A 25-year-old man presents with right chest pain， tightness and dyspnea in sudden onset.Which of the following is most likely to be seen at physical examination

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• 1A 62-year-old man complains of cough and expectoration for more than 20 years and a resent dyspne

  A.Which of the following is most unlikely to be seen at physical examinationA.intercostal space bulging

  B.the gradient of the costal decreased

  C.subcutaneous crepitus

  D.barrel chest

  E.cyanosis

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• 2A 37-year-old woman complains of hectic fever， night sweat， acratia， emaciated for more than 1 year.Which of the following may be detected at physical examination

  A.flat chest

  B.barrel chest

  C.rachitic chest

  D.chest bulging in one side

  E.funnel chest

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• 3A 48-year-old woman presents with a tough， rough， unmovable and painless mass in left breast through breast self-examination. Which of the following is most unlikely to be seen

  A.local peau deorange

  B.nipple retraction

  C.bloody secretion of nipple

  D.local red swelling and pain

  E.axillary lymphadenectasis and adhesions

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• 4A 60-year-old man with a history of DM for more than 10 years presents with nausea， vomiting， diarrhea and drowsiness after ceasing hypoglycemic drug treatment by himself. Which of the following is the most likely respiratory rhythm

  A.shallow breathing

  B.sighing breathing

  C.meningitic breathing

  D.hypopnea

  E.kussmaul breathing

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• 5一小孩吃糖，突然出现惊慌，气促，抱送急诊发现患儿呼吸极度困难，出现“三凹征”。最可能诊断为

  A.小儿肺炎

  B.胸膜炎

  C.气管异物

  D.支气管哮喘发作

  E.受环境惊吓

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• 6患儿幼年曾怀疑先天性心脏病，室间隔缺损，则心脏查体时可触及的震颤是

  A.胸骨左缘第二肋间舒张期震颤

  B.胸骨右缘第二肋间收缩期震颤

  C.胸骨左缘第二肋间收缩期震颤

  D.胸骨右缘第二肋间舒张期震颤

  E.胸骨左缘第三、四肋间收缩期震颤

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• 7男性，64岁。因头晕、黑矇一年来诊。查体：心率42次/分，心律整齐，心音强弱不等，可闻及大炮音。最可能的诊断是

  A.二尖瓣狭窄

  B.三度房室传导阻滞

  C.高血压

  D.主动脉瓣狭窄

  E.频发室性期前收缩

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• 8男，5岁。于胸骨左缘2肋间闻及S2分裂，吸气相明显，呼吸消失。则最可能是

  A.S2固定分裂

  B.肺动脉高压

  C.S2生理性分裂

  D.房间隔缺损

  E.S2反常分裂

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• 9心源性水肿最可能伴随的症状是

  A.颜面水肿

  B.肝颈静脉回流征阳性

  C.肝大

  D.腹水

  E.伴胸水和肺部啰音

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• 10男性，38岁。心悸3个月。体检：胸骨左缘第3～4肋间闻及收缩期吹风样、粗糙的杂音，伴有震颤，Valsalva动作（吸气后紧闭声门，用力做呼气动作）时杂音增强。该患者最有可能的诊断是

  A.主动脉瓣狭窄

  B.主动脉瓣关闭不全

  C.二尖瓣关闭不全

  D.主动脉瓣关闭不全

  E.肥厚型梗阻性心肌病

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