问题 单项选择题 案例分析题

男,46岁。主诉四肢麻木无力1年半。1年半前无诱因出现颈背部酸痛不适,伴双手麻木无力。半年后出现双手麻木逐渐向双上臂至双下肢发展伴四肢无力。病后曾按"颈椎病"给予牵引,口服"颈复康"对症治疗,无明显效果。发病以来精神、饮食好,无明显消瘦,发热。小便时费力,无大便秘结。查体:C平面以下皮肤痛、温觉减退。四肢肌容积正常,四肢肌力Ⅳ级,四肢肌张力增高,双侧肱二、三头肌反射,膝跟腿反射均无,双侧巴氏征阳性。余神经系统检查无异常。MRI影像提示颈~胸病变。脑脊液检查正常。诊断为髓内室管膜瘤。在全麻下行显微手术脊髓内室管膜全切除术。术后双下肢肌力减退为Ⅱ级,2周后恢复至Ⅴ级。卧床3周后,起床解便时,突然出现呼吸急促,大汗淋漓,继之出现血压下降,意识不清。查体:意识处于昏睡状态,双侧瞳孔0.3cm,对光反射迟钝,呼吸急促50次/分,心率快160次/分,血压70/40mmHg。口唇发绀。SPO为80%,心电图检查窦性心动过速。

Brown-Square综合征包括下列哪些征象()

A.同侧损伤平面以下痛温觉消失

B.同侧损伤平面以下运动消失

C.同侧损伤平面以下深感觉消失

D.同侧损伤平面节段性痛觉温觉消失

E.对侧损伤平面以下1~2节段痛温觉消失

F.同侧损伤平面运动消失

答案

参考答案:C

阅读理解

The hole in the Earth’s ozone layer(臭氧层) has until now protected Antarctic from the worst effects of global warming, but scientists have warned that as the hole closes up in the next few decades, temperatures on the continent could rise by around 3℃ on average, with melting ice contributing to a global sea level increase of up to 1.4 meters.

In the past decades the western Antarctic has seen rapid ice loss as the world has warmed, but the other parts of the continent have, paradoxically, been cooling, resulting in a 10% increase in ice in the seas around the region. This is because the hole in the ozone layer has increased cold winds in Antarctic, making much of the continent surface colder than usual.

But now that the gases that cause the ozone hole have been banned, scientists expect the hole to repair itself within the next 50 to 60 years. By then the cooling effect will have faded out and the Antarctic will face the full impact of global warming. This means an increase in average air temperatures of around 3℃ and a reduction in sea ice by around a third.

The biggest threat to the continent comes from warming seas. Robert Johnson, a scientist who monitors Antarctic ice sheets, said, “The ice sheets in Antarctic are hundreds of meters thick. But once warm ocean waters start flowing underneath, the ice will begin thinning and could break up very quickly.” Thinning ice sheets cause ice to break away from the continent and to melt even faster. Escaping ice from western Antarctic has already resulted in a 10% rise in global sea level in recent decades.

Johnson believes that international action to reduce global warming is required immediately or it may be too late. “Everything is connected——Antarctic may be a long way away but it is an important part of the Earth’s system,” said Johnson. “It contains 90% of the world’s ice, 70% of the world’s fresh water and that is enough, if it melts completely, to raise sea levels by 63 meters.”

Even in a worse-case situation scientists don’t expect the ice to entirely disappear, but predict that, because of the melting ice sheets, average sea level rise will be around 1.4 meters higher by the end of the century.

小题1:

The underlined word “paradoxically” (in paragraph 2) most probably means “     ”.

A.rapidly

B.generally

C.contradictorily

D.apparently小题2:

What is the effect of the hole in the ozone layer on Antarctic?

A.It is causing the ice to melt faster.

B.It is making much of the continent colder.

C.It is making the effects of global warming in the region worse.

D.It is reducing the amount of water in Antarctic.小题3:

What do scientists think is the biggest danger facing Antarctic?

A.Rising sea levels.

B.Warming sea water temperature.

C.Water pollution.

D.Growing ice sheets.小题4:

Which of the following is true according to the passage?

A.Antarctic is currently experiencing the full effects of global warming.

B.The average temperature has increased by 3℃ in recent decades.

C.Antarctic contains most of the world’s fresh water.

D.Ten percent of Antarctic’s ice has already been lost.

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