问题 单项选择题 案例分析题

患者,女性,23岁,右眼突发视力下降3天。3天前无明显诱因突发右眼视物模糊并逐渐加重,无眼前黑影遮挡、闪光感、视物变形、变色,无眼红、眼痛、畏光、流泪等不适,未诊治。既往病史无特殊,否认眼部、颜面部及头颅外伤史,否认高血压、糖尿病、血液病等全身病史。体查:Vod0.1(矫正不能提高),Vos1.5,双眼眼压正常,双眼眼前段未见异常。

确诊后若患者告知医师已妊娠两个月,当时体重49kg,则应给予以下何种处理()

A.给予大剂量激素冲击治疗,1000mg/d静脉滴注,连用3天,再改口服泼尼松50mg/d,并逐渐减量,同时辅以胃黏膜保护药、视神经营养药

B.给予泼尼松50mg/d口服,逐渐减量,辅以胃黏膜保护药及神经营养药

C.告知患者行人工流产后再予大剂量激素冲击治疗

D.保胎的同时予口服中等量激素治疗,30mg/d,维持1周并逐渐减量,辅以胃黏膜保护药和神经营养药

E.只给予维生素B6、B12、叶酸等神经营养药,定期随访观察

答案

参考答案:E

选择题
完形填空

A few days ago, I got a letter from a student. In his letter, he told me, “I have this friend at school. She’s one of my good friends but lately she has been ___36__ strange. When I talked to her the other day, she said coldly, ‘Do I look like I care?’ She was being all strange to me. She told me __37___ she thought I was a bad friend, but she still thinks I am her best friend. I am so confused.”

In my letter in reply, I gave him my advice:

After reading your question, I can understand why you’re confused. It sounds like your relationship with your friend is a little shaky. There could be several reasons for her __38__. For example, maybe she has a lot on her mind and is __39__ a few challenges of her own. She may not feel comfortable talking to anyone about them __40__ and may just need a little time to sort through her own feelings. Or, on the day you talked to her, she could have been having a bad day and didn’t realize she was very cold to you. I could list a few more __41__for you, but you know, __42__, the only person who knows why your friend reacted that way is your friend. My__43__ to you is to tell her how you feel. Let her know she hurt your feelings and ask why on some days she’s nice to you, and on other days she isn’t __44__ nice. It could be that your friend is making some other new friends at school and is having difficulty __45___ her old relationships. Whatever her reasons are, you should let her know that you are a unique, caring person who certainly deserves a good friendship at school, _46__ you wouldn’t have taken the time to write me. If your __47__ with this person fades a bit, it’s OK, because you will develop may other friendships.

36. A. proving                B. thinking               C. showing            D. acting      

37. A. before                B. if                    C. until               D. in case

38. A. background             B. feelings              C. reaction          D. appearance

39. A. getting alone          B. going through          C. blaming for        D. standing up

40. A. already                B. too                 C. yet              D. afterwards

41. A. choices                B. questions            C. opportunities      D. excuse

42. A. last but not least        B. to conclude        C. to be honest       D. as a result

43. A. letter                B. focus             C. recommendation      D. advice

44. A. too                   B. as                  C. also                 D. such

45. A. refusing                B. finding               C. remembering        D. balancing

46. A. and                   B. otherwise           C. because          D. so

47. A. attitude              B. progress            C. hesitation           D. closeness