内科学8风湿性疾病（Internal science 8 rheumatic disease）

内科学8风湿性疾病(Internalscience8rheumaticdisease)

ChapterIrheumatoidarthritis

1.ThemainpathologicalchangesofRAare:

A.Chronicinflammationofjointsynovialmembrane.

Inflammatorycellinfiltration

C.synovitisformstheerosionofD.Cartilageandbonetissue

E.thedestructionofjointstructures

2.WhichofthefollowingisnotthecauseofRA?

A.geneticfactorsb.infectionc.sexhormoned.blood

transfusione.alloftheabove

3.WhichautoantibodiesexistinRApatients?

A.rFB.AKAC.APFD.Anti-collagenantibodye.allabove

4.ThecorrectdescriptionofRAangiitisis:

A.RAvasculitisisAcommonexternallesion,andvasculitis

isAseriousmanifestationofRA

B.r.Avasculitisismainlyinvolvedinsmallarteries(between

250and400FTM)andmayalsoinfringethemicrovein

C.Pathologicalfeaturesarenecroticfull-layerarteritis,

andlesionsaresometimesindistinguishablefromtypical

nodularpolyarteritis

D.Theoccurrenceofvasculitisisbelievedtobecausedbythe

depositionoftheimmunecomplexinbloodvessels

5.Theincorrectdescriptionofrheumatoidnodulesis:

A.rheumatoidnodulesareoneofthemostcharacteristicofthe

arthropathologiclesioninRA

B.Mostcommonlyseeninfrontarmcompression

C.AlmostallRApatientswithrheumatoidnoduleswereRF

positive

D.Theformationofearlyformsofrheumatoidnodulesdoesnot

havethecharacteristicsofgranulationtissue

6.ThedescriptionofFeltysyndromeisincorrect:

A.Feltysyndrome(FS)isaserioustypeofRA

B.Prominentmanifestationsarerheumatoidarthritiswith

neutrophilsandsplenomegaly

C.thejointlesionsareseriousandoftenaccompaniedbyahigh

degreeofRF

Theoccurrenceofd.f.Smayberelatedtogeneticfactors

E.Thereductionofneutrophilsisthemostbasic

characteristicofFS,whichisthemaincauseofrecurrent

infectioninFSpatients

7.Animalmodelsofrheumatoidarthritisincludethefollowing:

A.collagenarthritis

B.streptococcuscellwallcomponentinducedarthritis

C.Adjuvantarthritisandprotein-inducedarthritis

D.spontaneousarthritisandgenetictransformationanimal

arthritismodel

E.alloftheaboveare

8.DiagnosticcriteriaforRAinclude:

A.morningstiffnessatleast1hour(>6weeks)and2,3or

morejointswelling(>6weeks)

B.wrist,knucklejointorproximalinterphalangealjoint(>

6weeks)andsymmetricjointswelling(>6weeks)

C.SubcutaneousnodulesandhandXchanges

D.Positiverheumatoidfactor(drip>1:32)

E.alloftheaboveare

9.Thetypesofjointdamagearenotincluded:

A.singlejointpathogenesisB

C.SymmetricjointpathogenesisD.Sometimesthejointswith

nosynovialmembranesarealsoinvolved

10.ThefollowingtypesofRAare:

A.robusttyperheumatoidarthritis

B.Mildserumpositivesynovialsynovitiswithsagsyndrome

C.RetyperheumatismD.AdultStilldiseaseE

11.ThecharacteristicsofRA'ssynovialinflammatoryresponse

are:

A.Thicknessoftheliningcells

B.

