问题 单项选择题

女性,40岁,体检发现血糖高并诊断糖尿病病史3年,体重下降10kg,因服用格列齐特240mg/日,空腹血糖控制在9~10mmol/L,餐后两小时13mmol/L左右,HbAlC8.5%,尿检查酮体反复阳性,改用胰岛素治疗2个月余,HbAlC下降至7%。父亲患糖尿病,BMI21.3kg/m2,ICA阴性,GAD抗体阳性。此例患者最可能的诊断是()

A.缓慢进展1型糖尿病

B.2型糖尿病,磺脲类药物失效

C.特发1型糖尿病

D.MODY

E.无法分型

答案

参考答案:A

解析:年轻发病的,反复酮症倾向,口服降糖药疗效差,无明显肥胖,GAD抗体阳性,应考虑缓慢进展l型糖尿病可能,可进一步评价胰岛B细胞功能,治疗上要用胰岛素。

阅读理解

阅读理解。

     Mr. and Mrs. Smith had always spent their summer holidays in New Jersey in the past, staying in a small

inn at the foot of a hill. One year, however, Mr. Smith made a lot of money in his business, so they decided

to go to London and stay at a really good hotel while they went t turning around that famous city.

     They flew to London and arrived at their hotel late one evening. They expected that they would have to

go bed hungry, because in that small inn in New Jersey, no meals served after seven. They were therefore

surprised when the man who received them in the hall asked whether they would take dinner there that night.

     "Are you still serving dinner?" asked Mr. Smith.

     "Yes,certainly, sir," answered the man. "We serve it until half past nine."

     "What are the times of meals then?" asked Mr. Smith.

     "Well, sir," answered the man. "We sever breakfast from seven to half past eleven in the morning, lunch

from twelve to three in the afternoon, tea from four to five, and dinner from six to half past nine."

     "But that hardly leaves any time for us to see the sights of London!" said Mrs. Smith.

1. Mr. and Mrs. Smith had _____ in the past.

A. often stayed in a quite good hotel

B. often stayed in a small inn

C. travelled to many places

D. made a lot of money

2. They decided to go to a really good hotel because _____.

A. it was said to be a quite good one

B. they were tired of small inns

C. it was near many places of interest

D. they now had enough money

3. When they got to the hotel, _____.

A. no meals wre served after seven

B. dinner was still being severed

C. there wre no visitors

D. the waiters were asleep

4. Mrs. Smith _____.

A. would have lots of time to see the sights

B. was afraid that they would have no time to tour around London

C. thought the hotel wasn't so good as they expected

D. did know why the hotel was better than the small inn

问答题 简答题