Type A1 question (Best Choice Affirmative)

Instructions for answering the question

For each question, there are five alternatives, A, B, C,D,E. The guiding sentence is an affirmative statement, in answering the question, only one of the five alternatives should be allowed to be chosen as the correct answer, and the corresponding letter of the corresponding question number will be underlined in bold black on the answer sheet.

1. Which is the most appropriate treatment for choriocarcinoma?

A. Hysterectomy alone

B. Immunotherapy

C. Widespread total hysterectomy with pelvic lymph node dissection

D. Herbal medicine alone

E. Combination therapy based on chemotherapy

2. A pregnant woman of 36+5 weeks of age, aged 24 years old, comes to the outpatient clinic for examination and complains of a small amount of vaginal bleeding a week ago. She complains of a small amount of vaginal bleeding a week ago, which was left untreated and stopped on its own. Last night, the vaginal bleeding resumed in a large amount, accompanied by paroxysmal abdominal pain. Bp 14/9kPa (105/68mmHg), fetal heart rate 166 beats/min, breech position. The best management at this time is

A. Fluid infusion + antiemetic drugs

B. Oxygen administration to correct fetal distress

C. Cesarean section

D. Expectant therapy

E. Foot traction to compress the placenta to stop the bleeding

3. The most common causative agent of puerperal infections is

A. Streptococcus solubilis

B. Streptococcus oxytocaemia

B. Streptococcus pyogenes

C. Escherichia coli

D. Staphylococcus

E. Staphylococcus pyogenes

4. A 25-year-old pregnant woman in her first trimester of pregnancy at 38 weeks of gestation complains that her fetal movements have decreased over the course of the day and her fetal heart rate is 148 beats per minute.

A. Fetal electrocardiogram

B. CST test

C. Fetal scalp blood PH measurement,

D. NST test

E. Amnioscopy

5. Which of the following tests would be indicated in a 24-year-old married woman presenting to the outpatient clinic complaining of menopausal menopause of 77 days?

A. Basal body temperature

B. Abdominal X-ray

C. Pregnancy test

D. Progesterone test

E. B-mode ultrasound

6. A 24-year-old primigravida in the emergency room complains of sudden, one hour of nocturnal, menstrual vaginal bleeding, with mild distension of the abdomen. Examination: BP 14/9kPa (105/68mmHg), fetal heart rate 140/min, fetal position LOA, head floating. The uterus has irregular contractions without pressure. The most likely diagnosis is:

A. Miscarriage with preterm labor

B. Placental abruption

C. Rupture of blood sinus at the edge of the placenta

D. Placenta praevia

E. Bleeding cervical polyp

7. A 16-year-old schoolgirl complained of disorders of the menstrual flow for one and a half years after the first menstruation, and the current menstruation lasted for a week or more. Examination: pale, scanty pubic hair, clear red blood clots visible at the vaginal opening, uterus slightly smaller than normal, bilateral adnexa normal. The preferred treatment for hemostasis is early

A. Estrogen for hemostasis

B. Progesterone for hemostasis

C. Combination of estrogen and progesterone

D. Other antiemetic medications

E. Scraping to stop hemostasis

8. A 28-year-old woman has had 2 spontaneous abortions and has now been menopausal for 4.5 months and has been bleeding from the vagina for 2+ months. She has refused gynecologic examination to preserve the pregnancy. This patient is first examined before treatment

A. liver and kidney function

B. electrocardiogram

C. blood and urine routine

C. ultrasound

E. hormone level

9. A 48-year-old woman with G3P2 complains that she had an abortion 18 years ago, and her menstruation has been disorganized for one year, with the last menstruation occurring 10 days ago, and she has been experiencing hot flashes lately. Gynecological examination: vulva, vagina is normal, cervix is smooth, uterus is normal in size, medium in texture, no tenderness, both adnexa are normal, basal body is hurricane-phase, the probable diagnosis is

A. endometritis

B. tuberculous endometritis

C. senile vaginitis

D. endometrial cancer

E. menopausal menstrual dysfunction

A 21-year-old unmarried woman, who had her first menstruation at 18, has a low menstrual flow, which occurs once every 3-6 months, with the last menstruation occurring 8 months ago, when the flow was even lower. Follow-up history, do not eat fat meat, daily meal size of 2 ~ 3 two and a small amount of vegetables, examination: physical recovery, breast development is still possible, scanty pubic hair, vulva unmarried style. Anal examination: the uterus is slightly small, double annex normal. The patient's treatment of choice

