【医学类职业资格】临床执业医师-11及答案解析.doc

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1、临床执业医师-11 及答案解析(总分:35.00,做题时间:90 分钟)一、第一站(总题数:2,分数:15.00)1.一、病史采集简要病史:女性,30 岁,多食、消瘦伴心悸 3 周。要求:你作为住院医师,按照标准住院病例要求,围绕以上主诉,请叙述应如何询问该患者现病史及相关的内容。(分数:7.50)_2.二、病例分析病例摘要 男性, 32 岁,间断上腹痛,返酸、烧心 8 余年,加重 2 天,呕血、黑便 6 小时。8 余年前开始无明显诱因间断上腹胀痛,返酸、烧心,餐后半小时明显;自服一些制酸胃药,可缓解。近2 天来加重,纳差,服药后无效。6 小时前突觉上腹胀,恶心、头晕,先后两次解柏油样便,共约

2、 500g,并呕吐咖啡样液 1 次,约 200ml。此后心悸、头晕、出冷汗,发病以来无发热。平素二便正常,睡眠好。既往 30 年前查体时发现肝功能异常,经保肝治疗后恢复正常,无手术、外伤和药物过敏史,无烟酒嗜好。查体:T 36.7,P 108 次/分,R 22 次/分,BP 90/70mmHg。神清,面色稍苍白,四肢湿冷,巩膜无黄染,皮肤黏膜无出血点和蜘蛛痣,全身浅表淋巴结不大,心肺无异常腹平软,未见腹壁静脉曲张,中上腹轻压痛,无肌紧张和反跳痛,全腔未触及包块,肝脾未及,移动性浊音 (-),肠鸣音 10 次/分,双下肢无水肿。化验:Hb 80g/L, WBC 5.0109/L,分类 N 65%,L 32%,M 3%,Plt 300109/L,大便隐血强阳性。(分数:7.50)_二、第二站(总题数:2,分数:20.00)3.一、眼(眼球运动、间接对光反射、直接对光反射、辐辏反射、眼球震颤检查) 。(分数:10.00 )_4.二、患者男性,60 岁,患慢性支气管炎 15 年,近日又患声带水肿。请你为患者作雾化吸入术 (在医学模拟人上操作)。(分数:10.00 )_临床执业医师-11 答案解析

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