昆明医科大学外科学专业课考博真题博士试题

全国外科学考博试题总结名词解释：1.高钾血症；2.心脏按摩；3.中心静脉压；4.非少尿型急性肾功能衰竭；5.呼吸性酸中毒；6.肠源性感染；7.脓毒症（sepsis）；8.Superinfection；9.ARDS；10.过继免疫疗法；11.CARS12.GVHR；13.SIADH；14．基因诊断；15.条件性感染；16.SIADH；17.SIRS；18. 预存式自体输血；19．休克抑制期；20. 痈；21.海绵状血管瘤；22.负氮平衡；23. 脑再灌注损伤；24.中厚皮片；25. 脓血症26.烧伤面积的中国九分法；27.systemic inflammatory response syndrome ；28.功能性细胞外液；29.心肺复苏；30.MSOF；31.ARF；32.ARDS；33.ICU；34.休克指数；35.MODS；36.条件感染；37.载体和重组质粒；38.MAC；39.导向复苏40.精准医疗论述题：1、较广泛的或剧烈的创伤性炎症对机体可引起哪些不利影响？（10 分）2、成人呼吸窘迫综合症的临床表现和分期（15 分）。

3.输血适应症4.外科抗菌药应用原则5.理想手术切口应具备的条件6.肾替代疗法应达到的指标7.DIC 的临床表现8.创伤治愈的分期、处理原则9.理想的肿瘤标志物应具备的特点10. 肾在体内酸碱平衡调节的机制11. 肠外营养的适应证和并发症12. 自体输血的方式和禁忌证13.试述肠内营养适应证14.试述自体输血的适应证与禁忌症15.分输血的种类和适应症16.肠源性感染的发病机制17.代谢性酸中毒的分型及常见原因18.创伤的检查与诊断步骤（13）19.脑复苏的现代观念及主要方法20.灭菌与消毒有何区别？21.高钾血症的原因和诊断处理？22.肠外营养有哪些常见并发症如何处理23.简述外科如何选择和使用抗菌药物？24..创伤后组织修复分几个阶段？简述其修复过程？25.创伤后组织修复过程分为哪几个阶段？各阶段的主要特点是什么？26.试述肿瘤浸润与转移过程中的相关因素？27.试述创伤的代谢变化及其临床意义？28.溶血反应的发病机理及病理变化？29.感染性休克病理生理变化过程中血流动力学改变有何特征？治疗要点是什么？30.全胃肠外营养的并发症31..肠细菌移位的发生机制32.腹部外科术后心力衰竭的紧急处理，应从哪些方面着手？33.有哪些腹部外科疾病与病毒感染有关？如何预防和治疗。

博士医生考试题库及答案博士医生考试题库及答案通常包含一系列医学领域的专业问题，旨在评估考生的医学知识和临床技能。

以下是一些模拟题目及其答案的示例：1. 问题：请简述心脏瓣膜病的分类及其临床表现。

答案：心脏瓣膜病可分为狭窄和反流两大类。

狭窄会导致心脏输出量减少，可能出现呼吸困难、乏力等症状；反流则会导致血液回流，可能引起心悸、气短等症状。

2. 问题：何谓糖尿病酮症酸中毒（DKA）？其常见诱因有哪些？答案：糖尿病酮症酸中毒是糖尿病患者体内胰岛素不足，导致酮体生成过多，引起代谢性酸中毒的一种并发症。

常见诱因包括感染、胰岛素治疗不当、饮食不当等。

3. 问题：请列举至少三种常见的肿瘤标志物，并简述其临床意义。

答案：常见的肿瘤标志物包括AFP（甲胎蛋白，与肝癌相关）、CEA （癌胚抗原，与结直肠癌相关）、CA125（卵巢癌相关抗原，与卵巢癌相关）。

这些标志物的升高可以提示相应肿瘤的存在，但并非特异性诊断指标，需结合其他检查结果综合判断。

4. 问题：简述急性心肌梗死（AMI）的心电图特征。

答案：急性心肌梗死的心电图特征包括：ST段抬高、Q波形成、T 波倒置。

这些改变反映了心肌缺血和坏死的电生理变化。

5. 问题：何为慢性阻塞性肺疾病（COPD）？其主要危险因素是什么？答案：慢性阻塞性肺疾病是一种慢性炎症性肺部疾病，主要表现为持续的气流受限。

其主要危险因素是吸烟，还包括空气污染、职业暴露和遗传因素等。

6. 问题：请解释何为高血压危象，并描述其紧急处理措施。

答案：高血压危象是一种急性血压升高的情况，伴有靶器官损害的风险。

紧急处理措施包括立即给予降压药物、评估并处理可能的并发症、监测生命体征等。

7. 问题：何为免疫缺陷病？请列举至少两种常见的免疫缺陷病。

答案：免疫缺陷病是指由于免疫系统功能缺陷导致的疾病，可分为原发性和继发性。

常见的原发性免疫缺陷病包括X连锁无丙种球蛋白血症和严重联合免疫缺陷病。

8. 问题：请简述甲状腺功能亢进症的临床表现和治疗方法。

去年在小木虫、百度文库、丁香园、爱爱医收集的博士入学考试外科学简答题，是好几个学校在一块的，北医、上交、协和、山大,301，华科的，受益颇大，当时下载也花了不少心血，总结费了不少时间，分享给大家，一份耕耘，一份收获，但愿好运常相随！！！考博问答题整理无菌术1.什么是无菌术？无菌术的内容包括那些？无菌术是针对微生物及感染途径所采取的一系列预防措施。

