问题 单项选择题 A1型题

关于糖尿病的胰岛素治疗,正确的是()。

A.肥胖的糖尿病人较适宜于胰岛素治疗

B.Ⅰ型糖尿病人可不用胰岛素治疗

C.清晨高血糖而半夜有饥饿感、出冷汗的糖尿病人应增加胰岛素剂量

D.因感染发热而厌食的糖尿病人应将胰岛素剂量加倍

E.经一段时间的胰岛素治疗后,可产生胰岛素抗体

答案

参考答案:E

解析:【考点】糖尿病的胰岛素治疗。肥胖的糖尿病人为2型糖尿病,常常不是胰岛素缺乏而是对胰岛素不敏感、有抵抗,胰岛素治疗往往使病人发胖、体重增加,所以肥胖的糖尿病人没有急、慢性并发症时一般不采用胰岛素治疗;1型糖尿病人体内缺乏胰岛素,必须用胰岛素治疗;而半夜有饥饿感、出冷汗是低血糖反应表现,清晨高血糖是低血糖后继发的反应性高血糖,称为Somogyi反应,增加胰岛素剂量会加重夜间低血糖而无助于改善清晨高血糖;当糖尿病人感染、发热而出现厌食等情况时胰岛素剂量需调整,此时更应注意是否发生了酮症,因不能正常进食而输液,依据血糖水平随时调整胰岛素剂量,不能简单地加倍;胰岛素是蛋白质类多肽激素,不论是动物源的还是纯度较高的基因工程制造的人胰岛素使用一段时间后皆可能产生一些胰岛素抗体。因此正确答案是E。

单项选择题


Passage One

My First Experience with AIDS Patients
我初次接触艾滋病人

by Marc Kielburger
I was ushered to the AIDS ward of a hospice in the slum.I would later learn that the ward did not exist,at least not officially.Not a single person in Thailand had AIDS,according to the Thai government at the time.People got"sick,"of course,sometimes"very sick."but no one had AIDS.The hospice was home to an ever-growing number of"very sick"people.
I entered the ward and was greeted by two Thai nurses.
"Thank goodness you are here,Marc,"said the first.
"You’re a doctor,right "
I shook my head.
"So you are a medical student then!"
I shook my head again.
"But you know medicine,right "
"Kinda,"I offered."I watch E.R.,every Thursday"
After a rapid exchange in Thai,the first one said,"NO problem.Get ready for your fou- hour medical school training!"
"But in my country medical school takes years!" I protested.
"We don’t have that long," she replied. "So we better get started. "
During the next few hours, I learned to clean wounds, administer IVs, treat bedsores, and dispense medicine. The work was punishing, made worse by stifling heat, frequent blackouts, and an incredible stench in the air. I tried desperately to hide my weak nerves and queasy stomach, but more than once dashed for the bathroom to throw up.
Just when it seemed my training was coming to an end, the nurse took me aside. "There are only two more things you need to know," she said. "On the left-hand side of the ward, you will find what we call the Exit Area. " As it turned out, she meant "exit" in the largest sense of the word. Terminally ill patients were hidden behind a curtain and then exited out of the ward after death. "The second thing you need to know," she continued, "is that we haven’t had a day off in three weeks. You’ll be looking after the ward by yourself for the next shift. "
My jaw dropped.
"Don’t worry, Mare," said the other nurse, patting me on the shoulder before turning to leave. "Think of this as the beginning of your residency !" And with that, they walked out. Alone and petrified, I tried unsuccessfully to keep calm.
I counted to twenty-four. That’s how many AIDS patients were in my charge. What am I going to do I thought. What can I do I fell back on my training with the Canadian government and put my talents to work. I served patients water-some with ice, some without. Next, I tried to cheer up everyone, myself included, giving enthusiastic high-fives to patient after patient. Soon enough, everyone was laughing. Some were laughing with me, others most definitely at me, but I didn’t care. As long as I could keep people smiling, I was sure it would all be fine. And it was. Until a short while later, when a patient in the Exit Area began to choke. He had fluid in his lungs and could not breathe. As I crossed the floor, I could hear the man gasping for air. Fumbling and scared, I pulled back the curtain and administered the medicine the nurses had recommended. The man didn’t respond. With nothing left to offer, I sat down and held his hand, looking into his eyes as he breathed heavily for a while and then stopped. Watching him slip away, I was hit by a feeling of anguish such as I’d never felt, either before or since. It haunts me to this day.

What was the AIDS patients’response toward Marc’s efforts to cheer them up

A.They all appreciated his efforts.

B.They were all grateful for his efforts.

C.They all enjoyed his efforts.

D.Some of them thought his efforts were ridiculous.

多项选择题