问题 多项选择题 案例分析题

患者男,46岁,因“乏力、食欲减退3个月,检查发现低钠血症1d”来诊。既往体健,无吸烟史。查体:BP135/90mmHg;HR80次/min,律齐,各瓣膜区未闻及杂音;双手示指呈杵状指,双下肢无水肿。

目前最可能的诊断包括(提示实验室检查:血钠112mmol/L;尿液渗透压150mmol/L;ACTH和血皮质醇水平升高,且节律消失,不能被大剂量地塞米松抑制试验所抑制。垂体CT:未见明确异常。经支气管镜活检:小细胞肺癌。)()

A.肺癌

B.伴抗利尿激素分泌不当综合征(SIADH)

C.库欣病

D.间质性肾炎

E.伴异位ACTH分泌综合征

F.肾上腺皮质功能不全

答案

参考答案:A, B, E

单项选择题 案例分析题

Questions 26 to 30 are based on the following passage.

Exercise is one of the few factors with a positive role in long-term maintenance of body weight. Unfortunately, that message has not gotten through to the average American, who would rather try switching to “light” beer and low-calorie bread than increase physical exertion. The Centers for Disease Control, for example, found that fewer than one-fourth of overweight adults who were trying to shed pounds said they were combining exercise with their diet.

In rejecting exercise, some people may be discouraged too much by caloric-expenditure charts: for example, one would have to briskly walk three miles just to work off the 275 calories in one delicious Danish pastry (小甜饼). Even exercise professionals concede half a point here. “Exercise by itself is a very tough way to lose weight,” says York Onnen, program director of the President’s Council on Physical Fitness and Sports.

Still, exercise’s supporting role in weight reduction is vital. A study at the Boston University Medical Center of overweight police officers and other public employees confirmed that those who dieted without exercise regained almost all their old weight, while those who worked exercise into their daily routine maintained their new weight.

If you have been sedentary (极少活动的) and decide to start walking one mile a day, the added exercise could burn an extra 100 calories daily. In a year’s time, assuming no increase in food intake, you could lose ten pounds. By increasing the distance of your walks gradually and making other dietary adjustments, you may lose even more weight.

Some people dislike exercise because ()

A.they think it is physically exhausting

B.they find it hard to exercise while on a diet

C.they don’t think it possible to walk 3 miles every day

D.they find consulting caloric-expenditure charts troublesome

填空题