男，68岁。间断全程无痛性肉眼血尿半年，无其他不适。查体：双侧肾区未及肿物，无叩击痛，右侧阴囊可触及蚯蚓状团块，平卧后不消失。下列哪项检查最有助于明确诊断（）。
A.静脉肾盂造影
B.B超检查
C.膀胱镜检查
D.阴囊多普勒超声
E.腹部X线平片
参考答案：B
解析：老年男性间断全程无痛性肉眼血尿半年，此症状是泌尿系肿瘤的特点。泌尿系肿瘤最常见的是膀胱癌，且肾癌、肾盂癌、输尿管癌也都有可能。结合右侧精索静脉曲张，且平卧后不消失提示腹膜后有肿瘤压迫精索静脉。血尿+后腹膜肿瘤的特点，首先考虑肾癌的可能性最大，故选择B超检查最为恰当。如果怀疑肾盂和输尿管肿瘤应首选静脉肾盂造影；怀疑膀胱癌就应首选膀胱镜检查。
| 阅读理解。 |
| Fred liked playing tricks on others. One afternoon he went to a shop and bought some bread. On his way home he saw Johnson, an old man about sixty riding a donkey (驴). The boy walked to the old man and decided to play a trick on him. He thought for a moment and then he had an idea. "Hello, my friend," Fred said in a loud voice. "Please come and have a piece of bread." "Thank you very much." Johnson got off the donkey and said gladly." "But I have already had lunch." "I'm sorry. I'm talking to your donkey, not to you." Fred said with a smile. Johnson understood at once that the boy was playing a trick on him. He became angry, but he didn't show his anger. He just turned quickly to his donkey, held up the lash (鞭子) and hit it on the back. "Before we set off, I asked if you had friends in the town. You said again and again that you hadn't. Can you explain why the young man asked you to have the bread, then?" The more the old man said, the less he could control his anger. He finally shouted, "I'll beat you to death if you dare fool me again!" Hearing this, Fred's face turned red and he left away quickly. |
| 1. Fred ______. |
[ ] |
| A. was clever but not polite. B. liked playing with donkeys C. often help others D. wasn't clever |
| 2. Johnson ______ at first. |
[ ] |
| A. beat his donkey to death B. was angry to meet the boy C. wanted to eat the bread D. thought the boy was talking to him |
| 3. Which of the following is true? |
[ ] |
| A. The old man didn't beat the donkey. B. The old man taught Fred how to be polite. C. The old man beat the donkey to death. D. The man played a trick back on the boy. |