问题 单项选择题

女性,65岁,慢性咳喘25年,近1月来加重,伴双下肢浮肿。查体:端坐位,口唇及肢端紫绀,两肺可及干性和湿性哕音,双下肢浮肿,颈静脉怒张,肝大。经利尿、消炎等治疗后好转。两天后突发神志不清,手足抽搐。血气分析:pH 7.50,PaO270mmHg,PaCO260mmHg,

43mmol/L,K+3.0mmol/L,Na+ 132mmol/L,C1- 70mmol/ L,以下诊断正确的是

A.原发性代谢性酸中毒+原发性代谢性碱中毒
B.原发性代谢性碱中毒
C.原发性呼吸性酸中毒+原发性代谢性碱中毒
D.原发性代谢性酸中毒
E.原发性呼吸性酸中毒+继发性代谢性碱中毒

答案

参考答案:C

解析:[考点] 慢性阻塞性肺疾病常见酸碱平衡紊乱的原因及判断

[分析]: 患者老年女性,慢性咳喘病史多年,近期加重,入院时有肺部感染、缺氧和右心功能不全表现,考虑存在阻塞性肺疾病和慢性肺源性心脏病失代偿期。因此,给予利尿、消炎等治疗后好转,后突然出现神志不清,手足抽搐,血气分析示二氧化碳分压升高,考虑为慢性阻塞性肺疾病引起原发性呼吸性酸中毒,同时有pH碱性,碳酸氢根升高,低钾和低氯,考虑是由利尿剂引起的低钾低氯性碱中毒。因此,选项C是本题的正确答案。

完形填空

People always say that the earlier one learns a language, the ___1___ it is to do so, in theory it is that, ___2___, in my opinion, that refers to spoken language. Capability(能力) to practise some essential(基本的) ___3___ of a language and read between the lines can only be trained through proper reading ways and hard work ___4___. So spending money to help ___5___ learn English may ___6___ with disappointment. It is likely that the more you ___7___, the more you are let down.

The daughter of one of my friends ___8___ English in primary school, ___9___ her foreign teacher’s blindness ___10___ psychology(心理学). She did not want to go on ___11___ English until middle school, ___12___ a college student studying in English slowly ___13___ her interest in the language.

It is better to have the child learn Chinese, than to have some difficulty ___14___ learning English for several years. Having been engaged in English education, ___15___ find that despite(不管) their excellent ___16___, many students have ___17___ command(掌握) of English words and phrases. So I suggest that children ___18___ classical Chinese prose(散文), rather than ___19___ them to learn English hurriedly. Otherwise, they may ___20___ the best time to improve the language ability of their mother tongue.

1.A.easy  B. difficult     C. easier  D. more difficult

2.A.but   B. however     C. though       D. yet

3. A. opinions B. regards       C. requests      D. expressions

4.A.directly    B. orally  C. properly     D. indirectly

5.A.people      B. girls    C. children     D. boys

6.A.begin       B. start    C. finish  D. end

7.A.pay   B. get      C. buy     D. take

8.A.loved       B. liked   C. disliked      D. learned

9.A.because of       B. because      C. instead of   D. instead

10.A.of   B. at       C. in       D. to

11.A.learning  B. to learn      C. with learning     D. for learning

12.A.while     B. where C. when  D. as

13.A.introduced     B. practised    C. explained   D. developed

14.A.in   B. to       C. at       D. of

15.A.He  B.I   C. She     D. They

16.A.pronunciation B. phrase C. language    D. writing

17.A.few B. less     C. little   D. fewer

18.A.write      B. do      C. remember   D. memorize

19.A.have       B. let      C. cause  D. make

20.A.get back B. let go  C. bring in      D. go away

单项选择题 A3/A4型题