下载文档原格式
2012北医专业基础—病理生理学（原题）一、名词解释（30分）1.pathogenesis process2.hypervolemic hyponatremia3.anion gap4.histogenous hypoxia5.hyperthermia6.oxygen paradox7.shock8.restrictive hypoventilation9.pulmonary encephalopathy10.false neurotransmitter二、简答（70分）1.血管内外液体交换异常引起水肿的机制2.代谢性酸中毒的类型及发生原因3.热休克蛋白的定义及其功能4.DIC的分期及各期的特点5.什么是无复流现象，其发生机制如何6.呼吸困难在哪种类型的心衰最常见？该型心衰引起的呼吸困难与那些因素有关？7.急性肾衰少尿期最严重的并发症是什么？其发生机制是？2012年同济大学病理生理学真题（回忆）一、名词解释：1.脑死亡2.MODS3.ARDS4.肾功能不全5.呼吸衰竭6.应激性溃疡7.充血性心力衰竭8.PH反常9.内生致热源10.热休克蛋白11.心室重构12.微血管性溶血性贫血13.激素不敏感14.等渗性脱水二、选择题三、问答题1.急性全身性DIC为何会引起广泛出血和休克，其机制如何？2.心力衰竭者腹水的发生机制（是一个案例分析，大概是这个意思）3.风湿性心脏病二尖瓣狭窄的病理生理变化4.简述急性肾炎发生的机制5.肝性脑病时假神经递质有哪些？它们是如何引起肝性脑病的？2012中山大学病理生理（A）：1.名词解释：（都是英文）缺血再灌注损失凋亡心源性休克功能性分流2.论述题1）急性低钾血症和急性高钾血症引起肌无力的机制区别2）DIC的发病机制3）从细胞增殖和凋亡方面论述肿瘤的分子机制4）什么是SIRS、CARS、MARS？它们和多器官功能衰竭的关系？交大病生简答：内毒素引起MODS的机制。
DIC晚期患者易发生出血倾向的机制。
XXX2019年考博真题试卷
XXX医学考博真题试卷攻读博士学位研究生入学考试试卷
XXX2019年攻读博士学位研究生入学考试试题
考试科目：妇产科学
注意：所有答案一律写在答题纸上，写在试题纸上或其他地方一律不给分。
一、选择题（30个）
二、名词解释
1.席汉综合征
2.前置胎盘/植入
3.绝经过渡期
4.TORCH综合症
5.卵泡募集
三、XXX
1.Poi dor Pof含义
2.子宫肌瘤用
3.gnrh指证
4.胎儿非整倍体产前筛查
四、论述题
1.子宫内膜异位症合并不孕的因素
2.葡萄胎后滋养细胞疾病的诊断
3.XXX前期的预测和预防
五、病例分析题
停经51天hcg6000多，b超提醒宫外孕，双侧卵巢囊肿，后手术，术中没瞥见反常，只剥了右边囊肿，术后查hcg ,mtx 保守医治，复查hcg，查b超提醒右边附件宫外孕约7周，胚胎存活，问诊断鉴别诊断，医治方案？。
南⽅医科⼤学历年考博真题⼈体解剖学南⽅医科⼤学解剖历年真题1998年1、椎⾻间连接的有关结构名称2、髂内动脉的分⽀名称3、按肝内管道系统介绍肝的分叶和分段4、分布⾄颅顶的动脉和神经系统名称5、臂丛神经的组成分⽀6、运动髋关节的肌⾁名称、作⽤和神经⽀配7、急性脑疝形成的解剖学基础1999年⼀、必答题1、髋关节属于何类型关节？能做哪些运动？写出各运动作⽤的肌名称。
2、按顺序写出各⼼腔名称及该⼼腔内主要结构名称3、写出肺肝肾三个重要器官的结构分段名称4、写出12对脑神经名称、进出颅部位、与脑链接部位、纤维成分性质。
5、腋窝的境界，主要内容名称及临床意义。
⼆、选答题1、⾯部浅层的结构2、⼿背部⽪肤筋膜的结构特点2004年1、神经⼲细胞2、腹股沟三⾓3、肋膈隐窝4、股疝和斜疝的解剖学特点5、腕管的构成和其中的结构6、⽓官前间隙的组成和其中的结构7、股三⾓的构成和结构8、眶上裂通过的结构和功能2006年肘窝的组成，边界结构，内容物的排列关系胸长神经⽀配的肌⾁眼球中膜内包含的结构椎⾻的连接⽅式开⼝于下⿐道的结构胸膜的神经⽀配特点和胸膜炎时为何颈肩痛阴部神经通过何种结构通过腹股沟管的神经从解剖⾓度分析斜疝和直疝的区别胆总管的分段和各段的吡邻关系尺，挠，正中神经损伤后的表现尿道球部，前列腺部，膜部损伤后尿液渗⼊的间隙关于腹股沟管⽪下环的说法⾯神经和腮腺的关系及⾯神经出腮腺后的分⽀头顶部的神经⾎管分布及其分布范围窦房结动脉的分⽀来源⼩⽹膜构成及其内包含的结构肾的3层被膜及其意义脊髓的3层被膜及其特点构成肛直肠环的结构防⽌⼦宫左右移动的韧带膀胱后的结构及膀胱尖后的结构（男和⼥）紧张声带及缩⼩声门的肌⾁甲状腺被膜的构成颈部的筋膜脑神经后不是双侧神经来源的是集合淋巴滤泡分布的部位视神经盘的说明病历题：动眼神经损伤，可能同时伴有滑车神经损伤⾯神经颅内及颅外分⽀三叉神经脊束核通过丘脑的部位踝管及其内通过的结构内侧丘系的构成椎动脉，甲状腺上下动脉的来源2008年选择题单选，多选。
1. 整体死亡的标志是（）A.心跳停止B.脑死亡C.呼吸停止D.瞳孔散大E.脑电波处于零电位2. 下列哪项属于免疫缺陷病？（）A.红斑性狼疮B.青霉素过敏C.乳腺癌D.艾滋病E.肝炎3. 疾病发生必不可少的因素是（）A.疾病的条件B.疾病的原因 C,疾病的危险因素 D.疾病的诱因 E,疾病的外因4. 有关健康的正确概念是（）A.不生病就是健康B.是指体格健全C.精神完全良好状态D.是指社会适应能力的完全以好状态E.是指如体上、心理上和社会上的完全良好状态5. 决定细胞外液渗透压的主要因素是（）A. Ca 2+B. NaC. Cl -D. K'E. Pr'6. 正常成人每天最低尿量（）A. 1000mlB. 800mlC. 500mlD. 300mlE. 100ml7. 代谢性酸中毒中的过度通气可产生（）A.高渗性脱水B.低渗性脱水C.等渗性脱水D.水中毒E.水肿8. 可导致旧部脑内出血利蛛网膜下腔出血的水电解质紊乱是（）A.高渗性脱水B.低渗性脱水C.等渗性脱水D.急性水中毒E.脑水肿9. 低钾血症是指血清钾浓度低于：（）A. 1. 5mmol/LB. 2. 5mmol/LC. 3. 5mmol/LD. 4. 5mmol/LE. 5. 5mmol/l10. 低钾血症时出现肌肉松驰无力的机制是（）A. Em 负值t, Et 不变，Em-Et 距离fB. Em 负值I , Et 不变，Em-Et 距离IC. Em 负值不变,Et t , Em-Et 距离 tD. Em 负值 f , Et I , Em-Et 距离 IE. Em 负值 t , Et t , Em-Et 距离 t11. 反常性碱性尿常见于（）A.乳酸酸中毒B.呼吸性酸中毒C.缺钾性碱中毒D.高钾性酸中毒E.呼吸性碱中毒12. 组织液生成大于回流是由于（）A. GFR 降低B.血浆胶体渗透压降低C.抗利尿激素分泌过多D. 醛固酮分泌增多E.肾小球滤过分数增加13. 血浆中最重要的缓冲系统是（）A. NaHC03/H 2C03B. NaPr/HPrC. N^HPOi/NaHzPO ；D. KHb/HHbE. KHbO 2 / HHbO 214. 血浆[HC （V]原发性降低可见于（）A.代谢性酸中毒B.代谢性碱中毒C.呼吸性酸中毒D.呼吸性碱中毒E. 呼吸性碱中毒合并代谢性碱中毒15. 某慢阻肺患者,血pH 7.25, PaCO 2 9. 33 kPa （70mmHg ）, [HCO 3 ] 34nimol/L,其酸碱平衡紊乱的类型是（）A.代谢性酸中毒B.呼吸性酸中毒C.代谢性碱中毒D.呼吸性碱中毒E.呼吸性酸中毒合并代谢性酸中毒16. 酸中毒引起心肌收缩力（）A.先增强后减弱B.先减弱后增强C.减弱D.增强E.不变17. 健康者进入高原地区或通风不良的矿井可发生缺氧的主要原因在于（）A.吸人气的氧分压过低B.肺部气体交换差C.肺循环血流量少D.血液携氧能力低E.组织血流量少18. 输液反应出现发热的原因多数是（）A.药物毒性反应B.外毒素污染C.内毒素污染D.病毒污染E.真菌污染19. 细胞凋亡增强性疾病为（）A.原发性肝癌B.系统性红斑狼疮C.前列腺癌D.胰岛素依赖型糖尿病E.老年性痴呆20. 应激是指机体在受到各种内外环境因素刺激时所产生的（）A.特异性反应B.非特异性反应C.生理性反应D.损害性反应E.代偿性反应21.应激时交感-肾上腺髓质系统兴奋所产生的对机体不利的反应是（）A.组织缺血B.血黏度增高C.促进脂质过氧化物生成D.能量消耗过多E.以上都是22.休克早期微循环灌流的特点是（）A.多灌少流，灌多于流B.少灌少流，灌少于流C.少灌多流，灌少于流D.多灌多流，灌多于流E.多灌多流，灌少于流23.休克早期机体发挥代偿功能的主要表现为（）A.神志清醒B.尿量有所恢复C.肛温由下降开始回升D.血压雄•持在正常水平E.以上都不对24.休克早期“自身输液”作用主要是指（）A.容量血管收端，回心血量增加B.抗利尿激素增多，肾重吸收水增加C.醛固酮增多，肾钠水重吸收增加D.毛细血管内压降低，组织液回流增多E.动一静脉吻合支开放，回心血量增加25.在休克II期微循环淤血发生发展中起着非常重要作用的是（）A.乳酸酸中毒B.代谢产物的积聚C.细菌内毒素D.内源性阿片样物质E.血液流变学的改变26 .导致右心室前负荷过度的原因是（）A.主动脉瓣狭窄B.高血压病C.室间隔缺损D.肺动脉高压E.冠心病27.心肌肥大不平衡生长引起心衰的诸因素中，哪项涉及胞外钙内流障碍？（）A.心肌毛细血管数增加不足B.心肌去甲肾上腺素含量下降C.肌球蛋白ATP酶活性下降D.心肌线粒体数增加不足E.肌浆网钙释放减少28.呼吸衰竭通常是指：（）A.内呼吸功能障碍B.外呼吸功能严重障碍C.血液携带氧障碍D.二氧化碳排出功能障碍E.呼吸系统病变造成机体缺氧29.氨中毒患者脑内能量产生减少的主要机制是（）A.酵解过程障碍B.三梭酸循环障碍C.磷酸肌酸分解障砖D.脂肪氧化障砖E.酮体利用障码30.急性肾衰少尿期中，对患者危害最大的变化是（）A.水中毒B.少尿C.高钾血症D.代谢性酸中毒E.貌质血症单选（二）1、组织间液和血浆所含溶质的主要差别是A、Na+B、K+C、有机酸D、蛋白质2、低渗性脱水患者体液丢失的特点是A、细胞内液无丢失，仅丢失细胞外液B、细胞内液无丢失，仅丢失血浆C、细胞内液无丢失，仅丢失组织间液D、细胞外液无丢失，仅去•失细胞内液3、对高渗性脱水的描述，下列哪-•项不正确？A、高热患者易于发生B、口渴明显C、脱水早期往往血压降低D、尿少、尿比重高4、某患者做消化道手术后，禁食三天，仅静脉输入大量5%葡萄糖液，此患者最容易发生的电解质紊乱是A、低血钠B、低血钙C、低血磷D、低血钾5、各种利尿剂引起低钾血症的共同机理是A、抑制近曲小管对钠水的重吸收B、抑制髓祥升支粗段对NaCl的重吸收C、通过血容量的减少而导致醛固酮增多D、远|11|小管Na+-K+交换增强6、下列哪项不是组织间液体积聚的发生机制？A、毛细血管内压增加B、血浆胶体渗透压升高C、组织间液胶体渗透压升高D、微血管壁通透性升高7、高钙血症患者出现低镁血症的机制是A、影响食欲使镁摄入减少B、镁向细胞内转移C、镁吸收障碍D、镁随尿排出增多8、慢性肾功能不全患者,因上腹部不适呕吐急诊入院，血气检测表明PH7. 39, PaCO 25. 9Kpa（43. 8mmHg）,HCO 3 _ 26. 2mmol/L, Na+142mmol/L, Cl ~ 96. 5mmol/l,可判定该患者有A、正常血氯性代谢性酸中毒B、高血氯性代谢性酸中毒C、正常血氯性代谢性酸中毒合并代谢性碱中毒D、高血饭性代谢性酸中毒合并代谢性碱中毒9、血浆【HC。
