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5c22413b-0b8d-5825-b20f-8987f0f7be7b | 4 | D | 1 | A liver failure patient may show all of the following clinical signs EXCEPT which one? | Jaundice | Easy bruising | Confusion | Hyperglycemia | 肝功能衰竭患者可能出现以下所有临床症状，除了哪一个？ | 黄疸 | 容易瘀伤 | 意识混乱 | 高血糖 | null | null | null | null | null | null | null | null | null | null |
21ad81ec-c414-5ff7-9084-7dcc69eca92c | 4 | D | 1 | The level of which coagulation factor may not be affected by advanced liver disease? | II | V | VII | VIII | 哪种凝血因子的水平可能不受晚期肝病的影响？ | II | V | VII | VIII | null | null | null | null | null | null | null | null | null | null |
9cdc906d-1a75-5039-b7a9-cbb45dad5430 | 4 | A | 1 | 14. A patient with an elevated total serum bilirubin and an elevated indirect serum bilirubin may have which of the following conditions? | Gilbert syndrome | Primary biliary cirrhosis | Primary sclerosing cholangitis | Wilson disease | 14. 一名患者的总血清胆红素升高和间接血清胆红素升高，可能患有以下哪种疾病？ | Gilbert 综合征 | 原发性胆汁性肝硬化 | 原发性硬化性胆管炎 | Wilson 病 | null | null | null | null | null | null | null | null | null | null |
d8931793-2391-54a9-a3ee-c57dac39cd10 | 4 | C | 1 | Which of the following is the mechanism by which lactulose relieves symptoms of hepatic encephalopathy? | Inhibition of hepatic ammonia production | Increasing the conversion of ammonia to urea | Acidification of the colon | Diuresis to decrease intracranial pressure | 以下哪项是乳果糖缓解肝性脑病症状的机制？ | 抑制肝脏氨的产生 | 增加氨转化为尿素的过程 | 结肠酸化 | 利尿以降低颅内压 | null | null | null | null | null | null | null | null | null | null |
6765f344-32cf-5234-b788-62793909b5a1 | 4 | D | 1 | Metabolism and clearance of morphine may be increased in which of the following situations? | Congestive heart failure | Inhaled anesthetics | Intra-abdominal surgery | Sepsis | 在以下哪种情况下，吗啡的代谢和清除可能会增加？ | 充血性心力衰竭 | 吸入麻醉剂 | 腹腔手术 | 败血症 | null | null | null | null | null | null | null | null | null | null |
048cc8b5-4f65-5659-b039-b8efec3bd577 | 4 | D | 1 | The clearance of which of the following drugs through the liver is NOT dependent on liver blood flow? | Propofol | Morphine | Fentanyl | Midazolam | 以下哪种药物通过肝脏的清除不依赖于肝血流？ | 丙泊酚 | 吗啡 | 芬太尼 | 咪达唑仑 | null | null | null | null | null | null | null | null | null | null |
e0408564-e497-5016-838a-d90a978ac5dd | 4 | C | 1 | Inducers of cytochrome P450 system include all of the following EXCEPT which one? | Ethanol | Phenytoin | Isoniazid | Rifampin | 以下哪一项不是细胞色素P450系统的诱导剂？ | 乙醇 | 苯妥英 | 异烟肼 | 利福平 | null | null | null | null | null | null | null | null | null | null |
dfb63db2-dbd4-5129-8517-e2d714ad84e4 | 4 | A | 2 | A 60-year-old man who has just been listed for a liver transplant remains overly sedated for 24 hours after being administered midazolam 4 mg IV. What other medication might he be taking at the same time? | Erythromycin | Penicillin | Gentamicin | Vancomycin | 一名60岁的男性刚被列入肝移植名单，在静脉注射4毫克咪达唑仑后，过度镇静持续了24小时。他可能同时服用了哪种药物？ | 红霉素 | 青霉素 | 庆大霉素 | 万古霉素 | null | null | null | null | null | null | null | null | null | null |
28d37126-1d53-5a7b-8126-26acd2d5cf8d | 4 | B | 1 | A patient with deactivating mutation in the cytochrome P450 2D6 gene may have ineffective analgesia from which of the following opioids? | Morphine | Codeine | Fentanyl | Methadone | 具有细胞色素P450 2D6基因失活突变的患者可能对以下哪种阿片类药物无效？ | 吗啡 | 可待因 | 芬太尼 | 美沙酮 | null | null | null | null | null | null | null | null | null | null |
67e06cd2-9541-5061-b81c-b7930cae2788 | 4 | B | 1 | What is the approximate glomerular filtration rate (GFR) in a patient with normal renal function? | 10 mL/min | 125 mL/min | 500 mL/min | 1000 mL/min | 在肾功能正常的患者中，近似的肾小球滤过率（GFR）是多少？ | 10 mL/min | 125 mL/min | 500 mL/min | 1000 mL/min | null | null | null | null | null | null | null | null | null | null |
d47389af-bcc1-548b-af1b-3126a6317b01 | 4 | A | 1 | Which of the following tissues has the highest oxygen extraction ratio in the body? | Renal medulla | Cardiac myocytes | Neurons | Hepatocytes | 以下哪种组织在体内具有最高的氧提取率？ | 肾髓质 | 心肌细胞 | 神经元 | 肝细胞 | null | null | null | null | null | null | null | null | null | null |
f1bb30d5-4b0c-51e5-bbf2-a33baf2be790 | 4 | D | 1 | Which of the following factors will increase sodium resorption in the proximal tubule? | Increased blood pressure | Increased extracellular volume | High salt intake | Angiotensin II | 下列哪项因素会增加近端小管的钠重吸收？ | 血压升高 | 细胞外液量增加 | 高盐摄入 | 血管紧张素 II | null | null | null | null | null | null | null | null | null | null |
f5c09835-f5b9-56f4-a0f9-1d4660c60744 | 4 | A | 1 | Sodium reabsorption in the distal nephron (connecting the segment and | Aldosterone | Angiotensin II | Vasopressin | Renin | 远曲小管（连接段和）中的钠重吸收 | 醛固酮 | 血管紧张素 II | 加压素 | 肾素 | null | null | null | null | null | null | null | null | null | null |
24df18b2-9733-5c85-8ae1-056b22d12d42 | 4 | C | 2 | An increase in which of the following will decrease the GFR? | Renal blood flow (RBF) | Afferent arteriolar pressure | Efferent arteriolar pressure | Plasma osmotic pressure | 以下哪项增加会降低肾小球滤过率（GFR）？ | 肾血流量（RBF） | 入球小动脉压力 | 出球小动脉压力 | 血浆渗透压 | null | null | null | null | null | null | null | null | null | null |
bba94c6b-8526-5739-9abe-9d3bf315d15b | 4 | D | 1 | 6. Sympathetic stimulation increases sodium and water retention through which of the following mechanisms? | Increased Na + /H2O reabsorption in the nephron | Vasoconstriction leading to decreased net filtration | Activation of the renin-angiotensin-aldosterone system (RAAS) | All of the above | 6. 交感神经刺激通过以下哪种机制增加钠和水的潴留？ | 增加肾单位中的Na+/H2O重吸收 | 血管收缩导致净滤过减少 | 激活肾素-血管紧张素-醛固酮系统（RAAS） | 以上所有 | null | null | null | null | null | null | null | null | null | null |
e74d08cf-6cf0-5ece-b604-c443c92e2534 | 4 | B | 1 | Which of the following statements is true of renal function and aging? | Production of vitamin D is preserved in the aging kidney. | Progressive decline in renal function begins to occur at 30-40 years of age. | Serum creatinine tends to rise with age. | GFR is preserved in healthy adults at the age of 80 years. | 以下关于肾功能和衰老的说法哪一项是正确的？ | 老年肾脏的维生素D生成能力得以保留。 | 肾功能的逐渐下降始于30-40岁。 | 血清肌酐水平随着年龄增长而上升。 | 健康成人在80岁时肾小球滤过率得以保留。 | null | null | null | null | null | null | null | null | null | null |
