女，40岁，发现颈部肿大6年，近半年来常感心悸，多汗，食量加大，检查：无突眼、甲状腺Ⅱ。肿大、结节状，脉搏116次／分，心、肺、腹无异常发现，其诊断可能是（）
A.结节性甲状腺肿
B.原发性甲状腺功能亢进
C.继发性甲状腺功能亢进
D.高功能甲状腺腺瘤
E.甲状腺腺癌
参考答案：C
解析：原发性甲状腺功能亢进：20～40岁多发甲状腺肿大与甲亢同时出现；继发性甲状腺功能亢进：40岁以上多见，先有甲状腺肿大，多年后甲亢；高功能甲状腺腺瘤：单发结节或囊肿；甲状腺腺癌少见。患者先发现甲状腺肿大，多年后出现甲亢症状，因此考虑为继发性甲亢，结合查体无突眼、甲状腺Ⅱ。肿大、结节状，双侧不对称。因此选C。
| Mankind’s fascination with gold is as old as civilization itself. The ancient Egyptians esteemed gold, which had religious significance to them, and King Tutankhamen was buried in a solid-gold coffin 3300 years ago. People have always longed to possess gold. Unfortunately, this longing has also brought out the worst in the human character. The Spanish conquistadores robbed palaces, temples and graves, and killed thousands of Indians in their ruthless search for gold. Often the only rule in young California during the days of the gold rush was exercised by the mob with a rope. Even today, the economic running of South Africa’s gold mines depends largely on the employment of black labourens who are paid about 40 a month, plus room and board, and who must work in conditions that can only be described as cruel. About 400 miners are killed in mine accidents in South Africa each year, or one for every two tons of gold produced. Much of gold’s value lies in its scarcity. Only about 80,000 tons have been mined in the history of the world. All of it could be stored in a vault 60 feet square, or a supertanker. Great Britain was the first country to adopt the gold standard, when the Master of Mint, Sir Isaac Newton, established a fixed price for gold in 1717. But until the big discoveries of gold in the last half of the nineteenth century — starting in California in 1848 and later in Australia and South Africa — there simply wasn’t enough gold around for all the trading nations to link their currencies to the precious metal. An out-of-work prospector named George Harrison launched South Africa into the gold age in 1886 when he discovered the metal on a farm near what is now Johannesburg. Harrison was given a 12 reward by the farmer. He then disappeared and reportedly was eaten by a lion. Historically, the desire to hoard gold at home has been primarily an occupation of the working and peasant classes, who have no faith in paper money. George Bernard Shaw defended their instincts eloquently: "You have to choose between trusting to the natural stability of gold and the natural stability of the honesty and intelligence of the members of the government", he said, "and with due respect to these gentlemen, I advise you to vote for gold." |
George Bernard Shaw thought that ______ .
A．( the members of the government were honest and intelligent
B．( the value of gold was likely to change unexpectedly
C．( gold was more valuable than paper money
D．( one could place more faith in gold than in politicians