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急腹症试题

1.急腹症手术治疗的适应证，下列哪项是错误的( )

A 腹膜刺激征严重或有扩大趋势或抗炎治疗无效者

B 腹内脏器破裂或穿孔

C 急性机械性完全性肠梗阻

D 急性水肿性胰腺炎

E 嵌顿疝

2.单纯空腔器官梗阻的腹痛特点( )

A 持续性腹痛

B 阵发性腹痛

C 持续性痛阵发性加重

D 持续性痛伴腹泻

E 阵发性痛伴发热

3.哪项不是炎症性急腹症的特点( )

A 腹痛由轻转重

B 持续性腹痛

C 病变部位有固定压痛

D 腹膜刺激征局限于病变局部

E 腹膜炎范围不随病变加重而扩展

4.对未明确诊断的急腹症病人，下列哪项处置是错误的( )

A 严密观察

B 禁用吗啡、杜冷丁等止痛剂

C 禁用泻药和灌肠

D 流食

E 抗炎治疗

5.诊断性腹腔穿刺不应用于( )

A 小儿及老年人

B 精神状态不正常者

C 昏迷病人

D 诊断已明确的病人

E 诊断不明确的病人

6.男性，30岁，上腹隐痛，与饮食有关已4年，此次突然上腹部剧痛，不敢深呼吸。体检:面色苍白，上腹部压痛明显，伴反跳痛及肌紧张，下腹轻度压痛，白细胞15×10的9次方/L，中性80%，为明确诊断首先应( )

A 腹部立位平片

B 紧急钡餐透视

C 腹腔穿刺

D 急查血淀粉酶

E 紧急静脉胆道造影

7.女性，30岁，农民，2小时前劳动中无诱因突然上腹刀割样疼痛，迅速波及全腹，不敢直腰，肝浊音界消失，舟状腹，有腹膜刺激征，应诊断为( )

A 阑尾炎穿孔，弥漫性腹膜炎

B 宫外孕破裂

C 溃疡病穿孔

D 绞窄性肠梗阻

E 急性出血性胰腺炎

8.女性，30岁，乘车后突然发生右下腹痛，伴恶心，近年来有同样发作史。查:腹软，右下腹有深压痛，血常规:白细胞9.0×10的9次方/L。尿镜检:红细胞（++），白细胞0～6/HP个，应诊为( )

A 慢性阑尾炎急性发作

B 右侧输尿管结石

C 右侧输卵管炎

D 单纯性不完全性肠梗阻

E 麦克尔憩室炎

9.男性，35岁，右下腹痛2周，伴有发热，右下腹扪及5cm×4cm肿块，压痛明显，查白细胞6.0×10的9次方/L，中性85%，截石位直肠指诊:右前方有触痛，应考虑其诊断为( )

A 盆腔脓肿

B 局限性肠炎

C 恶性淋巴瘤

D 回盲部结核

E 阑尾周围脓肿

10.男性患儿3岁，上腹部汽车撞伤2小时入院，腹腔诊断性穿刺（-）。诊断为腹壁挫伤。伤后8小时腹部逐渐饱胀，腹部扪诊时哭闹，腹肌紧张，肠鸣音消失，应考虑( ) A 胃破裂，弥漫性腹膜炎 B 腹壁挫伤 C 肝破裂 D 脾破裂 E 胰腺损伤

11.女性，46岁，因上腹剧痛，休克12小时入院。巩膜轻度黄染，高度腹胀，肠鸣音消失，血糖8.3mmol/L，血钙6.5mg%， CO2CP20.1mmol/L，血淀粉酶126温氏单位。心电图:T波倒置，ST段下降，应诊断为( )