8d7ac41c-9c1b-57b1-a67f-2f2114d45c0f | 4 | C | 1 | Which of the following situations meets criteria for stage 3 acute kidney injury (AKI) according to the Acute Kidney Injury Network (AKIN) classifications? | Creatinine rise from 0.8 to 1.5 | Creatinine rise from 4.1 to 4.3 | Commencement of renal replacement therapy | Urine output of 40 mL/h for a 70-kg man | 根据急性肾损伤网络（AKIN）分类，以下哪种情况符合3期急性肾损伤（AKI）的标准？ | 肌酐从0.8升高到1.5 | 肌酐从4.1升高到4.3 | 开始肾脏替代治疗 | 70公斤男性尿量为40毫升/小时 | null | null | null | null | null | null | null | null | null | null |
c13f75bb-cdca-5dce-80c5-9a886a338793 | 4 | B | 1 | RBF represents what fraction of cardiac output? | 10% | 25% | 40% | 50% | RBF代表心输出量的多少百分比？ | 10% | 25% | 40% | 50% | null | null | null | null | null | null | null | null | null | null |
06348ebd-b381-5269-ad6c-a303ab46ae53 | 4 | A | 1 | Which of the following classes of drugs is known to raise serum creatinine by decreasing tubular secretion? | Cimetidine | Cephalosporins | Vitamin D | Aminoglycosides | 以下哪类药物通过减少肾小管分泌而已知会升高血清肌酐？ | 西咪替丁 | 头孢菌素 | 维生素D | 氨基糖苷类 | null | null | null | null | null | null | null | null | null | null |
7a3ce04e-5cb3-56f1-99ce-fc6acfcfc248 | 4 | D | 2 | A patient is admitted to the surgical ICU following a motor vehicle accident and is now status post an open splenectomy with massive hemorrhage. Which of the following sets of laboratory indices is most consistent with a diagnosis of prerenal AKI, assuming a serum sodium of 140 mEq/L and a urine creatinine of 50 mg/dL? | | Cr 2.1(mg/dL) | BLOOD UREA NITROGEN 30(mg/dL) | Urine 40 + Na (mEq/L) | URINE OSMOLALITY 300(mOsm/L) | | | Cr 2.1(mg/dL) | BLOOD UREA NITROGEN 45(mg/dL) | Urine 40 + Na (mEq/L) | URINE OSMOLALITY 200(mOsm/L) | | | Cr 2.1(mg/dL) | BLOOD UREA NITROGEN 30(mg/dL) | Urine 14 + Na (mEq/L) | URINE OSMOLALITY 400(mOsm/L) | | | Cr 2.1(mg/dL) | BLOOD UREA NITROGEN 45(mg/dL) | Urine 14 + Na (mEq/L) | URINE OSMOLALITY 800(mOsm/L) | | 一名患者在发生机动车事故后被送入外科ICU，目前处于开放性脾切除术后伴有大量出血状态。假设血清钠为140 mEq/L，尿肌酐为50 mg/dL，以下哪组实验室指标最符合肾前性急性肾损伤的诊断？ | | Cr 2.1(mg/dL) | 血尿素氮 30(mg/dL) | 尿 40 + Na (mEq/L) | 尿渗透压 300(mOsm/L) | | | Cr 2.1(mg/dL) | 血尿素氮 45(mg/dL) | 尿 40 + Na (mEq/L) | 尿渗透压 200(mOsm/L) | | | Cr 2.1(mg/dL) | 血尿素氮 30(mg/dL) | 尿 14 + Na (mEq/L) | 尿渗透压 400(mOsm/L) | | | Cr 2.1(mg/dL) | 血尿素氮 45(mg/dL) | 尿 14 + Na (mEq/L) | 尿渗透压 800(mOsm/L) | | null | null | null | null | null | null | null | null | null | null |
8abf576f-873b-521b-8856-e78d29494f8d | 4 | B | 1 | 12. What percentage of the kidney's nephrons must be affected to see a rise in serum creatinine? | 25% | 50% | 75% | 90% | 12. 肾脏多少百分比的肾单位受损会导致血清肌酐升高？ | 25% | 50% | 75% | 90% | null | null | null | null | null | null | null | null | null | null |
092ffc73-3572-5ef0-acc6-386caf36723f | 4 | C | 1 | Where is angiotensinogen produced? | Kidney | Lung | Liver | Muscle | 血管紧张素原在哪里产生？ | 肾脏 | 肺 | 肝脏 | 肌肉 | null | null | null | null | null | null | null | null | null | null |
993619b7-a947-58ae-b287-3bcf58f5be87 | 4 | A | 1 | Which of the following substances is principally responsible for renal vasodilation in the face of surgical stress? | Nitric oxide | Prostaglandins | Endothelial-derived hyperpolarizing factor | Atrial natriuretic peptide (ANP) | 以下哪种物质在手术应激时主要负责肾血管扩张？ | 一氧化氮 | 前列腺素 | 内皮源性超极化因子 | 心房利钠肽（ANP） | null | null | null | null | null | null | null | null | null | null |
66490fcf-08ee-530c-989b-8ce53e15868b | 4 | D | 1 | Release of which of the following substances is most likely to lead to postoperative hyponatremia? | Angiotensin II | Aldosterone | Renin | Vasopressin | 以下哪种物质的释放最有可能导致术后低钠血症？ | 血管紧张素 II | 醛固酮 | 肾素 | 加压素 | null | null | null | null | null | null | null | null | null | null |
f8f9d032-eba2-5279-b717-0eb7b4612bf9 | 4 | D | 1 | What is the net effect of angiotensin II on the glomerular arterioles and RBF? | | AFFERENT ARTERIOLE Vasodilation | EFFERENT ARTERIOLE Vasodilation | RENAL BLOOD FLOW Increased | | | AFFERENT ARTERIOLE Vasodilation | EFFERENT ARTERIOLE Vasoconstriction | RENAL BLOOD FLOW Increased | | | AFFERENT ARTERIOLE Vasoconstriction | EFFERENT ARTERIOLE Vasodilation | RENAL BLOOD FLOW Decreased | | | AFFERENT ARTERIOLE Vasoconstriction | EFFERENT ARTERIOLE Vasoconstriction | RENAL BLOOD FLOW Decreased | | 血管紧张素II对肾小球动脉和肾血流量的净效应是什么？ | | 入球小动脉 扩张 | 出球小动脉 扩张 | 肾血流量 增加 | | | 入球小动脉 扩张 | 出球小动脉 收缩 | 肾血流量 增加 | | | 入球小动脉 收缩 | 出球小动脉 扩张 | 肾血流量 减少 | | | 入球小动脉 收缩 | 出球小动脉 收缩 | 肾血流量 减少 | | null | null | null | null | null | null | null | null | null | null |
52cf6ead-ad84-52ff-92aa-8d3642654b71 | 4 | B | 1 | What is the net effect of ANP on the glomerular arterioles, RBF, and GFR? | | AFFERENT ARTERIOLE Vasodilation | EFFERENT ARTERIOLE Vasodilation | RENAL BLOOD FLOW Increased | RENAL BLOOD FLOW Unchanged | | | AFFERENT ARTERIOLE Vasodilation | EFFERENT ARTERIOLE Vasoconstriction | RENAL BLOOD FLOW Increased | RENAL BLOOD FLOW Increased | | | AFFERENT ARTERIOLE Vasoconstriction | EFFERENT ARTERIOLE Vasodilation | RENAL BLOOD FLOW Decreased | RENAL BLOOD FLOW Decreased | | | AFFERENT ARTERIOLE Vasoconstriction | EFFERENT ARTERIOLE Vasoconstriction | RENAL BLOOD FLOW Decreased | RENAL BLOOD FLOW Unchanged | | ANP对肾小球动脉、肾血流量和肾小球滤过率的净效应是什么？ | | 入球小动脉扩张 | 出球小动脉扩张 | 肾血流量增加 | 肾血流量不变 | | | 入球小动脉扩张 | 出球小动脉收缩 | 肾血流量增加 | 肾血流量增加 | | | 入球小动脉收缩 | 出球小动脉扩张 | 肾血流量减少 | 肾血流量减少 | | | 入球小动脉收缩 | 出球小动脉收缩 | 肾血流量减少 | 肾血流量不变 | | null | null | null | null | null | null | null | null | null | null |
906e8f64-8d29-5046-98a2-f70a540129da | 4 | B | 2 | 18. Which of the following is the treatment of choice for a patient who has acutely developed hypernatremia with a urine output of 600 cc/h in the postanesthesia care unit following transphenoidal resection of a pituitary adenoma? | Normal saline | Desmopressin | Spironolactone | Hydrocortisone | 18. 下列哪项是经蝶窦垂体腺瘤切除术后在麻醉后监护室急性出现高钠血症且尿量为600 cc/h的患者的首选治疗？ | 生理盐水 | 去氨加压素 | 螺内酯 | 氢化可的松 | null | null | null | null | null | null | null | null | null | null |
