1.

Thirst, decrease of skin elasticity, reduced

urine output with high specific gravity may
have
A. Metabolic acidosis
B. Hypertonic dehydration
C. Hyper pottassemia
D. Hypo pottassemia
E.Hypotonic dehydration
2. Long term gastric decompression in
patients with pyloric obstruction may lead to
A. Metabolic acidosis
B. Hypo chloremic and hypopottassemia
alkalosis
C. Hypo calcemia
D. Hypo pottassimic acidosis
E. Hyper chloremic alkalosis
3. Which injury usually causes acute renal
failure
A. Severe crush injury
B. Impact injury
 C. Traumatic asphyxia
D. Severe laceration
E. Avulsion of large area of skin
4. An old female patient, 60 yrs old, had a
carbuncle on the back, the infected focus
became aggravated due to improper
treatment .She had chills, high remittent
fever and found a fluctuated mass on the
bullocks without obvious tenderness a week
later, so she should be considered as
A. Cold abscess
B. Septicemia
C. Pyemia
D. Toxemia
E. Bacteremia
5. A mass on the back, which is 3X2 cm in
size, soft, lobular, poorly movable, no
tenderness, no skin flushing and swelling, is
most possibly considered as
A .Sebaceous cyst
B. Skin carcinoma
C. Lipoma
 D. Fibroma
E. Neuro fibroma
6. The most common cause of nausea and
vomiting after operationis
A. Intracranial pressure increasing
B. Psychatric effects
C. Diabetic acidosis
D. Anesthetic reaction
E. Water electrolyte disturbance
7. After rapid infusion of 250ml saline to a
shock patient, the blood pressure is raised
and CVP is not changed, it indicates
A. Cardiac insufficiency
B. Hypovolemia
C. Over contracted volemic vessels
D. Hypervolemia
E. None of the above
8. Double infection refers to
A. Infection caused by many kinds of
bacteria
 B. Infection caused by many kids of
pathogenic bacteria
C. Infection caused by special anaerobic
bacteria
D. Infection caused by drug resistance
bacteria
E. Secondary purulent infection of TB
9. The common factor in shock is
A. Insufficiency of blood volume
B. In sufficiency of heart output
C. Inadequate micro circulatory perfusion of
tissue and organ
D. Loss of blood
E. Infection
10. An adult male, weight 60 kg, was burnt,
the BSA of 1st degree burn was 5%, the BSA
of deep 2nd degree burn was 15%, the BSA of
3rd degree burn was 10%, then the fluid
needed in second 24 hr is
A. (25X60X1.5) /2 ml + 2000 ml
B. 25X60X1.5 ml + 2000 ml
 C. (30X60X1.5) /2 ml + 2000 ml
D. (25X60X1.5 ml + 2000 ml)/2
E. None of the above
11 .There is a mass in upper arm, 2X1 cm,
hard with clear border, movable, smooth
surface, it is most possibly considered as
A. Fibroma
B. Neuro fibroma
C. Lipoma
D. Lymphatic infection
E. lymphatic tumor
12. In hyperkalemia symptoms, the incorrect
one is
A. Fatigue of extremities
B. Numbness of body
C. Microcirculation dysfunction
D. Pallor of skin
E. Tachycardia
13. In hypotonic dehydration, the change of
fluid is
 A. All of the plasma, interstitial fluid and
intracellular fluid is decreased, plasma
decreased the most
B. All of the plasma, interstitial fluid and
intracellular fluid is decreased, intracellular
fluid decreased the most
C. All of the plasma, interstitial fluid and
intracellular fluid is decreased, interstitial
fluid decreased the most
D. Only the plasma decreased
E. None of the above
14. The indication to pull out the gastric tube
after abdominal operation, if not specially
required, is
A. The 2nd day after operation
B. The 4th day after operation
C. After anal flatus and restoration of
intestinal function
D. Disappearance of abdominal pain
E. After restoration of body temperature
15. Delayed suture refers to
A. Suture right after debrediment
 B. Suture 6-8 hrs after injury
C. Suture 12 hrs after injury
D. Suture 1-4 days after injury
E. Suture 5-7 days after injury

16. A six yr old boy was burnt throughout the

trunk except for perineum according to “rule
of nines”, the estimated BSA of burn
A.17%
B. 18%
C. 26%
D. 27%
E.35%
17. Among the following drugs which is the
most suitable one to increase blood supply of
