionD.Appendectomy with walled-off abscessE.Gunshot wound to the abdomen with injuries to the small bowel and sigmoid colon答案:A难度:153.Acro

24、ss-match for transplantation is performed by incubatingA.Donor serum with recipient lymphocytes and complementB.Donor lymphocytes with recipient serum and complementC.Donor lymphocytes with recipient lymphocytesD.Recipient serum with Donor red blood cell and complementE.Recipient serum with a known

25、panel of multiple donor lymphocytes答案:B难度:154.With regard to the “smoke inhalation syndrome”, which of the following statements is true?A.A normal carboxyhemoglubin count on admission precludes the diagnosisB.The presence of carbonaceous sputum mandates hospital admissionC.Manifestations are always

26、present within the first 24 hours after exposureD.Xenon scanning is easy to perform and can confirm the diagnosisE.Specific treatment includes the administration of humidified air, oxygen, and steroids答案:B难度:155.A 72-year-old man with a 50-year history of cigarette smoking presents with a non-tender

27、，hard mass in the lateral neck.The simplest way to establish an accurate histological diagnosis of a neck mass suspected to be cancerous isA.Fine needle aspiration cytologyB.Bone marrow biopsyC.NasopharyngoscopyD.CT scan of the head and neckE.Sinus X-ray答案:A难度:156.A 78-year-old man with a history of

28、 coronary artery disease and an asymptomatic reducible hernia repair.You explain to him that valid reasons for delaying the proposed surgery includeA.Coronary artery bypass surgery 3 months ealierB.A history of cigarette smokingC.Jugular venous distentionD.HypertentionE.Hyperlipidemia答案:C难度:157.Amon

29、g the physiologic responses to acute injury isA.Increased secretion of insulinB.Increased secretion of thyroxineC.Decreased secretion of vasopressinD.Decreased secretion of glucagonE.Decreased secretion of aldosterone 答案:A难度:158.With regard to the distribution and composition of the body fluid compartments，which of the following statements is not correct？A.The majority of intracellular water is in ske