E1.腹式呼吸增强见于：_______A.急性腹膜炎 B.膈麻痹 C.腹水 D.腹腔内巨大肿物 E.胸腔
疾病
E1. Abdominal breathing is enhanced in: _______ A. Acute peritonitis B. Diaphragmatic
paralysis C. Ascites D. Huge intra-abdominal tumors E. Thoracic diseases
C2.关于腹部膨隆正确的是：_______A.下腹部膨隆排尿后都可以消失 B.局部膨隆是长型
者多为囊肿 C.局部膨隆随呼吸移动者多为膈下脏器或其肿块 D.膨隆有搏动者可能为动脉后
面的肿块 E.于卧位出现而站立时消失的局部膨隆为腹外疝
C2. The correct statement about abdominal distension is: _______ A. Lower abdominal
distension can disappear after urination B. Local distension is often a cyst in long cases
C. Local distension that moves with breathing is often due to subdiaphragmatic organs or
their tumors D. Pulsating distension may be a tumor behind the artery E. Local distension
that appears in the supine position and disappears when standing is an extra-abdominal
hernia
C3.关于肠胃型和蠕动波不正确的是：_______A.胃蠕动波自右向左为逆蠕动波 B.小肠梗
阻所至的蠕动波多见于中腹部 C.严重的肠梗阻可呈多层梯型肠型，蠕动波运行方向一致 D.
结肠远端梗阻、肠型多位于腹部周边 E.如发生肠麻痹，则蠕动波消失
C3. The incorrect statement about intestinal type and peristaltic wave is: _______ A.
Gastric peristaltic wave from right to left is reverse peristaltic wave B. Peristaltic wave
caused by small intestinal obstruction is often seen in the middle abdomen C. Severe
intestinal obstruction can present as multi-layer ladder-type intestinal type, peristaltic
wave direction is consistent D. Distal colonic obstruction, intestinal type is often located
around the abdomen E. If intestinal paralysis occurs, the peristaltic wave disappears
C4.紫纹出现于：_______A.肥胖者 B.妊娠期 C.皮质醇增多症 D.Addison 病 E.传染病
C4. Striae appear in: _______ A. Obese people B. Pregnancy C. Hypercortisolism D.
Addison’s disease E. Infectious diseases
A5.关于紫纹出现的部位，不正确的是：_______A.上腹部 B.下腹部 C.臀部 D.股外侧 E.肩
背部
A5. The incorrect statement about the location of striae is: _______ A. Upper abdomen
B. Lower abdomen C. Buttocks D. Lateral thigh E. Shoulder and back
D6.关于腹外疝不正确的是：_______A.脐疝多见于婴幼儿 B.两侧腹直肌闭合不良者可有
白线疝 C.手术愈合不良处可有切口疝 D.股疝位于腹股沟韧带内侧，多见于男性 E.男性腹
股沟斜疝可下降至阴囊
D6. The incorrect statement about extra-abdominal hernia is: _______ A. Umbilical
hernia is common in infants and young children B. Bilateral rectus abdominis closure
defects can have linea alba hernia C. Incisional hernia can occur at the site of poor
surgical healing D. Femoral hernia is located on the inner side of the inguinal ligament,
more common in males E. Male inguinal oblique hernia can descend to the scrotum
C7.局限性右下腹肌紧张见于：_______A.急性胰腺炎 B.急性胆囊炎 C.胃肠穿孔 D.盆腔脏
器炎症 E.以上都不是
C7. Localized lower right abdominal muscle tension is seen in: _______ A. Acute
pancreatitis B. Acute cholecystitis C. Gastrointestinal perforation D. Pelvic organ
inflammation E. None of the above
A8.腹壁病变引起的腹部压痛特点是：_______B.抓捏腹壁疼痛减轻 C.仰卧曲颈抬肩时减
轻 D.转移性压痛 E.以上都不是
A8. The characteristics of abdominal tenderness caused by abdominal wall lesions are:
_______ B. Pinching the abdominal wall reduces pain C. Supine neck and shoulder lift
reduces D. Referred tenderness E. None of the above
B9.关于腹部反跳痛不正确的是：_______ A.检查时腹部出现压痛后手指于原处稍停片刻
B.检查时腹部出现压痛后迅速抬手 C.当突然抬手时腹膜被牵拉引起疼痛 D.阳性说明腹膜
壁层已受累及 E.见于急慢性腹膜炎
B9. The incorrect statement about abdominal rebound pain is: _______ A. When
abdominal tenderness occurs during the examination, the finger stays in place for a
moment B. When abdominal tenderness occurs during the examination, the hand is
quickly lifted C. When the hand is suddenly lifted, the peritoneum is pulled to cause pain
D. Positive indicates that the parietal layer of the peritoneum has been involved E. Seen
in acute and chronic peritonitis
C10.肝脏触诊方法不正确的是：_______ A.以示指前端桡侧指腹接肝 B.右手宜置于腹直
肌外缘稍外处向上触诊 C.吸气时手指上抬速度要快于腹壁的抬起 D.如遇腹水患者可应用
浮沉触诊法 E.如有腹部饱满，需下移初始触诊部位
C10. The incorrect method of liver palpation is: _______ A. The radial side of the index
finger touches the liver B. The right hand should be placed slightly outside the edge of
the rectus abdominis and palpated upwards C. When inhaling, the speed of the finger
lifting should be faster than the lifting of the abdominal wall D. If the patient has ascites,
the floating and sinking palpation method can be used E. If there is abdominal fullness,
the initial palpation site needs to be moved down
D11.成人肝大小正常范围为：_______ A.深吸气时肋缘下 3cm 以内 B.深吸气时肋缘下
2cm 以内 C.剑突尖端下 3cm 以内 D.剑突根部下 3cm 以内 E.剑突根部下 6lm 以内
D11. The normal range of adult liver size is: _______ A. Within 3cm below the costal
margin during deep inhalation B. Within 2cm below the costal margin during deep
inhalation C. Within 3cm below the tip of the xiphoid process D. Within 3cm below the
root of the xiphoid process E. Within 6lm below the root of the xiphoid process
A12.正常肝脏：_______ A.质地柔软 B.质地稍韧 C.轻压痛 D.有搏动 E.边缘整齐，薄厚
不一致
A12. Normal liver: _______ A. Soft texture B. Slightly tough texture C. Light pressure
pain D. Has pulsation E. The edge is neat, the thickness is inconsistent
B13.肝脏呈扩张性博动见于：_______ A.二尖瓣关闭不全 B.三尖瓣关闭不全 C.肝肿大压
到腹主动脉上 D.肝癌 E.肝缩小
B13. The liver shows expansive pulsation in: _______ A. Mitral valve insufficiency B.
