问题 单项选择题

患者男性,33岁,因胸闷、心悸发作2小时来院。既往有B型预激综合征,合并哪种情况不宜使用洋地黄类药物()。

A.窦性心动过速

B.心房颤动

C.阵发性室上性心动过速

D.窦性心律

E.以上均不适宜

答案

参考答案:B

解析:预激综合征并发心房颤动或心房扑动,正常房室结的传导受到抑制,房室结的不应期延长,因此心房颤动或心房扑动的快速激动可以更多地从传导速度较快的Kent束下传心室,因此心室率可以在用洋地黄后更快,因为洋地黄只能延长房室结的不应期,而对Kent束无影响,此点不同于奎尼丁。而阵发性室上性心动过速患者不论是否是由预激综合征引起,只要是室上性心动过速洋地黄就是适应证,应用洋地黄治疗,既能延长房室结的不应期,又能减慢窦房结的速率,所以即使有预激综合征存在也往往是安全的,这与预激综合征并发心房颤动者不同。

完形填空
完形填空(共20小题:每小题1. 5分,满分30分)
阅读下面短文,从短文后所给的四个选项(A、B、C、D)中,选出最佳选项。
It was to be our second Christmas in Germany and we decided to avoid the naked tree problem the year before. We wrote to my father, and he  1 to purchase a tree for us in States. He would ship it to us in several smaller  2 .
Two days before Christmas we were in a   3 .All the boxes had arrived except for one. The tree trunk and stand were still  4 .We decided to wait one more day.
  5 , in Bremerhaven, a young mail clerk  6 a long thin box under a counter. He picked it up and saw the customs tag(标签)which  7 “artificial(人造的)Christmas tree trunk and stand”. He realized that someone in Mannheim would be  8 a tree for Christmas. He felt  9for them, but there wasn’t much he could do. There was no  10 on Christmas.
He put the package on the  11 shelf and headed for the coffee bar. The place was 12 and he ended up sharing a table. Two men were speaking and the clerk  13 that one of his companions at the table was stationed in Mannheim. He had just picked up the  14 he had shipped from the States and was driving back that afternoon. The clerk thought of the 15 and said to the man,“You could really  16 Santa for someone in Mannheim tonight if you’d like to.”He explained about the lost tree trunk and stand. The man agreed.
The following day, my husband was reaching for his coat  17 the doorbell rang. There stood a  18 holding a long thin carton, our tree trunk and stand. He explained about the clerk and the coffee bar meeting. We invited him in,  19 it was Christmas Eve and he left in a hurry.
The next day as we celebrated the Christmas with the beautiful tree, I whispered:“Bless those two strangers who  20 our Christmas with their kindness.”
小题1:
A.agreedB.refusedC.stoppedD.failed
小题2:
A.bagsB.containersC.boxesD.parts
小题3:
A.hopeB.lossC.messD.panic
小题4:
A.brokenB.separatedC.unknownD.missing
小题5:
A.MeanwhileB.HoweverC.ThereforeD.Afterward
小题6:
A.hid B.forgotC.coveredD.found
小题7:
A.readB.wroteC.signedD.meant
小题8:
A.exceptB.byC.alongD.without
小题9:
A.sureB.happyC.painfulD.sorry
小题10:
A.passageB.messageC.deliveryD.labor
小题11:
A.safeB.highC.properD.secret
小题12:
A.takenB.orderedC.closedD.crowded
小题13:
A.supposedB.discoveredC.expectedD.wondered
小题14:
A.carB.mailC.passengerD.gift
小题15:
A.difficultyB.familyC.packageD.accident
小题16:
A.becomeB.playC.pretendD.assist
小题17:
A.beforeB.whileC.untilD.when
小题18:
A.postmanB.santaC.strangerD.driver
小题19:
A.butB.andC.soD.as
小题20:
A.celebratedB.decorated
C.confirmedD.brightened
单项选择题