患者，男性，64岁，有肺心病史5年，经常头痛头晕，1周来咳嗽加重，咳黄痰，呼吸困难，头痛加重，昨日起嗜睡，谵语。查体：神志不清，颜面水肿，球结膜水肿，口唇发绀，颈静脉充盈，双肺广泛干湿啰音，肝肋下4cm，腹腔积液症（+），下肢水肿，膝腱反射减弱，巴宾斯基症（+）。pH7.20，PaCO100mmHg，PaO40mmHg，HCO21mmol／L。
提示：CT未见异常，钾：4.6mmol／L，钠：138mmol／L，氯：78mmol／L，血糖：5.2mmol／L。提问：考虑诊断为（）
A.高渗性昏迷
B.肺性脑病
C.电解质紊乱
D.脑血管意外
E.高血压脑病
F.低血糖昏迷
参考答案：B
解析：
1.电解质紊乱不会导致神志不清，病理征阳性这类症状，一般是由于脑病导致。2.患者有腹腔积液症，应做腹部B超。
| 阅读理解。 | ||
| ||
| 1. Munchies Food Hall does NOT sell ____. | ||
| A. lamb B. beef C. pork D. chicken | ||
| 2. The prices at Munchies are _____. | ||
| A. lower than usual B. bargain prices for the opening C. lower far two people D. lower of you spend ＄21.00 | ||
| 3. Everyone who eats at Munchies well receive a _____. | ||
| A. free raffle ticket B. lucky draw coupon C. free meal D. balloon and whistle | ||
| 4. I will find out who has won the top to Western Australia when I ____. | ||
| A. watch Channel 3 television B. come down to Munchies at moon C. read The Straits Times on the 5th of January D. attend the lucky draw at Munchies Food Hall |