问题 单项选择题

女性患者,21岁。无明确诱因出现新鲜血便。查体:皮肤与黏膜可见成簇的细小的呈鲜红色的毛细血管扩张,肝脾未触及,最可能的诊断是()。

A.过敏性紫癜

B.白血病

C.流行性出血热

D.血小板减少性紫癜

E.遗传性毛细血管扩张症

答案

参考答案:E

解析:遗传性出血性毛细血管扩张症系常染色体显性遗传性疾病,以皮肤、黏膜以及内脏的多发性毛细血管或小动脉、小静脉扩张和病变部位反复出血为特征,最突出的症状是受累血管破裂出血,常在同一部位反复出血。儿童期多见鼻出血,到青少年期鼻出血渐趋好转,而内脏出血机会增加,以胃肠道出血最多见。其他可有咯血、血尿、眼底出血、月经过多、蛛网膜下腔出血等。

完形填空

One summer day my father sent me to buy wire for our farm. At 16, I liked 36 better than driving our truck, 37 this time I was not happy. My father had told me I’d have to ask for credit(赊账) at the store.

Sixteen is a 38 age, when a young man wants respect, not charity. It was 1976, and the ugly 39 of racial discrimination was 40 a fact of life. I’d seen my friends ask for credit and then stand, head down, while the store owner 41 whether they were “good for it.” I knew black youths just like me who were 42 like thieves by the store clerk each time they went into a grocery.

My family was 43 . We paid our debts. But before harvest, cash was short. Would the store owner 44 us ?

At Davis’s store, Buck Davis stood behind the cash desk, talking to a farmer. I nodded 45 I passed him on my way to the hardware shelves. When I brought my 46 to the cash desk, I said 47 , “I need to put this on credit.”

The farmer gave me an amused, distrustful 48 . But Buck’s face didn’t change.   “Sure,” he said 49 . “Your daddy is 50 good for it.” He  51 to the other man. “This here is one of James Williams’s sons.”

The farmer nodded in a neighborly 52 . I was filled with pride. James William’s son.  Those three words had opened a door to an adult’s respect and trust.

That day I discovered that the good name my parents had  53 brought our whole family the respect of our neighbors. Everyone knew what to 54 from a Williams: a decent person who kept his word and respected himself 55 much to do wrong.

36. A. something                B. nothing           C. anything                 D. everything

37. A. and                   B. so                   C. but                  D. for

38. A. prideful            B. wonderful               C. respectful               D. colorful

39. A. intention           B. shadow            C. habit               D. faith

40. A. thus                  B. just                 C. still                 D. ever

41. A. guessed             B. suspected         C. questioned       D. figured

42. A. watched            B. caught             C. dismissed         D. accused

43. A. generous           B. honest             C. friendly           D. modest

44. A. blame               B. excuse             C. charge             D. trust

45. A. until                 B. as                   C. once                D. since

46. A. purchases          B. sales                C. orders             D. favorites

47. A. casually            B. confidently      C. cheerfully        D. carefully

48. A. look                        B. stare                C. response          D. comment

49. A. patiently           B. eagerly            C. easily              D. proudly

50. A generally            B. never              C. sometimes       D. always

51. A. pointed             B. replied            C. turned             D introduced

52. A. sense                       B. way                       C. degree             D. mood

53. A. earned              B. deserved          C. given              D. used

54. A. receive              B. expect             C. collect             D. require

55. A. very                        B. so                   C. how                D. Too

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