无菌术的内容包括灭菌、消毒法、操作规则及管理制度。

2.无菌术、灭菌？所谓灭菌就是杀灭一切活的微生物。

而消毒是指杀灭病原微生物和其他活动有害微生物，但不要求奢靡额和清除所有微生物3.常用的灭菌消毒法有：(1)高压蒸汽法。

(2)煮沸法。

(3)火烧法。

(4)药液浸泡法。

(5)甲醛蒸汽熏蒸法。

4.手术过程中的无菌原则(1)手术人员穿无菌手术衣和戴无菌手套之后，手不能接触背部、腰部以下和肩部以上部位，这些区域属于有菌地带；同样，也不要接触手术台边缘以下的布单。

(2)不可在手术人员的背后传递手术器械及用品。

坠落到无菌巾或手术台边以外的器械物品，不准拾回再用。

(3)手术中如手套破损或接触到有菌地方，应更换无菌手套。

如前臂或肘部触碰有菌地方，应更换无菌手术衣或加套无菌袖套。

如无菌巾、布单等物已被湿透，其无菌隔离作用不再完整，应加盖干的无菌布单。

(4)在手术过程中，同侧手术人员如需调换位置，一人应先退后一步，背对背地转身到达另一位置，以防触及对方背部不洁区。

(5)手术开始前要清点器械、敷料，手术结束时，检查胸、腹等体腔，待核对器械、敷料数无误后，才能关闭切口，以免异物遗留腔内产生严重后果。

(6)切口边缘应以无菌大纱布垫或手术巾遮盖，并用巾钳或缝线固定，仅显露手术切口。

术前手术区粘贴无菌塑料薄膜可达到相同目的。

(7)做皮肤切口以及缝合皮肤之前，需再消毒皮肤一次。

(8)切开空腔脏器前，要先用纱布垫保护周围组织，以防止或减少污染。

(9)参观手术的人员不可太靠近手术人员或站得太高，也不可经常在室内走动，以减少污染的机会。

历年考博外科题目总汇. .1、Tme及直肠系膜的概念2、胰头癌引起梗阻性黄疸的处理办法3、原位肝移植的手术方式与适应症胃癌的淋巴结清扫范围与手术根治程度分级乳腺癌的内分泌治疗的方法与药物乳癌治疗原则Sirs sepsis MODS的概念与相互关系营养不良的分类与支持的适应症直肠癌前切除术的主要并发症胰岛素瘤的定位诊断肝癌的综合治疗, 肝癌的治疗原则门脉高压上消化道出血的治疗MODS的发病机理MODS的治疗。

胆道出血的诊治慢性甲状腺炎的诊治SAP的治疗：胰腺炎的治疗Bismuth的分类；医源性胆管损伤按Bismuth分类：Ⅰ型：距肝总管起始部向远端2cm以上。

Ⅱ型：距肝总管起始部向远端2cm以内。

Ⅲ型：左右肝管汇合部。

Ⅳ型：左侧肝管或右侧肝管。

Ⅴ型：左右肝管分支处。

甲状腺癌的病理特点胃癌的治疗原则如何正确的对手术病人进行术前肝功能评估，以利手术顺利进行？Child 评分Child-1、Tme及直肠系膜的概念2、胰头癌引起梗阻性黄疸的处理办法3、原位肝移植的手术方式与适应症胃癌的淋巴结清扫范围与手术根治程度分级乳腺癌的内分泌治疗的方法与药物乳癌治疗原则Sirs sepsis MODS的概念与相互关系营养不良的分类与支持的适应症直肠癌前切除术的主要并发症胰岛素瘤的定位诊断肝癌的综合治疗, 肝癌的治疗原则门脉高压上消化道出血的治疗MODS的发病机理MODS的治疗。

胆道出血的诊治慢性甲状腺炎的诊治SAP的治疗：胰腺炎的治疗Bismuth的分类；医源性胆管损伤按Bismuth分类：Ⅰ型：距肝总管起始部向远端2cm以上。

Ⅱ型：距肝总管起始部向远端2cm以内。

Ⅲ型：左右肝管汇合部。

Ⅳ型：左侧肝管或右侧肝管。

Ⅴ型：左右肝管分支处。

甲状腺癌的病理特点胃癌的治疗原则如何正确的对手术病人进行术前肝功能评估，以利手术顺利进行？Child 评分Child：二问答1 PMC（甲状腺乳头状微小腺癌）及其目前治疗原则2 Budd-Chiari syndrome的分型及手术治疗方法布加综合征由各种原因所致肝静脉和其开口以上段下腔静脉阻塞性病变引起的常伴有下腔静脉高压为特点的一种肝后门脉高压症。