Listening：无Vocabulary：Section A31. According to the Geneva ______no prisoners of war shall be subject to abuse.A. CustomsB. CongressesC. ConventionsD. Routines32. Environmental officials insist that something be done to ______acid rain.A. curbB. sueC. detoxifyD. condemn33. It is impossible to say how it will take place, because it will happen______, and it will not be a long process.A. spontaneouslyB. simultaneouslyC. principallyD. approximately34. Diabetes is one of the most______ and potentially dangerous disease in the world.A. crucialB. virulentC. colossalD. prevalent35. Rheumatologist advises that those with ongoing aches and pains first seek medical help to ______the problem.A. affiliateB. alleviateC. aggravateD. accelerate36. How is it possible that such______ deception has come to take place right under our noses?A. obviousB. significantC. necessaryD. widespread37. Now a paper in Science argues that organic chemicals in the rock come mostly from ______on earth rather than bacteria on Mars.A. configurationB. constitutionC. condemnationD. contamination38. Chronic high-dose intake of vitamin A has been shown to have ______effects on bones.A. adverseB. prevalentC. instantD. purposeful39. Generally, vaccine makers _____ the virus in fertilized chicken eggs in a process that can take four to six months.A. penetrateB. designateC. generateD. exaggerate40. We are much quicker to respond, and we respond far too quickly by giving ______ to our anger.A. ventB. impulseC. temperD. offenceSection B41. The patient's condition has worsened since last night.A. improvedB. returnedC. deterioratedD. changed42. Beijing Television-Station Transmitting Tower really looks magnificent at night when it’s lit up.A. decoratedB. illustratedC. illuminatedD. entertained43. Attempts to restrict parking in the city centre have further aggravated the problem of traffic congestion.A. amelioratedB. aggregatedC. deterioratedD. duplicated44. The applications of genetic engineering are abundant and choosing one appropriate for this case can be rather difficult.A. sufficientB. plentifulC. adequateD. countable45. The defect occurs in the first eight weeks of pregnancy, though no one understands why.A. deficitB. deviationC. draw backD. discrepancy46. He has been on hormone alternate therapy for four years and looks fantastic.A. successorB. replacementC. surrogateD. choice47. It had over 2,000 apartment complexes, a great market, a large number of industrial workshops, an administrative center, a number of massive religious edifices, and a regular grid pattern of streets and buildings.A. ancientB. carefullyC. very largeD. carefully protected48. When patients spend extended periods in hospital, they tend to become overly dependent and lose interest in taking care of themselves.A. extremelyB. exclusivelyC. exactlyD. explicitly49. The anxious parent was vigilant over the injured child in spite of a full array of emergency room of doctors and nurses.A. preoccupiedB. unwaryC. watchfulD. dozing50. The doctor vacillated so frequently on disease-prevention techniques that his colleagues accused him of inconsistency.A. waveredB. instigatedC. experimentedD. reliedClozeWe spend a lot of time looking at the eyes of others for social 51 —it helps us understand a person’ emotions, and make decisions about how to respond to them. We also know that adults avoid eye contact when anxious. But researchers have known far 52 about eye gazing patterns in children.According to new research by Kalina Michalska, assistant professor of psychology at the University of California, Riverside, we now, know that anxious children tend to avoid making eye contact, and this has consequences for how they experience fear. The 53 and less frequently they look at the eyes of others, the more likely they are to be afraid of them, even when there may be no reason to be. Her study, “Anxiety Symptoms and Children's Eye Gaze During Fear Leaming”, was published in the journal The Journal of Child Psychology and Psychiatry."Looking at someone’s eyes helps us understand whether a person is feeling sad, angry, fearful, or surprised. As adults, we then make decisions about how to respond and what to do next. But, we know much less about eye patterns in children—so, understanding those patterns can help us learn more about the development of social learning,” Michalska said.Michalska and the team of researchers showed 82 children, 9 to 13 years old, images of two women’s faces on a computer screen. The computer was equipped