Mesenchymallayersofinflammatorycellsinfiltratingand

microvascularregeneration

C.Thesurfaceofsynovialcellsexpressesmultipleactivation

antigens

D.Theformationofbloodvesselsandthedestructionof

cartilageandbonetissue

E.alloftheaboveare

12.TherightthingaboutRAChen'srigiddescriptionis:

A.morningstiffnessisAveryprominentclinicalmanifestation

ofRA

B.Thecauseofthemorningstiffnessmaybecausedbythe

accumulationofedemaintheinflammatorytissueduringa

decreaseinsleeporactivity

C.Withmusclecontractionandedemafluidbeingabsorbedby

lymphaticsandsmallveins,morningstiffnessisalso

alleviating

D.WhenRAisinremission,themorningstiffnessisfading,

anditisoneoftheindicatorsforassessingRAactivities

E.alloftheaboveare

13.Themechanismofnon-steroidalanti-inflammatory

analgesicsis:

A.inhibitT-lebarcellb.inhibitBlymphocytes

C.InhibitingprostaglandinsynthesisD.Inhibitsmacrophages

E.Inhibitstheformationofimmunecomplexes

14.Thefollowingclinicalfeaturesofrheumatoidarthritis,

exceptone:

A.Symmetricjointswellingpainb.proximalinterphalangeal

jointswellingpain

C.swollenpaininthedistalinterphalangealjoint

E.thepainintheknuckles

15.Therheumatismdetectedbytheclinicaluseoflatex

condensatemethodis:

A.IgAtyperheumatoidfactorbvtyperheumatoidfactor

Ci.gMtyperheumatoidfactorD.RheumatoidfactorandIgAform

immunecomplex

E.mixedtyperheumatoidfactor

16.Thearticularappearanceofrheumatoidarthritisisnot

present:

A.Feltysyndromeb.lowerlimbskinulcer

C.ScleraD.Subcutaneousrheumaticnodules

E.facialerythema

17.Thebasicpathologicalchangesofrheumatoidarthritisare:

A.synovitisb.tlymphocyteproliferation

C.InflammatorycellinfiltrationD.Immunecomplexdeposition

E.osteoarthritisofthejoints

18.TheX-rayexaminationoftheearlyhandandwristofRA

showed:

A.EarlyX-raymanifestationsincludesofttissueswelling,

osteopeniaaroundthejoints,andevennarrowingofjoint

clearance

B.thejointbetweentheknucklesandproximalinterphalangeal

jointsdisappeared

C.Theedgeofthearticularsurfaceisblurredbybone

absorptionandearlyerosion

D.Anmricandetectanearliererosionofthelesion

E.alloftheaboveare

19.ThedescriptionofBaker'scystiscorrect:

A.rheumatoidkneecavityeffusion,thepressureofthelumen

ishighinthelumencavityandtheeffusionoftheeffusion

iscrowdedintotheposteriorsideofthejoint

B.Causesthelattertoexpandintothepoplitealcavityand

formapoplitealcyst

C.cystcanbedevelopedintothesuralandcauseunilateral

calfenlargement

D.Theruptureofthecystcanproducesuddenpainintheback

ofthekneeandinthelowerleg,accompaniedbylocalredness,

evidenttendernessandfever

E.theabovedescriptioniscorrect

20.RAcanbeinvolvedinneckjoints:

A.Thesynovialcapsulearoundthedentateprocessandits

associatedligamentb.atlantoaxialjoints

C.Thebonypartofthedentateprocesscanalsobeseeninearly

childhood

E.alltheabovearewrong

21.Caplansyndromerefersto:

A.Anothertypeofrheumatoidnodulesisrheumatoid

pneumoconiosis

B.thecoalminersofrheumatoidarthritishavesymptomsofa

characteristicshadow

C.Multiplecircularnodulescanbeseeninthelungsofcoal

miners

D.Similarlesionscanbeseeninrheumatoidpatients,suchas

litter,asbestos,iron,lead,etc.Theoccurrenceofpulmonary

nodulesintheminerswithrheumatoidarthritisisthreetimes

greaterthanthatofordinaryminers

E.theabovedescriptioniscorrect

22.Thefemale,38,sorelimbsjointsfor12years,knuckles

andwristX-rayinhandshowbonedestruction,thejoint

inspectionstillhaspaininthejoints,spleenribunder2cm

hit,qualitativehard,checktheWBC2X109/L,platelet60

X109/L,theESR56mm/h,urineRt(-),havebeentaking

non-steroidalanti-inflammatorydrugsintenyears.Themost

likelydiagnosisofthepatientis:

A.Cirrhosisofthespleenandspleen.Rheumatoidarthritis

C.FeltysyndromeD.Systemiclupuserythematosus

E.drugredevelopment

23.Women,52yearsold,sufferingfromrheumatoidarthritis

hasbeen12years,knees,severedoublehipflexiondeformity

oflimbmuscleatrophy,unabletowalk,doawheelchairorlie

inbedallday,noswelling1imbsjoint,individualjointpain,

theESR10mm/h,urineroutineisnormal,X-raydoublehipgap,

jointdestruction.Thepatient'streatmentshouldbeselected:

A.TripterygiumB.Non-steroidalanti-inf1ammatoryanalgesics

C.MTX+oxyquine+SASPD.Surgicaltreatment,suchas

arthroplasty

E.penicillium+MTX+hormone

24.Theslow-actinganti-rheumatoidmedicineis:

A.a.a.b.b.c.d.c.d.c.d.

25.Thefollowingdrugsbelongtonon-steroidal

anti-inflammatoryanalgesics:

A.fernmusthaveB

26.Bioocagentsare:

A.a.a.b.b.c.d.c.d.c.d.

Theanswer

1.C2.D.D

6.C7.E8,E

11.E12.E13.C14.D15.C

16.A

21.C23.A

26.B

Thesecondchapterissystemiclupuserythematosus

1.Whichofthefollowingclinicalmanifestationshasnothing

todowiththeanti-phospholipidsyndrome:

A.Anti-phospholipidantibodypositiveB.Recurrentabortion

c.hemolyticanemiaD.Arteriovenousthrombosis.E.

thrombocytopenia

2.Whichofthefollowingisnotaclinicalmanifestationof

anti-phospholipidantibodysyndrome?

A.habitualabortionB.ThrombocytopeniaC.Arteriovenous

thrombosisD.Anti-phospholipidantibodypositivee.

anti-nuclearantibodypositive

3.Thesignatureantibodiesofdruglupusare:

A.antihistoproteinantibodyB.Anti-ssbantibodyC.Anti-ssa

antibodyD.Anti-jo-1antibodyE.Anti-scl-70antibody

4.Whichofthefollowingantibodiesdoesnotbelongtothe

anti-nuclearantibodyspectrum:

A.Anti-phospholipidantibodyB.Anti-jo.1antibodyC.

Anti-ssaantibodyD.

Anti-RNPantibodyE.Anti-filamentantibody

5.Thefollowingisnottrue:

A.Patientswithlupusnephritiscantreatjointpainwith

non-steroidalanti-inflammatorydrugs

B.Chokingiseffectiveincontrollingrashesand

photosensitivity.C.adrenocorticalhormoneisstillthemain

drugtotreatSLE

D.Immunosuppressiveagentsareusedtotreatthemoresevere

lupuserythema

6.ThecorrectdescriptionofdrugtreatmentforSLEpregnancy

is:

A.Estrogen-containingbirthcontrolpillscancauseArelapse

andnotbeused

B.thepatientwithnormalheart,liverandkidneyfunctionmay

allowpregnancy

C.Duringpregnancy,itisimportanttoobservethechangesof

thediseaseandmonitorthelaboratoryindicators

D.Allimmunosuppressantsexcepthormonesshouldbe

discontinuedduringthefirstthreemonthsofpregnancy

E.alloftheaboveiscorrect

7.TheetiologyofSLEisnotrelatedtowhichofthefollowing?

A.geneticb.bloodtransfusionc.environmentalfactors,uv,

foodd.sexhormonee.infection

8.Whichofthefollowingautoantibodiesisthemarkerantibody

ofSLE?

