问题 多项选择题

病历摘要:患儿女性,9岁。因浮肿,少尿并血尿收入院。起病无诱因,不伴发热,患儿曾对症治疗,颜面及四肢浮肿消退,而腹胀日益加重,出现持续肉眼血尿和大量蛋白尿。既往健康。家族无类同病人。体检:营养欠佳,发育中等,精神差,颜面不肿,双下肢中度可凹性水肿。心肺无异常。腹部高度膨胀,移动性浊音阳性,肝脾未触及,未及异常包块,余无特殊。

提问:为了证实诊断,必须做下列哪些检查?()

A.抗链球菌溶血素“O”(ASO)

B.循环免疫复合物(CIC)

C.血清补体C3

D.C反应蛋白(CRP)

E.抗核杭体(ANA)

F.血小板及凝血酶元时间

G.下腔静脉造影

H.血浆纤维蛋白原定量

I.肾活检

J.尿β2—微球蛋白(尿β2一MG)

答案

参考答案:C, E, F, G, H

解析:

根据以上的诊断及鉴别诊断,我们要证实该患儿是否有在肾病综合征的基础上合并下腔静脉血栓形成,继而引起大量蛋白尿及持续肉眼血尿。因此,选择下腔静脉造影及检查是否存在高凝状态是必须的。为了排除SLE,检查血清补体C3也是必须的。至于CIC的检查对诊断和鉴别诊断的意义并不十分重要,属可选可不选。在不明原因的肾功能衰竭时,肾活俭是必要的。但本例患儿肾功能损害属轻度,且血尿明显;再加上肾活检要求的条件比较高,不是每个医院都能开展的。因此,第9项可选可不选。关于尿β2—微球蛋白(尿β2—MG)是有关肾小管功能方面的检查,对估价病情的严重程度有一定的帮助,但对于诊断及鉴别诊断意义不大。也属可选可不选。

选择题
阅读理解

(D)

You can not see any object unless light from that object gets into your eyes. Some of the things you see give off light of their own. The sun, the stars, a lighted lamp are examples that can be seen by their own light. Such things are luminous. Most of the things you see are not giving off light of their own. They are simply reflecting light that falls on them from the sun or some other luminous bodies. The moon, for example, does not give off any light of its own. It is non-luminous. You see it because sunlight falls on it and some of it reflects in our direction. So moon light is only second hand sunlight.

When you look at a book, it sends to your eyes some of the light which falls on it, and you see the book. If light could be kept out from where you are so that there would be no light for the book to reflect, then you could not see the book even with your eyes wide open.

Light travels so fast that the time in which it travels from the book you are reading to your eyes is so short as if there were no time at all. Light reaches us from the moon, which is about 380 000 kilometers away, in only a little more than a second.

小题1:You can see the book because_______.

A.your eyes are close to it

B.it reflects some of the sunlight

C.it has light of its own

D.your eyesight can get to it小题2:The underlined word “luminous” means_______.

A.visible

B.all colors

C.giving off light

D.sunlight小题3:________ have light of their own.

A.The sun and the moon

B.The stars and the earth

C.The sun and the stars

D.The moon and the earth小题4:Which of the following is true?

A.All the things you can see give off light.

B.Light from the book is much shorter than that from the moon.

C.The moment you open your eyes the light from the book travels to your eyes.

D.Light travels so fast that there is no time for you to read.小题5:This article is probably from _________ .

A.a science magazine

B.a medical magazine

C.a biography

D.a story book.