The best choice of examinations for the location and severity of the stenosis in coronary arteries is:

A 55-year-old woman, suddenly developed symptoms of dizziness, amaurosis and aphasia. Blood pressure was measured at 220/130 mmHg. Which of the following antihypertensive drugs should be preferred ?

3.The blood pressure in a 65 years old man is 163/110 mmHg. Which category is suitable for the patient according to the definition and classification of blood pressure levels?

Which of the following disorders may limit using of Beta blockers?

Angiotensin converting enzyme inhibitors should not be applied in patients except for?

Which of the followings is the most important pathophysiologic mechanism of chronic heart failure?

A 57-year-old male had recurrent pain in the precordial area for more than 2 years on exertion. Today, he suddenly developed severe pain in the precordial area on exertion. The pain continued for 3 hours without relief after taking nitroglycerin. PE: BP 80/50mmHg, similar on both sides, low heart sounds, no rales in both lungs. What diagnosis should be considered?

A 65-year-old man presents to the emergency department because of dyspnea that started 1 month ago and aggravated for three days. On physical examination, distention of jugular vein and swelling of lower extremities can be seen, some moist rales are heard in the lungs. BP 110/60mmHg. ECG shows sinus tachycardia (116bpm). The echocardiogram shows biventricular dilation with LVEF 35%. Which of the following medications is NOT appropriate for this patient?

A 75-year-old woman goes to the hospital because of palpitation and dyspnea. The ECG shows atrial fibrillation. The echocardiogram shows moderate mitral valve stenosis. Which of the following drugs should be considered for this patient?

A 45-year-old woman goes to the hospital with an awareness of rapid beating of the heart. The ECG shows as below. What is the diagnosis of this patient?

A 78-year-old woman is brought to the emergency department because of fainting. The ECG shows as below. What is the diagnosis of this patient?

A 55- year-old, male, shortness of breath for more than 5 years, aggravated for 1 week. He was unable to perform daily activities, often woke up from sleep due to difficulty catching his breath. Physical examination suggested bilateral diffuse crackles in lungs, elevated jugular venous pressure, moderate pitting lower extremity edema. Which of the following tests should be done before we diagnose the patient has dilated cardiomyopathy?

A 65-year-old female, dyspnea for 2 months, with fever and chills. She had aortic valve replacement surgery 10 years ago. Physical examination found that she had new-onset cardiac murmurs. What is the most likely diagnosis of her?

A 36-year-old female, chest pain and short of breath on exertion for 3 years, aggravated for 2 months. She had no history of hypertension, hyperlipidemia or diabetes. Her father died suddenly and the detailed reason was unknown. Physical examination suggested systolic cardiac murmurs. Which of the following is the most important test for diagnosis?

A 35-year-old female, recurrent palpitations for 10 years. The palpitations could be abrupt terminated in about 30 minutes. When she admitted to the hospital, the symptoms were already relieved. Today, the palpitation reoccurred suddenly. The 12-lead electrocardiograph was obtained. Which of the following has both diagnostic and therapeutic value for this patient?

1.Which of the following iterms are complications of chronic obstructive pulmonary disease:

Which Drug belongs to short-acting beta-2 agonists (SABA):

Which is necessary condition for the diagnosis of community-acquired pneumonia (CAP):

Which of following is most common in anaerobic bacteria infection:

What is not correct for bronchiectasis:

A 30-year-old man has been treated with isoniazid, rifampin, and pyrazinamide for active pulmonary tuberculosis. After 4 months, he states he is having numbness and tingling of both feet but no back pain. He denies taking other medications. Which of the following is the most appropriate next step?

A 65-year-old male has had a chronic cough with sputum production for over 5 years. He has smoked one pack of cigarette per day for 20 years and continued to do so. X-ray of the chest shows hyperinflation without infiltrates. Arterial blood gases show a PH of 7.38, PaCO2 of 41 mmHg, and PaO2 of 67mmHg. Spirometry shows an FEV1/FVCpred of 45% without bronchodilator response. Which of the following is the most key treatment for this patient?

A 60 years old patient come to hospital for chief complain of breathless, without the symptom of chest pain，hemoptysis and weight loss，but he had a history of ankle fracture 1 month before admission. Smoking for more than 30 years with 20/day. No positive physical examination findings. Vital signs: T 36.3℃; P121; RR 23; BP 95/58 mmHg；Blood gas analysis PH 7.50 PaO₂ 50mmHg PaCO₂ 25mmHg. WBC 8.1*10^9/L CRP14. D-dimer＞ 20，what is the most likely diagnosis?

Which of the following is characteristic of asthma but not other obstructive lung disease?

Male, 50 years old. In recent 1-year, progressive aggravation of shortness of breath, occasionally dry cough. X-ray showed diffuse reticular nodules in both lungs, and pulmonary function examination showed restrictive ventilation disorder. Which of the following signs of suspected idiopathic pulmonary fibrosis (IPF) supports this diagnosis?

