男，47岁，颈部肿物5年，近3个月来感心悸，多汗，食量加大，检查：无突眼、甲状腺Ⅱ度肿大、结节状，脉搏116次／分，心、肺、腹无异常发现，根据临床表现考虑是（）
A.甲状腺腺癌
B.原发性甲状腺功能亢进
C.继发性甲状腺功能亢进
D.高功能甲状腺腺瘤
E.结节性甲状腺肿
参考答案：C
解析：原发性甲状腺功能亢进：20-40岁多发，甲状腺肿大与甲亢同时出现；继发性甲状腺功能亢进：40岁以上多见，先有甲状腺肿大，多年后甲亢；高功能甲状腺腺瘤：单发结节或囊肿；甲状腺腺癌少见。患者先发现甲状腺肿大，多年后出现甲亢症状，因此考虑为继发性甲亢，结合查体无突眼、甲状腺Ⅱ度肿大、结节状。因此选C。
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| On the first day of my school life in the USA, I showed a great interest in my marketing class. My teacher, Mrs. King, suggested I 1 a national marketing club called DECA 2 many students with talent and interest in business. 3 I did. The first 4 was to raise money for marketing activities and competitions later in the year by selling Gold Canyon Candles. Mrs. King said the money was 5 in a week and that 40 percent of the income would go into my personal account. At first I tried to sell some candles to my host mom. She said that if I could show 6 and do a wonderful sales presentation, she would 7 buy some. I started my presentation with a firm handshake. Then I introduced all the different kinds of candles and the special sales I could offer and 8 her that our candles were the best choice for gifts and home decorations. Finally she bought three candles. Greatly 9 I decided to sell my candles around the neighborhood. On Saturday morning, with great 10 , I knocked at the door of my first 11 buyer. "I'm a student at Skyline High School and we are raising money for DECA, I'm trying to sell …" "Not today, sorry," the man 12 me and shut the door. Embarrassed, I walked away and encouraged myself that the 13 thing that might happen was being refused like that again. I couldn't even count how many times I was 14 with reasons like "Not today","I don't have any 15 money right now" or "I just bought some". 16 , I had to continue with the day. Finally, a woman kindly bought nearly $60 worth of candles. I couldn't even hide my 17 and said,"Thank you very much" to her with a bow. After a 18 hard work, I turned in $408 worth of sales of candles, which gave me $163 in my own account. I was surprised to 19 I was the second highest seller in all classes. It was my first time working as a sales person. This experience let me know that worrying about difficulties was only wasting my time and a(an) 20 in my way to success. | ||||
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