100+ Free Clinical Medical Practitioner (China) Practice Questions

Clinical Internal Medicine & Subspecialties (临床医学综合 - 内科系统)

Core internal medicine disciplines and specialized organ systems: (1) Cardiovascular System: Primary & secondary hypertension, acute coronary syndromes (STEMI, NSTEMI, unstable angina), chronic/acute heart failure (NYHA & ACC/AHA staging, GDMT pharmacotherapy), cardiac arrhythmias (atrial fibrillation, SVT, VT, AV blocks), valvular heart disease (mitral stenosis, aortic regurgitation), infective endocarditis (Duke criteria), cardiomyopathy, and pericardial disease; (2) Respiratory System: Chronic Obstructive Pulmonary Disease (COPD / GOLD staging), Bronchial Asthma (GINA guidelines, step therapy), Community-Acquired & Hospital-Acquired Pneumonia (CURB-65 score), Pulmonary Embolism (Wells score, CTPA gold standard), Bronchiectasis, Primary Lung Cancer (NSCLC/SCLC staging), Pneumothorax, and Acute Respiratory Distress Syndrome (ARDS / Berlin definition); (3) Gastroenterology & Hepatology: Gastroesophageal Reflux Disease (GERD), Peptic Ulcer Disease (H. pylori eradication regimens), Acute Pancreatitis (Atlanta criteria, Ranson score), Cirrhosis & Portal Hypertension (ascites, SBP, esophageal variceal bleeding), Hepatic Encephalopathy (stages 1-4, lactulose/rifaximin), Inflammatory Bowel Disease (Ulcerative Colitis vs Crohn's Disease), and GI malignancies; (4) Nephrology & Urology: Acute Kidney Injury (KDIGO criteria), Chronic Kidney Disease (CKD staging 1-5), Glomerular diseases (Nephrotic syndrome, IgA nephropathy, Acute post-streptococcal glomerulonephritis), Tubulointerstitial nephritis, and Urinary tract infections; (5) Hematology: Anemias (Iron deficiency, Megaloblastic, Aplastic, Hemolytic), Acute & Chronic Leukemias (AML, ALL, CML, CLL), Lymphomas (Hodgkin vs Non-Hodgkin), Immune Thrombocytopenic Purpura (ITP), and Coagulation disorders (DIC); (6) Endocrinology & Metabolism: Diabetes Mellitus (Type 1 vs Type 2, DKA, HHS, target HbA1c), Thyroid disorders (Graves' disease, Hashimoto's, thyroid storm), Cushing syndrome, Primary aldosteronism, Adrenal insufficiency (Addison disease), and Hyperuricemia/Gout; (7) Neurology & Psychiatry: Acute ischemic stroke (rtPA intravenous thrombolysis window 4.5h), Intracerebral hemorrhage, Subarachnoid hemorrhage (aneurysm rupture, Hunt-Hess scale), Epilepsy/Seizures (status epilepticus first-line diazepam/lorazepam), Parkinson's disease, Myasthenia gravis, Depressive disorders, and Schizophrenia; (8) Infectious Diseases: Viral hepatitis (HBV serology, HCV DAA regimens), Pulmonary Tuberculosis (DOTS strategy, first-line HRZE), Bacterial dysentery, Typhoid fever, Rabies post-exposure prophylaxis, HIV/AIDS (CD4 count, ART), and COVID-19.

Surgery & Trauma (临床医学综合 - 外科系统与创伤)

