1.关于受精卵着床，下列叙述不正确的是（）A.受精卵着床经过定位、黏附、侵入三个过程B.滋养细胞黏附子宫内膜表面C.囊胚细胞滋养细胞分化出合体滋养细胞D.透明带消失E.孕妇体内分泌足够量的孕酮2.正常妊娠的生理改变为（）A.促性腺激素增加B.醛固酮降低C.血浆白蛋白降低D.皮质醇降低E.甲状腺素降低3.妊娠早期，子宫均匀增大超出盆腔是在A.妊娠8周B.妊娠9周C.妊娠10周D.妊娠11周E.妊娠12周4.关于输卵管壶腹部妊娠，其最常见的结局是A.输卵管妊娠流产B.输卵管妊娠破裂C.胚胎可发育至3个月以上D.易继发盆腔感染E.最易继发盆腔妊娠5.盆腔炎性疾病的病理变化不包括哪项A.急性子宫内膜炎及子宫肌炎B.子宫内膜异位症C.输卵管积脓D.败血症及脓毒血症E.急性盆腔结缔组织炎6.下列哪种溶液冲洗阴道可以提高外阴阴道假丝酵母菌病疗效A.2%-4%碳酸氢钠溶液B.1:5000高锰酸钾溶液C.0.5%醋酸溶液D.0.9%生理盐水溶液E.1%乳酸溶液7.多囊卵巢综合征内分泌变化是A.FSH持续高水平，LH持续低水平B.E2水平低，FSH升高C.LH/FSH可在正常范围D.FSH、LH低水平E.孕酮升高8.患者27岁，结婚3年不孕，月经周期24-25天，经期3-5天。
妇检正常，连测3周期BBT双相，高温相持续9-10天，考虑A.无排卵型月经B.正常月经C.黄体发育不全D.黄体萎缩不全E.子宫内膜结核9.女性，25岁，已婚，结婚3年不孕。
现停经55天。
查子宫与停经天数相符，质软。
左附件区触及直径约12cm、表面光滑、质韧肿物，活动良好。
B超提示肿物包膜完整，回声均匀。
宫腔内可见妊娠囊。
对此疾病不正确的描述是A.妊娠合并卵巢囊肿若无并发症一般无明显症状B.立即行人工流产术，观察附件肿物是否增大C.妊娠合并卵巢囊肿妊娠晚期发现者，可等待至妊娠足月行剖宫产。
D.应于妊娠12周后行剖腹手术切除囊肿E.妊娠合并卵巢肿瘤早期妊娠妇检时可扪及盆腔肿块，中期妊娠后不易发现10.孕妇，于妊娠早期因先兆流产服用人工合成的孕激素保胎治疗。
如胎儿出生后发现异常，应采取何种治疗方法A.期待疗法B.终身使用可的松C.整形术D.长期服用雄激素E.切除睾丸11.女性，29岁，婚后不孕5年。
现闭经1年。
幼时曾有胸膜炎病史。
查体：子宫稍小，欠活动，双侧附件增厚，未扪及包块。
BBT 曾双相，诊刮未刮出组织。
该患者最可能诊断是A.卵巢功能早衰B.子宫发育不良C.宫腔结核D.慢性盆腔炎E.宫腔粘连12.已婚未孕女性，30岁，因经量明显增多查体发现单个较大肌壁间肌瘤，大小7×6×5cm，最恰当的处理是A.随访观察B.雄激素小剂量治疗C.子宫肌瘤剥除术D.子宫切除术E.子宫次全切除术13.女性30岁，月经不规律3年，闭经7个月，溢乳2个月。
对诊断最有价值的测定项目是A.孕激素B.雄激素C.泌乳素D.雌激素E.促甲状腺激素14.患者，女，62岁，绝经12年。
近3月阴道出血2次，每次持续4天。
妇检：外阴、阴道无萎缩，宫颈光滑，子宫前位，正常大小，右侧附件区10×5×3cm肿物，质地中等，光滑，实性，活动良好，无腹水，全身淋巴结无转移。
最可能的诊断是A.子宫内膜癌B.卵巢颗粒细胞瘤C.卵巢无性细胞瘤D.宫颈癌E.卵巢睾丸母细胞瘤15.上述病人最恰当的治疗是A.化疗B.放疗为主C.右侧附件切除术D.全子宫加双侧附件切除术E.全子宫加双附件加大网膜切除术16.上述病人辅助治疗应加用A.化疗或放疗B.雌激素治疗C.雄激素治疗D.孕激素治疗E.观察17.女性21岁原发闭经，第二性征发育，但乳头小，阴毛和腋毛缺如。
黄体酮注射后无撤退性出血。
妇检：外阴女性，但阴道短浅，呈盲端。
双侧腹股沟扪及12×14×12mm大小包块，实性，质中。
下一步检查首先考虑A.盆腔超声检查B.染色体检查C.垂体MRI检查D.子宫输卵管造影E.腹腔镜检查18.该患者为进一步诊断，下一步的诊断方法是A.性激素测定B.糖耐量测定C.地塞米松抑制试验D.尿LH测定E.垂体兴奋试验19.该患者性激素检查后，最可能的结果是A.雌激素如正常女性B.雄激素如正常女性C.孕激素如正常女性D.雄激素如正常男性E.雌激素及雄激素均如正常女性20.双侧腹股沟包块首先考虑A.双侧卵巢B.双侧肾上腺C.双侧睾丸D.双侧淋巴结E.双侧转移性肿瘤妇产科出科考1、做全子宫及单侧附件切除术时下列哪项最不易损伤输尿管( A )A. 骨盆漏斗韧带B. 卵巢固有韧带C．子宫骶骨韧带D．子宫动脉E．主韧带2、关于月经的临床表现，下述哪项是正确的( A )A．初潮的迟早与营养及体质强弱等有关B．初潮的年龄大多数在18岁左右C．正常月经呈鲜红色，易凝固D．决定月经周期长短的是黄体期E．月经周期是从月经干净到下次月经的第一天3、习惯性早期流产最常见的原因( D )A．孕卵发育异常B．黄体功能不全C．甲状腺功能不足D．染色体异常E．宫颈内口松弛4、有关诊断妊娠的方法中哪项是正确的( B )A．尿妊免试验（+）则可确认妊娠B．以B型超声波检查是只要看到胎囊即可诊断妊娠，看到胎心搏动即可诊断活胎C．HCG放免测定法用于诊断早孕是不敏感的D．超声多普勒法，在孕妇下腹部听到吹风样声音妊娠的诊断即可确定E．胎心听诊器只能用于听胎心而听不到胎动5、正常分娩保护会阴的时间是( E )A．初产妇宫口开全B．初产妇先露着冠时C．经产妇宫口开大4-5cm，宫缩规律有力时D．经产妇宫口开全时E．初产妇儿头拨露，使会阴后联合皮肤紧张时6、宫外孕最常见的部位是( C )A．输卵管峡部B．输卵管间质部C．输卵管壶腹部D．卵巢E．以上都不是7、胎儿娩出后，阴道持续流血10分钟，量已超过200ml，色鲜红，子宫轮廓清楚，应首选那种措施( D )A．按摩子宫B．注射缩宫素C．输血D．立即娩出胎盘，检查软产道E．注射抗生素8、生殖器结核最先侵犯的部分是( D )A．卵巢、其次是输卵管B．子宫内膜，其次是输卵管C．阴道，其次是宫颈D．输卵管，其次是子宫内膜E．外阴，其次是阴道9、关于尖锐湿疣，哪项是错误的( A )A．