问题 多项选择题 案例分析题

患者男,69岁。丙肝后肝硬化24余年。2天前聚餐后出现意识淡漠,行为反常,扑翼样震颤阳性,病情逐渐加重。查体:巩膜黄染,不能唤醒,腱反射和肌张力亢进,血氨230μmol/L。

该患者目前可能出现哪些表现?()

A.各种反射都消失

B.扑翼样震颤无法引出

C.不能唤醒

D.肌张力亢进

E.脑电图呈特征性改变

F.腱反射亢进

G.唤醒后可正确回答问题,但很快再次入睡

H.定向力差

I.睡眠倒错

J.书写障碍

K.情绪激动

答案

参考答案:B, C, D, E, F

解析:2.肝性脑病发病机制有:(1)神经毒素学说,包括:①血氨干扰脑细胞三羧酸循环;②大脑对中牲氨基酸(如酪氨酸、苯丙氨酸、色氨酸)的摄取增加;③脑星形胶质细胞含有谷氨酰胺合成酶,可促进氨与谷氨酸合成谷氨酰胺,当脑内氨浓度增加,星形胶质细胞合成的谷氨酰胺增加,导致星形胶质细胞和神经元细胞肿胀;④氨可直接干扰神经的电活动。

阅读理解

Jeans are very popular especially with teenagers. It’s said that the material came originally from Nimes, a city in France. These jeans were particularly created for the sailors, who loved wearing jeans very much. These jeans could be worn when wet and it could even be rolled over with ease. This was particularly useful when the sailors were busy with their everyday work.

Our favorite pair of blue, jeans was originally worn by workers particularly during World War II. Perhaps the strong and durable(耐用的) look made these blue jeans popular among all the factory workers. A strange thing that can be noticed happened in the early period of the 1950s when blue jeans worn by teens were considered to be a form of being against others. Besides, adults who wore blue jeans were not allowed to enter a movie theatre. It was only during the 1960s that blue jeans were accepted as a fashion trend in the United States of America. Movie stars wore them in films and in public. Many young people follow them.

The different looks of the regular blue jeans which are enjoyed by people were introduced by the mid 1950s. It was Donald Freeland who gave jeans a whole new look and brought it to the front. Originally, jeans were always worn loose. At first, jeans worn by men had the zipper(拉链)on the front. However, for women, it was on the side. By the late 1960's , the zipper finally was on the front side for women as well.

Today, there are many new designs that are being created by fashion designers to meet the increasing demands from jean lovers! A pair of basic blue jeans, however, is one such piece of clothing that will never go out of fashion! When you open one's cupboard, there is always one pair of jeans one likes best.

小题1:The sailors originally were interested in wearing jeans because jeans     .

A.could give them a pleasant look

B.were convenient and easy to use

C.were cheaper than other trousers

D.could be washed and made easily小题2:According to the passage, blue jeans          .

A.were once a sign of being against their parents

B.were popular with people of different ages in the 1950s

C.began to be poplar with American people in the 1960s

D.have been worn by the factory workers after World War II小题3:The following all lead to the popularity of jeans EXCEPT        .

A.American culture

B.various designs

C.movie stars' influence

D.its cloth quality小题4:It is known from the passage that       .

A.Donald Freeland gave jeans a whole new design

B.the zipper was always on the front side of all jeans

C.The jeans were introduced into America in the 1950s

D.Donald Freeland was the first to make jeans popular in the world小题5:In the last paragraph, the writer is trying to          .

A.show his interest in blue jeans

B.tell us the popularity of jeans

C.praise the benefits of blue jeans

D.discuss the development of jeans

单项选择题