2016 Executive Physician True Questions (the third set of volumes and answers)

1. The most prominent characteristic of secondary abdominal pain in secondary peritonitis is

A degree of pain changes over time

B The range of abdominal pain changes in size

C The pain at the original lesion is the most significant

D Pain is paroxysmal intensified

E anal defecation, abdominal pain after exhaust can be relieved

2. The following is a specific infection

A does not hurt back

B 疖 disease

C acute lymphitis

D acute mastitis

E lymph node tuberculosis

3. The most commonly used detection method for diagnosis of typhoid fever is

A feces cultivation

B blood culture

C urine culture

D bone marrow culture

E bile training

4. The most easily induced electrolyte disorders of the giant colon is

A hybridmia

B hypercaliasis

C hyponiasis

D hypocalcemia

E hyposyoniamia

5. The most common disease of AIDS patients is

A giant cell viral retinitis

B cerebral bow -shaped disease disease

C pulmonary spare bacteria pneumonia

D cardsus sarcoma

E Oral Candida

6. When the abdominal closure is damaged, the most commonly damaged cavity organs are

A sigmatic colon

B stomach

C twelve -finger intestine

D littering

E -small intestine

7. Patients with pylorus obstruction, the most important thing prepared before surgery is

A correct alkali poisoning

B low osmotic saline gastric lavage

C physiological saline gastric lavage

D oral antibacterial drug

E high -lying saline gastric lavage

8. The pharmacological role of choline enzyme compound drugs does not include

A improve the activity

B restore the inhibitory choline active activity

C to restore the activity of the aging choline enzyme

D and phosphorhoids in phosphate formation binding

E reduction of nicotine -like symptoms

9. The main basis for determining the exploration of acute intestinal obstruction surgery is

A is a twisted narrow intestinal obstruction

B degree expansion degree of intestinal tube

C obstruction site

D whether to be a complete obstruction

E obstruction duration

10. The clinical staging of ordinary epidemic cerebrospinalitis does not include

A recovery period

B Defense Period

C front drive period

D meningitis period

E -heating period

11. The preferred drug of the original treatment of blood absorption disease is

A chlorine

B methyl deedazole

C sodium sodium

D metronidazole

Eorellytone

12. Determine whether rectal cancer can retain the anus is the important factor is

A distance between the lower edge of the tumor from the tooth line

B tumor infiltrate the depth of the rectal wall

C Whether the lymph node transfer around the rectum is merged

D Whether there is liver transfer if it is combined

E tumor infiltrate the depth of the rectal wall

13. The key measures for correction of low -irrigation and hypoxia caused by the shock are

A Application of vascular active drugs

B blood supplement capacity

C actively deal with primary disease

D high concentration oxygen absorption

E correcting acid poisoning

14. The main reason for the superficial veins of the lower limb is

A vein wall is weak

B long -term standing activity

C Pelvic Occupation Leisure

D in the late pregnancy uterine compression

E -iliac femur vein thrombosis

15. The typical feces characteristics of patients with ulcerative colitis are

A asphalt -like

B pottery -like

C blood stool

D thin water -like

E mucus pus and blood

16. In the following situations, the results of the plasma D-di gymnaria are normal

A primary slim hyperthyroidism

B acute pulmonary infarction

C Deep venous thrombosis of the lower limb

D acute myocardial infarction

E is scattered in intravascular coagulation

17. The invasion of the pathogen refers to

A.

B The ability to produce toxins in pathogens

C The number of pathogens

D Pental Power Power

E capability of the pathogen to invade the body and grow and reproduce in the body

18. After rectal cancer, the most commonly used tumor logo for monitoring recurrence is

A.CA199

B.CA153

C.AFP

D.CA242

E.cea

19. The most meaningful examination of the most meaningful condition of the local infiltration status of rectal cancer is

A colonoscopy

B full digestive tract X -ray 造 meal angiography

C colon X -ray tadpole radiography

D abdomen B ultrasound

E porcelain abdomen enhancement CT

20. The following disease is the most prone to secondary anal fistula after treatment

A perianal abscess

B external hemorrhoid

C anal fissure

D mixed hemorrhoids

E internal hemorrhoids

21. The most important treatment measure for acute obstructive purulent cholangitis is

A Early Fatate Application Flower Antibiotics

B expansion of the capacity and prevention of shock

C protect the liver function, reduce the total serum total bilirubin

D to remove the biliary obstruction, smooth drainage

E corrective water, electrolyte disorders

22. Mainly due to abnormal immune factors caused by hemolytic anemia is

A large area burns

B malaria

C blood type disagreement blood transfusion

D artificial heart valve replacement after surgery

E poisonous snake bite

23. When treating hepatic encephalopathy, the drug that can promote ammonia metabolism is

A texyrin

B branch chain amino acid

C lactatose

D fluinitini

E.L-birdine -l-daily cinemic acid

24. For patients with cardiovascular and cerebrovascular diseases, the following statement about pre -surgery is wrong.

A correct water, electrolyte metabolism disorders

B The optional surgery of the stroke of B is delayed at least 2 weeks after

C continues to take medicine before surgery for patients with hypertension

D Social Syntomies 2 months after the incidence of illness.

E does not require blood pressure to fall to normal postoperative surgery

25. The most common cause of breathing difficulties after hyperthyroidism in thyroid function is the most common cause of breathing difficulties.

A wound hematoma

B thyroid crisis

C bilateral throat nerve injury

D thyroid function is low

E organs collapse

26. The narrative about the characteristics of latent infection during the infection process is correct

A quickly causes explicit infection

B Once the immune function decreases, it can cause explicit infection

C pathogens after invading the human body, lurking in various parts

D infectious diseases have latent infections

E pathogen is constantly excreted from the body

27. The following test results are not belonging to giant cellular anemia laboratory

A outer peripheral blood neutral granulocytes show multiple leaves

B bone marrow can be seen in giant middle and late -grained cells

C -peripheral blood red blood cell MCV increase

D osteophyllus giant cell cells increase, too much leaves

E bone marrow has nuclear red blood cells in the phenomenon of “young paste”

28. The anti -wind and damp drugs that are preferred by the treatment of rheumatoid arthritis are

A amino phenetic

B glucose cortex hormone

C non -sterite anti -inflammatory drug

D cycle phosphide

E -hydroxyl chloride

29. Patients with peritonitis should undergo surgical investigation.

A body temperature exceeds 38 ℃

B age is over 60 years old

C symptoms of shock

D. The onset time is greater than 6 hours

E blood WBC exceeds 10 × 109/l

30. The typical clinical manifestations of anal fissure are

A does not have the defecation

B.

