I. a 1
The pain will not spread.
B, with the increase of water seepage.
C, aggravated when prone.
D, reduce when taking a deep breath
E, reduce when prone.
The correct answer is: e
Question 2: Which of the following measures does not belong to advanced cardiopulmonary resuscitation?
First, artificial respiration
B, tracheal intubation
C, defibrillation
D, establishing venous access
E. medicine
The correct answer is: a.
Question 3: The most valuable invasive test for diagnosing coronary heart disease is
A, phonocardiogram examination
B, intracardiac electrophysiological examination
C, coronary angiography
D, intracardiac electrocardiogram examination
Endocardial myocardial biopsy
The correct answer is: c
Question 4: pericardial effusion sign (Ewart sign) is
A, the apical pulsation is weak, located in the inner side of the left margin of the voiced boundary of the heart or inaccessible.
B, left scapular dullness and bronchial breathing sounds caused by lung compression.
C, left sternum 3, 4 intercostal can hear pericardial tapping.
D, the voiced boundary of heart percussion extends to both sides.
E, heart sounds are low and far away.
The correct answer is: b
Question 5: The main risk factors of coronary atherosclerosis are wrong.
First, cerebral embolism
B, dyslipidemia
C, age
smoke
blood pressure
The correct answer is: a.
Question 6. Indications for aortic-coronary artery bypass grafting do not include
First, left main coronary artery stenosis >; 50%
B, there is mild ventricular arrhythmia with left main artery or 3 branch lesions.
C, stable angina pectoris does not respond well to medical treatment, affecting work and life.
D coronary heart disease with left ventricular ejection fraction < 50%
E. Proximal stenosis of left anterior descending branch and circumflex branch? 70%
The correct answer is: b
Question 7: You can see the late stage of aortic stenosis.
A, systolic blood pressure increased, pulse pressure is normal.
B, systolic blood pressure and pulse pressure increased.
C pulse pressure and systolic blood pressure are normal.
D, systolic blood pressure and pulse pressure decreased.
E, systolic blood pressure and diastolic blood pressure decreased.
The correct answer is: d
Question 8: There is no obvious hemodynamic disorder in persistent ventricular tachycardia, so drug treatment is the first choice.
A. Ceylon
B, is it? Receptor blocker
C. propafenone
lidocaine
amiodarone
The correct answer is: d
Question 9: What are the meaningful tests for the diagnosis of pheochromocytoma?
Determination of urine 17- hydroxysteroid
Determination of VMA in urine for 24 hours
Renal CT scan
Determination of blood potassium
Basic metabolic analysis
The problem 10 is the energy of direct current defibrillation.
I. 50J
b、 150J
c、250J
d、 100J
200J
The correct answer is: e
Patient 1 1, a 24-year-old female, had recurrent palpitations for 2 years. Paroxysmal ventricular tachycardia was recorded by dynamic electrocardiogram, and the right ventricle was enlarged and the ventricular wall was thinned by echocardiography. The most likely diagnosis should be
I. Idiopathic ventricular tachycardia
B, viral myocarditis
C. coronary atherosclerotic heart disease
D, pulmonary heart disease
E. Arrhythmogenic right ventricular cardiomyopathy
The correct answer is: e
Question 12: What are the main signs of dilated cardiomyopathy?
First, arrhythmia
B, you can hear the rules of horse racing.
C, jugular vein dilatation
D, heart enlargement
E, pulmonary edema
The correct answer is: d
Question 13 Differential diagnosis of myocardial infarction does not include
First, acute pulmonary embolism
B, angina pectoris
C, acute pericarditis
D, arrhythmia
Aortic dissection
The correct answer is: d
Question 14: What is the earliest enzyme test that can reflect the occurrence of acute myocardial infarction?
creatine phosphokinase
B CPK-MM subtype: MM3/MM 1 ratio.
Chlorinated paraffin-methyl bromide
d？ -hydroxybutyrate dehydrogenase (? -HBDH)
E serum myoglobin
The correct answer is: b
Question 15: What is the typical site of angina pectoris?
precordia
The middle and upper part of the sternum is behind the sternum.
