问题 问答题 简答题

试述有机磷酸酯类中毒的机制及临床表现。

答案

参考答案:

中毒机制:有机磷酸酯类可与胆碱酯酶牢固结合,从而抑制了胆碱酯酶的活性,使其丧失水解乙酰胆碱的能力。有机磷酸酯类进入人体以后,其亲电子性的磷原子与胆碱酯酶的酯解部位丝氨酸的羟基的亲核性的氧原子之间易于形成共价键,生成难以水解的磷酰化胆碱酯酶,因此酶难以恢复活性,使胆碱酯酶失去水解乙酰胆碱的能力,造成乙酰胆碱在体内大量堆积,引起一系列中毒症状。临床表现:

①M样中毒症状:如缩瞳、视力模糊、流涎、口吐白沫、出汗、皮肤湿冷、恶心呕吐、腹痛腹泻、大小便失禁、支气管痉挛、心动过缓和血压下降等。

②N样中毒症状:如肌震颤、抽搐、肌无力甚至麻痹、心动过速、血压先升高后下降等。

③中枢症状:如先兴奋后抑制,出现头痛、头晕、不安、失眠、谵妄、昏迷、呼吸和循环衰竭等。轻度中毒以M样症状为主;中度中毒同时出现M和N样症状;重度中毒除出现M、N样症状外,还出现中枢症状。

单项选择题

Pupils at GCSE are to be allowed to abandon learning traditional "hard" science, including the meaning of the periodic table, in favour of "soft" science such as the benefits of genetic engineering and healthy eating. The statutory requirement for pupils to learn a science subject will be watered down under a new curriculum introduced next year. There will be no compulsion to master the periodic table—the basis of chemistry—nor basic scientific laws that have informed the work of all the great scientists such as Newton and Einstein. The changes, which the government believes will make science more "relevant" to the 21st century, have been attacked by scientists as a "dumbing down" of the subject. In June the government had to announce financial incentives to tackle a shortage of science teachers. Academics have estimated that a fifth of science lessons are taught by teachers who are not adequately qualified.
Most children now study for the double-award science GCSE, which embraces elements of biology, chemistry and physics. This GCSE will be scrapped and ministers have agreed that from next year all 14-years-old will be required to learn about the general benefits and risks of contemporary scientific developments, in a new science GCSE. A harder science GCSE will also be introduced as an optional course. One expert involved in devising the new system believes it will halve the number of state school pupils studying "hard" science. Independent schools and more talented pupils in the state sector are likely to shun the new papers in favour of the GCSEs in the individual science disciplines of physics, chemistry and biology. These will continue to require pupils to achieve an understanding of scientific principles.
The new exams were devised after proposals by academics at King’s College London, who told ministers that science lessons were often "dull and boring" and required pupils to recall too many facts. Their report said: "Contemporary analyses of the labour market suggest that our future society will need a larger number of individuals with a broader understanding of science both for their work and to enable them to participate as citizens in a democratic society. "
However, Professor Colin Blakemore, chief executive of the Medical Research Council, warned that reducing the "hard" science taught in schools would create problems. "I can understand the government’s motives," he said. "There is a crisis of public confidence in science which is reducing the progress of policy on such issues as nuclear energy and stem cell research. But sixth-formers are already arriving at university without the depth of knowledge required." Others endorse the new approach. Results at North Chadderton upper school in Oldham—one of 80 schools piloting the new "softer" GCSE, named Twenty first Century Science have improved. Martyn Overy, the head of science, said: "The proportion getting higher grades in science went up from 60% to 75%. The course kept their interest, had more project work and was more relevant. "
As part of their course, the pupils studied what kind of food they needed to keep fit and healthy. Critics say it is only marginally more demanding than following the advice of Nigella Lawson, the television chef, who promotes the benefits of eating proper meals instead of snacking from the fridge. Some science teachers are skeptical. Mo Afzal, head of science at the independent Warwick school, said. "These changes will widen the gap between independent and state schools. Even the GCSE that is designed for those going on to A-level science is not as comprehensive as the test it replaces." John Holman, director of the National Science Learning Centre at York University, who advised the government on the content of the new system, said: "The new exam is not dumbing down. The study of how science works is more of a challenge than rote learning. "

SCIENCE LESSONS


Out

                

In


Periodic table______ The drugs debate______
Ionic equations______ Slimming issues______
Structure of the atom______ Smoking and health______
Boyle’s law______ IVF treatment______
Ohm’s law______ Nuclear controversy______

The phrase "watered down" in the sentence "The statutory requirement for pupils to learn a science subject will be watered down under a new curriculum introduced next year. " (para. 1) can best be replaced by which of the following

A.removed completely

B.reduced much in force

C.revised greatly

D.reinforced to a certain extent

单项选择题