内科学试题及答案甲状腺疾病

1、甲状腺疾病习题Translate and explanate：1. hyperthyroidism2. TSH receptor antibody3. hyperthyroidic heart disease4. subclinical hyperthyroidism5. apathetic hyperthyroidismQuestion and answe：r1. Please explanate the three types of TSH receptor antibodies.2. Please state the three thyroid antibodies occuring i

2、n Graves disease？3. Which of the two antibodies can be used as a sign of Graves ophthalmopathy activities?4. what is the Induced factors of Thyrotoxic periodic paralysis ?5. what is characterized of Hematopoietic system when hyperthyroidism?6. Which causes can make thyroid-hormone binding immunoglob

3、ulins chang？e7. what is the most sensitive indicator to reflect Thyroid function?1318. Which diseases were been found that the uptake rate of 131I increase or reduce (Give an example respectivly) ?9. What is the diagnosis stantard for hyperthyroidism？10. What are the adverse reactions of Antithyroid

4、 drugs? 11.What is the mechanism of thyroid crisi？s 12. What are the main inducement of Hyperthyroidism crisis? Statemen：ts1. what of clinical manifestations of Graves Simple ocular symptoms?2. Please state the peculiar clinical features and types of Graves disease？3. W hat is indications of Antithy

5、roid drug treatment?4. what are kinds and action mechanism of Antithyroid drug?Given two representatives of drugs respectivly5. What are the clinical features of thyroid crisi？s6. Please state the salvage principle of thyroid cris？is 单选题：1. TSH receptor is a kind of G-protein-coupled receptor family

6、 ,and composed by _ amino acid .A.544 B.644 C.744 D.844 E.4442. The highest positive rate of antibody in patients with GravesA.TPOAbB.TgAb C . TRAb D.NIS E.TSBAb3. The antibody that could reflect the disease activity markers in blood circulation of patients with Graves ophthalmopathyA. D. 针对眼外肌的抗体 B

7、. TRAb C. TPOAb D. TgAb4. The most common disorders of the heart rate in patients withhyperthyroidismA. 心房颤动 B. 室性早博 C. 房室传导阻滞 D. 交界性 早博E. 室速5. The age of morbidity of thyrotoxic periodic paralysisA.40-50 岁 B.50-60 岁 C.60-70 岁 D.20-40 岁E.10-20 岁6. Mild degree of hyperthyroidism exophthalmos in gener

8、al does not exceed A.16mm B.18mm C.20mm D.22mm7. The sequence relations of occurrence of hyperthyroidism andGraves ophthalmopathyA.45%两者同时发生B.43% 两者同时发生 C.45% 甲亢先于 Graves 眼病发生D.46%甲亢先于Graves眼病发生E.47%甲亢先于Graves眼病发生8. Serum _is a reflection of the most sensitive indicator of thyroidfunctionA. FT 3B.FT

9、 4C.TSHD. TRAbE. TgAb9. what is hyperthyroidism drug therapy adverse reactions?A. 粒细胞减少 B. 皮疹 C. 中毒性肝炎D.管神经性水肿E. 急性关节炎10. The preferred choose drug is given during the full pregnancyA. 丙基硫氧嘧啶 B. 甲基硫氧嘧啶 C. 他巴唑 D. 甲 亢平E. 心得安11. Thyrotoxic crisis is the most commonly founAd. 甲亢口服药治疗时 B. 甲亢合并感染时 C.妊娠期甲亢

10、D.淡漠型甲亢E.甲亢手术治疗后12. the main clinical manifestations of thyrotoxic crisis :A. 呕吐、腹泻、脱水、休克、心慌气短B. 心率加速、血压增高、脉压增大C 高热、脉率快、焦虑、大汗、呕吐、失水、休克D. 肺水肿、全身浮肿E 心慌、心率略快、血压下降、体温略高 多选题：1. The thyroid antibodies related with Graves disease A . TRAbB.TBHC.T POAb D.TgAb E.TSBAb2. The antibodies as a sign of disease ac

11、tivity in patients with GravesophthalmopathyA. TPOAb B. TgAb C.针对眶后成纤维细胞的自身抗体D. 针对眼外肌的自身抗体 E. TRAb3. the performance of cardiovascular system when hyperthyroidismA. 心悸气短 B. 第一心音亢进 C. 房颤多见 D. 脉压差大E.收缩压升高4. the performance of hematopoietic system when hyperthyroidism A. 淋巴细胞比例增加 B. 单核细胞增加c.白细胞总数减低D. 可

12、伴发血小板减少性紫癜 E. 白细胞总数增加5. The diagnosis of hyperthyroidismA. 高代谢症状和体征B.甲状腺肿伴或不伴血管杂音c. 血清 FT4 增高D.TSH 减低E. 高代谢体征6. The diagnosis of Graves diseaseA. 甲亢诊断成立B. 甲状腺肿大成弥漫性 C. 伴浸润性突眼D. TRAb 和TSAb阳性 E.胫前粘液性水肿7. Hyperthyroidism and thyroiditis-induced thyrotoxicosis resulting in leakage of thyroid hormone-ind

