复旦大学医学院儿科学考试试题

1、复旦大学医学院儿科学系20052006 学年第一学期期末考试试卷一、选择题（140分）A型题What is the most important clinical feature of nephriticsyndrome?ProteinuriaC.HypertensionE.HypercholesteolemiaEdemaD. HypoalbuminemiaThe range of serum natrium concentration in isonatremic dehydration shouldbe120140mmol/L C.140160mmol/LE.130 150mmol/LB.

2、 130 160mmol/LD. 140 150mmol/LWhich is main difference between dehydration of severe degree andmoderate degree?poor skinresiliencyC.oliguria oranuriaE. peripheral circulatory orbitpittingD. metabolic acidosisWhat time is better for weaning in breast feedingbaby?4-5 months ofageC.10-12 months ofE. 18

3、 months of age6-9 months ofageD. 13-15 months of ageThe ratio of Calcium and Phosphorus in breastmilkisA.1:2C.2:1E. 1.5:2B.1.5:1D.1.2:1During fetal life, the earliest synthesized immunoglobinisIgMC.IgGE. IgEB.IgDD.IgAVery low birthweight infant is the newborn whose birth weight is lessthanA.C.E.800g

4、B.2000g1500gD.lOOOgThe major early manifestation of tuberculous meningitis in childrenisA tense anteriorfontanealC.StuporE. Mood changesConvulsionD. Cranial nerve palsiesDTP (Diphtheria, tetanus, pertussis vaccine), Primary immunization shouldtakenJust onetimeOnce a month, twotimesOnce a month, thre

5、etimesOnce a week, twotimesOnce a week, threetimesPhysiologic weight lower of a normal newborn will be recoveredinA.C. 57 days E.10-14 daysl3daysB.35D.710daysIf a staphylococcal pneumonia patient suddenly breath difficultly, weshould consider that is because:A.highfeverC. pneumonia developedE. heart

6、 failureB. acidosisD. pyopneumothoraxIntrauterine life comprises two stages: embryonic and fetal, the fetal periodis usually considered tobe:the end of 6 th week of gestation to 40 th week ofgestationthe end of 8 th week of gestation to 40 th week ofgestationthe end of 10 th week of gestation to 40

7、th week ofgestationthe end of 12 th week of gestation to 40 th week ofgestationthe end of 12 th week of gestation to 37 th week ofgestationA newborn baby, gestational age 268 days, birth weight2.45kg,height 47.5cm,head circumference 34cm,chest circumference 32cm, heispre-term, large for gestational

8、agebabyfull-term, appropriate for gestational agebabyfull-term, small for gestational agebabypost-term,small for gestational agebabyfull-term,large for gestational agebabyWhich one of the following statement isn5t the clinical finding offebrile convulsionwith a family history ofseizuresoften occur i

9、n neonatalperiodassociated with a rapidly risingtemperatureless than 10 to 15 minutesepisodetypical generalizedseizuresPhysiologic hypogammaglobulinemia is commonly seeninImmediately afterbirthC. 10-12 months of ageE. 3 years of ageB. 3-4 months of ageD. 1-2 years of ageWhich one is the cyanostic ty

10、pe of congenital heartdiseaseventricular septaldefectC. tetralogy of Fallot E.pulmonary stenosisB. atrial septal defectD. Patent ductus arteriosusWhich one of the following statement isn5t the general regularity ofgrowth development inchildren?from the upper part to the lowerpartfrom the distal part

11、 to the proximalpartfrom the gross motion to finemotionfrom lower level to higherlevelfrom simple tocomplicatedThe range of serum natrium concertration in isonatremic dehydration shouldbe A.120-140mmol/1B.130-160mmol/1C.140-160mmol/1D. 140-150mmol/1E. 130-150 mmol/1The major manifestations of acute

12、glomerulonephritisarehypertension, hematuria,proteinuriaproteinuria,hypertensionedema, hypertension,hematuriaoliguria, edema, hypertension,hematuriaoliguria, edema, hematuria,hypercholesteolemiaPPD test is a reliable diagnostic test for tuberculosis, an infectedpatient respounds positively ofinfecti

13、onimmediatelyC. within 2-4 weekE. after 10 weekB.within12weekD. within 4-10week以下哪种情况与生长发育规律不符？生长发育是连续的过程各系统器官发育不平衡生长发育遵循由简单到复杂的规律神经系统发育先慢后快生长发育有个体差异一般来说头围等于胸围的年龄是A. 6个月C.1岁半E.2岁半B. 1岁D. 2岁婴儿每日需要量热能为376KJ (90Kcal)/kg419KJ(100Kcal)/kg461KJ(110Kcl)/kg502KJ(120Kcal)/kgE. 543(130Kcal)/kg轻度肥胖的标准为小儿休重超过同性

