Clinical Practitioner
(Category Code: 110)
Examination Date:
Examination Duration:
Candidate's Name: ________
Admit Card No.: ________
National Medical Examination Center of the Ministry of Health
The examination will be held on the same day as the written examination, and will be conducted in the same manner as the written examination.
2. Before you start to answer the questions, please check again whether your name, pass number, examination category and examination unit filled in on the answer card are complete and correct.
3. Before you start answering questions, please check the test paper for defects, reprints, and misprints, and report the above to the invigilator immediately.
4. All information points of candidates and answers on the answer card must be filled in with 2B pencils according to the requirements of the "Notes" column on the answer card, and if any modification is needed, the blackened areas should be erased with an eraser.
5. The "Examination Hall Record" column on the answer card will be filled in by the invigilator, and candidates are not allowed to fill in the column themselves.
6. The answer key will be read by computer, so please pay attention to keep the answer key flat and clean.
7. Candidates will not be allowed to hand in their papers within half an hour after the start of the examination.
8. At the end of the examination, please put the examination paper and the answer card on the table separately and do not take them out of the examination room.
9. Candidates will be allowed to leave the examination room only with the permission of the invigilator after the invigilator has accepted the examination paper and the answer card.
10. Candidates who violate the "Instructions for the Examination Room" and these "Instructions for Answering Questions" shall bear all the consequences.
Section I
Type A1 multiple-choice questions (1-41)
Answer Instructions
There are five alternatives, A, B, C, D and E, under each question. Please choose the best answer from them and blacken the box on the answer card that the corresponding letter belongs to for the corresponding question number.
1.The drug of choice for convulsions that occur in neonates with hypoxic-ischemic encephalopathy is
A. Mannitol
B. Dexamethasone
C. Phenobarbital sodium
D. Phenytoin sodium
E. Furosemide
2.The catabolic end-product of purine nucleotides in the body is
A. Urea
B. NH3
C. β-alanine
D. β-aminoisobutyric acid
E. Uric acid
3. Auer microsomes are not seen in
A. M1 leukemia
B. M2 leukemia
C. M3 leukemia
D. acute Lymphoblastic leukemia
E.Acute monocytic leukemia
4.The coenzyme of transaminase is
A.Pyridoxal phosphate
B.Thiamine pyrophosphate
C.Biotin
D.Tetrahydrofolic acid
E.Pantothenic acid
5.The wrong thing about metastasis of tumors is
A. Gastric cancer can metastasize to the pelvis
B. Breast cancer can metastasize to the supraclavicular lymph nodes
C. Junctional tumors do not show metastasis
D. Hepatocellular carcinoma can show brain metastasis
E. Lung cancer can show bone metastasis
6. Tests suggestive of a correlation with habitual miscarriage are
A. Anti-filarial point antibody
B. Antiphospholipid antibodies
C. Anti-RNP antibodies
D. Anti-histone antibodies
E. Anti-neutrophil cytoplasmic antibodies
7. The more meaningful test to diagnose early diabetic nephropathy is
A. Urine routine examination
B. Urine microalbumin measurement
C. Urine osmolality measurement
C. D. Ultrasound of both kidneys
E. Creatinine clearance
8. The normal fetal heart rate in a full-term pregnancy should be 90-130 beats per minute
A. 90-130 beats
B. 100-140 beats
C. 110-150 beats
D. 120- 160 beats
E. 130 to 170 beats
9. The complement system, when activated, can
A. induce immune tolerance
B. inhibit metaplasia
C. bind cytotoxic T cells
D. initiate class switching of antibodies
E. lyse bacteria
10. The enzyme within the nigrostriatal system that converts levodopa to dopamine is
A. monoamine oxidase
B. amino acid decarboxylase
C. tyrosine hydroxylase
D. catecholamine o-cyclohexyltransferase
E. cholinesterase
11. Acute damage sustained on top of a preexisting disease is more likely to occur in the case of MODS, excluding
A. chronic kidney disease
B. rheumatoid arthritis
C. diabetes mellitus
D. cirrhosis of the liver
E. coronary artery disease
12. The driving force of pulmonary ventilation is
A. expansion and retraction of the lungs
B. the difference between the intrapulmonary pressure and atmospheric pressure
C. Intrapleural pressure in the pleural cavity remains negative
D. Diastolic and contractile activity of the respiratory muscles
E. Surface tension of the alveoli
13. The basal metabolic rate of a patient with hyperthyroidism who can be operated on in preparation for surgery is lowered to a minimum of
A. Below 10%
B. Below 20%
C. Below 25%
D. Less than 30%
E. Less than 35%
14. The most meaningful laboratory test to differentiate Cushing's syndrome due to adrenocortical tumors from Cushing's disease is the
A. blood cortisol circadian rhythm
B. 24-hour urinary 17-hydroxysteroids
C. overnight dexamethasone suppression test
D. low-dose Dexamethasone suppression test
E. High-dose dexamethasone suppression test
