问题 单项选择题 A2型题

患者,女,26岁。有结核病史,近来感腹胀、乏力、活动后气短。查体:心尖搏动不易触及,心浊音界正常,心率120次/分,心房颤动;颈静脉怒张,吸气时明显;腹软,肝右肋下3cm,腹水征(+),双下肢轻度水肿;BP90/75mmHg。胸片:无肺淤血,主动脉弓小,上腔静脉扩张,心影大小正常。ECG:QRS波低电压,普遍导联T波低平、倒置。上述临床表现产生的主要机制是()

A.心脏收缩力减弱

B.心包缩窄心室充盈受阻

C.心脏后负荷过重

D.心脏前负荷过重

E.快速性心律失常

答案

参考答案:B

判断题
单项选择题 案例分析题

Questions 21 to 25 are based on the following passage.

Lead deposits, which accumulated in soil and snow during the 1960’s and 70’s, were primarily the result of leaded gasoline emissions originating in the United States. In the twenty years that the Clean Air Act has mandated unleaded gas use in the United States, the lead accumulation worldwide has decreased significantly.

A study published recently in the journal Nature shows that air-borne leaded gas emissions from the United States were the leading contributor to the high concentration of lead in the snow in Greenland. The new study is a result of the continued research led by Dr. Charles Boutron, an expert on the impact of heavy metals on the environment at the National Center for Scientific Research in France. A study by Dr. Boutron published in 1991 showed that lead levels in arctic (北极的) snow were declining.

In his new study, Dr. Boutron found the ratios of the different forms of lead in the leaded gasoline used in the United States were different from the ratios of European, Asian and Canadian gasolines and thus enabled scientists to differentiate (区分) the lead sources. The dominant lead ratio found in Greenland snow matched that found in gasoline from the United States.

In a study published in the journal Ambio, scientists found that lead levels in soil in the Northeastern United States had decreased markedly since the introduction of unleaded gasoline.

Many scientists had believed that the lead would stay in soil and snow for a longer period.

The authors of the Ambio study examined samples of the upper layers of soil taken from the same sites of 30 forest floors in New England, New York and Pennsylvania in 1980 and in 1990. The forest environment processed and redistributed the lead faster than the scientists had expected.

Scientists say both studies demonstrate that certain parts of the ecosystem (生态系统) respond rapidly to reductions in atmospheric pollution, but that these findings should not be used as a license to pollute.

The authors of the Ambio study have found that()

A.forests get rid of lead pollution faster than expected

B.lead accumulations in forests are more difficult to deal with

C.lead deposits are widely distributed in the forests of the US

D.the upper layers of soil in forests are easily polluted by lead emissions