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NAME________________________Stu. NO:_________________________GROUP:__________________________ BATCH:_________________
2019 级医学与外科学专业《Pathophysiology/病理生理学》
d.
e.
Acromegaly
Gynecomastia
（本科）考试试卷（A 卷）
（时量：120 分钟
题号
一
二
三
开卷
总分
合分人
复查人
Usman
王莉婷
得分
得分
评卷人
复查人
鲍美华
陈英
2022 年 6 月）
3.
Acute bacterial infections of the bone characteristically show which one of the
following?
a. Necrotic bone
b. Prolonged clinical course
c. Predominantly mononuclear cells
d. Congested and thrombosed blood vessels
e. Granulation tissue
I． Multiple Choice Questions (You will be presented with a question
and four possible answers． Choose the best answer and write it in the
table． Each question is worth 3 point and the total points are 60．)
Question 1
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20
Answer C
D
D
D
D
E
B
C
A
C
E
E
A
C
B
C
C
D
D
4.
Which one of the following organisms accounts for at least 50% of cases of
acute hematogenous and contiguous focus osteomyelitis?
a. Group A streptococci
b.
Group B streptococc
c. Mycoplasma
d. S. aureus
e. Pseudomonas aeruginosa
E
1.
A 48-year-old white woman has what she believes is a suspicious lump in her
breast, but a mammogram does not reveal any suspicious lesions. Truthful
statements concerning potential pitfalls in management and diagnosis include
a. Assuming that mammography is “diagnostic”
b. Assuming that a radiographic lesion seen on mammography is the same as a
palpable lesion
c.
Letting a negative or nonsuspicious mammogram influence the judgment of
whether a palpable mass needs to be biopsied
d. Assuming that a benign aspiration cytology is definitive
2.
A 55-year-old man has lung cancer in the right middle lobe. Which
paraneoplastic syndrome is associated with GHRH secretion and lung cancer?
a. Hypocalcemia
b. Hypocortisolemia
c. Hypophosphatemia
5.
a.
b.
c.
d.
e.
Which one of the following ECG components varies with heart rate?
PR interval
QRS duration
ST segment
QT interval
QRS voltage
6.
a.
b.
c.
d.
e.
Which of the following cardiac parameters decreases during pregnancy?
Cardiac output
Stroke volume
Heart rate
Blood volume
Systemic vascular resistance
7.
Which one of the following hemodynamic findings is the main derangement of
primary pulmonary hypertension?
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Transudative pleural effusion is caused by which one of the following diseases?
Bacterial pneumonia
Malignancy
Cirrhosis
Sarcoidosis
Viral infection
9.
a.
b.
c.
d.
Which is a common finding in acute glomerulonephritis?
Pulmonary congestion due to volume expansion
Hypovolemia due to tubular dysfunction
Uniformly progresses to chronic renal failure if untreated
Urine showing leukocytes and eosinophils
10.
a.
b.
c.
d.
e.
Which finding is fairly specific for chronic renal failure?
Anemia
Hyaline casts
Broad casts in urinalysis
Proteinuria
Hypocalcemia
11.
A 55-year-old man who is a longtime alcoholic comes to the emergency room after
vomiting small amounts of bright red blood four times today. Your differential diagnosis
is constructed around causes of bleeding from the
a. Colon
b.
Liver and pancreas
c. Kidneys
d.
Lungs
e. Upper gastrointestinal (GI) tract
12.
A patient in your office tells you that he had an episode of vomiting bright red
blood twice in 1 day about 1 week ago, followed the next day by three or four episodes of
vomiting material that looked like coffee grounds. He could not afford to seek medical
13.
a.
b.
c.
d.
e.
Serum alkaline phosphatase may be elevated in the diseases of which organ?
Liver
Salivary glands
Spleen
Heart
Bladder
14.
In parenchymal liver disease, which one of the following tests of liver function
likely will be decreased from normal?
a. AST (aspartate aminotransferase) and ALT (alanine aminotransferase)
b. Alkaline phosphatase
c. Albumin
d. Prothrombin time
e. γ-Glutamyl transpeptidase (GGT)
15.
In a patient with iodine-deficiency goiter who moves from an iodine- deficient
area to an iodine-replete area, the occurrence of hyperthyroidism most likely represents
a. Graves’ disease
b. Jod-Basedow phenomenon
c. Choriocarcinoma
d. Struma ovarii
e. Toxic multinodular goiter
16.
Thyrotoxicosis and uniformly increased radioactive iodine uptake in the
thyroid can occur without any thyrotropin receptor antibodies or any thyroid autoimmunity
in
a. Graves’ disease
b. Jod-Basedow phenomenon
c. Choriocarcinoma
d. Struma ovarii
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8.
a.
b.
c.
d.
e.
help then and he said that “it got better except for the pain.” The past 3 days he noticed
black “sticky” stools and he finally came to see you. What is your first concern?
a. Bleeding colon cancer
b. Bleeding from lung cancer
c. Crohn’s disease
d. Cirrhosis
e. Bleeding peptic ulcer
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Increased cardiac output early
Increased resistance to pulmonary blood flow
Decreased resistance to pulmonary blood flow
Decreased pulmonary capillary wedge pressure early
Normal diastolic filling of the left ventricle
密
a.
b.
c.
d.
e.
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NAME________________________Stu. NO:_________________________GROUP:__________________________ BATCH:_________________
e.
Toxic multinodular goiter
confused, and the condition cannot be reversed by a move to a nursing home where he
receives adequate nutrition and medical care
17.