C black stool

D pus and blood

E anus pain after defecation

31. The test of the gallbladder need to detect the gallbladder is

A gallbladder wall is significantly thickened

B gallbladder enlarged

C Bile Tube Diameter> 1cm

D gallbladder stones exceed 2cm

E gallbladder stones are accompanied by gallbladder polyps

32. The main way for neonatal trachoma infection is

A respiratory tract infection

Extradonish in Palace

C milk infection

D birth canal infection

E saliva infection

33. Serum science indicators to reflect liver fiber are

A direct bilirubin

B white protein

C choline

D Alanine aminotransferase

E.IV collagen

34.

3cm below a

3cm above B

1cm above C

2cm above D

2cm below E

35. Early clinical manifestations of digestive ulcers perforation do not include

A cold war, high heat

B nausea, vomiting

C has limited tenderness and reflective pain

D abdominal muscle tension

E intestine sounds weakened or disappeared

36. Prompt that the most important alarm symptoms of the diagnosis of colorectal cancer are

A bloating

B abdominal pain

C diarrhea

D constipation

E -blood stool

37. When the liver cirrhosis is combined with spontaneous bacterial peritonitis, the principle of choosing antibiotics is

A for g-bacteria, taking into account G+bacteria

B aimed at G+bacteria, both anaerobic bacteria

C for g+bacteria, combined with antifungal drugs

D for G-bacteria, both anaerobic bacteria

E for g-bacteria, combined with antifungal drugs

38. The narrative about iron absorption is correct

A -stomach’s most resection of the stomach iron absorption reduction after surgery

B Fantry Food Iron is easy to absorb than animal food iron

C large amount of tea can increase the absorption of iron in the food

D Evital Iron is easy to absorb compared to the three -valent iron

E vitamin C is not conducive to the absorption of iron in food

39. The performance of the incision “Class B” does not include

A effusion

B red swelling

C hematoma

D hardline

E purule

40. The following does not belong to the gastrointestinal ulcer surgical treatment.

A internal medicine treatment is invalid

B often occurs at night abdominal pain

C twelve -finger ulcer combined with pyloric obstruction

D Gastric ulcer perforation after a full meal

E stomach huge ulcer

41. The disease that is closely related to Helicobacter pylori infection is

A Crotn disease

B duodenal ulcer

C gastric spouse reflux disease

D Functional indigestion

E ulcerative colitis

42. For the most meaningful clinical manifestation of thyroid cancer, in addition to thyroid clocks, it is also accompanied by

A difficulty in swallowing

B sound hoarse

C weight loss

D obvious pain

E obviously stretching

43. According to the period of surgery, the following is a time limit surgery

A chronic appendicitis cutting surgery

B root cancer treatment

C complete intestinal infarction blocking fistula

D recoverable femoral hernia repair surgery

E acute upper digestive tract perforation repair

44. The most common cause of sudden death after surgery is acute left heart failure

A pneumothorax

Bards

C acute left heart failure

D pulmonary embolism

E intensive pneumonia

45. The main cause of the active incision hematoma is

A wound crack

Take aspirin before surgery

C dissatisfied with high blood pressure control

D surgery is incomplete hemostasis

E wound infection Subsequent bleeding

46. ​​The clinical manifestation of the most diagnostic significance of inguinal hernia is

A press deep ring hernia still returns

B is easy to occur

C Her hernia sac neck is located outside the lower side of the abdominal wall

D hernia block is pear -shaped

E most common middle -aged

47. The main cause of lactating acute mastitis is

A isola skin cracking

B Cymphus accumulation bacteria invasion

C breast tissue dysplasia

D milk secretion disorder

E breast cystic hyperplasia

48. The antibody related to the Renault phenomenon with systemic lupus erythematosus is

A anti -SM antibody

B anti -RNP antibody

C anti -DSDNA antibody

D anti -SSA antibody

E anti -ANA antibody

49. Male, 25 years old. Heat and fatigue for 2 weeks. Examination: T 38 ° C, anemia, swelling of gums, tenderness ( +) in the lower sternum section, 2cm under the spleen ribs. Blood routine: HB 71g/L, WBC 31.4 × 109/L. Bone marrow cytology tests are 0.68, Auer small body can be seen in a few cells, and MPO staining is weak positive. The most likely diagnosis is

A acute monocyte cell leukemia

B acute red and leukemia

C acute lymphocyte leukemia

D acute giant cell leukemia

E acute early early young younger granulocytopenia leukemia

50. Male, 45 years old. Continuous right upper abdomen pain with cold war, high fever, nausea, vomiting for 10 days, body check: skin and sclera no yellow stain, full right ribs, 4cm under the liver ribs, blunt edges, tenderness, no nodules, 7th on the right side of 7th side , 8 intercostal armpits midline skin edema and tenderness; blood routine: WBC 18.5 × 109/L, n 0.91; abdomen B -ultrasound shows 8cm × 6cm liquid dark regions in the right lobe of the liver; Essence The most likely diagnosis is

A bacterial liver abscess

B gallbladder stones with infection

C liver cancer with infection

D right diaphragm abscess

E liver cyst

51. Female, 25 years old. Come to the diagnosis in late June, diarrhea and vomiting with mild abdominal pain for 1 day. There are 6 times of diarrhea, and it starts with yellow stools, followed by water. Vomiting once, for the content of the stomach. No heat. Pole inspection of power test ( +), alkaline protein cymbals cultivate bacterial growth. The most likely diagnosis is

A Transformer Estatitis

B cholera

C Elway Candidal Perioditis

D Salmonella Food Poison

E bacterial dysentery

52. Male, 55 years old. Diagnosis of hepatitis B for 4 years, black for 2 days, do not recognize family and noise for 2 hours. The inappropriate thing in the following treatment is

A intravenous application of Omeprazole

B orally Xiyi

C Variety application growth hormone

D oral lactose sugar

E orally Lifu Shiming

53. Male, 45 years old, farmers. Heating with cold, headache, general pain, fatigue for 4 days, cough, blood phlegm, and hemoptysis from August 25. There are dozens of people in the local flood disaster. Examination: T 39 ° C, consciousness, conjunctiva of the ball, tenderness of gastrocity muscle, large lymph nodes in the groin. The most likely diagnosis is

