问题 单项选择题

女性,25岁,反复出现皮肤紫癜,月经量多1年余,此前无服药史。查体;脾肋下刚触及。血象:血红蛋白105g/L,白细胞5.4×109/L,血小板25×109/L。其余血沉、尿常规及肝功能均正常。抗核抗体谱阴性。骨髓象示颗粒型巨核细胞增多。以下最可能的诊断是

A.特发性血小板减少性紫癜
B.药物性血小板减少性紫癜
C.系统性红斑狼疮
D.Evans综合征

答案

参考答案:A

解析:[考点] 特发性血小板减少性紫癜的临床特点

[分析]: 患者年轻女性,反复出现皮肤紫癜,月经量多1年余,血常规示轻度贫血,血小板明显减少。患者以前无服药史,可排除药物性血小板减少性紫癜。尿常规和肝功能正常,轻度贫血考虑由月经量多引起,因此可排除Evans综合征。患者抗核抗体谱阴性,可排除系统性红斑狼疮。同时患者骨髓象仅有颗粒型巨核细胞增多,符合特发性血小板减少性紫癜。

阅读理解

阅读理解。

     Pulling heavy suitcases all day in the summer is hard work, especially when you're a thin 14-year-old.

That was me in 1940-the youngest and smallest baggage boy at New York City's Pennsyl-vania Railway

Station.

     After just a few days on the job, I began noticing that the other fellows were overcharging pas-sengers.

I'd like to join them, thinking,"Everyone else is doing it."

     When I got home that night, I told my dad what I wanted to do."You give an honest day's work," he

said, looking at me straight in the eye."They're paying you. If they want to do that, you let them do that."

     I followed my dad's advice for the rest of that summer and have lived by his words ever since.

     Of all the jobs I've had, it was my experience at Pennsylvania Railway Station that has stuck with me.

Now I teach my players to have respect for other people and their possessions. Being a member of a team

is a totally shared experience. If one person steals, it destroys trust and hurts everyone. I can put up with

many things, but not with people who steal. If one of my players were caught stealing, he'd be gone.

     Whether you're on a sports team, in an office or a member of a family, if you can't trust one another,

there's going to be trouble.

1. What can be inferred about the baggage boys?

A. They could earn much, but they had to work hard.

B. Many of them earned money in a dishonest way.

C. They were all from poor families.

D. They were all thin, young boys.

2. What does the father's advice imply?

A. It is wrong to give more pay to the passengers.

B. Don't believe them if they are paying you more.

C. Don't follow others to overcharge the passengers.

D. It is difficult to work hard and live as an honest boy.

3. The writer can't put up with stealing because he thinks that ______.

A. it is a totally shared experience

B. it is considered as the most dangerous

C. it does great harm to human relationship

D. it may lead to the loss of his sports team

4. It can be concluded from the text that ______.

A. his father's advice helped him to decide which job to take up

B. working in the sports team was his most important experience

C. he learnt much from his shared experience with his team members

D. his experience as a baggage boy had a great influence on his later life

单项选择题