问题 单项选择题 共用题干题

患者男,60岁,因“间断左上腹隐痛2个月,加重4h”来诊。查体:全身浅表淋巴结不大,左上腹压痛,肝、脾肋下未触及,肠鸣音正常。腹部超声:脾厚5.6cm,长10.4cm,上极可见5.1cm×5.0cm×5.0cm的低回声结节,边界清晰,轮廓规整,其内及周围均可见血流信号。腹部CT(增强):脾中下部可见一类圆形低密度灶,其内密度不均匀,大小为5.4cm×5.3cm,边界清楚,轻度强化,CT值44HU。PET-CT:脾下部膨隆,一类圆形高摄取病灶,约4.5cm×5.7cm,SUVmax18.29,边界清楚。

下一步采取的最佳治疗方案是()(提示脾肿瘤组织病理学:弥漫性大B细胞淋巴瘤(DLBCL),伴有脾门淋巴结累及。浅表淋巴结超声:右侧腋窝可见数枚淋巴结,最大者2.5cm×1.5cm,皮髓结构不清,内部可见血流信号。)

A.ABVD方案化学治疗

B.CHOP方案化学治疗

C.R-CHOP方案化学治疗

D.腹腔淋巴结局部放射治疗

E.等待观察

答案

参考答案:C

单项选择题
单项选择题 案例分析题

Today ,as in every other day of the year ,more than 3000 U.S. adlescents will smoke their first cigarette on their way to becoming regular smokers as adults. During their lifetime,it can be expected that of these 3000 about 23 will be murdered,30 will die in traffic accidents, and nearly 750 will be killed by a smoking-related disease. The number of deaths attributed to cigarette smoking outweithts all other factors, whether voluntary or involuntary, as a cause of death.

Since the late 1970s, when daily smoking among high school seniors reached 30 precent , smoking rates among youth have declined . While the decline is impressive ,several important issues must be raised.

First, in the past several years,smoking rates among youth have declined very little. Second,in the late 1970s ,smoking among male high school seniors exceeded that among female by nearly 10 percent . The statistic is reversing.Third ,several recent studies have indicate high school dropouts have excessively high smoking rates, as much as 75 percent .

Finally, thouth significant declines in adolescent smoking have occurred in the past decade,no definite reasons for the decline exist. Within this context,the Naional Cancer Instiute (NCI) began its current effort to determine the most effecive measures to reduce smoking levesl among youth.

The reason for declining adolescent smoking is that ().

A.NCI has taken effective measures

B.smoking is prevented among high school seniors

C.there are many smokers who have died of cancer

D.none of these