15. In developed countries, the most common cause of chronic mitral valve insufficiency is
A. Rheumatic heart disease
B. Connective tissue disease
C. Mucoviscidosis of the mitral valve
D. Infective endocarditis
E. Congenital anomalies of the mitral valve
16. In patients with type I respiratory failure in whom oxygen therapy at high concentrations is ineffective, the cause is most likely to be
A. Severe pulmonary ventilation dysfunction
B. Severe pulmonary arteriovenous shunt
C. Increased ventilation/blood flow ratios
D. Lung diffusion dysfunction
E. Oxygen consumption Increased
17. In a typical cholera patient, the first symptoms after the onset of the disease are
A. chills and fever
B. hoarseness
C. severe diarrhea followed by vomiting
D. abdominal cramps
E. gastrocnemius muscle spasms
18. In difficult-to-distinguish renal carcinoma and renal cysts, the most reliable examination is the method is
A.intravenous urography
B.retrograde pyelogram
C.ultrasound
D.renal arteriography
E.CT
19.The ****same characteristics of the clinical manifestations of mental disorders due to physical diseases are incorrectly stated as follows
A.Psychiatric symptoms tend to have "A. Mental symptoms tend to fluctuate from day to day and from night to night
B. Acute or chronic encephalopathy syndromes may be manifested
C. Mental symptoms usually occur during the recovery period of physical illnesses
D. The course of the illnesses and their prognosis depend on the status of the primary physical illnesses and whether the treatment is appropriate
E. The clinical manifestations and laboratory positive findings of physical illnesses are not the same as the clinical manifestations and laboratory positive findings of mental disorders due to physical illnesses
No, it is not correct to say that the clinical manifestations of mental disorders due to physical illnesses are the same. E. Clinical manifestations of physical disease and positive laboratory findings
20. The most important advantage of dry plate electrostatic mammography is that
A. vascularization is especially clear
B. the margins of the mass are more clearly defined
C. calcification is more clearly defined
D. the lobes of the breast are more clearly defined
E. the ducts of the breast are more clearly defined
21. >21. A boy is 1.5 years old. His basal metabolic caloric requirement as a percentage of total calories is
A. less than 30%
B. 30% to 40%
C. 50% to 60%
D. 70% to 80%
E. more than 80%
22. Hirsutine has the following effects on the eye
A. dilation of the pupil, regulation of Paralysis
B. Dilates the pupil and raises intraocular pressure
C. Constricts the pupil and regulates spasm
D. Dilates the pupil and lowers the intraocular pressure
E. Constricts the pupil and raises the intraocular pressure
23. The incorrect description of stage I syphilis is that
A. there is a history of impure sexual intercourse
B. a hard chancre may be present
C. . negative serology for syphilis
D. cardiovascular syphilis
E. ulceration of the vulvar surface with plasma exudate
24. The pathogenic type of amebas in the lysed tissues is
A. encapsulated
B. small trophozoite
C. large trophozoite
D. cleistothecium
E. gametocyte
25.The mechanism of penicillin's anti-Gram-positive (G ) bacterial action is
A. interference with bacterial protein synthesis
B. inhibition of bacterial nucleic acid metabolism
C. inhibition of bacterial lipid metabolism
D. inhibition of bacterial cell-wall peptidoglycan (mucopeptide) synthesis
E. disruption of bacterial cell-membrane structure
26 The cells most closely associated with acute allogeneic graft rejection are
A.NK cells
B.B cells
C.CD8 T cells
D.Mast cells
E.eosinophils
27.The temporal phases of pleural friction auscultation are characterized by the following
A.Early inspiratory phase
B. Mid-inspiratory stage
C. End-inspiratory stage
D. Expiratory stage
E. Respiratory two-phase 28. Posterior mediastinal tumors are most commonly
A. Teratoma
B. Neurogenic tumors
C. Thymoma
D. Lymphatic tumors
E. Thymic endothymus
E. Intrathymic thyroid
29. p>
29.The most important cause of hypertension in uremic patients is
A. Increased renin
B. Decreased erythropoietin
C. Sodium retention
D. Increased vasopressin
E. Sympathetic arousal
30.Acute urinary retention in the elderly male is a common etiology of
A. Prostatic hyperplasia
B. Urethral calculi
C. Urethral trauma
D. Foreign body in the bladder
E. Tumor of the urethra
31. The skeletal components that make up a polyribonucleotide are
A. Base and pentose sugar
B. Base and phosphate
C. Base and alkali
D. . pentose and phosphate
E. pentose and pentose
32. The most meaningful clinical sign for early diagnosis of measles is
A. fever, runny nose, and cough
B. history of exposure to the common cold
C. enlarged lymph nodes behind the ears
D. red maculopapular eruptions on the hands and feet
E. Koplik's spots
33.
33. The treatment of choice for patients with aortic stenosis who have angina and syncopal episodes on exertion is
A. Nitroglycerin at rest
B. Cardiotonic
C. Diuretic
D. Aortic valve valve replacement
E. Aortic balloon angioplasty
34. The key enzyme in glycolysis is
A.3.
