From: Javier Alonso
To: Patricia Kidd
Re: Research Assistant
Dear Ms. Kidd,
After consulting with my colleagues here at MedLab, I’m afraid that I will not be able to offer you a position as Research Assistant after all. I would like to stress that I think your credentials as a researcher (28) outstanding, and that this decision has nothing to do with your ability.
Rather, the problem is an internal one related to funding. We recently had our research finances (29) by a consulting firm, and the experts insisted that we slash our spending. As a result, we do not have room in our limited budget to take on another employee at this time.
I apologize for encouraging you to apply before I was aware of this fact.
I can offer you a casual role in a part-time capacity. However, I guess that someone with your ability and potential will be able to find better (30) elsewhere. In the unlikely event that you would like to take up this offer, please let me know as soon as you can.
All the best,
Javier Alonso

A．recognition

B．relations

C．opportunities

D．approval

男性患者，68岁，慢性咳嗽咳痰20年，活动后气短伴双下肢水肿5年，近一周上述症状加重伴有发热，查体：神志清楚，口唇发绀，颈静脉怒张，桶状胸，两下肺可闻及湿啰音，双下肢水肿。血常规示：WBC11×10⁹/1，中性粒细胞86%。

假设动脉血气示（鼻导管3L/min吸氧）：pH7.28，PaO₂56mmHg，PaCO₂70mmHg，HCO₃^-34.4mmol/L。肺功能示阻塞性通气功能障碍，可能的诊断有（）

A.支气管扩张症

B.慢性阻塞性肺疾病急性加重期

C.支气管哮喘

D.呼吸性酸中毒合并代谢性碱中毒

E.呼吸性酸中毒

F.代谢性酸中毒

G.Ⅱ型呼吸衰竭

H.Ⅰ型呼吸衰竭

I.慢性肺源性心脏病

J.肺部感染

K.肺结核