A kidney syndrome bleeding fever

B definition

C hook end spiral disease

D large leaf pneumonia

E flu

54. Female, 30 years old • Repeated constipation, abdominal pain for 10 years • Pure abdominal pain, abdominal discomfort, and relieved: Symptoms are worse when work tension. No blood and weight loss. Sleep poor. The most likely diagnosis is

A. Establishment syndrome

B. Crohn disease

C. Intestinal tuberculosis

D, ulcerative colon cancer

55. Male, 45 -year -old • Heat 4 days on January 20th. The body temperature fluctuates at 39 ° C ~ 40 ° C:, accompanied by cold, fatigue, and unwell cold medicine. There are rats in the place of residence • Checking: T36 ° C, P120/minute, BP70/50mmHg,: acute disease capacity, mental deficiency, skin congestion, facial edema, bleeding point under the armpit, soft abdomen. Laboratory inspection: Blood WBC 20 × 109/L. N 0.6, L 0.24. Heteroids L 0.16, P1T 80 × 109/L. Urine conventional: urine protein (+++), a few red blood cells. The most likely diagnosis is

A mista fever

B kidney syndrome bleeding fever

Tyle -typhoid

D hook end spiral disease

E upper respiratory tract infection

56. Male, 45 years old, with bloody AlT 42 (Alt42 ~ 78U/L) 丨 for a month, 170cn tall, weighing 90kg. Various virus indicators and autoimmune antibodies are negative. Beltic B -ultrasound: The echo of the liver is enhanced, and the rear is reduced. The best treatment measures are

A application lipid lower medicine

B rest and reduce physical activity

C Apply liver preservation drug

D anti -liver fibrosis treatment

E adjusts lifestyle and reduce weight

57. Female • 30 years old • 3 days of perianal pain, worsening during defecation. Examination: local tenderness on the left side of the anus, volatility. Blood WBC11.9 × 109/L preferred treatment method is

A. Flowing spectrum antibiotic vein drip

B. Potassium permanganate sitting bath

C. Analogy, calmness

D. Open and drainage of surgery

E. Anal application of anti -depth pain bolt

58. Male, 64 years old. The sclera yellow stain and the urine color is dark 2 weeks. No abdominal pain and fever. Examination: The upper abdomen can be swollen and bold, no tenderness. The total blood bilirubin 156 μm mol/L. The most likely diagnosis is

A. Acute hepatitis

B. Cancer around the pot belly

C. Biliary Tube Stone

D. Chronic pancreatitis

E. gallstones

59. Male, 19 years old. In the scorching day, a basketball under the scorching sun, headache, dizziness, chest tightness, palpitations, nausea, and abdominal muscle pain after sweating. T 38.3 ℃, P 108 times/minute, BP 90/60mmHg. The consciousness is clear, the complexion is flushed, the lungs are unheard of, and the wet and wetness sounds, the heart rhythm. The most likely diagnosis is

A. Hot spasm

B. Hot failure

C. Hypoglycemia

D. Fever

E. dehydration

60. Male, 19 years old. The upper abdomen was injured by a car for 2 hours, checking: P 138 points/time, BP 80/60

MMHG, pale complexion, cold limbs, and abdominal muscles. Tenderness and reflective pain are positive, and the intestinal sounds weakened. Laboratory testing: HB 85G/L, WBC 2.8×1012/L. The most likely diagnosis is

A. Small intestine rupture

B. Stomach rupture

C. colon injury

D. Liver rupture

E. duodenum and pancreas damage

61. Male, 76 years old. 7 days without row, abdominal pain and vomiting for 2 days. Constant constipation. Examination: Hypertension, the most likely diagnosis is

A. Acute gastritis

B. Acute peritonitis

C. Acute appendicitis

D. Acute pancreatitis

E. Acute intestinal obstruction

62. Male, 19 years old. Heating and headache for 3 days, the consciousness was unclear for half a day, and came to the diagnosis on August 5. The body temperature is 39 ° C, and the cold medicine is invalid. The headache was severe and unbearable, accompanied by vomiting. There are many mosquitoes in residence. Examination: T 40 ° C, P 120 times/min, BP 130/90 mmHg, blurred consciousness, restlessness, skinless skin, bilateral pupils, etc. Pastel (+). Laboratory testing: Blood WBC 16.5×109/L, N 0.8. In order to clarify the most important detection of diagnosis is

A. skull CT

B. Blood culture

C. Cerebral spinal fluid detection

D. Blood coating tablets to check Plasmodium

E. Specific IGM antibody

63. Female, 50 years old. Repeated seizures for 1 week. Examination: BP 130/86 mmHg. Generally, it is good. Under the skin of the upper limbs, several soybeans can be touched. There is no tenderness. In order to clarify the cause diagnosis, the first examination should be done first is

A. Antuclear antibody examination

B. EEG

C. Skull CT

D. Wormpin test

E. subcutaneous nodule biopsy

64. Male, 64. The upper abdomen is full and discomfort for 4 months, and the skin is dyed for 3 months. Examination: The skin and sclera are obviously yellow. Under the ribs of the right upper abdomen, cystic mass can be touched without tenderness. In order to clarify whether the surgery can cure the resection, the first choice is

A. Gastrointestinal X -ray tadpole radiography

B. Abdomen B ultrasound

C. audition

D. Gastroscope

E. abdomen CT

65. Female, 25 years old. Five days ago, the cold war was suddenly, followed by the high fever accompanied by headaches, and the heat exit sweat after taking the heating medicine. After 2 days, the cold war, high heat, last hours, sweating after sweating, fatigue, poor spirit. One week ago, it was traveling from Yunnan to Beijing. Laboratory inspection: Blood WBC 6.5 × 103 /L, L 0.40.

