问题 单项选择题 A3/A4型题

患者,男性,35岁。因"双眼睑肿胀、眼球突出3个月"来诊。眼部检查Vod1.2Vos1.2,双眼睑轻度肿胀,无明显压痛,眶缘未触及明显肿物,眼球突出度右眼19mm,左眼18mm,眼球运动正常,眼球检查基本正常。

下列哪项检查结果对于确定该患者的诊断与鉴别诊断最有价值

A、CT或MRI检查提示双侧泪腺稍肿大

B、CT或MRI检查提示双侧眼外肌轻度增粗

C、甲状腺功能检查有异常

D、B超提示有眼外肌增粗

E、以上都是

答案

参考答案:C

解析:本病最重要的鉴别诊断是甲状腺相关眼病和炎性假瘤,CT或MRI以及B超提示双侧泪腺稍肿大,双侧眼外肌轻度增粗是甲状腺相关眼病和炎性假瘤均可出现的重要特征,因而不能作为两者鉴别诊断的依据,而出现甲状腺功能异常可诊断为甲状腺相关眼病。故正确答案是C。

阅读理解

Every year thousands of tourists visit Pompeii, Italy. They see the sights that Pompeii is famous for-its stadium and theatres, its shops and restaurants. The tourists do not, however, see Pompeii’s people. They do not see them because Pompeii has no people. No one has lived in Pompeii for almost 2000 years.

Once, Pompeii was a busy city of 22,000 people. It lay at the foot of Mount Vesuvius, a grass-covered volcano. Mount Vesuvius had not erupted for centuries, so the people of Pompeii felt safe, But they were not.

In August of AD 79 , Mount Vesuvius erupted. The entire top of the mountain exploded, and a huge black cloud rose into the air. Soon stones and hot ash began to fall on Pompeii . When the eruption ended , Pompeii was hurried under 20 feet of stones and ashes. Almost all of its people were dead.

For centuries, Pompeii lay buried under stone and ash. Then, in the year 1861,an Italian scientist named Ginseppe began to uncover Pompeii. Slowly, carefully, Ginseppe and his men dug. The city looked almost the same as it had looked in AD79 , There  were streets and fountains, houses and shops, There was a stadium with 20,000 seats , Perhaps the most important of all, there were everyday objects, which tell us a great deal about the people who lived in Pompeii. Many glasses and jars had some dark blue color in the bottom, so we know that the people of Pompeii liked wine, They liked bread, too; metal bread pans were in the bakery .In one bakery there were 81 round , flat loaves of bread –a type of bread that is still sold in Italy today . Tiny boxes filled with a dark, shiny powder tell us that women liked to wear eye-makeup.

小题1:Why do large numbers of people come to Pompeii each year?

A.To find the volcano

B.To shop and eat there

C.To watch sports and plays

D.To see how Pompeians lived小题2:Why did the city uncovered look almost the same as it had looked in AD 79?

A.Ginseppe and his men dug it slowly and carefully.

B.The city was buried alive and remained untouched.

C.Scientists successfully rebuilt the city with everyday objects.

D.Nobody had lived in the city ever since the volcano erupted.小题3:What do we know about the Pompeians who lived 2000 years ago?

A.They lived more or less the same as Italians now do .

B.They liked women wearing all kinds of makeup.

C.They enjoyed a lazy life with drinking and eating.

D.They went back to Pompeii after the eruption in AD79.

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