问题 问答题 简答题

患者:女性,45岁,因反复上腹疼痛8余年、加重伴皮肤巩膜黄染3天入院,并畏寒、发热。幼时有呕吐蛔虫史。体检:神志淡漠,体温39℃,血压10.0/6.7kPa(75/50mmHg),P130次/分,皮肤巩膜中度感染。上腹有压痛,反跳痛(±),血常规示WBC26×10/L,N94%。试述需作哪些进一步检查、诊断及治疗原则。

答案

参考答案:

病人首先需行急诊床旁肝胆胰B超以明确诊断,同时还需作血气分析、肝肾功能、血尿淀粉酶等血生化检查。最可能的诊断是:①急性梗阻性化脓性胆管炎;②肝内外胆管结石;③感染性休克。治疗原则是在积极抗休克的同时,紧急手术解除胆道梗阻并引流,及早而有效地降低胆管内压力。

阅读理解

阅读理解。

Dear Michelle,

    My mother is not a good example for me and my sister. She smokes, stays out late, and she curses (咒骂).

I love her but I am ashamed of her. I do not want to bring my friends home because she does not act like any

of the other mothers. She says I am a loser because I sit at home and study. I wish I could live in another

family that was normal, but it will be 5 years before I am 18. What am I supposed to do until then?

                                                                                                                     Prisoner of a Crazy House

Dear 7th Grader,

    I am glad that you love your mother because the rest of your feelings about her may change as you get

older and mature.

    While it is true that your mother's smoking, partying and cursing bring you shame, the fact that you want

to stay separate from her doings is notable and very smart. It shows that you are a winner, not a loser. I am

guessing, therefore, that you do not bring shame to yourself, and that is a good thing. So, keep it that way

and keep away from your mother's habits. 

    At the same time, try to get the best grades and join clubs and school activities. Offer social service on

weekends and visit your friends at their homes.

    Fortunately, you are not alone. Many teens live in homes with immature, misguided, selfish parents. But

they develop good friendships with nice kids, do well in school, and often find a teacher or guidance advisor

who makes all the difference!

    Do it, Miss Winning 13 years old, and keep looking forward to your own future. Maybe by then your

mother may even see the light and realize how good you really are.

                                                                                                                                          Michelle

1. Michelle doesn't address her letter receiver as "Prisoner of a Crazy House" possibly because she ______. [ ]

A. tries to be polite

B. doesn't write to the kid alone

C. knows that's a girl in Grade 7

D. wants to cheer the kid up

2. According to the passage, Michelle advises the girl to ______.[ ]

A. try talking to her mother for her future

B. stick to her attitude towards her mother's some habits

C. understand her mother's habits and get used to them

D. try to keep away from her mother

3. What does Michelle mainly express by writing the last four paragraphs? [ ]

A. Don't worry too much about the problem.

B. Many parents act terribly.

C. Parents' manners make little difference.

D. The girl is not speaking for herself.

4. What does Miss Winning 13 years old refer to in the last paragraph but one? [ ]

A. the girl who turns to Michelle for help

B. Michelle

C. the girl's mother

D. a famous person whom we all admire

单项选择题