A 50-year-old male presented with cough and expectoration for 3 months. Physical examination revealed enlargement of the right supraclavicular lymph node. Chest CT showed a space occupying lesion with a diameter of 35 mm in the right upper lobe, lobulation and spiculation, without pleural involvement, and a calcified nodule in the left upper lobe. The result of supraclavicular lymph node biopsy was metastatic lung adenocarcinoma. Systematic evaluation showed no signs of tumor metastasis in other sites. The stage of the patient was:

A 68 year old man，feel breathless after a violent cough, with some yellow sputum. He had been smoking for 40 years, with a history of emphysema. On the left side of the chest with decreased fremitus, decreased breath sound, Tympany to left percussion. What is the most likely diagnosis?

An 60-year-old male patient with chronic bronchitis has been suffering from severe cough recently. He came to our emergency department due to sudden right chest pain and dyspnea. If you are a doctor, which of the following physical examinations can distinguish pneumothorax from pleural effusion:

A 40 year-old female come to hospital for chief complain of hemoptysis, accompanying with low fever, cough, a little out of breath. No Smoking. Vital sign：T 37.5℃; P90; RR 26; BP 125/78mmHg；The breath sound of right lung was decreased. Blood gas analysis PaO2 78mmHg PaCO2 28mmHg. WBC 9.0*10^9/L；CRP 37mg/L；ESR 56mm/h; X ray indicate right pleural effusion. The pleural fluid appear with little yellow color, testing with a PH 7.40, WBC 1200, lymph% 80%. lactate dehydrogenase (LDH) level of 225 IU, ADA level of 60 and CEA level of 4.0. Which of the following disorders is most likely in this patient?

The patient, female, 43 years old, was admitted to the hospital with "recurrent cough with intermittent low-grade fever for more than one month and blood in the sputum for one week", T37.5℃, CT of the lung suggested patchy exudate with cavity formation in the right upper lung. Which of following tests can confirm tuberculosis?

Virchow's node is a sign of metastatic malignancy mainly from gastric cancer. Which part of the lymph nodes does it refer to?

Which of the following marker is not included in the Child-Pugh scoring system:

Which of the following measures to prevent acute pancreatitis is incorrect:

Which of the following clinical symptoms is not present in patients with irritable bowel syndrome:

The most important factor in the formation of duodenal ulcer is:

A 45-year-old male presented with intermittent epigastric pain for 8 years. The pain usually happened after meal, accompanied by acid regurgitation and burning, and can be relieved by antacids. The pain worsened in the recent 5 months, with loss of regularities.Antacids did not work as past. Which of the following investigation should be firstly considered in order to make a clear diagnosis?

A 68-year-old male presents with a complaint of fatigue. There is no history of alcohol abuse or liver disease, the patient is on no medication. Scleral icterus is noted on physical exam. And the liver and spleen are nonpalpable. The patient is noted to have a normocytic, nomochromic anemia. The first step in evaluation of this patient would be:

A 42-year-old man has had upper abdominal pain for 4 months. For the past week he has nausea. On labatory examination, a stool sample tested for occult blood is positive. An upper GI endoscopy reveals no esophageal lesions, but there is a solitary 1.5cm diameter shallow, sharply demarcated ulceration locating at the stomach’s antrum. What is the most probable diagnosis?

A 50 years old female patient had a sudden continuous pain after overeating, which spreaded to the whole abdomen. PE: whole abdomen tenderness、rebound tenderness and muscle rigidity. We could see crescent-shaped gas shadow in X-ray. Which is the diagnosis:

This patient (female, 32) had low fever and diarrhea for 5 months as well as pasty feces without bloody pus. This week, she had periodical umbilicus pain and had the sign of: 4*5 cm mass touchable in the right lower quadrant abdomen (slight tenderness and moderate texture), accentuated bowel sound. ESR 58 mm/h, PPD +++, the most likely disease:

Male, 28 years old, experienced acute pain in the left upper abdomen accompanied by nausea after excessive late alcohol consumption. He vomited, but the pain did not relieve after vomiting. Physical examination revealed obvious tenderness in the left upper abdomen, accompanied by muscle tension, mobile dullness (-), and weak bowel sounds. Emergency abdominal fluoroscopy showed obvious intestinal inflation, with liquid level visible in 2-3 intestinal tubes and free gas (-) under diaphragm. Which diagnosis is most likely for this patient :

A 30-year-old man complained of recurrent upper abdominal hunger-like pain for 6 years. Gastroscopy revealed duodenal ulcer. Which of the following bacteria infection was associated with this recurrent peptic ulcer of this patient?

