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问题 多项选择题

患者女性，28岁，初产妇，妊娠36周。产前检查：BP180/112mmHg，拒绝住院治疗。昨晚突然腹痛伴 * * 流血，BP80/60mmHg，P112次/分，宫高35cm，子宫左侧有压痛，肌紧张，胎位不清，胎心音消失，宫颈未消失。

提示：术后尿量小于17ml/h，如考虑为肾衰竭。 还应做的进-步检查是（）

A.血容量己补足而尿量不增加时再静脉推注速尿

B.立即给予20%甘露醇500ml快速静脉滴注或速尿20-40mg静脉推注

C.血液电解质和二氧化碳结合力的检查

D.血浆尿素氮和肌酐的检查

E.需排除腹腔内活动性出血

F.若血容量不足时及时补充液体量

G.透析治疗

答案

参考答案：A, C, D, E, F

解析：该患者术后尿量少，怀疑重型胎盘早剥并发肾衰竭时，首先要排除尿少是否因血容量不足引起，需排除腹腔内活动性出血造成血容量不足，若血容量不足时及时补充液体量，检查血液电解质和二氧化碳结合力及血浆尿素氮和肌酐，血容量己补足而尿量不增加时再静脉推注速尿或20%甘露醇500ml快速静脉滴注，如确诊肾衰竭，出现尿毒症时应透析治疗。

单项选择题

下列哪项体征提示急性细菌性心内膜炎（）

A.胸痛

B.咯血

C.水冲脉

D.Janeway损害

E.毛细血管搏动
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单项选择题

There are many kinds of friends. Some are always (1) you, but don’t understand you. Some say only a few words to you, but understand you. Many people will step in your life, but only (2) friends leave footprints.
I shall always recall the autumn and the girl with the (3) . She will always bring back the friendship between us. I know she will always be my best friend.
It was the golden season. I could see the yellow leaves (4) with the cool (5) . In such a season, I liked walking alone on the roads covered with leaves, (6) to the sound of them.
Autumn is a (7) season and life is uninteresting. The free days always get me (8) . But one day, the sound of a violin (9) into my ears like a stream flowing in the mountains. I was so surprised that I jumped to see what it was. A young girl, standing in the wind, was (10) in playing her violin.
I had (11) seen her before. The music was so nice that I listened quietly. Lost in the music, I didn’t know that I had been (12) there for so long but my existence did not seem to disturb her.
Leaves were still falling. Every day she played the violin at the comer of the building (13) I went downstairs to watch her performance. I was the only listener. The autumn seemed no longer lonely and life became (14) . (15) we didn’t know each other, I thought we were already good friends. I believe she also loved me.
Autumn was nearly over. One day, when I was listening carefully, the sound suddenly (16) . To my astonishment, the girl came over to me.
"You must like music from the violin." she said.
"Yes. And you play very well. Why did you stop’." I asked.
Suddenly, a (17) expression appeared on her face and I could feel something unusual.
"I came here to see my grandmother, but now I must leave. I once played very badly. It was your listening every day that (18) me. " she said.
"In fact, it was your playing (19) gave me a meaningful autumn," I answered, " Let’s be friends. "
The girl smiled, and so did I. I never heard her play again in my life. I no longer went downstairs to listen to her. Only thick leaves were left behind. But I will always remember the fine figure of the girl. She is like a (20) —so short, so bright, like a shooting star giving off so much light that makes the autumn beautiful.

Ⅱ. 完形填空/Close

A．once

B．never

C．often

D．usually
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