问题 多项选择题 案例分析题

患者男性,72岁。慢性咳嗽、咳痰20年,活动后气急5年,反复双下肢水肿2年。3天前症状加重并出现意识模糊入院。查体:嗜睡、球结膜水肿,口唇发绀,BP120/85mmHg,R26次/分,P106次/分,无颈静脉怒张,双肺可闻干湿啰音,心脏不大,肝脾未触及,双下肢轻度指凹性肿,双侧腱反射减弱。

该患者的诊断包括()

A.慢性肺源性心脏病

B.感染性休克

C.支气管扩张

D.支气管哮喘

E.肺性脑病

F.COPD急性加重

答案

参考答案:A, E, F

解析:

1.反复咳嗽、咳痰病史,活动后气促5年,反复双下肢水肿2年,伴有加重伴意识模糊,典型的慢性阻塞性肺疾病急性加重、肺性脑病及慢性肺源性心脏病表现。 2.慢性阻塞性肺疾病急性加重应首先给予控制性吸氧、抗生素治疗及支气管扩张药物治疗,观察病情进展再决定是否给予进一步处理方案。3.患者存在低钠血症 及二氧化碳潴留均可导致意识梗糊。4.根据病情与使用药物情况,最可能为加替沙星或糖皮质激素的副作用。两者均可导致精神症状。6.COPD患者出院后的 治疗和预防措施不主张长期使用激素,建议锻炼,不主张卧床休息,也不主张间断口服抗生素,规则使用支气管扩张药有助于改善肺功能。

单项选择题
阅读理解

As demand for power and fuel grows steadily in the coming decades, we must consider every possible energy source(来源)on hand if we're to meet the world's needs. And because clean natural gas is found in great plenty, there is little doubt that it will play a major role on the world energy stage in this century, much like oil did in the last. But, like oil, gas reserves are concentrated in just a few places in the world, usually far from where they're needed most. And that's only part of the challenge. The world has had well over 100 years to search for oil and to build the necessary facilities(设施)to bring it to market; the natural gas facilities, particularly when it comes to liquefied(液化)natural gas(LNG), are not nearly as developed.

So what needs to be done? On the supply side, producing nations need policies that allow for better development of their natural gas in an open, stable business environment, not one in which the rules of the game change without warning. The governments of consuming nations, on the other hand, must make policies for sustainable(可持续的)development to ensure they'll have enough supplies in the future. That means building the related facilities, including LNG stations. This, in turn, will require coastal areas to allow these necessary, but not necessarily pretty, facilities to be built in their backyards. And energy companies have a responsibility to be good neighbors in those areas by operating these facilities responsibly and safely. They must also continue to put in the billions of dollars needed to build the complex transport and storage facilities required to bring more gas to market.

Expanding and diversifying(使多样化)energy sources by using more natural gas could lead to lower fuel prices and to greater energy security. We've taken some of the steps to get started, but we need your help to get the rest of the way.

小题1:Which of the following is TRUE according to the passage?

A.Gas played a major part in the 20th century.

B.Natural gas facilities are far from satisfactory.

C.Gas reserves are widely spread around the world.

D.Necessary facilities are ready to bring gas to market.小题2: The underlined word "one"(in Paragraph 2)refers to _____________.

A.a gas supply side

B.a business environment

C.a gas consuming nation

D.a policy for gas development小题3:Consuming nations of natural gas need to ___________.

A.change the rules of the game

B.open markets in their backyards

C.build pretty facilities along the coast

D.have long-term policies for gas supply小题4: The main purpose of the passage is to _______.

A.warn people of the lack of power and fuel

B.discuss the importance of oil and natural gas

C.call for better use and development of natural gas

D.instruct people how to make use of energy sources小题5: The passage might be followed by a paragraph about

A.what kind of help you can offer

B.where energy sources are concentrated

C.which countries are in great need of gas

D.what problems of energy sources we may face