中南大学外科学（Department of surgery,Central South University）

中南大学外科学(Departmentofsurgery,CentralSouth

University)

Ageneralexaminationpaper

Amultiple-choicequestion:(45points,1pointspersubject)

[Altypequestions]

1..Itiseasytocausethethreelowphenomenon(low

temperature,lowwhitebloodpressurehypotension)ofsystemic

infectionofpathogenicbacteria:

A.gramnegativebacilliB.grampositivecocciC.nospore

anaerobicbacteriaD.fungiaboveE.arenot

2.thescopeofskindisinfectioninthesurgicalareashould

includetheareaaroundtheincision:

A.5cmB.10cmC.15cmD.20cmE.25cm

3.TwaveheightandcuspistheECGmanifestationofwhich

electrolyteabnormality:

A.hypokalemia,hyperkalemiaB.C.D.E.hypercalcinemia

hypomagnesemiahypocalcemia

4.themostobviousmanifestationofmetabolicacidosisis:

A.fatigue,vertigo,B.breathingdeep,exhaledbreathwith

ketoneflavor,C.heartrateincreased,lowbloodpressure

D.tendonreflexesweakenordisappear,E.isnotabove

5.Whatshouldbesupplementedaftertheisotonicdehydration

(isotonicwaterdeficit)cured?

A.Na+B.Mg2+C.Ca2+D.K+E.Cl-

6.thepositionofshockpatientsshouldbeadopted:

A.B.supinesemirecumbentpositionC.lateralD.15degreesto

30degreeshighlowlyingfootslope

E.headandtrunkelevation20〜30degrees,lowerlimb

elevation15~20degreeslyingposition

In7.casesofhepaticlobectomy,theincisionhematomaisnot

purulent,andtheincisionhealingshouldberecordedas

follows:1:

A.I/B.A/C.D./E.B/b

8.Todiagnoseshockisonthebasisof:

A.diastolic(diastolic)pressure<60mmHg,pulse

pressure<20mmHg

B.diastolic(diastolic)pressure<60mmHg,pulsepressure

<30mmHg

C.systolic(systolic)pressure<90mmHg,pulsepressure<20mmHg

D.systolic(systolic)pressure<90mmHg,pulsepressure<30mmHg

E.noneofabove

9.Thebasalenergyexpenditureofanormalmanis:

A.lOkcal/kgB.15kcal/kgC.20kcal/kgD.25kcal/kgE.30kcal/kg

10.themethodofanesthesiaforincisionanddrainageof

purulentfingeris:

A.localinfiltrationanesthesia,B.fingernerveblock,C.

brachialplexusblock,D.surfaceanesthesia,E.basic

anesthesia

11.thefirstmuscleinvolvedintetanusisthemusclegroup:

A.B.expressionofmuscleC.muscleofmasticatorymusclesD.

tergosternalmusclesE.limbmuscle

12.belongtothetruetumoris:

A.B.C.dermoidepidermoidcystofsebaceouscystD.ganglion

E.noneoftheabove

In13.shockpatients,thecentralvenouspressureisnormal

andthebloodpressureisstilllowafteradequateamountof

fluidissupplied:

A.vasoconstrictorB.vasodilatorC.diureticD.cardiacdrug

E.largedoseofglucocorticoids

14.intractablehiccupsafterupperabdominalsurgeryshould

beconsideredfirst:

A.surgeryresultedinphrenicnerveinjury,B.infectionunder

diaphragm,C.retroperitonealhematoma,stimulationofceliac

plexus,D.gastricretentionandEadhesion

Themostseriouscomplicationofparenteralnutritionis15:

A.pneumothorax,B.vascularinjury,C.nerveinjury,D.

thoracicductinjury,E.airembolism

Thetypicalelectrolyteimbalanceis16.inpatientswith

pyloricobstruction:

A.lowchlorineandlowpotassiumalkalosisB.lowchlorineand

lowpotassiumacidosisC.lowchlorineandhighpotassium

alkalosis

E.alkalosiscausedbyhighchlorineandlowpotassiuminD.

lowchlorineandhighpotassiumacidosis

17.forthepatientswithnormalpulmonaryfunction,themost

effectivemouthtomouthartificialrespirationcanmakePa02

reach:

A.65mmHgB.70mmHgC.75mmHgD.80mmHgE.90mmHg

18.Inexternalchestcompression,youshoulddepressthe

sternumtocmin(sternum)theadult.