Tricuspid valve insufficiency C. Liver enlargement presses on the abdominal aorta D.
Liver cancer E. Liver shrinkage
A14.脾脏触诊方法正确的是：_______ A.病人仰卧位，医生手掌与肋部大致成垂直方向
B.病人取仰卧位，医生右手掌与肋弓大致成平行 C.病人取右侧卧位时，右下肢屈曲，左下
肢伸直 D.病人取左侧卧位时，右下肢伸直，左下肢屈曲 E.呼气时向肋部方向迎触脾
A14. The correct method of spleen palpation is: _______ A. The patient is in the supine
position, and the doctor’s palm is roughly perpendicular to the ribs B. The patient is in the
supine position, and the doctor’s right palm is roughly parallel to the costal arch C. When
the patient is in the right lateral position, the right lower limb is flexed and the left lower
limb is straight D. When the patient is in the left lateral position, the right lower limb is
straight and the left lower limb is flexed E. Exhale towards the rib direction to touch the
spleen
B15.脾脏第一测量指：_______ A.左锁骨中线与左肋缘交点至脾最远点的距离 B.左锁骨
中线左肋缘至脾下缘的距离 D.脐至脾下缘的距离 E.脾右缘与脐的距离
B15. The first measurement of the spleen refers to: _______ A. The distance from the
intersection of the left clavicle midline and the left costal margin to the farthest point of
the spleen B. The distance from the left costal margin of the left clavicle midline to the
lower edge of the spleen D. The distance from the navel to the lower edge of the spleen
E. The distance from the right edge of the spleen to the navel
B16.脾脏中度肿大指：_______ A.脾缘不超过肋下 2cm B.脾缘超过肋下 2cm 至脐水平线
以上 C.脾缘超过肋下 3cm 至脐水平线上 D.脾缘超过脐水平线 E.脾缘超过前正中线
B16. Moderate splenomegaly refers to: _______ A. The spleen margin does not exceed
2cm below the ribs B. The spleen margin exceeds 2cm below the ribs to above the
horizontal line of the navel C. The spleen margin exceeds 3cm below the ribs to above
the horizontal line of the navel D. The spleen margin exceeds the horizontal line of the
navel E. The spleen margin exceeds the anterior midline
E17.肿大的脾触诊时显著特征是：_______ A.形态不规则，表面凸凹不平 B.边缘及表面
光滑 C.质软，压痛 D.质硬，轻压痛 E.有明显切迹
E17. The significant feature of the enlarged spleen during palpation is: _______ A.
Irregular shape, uneven surface B. Smooth edge and surface C. Soft texture, tenderness
D. Hard texture, light pressure pain E. Has a significant notch
D18.液波震颤（波动感）阳性能查出的腹水量为：_______ A.0～100ml B.10～2000m1
C.2000～3000ml D.3000～4000ml E.4000～5000ml
D18. The amount of ascites that can be detected by positive fluid wave tremor
(fluctuation) is: _______ A. 0～100ml B. 10～2000m1 C. 2000～3000ml D. 3000～
4000ml E. 4000～5000ml
A19.腹部叩诊鼓音范围缩小见于：_______ A.肝脾极度肿大 B.胃肠高度胀气 C.人工气腹
D.胃肠穿孔 E.肠梗阻
A19. The range of abdominal percussion tympany is reduced in: _______ A. Extremely
enlarged liver and spleen B. High degree of gastrointestinal distension C. Artificial
pneumoperitoneum D. Gastrointestinal perforation E. Intestinal obstruction
B20.肝上界为：_______ A.肝绝对浊音界 B.肝相对浊音界 C.膈顶部 D.肺下界 E.不被肺
遮盖部分的上缘
B20. The upper boundary of the liver is: _______ A. Absolute dullness of the liver B.
Relative dullness of the liver C. Top of the diaphragm D. Lower boundary of the lung E.
The upper edge of the part not covered by the lung
B21.匀称体型者正常肝上界位于：_______ A.右锁骨中线上第 4 肋间 B.右锁骨中线上第 5
肋间 C.右锁骨中线上第 6 肋间 D.右锁骨中线上第 8 肋间 E.右锁骨中线上第 9 肋间
B21. The normal upper boundary of the liver in a person with a symmetrical body type is
located at: _______ A. The 4th intercostal space on the right clavicular midline B. The 5th
intercostal space on the right clavicular midline C. The 6th intercostal space on the right
clavicular midline D. The 8th intercostal space on the right clavicular midline E. The 9th
intercostal space on the right clavicular midline
E22.正常脾脏大小为：_______ A.在左腋中线第 8～12 肋之间叩到脾浊音 B.在左腋中线
第 7～10 肋之间叩到脾浊音 C.其长度为 6～9cm D.其长度为 9～11cm
E22. The normal size of the spleen is: _______ A. Percuss the spleen dullness between
the 8th and 12th ribs on the left axillary midline B. Percuss the spleen dullness between
the 7th and 10th ribs on the left axillary midline C. Its length is 6-9cm D. Its length is 911cm
B23.中等量腹水病人腹部叩诊所见正确的是：_______ A.患者仰卧，腹中部呈浊音，两侧
腹部呈鼓音 B.患者仰卧，腹中部呈鼓音，两侧腹部呈浊音 C.患者向左侧卧位，左侧腹部
呈鼓音，右侧腹部呈浊音 D.患者向右侧卧位，右侧腹部呈鼓音，左侧腹部呈浊音 E.患者
站立，下腹部呈鼓音，上腹部呈浊音
B23. The correct percussion findings in patients with moderate ascites are: _______ A.
