南京医科大学历年病生期末试题全

1、填空：1.低渗性脱水尿量和尿比重变化及机制   2.肾性骨营养不良的机制   3.肺性脑病概念以及影响肺性脑病发生机制的因素   4.休克进展期微循环变化的机制  5.蛙心灌流水肿实验，用任氏液后心输出量减少及机制  6.心性水肿常发生部位和机制  7.代酸的代偿方式   8.兴奋收缩偶联障碍的机制   9.酸中毒导致血管内皮细胞释放什么因子，抑制了什么的作用，导致了。（剩下一个不记得了

2、）名解：代谢性碱中毒（英文）  功能性分流   组织性缺氧   急性期反应（英文）  尿毒症（英文）问答：高钾血症对神经肌肉的影响及机制         氧自由基导致缺血再灌注损伤的机制         血氨升高的机制以及降血氨方法 （至少两种）临床医学本科(五年制)病理生理学期末考试试卷 

3、0; 一、A型题                                                

4、;                         每道题下面均、五个备选答案，答题时                      

5、    只许从中选择一个最合适的答案，并在答题卡上将相应题                          号的相应字母划一黑线，以示正确回答。（每题0.5分）           

6、60;                            1.  肥大心肌细胞的表面积相对不足的主要危害是：               

7、0;                      A.影响细胞的进一步增大         B.影响细胞的分裂成熟               

8、;          C.影响细胞吸收营养物质         D.影响细胞氧供                           

9、60;   E.影响细胞转运离子的能力                                            &#

10、160;                                                 &#

11、160;                                     2.  下列指标中哪项能够反映左心室的后负荷变化      

12、0;                                 A.中心静脉压               

13、60; B.平均主动脉压                                     C.肺动脉楔压         

14、        D.肺总阻力                                       E.左心室舒张末期压力&

15、#160;                                                 &

16、#160;                                                 &

17、#160;                                   3.  急性心力衰竭时下列哪项代偿方式不可能发生过？        &

18、#160;                           A.心率加快                     &

19、#160;                                                B.心脏紧张源

20、性扩张                                                 

21、60;          C.交感神经兴奋                                      &

22、#160;                           D.心肌肥大                     &

23、#160;                                                E.血液重新分

24、配                                                  

25、;                                                  

26、;                                          4.  低输出量性心衰时下列哪种变化不可能发生  &#

27、160;                                       A.外周血管阻力降低        

28、0;       B.心肌收缩力减弱                              C.心室残余血量增多         

29、60;    D.循环时间延长                                E.休息时心率加快          

30、0;                                                 

31、0;                                                 

32、0;                             5.  心肌肥大不平衡生长的组织学特征是               

33、0;                                A.毛细血管总数增多                

34、                                              B.毛细血管间距减少  &#

35、160;                                                 &#

36、160;         C.闭合状态的毛细血管开放                                      &

37、#160;                 D.单位重量心肌毛细血管数减少                             

38、0;                      E.以上都不是                          

39、60;                                                 

40、60;                                                 

41、60;                 6.  下列指标中哪一项能够反映右心室的前负荷变化                          

42、0;         A.平均主动脉压                   B.肺动脉楔压                   &

43、#160;               C.右心室舒张末期压力             D.左心室舒张末期压力                 

44、60;         E.心输出量                                       

45、60;                                                 

46、60;                                                 

47、60;                                                 

48、60;                                                 

49、60;                                                 

50、60; 第2页          -    7.  下列哪种措施可减少肠内氨生成                             &

51、#160;                      A.利尿剂       B.给氧      C.酸灌肠      D.输液     E

52、.补碱                                                 

53、60;                                                8. &

54、#160;哪种措施可使血氨降低                                               

55、60;            A.慎用催眠、麻醉、镇静药          B.左旋多巴                        &#

56、160;           C.高支链氨基酸溶液                D.胰岛素                    

57、;                  E.新霉素                               

58、                                                  

59、                                                  

60、                 9.  氨中毒时，脑内能量产生减少的另一机制是                           

61、60;              A.苹果酸穿梭系统障碍                                 

62、0;                          B.脂肪酸氧化不全                      &

63、#160;                                         C.酮体利用减少       

64、;                                                  

65、;         D.磷酸肌酸分解减慢                                       &

66、#160;                      E.糖酵解过程增强                         

67、0;                                                 

68、0;                                                 

69、0;              10. 肝性脑病时的假性神经递质是:                                

70、;                     A.苯乙胺 B.酪胺酸                           

71、             C.羟苯乙醇胺 D.血氨                                   

72、       E.5-羟色胺                                          

73、;                                                  

74、;                                                  

75、;    11. 门体静脉吻合术后，血氨主要来自                                          

76、;        A.肝脏合成尿素不足                                        &

77、#160;                     B.肠道氨直接入血                          

78、0;                                   C.肌肉产氨增加             &#

79、160;                                                 &#

80、160;  D.尿降低，氨吸收入血增多                                             &

81、#160;      E.肾脏氨排出减少                                         

82、0;                                                 