A.2,3B.3,4C.4,5D.5,6E.6,7

19thefirstchoiceofdrugsincardiopulmonaryresuscitation:

A.lidocaine,B.adrenaline,C.calciumchloride,D.sodium

bicarbonate,E.atropine

Twenty

Themainpurposeoftheassessmentbeforeanesthesiaisto

assesstheconditionofthepatient:

A.recognizethepatientinordertopreventtheoccurrenceof

anesthesiaerrors,B.establishfeelingswithpatients,obtain

patienttrust,C.understandtheoperationmode

D.understandsthepatient'stolerancetoanesthesiaandE.

eliminatesstress

21.whatisthepurposeofclinicalanesthesia?Whichoneis

correct?

A.eliminatespain,B.safeguardssafety,C.convenience

surgery,D.accidentpreventionandtreatmentofE.areall

above

22.What,is,the,death,rate,for,anaesthesia,related,with?

A.ageB.stateoftheillnessC.themethodoftheoperation

D.themethodandthedurationofanaesthesiaE.allofabove

23.thepurposeofatropinebeforespinalanesthesiaistodo

so:

A.preventsvomiting,B.reducesgastrointestinalgland

secretionofC.,increasesvagalreflex,D.sedation,andE.

hypnosis

24.laboratorytestsforacuteliverfailure

A.transaminaseisnotincreased,B.acid-baseimbalanceis

mostlymetabolicalkalosis,C.whitebloodcells,

thrombocytopenia

D.usuallydoesnotshowelectrolytedisturbances.Fibrinogen

increasesandFDPdecreasesduringE.DIC

25.whentheamountofacutebloodlossexceedsthetotalamount,

thewholebloodcanbeconsidered.

A.10%B.15%C.20%D.30%E.isnotaboveall

(26.)ifthehemolyticreactionoccursduringtransfusion,the

earliestsignsare:()

A.chills,B.fever,C.dyspnea,D.hemoglobinuria

E.unexplainedbloodpressuredeclineandsurgicalfield

bleeding

27..Themaincauseofburnshockis:

A.alargeamountofwaterevaporation,Balargenumberofred

bloodcellslostC.,woundinfectionD.painE.,alargenumber

ofbodyfluidsfromthevascularexudate

28.Themostimportantlethalcauseofaburnedpatientis:

A.infectionB.hypovolemic(lowbloodvolume)shockC.septic

shock

D.MODSE.noneofabove

29.male,3yearsold,withburnsonthefaceandupperlimbs,

withdifferentsizesandblisters,withredandwhite

background,andthetotalareaofburnswas:

A.21%B.22%C.24%D.26%E.29%

[A2typequestions]

30.thecontentsofasepticsurgeryarenotincluded:

ApplicationofA.sterilizationB.disinfectionmethodC.

antibacterialdrugsD.operationrulesE.managementsystem

31.theplacewherethetourniquetistiedisincorrect:

A.thigh1/3B.thighlower1/3C.upperarm1/3D.upperarm1/3E.,

lowerarm1/3

32.whatshouldbeemphasizedbeforetheinterview?

A.historyofmarriage,B.pasthistory,C.historyof

anesthesia,historyofD.treatment,E.historyofprevious

surgery

33.thedescriptionofacuterenalfailureisincorrect:

A.systolicdysfunctionandrenalvasculardiseasecancause

oliguria

ProlongedB.obstructionmaycauserenalacuterenalfailure

C.acutetubularnecrosisisthemainformofrenalparenchymal

damage

MostoftheacuterenalfailureinD.isrelatedtotraumaand

surgery

E.decreasedwhenthemeanarterialpressuredroppedto60mmHg,

andGFRbegantodecrease

34.,thereisafebrilereactiontobloodtransfusion:

A.isoneofthemostcommoncomplicationsofearlyblood

transfusion.B.occursmostlywithin15hours-2hoursafter

bloodtransfusion

C.symptomslastedfor30minutesandgraduallyrelievedafter

-2hours.D.showedlittleincreaseinE.bloodpressureduring

generalanesthesia

[A3typequestions]

Awoman,accidentcausedbylower1imbbleeding,movement

disorders1hoursadmission.Check:thebloodpressureis

65/40mmHg,thepulsespeedisweak,theconsciousnessisfuzzy,

thelimbsarepurple,thelimbsarecold,andthelower

extremitieshaveactivebleeding.

