呼吸内科考试试卷及答案(B卷)

地形平坦开阔，地层由第四系全新冲积层，第四系上更新统冲层组成，局部表覆第四系全新统人工堆积层。第四系全新统冲积层厚度约25～50m，岩性主要为黏土、粉质黏土、粉土、粉砂、细砂；第四系上更新统冲积层厚度大于50m，岩性主要为黏性土、粉土、粉细砂等。管桩深度范围内地层主要为：粉土、黏土、粉质黏土，局部表层为杂填土。couplingCentreshallbechecked,thesecondpouredconcretestrengthofmorethan70%.Intheprocessofreamingorboring,apartfromthespecialprovisionsinfactory,doesnotallowanyworkthatmayaffectthecouplingCentre,suchasirrigation,tocylinderconnectionstofloodthecondenserpipesandsoon.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Mountingboltsshouldbeaddedlubricants,typinggentlywithasmallhammer,nottoolooseortootight,packedtheboltswiththecorrespondingsealscrewholeshouldbemarked.6.4.5.4.2couplingreamedandpairingsisclosetothediameterofboltbearinggoodhingeholes,dressedwithagoodtwocouplingboltsbeforeyoucanmovetherotor,boring-reamingholeinturn.Couplingboltsmustbetightcouplingissymmetricaldiameter,inboring,reaming,twoboltsout.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Duetothecouplingboltsinaccordancewithhingeholescorrespondingtothediameterofthescrewholesonebyoneafterprocessing,processingbackboltinstallationlocationcannotbechanged,soaccordingtoboltaftertheactualweightdifferenceofnutandlockwashertomatch.Generalrequirementsforcouplingtwosymmetricaldiameterbolt,nutandlockwasher'stotalweightdifferenceshouldnotbegreaterthan10gandknocksstampedmark.(SeeFigure18)Thecouplingboltsapplylubricant,andthengentlywithcopperhome,nottoolooseortootight.BoltAssemblyisfinished,symmetricaltighteningallboltsto30%,50%,70%,100%force,andcheckthecouplingflutterandbeforeconnectingthecirclegraduallychangesitsvalueshouldbelessthan0.02mm.Tighteningtorqueofthecouplingboltsshallcomplywiththetechnicalrequirementsmanufacturersdrawings,withadynamometricwrenchorlogtensiontools.Threewheelrotorswingtestcouplingconnectionsshouldbechecked:takingleave,(5分)[1]A、功能残气量B、肺活量C、肺总量D、深吸气量E、残气量(1)深吸气量+补呼气量为()(2)补呼气量+残气量为()(3)肺活量+残气量为()(4)补吸气量+潮气量为()(5)功能残气量-补呼气量为()(2分)[2]A、粉红色泡沫痰B、臭脓痰C、铁锈色痰D、粉红色粘稠乳状痰E、棕红色粘稠胶冻状痰(1)肺炎球菌肺炎()(2)克雷白杆菌肺炎()二、病例串型最佳选择题(A3-A4型题)(4小题,共12.0分)(4分)[1]女性，哮喘发作已持续2天，端坐呼吸，发绀，双肺满布哮鸣音。(1)判断病情严重程度，应作下列何种检查()A、胸片B、血清IgEC、肺功能D、血气分析E、心电图(2)下列何种诊断更确切()A、支气管哮喘B、喘息型支气管炎C、哮喘并发感染D、哮喘并发气胸E、哮喘持续状态(3)下列检查结果哪项最符合该患者目前的病情变化()A、PaCOPaOB、PaOPaCOC、PaCOPaOD、肺活量正常，残气量增加E、FEV(4)下列哪项治疗不正确()A、氧疗B、控制感染C、胸腔穿刺抽气地形平坦开阔，地层由第四系全新冲积层，第四系上更新统冲层组成，局部表覆第四系全新统人工堆积层。第四系全新统冲积层厚度约25～50m，岩性主要为黏土、粉质黏土、粉土、粉砂、细砂；第四系上更新统冲积层厚度大于50m，岩性主要为黏性土、粉土、粉细砂等。管桩深度范围内地层主要为：粉土、黏土、粉质黏土，局部表层为杂填土。