问题 单项选择题

尿毒症患者必有的症状(发生率最高的症状)是

A.恶心呕吐 

B.高血压 

C.少尿 

D.贫血 

E.气喘 

答案

参考答案:D

解析:

尿毒症的临床表现非常复杂,可累及全身各个脏器和组织。 一、胃肠道表现 :是尿毒症中最早和最常出现的症状。初期出现厌食、腹部不适等,以后逐渐出现恶心、呕吐、腹泻、舌炎、口有尿臭味和口腔粘膜溃疡等。 二、

精神、神经系统症状:精神萎靡、疲乏、头晕、头痛、记忆力减退、失眠等,部分患者可有四肢发麻、手足灼痛和皮肤瘙痒感。晚期可出现嗜睡、烦躁、谵语、肌肉颤动甚至抽搐、惊厥、昏迷等。 三、造血系统症状 贫血是尿毒症患者必有的症状,除贫血外尚容易出血,如皮下淤斑、鼻衄、牙龈出血、黑便等症状。 呼吸系统症状酸中毒时呼吸深而长。 皮肤表现皮肤失去光泽,干燥、脱屑。严重时会出现皮肤尿毒霜,它刺激皮肤会引起尿毒症性皮炎,患者觉奇痒而搔抓。 四、代谢性酸中毒 :尿毒症患者都有轻重不等的代谢性酸中毒,患者疲乏软弱、感觉迟钝、呼吸深而长,甚至进入昏迷状态。 五、脱水或水肿 :患者一方面因为肾浓缩尿液的功能差而导致多尿、夜尿,加上厌食、恶心、呕吐和腹泻,常引起脱水,另一方面因为肾排水能力差,多饮水则水会潴留体内,造成水肿。 六、电解质平衡紊乱 ,低钠血症和钠潴留:一方面,患者对钠的调节能力差,容易产生低钠血症,表现为疲乏无力、表情淡漠、厌食,严重时恶心、呕吐、血压下降。另一方面,若患者摄入钠过多,又会潴留体内,引起水肿、高血压,严重时可发生心力衰竭。 七、低钙血症和高磷血症 :患者肾功能障碍,尿磷排出减少,导致血磷升高。磷从肠道排出与钙结合,又限制了钙的吸收,导致低钙血症。高血磷和低血钙引起继发性甲状旁腺功能亢进,导致骨质钙化障碍,患者出现尿毒症性骨病,如纤维化骨炎、骨软化病、骨质疏松、骨硬化症等。 八、低钾血症和高钾血症 :当患者出现厌食、腹泻、大量使用利尿剂时会造成严重的低钾血症,表现为:全身软弱无力、软瘫、麻痹、心律失常、严重时出现嗜睡甚至昏迷。 当患者出现感染、酸中毒、长期使用保钾利尿剂、输库存血、或晚期无尿时,会出现严重的高钾血症,表现为:各种心律失常、心脏骤停等。 九、高镁血症 :尿毒症患者极少发生高镁血症,但在使用镁剂或发生严重感染和酸中毒时,会使血镁升高。表现为:倦怠、嗜睡、肌肉无力、恶心、呕吐、排便障碍、各种心律失常等。多数都不是特异性症状,早期发现还要靠临床化验检查。 

阅读理解

Normally a student must attend a certain number of courses in order to graduate, and each course which he attends gives him a credit (学分) which he may count towards a degree. In many American universities the total work for a degree consists of thirty-six courses each lasting for one semester (学期). A typical course consists of three classes per week for fifteen weeks; while attending a university a student will probably take four or five courses during each semester. Normally a student would expect to take four years attending two semesters each year. It is possible to spread the period of work for the degree over a longer period. It is also possible for a student to move between one university and another during his degree course, though this is not in fact done as a regular practice.

For every course that he follows, a student is given a grade, which is recorded, and the record is available for the student to show to prospective(预期的) employers. All this imposes a constant pressure and strain of work, but in spite of this some students still find time for great activity in student affairs. Elections to positions in student organizations arouse much enthusiasm (热情). The effective work of maintaining discipline is usually performed by students who advise the academic authorities (权威). Any student who is thought to have broken rules, for example, by cheating has to appear before a student court. With the enormous numbers of students, the operation of the system does involve a certain amount of activity. A student who has held one of these positions of authority is much respected and it will be of benefit to him later in his career.

72. Normally a student would at least attend ______ classes per week.

A. 36      B. 12     C. 20       D.15

73. According to the first passage an American student is allowed ______.

A. to live in a different university

B. to take a particular course in a different university

C. to live at home and drive to classes

D. to get two degrees from two different universities

74. American students are usually under pressure of work because ______.

A. their academic performance will affect their future careers

B. they are heavily involved in student affairs

C. they have to observe university discipline

D. they want to run for positions of authoring

75. Some students are enthusiastic for positions in student organizations probably because_____.

A. they hate the constant pressure and strain of their study

B. they will then be able to stay longer in the university

C. such positions help them get better jobs

D. such positions are usually well paid

单项选择题