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本课程起止时间为:2020-11-23到2021-02-03
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2.History Taking Unit test

1、 问题:If the patient wants to go to the bathroom during the health history interview, the best way for the doctor to deal with the situation is
选项:
A:Accompanying the patient into the bathroom and continue the interview
B:Asking a nurse to help the patient with defecation/urination while the doctor waits nearby
C:Asking the patient’s family to help him/her with defecation/urination while the doctor waits nearby
D:Staying in the room and continue the interview after the patient comes back from the bathroom
E:Asking the patient to go to the bathroom after the interview is done
答案: 【Staying in the room and continue the interview after the patient comes back from the bathroom

2、 问题:The health history interview should be cut off if the patient
选项:
A:Develops a high fever
B:Has a yellow sclera
C:Suffers from a chest pain attack
D:Has ecchymosis
E:Coughs a blood-streaked sputum
答案: 【Suffers from a chest pain attack

3、 问题:The best way to deal with the patient who digresses from the topic during a health history interview is
选项:
A:To stop the interview and continue another day
B:To wait patiently for him/her to finish
C:To tell the patient that he/she has digressed from the topic
D:To politely lead the conversation back to the topic
E:To stop the patient right away
答案: 【To politely lead the conversation back to the topic

4、 问题:The best way to acquire accurate medical history during an interview is
选项:
A:By listening attentively
B:By giving hints and guiding the patient
C:By questioning continuously
D:By health promotion
E:By using medical terminology
答案: 【By listening attentively

5、 问题:A female patient who is 56 years old is expected to undergo coronary stenting and the resident needs to know if the patient has any past history of peptic ulcer and whether she has fully recovered. The best way to question is
选项:
A:”Have you suffered from abdominal pain before?”
B:”Have you suffered from gastric ulcer before?”
C:”Have you done a gastroscopy before?”
D:”Have you suffered from gastrointestinal hemorrhage before?”
E:”Have you suffered from duodenal ulcer before?”
答案: 【“Have you suffered from abdominal pain before?”

3. Dyspnea Unit test

1、 问题:A male patient who is 43 years oldcomplains of shortness of breath for five years with physical exertion and is admitted to the hospital because of paroxysmal dyspnea at night lasting for a week. Physical examination shows enlarged left heart border, mid-diastolic and late diastolic mumurs can be heard at the apex. Crackles can be heard at the base of lung. Which of the following should be written in the presenthistory section of the patient’s medical record?
选项:
A:No hemoptysis
B:20 years of smoking
C:Hypertension for 2 years
D:Developed fever 2 weeks ago after catching a cold
E:Has a cough for 2 weeks with yellow sputum
答案: 【Hypertension for 2 years

2、 问题:A child wasrestless, having cyanosis in his lips and inspiratory dyspneaand presenting with three depressions sign.These symptoms occurred suddenly when he was playing. Which of the following may be the most likely cause?
选项:
A:Foreign bodies in the trachea
B:Respiratoryfailure
C:Severe pleural effusion
D:Spontaneous pneumothorax
E:Acute bronchitis
答案: 【Foreign bodies in the trachea

3、 问题:A 32-year-old female presents to the clinic with the complaint of progressive dyspnea and fatigue for 3 months which is accompanied by abdominal distention and edema for one week. She has a history of tuberculosis three years ago with full recovery. On examination: Jugular venous distension is detected, which is especially obvious in inspiration, and cardiac size is normal. Heart rate is 103bpm. Pericardial knock is detected upon auscultation. The liver is enlarged with obvious tenderness and its rounding edge is palpable 8 cm below the right costal margin. Shift dullness is detected. Edema is obvious in her lower extremities. What is the most likely diagnosis?
选项:
A:Right-sided heart failure
B:Constrictive pericarditis
C:Malignant pleural effusions
D:Severepericardial effusion
E:Superior vena cava obstruction syndrome
答案: 【Right-sided heart failure

4、 问题:A 16-year-old male has had dyspnea for 2 days. Findings of the physical examination: asthenic type, obvious trachea deviation to the right , tympany to percussion over the left lung and diminished breath sound of the left lung. No rales or rhonchi are found. What’s the most likely diagnosis?
选项:
A:Large pleural effussion of the left lung
B:Left lung pneumothorax with the left lung collapsing to 5% the size of the left hemithorax
C:Severepericardial effusion
D:Left lung pneumothorax with the left lung collapsing to 70% the size of the left hemithorax
E:Right lung atelectasis
答案: 【Large pleural effussion of the left lung