The patient is supine, the middle abdomen is dull, and both sides of the abdomen are
tympanic B. The patient is supine, the middle abdomen is tympanic, and both sides of the
abdomen are dull C. The patient is in the left lateral position, the left abdomen is
tympanic, and the right abdomen is dull D. The patient is in the right lateral position, the
right abdomen is tympanic, and the left abdomen is dull E. The patient is standing, the
lower abdomen is tympanic, and the upper abdomen is dull
A24.Cullen 征是指：_______ A.脐周围发蓝 B.左腰部呈蓝色 C.下腹部紫纹 D.脐周簇状
曲张静脉 E.系腰带部位皮肤发黑
A24. Cullen’s sign refers to: _______ A. Periumbilical cyanosis B. Left lumbar area is
blue C. Lower abdominal striae D. Periumbilical cluster of varicose veins E. Skin around
the waistband is black
A25.Grey-Turner 征是指：_______ A.左腰部皮肤呈蓝色 B.脐周围皮肤呈蓝色 C.系腰带
部呈黑色 D.脐与趾骨之间有褐色沉着 E.上腹部地图样红褐色
A25. Grey-Turner’s sign refers to: _______ A. The skin of the left lumbar area is blue B.
The skin around the navel is blue C. The waistband area is black D. There is brown
deposition between the navel and the toe bone E. The upper abdomen is map-like
reddish-brown
D26.腹部反跳痛发生的病理机制是：_______ A.空腔脏器扩张 B.内脏肿大与肿瘤 C.腹膜
后淋巴结肿大 D.腹腔脏器炎症累及壁层腹膜 E.腹腔脏器炎症累及脏层腹膜
D26. The pathological mechanism of abdominal rebound pain is: _______ A. Expansion
of hollow organs B. Enlargement of viscera and tumors C. Enlargement of retroperitoneal
lymph nodes D. Inflammation of abdominal organs involves the parietal peritoneum E.
Inflammation of abdominal organs involves the visceral peritoneum
E27.肝浊音界消失见于：_______ A.急性胆囊炎 B.急性胃炎 C.急性胰腺炎 D.急性阑尾
炎 E.溃疡病穿孔
E27. The disappearance of liver dullness is seen in: _______ A. Acute cholecystitis B.
Acute gastritis C. Acute pancreatitis D. Acute appendicitis E. Perforation of peptic ulcer
B28.查体时发现胆囊肿大有压痛，见于：_______ A.慢性胆囊炎 B.急性胆囊炎 C.胆囊癌
D.胰头癌 E.健康查体时 B 超诊断胆囊炎
B28. Gallbladder enlargement with tenderness found on physical examination is seen in:
_______ A. Chronic cholecystitis B. Acute cholecystitis C. Gallbladder cancer D.
Pancreatic head cancer E. B-ultrasound diagnosis of cholecystitis during health
examination
C29.胆囊肿大、无压痛，伴显著黄疽，应考虑：_______ A.胆囊炎 B.胆管炎 C.胰头癌
D.胆囊结石 E.胆总管结石
C29. Gallbladder enlargement, no tenderness, accompanied by significant jaundice,
should consider: _______ A. Cholecystitis B. Cholangitis C. Pancreatic head cancer D.
Gallbladder stones E. Common bile duct stones
D30.幽门梗阻时体格检查有：_______A.压痛 B.移动性浊音 C.液波震颤 D.振水音 E.全
腹膨隆
D30. Physical examination of pyloric obstruction has: _______ A. Tenderness B. Mobile
dullness C. Fluid wave tremor D. Shifting dullness E. Whole abdomen distension
C31.关于急性阑尾炎的腹痛不正确的是：_______ A.早期为上腹痛或脐周围痛 B.早期在
上腹部或其周围有位置不定的痛 C.早期阑尾点（McBurneg 电）有压痛和反跳痛 D.起病
数小时后 McBurneg 点有压痛和反跳痛 E.加压于左下腹并突然松手时可引起右下腹痛
C31. The incorrect statement about abdominal pain in acute appendicitis is: _______ A.
Early stage is upper abdominal pain or periumbilical pain B. Early stage has
undetermined pain in the upper abdomen or its surroundings C. Early stage McBurneg
point (McBurneg electricity) has tenderness and rebound pain D. A few hours after the
onset, McBurneg point has tenderness and rebound pain E. Pressing on the lower left
abdomen and suddenly letting go can cause lower right abdominal pain
E32.急性阑尾炎时，最有诊断意义的体征是：_______ A.腹肌紧张 B.腰大肌试验阳性 C.
结肠充气试验阳性 D.闭孔肌试验阳性 E.阑尾点固定性压痛
E32. The most diagnostic sign in acute appendicitis is: _______ A. Abdominal muscle
tension B. Psoas major test positive C. Colon inflation test positive D. Obturator test
positive E. Fixed tenderness at the appendix point
E33.急性阑尾炎，当腹痛尚未转移至右下腹前，最具诊断意义的是：_______ A.发热 B.
白细胞升高 C.脐区压痛及反跳痛 D.脐区及右下腹均有压痛、反跳痛 E.压痛已固定在右下
腹
E33. In acute appendicitis, when the abdominal pain has not yet moved to the lower right
abdomen, the most diagnostic is: _______ A. Fever B. Increased white blood cells C.
Umbilical area tenderness and rebound pain D. Tenderness and rebound pain in the
umbilical area and lower right abdomen E. Tenderness has been fixed in the lower right
abdomen
C34.机械性小肠梗阻时出现：_______ A.持续性绞痛 B.阵发性胀痛 C.频繁呕吐 D.早期
即无排气、排便 E.肠鸣音减弱或消失
C34. Mechanical small bowel obstruction occurs: _______ A. Persistent colic B.
Paroxysmal distension pain C. Frequent vomiting D. No gas or bowel movements in the
early stage E. Decreased or absent bowel sounds
E35.早期机械性肠梗阻时不出现：_______ A.腹胀 B.频繁呕吐 C.阵发性绞痛 D.肠型及
蠕动波 E.肠鸣音减弱或消失
E35. Early mechanical intestinal obstruction does not occur: _______ A. Abdominal
distension B. Frequent vomiting C. Paroxysmal colic D. Intestinal type and peristaltic
wave E. Decreased or absent bowel sounds
A36.麻痹性肠梗阻时表现为：_______ A.腹胀及胀痛感 B.腹部绞痛 C.肠型及蠕动波 D.