Inferior sternum
D vertex
ensiform process
The correct answer is: b
Question 16 normal mitral valve orifice area is
A< 1.5 cm2
B& lt； 2cm2
C2 ~ 2.5 square centimeters
D 3~4cm2
E4 ~ 6 cm2
The correct answer is: e
Question 17 The treatment plan that should be considered after the diagnosis of chronic constrictive pericarditis is
First, anti-tuberculosis treatment
B, use antibiotics
C, a small amount of blood transfusion
D pericardiectomy should be performed as soon as possible after full preparation.
E, cardiotonic diuretic therapy
The correct answer is: d
Question 18: Which of the following is the clinical manifestation of myocardial infarction?
First, the progressive changes of electrocardiogram
B, serum myocardial necrosis markers increased.
C, severe pain behind sternum
palpitate
E, fever
The correct answer is: d
Question 19: A 64-year-old male patient suddenly felt severe chest pain for 2 hours, which radiated to his back like a tear. He has a history of hypertension for 10 years, but he still can't relieve it after taking 3 tablets of nitroglycerin. The first diagnosis that should be considered is
First, aortic dissection
B, acute cholecystitis
C, acute myocardial infarction
D, acute pleurisy
E, acute pancreatitis
The correct answer is: a.
Question 20: Sinus bradycardia is rare in which of the following clinical situations?
First, anemia
athlete
Hypothyroidism medicine is all there. The line to provide.
D, normal healthy people
E, acute inferior myocardial infarction
The correct answer is: a.
Question 2 1 Which of the following diseases is most suitable for hypertension? Receptor blocker therapy?
First, hypertension with bronchial asthma
B, hypertension with hypertrophic obstructive cardiomyopathy
C, hypertension with bradycardia
D, hypertension acute left heart failure
E, hypertension with ECG second degree atrioventricular block.
The correct answer is: b
Question 22. The main difference between unstable angina pectoris and non-ST-segment elevation myocardial infarction (non-Q-wave myocardial infarction) is
CK MB？ Troponin is normal or increased by 2 times of the upper limit.
B, the results of coronary angiography
C, whether there is thrombosis on the surface of plaque.
D, the severity of angina pectoris
E, ST segment depression duration
The correct answer is: a.
Question 23: The causes and inducement of angina pectoris do not include
First, aortic stenosis
B, hyperthyroidism
mitral stenosis
D, coronary artery malformation
E, hypertrophic cardiomyopathy
The correct answer is: c
Question 24: Patients with coronary heart disease suddenly feel flustered and chest tightness, with different BP90/60mmHg, HR 150bpm and apical first heart sound intensity. ECG shows that atrial rate is slower than ventricular rate, and there is no fixed relationship between them. QRS complex widened to 0. 12ms, and ventricular fusion wave was seen. The diagnosis is as follows.
Room fibrillation
B, paroxysmal supraventricular tachycardia
C, ventricular fibrillation
D, frequent ventricular premature beats
E. Paroxysmal ventricular tachycardia
The correct answer is: e
Question 25: A 2-year-old male patient found that the second intercostal contraction on the left sternum had a blowing murmur, and the second heart sound was hyperactive and split. The patient is likely to be
I. Ventricular septal defect
Patent ductus arteriosus
C, atrial septal defect
mitral stenosis
Mitral regurgitation
The correct answer is: c
Question 26: Acute myocardial infarction has high-risk ventricular premature beats, and treatment is the first choice.
A, the Spanish law (slow-paced)
B, procainamide (procainamide)
Propyramide (diisopropyramide)
lidocaine
Amiodarone (amiodarone)
The correct answer is: d
Question 27. Which of the following accords with the ECG characteristics of second degree type I sinus block?
A, sinus PP interval gradually prolonged, and finally atrial leakage appeared.
A long PP interval appears after B and P wave leakage, and its length is equal to the sum of the first two consecutive PP intervals.
A long PP interval appears after the leakage of C wave and P wave, and its length is equal to the sum of any two PP intervals.
D, sinus PP interval gradually shortened, and finally atrial leakage appeared.
A long PP interval appears after the leakage of E and P waves, and its length is equal to the sum of any two short PP intervals.
The correct answer is: d
Second, the A3 problem.