考博外科学试题及答案一、选择题（每题2分，共20分）1. 以下哪项不是外科手术的基本原则？A. 无菌操作B. 无创原则C. 快速切除D. 保护组织2. 外科手术中，以下哪项不是常用的止血方法？A. 压迫止血B. 电凝止血C. 药物止血D. 物理止血3. 以下哪种情况不适合进行手术治疗？A. 急性阑尾炎B. 慢性胆囊炎C. 严重营养不良D. 早期乳腺癌4. 外科手术中，以下哪项不是术后并发症？A. 感染B. 出血C. 疼痛D. 血栓形成5. 以下哪项是腹腔镜手术的优点？A. 切口大B. 恢复快C. 视野差D. 并发症多6. 以下哪项是外科手术前的常规准备？A. 禁食禁水B. 立即手术C. 无需体检D. 无需心理辅导7. 以下哪种麻醉方式适用于短小手术？A. 全身麻醉B. 局部麻醉C. 椎管内麻醉D. 神经阻滞麻醉8. 以下哪项是外科手术中常见的感染类型？A. 细菌性感染B. 真菌性感染C. 病毒性感染D. 寄生虫感染9. 以下哪项是外科手术中常见的并发症？A. 心律失常B. 肾功能衰竭C. 肺栓塞D. 以上都是10. 以下哪项是外科手术中的无菌操作原则？A. 无菌区域与非无菌区域分离B. 手术器械随意摆放C. 手术人员可以随意进出手术室D. 手术人员可以不戴口罩答案：1-5 C, D, C, D, B；6-10 A, B, A, D, A二、简答题（每题10分，共30分）1. 简述外科手术前的基本准备流程。

答：外科手术前的基本准备流程包括：患者体检、病情评估、术前讨论、手术方案制定、患者及家属的知情同意、禁食禁水、皮肤准备、术前用药等。

2. 请列举三种常见的外科手术并发症，并简要说明其预防措施。

答：常见的外科手术并发症包括感染、出血和血栓形成。

预防措施分别为：严格遵守无菌操作原则、术中控制出血、术后使用抗凝药物和鼓励患者早期活动。

3. 描述腹腔镜手术与传统开腹手术的主要区别。

答：腹腔镜手术与传统开腹手术的主要区别在于：腹腔镜手术切口小、创伤小、恢复快、疼痛轻、住院时间短；而传统开腹手术切口大、创伤大、恢复慢、疼痛重、住院时间较长。

昆明医学院博士学位研究生招生入学考试英语试题（EETMARCH282009）考试注意事项一、本试卷由客观评分题和主观评分题两部分组成：客观评分题包括词汇与结构、阅读理解与完型填空三部分，共65题，按顺序统一编号；主观评分题包括翻译与写作两部分，共3题。