A. 3-phosphoglyceraldehyde dehydrogenase
B. Pyruvate dehydrogenase
C. Phosphofructokinase-1
D. Phosphoglycerate kinase
E. Lactate dehydrogenase
35.The three main functions of the immune system are
A. Immune defense, immune response, immune memory
B. Immune response, immune memory, and immune surveillance
C. Immune defense, immune memory, and immune surveillance
D. Immune defense, immune self-stabilization, and immune surveillance
E. Immune response, immune self-stabilization, and immune surveillance
36. The most important sign of Graves' disease is
A. moist, sweaty skin and hand tremor
B. enlarged eye lobes and protruding eyeballs
C. diffuse goiter with vascular murmur
D. increased systolic blood pressure and decreased diastolic blood pressure
E. an enlarged heart with arrhythmia
37.The organs that make blood outside of the bone marrow in the pediatric patient are the
A. ovaries
B. gallbladder
C. spleen
D. lymphatic vessels
E. cecum
38. The following are pathophysiologic types of chronic diarrhea, except
A. osmotic diarrhea
B. exudative diarrhea
C. secretory diarrhea
D. diarrhea with abnormal motor function
E. medically induced diarrhea
39. community acquired In community-acquired pneumonia, the most common causative organism is
A. Haemophilus influenzae
B. Mycoplasma pneumoniae
C. Streptococcus pneumoniae
D. Klebsiella pneumoniae
E. Staphylococcus pneumoniae
40. The loudness of the heart murmur in Tetralogy of Fallot is determined by the
A. difference in pressure between the left and right ventricles <
B. The degree of pulmonary valve stenosis
C. The size of the ventricular septal defect
D. The degree of aortic ride
E. The degree of right ventricular hypertrophy
41. The wrong statement about thrombosis is that
A. There are more venous than arterial thrombosis
B. There are more thrombosis in the lower extremities than in the upper extremities
C. Intra-aneurysmal thrombus is more often a mixed thrombus
D. Intra-venous thrombus tails more often a red thrombus
E. Intra-capillary thrombus is more often a white thrombus
Multiple-choice questions of type A2 (42-53)
Answer instructions
Alternative answers. Please choose the best answer from them and put the corresponding letter of the corresponding question number on the answer card
42. Male, 34 years old, fever for 1 week accompanied by chest pain, with nitroglycerin ineffective, physical examination: muffled heart sounds, with diastolic surges, blood pressure 110/80 mmHg (14.7/10.7 kPa), venous pressure at the elbow 180 mmH2O, electrocardiogram: ST-segment elevation, bowed back downward, no pathologic Q waves are seen, the diagnosis may be
A. Acute myocardial infarction
B. Constrictive pericarditis
C. Variable angina pectoris
D. Stable angina pectoris
E. Acute exudative pericarditis
43. A 70-year-old elderly male patient with a hemispherical mass protruding from the left groin, which does not descend into the A. Syringomyelia
B. Cryptorchidism
C. Femoral hernia
D. Hiatal hernia
E. Rectal hernia
44. Newlyweds come to the clinic for counseling on the most appropriate method of contraception for a six-month pregnancy
A. Safe period contraception
A. Contraceptive method
B. Choose male condom for contraception
C. Choose oral contraceptive pills
D. Place intrauterine device
E. Subcutaneous implantation of contraceptive pills 45. Male, 32 years old, suffering from aplastic anemia needs blood transfusion, when the input of red blood cells in suspension of about 200 ml, suddenly chills, fever, vomiting once, the urine was soy sauce-like, blood pressure 10.0/6.0 kPa (75/45 mmHg). The patient is most likely to have which of the following adverse transfusion reactions (complications)
A. Nonhemolytic febrile transfusion reaction
B. Hemolytic transfusion reaction
C. Allergic reaction
D. Bacterial contamination reaction
E. Circulatory overload
46. Weakness of the limbs, double lower extremity swelling and subcutaneous bleeding spots for 2 months, check urine protein , red blood cells , ANA ( ), there is photoallergy, the most likely diagnosis is
A. polymyositis
B. systemic lupus erythematosus
C. acute glomerulonephritis
D. chronic glomerulonephritis, nephritis
E. anaphylactic purpura
47. A primigravida, 26 years old. At 34 weeks of gestation presented with headache and blurred vision. Blood pressure was 180/100 mmHg, urinary protein ( ), fundus
Arteriovenous ratio of 1:2, and retinal edema. The diagnosis in this case should be
A. Moderate hyperemesis gravidarum
B. Preeclampsia
C. Eclampsia
D. Combined essential hypertension in pregnancy
E. Combined renal hypertension in pregnancy
48. 9-year-old boy. Sudden loss of consciousness at lunchtime, losing the bowl in his hand and waking up when the bowl was broken. The EEG shows regular and symmetrical release of 3-week/second spikes and slow waves. The most likely diagnosis is
A. Complex partial seizures
B. Partial seizures
C. Jacksonian epilepsy
D. Epileptic catatonic seizures
E. Unclassifiable epileptic seizures
49. Lin, a graduate of a secondary school of health care, worked in a township health center and obtained a license to practice as a physician assistant in 2000. obtained a license to practice as a licensed physician assistant. He wants to take the licensing examination for a licensed physician, and according to the Licensed Physician Law, he should obtain the license to practice as a licensed assistant physician and then work in a medical institution for a full period of
A.6 years
B.5 years
C.4 years
D.3 years
E.2 years