with an eye tracking device that allowed them to measure 54 on the screen children were looking, and for how long. The participants were originally shown each of the two women a total of four times. Next, one of the images was 55 with a loud scream and a fearful expression, and the other one was not. At the end, children sawboth faces again without any sound or scream.The following three conclusions can be drawn from the study:1. All children spent more time looking at the eyes of a face that was paired with the loud scream than the face that was not paired with the scream, 56 they pay attention to potential threats even in the absence of outward cues.2. Children who were more anxious avoided eye contact during all three phases of the experiment, for both kinds of faces. This had consequences for how afraid they were of the faces.3. The more children avoided eye contact；the more afraid they were 57 the faces.The conclusions suggest that children spend more time looking at the eyes of a face when previously paired with something frightening suggesting they pay more attention to potentially threatening information as a way to learn more about the situation and plan what to do next.However, anxious children tend to avoid making eye contact, which leads to greater 58 experience. Even though avoiding eye contact may reduce anxiety 59 , the study finds that—over time—children may be missing out 60_ important social information. This includes that a person may no longer be threatening or scary, and yet the child continues feeling fearful of that person.51. A. environment B. cues C. relations D. answers52. A. less B. more C. enough D. beyond53. A. longer B. more anxious C. shorter D. more54. A. where B. when C. how D. what55. A. followed B. recorded C. paired D. marked56. A. suggest B. suggesting C. suggests D. being suggested57. A. to B. of C.at D. about58. A. fear B. surprise C. sad D. angry59. A. in the long run B. for a long timeC. in the short timeD. in a long time60. A. with B. without C. of D. onReading ComprehensionPassage OneThe British psychoanalyst John Bowlby maintains that separation from the parents during the sensitive “attachment” p eriod from birth to three may sca r a child’s personality and predispose to emotional problems in later life.Some people have drawn the conclusion from Bowlby' s work that children should not be subjected to day care before the age of three because of the parental separation it entails, and many people do believe this. It has been argued that an infant under three who is cared for outside the home may suffer because of the separation from his parents. But there are also arguments against such a strong conclusion.But traditional societies are so different from modem societies that comparisons based on just one factor are hard to interpret. Firstly, anthropologists point out that the insulated love affair between children and parents found in modem societies does notusually exist in traditional societies. For example, in some tribal societies, such as the Ngoni, the father and mother of a child did not rear their infant alone—far from it.Certainty, Bowlby’s analysis raises the possibilities that early day care had delayed effects. The possibility that such care might lead to, say, more mental illness or crime 15 or 20 years later can only explored by the use of statistics. However, statistical studies of this kind have not yet been carried out, and even if they were, the results would certainly be complicated and controversial. Secondly, common sense tells us that day care would not be so widespread today if parents, care-takers found children had problems with it. Thirdly, in the last decade, there have been a number of careful American studies of children in day care, and they have uniformly reported that care had a neutral or slightly positive effect on childre n’s development.Whatever the long-term effects, parents sometimes find the immediate effects difficult to deal with. Children under three are likely to protest at leaving their parents and show unhappiness. At the age of three or three and a half almost all children find the transition to nursery easy，and this is undoubtedly why more and more parents make use of child care at this time. The matter, then, is far from clear-cut, though experience and available evidence indicate early care is reasonable for infants.61. According to the passage, the consequence of parental separation________.A. still needs more statistical studiesB. has been found negative is more seriousC. is obviousD. in modem times62. The author thinks that John Bowlby’s concern___________.A. is relevant and justifiableB. is too strong to RelieveC. is utterly