问题 单项选择题

女,28岁,21岁时因心慌、怕热、多汗、消瘦就诊,确诊Graves病,他巴唑规则治疗2年。25岁时甲亢复发。再次他巴唑治疗,2个月后甲状腺功能正常,继续治疗一年半停药。最近2个月甲亢的症状、体征再现,查血T3,T4及TSH确认为甲亢第2次复发。患者结婚5年,尚未生育,希望治疗甲亢后怀孕,甲亢的治疗拟()。

A.大剂量碘剂

B.再次他巴唑治疗,疗程延长至3~4年

C.用他巴唑,甲功正常后加用131I治疗

D.用他巴唑,甲功正常后行甲状腺大部切除手术

E.直接行甲状腺大部切除术

答案

参考答案:D

解析:手术及放射性碘治疗前均需口服药物治疗。大剂量碘剂仅用于甲状腺危象及术前准备,故首先排除。该病人希望甲亢治疗后即怀孕,而妊娠为放射性碘治疗禁忌证,因此,最合适的方案是D。

完形填空

It was an afternoon in the winter. Some friends and I were talking at a restaurant. We talked and talked and soon swimming became the ___1____. Suddenly I hit upon an idea. “Wouldn’t it be ___2___ if we went swimming? Others went swimming in winter, and __3___ couldn’t we? Besides, we could be ___4__ if we did. ” I told them about this and they all said it was a good idea indeed.
Early in the morning, three days __5____, we four were standing at the bus stop, with bags in our hands, ___6___ for a bus to take us to the __7___. The sky was clear, the sun was shining, but all the same, it was very cold, __8___ our heavy overcoats were not enough to keep us ___9__. We all felt that we should go back, but no one wanted to __10___.
We soon reached the sands. There was nobody there, but we were not to be discouraged. __11___ we were proud that we were the __12___ ones that dared to challenge the weather. Besides, the sun could keep us warm. So we __13__ ourselves quickly.
But things were not going to be so nice as we thought. The sea wind was blowing, we felt __14___ cold and we shook from head to feet. At last we decided to ____15__ the sea water. We put our feet in first, only to take them back___16___. The water was unbelievably cold. ___17___ I suggested that we should all jump in at the same time. We all went back ten steps. I gave the order and we all rushed forward. We jumped. That feeling I had when I was in the water I shall never ___18___. I was up and rushed again to the seaside. So __19___ my friends. We put on our clothes as quickly as possible and went home.
We four did not go to school the next three days, for we all __20__ a bad cold. We missed the lessons, but we had this unforgettable experience.
小题1:
A.objectB.topicC.opinionD.center
小题2:
A.interestingB.luckyC.happy D.surprising
小题3:
A.whatB.howC.thatD.why
小题4:
A.worseB.illC.strongerD.better
小题5:
A.laterB.pastC.since D.before
小题6:
A.askingB.meetingC.waitingD.looking
小题7:
A.swimming poolB.sandsC.lakeD.river
小题8:
A.onlyB.thoughC.evenD.since
小题9:
A.coldB.warmC.hotD.cool
小题10:
A.speak outB.talk aboutC.shout atD.think over
小题11:
A.ForB.InsteadC.SometimesD.Unless
小题12:
A.onlyB.luckyC.youngerD.happy
小题13:
A.helpedB.enjoyedC.dressedD.changed
小题14:
A.suchB.a littleC.veryD.a bit
小题15:
A.go downB.go intoC.jump intoD.take off
小题16:
A.carefullyB.quicklyC.bravelyD.finally
小题17:
A.LastB.NextC.WhenD.Then
小题18:
A.rememberB.forgetC.believeD.tell
小题19:
A.didB.doC.wereD.had
小题20:
A.becameB.feltC.turnedD.caught
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