问题 单项选择题

患儿男,6岁,排便时肛门脱出一种物,呈环形,色鲜红,便后自行回纳,有时伴有点滴出血,多染于便纸上。最可能的诊断是

A.息肉脱出

B.内痔脱出

C.完全性直肠脱垂

D.直肠黏膜脱垂

E.以上均非

答案

参考答案:D

解析:[解题思路] 脱肛多见于幼儿、老年人、久病体弱者及身高瘦弱者。女性因骨盆下口较大及多次分娩等因素,发病率高于男性。起病缓慢,无明显全身症状,早期便后有黏膜肛门脱出,呈环状黏膜皱襞,便后能自行还纳,以后渐渐不能自然回复,须手托或平卧方能复位。日久失治,致使直肠各层组织向下移位,直肠或部分乙状结肠脱出,甚至咳嗽、蹲下或行走时也可脱出。患者常有大便不尽和大便不畅,或下腹部坠痛,腰部、腹股沟及两侧下肢有酸胀和沉重感觉。因直肠黏膜反复脱出暴露在外,常发生充血、水肿、糜烂、出血,故肛门可流出黏液,刺激肛周皮肤,可引起瘙痒。[命题规律] 考查“脱肛”。重点掌握。

单项选择题 A3型题
单项选择题

We once had a poster competition in our fifth grade art class.

"You could win prizes," our teacher told us as she wrote the poster information on the blackboard. She passed out sheets of construction paper while continuing. "The first prize is ten dollars. You just have to make sure that the words on the blackboard appear somewhere on your poster. "

We studied the board critically. Some of us looked with one eye and held up certain colors against the blackboard rocking the sheets to the right or left while we conjured up our designs. Others twisted their hair around their fingers or chewed their erasers while deep in thought. We had plans for that ten-dollar grand prize, each and every one of us. I’m going to spend mine on candies one hopeful would announce while another practiced looking serious wise and rich.

Everyone in the class made a poster. Some of us used parts of those fancy paper napkins, while others used nothing but colored construction paper. Some of us used big designs and some of us preferred to gather our art tidily down in one comer of our poster and let the space draw the viewer’s attention to it. Some of us would wander past the good students’ desks and then return to our own projects with a growing sense of hopelessness. It was yet another grown up trick of the sort they seemed especially fond of making all of us believe we had a fair chance and then always—always—rewarding the same old winners.

I believe I drew a sailboat, but I can’t say that with any certainty. I made it. I admired it. I determined it to be the very best of all of the posters I had seen and then I turned it in.

Minutes passed.

No one came along to give me the grand prize and then someone distracted me and I probably never would have thought about that poster again.

I was still sitting at my desk thinking, what poster When the teacher gave me an envelope with a ten-dollar bill in it and everyone in the class applauded for me.

After seeing the good students’designs, some students ().

A.loved their own designs more

B.thought they had a fair chance

C.put their own designs in a comer

D.thought they would not win the prize