groundlessD. has something that deserve our attention63. What’s the result of American studies of children in day care in the last decade?A. The children’s unhappiness and protest was due to the day car e the children received.B. The bad effects of parental separation were hard to deal with.C. The effect of day care was not necessarily negative on children’s development.D. Early care was reasonable for babies since it’s practiced by so many people nowadays.64. According to the passage, which of the following is probably a reason for parents to send their children under three to day care?A. They don’t know about day care’s negative effect.B. They are too busy to care for their children.C. They want their children to be independent as early as possible.D. They want to facilitate their children to adapt to nursery at the age of about three.65. What’s the author’s attitude to people who have drawn the conclusion from Bowlby’s work that children should not be subjected to day care before the age of three?A. He supports most of their belief because Bowlby's proposition is well-grounded.B. He is sympathetic for them, for he thinks they have been misled by Bowlby.C. He doesn't totally agree with them, since the long-term effect of day care still needs further study.D. He doesn't quite understand them, as they are contradictory in themselves. Passage TwoBy the end of this century, the average world temperature is expected to increase between one and four degrees, with widespread effects on rainfall, sea levels and animal habitats. But in the Arctic, where the effects of climate change are most intense, the rise in temperature could be twice as much.Understanding how Arctic warming will affect the people, animals, plant and marine life and economi c activity in Canada’s North are important to the country's future, says Kent Moore, an atmospheric physicist at University of Toronto Mississauga who is participating in a long-term, international study of the marine ecosystem along the Beaufort Sea, from Alaska to the Mackenzie delta.The study will add to our knowledge of everything from the extent of sea ice in the region to how fish stocks will change to which areas could become targets for oil and gas exploration to the impact on the indigenous people who call this part of the country home.Moore, who has worked in the Arctic for more than 20 years, says his research hasalready found that thinning sea ice and changes in wind patterns are causing an important change in the marine food chain: phytoplankton（淳游植物）is blooming two to three weeks earlier. Many animals time their annual migration to the Arctic for when food is plentiful, and have not adapted to the earlier bloom. " ' Animals' behavior can evolve over a long time, but these climate changes are happening in the space of a decade, rather than hundreds of year s, ” says Moore, " Animals can't change their behavior that quickly. ”A warmer Arctic is expected to have important effects on human activity in the region, as the Northwest Passage becomes navigable during the summer, and resource extraction becomes more feasible. Information gained from the study will help government, industry and communities make decisions about resource management, economic development and environmental protection.Moore says the study—which involves Canadian, American and European researchers and government agencies will also use a novel technology to gather atmospheric data: remotely piloted drones. "The drones have the capability of a large research aircraft，and they’re easier to deploy,” he says, showing the researchers to gather information on a more regular basis than they would be able to with piloted aircraft.66. By the end of this century, according to the author, global warming will ______.A. start to bring about extreme weather events to humans and animalsB. increase the average world temperature by four degreesC. cause more damages to the whole world than expectedD. affect the Arctic more than any other parts of the earth67.To help understand the destructive mechanism of Arctic warming, as indicated by the passage, the international study ______.A. is conducted with every single discipline of University of TorontoB. pioneers in pursuing the widespread effects of climate changeC. involves so many countries for different investigationsD.is intended to deal with various aspects in research68. When he ways, “Animals can’t change their behavior that quickly,” what does Moore mean by that quickly?A. The migration of the animals to the Arctic.B. The widespread effects of global warming.C. The rate of the climate change in the Arctic.D.The phytoplankton within the marine ecosystem.69. According