Multiple choice questions in Internal Medicine

1. The primary rescue measures for patients with massive hemoptysis accompanied by
dyspnea are
A. Use A large dose of strong hemostatic drugs
B. Clear the airway and keep it unobstructed
C. High flow of oxygen
D.Transfusion
E. Administering sedatives

2. The first choice for aplastic treatment is

A. Adrenocorticosteroids
B. Splenectomy
C. Androgen
D. Bone marrow transplantation
E. Immunosuppressive drugs

3. The most valuable way to diagnose peptic ulcer is

A. Determination of gastric acid
B. Serum anti-mIP antibody
C. Determination of serum gastrin
D. Gastroscopy and biopsy
E. X - ray barium meal examination

4. The most common pathogens causing acute glomerulonephritis are

A. Diphtheria
B. Streptococcus viridis
C. Staphylococcus aureus
D. Escherichia coli
E. β hemolytic streptococcus

5. Which of the following is not characteristic of atrial fibrillation

A. Irregular rhythm
B. Heart rate usually < 60 beats/min
C. Prone to systemic circulation embolism
D. The intensity of the first heart sound varies
E. The pulse is short

6. A 40-year-old female was admitted with purpura of the skin. Laboratory tests:
platelets 60x109/L, poor clot contraction. Its thrombocytopenia was not related to any
of the following
A. Drugs such as benzene and its derivatives, thiazides, androgens, etc
B. Viral infections such as rubella, cytomegalovirus infection, etc
C. Ionizing radiation, such as radiation exposure
D. Autoimmune diseases such as SLE, etc
E. Massive bleeding, such as menorrhagia, hemorrhoid bleeding, etc

7. The main differences between type 1 and Type 2 diabetes are

A. Age of onset
B. Severty of illness
C. Weight
D. Family history of diabetes
E. Insulin dependence and ketosis

8. The most common systemic symptoms of tuberculous peritonitis are

A. Fever and night sweats
B. Emaciation
C. Puffy and pale
D. Glossitis, stomatitis
E. Vitamin A deficiency

9. A 25-year-old healthy man felt chest tightness after lifting heavy weights. He
immediately came to the hospital for chest X-ray examination and found that his lung
was compressed by 50%. The first treatment should be
A. Thoracoscopy for treatment
B. Don't pump air and let it absorb
C. Closed drainage and exhaust should be extubated 12 hours after lung recovery
D. Artificial pneumothorax chamber pressure measurement, exhaust
E. Thoracotomy in thoracic surgery

10. The patient, male, 36 years old, felt dizziness, upper abdominal discomfort, nausea,
vomiting, sweating and tears about hours after lunch due to eating too much
spinach. Acute organophosphorus pesticide poisoning was suspected. Which of the
following laboratory tests can make a quick diagnosis
A. Determination of urinary organophosphorus pesticides
B. Determination of lactate dehydrogenase in serum
C. Determination of cholinesterase activity in whole blood
D. Determination of liver and kidney function
E. Determination of organophosphorus pesticides in vomit

11.52 years old male, hospitalized for 14 days due to acute myocardial infarction, had
no risk factors for coronary heart disease before myocardial infarction. In order to
prevent recurrence of myocardial infarction, which of the following examinations
should be performed is the most appropriate
A. Echocardiography
B. radionuclide test
C. 24-hour dynamic electrocardiogram
D. coronary angiography
E. Cardiac function
12. In the treatment of ventricular fibrillation, which of the following measures is most
effective
A. Artificial respiration
B. Electric shock
C. Heart pressure
D. Intracardiac epinephrine injection
E. Intravenous lidocaine injection

13. Female, 48 years old, has had hepatitis B for 10 years and cirrhosis has been
diagnosed for 2 years. Patients often have bleeding gums, nose bleeding. Most of
bleeding.The main reason is that
A. Vitamin K deficiency
B. Capillary brittleness increased
C. Liver detoxification function and toxic reaction
D. Platelet dysfunction
E. Coagulation factor synthesis disorder