肠鸣音呈金属音调 E.频繁排气排便
A36. Paralytic intestinal obstruction manifests as: _______ A. Abdominal distension and
distension pain B. Abdominal colic C. Intestinal type and peristaltic wave D. Bowel
sounds are metallic E. Frequent gas and bowel movements
E37.关于门静脉高压脾肿大不正确的是：_______ A.开始为淤血性肿大 B.伴有脾功能亢
进 C.上消化道出血时可暂时缩小 D.有脾周围炎时可引起左上腹疼痛 E.脾为浸润性肿大
E37. The incorrect statement about portal hypertension splenomegaly is: _______ A. It
starts as congestive enlargement B. Accompanied by hyperactive spleen function C.
Upper gastrointestinal bleeding can temporarily shrink D. Perisplenitis can cause upper
left abdominal pain E. The spleen is infiltrative enlargement
C38.肝硬化代偿期可出现：_______A.腹水 B.肝脏缩小 C.脾脏肿大 D.食管静脉曲张 E.出
血倾向和贫血
C38. Hepatic cirrhosis compensation period can occur: _______ A. Ascites B. Liver
shrinkage C. Splenomegaly D. Esophageal varices E. Bleeding tendency and anemia
C39.门脉高压症侯群应除外：_______A.腹水 B.脾大 C.肝大 D.痔核形成 E.食管和胃底静
脉曲张
C39. Portal hypertension syndrome should exclude: _______ A. Ascites B.
Splenomegaly C. Hepatomegaly D. Hemorrhoid formation E. Esophageal and gastric
varices
[试题答案]
1.E 2.C 3.C 4.C 5.A 6.D 7.C 8.A 9.B 10.C 11.D
12.A 13.B 14.A 15.B 16.B 17.E 18.D 19.A 20.B 21.B
22.E 23.B 24.A 25.A 26.D 27.E 28.B 29.C 30.D 31.C
32.E 33.E 34.C 35.E 36.A 37.E 38.C 39.C
E1.男性，30 岁，有 10 年消化性溃疡病史，近半年来发生瘢痕性幽门梗阻，在出现
的临床表现中，哪项不符合实际情况：_______
A.呕吐物有酸臭味
B.呕吐量大，有宿食
C.有胃型和胃蠕动波
D.消瘦、脱水，碱中毒
E.呕吐物有粪臭味
E1. A 30-year-old male with a 10-year history of peptic ulcer disease has developed
pyloric stenosis due to scarring in the past six months. Which of the following clinical
manifestations does not match the actual situation: _______ A. The vomit has a sour
smell B. Large amount of vomit, with food residue C. Presence of gastric pattern and
gastric peristaltic wave D. Emaciation, dehydration, alkalosis E. The vomit has a fecal
odor
A2.女性、45 岁，进行性贫血一年，查体左肋缘下触到包块，位置较深，边缘钝圆，
无切迹，随呼吸上下移动，质地不硬，应考虑为：_______
A.增大的左肾
B.脾
C.胰尾部囊肿
D.结肠
E.肿大的肝左叶
A2. A 45-year-old female with progressive anemia for one year, a mass was
palpated under the left costal margin during physical examination, the position is deep,
the edge is blunt and round, no notch, moves up and down with breathing, the texture is
not hard, it should be considered as: _______ A. Enlarged left kidney B. Spleen C. Cyst
in the tail of the pancreas D. Colon E. Enlarged left lobe of the liver
E3.男性，30 岁。有胃病史 5 年，近一个月症状加剧就诊，胃镜检查见胃角溃疡，询
问病史时，病人的典型症状为：_______
A.午夜痛为主
B.发作性剧痛
C.上腹部疼痛无规律性
D.饥饿痛为主，进食后缓解
E.疼痛经常于餐后 0.5～l 小时出现
E3. A 30-year-old male with a 5-year history of gastric disease, whose symptoms
have worsened in the past month, was diagnosed with gastric angle ulcer by
gastroscopy. When asking about the medical history, the patient’s typical symptoms are:
_______ A. Mainly midnight pain B. Paroxysmal severe pain C. Irregular upper
abdominal pain D. Mainly hunger pain, relieved after eating E. Pain often occurs 0.5 to 1
hour after meals
C4.女性，30 岁。有十二指肠溃疡史 5 年，近一个月来腹部胀痛加重且伴有呕吐就
诊，呕吐后症状可暂时缓解，疑有幽门梗阻，诊断此症最重要的表现是：_______
A.胃部振水音
B.饭后上腹饱胀感
C.呕吐物为酸酵宿食
D.呕吐后感到舒适
E.胃型及蠕动波
C4. A 30-year-old female with a 5-year history of duodenal ulcer, has had
abdominal distension and vomiting in the past month, and the symptoms can be
temporarily relieved after vomiting. She is suspected of having pyloric obstruction. The
most important manifestation for diagnosing this condition is: _______ A. Gastric shifting
dullness B. Feeling of fullness in the upper abdomen after meals C. The vomit is sour
fermented food D. Feeling comfortable after vomiting E. Gastric pattern and peristaltic
wave
A5.女性，30 岁，转移性右下腹痛 10 小时，除考虑急性阑尾炎外，还应考虑：
_______
A.十二指肠溃疡穿孔
B.输卵管扭转
C.宫外孕破裂
D.输尿管结石
E.肠系膜淋巴结炎
A5. A 30-year-old female with migratory pain in the lower right abdomen for 10
hours, in addition to considering acute appendicitis, should also consider: _______ A.