to the author, to carry out proper human activities in the Arctic______.A. becomes more difficult than ever beforeB. is likely to build a novel economy in the regionC. will surely lower the average world temperatureD. needs the research-based supporting information70. With the drones deployed, as Moore predicts, the researchers will _______.A. involve more collaborating countries than they do nowB. get more data to be required for their researchC. use more novel technologies in researchD. conduct their research at a regular basisPassage ThreeHaving too much caffeine during pregnancy may impair baby’s liver development and increase the risk of liver disease in adulthood, according to a study published in the Journal of Endocrinology. Pregnant rats given caffeine had offspring with lower birth weights, altered growth and stress hormone levels and impaired liver development. The study findings indicate that consumption of caffeine equivalent to 2-3 cups of coffee may alter stress and growth hormone levels in a manner that can impair growth and development, and increase the risk of liver disease in adulthood.Previous studies have indicated that prenatal caffeine intake of 300 mg/day or more in women, which is approximately 2 to 3 cups coffee per day, can result in lowerbirth weights of their children. Animal studies have further suggested that prenatal caffeine consumption may have more detrimental long-term effects on liver development with an increased susceptibility to non-alcoholic fatty liver disease, a debilitating condition normally associated with obesity and diabetes. However, the underlying link between prenatal caffeine exposure and impaired liver development remains poorly understood. A better understanding of how caffeine mediates these effects could help prevent these health issues in people in the future.In this study, Prof Hui Wang and colleagues at Wuhan University in China, investigated the effects of low (equivalent to 2-3 cups of coffee) and high dose (equivalent of 6-9 cups of coffee) caffeine, given to pregnant rats, on liver function and hormone levels of their offspring. Offspring exposed to prenatal caffeine had lower levels of the liver hormone, insulin like growth factor (IGF-1), and higher levels of the stress hormone, corticosteroid at birth. However, liver development after birth showed a compensatory 'catch up' phase, characterised by increased levels of IGF-1, which is important for growth.Dr. Yinxian Wen, study co-author, says, “Our results indicate that prenatal caffeine causes an excess of stress hormone activity in the mother, which inhibits IGF-1 activity for liver development before birth. However, compensatory mechanisms do occur after birth to accelerate growth and restore normal liver function, as IGF-1 activity increases and stress hormone signalling decreases. The increased risk of fatty liver disease caused by prenatal caffeine exposure is most likely a consequence of this enhanced, compensatory postnatal IGF-1 activity. ”These findings not only confirm that prenatal caffeine exposure leads to lower birth weight and impaired liver development before birth but also expand our current understanding of the hormonal changes underlying these changes and suggest the potential mechanism for increased risk of liver disease in the future. However, these animal findings need to be confirmed in humans.Dr. Wen comments, "Our work suggests that prenatal caffeine is not good for babies and although these findings still need to be confirmed in people, I would recommend that women avoid caffeine during pregnancy."71. Which of the following is NOT the problem of baby rats of pregnant rats given caffeine?A. Lower birth weight.B. Smaller stress.C. Liver development problem.D. Growth problem.72. If a pregnant woman takes 3 cups of coffee, what will probably happen?A. Her weight will get lower and lower.B. The weight of her baby will get lower and lower.C. She will suffer from non-alcoholic fatty liver disease in a long run.D. Her baby will be more vulnerable to obesity and diabetes because of liver problem.73. Which of following is not correct according to the passage?A. A better understanding of the relationship between caffeine and effects has been achieved.B. 4-5 cups of coffee could be categorized as medium-dose intake.C. Liver development problem may be remedied after birth by increased growth factor.D. The study is mainly conducted on the rats instead of human.74. What is the relationship between stress hormone and liver development when taking in prenatal caffeine?A. Lower stress hormone, lower birth weight before birth.B. Higher stress hormone, lower growth hormone before birth.C. Higher