14.The most basic treatment for diabetes is

A. Dietary therapy
B. Sulfonylureas
C. Biguidine hypoglycemic drugs
D. α -glycosidase inhibitors
E. Insulin

15. The main treatment for acute glomerulonephritis is

A. Low protein diet
B. Rest and symptomatic treatment
C. Oral cyclophosphatil
D. Oral prednisone
E. Dialysis

16. The main cause of cirrhosis in China is

A. alcohol poisoning
B. toxic hepatitis
C. viral hepatitis
D. Malnutrition
E. Chronic intestinal infections

17. The diagnostic criteria for chronic bronchitis are cough, expectoration and recurrent
time
A. Attacks for at least 3 months each year and last for 5 years or more
B. It occurs for at least 1 month each year and lasts for 2 years or more
C. Attacks for at least 3 months each year and last for 2 years or more
D. Attacks for at least 2 months each year and last for 3 years or more
E. Attacks occur for at least 1 month each year and last for 3 years or more

18. The characteristic manifestations of diabetic ketoacidosis are

A. Coma
B. Dry skin and mucous membrane
C. Smell of rotten apple on breath
D. Carbon dioxide binding reduces
E. thirst

19. The first symptom of myocardial infarction pain

A. Pain
B. Nausea
C. Palpitation
D. Shock
E. Fever

20. Changes in ST-T segment during myocardial infarction

A. Raise up
B. Up down
C. The hook shaped
D. Temporarily elevated
E. None of the above

21. Splenomegaly is the main cause of cirrhosis

A. Increased hepatic venous pressure
B. Portal hypertension
C. Increased pressure in the hepatic artery
D. Obstruction of splenic blood return due to compression of ascites
E. Irritation of toxic products

22. In the treatment of peptic ulcer, which of the following drugs is the most effective
for inhibiting gastric acid and pepsin secretion
A. Proton pump inhibitor
B. H2 receptor antagonist
C. M choline receptor blocker
D. Gastrin receptor antagonist
E. Gastric acid neutralizer

23. Treatment of chronic respiratory failure is not included

A. Oxygen cure
B. Anti-infection
C. Diuretic
D. Correcting acid-base imbalance
E. Respiratory stimulants
24. The most common and specific method for diagnosing cancerous pleural effusion
is
A. Pleural biopsy
B. Thoracoscopy
C. The pathological cells were obtained from the exudate centrifugal precipitated
smear
D. The level of CEA in pleural effusion
E. The discovery of primary tumor focus

25. Male, 56 years old, cirrhotic ascites, 24 hours urinary sodium 11mmol normal 130-
261mmol, 24 hours urinary potassium 117mmol normal 51-102mmol. Choose what
kind of diuretic is better
A. Dihydrochlorothiazide
B. Sodium risurate
C. Spironolactone
D. Chlorothalidone
E. Furosemide

26. Which of the following is not a common cause of essential hypertension

A. Diet
B. Mental stress
C. Birth control pills
D. Weight
E. Autoimmune

27. The main basis for the diagnosis of aml is

A. Pancytopenia
B. Abnormal increase in white blood cell count
C. Immature cells can be seen on the peripheral blood smear
D. Hyperactive myelodysplasia
E. Marrow smear primordial granulocytes > 30%

28. The most effective treatment for uremia hyperpotassium is

A. Intravenous calcium gluconate
B. Intravenous sodium bicarbonate
C. Hypertonic sugar plus insulin
D. Do hemodialysis
E. Chinese medicine rhubarb enema catharsis

29. Which of the following is small cell hypochromic anemia

A. Megaloblastic anemia
B. Aplastic anemia
C. Hemolytic anemia
D. Iron deficiency anemia
E. Acute hemorrhagic anemia

30. The sinus heart rate range is usually

A. 60 ~ 80 times/min
B. 80 ~ 100 times/min
C. 60 ~ 100 times/min
D. 180 ~ 200 times/min
E. 200 ~ 220 times/min

31. The main features of chronic obstructive pulmonary disease are

A. Airway obstruction
B. Small airway obstruction
C. There was a wheezing in both lungs
D. Barrel chest
E. Chest radiograph showing thickening of lung texture