003114ff-e336-514e-8621-519789052303 | 4 | A | 1 | Which of the following mechanisms primarily accounts for the normalization of arterial pH after prolonged hyperventilation in a patient with head injury? | Increased renal excretion of bicarbonate ions | Decreased RBF | Decreased renal absorption of hydrogen ions | Increased renal resorption of bicarbonate ions | 以下哪种机制主要解释了头部损伤患者长期过度通气后动脉pH值的正常化？ | 增加肾脏排泄碳酸氢根离子 | 肾血流量减少 | 减少肾脏对氢离子的吸收 | 增加肾脏对碳酸氢根离子的重吸收 | null | null | null | null | null | null | null | null | null | null |
c0cc840f-8707-53b4-af5d-1fbe9e3b2c57 | 4 | C | 3 | The following laboratory values are most consistent with which of the following acid-base disturbances? | Anion gap acidosis | Respiratory alkalosis with metabolic compensation | Mixed anion gap and nonanion gap metabolic acidosis | Combined metabolic and respiratory acidosis | 以下实验室数值最符合下列哪种酸碱失衡？ | 阴离子间隙性酸中毒 | 代谢性代偿的呼吸性碱中毒 | 混合阴离子间隙性和非阴离子间隙性代谢性酸中毒 | 代谢性和呼吸性酸中毒的结合 | null | null | null | null | null | null | null | null | null | null |
2587235c-01d8-5930-b44a-aedab20adb63 | 4 | A | 1 | Which of the following is a cause of metabolic alkalosis? | Prolonged suction on nasogastric tube | Administration of acetazolamide | Diarrhea | Ethylene glycol administration | 以下哪项是代谢性碱中毒的原因？ | 长时间使用鼻胃管吸引 | 使用乙酰唑胺 | 腹泻 | 乙二醇的使用 | null | null | null | null | null | null | null | null | null | null |
aac0a4b5-8981-590a-83dc-1b04474788a6 | 4 | C | 1 | An increase in which of the following ions will decrease the strong ion difference (SID)? | Calcium | Sodium | Chloride | Magnesium | 以下哪种离子的增加会降低强离子差（SID）？ | 钙 | 钠 | 氯 | 镁 | null | null | null | null | null | null | null | null | null | null |
caae5666-0a8b-5eaf-8220-988c64cef317 | 4 | D | 1 | An anion gap metabolic acidosis with a normal osmolar gap is seen with ingestion of which of the following substances? | Methanol | Ethanol | Ethylene glycol | Aspirin | 在摄入以下哪种物质时，会出现阴离子间隙代谢性酸中毒且渗透间隙正常？ | 甲醇 | 乙醇 | 乙二醇 | 阿司匹林 | null | null | null | null | null | null | null | null | null | null |
0abac0e5-de25-588d-b9a6-e551373ad5a5 | 4 | C | 1 | 24. Which of the following best describes the acid-base disturbances seen with salicylate overdose? | Anion gap metabolic acidosis with respiratory compensation | Respiratory alkalosis with renal compensation | Combined metabolic acidosis and respiratory alkalosis | Combined metabolic and respiratory acidosis | 24. 以下哪项最能描述水杨酸盐过量时的酸碱失衡？ | 阴离子间隙代谢性酸中毒伴呼吸性代偿 | 呼吸性碱中毒伴肾性代偿 | 代谢性酸中毒和呼吸性碱中毒的结合 | 代谢性和呼吸性酸中毒的结合 | null | null | null | null | null | null | null | null | null | null |
046f7b6d-20a3-58ee-8866-a7cb88dad61d | 4 | A | 1 | Excretion of which of the following intravenous anesthetics is unaffected in patients with end-stage renal disease (ESRD)? | Propofol | Ketamine | Etomidate | Thiopental | 下列哪种静脉麻醉药的排泄在终末期肾病（ESRD）患者中不受影响？ | 丙泊酚 | 氯胺酮 | 依托咪酯 | 硫喷妥钠 | null | null | null | null | null | null | null | null | null | null |
718153ee-4dc4-53f5-b895-618674ee3671 | 4 | B | 1 | Increased levels of normeperidine, seen in patients with renal failure, are associated with what symptoms? | Emesis | Seizures | Bradycardia | Hypotension | 在肾功能衰竭患者中，去甲哌啶水平升高与哪些症状相关？ | 呕吐 | 癫痫发作 | 心动过缓 | 低血压 | null | null | null | null | null | null | null | null | null | null |
b854966a-ce0a-5777-95b0-df69a347ddc9 | 4 | C | 1 | Which of the following classes of drugs must be dosage-adjusted in patients with renal impairment? | Phenothiazines (eg, promethazine) | Antidopaminergics (eg, droperidol) | H2 -receptor antagonists | 5-HT3 antagonists | 以下哪类药物在肾功能不全的患者中需要调整剂量？ | 吩噻嗪类（例如，异丙嗪） | 抗多巴胺药（例如，氟哌利多） | H2受体拮抗剂 | 5-HT3拮抗剂 | null | null | null | null | null | null | null | null | null | null |
936ad7b7-7147-5fb8-a247-5e4da776ccca | 4 | C | 1 | Which inhalation agent can react with barium hydroxide lime or soda lime to form compound A? | Isoflurane | Desflurane | Sevoflurane | Nitrous oxide | 哪种吸入性麻醉剂可以与氢氧化钡石灰或苏打石灰反应形成化合物A？ | 异氟醚 | 地氟醚 | 七氟醚 | 一氧化二氮 | null | null | null | null | null | null | null | null | null | null |
6ffbe3f9-0aea-53c2-95ef-4abfa8af5dc5 | 4 | B | 1 | Approximately how much is potassium concentration elevated following administration of succinylcholine in patients with ESRD? | 0-0.2 mEq/L | 0.5-1 mEq/L | 1.0-1.5 mEq/L | 1.5-2 mEq/L | 在终末期肾病（ESRD）患者中，给予琥珀胆碱后钾浓度大约升高多少？ | 0-0.2 mEq/L | 0.5-1 mEq/L | 1.0-1.5 mEq/L | 1.5-2 mEq/L | null | null | null | null | null | null | null | null | null | null |
e51a49f7-7756-54aa-bc8a-5386182071fc | 4 | B | 1 | What is the primary form of elimination of vecuronium? | Renal excretion | Biliary excretion | Degradation by nonspecific esterases | Hoffman elimination | 维库溴铵的主要消除形式是什么？ | 肾脏排泄 | 胆道排泄 | 非特异性酯酶降解 | 霍夫曼消除 | null | null | null | null | null | null | null | null | null | null |
9e589a44-7b04-5a41-99d3-0f409a4414a4 | 4 | D | 1 | Cisatracurium is often used in patients with renal impairment. What is the primary mode of metabolism of cisatracurium? | Renal excretion | Biliary excretion | Degradation by nonspecific esterases | Hoffman elimination | 西酰胺是一种常用于肾功能不全患者的药物。西酰胺的主要代谢方式是什么？ | 肾脏排泄 | 胆道排泄 | 非特异性酯酶降解 | 霍夫曼消除 | null | null | null | null | null | null | null | null | null | null |
d1754447-b9cb-52d8-b352-33e492f72de6 | 4 | B | 1 | 32. Which of the following morphine metabolites can be responsible for delayed respiratory depression in patients with renal impairment? | Morphine-3-glucuronide | Morphine-6-glucuronide | Normorphine | Codeine | 32. 以下哪种吗啡代谢产物可能导致肾功能不全患者的延迟性呼吸抑制？ | 吗啡-3-葡萄糖醛酸苷 | 吗啡-6-葡萄糖醛酸苷 | 去甲吗啡 | 可待因 | null | null | null | null | null | null | null | null | null | null |
