问题 单项选择题 A1/A2型题

女性,52岁,中上腹痛反复发作2月余,伴皮肤巩膜黄染10天,发热3天(38~38.5℃)。体格检查巩膜、皮肤黄染,直接胆红素156μmol/L,尿胆红素强阳性。为明确诊断,首选检查()

A.口服胆囊造影

B.静脉胆道造影

C.经皮肝穿刺胆道造影

D.逆行胰胆管造影

E.B型超声检查

答案

参考答案:E

解析:直接胆红素156μmol/L,口服胆囊造影和静脉胆道造影是禁忌证。经皮肝穿刺胆道造影虽为有效方法但适用于胆管扩张且有一定的并发症,如胆汁性腹膜炎和出血等。逆行胰胆管造影需有一定的经验。

阅读理解

London used to be “foggy” for the same reason that cities like Beijing or Chongqing are “foggy” today. The “fog” was in fact smog, a mixture of smoke and fog. In other words, it was made by air pollution. In London, some of this pollution came from factories, but much of it came from the coal (煤) that people burnt in their houses to keep warm during the winter. By the 1950s, London’s smog problem had become so bad that the government decided to do something to clean the air. A new law was made and nobody could burn coal in any British city. Within a few years, the air became much cleaner. There were no more “pea-soupers”.

Many Chinese cities now face the same sort of problem with air pollution that London faced 40 or 50 years ago. However, this problem is more difficult for Chinese cities to solve. One reason is that more of the pollution comes from the factories, rather than from coal burnt in people’s houses. If these factories were closed, this would harm the economy and lots of people would lose their jobs. Another reason is that changing from coal to cleaner fuel (燃料), like gas, is quite expensive.

However, the air in many Chinese cities is becoming cleaner and cleaner, as the government and people pay more and more attention to cutting down pollution. As a result, there are fewer “pea-soupers” in Beijing than there used to be.

小题1:What was the main reason for air pollution in London?

A.There was too much smoke in the sky.

B.There were too many factories in the city.

C.People burnt too much coal in the houses.

D.The city was too big for the cleaners to clean.小题2:How did the air in London become much cleaner?

A.There was not so much fog in the winter later.

B.A law was made to keep people from burning coal in their houses.

C.Many factories in the city were closed.

D.People paid more attention to cleaning their city.小题3:What does the underlined word “pea-soupers” refer to?

A.Smog.

B.Smoke.

C.Gas.

D.Coal.小题4:The problem of air pollution is more difficult for Chinese cities to solve because of _____ reasons.

A.one

B.two

C.three

D.four小题5:Which sentence is NOT true?

A.Air pollution is serious in Beijing and Chongqing.

B.Using coal is much more expensive than using gas.

C.Factories made much more pollution in China.

D.The reasons of air pollution in London and Beijing are different.

填空题