The most likely diagnosis is

A. Popularized encephalitis

B. Popular cold

C. Hook end spiral disease

D. Defense disease

E. malaria

66. Female, 30 years old, is physically healthy. After the thyroid glandular tumor was removed, the incision was not red and swollen. Surgical incision removal time period should be postoperative postoperative

A.6 ~ 7 days

B.2 ~ 3 days

C.10 ~ 12 days

D.7 ~ 9 days

E.4 ~ 5 days

67. Male, 25 years old. Back pain for 2 years. There were two left -eye irisitis. Examination: Light swelling of the left heel, tenderness (+); right knee swelling and tenderness (+), floating tag test (+). Laboratory inspection: HLA-B27 (+), blood sink 32mn/h. The most likely diagnosis is

A. Spinal arthritis

B. Baicai disease

C. Rheumatoid arthritis

D. Gouting arthritis

E. Infectious arthritis

68. Male, 76 years old. The left lower limb intermittent lameness is 3 years, which has been aggravated for 1 month. The previous history: 8 years of high blood pressure history, 5 years of coronary heart disease history. Examination: BP 150/90mmHg, pale left foot, the temperature of the left foot and left lower limb, the left foot artery and the tract arteries disappear, the left femoral artery can be touched. The most likely diagnosis is the left lower limb

A. Acute arterial embolism

B. Deep venous thrombosis

C. Arterius sclerosis occlusion

D. Thromacochyramnalitis

E. Thromer occlusion vasculitis

69. Female, 25 years old, first pregnant woman. At 12 weeks of pregnancy, frequent urination, urgency, and dysuria with vaginal discharge increased by 4 days. Examination: Pyomal secretions are found in the urethra mouth and cervix. To confirm the diagnosis, the preferred counseling examination is

A. Amniotic fluid cultivation

C. Cervical pipe secretion cultivation

D. Serum examination

E. urine culture

70. Female, 64 years old. A lot of vomiting for 1 day. For fasting and peripheral tonic treatment. Examination: P100/min, BP 90/60mmHg, CVP 5CMH2O. After the vein input is 250ml of saline water in 10 minutes, the BP 110/70mmHg is measured, and the CVP 5CMH2O. The most likely thing to indicate the condition is

A. Trauma response

B. Heart failure

C. Insufficient blood capacity

D. The blood capacity is relatively too much

E. Volume blood vessel excessive contraction

71. Male, 25 years old. 1 week of gum bleeding, bone marrow cytology test: extremely active hyperplasia, primitive lymphocytes accounted for 0.72. VDLP/scheme chemotherapy for 14 days of body temperature 37.4 ° C, review blood routine: HB 75G/L, WBC 1.4 × 109/L, classification n N 0.10, L 0.90, PLT 30 × 109/L. The preferred treatment is currently

A. Input suspended red blood cells

B. Application of antibiotic control infection

C. Infold fresh plasma

D. Enter concentrated platelets

E. Subcutaneous injection G-CSF

72. Female, 50 years old. The abdominal injury caused by a car accident for 3 hours. Abdominal pain and bloating after injury. During the non -surgical treatment observation in the emergency room, the most important measure is

A. Dynamic monitoring of laboratory inspection

B. Completely understand the injury

C. Abdominal X -ray examination

D. Dynamic examination of the abdomen B

E. Observe the change of abdominal recruitment

73. Male, 64 years old. The upper abdomen is discomfort and painful for 2 months. Gradually aggravate, have a full sense of swelling, decreased appetite, and have taken a variety of drugs to treat. History without a stomach. Examination: Slightly thin, no positive signs in the abdomen. Test blood HB 100g/L, dung hidden blood (+). First of all, the diagnosis is

A. Chronic gastritis

B. Stomach ulcer

C. Stomach mucosal prolapse

D. Stomach cancer

E. Acute gastric mucosal lesions

74. Male, 45 years old. The left lower limb was painful for half a year. In the past, there was a history of shallow vein venousitis in the left and lower limbs, with no history of hypertension and diabetes. 20 years of smoking, 20 years/day. Examination: The right lower limb is normal; the left foot is pale, the skin temperature is significantly reduced, the left foot of the left foot disappears, and the left shares and the artery can be touched. BUERGER test positive. The most likely diagnosis is the left lower limb

B. Thromer occlusion vasculitis

C. Primitive lower limb varicose veins

D. Arterius sclerosis occlusion

E. Deep venous thrombosis

75. Female, 30 years old. Four years ago, platelets decreased, and erythema at the section of the section was accompanied by low heat. Laboratory examination: anti -nuclear antibodies (+), heart phospholipid antibody (+), diagnostic systemic lupus erythematosus. In the 6 months of pregnancy, deep vein thrombosis in the left lower limbs appeared at the same time. Considering the merging disease is

A. Hypertension during pregnancy

B. Drying syndrome

C. Disposter blood vessels in the blood vessels

D. Anti -phospholipid syndrome

E. Vascular occlusion vasculitis

76. Male, 45 years old. The umbilicus was 2 hours after the abdomen injury, which was sustainable, accompanied by nausea, no vomiting, and the abdomen range expanded rapidly. Examination: P 126 times/min, BP 146/90mmHg, full abdominal muscles, tenderness and reflection pain positive, and the intestinal sound disappears. Prepare to explorate. The principle of surgical treatment does not include:

A. Try to separate the adhesion tissue

B. Treatment of primary lesions

C. Repeat the abdominal cavity with physiological saline before the abdomen

D. Reserve drainage, ensure that the drainage is smooth

E. After surgery, eating disease = and gastrointestinal decompression

77. Male, 19 years old. He was kicked into the abdomen, with abdominal pain for 8 hours and less than 2 hours of urine. Examination: BP 68/50mmHg, blurred consciousness, pale complexion, cold limbs, fine pulse speed, full abdominal tenderness, muscle tension, reflective pain (+), mobilization dull (+). The patient’s current condition is

A. Neurological shock

B. Heart source shock

C. Allergic shock

D. Infectious shock

E. Low blood capacity shock

78. Male, 55 years old. The history of chronic hepatitis B is 15 years, and the liver area is painful for 2 months. The B -ultrasound of the abdomen indicates a low -echo nodule with a diameter of about 2cm. The most meaningful laboratory examination for diagnosis is

A. Alkaline phosphatase

B. Cancelin antigen

C. γ -glutamyl metastases

D. A fetal protein

E.ca199

79. Female, 30 years old. After drinking alcohol, abdominal pain for 4 hours, no fever. Blood routine: HB 120g/L, WBC 8.5 × 109/L, PLT 125 × 109/L; blood amylase 1032U/L. Abdominal B -ultrasound: The pancreas is slightly full. The first treatment measure is

A. Application 5-fluoridine

B. Application wide -spectrum antibiotics

C. Fasting, gastrointestinal decompression

D. Bile diversion drainage

E. Caesarean section

80. Male, 70 years old. Suddenly severe headache, vomiting, left limb dysfunction for 6 hours, coma 5 hours, 1 hour ago, the dark red blood was once. The cause of vomiting blood first is to consider