901ebed5-ce68-5896-8197-f0c5adba1122 | 4 | C | 1 | In what population has mannitol been shown to be protective against AKI? | Patients undergoing laparoscopic partial nephrectomies | Patients undergoing infrarenal abdominal aortic aneurysm repair | Cadaveric kidney transplant recipients | Patients with traumatic rhabdomyolysis | 在什么人群中，甘露醇被证明对急性肾损伤（AKI）具有保护作用？ | 接受腹腔镜部分肾切除术的患者 | 接受肾下腹主动脉瘤修复术的患者 | 尸体肾移植受者 | 创伤性横纹肌溶解症患者 | null | null | null | null | null | null | null | null | null | null |
c8eddb3f-8985-56b6-9aa6-ebd833a568c4 | 4 | D | 1 | Which of the following statements is true of eplerenone? | It may cause gynecomastia in males. | Hypokalemia is a common side effect. | It acts in the distal convoluted tubule. | It is indicated in patients with ascites due to end-stage liver disease. | 以下关于依普利酮的说法哪一项是正确的？ | 它可能导致男性乳腺发育。 | 低钾血症是常见的副作用。 | 它作用于远曲小管。 | 它适用于因终末期肝病导致腹水的患者。 | null | null | null | null | null | null | null | null | null | null |
3e6005a3-ca56-5777-81bb-2f72ef0b9217 | 4 | A | 1 | Nonsteroidal anti-inflammatory drugs (NSAIDs) most commonly contribute to what type of kidney injury? | Prerenal | Acute tubular necrosis | Glomerulonephritis | Postrenal obstruction | 非甾体抗炎药（NSAIDs）最常导致哪种类型的肾损伤？ | 肾前性 | 急性肾小管坏死 | 肾小球肾炎 | 肾后性梗阻 | null | null | null | null | null | null | null | null | null | null |
848960df-c5f6-55c6-8e08-d8666d6cd558 | 4 | D | 1 | Which of the following is true of fenoldopam? | Rebound hypertension may occur when an infusion is discontinued. | It is a nonselective α- and β-agonist. | It is equipotent with dopamine. | It is a selective DA1 receptor agonist. | 以下关于芬多拉姆的说法哪一项是正确的？ | 停止输注时可能会出现反弹性高血压。 | 它是非选择性的α和β激动剂。 | 它与多巴胺效力相同。 | 它是选择性的DA1受体激动剂。 | null | null | null | null | null | null | null | null | null | null |
f052ddd8-27e9-5960-b507-478325ca4194 | 4 | B | 1 | On which part of the nephron do loop diuretics work? | Proximal tubule | Thick ascending limb | Distal convoluted tubule | Collecting duct | 袢利尿剂作用于肾单位的哪个部分？ | 近曲小管 | 粗升支 | 远曲小管 | 集合管 | null | null | null | null | null | null | null | null | null | null |
0274741f-1505-5c71-a324-848eaa93b643 | 4 | A | 1 | Which of the following is the mechanism of action of acetazolamide? | Inhibition of carbonic anhydrase | Blockade of NaCl cotransporter in the distal convoluted tubule | Increasing the oncotic pressure in tubular filtrate | Inhibition of the Na-K-2Cl cotransporter in the thick ascending loop | 以下哪项是乙酰唑胺的作用机制？ | 抑制碳酸酐酶 | 阻断远曲小管中的NaCl共转运体 | 增加肾小管滤液中的胶体渗透压 | 抑制粗升支袢中的Na-K-2Cl共转运体 | null | null | null | null | null | null | null | null | null | null |
9aae22b9-e40f-50da-89f6-372c346dcb54 | 4 | C | 1 | Which of the following electrolyte abnormalities is most likely to be seen with uremia? | Hypokalemia | Hypernatremia | Hyperphosphatemia | Hypomagnesemia | 以下哪种电解质异常最有可能在尿毒症中出现？ | 低钾血症 | 高钠血症 | 高磷血症 | 低镁血症 | null | null | null | null | null | null | null | null | null | null |
a6d3842a-3d61-59c6-ba58-d10fbf0cb63c | 4 | D | 1 | 40. In a patient with a blood urea nitrogen (BUN) of 80 mg/dL, which of the following elements meets criteria for a diagnosis of uremia? | Potassium of 6.1 mEq/L | Serum creatinine of 4.5 mg/dL | Urine output of 100 cc over a 24-hour period | Asterixis and hiccups | 40. 在一位血尿素氮（BUN）为80 mg/dL的患者中，下列哪一项符合尿毒症的诊断标准？ | 钾为6.1 mEq/L | 血清肌酐为4.5 mg/dL | 24小时尿量为100 cc | 扑翼样震颤和打嗝 | null | null | null | null | null | null | null | null | null | null |
b19acb01-ab45-5e7d-8000-f087e7d36bc4 | 4 | A | 1 | Clinical effects of unfractionated heparin (UFH) are best monitored by which of the following? | Partial thromboplastin time (PTT) | Prothrombin time (PT) | International normalized ratio (INR) | Antithrombin III (ATIII) | 非分级肝素（UFH）的临床效果最好通过以下哪项进行监测？ | 部分凝血活酶时间（PTT） | 凝血酶原时间（PT） | 国际标准化比值（INR） | 抗凝血酶III（ATIII） | null | null | null | null | null | null | null | null | null | null |
7e3edd74-e1e5-5675-becf-598db4257243 | 4 | B | 1 | With respect to reversal with protamine, which of the following statements is true when comparing UFH and low-molecular-weight heparin (LMWH)? | UFH results in less predictable reversibility. | UFH results in more predictable reversibility. | Hypotension is less likely with UFH. | Hypotension is more likely with UFH. | 关于使用鱼精蛋白逆转时，比较UFH和低分子量肝素（LMWH），以下哪项陈述是正确的？ | UFH的可逆性结果较不易预测。 | UFH的可逆性结果较易预测。 | 使用UFH时低血压的可能性较小。 | 使用UFH时低血压的可能性较大。 | null | null | null | null | null | null | null | null | null | null |
6538fe22-08cf-5fd7-8c2a-c0615ad1b2e5 | 4 | C | 1 | Heparin-induced thrombocytopenia type 2 (HIT2) is mediated by which of the following? | IgG antibodies binding to heparin-PF-4 complexes on the surface of red blood cells (RBCs) | IgG antibodies binding to ATIII on the surface of RBCs | IgG antibodies binding to heparin-PF-4 complexes on the surface of platelets | IgG antibodies binding to ATIII on the surface of platelets | 肝素诱导的血小板减少症2型（HIT2）是由以下哪种机制介导的？ | IgG抗体结合在红细胞（RBCs）表面的肝素-PF-4复合物 | IgG抗体结合在红细胞表面的ATIII | IgG抗体结合在血小板表面的肝素-PF-4复合物 | IgG抗体结合在血小板表面的ATIII | null | null | null | null | null | null | null | null | null | null |
8b4f9e88-6250-57f2-b156-bd50447b26fe | 4 | C | 1 | HIT typically presents in what period after the initiation of therapy? | 1-3 days | 3-5 days | 5-10 days | 10-15 days | HIT通常在治疗开始后的哪个时间段出现？ | 1-3天 | 3-5天 | 5-10天 | 10-15天 | null | null | null | null | null | null | null | null | null | null |
d23382d1-754b-5157-8f69-a7b9cca49431 | 4 | B | 1 | The mechanism of action of hirudin-derived compounds involves which of the following? | Inhibition of vitamin K–derived clotting factors | Inhibition of thrombin in its free and fibrin-bound states | Potentiation of vitamin K–derived clotting factors | Potentiation of thrombin in its free and fibrin-bound states | 水蛭素衍生化合物的作用机制涉及以下哪一项？ | 抑制维生素K衍生的凝血因子 | 抑制游离和纤维蛋白结合状态的凝血酶 | 增强维生素K衍生的凝血因子 | 增强游离和纤维蛋白结合状态的凝血酶 | null | null | null | null | null | null | null | null | null | null |