A 心肌梗死，心源性休克

B 急性梗阻性化脓性胆管炎

C 胃穿孔弥漫性腹膜炎感染性休克

D 急性水肿性胰腺为

E 急性坏死性胰腺炎

12.10岁男孩，右下腹持续性痛阵发性加剧4天，发热，呕吐5次，为胃内容物，2天未排大便，仍排气。查:体温38.8℃，脉搏100次/分，腹稍胀，未见肠形，右下腹扪及5cm×4cm肿块，边界不清有压痛，肌紧张和反跳痛，肠鸣音减少，直肠指诊阴性。白细胞18×10的9次方/L，中性80%，应诊断为( )

A 肠套叠

B 肠结核

C 蛔虫团肠梗阻

D 阑尾周围脓肿

E 盲肠癌

13.患者，男，56岁，既往多年风湿性心脏病史，今晨饭后突然出现腹部绞痛，伴恶心，呕吐，无寒战，发热3小时入院，查:急性病容，血压110/80mmHg，全腹轻压痛，反跳痛、肌紧张不明显，无移动性浊音，肠鸣音6次/分，无气过水声。血常规WBC 为10的9次方/L，分叶60%。该患者可能的诊断是( )

A 急性机械性肠梗阻

B 急性胃肠炎

C 急性胰腺炎

D 急性肠系膜上动脉栓塞

E 肠扭转

14.患者，男，56岁，既往多年风湿性心脏病史，今晨饭后突然出现腹部绞痛，伴恶心，呕吐，无寒战，发热3小时入院，查:急性病容，血压110/80mmHg，全腹轻压痛，反跳痛、肌紧张不明显，无移动性浊音，肠鸣音6次/分，无气过水声。血常规WB C 为

9.0×10的9次方/L，分叶60%。该患者便常规可能的改变是( )

A 完全正常

B 含有未消化食物及脂滴

C 含有血红细胞

D 有大量白细胞

E 含有大量脓细胞

15.患者，男，56岁，既往多年风湿性心脏病史，今晨饭后突然出现腹部绞痛，伴恶心，呕吐，无寒战，发热3小时入院，查:急性病容，血压110/80mmHg，全腹轻压痛，反跳痛、肌紧张不明显，无移动性浊音，肠鸣音6次/分，无气过水声。血常规WB C 为9.0×10的9次方/L，分叶60%。为明确诊断，需进行下列那项检查( )

A 肝胆胰脾彩超

B 胸腹部X线摄片

C 肠系膜上动脉造影

D 血尿淀粉酶测定

E 心电图检查

16.患者，男，56岁，既往多年风湿性心脏病史，今晨饭后突然出现腹部绞痛，伴恶心，呕吐，无寒战，发热3小时入院，查:急性病容，血压110/80mmHg，全腹轻压痛，反跳痛、肌紧张不明显，无移动性浊音，肠鸣音6次/分，无气过水声。血常规WBC 为

9.0×10的9次方/L，分叶60%。该患应采取哪种治疗方法( )

A 抗炎治疗

B 镇痛解痉

C 观察疗法

D 短期（2小时）观察，如不缓解剖腹探查

E 立即剖腹探查

17.男性，42岁，突发性中上腹持续性疼痛，阵发性加剧3小时，并向右肩背部放射，频繁呕吐，吐出胃液及少量胆汁。查体：腹软，肠鸣音活跃。心电图示：房颤，白细胞：17×109/L。最应做何检查以助于诊断( )。

A．血常规 B．尿常规 C．B超 D．诊断性腹腔穿刺 E．立卧位腹部X 线平片

18.男性，10岁，突发性中上腹疼痛1小时，伴呕吐。查体：腹软，中上腹有轻度深压痛，无肌紧张及反跳痛，拟诊为 ( )。

A．胆石症 B．胃溃疡穿孔 C．急性胃肠炎 D．胆道蛔虫症 E．急性肠梗阻

19.男性，66岁，中上腹疼痛6小时，伴畏寒、高热2小时，以往曾行胆囊切除术。查体：T：39、6℃，腹软，剑突下及右上腹均有压痛，有轻度肌紧张及反跳痛，肝区叩击痛阳性，白细胞：13、9×109/L中性粒89%，拟诊为( )。

