Blood system.docx
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Blood system.docx
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Bloodsystem
Bloodsystem
Bloodsystem-3aTheoreticalcomprehensiveexaminationpaper(A)2003-5-13--------------------------------A1problem(bestchoicequestion--affirmative.)EachofthesequestionshasA,B,C,D,andE,andtheanswerisintheformofaffirmativestatementsAnswerthequestiononlybyselectingoneofthefivecandidatesforthecorrectanswerDrawablackandboldlineinthecorrespondingletterofthecorrespondinginscription.--------------------------------Male,17yearsold,dizziness,skinpurpuramonth,nearlyaweek,headache,vomitinghospitalization,check:
thefaceispale,thewholebodyisshallowThelymphnodesareenlarged,theneckisslightlyresisted,andtheliveris1.5cmunderthelargerib,andthespleenisinthelowerribs10/L,PLT45.0x10/L,bonemarrowexamination:
hyperplasiaobviouslyactive,originalearlyyounglymphocytes(48%),Megakaryocyteandplateletrare,cerebrospinalfluidexaminationbytest(+)cells0.02x10/L,diagnosisthebiggestofallMaybeA.infectiousmononucleosisB.ViralmeningitisC.tuberculousmeningitisD.AcutelymphoblasticleukemiaE.epidemiccerebrospinalmeningitisThemanis68yearsold,mildfeverandachingbonesforthreemonths,andheisadmittedtothehospitalwithHb56g/L,ESR102mm/h,IgG30g/L,andthechestX-raytotherightThreeanteriorcostalpathologicalfracture,tobediagnosedstillneedtodowhatofthefollowingexamination?
A.serumironproteinB.AbonemarrowbiopsyC.plasmaproteinelectrophoresisD.bloodcalcium,phosphorusdeterminationSerumalkalinephosphataseWhenplasmacoagulasewassignificantlyextended,themostlikelyfactorwastheabsenceofclottingfactorsA.ⅠⅡ,ⅤⅦ,ⅧB.ⅠⅡ,ⅤⅦ,ⅨC.ⅠⅡ,ⅤⅦ,ⅩD.ⅠⅡ,ⅤⅦ,ⅪE.ⅠⅡ,ⅤⅦ,ⅫThemostcommoncauseoffeverinpatientswithacuteleukemiaisA.leukemiaitselfB.thetotalnumberofwhitebloodcellsistoohighC.abacterialinfectionD.aviralinfectionE.drugfeverPeoplewithleukemia,haveaheadacheandvomiting.Whichofthefollowingtypesofleukemiaisthemostcommon?
A.acutemyeloidleukemiaAcutemonocyteleukemiaC.acutelymphocyticleukemiaD.AcuteredleukemiaE.chronicmyeloidleukemiaacute?
ThefunctionofthrombinintheclottingprocessA.strengthenⅤ.Ⅷ,ⅩfactorandplateletfunctionB.toenhanceⅤ.Ⅷ.ⅩⅡ,factorandplateletfunctionC.enhanceV,XⅠfactorsplateletfunctionandfibrinogenformationoffibrinD.enhancedⅤ,ⅩⅡ.ⅩⅢfactor,plateletfunction.FibrinolyticenzymeactivationandfibrinmonomerformationE.activatesfibrinolysinandpromotesplateletfunctionFemale,35yearsold,repeatedlyskinpurpura,palefortwoyears,withaslightlymoremenstrualperiod10/L,theWBC:
4.0x10/L,PLT30x10/L,bonemarrow:
activehyperplasia,grain:
red=2:
1,visiblelaterInthiscase,thefirstselectionoftheprojectwastobeexaminedinordertodeterminethediagnosisofthiscaseA.TcellsubgroupexaminationB.BloodcellsareclassifiedinthebloodcellMultiplepartsofthebonemarrowpunctureD.plateletantibodytestTheInternetiscountingtheredbloodcellsThemostsignificantidentificationofchronicmyeloidleukemiaandleukaemiaresponseisA.neutrophilshavebeenreducedbytheintegrationofalkalinephosphataseThebloodisredinthesurroundingbloodC.thebloodplateletsdecreaseinthesurroundingbloodD.PHchromosomepositiveE.eosinophilsincreaseWhichofthefollowingclinicalsymptomsismostconsistentwiththediagnosisofacutemononuclearleukemia?
A.thegumswellingB.exophthalmosC.neckstiffnessD.testicularswellingE.headachesandvomitingMale,15yearsold,student,self-youngoftenminorinjurythebleedingismorethan,therightkneejointisswollen5days.CheckyourskinafteradmissionNobleeding.Bleedingtime1minute,clottingtime30minutes,thrombintimeisnormal.ClassificationofdiseasesA.vascularwalldysfunctionPlateletanomalyC.coagulantenzymeformationdisorderD.ThrombinformationdisorderE.fibroinformationdisorderMen,45,workers.Oneday10dayscough,fever,epistaxis,skinwithpetechiae,leukocyte30x10/L,20%neutralandleaves20%,platelets20x10/L,lengthenprothrombintime,fibrinogen1.5g/L,3Ptestpositive.Inadditiontoactiveanti-infectiontreatment,themaintreatmentisTheapplicationofantifibrinolyticagentB.abloodtransfusionC.loseplateletD.heparintherapyE12.Male28patients,workers,paleface,anemia,5yearsinspection:
Hb60g/L,WBC2.8x10/L,PLT25x10/L.Themeshis0.003.Myelogenoushyperplasia,wheretheplasmacellsare5percentlymphocyte50percent,Hibasophiliccellswere3percent,andthemacroswere2,andplateletswererare.Acidhemolysistest
(1).ThepatientshouldbeWhichtreatmentisbest?