A 35-year-old man comes to your office with a complaint of recent
development of headaches that are generalized in nature. He is accompanied by his wife
who recently returned from a trip. She tells you that her husband has been somewhat
confused at times and clumsy. He does not confirm this, but he does report that he has
been short of breath at times. On examination, he is mildly tachycardia and there is a
reddish appearance to his mucous membranes, which is subtle. The only recent new
medical problem identified is that the patient was in a motor vehicle accident in which he
was struck in the rear end, and it left him with a sore neck. The most likely diagnosis is
a. Acquired spinal stenosis (cervical)
b. Normal pressure hydrocephalus
c. Carbon monoxide poisoning
d. Cocaine toxicity
e. Muscle tension
18.
A 40-year-old man is noted to have miosis of the right eye and ipsi- lateral
ptosis. He reports that he has noted that this side of his face is not sweating when he is
working recently. The most cause of this clinical picture may be
a. Pancoast tumor
b. Brainstem CVA
c. Dissection of the carotid artery
d.
Idiopathic
19.
Which clinical scenario best describes a patient with midstage dementia of
the Alzheimer’s type?
a. A patient has gradually developed memory deficits over the past four or five years;
the deficits worsen each time he has a “spell,” described by the family as “little strokes
that get better in a few days”
b.
A patient has had Parkinson’s disease for years, and after
becoming nearly immobile, he is also noted to have memory and language deficits
c.
A patient has become progressively more withdrawn and shows
deficits in short- and long-term memory; these deficits have been noticed by the family
since the patient’s wife and his last sibling died about 5 months ago
d. A patient became socially withdrawn a couple of years ago because he could not
keep up with his friends’ activities such as golf and bridge; now he is getting lost whenever
he leaves his house
e.
A long-term, often homeless, alcoholic becomes progressively disoriented and
20.
Which cerebral artery is blocked in an ischemic stroke that presents with the
following symptoms: aphasia, right hemiparesis, and right arm numbness?
a. Right anterior cerebral
b. Right middle cerebral
c. Right proximal posterior cerebral
d.
Left anterior cerebral
e.
Left middle cerebral
得分
评卷人
复查人
II． Descriptive quesions Each question is worth 10 points and the total
王莉婷
鲍美华
points are 20．
21. Describe the normovolemic hyponatremia in detailes. (10 points)
Metabolic disorders are conditions that affect any aspect of metabolism.
Hyponatremia is one of the most common metabolic disorders.The medical
Defination of normovolemic is a normal volume of blood in the body. The value
of Na+ in serum equalling 135 mmol/ l and lower is regarded as hyponatremia. Its
clinical manifestations are the following: headaches, nausea, vomiting, seizures,
numbness, coma and death. Normovolemic hyponatremia can be with or without
symptoms. Acute normovolemic hyponatremia is treated by the intravenous
administration of 3% NaCl and with the simultaneous use of loop diuretics (20- 40
mg Furosemide/ 24 hrs) and restriction of fluid intake.Another name for
normovolemic hyponatremia is Euvolemic hyponatremia. Euvolemic
hyponatremia implies normal sodium stores and a total body excess of free
water.
The most common etiology of normovolemic hyponatremia is the syndrome of
inappropriate antidiuresis (SIAD). Diagnosis of SIAD involves evaluation of a set of longstanding clinical and laboratory criteria for this diagnosis. Many treatment options for
SIAD exist, and choosing among them should be based on the chronicity of the
hyponatremia and neurological symptomatology. Importantly, clinical judgment and
risk/benefit analysis that is individualized for specific patients should drive therapeutic
decisions, because there is no single treatment that represents the “best” therapy for all
patients with SIAD.
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密
22. Draw the figure to describe the sequence of events in compensated and
decompensated heart faiulre. Also draw the figure describing hormonal regulation
in heart failure. (10 points)
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NAME________________________Stu. NO:_________________________GROUP:__________________________ BATCH:_________________
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vasculosum of the lamina terminalis (OVLT), where they induce
synthesis of prostaglandins, of which PGE2 is the most important.
These raise the thermostatic set point to initiate the febrile response.
复查人
III． Detailed Descriptive Questions． One question is worth 20 points.
Usman
艾珏萍
Two questions in total
23. Describe in details the role of endogenous pyogens (at least five) involved in
pathogenesis of fever. (20 points)
The hypothalamic thermoregulatory centre accomplishes heat
production by inducing shivering and heat conservation through
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分
评卷人
vasoconstriction. At an established degree, fever is regulated (even
at a temperature of over 41.0 °C) and heat production approximates
loss, as in health, though at a higher level of the set point. Therefore
In addition to the function as an endogenous pyrogen, IL-1 activates
substances from outside the body, exogenous pyrogens, initiate the
T-lymphocytes to produce various factors, such as INF and IL-2,
fever cycle. Endotoxin of Gram-negative bacteria, with their
which are vital for immune response. The production of fever
pyrogenic component lipopolysaccaride, is the most potent
simultaneously with lymphocyte activation constitutes the clearest
exogenous pyrogen. Fever is also a common finding in children
and strongest evidence in favour of the protective role of fever.
without obvious evidence of infection, for example hypersensitivity
The induction of fever results in inhibition of bacterial growth,
reaction, autoimmune diseases and malignancy.
increased bactericidal effects of neutrophils, production of acute-
Exogenous pyrogens initiate fever by inducing host cells (primarily
phase protein synthesis and other physiological changes such as
macrophages) to produce and release endogenous pyrogens such as
anorexia and somnolence. These changes suggest that fever has an
interleukin-1, which has multiple biological functions essential for
adaptive role in the host’s survival during infection.
the immune response. Endogenous pyrogens are transmitted to the
hypothalamic thermoregulatory centre, specifically organum
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The generation of fever involves the following steps: numerous
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fever does not climb up relentlessly.
NAME________________________Stu. NO:_________________________GROUP:__________________________ BATCH:_________________
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