问题 单项选择题 案例分析题

患者女性,37岁。于5天前行走时突发左侧腰部疼痛,并进行性加重入院。查体:体温36.9℃,心率90次/分,呼吸20次/分,血压100/70mmHg(1mmHg=0.133kPa)。全腹软,无压痛及反跳痛。左侧腰部肾区可触及包块,质地中等,有压痛,移动性浊音阴性。既往史:患者于3年前行宫颈癌根治性切除术,术后规律放化疗,随访未见复发。尿常规检查:白细胞8个/HP,红细胞2个/HP。血常规检查:血红蛋白90g/L,血细胞比容45%。

目前应采取的最佳治疗方式是()【提示】患者行超选择性肾动脉栓塞术后20天,再次出现左侧腰部剧烈疼痛,精神紧张,面色苍白,急诊查血常规:血红蛋白50g/L,血细胞比容25%。全腹增强CT示左肾周血肿,左肾中上级可见大小约15cm肿块,呈部分不均匀强化,腹腔积液。

A.行左肾探查术,必要时行根治性左肾切除术

B.输血,行保守治疗

C.再次行超选择性肾动脉栓塞术

D.左输尿管插管灌注冰盐水

E.手术修补左肾

答案

参考答案:A

解析:因患者血红蛋白>70g/L,所以暂不考虑输血。该患者考虑为自发性肾破裂,肾存在基础病变可能性大,全腹增强CT提示肾占位性病变,肿瘤可能性大,故考虑行左肾探查术,必要时行根治性左肾切除术,因此选择A项。

阅读理解

This is not a diet. It’s a simple way to lose weight. And you don’t even have to give up the food you love or join a gym (参加体育锻炼). You just follow some habits that thin people have. Keep them, and you’ll become thin.

(1) Wake - up

When you wake up in the morning, sit up slowly without using your hands. With legs straight out, bend(弯曲) forward until you feel sore(酸痛) in your back. It will burn about 10 calories.

(2) Start with soup

When you have a meal, order a clear soup, and have it before having the main food. In this way, you’ll feel fuller, so you’ll eat less when the main food comes.

(3) An apple (or more) a day

Apples are full of fiber(纤维) and water, so your stomach will want less. The study shows that people who eat at least three apples a day lose weight.

(4) Stand up and walk around

Every time you use the mobile phone, stand up and walk around. Heavy people sit on average (平均) two and a half hours more each day than thin people. This skill is very important as standing up and walking around will burn 50 0r more calories.

Use these skills, and you will have a big weight loss.

小题1:Why does eating apples make one’s stomach want less food?

A.Because apples are delicious.

B.Because apples are full of fiber and water.

C.Because apples are sour.

D.Because only apples are filled with calories.小题2:Which of the following may the author DISAGREE?

A.Sitting up slowly without using your hands helps burn calories.

B.Eating apples every day is good for people’s health.

C.You have to join a gym if you want to lose weight.

D.It’s good to walk around while talking on the mobile phone.小题3:What’s the purpose of the passage?

A.To give some advice on how to lose weight.

B.To advise people to eat apples every day.

C.To tell people how to enjoy a better life.

D.To advise people to give up bad habits.小题4:In which part of a newspaper would you most probably read the passage?

A.Shopping.

B.Teaching.

C.Family.

D.Health.

单项选择题 A3/A4型题