88. Acute gastric mucosal disease

89. Dieulafoy lesions

90, gastric cancer

91. Liver cirrhosis esophageal bottom varicose veins rupture

92, duodenal ulcer

81. Female, 50 years old. The thyroid gland is mostly 3 years. Cervical ultrasound reminder: thyroid bilateral leaf polymopergamic, solid nodules, laboratory examination: T3, T4, TSH are normal. During the follow -up process, the surgical treatment indicator is not included

A. Extraction of thyroid nodules with qi

B. The number of thyroid nodules increases

C. Hypertrophy of thyroid function appears

D. Pitthylsum after sternum

E. Nodule boundary is unclear and small calcification

82. Female, 30 years old. Her face was pale for half a year, and it was diagnosed with systemic lupus erythematosus 2 months ago. Examination: anemia, mild yellow yellow dyeing skin, 2cm under the spleen ribs. Blood routine: HB78G/L, WBC4.4*103/L, PLT72*103/L, RET0.14. The laboratory inspection that is most likely to have abnormal results is

A.HAM test

B.Coombs test

C. Urine Rous Test

D. Red blood cell penetration brittle test

E. isopropanol test

83. Male, 45 years old. The left and right leg wheels were crushed for 2 hours. Examination: T37.2. C, P145 times/min, R28 times/min, BP/55mmHg. The expression was indifferent, his complexion was pale, and his lips were dry. The two lung breathing sounds clear. Soft abdomen, no tenderness. Open trauma in the middle of the left calf, the near -end of the wound has been tied for 30 minutes with a hemostatic band outside the courtyard, and the wound has no obvious bleeding. The foot artery is weak. At this time, the patient’s handling measure is wrong

A. Supplement blood capacity

B. Let go of the hemostatic zone to avoid distal limb ischemia

C. Prepare before surgery, emergency surgery

D. Prepare blood

E. Central vein tube

84. Female, 25 years old. The right upper abdomen was stabbed for 1 hour, irritability, nausea, and vomiting. Examination: p106 times/minute, BP110/80mmHg. Abdominal muscles are tight, limited to tenderness and rebound pain. CVP4CMH2O, HB100g/L, blood cell ratio 0.35. The first process should be processed

A. Sending and pain relief

B. Gastrointestinal decompression

C. Antibiotic quiet drip

D. Quickly linked balanced salt solution

E. Quickly pass the whole blood

85. Female, 70 years old. 7 days after gastric cancer root treatment. Due to lung infection, abdominal surgical incision pain occurs after a severe cough, and there are a large amount of light red overflow.

A. Infection

B. Abdominal incision hernia

C. Hemorrhoids in the incision

D. Capped fat liquefaction

E. incision cracks

86. Female, 70 years old. After taking a bath in the bathroom for 2 hours, I was found in a coma in the bathroom. The indoor gas furnace was heated and the doors and windows were closed. Examination: coma, irregular breathing, BP110/70mmHg. The primary measure of on -site first aid is

A. Move away from the scene

B. Inhale high concentration of oxygen

C. Give the tracheal intubation ventilator auxiliary breathing

D. Port to the mouth to breathe artificially

E. Keep the respiratory tract unobstructed

87. Male, 64 years old. Deficiency and weight loss increased by 4 months. Examination: Pleated complexion, soft abdomen, and the right abdomen can be touched about 5cm in diameter. Laboratory inspection: HB80g/L, dung hidden blood (+). The most likely diagnosis is

A, twelve rectal cancer

B. Gallbladder cancer

C, appendic cancer

D. Lift colorectal cancer

E, pancreatic head cancer

88. Female, 70 years old. Sudden upper abdominal pain for 12 hours, accompanied by cold battles and fever. In the past, most of the duodenal ulcers were removed. Examination: T39.5 ° C, P110/minute, BP80/50mmHg, skin, sclera yellow stain, tight right upper abdomen and sword trustee, compression, reflector (+). Blood wbc16x103/L. Abdominal B -ultrasound shows: The biliary manus is expanded, and the lower section is not clearly observed by the intestinal qi. The patient’s preferred surgical method is

A, biliary intestinal convergence

B, gallbladder removal

C. Cut the bile pipe cutting and drainage

D, gallbladder creation

E. Meridoscopy duodenal intestinal nipple cutting surgery

89. Male, 45 years old. Gastroscopy indicates that the duodenal ulcer is prompted, and it is still repeatedly developed after 3 months of drug treatment. Most of the stomach resection Bi Ⅱ kiss, postoperative complications belong to long -term complications are

A. Enter 襻 obstruction

B. Early dumping syndrome

C. Output 襻 obstruction

D. Stomach empty disorder

E, twelve rectal residue ending rupture

[Analysis] Looking at the early stage, it is actually a long -term complication. This is the strategy and characteristics of the test center.

90. Male, 25 years old, abdominal pain, pus and blood, and fever for 2 months. 10 times/day, body temperature is 39 ° C. The pathogenic examination and cultivation of the pathogen are not seen. Catoscopy shows the erosion and ulcers of the colon. Pathology indicates severe chronic inflammation. Levofloxacin combined with metronidazole for 1 week of symptoms have not eased. The most suitable healing drug is

A. Pennisone

B. Amomaminelidine

C, azazine

D. Merrazine

E. Melisidine combined with Misharazide embolism

91. Male, 64 years old. Sudden upper abdominal pain for 3 hours, persistent, expands from the upper abdomen to the whole abdomen, accompanied by nausea and vomiting. Examination: P110/minute, BP138/96mmHg. Breathing is light and fast, abdominal distension, tight abdominal muscles, tenderness and reflection pain, the disappearance of the liver vocal, and the disappearance of the intestinal sound. The most important thing in the following treatment measures

A.