couplingCentreshallbechecked,thesecondpouredconcretestrengthofmorethan70%.Intheprocessofreamingorboring,apartfromthespecialprovisionsinfactory,doesnotallowanyworkthatmayaffectthecouplingCentre,suchasirrigation,tocylinderconnectionstofloodthecondenserpipesandsoon.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Mountingboltsshouldbeaddedlubricants,typinggentlywithasmallhammer,nottoolooseortootight,packedtheboltswiththecorrespondingsealscrewholeshouldbemarked.6.4.5.4.2couplingreamedandpairingsisclosetothediameterofboltbearinggoodhingeholes,dressedwithagoodtwocouplingboltsbeforeyoucanmovetherotor,boring-reamingholeinturn.Couplingboltsmustbetightcouplingissymmetricaldiameter,inboring,reaming,twoboltsout.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Duetothecouplingboltsinaccordancewithhingeholescorrespondingtothediameterofthescrewholesonebyoneafterprocessing,processingbackboltinstallationlocationcannotbechanged,soaccordingtoboltaftertheactualweightdifferenceofnutandlockwashertomatch.Generalrequirementsforcouplingtwosymmetricaldiameterbolt,nutandlockwasher'stotalweightdifferenceshouldnotbegreaterthan10gandknocksstampedmark.(SeeFigure18)Thecouplingboltsapplylubricant,andthengentlywithcopperhome,nottoolooseortootight.BoltAssemblyisfinished,symmetricaltighteningallboltsto30%,50%,70%,100%force,andcheckthecouplingflutterandbeforeconnectingthecirclegraduallychangesitsvalueshouldbelessthan0.02mm.Tighteningtorqueofthecouplingboltsshallcomplywiththetechnicalrequirementsmanufacturersdrawings,withadynamometricwrenchorlogtensiontools.Threewheelrotorswingtestcouplingconnectionsshouldbechecked:takingleave,D、静脉滴注氨茶碱+地塞米松E、纠正酸碱失衡(3分)[2]男性，63岁，近5年来反复出现咳嗽、咳痰伴胸闷、气短，每次经抗感染治疗后好转，近2周又出现咳嗽、咳黄痰，伴发热，经克林霉素抗感染治疗无明显好转，胸片可见双中下肺野弥漫斑片影，双下肺可闻及广泛湿啰音。(1)该患者考虑诊断为()A、亚急性血行播散型肺结核B、慢支急性感染C、肺间质纤维化D、肺炎球菌性肺炎E、慢性支气管炎+心脏衰竭(2)对于该患者目前应该做的检查是()A、痰细菌培养及药物敏感试验B、痰找癌细胞C、胸部CT检查D、PPD皮试E、痰真菌培养(3)对于该患目前适宜的治疗为()A、根据药物敏感试验选用敏感抗菌药抗感染、对症B、试验性抗结核治疗C、抗感染治疗+抗结核治疗D、改为大环内酯类抗感染治疗E、联合头孢Ⅱ代抗感染治疗(2分)[3]男性，50岁，左侧胸痛3个月，偶有发热，体温37.5℃，B超示左侧胸腔少量积液，胸腔积液为黄色渗出液，经正规抗结核治疗3个月，同时积极抽胸液(每周2次)，胸腔积液吸收不理想，仍有明显胸痛，胸CT：左侧胸膜呈波浪状增厚，肺内未见占位病变。(1)最有可能的诊断是()A、结核性胸膜炎B、胸膜间皮瘤C、非结核分枝杆菌性胸膜炎D、肺癌胸膜转移E、脓胸(2)对胸膜间皮瘤最具诊断意义的是()A、血性胸腔积液B、年龄和临床表现c、胸腔积液为渗出性改变D、胸腔积液透明质酸酶增高E、胸腔积液细胞学检查及胸膜活体组织检查(3分)[4]男性，60岁，6年前因痰结核菌阳性而诊为继发性肺结核，当时予以HRE治疗4个月，因病情好转而自动停药。3个月后低热、咳嗽，小量咯血再次自行用原方案治疗，症状改善。地形平坦开阔，地层由第四系全新冲积层，第四系上更新统冲层组成，局部表覆第四系全新统人工堆积层。第四系全新统冲积层厚度约25～50m，岩性主要为黏土、粉质黏土、粉土、粉砂、细砂；第四系上更新统冲积层厚度大于50m，岩性主要为黏性土、粉土、粉细砂等。管桩深度范围内地层主要为：粉土、黏土、粉质黏土，局部表层为杂填土。couplingCentreshallbechecked,thesecondpouredconcretestrengthofmorethan70%.Intheprocessofreamingo