二、客观评分题（题号1 -- 65）答案一律用中性（2B）铅笔做在机读答题纸上，在对应题号下所选的字母中间画黑道，如[A][B][C][D]。

三、主观评分题答案做在专用答题纸上。

为了不影响评分，请认真书写中英文答案。

四、试卷上均不得作任何记号，答案一律写在答题纸上，否则无效。

五、本考试全部时间为180分钟，每部分所占时间考生可自行掌握。

六、考试终了时间一到，考生一律停笔，等候监考教师收点试卷及答题纸。

待监考教师将全部试卷及答题纸收点无误并宣布本考试结束，方可离开考场。

Part I V ocabulary and Structure (20 points, 30 minutes)Directions: There are 20 incomplete sentences in this part. For each sentence there are four choices marked A, B, C, D. Choose the ONE answer that best completes the sentence. Then mark the corresponding letter on the Answer Sheet with a single line through the center.1.The school committee hoped that their choice of play would be ______ with the students andtheir parents.A. recognizedB. popularC. favorableD.fascinated2.But the Swiss discovered long years ago that constant warfare brought them ________suffering and poverty.A. nothing butB. anything butC. none other thanD. nomore than3.The small mountain village was _______ by the snow for more than one month.A. cut backB. cut outC. cut offD. cutaway4.The American peopl e’s ________ of being polite is different from that held here in China.A. mindB. conceptC. considerationD.thought5.The ______ of AIDS has led to an expansion in research seeking a cure.A. innovationB. selectionC. proliferationD.conviction6.When he was asked about the missing briefcase, the man _______ ever seeing it.A. refusedB. opposedC. resistedD. denied7.Modern appliances _______ us from a good deal of household work. For instance, the dryerfrees us from hanging the laundry.A. escapeB. benefitC. liberateD.comfort8.Our boss, Mr. Thompson, _______ a raise in salary for ages, but nothing has happened yet.A. was promisingB. has been promisingC. promisedD. haspromised9.People under stress have performed ________ feats of strength, like lifting an automobile offan accident victim.A．extraordinary B. specific C. abrupt D. abnormal10.After so many weeks without rain, the ground quickly ______ the little rain that fell last night.A. skippedB. soakedC. retrievedD.absorbed11.The government official can hardly find sufficient grounds ________ his arguments in favour ofthe revision of the tax law.A. on which to baseB. which to be based onC. to base on whichD. on which to be based12.Hydrogen is one of the most important elements in the universe ________ it provides thebuilding blocks from which the other elements are produced.A. so thatB. but thatC. provided thatD. inthat13. What are your _______ for judging a bottle of wine?A. regulationsB. rulesC. premisesD. criteria14.He was reading a piece of science fiction, completely _______ to the outside world.A. to be lostB. lost Ｃ. losingD. having lost15.Is it possible to make an early _______ to have my hair cut tomorrow?A. enrollmentB. engagementC. appointmentD. arrangement16.Since I could not see anything through the microscope, _ ____my careful adjustment, I gaveup.A. for allB. above allC. after allD. in all17.The _______ populated area was a breeding place for infectious diseases.A. denselyB. sparselyC. improperlyD. poisonously18.Renewing my driver’s license today is _________. Otherwi se, the license will expire atmidnight.A. imaginativeB. feasibleC. imperativeD.empirical19.An atom bomb would ________ a city.A. destroyB. damageC. moistD. wet20. All flights _______ because of the snowstorm, many passengers could do nothing but take thetrain.A. had been cancelledB. were cancelledC. have been cancelledD. having been cancelled Part II Reading Comprehension. (25 points, 60 minutes)Directions: There are 5 passages in this part. Each passage is followed by some questions or unfinished statements. For each of them there are four choices marked A, B, C, and D.You should decide on the best choice and mark the corresponding letter on the AnswerSheet with a single line through the center.Questions 21 to 25 are based on the following passage.Language is often irrational even in the way it combines words into sentences – in its synthesis. If language were perfectly rational in this respect, we should be able to handle words like the nine digits in arithmetic, and combine them into sentences at pleasure by applying a few simple grammaticalrules. In practice, however, we find that a great part of all languages consists of a limited number of natural sentences, only some of which admit of being formed a priori and freely modified by the substit ute of the other words, as when from “have”, “ink”, “pen”, we make up such sentences as “I have the ink”, “Who has the pen?” “Who has the ink?” “He has the ink,” and so on.But just as we cannot go on speaking long without using irregular inflections, so also we cannot go on speaking naturally for any length of time without using irregular combinations of words –combinations which cannot be constructed a priori. The sentences which make up natural speech are of two kinds – general sentences, such as those which have just been given, and special sentences or idioms, such as “how do you do?” “never mind”, which are really on a level with simple words, such as salutation, indifference, and like them, have to be learnt one by one, in the same way as the irregularities of the grammar. Many of them, indeed, have meanings inconsistent with those of the words of which they are made up. Thus “do” never has the meaning it has in “how do you do?” and “help” in the idiomatic expression “I could not help being late” has the meaning “prevent” “avoid”, which is the exact contrary of its ordinary meaning.Again, even in those cases in which the grammar and dictionary allow us to express an idea by various combinations of words, there is often only one of these combinations in actual use. Those who have had to do Latin prose composition know that the main difficulty of the art consists in having an instinctive knowledge of what combinations to avoid. French has a similar character. English and Greek are much freer in this respect, a fact which many foreigners find it difficult to realize. When they ask me such questions as “Can one speak of an ‘elegant supper?” “Can you say, ‘He was bad last night?” I always answer that English is a free language, and that there is nothing t o prevent any one calling a supper “elegant” although I do not remember ever doing so myself. Nevertheless, English has its imitations as well as other languages. Foreigners’ English often presents the curious spectacle of a language constructed on strict grammatical principles, but with hardly a single genuinely English sentence in it.21. Language is irrational in that ___________.A.we can combine words by using simple grammatical rulesB.words in a language are like the nine digits in arithmeticC.the meaning of a sentence can be inferred from the meanings of the words in itD.the meaning of a sentence does not always conform to the meaning of the words in it22.According to the author, __________.A.all languages have a limited number of natural sentencesB.not all sentences in a language can be modified by substituting different wordsC.regular combinations of words should be avoided in our speechD.we should construct a priori before we combine words into sentences23.Which of the following is true?A.Grammatically correct sentences are definitely correct.B.Grammatically correct sentences are not necessarily used in practice.C. A sentence based on grammar should be idiomatic.D. A sentence in practical use must be rational.24.The author thinks it ________ to call a supper “elegant”.A. not idiomaticB. impossibleC. wiseD. good English25.The main idea of the passage is that ________.A.We cannot speak by strict grammatical rulesB.No rule but has exceptionsC.There are two kinds of sentences in a languagenguage has strict grammatical rules to followQuestions 26 to 30 are based on the following passage.Predicting the future is always risky. But it's probably safe to say that at least a few historians will one day speak of the 20th century as America's “Disney era ”. Today, it's certainly difficult to think of any other single thing that represents modern America as powerfully as the company that created Mickey