35.estimatedtheamountofbloodloss:

A.800mlbelowB.800mlC.800ml-1600mlD.1600mlE.1600mlabove

36.supplementitsbloodvolume,considertheuseof:

A.crystalfluid,colloidsolutionB.,plasmaC.concentration

redbloodcellD.,wholebloodE.aboveareall

Female,45yearsold,50Kg,flameburnmultiplebody,thedeep

IIdegree30%TBSA,III30%TBSA,anuriaafterinjury,heartrate

of150beatsperminute,breathing33times/min.8hoursafter

injury,fluidinfusionof3500ml(colloid1800ml)stillshowed

nourine.

Thirty-seven

Forthefirsttime,nourineshouldbetaken:

A.tospeeduptheinfusionrate,B.diureticC.tofurtherask

themedicalhistory,understandthesituationbeforeinjury

D.bloodelectrolytes,ureanitrogenandcreatinineE.

inspectionareaandbladdercatheter

38.,whichofthefollowingmeasuresshouldbechosento

facilitatethediagnosisandtreatment?:

A.examinationofliverandkidneyfunction,B.bloodgas

analysis,C.emeticorgastriclavage

D.wasaddedtoinquireaboutthehistoryofE.beforeinjury

andthehistoryofinjury

A32yearoldmansufferedfrompelvicfracturesandopen

fracturesoftherightfemoralshaftafterameal.38.90C50

/20mmHgtemperature,bloodpressure,pulserate130/min..

Therewasnogastrointestinaldecompressiontubebefore

operation,andopenreductionandinternalfixationwas

performedinemergency.

39.preoperativeanticholinergicdrugsshouldbeselected:

A.atropine,B.scopolamine,C.anisodamine,D.stomach,

Changning,E.ormorearenot

40.thebestanestheticregimenis:

A.epiduralanesthesia,B.lumbaranesthesia,C.general

anesthesia,awakeintubation,D.generalanesthesia,rapid

inductionintubation,E.ormorearenot

[Bltypequestions]

A.StaphylococcusaureusB.StaphylococcusepidermidisC.

StreptococcusE.StreptococcuspneumoniaeD.Escherichiacoli

anaerobicbacteria

Themainpathogenicbacteriais41.erysipelas:

Themainpathogenicbacteriais42.furuncle:

A.alkalinephosphataseincreased,B.acidphosphatase

increased,C.bloodsugardecreased,D.bloodsugarincreased,

E.increasedbloodcalcium

43.livercancercanoccur:

44.prostatecancercanoccur:

45.osteosarcomacanoccur:

Two,nounsexplained:(10points,2pointspersubject)

1.gradetwopreventionofcancer

2.BorderlineTumors

3.hypotonicdehydration

4.cpr:

5.highsensitivityreaction:

Three,theanswer:(15points,3pointsforeachquestion)

1.brieflydescribethetherapeuticprincipleofsepticshock

2.whatarethemostcommonlyusedemergencyhemostasis

methods?

3.patientshadlessurineandelevatedserumcreatinine.When

thecentralvenouspressureislowered,normalandelevated,

whatisthedifferencebetweenthemethodsoffluidinfusion

experiment?

4.whataretheeffectivesignsofchestcompressions?

5.whatisthepurposeofpremedication?

Four,medicalrecordsanalysis:(30points,15pointseach

problem)

(1)malepatient,38yearsold,wasadmittedtohospitalfor

3daysduetoabdominalpain,vomiting,analexhaustand

defecation.Physicalexamination:T37degrees,PHO/min,R25

/min,Bp90/60mmHg,weight60Kg,socket,poorskinelasticity.

Theabdomen,visiblebowel,abdominaltenderness,nomuscle

tensionandpain,hyperactivebowelsounds,gurgling.

Admissiondiagnosis:adhesiveintestinalobstruction.