kidney and volume of urine
A. Nor-adrenaline
B. Aramine
C. Wyamin
D. Dopamine
 E. Methoxamine
18. The malignant gastric tumortransfer 1st to
the following organ through hematogeneous
metastasis
A. Lung
B. Kidney
C. Liver
D. Spleen
E. Pancreas
19. For a major burn and shock patient, the
most important treatment is
A. Analgesics
B. Fluid infusion
C. Wound management
D. Antibiotics
E. TAT injection
20. Carbuncle usually can be found in patient
with
A. Heart disease
B. Hypertension
 C. Diabetes
D. Tuberculosis
E. Renal disease
21. Chronic water deficit means
A. Hypertonic water deficit
B. Hypotonic water deficit
C. Isotonic water deficit
D. Mixed water deficit
E. Primary water deficit
22. A male patient, 36 yrs old, got injury with
bleeding, skin temp is low, blood pressure
16/12 Kpa, pulse rate 96/min, urine out put is
normal, so the estimated blood volume loss
is(in percentage)
A. <20%
B. 20-30%
C. 30-40%
D. 40-50%
E. >50%
23. In moderate shock, the blood volume loss
is (in percentage)
A. <10%
B. 10-20%
C. 20-40%
D. 40-60%
E. None of the above
24. A male patient, 41 yrs old, got
hemorrhagic shock, the estimated blood
volume loss is 40% of total blood volume, in
the following examination, which one may be
incorrect
A. Systolic blood pressure is 9 Kpa
B. pulse rate is 114/min
C. Consciousness change
D. Skin temp is cold
E. Anuria
25. Which one of the following factors does
not affect the healing process of trauma
A. Infection
B. Hypertension
 C. Diabetes
D. Using hormone
E. Liver cirrhosis
26. The first step to save the severe wounded
is to treat
A. Hemorrhage
B. Shock
C. Asphyxia
D. Fracture
E. Injury of internal organ
27. Character of pus of pyocyanic bacilli is
A. Thin bloody
B. Sticky, necrosis and yellow
C. Light green, smelly
D. Sticky, smelly (mixed)
E. Light green, no smell
28. We can usually find pyocyanic bacilli in
A. Nose, laryangeal mucous membrane, skin
?B. Intestinal tract, skin
 C. Nose, laryangeal mucous membrane,
intestinal tract
D. Intestinal tract
E. Skin
29. Which one of the following solution is
balanced salt solution
A. Isotonic solution
B. 1.86% Natrium lactate + Co. Natrium
chloride Ratio 1:2
C. 1.25% NaHCO3
D. 1.86% Natrium Lactate
E. Co. Natrium Chloride
30. In metabolic acidosis patient the change
of respiration is
A. Rapid and superficial
B. Rapid and deep
C. Slow and deep
D. Sometimes slow and sometime rapid
E.
31. When central venous pressure is more
than_____, it means heart congestive failure
A. 5 cm H2O
B. 10 cm H2O
C. 15 cm H2O
D. 20 cm H2O
E. 25 cm H2O
32. A hypovolemic shock patient, at first, bp
10/8 Kpa, CVP 8 cm H2O, after given isotonic
saline 250 ml in 10 mints, bp 10/8 kpa CVP 12
cm H2O, it means
A. Hypovolemia
B. Heart dysfunction
C. Hypervolemia
D. Venous vessel contraction
E. None of the above
33. In urine high out put period of acute renal
failure, the urine output increase to
A. 100 ml
B. 400 ml
 C. 800 ml
D. 1000 ml
E. 2000 ml
34. In oliguria and anuria period of ARF, the
urine specific gravity is
A. < 1.000
B. 1.000-1.010
C. 1.010-1.014
D. > 1.020
E. > 1.040
35. In preoperative preparation, the patient
should stop smoking
A. 3-5 days
B. 1 week
C. 2 week
D. 3 week
E. one month
36. A patient received breast operation, with
local anesthesia
, no discomfort, no reaction, when can she
eat.
A. Just as she likes
B. 3-6 hrs after operation
C. 3-4 days after operation
D. 24-48 hrs after operation
E. 5-6 days after operation
37. When there is necrotic tissue or foreign
body in local tissue, how many bacteria can
cause infection
A. 10
B. 100
C. 1000
D. 10..7
E. 10..5
38. The direct factor to cause tetanus is
A. tetanus bacilli
B. exotoxin
C. endotoxin
D. alpha toxin
 E. DNA ase
39. After wounded, tetanusantitoxin(TAT)
____ u Should be given as early as possible
A. 250
B. 500
C. 250-500
D. 1000
E. 1500
40. U wave appears in ECG- A
HYPOPOTASSEMIA
41. Weakness of muscle-C BOTH
A. Hypopottassemia
B. Hyperpottassemia
C. Both
D. Neither
42. Severe pelvic fracture---A-TRAUMATIC
SHOCK.
