问题 单项选择题

患者,男,20岁。因车祸致耻骨骨折,3小时后发现下腹胀,排尿困难。应首先考虑的是

A.膀胱破裂

B. * * 球部损伤

C.肾损伤

D. * * 海绵体部损伤

E. * * 膜部损伤

答案

参考答案:E

解析:[考点评析] 1.烧伤的辨证论治:内治:①火毒伤津证:壮热烦躁,口干喜饮,便秘尿赤;苔黄或黄燥,或舌光无苔,脉洪数或弦细数。治法:清热解毒,益气养阴。方用黄连解毒汤、银花甘草汤、犀角地黄汤或清营汤加减。②阴伤阳脱证:神疲倦卧,面色苍白,呼吸气微,表情淡漠,嗜睡,自汗肢冷,体温不升反低,尿少;全身或局部水肿,创面大量液体渗出;舌淡暗苔灰黑,或舌淡嫩无苔,脉微欲绝或虚大无力。治法:回阳救逆,益气护阴。四逆汤、参附汤合生脉散加味。③火毒内陷证:壮热不退,口干唇燥,躁动不安,大便秘结,小便短赤;舌红绛而干,苔黄或黄糙,或焦于长刺,脉弦数等。若热入营血,火毒传心,可见烦躁不安,神昏谵语等。治法:清热凉血解毒,方用清营汤或黄连解毒汤合犀角地黄汤加减。④气血两虚证:疾病后期,火毒渐退,低热或不发热,精神疲倦,气短懒言,形体消瘦,面色无华,食欲不振,自汗,盗汗;创面肉芽色淡,愈合迟缓;舌淡,苔薄白舌薄黄,脉细弱。治法:益气养血兼清余毒。方用托里消毒散或八珍汤加金银花、黄芪。⑤脾虚阴伤证:疾病后期,火毒已退,脾胃虚弱,阴津耗损。面色萎黄,纳呆食少,腹胀便溏,口干少津,口舌生糜;舌黯红而干,苔花剥或光滑无苔,脉细数。治法:补气健脾,益胃养阴。方用益胃汤合参苓白术散加减。 2.损伤的临床表现:局部表现:疼痛、肿胀或瘀斑、功能活动受限、组织损伤。全身表现:损伤性休克,肾功能变化:常发生在肌肉较丰富的部位,受到严重挤压伤后。由于大量肌肉严重受压时间较长,致使损伤的肌肉释放出大量肌红蛋白,肌红蛋白在肾小球过滤后,在酸性尿液中沉淀而凝结,堵塞肾小球,临床出现尿少或无尿、酸中毒、高钾血症及尿毒症或急性肾功能不全的症状。以上表现统称为挤压综合征。其他表现:损伤后经常出现发热,一般在38℃左右,如体温更高,常提示可能存在继发感染。根据不同程度的损伤可出现脱水、胃纳不佳、腹胀、肺活量减少及呼吸加快,支气管内分泌物增加及全身乏力等临床表现。

完形填空

(Miss Yu is giving a class. Suddenly some bottles drop out of a student’s desk.)
T: What’s the noise there?.
S: Sorry, Miss Yu. 1                                   
T: (Walking over to take a look) Oh, so many bottles.
S: I’m collecting bottles.
T:2.                                  
S: Because I want to make toys out of them.
T:3                           If so, why not put a big paper box at the back of our classroom? Then your classmate can help collect the bottles.
S: Thanks for your advice.
T:4                            
S: Yes, quite a few.
T:5.                                           
S: Of course, I’ll bring a few here tomorrow.
T: Perfect!
That’s an interesting idea.          We can’t wait to see the toys you’ve made.
Some bottles dropped onto the floor.  Can you show some to us one day?
Could you help us make some toys?  Have you already made some toys?
Why do you collect bottles?
B) 根据下面对话中的情境,在每个空白处填入一个适当的语句,使对话恢复完整。
A: Hi, Bob! How was your last weekend?
B:6.                                        I really had a good time.
A:7.                                            
B: I played basketball.
A:8                                   
B: Twice a week. I like it very much. How did you spend your last weekend?
A: 9.                                    
B: Sounds interesting. Do you often go to the mountains?
A: Yes. Once a week. 10                                                    
B: I’d love to. But I’m afraid I can’t go with you this weekend. Maybe next week is OK.
单项选择题