南京大学军总外科学总论 外总 08级考试题目.doc

感谢任建安主任，感谢张恋茹、徐骁盟、孙静、雷艺珊、廖延年、姜婷婷、刘乃成、张吉庆等同学（排名不分先后）为大家的贡献，祝大家考出好成绩！ 一、 选择题部分（CK，09, 10 ） 1. CK部分 Step2CK A healthy 35-year-old man comes to the emergency department because of a-hour history of severe abdominal pain. The pain had initially started in the periumbilical area but has now shifted to the right lower quadrant (RLQ). He also complains of nausea and two episodes of vomiting. He has no other medical problems or previous surgeries. He takes no medication. He does not use tobacco, alcohol, or illicit drugs. His temperature is 38.9C (102F), blood pressure is 125/80 mm Hg, pulse is 100/min, and respiration are 20/min. Examination shows clear lung fields and normal first and second heart sounds. Abdominal examination shows tenderness in the RLQ that does not worsen with inspiration. Palpation of the left lower quadrant (LLQ) produces pain in the RLQ. Urinalysis is negative. The patient’s laboratory findings reveal: WBC 16,000/ul Hematocrit 42% Platelet count 220,000/ul Leukocytes Neutrophils 86% Eosinophil 2% Lymphocytes 8% Monocytes 4% Which of the following is the most appropriate next step in management? Ultrasound of the abdomen Computed tomography (CT) scan of the abdomen Conservative management Immediate surgery Colonoscopy A 34-year-old obese man is brought to the emergency department by the paramedics after being shot while in a street fight. The patient is obtunded and had an episode of en route. He receives3 Lof normal saline. His temperature is37C(98.8F), blood pressure is 85/43 mm Hg, pulse is 126/min, and respiration are 21/min. The trachea is midline, and there are breath sounds bilaterally. Examination shows a gunshot entry wound in the left sixth intercostal space anter