43. Acute strangulated intestinal obstruction-
C SEPTIC SHOCK
A. Traumatic shock
 B. Cardiogenic shock
C. Septic shock
D. Hemorrhagic shock
E. Neurogenic shock
44. The main points of septicemia treatment
are
A. Treat local focus correctly
B. Supporting therapy of whole body
C. Combined application of antibiotics
D. Using hormones
45. The surgical infection may have the
following result.-------all
A. Localization
B. Change to chronic infection
C. Spread of infection
D. Absorption
46. The local change of malignant change of
tumor may include=----all
A. Surface ulcer
B. Congestion
 C. Venous engoragement
D. Increase of local temp
47. The main reason of death in ARF is
A. Water toxication
B. Acidosis
C. Hyperpottassemia
D. Hypocalcemia
48. Once blood transfusion is done by
mistake during operation, the first step to
prevent ARF should be
A. Injection of glucose and mannittol
B. Injection of heparin to prevent DIC
C. Transfusion of NaHCO3
D. Giving adrenaline to increase blood
pressure
49. The internal factor of tumor etiology
include
A. Genitic factor
B. Immune factor
C. Endocrine factor
 D. Biologic factor
50. Which of the following drug should be
avoided in the case of renal dysfunction
A. Sulfonamide
B. Gentamycin
C. Kanamycin
D. Penicillin
51. the principle of first aid of burn
A. Get rid of cause of burn
B. Protect the wound of burn
C. Relieve pain
D. Immediate debrediment and prevention
of infection
52. In highoutput period of ARF, the main
complication are------all
A. metabolic acidosis
B. Hypopottassemia
C. Azotemia
D. Infection
53. The criteria for using dialysis therepy are
 A. Severe water intoxication failed to
conservative treatment
B. Severe metabolic acidosis
C. Serum BUN>25mmol/L, serum
Cr>442umol/L
D Serum k+ > 6.5 mmol/L
54. Which of the following is wrong in
moderate hypertonic dehydration
A. thirst ant fatigue
B. Dry lips and tongue
C. Decrease of skin elasticity
D. Obvious decrease of urine out put
E. Water deficit is about 2-3% of body
weight
55. Thirst, decrease of skin elasticity,
reduced urine output may have
A. Metabolic acidosis
B. Hypertonic dehydration
C. Hypopottassemia
D. Hyperpottassemia
 E. Hypotonic dehydration
56. Except for clinical manifestation,
diagnosis of hypopottassemia mainly
depends on
A. Clinical symptoms and history
B. To determine serum potassium and ECG
C. Clinical symptoms and ECG
D. To take ECG
E. Symptoms and ECG
58. Metabolic acidosis usually occur in
A. Colon obstruction
B. Small intestine obstruction
C. Pyloric obstruction with continous
vomiting
D. Shock
E. Dehydration
59. Long term gastric compression in patient
with pyloric obstruction may lead to
A. metabolic acidosis
 B. Hypochloremic and hypopottassemic
alkalosis
C. Hypocalcemia
D. Hyperpottassemic acidosis
E. Hyperchloremic acidosis
60. A 40 yr old patient with acute adhesive
obstruction was admitted to the hospital due
to abdominal pain for four days. He was weak
in general, fatigue and moderately
dehydrated. The bp was 80/60 mmHg, serum
na 120 mmol/L, Serum K 3.1 mmol/L and CO
OP was 32%. The first choice treatment
Should
A. To correct acidosis
B. To supplement potassium
C. To supplement sodium
D. To replace blood volume
E. To supplement electrolyte
61. Which injury usually causeARF
A. Severe crush injury
B. Impact injury
 C. Traumatic asphyxia
D. Severe laceration
E. Avulsion of large area of skin
62. CVP and BP are low in shock patient, the
reason are
A. Over contraction of capacity vessel
B. Inadequate blood volume
C. Increase of pulmonary circulating
resistance
D. Insufficiency of cardiac function
E. Congestive heart failure
63. The most important index to adjust fluid
replacement in shock patient is
A. urine output
B. Mental status
C. Peripheral circulation
D. Pulse rate
E. CVP
64. The proper body position for shock
patient is
A. Low head and high feet position
B. Horizontal position
C. Lateral position
D. Head and trunk elevated 20-30 degree,
lower extremities elevated 15-20 degree
E. Head and trunk are in horizontal position
and lower limb elevated 10 degree
65. The purpose of preoperative fasting
before GI tract operation is
A. To avoid difficulties during operation
B. To avoid postoperative abdominal
distension
C. To avoid asphyxia or aspiration
pneumonia by aspirating vomitus during
anesthesia
D. To prevent from postoperative anatomic
fistula
E. To restore intestinal peristalsis in early
stage
66. The features of pus produced by
Staphylococcus aureus infection are
A. Thin with light red
B. Thick with foul smell
C. Thick, peach blossom like and yellowish
without foul smell
D. Light green with foul smell
E. Dark red with stinking smell
67. Carbuncle usually occurs on
A. Chest
B. Upper limbs
C. Neck and back
D. Abdomen
E. Lower extremities
68. The most reliable and effective
prevention of tetanus is
A. To deal with wound timely
? B. To inject horse serum anti toxin
C. To inject human immunoglobulin
D. To inject tetanus toxoid
 E. To inject large dosage of penicillin
69. Injury after crushing syndrome often
leads to
A. Renal failure
B. Dyspnea
C. Coma
D. Internal hemorrhagic shock
E. Heart failure