问题 多项选择题 案例分析题

女性,60岁,既往有糖尿病史。寒战高热5天,伴有咳嗽咳脓痰,乏力,周身关节痛,查体:T39.6℃,双肺未闻及干湿啰音。胸片示右肺下叶大片状密度稍高浸润影,白细胞19.0×109/L,中性粒细胞0.90。

假设多次痰培养示MRSA生长,则下列哪些药物可以选用()

A.万古霉素

B.替考拉宁

C.利奈唑胺

D.美罗培南

E.阿奇霉素

F.左氧氟沙星

G.头孢哌酮/舒巴坦

答案

参考答案:A, B, C

解析:

1.本例初步考虑为肺炎,明确病原学可指导用药。2.金黄色葡萄球菌为革兰阳性球菌,90%对青霉素G耐药,金葡菌肺炎可表现为咳嗽,咳脓痰,全身毒血症状,化验白细胞总数及分数增高,胸片可表现为肺段或肺叶实变可形成空洞或呈小叶状浸润,其中可见气囊腔。3.MRSA为耐甲氧西林金黄色葡萄球菌,对常见青霉素类、头孢类、大环内酯类、氟喹诺酮类耐药,对糖肽类(万古霉素、替考拉宁)及噁唑烷酮类(斯沃)敏感。4.本病早期可无体征,常与严重的呼吸道症状不平行,血行播散者早期以中毒症状表现为主,呼吸道症状不明显。

阅读理解

C

Everyone’s at it, even my neighbors. I thought I might be the only person left in the world who hadn’t done an eBay deal. So, I decided to try my hand at online auction(网上拍卖).

Buying for Beginners

Sign up on www. eBay. co. uk. Most items (e.g. tables, computers and books) ready for auction will come with a picture and a short description; others may be marked with “Buy It Now ” and have a fixed price. You can buy these right away.

If the item is being auctioned, you offer the highest price you are prepared to pay and eBay bids (出价) for you. The bid will be increased little by little until it goes beyond your highest bid, then you are emailed and asked if you would like to bid again. Auctions last up to 10 days and when they finish, you get an email telling you whether you have won the item.

How to Pay

Sellers decide how they would like to be paid and you need to check this before placing a bid as you might not want to post a check or postal orders. The easiest way is through PayPal, an online payment system that takes the money away from your credit card.

Selling Made Simple

If you plan to sell on eBay, it helps to include a picture of the item. I followed my friends’ advice and put up the items I wanted to sell for a 10-day auction, starting on a Thursday. This way buyers had two weekends to bid.

The big Things in Life

It’s easy to post a small item, but furniture is a big part of eBay and this has to be collectively sent by deliverymen. Check the ways of delivery before you bid.

64. What is the passage mainly about?

A. How to make payment online.                       B. Ways of making delivery online.

C. How to use an online-auction system.             D. Advantages of an online auction system.

65. After bidding for an item, a buyer ________.

A. has chances to make higher bids                    B. will get what he wants in ten days

C. should make payment immediately          D. may check its picture and description

66. The easiest way of making payment mentioned in the passage is ________.

A. through a local banking system                      B. by sending the money to the seller

C. through an online payment system                 D. by paying the deliveryman directly

单项选择题