试题库|《内科学》心力衰竭
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">第十章</span> <span style="color: black;">心力衰竭</span></span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">单选题</span></span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1. <span style="color: black;">慢性心功能不全的基本病因是：</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">A<span style="color: black;">．<span style="color: black;">各样</span>感染 </span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">B. <span style="color: black;">摄入钠盐<span style="color: black;">太多</span>心力衰竭</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">C<span style="color: black;">．严重<span style="color: black;">心率</span>失常 </span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">D. <span style="color: black;">心脏负荷过重<span style="color: black;">反常</span>和心肌病变</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">E<span style="color: black;">．<span style="color: black;">心情</span>激动和过重体力劳动</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>: D<span style="color: black;">）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2. <span style="color: black;">慢性心功能不全最早<span style="color: black;">显现</span>的临床表现是：</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">A<span style="color: black;">．下肢水肿</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">B. <span style="color: black;">舒张期奔马律</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">C<span style="color: black;">．胸水和腹水 </span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">D. <span style="color: black;">肝颈静脉回流阳性</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">E<span style="color: black;">．劳力性<span style="color: black;">呼气</span>困难</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:E<span style="color: black;">）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3. <span style="color: black;">提示左心功能不全的脉搏是： </span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">A<span style="color: black;">．交替脉</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">B. <span style="color: black;">水冲脉</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">C<span style="color: black;">．奇脉</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">D. <span style="color: black;">重搏脉</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">E<span style="color: black;">．脉搏短绌</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:A<span style="color: black;">）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">4. </span><span style="color: black;"><span style="color: black;">右心衰竭时肝肿大与肝硬化最<span style="color: black;">重点</span>的鉴别点是</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">A. </span><span style="color: black;"><span style="color: black;"><span style="color: black;">没</span>黄疸</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">B. <span style="color: black;"><span style="color: black;">没</span><span style="color: black;">海量</span>胸水</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">C. <span style="color: black;">肝颈静脉回流征阳性 </span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">D. <span style="color: black;">血白蛋白正常</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">E. <span style="color: black;"><span style="color: black;">没</span>脾脏肿大</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:C<span style="color: black;">）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">5. <span style="color: black;">治疗急性左心衰竭不宜<span style="color: black;">选择</span>的<span style="color: black;">药品</span>是：</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">A. <span style="color: black;">速尿</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">B. <span style="color: black;">氨茶碱</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">C.<span style="color: black;">吗啡</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">D. <span style="color: black;">西地兰</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">E. <span style="color: black;">美托洛尔</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:E<span style="color: black;">）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">6. <span style="color: black;">不会<span style="color: black;">导致</span>左室后负荷过重的病因是：</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">A. <span style="color: black;">高血压</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">B. <span style="color: black;">主动脉瓣狭窄</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">C. <span style="color: black;">肺动脉高压</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">D. <span style="color: black;">甲亢</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">E. <span style="color: black;">肺动脉狭窄</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:D<span style="color: black;">）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">多选题</span></span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1. <span style="color: black;">洋地黄的适应症<span style="color: black;">包含</span>：</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">A. <span style="color: black;">中、重度收缩性心力衰竭</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">B. <span style="color: black;">快速房颤</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">C. <span style="color: black;">单纯舒张性心力衰竭</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">D. III<span style="color: black;">度房室传导阻滞</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">E. <span style="color: black;">病态窦房结<span style="color: black;">综合症</span></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:A B<span style="color: black;">）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">填空题</span></span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1. <span style="color: black;">感染常诱发心衰，其中以</span></span><span style="color: black;"><span style="color: black;">感染最<span style="color: black;">平常</span>；<span style="color: black;">心率</span>失常<span style="color: black;">亦</span>可诱发心衰，其中以</span></span><span style="color: black;"><span style="color: black;">最<span style="color: black;">平常</span>。