32. Atrial fibrillation can occur

A. Paradoxical pulse
B. Dicrotic pulse
C. Alternating pulses
D. Corrigan's pulse
E. Pulse deficit

33. A 28-year-old male presented with high fever and chills on the night after exposure
to rain, complaining of muscle soreness and right chest pain radiating to the right
shoulder, aggravated by respiration. Physical examination: Body temperature was
39℃, BPL20/80mmHg, pulse rate was 85 beats/min, right lower lung fibrillation was
enhanced, breathing sounds were thickened, and wet rale could be heard. Laboratory
examination of WBCL was 5×109 / L, and neutrophil 0.8, so it should be considered
as
A. Acute bronchitis
B. Lung cancer
C. Lung abscess
D. Lobar pneumonia
E. Tuberculosis

34. How many grade of cardiac function are classified according to the patient's ability
to consciously move
A. Grade III
B. Grade IV
C. Grade V
D. Grade VI
E. Grade VII
35. The blood gas diagnostic criteria for type I respiratory failure should be
A. Arterial blood oxygen content was lower than 20mL %
B. Arterial blood oxygen partial pressure was lower than 60mmHg
C. Ph < 7.35
D. Arterial oxygen saturation is below 90%
E. Arterial partial pressure of carbon dioxide was higher than 50mmHg

36. The physiological functions of the kidney include

A. Discharge of metabolites
B. Regulate acid-base balance of water and electrolyte
C. Can produce endocrine hormones
D. Biodegradable endocrine hormone
E. All of above

37. The current diagnostic criteria for adult hypertension in China are more than
A. 160/95 mmHg
B. 150/100 mmHg
C. 120/80 mmHg
D. 140/90 mmHg
E. 130/90 mmHg

38. In patients with cirrhotic ascites, which of the following treatments is incorrect
A. Ascites concentration and return
B. Oral mannitol
C. Albumin infusion
D. Use spironolactone
E. Limit sodium and water intake

39. Male, 55 years old, with a history of hypertension for 10 years, was diagnosed with
type 2 diabetes 2 years ago. Physical examination: blood pressure 150/95mmHg,
hyperactivity of the second heart sound of the aortic valve by heart auscutation
A. Low risk
B. Medium risk
C. High risk
D. Very high-risk
E. None of the above

40. Chronic gastritis is mainly caused by which of the following factors

A. Intemperance
B. Non - steroidal anti-inflammatory drugs
C. Bile reflux
D. Helicobacter pylori infection
E. Smoking
41. Female, 20 years old, has been suffering from recurrent chest tightness and asthma
since childhood, which occurs when she smells peculiar smell or encounters dust. The
main causes of this patient's onset are
A. Airway nonspecific inflammation
B. α -receptor hyperfunction
C. β -receptor hypofunction
D. M- cholinergic receptor excitation
E. Vagus hyperfunction

42. Which of the following is not a muscarinic manifestation of organophosphorus

poisoning
A. Nausea, vomiting and abdominal pain, diarrhea
B. Sweating
C. Muscle tremor
D. Corestenoma
E. Heart rate reduction

43. A 32-year-old female who had been suffering from hyperthyroidism for 5 years and
had relapsed twice on medical antithyroid medication was to be treated with 131 iodine.
The most common complications were
A. Thyroid cancer
B. Leukemia
C. Thrombocytopenia
D. Induced hyperthyroidism crisis
E. Hypothyroidism

44. Which of the following signs should not appear during a medical examination of a
patient with aplastic anemia
A. Pale
B. Bleeding gums
C. Epistaxis
D. Hepatosplenomegaly
E. Rales in lungs

45. Which of the following is not a clinical manifestation of hyperthyroidism

A. Indifferent
B. Myxedema of the lower extremities
C. Low thermal
D. Arrhythmia
E. Menorrhagia

46.The typical clinical manifestations of the prodromal phase of hepatic

encephalopathy are
A. Can have flapping wing like tremor
B. Can be lethargic but can be awakened
C. Loss of orientation
D. Abnormal electroencephalogram
E. Inability to recognize the shape and function of objects

47. Rheumatic mitral stenosis first causes

A. Left ventricular enlargement
B. Right ventricular enlargement
C. Left atrial enlargement
D. Eenlargement of right atrium
E. Pulmonary artery

48. A 25-year-old man was taken to the emergency room in a coma due to poor
ventilation in his dorm room heated by a gas stove. He was diagnosed with carbon
monoxide poisoning
A. Lung
B. Liver
C. Kidney
D. Brain
E. Pancreas

