问题 多项选择题

病历摘要:患者、男性,35岁,已婚。一年前可能因工作挫折致内心不愉快,经常忧虑,精神紧张,始后渐有失眠,每月有数次无明显诱因的阵发性强烈心慌、心悸、胸闷、呼吸不畅和莫名的恐惧感,伴面色苍白,持续数分钟至一小时不等。曾住某医院作全面检查,血压正常,EKG示“偶发性房性早搏”,脑CT、EEG、超声心动图、血糖、尿24小时17KS、VMA、儿茶酚胺均无阳性结果。患者偶感胃肠不适和腹痛伴腹泻,曾经心血管内科、神经内科、内分泌科会诊,均已初步排除该科明确疾病。但患者心境忧愁,自感身患重病,不敢远途出差,曾提出不担任领导职务。用过多种正规抗癫痫药治疗无效,连续服用阿米替林75mg/日,2周疗效亦不明显。追溯少年时已偶有易惊慌感,但学习、工作能力良好。无精神活性物质嗜癖史。

提示:心电图示“偶发性房性早搏”,而超声心动图正常。 提问:需进一步做哪些检查有助于诊断?()

A.24小时动态心电图监测

B.颅脑MR

C.脑血管造影

D.脑电图诱发试验

E.MMPI

F.T3,T4

G.Hamiltom焦虑量表

H.Hamiltom抑郁量表

I.踏车试验

J.血电解质

答案

参考答案:A, E, F, G, H

解析:

此处提示医生应明确判断心律失常的性质,以及它与患者主要自觉症状之间的关系。“偶发性房性早搏”常为功能性,亦可见于某些器质性心脏病。患者虽做过全面检查,包括超声心动图,但未能出示其它心血管功能检查资料,若有怀疑,需请心血管内科会诊,同时有必要做一些精神科常用量表以助诊断(第5、7、8项),第6项有助于排除甲状功能障碍所致的心律失常,第10项有助于排除低血钾。第1、2、3、4、9项较复杂或有损伤性,对诊断无重意义。

阅读理解

The Elysee Palace in France enjoys equal popularity in the world with the Buckingham Palace in the United Kingdom, the Kremlin in Russia as well as the White House in the U. S. It is the residence of the president of the French Republic and the symbol of the supreme authority in France.

The Elysee palace, with an area of 11,000 square metres, is at the eastern end of the Champs Elysee in the city of Paris proper and backed by a large and peaceful garden of more than twenty thousand square metres. Its main building, quite handsome and graceful, is a two-story classical stone architecture of European style, and beside it are two side buildings facing each other and with an extensive rectangular courtyard in the middle. There are altogether 369 halls and rooms of different sizes.

The Elysee Palace, built in 1718, has a ling history of close to300 years to date. This house was at first a private residence of a count named d’Evreau, so it was called Hotel d’Evreau. It had later gone through many changes and its owners had been changed for many times, but all the residents in it were distinguished persons and high officials. The house was renamed Bonaparte Mansion when it was owned by Louis X V and Louis X VI successively when they acted as emperors. Napoleon I signed his act of abdication here when he had suffered defeat in the Battle of Waterloo in 1815. Nopoleon III moved in the   Mansion in 1848 when he was elected president, and the house became a Royal Palace when he declared himself as emperor. The Third French Republic issued a decree in 1873, appointing officially the Elysee Palace as the residence president of the French Republic. Over the hundred years since then, almost all the president of the French Republic worked and lived there. Starting from 1989, the Elysee Palace is open to the public every year in September on the French Castles Day.

小题1:The number of the buildings of the Elysee Palace is ______.

A.3

B.4

C.5

D.6小题2: Why does the writer mention the Buckingham Palace?

A.To tell us it’s very famous in the world

B.To tell us the Elysee Palace is as large as it.

C.To show that the Elysee Palace is also a symbolic building.

D.To show that it is also the living place of the president.小题3:What’s the purpose of the passage?

A.To tell us the long history of the Elyseee Palace.

B.To make an introduction of the Elysee Palace.

C.To show the political importance of the Elysee Palace.

D.To explain how the Elysee Palace became the residence of presidents.小题4: Which of the following is NOT mentioned in the passage?

A.The time when the Elyusee Palace is open to the public.

B.The reason why Napoleon I signed his act of abdication.

C.The time when the Elysee Palace became the residence of president of the French Republic.

D.The reason why there’s the French Castles Day.

单项选择题 A1型题