女性，60岁，因右上腹痛伴发热3天入院，2个月前因心衰住院，治疗_爱下问搜题

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问题单项选择题案例分析题

女性，60岁，因右上腹痛伴发热3天入院，2个月前因心衰住院，治疗后好转．体检：巩膜无黄染，心率120次／分，右上腹压痛、肌紧张，Murphy征（+），可扪及肿大的胆囊

进一步确诊应首选下列哪项检查（）

A.PIE

B.ERCP

C.CT

D.静脉胆道造影

E.B超

答案

参考答案：E

解析：1.休克纠正后，应卧床休息，禁食水，止血治疗，监测血红蛋白，血红蛋白140g/L，为血液浓缩时的结果，测血红蛋白可明确出血原因及是否有活动性出血。2.因患者有心衰的病史，现心率120次／分，右上腹压痛、肌紧张，腹膜刺激征，Murphy征（+），可扪及肿大的胆囊，病情较重，单纯保守治疗效果差，且感染可诱发心衰，应尽快胆囊造瘘术。

单项选择题

刺激右侧角膜时出现右侧直接角膜反射，但左侧不出现间接反应，说明病变在（）

A.右三叉神经

B.左面神经

C.右面神经

D.左三叉神经

E.右三叉神经伴右面神经

完形填空

Recent studies show that only one out of three people have strong and healthy self-confidence. That 36 two out of every three people simply don’t know the 37 they already have to be successful when it’s 38 there in their hands! 39 if you want others to believe in you, you have to believe in yourself first. Remember: “No one can make you feel inferior (差的) unless you 40 them.” A successful businessman says, “You can’t push anyone up a ladder 41 he knows he can climb himself.”
Many of us have an image 42 , the image（形象）we have of ourselves. 43 one guy put it: “You can’t win a horse race if you think you look 44 on a horse.” To succeed, the first person you have to 45 is yourself! So stop believing your own lies about yourself. Just 46 your mind and you’ll change your life.
One of the most harmful weapons that can kill your success in life is the two little words: “47 ”. You know that people used to 48 that if human beings traveled faster than 30 miles an hour it would 49 our circulation（循环）of blood and kill us? Thank goodness a few people didn’t believe that 50 thinking, or we wouldn’t be riding in cars, buses, and flying in airplanes today. You’ll never know until you 51 .
Roger Bannister was the first human being to run a mile in less than 4 minutes. But 52 he did it, most people in the world didn’t think it was even 53 Yet only weeks after Bannister did it, suddenly 54 all over the world began running a mile in less than 4 minutes! If we believe something can be done, we’ll 55 do it.

A．immediately

B．good-looking

B．unbelievable

C．competitors