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:<span style="color: black;"><span style="color: black;">呼气</span>道、心房颤动）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2. <span style="color: black;">左心衰竭的<span style="color: black;">呼气</span>困难<span style="color: black;">包含</span></span></span><span style="color: black;"><span style="color: black;">、</span></span><span style="color: black;"><span style="color: black;">、</span></span><span style="color: black;"><span style="color: black;">。其中最早<span style="color: black;">显现</span>的是</span></span><span style="color: black;"><span style="color: black;">。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:<span style="color: black;">劳力性<span style="color: black;">呼气</span>困难、端坐<span style="color: black;">呼气</span>、夜间阵发性<span style="color: black;">呼气</span>困难、劳力性<span style="color: black;">呼气</span>困难）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3<span style="color: black;">．<span style="color: black;">日前</span>对心力衰竭<span style="color: black;">病人</span>心功能<span style="color: black;">评定</span>常用的分级法是 、</span> </span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（标答</span>:NYHA<span style="color: black;">心功能分级、</span><span style="color: black;">6</span><span style="color: black;">分钟步行<span style="color: black;">实验</span>）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">名词解释</span></span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1. <span style="color: black;">心源性哮喘</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（即夜间阵发性<span style="color: black;">呼气</span>困难，为左心功能衰竭的临床表现，<span style="color: black;">病人</span>表现为熟睡后<span style="color: black;">忽然</span>憋醒，可伴阵咳，<span style="color: black;">呼气</span>急促，咯<span style="color: black;">泡泡</span>样痰或呈哮喘状态。）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">简答题</span></span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">简述心功能不全</span>NYHA<span style="color: black;">分级的分级<span style="color: black;">办法</span>。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（</span>I<span style="color: black;">级 有心脏病但活动不受限，<span style="color: black;">通常</span>活动不<span style="color: black;">导致</span>心衰症状或心绞痛</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> II<span style="color: black;">级 心脏病<span style="color: black;">病人</span>体力轻度受限，<span style="color: black;">休憩</span><span style="color: black;">没</span>症状，<span style="color: black;">通常</span>活动下<span style="color: black;">导致</span>心衰症状或心绞痛</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> III<span style="color: black;">级 心脏病<span style="color: black;">病人</span>体力活动<span style="color: black;">显著</span>受限，<span style="color: black;">少于</span>平时<span style="color: black;">通常</span>活动即<span style="color: black;">导致</span><span style="color: black;">以上</span>症状</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> IV<span style="color: black;">级 心脏病<span style="color: black;">病人</span><span style="color: black;">不可</span>从事任何体力活动。<span style="color: black;">休憩</span>状态下<span style="color: black;">亦</span>可<span style="color: black;">显现</span>心衰症状，体力活动后加重。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">简述急性肺水肿<span style="color: black;">救治</span><span style="color: black;">办法</span>。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（坐位，双腿下垂，吸氧</span>4-6L/<span style="color: black;">分，吗啡，利尿，血管扩张剂，洋地黄类<span style="color: black;">药品</span>，茶碱类）</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">病例分析</span></span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">李某，男，</span>59<span style="color: black;">岁。患高血压病史</span><span style="color: black;">7</span><span style="color: black;">年余，平时不规则<span style="color: black;">吃下</span>硝苯地平片降压，血压<span style="color: black;">掌控</span><span style="color: black;">不良</span>：</span><span style="color: black;">150-160/105mmHg</span><span style="color: black;">，一年前曾拍胸片提示：心影向左下扩大，靴型心。今晨<span style="color: black;">病人</span>因琐事与邻居争吵中，<span style="color: black;">忽然</span><span style="color: black;">显现</span><span style="color: black;">呼气</span>困难、咳嗽并咯吐粉红色<span style="color: black;">泡泡</span>痰、面色苍白、口唇发绀、大汗淋漓、烦躁不已，救护车送入急诊，体检提示：血压：</span><span style="color: black;">185/120mmHg</span><span style="color: black;">，两肺满布湿罗音和哮鸣音，心率：</span><span style="color: black;">120</span><span style="color: black;">次</span><span style="color: black;">/</span><span style="color: black;">分，律齐，可及舒张<span style="color: black;">初期</span>奔马律。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1. <span style="color: black;">请对该<span style="color: black;">病人</span>作出完整诊断 </span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2. <span style="color: black;">处理原则是什么？</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">（</span>1. <span style="color: black;">高血压病</span><span style="color: black;">II</span><span style="color: black;">级 高血压心脏病 急性左心衰竭</span><span style="color: black;">2</span><span style="color: black;">．坐位，双腿下垂，吸氧</span><span style="color: black;">4-6L/</span><span style="color: black;">分，吗啡，利尿，血管扩张剂，洋地黄类<span style="color: black;">药品</span>，茶碱类）</span></span></p>医学资料共享平台友情提：此导航窗格搭建升级中，每期更新，<span style="color: black;">近期</span>一期请查看最新一期推送！<img src="https://mmbiz.qpic.cn/mmbiz_gif/p6Wl2LDMQlHC6pDXyQRaWjlWR5PIhukIUGV1nfK6H9qtHZoxnXtVdeztoFexkaevudmZ1MbV9qWNZTXiaopLyoQ/640?wx_fmt=gif&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;">
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楼主果然英明！不得不赞美你一下！ 我深感你的理解与共鸣，愿对话长流。 感谢你的精彩评论，为我的思绪打开了新的窗口。 “板凳”（第三个回帖的人） 楼主发的这篇帖子，我觉得非常有道理。
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