General surgery, traumatology, perioperative management, and surgical subspecialties: (1) Surgical Principles & Critical Care: Water, electrolyte, and acid-base disturbances (hypokalemia, hyperkalemia, isotonic/hypotonic/hypertonic dehydration, metabolic acidosis), Hemorrhagic and septic shock resuscitation (fluid challenge, vasoactive agents, MAP targets), Surgical nutrition (enteral vs parenteral), Surgical infection classification (furuncle, carbuncle, necrotizing fasciitis, tetanus prophylaxis), Perioperative management, Wound healing, and Burns (Rule of Nines, Parkland fluid formula); (2) General Surgery & Acute Abdomen: Acute appendicitis (clinical signs: McBurney's, Rovsing's, psoas sign; surgical indications), Intestinal obstruction (mechanical vs paralytic, dynamic vs vascular, strangulated bowel signs), Inguinal hernias (indirect vs direct, femoral hernia incarceration risk), Gallstone disease & Acute cholecystitis (Murphy's sign, laparoscopic cholecystectomy), Choledocholithiasis & Acute cholangitis (Charcot's triad, Reynolds' pentad), Upper GI perforation (subdiaphragmatic free air), and Colorectal/Gastric malignancies; (3) Orthopedics & Trauma: Fractures (classification, healing stages, complications: compartment syndrome, fat embolism syndrome), Upper limb fractures (clavicle, humerus, Colles' fracture, Smith's fracture), Lower limb fractures (femoral neck Garden classification, femoral shaft, tibial plateau), Joint dislocations (anterior shoulder dislocation, posterior hip dislocation), Spinal fractures and spinal cord injury (ASIA impairment scale), Intervertebral disc herniation (L4-L5, L5-S1 nerve root compression signs), and Bone tumors (osteosarcoma Codman triangle, sunburst sign); (4) Cardiothoracic Surgery: Chest trauma (rib fractures, flail chest, tension pneumothorax needle decompression/chest tube, massive hemothorax), Esophageal carcinoma, and Lung cancer resection indications; (5) Urologic Surgery: Urinary tract calculi (renal, ureteral, bladder stones; ESWL and ureteroscopy indications), Benign Prostatic Hyperplasia (BPH / IPSS score, alpha-blockers, 5-ARIs, TURP), Renal cell carcinoma (classic triad), and Bladder cancer (painless gross hematuria); (6) Neurosurgery: Traumatic brain injury (Glasgow Coma Scale GCS), Epidural hematoma (middle meningeal artery rupture, lucid interval, biconvex hyperdensity on CT), Subdural hematoma (crescentic hyperdensity), and Intracranial hypertension (Cushing's triad: hypertension, bradycardia, irregular breathing).

Basic Medical Sciences (基础医学综合)

Essential pre-clinical disciplines establishing physiological, biochemical, pathological, and pharmacological foundations for clinical medicine: (1) Physiology: Cellular resting and action potentials, sliding filament muscle contraction, cardiac electrophysiology and pressure-volume loops, systemic vascular resistance, microcirculation regulation, pulmonary ventilation and gas exchange (V/Q ratio), digestive secretion and gastrointestinal motility, renal glomerular filtration rate (GFR) autoregulation, countercurrent multiplier mechanism, neuroendocrine reflexes, synaptic transmission, and autonomic nervous system regulation; (2) Biochemistry & Molecular Biology: Protein structure-function relationships, enzyme kinetics (Km, Vmax, competitive vs non-competitive inhibition), carbohydrate metabolism (glycolysis, pentose phosphate pathway, citric acid cycle, gluconeogenesis, glycogen synthesis/breakdown), lipid metabolism (beta-oxidation, ketone body synthesis, lipoprotein transport HDL/LDL/VLDL), amino acid transamination/deamination and urea cycle, purine/pyrimidine nucleotide metabolism, DNA replication/repair, RNA transcription, and protein translation; (3) Pathology: Cellular adaptations (hypertrootherapy, hyperplasia, atrophy, metaplasia), reversible cell injury (fatty change, hydropic swelling), irreversible injury (coagulative, liquefactive, caseous, fat, and gangrenous necrosis, apoptosis), acute and chronic inflammation (chemical mediators, cellular exudate), hemodynamic disorders (thrombosis, embolism types, infarction), and neoplasia pathology (differentiation, benign vs malignant criteria, carcinoma vs sarcoma, TNM classification, dysplasia vs carcinoma in situ); (4) Pharmacology: Pharmacokinetics (bioavailability, volume of distribution, clearance, half-life, steady state), Pharmacodynamics (agonists, antagonists, receptor up/downregulation), Autonomic drugs (adrenergic agonists/antagonists, cholinergic agonists/antagonists), Cardiovascular agents (antiarrhythmics Classes I-IV, ACEIs/ARBs, calcium channel blockers, statins, diuretics), Central nervous system drugs (sedatives, analgesics, antipsychotics), Antimicrobial agents (beta-lactams, macrolides, fluoroquinolones, aminoglycosides, antifungals; mechanisms and resistance), and Endocrine drugs (insulin preparations, oral hypoglycemics, corticosteroids); (5) Medical Microbiology & Immunology: Bacterial structure and virulence factors, viral replication, innate vs adaptive immunity, antigen presentation (MHC Class I vs Class II), immunoglobulin isotypes (IgG, IgM, IgA, IgE), hypersensitivity reactions (Types I-IV), and autoantibody profiles.