49. The most common complication of peptic ulcer is

A. Pyloric obstruction
B. Acute perforation
C. Canceration
D. Bleeding
E. Peritonitis

50. Which of the following is incorrect regarding the etiology and pathogenesis of
chronic renal insufficiency
A. Various chronic kidney diseases can lead to renal insufficiency
B. Retention of protein metabolites in the body is the main cause of uremia
C. Progression from renal insufficiency to uremia is usually explained by "surviving"
nephrons
D. The theory of correctional imbalance supplements the pathogenesis of uremia
E. The state of hyperperfusion and hyperfiltration of glomerular capillaries caused by
the reduction of viable nephron can accelerate glomerulosclerosis

51. Pale skin and mucous membranes are the most reliable sites for anaemia
A. Cheek and palatal mucosa
B. Back of hand and oral mucosa
C. Auricle skin
D. Neck skin and tongue
E. Palpebrae conjunctiva, nails and lips
52. The position to be taken in case of tuberculosis with massive hemoptysis is
A. Lateral decubitus towards the undiseased side
B. Lateral decubitus facing the diseased side
C. Horizontal position
D. Prone position
E. Sitting position

53. The most common sites of intestinal tuberculosis are

A. Duodenum
B. Jejunum
C. Ileum
D. Ascending colon
E. Ileocecum of the colon

54. Which of the following drugs is the preferred treatment for hypertensive crises
A. Betaloc
B. Captopril
C. Sodium nitroprusside
D. Hydrochlorothiazide
E. Prazosin

55. The preferred drug for the treatment of mild and medium-sized ulcerative colitis
is
A. Glucocorticoid
B. Aminosalicylic acid
C. Immunosuppressant
D. Antibiotics
E. Lactobacillus

56. The main basis for diagnosing bronchial asthma is

A. Recurrent dyspnea with wheezing
B. Elevated blood eosinophils
C. Respiratory function test
D. Respiratory function test airway stimulation test was positive
E. Positive skin sensitivity test

57. The main cause of anaemia in uremia patients is

A. Toxicity inhibits hematopoiesis in bone marrow
B. Shortenlife of red blood cells
C. Low nutrition low in iron and protein
D. Decreased erythropoietin
E. Loss of blood due to bleeding from intestinal ulcers

58. Which of the following drugs has no therapeutic effect on Hp

A. Esomeprazole
B. Tinidazole
C. Ampicillin
D. Domperidone
E. Colloidal Bismuth Pectin Capsules

59. Male, 60 years old, with recurrent cough and sputum for more than 20 years,
shortness of breath after activity for more than 10 years, smoking for 30 years, 20
cigarettes a day, the most valuable test to consider for a diagnosis of COPD is
A. Chest X-ray
B. Chest CT
C. Lung function
D. Blood gas analysis
E. Lung radionuclide scan

60. A 30-year-old female is bedridden with sudden lumbago. Urine routine

examination: protein negative, erythrocyte 0~5/HP, white blood cell +++, which of the
following does not conform to the clinical manifestations of acute pyelonephritis
A. Fever
B. Bladder irritation
C. Hypertension
D. Percussion tenderness over kidney region
E. White blood cell tubular type in urine test

61. Hepatic encephalopathy is mainly induced by the following substances

A. Glutamine (Gln)
B. NH3
C. NH4+
D. Carbamide
E. NH2

62. The body contains the most iron in the body

A. Myoglobin
B. Hemosiderin
C. Hemoglobin
D. Transfer of medium iron
E. Ferritin

63. The first symptom of most patients with primary liver cancer is
A. Pain in liver region
B. Fever
C. Thin
D. Jaundice
E. Anemia
64. A 35-year-old woman with an acute attack of asthma whose physical examination
revealed signs of hyperaeration that are very similar to COPD is best identified
A. Take A chest X-ray
B. Determine RV and TLC, and calculate RV/TLC%
C. Airway relaxation drugs were given, and chest radiographs were taken to measure
RV and TLC after dyspnea was relieved
D. High resolution CT
E. Percutaneous lung biopsy

65. Nephrotic syndrome often has thrombotic and embolic complications, most of
which are
A. Renal venous thrombosis
B. Lower limb venous thrombosis
C. Coronary embolism
D. Pulmonary embolism
E. Cerebral embolism