A.Anti-dsdnaantibodyB.Anti-ssaantibodyC.Anti-ssb

antibodyD.Anti-phospholipidantibodye.anti-smantibody

9.Themostcommonclinicalmanifestationsof

anti-phospholipidsyndromeare:

A.arteriovenousthrombosisb.habitualabortionc.platelet

reductiond.anti-phospholipidantibodypositiveE

10.ItisnotthecharacteristicofSLEoralulcer:

A.nonspecificmucosalerosiveB.Painfululcer

C.PainlessulcerD.Mucosallesionssimilartodiscoidlupus

E.Noneoftheabove

11.ThetotalamountofCTXveinimpacttherapyforthenatural

logis:

A.10gB.20gC.30g

D.Accordingtothepathologyofrenalbiopsyandtheresponse

ofpatients,itisusually12g

E.40g

12.ThemechanismofcyclosporinAandCYAtotreatSLEis:

A.inhibitstheactivationofBcellsbyinhibitingthe

activationofTcells

C.InhibittheactivationofTandSBcellsandinhibitthe

activationofAFCcells

E.alloftheaboveare

13.ThemaincausesofSLEare:

A.renalfailureb.infectionc.coronaryatherosclerosisD

E.Noneoftheabove

14.Whichofthefollowingstatementsagainstnuclear

antibodiesiswrong?

A.IsthescreeningindexofSLE

C.Includesanti-rnp,anti-sm,anti-ssaandanti-ssb

antibodies

D.Theanti-dsdnaantibodyisrelatedtotheactivityofkidney

disease

E.alltheabovearewrong

15.ThemechanismofglucocorticoidtherapyforSLEis:

A.Inhibitthemovementandaggregationofmulticellularcells

towardtheinflammatorysites

B.Inhibitthephagocytosisandthereleaseofvariousenzymes

C.cellularimmunefunctionisinhibited

E.Noneoftheabove

16.ThemeasuresthatshouldbetakeninresponsetoSLEand

ischemicosteonecrosisarenot:

A.Youshouldstoptakinghormones

B.protectthejointsfromallkindsofgravity.

Toreconstructthevesselsofthediseasedjoints

C.Usethenon-weight-bearingbodyfor6months

D.Afemoralheadreplacementshouldbeusedforthecollapse

ofthefemoralhead

E.Strengthenactivitiestopromotebloodcirculationand

facilitaterecovery

17.SLEisgood:

A.WomenofchildbearingageB.OlderwomenC.MaleD.Children

E.Allabove

18.Theadversereactionsfollowingthetreatmentoflupus

nephritiswithCTX:

A.bladderbleedingb.sexualglandfunctionaffectedc.hair

lossd.gastrointestinalreactione.allabove

19.PatientswithSLEforlong-termuseofglucocorticoidswere

mostlikelytooccur:

A.hypertensionb.diabetesc.osteoporosisd.obesityE

20.WhichofthefollowingistheskinchangeofSLE?

A.vascularskinlesionsb.photoallergyc.hairloss

D.subacutecutaneouslupuserythematosus(sle)E

21.Whichofthefollowingstatementsisincorrecttodescribe

theanti-phospholipidantibody?

A.Anti-phospholipidantibodyb.lupusanticoagulantC.Serum

anti-nuclearantibodypositive

D.Theserumfalsepositiveofsyphilisisnotcorrect

22.Thefollowingindicatorsindicatethatlupusactivityis:

A.Thetiterofanti-dsdnaantibodyincreasesthelevelofb.

complement(C3andCHSO)

C.Systemicsymptoms,fever,etc

D.Changesinactiveinflammation,nephritis,rashes,serous

meningitisandnewrashappear

E.alloftheaboveare

23.Thepathologicaltypesoflupusnephritisare:

A.MesangialproliferativelupusnephritisB.Focal

proliferativelupusnephritis

C.diffuseandproliferativelupusnephritisD.Membranous

lupusnephritis

E.alloftheaboveare

24.ThetreatmentwithlupusnephritisIVwallchoicedrugfor:

A.prednisoneB.ThiazoleC.CyclophosphamideD.Cyclosporine

A

25.Thecharacteristicimmunopathologicalmanifestationsof

lupusnephritisare:

A.Allkindsofimmunoglobulinandcomplementarepositive

B.thephenomenonof"foilhouse”

C.Thepositiverateofimmunofluorescenceinthebasal

membraneoftheglomeruluswasmorethan60%

D.Thepositiveratecanbeashighas40%~50%

E.alloftheaboveare

26.AccordingtotheWHOclassificationcriteria,IVtypewith

lupusnephritispathologicalchangesasfollows:

A.thesmallIgGIgG,IgM,IgA,Clq,ClandC2weredeposited

bytheepithelium

B.Theelectrondensitydepositioninthemesangialareawas

observedwhentheelectronmicroscopewasexamined

C.Canbedividedintoa,b,Candd4subtypes

D.Alloftheaboveare

27.Thefollowingstatementofpregnancyandlupusis

incorrect:

A.itiseasytoabortBduringthefirst3monthsofpregnancy.