Mouse. Globally, brands like Coca-Cola and McDonalds may be more widely known, but neither encapsulates 20th-century America in quite the same way as Disney. The reasons for Disney's success are varied and numerous, but ultimately the credit belongs to one person — the man who created the cartoon and built the company from nothing, Walt Disney. Ironically, he could not draw particularly well. But he was a genius in plenty of other respects. In business, his greatest skills were his insight and his management ability. After setting himself up in Hollywood, he single-handedly pioneered the concepts of branding and merchandising — something his company still does brilliantly today.But what really distinguished Disney was his ability to identify with his audiences. Disney always made sure his films championed the “ little guy ”, and made him feel proud to be American. This he achieved by creating characters that reflected the hopes and fears of ordinary people. Some celebrated American achievements — Disney's very first cartoon Plane Crazy, featuringa silent Mickey Mouse, was inspired by Charles Lindbergh's flight across the Atlantic. Others, like the There Little Pigs and Snow White and the Seven Dwarves, showed how, through hard work and helping one's fellow man, or Americans could survive social and economic crises like the Great Depression.Disney's other great virtue was the fact that his company — unlike other big corporations —had a human face. His Hollywood studio —the public heard —operated just like a democracy, where everyone was on first name terms and had a say in how things should be run. He was also regarded as a great patriot because not only did his cartoons celebrate America, but, during World War II, studios made training films for American soldiers.The reality, of course, was less idyllic. As the public would later learn, Disney's patriotism had an unpleasant side. After a strike by cartoonists in 1941, he became convinced that Hollywoodhad been infiltrated by Communists. He agreed to work for the FBI as a mole, identifying and spying on colleagues whom he suspected were subversives.But, apart from his affiliations with the FBI, Disney was more or less the genuine article.A new book, The Magic Kingdom; Walt Disney and the American Way of Life, by Steven Watts, confirms that he was very definitely on the side of ordinary Americans — in the 30s and 40s he voted for Franklin Roosevelt, believing he was a champion of the workers. Also, Disney was not an apologist for the FBI, as some have suggested. In fact, he was always suspicious of large, bureaucratic organizations, as is evidenced in films like That Darned Cat, in which he portrayed FBI agents as bungling incompetents.By the time he died in 1966, Walt Disney was an icon like Thomas Edison and the WrightBrothers. To business people and filmmakers, he was a role model; to the public at large, he was “Uncle Walt ”—the man who had entertained them all their lives, the man who represented them all their lives, the man who represented all that was good about America.26. Walt Disney is believed to possess the following abilities EXCEPT ___________.A. paintingB. creativityC. managementD. merchandising27. According to the passage, what was the pleasant side of Disney’s patriotism?A. He sided with ordinary Americans in his films.B. He supported America’s war efforts in his own way.C. He had doubts about large, bureaucratic organizations.D. He voted for Franklin Roosevelt in the 30s and 40s.28. In the sixth paragraph the sentence “Disney was more or less the genuine article” means that__________.A. Disney was a creative and capable personB. Disney once agreed to work for the FBIC. Disney ran his company in a democratic wayD. Disney was sympathetic with ordinary people29. The writer’s attitude toward Walt Disney can best be described as __________.A. sympatheticB. objectiveC. criticalD. skeptical30. The word icon in the last paragraph means __________.A. an imageB. a pictureC. an object of great attentionD. a great scientistQuestions 31 to 35 are based on the following passage.Dramatically increasing costs of developing new drugs and more stringent regulatory requirements made by the U.S. Food and Drug Administration further dampened the drug industry’s appetite for jumping into new antibiotic research and development.The result was virtual paralysis in antibiotic development just when the resistance was careering out of control. “In 1991 an informal survey among pharmaceutical companies in the United States andJapan suggested that at least 50 percent of them had either diminished substantially or totally gotten out of antibacterial research,” says Shlaes. “People simply sloughed off the problem of resistance.”But it’s no surprise that bugs should develop resistance to our efforts to wipe them out. It’s only natural for an organism to do everything it can to evade its killer. By developing new drugs, we attempt to stay one step ahead of our microbial enemies, and the microbes furiously return the favor. Antibiotics actually promote resistance. For example, let’s say that Shoemaker’s young patient was indeed suffering from and ear infection. An antibiotic might wipe out most of those bad bugs, but a few might survive. If the child’s besieged immune system were capable of mopping up, all would be well. But if it weren’t, with the susceptible bacteria now dead, the resistant strains could spread like weed through a newly harvested fiel d. And if the child didn’t take the entire prescribed course of drugs, or if they were the wrong kind, more resistant strains might propagate.To compound the problem, antibiotics don’t just kill bad bugs, they also cut down innocent bystanders. That’s unfortunate, says Levy. “Non-disease-causing bacteria are essential parts of the body’s natural armor against invading infectious bacteria.” These benign microbes limit the spread of their dangerous brethren simply by being in the way. With them gone, the field is even more wide open to resistant bugs to grow rapidly.All that may be unintended result when antibiotics are used to cure disease. But much of antibiotic use is preventive – the penicillin given to the Vietnamese prostitutes, say, or antibiotics prescribed before surgery. Often the doses involved are comparatively low, and the drugs are given over long periods. This regime can be even more favorable for breeding resistance, as can low doses in animalfeed or in agriculture – or in antibacterial products like plastics, household cleaners, soaps, and toothpaste, a more recent menace.31. One of the reasons that made antibiotics research and development paralyzed is that __________.A. the cost of developing new drugs kept risingB. regulatory requirements are not so strictly observed as beforeC. there aren’t enough funds, and labors for drug industry to develop in this fieldD. the market demand is not high32. The case of Shoemaker’s young patient is taken to show that ___________.A. antibiotics can promote resistance of bugsB. antibiotics can kill all the bad bugsC. antibiotics can prevent the bugs from reproducing for goodD. antibiotics research is not well developed33. According to the text, which of the following statements in N0T true?A. Antibiotics kill innocent bacteria as well as bad bugs.B. If drugs were not taken properly, more resistant strains might breed.C. A person’s immune system plays a significant role in the effects of antibiotics.D. Antibiotics are not effective by and large.34. If non-disease-causing bacteria were killed, __________.A. the spread of infectious bacteria would slow downB. the positive effect of antibiotics would be proven fullyC. the spread of bad bugs would be freer and quickerD. resistant bugs would lose their ground to function35. In the last paragraph, it is inferred that ____________.A. preventive use of antibiotics leaves no room for bugs to develop resistanceB. low-dosed or long-term use of antibiotics can be a threat to our health as wellC. low-dosed or long-term use of antibiotics is not likely to breed resistance of bugsD. daily-used antibiotic products can thoroughly prevent the breed of resistant bugsQuestions 36 to 40 are based on the following passage.Until recently, questions about managed care focused on the issues of access to services, choices of doctors and waiting time. Now though, patients and employers are demanding to know more about their managed care plans. What percentage of breast cancer sufferers in a given plan survive? How many babies delivered are healthy? How many times a year do asthma sufferers get rushed to the emergency room?The emphasis on outcomes, though, is relatively new. The Foundation for Accountability a Portland(Ore.)