50.A 65-year-old male with radiating pain in the right upper limb accompanied by numbness and inflexibility of the fingers for 2 years has been suffering from a seizure. numbness and inflexible movements for 2 years. Examination revealed neck and shoulder tenderness, positive nerve pull test and head press test, decreased skin sensation on the radial side of the right upper extremity, decreased grip strength, and decreased muscle tone. The most likely diagnosis is
A. Sympathetic cervical spondylosis
B. Spinal cord cervical spondylosis
C. Vertebral artery cervical spondylosis
D. Neurogenic cervical spondylosis
E. Mixed cervical spondylosis. 51. A 42-year-old man suffered from acute severe pancreatitis with shock for 36 hours, and the pancreas and the necrotic tissues surrounding it were removed and drained by abdominal cavity after antishock treatment. The pancreas and its surrounding necrotic tissue were removed and abdominal drainage was performed. Postoperative heart rate was 106 beats, blood pressure was 12.8/8kPa (96/60mmHg), central venous pressure was 10cmH2O, respiratory rate was 22 breaths/min, arterial partial pressure of oxygen was 11.5kPa (86mmHg), urine output was 10ml/hour, and the specific gravity of urine was 1.002. The most urgent complication for the patient at the moment is
A. cardiac insufficiency
B. pulmonary failure
C. renal failure
D. blood volume insufficiency
E. excessive secretion of antidiuretic hormone in the body
52. Female patient with 10 years of cardiac united valvular disease has been febrile for 1 month, with a temperature of 37.2-37.6°C, anorexia, emaciation, and anemic appearance. Diagnostic means preferred
A. Chest X-ray
B. Blood culture
C. Determination of hemoglobin
D. Cardiac enzyme examination
E. Determination of blood sedimentation
53. A patient was brought to the hospital 2 hours after a car accident, complaining of cough and chest pain. T36.5℃, P130 times/min, R30 times/min, BP90/60mmHg, clear, right chest pressure pain obvious, right lung breath sounds low, right lower limb has fracture sign. Chest radiographs showed a right-sided liquid pneumothorax. The type of trauma was
A. Penetrating injury
B. Blind tube injury
C. Open injury
D. Crush injury
E. Closed injury
B1 multiple choice questions (54-65)
Answer notes
Several groups of questions are provided below, each group of questions **** use A, B, C, D, E, E, A, B, C, D, E, E and E as listed in the front of the exam. B, C, D, and E. Choose the answer that most closely relates to the question and blacken the box under the corresponding question number to which the corresponding letter belongs. An alternative answer may be chosen once, more than once, or not at all.
(Use alternate answers for questions 54 to 55***)
A. Methotrexate
B. Adriamycin
C. DA regimen
D. Cyclophosphamide
E. VP regimen
54. Acute granulocytic leukemia treatment of first choice
55. Acute lymphoblastic leukemia treatment of Preferred
(Use alternate answers for questions 56-57***)
A. Positive Kemig's sign
B. Dissociative sensory disorder
C. Positive Babinski's sign
D. **** Jejunoids
E. Positive cervical flexion test
56. A sign that may be present in a normal infant under 1 year of age is
57. A sign that may be present in cervical 1-4 nerve root irritation is (use alternate answers for questions 58 to 59***)
A. gastroscopy
B. barium meal imaging
C. abdominal CT
D. abdominal ultrasound
E. gastric fluid analysis
58. Diagnosis of acute gastritis should be used
59. Understanding gastric acid secretion in patients with ulcer disease should be used
(60-63 questions***Use alternative answers)
A. Patient with markedly elevated blood pressure, physical examination: blood pressure of 200/130 mmHg (26.6/16.9 kPa), hemorrhagic oozing from the fundus of the eye, optic papillae edema, laboratory report: renal insufficiency
B. The patient's blood pressure was significantly elevated, accompanied by severe headache, vomiting, and convulsions. C. The patient had palpitations, chest pain, shortness of breath on exertion, and dizziness on standing up or during exercise during weekdays. Physical examination: a rougher jet systolic murmur could be heard at the left edge of the sternum between the 3rd-4th ribs and was enhanced when the murmur was held in breath
D. The patient developed fever and generalized weakness one week ago. Fever, generalized weakness, now self-conscious palpitations, chest tightness, physical examination: heart rate 120 beats / min, occasional ventricular premature beats, laboratory returns CPK, GOT (AST), LDH increased
E. Patient shortness of breath, sitting breathing, physical examination: heart enlargement, auscultation can be heard the fourth heart sound prancing rhythm, double lower limbs swelling, echocardiography report: left ventricle cavity significantly enlarged
60 .dilated cardiomyopathy
61.hypertrophic cardiomyopathy with left ventricular outflow tract obstruction
62.viral myocarditis
63.malignant hypertension
(Questions 64-65***Use alternative answers)
A.penicillin G
B.sulfonamides
C.macrolides<
D. Cephalosporins
E. Vancomycin
64. The most effective drug for the treatment of staphylococcal pneumonia is
65. The treatment of mycoplasma pneumonia should be A3/A4 multiple-choice questions (66-80)
Answer Notes
Several case studies are provided below. A number of questions are provided under each case. Based on the information provided in the answers, please choose the best answer among the five alternatives A, B, C, D, and E below each exam question and put it on the answer card卑-将
(66～68Questions***用题干)
Male,33歲，who was found to be proteinuric 15 years ago, has not been examined and treated. Three weeks ago nausea, vomiting, check: blood pressure 190/120 mmHg, mild swelling, blood creatinine 360 μmol / L, ultrasound both kidneys shrink.