主要累积阴道、宫颈B．主要经性交直接传播C．醋酸试验阳性D．组织学检查可见鳞状上皮细胞增生E．部分尖锐湿疣可自然消失10、子宫肌壁间肌瘤最主要的症状为( C )A．月经不调B．绝经后出血C．月经过多D．接触性出血E．不规则阴道出血11、下述哪项是早期宫颈癌的症状( D )A．生育年龄，月经前后的点滴出血B．更年期，周期缩短的阴道出血C．绝经后的出血D．接触性出血E．阴道水样排液12、早期诊断子宫内膜癌最简便可靠的方法是( B )A．阴道图片细胞学检查B．分段诊刮术组织病理学检查C．宫腔镜直视法D．子宫腔冲洗细胞学检查E．腹腔镜检查13、卵巢囊中最常见的并发症是( A )A．蒂扭转B．囊肿破裂C．感染D．恶变E．囊内出血14、哪一种是卵巢生理性肿物( E )A．输卵管卵巢囊肿B．多囊卵巢C．单纯性浆液性囊腺瘤D．卵巢子宫内膜异位囊肿E．黄素化囊肿15、早期诊断宫颈癌采用以下何项检查( E )A．子宫颈刮片细胞学检查B．阴道镜检查C．宫颈上皮染色体检查D．碘试验E．活体组织检查16、在我国引起输卵管阻塞导致女性不孕的常见主要因素是( A )A．输卵管炎症B．输卵管畸形C．子宫内膜异位症D．子宫肌瘤压迫E．生殖器结核17、宫内节育器避孕原理，下列哪项是错误的(D)A．通过异物的局部效应发挥作用B．异物刺激子宫内膜产生非细菌性炎症反应，不利于胚胎发育C．机械作用，组织孕囊着床D．宫内节育器通过抑制下丘脑-垂体-卵巢轴起作用E．节育器刺激内膜产生前列腺素，影响孕卵着床患者40岁，孕2产1，2天前突然发生尿潴留，导尿后腹部检查触及下腹部正中有一肿块，硬，活动，形状不规则，肿块如孕12周大小，患者平素月经周期28天，经期7-8天，量多，有血块，无明显痛经。
18、最好确定其诊断的简便辅助方法为( A )A．B型超声B．子宫探针试验C．子宫碘油造影D．CTE．尿妊免试验19、最可能的诊断为( B )A．卵巢囊肿B．子宫肌瘤C．妊娠子宫D．子宫肥大症E．盆腔子宫内膜异位症20、最好的治疗方案为( B )A．追踪观察B．全子宫切除C．开腹探查术D．全子宫及双附件切除术E．诊刮术年硕士研究生专业课考试试卷《外科学》——专业英语仅供2019级临床医学院硕士研究生使用本试卷共 页共 大题。
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一、翻译。
（约1000个单词量） Tests commonly recommended to screen healthy women for ovarian cancer do more harm than good and should not be performed, a panel of medical experts said.The screenings — blood tests for a substance linked to cancer, and ultrasound scans to examine the ovaries — do not lower the death rate from the disease, and yield many false-positive results that lead to unnecessary operations with high complication rates, the panel said.The advice against testing applies only to healthy women with an average risk of ovarian cancer, not to those with suspicious symptoms and not to women at high riskof Internal Medicine. The warning is not new — the panel isreaffirming its own earlier advice. And though the task force has sometimes drawn fire in the past, particularly with its stand on mammograms, in this case it has plenty of support. Other medical groups, including the American Cancer Society and the American Congress of Obstetricians and Gynecologists, have for years been discouraging tests to screen for ovarian cancer.But some doctors continue to recommend screening anyway, and patients request it, clinging to the mistaken belief that the tests can somehow find the disease early enough to save lives. A reportpublished in February in Annals of Internal Medicine, based on a survey of 1,088 doctors, said that about a third of them believed the screening was effective and that many routinely offered it to patients.Ovarian cancer is among the more rapidly fatal forms of cancer. In most cases, it is