A. Small-dose estrogen cycling

B. Multivitamin supplementation

C. HCG to induce ovulation

D. Correction of systemic health conditions

E. Pulsed trace GNRH to promote blood-brain function

11. A 35-year-old woman, infertile for 5 years, menopause for 40 days, vaginal bleeding for 1 day and abdominal pain. A 35-year-old woman with 5 years of infertility, 40 days of menopause, vaginal bleeding for 1 day, abdominal pain under the sky, pulse 102 beats/min, blood pressure 13/9.3kPa (98/70mmgh), mobile turbidities (-), gynecological examination: uterus is slightly enlarged, cervical wobbling pain (+-), and a painful mass is palpated in the right adnexa, with an unclear border. The most accurate method for definitive diagnosis is:

A. Blood HCG quantification

B. Posterior fornix puncture

C. Ultrasound

D. Laparoscopy

E. Diagnostic scraping

12. A 20 year old woman was found to have abdominal distension and loss of appetite for 2 months, and the examination revealed the following findings: abdominal distension, uterus of normal size in anus examination, and a mass on the right lower abdomen, such as Infant's head is large, activity, caesarean section: ascites yellowish, clear 2000 ml, uterus normal size, double fallopian tubes, left ovary, greater omentum, appendix appearance is not abnormal, right ovary mass diameter 10CM, the surface of the nodular, cut surface like brain tissue, brittle texture, frozen section: right ovary in the immature teratoma, the best range of surgery should be

A. right ovariectomy

B. Right adnexectomy + total hysterectomy

C. Double adnexectomy + hysterectomy

D. Double adnexectomy + hysterectomy + salpingo-oophorectomy

E. Double adnexectomy + uterotomy + salpingo-oophorectomy

13. The most important indicator of the progression of labor is the

A. Strength of uterine contractions

B. Frequency of uterine contractions

B. Frequency of uterine contractions

C. Rhythmicity of uterine contractions

D. Degree of descent of the fetal head

E. Whether or not the membranes are ruptured

14. The main basis for differentiating chorioamnionic carcinoma from erosive hyperemesis gravidarum is

A. Positive urinary HCG

B. Cotton wool shading on X-ray chest radiograph

C. Irregular Vaginal bleeding

D. Violet-colored metastatic nodules in the vagina

E. Pathology: no villous structure

15. The patient is 50 years old, and the pathology of the cervix sampled by colposcopy shows heterogeneous epithelium that reaches the entire epithelial layer, so which is the most appropriate treatment?

A. Laser treatment

B. Iron treatment

C. Cryotherapy

D. Cervical conization

E. Total hysterectomy

16. The patient is 32 years old, has been married for 5 years and is infertile, and has had scanty menstrual periods for two years, with amenorrhea in the last 3 months, and often has low-grade fever, and her gynecological examination shows that the uterus is a little small, with poor mobility and thick parietal tissue troughs on the right side of the toilet. Para-uterine tissue groove thickness, the right side of the 4 × 4 × 6CM swelling, mild pressure pain, blood sedimentation 30mmH2O an hour, uterine tubal iodine oil angiography was bead-like changes, the preferred treatment measures are

A. danazol orally

B. traditional Chinese medicine to activate the blood circulation and eliminate blood stasis

C. IV penicillin

D. systemic anti-tuberculosis therapy

E. Open abdominal exploration

17. The patient is 65 years old, complaining of bloody leukorrhea, gynecological examination: the cervix has no erosion and the uterine body is slightly large, and cancer cells are found in the smear examination of the secretion of the posterior fornix. Further treatment of the best

A. Ultrasound

B. Iodine test

C. Colposcopy

D. Segmental diagnostic curettage

E. Cervical fluorescence examination

18. A woman, forceps delivery, ten days postpartum, the left lower extremity is swollen, painful, aggravated by activity, body temperature 37.2 ℃, check: The circumference of the left lower limb at 10cm above the ilium is 2cm larger than that of the other limb, the most probable diagnosis is

A. Thromboembolic vasculitis

B. Thrombophlebitis of femoral vein

C. Thrombophlebitis of national vein

D. Thromboembolic phlebitis of pelvic cavity

E. Left paraphimosis connective tissue inflammation

19. Endometrial cancer invading the cervix is the treatment of choice

A. Total hysterectomy with double adnexectomy

B. Wide hysterectomy with pelvic lymph node dissection

C. Total hysterectomy

D. Progesterone therapy

E. Radiation therapy

20. A full-term pregnant primigravid woman, 24 years old, is in the second stage of labor for 2 ? hours and the placenta has been delivered. There is intermittent vaginal bleeding with blood clots discharged, the amount of more than 500mL, check: the uterine contour is unclear, the first should be considered for

A. vaginal vein rupture

B. coagulation mechanism disorders

C. placenta residue

D. cervical laceration

E. uterine contraction weakness

21. the patient, 45 years old, leukorrhea, bleeding after intercourse for 3 months, the patient has been in the hospital for 3 months. Bleeding after sexual intercourse for 3 months, examination of the cervix has a vesicular appearance and contact bleeding, what is the most appropriate test to make a definitive diagnosis?