66. The following tests should not be performed
A. Blood routine
B. Endogenous creatinine clearance
C. Blood electrolytes
D. Intravenous pyelogram
E. Electrocardiography
67. The following biochemical abnormalities should not be present
A. Hyperkalemia
B. Low blood calcium
C. Low blood sodium
D. Low blood phosphorus
E. Acidosis
68. The most probable primary pathology in this patient is
A. Chronic glomerulonephritis
B. Chronic pyelonephritis
C. Chronic interstitial nephritis
D. Diabetic nephropathy
E.Hypertensive nephropathy
(69-71 questions***Use stem)
Male, 36 years old, had fever and sore throat 5 days ago, and antibiotic treatment was ineffective. Superficial lymph nodes in the neck are enlarged, pharynx is congested, tonsils are II° enlarged, and a few petechiae are present in the lower extremities. Leukocytes were 16.6×109/L, primitive cells were 0.60, hemoglobin was 80g/L, and platelets were 34×109/L.
69. The most likely diagnosis was
A. idiopathic thrombocytopenic purpura
B. iron deficiency anemia
C. aplastic anemia
D. hemolytic anemia
E. Acute leukemia
70. The signs that should be paid special attention to during the physical examination are
A. pale lid conjunctiva
B. sternal tenderness
C. enlarged superficial lymph nodes
D. skin hemorrhages
E. cardiac murmur
71. The test that should be done to make a definite diagnosis is
A. platelet antibodies
B. serum ferritin
C. bone marrow scan
D. lymph node biopsy
E. bone marrow smear cytology (72-76 questions***Use the stem) Female, 65 years old. History of angina pectoris of coronary heart disease for 8 years, no history of hypertension, sudden onset of anterior cardiac pain at night for 8 hours was admitted to the hospital, and her blood pressure was 150/90 mmHg (20/12 kPa) at the time of admission, and she was diagnosed with acute anterior myocardial infarction by electrocardiography
72.The most probable electrocardiographic manifestations are
A. Abnormal Q waves in II, III, and aVF,
with ST-segment bowing upwards. p>with ST-segment bow-back elevation
B. Abnormal Q waves with ST-segment bow-back elevation in V1-V4
C. Coronal T waves in V1-V4
D. Frequent premature ventricular beats
E. Third-degree atrioventricular block
73. The most characteristic laboratory change at this time is
A. Increased serum The most characteristic laboratory change in this case is
A. Increased serum LDH level
B. Increased serum GOT (AST) level
C. Increased serum GPT (ALT) level
D. Increased serum CPK-MB level
E. Decreased serum myoglobin
74. In the above patient, there were frequent ventricular premature beats, sometimes with short bursts of ventricular tachycardia.
A. Intravenous verapamil
B. Oral mesylate
C. Intravenous lidocaine
D. Oral procainamide
E. Intravenous nitrates
75. On day 2, the patient presented with tightness in the chest, profuse sweating, and pallor, and on physical examination, the heart rate was 126 beats per minute, with rhythmic congruence, blood pressure 80/50 mmHg, and both lungs were full. 50mmHg, and both lungs were full of small and medium-sized vesicular sounds. At this time, the patient's cardiac function was graded as
A. Killip class IV
B. Killip class III
C. New York Heart Association (NYHA) class IV
D. New York Heart Association (NYHA) class III
E. Total heart failure
76. Four weeks after the onset of the disease, the patient has recurrent low-grade fever, wet rhonchi at the base of the left lung, and pericardial friction heard in the precordial area; at this time, complications should be considered
A. Pulmonary infection
B. Acute pericarditis
C. Infective endocarditis
D. Post-myocardial infarction syndrome
E. Pulmonary embolism
(Questions 77-80***) Use stem)
Male, 45 years old. Cirrhosis has been detected for 5 years.
Vomiting blood, bright
red in color, amounting to about 1000 ml, occurred 3 days ago during a dinner with friends.The patient experienced dizziness,
panic and cold sweat. After blood transfusion, rehydration and treatment with hemostatic drugs, her condition improved, and her blood pressure
and heart rate returned to normal. 1 day ago, she developed sleep
disorder. She also had auditory hallucinations and slurred speech. Laboratory tests showed 130 μtg/dl of ammonia, 5.6 mmol/L of glucose, and 7.2 mmol/L of urea nitrogen.