B. Gastrointestinal decompression

C. Application antibiotics

D. Half -bed

E, oxygen absorption

92. Female, 30 years old. Bloating, constipation, fever, and fatigue for 7 months. The symptoms have increased for 1 week. Examination: T37.7 ° C, the lower right abdomen hit 4cmx5cm lumps, quality, etc., the boundary is unclear, and the light tenderness. Rich routine (-). Annemia was found to be ring -shaped ulcers. The most likely diagnosis is

A. The cysts around the appendix

B. Crohn disease

C. Right ovary cyst

D, intestinal tuberculosis

E, colon cancer

93. Female, 50 years old. Skin and sclera yellow dye for 2 months, aggravated in sexuality, accompanied by anorexia and weakness. The stool is gray and the weight is alleviated by 3kg. Examination: sclera, skin yellow stain, 3cm under the liver ribs, blunt edges, no nodules, can touch the bold bold pork, Murphy signs (-). The total cholesterol, bilirubin, ALP, and R-GT are significantly higher, and the CA100 is elevated. The preferred imaging examination is

B. Blood culture

A. Acute arterial embolism

A, nuclear scanning

B, abdomen CT

C, MRCP

D, abdomen MRI

E, abdomen B ultrasound

94. Male, 45 years old. Repeated abdominal pain for 2 years, black for 2 days, vomiting blood with dizziness for 4 hours. The most suitable hemostatic treatment is

A. emergency surgery

B. Temperature gastroscopy to stop bleeding

C. Varic vessel application blood vessels plus acin

D. Ice saline and gastric cavity washing

E. Oral coagulation

95. Male, 55 years old. After drinking and a high -fat diet, abdominal pain for 4 hours, radiation to the back, accompanied by vomiting, sweating, and yellow urine. The most helpful examination for diagnosis is

A. Gastrointestinal X -ray tadpole radiography

C. Hepatobiliary nuclein scan

D. Establishing abdomen X -ray flat film

E. Gastroscope

96. Male, 55 years old. Burning a large area for 5 days, and the awareness of the cold war and the high fever was unclear for 1 day. Examination: T35.6 ℃, P120/minute, BP90/55mmHg. Blood WBC2.7X109/L. The most likely to be infected with the patient’s infection is

A. Gram -negative

B. Staphylococcus aureus

C. Enterococcus

D. Type B hemolytic splitter

E. White Candida

97. Female, 64 years old. Root treatment of rectal cancer. Type 2 diabetes history has a history of more than 20 years. Inject insulin in the daily skin injection, insulin 12U is applied in the morning. The blood glucose is often 7 ~ 10mmo1/L, urine glucose (+~ ++). The following is an inappropriate handling during the operation.

A. Term of empty blood glucose on the day of surgery

B. To control the empty blood glucose to normal level

C. Apply glucose and insulin before surgery

D. Urinary sugar can maintain the original level

E. Surgery Day Disable insulin

98. Male, 25 years old, with severe anal pain with a foreign body sensation for 1 day, and the local mass is protruding. Constant constipation, no blood history. Examination: T36.5 ° C, the diameter of 2.0cm in the anus, slightly harder, dark purple, tenderness. The most likely diagnosis is

A. Anal fissure

B. Mixed hemorrhoids

C. Throsty external hemorrhoids

D. Rectal polyps

E. Internal hemorrhoids protruding

99. Female, 50 years old. For 5 years, his complexion is pale and weak for half a year. Gastroscopy is pale, thin, and obviously visible to the blood vessels. The result is most likely to be experimental inspection.

A. Increased basic gastric acid secretion

B. Positive cell positive pigment anemia

C. Efficacy of blood acid

D. Blood -promoting gastric liquid levels decrease

E. Blood vitamin B12 level decreases

100. Female, 25 years old, 26 weeks of pregnancy. The neck is thickened with qi for 1 month. Examination: P100/minute, BP100/70mmHg. The thyroid swelling is 3 degrees, and the trachea is left. Laboratory inspections: T3 and T4 are higher than normal. The preferred treatment method is

A. Oral thyroxine tablets

B. Hemotopen 1 treatment

C. External radiation therapy

D. Oral propyl oxyraine

E. Surgical treatment

101. Female, 30 years old. The abdomen is accompanied by low heat and diarrhea constipation for 1 month. Examination: Tears on the right lower abdomen, which can touch the unclear block of the boundary, and the activity is poor. The most meaningful test for clear diagnosis is

A. Abdomen CT

B.B Ultra -guided lower abdomen block puncture

C. colon X -ray tadpole radiography

D. Abdominal angiography

E. colonoscopy

102. Male, 64 years old. It is intended to treat gastric cancer root treatment, and 20 cigarettes are placed. Examination: T 37.5 ° C, P 90 times/minute, BP 155/95mmHg. Blood K*3.0mmol/L, A1B35G/L. The correct preoperative preparation is

A. Varicose supplement human hemurin

B. Oral intestinal antibiotics

C. Quit smoking 3 days before surgery

D. Potassium

E. Reduce blood pressure to normal

103. Female, 41 years old, bloating, abdominal pain, low heat for 2 months. The abdomen B ultrasound shows the abdominal effusion. Bloodylin is 30g/L, and the abdominal pest was pulled out of the grass yellow and turbid liquid on the day. The ascites test showed that the gravity was 1.023, the albumin was 22g/L, and the ratio of a single nuclear cell was 0.88. The most likely diagnosis is

A. connective tissue disease

B. Malignant tumor

C. Secondary peritonitis

D. Tuberculosis peritonitis

E. Primary peritonitis

104. Male, 45 years old. Over the past half an hour after meals, the upper abdomen is full and painful. It can be relieved by itself after about 2 hours. It often has acid reflux and heating. Recently, the radioscope of the gastrointestinal X -ray agent indicates that the gastric sinus sinus sideline side 1cm size wall photo, the edges are smooth. The patient is often used by surgical treatment

A. Most of the stomach resection (Bi II -type type consistency)

B. Most of the stomach resection (compatible of Bi I)

C. High -selective vagus nerve cutting

D. General gastric resection

E. Selective vagus nerve resection

105. Male, 64 years old, 5 hours of upper abdomen pain, 5 years of multi -stones disease in computer, physical examination: T38.3 ° C, P100/min, BP85/60mmHg, skin, sclera yellow dye +), For a clear diagnosis, the first choice is.