5、 问题:A 35-year-old man has had chest pain and dyspnea on exertion for 3 years. The blood pressure is 150/30mmHg and his heart enlarges like a boot. Which of the following signs is most likely to be found on physical examination:
选项:
A:Systolic thrills in the second intercostal space close to the right sternal border
B:Holosystolic apical murmurs
C:Apical rumbling diastolic murmurs
D:Diastolic murmurs in the third intercostal space close to the left sternal border
E:Systolic murmurs in the third intercostal space close to the left sternal border
答案: 【Diastolic murmurs in the third intercostal space close to the left sternal border

4.Fever Unit test

1、 问题:Which is the most common pattern of fever in malaria?
选项:
A:Continued fever
B:Remittent fever
C:Intermittent fever
D:Relapsing fever
E:Undulant fever
答案: 【Intermittent fever

2、 问题:Which is the most common pattern of fever in Septicaemia?
选项:
A:Continued fever
B:Remittent fever
C:Intermittent fever
D:Relapsing fever
E:Undulant fever
答案: 【Remittent fever

3、 问题:A 23-year-old woman was admitted to hospital for low-grade fever, fatigue, dyspnea, and emaciation with a duration of half a month. Physical examination reveals lower right chest enlargement, broadened intercostal spaces, decreased breathing motion, and decreased tactile fremitus. Percussion detects the right lung inferior margin at 4th intercostal space with 2cm tidal percussion area on the back. Auscultation reveals decreased breathing sounds over the right lung. Which of the following is the most likely diagnosis?
选项:
A:Pneumothorax
B:Emphysema
C:Atelectasis
D:Plural effusion
E:Consolidation
答案: 【Plural effusion

4、 问题:A 25-years-old man has had frequent lower back pain for 1 years, accompanied by low grade fever of 37.5-38°C body temperature in the afternoon. He also has night sweats, poor appetite and fatigability. Which of the following is the most likely diagnosis?
选项:
A:Tuberculosis of the spine
B:Rheumatoid arthritis
C:Ankylosing spondylitis
D:Systemic lupus erythematosus
E:Osteoarthritis
答案: 【Tuberculosis of the spine

5、 问题:A 50-years-old man complains of swelling of the 1st metatarsophalangeal joint accompanied by redness, swelling, heat and pain. He has no history of trauma and infection. Which of the following is the most likely diagnosis?
选项:
A:Rheumatic fever
B:Gouty arthritis
C:Tenosynovitis
D:Bursitis
E:Osteoarthritis
答案: 【Gouty arthritis

5. Hematemesis and Hematochezia unit test

1、 问题:A 28-year-old man presents with recurrent mucopurulent bloody stools for 2 years, 3-4 times a day, accompanied by tenesmus. He doesn’t complain of fever, and reports that after oral administration of 5-aminosalicylic acid, his symptoms oscillate. His physical examination is unremarkable.Which of the following is the most likely diagnosis for this patient?
选项:
A:Crohn’s disease
B:Bleeding of hemorrhoids
C:Bacterial food poisoning
D:Ulcerative colitis
E:Intestinal tuberculosis
答案: 【Ulcerative colitis

2、 问题:A 35-year-old man presents with dark red blood for 3 days, accompanied by dizziness, palpitation, cold sweats, and drop serene. He was previously healthy. Physical examination: HR 110 beats/min, BP 90/60mmHg, abdomen examination unremarkable.Which of the following is the most likely site of this patient’s bleeding?
选项:
A:Upper gastrointestinal tract
B:Lower gastrointestinal tract
C:Middle gastrointestinal tract
D:All A, B, C are possible
E:Middle or lower gastrointestinal tract
答案: 【All A, B, C are possible

3、 问题:A 27-years-old man complains of constipation, pain associated with defecation and little blood in the stool. Which of the following is the most likely diagnosis?
选项:
A:Anal fissure
B:Hemorrhoids
C:Anorectal fistula
D:Rectal prolapse
E:Rectal cancer
答案: 【Anal fissure

4、 问题:A patient complains of a sensation of rectal tenesmus, blood in stool, and masses coming out of the anus while defecation and returning spontaneously after defecation. Soft masses can be palpated above the dentate line on anal examination. Which of the following is a likely diagnosis?
选项:
A:Anal fissure
B:Hemorrhoids
C:Anorectal fistula
D:Rectal prolapse
E:Rectal cancer
答案: 【Hemorrhoids

5、 问题:A 24-year-old man has regular upper abdominal pain for 1 year, and it worsens with hunger or at night. The patient reports black stool 2 days ago and 300ml bloody vomitus today. Which of the following test should not be considered?
选项:
A:Emergent gastroscopy
B:Emergent barium swallow study of gastrointestinal tract
C:Ultrasound scan for upper abdominal

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