问题 单项选择题 A1/A2型题

患者,男,40岁。因外伤性闭合性股骨干骨折而入院。次日突然出现呼吸困难,烦躁不安,昏迷,皮下出血,血压10.7/8.0kPa(80/60mmHg),其诊断最可能是()

A.继发感染

B.大血管破裂

C.脂肪栓塞

D.骨筋膜室综合征

E.骨折断端严重再移

答案

参考答案:C

解析:骨折后突然出现呼吸困难,烦躁不安甚至昏迷,应想到脂肪栓塞的可能。脂肪栓塞发生于成人,是由于骨折处血肿过大,骨髓破坏,脂肪滴进入破裂的静脉窦而引起肺脑栓塞。本例为股骨干闭合骨折,出血量大,血肿内压力高,成人股骨干是黄骨髓,故可发生。

多项选择题

Most people would be (1) by the high quality of medicine (2) to most Americans. There is a lot of specialization, a great deal of (3) to the individual, a (4) amount of advanced technical equipment, and (5) effort not to make mistakes because of the financial risk which doctors and hospitals must (6) in the courts if they (7) things badly.

But the Americans are in a mess. The problem is the way in (8) health care is organized and (9) . (10) to pubic belief it is not just a free competition system. The private system has been joined a large public system, because private care was simply not (11) the less fortunate and the elderly.

But even with this huge public part of the system, (12) this year will eat up 84.5 billion dollars—more than 10 percent of the U. S. Budget—large number of Americans are left (13) . These include about half the 11 million unemployed and those who fail to meet the strict limits (14) income fixed by a government trying to make savings where it can.

The basic problem, however, is that there is no central control (15) the health system. There is no (16) to what doctors and hospitals charge for their services, other than what the public is able to pay. The number of doctors has shot up and prices have climbed. When faced with toothache, a sick child, or a heart attack, all the unfortunate persons concerned can do is (17) up. Two thirds of the population (18) covered by medical insurance. Doctors charge as much as they want (19) that the insurance company will pay the bill.

The rising cost of medicine in the U. S. A. is among the most worrying problems facing the country. In 1981 the country’s health bill climbed 15.9 percent--about twice as fast as prices (20) general.

14()

A.for

B.in

C.with

D.on

填空题