问题 多项选择题 案例分析题

患者女,49岁。21年前查体发现血糖高,应用二甲双胍、格列本脲治疗,15年前开始加用胰岛素治疗,空腹血糖控制在6~9mmol/L左右,餐后血糖未监测。2周前出现尿频伴下腹部隐痛2周,在当地医院按尿路感染治疗病情未见好转,1天前出现排尿困难。查体:T36.7℃,P87次/分,BP130/82mmHg,BMI17.8kg/2,甲状腺无肿大,心肺查体未见异常,腹软,下腹部膨隆,膀胱区叩诊呈浊音。膝腱反射减弱。

为明确诊断应进行下列哪些检查()

A.肝功

B.心电图

C.腹部超声

D.尿常规

E.腹部平片

F.心脏超声

G.残尿量测定

答案

参考答案:C, D, G

解析:

1.糖尿病自主神经病变表现在泌尿生殖系统可以表现为:排尿障碍,尿潴留、残余尿多,无张力性膀胱,有时尿失禁,容易并发尿路感染。

2.糖尿病神经病变的治疗包括:控制血糖,阻断高血糖对神经的进一步损害,扩张血管,改善循环,营养神经等治疗,重症尿潴留患者可以导尿或保留导尿管,必要时膀胱造瘘。

阅读理解

For most people, shopping is still a matter of wandering down the street or loading a cart in a shopping mall. Soon, that will change. Electronic commerce (trade) is growing fast and will soon bring people more choices. There will, however, be a cost: protecting the consumer from being cheated will be harder. Many governments therefore want to apply street regulations to the electronic world. But politicians would be wiser to see cyberspace as a basis for a new era of corporate self-regulation.

Consumers in rich countries have grown used to the idea that the government takes responsibility for everything from the stability of the banks to the safety of the drugs or their rights to refund when goods are faulty. But governments cannot enforce national laws on businesses whose only presence is on the screen. Even in a country where a clear right to compensation exists, the on-line customer in Tokyo, say, can hardly go to New York to get a refund (退款) for a clothes purchase.

One answer is for government to cooperate more: to recognize each other’s rules. But that requires years of work and volumes of detailed rules. And plenty of countries have rules too fanciful for sober countries to accept. There is, however, another choice. Let the electronic businesses do the regulation themselves. They do, after all, have a self-interest in doing so.

In electronic commerce, a reputation for honest dealing will be a valuable competitive asset. Governments, too, may compete to be trusted. For instance, customers ordering medicines on- line may prefer to buy from the United States because they trust the rigorous screening of the Food and Drug Administration; or they may decide that the FDA’s rules are too strict, and buy from Switzerland instead.

Customers will still need to use their judgment, but precisely because the technology is new, electronic shoppers are likely for a while to be a lot more cautious than customers of the normal sort. And the new technology will also make it easier for them to complain when a company lets them down. In this way, at least, the advent(出现) of cyberspace may argue for fewer consumer protection laws, not more.

小题1:In case an electronic shopper bought faulty goods from a foreign country, what could he do?

A.Refuse to pay for the purchase.

B.Go to the seller and ask for a refund.

C.Appeal to consumer protection law.

D.Complain about it on the Internet.小题2:In the author’s view, businesses would place a high emphasis on honest dealing because in the electronic world _______.

A.international cooperation would be much more frequent

B.consumers could easily seek government protection

C.a good reputation is a great advantage in competition

D.it would be easy for consumers to complain小题3:We can infer from the passage that in licensing new drugs the FDA in the United States is______.

A.very quick

B.very cautious

C.very slow

D.rather careless小题4:According to the author, what will be the best policy for electronic commerce?

A.Self-regulation by the business.

B.Strict Consumer protection laws.

C.Close international cooperation.

D.Government protection.

单项选择题 A1/A2型题