A.thebloodbornB.losewholebloodC.loseplateletD.stanozololE.glucocorticoidThemostcommonandearliestsymptomsofanemiaareA.theskin,themucousmembraneispaleB.HeartpalpitationsC.fatigueandweaknessDizziness,tinnitus,dizzinessE.abdominaldistention,nausea,constipationThepatient,female,20-year-oldworker,aweekagocaughtacold,tookoffthehotpainkillersandSMZthreedayslatertheheartpalpitations,Weaksolutionofsoysaucecoloururine.Examination:
sclerayellowdye,Hb40g/L,urinecryophemictest(+++)toclarifythecauseWhichexaminationshouldbefirstmade?
AB.highironbloodredproteinreductiontestC.redbloodcelllifeexpectancyD.WiththedeterminationofthepearlproteinE.HemoglobinWomen,56,foundanemiatwoweeks,mildjaundice,2cmoftheliver,andlowerandlowerspleenunderthespleen,withahemoglobin70g/LweavingredCell8%,serumiron80mug/dL,ALT(GPT)normal,directCoombstest(+),whichprocessingshouldbepreferred?
A.protectlivertreatmentB.tolosenewbloodC.glucocorticoidD.theinterferonE.splenectomyWhichofthefollowinginformationaboutthelaboratoryexaminationofDICishyperkarst?
A.plateletsaresignificantlyreducedorprogressiveB.PTislongerthannormalfor3secondsC.Fibrinogendecreases1.5g/LD.FDP20mg/LE.peripheralbloodsmearredbloodcellsarehelmets,triangles,etcMen,46yearsold,havechronicmyelogenousleukemia,whichisnotalleviatedforayear.ThereisacontinuoushighfeverandresistancetolifeThetreatmentisineffectual,withthepersistentitchingofthewholebody,thenodulesandthelimitedinfiltratingplaques,thehardknot,theDefarge,theabdominalstockThelymphnodes,suchasbroadbean,peripheralblood,8percentofeosinophilicacid,andantiallergicdrugtherapy,arethemostlikelyclinicalmanifestationsisA.allergicdermatitisB.stripdermatitisC.skinlymphomaD.chroniclymphocyticleukemiaE.slowgrainchangesInpatientswithhighdisease,bleedingfromthevaginaaftercaesareansection,bleedingfromthegumsandbleedingfromtheskininjectionsitePressure10/6kPa(75/45mmhg).Urgentcheckplatelet30x10/L,prothrombintimecomparedwithextended8seconds.Whichofthefollowingtestsshouldbeaddedforthediagnosis?
A.bloodretractiontestB.whiteclaypartiallythrombintimeBloodtime(testtube)D.theserumFDPcontentE.plateletadhesionandaggregationtestsPatientwoman,40yearsold,dizziness,fatigue,feverandgumbleeding3months,liverspleennotswollen,whitebloodcell2.010/L,thehemoglobin45g/L,platelet23x10/L.Themyelogenoushyperplasiaisbad,andthegiantnuclearcellsarenotseen.HamTestnegative,themostlikelydiagnosisisA.bonemarrowsyndrome(MDS)B.AplasticanemiaC.EpisodicsleephemoglobinuriaD.malignantcellhyperplasiaThespleenishyperactiveWomen,28,workers.Theamountofmenstruationincreased,accompaniedbydizziness,theheartpalpitationsforhalfayear,thetwolimbswerevisibleinthestasis,Lymphnodes,spleen,livernotenlarged,hemoglobin65g/L,redbloodcell2.2x10/L,white3.3x10/L,neutral,54%,46%,lymphaticplatelet36x10/L.MCV84fl,MCHC33percent,bonemarrowDecreasedhyperplasia,reducedmacrokaryoticcells,normalcelllinesandredlinecells,andlymphocytesaccountedfor42%ofthesecasesThefirstoptionistreatmentA.ironB.glucocorticoidC.testosteroneimmunosuppressantE.folicacidandvitaminBWhichofthefollowingtestsofchronicidiopathicthrombocytopeniaisthemostdiagnostic?
A.bleedingtimeisnormalB.clottingtimeislengthenedThenumberofmacrosinthebonemarrowisincreasingD.ProthrombintimeisextendedThebeamarmtestwasnegativeAnacuteleukemiapatient,withabnormalchromosomestructure,wasthemostlikelytypeofchromosome(15,17)(q22;q21)Leukaemia?
A.slowquickchangeB.acutelymphocyticleukemiaC.MblamedrenchsleukemiaD.MblamedrenchsleukemiaE.MblamedrenchsleukemiaMale,38yearsold.Earlydiagnosisofacuteyounggranulocyteleukemia(M).Afterchemotherapy,thegumsbleedandtheskinisbruisedSpot.Platelet30x10/L.Thebloodchipwas2.2percentoftheredbloodcells,andtheprothrombinwasprolongedandthefibrinogencontentLower,3Ptestpositive.ThepatientismostlikelytobeA.idiopathicplateletsreducepurpuraB.AllergicpurpuraC.disseminatedbloodvesselsD.drugimmunologicalthrombocytopeniaE.MmergerdisseminatedintravascularcoagulationMale,18yearsold,recentlyhadsoysaucecolorurine,lumbago,pale,weak.Thewholebloodcellsdecreased,theneutrophilswerealkalineTheacidenzymewasreducedby0.028andHamtestpositive.ThemostappropriatetreatmentforthiscaseisA.long-termuseofprednisoneB.splenectomyC.losealotoffreshbloodD.malehormoneE.heparintherapyWhichofthefollowingfactorsisthe
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