Perforation of duodenal ulcer B. Torsion of the fallopian tube C. Rupture of ectopic
pregnancy D. Ureteral stones E. Mesenteric lymphadenitis
A6.男，30 岁，饱餐后劳动时，突然腹部剧烈绞痛，阵发性加重，伴呕吐。6 小时末
排气、排便，查体：体温 37℃，脉率 84 次/分，左腹部膨隆，压痛明显，肠鸣音高亢，移
动性浊音阴性，最可能诊断为：_______
A.肠梗阻
B.肠道蛔虫病
C.急性胰腺炎
D.溃疡病穿孔
E.肠系膜血管栓塞
A6. A 30-year-old male, suddenly had severe colic in the abdomen after a full meal
and labor, the pain was paroxysmal and aggravated, accompanied by vomiting. At the
end of 6 hours, there was no gas or bowel movements. Physical examination: body
temperature 37°C, pulse rate 84 beats/min, left abdomen was distended, tenderness was
obvious, bowel sounds were hyperactive, mobile dullness was negative, the most likely
diagnosis is: _______ A. Intestinal obstruction B. Intestinal ascariasis C. Acute
pancreatitis D. Perforation of peptic ulcer E. Mesenteric vascular embolism
C7.女性，30 岁，农民，2 小时前无诱因突然上腹刀割样疼痛，不敢直腰，腹肌紧
张，压痛反跳痛明显，肝浊音界消失，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.急性出血坏死性胰腺炎
C7. A 30-year-old female farmer, without any inducement, suddenly had a knifecutting pain in the upper abdomen two hours ago, she dared not straighten her waist, the
abdominal muscles were tense, tenderness and rebound pain were obvious, the liver
dullness disappeared, the diagnosis should be: _______ A. Perforation of appendicitis,
diffuse peritonitis B. Rupture of ectopic pregnancy C. Perforation of peptic ulcer D.
Strangulated intestinal obstruction E. Acute hemorrhagic necrotizing pancreatitis
C8.男性，33 岁，5 年来常有空腹痛和夜间痛，以秋季为重，服用雷尼替丁可以减
轻。体格检查：_______上腹部偏右轻压痛，最可能的诊断：_______
A.胆囊炎
B.胃溃疡
C.十二指肠溃疡
D.胃炎
E.肾结石
C8. A 33-year-old male has been having fasting pain and nocturnal pain for 5 years,
which is more severe in autumn. Taking ranitidine can alleviate it. Physical examination:
_______ There is slight tenderness in the upper abdomen on the right, the most likely
diagnosis is: _______ A. Cholecystitis B. Gastric ulcer C. Duodenal ulcer D. Gastritis E.
Kidney stones
B9.男性，23 岁，3 年来经常有餐后半小时上腹痛，以秋末冬初为重，伴腹胀，暖
气。查体：_______腹软，上腹部偏左轻压痛，无反跳痛，最可能诊断为：_______
A.肠癌
B.胃溃疡
C.十二指肠溃疡
D.胰腺炎
E.肠梗阻
B9. A 23-year-old male has been having upper abdominal pain half an hour after
meals for 3 years, which is more severe at the end of autumn and the beginning of
winter, accompanied by abdominal distension and warmth. Physical examination:
_______ The abdomen is soft, there is slight tenderness in the upper abdomen on the
left, no rebound pain, the most likely diagnosis is: _______ A. Intestinal cancer B. Gastric
ulcer C. Duodenal ulcer D. Pancreatitis E. Intestinal obstruction
D10.男性，35 岁经常上腹部不适 10 年，近两月来，呕吐频繁。体格检查，上腹部见
蠕动波，振水声阳性，其呕吐物的性状应是：_______
A.黄绿色液体
B.咖啡样液体
C.鲜血
D.酸酵食物
E.带粪臭味
D10. A 35-year-old male has been having frequent vomiting for two months due to
discomfort in the upper abdomen for 10 years. Physical examination, peristaltic wave is
seen in the upper abdomen, shifting dullness is positive, the nature of his vomit should
be: _______ A. Yellow-green liquid B. Coffee-like liquid C. Fresh blood D. Sour
fermented food E. With a fecal odor
E11.女性，30 岁，脐周阵发性腹痛 3 天伴呕吐，肠鸣音亢进，有气过水声，诊断为
急性肠梗阻，其原因应除外：_______
A.肠粘连
B.肠扭转
C.肠套叠
D.肠狭窄
E.肠麻痹
E11. A 30-year-old female has had paroxysmal umbilical pain for 3 days
accompanied by vomiting, hyperactive bowel sounds, and the presence of borborygmi,
diagnosed as acute intestinal obstruction, the cause should exclude: _______ A.
Intestinal adhesion B. Intestinal torsion C. Intussusception D. Intestinal stenosis E.
Intestinal paralysis
A12.男性，30 岁，急性化脓性阑尾炎，术后一周腹部持续性胀痛，排气排便消失，
诊断为麻痹性肠梗阻，其临床表现应除外：_______
A.肠鸣音亢进
B.肠鸣音消失
C.大小肠均胀气
D.无肠型及蠕动波
E.呕吐
A12. A 30-year-old male with acute suppurative appendicitis, one week after
surgery, persistent abdominal distension and pain, no gas or bowel movements,
diagnosed as paralytic intestinal obstruction, the clinical manifestation should exclude:
_______ A. Hyperactive bowel sounds B. Absence of bowel sounds C. Both small and
large intestines are distended with gas D. No intestinal pattern and peristaltic wave E.
Vomiting
D13.女性，30 岁，转移性右下腹痛 3 天，伴呕吐 4 次，体温 39℃。体格检查：
_______右下腹压痛和肌紧张，诊断为：_______
A.异位妊娠
B.急性肠系膜淋巴结炎
C.卵巢囊肿扭转
D.急性阑尾炎
E.翕室炎
D13. A 30-year-old female with migratory pain in the lower right abdomen for 3
days, accompanied by vomiting 4 times, body temperature 39°C. Physical examination:
_______ Tenderness and muscle tension in the lower right abdomen, the diagnosis is:
_______ A. Ectopic pregnancy B. Acute mesenteric lymphadenitis C. Ovarian cyst
torsion D. Acute appendicitis E. Diverticulitis
A14.男，40 岁，腹胀 5 年，加重 1 年，近一周发热，伴腹痛，有慢性乙型肝炎史。
查体：_______巩膜黄染，全腹膨隆，压痛、反跳痛阳性，脾肋下 4cm，移动性浊音阳
性。最可能的诊断：_______
A.肝硬化并发原发性腹膜炎
B.结核性腹膜炎
C.肝癌并癌性腹水
D.溃疡病穿孔
E.急性化脓性腹膜炎
A14. A 40-year-old male with abdominal distension for 5 years, aggravated for one
year, fever in the past week, accompanied by abdominal pain, has a history of chronic
hepatitis B. Physical examination: _______ Jaundice of the sclera, full abdomen
distension, tenderness and rebound pain are positive, the spleen is 4cm below the ribs,
mobile dullness is positive. The most likely diagnosis is: _______ A. Liver cirrhosis
complicated by primary peritonitis B. Tuberculous peritonitis C. Hepatocellular carcinoma
and malignant ascites D. Perforation of peptic ulcer E. Acute suppurative peritonitis
A15.男，40 负，有慢性肝炎史 15 年，近来腹胀消瘦，体格检查：_______巩膜黄
染，上腹部触到拳头大质硬、表面不光滑包块，最可能的诊断是：_______
A.原发性肝癌
B.转移性肝癌
C.慢性肝炎
D.肝脓疡
E.肝硬化
A15. A 40-year-old male with a 15-year history of chronic hepatitis, recently had
abdominal distension and emaciation. Physical examination: _______ Jaundice of the
sclera, a fist-sized hard mass with a rough surface was palpated in the upper abdomen,
the most likely diagnosis is: _______ A. Primary hepatocellular carcinoma B. Metastatic
liver cancer C. Chronic hepatitis D. Liver abscess E. Liver cirrhosis
D16.男，50 岁，发现左上腹部有一包块，随呼吸上下移动，考虑来源于以下脏器，
除外：_______
A.脾脏
B.肾脏
C.结肠脾曲
D.胰
E.胃
D16. A 50-year-old male found a mass in the left upper abdomen that moved up
and down with breathing. Consider the origin of the following organs, except: _______ A.
