问题 单项选择题 A3/A4型题

患者男,42岁。呕吐、腹泻两天,意识模糊、烦躁不安半天急诊入院。查体:BP110/70mmHg,神志恍惚,巩膜中度黄染,颈部可见数枚蜘蛛痣,心肺未见异常,腹软,肝肋下未触及,脾肋下3cm,双上肢散在出血点。Hb90g/L,WBC3.2×10/L,血糖13.0mmol/L,尿糖(+),尿酮(-),尿镜检(-)。

最可能的诊断是()

A.肝性脑病

B.糖尿病酮症酸中毒

C.高渗性非酮症糖尿病昏迷

D.尿毒症

E.脑血管病

答案

参考答案:A

解析:根据题中描述,该患者为肝硬化后肝性脑病。故选A。糖尿病酮症酸中毒时血糖和酮体均高,故不选B。高渗性非酮症糖尿病昏迷时血糖应高,故不选C。尿毒症和脑血管病均不能诊断,故不选D、E。

填空题
单项选择题

Writing about music is like dancing about architecture, or so the saying goes. Sometimes attributed to Frank Zappa, other times to Elvis Costello, this quote is usually intended to convey the futility of such an endeavor, if not the complete silliness of even attempting it. But Glenn Kurtz’s graceful memoir, Practicing: A Musician’s Return to Music, turns the expression on its head, giving it a different meaning by creating a lovely, unique book.
Kurtz picked up the guitar as a kid in a music-loving family, attended the Long Island music school, and went on to play on Merv Griffin’s TV show before graduating from Tufts University. Motivating the young Kurtz was the dream of reinventing classical guitar, as if by his great ambition alone he could push it from the margins of popular interest to center stage-something not even accomplished by the late Spanish guitarist Andres Segovia, perhaps the only artist of the form ever to reach anything resembling widespread celebrity.
This book reads like a love story of sorts: Boy meets guitar. Boy loves guitar. Guitar breaks boy’s heart or, more precisely, the ordinariness of a working musician’s life does so. "I’d just imagined the artist’s life naively, childishly, with too much longing, too much poetry and innocence and purity," Kurtz writes. "The guitar had been the instrument of my dreams. Now the dream was over. "
Boy leaves guitar. Were the story to end here, this book would be a tragedy, but after nearly a decade the boy returns to guitar, and although he has lost the enthusiasm he had in his youth, he finds his love of the guitar again in a way he never could have appreciated before.
Although Kurtz is writing about a unique musical path, his journey speaks eloquently to the heart of anyone who has ever desperately yearned to achieve something and felt the sting of disappointment. "Everyone who gives up a serious childhood dream—of becoming an artist, a doctor, an engineer, an athlete—lives the rest of their life with a sense of loss, with nagging what it is," he writes. "Is that time and effort, that talent and ambition, truly wasted \

The word "convey" underlined in Paragraph 1 is closest in meaning to ______.

A.transmit

B.imply

C.hint

D.unsafe