A 36-year-old male peasant was crushed on the upper trunk for 30 minutes when his house collapse The patient has dyspnea and is conscious with BP18/14kPa， pulse 100/min， breath 30/min， conjunctival congestion in both eyes， distended jugular veins， bruised skin on the chest，soft abdomen， normal urine routine test findings，and without tenderness. The most likely diagnosis is(    )

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• 1一农民，左大腿被柴刀砍伤，8小时后送医院急诊。检查：左大腿外侧有5cm长伤口，边缘尚整齐，伤口内沾有较多泥土，处理宜(    )

  A.冲洗、消毒后缝合

  B.清创后一期缝合

  C.清创后延期缝合

  D.清创后不予缝合

  E.伤口换药

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• 2有关损伤的诊治，下列哪些是错误的(    )

  A.扭伤是外力作用于四肢关节引起的

  B.严重挤压伤和剥脱伤可引起休克和急性肾衰竭

  C.胸腹部严重挫伤，要注意内部组织器官的损伤

  D.刺伤是一类较易感染的损伤

  E.裂伤可行简单缝合术

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• 3创伤性窒息，下列哪项是错误的(    )

  A.受伤可致声门关闭，使胸膜腔内压力骤升

  B.呼吸困难，非常突出

  C.上半身广泛淤血

  D.眼眶内出血，眼球突出

  E.预后一般良好

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• 4挤压伤，下列哪项是错误的(    )

  A.乃重物挤压人体某一肌肉丰富部位所致

  B.伤处有较广泛的组织破坏

  C.常有局部明显肿胀，甚至静脉回流受障

  D.有大量红细胞和肌细胞破坏

  E.可并发休克和急性肾衰竭

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• 5病人，男性，20岁，自高处坠地，右胸部着地，来诊，途中呕吐一次，约50ml，呕吐物中有少量血液，2小时后大便呈黑色，量不多。体格检查：血压12/8kPa，脉搏100次/分，右下胸部肿胀，压痛明显，全腹压痛，肌紧张，肝区叩痛明显，右下腹诊断性穿刺抽到不凝血2ml，X线胸片示右9、10肋骨骨折，腹部X线平片未见异常，该病人可能的诊断是(    )

  A.肝破裂伴胆道出血

  B.脾破裂

  C.十二指肠破裂

  D.胃破裂

  E.肋骨骨折伴胸部损伤出血

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• 6A female student， aged 18 years，w ho fell on her buttocks in a bicycle accident presents with swollen soft tissue， hot skin， and tenderness in the left buttock. The doctor suspects inflammation， where the patient has traumatic inflammation besides bacterial infection. Which of the following is NOT among the possible pathologic responses?(    )

  A.Vascular response

  B.Infiltration of water， electrolyte，and plasma protein into the interstitial space

  C.Entry of neutrophils and monocytes into the interstitial space

  D.Increased arachidonic acid

  E.Rupture and bleeding of blood vessels

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• 7Which of the following injury is closed injury(    )

  A.abrasion

  B.laceration

  C.sprain

  D.gun shot wound

  E.cut wound

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• 8Which of the following injury is open injury(    )

  A.contusion

  B.sprain

  C.dislocation

  D.abrasion

  E.rupture of spleen

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• 9Which of the following is NOT usually present in severe injury(    )

  A.enhanced basic metabolic rate

  B.increased energy consumption

  C.enhanced immune function

  D.decreased neutrophil and monocyte function

  E.increased accumulation of water and natrium

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• 10男性，64岁，农民，2天前因棉花包滚下压伤身体，检查：精神不振，呼吸18次/分，脉搏110次/分，血压18/12kPa，两下稍肿有瘀斑，股骨动脉良好，pH升高，PCO2正常，此时的暂时性酸碱平衡失调为(    )

  A.代谢性酸中毒

  B.代谢性碱中毒

  C.混合性酸中毒

  D.混合性碱中毒

  E.呼吸性碱中毒

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