基础医学各论Ⅰ：各论1试卷

浙江大学20_08–2009学年春夏学期《基础医学各论I》课程期末考试试卷(A卷)开课学院：医学院考试形式：闭卷考试时间：2009年6月30日10:30-12:30所需时间：120分钟一、单项选择题（每题1分，共50分）1.肩胛骨下角平对A.第2肋B.第3肋C.第4肋D.第5肋E.第7肋2.奇静脉注入A.下腔静脉B.上腔静脉C.头臂静脉D.肝静脉E.门静脉3．下列哪一结构不属于三尖瓣复合体？A.纤维环B.乳头肌C.瓣膜D.肉柱E.腱索4．下列哪一块肌属于大腿后群肌？A.缝匠肌B.大收肌C.股薄肌D.股二头肌E.股四头肌5.SuperiorthyroidarterycomesfromA.externalcarotidarteryB.internalcarotidarteryC.subclavialarteryD.maxillaryarteryE.vertebralartery6.关于乳糜池的描述，错误的为A.位于第1腰椎前方B.是胸导管的起始部位C.由左、右腰干和肠干汇合而成D.收集身体3/4的淋巴E.向上经胸导管注入左静脉角7.Thefollowingstructuresbelongtothejointofthevertebralarches,excepttheA.supraspinalligamentsB.interspinalligamentsC.anteriorlongitudinalligamentD.ligamentaflava(yellowligaments)E.intertransverseligaments8.下列哪一块骨不属于脑颅骨？A.额骨B.筛骨C.颞骨D.上颌骨E.枕骨9.以下称为肌性动脉的主要动脉为A.大动脉B.中动脉C.小动脉D.微动脉E.以上都不是10.以下称为弹性动脉的是A.大动脉B.中动脉C.小动脉D.微动脉E.以上都不是11.称为外周阻力动脉的是A.大动脉B.中动脉C.小动脉D.微动脉E.以上都不是12.Plateletsarederivedfrom_______inbonemarrowA.cytoplasmicfragmentsofmacrophageB.cytoplasmicfragmentsofmegakaryocyteC.cytoplasmicfragmentsoflymphoblastD.cytoplasmicfragmentsofmonoblastE.cytoplasmicfragmentsoferythroblast13.造血干细胞，最早来源于A.肝B.脾C.胎盘D.红骨髓E.卵黄囊血岛14.红细胞的平均寿命为A.1周B.3周C.约1个月D.约120天E.半年15.寿命最长的血细胞是A.红细胞B.网织红细胞C.中性粒细胞D.淋巴细胞E.单核细胞16.在最适初长条件下进行收缩，肌肉产生的张力最大。因为在此情况下A.起作用的横桥数目最多B.横桥释放的能量最多C.ATP酶的活性最多D.横桥循环的速度最快E.钙通道开放的数目最多17.Whichcharacteristicorcomponentissharedbyskeletalmuscleandsmoothmuscle?A.ThickandthinfilamentsarrangedinsarcomeresB.TroponinC.Elevationofintracellular[Ca2+]forexcitation-contractioncouplingD.SpontaneousdepolarizationofthemembranepotentialE.Highdegreeofelectricalcouplingbetweencells18.Atthemuscleendplate,acetylcholine(ACh)causestheopeningofA.Na+channelsanddepolarizationtowardtheNa+equilibriumpotentialB.K+channelsanddepolarizationtowardtheK+equilibriumpotentialC.Ca2+channelsanddepolarizationtowardtheCa2+equilibriumpotentialD.Na+andK+channelsanddepolarizationtoavaluehalfwaybetweentheNa+andK+equilibriumpotentialsE.Na+andK+channelsandhyperpolarizationtoavaluehalfwaybetweentheNa+andK+equilibriumpotentials19.促进红细胞成熟的因子是A.蛋白质和铁B.促红细胞生成素C.内因子D.维生素B12和叶酸E.雄激素20.红细胞所需的能量主要来自于A.葡萄糖的有氧氧化B.糖原异生C.糖原分解D.糖酵解E.脂肪酸氧化21.通常所说的血型是指A.红细胞上受体的类型B.红细胞表面特异凝集素的类型C.红细胞表面特异凝集原的类型D.血浆中特异凝集素的类型E.血浆中特异凝集原的类型22.下列关于生理止血机制的描述，错误的是A.包括局部血管收缩、血小板血栓形成和血凝块形成B.血小板与凝血块的形成有关C.血小板与局部缩血管反应有关D.血小板减少时出血时间延长E.FⅡ缺乏时体内生理性凝血启动发生障碍23.Currentscausedbyopeningofwhichofthefollowingchannelscontributetotherepolarizationphaseoftheactionpotentialofventricularmusclefibers?A.Na+channelsB.Cl-channelsC.Ca2+channelsD.K+channelsE.HCO3-channels24.Duringwhichphaseofthecardiaccycledoesthemitralvalveopen?A.AtrialsystoleB.IsovolumetricventricularcontractionC.RapidventricularejectionD.ReducedventricularejectionE.Isovolumetricventricularrelaxation25.Whichofthefollowingdoesnotoccurasbloodpassesthroughthesystemiccapillaries?A.ItshematocritincreasesB.ItshemoglobindissociationcurveshifttotheleftC.ItsproteincontentincreasesD.ItspHdecreasesE.Itsredbloodcellsincreaseinsize26.Whentheviscosityofthebloodisincreased,whichofthefollowingisincreased?A.MeanbloodpressureB.RadiusoftheresistancevesselsC.RadiusofthecapacitancevesselsD.CentralvenouspressureE.Capi1larybloodflow27.ThevelocityofbloodflowA.IshigherinthecapillariesthanthearteriolesB.IshigherintheveinsthaninthevenulesC.IshigherintheveinsthanthearteriesD.FallstozerointhedescendingaortaduringdiastoleE.Isreducedinaconstrictedareaofabloodvessel28.Whichreceptorisblockedwhenpropranololisadministeredtoreducecardiacoutput?A.a1receptorsB.b1receptorsC.b2receptorsD.MuscarinicreceptorsE.Nicotinicreceptors29.霍奇金病按预后好坏，排列顺序为A.混合细胞型→淋巴细胞消减型→结节硬化型→淋巴细胞为主型B.淋巴细胞消减型→混合细胞型→结节硬化型→淋巴细胞为主型C.淋巴细胞为主型→结节硬化型→淋巴细胞消减型→混合细胞型D.淋巴细胞为主型→结节硬化型→混合细胞型→淋巴细胞消减型E.淋巴细胞消减型→淋巴细胞为主型→结节硬化型→混合细胞型30.高血压病脑出血的血管最常发生于A.Willi’s环B.大脑中动脉C.大脑后动脉D.基底动脉E.豆纹动脉31.引起左心室向心性心肌肥大的疾病是A.动脉瓣关闭不全B.高血压病C.二尖瓣狭窄D.严重贫血E.心肌炎32.风湿性心内膜炎最常累及的瓣膜是A.二尖瓣B.肺动脉瓣C.三尖瓣D.二尖瓣和主动脉瓣E.主动脉瓣33.二尖瓣关闭不全与单纯二尖瓣狭窄的区别是A.左心室肥大扩张B.左心房肥大扩张C.右心室肥大扩张D.右心房肥大扩张E.两者无区别34.女性患者，37岁，风湿性心脏病反复发作12年，近几个月来低热，无力，近日感左上腹部疼痛、腰痛、偏瘫。体检：皮肤及黏膜见点状出血，听诊发现心杂音性质和强度改变。尿常规：RBC（++）。此患者所患主要疾病为：A.风湿性心内膜炎B.急性感染性心内膜炎C.亚急性感染性心内膜炎D.病毒性心肌炎E.心瓣膜病35.ThemostcommonandseriouscomplicationofbenignhypertensionisA.cerebralhemorrhageB.glomerulosclerosisC.chronicpulmonarycongestionD.atherosclerosisE.myocardialinfarction36.FoamycellsinatherosclerosisarederivedfromA.endothelialcellsB.lipidcellsC.smoothmusclecellsD.neutrophiliccellsE.fibroblasts37.ThemainhumoralfactorchangescausedthevasoconstrictionofmicrocirculatoryduringtheischemiahypoxiastageofshockisA.ATII↑B.Vasopressin↑C.Catecholamine↑D.MDF↑E.TXA2↑38.WhichoneisNOTthecharacteristicofearlyshockA.PaleB.ColdinskinC.QuickinpulseD.DecreaseinurineE.Coma39.TherightprincipleoffluidinfusionforshockisA.Ifbloodpressureisnormal,noneedforfluidinfusion.B.Fluidinfusionforthefluidlost.C.Fluidinfusionforthefluidthatwaslostandthedaymaylose.D.FluidinfusionasneedsE.Themorethebetter40.哪型休克易于发生DIC:A.感染性休克B.心源性休克C.过敏性休克D.失血性休克E.神经源性休克41.引起左心室向心性心肌肥大的疾病是A.高血压病B.动脉瓣关闭不全C.二尖瓣狭窄D.严重贫血E.心肌炎42.心脏肌源性扩张的特点是A.容量减小伴有收缩力增强B.容量加大伴有收缩力增强C.肌节长度小于2.2µmD.肌节长度正处于2.2µmE.心肌拉长不伴有收缩力增强43.Heparin抗凝血的特点是A.仅用于体内抗凝血B.仅用于体外抗凝血C.体内外均有抗凝血作用D.抗凝血作用通过抑制抗凝血酶III的活性E.抗凝血作用通过促进纤溶酶活性44.p-Aminomethylbenzoicacide(PAMBA)的作用机制为A.抗血小板聚集B.激活纤溶酶原C.激活凝血酶D.竞争性对抗纤溶酶原激活因子E.灭活凝血酶45.扩张血管作用较强的钙拮抗药是A.VerapamilB.DiltiazemC.SodiumnitroprussideD.NitroglycerinE.Nifedipine46.强心苷减慢房颤患者的心室率原因是A.缩短心房有效不应期B.减慢房室传导，增加房室结中的隐匿性传导C.抑制窦房结D.降低浦肯野纤维自律性E.降低心室肌自律性47.Nitroglycerin、b受体阻断药和钙拮抗剂治疗心绞痛的共同作用是A.抑制心肌收缩力B.延长射血时间C.减慢心率D.降低心肌耗氧量E.减少心室容积48.关于他汀类调血脂药物的叙述，错误的是A.可以上调LDL受体B.可以减少胆固醇的合成C.可以降低血液总甘油三酯的含量D.能够促进胆固醇降解E.能够减少胆汁酸重吸收49.高血压病人合并左心室肥厚，请问最好应服用哪类药？A.钙拮抗剂B.利尿药C.神经节阻断药D.中枢性降压药E.血管紧张素转换酶抑制剂50.Propranolol治疗高血压的可能机制，不包括以下哪一项？A.阻断心脏b1受体，减少心输出量B.阻断肾脏b受体，减少肾素分泌C.阻断去甲肾上腺素能神经突触前b2受体，减少去甲肾上腺素释放D.