女，60岁，慢性咳喘20年，剧烈咳嗽3天，无咳痰、咯血及发热，半小时前突发胸痛，呼吸困难，不能平卧，伴发绀。体检：血压150/100mmHg，呼吸40次1分。右胸语颤减弱，呼吸音减低。心率110次／分。以上表现符合（）
A.肺梗死
B.急性心肌梗死
C.急性左心衰竭
D.阻塞性肺气肿
E.自发性气胸
参考答案：E
解析：患者有突然加重的呼吸困难，并伴有明显的发绀，患侧肺部听诊呼吸音减弱，并伴有发绀，应考虑自发性气胸。COPD患者的呼吸困难多呈长期缓慢性进行性加重。急性心肌梗死的患者常有高血压／冠状动脉粥样硬化性心脏病史。
Woodland International Summer School Our International Summer School has been designed to provide a complete British experience. Here pupils not only learn English but come face-to-face with history in some of Europe’s oldest cultural centres. They can also enjoy exciting activities. About the 2013 Course This course is designed for boys and girls from 10-16 years and provides a wonderful chance to experience life in a traditional British boarding(寄宿) school. English Lessons Our programme provides 24 hours of English teaching each week. Students study grammar, writing, speaking, listening, reading, and comprehension. They can practice their new skills while interviewing visitors and local people in the town of Woodland and villages around. Excursions(远足) & Entertainment Each week includes cultural and activity trips. In 2013 our excursion will be to: 12th July—Manchester 19th July—York 26th July—Edinburgh 2nd August—Liverpool Dates & Price
Woodland School, Cumbria, LA10 5HG， UK TEL: (+44)1-539-622-613(overseas) or 01539622613 (UK) EMAIL: enquiries@woodlandsummerschool. Org 小题1:The main purpose of the summer school is to help the students _____________.
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