问题 单项选择题 案例分析题

患者,女性,25岁,1月来低热、咳嗽,偶有痰中带血丝,伴乏力。胸透示“右肺炎症”,给予抗炎治疗。2周来晨起眼睑浮肿,尿量逐渐减少。查体:血压150/105mmHg,右肺少许啰音,双下肢浮肿,化验血红蛋白89g/L,尿沉渣检查RBC20~35/HP,WBC3~5/HP,血肌酐456μmol/L,尿素氮23mmol/L,血清抗肾小球基底膜抗体(+)。诊断为“急进性肾小球肾炎Ⅰ型。

原发性急进性肾小球肾炎Ⅰ型免疫病理是()

A.IgG、IgA、IgM、C3、Clq呈多部位沉积

B.IgG、C3呈线条状沉积于毛细血管壁

C.IgG、C3呈颗粒状沉积于细膜区及毛细血管壁

D.IgG、C3呈颗粒状沉积于毛细血管壁

E.无或仅有微量免疫沉积物

答案

参考答案:B

解析:急进性肾炎可有线型(抗肾小球基底膜型,即Ⅰ型)表现,本例抗肾小球基底膜抗体阴性,又无咯血(提示不符合肺出血-肾炎综合征),故不可能;只有颗粒型(免疫复合物型,即Ⅱ型)与本题较为贴切。IgA肾病可以呈急进性表现,但其免疫荧光着染区主要在系膜区,而不是在毛细血管壁IgA颗粒状沉积。IgM肾病常有局灶IgM沉积,而该病以肾病综合征、缓慢进展病程为特点,与本例临床资料不符。

阅读理解

阅读下面短文,并根据短文后的要求答题。

    Walking is a popular form of exercise. It is an easy activity and offers a good way

to improve physical fitness. Walking also gives many of the same benefits as other kinds

of exercise.

    Regular, brisk walks help a person's body work better. Walking builds a stronger heart

and healthier lungs. The heart pumps blood through the body. It gets more rest between

beats. Walking also seems to help protect the heart from heart diseases. The lungs work

better because they take in and use oxygen more effectively. Walking can help , too. A

quick fifteen-minute walk buns as many calories as jogging the same distance in half the

time. Walking causes very few injuries. So there is also a lower "dropout" rate among

walkers than among runners. People are more likely to continue a walking program. This

gives a better chance for success.

    Walking offers some mental benefits, too. It seems to make people feel better. Many

walkers say they sleep better at night when they take regular walks. Others say they have

a better attitude about life.

    Walking offers many of the same physical and mental benefits as other forms of

exercise, but walking offers some special advantages, too.

    ★Almost everyone can walk. There are no special lessons of coaching. To become a

serious walker, a person only needs to walk faster, farther and more often.

    ★People can walk almost anywhere. There are no special playing fields or courts for

walking. Sidewalks, streets, parks, fields and malls are excellent places for walking.

    ★People can walk almost anytime. A person doesn't need a team or a partner for

walking. There is no "season" for walking. Most walkers walk in all kinds of weather.

    ★Walking doesn't cost anything. There are no special fees for walking. Good walking

shoes and comfortable clothes are only equipment that a walker needs.

    Walking offers a form of exercise within the reach of nearly everyone. With a little

time and effort, people can rediscover a valuable form of exercise and improve their

fitness.

1. What's the best title of the passage? (within 10 words)

   _____________________________________________________________________________________

2. Which sentence in the passage can be replaced by the following one?  

   Comparing with running, more people can continue walking as a form of exercise.

   _____________________________________________________________________________________

3. Please fill in the blank in the 2nd paragraph with proper words or phrases. (within 10

   words)

   _____________________________________________________________________________________

4. Among the special advantages of walking, which one do you think is the most important?

   Why (within 30 words)

   _____________________________________________________________________________________

5. Translate the underlined sentence into Chinese.

   _____________________________________________________________________________________

单项选择题