阻断去甲肾上腺素能神经突触后b2受体，扩张血管平滑肌E.阻断中枢b受体，降低外周交感神经活性二、名词解释（每题2分，共12分）1.Sternalangle2.Reticulocyte3.Cardiacoutput4.Achoffbody5.Shock6.Angiotensinconvertingenzymeinhibitors(ACEI)三、问答题（每题5分，共30分）1.Describelocation,tributariesanddrainageofthehepaticportalveinandanastomoseswiththesuperiorandinferiorvenacavae.2.Describethecomponentandsignificanceofplasmaosmoticpressure.3.A70-year-oldmanwasadmittedtothehospitalwithshortnessofbreath,severefatigueandweakness,abdominaldistension,andswellingofankles.Atnightherequiresfourpillowsandoftenwakesupbecauseofacuteairhunger.Hishistoryrevealedepisodesofanginapectorisandaprogressiveshortnessofbreathwithexertionforseveralyears.Onexaminationthechiefabnormalitieswereslightcyanosis(bluishcasttotheskin),distensionoftheneckveins,rapidrespirations(20/min),rales(cracklingsounds)atthelungbasesbilaterally,anenlargedheartwithslighttachycardia(110beats/min)andadiastolicgalloprhythm(soundslikegallopinghorse),enlargedliver,excessfluidintheabdomen,andedemaattheanklesandoverthelowertibias.Hisbloodpressurewas115/80mmHg.Thechestx-rayexaminationshowedanenlargedheartanddiffusedensity(indicativeoffluidinthelungs)atbothlungbases.Anelectrocardiogram(ECG)showednormalsinusrhythm,Qwaves,andleftaxisdeviation.Treatmentincludedbedrestandadministrationofdigitalisandadiuretic.(1)Wouldyouexpectcardiacoutputandstrokevolumetobenormal,high,orlow?Why?(2)Wouldacalciumchannelantagonistbeadvantageous?Why?(3)Whyistheheartenlarged?4.Pleasecomparethebasicpathologicalchangesanddiseaseoutcomesbetweenbenignandmalignanthypertension.5.Pleasedescribetheclassificationofantiarrhythmicdrugs（抗心律失常药）andpresentonerepresentativedrugforeachclass.6.Ayoungmanisbroughttotheemergencydepartmentbyambulanceonthenextdayafteraseveretrafficaccident.Heisunconscious.Hisbloodpressureis78/48mmHg,heartrateis130beatsperminute.Thereisnoevidenceofheadtrauma.Thepupilsare2mmandreactive.Hewithdrawstopain.Cardiacexaminationrevealsnomurmurs,gallops,orrubs.Thelungsarecleartoauscultation.Theabdomenistense,withdecreasedbowelsounds.Thepatientshowscyanosis,withthreadypulses.Questions:(1)Whatarethethreegeneralstagesofshockaccordingtothedifferentchangesinmicrocirculation?Whichwaslikelyinthispatient?Why?(2)Whatpathogeneticmechanismaccountsforthispatient’sunresponsivenessandcyanosis?四、段落翻译（中国学生只做第1、2题英译中，每题4分，共8分；留学生只做第3题汉译英，该题8分）1.ENDOTHELIALCELLSEndothelialcells(ECs)comprisethesinglecell-thick,continuousliningoftheentirecardiovascularsystem,collectivelycalledtheendothelium.Endothelialstructuralandfunctionalintegrityisfundamentaltothemaintenanceofvesselwallhomeostasisandnormalcirculatoryfunction.ECsuniquelycontainWeibel-Paladebodies,0.1µm-wide,3µm-longmembrane-boundstorageorganellesthatcontainvonWillebrandfactor(vWF).ECscanbeidentifiedimmunohistochemicallywithantibodiestoPECAM-1(CD31,aproteinlocalizedtointerendothelialjunctions)