Obstetrics & Gynecology (妇产科系统)

Comprehensive obstetric care, maternal-fetal medicine, gynecologic oncology, reproductive endocrinology, and contraception: (1) Physiological Obstetrics: Menstrual cycle physiology (HPO axis, follicular/luteal phases), fertilization and implantation, placenta and fetal membranes, physiological changes during pregnancy (cardiovascular, renal, hematologic), diagnosis of pregnancy (hCG, ultrasound fetal cardiac activity), prenatal examination schedule, fetal presentation/position/lie, and stages of normal labor (First stage: latent/active, Second stage: fetal expulsion, Third stage: placental delivery, Fourth stage: immediate postpartum); (2) Pathological Obstetrics: Hypertensive disorders of pregnancy (Gestational hypertension, Preeclampsia with/without severe features, Eclampsia first-line magnesium sulfate seizure prophylaxis/control), Gestational Diabetes Mellitus (OGTT screening 24-28 weeks), Ectopic pregnancy (tubal ampullary implantation, ruptured ectopic hemorrhagic shock, surgical vs methotrexate indications), Placenta previa vs Placental abruption (painless vaginal bleeding vs painful rigid abdomen with fetal distress), Premature rupture of membranes (PROM), Preterm labor (tocolysis, corticosteroids for fetal lung maturity), Postpartum hemorrhage (4 Ts: Tone/uterine atony, Trauma, Tissue/retained placenta, Thrombin/coagulopathy; first-line uterine massage and oxytocin/carboprost), and Puerperal infection; (3) Gynecologic Oncology: Cervical Cancer (HPV etiology 16/18, Pap smear/HPV co-testing, CIN staging, FIGO staging, radical hysterectomy vs chemoradiation), Endometrial Carcinoma (risk factors, postmenopausal bleeding, diagnostic endometrial biopsy/curettage), Ovarian Neoplasms (epithelial, germ cell, sex cord-stromal; CA-125 marker, ovarian torsion emergency management), and Gestational Trophoblastic Disease (Hydatidiform mole, Choriocarcinoma, beta-hCG monitoring); (4) Reproductive Endocrinology & Benign Gynecology: Abnormal Uterine Bleeding (PALM-COEIN classification), Polycystic Ovary Syndrome (Rotterdam criteria, insulin resistance, ovulation induction with letrozole/clomiphene), Endometriosis & Adenomyosis (dysmenorrhea, pelvic nodules, CA-125, GnRH agonists/laparoscopy), Pelvic Inflammatory Disease (PID / empiric broad-spectrum antibiotics), and Family Planning (IUD indications/contraindications, hormonal contraceptives, emergency contraception).

Pediatrics (儿科系统)