A. Cervical smear cytology

B. Cervical biopsy

C. Colposcopy

D. Cervical conization

E. Chromosomal examination of the cervical epithelium

22. The woman is 23 years old, menopause for 3 months, a month ago, there is a slight pain in the lower abdomen and a small amount of vaginal bleeding, and now there is a vaginal bleeding for a week. The amount of small, no abdominal pain, urine deletion (-), vaginal examination of the uterus subadult fist size, intrauterine echogenicity is not uniform, such as the river treatment is the most appropriate?

A. continue to observe two weeks

B. scraping to send pathology examination

C. hysteroscopy

D. according to the treatment of miscarriage

E. estrogen induced abortion

23. paroxysmal colic in the right lower abdomen, with nausea and vomiting for five days, six months ago, when the IUD was found on the left side of the ovary incident cystic mass of 4 × 5 × 5CM . Examination: T38℃, right lower abdominal pressure and pain (+), the uterus is normal and large, the right side of the uterus touched a 8×6×6CM cystic mass, tension is large, pressure and pain, activity is limited, the left side of the adnexa is normal.

WBC12000/MM3, N90%, the most likely diagnosis is

A. Ovarian cyst torsion

B. Ovarian cyst torsion combined with infection

C. Renal pelvic fluid accumulation

D. Ectopic pregnancy

E. Uterine subplasma leiomyoma torsion

24. 6 months after the second clearing of the womb for a gravida. The first six months after the second cleansing of the uterus, the second month after the second cleansing. Vaginal bleeding is intermittent, gynecological examination: 2CM purple-blue bulge is seen at the vaginal opening at 5 o'clock, the cervix is smooth, the uterus is slightly larger and softer, and both adnexa are normal. Chest X-ray did not show any abnormality, urine pregnancy test (+), excavation of the vaginal lesion histologic section to see piles of highly proliferative trophoblasts and blood clots, no chorionic villi shadow, the most likely diagnosis is

A. Uterine dysplasia

B. Miscarriage

C. Suction of incomplete

D. Chorionic villus carcinoma

E. Eclamatory gravidarum

25. p> 25. The most common complication of ovarian tumors is

A. Torsion

B. Rupture

C. Infection

D. Hemorrhage

E. Malignancy

26. The most important underlying pathophysiologic change in hypertensive syndrome of pregnancy is

A. Increased renal tubular reabsorption

B. Increased uric acid in the blood

C. Systemic small arterial spasm

D. Increased ghrelin

E. Hypovolemia

27. 30 years old, 34 weeks of gestation in the first trimester of pregnancy, prenatal examination of BP24/15KPA (180/112mmHg) refused to be hospitalized, suddenly abdominal pain accompanied by vaginal bleeding 3 hours ago, Bp10/4kPa (75/30mmHg), Pl 20 times / min, the bottom of the uterus 2 fingers below the raphe, plate abdomen, fetal position is unclear, fetal heart sounds disappeared, the cervix has not disappeared, the most correct treatment should be

A. Immediate cesarean section to terminate the pregnancy

B. Rescue shock, drip drip oxytocin induced labor

C. Artificial rupture of the membranes, drip perfusion of oxytocin induced labor

D. rescue shock, because the fetal death in utero is not urgent, and the baby is not in the uterus, but in the uterus. E. Rescue shock, as soon as possible cesarean section, termination of pregnancy

28. 30 years old, female, pregnancy 2 birth 1, one year ago due to central placenta previa uterine body cesarean section, is now 7 months pregnant, 6 hours ago, a sudden feeling of severe abdominal pain, dizziness, profuse sweating, cessation of fetal movement, the fetal heartbeat disappeared, the fetus floating, the left lower abdomen can be found and the 4 months of pregnancy The most likely diagnosis is

A. Uterine rupture with preeclampsia

B. Abdominal pregnancy

C. Uterine rupture

D. Placental abruption

E. Incomplete rupture of the uterus

29. 49 years old, menopausal for 1 year, uterus is slightly small, and a cystic uneven mass of 6x6x4 cm is palpated on the right side of the toilet. A. Total hysterectomy and right adnexectomy

