患者，男，76岁。因“COPD、慢性肺源性心脏病”住院治疗。查体：颈静脉怒张，双肺散在干湿性啰音，双下肢水肿。鼻导管吸氧2L/min，血气分析示：pH7.23，PaCO276mmHg，PaO256mmHg，血生化示：K+5.9mmol/L，Na+138mmol/L，Cl-98mmol/L。该患者应首选的治疗药物是（）
A.氢氯噻嗪
B.螺内酯
C.氨苯蝶啶
D.5%碳酸氢钠
E.呋塞米
参考答案：E
解析：
患者颈静脉怒张，双肺干湿啰音，双下肢水肿，考虑右心功能不全，且患者血钾升高，应给予速效排钾利尿剂呋塞米。螺内酯和氨苯蝶啶为保钾利尿剂，氢氯噻嗪为中效利尿剂。患者PaCO大于50mmHg，pH低为呼吸性酸中毒，碳酸氢钠在体内分解为水和二氧化碳，二氧化碳须经肺排除，增加该患者二氧化碳潴留，故不予应用。
A little girl was given so many picture books on her seventh birthday that her father. Who should have run his office and let her mother run the home, thought his daughter should give one or two of her new books to a little neighbor boy named Robert, who had visited their home sometimes. Now, taking books, or anything else, from a little girl is like taking sweets from a baby, but the father of the little girl had his way and Robert got a couple of her books. “After all, that leaves you with nine,” said the father, who thought he was a child psychologist（心理学家）,and couldn’t shout his big stupid mouth on the subject. A few weeks later, the father went to his library to look up “father” in The Oxford English Dictionary, eager to enjoy the praise of fatherhood through the centuries, but he couldn’t find volume（册）F-G and then he discovered that others were missing too. A-B,L-M, V-Z. He looked everywhere for them, and learned what had happened to the four missing volumes. “A man came to the door this morning” said the little daughter, “and he didn’t know how to get from here to Torrington or from Torrington to Wintec, and he was a kind man, much nicer than Robert, and so I gave him four of your books After all, there are thirteen volumes in the Oxford English Dictionary, and that leaves you with nine. 小题1:According to the writer’s opinion,
A. the father went out to work in his office B. the father decided to the girl a lesson C. the father still did what he wanted to. 小题3:Considering himself a psychologist, the father A. couldn’t stop discussing the subject B. couldn’t helping（禁不住）talking about the subject B. couldn’t refuse to listen to the subject D. couldn’t give an explanation of he subject 小题4:What’s still unclear to us in the story?
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