A. Rebroar angiography of endoscopy

B. Abdomen B ultrasound

C. Abdominal CT

D. Baldioscopy

E. Spechetic liver puncture bile duct angiography

106. Female 25 years old, with ecchymosis of the limbs for 2 weeks. Blood routine: HB80g/L, RBC2.6 × 1012/L, WBC1.5 × 109/L, PLT × 109/L, RET0.004. The most likely diagnosis is

A.EVANS syndrome

B. Bone marrow hyperplasia abnormal syndrome

C. Small plate reduction purposes

D. Matrobine sleeping hemoglobinuria

E. Regenerative disorder anemia

107. Male, 19 years old, bleed more than 2 days after extraction. Laboratory inspection: HB115G/L, WBC5.4-109/L, PLT130 × 109/L, PT11S (normal control 13s), AptT65S (normal control 38s), TT16S (normal control 17s). The most likely cause of the patient’s bleeding is

A. Fibrin deficiency

B. Vitamin K deficiency

C. Coagulation factor X deficiency

D. The original lack of coagalase

E. Coagulation factor IX deficiency

(108-109 question sharing questions)

Male, 45 years old, pain in the upper abdomen for 9 hours, radiation to the back of the waist, with nausea and vomiting. Drink in the beam before the onset, check the body: T38.3 ° C, P100/minute, the upper abdominal muscles are tight, toothache and reflective pain are positive.

108. The most likely diagnosis is

A. Acute pancreatitis

B. Duodenal collapse perforated

C. Acute cholecystitis

D. Acute gastroenteritis

E. Acute biliary brainitis

109. No clear diagnosis, the preferred examination is

A. serum lipase

B. serum amylase

C. Urine amylase

D. Liver function

E. Establishing abdomen X -ray flat film

(110 ~ 112 questions shared questions)

Male, 25 years old. In the morning, the umbilical umbilical was painful, accompanied by nausea. In the afternoon, I felt a significant pain in the right lower abdomen and could not bear it. Examination: T 38.0 ° C, BP ​​110/80mmHg, the right lower abdominal muscles are tight, tender, and positive.

110. The most likely diagnosis of the patient is

A. Twelve -finger ulcer perforation

B. Intestinal analogenic arterial embolism

C. Acute intestinal obstruction

D. Acute appendicitis

E. Acute cholecystitis

111. In order to clear the first choice of the diagnosis, it is

A. Diagnostic abdominal puncture

B. Gastroscope

C. Abdomen B ultrasound

D. Abdomen CT

E. Great Gastrointestinal X -ray Diamond Aging

112. The patient performed surgery, and abdominal pain, irritability and anxiety occurred twice after surgery. Examination: P 110 times/min, BP 80/60mmHg, pale complexion, wet skin, slightly bloated abdomen, full abdominal tenderness, mild abdominal muscles, and weakened bowel sounds. The most likely postoperative complication is

A. Gastrointestinal perforation

B. Intestinal thrombosis embolism

C. Intestinal necrosis

D. Insurance in the abdominal cavity

E. Acute intestinal obstruction

(113 ~ 114 questions shared questions)

Male, 45 years old. There is no memory. Zhao Zhao Medical Examination prompts that if it is intestinal disease, the first choice is colonoscopy.

113. In order to clear the diagnosis, the preferred examination is

A. Abdomen B ultrasound

B. Hematum tumor logo position

D. colonoscopy

E. lower digestive tract X -ray tadpole radiography

114. The most likely diagnosis is

A. Intestinal flora disorders

B. Ulcerative colitis

C. Salvation syndrome

D. Bacterial dysentery

E. colon cancer

(115 ~ 116 questions shared questions)

Male, 55 years old. Deficiency and loss of appetite for 1 month, the state gradually worsen, yellow urine and yellow eyes. Two months ago, the home decoration and moving were tired. The chronic hepatitis B is 20 years. It has obvious symptoms. It has not detected liver function and has not been treated with anti -HBV. Examination: chronic disease, consciousness, skin scleral yellow stain, abdominal flatulence, spleen under the ribs, which can be touched, ascites are suspicious. Laboratory inspection: AlT250U/L, AST300 U/L, TB11 300 U Mol/L. AIB30g/L, HBSAG (+), HBC (+), HBV DNA 6 × 107 copy/ml.

115. The most likely diagnosis is

A. Hepatitis

B. Acute severe hepatitis

C. Chronic severe hepatitis

D. subacute severe hepatitis

E. Chronic hepatitis

116. In order to further evaluate the severity of the condition, the inspection that needs to be performed is

A. Abdominal MRI

B. The original activity of coagulinase

D. Listennium routine

E. Blood routine

117. In order to rescue patients, the most urgent treatment measures are

A. Intravenous drip albumin

B. Varicose Drop Basin Chain amino acids

C. Varicose drip licorite acid preparation

D. Artificial liver support treatment

E. Antibiotic prevention infection

118. In order to curb the progress of the disease, the most needed treatment drugs are

A. Immunode

B. Enutcavir

C. Immunoagulant

D. White blood cellin

E. interferon

(119-121 questions shared questions)

Male, 45 years old, fell when he rode an electric car 8 months ago. The upper abdomen was injured and painful. After treatment, it was relieved. 6 months ago, I felt that the upper abdomen gradually raised, and the upper abdomen was full of nausea and vomiting. Examination; the upper abdomen can be touched about 10 cm in diameter, muscle -free, tender, and reflecting pain.

119. The choice should be preferred

A abdomen CT

B ultrasound

C stereo -abdomen X -ray flat film

D abdomen MRI

E gastroscope

120 imaging examination reminds the patient’s upper abdomen 10cmx10cm cystic mass. The most likely diagnosis is

A abdominal swelling blood

B diamond hernia

C liver left lobe cyst

D pancreatic cysts

E duodenal diverticulum

121 The most suitable surgical way for the patient is

A peritoneal hematoma clearance

B diamond hernia repair

C liver left lobe cysts open window

D pancreatic cysts

E duodenal diverticulum repair

(122-123 Questions shared questions)

Female, 55 years old, has a right breast mass for 6 months, without pain, no nipple overflow. Examination; the upper quadrant of the right milk can touch the 6cmx5cm lump, which is hard and the border is unclear. Right armpits can touch several enlarged lymph nodes. Partial fusion

123 After the lumps are diagnosed with breast cancer, the preferred treatment method is

A milk protection surgery

B improvement root treatment

C radiation therapy

D Preoperative Chemotherapy

E targeted therapy

123 Determine whether the patient needs to perform endocrine therapy is

A.Her2 expression situation

B. Tumor size

C.ER expression situation

D. Is it accompanied by lymph nodes transfer?

(124-125 question sharing questions)

Male, 25 years old. Flame burning the head and face, 30 minutes of the front chest and limbs. Examination: BP90 | 50mmHg, consciousness, painful expression, irritability. Fast heart rate and weak pulse. Some wounded surfaces are black, some of the wounded surfaces have blisters, and the base is red

, Pain sensitivity.