stress hormone, more accelerated growth of weight after birth.D. Lower stress hormone, less accelerated growth of liver after birth.75. What can be the best summary of the last paragraph?A. The r esearch hasn’t been done on humans so pregnant women can ignore the results.B. The compensatory mechanism for liver growth makes prenatal caffeine intake safe.C. Experts suggest pregnant women should still avoid caffeine.D. We have known enough about the hormone changes underlying the health Passage FourThe bizarre antics of sleepwalkers have puzzled police, perplexed scientists, and fascinated writers for centuries. There is an endless supply of stories about sleepwalkers. Persons have been said to climb on steep roofs, solve mathematical problems, compose music, walk through plate-glass windows, and commit murder in their sleepHow many of these stories have a basis in fact, and how many are pure fakery? No one knows, but if some of the most sensational stories should be taken with a barrel of salt, others are a matter of record.In Revere, Massachusetts, a hundred policemen combed a waterfront neighborhood for a lost boy who left his home in his sleep and woke up five hours later on a strange sofa in a strange living room, with no idea how he had got there.There is an early medical record of a somnambulist who wrote a novel in his sleep. And the great French writer V oltaire knew a sleepwalker who once got out of bed, dressed himself, made a polite bow, danced a minuet, and then undressed and went back to bed.At the University of Iowa, a student was reported to have the habit of getting up in the middle of the night and walking three-quarters of a mile to the Iowa River. He would take a swim and then go back to his room to bed.The world's champion sleepwalker was supposed to have been an Indian, Pandit Ramrakha, who walked sixteen miles along a dangerous road without realizing that he had left his bed. Second in line for the title is probably either a Vienna housewife or a British farmer. The woman did all her shopping on busy streets in her sleep. The farmer, in his sleep, visited a veterinarian miles away.The leading expert on sleep in America claims that he has never seen asleepwalker. He is Dr. Nathaniel Kleitman, a physiologist at the University of Chicago. He is said to know more about sleep than any other living man, and during the last thirty-five years had lost a lot of sleep watching people sleep. Says he, "Of course, I know that there are sleepwalkers because I have read about them in the newspapers. But none of my sleepers ever walked, and if I were to advertise for sleepwalkers for an experiment, I doubt that I'd get many takers."Sleepwalking, nevertheless, is a scientific reality. Like hypnosis, it is one of those dramatic, eerie, awe-inspiring phenomena that sometimes border on the fantastic. It lends itself to controversy and misconceptions, what is certain about sleepwalking is that it is a symptom of emotional disturbance, and that the only way to cure it is to remove the worries and anxieties that cause it. Doctors say that somnambulism is much more common than is generally supposed. Some have estimated that there are four million somnambulists in the United States. Others set the figure even higher. Many sleepwalkers do not seek help and so are never put on record, which means that an accurate count can never be made.The simplest explanation of sleepwalking is that it is the acting out of a vivid dream. The dream usually comes from guilt, worry, nervousness, or some other emotional conflict. The classic sleepwalker is Shakespeare’s Lady Macbeth. Her nightly wanderings were caused by her guilty conscience at having committed murder. Shakespeare said of her, “The eyes are open but their sense is shut.”The age-old question is: Is the sleepwalker actually awake or asleep. Scientists have decided that he is about half-and-half. Like Lady Macbeth, he has weighty problems on his mind. Dr. Zeida Teplitz, who made a ten-year study of the subject, says, “So me people stay awake all night worrying about their problems. The sleepwalker thrashes them out in his sleep. He is awake in the muscular area, partially asleep in the sensory area." In other words, a person can walk in his sleep, move around, and do other things, but he does not think about what he is doing.76. The second sentence in the second paragraph means that_________.A. no one knows, but certainly all the sleep walking stories have something incredibleB. the sleepwalking stories are lik e salt adding flavor to people’s lifeC. sleepwalking stories that are most fantastic should be sorted out from ordinary storiesD. the most fantastic sleepwalking