66. Pancytopenia is the most common cause of cirrhosis

A. Upper gastrointestinal bleeding
B. Hepatorenal syndrome
C. Hypersplenism
D. Lower GI bleeding
E. None of the above

67. The most reliable sign for diagnosis of right heart failure is
A. Difficulty in breathing
B. Edema
C. The liver enlargement
D. Positive jugular reflux sign
E. Chest and ascites

68. Bronchiectasis is the most significant sign

A. Anemia countenance
B. Clubbing
C. Limited wheezing
D. Localized rales
E. Emaciation

69. Uremia patients may have metabolic abnormalities which of the following is
incorrect
A. Hyperuricemia
B. Impaired glucose tolerance
C. Hyperlipidemia
D. Decrease in body temperature and basal metabolic rate
E. Decrease in insulin release causing mild increase in blood glucose

70. The most common cause of acute pancreatitis in China

A. Heavy drinking and binge eating
B. Surgical trauma
C. Hypercalcemia
D. Complicated with mumps
E. Biliary tract disease

71. In addition to antibiotics, another key measure in the treatment of lung abscesses
A. Blood transfusion
B. Bed rest
C. Drainage of pus
D. Surgical treatment
E. Supplementary nutrition

72. A 38-year-old female with low-grade fever and abdominal distension for 5
months. The nutritional status was slightly poor, the abdomen had a slight protuberance,
positive dullness and PPD. Tuberculous peritonitis was suspected. Which of the
following tests has the lowest positive rate
A. Determination of adenosine deaminase in ascites
B. Ascites smear for tuberculous bacilli
C. Ascites concentration for mycobacterium tuberculosis
D. Culture of tuberculous bacillus ascites
E. Vaccination of ascites

73. Male, 35 years old, lower extremity edema for 4 months, blood pressure
150/90mmHg. Urine routine examination: protein 3.1g/L, erythrocyte 6-10 /Hp,
normal renal function, chronic glomerulonephritis was considered, and the most
reliable diagnostic method was
A. Ultrasound
B. Intravenous pyelography
C. Renal biopsy puncture
D. Nephrogram
E. Renal CT

74. The preferred treatment for idiopathic thrombocytopenic purpura is

A. Splenectomy
B. Platelet transfusion
C. Immunosuppressant
D. Glucocorticoid
E. High dose immunoglobulin
75. The most important risk factor for lung cancer is
A. Long-term heavy smoking
B. Occupational carcinogens
C. The air pollution
D. Ionizing radiation
E. Diet and nutrition

76. Compound ulcer refers to

A. Ulcer of the fundus and lesser curvature of the stomach
B. Ulcer of the body and antrum of the stomach
C. Ulcers in the greater and lesser curvature of the stomach
D. Gastric and duodenal ulcers
E. Lesser curvature of the stomach and pyloric duct ulcers

77. The main pathological changes of RA were as follows

A. Chronic inflammation of synovium
B. Inflammatory cell infiltration
C. Synovitis is formed
D. Erosion of cartilage and bone tissue
E. Failure of joint structure

78. Female, 56 years old. Chronic cough and expectoration for more than 20 years,
shortness of breath after activity for 5 years, diagnosed as COPD. Hypertension has
been well controlled by medication for more than 10 years. This morning, after a
violent cough, I felt sudden chest pain on the right side, dyspnea was aggravated, and
the auscultation of breath sounds in the right lung was obviously weakened. The most
likely reason is that
A. Respiratory failure
B. Spontaneous pneumothorax
C. Acute myocardial infarction ami
D. Acute left heart failure
E. Pulmonary embolism

79. Diseases that do not cause hyperlipidemia are

A. Graves disease
B. Diabetes
C. Nephrotic syndrome
D. Cushing syndrome
E. Hypertension

80. The main reasons for the higher prevalence of urinary tract infections in women
than in men are
A. Low female resistance
B. Anatomical differences in urethra
C. Differences in living habits
D. Differences in health habits
E. Strong female susceptibility

答案
1 2 3 4 5 6 7 8 9 10
1 B C D E B E E A D C
10 D B E A B C C C A C
20 B A C C C E E D D C
30 B E D B B E D B D D
40 A C E E E A C D D B
50 E B E C B A D D C C
60 B C A C A C D D E A
70 C B C D A D C B A B