泰山医学院的核医学考试资料 08临床本科+07临床与英语本科核医学试卷A

泰山医学院2010～2011学年第二学期2008级临床医学专业本科、2007级临床医学与英语本科

《核医学》试卷(A)

一、选择题（每题只有一个答案，每小题1分，共30

分，请将答案填在下面的表格内）

1．介入或负荷显像的目的是（）

A．了解脏器或组织的储备功能

B．了解脏器的血流

C．鉴别病变的良恶性

D．提高图像的分辨率

E．加快显像剂的排泄

2．在SPECT的脏器显像剂中，最为理想的常用的放射性核素是（）A．131I

B．67Ga

C．99m Tc

D．125I

E．18F

3．具有特定的质子数、中子数及核能态的一类原子，其名称为（）A．同位素

B．原子核

C．核素

D．同质异能素

E．核子

4．核衰变后质量数减少4，原子序数减少2是哪类衰变（）

A．α衰变

B．β+衰变

C．β-衰变

D．电子俘获

E．γ衰变

5．18F-FDG在临床上最主要的应用领域是（）

A、心血管系统

B、神经系统

C、肿瘤系统

D、消化系统

E、以上均不是

6．131I治疗的原理主要是利用其发射的那种射线或粒子：（）

A、α

B、β

C、γ

D、n

E、β+

7．寻找异位甲状腺可选用：（）

A、131I全身显像

B、99m TcO4-甲状腺显像

C、99m Tc-奥曲肽显像

D、甲状腺吸碘率测定

E、甲状腺激素抑制试验

8．放射性核素消化道出血显像主要用于什么部位的消化道出血的诊断：（）

A、胃、十二指肠上消化道

B、口腔出血

C、直肠出血

D、胃、十二指肠以下，乙状结肠部位以上的小肠和结肠部位

E、乙状结肠部位以下

9．癫痫在局部脑血流断层显像（rCBF）中的特征性表现为（）

A、存在大小脑失联络现象

B、大脑皮质不同部位存在rCBF低灌注区

C、大脑皮质不同部位存在rCBF高灌注区

D、发作间期，病灶区的局部脑血流（rCBF）减低，放射性减低，发作期病灶的局部脑血流增高，放射性增高

E、发作间期，病灶区的放射性增高，局部脑血流增高，发作期病灶区放射性降低，局部脑血流（rCBF）减低

10．肺动脉栓塞典型的影像学表现不包括：（）

A、肺灌注显像表现为多发的肺段性放射性分布减低或缺损区

B、肺灌注显像表现为多发的肺段性放射性分布浓聚区

C、同期肺通气显像正常

D、胸部X线检查正常

11．血清T3、T4水平升高，甲状腺摄131I率下降，可用于诊断（）A．急性甲状腺炎

B．亚急性甲状腺炎

C．慢性淋巴细胞性甲状腺炎

D．甲状腺功能亢进

E．甲状腺功能减退

12．甲状腺结节的判定下列哪项正确（）

A、“热结节”说明结节的功能增高，多见于功能自主性甲状腺瘤等

B、“温结节”说明结节的功能与正常甲状腺组织相似，多见于甲状腺瘤、结节性甲状腺肿

C、“凉结节”和“冷结节”说明结节的组织分化不良或功能减低，可见于腺瘤

D、单发“凉结节”和“冷结节”甲状腺癌的发生率较高

E、以上都是

13．急性胆囊炎在核素肝胆动态显像中最典型的特征是：（）

A．胆囊很快显影

B．胆囊持续不显影

C．肠道中可见大量放射性

D．肠道始终无放射性

E．肝管显影

14．临床上鉴别肿瘤治疗后瘢痕与肿瘤病灶残留或复发的有效方法是（）A．常规X线摄片

B．超声检查

C．CT

D．18F-FDG PET

E．MRI

15．对于肝血管瘤诊断效果最好的显像方法是（）

A．201Tl显像

B．67Ga显像

C．肝胆动态显像

D．肝胶体显像

E．肝血池显像

16．去除残余甲状腺组织的理由或目的意义是（）

A．消除隐匿在残余甲状腺组织中的微小DTC病灶

B．降低DTC的复发率和转移发生的可能性

C．完全去除后，TSH升高，促进DTC转移灶摄碘能力增加，利于转移灶的诊断

D．有利于检出诊断剂量131I显像未发现的转移病灶

E．以上都对

17．常用的治疗分化型甲状腺癌的综合措施不包括（）

A．甲状腺全切术或次全切除

B．131I去除术后残留甲状腺组织

C．外放射治疗或化疗

D．131I治疗分化型甲状腺癌转移灶

E．甲状腺激素抑制治疗

18-30题为共干题

心肌灌注显像时可出现下列情况：

第1种情况：运动负荷局部放射性稀疏、缺损，静息时放射性分布正常；

第2种情况：运动负荷局部放射性稀疏、缺损，静息时放射性无变化；

第3种情况：运动负荷局部放射性稀疏、缺损，静息时放射性分布部分恢复；第4种情况：运动负荷局部放射性弥漫不均，静息时放射性分布弥漫不均；

第5种情况：运动负荷局部放射性正常，静息时放射性分布稀疏、缺损；18.第一种情况多见于（）

A．心肌缺血

B．心肌梗死

C．心肌梗死+心肌缺血

D．心肌病或心肌炎

E．瓣膜病

19.第二种情况多见于（）

A．心肌缺血

B．心肌梗死

C．心肌梗死+心肌缺血

D．心肌病或心肌炎

