问题 单项选择题 案例分析题

男性,40岁。餐后出现上腹部剧痛伴畏寒、发热、频繁呕吐30小时入院。查体:T39℃,P120次/分,R28次/分,BP80/50mmHg,体重60kg。急性痛苦面容,被迫体位,烦躁不安,表情淡漠,皮肤、巩膜轻度黄染,眼眶凹陷,唇干,四肢较冷,口唇有轻度发绀。腹胀,腹式呼吸存在,右中上及下腹部肌紧张,压痛、反跳痛明显,以右上腹为甚,Murphy征(+),肠鸣音弱。实验室检查:RBC2.42×1012/L,Hb71g/L,WBC13.8×109/L,N86%,尿常规:BUG(++),BIL(+)。肝功能检查:TBIL74μmol/L,DBIL54μmol/L,IBIL20μmol/L,ALT6IU/L。血清淀粉酶:148U。血生化检查:血K+3.07mmol/L,Na+130mmol/L,TCO29mmol/L,BUN7.9mmol/L。

患者在治疗过程中,最重要的措施是()

A.纠正水钠代谢失调,采取先盐后糖,糖盐交替,必要时补充胶体液

B.必须根据临床表现、尿量等调整补液量、速度和种类

C.避免输液过多、过快

D.每日复查电解质和动脉血气分析,及时调整治疗

E.积极治疗原发病

答案

参考答案:E

解析:根据公式计算:患者补钠量=[142-130]×60×0.6=432mmol/L。以17mmol/LNa等于1g钠盐计算,补氯化钠量约为25.4g,一般先补给1/2,即12.7g,再加上钠的日需要量4.5g,共17.2g。

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第II卷(选做题,40分)

友情提醒:

本部分试卷分为A、B两类,同学们可以选做A、B两类中任何一类,但选择要统一,不可两类混做,多做或混做均不得分。

A类题

第四部分单词拼写(共20小题, 每小题1分,满分20分)

76. The castle was once owned by the king, but now it lies in r__________.

77. To my great d__________, my son has passed all his exams.

78. The next day, US President Franklin Roosevelt d________ war against Japan.

79. The United Kingdom c__________ of Great Britain and Northern Ireland.

80. I got i__________in the quarrel between Tom and Jack.

81. Government promises to _______(创造)more jobs for laid-off workers.

82. Humans ________(不同于) from other mammals in their ability to speak.

83. She is so ____________(特别的;挑剔的)about food that no cook can please her.

84. We should keep the __________(平衡) of nature.  

85. We all hope that there’s no war and the people all over the world can live p___________ (和平地) side by side.

86. Apparently s__________ to criticism, the bull forgot all about the matador and charged at the drunk.

87. When the bull got close to him, he c__________ stepped aside to let it pass.

88. It is not only of immense size, but is extremely a__________ as well.

89. Following in his father’s f__________ many years later, Sir Malcolm’s son, Donald, also set up a world record.

90. Children who play t__________ from school are unimaginative.

91. The next car the boy stopped did not take him into the centre of Paris as he hoped it would, but to Perpignan on the French-Spanish __________(边界).

92. Dressed in dark glasses and old clothes, they had taken special __________(预防措施) so that no one should recognize them.

93. “Oh, is it?” said the sheriff with a __________(冷笑).

94. She __________(跺,踩) out the letters “SOS” in the snow.

95. It was not long before a helicopter arrived on the scene to rescue the __________(幸存者) of the plane crash.

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