问题 单项选择题 案例分析题

患者,男性,46岁。2003年9月就诊。间歇性发热2个月,发热间隔不规律,伴寒战、乏力、恶心、呕吐,近两日出现尿少,尿黄,头痛,腰痛,1日前出现意识障碍。发病前40天由泰国考察归国。体检∶T40.5℃,R23次/min,P98次/分,BP125/80mmHg,巩膜轻度黄染,肝区扣痛(-),化验∶HB90g/L,WBC8.5×109/L,RBC2.4×1012/L,脑脊液∶白细胞110×109/L,糖2.8mmol/L,氯化物110mmol/L,蛋白定量0.64g/L。

给予氯喹+伯氨喹及糖皮质激素治疗后患者体温骤降并自行出院,但1日后再次出现高热,目前应如何处理()。

A.改用青蒿素

B.可能是并发细菌感染,给予抗生素

C.给予退热降温

D.加大氯喹和伯氨喹剂量

E.改用喹宁

F.停氯喹及伯氨喹,对症处理

答案

参考答案:A

选择题
单项选择题

On a weekday night this January, thousands of flag-waving youths packed Olaya Street, Riyadh’s main shopping strip, to cheer a memorable Saudi victory in the GCC Cup football final. One car, rock music blaring from its stereo, squealed to a stop, blocking an intersection. The passengers leapt out, clambered on to the roof and danced wildly in front of the honking crowd. Having paralyzed the traffic across half the city, they sped off before the police could catch them.

Such public occasion was once unthinkable in the rigid conformist kingdom, but now young people there and in other Gulf states are increasingly willing to challenge authority. That does not make them rebels: respect for elders, for religious duty and for maintaining family bonds remain pre-eminent values, and premarital sex is generally out of the question. Yet demography is beginning to put pressure on ultra-conservative norms.

After all, 60% of the Gulf’s native population is under the age of 25. With many more of its citizens in school than in the workforce, the region faces at least a generation of rocketing demand for employment. In every single GCC country the native workforce will double by 2020. In Saudi Arabia it will grow from 3.3m now to over 8m. The task of managing this surge would be daunting enough for any society, but is particularly forbidding in this region, for several reasons.

The first is that the Gulf suffers from a lopsided labor structure. This goes back to the 1970s, when ballooning oil incomes allowed governments to import millions of foreign workers and to dispense cozy jobs to the locals. The result is a two-tier workforce, with outsiders working mostly in the private sector and natives monopolizing the state bureaucracy. Private firms are as productive as any. But within the government, claims one study, workers are worth only a quarter of what they get paid.

Similarly, in the education sector, 30 years spent keeping pace with soaring student numbers has taken a heavy toll on standards. The Saudi school system, for instance, today has to cope with 5m students, eight times more than in 1970. And many Gulf countries adapted their curricula from Egyptian models that are now thoroughly discredited. They continue to favor rote learning of "facts" intended to instill patriotism or religious values.

Even worse, the system as a whole discourages intellectual curiosity. It channels students into acquiring prestige degrees rather than gaining marketable skills. Of the 120, 000 graduates that Saudi universities produced between 1995 and 1999, only 10,000 had studied technical subjects such as architecture or engineering. They accounted for only 2% of the total number of Saudis entering the job market.

The word "lopsided" (Paragraph 4) most probably means()

A.Detrimental

B.Unappealing

C.Harmonious

D.Unbalanced