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休克精选选择题(含答案)

休克精选选择题(含答案)
休克精选选择题(含答案)

第八章休克

一、多选题A型题

1 ?休克的发生主要由于

A ?中枢神经系统在剧烈震荡与打击下由兴奋转入超限抑制

B. 血管运动中枢麻痹,小动脉扩张,血压下降

C. 交感-肾上腺髓质系统衰竭与麻痹

D. 血量减少,回心血量不足,心输出量减少

E ?重要生命器官低灌流和细胞功能代谢严重障碍

[答案]E

[题解]休克的本质不是交感衰竭导致血管麻痹而是各种强烈致病因子作用于机体引起的急性循环衰竭,其特点是微循环障碍、重要器官的灌流不足和细胞功能代谢障碍,由此引起的全身性危重的病理过程。

2. 过敏性休克属

A .1型变态反应D.W型变态反应

B. H型变态反应 E.混合型变态反应

C. m型变态反应

[答案]A

[题解]给过敏体质的人注射某些药物(如青霉素)、血清制剂或疫苗可引起过敏性休克,这种休克属于I型变态反应。发病机制与IgE及抗原在肥大细胞表面结合,引起组胺和缓激肽大量入血,造成血管床容积扩张、毛细血管通透性增加有关。

3. 以下哪种情况不引起心源性休克

A .大面积心肌梗死 D .严重心律紊乱

B. 急性心肌炎 E.充血性心力衰竭

C. 心脏压塞

[答案]E

[题解]大面积心肌梗死、急性心肌炎、心脏压塞、严重心律紊乱都可引起急性心力衰竭,引起心输出量明显减少,有效循环血量和灌流量下降,引起心源性休克;充血性心力衰竭呈慢性心衰改变,早期心输出量下降不明显,一般不引起心源性休克。

4. 成年人急性失血,至少一次失血量超过总血量多少才能引起休克?

A . 15% D . 40%

B. 20% E. 50%

C. 30%

[答案]B.

[题解]休克的发生取决于血量丢失的速度和丢失量,一般 15分钟内失血少于全血量10%时,机体可以通过代偿使血压和组织灌流量保持稳定。若快速失血量超过总血量20%以上,即可引起休克,超过总血量的 50%则往往导致迅速死亡。

5. 失血性休克血压下降早期主要与

A .交感神经-肾上腺髓质系统衰竭有关

B. 低血容量引起回心血量不足、心输出量降低有关

C. 血管紧张度下降、外周阻力降低有关

D .血液灌流不足、微循环血管大量扩张有关

E. 细胞严重缺氧能量代谢障碍有关

[答案]B

[题解]失血性休克早期交感神经-肾上腺髓质系统呈兴奋,全身小血管包括小动脉、微动脉、后微动脉、毛细血管前括约肌和微静脉、小静脉都持续痉挛,外周阻力增高。血压下降是与低血容量引起回心血量不足、心输出量降低有关。

6. 微循环的营养通路是

A .微动脉f后微动脉f直通毛细血管f微静脉

B. 微动脉f后微动脉f真毛细血管f微静脉

C. 微动脉f动静脉吻合支f微静脉

D .微动脉f后微动脉f直通毛细血管f真毛细血管f微静脉

E.微动脉f动静脉吻合支f真毛细血管f微静脉

[答案]B

[题解]营养通路是经过后微动脉到达真毛细血管网的通路。

7. 正常微循环中经常开放的通路指

A .直捷通路 D.动-静脉短路

B. 迂回通路 E.以上都不是

C. 营养通路

[答案]A

[题解]直捷通路经常处于开放状态,血流速度较快,其主要功能不是物质交换,而是使一部分血液能迅速通过微循环而进入静脉,以保证血液回流。

8. 正常微循环中经常关闭的通路

A .直捷通路 D.动-静脉短路

B. 迂回通路E以上都不是

C. 营养通路

[答案]D

[题解]动-静脉短路是吻合微动脉和微静脉的通道,在功能上不是进行物质交换,而是在体温调节中发挥作用。在正常微循环中动 -静脉短路经常处于关闭状态。

9. 正常真毛细血管血流的调节主要与

A .交感神经的支配有关

B. 毛细血管前括约肌自身节律性舒缩有关

C. 局部体液因素有关

D .全身体液因素有关

E.毛细血管内皮细胞收缩有关

[答案]C

[题解]正常生理情况下,全身血管收缩性物质浓度很少变化,微循环血管平滑肌特别是毛细血管前括约肌有节律的收缩与舒张,主要由局部产生的舒血管物质进

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