83、0;                                                12. 肝

84、性脑病的正确概念是                                                

85、60;           A.肝脏疾病并发的脑部疾病                                    &#

86、160;                   B.肝功能衰竭并发的脑水肿                            &

87、#160;                           C.肝功能衰竭导致的精神神经综合征                   &#

88、160;                            D.肝功能衰竭导致的精神紊乱                   

89、                                 E.肝功能衰竭导致的神经紊乱              

90、0;                                                 

91、0;                                                 

92、0;                                                 

93、0;                                         13. 人体内胆红素的是来自     

94、60;                                          A.血红蛋白      

95、60;                                                 

96、60;             B.肌红蛋白                                   

97、60;                                  C.细胞色素              

98、60;                                                 

99、60;     D.过氧化物酶                                           &#

100、160;                        E.过氧化氢酶                        &

101、#160;                                                 &

102、#160;                                                 &

103、#160;                                                 &

104、#160;                                  第3页          -    14.

105、 阻塞性通气不足，主要是由于                                               

106、;       A.肺顺应性降低                                         

107、60;                        B.肺泡通气血流比例失调                       

108、60;                                  C.非弹性阻力增加              

109、                                                  

110、D.肺泡扩张受限制                                                

111、60;               E.肺循环短路增加                                 

112、                                                  

113、                                                  

114、       15. 关于通气血流比值的变化，下述哪项正确                                      

115、60;   A.阻塞性通气障碍比值升高                                            &#

116、160;           B.限制性通气障碍比值升高                                    &

117、#160;                   C.肺内动静脉分流增加, 比值升高                          

118、60;                       D.死腔通气时, 比值降低                       

119、60;                                  E.以上都不正确              &

120、#160;                                                 &

121、#160;                                                 &

122、#160;                           16. 肺能生成也能消除的血管活性物质是                  

123、                              A.白三烯                   &

124、#160;                                                 &

125、#160;  B.PGA                                              &#

126、160;                          C.组胺                      

127、0;                                                 

128、0; D.物质                                                

129、                        E.肠血管活性肽                        

130、0;                                                 

131、0;                                                 

132、0;                 17. 急性型呼吸衰竭患者血中二氧化碳增多主要表现为                           

133、60;      A.溶解的二氧化碳增加                                         

134、0;                  B.碳酸增加                              

135、0;                                       C.氨基甲酸血红蛋白增加        

136、0;                                                 D.血浆

137、重碳酸盐增加                                                 

138、             E.红细胞内重碳酸盐增加                                   

139、                                                  

140、                                                 18.

141、60;引起夜间阵发性呼吸困难的最关键因素是                                            A.迷走神经兴奋性升高

142、0;                                                 

143、0;         B.呼吸中枢抑制                                       &#

144、160;                          C.左心衰竭而右心功能尚好                     &

145、#160;                                  D.夜间肺淤血急剧加重             &#

146、160;                                              E.冠状动脉血流减少，心功能下降

147、0;                                                 

148、0;                                                 

149、0;                         19. 呼吸衰竭产生胃溃疡、胃出血的基本机制是：                    

150、;                    A.胃酸增多，胃粘膜屏障作用降低                           &

151、#160;                      B.缺氧增强胃壁细胞碳酸酐酶活性                        

152、60;                         C.二氧化碳潴留可使胃壁血管收缩                      

153、;                          D.缺氧使胃壁血管扩张，胃酸分泌增多                     

154、;                         E.以上全是                        

155、;                                                  

156、;                                                  

157、;                                                  

158、;                                     第4页          -  &

159、#160; 20. 下列哪种表现属于症状                                             

160、               A.心跳加快                                  

161、                                    B.呼吸困难             

162、                                                  

163、       C.呼吸增快                                          

164、                        D.呼吸音增强                         

165、;                                           E.咳泡沫样痰     

166、0;                                                 

167、0;                                                 

168、0;                                      21. 疾病发生、发展的一个基本环节是       

169、0;                                          A.稳态破坏      

170、0;                                                 

171、0;             B.因果转化                                   

172、0;                                C.损害反应                

173、0;                                                 

174、0;   D.抗损害反应                                             

175、60;                      E.损害和抗损害反应                          

176、;                                                  

177、;                                                  

178、;            22. 下列哪种疾病与精神心理因素有关                                  

179、;                A.潜水员病                                 

180、;                                     B.缺血性心脏病           

181、60;                                                 

182、60;    C.消化性溃疡                                            &#

183、160;                     D.溃疡性结肠炎                           

184、                                       E.支气管哮喘          

185、;                                                  

186、;                                                  

187、;                                                  

188、;                                                  

189、;            23. 水和无机盐能从毛细血管动脉端滤出的主要原因是                                

190、0;   A.动脉端毛细血管通透性大                                            

191、60;           B.动脉端血压大于血浆胶渗压                                    &

192、#160;                 C.血浆胶渗压大于血压                              &#

193、160;                             D.组织胶渗压大于血浆胶渗压                  

194、                                    E.组织间液负压            

195、0;                                                 

