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。

患者住院10天后,病情缓解,准备出院,患者出院后的治疗和预防措施有()

A.适当锻炼

B.间断口服抗生素

C.卧床休息

D.规则使用支气管扩张药

E.戒烟

F.尽量避免受凉

G.长期使用激素

答案

参考答案:A, B, 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。

阅读理解

At a meeting, a well-known speaker lifted up a bill of 20 dollars before starting his speech.

Facing 200 people, he asked, “Who wants this 20-dollar bill?” A great many hands were put up. Then he continued to say, “I intended to give it to any one of you, but allow me to do a thing before giving it to you.” Suddenly he crumpled (揉)it into a round mass. Then he asked, “Who wants it? ” Still some hands were lifted up.

He asked again, “Well, how could it be if I do it like this?” he threw the bill onto the ground, stepped on it and twisted it. As he picked it up, the bill had become not only dirty but wrinkled.

“Who still wants it?” Still a few people put up their hands.

“My dear friends, you have had a meaningful class. No matter how I treated this bill, you still want it, because it is worth 20 dollars. On your life road, you may be knocked down(击垮) or even broken into pieces by your determination or unfavorable situations. We may feel ourselves worth nothing, but, my darling, remember that whatever happens in the future, you should never lose your value(价值) in the God’s heart. You’re particular ---- never forget it.”

小题1:How many times did the speaker ask the people whether they wanted the bill?

A.Once

B.Twice

C.Three times

D.Four times小题2: The underlined word “wrinkled” in the third paragraph probably means ________.

A.broken

B.having small lines or folds in it

C.flat

D.having holes on it小题3:The speaker did this test in order to _____________.

A.tell the audience that one should never lose one’s own value

B.tell the audience that God values money most

C.test if some of the audience were extremely interested in money

D.play a trick on the audience小题4: What would the speaker probably talk about next?

A.How money can make people crazy.

B.How to avoid being knocked down in one’s life.

C.How to keep one’s value of life.

D.How to give a meaningful class

单项选择题