1.

A 45-year-old male was admitted because of dull right abdominal pain for 1 month,
which was accompanied with anorexia and nausea. P.E on admission showed that
T36.5℃, P 78/min. He has deep tenderness in right upper quadrant, without rebound
tenderness or muscle rigidity. Bowel sounds normal. Laboratory findings: WBC
7.6×109/L, N 0.73; HBsAg (+), AFP: 8700ng/L, BUS: 3cm mass in the right lobe of
liver.
a) Please discuss the impressive diagnosis and the diagnostic criteria? (5 分)
b) What is the possible treatment for the patient? (5 分)

2. Please list the Symptoms and Signs of Perforated Peptic Ulcer

3. The most common early symptom of lung cancer is

A. chest pain  
B. bloody sputum  
C. cough  
D. low fever

4. Meningioma occurred commonly in

A. Male
B. Children
C. Male more than female
D. Women slightly more than men
E. Men and women are equal

5. Which type of shock is a burn patient prone to?

A. Anaphylactic
B. Hypovolemic
C. Cardiogenic
D. Septic
E. Traumatic

6. Clinical diagnosis on intracranial hypertension mainly depends on

A The lumbar puncture, cerebrospinal fluid pressure
B  CT, MRI
C  EEG examination
D  Cerebral blood flow examination
E  Clinical symptoms and physical examination

7. Hematuria is the symptom of the injury of:

A.liver
B.gallbladder
C.spleen
D.kidneys

8. … is the most common rejection that impact the graft long-term survival
A. Hyperacute rejection
B. Accelerated rejection
C. Acute rejection
D. Chronic rejection
E. Host versus graft reaction
9. 24 years old female, she have been right lower quadrant abdominal pain repeatedly for 2
years, no fever、diarrhea、 constipation and discomfort. Six months ago she had been
attack by acute appendicitis, and then she accept devia the improved after conservative
therapy. Physical examination: she has direct tenderness localizing to McBurney’s point
in the right lower quadrant.no rebound tenderness and muscle tension. X-ray barium meal
enema shows the appendix filling defect. Diagnosis of
A ileocecus tuberculosis
B Appendiceal Cancer
C Crohn’s disease
D chronic appendicitis
E Chronic appendagitis

10. Of the following conditions, which is not considered a urological emergency?

A. Paraphiomosis
B. Priapism
C. Orchitis
D. Testicular torsion
E. Vesical rupture

11. The incidence of breast cancer

a. Increases with increasing age
b. Has declined since the 1940s
c. Is related to dietary fat intake
d. Is related to coffee intake
e. Is related to vitamin C intake

12. A 55-year-old woman suffered from spinal tuberculosis for 1 year. Which clinical feature
you will find in her present illness history?  
A. She had high-grade fever (>39℃) and chill for 3 months
B. She sweated a lot when she fell sleep
C. She found a painful mass with its skin becoming red and hot on her back 6 months ago
D. Her body weight increased 20kg in the last 6 months

13. A 24-year-old woman was transferred from local hospital because of pelvic fracture. On
physical examination, you found ecchymosis on perineal region. What is our first
impression of this patient?
A.Sacral fracture
B.Iliac facture
C.Pubic Fracture
D.Femoral neck fracture

14. The largest value and commonly examination used in diagnostic of cerebral gliomas is
A  Skull X-ray examination
B  Cerebral angiography
C  Ventriculography
D  Radioisotope scanning
E  CT or MRI with enhanced scan

15. In which kind of situation of the following options the fracture heals fastest?
A. Fracture of tibia shaft
B. Fractures in children
 C. Soft tissue inserts into the fracture site
D. Repeated manipulative reduction

16. Mike was diagnosed as Lumbar Disk Herniation in outpatient clinic. Which of the
following signs indicates his diagnosis?
A. Straight leg rising test (+)
B. Hoffman’s Sign (+)
C. Babinski’s Sign (+)
D. Chadock’s Sign (+)