3monthsandpostpartumcanaggravatethecondition

C.avoidanymedicationtopreventtheoccurrenceofthe

pregnancy

D.Patientswithlupusshouldbeabletoconsiderpregnancyfor

atleastayear

E.Pregnantwomenalsotakehormonetherapy

28.WhichofthefollowingarenottheantibodiesintheSLE

classificationstandard?

A.anti-dsdnaantibodypositiveB.Anti-smantibodypositive

C.

TheserumtestofsyphiliswasfalsepositiveD.Anti-nuclear

antibody

E.Anti-ssaantibody

29.ThespecificautoantibodiesofSLEare:

A.Anti-smantibodyB.Anti-dsdnaantibodyC.Anti-ulrnp

antibodyD.Anti-cardiophospholipidantibodye.anti-ssa

antibody

30.WhichorganofSLEpatientsisrelatedtotheriseofdsDNA:

A.Brainb.heartc.kidneyd.skine.blood

31.Thefollowingnon-sleclassificationcriteriaare:

A.DiskerythemaB.SerousmeningitisC.Arthritis

D.Lymphocyteislessthan35,000/mmE.Hemolyticanemiais

associatedwithanincreaseinthenumberofpolycytes

32.Whatarethemodeloflupusmice?

A.NewZealandblackmice(NZB)andNZB/NZWFI(BW)

BNZB/SWRFL(SNF1)

D.RL/lPrmousee.allabove

33.Thephotoallergyofpatientswithlupusrefersto:

A.thepatienthasArashafterexposuretosunlight

B.Thepatientdevelopedfacialrashesafterexposureto

ultravioletlightfromothersources

C.Theoriginalskinrashesbecomered,aggravatingwithheat,

itchingortingling

D.Theseverityofskinlossisindirectproportiontothe

intensity,distanceanddurationofexposure

E.alloftheaboveiscorrect

34.ThecorrectdescriptionofthehairlossinSLEpatients

is:

A.hairlossoccursnotonlyinhair,butalsoineyebrows,

eyelashesandbodyhair

B.Afterabout3monthsoftreatment,thehairofthehairwas

widespread,anditwascalledstatic

C.hairlossisstableandnewhaircanberenewed

D.Thehairisbrittle,itlosesitsluster,itisyellowand

easytobreak,causingdiffusehairloss,anditisalsocalled

/zlupushair”.

E.alloftheaboveiscorrect

35.Thecorrectdescriptionofthereticulais:

A.becauseofthesmallarterialupliftspasminthedermis,

thebloodflowtothesuperficialhorizontalveinplexusofthe

skin,resultinginAnetworkofreddishandreddishspotson

thesurfaceoftheskin

B.thereticularbluepatchesareassociatedwith

anti-cardiophospholipidantibodies

C.althoughthemeshismorecommoninSLE,itcanalsobeseen

inotherrheumaticdiseases

D.Severevascularlesioncanoccurintheskinlesionsknown

asPVD(livedoidvasculitis)

E.alloftheabove

36.TheorderofskinchangesinReynoldsphenomenonis:

A.Typicalskinchangesinclude3periods:thepurpleofthe

fingers,andthepaintotheabovepartoftheskinturnspale,

andtheoriginalpurpleskinturnsredagain

B.Typicalskinchangesincludethreeperiods:thefingersare

paleandtheskinturnspurplewithpain,andtheoriginal

purpleskinturnsredagain

C.Typicalskinchangesinclude3periods:redfinger,andpain

totheabovepartoftheskintobecomepurple,andtheoriginal

purpleskinbecomespaleagain

D.Typicalskinchangesincludethreeperiods:thefingersare

paleandtheskinturnsredwithpain,andtheoriginalpurple

skinturnspurple

E.alloftheaboveiscorrect

37.Thetherapeuticprincipleoflupusnephritisiscorrect:

A.

