中南大学医学影像学考试真题1.docx
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中南大学医学影像学考试真题1.docx
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中南大学医学影像学考试真题1
中南大学考试试卷
2006~2007学年二学期2004级五年制临床专业课程时间120分钟
姓名:
学号:
题号
一
二
三
四
合计
得分
评卷人
合分人
复查人
登分人
一.名词解释(pleaseanswerinEnglish)(20分)
1.Artificialcontrast:
2.Destructionofbone:
3.Airbronchogramsign:
4.Doublecontour:
5.Stirlinsign:
二简答题(pleaseanswerinEnglish)(20分)
1.HowtodistinuishbenignulcerfrommaliganulcerInthestomach?
2.Pleasewrittedownthedifferentiatebetweenbenignandmalignantpulmonarytumor
三阅片(48分)
1.25岁男性,高热,咳嗽,痰为铁锈色
Whatisthediagnosis?
2.男,40岁,腰痛十余年。
WhatWhatisthediagnosis?
3.男,8岁,一月前麻疹后,一直咳嗽,低烧。
体查:
颈内淋巴结肿大。
Whatisthediagnosis?
456岁男性,咳嗽,痰中带血3月.
Whatisthediagnosis?
5反复上腹部痛3月,以夜间痛明显.
Whatisthediagnosis?
6腹痛,肛门停止排气排便1天.
Whatisthediagnosis?
7右腰痛半年,加重1天.体查:
右肾区扣痛.
Whatisthediagnosis?
8右碗外伤,活动受限.
Whatisthediagnosis?
960岁男性,突发晕厥,意识障碍.
Whatisthediagnosis?
10头颅外伤半小时.
Whatisthediagnosis?
11女,47岁病史:
咳嗽、胸闷20天
.Whatisthediagnosis?
12男,81岁,高血压病史十年余,现感心悸、气促。
Whatisthediagnosis?
四.病例分析题(pleaseanswerinEnglish)(12分)
1.A76-year-oldmanpresentstotheemergencydepartmentwithsudden-onsetabdominalpainof4hoursduration.Thepainispresentintheupperabdomen,centeredintheepigastrium,anddescribedasdeepandburning.Thepatienthasamedicalhistoryofcoronaryarterydiseaseandhypertension.Healsoreportshaving"indigestion,"whichcausedpainsimilartotoday'sepisodeinhisupperabdomen.Inthepast,fooddidnotrelievethissymptom.
Onphysicalexamination,thepatientispaleandinobviousdiscomfort.Hisheartrateis122beatsperminute,andhisbloodpressureis110/65mmHg.Cardiovascularandrespiratoryfindingsareunremarkable,buthehastendernessintheepigastricregionofhisabdomen.Hisstoolisbrownandguaiacpositive.Hyperactivebowelsoundsareheardonauscultation.Laboratoryinvestigationsshowamildanemiawithhemoglobinconcentrationof127g/L(12.7g/dL)andBUNandcreatininevaluesof17.1mmol/L(48mg/dL)and106µmol/L(1.2mg/dL),respectively.
Whatisthediagnosis?
2.A29-year-old,previouslyhealthywhitefemalewasseen3timesbyherprimarycareproviderforupperrespiratorysymptoms2weeksaftercompetinginanoutdoorobstaclecoursethatinvolvedcrawlingonthedirtintheCaliforniaSanJoaquinValley.Thepatientdeniesanyrecentsickcontactsortraveloutsideofthelocalarea.Shewasgiven3separatecoursesofantibiotics,overthecourseof6-8weeks,forthediagnosisofcommunity-acquiredpneumoniawithoutimprovement.Eventually,shepresentedtotheurgentcareclinicwithworseningcough,productionofmalodoroussputum,anorexia,fevers,chills,sweats,nausea,vomiting,andmalaise.Shehaslost20lbssincetheonsetofsymptoms.
Onphysicalexamination,thepatientismildlyill-appearingwithatemperatureof102.4°F,aheartrateof106beatsperminute,arespiratoryrateof22breathsperminute,abloodpressureof118/64mmHg,andanoxygensaturationof95%onroomair.Lungauscultationrevealedcoarserhonchiintheleftupperlungfield.Herheartrateisrapid,butnomurmursareappreciated.Theremainderofherphysicalexaminationisunremarkable.
Laboratorytestsperformedinurgentcareshowedamildleukocytosisof13.4WBCcountwithotherwisenormalresults.Chestradiographshowsa4.2-cmdiametercavitarylesionwithanairfluidlevelintheleftupperlobe,alongwithmediastinallymphadenopathy(seeImages1-2).
Whatisthediagnosis?
答案
一.名词解释(20分)
1.Artificialcontrast:
Thoseorgansorspaceslackofnaturalcontrast,canberenderdetobevisiblebymeansofcontrastagentstocreateanartificialcontrast.
2.Destructionofbone:
Bonetissueeliminationcausedbysclerotinpartlysubstitutedwithpathologicorganism.Roentgenologically,itshowsosteolyticboneareasofdecreaseddensityandlossofbonestructures.
3.Airbronchogramsign:
Becausetheairinthealveoliisreplacedbyexudates,whiletheairinthebronchusisnotdisplacedandremainpatent.Thisproducescontrastbetweentheairinthebronchialtreeandthesurroundingairlessparenchyma.
4.Doublecontour:
OnPAfilm,therightborderofanenlargedleftatriummayproduceanextrashadowsuperimposedontherightcardiacborder,givingadoublecontour.
5.Stirlinsign:
Thereisalackofbariumretentioninadiseasedsegmentofileumandcaecumbutwithacolumnofbariumremainsoneithersideoftheaffectedarea.Thisphemonenonmayresultfromspasm,organicconstractureofacombinationofboth.Itissuggestiveoftuberculosisofintestine.
二简答题(20分)1.
Benigngastriculcer
Malignantgastriculcer
Location
Penetrationbeyondlumen
Intraluminalcrater
Shape
Round,sharplycircumscribedcrater
Irregularshapedulcer
Mucosal
Membrance
Mucosalfoldsradiatetocrateredge,Edematoustissuesurroundinganulcerproduceulcermoundorcollar
Amputationofmucosalfoldsnodularityofsurroundingmucosal
Gastricwall
pliable,presenceofpeistalsis
Rigidityofwall
2.
Benigntumor
Malignanttumor
Shape
Globular
Irregularity
Peplosornot
Yes
No
Margin
Sharp、smoothandglossy
Nosharp,shortandfinesentus,sublobeorhilumnotch
Neoplasmnecrosis
No
Yes,partmayformcavity
Growth
Slowly,noperipheryinfiltrating
Fast,infiltrativegrowth
ContrastCTscanning
Lightornopotentialize
Obviouslyotentialize,CTvalueaddedmorethan20HU。
三阅片(48分)
1.Rightmiddlelobelobarpneumonia
2.Tuberculosisofthe3、4lumbarveterbra
3.Primarycomplextuberculosis
4.Rightupperlobecentralcarcinoma
5.Duodenumulceration
6.Mechanicalsmall-intestineobstruction
7.Renalcalculi
8.Colles’fracture
9.Hemorrhage
10.Epidralhematomas
11.Pericardialeffusion
12.Hypertensiveheartdisease(Leftventricularenlargement)
四.病例分析题(12分)
1.Pneumoperitoneumfromduodenalulcerperforation.
2.Lungabscess
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