f2e07e57-8540-5e1d-871a-22892b5a63ef | 4 | D | 1 | 6. Warfarin's primary mechanism of action is inhibition of the synthesis of vitamin K–dependent clotting factors. These factors include which of the following? | Factors II, VII, VIII, and X and protein C | Factors II, VII, VIII, and XII and proteins C and S | Factors VII, IX, X, and XII and protein S | Factors II, VII, IX, and X and proteins C and S | 6. 华法林的主要作用机制是抑制维生素K依赖性凝血因子的合成。这些因子包括以下哪项？ | 因子II、VII、VIII和X以及蛋白C | 因子II、VII、VIII和XII以及蛋白C和S | 因子VII、IX、X和XII以及蛋白S | 因子II、VII、IX和X以及蛋白C和S | null | null | null | null | null | null | null | null | null | null |
adbd859b-66df-5dd1-8aba-f1117e5d422e | 4 | B | 1 | Before undergoing a trigger finger release under local anesthesia at an orthopedic surgeon's office, a patient's dabigatran should be discontinued for what length of time? | 12 hours | 24 hours | 36 hours | 48 hours | 在骨科医生办公室进行局部麻醉下的扳机指松解术之前，患者的达比加群应停用多长时间？ | 12小时 | 24小时 | 36小时 | 48小时 | null | null | null | null | null | null | null | null | null | null |
e2a2c722-d6b8-5089-b729-3a85d379aac8 | 4 | A | 1 | Tranexamic acid, a lysine analogue, acts by which of the following mechanisms? | Reversibly binds to plasminogen, thereby preventing the degradation of fibrin | Inhibition of COX-1 and COX-2 | Inhibition of vitamin K–dependent clotting factors | Inhibition of glycoprotein (GP) IIb/IIIa expression on the surface of activated platelets | 氨甲环酸，一种赖氨酸类似物，其作用机制是以下哪一种？ | 可逆性结合纤溶酶原，从而防止纤维蛋白的降解 | 抑制COX-1和COX-2 | 抑制维生素K依赖的凝血因子 | 抑制活化血小板表面的糖蛋白（GP）IIb/IIIa表达 | null | null | null | null | null | null | null | null | null | null |
0f4c02bf-29de-51f6-ac3b-45525895f2f3 | 4 | A | 1 | When comparing prothrombin complex concentrates (PCCs) with fresh frozen plasma (FFP), which of the following is true? | PCCs have a faster correction of coagulopathy. | PCCs have a higher risk of infection. | PCCs require a larger volume for administration. | PCCs require a type and cross before administration. | 在比较凝血酶原复合物浓缩物（PCCs）与新鲜冰冻血浆（FFP）时，下列哪项是正确的？ | PCCs能更快纠正凝血功能障碍。 | PCCs有更高的感染风险。 | PCCs需要更大的给药体积。 | PCCs在给药前需要进行血型和交叉配型。 | null | null | null | null | null | null | null | null | null | null |
56f4a95c-4b5f-5f67-9601-6d1d675c355e | 4 | C | 1 | Fondaparinux exerts its effects by which of the following? | Acting as an antagonist to free factor VII | Acting as an antagonist to free factor IX | Acting as an antagonist to free factor Xa | Acting as an antagonist to the expression of GP IIb/IIIa | 磺达肝癸钠通过以下哪种方式发挥作用？ | 作为游离因子VII的拮抗剂 | 作为游离因子IX的拮抗剂 | 作为游离因子Xa的拮抗剂 | 作为GP IIb/IIIa表达的拮抗剂 | null | null | null | null | null | null | null | null | null | null |
639ab579-0252-5ff6-bcce-f12c40842480 | 4 | B | 1 | The effects of aspirin therapy can be reversed by infusing which of the following products? | Vitamin K | Platelets | Protamine | von Willebrand factor | 阿司匹林治疗的效果可以通过输注以下哪种产品来逆转？ | 维生素K | 血小板 | 鱼精蛋白 | 血管性血友病因子 | null | null | null | null | null | null | null | null | null | null |
957b2369-ceb5-5fe0-856d-4fa34cc182f6 | 4 | C | 1 | The effects of aspirin therapy rely primarily on the direct inhibition of which of the following? | COX-1, TxA2 | COX-2, TxA1 | COX-1, COX-2 | COX-1 only | 阿司匹林治疗的效果主要依赖于直接抑制以下哪一项？ | COX-1, TxA2 | COX-2, TxA1 | COX-1, COX-2 | 仅 COX-1 | null | null | null | null | null | null | null | null | null | null |
deb6367a-356d-58c4-9574-4a9a08f8cf22 | 4 | B | 2 | For patients on aspirin therapy at a high risk of cardiac events in the perioperative period, which of the following should be performed? | Aspirin should be discontinued 24 hours before surgery and resumed after 6 weeks. | Aspirin should be continued throughout the perioperative period. | Aspirin should be discontinued at least 5 days (preferably 10 days) before surgery and resumed after 24 hours. | Aspirin should be continued until surgery and discontinued for 6 weeks postoperatively. | 对于在围手术期有高心脏事件风险的阿司匹林治疗患者，应执行以下哪项措施？ | 阿司匹林应在手术前24小时停用，并在6周后恢复。 | 阿司匹林应在整个围手术期持续使用。 | 阿司匹林应在手术前至少5天（最好10天）停用，并在24小时后恢复。 | 阿司匹林应持续使用直到手术，并在术后停用6周。 | null | null | null | null | null | null | null | null | null | null |
ffa59f8e-77ab-5413-860b-fbe1428b7802 | 4 | A | 1 | 14. Which of the following is the mechanism of action of ADP receptor antagonists such as clopidogrel? | Inhibition of GP IIb/IIIa expression on the surface of activated platelets | Inhibition of the action of GP Ib | Promotion of GP IIb/IIIa expression on the surface of activated platelets | Promotion of the action of GP Ib | 14. 以下哪项是ADP受体拮抗剂如氯吡格雷的作用机制？ | 抑制活化血小板表面的GP IIb/IIIa表达 | 抑制GP Ib的作用 | 促进活化血小板表面的GP IIb/IIIa表达 | 促进GP Ib的作用 | null | null | null | null | null | null | null | null | null | null |
2576f3bb-d3cd-5e8c-b74b-a77fddf5bf60 | 4 | D | 1 | Eptifibatide (integrellin) is an inhibitor of which of the following? | Cyclooxygenase | Phosphodiesterase | ADP receptors | GP IIb/IIIa receptors | Eptifibatide（Integrellin）是以下哪种物质的抑制剂？ | 环氧合酶 | 磷酸二酯酶 | ADP受体 | GP IIb/IIIa受体 | null | null | null | null | null | null | null | null | null | null |
240c6416-ab19-562e-936d-d06f583ef0f4 | 4 | A | 1 | Autologous blood transfusion involves which 3 methods? | Preoperative autologous blood donation, acute normovolemic hemodilution, and perioperative blood cell salvage | Preoperative allogenic blood donation, acute normovolemic hemodilution, and perioperative blood cell salvage | Preoperative autologous blood donation, acute hypervolemic hemodilution, and perioperative blood cell salvage | Preoperative allogenic blood donation, acute hypovolemic hemodilution, and perioperative blood cell salvage | 自体输血包括哪三种方法？ | 术前自体献血、急性等容血液稀释和围手术期血液回收 | 术前异体献血、急性等容血液稀释和围手术期血液回收 | 术前自体献血、急性高容量血液稀释和围手术期血液回收 | 术前异体献血、急性低容量血液稀释和围手术期血液回收 | null | null | null | null | null | null | null | null | null | null |
50568e83-8765-5e0e-affa-79c43ef8714f | 4 | D | 1 | To increase the amount of times one may safely donate his/her own blood (autologous blood donation) for a future surgical procedure, which of the following may be administered to the patient before donation? | Intravenous iron | Oral iron | Factor VIII concentrate | Erythropoietin | 为了增加一个人可以安全捐献自身血液（自体输血）用于未来的手术次数，以下哪种药物可以在捐献前给予患者？ | 静脉注射铁剂 | 口服铁剂 | 第八因子浓缩物 | 促红细胞生成素 | null | null | null | null | null | null | null | null | null | null |
