问题 多项选择题 案例分析题

患者、男性,35岁已婚。一年前可能因工作挫折致内心不愉快,经常忧虑,精神紧张,始后渐有失眠,每月有数次无明显诱因的阵发性强烈心慌、心悸、胸闷、呼吸不畅和莫名的恐惧感,伴面色苍白,持续数分钟至一小时不等。曾住某医院作全面检查,血压正常,EKG示“偶发性房性早搏”,脑CT、EEG、超声心动图、血糖、尿24小时17KS、VMA、儿茶酚胺均无阳性结果。患者偶感胃肠不适和腹痛伴腹泻,曾经心血管内科、神经内科、内分泌科会诊,均已初步排除该科明确疾病。但患者心境忧愁,自感身患重病,不敢远途出差,曾提出不担任领导职务。用过多种正规抗癫痫药治疗无效,连续服用阿米替林75mg/日,2周疗效亦不明显。追溯少年时已偶有易惊慌感,但学习、工作能力良好。无精神活性物质嗜癖史。详细阅读病历摘要:病历特点可归纳为:

1)发病于青壮年,有一定精神诱因,病程超过一年;

2)以阵发性强烈心慌、心悸、胸闷、呼吸不畅、胃肠功能紊乱等植物神经功能紊乱为主诉;

3)EKG示“偶发房性早搏”,但超声心动图正常;

4)情绪忧愁,自信心降低,但无怪异思维及感知障碍;

5)脑CT、EEG未获颅内器质性病变征;

6)内分泌方面,基本排除肾上腺病变、糖尿病;

7)经过正规抗癫痫冶疗无效,基本上排除癫痫;

8)抗抑郁治疗不正规,未以完全排除非典型抑郁,如MaskedDepression(隐匿性抑郁);

9)消化系统检查资料不足以完全排除消化系统疾病。

本例初步考虑什么诊断?()

A.癫痫

B.癔病

C.抑郁症

D.其它型精神分裂症

E.抑郁性神经症

F.延迟性心因反应

G.焦虑症

H.疑病性神经症

I.恐怖性神经症

J.焦虑症伴惊恐发作

答案

参考答案:G, J

阅读理解

When an NBA player is young he thinks he can win the championship by himself. It is only later when he has aged and been through many battles that he learns an important lesson: there is no “I ” in “team”.

There is no better example of the value of teamwork than the Boston Celtics. Paul Pierce, Ray Allen and Kevin Garnett were all superstars on three different teams. Yet, none of them had any titles to show for it. Then, last season, they decided to sacrifice money and individual statistics to play together. Garnett and Allen joined Pierce on the Celtics and changed the NBA in the process.

It started in simple ways. Garnett and Allen are two of the most intense athletes in the world. They treat every second of every practice like it is the NBA championship. If you want to play alongside them then you will have to do the same. So, the young guys on the Celtics started giving their full effort too.  

Pierce had been the star of the Celtics for many years. He used to shoot the ball many times a game. But with the addition of Allen and Garnett he shot less and focused on defense. His selflessness showed the young players that doing what made the team better was the only thing that mattered.  

When the Celtics were winning and the game was almost over, Garnett, Pierce and Allen would come out of the game. But they wouldn’t just sit on the bench. Instead, they stood and cheered and screamed for their teammates. They wanted to support their friends and teammates.

Now, the guys who don't play know they can still affect the game by cheering so they scream and cheer when Garnett, Allen and Pierce are playing. The Celtics have developed a strong relationship. They are more than just teammates. They are brothers. 

The result: the Boston Celtics won the championship and are considered the favorites to win the Eastern Conference championship again this year.  

There is a saying that goes, "A successful team beats with one heart." If that is the case, the Celtics may have the biggest heart in the NBA. 

小题1:What does the passage mainly talk about?

A.The stories of three famous basketball superstars.

B.A famous basketball team named the Boston Celtics.

C.The importance of teamwork among teammates.

D.Matches between the Boston Celtics and other teams.小题2:What does this sentence “there is no ‘I’ in ‘team’.” mean in Paragraph 1?

A."I" will be missing once "I" am on the court.

B.The cooperation of the teammates is more important than the individual.

C."I" work so hard in a team that "I" will forget who "I" am

D.Surrounded by other players, "I" don’t seem to exist.小题3:Which of the following is NOT true about Pierce’s recent performance?

A.He became an even better shooter with others’ help.

B.He focused much more attention on defense.

C.He created more chances for teammates.

D.He stood and cheered for his teammates小题4:Which of the following didn’t contribute to the success of the Boston Celtics?

A.The whole team has become devoted to each and every stage of the game.

B.The cooperation and teamwork among the teammates in the match.

C.The influence of Garnett, Allen, Pierce and other teammates’ cheering.

D.The increasing frequency of team players on the bench

单项选择题