124 The most important emergency treatment is

A analgesic, sedation

B fast vein tonic

C wound treatment

D vein antibiotics

E injection wave injury wind antitoxin

125. When the patient’s venous tonic, the most objective and simple clinical indicators to adjust the amount and speed of the adjustment of the fluid are

A: Heart rate

B: blood pressure

C: urine volume

D: Fundamental condition of nail capillaries

E: Status and consciousness

(126-128 questions shared questions)

Male, 55 years old, the neck lymph nodes have been swollen for 2 months, fever for 2 weeks, and weighed 14kg in weight since the onset. Examination: T38.7 ° C, there are several diameter of 2-5cm lymph nodes on both neck and right axillary on both sides, all movement, no tenderness, no abnormal heart and lungs, soft abdomen, no touches on the liver and spleen ribs, routine blood and routine blood and blood ribs. No abnormalities were seen in the bone marrow examination, and the left neck lymph nodes were recognized as diffuse large B -cell lymphoma.

126. To determine the diagnosis of the patient’s lymphoma is group A or B. The medical history that should be asked is

A: Heating type

B: Is the skin?

C: Is there night sweats?

D: Situration

E: Sleep situation

127. In order to judge the clinical stages of lymphoma, the first choice of auxiliary examination is

A: chest, abdomen CT

B: liver function

C: kidney function

D: ECG

128. The patient’s treatment plan should be preferred

A: ABVD

B: R-chop

C: MOPP

D: DA

E: VDLP

(129-130 question sharing questions)

Male, 55 years old, a history of chronic hepatitis B, 15 years, fatigue, and interruption of lower limb edema for 5 years. Diarrhea for 4 days, fever, bloating, urine less than 3 days. Examination: full abdominal pressure, movement of voicing.

129. The most likely diagnosis is

A: Remembering bacterial dysentery

B: Acute renal functional endless

C: Tuberculosis peritonitis

D: Spontaneous peritonitis

E: liver cancer

130. The inspection of the most helpful for the most helpful is

C: Tunger bacterial culture

D: Abdominal puncture and drawing fluid examination

E: Tuberculin Test

(131-132 Questions shared questions)

Male, 25 years old, red swelling for 2 days, chills, fever for 1 day, local epidermal red, slightly bulging, fingers slightly decay, the boundary is clear, and the right groin has lymphatic swelling and pain.

131. The most likely diagnosis is

A: Pain

B: Qi Gang

C: 疖

D: Dan poison

E: Acute Honeycomb Group Inflammation

132. The most important treatment measures are currently

A: Physical therapy

B: Local antibiotics wet compress

C: Restricted activities

D: Intravioplasty

E: Cut the drainage

2016 practicing physician Volume 3

(133-134 Questions shared questions)

Male, 25 years old. Back pain for 8 years, obvious in the morning, decreased after the activity. The back pain worsened in the past 1 month, limited activities, physical examination: lumbar spine forward flexion, back extension, Schober test (+), bilateral “4” word Test (+).

133. The most likely diagnosis is

A: Rheumatoid arthritis

B. gout arthritis

C. Rheumatism arthritis

D. Reactive arthritis

E. Announced spinalitis

134. The most valuable examination of confirmed diagnosis is

A. Blood Site

B. sacroiliac joint X -ray film

C. Blood routine

D.HLA-27

E. rheumatoid factor

(135-136 Question alternative answer)

B, abdomen CT

A. Abdomen CT

B. Abdomen B ultrasound

C. Abdominal CT

C. Abdomen B ultrasound

E. Blood routine

Male, 64 years old. The sternum burning pain for 2 weeks, accompanied by qi, occasionally swallowed, oral oral oralprazole treatment was relieved after 2 weeks of treatment.

135. The first consideration of the first consideration is

A. Gastrointestinal ulcer

B. Food official cancer

C. Angimina

D. Cardiac loss

E. Gastroesophageal reflux disease

136. The current preferred inspection is

A. ECG

B. Coronary arteries

C. Gastroscope

D.24 -hour esophageal pH monitoring

E. Ultrasonic heart movement

(137-138 Question alternative answer)

A. Pole of appendix bad gangrene

B. Plane cancer

C. Form an appendix abscess

D. Divisory veinitis

E. Slap post appendicitis

137. Patients with acute appendicitis do not go to the doctor in time. The right lower abdomen block occurs. There is tenderness. The most likely situation is C.

138. Patients with acute appendicitis have chills, high fever and sclera yellow stains. The most likely situation is D

(139-140 Question alternative answer)

A. Difficulty of vomiting

B. Abdominal pain with anemia

C. Repeated acid and heart pain with heart pain

D. Sudden upper abdominal knife cut -like pain to the back of the waist and back

E. The upper abdomen is accompanied by heating after the intermittent meal, which does not affect sleep

139. First of all, the clinical manifestation of functional indigestion is e

140. First of all, the clinical manifestation of gastric cancer is B

(141-142 Questions sharing alternative answers)

A. Edge area lymphoma

B. Inter -alien large cell lymphoma

C.Burkitt lymphoma

D. Persistent large B -cell lymphoma

E. Set cell lymphoma

141. It is B belonging to T cell lymphoma

F. It is an inert lymphoma tumor A

(143-144 Questions sharing alternative answers)

A.barrett epithelium

B. Everburization of the stomach

C. Polytic tumor

D. Stomach mucosal epithelial cells hyperplasia

E. Infiltration of neutral cells in the mucosa

143. The pathological changes that are closely related to the incidence of gastric cancer are D

144. Pathological changes that are closely related to esophageal adenocarcinoma

A

(145-146 Questions sharing alternative answers)

A.Pacoc rise

B.HCO3 increase

C. PACO c reduction

D. Anti -ion gaps decrease

E.HCO3 decrease

145. Metabolic acid poisoning is mainly due to the body E in the body

146. Metabolic alkali poisoning is mainly due to the body D in the body

(147-148 Questions sharing alternative answers)

A. Popular herpes virus

B. Pale and dense spiral body

C. Human immune defect virus

D. Human nipple virus

E. Grand Blue negative bisoccinius

147. The pathogen of sharp eczema is D

148. The pathogen of syphilis is B

(149-150 question sharing alternative answers)

A. Full of filling and defect

B. Cobblestone

C. Cup Express

D. Lead pipe signs

E. Bird’s mouth signs

149. Crohn’s typical x first signs B

150. Typical X -ray signs of sigmal colon torsion are e