-based group, is developing the first comprehensive set of measurements. Patients, employers and government purchasers of health plans formed the foundation 18 months ago to improve quality in health care delivery.So far, the group has developed seven sets of measurements about specific diseases such as asthma, breast cancer, diabetes and heart disease. No community has yet begun to use these measurements. But David Lansky, the foundation’s president, said that M edicare is preparing to test them in Florida, Minnesota and Washington State. It’s a four-year project and involves gathering data for analysis and giving feedback to doctors and managed care plans.Take breast cancer. The foundation measures quality of care three ways. It tries to determine whether the health plan has steps in place that lead to good care. For example, does it allow mammograms as often and early in life as the latest guidelines suggest? Does the patient understand all of the treatment options available to her?Patient satisfaction is another consideration. Does the health plan communicate well with the patient? Is the patient involved in treatment decisions? Does the patient have access to specialists? How long does the patient have to wait to get the results of a breast biopsy?The result, or outcome, is the final question. People want to know how long patients with breast cancer live and avoid recurrences of their disease. Do they have access to reconstructive surgery and counseling? Do they return to normal life as soon as possible?The ultimate goal, Lansky said, is to get this information into the hands of consumers while they’re choosing a doctor, a hospital or a health maintenance organization (HMO)36. Which of the following statements is true concerning people’s attention to managed care service?A.They used to focus on outcomes.B.They don’t care about access to services, choices of doctors and waiting time for the timebeing.C.They begin to stress the outcomes.D.They begin to stress delivery time.37. The Foundation for Accountability is an organization that __________.A. was set up to improve quality in health care deliveryB. has got its sets of measurements into effectC. is formed exclusively by patients and government purchasers of health plansD. develops sets of measurements about minor diseases38. The set of measurements will be tested ___________.A. over half a decadeB. in three states of the United StatesC. in PortlandD. and the result will be reported to patients other than doctors39. Regarding measuring quality of breast cancer care, it is mentioned in the text that _________.A. it takes three ways to measure, i.e., doctors’ attitude, patient satisfaction and o utcomeB. the Foundation worked out three sets of measurementC. the measurement should take the communication between patient and the health plan intoconsiderationD. the outcome is the least important.40. The significance of measurements mainly lies in that __________.A. health care will be more popularly accepted by consumersB. the Foundation can make some profits by providing informationC. consumers divert their attention on health care from choices of doctors to outcomesD. consumers can have information about the quality of health care when they needQuestions 41 to 45 are based on the following passage.One method of determining your strong points is to appraise past performance honestly and to draw a balance sheet of your assets and liabilities. An appraisal of this sort might profitably be discussed with a friend to obtain a fresh, objective viewpoint on what one should try to do.Second, in job hunting it is important to advertise yourself. One young man – fortunately, a wealthy one – has turned his worries over to the bank where he keeps his money. He has told the bank that sooner or later something will turn up which he would be glad to have called to his attention. To be sure, this man is an exception. Many others, however, are content to call on their friends of business acquaintances, mention that they are “looking” not leaving a clear impression for what, and expect to get results.Job hunting is the hardest of all types of work, and it can be the most interesting. An orderly planned approach is essential. Let us assume you have decided what you want to do, believe and can prove you can do it well, know where you are willing to live, and have an idea of your worth. In short, you have prepared yourself to look for a job.No matter how flexible you are, there are certain companies to which you might be useful and many others to which you will not. Type of industry and size of company are two limiting factors to begin with, aside from your own personal preferences as to location, travel, salary, etc.41. If you want to have a self-appraisal, you should ___________.A. be aware of your strong pointsB. be honest with yourselfC. have enough assetsD. have a balanced mind42. The author suggests that one need discuss with a friend about jobs ___________.A.because friends might know more job opportunitiesB.because friends know you better than you doC.because friends are more honest than you areD.because friends can be more objective43. The example of the young man is used to show that ___________.A. even rich people need to look for a jobB. one should look for the right person in job huntingC. the young man is rich and fortunateD. self-advertising is important in job hunting44. When you prepare yourself to look for a job, you should do all the followingEXCEPT___________.A.knowing what you want to doB. deciding what you candoC. being flexible for everythingD. knowing your ownworth45. The passage discusses ____________.A. the job seekerB. the job marketC. the ideal jobsD. limiting factors in job huntingPart III Cloze (20 points, 1 point each, 30 minutes)Directions: There are 20 blanks in the following passage. For each blank there are four choices marked A, B. C, and D. You should choose the One that best fits into the passage. Then mark the corresponding letter on the Answer Sheet with a single line through the center.The normal human daily (46) of activity is of some 7-8 hours’ sleep (47) alternation with some 16-17 hours’ cycle and that the sleep normally coincides(48) the hours of darkness. Ourpresent concern is with how easily and to what extent this (49) can be modified.The question is no mere academic one. The ease (50) people can change from working in the day to working at night is a (51) of growing importance in industry where automation (52)round-the-clock working of machines. It normally (53) from five days to one week for a person to adapt to a (54) routine of sleep and wakefulness, sleeping during the day and working at night. (55) , it is often the case in industry that (56) are changed every week. This means that no sooner has he (57) one routine (58) he has to change to another, (59) much of his time (60) neither working nor sleeping very well .One answer would seem to be better periods on each sh ift, a month, or even three months. (61) , recent research has shown that people (62) such systems will revert to go back to their(63) habits of sleep and wakefulness during the week-end and that this is quite enough to destroy any(64) to night work built up during the week. The only real solution appears to be to hand over the night shift to those night workers whose(65) may persist through all week-ends and holidays.。