279e7f30-b00b-5658-8c94-b3f871ceecfe | 4 | B | 1 | Which of the following examples could be an indication for using the process known as "acute normovolemic hemodilution"? | Congenital heart disease | Refusal of allogenic blood products | Anticipated blood loss of one-third of the patient's volume | Preoperative anemia | 以下哪种情况可能是使用“急性等容血液稀释”过程的指征？ | 先天性心脏病 | 拒绝异体血制品 | 预计失血量为患者血容量的三分之一 | 术前贫血 | null | null | null | null | null | null | null | null | null | null |
c1de9c0b-efd2-51a8-b1dc-c9984fd79081 | 4 | C | 1 | A primary concern with intraoperative blood cell salvage includes which of the following? | Lack of validated evidence | Increased rates of infection compared with allogenic blood products | Dilutional coagulopathy | Decreased stimulation of erythropoiesis | 术中血液回收的主要关注点包括以下哪一项？ | 缺乏验证的证据 | 与异体血制品相比感染率增加 | 稀释性凝血病 | 促红细胞生成减少 | null | null | null | null | null | null | null | null | null | null |
a96f2832-8f0e-5717-bcb7-8b458abbfd31 | 4 | B | 1 | Perioperative blood salvage can be considered if the estimated blood loss will likely exceed which of the following? | 500 mL | 1000 mL | 1500 mL | 2000 mL | 如果预计失血量可能超过以下哪一数值，可以考虑围手术期血液回收？ | 500 毫升 | 1000 毫升 | 1500 毫升 | 2000 毫升 | null | null | null | null | null | null | null | null | null | null |
b95ce0f1-be9e-5b6a-b793-a44fa8085017 | 4 | C | 3 | 21. Jehovah's Witnesses are a population whose beliefs lead to a refusal to accept blood products. Which of the following represents the best management of a conscious Jehovah's Witness patient who presents for emergency surgery with a high likelihood of significant blood loss? | Transfuse blood products as clinically indicated. | Refuse to transfuse blood products. | Have a discussion with patients about their beliefs about blood products. | Meet with hospital ethics team and legal counsel before surgery. | 21. 耶和华见证人是一个因信仰而拒绝接受血液制品的人群。以下哪项代表对一位意识清醒且因紧急手术而可能出现大量失血的耶和华见证人患者的最佳管理方式？ | 根据临床指征输注血液制品。 | 拒绝输注血液制品。 | 与患者讨论他们对血液制品的信仰。 | 在手术前与医院伦理团队和法律顾问会面。 | null | null | null | null | null | null | null | null | null | null |
03e59db0-b606-5279-adb7-b1b3ed0047a6 | 4 | B | 1 | When an individual's hematocrit falls below a certain value, erythropoietin is released. Which of the following %is the "critical" value for its release? | 25% | 30% | 35% | 40% | 当一个人的血细胞比容低于某个值时，会释放促红细胞生成素。以下哪个百分比是其释放的“临界”值？ | 25% | 30% | 35% | 40% | null | null | null | null | null | null | null | null | null | null |
ea6db718-69b2-542e-92f1-ca30a63a41d5 | 4 | B | 1 | A 66-year-old man is scheduled to undergo a right total hip replacement and prefers a neuraxial technique. You note that he has a history of thrombocytopenia. Which of the following is the platelet transfusion threshold for patients undergoing neuraxial anesthesia? | 10 000 | 50 000 | 75 000 | 100 000 | 一名66岁的男性计划进行右侧全髋关节置换术，他更倾向于使用神经轴技术。你注意到他有血小板减少的病史。以下哪项是接受神经轴麻醉的患者的血小板输注阈值？ | 10 000 | 50 000 | 75 000 | 100 000 | null | null | null | null | null | null | null | null | null | null |
9efd5ff2-da5f-57e2-857d-2769053f2c7b | 4 | C | 1 | Routine transfusion of packed red cells in a (stable) critically ill patient is NOT necessary unless the hemoglobin concentration is below which of the following? | 5.8 g/dL | 6.5 g/dL | 7 g/dL | 8.6 g/dL | 对于（稳定的）危重病人，常规输注浓缩红细胞是不必要的，除非血红蛋白浓度低于以下哪个值？ | 5.8 g/dL | 6.5 g/dL | 7 g/dL | 8.6 g/dL | null | null | null | null | null | null | null | null | null | null |
5d0671ee-499b-5ca9-ae9c-50b957b6f06d | 4 | A | 1 | What is the most appropriate storage parameters for packed RBCs that LACK an additive solution? | 1°C-6°C for 21-35 days | <−65°C for 10 years | 20°C-24°C for 5 days | <−18°C for 1 year | 对于缺乏添加剂溶液的浓缩红细胞，最合适的储存参数是什么？ | 1°C-6°C，储存21-35天 | <−65°C，储存10年 | 20°C-24°C，储存5天 | <−18°C，储存1年 | null | null | null | null | null | null | null | null | null | null |
7e2dcd0a-5198-5d1e-b9d1-0878bb8e5697 | 4 | D | 1 | Blood donors in the United States are required to have a minimum hemoglobin level of which of the following? | 7 | 9.5 | 11 | 12.5 | 美国的献血者需要达到以下哪一项的最低血红蛋白水平？ | 7 | 9.5 | 11 | 12.5 | null | null | null | null | null | null | null | null | null | null |
fa13d773-3458-54a6-8cd6-7f60acfd0e38 | 4 | A | 1 | Which of the following statements is true with regard to transfusing FFP? | It contains all factors involved in hemostasis. | It does not need to be ABO-compatible. | It must be used within 1 year of collection. | It carries no risk of transfusion-related acute lung injury (TRALI). | 以下关于输注新鲜冰冻血浆（FFP）的说法中哪一项是正确的？ | 它包含所有参与止血的因子。 | 它不需要与ABO血型相容。 | 它必须在采集后1年内使用。 | 它没有输血相关急性肺损伤（TRALI）的风险。 | null | null | null | null | null | null | null | null | null | null |
546b6255-752b-5e6f-ac19-c2cad07129d6 | 4 | C | 1 | 28. Cryoprecipitate contains all of the following factors EXCEPT which one? | von Willebrand factor | Factor VIII | Factor IX | Factor XIII | 28. 冷沉淀含有以下所有因子，除了哪一个？ | von Willebrand 因子 | 凝血因子 VIII | 凝血因子 IX | 凝血因子 XIII | null | null | null | null | null | null | null | null | null | null |
c478f37e-b16d-5a26-ad9c-bae749d58211 | 4 | B | 1 | The most common reaction observed during transfusions of blood products is which of the following? | An anaphylactoid reaction | Febrile nonhemolytic transfusion reaction (FNHTR) | Acute hemolytic transfusion reaction (AHTR) | Delayed hemolytic transfusion reaction (DHTR) | 在输注血液制品过程中观察到的最常见反应是以下哪一种？ | 类过敏反应 | 发热性非溶血性输血反应 (FNHTR) | 急性溶血性输血反应 (AHTR) | 延迟性溶血性输血反应 (DHTR) | null | null | null | null | null | null | null | null | null | null |
bfabd796-9dfc-57b1-b9c0-a1b01d379c27 | 4 | B | 2 | Immediately following a blood transfusion in the PACU, a patient becomes tachycardic, hypotensive, and febrile, and his nurse notes that he appears to have blood leaking from his incision. After stopping the transfusion and administering IV fluids, which of the following is the most appropriate test to conduct? | Tryptase | Direct Coombs test | Indirect Coombs test | Caffeine-halothane contracture test | 在恢复室输血后，患者出现心动过速、低血压和发热，护士注意到他的切口似乎有血液渗出。在停止输血并给予静脉输液后，以下哪项是最合适的检查？ | 胰蛋白酶 | 直接抗球蛋白试验 | 间接抗球蛋白试验 | 咖啡因-氟烷收缩试验 | null | null | null | null | null | null | null | null | null | null |
