问题 多项选择题 案例分析题

患者男,42岁,饱餐后上腹部剧痛6h,伴恶心、呕吐,呕吐物为胃内容物,吐后腹痛更加剧,如刀割样。查体:体温37.8℃,脉搏124次/min,血压80/50mmHg,呼吸25次/min,痛苦面容,巩膜轻度黄染,腹胀,全腹肌紧张,压痛及反跳痛,上腹部为重,肠鸣音消失,肝浊音区存在,移动性浊音阳性,右下腹穿刺得淡红色血性液体,白细胞12×109/L,血淀粉酶3200U/L,血脂肪酶1600U/L,血钙1.5mmol/L。

需要的治疗是(提示此患者进一步治疗后病情缓解不明显,同时影像学检查发现胆囊、胆总管结石。)()

A.广谱高效抗生素治疗

B.急诊手术胆囊切除、胆管引流

C.经皮经肝胆囊穿刺引流术

D.十二指肠 * * 切开取石/引流术

E.腹腔穿刺引流

F.急诊胰腺坏死组织清除引流术

答案

参考答案:A, D, E

阅读理解

Where the Wild Things Are  by Maurice Sendak

List Price:       $16.95     Price: $14.35     

Where the Wild Things Are is one of those truly rare books that can be enjoyed equally by a child and a grown-up. Max puts on his wolf suit, trying to do something bad and gets sent to bed without supper. Quite by accident, a forest grows in his room, allowing his wild behaviour to continue. Sendak’s color illustrations (插图) are beautiful, and each turn of the page brings the discovery of a new wonder.

Goodnight Moon  by Margaret Wise Brown

List Price:       $17.95     Price: $10.77     

Perhaps the perfect children’s bedtime book, Goodnight Moon is a short poem of goodnight wishes from a young rabbit preparing for his own sleep. He says goodnight to every object in sight. Clement Hurd’s illustrations are simple and effective.

Happy Birthday, Baby  by Dr. Smith 

List Price:       $9.99      Price: $9.99

The Great Birthday Bird says, “Get dressed! Today is your day. It’s the Best of the Best!” This fun-filled book can be touched, moved, and smelt, helping babies celebrate their day of all days with the Great Birthday Bird! It’s illustrated by Jan Gerardi.

You're Only Old Once!  by Dr. Seuss

List Price:       $11.70     Price: $10. 53     

If laughter is the best medicine, then You’re Only Old Once! is a delightful new defense against aging. As we follow him through his checkup with the experts at the Golden Years Clinic, Dr. Seuss lightens the aches and pains of growing old with his unique wisdom. A perfect gift for anyone over fifty!

57. If you buy the books above, whose book will save you most?

A. Maurice Sendak’s.                       B. Dr. Smith’s.

C. Dr. Seuss’s.                             D. Margaret Wise Brown’s.

58. You’re Only Old Once! talks mainly about ________.

A. the happy time with the Great Birthday Bird          

B. the adventure of a naughty boy named Max

C. some suggestions about reducing pains of aging                     

D. the goodnight wishes of a rabbit before sleep

59. Happy Birthday, Baby is illustrated by ________.

A. Jan Gerardi    B. Clement Hurd   C. Sendak        D. Margaret Wise Brown

60. Which book is suitable for both kids and adults?

A. Happy Birthday, Baby.               B. Where the Wild Things Are.

C. Goodnight Moon.                     D. You’re Only Old Once!

选择题