Hbl40g/L,HCTO.50,serumsodium137mmol/L,chlorine101mmol/L,

potassium2.9mmol/L,calcium2.45mmol/L.Bloodgasanalysis:

pH7.33,HC0318mmol/L,PaC0238mmHg.

Question:whatarethe1.patientswithwaterelectrolyteand

acid-baseimbalance?2.calculatethefirst24hoursof

rehydrationprogram,(writeoutthecalculationprocess,the

typeandamountoffluidinfusion)

(two)female,21yearsold,withatotalof3hoursofburns.

Checkthebloodpressure:40Kg,90/70mmHg,heartrateof140

beatsperminute,25breaths/min,Godclear.Visibleerythema

anddrynessonbothhands;largeblistersonleftforearm,left

upperarmanddoublebuttocks;flushedandsensitiveatthe

bottom;smallblistersonboththighsandlegs;redandwhite

atthebase;dullpain.

1.whatistheinitialdiagnosisofthepatient?

The2.trialliststhefirst,seconddayrehydrationprogram

forthepatient,(writeoutthetypesandamountoffluids

neededfordifferentperiods)

3.toobservetheadequacyoffluidinfusion,whatarethe

indicators?

Referenceanswersandscoringcriteria:

First,multiple-choicequestions:(1pointspersubject)

1.A2.C3.B4.B5.D6.E7.E8.C9.D10.B11.A12.A13.A14.B

15.E16.A17.C18.C19.B20.D21.E22.E23.B24.A25.D26.E27.E

28.A29.C30.C31.D32.A33.E34.E35.E36.E37.E38.D39.B40.C

41.C42.A43.A44.B45.A

Two,nounexplanation:(2pointspersubject)

1.earlydetection,earlydiagnosisandearlytreatmentof

cancer,inordertoreducecancermortalityandimprovethecure

rate.

2.Thereareminoritiesoftumors,

这是形态良性但之间的良性和恶性的生物学行为呈浸润生长，术后复

发和转移。

三.氯化钠损失大于水。血清钠浓度小于135mmol/L

4O针对呼吸和循环骤停所采取的抢救措施。即以人工呼吸替代病人

的自主呼吸，以心脏按压形成暂时的人工循环并诱发心脏的自主博动,

并尽量维持脑组织的灌流。

5o用小量局麻药即出现毒性反应症状者，称为高敏反应。

三、简答题：(每题3分)

1。在休克未纠正前，应着重治疗休克，同时治疗感染；.....2分

休克纠正后，则应着重治疗感染......1分

20(1)加压包扎法；.....1分

(2)指压法；.....0.5分

(3)填塞法；.....0.5分

（4）止血带法......1分

三.中心静脉压降低，血容量不足，则：30-60分钟内输入250〜500ml

5%葡萄糖水或5%糖盐水......1分

中心静脉压正常，则：甘露醇12.5-25g,10T5分钟内输入.....1

分

中心静脉压高，贝U：利尿剂吠塞米4mg/kg静注.....1分

4o⑴可触及颈动脉或股动脉的博动.....1分

⑵可测得血压达80lOOmmhg.....1分

⑶发绢减轻或消失，皮肤转为红润.....0.5分

⑷瞳孔立即缩小并有光反应者，预后较好。但不宜根据瞳孔的反应变

化来决定是否继续复苏......0.5分

50⑴解除焦虑，充分镇静和产生遗忘.....1分

⑵稳定血流动力学和内环境.....1分

⑶提高痛阈，减少麻醉药需求量.....0.5分

⑷抑制呼吸道腺体分泌，保持呼吸道通畅.....0.5分

四、病例分析：（每题15分）

（一）

Io（1）等渗性缺水.....2分

（2）2（1代谢性酸中毒.....分答合并呼碱着扣分）

（3）低钾血症.....1分

2。额夕卜丢失量：60X5%X1000X（l/2~2/3）=1500~2000ml..........

2分

补液种类：平衡盐溶液.....2分

生理需要量：0.9%生理盐水500ml+5%葡萄糖溶液1500ml..........2

分

补钾：10%氯化钾60〜80nli..........1分（尿量＞40ml/小时后补）.....