攻读博士学位研究生入学考试试卷医学考博历年真题试卷昆明医学院2010年博士入学考试外科学试题第一大部分必做题一、单项选择（一个2分，10题，共20分）1、灭菌2、病例：钾代谢异常、脱水类型3、高渗性脱水诊断指标4、ARDS的病理改变5、疝气6、烧伤三度四分法7、急性腹膜炎休克原因8、失血性休克补充血容量，最优晶体液9、术后感染预防措施10、想不起来了二、名词解释（6个中文，4个英文，每个2分，共20分）1、等渗性缺水2、低血容量性休克3、肠外营养4、脓毒症5、肿瘤TNM分期6、急性移植排斥反应7、acute cholecystitis8、hernia9、PTCD 10、colon cancer三、简答题（一个10分，共30分）1、病例：脱水类型，补什么，补多少？2、病例：肠梗阻，检查方法，治疗原则。

3、鉴别癌性阻塞性黄疸和结石性阻塞性黄疸。

第二大部分根据专业选作普外（一个简答10分，一个论述20分）1、简答：乳腺癌前哨淋巴结概念及意义。

2、论述：原发性肝癌治疗原则，治疗方法及新进展。

昆明医学院2011年博士研究生入学考试外科学试题昆明医学院2011年博士研究生入学考试外科学试题特别提示：1、本试题共4页。

2、试题答案请写在专用答题纸上。

3、本试题共计100分，包括公共部分（70分），每位考生必答；选答部分（30分），考生可导师相近或相关专业选择作答，多选无效。

4、考生将选答部分专业注明在答题纸“考试科目名称”一栏中，例如：外科学（骨科）。

第一部分公共部分试题（70分）一、单项选择题（每题2分，共20分）1.杀灭芽胞细菌所需的温度和时间为：A. 高温1240C , 持续30分钟B．高温1000C ，持续20分钟C. 高温1200C ，持续20分钟D．高温1190C ，持续20分钟2. 低钾血症时，心电图不应表现A．出现u波B．T波变宽C. 高而尖的T波D．T波双向3．循环骤停进行复苏时，最有效的药物是A. 肾上腺素B．异丙肾上腺素C. 去甲肾上腺D．间羟胺4．上腹部出现顽固性呃逆，首先应想到的原因A. 膈下感染B．腹膜后血肿刺激腹腔神经丛C．手术造成膈神经损伤D. 粘连引起胃扭转5. 溶血性反应的治疗下列哪项是错误的：A. 使用抗组胺药物B．保护肾功能C. 换血治疗D．防治弥散性血管内凝血6．烧伤创面出现焦痂下积脓，下列处理方法哪项不正确A. 清除烧痂，充分引流B. 湿敷包扎治疗C. 控制感染下，切除焦痂植皮D．中药外用，蚕食脱痂7. 下列各项中，不符合DIC诊断标准的是A. 3P试验阴性B. 血浆纤维蛋白原<1．5g/LC. 血小板计数 < 80X109/LD. 凝血酶原时间比对照组延长3秒以上8. 有关休克的描述，不正确的是A. 血压低于90／60 mmHg，就可诊断为休克B. 急性梗阻性化脓性胆管炎可导致脓毒性休克C. 挤压伤可引起创伤性休克D. 鱼精蛋白副凝试验阳性是诊断弥散性血管内凝血的佐证9．ARDS最早期的症状是A. 呼吸加快窘迫感B．明显的呼吸困难C. 病人发绀D．呼吸道分泌物增多10．女，48岁，行胃大部分切除术，输血150ml后，出现寒战，肌肉注射异丙嗪25mg，继续输血，半小时．7℃，血压70／60mmHg，脉搏160次／分，发绀，意识不清，烦躁不安，可能原因:A. 输血后出血倾向B．发热反应C. 溶血反应D．细菌污染反应二、名词解释（每题2分，共20分）1．移植； 2. MODS；3.水中毒；4.急性胃肠功能障碍；5.低渗性缺水；6.代谢性酸中毒；7.全身炎症反应综合症； 8.肠内营养；9.心肺脑复苏； 10.charcot三联症。

