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患者男，62岁，因“声音嘶哑，咳嗽痰中带血”来诊。初诊为慢性咽喉炎，治疗3个月后，声音依然嘶哑不见好转，发音也越来越困难，病情明显加重，再次入上级医院诊治。患者吸烟40年。喉镜：左侧声带前有一菜花状肿物，质脆，触之易出血。

提示若显微镜下见癌巢内有小腺管样结构，细胞呈柱状围成小腔，形成所谓“真性菊形团”。最有可能的诊断为（）

A.鳞状细胞癌

B.疣状癌

C.小细胞癌

D.基底细胞样鳞状细胞癌

E.淋巴上皮癌

F.肉瘤样癌

G.腺癌

答案

参考答案：C

填空题

What is distance learning It means that you study on your own, at home or wherever suits you. Recently, the world famous Open University in the United Kingdom has designed a new style of distance learning, which is called (1) . The phrase "Open Learning" means you study (2) . You read course material, work on course activities, and write (3) . The word "Supported" means you have help (4) , the student services staff at regional centres, and centralized areas such as (5) . You can also contact other students through tutorials and (6) , the University’s online conferencing system, and events and clubs organized by (7) . Most distance learning courses use printed paper materials. They also include some (8) materials such as a CD, DVD or video. Many courses have a web site and an (9) . You’ll need access to a computer (10) to make use of these. The Open University can help its students buy a computer and (11) the cost of accessing the Internet.

With most distance learning courses, no (12) are required to study. of course, you have to be aged 18 when your course starts but there is no (13) . Currently the Open University has around (14) undergraduate and more than 30,000 postgraduate students, of which 10,000 have (15) . Nearly all students are studying (16) . About 70 per cent of undergraduate students are in (17) . More than 50,000 students (18) by their employers for their studies. Most distance learning courses (19) . Some of them are even available in other parts of the world. With over 25,000 of its students living outside the UK, the Open University is the (20) that offers distance learning throughout the world.

15（）
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单项选择题

泌尿系统问诊内容( )

A．咳嗽、咳痰、咯血、胸痛、呼吸困难
B．食欲不振、苍白、黄染、腹胀、便秘、腹泻
C．呼吸困难、咳嗽、咳痰、咯血、心悸、水肿
D．心悸、气短、水肿、头晕、头痛、苍白、黄染
E．尿频、尿急、尿痛、尿量、尿颜色、腹痛、水肿
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