问题 多项选择题 案例分析题

患者女,63岁。间断上腹痛伴腹胀10余年,加重伴乏力5个月。10多年来,多于餐后出现上腹部不适、嗳气、反酸,曾行多次上消化道造影提示:胃窦炎症。间断口服中药治疗。2月来,上腹疼痛加重,餐前餐后均有发作,伴有食欲下降、乏力,体重减轻1kg。既往血脂升高。查体:剑突下、左上腹轻度压痛。化验:Hb115g/L。

胃镜检查结果考虑为非萎缩性胃炎,为帮助诊断可考虑使用哪些药物?()

A.PPI

B.H2RB

C.黏膜保护剂

D.胃肠道促动力剂

E.抗胆碱能药物

F.消化酶制剂

G.益生菌

答案

参考答案:A, B, D

解析:

1.老年患者应该注意除外胃肠道肿瘤的可能,大便检查、腹部超声检查很重要。老年患者在没有除外消化道肿瘤的时候,不考虑首先Hp的检查。

2.按照我国功能性消化不良的诊治要求,可进行2周的试验性治疗,包括抗酸药和胃肠道促动力剂。

3.血清Hp抗体不作为根除治疗Hp的检查方法。

4.患者年龄较大,不适合强力抗酸和首先进行抗Hp治疗。

阅读理解与欣赏

神奇的“太阳大夫”

①太阳,素有“神奇大夫”之称。看看它在医学上的许多奇迹,你会为之感叹不已。

② 丹麦科学家芬森无意之中看到一只猫躺在地上晒太阳,当时天气不算寒冷,经细心观察,发现猫身上有个流脓的伤口,猫在利用阳光治疗。这一发现,使他获得了1930年的诺贝尔奖。

③美国一批研究人员指出,每天晒太阳10分钟可预防结肠癌和乳腺癌。实地调查表明,阳光强烈的赤道地区居民,患乳腺癌和结肠癌的比例最低,且居住地方越远离赤道,患乳腺癌率越高。这可以说明人缺乏维生素D(阳光中的紫外线使人皮肤中的胆固醇转变成维生素D),可能是形成乳腺癌和结肠癌的原因。日照对防治忧郁症颇具奇效。据美国专家研究,由于日照不足,全世界至少每年有500万人患忧郁症,他们常焦虑不安、精神萎靡、浑身无力甚至失眠,反应变得迟钝、爱吃烈性食物、身体过胖、工作易发生事故。但患者若设法多“拜会”太阳大夫,康复之神便会很快降临。

④ “太阳大夫”妙手回春的病例多不胜举。太阳的短波红外线透射力可直达人体深层组织,使血液加快,促进新陈代谢,起到消炎镇痛等作用;对关节炎、肌营养不良也有良好疗效;太阳的紫外线能直接杀菌消毒,又能防治气管炎之类的感染性疾病;阳光还是免费的优质“鱼肝油”,常晒太阳能使儿童软骨病等得到防治。此外,对老人冠心病、糖尿病的治疗也具有一定疗效。

⑤ 不过,日照过量也会导致皮肤早衰老、白内障及皮肤癌等疾病。此外,日光健身还应该注意选择时间,因为一天中各个时间的阳光会对人体起不同的反应。上午6至9时,阳光含有大量使人体感到暖和的红外线,对皮肤有益。9至12时,这是日光浴的最好时光,有益的紫外线A光束会把皮肤很快晒成褐色,而不会晒成黑色。12时至16时,不宜晒太阳在这段时间里,对皮肤有害的紫外线B光束和紫外线C光束的含量。

小题1:“太阳大夫”的疗效有哪些?请列举其中四项。(4分)

小题2:第③段中“全世界至少每年有500万人患忧郁症”句中划线词语为什么不能省略?(2分)

小题3:选文中运用了多种说明方法,请任选其中一种,举例分析它在文中的作用。(3分)

阅读理解

Have you ever wondered why birds sing? Maybe you thought that they were just happy.After all,you probably sing or whistle when you are happy.

Some scientists believe that birds do sing some of the time just because they are happy.However,they sing most of the time for a very different reason.Their singing is actually a warning to other birds to stay out of their territory

Do you know what a “territory” is? A territory is an area that an animal,usually the male,claims(声称)as its own.Only he and his family are welcome there.No other families 0f the same species(物种)are welcome.Your yard and house are your territory where only your family and friends are welcome.If a stranger should enter your territory and threaten you,you might shout.Probably this would be enough to frighten him away.

If so,you have actually scared the stranger away without having to fight him.A bird does the same thing。But he expects an outsider almost any time,especially at nesting(筑巢) season.So he is screaming all the time,whether he can see an outsider or not This screaming is what we call a bird’s song,and it is usually enough to keep an outsider away.

Birds sing loudest in the spring when they are trying to attract a mate and warn others not to enter the territory of theirs.

You can see that birds have a language all their own.Most of it has to do with attracting mates and setting up territories.

小题1:Some scientists believe that most of the time birds’ singing is actually.

A.an expression of happiness

B.a way of greeting

C.an expression of anger

D.a way of warning小题2:What is a bird’s “territory”?

A.A place where families of other species are not accepted.

B.An area which a bird considers to be its own

C.an area for which birds fight against each other.

D.A place where a bird may shout at the top of its Voice.小题3:Why do birds keep on singing at nesting season?

A.Because they want to invite more friends

B.Because their singing helps get rid of their fears.

C.Because they want to find outsiders around.

D.Because their singing helps frighten outsiders away.