77. The most probable diagnosis of the patient's condition in the past day is
A. Uremia
B. Cerebrovascular accident
C. Encephalitis B
D. Diabetic ketoacidosis
D. Diabetic ketoacidosis
D. Diabetic ketosis
D. D. diabetic ketoacidosis
E. hepatic encephalopathy 78.The first treatment option to be considered is
A. antibiotic therapy
B. application of ammonia-lowering medication
C. insulin therapy
D. hemodialysis therapy
E. application of sedative medication
79.The most probable cause of gastrointestinal bleeding is A. Gastric cancer
B. Gastric ulcer
C. Duodenal ulcer
D. Rupture of esophageal varices
E. Gastric mucosal lesion
80. In order to determine the cause of bleeding, which of the following examinations should be performed after the condition is stabilized
A. Barium meal fluoroscopy
B. Swallowing test
C. Gastroscopy
D. Abdominal ultrasound
E. Abdominal CT
Please continue to complete the second section of the test
Section II
Type A1 multiple-choice questions (81 to 125)
Answer instructions
Below each test question, there are five alternatives, A, B, C, D, and E . Please choose the best answer from them and blacken the box on the answer card that the corresponding letter belongs to for the corresponding question number.
81. Effective glomerular filtration pressure is equal to
A. glomerular capillary blood pressure plasma colloid osmolality - intracapsular pressure
B. glomerular capillary blood pressure - plasma crystalloid osmolality intracapsular pressure
C. glomerular capillary blood pressure plasma colloid osmolality intracapsular pressure
D. Glomerular capillary blood pressure - plasma crystalloid osmolality - intracapsular pressure
E. Glomerular capillary blood pressure - plasma colloid osmolality - intracapsular pressure
82. Intoxicating bacillary dysentery is seen most often in <
A.2-7 years old robust pediatrics
B.3-6 months old robust infants and young children
C.Low birth weight infants
D.8-10 years old children with poor nutritional status
E.12-14 years old adolescents
83.With regard to the degree of malignancy of tumors A. Grade I differentiated cells are highly malignant
B. Grade III differentiated cells are close to the normal degree of differentiation
C. Highly differentiated cells have more nuclear divisions than lowly differentiated cells
D. Lowly differentiated cells have increased levels of DNA and RNA compared with the highly differentiated cells
E. Grade I differentiated cells have disorganized cellular arrangement compared with the grade III cells
E. Grade I differentiated cells have disorganized cellular arrangement compared with grade III cells
E. Grade I differentiated cells have disorganized cellular arrangement compared with grade III cells
E. Grade I differentiated cells are disorganized compared with grade III cells
E. Grade I differentiated cells are disorganized. 84. Realization of the functional link between the hypothalamus and the neuropituitary gland relies on
A. pituitary portal system
B. hypothalamic-promoting pituitary zone
C. hypothalamic-pituitary tract
D. median eminence
E. hypothalamic regulatory peptide
85. The following are conditioned reflexes
A. Chewing, Swallowing food causes secretion of gastric juice
B.Contact of a foreign object with the eyeball causes eyelid closure
C.Knocking on the quadriceps tendon causes anterior extension of the calf
D.Stimulation of the retina by a bright light causes pupil constriction
E.Smelling of the food causes salivary secretion
86.In hypertension, the pathological changes of atherosclerosis of the fine arteries are
A. arterial wall fibrosis
B. arterial wall edema
C. arterial wall vitreous degeneration
D. arterial wall fibrinoid necrosis
E. arterial wall lipid deposits
87. The most important source of social transmission of tuberculosis is
A. primary tuberculosis
B. infiltrative tuberculosis
C. Acute cornual tuberculosis
D. Chronic hematogenous tuberculosis
E. Chronic fibro-cavitary tuberculosis 88. The main objectives of treatment of chronic nephritis do not include
A. Preventing progressive deterioration of renal function
B. Delaying the progressive deterioration of renal function
C. Ameliorating or relieving clinical symptoms
D. preventing and treating serious complications
E. eliminating urinary proteins and urinary erythrocytes
89. A large number of fat droplets enter the bloodstream after femur fracture due to mishandling, and this fat embolus is often embolized in the
A. pulmonary vein and its branches
B. left atrium
C. left ventricle
D. branches of the aorta
E. .pulmonary artery and its branches
90.Preventive medicine is the study of
A.the relationship between human health and the environment
B.the health of individuals and groups
C.the health of populations
D.the relationship between the social environment and health
E.the healthy and asymptomatic patient
91.For those engaged in the prevention of infectious diseases, medical and scientific research and those who deal with outbreaks on the spot, in order to safeguard their health, their organizations should take
A. Preventive and curative measures and compulsory treatment measures
B. Preventive and curative measures and compulsory isolation measures
C. Preventive and curative measures and medical care measures
D. Preventive and curative measures and tracking and investigative measures
E. Preventive and emergency control measures
92. The most prominent site of pathological changes in bacillary dysentery is the
A. cecum
B. terminal ileum
C. rectum and sigmoid colon
D. ascending colon
E. descending colon
93. The most prominent symptom of acute pericarditis in the case of pericardial effusion is
A.precordial pain
B.fever
C.dyspnea
D.hoarseness
E.dysphagia
94.Embolisms caused by decompression sickness are
A.gas embolism
B.thromboembolism
C.amniotic fluid embolism
D. Fat embolism
E. Foreign body embolism
95. Side effects of drugs are incorrectly described as
A. reactions to drugs at therapeutic doses
B. reactions related to therapeutic purposes
C. less severe reactions
D. reactions when the drug's action is less selective. E. A reaction that is difficult to avoid
96. The side effects of compound short-acting oral contraceptives are correctly described as follows
A. Increase in menstrual blood flow, which is not suitable for women with heavy menstrual flow
B. Increase in leukorrhea due to increase in the amount of cervical mucus caused by progestins
C. Loss of body weight due to poor appetite and low intake of food
D. Loss of weight due to poor appetite and low intake of food
C. Loss of body weight due to poor appetite and poor intake of food
C. Loss of body weight due to poor appetite and low intake of food
D.