1分

轻度代酸经纠正缺水后可恢复，不需补充碱性液体纠正.....2分

（二）

1。初步诊断

1）火焰烧伤全身多处47%（H度）（”1分火焰烧伤全身多处”；

“477”1分；“二度”1分）

2）重度烧伤（1分）

3）低血容量性休克（1分）

20补液计划:

1）第一天补液总量:4820ml（0.5分）

其中，第一个8小时：胶体470ml（0.5分）；晶体940ml（0.5分）;

5%糖水1000ml（0.5分。“糖水”答成糖盐水、盐水均不给分）。

第二、第三个8小时各补：胶体235ml；晶体470ml；5%糖水500ml。

（1分。“糖水”答成“糖盐水“、“盐水”扣0.5分）

2）第二天补液总量：3410ml。（1分）

其中：胶体470ml；晶体940ml；5%糖水2000ml。（1分。“糖水”答

成“糖盐水“、“盐水”扣0.5分）

3o监测指标：

（1）尿量给1分）：成人不低于20ml/h,以3050ml/h为宜（给0.5

分）；小儿每公斤体重每小时不低于1ml（给0.5分）

2）病人安静，无烦躁不安（0.5分）

3）无明显口渴（0.5分）

4）脉搏、心跳有力，脉率在120次/分以下（0.5分）

5）systolicbloodpressuremaintainedat90mmHgandpulse

pressureabove20mmHg（1points）

6）stablerespiration（0.5points）

Extracurricularscientificgeneralexaminationpapertwo

First,multiple-choicequestions(45points,1pointsper

subject)

[Altypequestions]

1.themostcommonlyusedsterilizationmethodis:

A.highpressuresteammethod,B.boilingmethod,C.burning

method,D.liquidimmersionmethod,E.formaldehydesteam

fumigationmethod

2.Whatisthecommonestacid-basedisturbanceinclinic?

A.metabolicacidosisB.metabolicalkalosisC.respiratory

acidosis

D.respiratoryalkalosisE.noneofabove

3.thekeytocorrectingmetabolicacidosisduringshockis:

A.timelyuseofbasicdrugsB.hyperventilationC.,toensure

completerespiratoryfunction,D.improvetissueperfusionE.

diureticaciddischarge

4.appendectomyshouldberemovedseveraldaysaftersurgery:

A.4~5B.6~7c.7~9D.10~12E.14

5.purulentfingerinflammationisnottimelytreatment,prone

tooccur:

A.B.paronychiasuppurativetenosynovitisC.purulent

bursitisD.phalanxnecrosisE.sepsis

6.themostreliablewaytopreventtetanusisto:

A.thoroughlydebridementB.injectionofTetanusAntitoxinC.

injectiontetanushumanimmunoglobulin

D.injectionoftetanustoxoidE.isnotabove

7.themostcommonpartofwoundhealingis:

A.damagerangeislarge,B.foreignbodyretainedC.local

bloodtransportdisorder,D.partialbrakeinsufficiencyE.

woundinfection

8.whenusingpneumatictourniquet,thepressureonadultupper

limbshouldbe:

A.lOOmmHgB.200mmHgC.300mmHgD.400mmHgE.500mmHg

9.rectalcancerpatientswithrectalexaminationfound

multiplepelvicnodules,thewayofmetastasisis:

A.directspreadofB.lymphnodemetastasis,C.hematogenous

metastasis,andD.metastasisofE.arenotallabove

10.oftheinfectedfocineartheredlineare:

A.B.erysipelassuperficiallymphangitisC.deepsubcutaneous

lymphangitisD.phlebitisE.lymphadenitis

11..Themainreasonofurinarytractinfectionafteroperation

isthatthemainreasonisurinarytractinfection:

A.prolongedbedrest,B.urinaryretention,C.systemic

immunity,D.violationofasepticoperationprinciple,E.

hematogenousdissemination

12.theaminoacidpreparationshouldbechosenforpatients

withliverdisease:

A.balancedaminoacidB.wasmainlyaromaticaminoacid,and

C.wasmainlybranchedchainaminoacid

D.ismainlycomposedofessentialaminoacidsandE.glutamine

twopeptide

13.Whatwillhypokalemia(hypokalemia)leadto?