Adrenalcorticalhormoneandcytotoxicimmunosuppressive

agentsarethemaindrugoptionsfortreatinglupusnephritis.

Adrenalcorticalhormoneisthepreferreddrugforlupus

nephritis

B.whenthereisnooronlyslightkidneydiseaseclinical

symptoms.I,IItypeforhistologiclesions,usingonlyasmall

amountofglucocorticoid(0.5mg/kgdailyprednisone)outside

thecontrolofrenalperformance

C.whenasignificantproteinuriaornephroticsyndrome,

especiallyIII,IVandVtypeshouldbeusedwithlupus

nephritislargerdosesofadrenalcorticalhormone(prednisone

daily「1.5mg/kg),canalsobeusedwiththeimmuneinhibitors

CTXshare

D.ifrecenthasrapidlyworseningrenalfunction,suchas

activeIVtypewithlupusnephritis,shouldbetreatedwith

largedoseofmethylprednisoloneimpact,atthesametime,

combineduseofimmunosuppressantsorhigh-dose

cyclophosphamidepulsetherapy

E.alloftheaboveiscorrect

38.ThecausesofcardiovasculardiseaseinSLEpatientsare:

A.thetreatmentofhormoneb.thediseaseitselfisrelated

toc.secondaryhighbloodlipidD.Secondaryhypertensione.

alloftheabovearecorrect

39.ThecorrecttreatmentprincipleforSLEis:

A.Treatmentprogrammesanddosagemustbeindividualized,and

therisk/effectivenessratiooftheselecteddruganddoseto

thepatientshouldbeassessedregularly,andthemost

appropriatedruganddoseshouldbesought

B.thepatientwillbefollowedforalongtime,regardlessof

theactivityortheremission

C.Patientswithhightidsofanti-dsdnaantibodiesshouldbe

alerttodiseaseactivity,especiallynephritis

D.Toimprovethequalityoflife,andtogivemoralsupport

topatients.Toparticipateintheappropriateworkaccording

tothesituation,childrenshouldlearnasmuchaspossible,

andafterlong-termcontrolorrelief,theycanconsider

marriageandchildbirth

E.alloftheaboveiscorrect

40.Female,30yearsold,sufferfromSLF5years,urineprotein

2years,long-termtreatmentwithhormoneandCTX,urine

proteinswingsbetween1~2g.Noobviousdrop,nearlyamonth

rises330mubloodCrmol/L,andasenseofnauseaandvomiting,

whichofthefollowingmeasuresshouldbetaken?

A.traditionalChinesemedicine

B.hemodialysis

C.Renalpuncturewasusedtoidentifythepathologicaltype

andtoplan

D.ANA+ENAcheck

E.anti-dsdnatest

41.Female,27yearsold,foundurinaryprotein+2years,

relatedsectionpainandfacialerythemahistory,inorderto

makeacleardiagnosis.Whichofthefollowingtestsshouldbe

donebythepatient?

A.RFB.ANA+ENAC.ASOd.c.RPE.BUN+Cr+UA

42.Female,43,hadbeendiagnosedwithSLEformorethan10

years,andhadbeenonregularoutpatientvisits.Thistime,

shehadnotbeenrecheckedfor5monthsanddidnotcomplain

ofspecialdiscomfort.Check:ESRnormal,ANAI:640granule,RNP

(+),UIRNP(+),thepatient'sconditionis:

A.theconditionisnotcontrolledb.theconditionisstable

c.theconditionismild

E.Notsure

43.Female,20,feveronMarch1time,withjointpainaweek

agoappearsymmetryfacialerythemaandrecurrentoralulcer.

ExaminationrevealedESRHOmm/h,WEC3.0x109son,thepatient

shouldbeconsideredfirsthave:

A.Ra.B.S.LEc.rheumatoidarthritisD

44.Female,24