浙江大學(xué)20_08–2009學(xué)年春夏學(xué)期《基礎(chǔ)醫(yī)學(xué)各論I》課程期末考試試卷(A卷)開(kāi)課學(xué)院：醫(yī)學(xué)院考試形式：閉卷考試時(shí)間：2009年6月30日10:30-12:30所需時(shí)間：120分鐘一、單項(xiàng)選擇題（每題1分，共50分）1.肩胛骨下角平對(duì)A.第2肋B.第3肋C.第4肋D.第5肋E.第7肋2.奇靜脈注入A.下腔靜脈B.上腔靜脈C.頭臂靜脈D.肝靜脈E.門(mén)靜脈3．下列哪一結(jié)構(gòu)不屬于三尖瓣復(fù)合體？A.纖維環(huán)B.乳頭肌C.瓣膜D.肉柱E.腱索4．下列哪一塊肌屬于大腿后群肌？A.縫匠肌B.大收肌C.股薄肌D.股二頭肌E.股四頭肌5.SuperiorthyroidarterycomesfromA.externalcarotidarteryB.internalcarotidarteryC.subclavialarteryD.maxillaryarteryE.vertebralartery6.關(guān)于乳糜池的描述，錯(cuò)誤的為A.位于第1腰椎前方B.是胸導(dǎo)管的起始部位C.由左、右腰干和腸干匯合而成D.收集身體3/4的淋巴E.向上經(jīng)胸導(dǎo)管注入左靜脈角7.Thefollowingstructuresbelongtothejointofthevertebralarches,excepttheA.supraspinalligamentsB.interspinalligamentsC.anteriorlongitudinalligamentD.ligamentaflava(yellowligaments)E.intertransverseligaments8.下列哪一塊骨不屬于腦顱骨？A.額骨B.篩骨C.顳骨D.上頜骨E.枕骨9.以下稱(chēng)為肌性動(dòng)脈的主要?jiǎng)用}為A.大動(dòng)脈B.中動(dòng)脈C.小動(dòng)脈D.微動(dòng)脈E.以上都不是10.以下稱(chēng)為彈性動(dòng)脈的是A.大動(dòng)脈B.中動(dòng)脈C.小動(dòng)脈D.微動(dòng)脈E.以上都不是11.稱(chēng)為外周阻力動(dòng)脈的是A.大動(dòng)脈B.中動(dòng)脈C.小動(dòng)脈D.微動(dòng)脈E.以上都不是12.Plateletsarederivedfrom_______inbonemarrowA.cytoplasmicfragmentsofmacrophageB.cytoplasmicfragmentsofmegakaryocyteC.cytoplasmicfragmentsoflymphoblastD.cytoplasmicfragmentsofmonoblastE.cytoplasmicfragmentsoferythroblast13.造血干細(xì)胞，最早來(lái)源于A.肝B.脾C.胎盤(pán)D.紅骨髓E.卵黃囊血島14.紅細(xì)胞的平均壽命為A.1周B.3周C.約1個(gè)月D.約120天E.半年15.壽命最長(zhǎng)的血細(xì)胞是A.紅細(xì)胞B.網(wǎng)織紅細(xì)胞C.中性粒細(xì)胞D.淋巴細(xì)胞E.單核細(xì)胞16.在最適初長(zhǎng)條件下進(jìn)行收縮，肌肉產(chǎn)生的張力最大。因?yàn)樵诖饲闆r下A.起作用的橫橋數(shù)目最多B.橫橋釋放的能量最多C.ATP酶的活性最多D.橫橋循環(huán)的速度最快E.鈣通道開(kāi)放的數(shù)目最多17.Whichcharacteristicorcomponentissharedbyskeletalmuscleandsmoothmuscle?A.ThickandthinfilamentsarrangedinsarcomeresB.TroponinC.Elevationofintracellular[Ca2+]forexcitation-contractioncouplingD.SpontaneousdepolarizationofthemembranepotentialE.Highdegreeofelectricalcouplingbetweencells18.Atthemuscleendplate,acetylcholine(ACh)causestheopeningofA.Na+channelsanddepolarizationtowardtheNa+equilibriumpotentialB.K+channelsanddepolarizationtowardtheK+equilibriumpotentialC.Ca2+channelsanddepolarizationtowardtheCa2+equilibriumpotentialD.Na+andK+channelsanddepolarizationtoavaluehalfwaybetweentheNa+andK+equilibriumpotentialsE.Na+andK+channelsandhyperpolarizationtoavaluehalfwaybetweentheNa+andK+equilibriumpotentials19.促進(jìn)紅細(xì)胞成熟的因子是A.蛋白質(zhì)和鐵B.促紅細(xì)胞生成素C.內(nèi)因子D.維生素B12和葉酸E.雄激素20.