Spleen B. Kidney C. Splenic flexure of the colon D. Pancreas E. Stomach
D17.男，40 岁，因呼吸困难入院，体格检查：肝右锁骨中线肋缘下 4cm，表面光
滑，有压痛，肝颈静脉回流阳性，移动性浊音阳性，最可能的诊断：_______
A.肝硬化、腹水
B.肝癌
C.血吸虫病
D.右心衰竭
E.肾病综合征
D17. A 40-year-old male was admitted to the hospital due to dyspnea. Physical
examination: The liver is 4cm below the costal margin on the right clavicular midline, the
surface is smooth, there is tenderness, the hepatojugular reflux is positive, mobile
dullness is positive, the most likely diagnosis is: _______ A. Liver cirrhosis, ascites B.
Liver cancer C. Schistosomiasis D. Right heart failure E. Nephrotic syndrome
B18.男，55 岁，食欲不振 2 月。体格检查：_______左锁骨上触及
1.5cm×1cm×1cm 包块，质硬，上腹部触及 4cm×3cm×2cm 大小包块，质硬，表面不光
滑，无压痛，随呼吸上下移动，最可能的诊断为：_______
A.肝癌
B.胃癌
C.胰腺癌
D.胰腺囊肿
E.腹膜间皮瘤
B18. A 55-year-old male, loss of appetite for 2 months. Physical examination:
_______ A 1.5cm×1cm×1cm mass was palpated above the left clavicle, the texture was
hard, a 4cm×3cm×2cm mass was palpated in the upper abdomen, the texture was hard,
the surface was not smooth, no tenderness, it moved up and down with breathing, the
most likely diagnosis is: _______ A. Liver cancer B. Gastric cancer C. Pancreatic cancer
D. Pancreatic cyst E. Peritoneal mesothelioma
[试题答案]
1.E 2.A 3.E 4.C 5.A 6.A 7.C 8.C 9.B 10.D 11.E 12.A 13.D 14.A 15.A 16.D 17.D 18.B
诊断学辅导试题——腹部（A3A4 型题）
题 1～4
女性，50 岁，有乙肝病史 20 年，近来感腹胀而就诊。查体：面部见蜘蛛痣，腹肌柔
软，移动性浊音阳性。
A1.该病人病史及临床表现支持下列哪项诊断：_______
A.肝硬化腹水
B.卵巢囊肿
C.肥胖
D.肠穿孔
E.肠梗阻
A1. The patient’s medical history and clinical manifestations support which of the
following diagnoses: _______ A. Liver cirrhosis with ascites B. Ovarian cyst C. Obesity
D. Intestinal perforation E. Intestinal obstruction
B2.治疗后 1 个月复查，检体移动性浊音消失、水坑征阳性提示：_______
A.腹水增多
B.腹水减少
C.腹水消失
D.腹壁水肿
E.肾盂积液
B2. One month after treatment, the physical examination shows that the shifting
dullness has disappeared and the puddle sign is positive, indicating: _______ A.
Increase in ascites B. Decrease in ascites C. Disappearance of ascites D. Abdominal
wall edema E. Hydronephrosis
A3.1 年后复查，查体出现液波震颤提示：_______
A.腹水增多
B.腹水减少
C.腹水消失
D.幽门梗阻
E.肝周围炎
A3. One year later, the physical examination shows fluid wave tremor, indicating:
_______ A. Increase in ascites B. Decrease in ascites C. Disappearance of ascites D.
Pyloric obstruction E. Perihepatitis
C4.病重期间，腹部查体反跳痛阳性，但无呕吐亦无肛门停止排气提示：_______
A.急性弥漫性腹膜炎
B.肠穿孔
C.原发性腹膜炎
D.肠梗阻
E.肠粘连
C4. During the critical period, the abdominal physical examination shows rebound
tenderness, but there is no vomiting and no cessation of gas from the anus, indicating:
_______ A. Acute diffuse peritonitis B. Intestinal perforation C. Primary peritonitis D.
Intestinal obstruction E. Intestinal adhesion
题 5～7
男性，50 岁，已确诊晚期肝癌。突然右上腹痛，面色苍白，大汗。
E5.最可能的诊断是：_______
A.急性胆囊炎
B.急性阑尾炎
C.心肌梗死
D.十二指肠溃疡穿孔
E.肝癌破裂
E5. The most likely diagnosis is: _______ A. Acute cholecystitis B. Acute
appendicitis C. Myocardial infarction D. Perforation of duodenal ulcer E. Rupture of liver
cancer
A6.腹部可能出现的体征除外：_______
A.腹式呼吸增强
B.腹部膨隆
C.肝浊音界消失
D.移动性浊音阳性
E.腹肌紧张压痛和反跳痛
A6. Which of the following signs may not appear in the abdomen: _______ A.