1、hyaline degeneration 概念及分型。

2、滋养层细胞疾病包括什么？他们之间有什么共同点，又有什么区别？3、A动脉粥样硬化和高血压病所致心、肾、脑病变有什么不同？B高血压病颗粒性固缩肾是怎么形成的？C 高血压病小动脉病变是什么？4、大叶性肺炎分哪几个自然分期，有什么并发症？5、肠阿米巴、肠伤寒、肠菌痢的区别？6、结核球是来自哪些病变，临床上怎么治疗，为什么？7、良性肿瘤和恶性肿瘤的区别？8、流行性脑脊髓膜炎和乙脑的区别？9、胃癌种植转移于卵巢是什么诊断？胃癌转移途径有哪些？10、萎缩的概念及病理性萎缩类型？11、thrombus 概念及分型？12、坏死的基本病变？1 、简述下肢申报静脉血栓脱落后，栓子的运行途径和对机体造成影响（10 分）。

2、肉芽肿是由什么成分组成的？简述肉芽肿的作用、演变及瘢痕形成的过程（10 分）。

3、简述继发性肺结核各种类型互相转变的规律（10 分）。

4、简述肿瘤性增殖和非肿瘤性增殖的特点及二者的区别（8 分）。

5、何谓Abscess和Phlegmonous?二者的区别是什么（10分）。

6、简述粥样硬化动脉的发生发展过程（10分）。

7、简述凋亡细胞的形态学特点（6 分）。

8、男性患者，65 岁，反复咳嗽、咳痰10 年余，冬季加重。

近半年来感心悸、气急。

1周前发热，体温38C左右。

查体：颈静脉充盈，桶状胸，肺部可闻及湿性啰音，肝肿大，腹水，双下肢水肿。

X 线检查提示肺部散在小灶状阴影。

（ 1 ）患者患哪些疾病，请写出所患疾病名称（ 5 分）。

（2）试述患者所患疾病直接的相互关系及发病机制（10分）。

9、请写出可导致呕血的疾病或病变，至少写出3种，并简述它们的疾病特点（10分）。

10、C rescent 是哪种疾病的特征性病变，并简述这种疾病的病理表现（5 分）。

11、何谓Cervical Intraepithelial neoplasm ?并简述其分级的主要依据（ 6 分）。

一、名词解释1.脓毒症（sepsis）:是指由感染引起的全身炎症反应综合征（systemic inflammatory response syndrome, SIRS），临床上证实有细菌存在或有高度可疑感染灶。

是机体对感染性因素的反应。

2.缺血一再灌注损伤（ischemia-reperfusion injury）:在缺血基础上恢复血流后组织损伤反而加重，甚至发生不可逆性损伤的现象3. APUD瘤（Apudoma）:由APUD系统的细胞（弥散的神经内分泌细胞）发生的肿瘤，统称为APUD瘤（apudoma）。

APUD细胞指广泛分布在全身各部位的一些内分泌细胞和细胞群，这些细胞内含有胺或具有摄取胺的前体，进行脱羧反应的能力［（Amine （胺）,Pre- cursor （前体），Uptake （摄取），Decarboxylation（脱羧）］, 把具有这种特性（或能力）的细胞称为APUD细胞。

4.肝脏couinaud分段法：以肝裂和门静脉及肝静脉在肝内分布为基础的Couinaud分段法，将肝脏分为八段：相当于尾状叶为I段，左外叶为n、III 段，左内叶为W段，右前叶为V、训I段，右后叶为W、皿段。

5.肠道细菌移位（bactrial translocation）:是指肠道细菌及其产物从肠腔移位至肠系膜或其他肠外器官的过程。

研究证明，肠道细菌移位的发生部位主要在小肠。

6.甲状腺危象：是甲状腺功能亢进最严重的并发症，多发生在甲亢未治疗或控制不良患者，在感染、手术、创伤或突然停药后，出现以高热、大汗、心动过速、心律失常、严重呕泻、意识障碍等为特征的临床综合征。

二、简答 1.乳腺癌术后辅助化疗的目地及适应症目地：消灭全身潜在的微小转移灶，降低复发、转移风险，提高生存率。

适应症（1）腋窝淋巴结阳性的绝经前妇女，不论雌激素受体情况如何，均用已规定的联合化疗，应当作为标准的处理方案。

（2）腋窝淋巴结阳性和雌激素受体阳性的绝经后妇女，应当首选抗雌激素治疗。

2023年医学博士考试真题及答案
1. 题目：心脏病的常见症状包括哪些？
答案：心脏病的常见症状包括胸痛、心悸、呼吸困难、乏力等。

2. 题目：抗生素的作用是什么？
答案：抗生素是一种用于治疗感染性疾病的药物。

它可以通过
抑制或杀死病原体，阻止或减缓感染的发展。

3. 题目：什么是免疫系统？
答案：免疫系统是人体内一组组织、器官和细胞的集合，负责
保护机体免受外来物质和致病微生物的侵害。

4. 题目：请列举感染疾病的传播途径。

答案：感染疾病的传播途径包括空气飞沫传播、接触传播、食
品或水源传播等多种途径。

5. 题目：癌症是一种怎样的疾病？
答案：癌症是一种由异常细胞无限制生长和分裂导致的疾病。

它可以侵犯身体的多个组织和器官，并具有恶性转移的能力。

6. 题目：什么是心电图？
答案：心电图是一种记录心脏电活动的检测方法。

它可以显示
心脏在不同时间点的电压变化，用于判断心脏功能和心律是否正常。

以上是2023年医学博士考试真题及答案的一部分内容，供参考。

请注意，以上答案仅为参考，具体解答可能因人而异，应以正
式考试标准答案为准。