Pediatric growth and development, neonatal intensive care, pediatric organ system pathology, and common pediatric infectious diseases: (1) Pediatric Growth & Development: Physical growth metrics (weight formula, height, head circumference 34cm at birth -> 48cm at 1 year), dental eruption timelines, primitive reflexes and motor milestones (head control 3 mo, sitting 6 mo, standing 9 mo, walking 12 mo), cognitive/language developmental milestones, and immunization schedules; (2) Infant Nutrition & Nutritional Disorders: Breastfeeding advantages vs formula feeding, complementary feeding introduction (4-6 months), Protein-Energy Malnutrition (Marasmus vs Kwashiorkor), Vitamin D Deficiency Rickets (pathophysiology, clinical stages: craniotabes, rachitic rosary, Harrison's groove, bowlegs/knock-knees; serum calcium/phosphorus/ALP, radiographic cupping/fraying), and Infantile Tetany (hypocalcemic convulsions, Chvostek/Trousseau signs, IV calcium gluconate); (3) Neonatal Medicine: Apgar score assessment (1 and 5 minutes), Physiological vs Pathological Jaundice (onset within 24 hours, bilirubin >221 umol/L or >12.9 mg/dL, direct bilirubin >34 umol/L, prolonged duration; phototherapy indications, bilirubin encephalopathy / kernicterus stages), Neonatal Hypoxic-Ischemic Encephalopathy (HIE / clinical staging mild/moderate/severe, therapeutic hypothermia), Neonatal Respiratory Distress Syndrome (NRDS / surfactant deficiency, ground-glass X-ray, CPAP & surfactant replacement), and Neonatal Sepsis; (4) Pediatric Organ-System Diseases: Congenital Heart Disease (Acyanotic: VSD with holosystolic murmur at left lower sternal border, ASD with wide fixed split S2, PDA with continuous machinery murmur; Cyanotic: Tetralogy of Fallot TOF: VSD, overriding aorta, pulmonary stenosis, RV hypertrophy; hypercyanotic tet spells, knee-chest position), Pediatric Respiratory (Acute bronchiolitis RSV, Pediatric pneumonia, Mycoplasma pneumonia azithromycin), Pediatric Gastroenterology (Rotavirus diarrhea, dehydration classification mild/moderate/severe, ORS and IV fluid replacement protocols with 2:1 / 4:3:2 solutions), Pediatric Nephrology (Acute Post-Streptococcal Glomerulonephritis APSGN: hematuria, edema, hypertension, low C3; Pediatric Nephrotic Syndrome: heavy proteinuria, hypoalbuminemia, hyperlipidemia, severe edema, corticosteroid therapy); (5) Pediatric Infectious Exanthems & Immunology: Measles (Koplik spots, cephalocaudal rash eruption with skin peeling and pigmentation), Scarlet Fever (Group A Strep, strawberry tongue, Pastia lines, sandpaper rash), Rubella, Erythema Infectiosum, Exanthem Subitum (roseola infantum: high fever dropping abruptly as rash appears), Chickenpox (varicella: teardrop vesicles in crops across scalp/trunk), and Kawasaki Disease (Mucocutaneous Lymph Node Syndrome: 5-day fever + 4/5 criteria: conjunctivitis, strawberry tongue/lips, polymorphic rash, cervical lymphadenopathy, extremity changes; IVIG and high-dose aspirin to prevent coronary artery aneurysms).

Medical Humanities & Health Regulations (医学人文综合、预防医学与卫生法规)

Statutory healthcare laws, medical ethics, patient rights, medical dispute resolution, and public health epidemiology: (1) PRC Physician Law (《中华人民共和国医师法》, effective March 1, 2022): Physician qualification and licensing registration, scope of practice, multi-site practice (医师多点执业), emergency medical rescue duties (prohibition of refusal to treat emergency patients), informed consent requirements (知情同意), patient privacy protection, prescription rights and narcotic/psychotropic drug regulations, professional continuing education, and legal liabilities for medical negligence or illegal practice; (2) Infectious Disease Prevention and Control Law (《中华人民共和国传染病防治法》): Classification of statutory infectious diseases: Class A (甲类: Plague, Cholera - mandatory reporting within 2 hours), Class B managed as Class A (乙类甲管: SARS, Anthrax pulmonary), Class B (乙类: AIDS, Viral hepatitis, Tuberculosis, etc. - reporting within 24 hours), and Class C (丙类: Influenza, Mumps, Hand-foot-mouth disease, etc. - reporting within 24 hours); isolation measures, epidemiological investigation, and disease surveillance; (3) Medical Dispute Prevention and Handling Regulations (《医疗纠纷预防和处理条例》): Medical record management, preservation of objective medical records (封存病历), medical appraisal procedures, adverse event reporting, and dispute mediation mechanisms; (4) Medical Ethics: Four fundamental principles of biomedical ethics (Autonomy 尊重/自主, Beneficence 有利, Non-maleficence 不伤害, Justice 公正), ethical dilemmas, truth-telling in terminal diagnoses, organ transplantation ethics, end-of-life care and DNR orders; (5) Medical Psychology: Doctor-patient communication skills, handling difficult patient interactions, clinical empathy, psychological stress responses, psychosomatic diseases; (6) Preventive Medicine & Epidemiology: Primary, secondary, tertiary disease prevention levels, epidemiological study designs (cross-sectional, case-control, cohort, randomized controlled trials), diagnostic test evaluation (sensitivity, specificity, positive/negative predictive value), and environmental/occupational health.