Enhanced abdominal breathing B. Abdominal distension C. Disappearance of liver
dullness D. Positive shifting dullness E. Abdominal muscle tension, tenderness, and
rebound pain
D7.若腹部移动性浊音阳性，哪项检查对明确诊断最为可靠：_______
A.CT
B.B 超
C.腹部平片
D.腹腔穿刺
E.胃镜
D7. If the shifting dullness in the abdomen is positive, which examination is most
reliable for a clear diagnosis: _______ A. CT scan B. Ultrasound C. Abdominal plain film
D. Abdominal puncture E. Gastroscopy
[试题答案]
1.A 2.B 3.A 4.C 5.E 6.A 7.D
B1.男性，50 岁，“胃痛”20 年，近来出现持续性呕吐宿食，形体消瘦。
A 50-year-old male has had “stomach pain” for 20 years and recently has persistent
vomiting of food residue and weight loss.
1.体格检查时最可能的发现是：_______
A.肛指检查直肠前窝可触及肿块
B.腹部有胃型及蠕动波
C.有锁骨上淋巴结可扪及
D.贫血
E.腹部包块
B1. The most likely finding during physical examination is: _______ A. A mass can
be palpated in the anterior rectal fossa during digital rectal examination B. There is a
gastric pattern and peristaltic wave in the abdomen C. Supraclavicular lymph nodes can
be palpated D. Anemia E. Abdominal mass
D2.哪项检查能明确诊断：_______
A.钡餐透视
B.B 超
C.CT
D.胃镜
E.磁共振
D2. Which examination can make a definite diagnosis: _______ A. Barium meal
fluoroscopy B. Ultrasound C. CT D. Gastroscopy E. MRI
题 3～4
男性，40 岁，突发性上腹部疼痛 2 小时来院急诊。体格检查：腹平，全腹均有压
痛，腹肌呈板样强直，肠鸣音消失，肝浊音界缩小。
A 40-year-old male suddenly had severe pain in the upper abdomen and came to
the emergency department 2 hours later. Physical examination: The abdomen is flat,
there is tenderness all over the abdomen, the abdominal muscles are board-like rigid,
bowel sounds disappear, and the liver dullness boundary is reduced.
D3.此时的诊断应考虑为：_______
A.急性胰腺炎
B.急性机械性肠梗阻
C.急性阑尾穿孔
D.溃疡病穿孔伴腹膜炎
E.胆道蛔虫
D3. The diagnosis at this time should be considered as: _______ A. Acute
pancreatitis B. Acute mechanical intestinal obstruction C. Acute appendiceal perforation
D. Perforation of peptic ulcer with peritonitis E. Biliary ascariasis
E4.在体检中肠鸣音消失的原因是：_______
A.肠坏死
B.机械性肠梗阻
C.肠运动障碍
D.剧痛而不敢腹式呼吸
E.炎症刺激而致肠麻痹
E4. The reason for the disappearance of bowel sounds during physical examination
is: _______ A. Intestinal necrosis B. Mechanical intestinal obstruction C. Intestinal
motility disorder D. Severe pain and dare not breathe abdominally E. Inflammation
stimulation causes intestinal paralysis
题 5～6
男性，30 岁。近 lo 年来常有空腹痛和夜间痛，服用制酸剂可使腹痛减轻，1h 前餐后
突 感上腹持续性剧痛入院。
A 30-year-old male has been having fasting pain and nocturnal pain for 10 years.
Taking acid inhibitors can alleviate abdominal pain. He was admitted to the hospital due
to persistent severe pain in the upper abdomen 1 hour after a meal.
B5.该病人目前的诊断是：_______
A.胃穿孔
B.十二指肠溃疡穿孔
C.肠梗阻
D.胃炎
E.肠痉挛
B5. The current diagnosis of this patient is: _______ A. Gastric perforation B.
Perforation of duodenal ulcer C. Intestinal obstruction D. Gastritis E. Intestinal spasm
B6.该病人查体最有诊断意义的是：_______
A.右上腹有压痛
B.肝浊音界消失
C.腹式呼吸消失
D.肠鸣音消失
E.腹部有移动性浊音
B6. The most diagnostic significance of this patient’s physical examination is:
_______ A. Right upper abdominal tenderness B. Disappearance of liver dullness C.
Disappearance of abdominal breathing D. Disappearance of bowel sounds E. Mobile
dullness in the abdomen
题 7～8
男性，30 岁，工人，突发上腹部剧痛，并很快扩散至右下腹，疼痛呈持续性，伴有
恶心、呕吐。体格检查：腹部平坦，腹肌紧张，全腹压痛，反跳痛明显，以右上腹与中上
腹为甚，肝浊音界不清，肠鸣音微弱。
A 30-year-old male worker suddenly had severe pain in the upper abdomen, which
quickly spread to the lower right abdomen. The pain was persistent and accompanied by
nausea and vomiting. Physical examination: The abdomen is flat, the abdominal muscles
are tense, there is tenderness all over the abdomen, rebound pain is obvious, especially
in the right upper abdomen and upper middle abdomen, the liver dullness boundary is
unclear, and the bowel sounds are weak.
C7.此例患者最可能的诊断为：_______
A.胆囊穿孔
B.肝破裂
C.消化性溃疡穿孔
D.结肠穿孔
E.急性阑尾炎
C7. The most likely diagnosis of this patient is: _______ A. Gallbladder perforation
B. Liver rupture C. Perforation of peptic ulcer D. Colon perforation E. Acute appendicitis
D8.此例患者腹腔的改变除外：_______
A.腹腔积液
B.腹腔积气
C.腹膜无菌性炎症
D.腹膜化脓性炎症
E.腹膜化学性炎症
D8. The change in the abdominal cavity of this patient should exclude: _______ A.
Abdominal effusion B. Abdominal gas C. Aseptic inflammation of the peritoneum D.
Suppurative peritonitis E. Chemical peritonitis
题 9～10
男性，20 岁，2 年来右上腹时有疼痛，痛向背部放射，尤以夜间为甚，曾有柏油样大
便史。
A 20-year-old male has had pain in the right upper abdomen for 2 years. The pain
radiates to the back, especially at night. He has a history of tarry stools.
C9.首选的检查为：_______
A.钡餐透视
B.B 超
C.胃镜
D.CT
E.腹腔动脉造影
C9. The preferred examination is: _______ A. Barium meal fluoroscopy B.