Question 1-2:30-year-old female, upper limb blood pressure 165/ 105mmHg, lower limb blood pressure 130/85mmHg, weak pulse, fatigue and numbness in both lower limbs, and vascular murmurs can be heard in the upper abdomen.
1, initially diagnosed as
First, hypertension crisis
primary hypertension
C. Takayasu arteritis
Primary aldosteronism
hypercortisolism
2. In order to make a definite diagnosis, which of the following tests should be selected?
First, abdominal aortography
Intravenous pyelography
C. CT examination of both kidneys
D, urine 17- hydroxycorticosteroids detection
E, urine VMA detection
The correct answer is: CA
Think about solving problems:
1. Young patients have abnormal blood pressure difference between upper and lower limbs, and the possibility of Takayasu's arteritis should be considered.
Question 3-4 The patient is a 32-year-old male with a history of rheumatic heart disease for 5 years, 4 weeks ago? A cold? Since then, I have had a low fever and a sore throat. 1 week, palpitation, chest tightness worse than before, fatigue, sweating. Physical examination; Pale face and musical systolic murmur at the apex.
1, the most likely cause of this patient's low fever is
A. Staphylococcus aureus infection
B, fungal infection
Infection by C and Rickettsia
D. Streptococcus viridis infection
E, chlamydia infection
2. Which of the following diagnosis should be considered first?
First, rheumatic heart disease complicated with hyperthyroidism
B, rheumatic heart disease complicated with anemia
Rheumatic heart disease complicated with acute infective endocarditis
Rheumatic heart disease complicated with subacute infective endocarditis
E rheumatic heart disease complicated with mitral valve prolapse
The correct answer is: DD
Question 5-6: On the third day of hospitalization, patients with acute myocardial infarction suddenly sweated, felt chest tightness, and their blood pressure dropped. The electrocardiogram showed sinus tachycardia.
1, regardless of the patient's current diagnosis.
First, the heart free wall rupture
B, ventricular septal perforation
C, reinfarction or infarction expansion
Dressler's?syndrome
E, papillary muscle rupture
2, emergency disposal, should not include.
First, venous access should be established quickly.
B, coronary angiography immediately.
C, antihypertensive drugs to maintain blood pressure
D, bedside ultrasound diagnosis.
E get the defibrillator ready.
The correct answer is: DB
Think about solving problems:
2. The possibility of mechanical complications is high, and angiography is not necessary unless bypass surgery is performed at the same time.
Question 7-8 The patient is a 45-year-old male with dizziness for 6 months and a history of hypertension. Blood cholesterol and triacylglycerol (triglyceride) in outpatient laboratory were higher than normal.
1, which lifestyle seems inappropriate?
First, control weight
B, high-fat diet
C, a balanced diet
D, aerobic exercise
E, regular physical examination
2. If there is a physical examination, which one is unnecessary?
First, measure blood pressure, including lower limb blood pressure.
B, heart auscultation
C, cardiac radionuclide examination
D, carotid artery ultrasound examination when necessary.
E, biochemical examination, including blood lipids, blood sugar, etc.
The correct answer is: BC.
Question 9- 10: Patients with acute anterior myocardial infarction, who have not yet started thrombolytic therapy, are fidgety, have cold sweat, oliguria, and their blood pressure is 90/70mmHg.
1, the most likely reason for the patient's blood pressure decrease is
First, heart rupture
B, cardiogenic shock
C, heart failure
D, insufficient blood volume
E, hypotensive state
2, the following improper disposal or risk.
First, dopamine maintains blood pressure
B, intra-aortic balloon counterpulsation
Intravenous morphine for analgesia.
D, appropriate blood volume.
E, improve heart function
The correct answer is: BC.
Question 1 1- 12 A 35-year-old female with rheumatic mitral stenosis for 2 years. She has been working hard for nearly two weeks. During the two-day activity, her chest tightness was worse than before, and she had paroxysmal dyspnea at night, so she was hospitalized. Two minutes ago, there was a sudden massive bleeding.
1, the reason for hemoptysis is
First, bleeding after pulmonary arteriole dilatation
B, pulmonary capillary bleeding
C, pulmonary infarction
D, pulmonary embolism
E. rupture of bronchial vein
2. Which of the following is incorrect?
A, supine position, raise both lower limbs to ensure the patient's blood volume.
