儿科学课程期末试卷A卷(试卷及答案详解)

PAGEPAGE10复旦大学上海医学院儿科学系期末考试试卷A卷 □B卷课程名称：_儿科学 课程代码：_MED130029 开课院系：_儿科学

考试形式：开卷/闭卷/课程论文/姓名： 学号： 专业：题号题号12345678总分得分一、选择题（每题1分，共40分）A型题Duringfetallife,theearliestsynthesizedimmunoglobinisIgM D.IgAIgD E.IgEIgGTherangeofserumnatriumconcentrationinisonatremicdehydrationshouldA.120~140mmol/L D.140~150mmol/LB.130~160mmol/L E.130~150mmol/LC.140~160mmol/LAboy,oneyearold,withighfeve6dayslistlessneequencough,paroxysmarespiratoistress.Physicalexamination:naresflaring,markedinspiratoryretractions,dullnessatbothlowerlungs,soundssmallamountoffinmoistralthrougbothlungs.Thwhitebloodcountwas9.×109/Lthechestx-rayshowedbilaterallypatchyshadowofdensity.Themostlikelydiagnosisis:staphylococcalpneumoniarespiratorysyncytialviruspneumoniaadenoviruspneumoniamycoplasmapneumoniapneumoncoccuspneumoniaWhichismaindifferencebetweendehydrationofseveredegreeandmoderatedegree?poorskinresiliency D.metabolicacidosisorbitpitting E.peripheralcirculatoryfailureoliguriaoranuriaApre-termbabyofonemonthandtwodaysold,gestationalage35weeks,borninwinter,breastfeeweightisincreasingfrom2.0kgto3.0kg.Nowwhichsupplementaryfoodisaddedtoatfirstandwhy?rice-water,forsupplementationofenergyvegetablesoup,forsupplementationofmineralsubstancesrice-paste,forsupplementationofenergycodliveroil,forsupplementationofVitAcodliveroil,forsupplementationofVitDWhattimeisbetterforweaninginbreastfeedingbaby?4-5monthsofage D.13-15monthsofage6-9monthsofage E.18monthsofage10-12monthsofageTheratioofCalciumandPhosphorusinbreast-milkA.1:2 D.1.2:1B.1.5:1 E.1.5:2C.2:1Whatisthemostimportantclinicalfeatureofnephriticsyndrome?Proteinuria D.HypoalbuminemiaEdema E.HypercholesteolemiaHypertension9.Ofthefollowing,theonlyonethatnormallyrisesintheinfantinthefirstweekafterbirthisA.hematocritD.temperatureB.bodyweightC.pulmonaryarterialpressureE.bilirubinThemajormanifestationofTuberculousmeningitisinchildrenisAtenseanteriorfontaneal D.CranialnervepalsiesConvulsion E.MoodchangesStupormother’sRhbloodtypethefetusisCcDdEe,thenRhincompatibilityshouldbeCantigen D.Eantigencantigen E.eantigenDantigenDTP(Diphtheria,tetanus,pertussisvaccine),PrimaryimmunizationshouldbetakenJustonetime D.Onceaweek,twotimesOnceamonth,twotimes E.Onceaweek,threetimesOnceamonth,threetimesPhysiologicweightlowerofanormalnewbornwillberecoveredin1~3days D.7~10days3~5days E.10~14days5~7daysAhealthyboy,oneyearandsixmonthsold,howmuchenergyandwatershouldherequireeveryday?energy(kj)/kg water(ml)/kgA. 418(100kcal)100B. 460(110kcal)100C. 418(100kcal)110D. 418(100kcal)125E. 925(150kcal)150Aninfant,weight7kg,length65cm,headcircumference42cm,theinfantshouldbe5monthsold D.8monthsold6monthsold E.9monthsold7monthsoldIfastaphylococcalpneumoniapatientsuddenlybreathdifficultly,weshouldconsiderthatishighfever D.pyopnemothoraxacidosis E.heartfailurepneumoniadevelopedWhichoneisthemostcommontypeofTBinchildrenPrimarypulmonarytuberculosis D.TubeculosisofabdomenMiliarytuberculosis E.TuberculouspleurisyTuberculosismeningitisWhichoneisthecyanotictypeofcongenitalheartdiseaseventricularseptaldefect D.Patentductusarteriosusatrialseptaldefect E.pulmonarystenosistetralogyofFallotThemajormanifestionsofacuteglomerulonephritisarehypertension,hematuria,proteinuria D.oliguria,edema,hypertension,hematuriaproteinuria,hypertension E.oliguria,edema,hematuria,hypercholesteolemiaedema,hypertension,hematuriaPPDtestisareliablediagnostictestfortuberculosis,aninfectedpatientrespoundspositivelyimmediately D.within4-10weekwithin1-2week E.after10weekwithin2-4week1补充维生素D B.补充钙剂C.多晒太阳 D.减少行走E.外科矫形术缓解支气管哮喘急性发作的首选治疗方法为：吸入短效2受体激动剂吸入色甘酸二钠氨茶碱静脉注射口服抗组织胺药静滴抗生素舌尖及反甲皮肤瘀点伴黄疸肝、脾及淋巴结肿大,10自然吸收或钙化发展为肺门淋巴结结核病灶溶解、坏死形成空洞血行播散发展为胸膜炎4叶酸与维生素B12矿物质含量过高100ml,Apgar1min5min376h新生儿低血钙新生儿低血糖新生儿脑膜炎脑室管膜下出血新生儿缺氧缺血性脑病,Apgar10拥抱反射颈肢反射腹壁反射觅食反射交叉伸腿反射310～15s5～10s给咖啡因给氨茶碱(CPAP)吸氧向家长解释小儿33、4肋间闻及Ⅲ～Ⅳ2X小型室间隔缺损大型室间隔缺损风湿性心脏病房间隔缺损动脉导管未闭患儿6岁,易有呼吸道感染,劳累后气促。体检:胸骨左上方闻及连续性杂音,血压12.8/5.3kPa(96/40mmHg)室间隔缺损 E.法洛四联症房间隔缺损动脉导管未闭肺动脉狭窄0级 B.Ⅰ级C.Ⅱ级 D.Ⅲ级E.Ⅳ级,10自我控制力不足 B.活动过多C.注意力不集中 D.冲动、任性E.学习困难33.18个月男孩,于确诊川崎病后出院,2周后猝死于家中,死前并无明显诱因。其死因可能为:脑出血脑栓塞心肌炎心包炎冠状动脉瘤破裂扁桃体炎血白细胞总数增高ASO舞蹈病心电图ST,12d1d呼吸急促 D.肺部细小口)音口唇、甲床青紫 E.鼻翼扇,张口呼吸6炎。病原体主要是：流感病毒 D.呼吸道合胞病毒流感杆菌 E.肺炎支原体腺病毒4大量尿蛋白 B.低白蛋白血症C.明显浮肿 D.高胆固醇血症E.血清尿素氮、肌酐在正常范围基础代谢所需的营养素和能量生长发育所需的营养素和热量食物特殊动力作用所需的热量活动所需的营养素与热量排泄物中热量的损失G1P13.5kg0.5h2～3h12h24h24～48h新生儿肺透明膜病出现呼吸困难的时间一般不超过：26122472二、问答题（每题15分，共60分）试述新生儿病理性黄疸和生理性黄疸的鉴别诊断。试述急性肾小球肾炎的发病机制、临床表现、治疗原则。引起小儿腹泻的病因有哪些？婴幼儿易患腹泻的内在因素有哪些？试述室间隔缺损的血流动力学特点和临床表现。2008~2009（A答案姓名 学号 班级 成选择题：1（A）21、（D）2（E）22、（A）3（C）23、（E）4（E）24、（A）5（E）25、（C）6（C）26、（E）7（C）27、（C）8（A）28、（E）9（D）29、（B）10（E）30、（C）（D）31、（C）12（C）32、（A）13（D）33、（E）14（D）34、（D）15（B）35、（D）16（D）36、（D）17（A）37、（E）18（C）38、（B）19（D）39、（A）20（D）40、（C）问答题1.试述新生儿病理性黄疸和生理性黄疸的鉴别诊断。病理性黄疸生理性黄疸黄疸出现时间生后24小时或其他时间生后2～3天黄疸高峰时间不定生后4～6天黄疸消退时间2周后不退足月儿生后2周3～4血清总胆红素>204umol/L<204umol/L血清结合胆红素>25umol/L<25umol/L试述急性肾小球肾炎的发病机制、临床表现、治疗原则。免疫损伤（5分）肾小球毛细血管狭窄、闭锁 肾小球基底膜受损肾小球血流量减少肾小球滤过率下降 血浆水钠储留，细胞外液增加 红细胞渗入肾小球白细胞少尿、水肿、高血压肺水肿、心衰、氮质血症 红白细胞尿、管型激活补体全身毛细血管通透性增加水肿临床表现：前驱期表现，少尿、水肿、血尿、高血压（5分治疗原则：消除残余病原、对症处理、