问题 多项选择题

患者男性,59岁。有高血压病史5年,否认其他疾病史。于晚餐后4小时突发胸闷、恶心、呕吐胃内容物,伴上腹疼痛,到急诊室就诊。体检:Bp 80/50mmHg,T 37.4℃,HR 56次/分,上腹部轻度肌紧张伴压痛。

该患者可能的诊断是

A.心绞痛

B.心肌梗死

C.急性心肌炎

D.急性胰腺炎

E.急性肺动脉栓塞急性脑梗死急性胆囊炎

答案

参考答案:A,B,D,G

解析: 本患者临床表现主要包括消化系统和循环系统症状和体征,涉及的常见疾病包括上消化道、胰腺和心脏。结合患者多个心血管疾病高危因素(年龄、性别、高血压)和循环系统表现急性心肌梗死必须予以排除。

单项选择题
单项选择题

Beyond question, Clinton was supposed to close up, stay out of sight, and avoid second- guessing his wife’s boss. After his ego blustered into oncoming traffic during Hillary’s heated primary race (1) Obama, the nation suffered from yet another turn of Clinton fatigue.

(2) this week Bill Clinton showed an instinct for robust, inclusive leadership that the (3) White House occupant could make good use of right for the time being. With President Obama struggling to (4) the political damage from the Gulf oil spill, Clinton not only can’t help himself—he’s worth being listened.

The conventional-wisdom (5) on President Obama’s early reaction to the spill was (6) he didn’t emote enough. He didn’t feel the (7) of all those people in the crisis whose livelihood would be destroyed, whose clean waters and wildlife would be (8) in black gunk.

Clinton considers this is an unfair (9) but offers a different—and more pointed— lesson to his young successor. "I think we ought to (10) in the same boat for a while... Let’s just (11) the problem, and then we can hold everybody responsible and emote or not emote, " Clinton conversed (12) CNN Anchor Wolf Blitzer.

Obama’s first (13) after the oil spill was to "feel the blame" rather than "feel the pain, " which are pretty sarcastic words as it were. No one intends to let British Petroleum (BP) management (14) the hook—for dangerously cutting corners, and for a (15) safety record. However, the President’s (16) focus on scolding BP consumed (17) White House energy while the oil gushed.

Great leaders don’t rush to criticise; Instead they instinctively (18) solutions. Rudy Giuliani, who didn’t stop to blame (19) intelligence for letting it happen, stood out from New York mayor with a girlfriend problem to 9/11 hero when he took control of a crisis and instilled confidence that a ravaged city could (20) beyond a terrorist attack.

18()

A. call for

B. sum up

C. go over

D. look for