问题 单项选择题 C型题

患者,男,66岁。体检时发现血糖高前来就诊,有磺胺药过敏史,体型肥胖。医师处方二甲双胍片(0.5g,tid)控制血糖。

该患者复诊发现糖耐量异常及餐后血糖升高,单药控制未达标,建议联合应用的降糖药是()。

A.格列喹酮

B.格列苯脲

C.胰岛素

D.阿卡波糖

E.罗格列酮

答案

参考答案:D

解析:

1.二甲双胍片口服:从小剂量开始渐增剂量。通常起始剂量为一次0.5g,一日2次;或0.85g,一日1次;随餐服用;可每周增加0.5g,或每2周增加0.85g,逐渐加至一日2g,分次服用。2.如单独使用二甲双胍治疗而血糖仍未达标,则可加用胰岛素促分泌剂或α葡萄糖苷酶抑制剂(二线治疗)。格列喹酮起效和餐后血糖上升高峰时间比较一致。3.与二甲双胍合用会增加发生低血糖的危险性,所以应监测低血糖反应。

阅读理解

A few years ago, an Englishman called Roy Jones went on holiday to a small seaside town in the west of England. He was swimming in the sea one day when, as he opened his mouth, his false teeth fell out and floated away. The following year, Mr. Jones returned to the same town. As he was having dinner in a local café one evening, he mentioned the story of his lost teeth to the manager. The manager looked surprised. He explained that he had found a set of false teeth on the beach last month. Then he asked Roy Jones if he wanted to try them on. “OK”, said Mr. Jones. “I suppose it won’t do any harm.” When the manager brought him the teeth, Mr. Jones put them into his mouth, and laughed and laughed. They were his.

In 1987, an American couple called Jane and Robert Bentley went for a picnic on a beach in California. When they returned home, Mrs. Bentley realized that she had lost her wedding ring. It wasn’t a lot of money but it was valuable to Jane Bentley. The Bentleys drove straight back to the beach, and searched for the ring for three hours, but could not find it. A few months later, Mr. Bentley went fishing off the same beach. As he pulled a large crab out of the sea, he noticed that there was something attached to one of its claws. It was his wife’s wedding ring!

At the end of the 19th century, a young woman called Rose Harcourt was on her honeymoon in Barmouth, North Wales, when she lost a gold bracelet her husband had given her as a wedding gift. Feeling very upset, she went straight to the police stations and asked if anyone had found her bracelet. Unfortunately, no one had. Twenty-five years later, the Harcourts returned to Barmouth to celebrate their wedding anniversary. They were sitting on the beach one day when Mrs. Harcourt noticed something gold in the sand by the edge of the sea. She walked down to see what it was, and discovered her gold bracelet that had been missing for 25 years.

小题1:Roy Jones lost his false teeth __________ .

A.when he opened his mouth to have some food

B.when he opened his mouth as he was swimming

C.The moment he got into the sea to start swimming

D.when he was having his holiday at the sea side小题2:Jane Bentley’s wedding ring was missing for __________ before it was found.

A.three hours

B.almost a year

C.several months

D.25 years小题3:From the story of the Harcourts we may understand the underlined “to celebrate their wedding anniversary” may be close in meaning to __________ .

A.having a wedding again

B.experiencing their honeymoon feelings again

C.having a honeymoon again

D.joining in the local celebrations

单项选择题