问题 单项选择题 共用题干题

患者女,62岁。因上腹突发剧痛8小时急诊入院,患者有多年胃病史,经服药后好转。患者近来感上腹隐痛,乏力,易疲倦,体重减轻约10kg。近1个月来进食后上腹部胀闷不适,时有呕吐和黑便,呕吐物多为胃液及宿食,无胆汁,呕吐后腹部闷胀感减轻,曾在当地卫生院对症处理,疗效欠佳。8小时前进食后突然出现上腹剧痛,如刀割样,为持续性腹痛,曾呕吐一次,量约200ml。体检发现患者消瘦,贫血貌,大汗淋漓,痛苦面容,心肺正常,腹式呼吸消失,板状腹。

最可能的诊断是()。

A.胃窦癌并幽门梗阻和穿孔

B.十二指肠溃疡并幽门梗阻和紊乱

C.十二指肠溃疡急性穿孔

D.胃溃疡急性穿孔

E.急性胆囊炎并穿孔

F.胃溃疡合并幽门梗阻

答案

参考答案:A

阅读理解

阅读理解。

     It was the first snow of winter-an exciting day for every child but not for most teachers. Up until now,

I had been old enough to dress myself, but today would need some help. Miss Finlayson, my kindergarten

teacher, had been through first snow days many times, but I think she may still remember this one.

     I managed to get into my wool snow trousers. But I struggled won my jacket because it didn't fit well.

It was a hand-me-down from my brother, and if made me wonder why I had to wear his ugly clothes, At

least my hat and scarf were mine, and they were quite pretty. Finally it was time to have Miss Finlayson

help me with my boots (靴子).

     In her calm, motherly voice she said, "By the end of winter, you will all be able to put on your own boots."

I didn't realize at the at the time that this was more a statement of hope than of confidence (信心).

     I handed her my boots and stuck out my foot. Like most children, I expected grown-ups to do all the

work. After much pushing, she managed to get first one into place and then, with a sigh, worked the second

one on too.

     I announced, "They're on the wrong feet."

     She struggled to get the boots off and went through the joyless task of putting them on again.

     "They're my brother's boots, you know," I said. "I hate them".

     Somehow, from long years of practice, she managed to act as though I wasn't an annoying (烦人的) little

girl, She struggle with me, she asked, "Now, where are your mittens (连指手套)?"

     I looked into her eyes and said, "I didn't want to lose them, so I hid them in the toes of my boots."

1. The little girl was more satisfied with her _____.

A. trousers

B. jacket

C. boots

D. hat

2. Miss Finlayson had difficulty with the girl's boots mainly because _____.

A. the girl got them from her brother

B. the girl put something in them

C. they were on the wrong feet

D. they did not fit the girl well

3. Why does the author Miss Finlayson would remember that first snow day?

A. Because the little girl was in her brother's clothes.

B. Because it was the most exciting day of the winter.

C. Because the little girl played a trick on her.

D. Because the little girl wore a pretty scarf.

4. We can learn from the text that Miss Finlayson _____.

A. was losing confidence in the little girl.

B. gradually lost patience with the little girl.

C. became disappointed with the little girl.

D. was getting bored with the little girl.

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