问题 单项选择题

75岁女患者,右大腿卵圆窝部反复出现圆形突起已多年。此次因便秘突出包块增大,用力还纳后右下腹持续疼痛伴呕吐而求医,下腹压痛,反跳痛肌紧张,叩诊肝浊音界缩小,肠鸣音减弱。

此时对诊断帮助最小的检查是______

A.白细胞计数与分类

B.子宫及附件B超检查

C.立位做腹部X线透视

D.直肠镜检查

E.肛门直肠指检

答案

参考答案:D

解析:腹膜刺激征明显,高度怀疑腹膜炎,应做白细胞计数与分类。便秘可能与子宫及附件压迫有关,应做子宫及附件B超检查。叩诊肝浊音界缩小,肠呜音减弱,高度怀疑有胃肠破裂或穿孔,应做立位腹部X线透视及肛门直肠指检以了解盆腹腔内气液状况。患者便秘,不宜做直肠镜检杏。

单项选择题

Passage oneLong bus rides are like television shows .They have a beginning ,a Middle and an end –with commercials thrown in every three or four minutes .The commercials are unavoidable .They happen whether you want them or not .Every couple of minutes a billboard glides by outside the bus window . “buy super clean toothpaste”. “Drink Good’n Wet Root Beer .””Fill up with Pacific Gas .”Only if you sleep ,which site equal to turning the television set off ,are you spared the unending cry of “You Need It ! Buy It Now !” The beginning of the ride is comfortable and somewhat exciting ,Even if you’ve traveled that way before .usually some things have changed-new houses ,new buildings ,sometimes even a new road .The bus driver has a style of driving and it’s fun to try to figure it out the first hour or so . If the driver is particularly reckless or daring ,the ride can be an thrilling as a suspense story .Will the driver pass the truck in time Will the driver move into the right or the left –hand lane After a while,of course,the excitement dies down .sleeping for a while helps pass the middle hours of the ride .Food always makes bus rides more interesting .But you’ve got to be careful of what kind of foodyou eat .Too much salty food can make you very thirsty between stops. The end of the ride is somewhat like the beginning .You know it will soon be over and there’s a kind of expectation and excitement in that .The seat ,of course ,has become harder as the hours have passed.By now you’ve sat with you legs crossed ,with your hands crossed behind your head .the end comes just at the right time . There are just no more ways to sit.

The writer feels long bus rides are like TV shows because ( )

A.the commercials both on TV shows and on billboards along the road are fun

B.they both have a beginning ,a middle ,and an end , with commercials in between

C.the drives are always reckless on TV shows just as they are on buses

D.both travelling and watching TV are not exciting

问答题