问题 多项选择题 案例分析题

患者男性,68岁,主因“左侧腰腹部疼痛10天,少尿1天”就诊。患者10天前无明显诱因出现左侧腰腹部绞痛,阵发性发作,无恶心、呕吐,伴尿频、尿急、尿痛,无肉眼血尿。近1天来少尿。既往双肾结石病史3年。查体:体温39.6℃,血压100/60mmHg(1mmHg=0.133kPa),神志清,精神差,腹平,无压痛、反跳痛、肌紧张,Murphy征阴性,肠鸣音正常,左肾区叩击痛阳性,左侧肋脊点、肋腰点压痛阳性,双侧输尿管压痛点压痛阴性。实验室检查,尿常规:白细胞(++++),红细胞(+)。血常规:白细胞20.4×109/L,血红蛋白128g/L。

该患者下一步较为合理的治疗方法是()【提示】患者入院后复查肾功能:肌酐250μmol/L,尿素氮22.09mmol/L,K+3.98mmol/L,CO2结合力16mmol/L。

A.抗炎对症治疗

B.抗结核治疗

C.双侧输尿管镜碎石取石术

D.左肾穿刺造瘘

E.左肾输尿管全长切除术

F.左侧经皮肾镜碎石取石术(PCNL)

G.留置左侧D-J管

H.右肾穿刺造瘘术

答案

参考答案:A, D, G, H

多项选择题
阅读理解

阅读理解。

     If your mother wants to tell you something, she uses words. Birds cannot talk as we do. But some birds

can make sounds to warn their young of danger. They have their own way to make the young birds do certain

things.

     The jackdaw is a kind of blackbirds that lives in Europe. Jackdaws live together in flocks (群). Young

jackdaws do not know their enemies. When an older jackdaw sees a dog, it makes a loud rattling (格格响的)

sound. The younger birds know this sound means an enemy is nearby. The sound warns them to know their

enemies.

     If a young jackdaw is in a dangerous place, a jackdaw parent flies over him from behind. The parent bird

flies low over the young bird's back. The parent's tail feathers (羽毛) move quickly from side to side. It is

trying to say, "Follow me."

     At the same time, the parent calls out, "Key-aw, key-aw." The parent means, "Fly home with me." The

young bird then follows the older home.

     Young jackdaws do not have to learn what certain sounds mean. They know the meaning of these sounds

from the time they hatch.

1. The jackdaw lives in _____. [ ]

A. Europe

B. Australia

C. America

D. Africa

2. When an old jackdaw sees a dog, it _____. [ ]

A. calls out, "Follow me."

B. makes a loud sound

C. flies away

D. fights the dog

3. Which of the following does this story lead you to believe? [ ]

A. All animal parents can talk to their young.

B. Dogs are the most dangerous enemies for jackdaws.

C. Young jackdaws know the meaning of their parents' sound when they grow older.

D. Some birds can give certain information to one another.