B, give sedatives
C, giving diuretics
D, give sedatives and diuretics.
Give nitrate.
The correct answer is: EA
Three. Type B 1 questions.
Question 1-3: Type B 1
First, surgery as soon as possible
B, pre-school surgery
C, 6 ~ 12 years old surgery
D, adult surgery
E, drug therapy
1. The patient is an asymptomatic 2-year-old girl. Physical examination found that there was a persistent machine-like murmur in the second intercostal space of the left sternum, and treatment was taken.
2. The patient is a 3-year-old male with systolic murmur between the third and fourth ribs of the left sternum, accompanied by tremor. therapeutic method
3. The patient, a 4-year-old boy, had systolic murmur in the second intercostal region of the left sternum, and the echo of atrial septum disappeared by echocardiography. therapeutic method
The correct answer is: ABB
Question 4-8 B 1
First, ventricular fibrillation
ventricular flutter
C, atrial flutter
D, atrial fibrillation
Torsion de pointes ventricular tachycardia
1, QRS-T complex disappears, and is replaced by irregular waveforms with different shapes and sizes.
2.P wave disappears and is replaced by wavelets of different sizes. f？ wave
3.QRS T complex? Shaw lost and was replaced by a uniform and continuous sine wave.
4. With the equipotential line as the axis, the main peak direction of QRS-T complex is continuously twisted from top to bottom and from bottom to top.
5.P wave disappears and is replaced by homogeneous wave? f？ wave
The correct answer is: Adeback.
Question 9- 12: Type B 1
A: Receptor blockers
Calcium antagonist
C, nitrate
dopamine
e、ACEl
1, used for acute myocardial infarction with ventricular tachycardia.
2. Prevent sudden death from acute myocardial infarction.
3. Variant angina pectoris
4. Reduce the incidence of myocardial infarction and death in all patients with coronary heart disease.
The correct answer is: AABA
Question 13- 14: type B 1
1. Changes of fundus ⅰ in patients with hypertension
B, blood pressure disease fundus Ⅱ changes
C, ⅲ degree changes of hypertensive fundus.
D, hypertensive fundus ⅳ changes
E, the fundus is normal
1. The patient was a 65-year-old male who smoked for 30 years, had hyperlipidemia and coronary heart disease, and his blood pressure increased for 6 years, with the highest value of 160/90mmHg. Fundus examination showed that fundus hemorrhage and cotton wool exudation met the requirements.
2. The patient is a 60-year-old female with elevated blood pressure 17 years, and the highest is 200/1.20mmhg.. Fundus examination showed bleeding, exudation and papilla edema, which met the requirements.
The correct answer is: CD
Question 15- 16: type B 1
I. Infectious endocarditis
B, atrial fibrillation
C, thromboembolism
D, right heart failure
E, acute pulmonary edema
1, a male patient, 3 1 year old, suffered from severe mitral stenosis. The most serious complications that may occur in this patient are as follows
2. The patient is a 50-year-old woman with a history of rheumatic heart disease for more than 30 years and atrial fibrillation for 6 years. At present, oral warfarin prevention.
The correct answer is: EC
Question 17- 18: type B 1
I. Ischemic cardiomyopathy
B, pericardial effusion
C, dilated cardiomyopathy
D, hypertrophic cardiomyopathy
Rheumatic valvular heart disease
1. The patient is a 49-year-old female. In the last three months, she has been flustered, short of breath, edema of both lower limbs and can't lie flat. Physical examination found that the boundary of cardiac dullness extends to both sides, which can change with the change of body position. Apical heartbeat is unclear, there is no murmur in the auscultation heart, and the heart sounds are far away. The first diagnosis to consider is
2. The patient, a 35-year-old male, had palpitation, shortness of breath, edema of both lower limbs, progressive aggravation, unable to lie flat, physical examination, the voiced boundary expanded to both sides, and the apical pulsation weakened; But it can't change with the change of posture. There is a level 3/6 systolic puff murmur in the auscultation mitral valve area. The diagnosis that should be considered is
The correct answer is: BC.
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