17. Which scan of the appendix should usually be the first test for acute appendicitis
A. CT scan ultrasound scan
B. MRI
C. ultrasound scan
D. abdominal X-Ray
E.  all of the above

18. Which of following ways was forbidden in preservation of amputated finger?

A. keep it dry and refrigerated;
B. pack it with sterile dressings;
C. immerse it into NS or 75% alcohol;
D. put it into 4° refrigerator packed with clean towel;

19. Mc. Murray’s sign is seen in injury to

(a) Medial meniscus
(b) Medial collateral ligament
(c) Anterior cruciate ligament
(d) Posterior cruciate ligament

20. 14 years old girl presents with a swollen lesion in upper tibia, X-ray shows radiolucent
area with codman’s triangle and sunray appearance. Diagnosis is                                        

   A. Ewing’s sarcoma               B. Osteosarcoma

   C. Osteoid osteoma                D. Chondrosarcoma

21. what is the chief clinical presentation of acute pyelonephritis

A. interruption of urinary stream
B. painless hematuria
C.fever, lumbar pain, Bladder irritation
D. Intermittent gross hematuria
E.hypertention, polydipsia, polyuria, amyasthenia

22. Which of the following is NOT specific infection?          【       】

A. Tuberculosis       B. Gas gangrene     C. Tetanus      
D. Lymphadenitis       E. All the above

23. Mr. Wang fell down from a 3-meter-high tree; with his head hit the ground first. He felt
pain on his neck, and could not move his extremities. How to transfer him to the
ambulance?
A. One guy holds his arm, another guy holds his leg
B. One guy holds his arm, let the leg on the ground
 C. One guy holds his head, another two guys hold his body, making sure that his neck
does not rotate or flex
D. One guy holds his head , another guy holds his leg, making sure that his trunk does not
rotate or flex

24. Which one is not the character of anaphylactic Shock?

A. Results from severe allergic reaction
B. Body responds to allergen by releasing histamine
C. Histamine causes vessels to dilate
D. Histamine causes vessels to become “leaky”
E. Fever

25. Which one is the symptom most frequently seen?

A、colicky pain of right upper abdomen
B、nausea and vomiting
C、shivering and fever
D、dull pain of right upper abdomen
E、abdominal distension

26. Temporal uncinate herniation of early clinical manifestation is

A  Loss of consciousness, slower breathing
B  Bilateral mydriasis
C  One side of the pupil to expand, the contralateral limb paralysis
D  Bilateral mydriasis, loss of consciousness
E  Loss of consciousness, side mydriasis, contralateral limb paralysis

27. Intrinsic factor is generated by which cell of gastric mucosa?

A. D cell
B. Mucous cell
C. Chief cell
D. Parietal cell
E. G cell

28. Which is the common typical clinical manifestations of acute appendicitis?

A. Paroxysmal right lower abdominal pain
B. Psoas sign
C. Fever
D. Periumbilical or epigastric pain that migrates to the right lower quadrant of abdomen
E. nausea and vomiting

29. The peculiarity of flail chest is

A. extreme stress
B. multiple adjacent ribs are broken in multiple places
C. a part of the chest wall moves independently
D. the flail segment moves in the opposite direction as the rest of the chest wall
E. All above

30. The most common ligament injured around ankle joint is

A. Anterior talofibular ligament
B. Deltoid ligament
C. Posterior talofibular ligament
 D. Spring ligament

31. Which of the following options is the most common dislocation of elbow joint?
A. Anterior
B. Superior
C. Posterior
D. Lateral

32. A patient is suffering from myocardial infarction prone to?

A. Anaphylactic shock
B. Hypovolemic shock
C. Cardiogenic shock
D. Septic shock
E. Traumatic shock

33. Which is true about T3 stage for rectal cancer?

A. invades submucosa
B. invades subserosa
C. invades muscularis
D. invades organs outside
E. Above all

34. A 40-year-old woman comes to the emergency department because she has pain in the
right arm two hours after she fell in her home. Physical examination shows swelling and
deformity of the right arm. The patient is unable to dorsiflex the wrist. X-ray studies show
a spiral midshaft fracture of the humerus. Which of the following nerves is most likely
affected by this fracture?
(A) Axillary
(B) Median
(C) Musculocutaneous
(D) Radial
(E) Ulnar