A 35 year-old man requires surgical resection for an intestinal disorder. Three years later, he returns with diarrhea, macrocytic anemia, and gallstones. What was the underlying disorder?

Male, 32 years old, repeated solution of mucus pus and blood for 2 years, physical examination: mild anemia appearance, no abnormalities in heart, lung and abdomen, red blood cell (++) and white blood cell (++) in stool routine, the most likely diagnosis?

Male, 50 years old, past medical history of diabetes, hepatitis B for 10 years. After eating a lot of meat 1 day ago, he had consciousness obstacle, accompany unreal hearing vision. Physical examination: positive flapping wing tremor and bilateral pap sign. Electroencephalogram showed mild abnormalities. the most likely diagnosis?

Which of the following is the major difference of acute and chronic leukemia:

Which is NOT correct about the “B” symptoms of Hodgkin lymphoma?

When hemolytic anemia happens, evidence of increased destruction of RBC is:

Anemia and jaundice is commonly seen in?

The main cause of aplastic anemia:

Which is NOT correct about acute leukemia？

Female, 42y, Chief complaint:dizzy for 1 week. Physical Examination:Anemic appearance. Blood routine:WBC 6×109/L,Hb 83g/L,PLT 150x109/L, MCV 75fl , MCH 20pg, MCHC 280g/L.The possible disease diagnosis is:

Female, 35 years old, blood routine examination found that pancytopenia for more than 1 month, and fever for 3 days. Physical examination: T 38.5℃, normal size of liver and spleen. Bone marrow cytology examination: hyperplasia is extremely low, and there are many fat droplets. The first diagnosis considered is :

A 30 year old male was admitted for the complaint of recurrent fever, night sweat and skin itch for two months. Physical examination revealed enlarged lymph nodes in cervical, axillary and inguinal areas. The liver could be palpated 2 centimeters below the ribs, and the liver was 3 centimeters below the ribs. Blood routine test revealed Hemoglobin 120g/l, WBC 9.0 * 10⁹/l, PLT 100*10⁹/l; ESR 60mm/h; and PPD test was negative. His temperature could not restored normal after administration of cephalosporin. Indometacin could lower the temperature temporally. Which examination was the first choice to diagnose?

A 18 years old female felt dizziness and fatigue for 1 year. Her hemoglobin was 80g/l, and blood smear showed unequal-sized erythrocytes with light colored center. The number of sideroblasts was decreased in the bone marrow. Which option is the best treatment?

A 27 years old male felt dizziness and purpura of the skin for nearly one month, and headache and vomiting for one week. Physical examination showed pale face, neck rigidity and enlarged superficial lymph nodes. The liver was 1.5cm below the costal margin and the spleen was 2cm below the costal margin. His blood routine test showed hemoglobin 60g/l, WBC 22*10⁹/l, PLT 54*10⁹/l. bone marrow smear showed active proliferation and 40% premature lymphocytes. His cerebral-spinal fluid test showed WBC 20/mm3 and positive Pandy test. What is the diagnosis of the patient?

12.Male, 70y, long term vegetarian, Chief complaint：dizzy with numbness of hands and feet for 1 week. Physical Examination:Anemic appearance. Blood routine:WBC 6×10⁹/L,Hb 83g/L,PLT 150x10⁹/L, MCV 112 fl , MCH 38 pg, MCHC 370 g/L.The possible disease diagnosis is:

What is the common pathological type of nephrotic syndrome in middle aged and elderly people?

The diagnosis of nephrotic syndrome is established by the findings of：

Which is not the reason leading to postrenal acute renal injury?

Which of the following is Secondary renal Disease?

Which one is the common clinical manifestation of chronic renal failure?

A 35-year-old Chinese male patient got fever due to upper respiratory tract infection, three days later, urine analysis revealed evident hematuria and the RBC was ++ with proteinuria +++. What is the most possible pathological manifestation you expect if the patient receives renal biopsy?

Female, 22 years old, presents with chills, fever, loin pain, dysuria, frequent and urgent urination for two days. Laboratory examination: urine white blood cells (4+).How would you manage this girl：

Male, 15 years old. After more than 10 days of upper respiratory tract infection, he developed abdominal pain and bloody stools. He improved after treatment with prednisone. In the fourth week, he had urinary protein (+ +) and 15-20 red blood cells/HP, normal renal function, and serum complement C3.

A 56-year-old female complained repeatedly edema, oliguria for 1 week. Physical examination: blood pressure 168/102mmHg, edema of both lower extremities. Serum creatinine was 169μmol/L 1 month ago and increased to 950μmol/L on admission, urine analysis: protein (+++), RBC (+++). Serum complement C3 was normal. Ultrasonic test: Left kidney 11.3 * 5.3 * 4.5cm, right kidney 10.7 * 5.3 * 4.1cm. What is the most possible diagnosis?