14、别同身高正常儿均值的A. 10 19%B. 2029%C. 3039%D. 4049E. 50 59%在新生儿窒息复苏方案中，应首先采取哪一步骤？建立呼吸，增加通气尽量吸净呼吸道粘液，保持气道通畅给肾上腺素维持正常循环，保证足够心输出量以上都不是下列哪一项与新生儿肺透明膜病的发病关系最不密切？肺表面活性物质缺乏早产儿足月儿小样儿糖尿病母亲婴儿剖宫产以下哪项不是新生儿败血症的临床表现？不吃、不哭、体温不升黄疸气急抽搐颅内出血腺病毒肺炎主要临床特点为年长儿多见喘憋明显而肺部罗首不明显常有高热而一般情况良好咳嗽有粉红色泡沫痰夏季最多见下列哪种情况符合小儿重症肺炎？气胸脓胸肺脓疡中毒性脑病败血症室间隔

15、缺损首先导致哪个心腔扩大左心房增大左心室增大右心房增大右心室增大都有可能金黄色葡萄球菌肠炎典型大便为黄色水样蛋花汤样粘液血便豆腐渣样暗绿色海水样牛理性贫血的主要原因是先天储铁不足肾功能不全红细胞生成素不足铁摄入不足疾病影响癫痫失神发作应首选下列哪种抗癫痫药物治疗?氯硝西泮苯巴比妥苯妥英钠卡马西平丙戊酸钠典型苯丙酮尿症的发病机理为A.苯丙氨酸-4B四氢生物喋吟生成不足酪氨酸轻化酶受抑制5-疑色胺不足二氢生物喋吟还原酶先天缺陷下列哪项对鉴别小儿风湿热与类风湿病最有价值？发热关节炎心脏炎血沉增快X线示关节面破坏女孩，10210mmol/Lo可诊断为糖尿病中枢性尿崩症肾性尿崩症甲亢以上都不是肾炎性肾病

16、与单纯性肾病的区别在于水肿更严重高胆固醇血症有血尿或高血压对激素不敏感低蛋白血症更明显10170/120mmHg,H500ml,应诊断为：心力衰竭高血压脑病代谢性酸中毒并发化脓性脑膜炎肾功能衰竭小儿尿路感染最常见的病原菌是大肠杆菌变形杆菌克雷白菌金黄色葡萄球菌真菌惊厥持续状态是指1小时1小时，间期无清醒期抽搐间期无清醒期惊厥持续时间超过半小时抽搐超过半小时，间期无清醒期二问答题（1560分）试述新生儿缺氧缺血性脑病的病因和临床表现。简述小儿轻、中、重度脫水的临床表现及鉴别要点。试述小儿急性肾炎的临床表现和治疗原则。试述动脉导管未闭的血流动力学特点和临床表现。试卷答案1、 A)21(D)(2 、

17、 E(22、(B)3、 E)(4(4、C)(5、C)(6、A)(7、C)(8、E)9、(C)10、(D)11、(D)12 、（D)13、(C)14、(B)15、(B)16、(C)17、(B)18、(E)19、(D)20、(D)23(C)、24(B)、25(B)、26(C)、27(E)、28(B)、29(D)、30(B)、31(E)、32(C)、33(E)、34(A)、35(E)、36(A)、37(C)、38(B)、39(A)、40(E)、1.病因：试述新牛儿缺氧缺血性脑病的病因和临床表现。母亲因素：妊娠相关疾病：妊高症、子痫全身性疾病：糖尿病、心血管疾病、肾脏病（2 分）其他因素：各种手术产、

18、急产、产程延长、头盆不称（2分）胎儿因素：早产儿、过期产、小于胎龄儿、巨大儿、多胎先天畸形、宫内感染、羊水或胎粪吸入（2 分）临床表现：出生后 12-24 小时出现神经系统症状，根据意识、肌张力改变、原始反射异常、惊厥和脑干受损等表现，可分为轻、中、重度。（9 分）临床表现轻度中度重度意识激惹抑制、嗜睡昏迷肌张力改变正常或升高减弱松软拥抱反射正常或活跃减弱消失惊厥无半数有惊厥频繁惊厥2.简述小儿轻、屮、重度脱水的临床表现及鉴别要点。轻、屮、重度失水的临床表现:轻度中度重度皮肤相当于体重 5%5-10%口唇粘膜变略差口唇粘膜变略差较差非常烦躁眼眶前区 1稍凹明显凹陷深度凹陷眼泪尿量减少尿少、泪少甚至无尿、无泪循环尚可、肢温脉细、肢凉循环障碍、甚至