stories may be just fictions, yet there are still truthfully recorded stories77. ________was supposed to be the world's champion sleepwalker.A. The student habitually walked to the Iowa River and swam in his sleepB. The man danced a minuet in his sleepC. The man walker sixteen miles along a dangerous roadD. The boy walked five hours in his sleep78. Sleepwalking is the result of ______ according to the passage.A. emotional disorderB. a vivid dreamC. lack of sleep and great anxietyD. insanity79. Dr. Zeida Teplitz seemed to_________.A. agree that sleepwalking sometimes leads to dangerous actsB. conclude that sleepwalkers are awake in their sensory areaC. disagree with the belief that sleep walkers are immune to injuryD. think that sleepwalking can turn into madness80. The writer makes it obvious that_________.A. sleepwalkers are often awakened by dangersB. most sleepwalkers can find ways to avoid self-injuryC. it is important to find out the underlying cause of sleepwalkingD. sleepwalking is actually a kind of hypnosisPassage FiveBeyond the basic animal instincts to seek food and avoid pain, Freud identified two sources of psychic e nergy, which he called "drives”: aggression and libido. The key to his theory is that these were unconscious drives, shaping our behavior without the mediation of our waking minds; they surface, heavily disguised, only in our dreams. The work of the past half-century in psychology and neuroscience has been to downplay the role of unconscious universal drives, focusing instead on rational processes in conscious life. But researchers have found evidence that Freud s drives really do exist, and they have their roots in the limbic system, a primitive part of the brain that operates mostly below the horizon of consciousness. Now more commonly referred to as emotions, the modem suite of drives comprises five: rage, panic, separation distress, lust and a variation on libido sometimes called seeking.The seeking drive is proving a particularly fruitful subject for researchers. Although like the others it originates in the limbic system, it also involves parts of the forebrain, the seat of higher mental functions. In the 1980s, Jaak Panksepp, a neurobiologist at Bowling Green State University in Ohio, became interested in a place near the cortex known as the ventraltegmental area, which in humans lies just above the hairline. When Panksepp stimulated the corresponding region in a mouse, the animal would sniff the air and walk around, as though it were looking for something. Was it hungry? No. The mouse would walk right by a plate of food, or for that matter any other object Panksepp could think of. This brain tissue seemed to cause a general desire for some thing new. “What I was seeing,”he says, “was the urge to do stuff. ” Panksepp called this seeking.To neuropsychologist Mark Solms of University College in London, that sounds very much like libido. “Freud needed some sort of general, appetitive desire to seek pleasure in the world of objects,” says Solms. "Panksep p discovered as a neuroscientist what Freud discovered psychologically.” Solms studied the same region of the brain for his work on dreams. Since the 1970s, neurologists have known that dreaming takes place during a particular form of sleep known as REM—rapid eye movement—which is associated with a primitive part of the brain known as the pons. Accordingly, they regarded dreaming as a low-level phenomenon of no great psychological interest. When Solms looked into it, though, it turned out that the key。
南方医科大学2003年病理生理学（博士）一、名词解释：1、热限2、缺氧诱导因子3、脑死亡4、阴离子间隙二、问答题：1、DIC时为什么不用止血药止血？2、什么是EPO？它在体内的病理生理作用？3、各型休克为什么都要进行补液？南方医科大学2004年病理生理学（博士）一、选择题：40题×1分A1、A2、B、X型二、简答题：4题×5分1.简述GABA在肝性脑病中的作用2.为什么部分肺泡通气/血流比例下降只导致低氧血症，而不会导致PaCO2升高？3.简述DIC时出血的机制4.肾性高血压的发病机制三、论述题：1.一患者，血压波动于160/100近十年，近期发生左心衰竭，，请分析其发病机制（15分）2.试述休克I 期微循环变化的特点、机制和代偿意义（10分）3.一肺心病患者，入院呈昏睡状态，查：PH 7.26，PaCO2 65.5, HCO3－30,CL－92, Na＋145,试分析患者为何种酸碱失衡及电解质紊乱？根据是什么？并分析期昏睡的机制？（15分）南方医科大学2005年病理生理学（专基）（博士）1.请简述肾素——血管紧张素系统2.请简述第二心音固定分裂的病理生理基础3.请简述心室舒张充盈受阻的病理生理基础4.请简述心源性休克的病理基础5.请简述环形运动折返的三个条件6.请描述心肌收缩和舒张的基本过程，并从而阐述心力衰竭发生的基本机制。
7.请描述酸中毒对心肌收缩力的影响。
8.临床对心力衰竭病人检测心率的基本意义是什么？9.休克早期病人通过什么途径代偿血压的下降？10.请区分SIRS、Sepsis和Septic shock的概念。
2012年攻读博士学位研究生入学考试试题考试科目：病理生理学注意：所有答案一律写在答题纸上，写在试题纸上或其他地方一律不给分。
一、简答题1、健康与疾病关系，有哪些影响因素2、DIC诱因有哪些，其影响机制如何3、左心衰与右心衰引起水肿的异同4、SIRS、MODS为什么均是肺先受累5、第二信使6、VEC抗凝血与促凝血的机制二、问答题1、失血性休克从代偿到失代偿的机制？从中可以给临床什么启示2、心功能的定义及判断指标3、何为蛋白质修饰？对细胞传导的影响三、病例分析题题目太长，大意是外伤后的一个年轻人表现为肾功能进行性恶化，少尿、肺部病变、昏迷、代谢性酸中毒、多器官功能衰竭。
南方医科大学人体解剖学真题简答题:1、肩关节的构成，结构特点和运动方式由肱骨头与肩胛骨关节盂构成，也称盂肱关节,属球窝关节。
其结构特点是：肱骨头大，关节盂浅而小,关节盂周缘有盂唇来加深关节窝,但仍仅能容纳关节头的1／4－l／3。
关节囊薄而松弛。
关节囊的上壁有喙肱韧带，连于喙突至肱骨大结节之间，囊的前壁和后壁也有许多肌腱加入，以增加关节的稳固性。
囊的下壁相对最为薄弱.故肩关节脱位时，肱骨头容易发生前下方脱位。