13295e24-70b5-5058-afc9-056bf9d508ec | 4 | D | 2 | Seven days following embolization for an occult gastrointestinal (GI) bleed, a patient is noted to be jaundiced, in addition to having a mild fever and | Liver biopsy | Aspartate aminotransferase/alanine aminotransferase | Prothrombin time/international normalized ratio | IV fluids | 在进行隐匿性胃肠道（GI）出血的栓塞术后七天，患者被发现出现黄疸，此外还有轻度发热和 | 肝活检 | 天冬氨酸氨基转移酶/丙氨酸氨基转移酶 | 凝血酶原时间/国际标准化比值 | 静脉输液 | null | null | null | null | null | null | null | null | null | null |
7071feb3-e583-5691-8595-f354e286cd52 | 4 | B | 2 | Allergic reactions to blood products in patients with a known IgA deficiency can be avoided by which of the following? | Leukoreduction | Washing | Irradiation | Premedication with acetaminophen | 在已知IgA缺乏的患者中，过敏反应可以通过以下哪种方法避免？ | 白细胞减少 | 洗涤 | 辐照 | 用对乙酰氨基酚预处理 | null | null | null | null | null | null | null | null | null | null |
66ebc394-a304-5837-a8bd-70f5d8b1262c | 4 | A | 1 | Which of the following is true about anaphylactoid responses to blood product tranfusions? | They show evidence of anti-IgA antibodies. | They are type I hypersensitivity IgE-mediated reactions. | The majority occur secondary to IgM-mediated antibody-antigen complexes. | They show evidence of IgG alloantibodies to Rh. | 以下哪项关于输血制品的类过敏反应是正确的？ | 它们显示出抗IgA抗体的证据。 | 它们是由IgE介导的I型超敏反应。 | 大多数是由IgM介导的抗体-抗原复合物引起的。 | 它们显示出对Rh的IgG同种抗体的证据。 | null | null | null | null | null | null | null | null | null | null |
c57e3e9c-5801-5243-baac-0621b1540c13 | 4 | C | 1 | To decrease the risk of transfusion-related graft-versus-host disease (GVHD), cellular components of blood should undergo which of the following? | Leukoreduction | Washing | Irradiation | Preservation using citrate phosphate dextrose adenine (CDPA) solution | 为了降低输血相关移植物抗宿主病（GVHD）的风险，血液的细胞成分应进行以下哪种处理？ | 白细胞减少 | 洗涤 | 辐照 | 使用柠檬酸磷酸葡萄糖腺苷（CDPA）溶液保存 | null | null | null | null | null | null | null | null | null | null |
b6e46dce-35fc-5290-9daa-e8e2a2245079 | 4 | C | 2 | 35. Following exploratory laparotomy for trauma in which a patient underwent a massive transfusion, the patient is noted to have twitching of the ipsilateral facial muscles when tapping on the face just below the zygomatic bone, as well as wrist flexion and hyperextension of the fingers when a blood pressure cuff is inflated above systolic blood pressure. Which of the following is the most likely cause for these symptoms? | Hyperkalemia | Hypokalemia | Citrate toxicity | Hypothermia | 35. 在创伤性探查性剖腹手术后，患者接受了大量输血，发现当在颧骨下方轻拍面部时，患者同侧面部肌肉出现抽搐，以及当血压袖带充气至高于收缩压时，手腕屈曲和手指过度伸展。以下哪项最可能是这些症状的原因？ | 高钾血症 | 低钾血症 | 枸橼酸盐中毒 | 低体温 | null | null | null | null | null | null | null | null | null | null |
7ec7bae3-4d5f-5b55-9dbb-beeb0e0ec35a | 4 | D | 3 | A patient received several units of blood products because of a massive GI hemorrhage. Which of the following sets of parameters is most concerning for | Onset of shortness of breath 3 days after transfusion with chest X-ray (CXR) showing focal infiltrates in the right lower lobe | Decreased lung compliance after induction of anesthesia with CXR showing no acute changes | CXR showing pulmonary edema, elevated B-type natriuretic peptide, and transthoracic echocardiogram showing left atrial enlargement | CXR showing pulmonary edema with acute bilateral infiltrates, PaO2 /FiO2 <300, SaO2 , 90% on room air, no evidence of left atrial hypertension | 一名患者因大出血性胃肠道出血接受了几单位的血液制品。以下哪组参数最令人担忧？ | 输血3天后出现呼吸急促，胸部X光片（CXR）显示右下叶局灶性浸润 | 麻醉诱导后肺顺应性下降，CXR显示无急性变化 | CXR显示肺水肿，B型利钠肽升高，经胸超声心动图显示左心房扩大 | CXR显示肺水肿伴急性双侧浸润，PaO2/FiO2 <300，室内空气SaO2 90%，无左心房高血压证据 | null | null | null | null | null | null | null | null | null | null |
7082c677-c0d4-51cd-ad11-c5a46849cf50 | 4 | C | 2 | A patient received several units of blood products because of a massive GI hemorrhage. Which of the following sets of parameters is most concerning for transfusion-related acute cardiovascular overload (TACO)? | Onset of shortness of breath 3 days after transfusion with CXR showing focal infiltrates in the right lower lobe | Decreased lung compliance after induction of anesthesia with CXR showing no acute changes | CXR showing bilateral pulmonary edema, elevated B-type natriuretic peptide, and transthoracic echocardiogram showing left atrial hypertension | CXR showing pulmonary edema with acute bilateral infiltrates, PaO2 /FiO2 <300, SaO2 , 90% on room air, no evidence of left atrial hypertension | 一名患者因大出血性胃肠道出血接受了多单位血液制品输注。以下哪组参数最令人担忧的是输血相关急性心血管超负荷（TACO）？ | 输血后3天出现呼吸急促，胸片显示右下叶局灶性浸润 | 麻醉诱导后肺顺应性下降，胸片无急性变化 | 胸片显示双侧肺水肿，B型利钠肽升高，经胸超声心动图显示左心房高血压 | 胸片显示肺水肿伴急性双侧浸润，PaO2/FiO2 <300，室内空气下SaO2 <90%，无左心房高血压证据 | null | null | null | null | null | null | null | null | null | null |
b145e766-ab15-5f31-91ba-ed52b52faf9d | 4 | D | 1 | Which of the following infections carries the highest residual risk post blood product transfusion in the United States? | Human immunodeficiency virus (HIV) | Hepatitis C virus | Hepatitis B virus | Cytomegalovirus (CMV) | 以下哪种感染在美国输血后具有最高的残余风险？ | 人类免疫缺陷病毒（HIV） | 丙型肝炎病毒 | 乙型肝炎病毒 | 巨细胞病毒（CMV） | null | null | null | null | null | null | null | null | null | null |
eaf149d2-70ae-5bdf-8e5f-2aa9522fa5c8 | 4 | B | 1 | Transfusion of which of the following blood products has the highest rate of infection? | Red blood cells | Platelets | Fresh frozen plasma | Cryoprecipitate | 输注以下哪种血液制品的感染率最高？ | 红细胞 | 血小板 | 新鲜冰冻血浆 | 冷沉淀 | null | null | null | null | null | null | null | null | null | null |
a1efff1d-18e9-555f-8271-fdcbce172d42 | 4 | B | 1 | Transfusion of blood products has been associated with which of the following? | Increased flares in patients afflicted with Crohn disease | Decreased rate of miscarriages in women with history of recurrent spontaneousabortion | Decreased reactivation of latent tuberculosis | Decreased rates of recurrent malignancies | 输注血液制品与以下哪项有关？ | 克罗恩病患者的发作次数增加 | 有复发性自然流产史的女性流产率降低 | 潜伏性结核病的再激活减少 | 复发性恶性肿瘤的发生率降低 | null | null | null | null | null | null | null | null | null | null |