D. Progesterone stimulates the gastric mucosa to cause an early pregnancy-like reaction
E. It can cause water and sodium retention
97. Strangulated inguinal hernias should be treated with
A. Ferguson hernia repair
B. Bassini hernia repair
C. McVay hernia repair
D. Hernia repair
C. p>D. Hernia sac high ligation
E. Shouldice repair
98. The diagnosis of female genital condyloma acuminatum is confirmed, and the inappropriate treatment is
A. 50% trichloroacetic acid
B. Freezing
C. Laser
D. Oral erythromycin
E. Microwave
99. The clinical manifestations not consistent with simplex nephropathy are
A. generalized swelling
B. massive proteinuria
C. hypoalbuminemia
D. polycythaemia
E. hypercholesterolemia
100. The main clinical manifestations of acute nephritis are
A. edema, proteinuria, hypertension and hyperlipidemia
B. Hypertension, hematuria, proteinuria, and hypoproteinemia
C. Edema, hematuria. Urine, oliguria, hypertension
D. oliguria, edema, proteinuria, hyperlipidemia
E. oliguria, edema, hematuria, hypoproteinemia
101.Acute poisoning by organophosphates is manifested by
A. decreased glandular secretion, excitation of gastrointestinal smooth muscle
B. relaxation of bladder forced urinary muscles, paralysis of respiratory muscles
C. relaxation of bronchial smooth muscle and increased salivary gland secretion
D. ganglionic excitation and complex cardiovascular effects
E. decrease in brain acetylcholine levels and dilation of the pupil
102.The drug that can diminish the cardiac murmur in hypertrophic obstructive cardiomyopathy is
A. nitroglycerin
B. digoxin
C. .isoprenaline
D.isoamyl nitrite
E.propranolol
103.Regarding the indications for the surgical treatment of hyperthyroidism, the incorrect one is
A.high-functioning adenomas
B.primary hyperthyroidism of more than moderate degree
C.goiter with compression symptoms
D.antithyroid drugs or radioactive 131 iodine treatment is ineffective
E. Children and adolescent patients
104. Convulsive generalized status epilepticus intravenous injection of phenytoin sodium should not be injected at a rate of up to more than
A.10 mg
B.20 mg
C.50 mg
D.70 mg
D.