肱二头肌长头腱穿过关节腔。
肩关节为全身运动最灵活的关节，可作屈和伸，收和展，旋内和旋外运动以及环转运动（三轴运动).臂外展超过40—60°,继续抬高至180°时,常伴随胸锁、肩锁关节的运动及肩胛骨的旋转运动2、甲状腺手术切口的层次关系问：甲状腺手术入路经过哪些层次？这些层次有哪些形态特点?（复旦)如果甲状腺肿大能影响哪些局部器官? （复旦）经过的层次：皮肤——浅筋膜（含颈阔肌)—-封套筋膜-—舌骨下肌群（胸骨舌骨肌—-胸骨甲状肌）——气管前筋膜-—甲状腺真被膜——甲状腺实质。
毗邻:左右两侧叶的后内侧临近喉与气管，咽与食管以及喉返神经，侧叶的后外侧与颈动脉鞘及颈交感干相邻，甲状腺侧叶后面有两对扁圆形的甲状旁腺。
当甲状腺肿大时,如向后压迫，可出现呼吸、吞咽困难和声音嘶哑：如向后外方压迫交感干时．可出现Horner综合征，即瞳孔缩小、眼裂变窄(上睑下垂）及眼球内陷等。
侧叶的后内侧与喉和气管、咽和食管以及喉返神经等相邻；侧叶的后外侧与颈动脉鞘及鞘内的颈总动脉、颈内静脉和迷走神经，以及位于椎前筋膜深面的颈交感干相邻。
3、子宫的形态，分部和固定装置问:子宫的位置,形态,分部，动、静脉来源、淋巴回流？（华西2001）试述子宫的形态、位置、姿势和固定装置。
（华西2002、2003）位置:子宫位于盆腔中部，前为膀胱，后为直肠，两侧有输卵管、卵巢及子宫阔韧带,下接阴道.成年正常女性子宫为前倾前屈位。
2009年全国医学博士入学考试专业基础（病理生理学）一、选择题（1分X40）A型30道，B型5道，X型5道二、简答题（5分X4）1、左心衰竭出现夜间阵发性呼吸困难的机制。
2、ARDS出现I型呼吸衰竭的机制。
3、肾性贫血的机制。
4、产科意外导致DIC的机制。
三、论述题（10分X4）1、一位流感病人体温39.7C，试述其发热的基本机制。
2、缺氧的类型以及各型的血氧指标的变化。
3、病例分析题，考水、电解质、酸解平衡紊乱的。
4、假神经递质在肝性脑病发病中的作用。
09病生1. 恶性肿瘤发生过程中有哪些细胞调控障碍？原因？2. 细胞信号转导异常的环节有哪些？3. 低钾血症对机体的影响？4. 自由基在缺血-再灌损伤中的作用？5. 血液性缺氧的原因及血气变化？6. 何谓抑癌基因？举例说明其失活机制。
7. 肝功能异常时血氨升高的原因？8. 原发性高血压中有哪些离子转运障碍？有什么结果？9. DIC引起休克的机制？10. 患者车祸后，表情淡漠，面色青灰，血压70/50mmHg，脉快，补液后尿量≤30ml/24h。
该患者处于哪一时期？发生机理？08病生1.哪些因素可以引起细胞信号转导异常？2.何谓水中毒？产生机制与对机体的影响？3.呼酸的发生原因基对机体的影响？4.低张性缺氧的原因血氧变化特点?5.DIC的主要临床表现？产生机制？6.钙超载在心肌缺血-再灌损伤中的作用？7.主要细胞癌基因的致癌机制?8.心衰使兴奋-收缩偶偶联障碍机制?9.女，65岁，支气管哮喘15年，近来呼吸困难加重，且出现嗜睡等表现，血气PaCO2 75mmHg ，PaO2 50mmHg。
试述患者发生上述临床表现的机制？10.男，22岁，因胆囊炎滴注庆大霉素4周后出现少尿，恶心，呕吐等症状，PH7.25 BE-15mm ol/l PaCO2 28mmHg, SB 18 mmHg, K 6.8 mmol/l ,BUN 25.8 mmol/l.试述该患者有哪些病理生理过程，是怎样发生的？南方医科大学2019年病理生理学（博士）一、简答题：4题×5分_1.简述gaba在肝性脑病中的作用2.为什么部分肺泡通气/血流比例下降只导致低氧血症，而不会导致paco2升高？:3.简述dic时出血的机制TY M6P"_Ep4.肾性高血压的发病机制二、论述题：1.一患者，血压波动于160/100近十年，近期发生左心衰竭，，请分析其发病机制（15分）2.试述休克i 期微循环变化的特点、机制和代偿意义（10分）3.一肺心病患者，入院呈昏睡状态，查：ph 7.26，paco2 65.5, hco3－30,cl－92, na＋145,试分析患者为何种酸碱失衡及电解质紊乱？根据是什么？并分析期昏睡的机制？（15分）2009年病理生理题目：简答题：1．肾性贫血发病机制2．产科意外导致DIC机制3．阵发性夜间呼吸困难的发病机制4．ARDS发生1型呼吸衰竭的机制问答题：1．感染发热的机制2．缺氧的类型以及血液氧指标的变化3．病例分析（酮症酸中毒），写出该病例的水、电介质、酸碱平衡混乱的类型及机制4．假性神经递质在肝性脑病发病中的作用2009年中山大学博士入学考试病理生理学专业基础真题！一、名词解释（5分一个）1、paroxysmal nocturnal dyspnea2、SIRS3、stress disease4、renal tubular acidosis二简答题（20分一个）1、DIC引起出血的发病机制。
本人在网内收集各校考博真题,全是园子里的,以利考生复习用,如果能加分,希望加分,谢谢!2005年中山医大病生试题：一，名词解释：1。
肺性脑病(英文)2。
非少尿型3。
凋亡(英文)4。
过热(英文)二，问答题1。
试述应激反应时下丘脑-垂体-肾上腺激活的生物学效应(利及敝) 2。
述肝性脑病时氨基酸失衡的原因和引起肝昏迷的机制。
3。
为何革兰氏阴性菌感染易引起4。
晚期休克引起呼吸衰竭的机制2007交名解12345678简答1、劳力性呼吸困难的原因、机制2、缺血再灌注组织局部白细胞增多、聚集？？？的机制3、？失活及癌细胞发生的关系4、时下降的原因、机制问号这个地方有三个字当时抄的潦草，不认识了。
2007山东大学病生试题：非病理生理专业做1-10题。
病理生理专业做3-12题1. 请列举基因突变的类型；2. 信号转导发生的机制及环节；3. 缺血再灌注损伤时自由基生成增多的主要机制；4. 血液性缺氧的原因及血氧参数变化；5. 发热的时相及各相热代谢的特点；6. 应激及心脑血管疾病的关系；7. 代谢性碱中毒时机体的代偿机制及血气变化的特点；8. 低钠血症的病因和发病机制；9. 心力衰竭时心肌代谢障碍的主要机制；10.休克缺血缺氧期和淤血缺氧期血压变化的主要特点和机制；11.简述肺通气血流比值失调时血气变化及呼吸衰竭的发病关系；12.肾功能衰竭时肾脏内分泌功能的改变及机制1.2006博士全国统考病生试题（回忆版选择题40分单选30分Ｂ型选择4分Ｘ型选择6分简答题20分1.影响组织液生成的影响因素2.急性肾衰出现什么类型的钾代谢紊乱，为什么？3.肝功能受损，激活的星形细胞的变化？4.为什么弥散功能障碍时只有2的降低，2无变化？论述题40分1.急性肾衰少尿的机制2.长期高血压导致心衰的机制3.严重感染导致ＤＩＣ的机制协和医科大学2005年病理生理学（博士）一、名词解释：每题3分，共30分。
1.热休克蛋白：2.发热及过热3.细胞凋亡4.粘附分子5.二氧化碳结合力6.肺性脑病7.一氧化氮合酶8.丝裂原激活的蛋白激酶（）9.红细胞生成素10.多器官功能衰竭二、是非题：每题1分，共10分1.临床上使用利尿剂，在利尿过程中均有钾的大量排出。
病理生理学考博试题及答案病理生理学是研究生物体在疾病状态下的生理变化及其机制的科学。
本试题旨在考察考生对病理生理学基本概念、原理和机制的理解与应用能力。
一、选择题（每题2分，共20分）1. 病理生理学主要研究的是：A. 疾病的预防B. 疾病的治疗C. 疾病的病因D. 疾病状态下的生理变化2. 细胞凋亡是：A. 一种病理性死亡B. 一种生理性死亡C. 细胞分裂D. 细胞生长3. 炎症反应的目的是：A. 清除损伤因子B. 促进细胞增殖C. 抑制细胞凋亡D. 促进组织修复4. 以下哪项不是细胞应激反应的类型？A. 热休克反应B. 氧化应激反应C. 免疫应激反应D. 营养应激反应5. 细胞程序性死亡的调控机制不包括：A. 基因调控B. 信号传导C. 细胞代谢D. 细胞外基质答案：1. D2. B3. A4. C5. C二、简答题（每题10分，共30分）6. 简述病理性钙化的特点及其对机体的影响。
7. 描述缺氧对细胞代谢的影响。
8. 解释什么是细胞信号转导异常，以及它在疾病中的作用。
答案：6. 病理性钙化是指在非骨骼组织中异常沉积的钙盐，其特点包括钙化部位的非特异性、钙化过程的病理性以及可能伴随的组织损伤。
对机体的影响包括影响组织功能、引起疼痛和功能障碍等。
7. 缺氧时，细胞内ATP生成减少，导致细胞代谢活动受限。
细胞可能通过糖酵解途径产生能量，但效率较低。
长期缺氧可导致细胞损伤甚至死亡。
8. 细胞信号转导异常是指细胞内信号传递过程中的某个环节出现问题，导致细胞功能失调。
这可能涉及到信号分子的异常表达、受体功能的改变或信号传导途径的障碍等。
在疾病中，信号转导异常可能导致细胞增殖失控、细胞凋亡受阻等病理变化。
三、论述题（每题25分，共50分）9. 论述细胞凋亡与坏死的区别及其在疾病中的意义。
10. 阐述肿瘤微环境对肿瘤发展的影响。
答案：9. 细胞凋亡是一种有序的、程序化的细胞死亡过程，通常不引起炎症反应，而坏死是一种非程序化的、由外界因素引起的细胞死亡，常伴随炎症反应。
病理生理学考试试题及答案一、选择题（每题5分，共10题，共计50分）1. 病理生理学研究的是（）。
a. 医学生理学b. 医学经典文献c. 生理学病理学d. 医学卫生学2. 哪个是病理生理学的基本概念（）。
a. 病理变化与机体反应b. 细胞构造与功能c. 器官解剖与生理功能d. 免疫反应与炎症3. 组织病理生理学的研究对象是（）。
a. 组织层面的生理功能b. 细胞层面的生物反应c. 机体层面的变化d. 分子层面的变化4. 以下哪项是机体对炎症反应进行调控的生理学原理（）。
a. 温度调节b. 血液循环c. 水盐平衡d. 免疫系统5. 炎症反应的主要特征是（）。
a. 红、肿、热、痛、功能障碍b. 刺痛、麻木、肿胀c. 发热、腹泻、呕吐d. 皮疹、搔痒、过敏6. 组织坏死的主要类型有（）。
a. 凋亡、坏死b. 坏死、病变c. 无功、有功d. 炎性、非炎性7. 组织再生的基本过程包括（）。
a. 细胞增殖和修复b. 细胞衰老和死亡c. 组织退变和坏死d. 组织纤维化和硬化8. 组织纤维化的主要特征是（）。
a. 组织增生和功能恢复b. 细胞核出现异常c. 细胞凋亡和坏死d. 纤维组织增多和沉积9. 免疫性疾病的发生机制是（）。
a. 免疫系统异常反应b. 免疫机能衰退c. 细胞分裂和增殖d. 组织再生不良10. 肿瘤的发生与发展和哪个过程密切相关（）。
a. 细胞分化和增殖b. 组织坏死和退变c. 免疫系统异常d. 器官功能退化二、简答题（每题10分，共5题，共计50分）1. 请简要介绍病理生理学的研究对象和重要性。
2. 什么是炎症反应？请简述炎症反应的发生机制和主要特征。
3. 简要描述组织坏死的类型和机制。
4. 请解释组织再生的过程和细胞增殖修复的关系。
5. 简述免疫性疾病的发生机制和常见类型。
三、案例题（每题20分，共2题，共计40分）案例一：一位55岁女性患者因胸闷、气促，持续半年来就诊。
体格检查发现心音减弱，心尖搏动增强，四肢杂音、下肢水肿。