4d5f199d-9df8-51bf-9549-fc6e855f2d16 | 4 | B | 1 | While performing a preoperative assessment on a patient with acromegaly, you note that his home medication list includes octreotide. Which of the following is the mechanism of action of octreotide? | Competitive inhibition at the growth hormone (GH) receptor | Inhibition of GH and IGF-1 secretion | Stimulation of insulin secretion | Agonism at the dopamine receptor | 在对一名患有肢端肥大症的患者进行术前评估时，您注意到他的家庭用药清单中包括奥曲肽。以下哪项是奥曲肽的作用机制？ | 在生长激素（GH）受体处的竞争性抑制 | 抑制GH和IGF-1的分泌 | 刺激胰岛素分泌 | 在多巴胺受体处的激动作用 | null | null | null | null | null | null | null | null | null | null |
ff91e6d8-656c-580c-bcdb-8bafec24ae8e | 4 | B | 1 | Which of the following hormones is released from the posterior pituitary gland? | Thyroid-stimulating hormone (TSH) | Vasopressin (antidiuretic hormone [ADH]) | Corticotropin (adrenocorticotropic hormone [ACTH]) | Growth hormone | 下列哪种激素是由后叶垂体释放的？ | 促甲状腺激素 (TSH) | 加压素 (抗利尿激素 [ADH]) | 促肾上腺皮质激素 (ACTH) | 生长激素 | null | null | null | null | null | null | null | null | null | null |
561314d4-fc38-5ef2-9a25-6980b1dcfe87 | 4 | D | 1 | Which of the following statements is true of the syndrome of inappropriate antidiuretic hormone (SIADH)? | Chronic hyponatremia from SIADH should be corrected with hypertonic saline. | Peripheral edema is a common physical exam finding. | Most cases of SIADH are due to an intrinsic pituitary disorder. | Demeclocycline may be used to treat SIADH. | 以下哪项陈述是关于抗利尿激素分泌异常综合征（SIADH）的正确描述？ | SIADH引起的慢性低钠血症应使用高渗盐水纠正。 | 外周水肿是常见的体格检查发现。 | 大多数SIADH病例是由于内在的垂体疾病引起的。 | 去氯羟四环素可用于治疗SIADH。 | null | null | null | null | null | null | null | null | null | null |
e073e9bf-176e-57c3-bf43-c3c81e6afcac | 4 | A | 1 | Which of the following statements is true with regard to diabetes insipidus (DI)? | Desmopressin administration can distinguish central versus nephrogenic DI. | Patients with nephrogenic DI will increase urine osmolality in response to desmopressin. | Thiazide diuretics may be used to treat central DI. | Patients with central DI will fail to respond to exogenous desmopressin administration. | 以下关于尿崩症（DI）的说法哪一项是正确的？ | 去氨加压素的使用可以区分中枢性和肾性尿崩症。 | 肾性尿崩症患者在使用去氨加压素后尿液渗透压会增加。 | 噻嗪类利尿剂可用于治疗中枢性尿崩症。 | 中枢性尿崩症患者对外源性去氨加压素的使用无反应。 | null | null | null | null | null | null | null | null | null | null |
ce35483c-34ec-5993-aef6-6501116c139d | 4 | B | 1 | Which of the following features is more consistent with a diagnosis of a pituitary macroadenoma than that of a pituitary microadenoma? | Galactorrhea | Visual field deficit | Thyrotoxicosis | Cushing disease | 以下哪一特征更符合垂体大腺瘤的诊断，而不是垂体小腺瘤？ | 泌乳 | 视野缺损 | 甲状腺功能亢进 | 库欣病 | null | null | null | null | null | null | null | null | null | null |
44e5e751-4398-5ecd-85f2-499868b933d0 | 4 | B | 1 | Which of the following statements pertaining to thyroid storm is true? | Atrial fibrillation is required for diagnosis. | Mortality rate may exceed 20%. | TSH levels are elevated. | Hyperthermia is rare. | 以下关于甲状腺危象的陈述中哪一项是正确的？ | 诊断需要心房颤动。 | 死亡率可能超过20%。 | TSH水平升高。 | 高热很少见。 | null | null | null | null | null | null | null | null | null | null |
b271a8c1-eeed-51b0-a2c9-1554f7a2a9a4 | 4 | C | 1 | Which of the following is likely to be seen when a patient with hypothyroidism is under general anesthesia? | Hypotension | Prolongation of nondepolarizing neuromuscular blockers | Bradycardia | Hyperglycemia | 在甲状腺功能减退的患者接受全身麻醉时，以下哪种情况可能会出现？ | 低血压 | 非去极化肌松药作用时间延长 | 心动过缓 | 高血糖 | null | null | null | null | null | null | null | null | null | null |
5bf0bd53-fa49-53f4-bf80-7e469a3b923f | 4 | B | 1 | Which of the following statements is true with regard to potential complications associated with thyroid surgery? | Unilateral recurrent laryngeal nerve damage will cause aphonia. | Unanticipated difficult airway is present in 5%-8% of thyroid cases. | Retrosternal thyroid may cause airway obstruction with prone positioning. | Postoperative hypocalcemia typically manifests immediately in the postanesthesia care unit. | 以下关于甲状腺手术相关潜在并发症的说法中哪一项是正确的？ | 单侧喉返神经损伤会导致失音。 | 5%-8%的甲状腺病例中存在意外的困难气道。 | 胸骨后甲状腺可能在俯卧位时导致气道阻塞。 | 术后低钙血症通常在麻醉后护理单元立即表现出来。 | null | null | null | null | null | null | null | null | null | null |
1f68d89a-1547-55d0-83a9-b413f23f8821 | 4 | C | 1 | Which of the following diagnostic results is consistent with a diagnosis of Grave disease? | Elevated TSH | Normal free T4 | Diffusely increased radioactive iodine uptake | Decreased free T3 | 以下哪项诊断结果与Grave病的诊断一致？ | TSH升高 | 游离T4正常 | 放射性碘摄取弥漫性增加 | 游离T3降低 | null | null | null | null | null | null | null | null | null | null |
09c55fbf-4272-5c1e-b52c-740fc738058e | 4 | A | 1 | Which statement correctly describes one of the actions of parathyroid hormone (PTH)? | PTH increases Ca 2+ resorption in the ascending loop of Henle, distal tubule, and collecting tubule of the kidney. | PTH inhibits 1α-hydroxylase gene in renal cells. | PTH promotes uptake of calcium by osteocytes. | PTH increases the reabsorption of phosphate and bicarbonate in the nephron. | 哪项陈述正确描述了甲状旁腺激素（PTH）的一种作用？ | PTH增加肾脏亨利氏袢升支、远曲小管和集合小管中Ca 2+的重吸收。 | PTH抑制肾细胞中1α-羟化酶基因。 | PTH促进骨细胞对钙的摄取。 | PTH增加肾单位中磷酸盐和碳酸氢盐的重吸收。 | null | null | null | null | null | null | null | null | null | null |
c710469b-0b0c-5c2e-8df4-390943710671 | 4 | D | 1 | Which of the following is the primary mechanism by which calcitonin reduces serum Ca 2+ levels? | Increasing the renal excretion of phosphate | Decreasing the intestinal absorption of calcium | Promotion of osteoblastic activity to increase bone formation | Inhibition of osteoclast activity to decrease bone resorption | 以下哪项是降钙素降低血清钙离子水平的主要机制？ | 增加磷酸盐的肾脏排泄 | 减少钙的肠道吸收 | 促进成骨细胞活动以增加骨形成 | 抑制破骨细胞活动以减少骨吸收 | null | null | null | null | null | null | null | null | null | null |
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