E.100mg105.The following measures to prevent acute renal failure in patients with shock are incorrect
A. Correct hypovolemic shock in time to avoid renal ischemia
B. Drugs that tend to cause renal vasoconstriction should not be used in the treatment of corrective shock
C. Patients with a tendency to hemolysis should be treated by maintaining renal tubular patency and alkalinizing the urine to avoid Renal tubular damage
D. When shock is combined with DIC, heparin should be applied promptly
E. Whenever the patient has a decrease in urine output, diuretics should be used in a timely manner
106. The first regulatory response that occurs during an acute blood loss. The first regulatory response to occur in blood loss is
A. vascular autoregulation
B. sympathetic excitation
C. vagal excitation
D. increase in vasopressin in the blood
E. increase in angiotensin II in the blood
107. After labor, a soap and water enema can be used for
A. premature rupture of the membranes Premature rupture of membranes
B. Fetal head not articulated
C. Fetal position abnormality
O. Opening of the uterus by 3 cm in primiparous mothers
E. Severe cardiac disease
108. Junctional or borderline tumors are defined as
A. Benign tumors located at the junction of two organs
B. Benign tumors originating from two types of tissues
C. Benign in form but with infiltrative growth
D. Benign tumors located in vital organs
E. Benign tumors with endocrine function
109. The disease that causes an increase in pulse pressure is
A. Aortic valve stenosis
B. Heart failure
C. Hypotension
D. Aortic valve closure insufficiency
E. Constrictive pericarditis
110.The mechanism of action of lactulose in the treatment of hepatic encephalopathy is
A. Promoting regeneration of hepatocytes
B. Inhibiting proliferation of intestinal bacteria
C. Adsorbing intestinal toxins
D. Reducing formation and absorption of ammonia from the intestinal tract
E. Supplying sugar that to provide calories
111.The degeneration that tends to occur in uterine leiomyomas during pregnancy is
A. vitreous degeneration
B. cystic degeneration
C. red degeneration
D. sarcomatous degeneration
E. calcification
112.The rate-limiting enzyme for the synthesis of bile acids is
A.1-a-hydroxylase
B.12-a-hydroxylase
C.HMGCoA reductase
D.HMGCoA synthase
E.7-a-hydroxylase
113.Glycogen-containing vesicles begin to appear under the nucleus of the glandular epithelial cells of the endometrium, which corresponds to the
A.Early hyperplasia phase
B. Early secretory stage
C. Middle proliferative stage
D. Middle secretory stage
E. Late proliferative stage 114.The comorbidity that occurs more often months or years after major gastrectomy is
A. Diarrhea
B. Alkaline reflux gastritis
C. Bleeding
D. Vomiting
E. .anastomotic ulcers
115.The pharmacological treatment of choice for hyperprolactinemia
A.Cyproheptadine
B.Bromocriptine
C.Octreotide
D.Ketoconazole
E.Progesterone
116.In suppurative meningitis combined with a subdural effusion, the common etiologic organism is
A .Staphylococcus aureus
B.Escherichia coli
C.Group B hemolytic streptococcus
D.Haemophilus influenzae
E.Pseudomonas aeruginosa (Pseudomonas aeruginosa)
117.The causative agent of hemorrhagic fever in renal syndrome is
A.Hantavirus
B.Dengue virus
C.Xinjiang hemorrhagic fever virus
D.Yellow fever virus
E.Lassa virus
118.The most important marker on the surface of B cells is
A.SmIg
B.FCYR
C.CD40
D.CD5
E.CD80
119.Early changes in the patient's vital signs during acute intracranial pressure increase are
A.Increased blood pressure, slowed pulse, and decreased pulse pressure
B.Increased blood pressure, faster pulse, and increased pulse pressure
C.Decreased blood pressure, slowed pulse, and decreased pulse pressure
D.Decreased blood pressure, faster pulse, and decreased pulse pressure
E.Increased blood pressure, faster pulse, and decreased pulse pressure
E.Increased blood pressure, faster pulse, and decreased pulse pressure
E.Increased blood pressure, faster pulse, and decreased pulse pressure
E.Increased blood pressure, increased blood pressure, and decreased pulse pressure
E.Increased blood pressure, decreased blood pressure, and decreased blood pressure
E. E. Blood pressure rises, pulse rate slows, pulse pressure increases
120.The incorrect description of cerebral debility syndrome is that
A. The core symptoms are euphoria and fatigue
B. Sleep disturbances are one of the common symptoms of the syndrome
C. It can be secondary to a number of physical illnesses
D. It can be seen in schizophrenia
E. It has a diagnostic specificity for Neurasthenia has diagnostic specificity
121.The most common cause of ventricular fibrillation and sudden cardiac arrest leading to sudden death in patients with pulmonary heart disease is
A. Acute extensive myocardial infarction
B. Acute severe myocardial hypoxia
C. Right cardiac insufficiency
D. Left cardiac insufficiency
E. Combination cerebrovascular Accident
122.In the implementation of assisted human reproduction technology in China, the following are against the principles set by the Ministry of Health
A.Use of donor sperm
B.Use of donor eggs
C.Implementation of surrogacy by relatives
D.Implementation of intracytoplasmic monosperm injection
E.Use of donor embryos
E.
123.The most commonly used drug for the treatment of trichomonas vaginitis is
A. penicillin
B. metronidazole
C. haloperidol
D. cephradine
E. mycobacterium mycoplasma 124.The rheumatologic disease in which the main pathologic change is the degenerative destruction of cartilage is
A. rheumatoid arthritis
B. Ankylosing spondylitis
C. Rheumatic fever with joint involvement
D. Osteoarthritis
E. Gouty arthritis
125.Regarding medullary carcinoma of the thyroid gland, the following statements are incorrect
A. Medullary carcinoma of the thyroid gland originates from the follicular epithelium of the thyroid gland
B. Medullary carcinoma accounts for 7% of all thyroid cancer
C. The tumor marker for medullary thyroid carcinoma is calcitonin
D. The principle of surgery is the same as that of papillary adenocarcinoma
E. It may have both lymphatic and hematogenous metastasis
Type A2 multiple-choice questions (126-139)
Answer notes
Each question of the examination is presented as a small case, and underneath it, there are five A, B, C, D and E alternative answers. Please choose the best answer from these and blacken the box on the answer card where the corresponding letter belongs to the corresponding question number.
126.Middle-aged woman with a sudden enlargement of a swelling in the fossa ovalis of the right thigh after a severe cough