already advanced by the time it is diagnosed. Doctors say the only advice they can give women is not to ignore symptoms that may be the first warning of the disease: persistent bloating, pelvic or abdominal pain, feeling full early while eating and needing to urinate frequently.For its latest recommendations, the panel relied heavily on a large study published last year in The Journal of the American American Medical Association of 78,216 women from 55 to 74. Half got screening and half did not, and they were followed for 11 to 13 years. The screening consisted of ultrasound exams and blood tests for elevated levels of substance called CA-125, which can be a sign of ovarian cancer.There was no advantage to screening: the death rate from ovarian cancer was the same in the two groups. But among the women who were screened, nearly 10 percent — 3,285 women — had false positive results. Of those women with false positives, 1,080 had surgery, usually to remove one or both ovaries. Only after the operations were done was it clear that they had been unnecessary. And at least 15 percent of the women who had surgery had at least one serious complication, like blood clots, infections or surgical injuries to other organs.Dr. Barbara A. Goff, a gynecologic oncologist at the Fred Hutchinson Cancer Research Center in Seattle, said: “If patients request it, then I think a lot of times physicians feel it’s just easier to order the test, particularly if it’s covered by insurance, rather than taking the time to explain why it may not be good, that it could lead to inappropriate surgery, could lead to harm. I don’t think they think through the consequences.”It is often easier, she said, to talk patients into surgery than to talk them out of an operation or test they have set their minds on.Dr. Edward E. Partridge, director of the cancer center at the University of Alabama, Birmingham, said that even if the testing could be improved to reduce false positives, it still would not save women’s lives. Even with the false positives eliminated, the fact remains that the death rate from the cancer was the same whether women were screened or not, suggesting that the test simply could not find the cancer early enough to make a difference.Dr. Partridge said: “I think it’s really important that both the physician and the public really learn and assimilate that this test as it’s currently delivered is not effective at reducing death rates from ovarian cancer. We’ve got to find something else.”A large-scale randomised