问题 单项选择题 A1型题

苯丙酮尿症最突出的特点是()

A.毛发棕黄

B.尿有"酸臭"气味

C.智力低下

D.皮肤粗糙

E.锥体束受损

答案

参考答案:C

解析:

这是一道记忆题,错选率达70%,以错选B为主。要掌握苯丙酮尿症(PKU)的特征,不应死记硬背,应从理解PKU的生化缺陷角度去记忆。PKU具苯丙氨酸羟化酶缺陷,它催化苯丙氨酸转化为酪氨酸。和所有先天代谢病一样,酶缺陷导致酶催化的反应的底物堆积,终产物缺乏和旁路代谢亢进。

对PKU而言,堆积的是苯丙氨酸,故高苯丙氨酸血症是其主要生化特征,它引起的症状也是主要临床表现。高苯丙酸血症引起中枢神经系统(大脑)的分化和发育障碍;因此,智能低下是其突出症状。酶催化的终产物是酪氨酸,它是黑色素合成的底物,因此黑色素不足产生毛发,皮肤色素减退。高苯丙氨酸堆积经旁路代谢形成苯丙酮酸和苯乙酸从尿中排出,使尿有异臭味,呈鼠尿臭或发霉的臭味。从以上分析我们回至题目,首先要找出PKU的特征,再选择出"最突出"。

在5个选择中只有A、C是PKU的特征,但C是主要的最突出的,A无特异性,可见于其他代谢病。因未注意"最突出",故少数人错选"A"。B提示的尿嗅味是"酸臭"而非鼠尿臭或霉臭味,错选者只注意了"气味",但未记住其性质。D、E完全不属PKU的特征,不应选择。

问答题 简答题
单项选择题

Part 4


Questions 26-45


·Read the following article and choose the best word for each space.
·For questions 26-45, mark one letter A, B, C or D on the Answer Sheet.

iPhone Left in Hot Car for Three Hours


The normally peaceful suburban town of Winnetka is still reeling following the news Monday (26) a local resident, whose name is being (27) by police pending a full investigation, left an iPhone unattended for more than three hours in a car (28) in the hot sun.
"Responding to calls from (29) . passersby, who observed the iPhone sitting in a vehicle in the parking (30) of the Westfield Shopping Center, police arrived on the (31) at approximately 4 p.m. and immediately intervened to save the device," said Winnetka police chief Douglas Blaine. "Security cameras have shown that the iPhone had been in the car— with the doors (32) and the windows rolled (33) —since 1 p.m. Due to the tragic and highly emotional (34) of this case, we cannot say any (35) at this time."

A. less B. much C. thing D. more

According to official police records, two officers forcibly (36) into the car at 4:07 p.m. and found the iPhone (37) face down on the dashboard. The iPhone at first showed no (38) of life, but after a tense few seconds, officers were able to wake it and get it to (39) to a series of simple touch commands. Police said that if the iPhone were left in the extreme (40) for any longer, it could have died.
The iPhone was rushed by ambulance to a nearby Apple facility for careful (41) .Miraculously, no damage to its memory, screen, or wireless capabilities was reported.
Upper-middle-class suburbanites from all over the North Shore area have reacted to the near-tragedy with an unprecedented outpouring of (42) . Hundreds of cards and letters have come streaming in, and local talk radio shows have been flooded (43) calls demanding that the iPhone’s (44) be prosecuted. Many have come forward offering to take the iPhone into their custody, and still (45) have donated free downloads, ringtones, and MP3s to the victimized object.