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1、中国医科大学2021年7月考试?病理生理学?考查课试题China Medical University July 2021 exam pathophysiology examination questionsChina Medical University July 2021 exam pathophysiology examination questionsTotal score: 100 test time: -Radio examinationShort Answer QuestionsExpositionSubjective cloze testRadio examination qu
2、estions (20 questions, 20 points)In the 1.ARF polyuria stage, the mechanism of polyuria isA. glomerular filtration function recoveryB. renal tubular immature functionC. renal tubule obstruction is alleviatedD. osmotic diuresisE. GFR addedFull marks: 1Answer: B2., when stress occurs, the sympathetic
3、adrenal system has an adverse effect on the organismA. suppresses thyroid axisB. raises blood sugarC. promotes protein gluconeogenesisD. grows slowlyE. gastrointestinal ischemiaFull marks: 1Answer: E3. which of the following factors is most likely to be the most closely related to DIC in obstetric a
4、ccidents?A. the blood is in hypercoagulable stateB. mononuclear phagocyte system is low functioningC. microcirculation and blood stasisD. fibrinolytic system increased activityE. increased levels of procoagulant substances in bloodFull marks: 1Answer: A4. The most characteristic changes in arterial
5、blood are hypoxia, which occurs when respiratory insufficiency occursA. oxygen capacity decreasedB. oxygen partial pressure decreaseC. oxygen content decreasedD. oxygen desaturationE. oxygen shift curve right shiftFull marks: 1Answer: B5. which of the following is not the cause of respiratory acidos
6、is?A. respiratory paralysisB. respiratory muscle paralysisC. airway obstructionD. hypoxemiaE. pneumothoraxFull marks: 1Answer: EThe central link of the 6.ARF isA. renal tubule regurgitationB. renal tubule obstructionC. capillary coagulation in the kidneyD. GFR downE. necrosis of renal tubular epithe
7、lial cellsFull marks: 1Answer: D7. when hemorrhagic shock occurs, the sympathetic adrenal medulla system is in placeA. has been very excitedB. gets excited first, then suppresses, and finally failsC. has been inhibitingD. inhibits first and then gets excitedE. gets excited first, then suppresses, an
8、d then gets excitedFull marks: 1Answer: B8. which of the following clinical manifestations of shock is wrong?A. irritability or indifference or even comaB. has shortness of breath and rapid pulseC. blood pressure dropsD. pale or cyanoticE. oliguria or absence?Full marks: 1Answer: B9. when acute resp
9、iratory acidosis occurs, the main mode of compensation isA. extracellular bufferingCompensatory regulation of B. lungC. intracellular bufferingD. skeletal bufferCompensatory regulation of E. kidneyFull marks: 1Answer: E10. hyponatremia means lower blood sodium concentrationA. 120mmol/LB. 130mmol/LC.
10、 140mmol/LD. 150mmol/LE. 160mmol/LFull marks: 1Answer: B11. which of the following is the clinical manifestation of the rise in body temperature?A. cold or coldB. consciously hotC. lips are dryD. KhanE. dehydrationFull marks: 1Answer: C12. is a structurally similar neurotransmitter that is similar i
11、n chemistry to that of the pseudo neurotransmitter, phenethyl and ethanolamine.A., 5-, serotonin, and dopamineB. norepinephrine and dopamineC. epinephrine and norepinephrineD. acetylcholine and ethylamineE. glutamic acid and glutamineFull marks: 1Answer: B13. etiology studyThe general rule of A. dis
12、easeCauses and conditions of B. diseaseThe cause of C. diseaseD. conditions for disease occurrenceThe basic mechanism of E. disease developmentFull marks: 1Answer: B14. which of the following substances belongs to endogenous pyrogen?A. aetiocholanoloneB. IL-6Exotoxin C.D. antigen antibody complexE.
