问题 单项选择题 A3/A4型题

患者男,40岁。餐后出现上腹部剧痛伴畏寒、发热、频繁呕吐30小时入院。查体:T39℃,P120次/分,R28次/分,BP80/50mmHg,体重60kg。急性痛苦面容,被迫体位,烦躁不安,表情淡漠,皮肤、巩膜轻度黄染,眼眶凹陷,唇干,四肢较冷,口唇有轻度发绀。腹胀,腹式呼吸存在,右中上及下腹部肌紧张,压痛、反跳痛明显,以右上腹为甚,Murphy征(+),肠鸣音弱。实验室检查:RBC2.42×1012/L,Hb71g/L,WBC13.8×109/L,N86%,尿常规:BUG(++),BIL(+)。肝功能检查:TBIL74μmol/L,DBIL54μmol/L,IBIL20μmol/L,ALT61U/L。血清淀粉酶:148U。血生化检查:血K+3.07mmo/L,Na+130mmol/L,TCO229mmol/L,BUN7.9mmol/L。

患者在治疗过程中,最重要的措施是()

A.纠正水钠代谢失调,采取先盐后糖,糖盐交替,必要时补充胶体液

B.必须根据临床表现、尿量等调整补液量、速度和种类

C.避免输液过多、过快

D.每日复查电解质和动脉血气分析,及时调整治疗

E.积极治疗原发病

答案

参考答案:E

选择题
完形填空

PART FOUR WRITING
Section A (10分)
Directions: Read the following passage. Complete the diagram by using the information for the passage.  Write NO MORE THAN THREE WORDS for each answer.
Losing weight is difficult, and keeping it off may be even harder. So Harvard researchers set out to determine exactly how much physical activity women need in midlife to avoid gaining weight as they age.
The researchers found that an hour of moderate activity a day — including such recreational activities as brisk walking, leisurely bicycling, ballroom dancing and playing with children — prevented women of normal weight from gaining more than five pounds over any three-year period. Half that amount of vigorous activity, like running, jogging or fast biking, will do the trick as well, they said.
Women who got the same amount of exercise but were heavier to start with were not able to avoid gaining weight, however. Neither were women of normal weight who got less than seven hours a week of moderate activity, according to the study, published in the March 24 issue of The Journal of the American Medical Association.
The average weight gain over the course of the 15-year study, which followed 34,079 healthy women with an average age of 54 at the beginning, was just over five pounds. The researchers did not take diet into account.
“It’s so hard to lose weight and maintain the loss, so whatever weight you are, you should try to stay that weight — that is a success,” said the paper’s lead author, Dr. I-Min Lee, an associate professor of epidemiology at Harvard School of Public Health.
But any amount of exercise is beneficial, she emphasized. “People shouldn’t just throw up their hands and say, ‘Sixty minutes? I can’t do that,’ and give up. Health is more than weight.”
Title: A research on how to     71   
    72   
To determine how much physical activity women need in midlife to avoid gaining weight as they age
    73    
Research objects
    74    
Types of exercise
Weight gain
Women
75  
An hour of moderate activity a day
● Brisk walking
● Leisurely bicycling
●     76   
● Playing with children
    77   five pounds over a three-year period
Half an hour of
vigorous activity a day
● Running
● Jogging
●     78   
Less than
79   a week of moderate activity
 
Not being avoided
Heavier women
The same as the above
Suggestions
● Staying your weight
●     80