问题 单项选择题

患者女性,60岁,有喘息性支气管炎病史20余年,近2年有下肢水肿。5天前受凉,咳嗽加重,彻夜不眠,意识模糊伴躁动不安。尿常规检查正常。血气分析显示:pH7.14,PaO248mmHg,PaCO285mmHg,HCO3-30mmol/L。符合()。

A.原发性代谢性酸中毒,失代偿

B.原发性呼吸性酸中毒,代谢性酸中毒,失代偿

C.原发性呼吸性酸中毒+原发性代谢性酸中毒

D.原发性呼吸性酸中毒+原发性代谢性碱中毒

E.原发性代谢性酸中毒,代偿

答案

参考答案:B

解析:根据患者的既往史、现病史和血气分析结果,患者的诊断是COPD、肺源性心脏病、呼吸衰竭、肺性脑病。血气分析:呼吸性酸中毒是原发的,HCO3-应代偿至42mmol/L,而实际HCO3-30mmol/L,说明合并代谢性酸中毒。因pH<7.35,诊断为原发性呼吸性酸中毒,合并代谢性酸中毒,失代偿。

多项选择题
完形填空

第二节完形填空 (共15小题; 每小题1分, 满分15分)

阅读下面短文,掌握其大意,然后从41-55各题所给的A,B,C,D四个选项中,选出最佳选项。

Playing organized sports is such a common experience in the United States that many children and teenagers take them for granted. This is especially true __41__ children from families and communities that have the resources needed to organize and sponsor sports programs and make sure that there is easy __42__ to participation opportunities. Children in low-income families and poor communities are __43__ likely to take organized sports for granted because they often __44__ the resources needed to pay for participation __45__, equipment, and transportation to practices and games __46__ their communities do not have resources to build and maintain facilities.

Organized youth sports __47__ appeared during the early 20th century in the United States and other wealthy nations. They were originally developed __48__ some educators and experts __49__ that the behavior and character of children were __50___ influenced by their social surroundings and everyday experiences. This __51__ many people to believe that if you could organize the experiences of children in __52__ ways, you could influence the kinds of adults that those children would become.

This belief that the social environment influenced a person’s overall development was very __53__ to people interested in reforms at the beginning of the 20th century. It caused them to think about __54__ they might control the experiences of children to __55__ responsible and productive adults.

41. A. among         B. within              C. on             D. towards

42. A. entrance              B. access           C. chance          D. route

43. A. higher         B. less                   C. more          D. fewer

44. A. shrink          B. tighten                 C. limit          D. lack

45. A. bill                     B. accounts            C. fees           D. fare

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

47. A. last                     B. later                  C. first           D. finally

48. A. before         B. while                C. until          D. when

49. A. realized              B. recalled             C. expected     D. distributed

50. A. specifically  B. largely             C. strongly     D. exactly

51. A. moved         B. led          C. put            D. convinced

52. A. precise         B. precious            C. particular   D. clear

53. A. encouraging B. disappointing    C. upsetting  D. surprising

54. A. what            B. how                  C. whatever    D. whom

55. A. produce              B. provide             C. grow          D. become