问题
单项选择题 A3/A4型题
患者男，53岁，间断发作上腹部疼痛15年，近一个月来出现呕吐症状并逐渐加重，呕吐物为隔餐所进食物，量大，体重减轻8kg。
该患者行体格检查时最可能发现（）
A.腹部有胃型及蠕动波
B.口唇苍白
C.左侧锁骨上淋巴结可触及肿大
D.肛门指诊检查直肠前窝可触及有肿块
E.腹部触诊发现肿物
答案
参考答案：A
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患者男，53岁，间断发作上腹部疼痛15年，近一个月来出现呕吐症状并逐渐加重，呕吐物为隔餐所进食物，量大，体重减轻8kg。
该患者行体格检查时最可能发现（）
A.腹部有胃型及蠕动波
B.口唇苍白
C.左侧锁骨上淋巴结可触及肿大
D.肛门指诊检查直肠前窝可触及有肿块
E.腹部触诊发现肿物
参考答案：A
As a young man, Al was a skilled artist．He had a wife and two fine sons．One night, his oldest son developed a serious stomachache．Thinking it was only some 11 intestinal （肠内的）disorder, neither Al nor his wife took the condition very seriously．But the boy 12 suddenly that night． Knowing the death could have been 13 if he had only realized the seriousness of the situation, Al's emotional health became worse under the huge burden(重负) of his 14 .To make matters worse his wife 15 him a short time later, leaving him alone with his six-year-old younger son．The hurt and pain of the two 16 were more than Al could handle, and he 17 to alcohol(烈酒)．In time Al became an alcoholic. 18__ the alcoholism progressed, Al began to lose everything he 19 — his home, his land, his art objects, everything．20 Al died alone in a San Francisco motel room． When I heard of Al's death, I thought that Al's life was a complete 21 ． As time went by, I began to reconsider my earlier judgment．I knew Al's now 22 son, Ernie．He is one of the kindest, most caring, most loving men I have ever known．I watched Ernie with his children and saw the free 23 of love between them．I knew that kindness and caring had to come from somewhere． I hadn't heard Ernie talk much about his 24__．One day I worked __25 my courage to ask him．"I'm really 26__ by something," I said．"I know your father was 27 _ the only one to raise you．What on earth did he do that you became such a special person?" Ernie sat quietly and _28_ for a few moments．Then he said, "From my earliest _29 as a child until I left home at 18, Al came into my room every night, gave me a kiss and said, ' I love you, son．' " Tears came to my eyes as I realized what a fool I had been to __30_ Al as a failure．He had not left any material possessions behind．But he had been a kind loving father, and he left behind one of the finest, most giving men I have ever known．
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