紅細(xì)胞所需的能量主要來(lái)自于A.葡萄糖的有氧氧化B.糖原異生C.糖原分解D.糖酵解E.脂肪酸氧化21.通常所說(shuō)的血型是指A.紅細(xì)胞上受體的類(lèi)型B.紅細(xì)胞表面特異凝集素的類(lèi)型C.紅細(xì)胞表面特異凝集原的類(lèi)型D.血漿中特異凝集素的類(lèi)型E.血漿中特異凝集原的類(lèi)型22.下列關(guān)于生理止血機(jī)制的描述，錯(cuò)誤的是A.包括局部血管收縮、血小板血栓形成和血凝塊形成B.血小板與凝血塊的形成有關(guān)C.血小板與局部縮血管反應(yīng)有關(guān)D.血小板減少時(shí)出血時(shí)間延長(zhǎng)E.FⅡ缺乏時(shí)體內(nèi)生理性凝血啟動(dòng)發(fā)生障礙23.Currentscausedbyopeningofwhichofthefollowingchannelscontributetotherepolarizationphaseoftheactionpotentialofventricularmusclefibers?A.Na+channelsB.Cl-channelsC.Ca2+channelsD.K+channelsE.HCO3-channels24.Duringwhichphaseofthecardiaccycledoesthemitralvalveopen?A.AtrialsystoleB.IsovolumetricventricularcontractionC.RapidventricularejectionD.ReducedventricularejectionE.Isovolumetricventricularrelaxation25.Whichofthefollowingdoesnotoccurasbloodpassesthroughthesystemiccapillaries?A.ItshematocritincreasesB.ItshemoglobindissociationcurveshifttotheleftC.ItsproteincontentincreasesD.ItspHdecreasesE.Itsredbloodcellsincreaseinsize26.Whentheviscosityofthebloodisincreased,whichofthefollowingisincreased?A.MeanbloodpressureB.RadiusoftheresistancevesselsC.RadiusofthecapacitancevesselsD.CentralvenouspressureE.Capi1larybloodflow27.ThevelocityofbloodflowA.IshigherinthecapillariesthanthearteriolesB.IshigherintheveinsthaninthevenulesC.IshigherintheveinsthanthearteriesD.FallstozerointhedescendingaortaduringdiastoleE.Isreducedinaconstrictedareaofabloodvessel28.Whichreceptorisblockedwhenpropranololisadministeredtoreducecardiacoutput?A.a1receptorsB.b1receptorsC.b2receptorsD.MuscarinicreceptorsE.Nicotinicreceptors29.霍奇金病按預(yù)后好壞，排列順序?yàn)锳.混合細(xì)胞型→淋巴細(xì)胞消減型→結(jié)節(jié)硬化型→淋巴細(xì)胞為主型B.淋巴細(xì)胞消減型→混合細(xì)胞型→結(jié)節(jié)硬化型→淋巴細(xì)胞為主型C.淋巴細(xì)胞為主型→結(jié)節(jié)硬化型→淋巴細(xì)胞消減型→混合細(xì)胞型D.淋巴細(xì)胞為主型→結(jié)節(jié)硬化型→混合細(xì)胞型→淋巴細(xì)胞消減型E.淋巴細(xì)胞消減型→淋巴細(xì)胞為主型→結(jié)節(jié)硬化型→混合細(xì)胞型30.高血壓病腦出血的血管最常發(fā)生于A.Willi’s環(huán)B.大腦中動(dòng)脈C.大腦后動(dòng)脈D.基底動(dòng)脈E.豆紋動(dòng)脈31.引起左心室向心性心肌肥大的疾病是A.動(dòng)脈瓣關(guān)閉不全B.高血壓病C.二尖瓣狹窄D.嚴(yán)重貧血E.心肌炎32.風(fēng)濕性心內(nèi)膜炎最常累及的瓣膜是A.二尖瓣B.肺動(dòng)脈瓣C.三尖瓣D.二尖瓣和主動(dòng)脈瓣E.主動(dòng)脈瓣33.二尖瓣關(guān)閉不全與單純二尖瓣狹窄的區(qū)別是A.左心室肥大擴(kuò)張B.左心房肥大擴(kuò)張C.右心室肥大擴(kuò)張D.右心房肥大擴(kuò)張E.兩者無(wú)區(qū)別34.女性患者，37歲，風(fēng)濕性心臟病反復(fù)發(fā)作12年，近幾個(gè)月來(lái)低熱，無(wú)力，近日感左上腹部疼痛、腰痛、偏癱。體檢：皮膚及黏膜見(jiàn)點(diǎn)狀出血，聽(tīng)診發(fā)現(xiàn)心雜音性質(zhì)和強(qiáng)度改變。尿常規(guī)：RBC（++）。此患者所患主要疾病為：A.風(fēng)濕性心內(nèi)膜炎B.急性感染性心內(nèi)膜炎C.亞急性感染性心內(nèi)膜炎D.