B. Total hysterectomy and double adnexectomy

C. Total hysterectomy and double adnexectomy

C. Total hysterectomy and pelvic adnexectomy

D. Complete rupture of the uterus and pelvic adnexa

E. Complete rupture of the uterus and pelvic adnexa

C. Total hysterectomy with double adnexa and pelvic lymph node dissection

D. Total hysterectomy with double toilet adnexa and omentectomy

E. Total hysterectomy with bilateral adnexa and omentectomy and postoperative chemotherapy

30. 58 years old, menopausal for 8 years, with vaginal discharge of sorghum watery substance for 3 months, leptomeningeal protrusion of the posterior cervical lip, roughness of the mucous membrane of the posterior fornix, uterus is smaller than normal and in a horizontal position with normal adnexa, and bilateral main ligaments. The adnexa is normal, the main ligaments are thickened bilaterally, not reaching the pelvic wall, and the cervical biopsy shows squamous epithelial carcinoma of grade II, which is the most correct method?

A. Radical uterine surgery

B. Radical uterine surgery and pelvic lymph node dissection

C. Radiation therapy

D. Radical uterine wood with postoperative radiation therapy

E. Radiation therapy followed by radical uterine surgery

31. 54 years old, 2 years of menopause, vaginal bleeding for 1 month, vulva, vaginal atrophy is not obvious. The cervix is smooth, the uterus is normally large, the right side touched 8X6X4cM size tough ellipsoidal mass, slightly active, the left adnexa is normal, vaginal cytology smear suggests that estrogen levels are highly affected, segmental diagnostic scraping, endometrial biopsy clean up section of the endometrium adenocystic hyperplasia, cervical lining did not see the abnormality of the cervical lining, the first thing that should be taken into account in this case is

A. dysfunction in the uterine hemorrhage

B. Ovarian dermatomycosis

C. Ovarian endometriotic cyst

D. Ovarian granulosa cell tumor

E. Endometrial cancer

32. 26 years old, dysmenorrhea has been worsening gradually for 3 years, with an increase in menstrual flow, and the current menstrual flow is 10 days, and the blood still hasn't stopped, and she had a tubal ligation treatment for infertility 2 years ago. The uterus is slightly larger than normal, posterior, inactive, and the right side of the uterus is touched with a 4*4*3 CM3 large tough mass that is adherent to the uterus; the left side of the adnexa is thickened, and there are painful nodules of pea grains on both uterosacral and sacral cord bands, which is firstly considered to be

A. Paroxysmal ectopic pregnancy

B. Tuberculosis of the genitals

C. Chronic pelvic inflammatory disease

D. Endometriosis

E. Tubo-ovarian cysts < /p>

33.

33. At 40 weeks of gestation, with regular abdominal pain for 20 hours and rupture of membranes for 6 hours, the uterine fundus is 1 finger under the sword, and the fetal head is touched on the right lower part of the mother's abdomen, with the fetal heart between the umbilicus and the umbilicus. Transverse position

D. Left anterior shoulder position

E. Left posterior shoulder position

34. 35 years old, G3P0, 37 weeks of gestation, woke up at night and found a lot of vaginal bleeding, no abdominal pain, after 20 weeks of gestation, repeated bleeding 4 times, had been treated with fertility preservation, uterus is soft, tenderness (-), no uterine contractions, fetal position LSA: buttocks are located in the upper part of the pubic symphysis high floated, fetal heartbeat 140 beats/minute, suprapubic smells

A. Central placenta praevia

B. Partial placenta praevia

C. Marginal placenta praevia

D. Low placenta praevia

E. Mild placenta previa

35. Full-term pregnancy, regular abdominal pain for 10 hours, the uterine mouth opened to 5 cm. In a full-term pregnancy with 10 hours of regular abdominal pain, the uterine opening is 5 cm wide, the head is S-2, the greater chimney is at 11 o'clock, and the lesser chimney is at 5 o'clock, which of the following is the most correct fetal position?

A. Occipital left anterior position

B. Occipital left posterior position

C. Occipital right anterior position

D. Occipital right posterior position

E. High rectus posterior position

36. Which one of the following is true about the clinical presentation of placenta praevia?

A. Painless vaginal bleeding in late pregnancy

B. The lower the position of the placenta, the later the appearance of vaginal bleeding

C. Fetal nuchal translucency is often in the pelvis on schedule

D. Anemia is not proportional to the amount of bleeding