trial of annual screening for ovarian cancer, funded by the NIHR, did not succeed in reducing deaths from the disease, despite one of the screening methods tested detecting cancers earlier.Results from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) have been published in a report in the medical journal The Lancet.In the UK, 4,000 women die from ovarian cancer each year. It is not usually diagnosed until it is at a late stage and hard to treat. UKCTOCS was designed to test the hypothesis that a reliable screening method that picks up ovarian cancer earlier, when treatments are more likely to be effective, could save lives.The latest analysis looked at data from more than 200,000 women aged 50-74 at recruitment who were followed up for an average of 16 years. The women were randomly allocated to one of three groups: no screening, annual screening using an ultrasound scan, and annual multimodal screening involving a blood test followed by an ultrasound scan as a second line test.The researchers found that, while the approach using multimodal testing succeeded in picking up cancers at an early stage, neither screening method led to a reduction in deaths.Professor Usha Menon (MRC Clinical Trials Unit at UCL), lead investigator of UKTOCS, said: “UKCTOCS is the first trial to show that screening can definitely detect ovarian cancer earlier. However, this very large, rigorous trial shows clearly that screening using either of the approaches we tested did not save lives. We therefore cannot recommend ovarian cancer screening for the general population using these methods.“We are disappointed as this is not the outcome we and everyone involved in the trial had hoped and worked for over so many years. To save lives, we will require a better screening test that detects ovarian cancer earlier and in more women than the multimodal screening strategy we used.”Professor Nick Lemoine, Medical Director, NIHR Clinical Research Network, said: “These important findings from a large-scale trial, involving 200,000 participants, show that annual screening did not succeed in reducing deaths from ovarian cancer.“However, it’s important to note that negative results can be as important as positive. The study has provided important new evidence and insights into how to conduct and analyse futurelarge-scale randomised clinical trials into ovarian cancer, in the hope that this will prevent and diagnose this disease more effectively in the future."We thank every single person who took part.”《外科学》——专业英语本试卷共 页共 大题。