患者女性，55岁。体检发现血压增高1个月来诊，有高血压家族史。则最不可能出现的是

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• 1患者女性，30岁。怕热多食消瘦半年，多饮多汗2个月，则下列体征最不可能出现的是

  A.S1减弱

  B.脉搏短绌

  C.心尖区收缩期2/6级杂音

  D.脉压增大

  E.心动过速

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• 2患者男性，66岁。因头晕半年来诊，查体：血压180/95mmHg，心界扩大，未闻及杂音。临床诊断原发性高血压。则下列最可能出现的体征是

  A.奇脉

  B.杜氏双重音

  C.烧瓶心

  D.P2增强

  E.靴形心

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• 3患者女性，18岁。2个月前重感冒，近1个月来心悸气促，进行性加重。查体BP90/60mmHg，交替脉，心界向双侧扩大，心律120次/分，心音低弱，可闻及舒张期奔马律，未闻及确切杂音。则诊断最可能是

  A.甲状腺功能低下

  B.缩窄性心包炎

  C.心包积液

  D.大面积心肌梗死

  E.心肌炎

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• 4下列最可能诊断为先天性心脏病、动脉导管未闭的病例是

  A.患儿男性，6岁。胸骨左缘第2肋间3/6级粗糙吹风样杂音，伴P2增强，S2固定分裂

  B.患者女，3岁。胸骨左缘第2肋间闻及连续性粗糙响亮机器样杂音，伴震颤

  C.患者，38岁。于胸骨左缘3、4肋间闻及舒张期哈气样递减杂音

  D.患儿男性，1岁。胸骨左缘3、4肋间闻及全收缩期4/6级粗糙响亮的杂音伴震颤

  E.患者男性，27岁。胸骨右缘第2肋间闻及粗糙喷射性收缩期递增递减性杂音伴震颤

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• 5患者男性，36岁。因头晕胸痛半个月来诊，查体：血压160/35mmHg，胸部X线片提示：靴形心。则下列不可能出现的体征是

  A.毛细血管搏动征

  B.水冲脉

  C.胸骨右缘第2肋间的收缩期震颤

  D.胸骨左缘3、4肋间的舒张早期递减性杂音

  E.枪击音

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• 6患者女性，2岁。因出生1个月感冒发现心脏杂音来诊。查体于胸骨左缘第2肋间闻及收缩期3/6级柔和吹风样杂音，伴P2增强，S2分裂且不受呼吸影响，则最可能是

  A.S2通常分裂

  B.肺动脉瓣狭窄

  C.S2生理性分裂和生理性杂音

  D.房间隔缺损

  E.S2反常分裂

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• 7A 34-year-old man complains of repeated precordial pain and shortness of breath for 3 years，BP：150/30mmHg，the cardiac dullness shaped as a boot，which of the following can’t be found in the physical examination

  A.systolic murmur in the 2nd right intercostal space

  B.pistol shot sound in brachial artery

  C.alternant

  D.diastolic murmur at apical area

  E.water-hammer pulse

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• 8A 29-year-old man came to the emergency room for dizziness.Echocardiography shows ventricular septum thickening，the part in left ventricle outflow tract protruding into left ventricle.Hypertrophic cardiomyopathy is considered.Which of the following is probably wrong

  A.Cardiac dullness mildly enlarged

  B.S4can be heard

  C.markedly increased A2

  D.3/6grade systolic murmur at apical area

  E.rough ejection systolic murmur in the 3rd-4th left intercostal space

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• 9A 25-year-old woman complains of shortness of breath and palpitation after exercise for 3 years.PE：cardiac dullness shifted to the lower and left，narrow cardiac waist，the heart shaped like a boot，which should be considered the first diagnosis

  A.aortic valve insufficiency

  B.pulmonary heart disease

  C.dilated cardiomyopathy

  D.pure mitral stenosis

  E.hypertensive heart disease

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• 10Echocardiography for a 38-year-old man showed mitral valve prolapse.Which of the following can be found during physical examination

  A.early systolic click

  B.opening snap

  C.presystolic gallop rhythm

  D.mid and late systolic click

  E.mid and late diastolic click

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