内科学_肾小球肾炎

试卷预览

• 21患者女性，17岁，上呼吸道感染2周后出现颜面下肢水肿，血压150/95mmHg，24小时尿蛋白定量1.5g，尿红细胞35个/HP，血红蛋白112g/L，血补体C3下降，血肌酐116μmol/L，最可能的诊断是

  A.急进性肾炎

  B.高血压肾损害

  C.慢性肾炎急性发作

  D.急性肾炎

  E.肾病综合征

  开始考试练习点击查看答案
• 22患者男性，32岁，平素体健。因反复咯血1周，进行性少尿4天入院，血压165/105mmHg。尿常规：尿蛋白（+++)，尿红细胞（++++)，入院后病情继续恶化，血压升高加重，血肌酐378μmol/L，考虑诊断为

  A.急性肾炎

  B.急进性肾炎

  C.流行性出血热

  D.过敏性紫癜

  E.慢性肾炎急性发作

  开始考试练习点击查看答案
• 23患者男性，18岁。1周来尿少色红，伴眼睑和双下肢水肿，血压150/90mmHg，尿蛋白（++)，RBC10〜20个/HP，WBC5〜10个/HP，血红蛋白136g/L，肌酐 95μmol/L。追问病史，3周前有咽痛发热史。该患者最可能的诊断为

  A.急性肾炎

  B.急进性肾炎

  C.急性肾盂肾炎

  D.肾病综合征

  E.慢性肾炎急性发作

  开始考试练习点击查看答案
• 24A 39-year-old male presents with a long-standing history of hypertension. Investigations show a urea of 9.2mmol/L and a Creatinine of 142μmol/L. Which one of the following would suggest a diagnosis of acute glomerulonephritis

  A.24 hour urinary protein excretion of 3.1g

  B.Unilaterally smaller kidney

  C.RBC casts in urinary sediment

  D.Dyslipidaemia

  E.Shrunken glomeruli on renal biopsy

  开始考试练习点击查看答案
• 25A 60-year-old previously healthy man has been feeling tired for the past 15 days. He goes to his physician when he passes dark-colored urine. On physical examination his blood pressure is 155/90mmHg. Laboratory studies show his serum creatinine is 390μmol/L, P-ANCA 1 ： 160( + ). A urinalysis reveals pH 6,specific gravity 1.011,4+ blood,2+ pro­tein, no glucose,and no ketones. Which of the following pathologic findings on renal biopsy is most likely to be present in this man

  A.大于50% glomerular crescents

  B.Widened proximal tubules

  C.Lymphocytes infiltration

  D.Severe interstitial fibrosis

  E.IgA deposited in glomerular capillaries

  开始考试练习点击查看答案
• 26患者女性，29岁，间歇性颜面及下肢水肿4年。查体：血压150/95mmHg，Hb90g/L，尿蛋白（++)，RBC 15〜20个/HP，BUN 8.7mmol/L，Cr148μmol/L。可能的诊断是

  A.隐匿性肾炎

  B.肾病综合征

  C.急性肾炎

  D.慢性肾炎

  E.高血压肾损害

  开始考试练习点击查看答案
• 27患者男性，13岁。上呼吸道感染后2周出现颜面水肿伴肉眼血尿，血压150/95mmHg，内生肌酐清除率下降，拟诊急性肾炎。实验室检查：血红蛋白95g/L，患者贫血的原因可能是

  A.水钠潴留，血液稀释

  B.骨髓抑制

  C.红细胞破坏增多

  D.失血

  E.促红细胞生成素生成减少

  开始考试练习点击查看答案
• 28患者男性，34岁，2年来反复镜下血尿，偶见红细胞管型。尿蛋白定量1.3g/d，血肌酐 102μmol/L，尿素氮5.4mmol/L，ALB 30g/L，IgA 0.6g/L，抗“O”600U。为了明确诊断，最有价值的进一步检查是

  A.膀胱镜检查

  B.肾活检

  C.尿查抗酸杆菌

  D.逆行肾盂造影

  E.清洁中段尿细菌培养

  开始考试练习点击查看答案
• 29A 23 year-old female presents at 16 weeks into her first pregnancy with a blood pressure of 144/96mmHg. A 24 hour urine collection reveals a protein excretion of 1.7g/ d. What is the most likely explanation for these findings

  A.Normal changes of pregnancy

  B.Gestational hypertension

  C.Essential hypertension

  D.Pre-eclampsia

  E.Hypertension secondary to chronic glomerulonephritis

  开始考试练习点击查看答案
• 30患者男性，16岁，上呼吸道感染后2周出现眼睑水肿、肉眼血尿。查体：血压145/90mmHg，血补体下降，血肌酐98μmol/L。其发生水肿的主要机制是

  A.全身毛细血管通透性增高

  B.低白蛋白血症

  C.抗利尿激素分泌增加

  D.肾小球滤过率下降

  E.淋巴回流受阻

  开始考试练习点击查看答案