13、endotoxinFull marks: 1Answer: B15. chronic emphysema caused by hypoxia belongs toA. blood hypoxiaB. hypotonic hypoxiaC. tissue toxic hypoxiaD.Cyclic hypoxiaNo more than E.Full marks: 1Answer: E16. which of the following can make oxygen move away from the curve?A. 2, elevated 3-DPG concentrationB. bl
14、ood H+ decreasedC. decreased the CO2 partial pressure of bloodD. decreased blood temperatureE. hypokalemiaFull marks: 1Answer: A17. which of the following is called hypertonic dehydration?A. high volume hyponatremiaB. hyponatremia of low volumeC. hyponatremia of low volumeD. high volume hypernatremi
15、aE. hyperkalemiaFull marks: 1Answer: E18. which of the following is not a clinical manifestation of insufficient cardiac output in heart failure?A. skin cyanosisB. decreased urine outputC. has difficulty breathingD. cardiogenic shockE. is tired and weakFull marks: 1Answer: C19. stress independent di
16、seases areA. primary hypertensionB. stress ulcerC. coronary artery diseaseD. albinismE. PTSDFull marks: 1Answer: D20. which of the following is an indicator of respiratory factors?A. AGCO2 partial pressure of arterial blood B.C. buffer baseD. base residueE. standard bicarbonateFull marks: 1Answer: E
17、China Medical University July 2021 exam pathophysiology examination questionsTotal score: 100 test time: -Radio examinationShort Answer QuestionsExpositionSubjective cloze testSimple answer (5 questions, 20 points)1. acute phase reactionAnswer: certain changes in serum components may occur within a
18、short period (hours to days) after infection, inflammation, tissue damage and other stressors are acting on the bodyFull marks: 42. ischemia-reperfusion injuryAnswer: is the main cause of fatal diseases, such as coronary atherosclerosis caused by myocardial infarction, stroke moderate. In ischemic d
19、isease rescue and treatment process, medical scientists gradually found the main factors causing damage to the organization, not the ischemia itself, but to restore the blood supply, excessive free radicals attack the regain blood supply within the tissue cells caused by this kind of injury, called
20、ischemia reperfusion injury.Full marks: 43. heat shock proteinAnswer: there is a class of heat responsive proteins widely found in bacteria and mammals. When organisms are exposed to heat, they are stimulated by heat to synthesize the protein to protect the organism itself. Many heat shock proteins
21、have molecular chaperone activity.Full marks: 44. respiratory acidosisAnswer: respiratory acidosis is characterized by accumulation of CO2 in the body and decreased pH. The main reason is that the pulmonary ventilation function is reduced. It is found in respiratory tract obstruction, pneumonia, ate
22、lectasis, chest and abdominal surgery, trauma, etc. The basic method of treatment is to relieve respiratory tract obstruction and improve pulmonary ventilation function.Full marks: 45. exertional dyspneaAnswer: mild heart failure occurs only during physical exertion, breathing difficulty, and disapp
23、ears after restFull marks: 4China Medical University July 2021 exam pathophysiology examination questionsTotal score: 100 test time: -Radio examinationShort Answer QuestionsExpositionSubjective cloze testDiscussion questions (5 questions, 50 points)1. Describe the pathogenesis of stress ulcer.Answer
24、: A gastric mucosal ischemia: This is the most basic condition for the formation of stress ulcer. Because of the increase of catecholamine in the stress, the splanchnic blood flow is reduced and the gastrointestinal mucosa is ischemic, and the degree of mucosal ischemia is positively correlated with
25、 the degree of lesion. The epithelial cells of mucosa ischemia energy shortage, can not produce enough bicarbonate and mucus, which by epithelial cell tight junctions between and covered on the mucosal surface of the bicarbonate - mucus layer of medical education collected gastric mucosal barrier co
26、nsisting of the destruction of the stomach cavity within the H+ concentration difference into the mucosa and mucosal blood the reduction in the flow and will not invade the mucosa H+ promptly removed,Cause H+ to accumulate in mucous membrane and cause damage.B reverse dispersion of H+ into the mucos
27、a of the stomach: This is a necessary condition for the formation of stress ulcers. The higher the concentration of H+ in the stomach cavity, the more serious the mucosal lesions, and if the pH in the stomach is maintained above 3.5, it can not form stress ulcer. It is thought that the decrease of p
28、H in mucosa mainly depends on the ratio of the reverse dispersion of H+ in the stomach cavity to the mucosal blood flow. In gastric mucosal perfusion under good conditions, excessive H+ reverse diffusion into the mucosa in the bloodstream can be HCO3- and / or carry away, thus preventing H+ damage o
29、f cells, whereas in trauma and shock stress, reducing gastric mucosal blood flow, even reverse diffusion to the mucosa H+ is not much, will also make changes in pH decreased significantly, resulting in cell damage.C other: there are some secondary factors may also be involved in the onset of stress
