老年男性，因咳嗽，咳黄痰3天就诊，查体发现主动脉瓣区粗糙的收

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问题单项选择题

老年男性，因咳嗽，咳黄痰3天就诊，查体发现主动脉瓣区粗糙的收缩期杂音。超声心动图示主动脉瓣狭窄，左室射血分数0.55，心电图检查正常。请问对该患者哪一项处置方法不恰当（）

A.抗生素

B.化痰药物

C.血管紧张素转换酶抑制剂

D.定期做超声心动图

E.胸部X线检查

答案

参考答案：C

解析：主动脉瓣狭窄内科治疗仅限于并发症和对症治疗，但需定期复查，如超声心动图，平均动脉压=心排血量×外周阻力。ACEI扩张动脉，可降低外周阻力。而主动脉瓣狭窄患者心排血量低，如应用ACEI类，会导致血压下降，可致致命性低血压，所以主动脉瓣狭窄患者禁用血管扩张剂，特别是血管紧张素转化酶抑制剂治疗。患者咳嗽、咳黄痰故应做胸部X线检查以明确是否存在肺部感染，对症予抗菌素、化痰药物是非常必要的

单项选择题

肺爆震伤属胸部()

A．减速伤

B．加速伤

C．枪弹伤

D．闭合性损伤

E．开放性损伤

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完形填空

完形填空。
Every summer, hundreds of thousands of students travel to other countries looking for work and adventure. Most of the opportunities are in 1 work. The pay is usually poor, but most people work 2 for the thrill of travel. You can pick grapes in France, entertain kids on American summer camps, and, of course, there are always 3 in hotels and restaurants. But it is not as easy as it used to be to find work. Unless you speak the language of the country well, there will be very 4 openings. For example, when you arrive to wash dishes in a restaurant in Paris, the owner will 5 you to speak French. British students only have a language 6 for jobs in the USA and Australia. Not every one 7 the experience. Sarah James was once responsible for forty American children in Europe. During the 8 , one child lost his passport; four children were lost in Madrid for a whole day; the whole group was thrown out of one hotel because of the 9 they made. Sarah says, "It really was a 24-hour-a-day job since the kids never 10 ! And the pay was awful. It wasn't worth it." The trouble is that 11 expect to have an easy time of it. After all, they see it as a 12 . In practice, though, they have to work hard. At the same time, all vacation work is casual work, and jobs are 13 only when the hotel, the restaurant, or the campsite is busy. But students have few employment 14 . As soon as the holiday season finishes, companies will get rid of them. And if their employer doesn't like them, they'll be 15 , too.
( )1. A. seasonal ( )2. A. hard ( )3. A. customers ( )4. A. good ( )5. A. teach ( )6. A. program ( )7. A. has ( )8. A. trip ( )9. A. promise ( )10. A. cried ( )11. A. children ( )12. A. job ( )13. A. countless ( )14. A. experiences ( )15. A. dismissed	B. mental B. voluntarily B. visitors B. new B. expect B. lesson B. enjoys B. flight B. progress B. studied B. students B. lesson B. available B. rules B. charged	C. professional C. abroad C. jobs C. attractive C. allow C. advantage C. forgets C. discussion C. complaint C. slept C. employers C. holiday C. interesting C. plans C. fined	D. formal D. continuously D. parties D. few D. forbid D. exam D. remembers D. ceremony D. noise D. helped D. parents D. shame D. boring D. rights D. punished

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