病毒性心肌炎E.心瓣膜病35.ThemostcommonandseriouscomplicationofbenignhypertensionisA.cerebralhemorrhageB.glomerulosclerosisC.chronicpulmonarycongestionD.atherosclerosisE.myocardialinfarction36.FoamycellsinatherosclerosisarederivedfromA.endothelialcellsB.lipidcellsC.smoothmusclecellsD.neutrophiliccellsE.fibroblasts37.ThemainhumoralfactorchangescausedthevasoconstrictionofmicrocirculatoryduringtheischemiahypoxiastageofshockisA.ATII↑B.Vasopressin↑C.Catecholamine↑D.MDF↑E.TXA2↑38.WhichoneisNOTthecharacteristicofearlyshockA.PaleB.ColdinskinC.QuickinpulseD.DecreaseinurineE.Coma39.TherightprincipleoffluidinfusionforshockisA.Ifbloodpressureisnormal,noneedforfluidinfusion.B.Fluidinfusionforthefluidlost.C.Fluidinfusionforthefluidthatwaslostandthedaymaylose.D.FluidinfusionasneedsE.Themorethebetter40.哪型休克易于發(fā)生DIC:A.感染性休克B.心源性休克C.過(guò)敏性休克D.失血性休克E.神經(jīng)源性休克41.引起左心室向心性心肌肥大的疾病是A.高血壓病B.動(dòng)脈瓣關(guān)閉不全C.二尖瓣狹窄D.嚴(yán)重貧血E.心肌炎42.心臟肌源性擴(kuò)張的特點(diǎn)是A.容量減小伴有收縮力增強(qiáng)B.容量加大伴有收縮力增強(qiáng)C.肌節(jié)長(zhǎng)度小于2.2μmD.肌節(jié)長(zhǎng)度正處于2.2μmE.心肌拉長(zhǎng)不伴有收縮力增強(qiáng)43.Heparin抗凝血的特點(diǎn)是A.僅用于體內(nèi)抗凝血B.僅用于體外抗凝血C.體內(nèi)外均有抗凝血作用D.抗凝血作用通過(guò)抑制抗凝血酶III的活性E.抗凝血作用通過(guò)促進(jìn)纖溶酶活性44.p-Aminomethylbenzoicacide(PAMBA)的作用機(jī)制為A.抗血小板聚集B.激活纖溶酶原C.激活凝血酶D.競(jìng)爭(zhēng)性對(duì)抗纖溶酶原激活因子E.滅活凝血酶45.擴(kuò)張血管作用較強(qiáng)的鈣拮抗藥是A.VerapamilB.DiltiazemC.SodiumnitroprussideD.NitroglycerinE.Nifedipine46.強(qiáng)心苷減慢房顫患者的心室率原因是A.縮短心房有效不應(yīng)期B.減慢房室傳導(dǎo)，增加房室結(jié)中的隱匿性傳導(dǎo)C.抑制竇房結(jié)D.降低浦肯野纖維自律性E.降低心室肌自律性47.Nitroglycerin、b受體阻斷藥和鈣拮抗劑治療心絞痛的共同作用是A.抑制心肌收縮力B.延長(zhǎng)射血時(shí)間C.減慢心率D.降低心肌耗氧量E.減少心室容積48.關(guān)于他汀類(lèi)調(diào)血脂藥物的敘述，錯(cuò)誤的是A.可以上調(diào)LDL受體B.可以減少膽固醇的合成C.可以降低血液總甘油三酯的含量D.能夠促進(jìn)膽固醇降解E.能夠減少膽汁酸重吸收49.高血壓病人合并左心室肥厚，請(qǐng)問(wèn)最好應(yīng)服用哪類(lèi)藥？A.鈣拮抗劑B.利尿藥C.神經(jīng)節(jié)阻斷藥D.中樞性降壓藥E.血管緊張素轉(zhuǎn)換酶抑制劑50.Propranolol治療高血壓的可能機(jī)制，不包括以下哪一項(xiàng)？A.阻斷心臟b1受體，減少心輸出量B.阻斷腎臟b受體，減少腎素分泌C.阻斷去甲腎上腺素能神經(jīng)突觸前b2受體，減少去甲腎上腺素釋放D.阻斷去甲腎上腺素能神經(jīng)突觸后b2受體，擴(kuò)張血管平滑肌E.阻斷中樞b受體，降低外周交感神經(jīng)活性二、名詞解釋?zhuān)款}2分，共12分）1.Sternalangle2.Reticulocyte3.Cardiacoutput4.Achoffbody5.Shock6.Angiotensinconvertingenzymeinhibitors(ACEI)三、問(wèn)答題（每題5分，共30分）1.Describelocation,tributariesanddrainageofthehepaticportalveinandanastomoseswiththesuperiorandinferiorvenacavae.2.Describethecomponentandsignificanceofplasmaosmoticpressure.3.A70-year-oldmanwasadmittedtothehospitalwithshortnessofbreath,severefatigueandweakness,abdominaldistension,andswellingofankles.Atnightherequiresfourpillowsandoftenwakesupbecauseofacuteairhunger.Hishistoryrevealedepisodesofanginapectorisandaprogressiveshortnessofbreathwithexertionforseveralyears.Onexaminationthechiefabnormalitieswereslightcyanosis(bluishcasttotheskin),distensionoftheneckveins,rapidrespirations(20/min),rales(cracklingsounds)atthelungbasesbilaterally,anenlargedheartwithslighttachycardia(110beats/min)andadiastolicgalloprhythm(soundslikegallopinghorse),enlargedliver,excessfluidintheabdomen,andedemaattheanklesandoverthelowertibias.Hisbloodpressurewas115/80mmHg.Thechestx-rayexaminationshowedanenlargedheartanddiffusedensity(indicativeoffluidinthelungs)atbothlungbases.Anelectrocardiogram(ECG)showednormalsinusrhythm,Qwaves,andleftaxisdeviation.Treatmentincludedbedrestandadministrationofdigitalisandadiuretic.(1)Wouldyouexpectcardiacoutputandstrokevolumetobenormal,high,orlow?Why?(2)Wouldacalciumchannelantagonistbeadvantageous?Why?(3)Whyistheheartenlarged?4.Pleasecomparethebasicpathologicalchangesanddiseaseoutcomesbetweenbenignandmalignanthypertension.5.Pleasedescribetheclassificationofantiarrhythmicdrugs（抗心律失常藥）andpresentonerepresentativedrugforeachclass.6.Ayoungmanisbroughttotheemergencydepartmentbyambulanceonthenextdayafteraseveretrafficaccident.Heisunconscious.Hisbloodpressureis78/48mmHg,heartrateis130beatsperminute.Thereisnoevidenceofheadtrauma.Thepupilsare2mmandreactive.Hewithdrawstopain.Cardiacexaminationrevealsnomurmurs,gallops,orrubs.Thelungsarecleartoauscultation.Theabdomenistense,withdecreasedbowelsounds.Thepatientshowscyanosis,withthreadypulses.Questions:(1)Whatarethethreegeneralstagesofshockaccordingtothedifferentchangesinmicrocirculation?Whichwaslikelyinthispatient?Why?(2)Whatpathogeneticmechanismaccountsforthispatient’sunresponsivenessandcyanosis?四、段落翻譯（中國(guó)學(xué)生只做第1、2題英譯中，每題4分，共8分；留學(xué)生只做第3題漢譯英，該題8分）1.ENDOTHELIALCELLSEndothelialcells(ECs)comprisethesinglecell-thick,continuousliningoftheentirecardiovascularsystem,collectivelycalledtheendothelium.Endothelialstructuralandfunctionalintegrityisfundamentaltothemaintenanceofvesselwallhomeostasisandnormalcirculatoryfunction.ECsuniquelycontainWeibel-Paladebodies,0.1μm-wide,3μm-longmembrane-boundstorageorganellesthatcontainvonWillebrandfactor(vWF).ECscanbeidentifiedimmunohistochemicallywithantibodiestoPECAM-1(CD31,aproteinlocalizedtointerendothelialjunctions)