30、ulcer, when the acidosis, the blood flow to the mucosal H+ buffer capacity is low, can promote the occurrence of stress ulcer. In the case of bile reflux gastric mucosal ischemia, mucosal barrier function can be impaired, mucosal permeability increased, and H+ reverse reflux mucosa increased. Stress
31、 ulcer, if there is no bleeding or perforation and other complications, after the primary disease has been controlled, usually within a few days complete healing, without scarring.Full marks: 102. Describe the mechanism of renal anemia.Answer: when the renal function was damaged, in patients with ch
32、ronic kidney disease by renal secretion of erythropoietin amount will not be enough to meet the needs of the body, and thus become one of the major causes of renal anemia. In addition, chronic renal failure and uremia patients, in the accumulation of a large number of metabolic toxins, reduce red bl
33、ood cell survival time; iron intake reducing and iron loss increased, insufficient synthesis of red blood cells in patients with chronic kidney disease; long-term control of protein intake, and urinary protein source drain from the patients; patients with chronic nephropathy the bleeding tendency; t
34、hese are likely to lead to renal anemia in patients with chronic nephropathy.Full marks: 103. describe the bleeding mechanism in DIC patients.Answer: (1) the consumption of coagulation substancesDuring the development of DIC, all kinds of coagulation factors and platelet consumption, especially fibr
35、inogen, prothrombin, factor V, VIII, x, VIII generally reduced platelet. Therefore, DIC has been called coagulopathy (consrmptive). Right now. The coagulation process is hampered by a large reduction in coagulation substances.(two) activation of fibrinolysis systemThe activation of secondary fibrino
36、lysis system occurs after activation of the coagulation system at DIC. This is mainly because in the process of blood coagulation, activated by enzyme (protease enzyme hydrolysis effect caused by the formation of a f XII) XII, XII f prekallikrein into kallikrein, which plasminogen into plasmin. Some
37、 plasminogen activator organs (such as the uterus, prostate, lungs, etc.) undergo degeneration and necrosis due to intravascular coagulation. When activated, the activators release large amounts of blood into the blood and activate the fibrinolytic system. Endothelial cell damage, hypoxia, stress ca
38、n also activate fibrinolytic system, resulting in increased plasmin. In addition to plasminogen to fibrin (ogen) degradation, hydrolysis, but also coagulation factor VIII and prothrombin, the coagulation factor is further reduced, resulting in dysfunction of blood coagulation and bleeding.Full marks
39、: 10The mechanism of 4. stagnant anoxia phase of shock microcirculation stasis?Answer: the microcirculation and hemorheology changed obviously: blood flow rate was slowed down, the red blood cell and platelet aggregation, leukocyte rolling, adhesion, impaction, blood viscosity increased, the blood m
40、ud (sludge) microcirculation stasis, congestion, and further reduce the tissue perfusion, hypoxia is more serious. This is because in this period, the visceral microcirculation vasomotion disappeared, arteriole, after arterioles and precapillary sphincter contraction weakened or even expansion, a la
41、rge number of blood poured into true capillary network. Venules are dilated, too,But because of slow blood flow, cell impaction, microcirculation increased resistance to outflow, the resistance is greater than the capillary resistance before after.Full marks: 105. Briefly describe the mechanism of h
42、ypoxia induced by carbon monoxide poisoning.Answer: carbon dioxide through the respiratory inhalation lung, through blood and hemoglobin diffuse alveolar wall (Hb) combination of carboxyhemoglobin (cOHb); CO and Hb by wide oxygen affinity than 240 times larger than the normal Hb COHb dissociation wa
43、s 3600 times slower, therefore, CO and Hb in blood oxygen competition most of the hemoglobin CoHb. CoHb has poor oxygen carrying capacity, which results in tissue hypoxia, while coHb dissociation curve shifts left, oxygen is not easy to release, which aggravates hypoxia.Full marks: 10China Medical U
44、niversity July 2021 exam pathophysiology examination questionsTotal score: 100 test time: -Radio examinationShort Answer QuestionsExpositionSubjective cloze testFill in the blanks (a total of 4 questions, 10 points)1. the central airway obstruction is located in the chest, which usually causes dyspn
45、ea.Full Score: 1First empty sum: 1 pointsAnswer: (expiratory)2. the concentration of serum phosphorus is often the concentration of serum calcium in chronic renal failure patients.Full Score: 2First empty sum: 1 pointsSecond empty sum: 1 points(rising) (descending)3. pulmonary ventilation dysfunctio
46、n, including.Full Score: 3First empty sum: 1 pointsSecond empty sum: 1 pointsThird empty sum: 1 points(Mi Sanzhang) (ventilation and blood flow imbalance) (increased anatomic shunt)4., ARF, oliguria, the major internal environmental disturbances are, and.Full Score: 4First empty sum: 1 pointsSecond empty sum: 1 pointsThird empty sum: 1 pointsFourth empty sum: 1 pointsAnswer: water and sodium retention, electrolyte disorders, metabolic acidosis, uremia