问题 单项选择题

患者,男,52岁,发现左颈部包块3个月伴声音嘶哑,饮水反呛,无痛,不发热,无明显头痛、耳鸣、记忆力下降等不适。检查见左颈部,胸锁乳突肌前缘上份包块,直径约3.0cm,可活动,但活动度差,无触痛。听诊可闻及收缩期杂音及感到与脉搏一致的膨胀性搏动,压迫颈总动脉近端后,搏动及杂音减弱。追问病史,曾于半年前车祸中伤及颈部,但只是挫伤,局部未经特殊治疗而愈。本例最可能的诊断是()

A.颈动脉体瘤

B.颈静脉球体瘤

C.颈夹层动脉瘤

D.颈真性动脉瘤

E.颈假性动脉瘤

答案

参考答案:E

解析:颈动脉瘤由各种原因导致颈动脉壁变薄,在血流压力作用下膨大、扩张而形成动脉瘤。并分为真性动脉瘤、假性动脉瘤及夹层动脉瘤3类。其中,真性动脉瘤多由动脉硬化引起,假性动脉瘤多由创伤引起。颈动脉瘤的临床表现主要为颈部包块,若是颈内动脉或颈总动脉瘤,则可发生脑供血不足的一系列症状,轻者头痛、头昏,重者偏瘫。压迫神经可出现相应症状。于肿瘤表面可闻及血管杂音并能感到与脉搏一至的搏动,阻断近端血管其杂音和搏动都减轻。本例有明确外伤史,包块有杂音及搏动,阻断近端血管体征减轻皆提示诊断,其声音嘶哑及饮水呛咳为瘤体压迫迷走神经所致。

判断题
单项选择题

Comparisons were drawn between the development of television in the 20th century and the diffusion of printing in the 15th and 16th centuries. Yet much had happened between. As was discussed before, it was not until the 19th century that the newspaper became the dominant pre- electronic (61) , following in the wake of the pamphlet and the book and in the (62) of the periodical. It was during the same time that the communications revolution (63) UP, beginning with transport, the railway, and leading on through the telegraph, the telephone, radio, and motion pictures into the 20th-century world of the motor car and the air plane. Not everyone sees that process in (64) . It is important to do so.

It is generally recognized, (65) , that the introduction of the computer in the early 20th century, (66) by the invention of the integrated circuit during the 1960s, radically changed the process, although its impact on the media was not immediately (67) . As time went by, computers became smaller and more powerful, and they became "personal" too, as well as (68) , with display becoming sharper and storage (69) increasing. They were thought of, like people, (70) generations, with the distance between generations much (71) .

It was within the computer age that the term "information society" began to be widely used to describe the (72) within which we now live. The communications revolution has (73) both work and leisure and how we think and feel both about place and time, but there have been (74) view about its economic, political, social and cultural implications. "Benefits" have been weighed (75) "harmful" outcomes. And generalizations have proved difficult.

(71)是()

A.deeper

B.fewer

C.nearer

D.smaller