A．急性消化道溃疡穿孔 B．急性坏疽性阑尾炎 C．急性绞窄性肠梗阴

D．急性梗阻性化脓性胆管炎 E．急性出血性坏死性胰腺炎

20.女性，55岁，右上腹隐痛半年，加重3在，既往有慢性腹泻史。查体：39、6℃,肝肿大，触痛明显。白细胞：19×109/L，中性粒90%。核素肝扫描示肝右叶有—58mm ×66mm大小占位性病变。拟诊为( )。

A．原发性肝癌 B．慢性胆囊炎结石急性发作 C．细菌性肝脓肿 D．急性化脓性胆管炎

E．急性胆管炎，伴肝内脓肿形成

问答题：

1、试述急腹症常见腹痛的性质及其意义

2、试述腹腔穿刺在急腹症鉴别诊断中的应用

急腹症试题答案

1---5：DBEDD 6----10：ACBEA 11---15：EDDCC 16-20：DBDDE

1、答：腹痛性质反映了腹腔内脏器病变的性质，大体可分为三种：1、持续性钝痛或隐痛多表示炎症性或出血性病变。

2、阵发性腹痛多表示空腔脏器发生痉挛或阻塞性病变，腹痛持续时间长短不一，有间歇期，间歇期无疼痛。

3、持续性腹痛伴阵发性加重，多表示炎症和梗阻并存。

2、答：对诊断不确切的急腹症均可选择采用，尤期对疑有内出血，全腹膜炎病因不明，病人不能准确陈述病史或表达症状者更适用。多在两侧下腹，脐和髂前上棘连线的中外1/3交界处选择穿刺点。当疑有盆腔内积脓、积血等病变，女性病人可经后穹隆穿刺检查。如抽出不凝血，说明有内出血。如抽出腹腔液体可根据其颜色、混浊度、气味、涂片革兰染色镜检等帮助鉴别，还可作淀粉酶、胆红素的测定和细菌培养，对诊断和鉴别诊断有很大帮助。但对诊断已明确或严重腹胀者不宜采用此方法。

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【英语】历年全国高考英语动词试题汇总及答案.docx

【英语】历年全国高考英语动词试题汇总及答案一、单项选择动词 1．As a result, these countries are always struggling to their repayments; government finances that could be spent on health, education and long-term development are instead used for debt repayment. A． dive right in B ． catch up on C．push ahead with D ． split off from 【答案】 B 【解析】【详解】考查动词短语辨析。 A. dive right in 立即行动； B. catch up on 弥补、赶上； C. push ahead with 推动； D. split off from 脱离。句意：因此，这些国家总是努力偿还债务；原本可以用于医疗、教育和长期反战的政府财政被用于偿还债务。根据句意可知此处表示“弥补、偿还”，故 B 项正确。 2．Your own personal behavior as a teacher, outside school hours, _______ on the school itself. A．resembles B． reminds C． reflects D． remains 【答案】 C 【解析】【详解】考查动词词义辨析。句意：作为一名教师，你在课外的个人行为会给学校带来不良影响。 A. resembles 相似 B. reminds 提醒 C. reflects 反应 D. remains 保持。 reflect on 导致，招致，根据句意可知，选 C。 3．You probably have noticed that people express similar ideas in different ways, _______ the situation they are in. A． bringing about C． getting into 【答案】 B 【解析】B．depending on D． leading to 试题分析：考查动词短语。句意：你可能会发现人们会用不同的方式表达相同的观点，这主要取决于他们所处的情景。 A. bringing about 带来； B. depending on 取决； C. getting into 进入； D. leading to 导致；根据情景和词义，故选 B 项。考点：考查动词短语 4．To get promoted, I must _____ my colleagues, who are committed to their jobs. A． take after B． take to C． take in D． take on 【答案】 A 【解析】

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