问题 单项选择题 A3/A4型题

患者,男,21岁,近半年来反复心悸、胸痛、劳力性呼吸困难,时有头晕或短暂神志丧失。体检发现:心脏轻度增大,心尖部有2级收缩期杂音和第四心音,胸骨左缘第3~4肋间闻及较粗糙的喷射性收缩期杂音。

最有价值的诊断方法是()

A.胸部X线摄片

B.心电图

C.超声心动图

D.心脏核素检查

E.冠状动脉造影

答案

参考答案:C

解析:主动脉瓣狭窄的典型症状有:劳力性呼吸困难、心绞痛、晕厥。心脏听诊典型的杂音为:在第一心音稍后或紧随喷射音开始,止于第二心音前,为吹风样、粗糙、递增-递减型,在胸骨右缘第2或左缘第3肋间最响,向颈动脉、胸骨左下缘和心尖区传导,常伴震颤。患者的病史、临床表现符合主动脉瓣狭窄,故最可能的诊断为主动脉瓣狭窄。故49题选C。

单项选择题

C

When something goes wrong, it can be very satisfying to say," Well, it’s so-and-so’s fault. "or "I know I’m late, but it’s not my fault ; the car broke down. "It is probably not your fault, but once you form the habit of blaming somebody or something else for a bad situation, you are a loser. You have no power and could do nothing that helps change the situation. However, you can have great power over what happens to you if you stop focusing on whom to blame and start focusing on how to remedy the situation. This is the winner’s key to success.

Winners are great at overcoming problems. For example, if you were late because your car broke down, maybe you need to have your car examined more regularly. Or, you might start to carry along with you the useful phone numbers, so you could call for help when in need. For another ex-ample, if your colleague causes you problems on the job for lack of responsibility or ability, find ways of dealing with his irresponsibility or inability rather than simply blame the person. Ask to work with a different person, or don’t rely on the person. You should accept that the person. Ask to work with a different person, or don’t rely on this person. You should accept that the person is not reliable and find creative ways to work successfully regardless of how your colleague fails to do his job well.

This is what being a winner is all about—creatively using your skills and talents so that you are successful no matter what happens. Winners don’t have fewer problems in their lives ; they have just as many difficult situations to face as anybody else. They are just better at seeing those problems as challenges and opportunities to develop their own talents. So, stop focusing on "whose fault it is". Once you are confident about your power over bad situations, problems are just stepping stones for success.

When your colleague brings about a problem, you should()

A. find a better way to handle the problem

B. blame him for his lack of responsibility

C. tell him to find the cause of the problem

D. ask a more able colleague for help

单项选择题