A.metabolicacidosisB.metabolicalkalosisC.respiratory

acidosis

D.respiratoryalkalosisE.noneofabove

Alargeamountofisotonicsalineappearsin14.isotonicwater

deficientpatients:

A.hypernatremia,B.lowchlorineacidosis,C.alkalosis,D.

acidosis,E.alkalosis

15.itemsafterautoclavingshouldnotbeusedformorethan

thefollowingtime:

A.3days,B.5days,C.7days,D.10days,E.14days

16.themainindicationsofdeepabscessincisionanddrainage

are:

A.chills,highfever,B.whitebloodcellincreaseandleft

nucleusshift,C.localtendernessisobvious,D.puncturehas

purulentE.localdysfunction

17.,male,30yearsold,complainedofabdominalpainand

fatigueaftercarcrash.Physicalexamination:conjunctival

pallor,bloodpressure60/45mmHg,pulse120beats/min,

abdominalslightlytight,abdominaltenderness,pain,right

lowerabdomenpuncture0.5mlcoagulationofblood.Themost

appropriatetreatmentis:

A.inputcrystalsandcolloidB.activelyantishockC.

immediatebloodtransfusion

D.antishocksimultaneousrapidlaparotomyE.definitive

diagnosisaftersurgery

18.themostimportantsignofappendicitisdiagnosisis:

A.metastaticrightlowerabdominalpainB.rightlowerabdomen

tenderness,reboundpain,tendernesspointinafixedposition

C.feverD.rightlowerabdominalmassE.Rovsingsign(+)

19.Whatwillmassivebloodtransfusionleadto:

A.lowtemperature

B.acidosisC.hypercalcemiaD.hypokalemiaE.allofabove

Twenty

发热性输血反应的常见原因是什么？

A.immunoreactionBo热原（致热原）c.bacterialpollutiondo溶

血（溶血）e以上

21o目前治疗室颤的唯一有效方法是：

A.B.C.D.利多卡因心脏按压电除颤以上都是装起博器E.

22、在心肺复苏中应用药物的最佳途径是什么？

通过静脉上肢B.intratracheal（气管内）药物

C.intracardiac（心内）注入D.throughmucosa（粘膜）e.none以

上

230开胸心脏按压的常见适应症有：

A.B.C.D.胸廓严重畸形开胸手术时心脏停搏心包填塞以上都是多

发性肋骨骨折E.

24ASA的含义:

A.美国麻醉医师B.美国口腔协会

美国外科协会D美国标准协会Eo

25o预防胆心反射的最好方法是：

A.B.C.胆囊三角区神经封闭术前肌注阿托品避免牵拉胆囊

D.静注异丙肾上腺素E.以上都不是

26o下列局麻药中，酯类局麻药是：

A.B.C.D.利多卡因丁卡因布比卡因以上都不是依替卡因E.

27O东葭着碱和阿托品药理作用的区别，哪条正确？

A.B.C.阿托品散大瞳孔的作用弱阿托品的镇静作用强东食着碱抑制

腺体分泌作用强

D.东屈若碱对基础代谢影响大E.以上都不是

28O烧伤后发生体液渗出是逐步的，伤后()小时达到高峰。

由3~3~4c的e.12

29o男，18岁，被沸油烫伤双手及左大腿。双手起红斑，无水疱，

有明显烧灼感，左大腿起大小不一水疱，创底红白相间，其烧伤总面

积为：

a.10.5%%%%b.15.51116以上都不是E。

[A2型题】

30o肾调节酸碱平衡的机制不包括：

a.na+—H+交换b.k+—H+交换c.hco3-重吸收

D.产生NH3并与H+结合成NH4排出E.尿的酸化

31o婴幼儿皮肤消毒不能用：

A.2%碘酊B.络合碘c新洁尔灭d.0.1氯已定E.以上都不是%%

320关于冷沉淀，不正确的是：

A.是FP在4oc融解时不融的沉淀物B.含纤维蛋白原C.含FVHI

D.含血管性假血友病因子E,主要用于血友病甲、先天或获得性纤维

蛋白缺乏症

330关于输血发生过敏反应，不正确的是：

A.多发生在输血数分钟后

B.表现为皮肤局限性或全身性瘙痒或寻麻疹

C.重者可出现支气管痉挛、血管神经性水肿、会厌水肿

D.当病人表现为皮肤局限性瘙痒或寻麻疹时，应立即停止输血

E.献血员在采血前4小时应禁食

34o关于输血的速度，不正确的是:

A.依病情而定B.成人控制在5-10ml/明克。老年人或心功能较差者，

要调节到ml/min

D.小儿10滴/分左右E.在急性大出血时，经加压输血器快速输入或

手工挤压输血

35o下列哪项与烧伤休克期无关：

A.B.C.D.口渴烦躁手足湿冷高热澹妄尿少，并可有血红蛋白尿E.

心率增快

[A3型题】

男,40岁,50kg,火焰烧伤全身多处2小时，烧伤总面积40%TBSAIII,

其中度35%,伤后无尿。未行其它任何处理。

360

Whichofthefollowingisthepreferredtreatment?:

A.tracheotomy,B.woundhealing,C.veinincisionorvenous

catheterization,D.cuttingscaborcuttingscabE.isnotabove

37.theseverityofburnswas:

A.mildburns,B.moderateburns,C.severeburns,D.severe

burns,E.ormorearenot

Thepatient,female,was59yearsold.Acuteattackofchronic

cholecystitisandcholelithiasis.Historyofhypertensionand

coronaryheartdiseasefor10years.ECGshowedcoronary

insufficiency,heartrateof66beatsperminute,blood

pressure165/90mmHg,cholecystectomypluscommonbileductT

tubedrainage.Duringtheoperation,suddenheartrate,

ventricularprematurebeatandtwo-foldrhythmoccurred

suddenlyinthetreatmentofgallbladder.

38.thebestanestheticmethodis:

A.localanesthesiaB.spinalanesthesiaC.epiduralanesthesia

D.endotrachealintubationgeneralanesthesiaisnotaboveE.

39.whichofthefollowingisnotappropriate?

PreoperativeA.administrationofatropinetoB.inhibits

endotrachealintubationresponseandC.controls

intraoperativehypertension

D.maintainedanesthesiaaboveE.withlightgeneralanesthesia

andmusclerelaxant

40.thesuddenarrhythmiaduringtheoperationofthe

gallbladdershouldbeconsideredfirst:

A.gallbladderreflexB.hypoxiaC.hypotensionD.surgery

stimulationoftheheartaboveE.isnot

[Bltypequestions]

A.centralvenousdepression,lowbloodpressure,B.central

venousdepression,normalbloodpressure,highcentralvenous

pressureofC.,lowbloodpressure

D.centralvenouspressureishigh,bloodpressureisnormal,

E.centralvenouspressureisnormal,bloodpressureislow

41.suggestthatcardiacinsufficiencyorinsufficiencyof

bloodvolumeare:

42.indicatethatthebloodvolumeisseriouslyinsufficient:

A.AFPB.CEAC.CAI9-9D.VCA-IgAE.CA125

Postoperativemonitoringof43.colorectalcancer:

44.nasopharyngealcarcinomascreening:

Generalsurveyoflivercancerin45:

Two,nounsexplained:(10points,2pointspersubject)

1.boil

2.Sepsis

3.HypertonicDehydration

4.cardiaccompression

5.generalanesthesiainduction

Three,theanswer:(15points,3pointsforeachquestion)

1.whataretheemergencyinjuriesthatmustbegivenpriority?

2.themainmattersneedingattentioninpotassiumsupplement

arebrieflydescribed.

3.abdominalcavityorgandamagecanappearwhatabdominal

signs?

4.describethecurrentcommonmeasuresofcerebral

resuscitation.

5.commoncausesoflocalanesthetictoxicity.

Four,medicalrecordsanalysis:(30points,15pointseach

problem)

(a)malepatient,52yearsold,recurrentepigastricpainfor

5years,withaggravationofvomitingin1weeksafteradmission.

Forthepast1weeks,thepatienthasbeeneatingfluids,

vomitingandgastriccontents,malaise,dizziness,thirst,and

decreasedurination.Thediagnosiswasgastricantrumcancer

withpyloricobstruction.Physicalexamination:T37degrees,

P102/min,Bpl10/85mmHg,weight60Kg,God