13、uced identificationA.病史 B.甲状腺体征C. 131|摄碘率 D.FT 3、FT4E.EcT8. Inhibit the synthesis of thyroid hormone drugE. 碘B.A.硫脲类 B.咪唑类 C. P -受体阻滞剂 D.激素9. Indication for drug treatment of hyperthyroidism A. 孕妇术前准备 C.年龄V 20岁 D.甲状腺轻中度肿大E.迫症状10. Adverse effects of drug treatment of hyperthyroidismA.粒细胞减少B.皮疹 C.中毒性肝

14、炎D.胆汁淤积性黄疸E.急性关节炎11. The characteristic of Hyperthyroidism crisisA. 多见于感染， 各种应急时 B. 最常见于 I 治疗的后期C. 可能与交感神经兴奋有关D. 心率一般在 120140次/ 分E.可伴心衰和肺水甲状腺疾病习题答案单选题答案1.C2.C 3.A 4.A 5.D6.B 7.B 8.B9.E10.A 11.B 12.C多选题答案1. ABCDE 2.CD 3.ABCDE4.ABCD 5.ABCDE 6.ABCDE7.ABCDE 8.AB 9.ABCDE10.ABCDE11. ACE三、名词解释答案:1. 简称甲亢，是指

15、甲状腺腺体本身产生甲状腺激素过多而引起的甲状 腺毒症， 其病因包括弥漫性毒性甲状腺肿、 结节性毒性甲状腺肿和甲 状腺自主高功能腺瘤。2. 也称为TSH结合抑制性免疫球蛋白，是存在于 GD患者血清中的针对甲状腺细胞TSH受体的特异性自身抗体。3. 甲亢患者在原有临床表现的基础上出现心律失常、 心脏增大和心力 衰竭。以心房颤动等房性心律失常多见，偶见房室传导阻滞。4.本症需在排除其它能够抑制 TSH水平的疾病的前提下，依赖实验室检查结果才能诊断，即血清 T3、T4正常，但是TSH减低。5. 多见于老年患者，起病隐袭，高代谢综合征、眼征和甲状腺肿均不 明显。主要表现为明显消瘦、心悸、乏力、头晕、昏厥

16、、神经质或神志淡漠、腹泻、厌食。可伴有心房颤动、震颤和肌病等体征，70%患者无甲状腺肿大。临床中易被误诊。四、简答题答案:I. TRAb分为三种类型即TSH受体刺激性抗体（TSAb、TSH刺激阻断性抗体（TSBAb和甲状腺生长免疫球蛋白（TGI）2. Graves病中易被检测出的三种甲状腺抗体为 TSH受体抗体（TRAb甲状腺过氧化物酶抗体（ TPOAb 和甲状腺球蛋白抗体（ TgAb）3. 针对眶后成纤维细胞的自身抗体和针对眼外肌的自身抗体这两种 抗体可作为 Graves 眼病活动的标志。4. 发病诱因包括剧烈运动、高碳水化合物饮食、注射胰岛素等。5. 周围血淋巴细胞比例增加，单核细胞增加，

17、但是白细胞总数减低。可以伴发血小板减少性紫癜。6. 妊娠、雌激素、急性病毒性肝炎、先天因素等可以引起TBG升高,导致 T T4 增高；雄激素、糖皮质激素、低蛋白血症、先天因素等可以 引起TBG降低，导致T T4减低。7. 血清TSH是反映甲状腺功能的最敏感的指标。8. 131I摄取率增高见于Graves病，1311摄取率减低见于亚急性甲状腺炎。9. 高代谢症状和体征；甲状腺肿伴或不伴血管杂音；血清FT4增高、TSH减低。具备以上三项诊断即可成立。10.粒细胞减少皮疹胆汁淤积性黄疸、血管神经性水肿、中毒性肝炎、急性关节炎等。11.可能与循环内FT3水平增高，心脏和神经系统的儿茶酚胺激素受体数目增

18、加、敏感性增强有关。12. 主要诱因有感染、手术、放射碘治疗、创伤、严重的药物反应、 心肌梗死等。五、论述题答案:1.单纯性眼征包括下述表现：轻度突眼：突眼度不超过18mmStellwag征：瞬目减少，炯炯发亮；上睑挛缩，睑裂增宽； vonGraefe 征：双眼向下看时，由于上眼睑不能随眼球下落，出现白色 巩膜；Joffroy双眼向上看时，前额皮肤不能皱起； Mobius 征: 双眼看近物时，眼球辐辏不良。2. Graves 病特殊临床表现有甲状腺危象甲状腺功能亢进性心脏 病淡漠型甲状腺功能亢进症三碘甲腺原氨酸 (T3 )型和甲状腺素(T4)型甲状腺毒症亚临床甲状腺功能亢进症妊娠期甲状腺功能亢进症胫前粘液性水肿 Graves 眼病3. 适应症为病情轻、中度患者；甲状腺轻、中度肿大；年龄V 20岁；孕妇、高龄或由于其它严重疾病不适宜手术者；手术前或放射碘治疗前的准备；手术后复发且不适宜放射碘治疗者。4. 抗甲状腺药物可分为硫脲类和咪唑类两类， 硫脲类包括丙硫氧嘧啶 和甲硫氧嘧啶；咪唑类包括甲硫咪唑和卡比马唑。5.临床表现为原有的甲亢症状加重，包括高热（39C以上）、心动过速（ 140240次/