E．瓣膜病

20.第三种情况多见于（）

A．心肌缺血

B．心肌梗死

C．心肌梗死+心肌缺血

D．心肌病或心肌炎

E．瓣膜病

21.第四种情况多见于（）

A．心肌缺血

B．心肌梗死

C．心肌梗死+心肌缺血

D．心肌病或心肌炎

E．瓣膜病

某女，47岁，甲状腺乳头状癌术后1个月就诊，甲状腺显像示残留甲状腺左叶部分甲状腺组织，摄131I率5%。

22．该患者应进行（）

A．用131I治疗转移灶

B．马上进行甲状腺激素抑制治疗

C．用131I去除残留甲状腺组织

D．再次手术切除残留甲状腺组织

E．外放疗

23．如需采用131I治疗，合理的剂量为（）

A．1mCi（37MBq）

B．10mCi（370MBq）

C．20mCi（740MBq）

D．100mCi（3.7GBq）

E．200mCi（7.4GBq）

24．如用131I治疗后6个月复查，甲状腺床吸131I率4%，甲状腺显像可见甲状腺床有放射性浓聚，则应进行（）

A．再次用131I去除

B．再次手术切除

C．甲状腺床外照射

D．甲状腺激素抑制

E．化疗

某男，67岁，肺癌术后3个月，自觉全身多处骨骼疼痛，X线胸背部和腰部检查未见异常。

25．该患者应进一步选择什么检查（）

A．CT

B．MRI

C．B超

D．腰椎活检

E．全身骨显像

26．如骨显像发现肋骨、胸椎和腰椎有多处放射性异常浓聚，诊断应为（）A．原发性骨肿瘤

B．肺癌骨转移

C．多发性骨髓瘤

D．骨结核

E．骨髓炎

27．该患者可以采用哪种核医学治疗方法（）

A．131I治疗

B．211At治疗

C．153Sm或89Sr治疗

D．放射性核素胶体治疗

E．放射性核素动脉介入治疗

某女，34岁，甲亢131I治疗后2年，因怕冷、水肿、食欲减退半年就诊。28．此时最可能的诊断是（）

A．感染

B．甲状腺功能减低

C．亚急性甲状腺炎

D．慢性淋巴细胞性甲状腺炎

E．垂体腺瘤

29．下列哪项指标对确诊最有价值（）

A．Tg测定

B．TGAb测定

C．TPOAb测定

D．TRAb测定

E．TSH和甲状腺激素水平测定

30．此时应给予什么药物治疗（）

A．甲状腺激素

B．糖皮质激素

C．胰岛素

D．抗生素

E．能量合剂

二、判断题（对者打“√”，错者打“×”，每题1分，

共10分，请将答案填在下面的表格内）

1．外照射防护三要素为时间、距离和强度。（）

2．阳性显像的特点是病灶部位的放射性活度低于正常脏器组织。（）3．放射免疫显像显像剂聚集原理是化学吸附作用。（）

4．全身骨显像不能用于诊断骨折。（）

5．放射性核素示踪技术所采用的示踪剂是放射性核素或其标记化合物。（）6．PET肿瘤显像的原理是因为肿瘤细胞的葡萄糖代谢降低。（）7．131I（碘）既是治疗用放射性药物，又可以进行显像。（）

8．放射免疫分析技术原理为竞争抑制反应。（）

9．肝胆动态显像可以鉴别诊断新生儿胆道闭锁和新生儿肝炎。（）10．Meckel憩室表现为空肠部位较固定的放射性浓集，与胃影显示时间基本同步。（）

三、名词解释（每题3分，共15分）

1．湮灭辐射

2．放射性核素显像

3．放射免疫分析

4.核医学

5.放射性核素：

四、简答题（共12分）

1、18F-FDG PET肿瘤显像的临床应用适应证（7分）

2、简述肺灌注显像异常图像分析及临床意义。（5分）

五、应用题（共33分）

1、1例68岁男性前列腺癌患者，行去势治疗，并口服氟他胺，近1月感右下肢及腰背痛，行全身骨显像示：全身多处骨骼异常核素浓聚，考虑肿瘤多发骨转移，血常规、肝肾功能检查均无异常，请问患者下一步可选用那种放射性核素治疗方法？并简述其治疗原理。（8分）

。

2、一患者因心肌梗死要做心脏冠状动脉搭桥手术，为保证手术成功和有效，你认为术前除需要做冠状动脉造影检查外，还应到核医学科做哪项检查？了解什么情况？（7分）

3、患者，女性，36岁，近日突发右侧腰部疼痛，既往体健。肾脏超声发现右肾积水，右侧输尿管中段小结石，写出可选用进行辅助诊断的核医学显像检查名称。如要鉴别机械性梗阻与单纯的肾盂扩张，写出可选择的核医学显像检查方法及原理。（8分）

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高考04 2015年高考满分作文-五年高考(2014-2019年)英语满分作文解析及写作素材积累含解析

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2011年高考英语满分作文八大经典万能通用模板

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08高考英语满分作文

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