196、0;                                                 

197、0;                             24.引起肾小球滤过分数升高常见于：A 肾髓质产生前列腺素A2增加B 肾皮质形成缓激酞增加C 充血性心力衰竭D 抗利尿激素分泌增加E 利钠激素生成增加    

198、                                                  

199、                                                  

200、                                                  

201、                                                  

202、              25. 肾内“自由水”形成减少见于                                &#

203、160;                     A.低血钙症                           &#

204、160;                                          B.低血容量      &#

205、160;                                                 &#

206、160;             C.低钠血症                                   &#

207、160;                                  D.低钾血症              &#

208、160;                                                 &#

209、160;     E.低镁血症                                           &#

210、160;                                                 &#

211、160;                                                 &#

212、160;                                                 &#

213、160;                                                 &#

214、160;                                             第5页    

215、;      -    26. 尿崩症患者易出现                                     

216、;                           A.高渗性脱水                     

217、0;                                              B.低渗性脱水  

218、60;                                                 

219、60;               C.等渗性脱水                                 &#

220、160;                                  D.水中毒              

221、60;                                                 

222、60;       E.低钠血症                                         

223、60;                                                 

224、60;                                                 

225、60;    27. 下述哪一项不是高钾血症所致的病理变化                                         

226、   A.肌肉松弛无力    B.心律失常                                       C.T波高尖，Q-T间期缩短

227、   D.钾外流减慢，3期复极化时间延长                 E.心肌传导阻滞                          

228、;                                                  

229、;                                                  

230、;                28. 钙反常发生的钙超载损伤与                              &#

231、160;                         A.无钙期引起钙泵功能障碍有关                      

232、;                              B.细胞膜通透性增高有关                  

233、;                                        C.复钙期钙浓度过高有关        

234、;                                                  

235、;D.膜外板与糖被层表面分离有关                                               &#

236、160;    E.缺氧后又给氧有关                                           

237、0;                                                 

238、0;                                            29. 心脏缺血再灌注损伤时血浆内乳酸脱氢酶（LDH）和肌

239、酸磷酸激酶（CPK）含量变化为： A 增加B 降低C 先增加后降低D 先降低后增加E 不变                                     

240、60;                                                 

241、60;                                                 

242、60;            30. 评价脑缺血再灌注损伤的主要代谢指标是                                 

243、           A.ATP、CP及葡萄糖减少                                    

244、0;                      B.乳酸增多                          

245、0;                                           C.cAMP增多     &#

246、160;                                                 &#

247、160;              D.cGMP减少                                  

248、                                    E.过氧化脂质生成增多            &

249、#160;                                                 &

250、#160;                                                 &

251、#160;                       31. 缺血再灌注损伤最常见于                       

252、;                                 A.心                &#

253、160;                                                 &#

254、160;         B.脑                                        

255、;                                    C.肺             &#

256、160;                                                 &#

257、160;            D.肾                                     

258、;                                       E.肠          &#

259、160;                                                 &#

260、160;                                                 &#

261、160;                                         32. 缺血再灌注损伤的防治措施不包括：    &

262、#160;                                         A.抗炎以减轻白细胞积聚      &

263、#160;                                                 &

264、#160; B.尽快恢复血流                                               

265、;                 C.再灌注时低流、低压、低温                              

266、60;                       D.改善缺血组织的代谢                        

267、0;                                 E.清除自由基               

268、60;                                                 

269、60;                                                 

270、60;                                                 

271、60;                                           第6页      

272、    -    33. 血浆鱼精蛋白副凝试验阳性说明                                      

273、              A.血中凝血因子消耗                                  &#

274、160;                           B.因子被激活                     &

275、#160;                                            C.血中出现纤维蛋白降解产物   

276、;                                                  

277、; D.组织凝血因子激活入血                                               

278、;           E.血中纤溶酶激活                                     &#

279、160;                                                 &#

280、160;                                                 &#

281、160;  34. 弥散性血管内凝血患者发生出血的机制中，下列哪一项是错误的？                      A.凝血物质消耗                 

282、0;                                                B.FP 

283、释放增多                                                 &#

284、160;               C.形成增多                                 &#

285、160;                              D.纤溶系统激活                  

286、                                                E.纤维蛋白原含量减少&

287、#160;                                                 &

288、#160;                                                 &

289、#160;                                   35. 弥散性血管内凝血病人发生出血时的治疗原则是         &

290、#160;                            A.立即给止血剂（如维生素等）                  

291、0;                               B.立即给抗凝剂（如肝素等）                &#

292、160;                                     C.立即给纤溶抑制剂（如氨基乙酸等）         &#

293、160;                                D.立即去除病因，恢复凝血和纤溶的平衡（给肝素和新鲜血等）            

294、60;           E.给抗凝血酶