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试述先天性肥厚性幽门狭窄的临床表现。

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参考答案:

先天性肥厚性幽门狭窄的临床表现:

①呕吐为主要症状,多在出生后3~4周内开始,特点为进行性加重,最初病儿仅有溢奶,很快几乎每次喂奶后15~30分钟均将发生呕吐,不伴恶心,呈喷射状,呕吐物为带凝块的奶汁,白色而不含胆汁,其量有时可多于一次的喂奶量,少数病例有带凝血的咖啡色呕吐物。病儿有很强的饥饿感,呕吐后有觅食反射,如再喂奶,仍能用力吸吮。

②腹部检查可见上腹部膨胀,并有起自左肋下向右上腹移行的胃蠕动波,在喂奶10分钟后最容易观察到这个体征。本病的特征是右上腹触摸到幽门肥厚形成的橄榄样肿块,在病儿熟睡或在呕吐后胃空虚时较易触及。

③尿少、便秘、消瘦,体重非但不增,且逐渐下降,时间越久,消瘦越严重。呕吐可引起碱中毒,呼吸变浅而慢,碱中毒可使血中游离钙下降,表现有喉痉挛和手足抽搐,晚期脱水严重,肾功能受损,酸性代谢产物潴留,可形成代谢性酸中毒,碱中毒症状不明显。

阅读理解

D

Have you ever thought about what determines the way we are when we grow up? Remember the TV program Seven Up? It started following the lives of a group of children in 1973. We first meet them as wide-eyed seven-year-olds and catch up with them at seven-year intervals: nervous 14-year-olds, serious 21-year-olds and then grown-ups.

Some of the stories are inspiring, others sad, but what is interesting in almost all the cases is the way in which the children’s early hopes and dreams are shown in their future lives. For example, at seven, Tony is a lively child who says he wants to become a sportsman or a taxi driver. When he grows up, he goes on to do both. How about Niki? She says, “I would like to find out about the moon.” And she goes on to become a space scientist. As a child, soft-spoken Bruce says he wants to help “poor children” and ends up teaching in India.

But if the lives of all the children had followed this pattern, the program would be far less interesting than it actually was. It was the children whose childhood did not prepare them for what was to come that made the program so interesting. Where did their ideas come from about what they wanted to do when they grew up? Are children influenced by what their parents do, by what they see on television or by what their teachers say? How great is the effect of a single important event? Many film directors, including Steven Spielberg, say that an early visit to the cinema was the turning point in their lives. Dr. Margaret McAllister, who has done a lot of research in this area, thinks that the major factors are parents, friends and their wider society.

68. What does the text mainly discuss?

A. New ways to make a TV program interesting.

B. The importance of TV programs to children.

C. Different ways to make childhood dreams come true.

D. The influence of childhood experience on future lives.

69. What does the underlined word “influenced” mean in the last paragraph?

A. Impressed.     B. Improved.        C. Affected.          D. Attracted.

70. What are the examples in Paragraph 2 meant to show?

A. Many people’s childhood hopes are related to their future jobs.

B. There are many poor children in India who need help.

C. Children have different dreams about their future.

D. A lot of people are very sad in their childhood.

71. Spielberg’s story is meant to show that _______.

A. going to a movie at an early age helps a child learn about society

B. a single childhood event may decide what one does as a grown-up

C. parents and friends can help a child grow up properly

D. films have more influence on a child than teachers do

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