21临床表现为突发性中上腹绞痛,有钻顶感,而忽又可缓解平稳,且伴恶心、呕吐。这是哪种疾病的特征表现( )
A.消化道穿孔
B.急性胰腺炎
C.胆道蛔虫症
D.急性胆囊炎
E.肠虫症
开始考试练习点击查看答案22某病人突感右下腹疼痛,伴恶心。近半年来常有右下腹疼痛史。体格检查:腹软,右下腹有深压痛,内细胞数8.2×109L,中性粒细胞72%,尿常规白细胞4〜6个,红细胞12〜14个。拟诊为( )
A.不完全性肠梗阻
B.慢性阑尾炎急性发作
C.尿路感染
D.右卵巢囊肿扭转
E.右输尿管结石
开始考试练习点击查看答案23慢性阑尾炎急性发作伴穿孔行急诊手术治疗,术中发现腹内有500ml左右脓性混浊液体。此时手术方案应为( )
A.吸尽腹腔内脓液后,再反复冲洗,切除阑尾后关腹
B.吸尽腹腔内脓液后,冉反复冲洗,切除阑尾后,腹内放置烟卷引流,关腹
C.吸尽腹腔内脓液,切除阑尾后关腹
D.吸尽腹腔内脓液,再反复冲洗后再关腹
E.上述方案均可以
开始考试练习点击查看答案24下列情况禁用诊断性腹腔穿刺术的是( )
A.小儿及老人
B.精神状态不正常者
C.严重腹胀者
D.昏迷者
E.病史不清者
开始考试练习点击查看答案25A previously healthy 15-year-old boy is brought to the emergency room with complaints of about 12h of progressive anorexia, nausea and pain of the right lower quadrant.On physical examination,he is found to have a rectal temperature of 38.18℃(100.58℉) and has direct and rebound abdominal tenderness localizing to McBurneys point as well as involuntary guarding in the right lower quadrant. At operation through a McBurney-type incision,the appendix and cecum are found to be normal,but the surgeon(
A.Perform a standard appendectomy
B.Close the abdomen after culturing the exudates
C.Resect the involved terminal ileum
D.Perform the ileocolic resection
E.Perform an ileocolostomy to bypass the involved terminal ileum
开始考试练习点击查看答案26男性,45岁,突发剑突下上腹部持续性刀割样剧烈疼痛,伴恶心、呕吐。体格检查皮肤巩膜无黄染,痛苦面容,腹平,全腹压痛,伴腹肌强直,明显反跳痛,压痛以上腹部最为明显。血压11/8kPa,脉搏124次/分。拟诊为( )
A.胆总管结石嵌顿
B.消化性溃疡穿孔
C.胆道蛔虫病
D.急性出血性胰腺炎
E.泌尿系结石
开始考试练习点击查看答案27男性,12岁,突发剑突下中上腹阵发性钻顶样剧烈疼痛,伴恶心、呕吐,疼痛间隙期缓解。体格检查巩膜皮肤无黄染。腹平、软,全腹仅有剑突下深压痛,余无阳性体征。拟诊为( )
A.胆总管结石嵌顿
B.消化性溃疡穿孔
C.胆道蛔虫病
D.急性出血性胰腺炎
E.泌尿系结石
开始考试练习点击查看答案28男性,58岁,突发上腹部绞痛,呈持续性,阵发性加重,伴有向右肩背部放射性疼痛,恶心、呕吐。体格检查腹平,右侧腹部均有压痛,以右上腹为著,剑突下有轻压痛,右上腹伴有轻度肌紧张,但无反跳痛,肝区叩痛呈阳性。拟诊为( )
A.胆总管结石嵌顿
B.消化性溃疡穿孔
C.胆道蛔虫病
D.急性出血性胰腺炎
E.泌尿系结石
开始考试练习点击查看答案29女性,47岁,突发上腹部持续性剧烈疼痛,放射至左腰背部,伴恶心、呕吐。4小时前曾吃过一碗排骨面。体格检查血压11/8kPa,脉搏116次/分,巩膜轻度黄染,腹平,全腹均有压痛,伴肌紧张与反跳痛,以左上腹为甚。拟诊为( )
A.胆总管结石嵌顿
B.消化性溃疡穿孔
C.胆道蛔虫病
D.急性出血性胰腺炎
E.泌尿系结石
开始考试练习点击查看答案30女性,32岁,突发右侧腹阵发性绞痛,疼痛加重时似欲解小便,伴明显的恶心与呕吐。体格检查腹平、软,右下腹麦氏点偏内侧部位有深压痛,无肌紧张与反跳痛,肠鸣音活跃。拟诊为( )
A.胆总管结石嵌顿
B.消化性溃疡穿孔
C.胆道蛔虫病
D.急性出血性胰腺炎
E.泌尿系结石
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