35. A 32-year-old female has the complain of fever, backache, urgency and frequency for
nearly 1 month. In recent 3 days, her lower urinary tract symptoms become more serious
with temperature 39.5℃, blood routine WBC 13x109/L, NEG 86%, urine culture
diagnosed Bacillus coli. What kind of drug will you choose for her?    
a) penicillin
b) Erythromycin
c) Griseofulvin
d) Ceftriaxone
e) Lincomycin

36. which of the following is not the macroscopic type of mid-late stage esophageal cancer？
A medullary type B sclerotic type C ulcer type D mushroom type E fungating type

37. Which of the following would most likely be a contributing factor to the development of
regurgitation of the tricuspid valve.
A Drinking alcohol
B Injecting heroin
 C Snorting cocaine
D Smoking marijuana

38. Pathological fractures can occur in all except.

A. Metabolic bone diseases B. Osteosarcoma
C. Bone cyst D. Osteochondroma

39. The substrate depleted earliest in the postoperative period is

A) Branched-chain amino acids
B) Non-branched-chain amino acids
C) Ketone
D) Glycogen
E) Glucose

40. Which one is the most common affected organ systems in MODS?
A.respiratory      B.cardiovascular     C.renal       D.hepatic    E.gastrointestinal

41. In which kind of situation of the following options the fracture heals fastest?
A. fracture of tibia shaft
B. fractures in children
C. soft tissue insert into the fracture site
D. repeated manipulative reduction

42. A sports person sustained an injury to the knee joint suspecting cartilage damage, which
of the following is the investigation of choice?
A. Plain X-ray B. Ultrasonography
C. Arthroscopy D. Arthrography

43. The way of postoperative analgesia includes:

A. Intraspinal analgesia
B. Caudal block
C. Peripheral nerve block
D. Intra-articular analgesia
E. All of above

44. Which is correct about the thyroid nodule?

A. Malignancy is common
B. It is very good prognosis for thyroid carcinoma
C. FNAC (Fine needle aspiration cytology) can be used for diagnosis
D. Total thyroidectomy is the first choice for thyroid adenoma
E. All above four are correct

45. The most common organ of hematogenous metastasis for colon cancer is
A. Lung
B. Bone
C. Liver
D. Brain
E. Above all

46. The normal diameter of lumen of the ureter:

A. 1 mm
 B. 2 mm
C. 3 mm
D. 5 mm

47. What is the most common serious complication of an end colostomy?

a. Bleeding
b. Skin breakdown
c. Parastomal hernia
d. Colonic perforation during irrigation
e. Stomal prolapse

48. The open pneumothorax patient should be managed immediately by

A.  hemostasis
B.  surgery
C.  closure of the defect
D.  chest rube
E.  anti-shock

49. Which of the following tissues was compressed in carpel tunnel of carpel tunnel
syndrome (CTS)?
A. Ulner nerve
B. Radius nerve
C. Radius artery
D. Median nerve

50. The most common intracranial tumor is

A. Glioma
B. Pituitary adenoma
C. Meningioma
D. Cerebral aneurysms
E. Acoustic neuroma

51. Which type of shock is a burn patient prone to?

A. Anaphylactic B. Hypovolemic C. Cardiogenic D. Septic E. Traumatic

52. The patient was admitted to the hospital as tibial plateau fracture and proximal fibula
fracture, the physical examination showed foot drop and anterior leg and dorsal foot sense
disorder, which of the following nerves was involved?
A. Tibia nerve
B. Sural nerve
C. Sciatic nerve
D. Common peroneal nerve