男性，40岁，有明显黄疸，皮肤瘙痒1个月，粪便颜色变浅，伴轻度乏力，腹胀，肝肋下触及2cm，脾侧未及，ALT120U/L，胆红素定量230μmol/L，碱性磷酸酶、胆固醇增高。此病人诊断应考虑为（）
A.急性黄疸型肝炎
B.胆汁性肝硬化
C.急性重型肝炎
D.淤胆型肝炎
E.中毒性肝炎
参考答案：D
解析：重型肝炎的主要临床表现为：①黄疸迅速加深；②肝脏进行性缩小、肝臭；③出血倾向，PTA(凝血酶原活动度)低于40%；④迅速出现的腹水、中毒性鼓肠；⑤出现肝性脑病症状；⑥肝肾综合征。根据病情和病程，临床把重型肝炎分为急性重型肝炎、亚急性重型肝炎、慢性重型肝炎。故1题选C。淤胆型肝炎主要表现为：①黄疸具有"三分离"的特征：黄疸深，但消化道症状轻；ALT升高不明显；PTA下降不明显；②黄疸具有"梗阻性"特征，主要为肝内胆汁淤积。故2题选D。
| 阅读下面短文，把A-D填入文中空缺处（1－4），使短文内容完整正确，然后完成第5题。 | |
| Nowadays, more and more young people are becoming vegetarians in most Western countries. They are thought of as vegetarians and they refused to eat meat, fish, eggs, cheese and milk. 1 . Some of them just don’t eat animal products such as milk, eggs, or yogurt, but some others are strict vegetarians and they eat mainly fruit and vegetables. As we know, it is very important to have a balanced diet, especially for the teenagers who are growing up. 2 . Well, each person chooses to become a vegetarian for different reasons. The main reasons are they want to protect animals and they want to stay healthy. I decided to be a vegan when I was 15 years old. But as a vegetarian, I have had a difficult time in getting the proper nutrition(营养). 3 . Of course, being a vegetarian isn’t for everyone. 4 .
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| 5. Which of the following is NOT true？ | |
| A. There are many vegetarians in most Western countries. B. The main reason for being vegetarians is they don’t like eating meat. C. Not everyone should be a vegetarian. D. Keeping healthy is important to teenagers. |