问题 单项选择题 A1/A2型题

有关溃疡病穿孔腹膜炎的早期临床表现,错误的是()

A.腹部有压痛

B.呕吐

C.腹肌紧张

D.肠鸣音消失

E.发热

答案

参考答案:E

解析:溃疡病穿孔根据其临床表现可分为急性、亚急性和慢性3种。穿孔的类型主要取决于溃疡的部位,其次决定于溃疡发展的进程与周围组织器官。十二指肠溃疡发生率高于胃溃疡。溃疡病穿孔在发生穿孔的初期,患者面色苍白,四肢发凉,出冷汗,脉搏快而弱,血压下降,体温不升,呼吸短促。约1~4h以后,患者觉四肢温暖,面色恢复常态,脉搏有力,血压回升,体温可略高于正常。此时如不来就诊常延误诊断。一般穿孔12h以后,多转变成细菌性腹膜炎,全身软弱,白干、恶心、呕吐,由于刺激横膈而引起呃逆、体温升高、心悸气短、尿量减少,血压开始下降,病情不断恶化,以至发展到真正休克。通常肠鸣音完全消失,若腹膜炎不十分广泛,还可能有节段肠蠕动,则仍能听到少量肠鸣音,或低调气过水声。故答案应选E。

阅读理解

   The old man walked with a cane(拐杖) slowly into the restaurant. His poor jacket, patched (打补丁的) trousers, and worn-out shoes made him stand out from the usual Saturday morning breakfast crowd. Unforgettable were his pale blue eyes that were bright like diamonds, large rosy cheeks, and thin lips held in a smile.

He walked toward a table by the window. A young waitress watched him and ran over to him, saying, “Here, Sir. Let me give you a hand with that chair.”

Without a word, he smiled and nodded a thank you. She pulled the chair away from the table. Steadying(稳住) him with one arm, she helped him move in front of the chair, and get comfortably seated. Then she pushed the table up close to him, and leaned his cane against the table where he could reach it.

In a soft, clear voice he said, “Thank you, Miss.”

“You are welcome, Sir.” She replied. “My name is Mary. I’ll be back in a moment. If you need anything, just wave at me!”

After he had finished a hearty meal of pancakes, bacon, and hot lemon tea, Mary brought him the change, helping him up from his chair and out from behind the table. She handed him his cane, and walked with him to the front door. Holding the door open for him, she said, “Come back and see us, Sir!”

He nodded a thank you and said softly with a smile, “You are very kind!”

When Mary went to clean his table, she was surprised. Under his plate she found a business card and a note written on the napkin, under which was a $100 bill.

The note on the napkin read, “Dear Mary, I respect you very much, and you respect yourself, too. It shows by the way you treat others. You have found the secret of happiness. Your kind gestures will shine through those who meet you.”

The man she had served was the owner of the restaurant. This was the first time that she, or any of his employees, had seen him in person(亲自).

71. The relationship between the old man and Mary was ______. 

A. father and daughter                B. employer and employee

C. waiter and customer                         D. uncle and nephew

72. Based on the passage, all of the following words can be used to describe Mary except _____.

A. kind       B. considerate       C. helpful       D. calm

73. Mary ran over to the old man because _______.

A. the old man was the boss of the restaurant

B. she saw the old man had some difficulty moving and taking a seat

C. she was worried that the old man might cause trouble to the restaurant

D. the old man had asked her to wait on him

74. The man came to the restaurant _______.

A. to have breakfast

B. to see his employees

C. to find out how his restaurant was working

D. to see how Mary served customers

75. The words the man left on the napkin indicated that _______.

A. respecting others means respecting oneself

B. serving others is a respectable job

C. Mary would get a rise as a result of her kindness

D. Mary’s kind service would bring in more money for her

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