Ultrasound C. Gastroscopy D. CT E. Abdominal artery angiography
C10.最可能的诊断是：_______
A.胃炎
B.胰腺炎
C.十二指肠溃疡
D.胃溃疡
E.急性胰腺炎
C10. The most likely diagnosis is: _______ A. Gastritis B. Pancreatitis C. Duodenal
ulcer D. Gastric ulcer E. Acute pancreatitis
题 11～12
男性，30 岁，脐周痛 5 小时，伴恶心、无呕吐和腹泻，此时来就诊。
A 30-year-old male has had umbilical pain for 5 hours, accompanied by nausea, no
vomiting and diarrhea, and is now coming for consultation.
C11.若为阑尾炎，最有诊断意义的发现是：_______
A.体温 38.5℃
B.脐周压痛
C.右下腹压痛
D.肠鸣音减弱
E.外周血白细胞明显增高
C11. If it is appendicitis, the most diagnostic finding is: _______ A. Body
temperature 38.5°C B. Umbilical tenderness C. Right lower abdominal tenderness D.
Decreased bowel sounds E. Significant increase in peripheral blood leukocytes
D12.1 天后病人出现下列哪种情况更有助于诊断：_______
A.尿镜检红细胞 1～2 个/高倍镜
B.大便每日 4～5 次，便稀
C.呕吐每日 2～3 次
D.右下腹疼痛
E.腹胀
D12. Which of the following conditions that the patient developed one day later is
more helpful for diagnosis: _______ A. Urine microscopy shows 1-2 red blood cells/HP
B. Stool 4-5 times a day, loose stool C. Vomiting 2-3 times a day D. Pain in the lower
right abdomen E. Abdominal distension
题 13～15
男，40 岁，突起呕吐鲜血 40m1，解柏油样便约 300m1，既往查体提示脾大，
HBsAg 阳性。
A 40-year-old male suddenly vomited about 40ml of fresh blood and passed about
300ml of tarry stools. Previous physical examination suggested splenomegaly, HBsAg
positive.
E13.此例最可能的诊断是：_______
A.消化性溃疡
B.急性糜烂性胃炎
C.胃癌
D.白血病
E.食管静脉曲张破裂出血
E13. The most likely diagnosis of this case is: _______ A. Peptic ulcer B. Acute
erosive gastritis C. Gastric cancer D. Leukemia E. Rupture of esophageal varices and
bleeding
B14.此例查体不可能有：_______
A.蜘蛛痣
B.肝大、质软
C.腹水
D.血压 12.0/8.0kPa（90/60mmHg）
E.肠鸣音增快
B14. This case may not have the following physical examination: _______ A. Spider
nevus B. Large liver, soft texture C. Ascites D. Blood pressure 12.0/8.0kPa (90/60mmHg)
E. Increased bowel sounds
A15.为明确出血原因哪项检查最可靠：_______
A.胃镜
B.钡餐
C.B 超
D.CT
E.核磁扫描
A15. Which examination is most reliable for clarifying the cause of bleeding:
_______ A. Gastroscopy B. Barium meal C. Ultrasound D. CT E. MRI
题 16～17
女性，30 岁，突然右下腹绞痛，伴有恶心。体格检查，腹部平坦，软，右下腹深压
痛，右肋脊点叩痛，血白细胞 9.8×10^9/L，中性粒细胞 0.4.尿镜检白细胞 5 个/HP，红细
胞 10 个/HP.
A 30-year-old female suddenly had colic in the lower right abdomen, accompanied
by nausea. Physical examination, the abdomen is flat, soft, deep tenderness in the lower
right abdomen, right costovertebral angle tenderness, white blood cells 9.8×10^9/L,
neutrophils 0.4. Urine microscopy shows 5 white blood cells/HP, 10 red blood cells/HP.
B16.最可能的诊断为：_______
A.急性阑尾炎
B.右侧输尿管结石
C.膀胱结石
D.右侧输卵管炎
E.肠梗阻
B16. The most likely diagnosis is: _______ A. Acute appendicitis B. Right ureteral
stone C. Bladder stone D. Right fallopian tube inflammation E. Intestinal obstruction
E17.为确诊最好选用哪一项检查：_______
A.CT
B.B 超
C.腹部平片
D.膀胱镜十逆行造影
E.腹部平片十静脉肾盂造影
E17. Which examination is best chosen for diagnosis: _______ A. CT B. Ultrasound
C. Abdominal plain film D. Cystoscopy and retrograde angiography E. Abdominal plain
film and venous renal pelvis angiography
题 18～19
男性，40 岁，突然呕吐鲜血约 40m1，l 小时后急诊入院。体格检查：_______血压
12.0/8.0kPa（90/60mmHg），脉率 27 次/分，面部毛细血管扩张，色素沉着，颈部见 2
个蜘蛛痣，腹平软，移动性浊音阴性。血红蛋白 4g/L，血白细胞数 3.2×10^9/L，血小板数
5.02× 10^9/L.
A 40-year-old male suddenly vomited about 40ml of fresh blood, and came to the
emergency department an hour later. Physical examination: _______ Blood pressure
12.0/8.0kPa (90/60mmHg), pulse rate 27 beats/min, facial capillary dilation, pigmentation,
2 spider nevi on the neck, abdomen is flat and soft, mobile dullness is negative.
Hemoglobin 4g/L, white blood cell count 3.2×10^9/L, platelet count 5.02×10^9/L.
B18.此病例上消化道出血的原因应首先考虑：_______
A.溃疡病
B.肝硬化门脉高压
C.胃癌
D.急性出血性胃炎
E.胆道出血
B18. The cause of upper gastrointestinal bleeding in this case should first be
considered as: _______ A. Peptic ulcer B. Liver cirrhosis portal hypertension C. Gastric
cancer D. Acute hemorrhagic gastritis E. Biliary bleeding
D19.本例病人的临床表现有：_______
A.肝大、腹水
B.腹痛、黄疸
C.腹痛、贫血
D.脾大、黑便
E.脾亢、腹痛
D19. The clinical manifestations of this patient are: _______ A. Large liver, ascites
B. Abdominal pain, jaundice C. Abdominal pain, anemia D. Splenomegaly, black stool E.
Splenomegaly, abdominal pain
[试题答案]
1.B 2.D 3.D 4.E 5.B 6.B 7.C 8.D 9.C 10.C 11.C 12.D 13.E 14.B 15.A 16.B 17.E 18.B
19.D