问题 单项选择题 A1型题

夏柯三联征包括()

A.疼痛、发热、黄疸

B.寒战、发热、黄疸

C.疼痛、发热、抽搐

D.疼痛、贫血、黄疸

E.发热、黄疸、休克

答案

参考答案:A

解析:

胆总管结石:结石原发于胆总管,少数可来自肝内胆管或胆囊。当结石阻塞胆总管、并发感染时,引起急性胆管炎,临床表现为:夏柯(Charcot)三联征:

①右上腹绞痛:剑突下阵发性刀割样绞痛,可反射至右肩背;

②寒战高热:并发胆管炎后,感染向上扩散,细菌和毒素经肝狄氏间隙进入血流引起中毒反应;

③黄疸:因结石梗阻、胆道压力增高,胆汁自毛细胆管流入肝血窦而引起黄疸,一般在发病后12~48小时出现。深度黄疸者,大便呈陶土色。

阅读理解

Schools have banned cupcakes, issued fatness report cards and cleared space in cafeterias for salad bars. Just last month, Michelle Obama’s campaign to end childhood fatness promised to get young people moving more and restore school lunch, and drink makers said they had cut the number of liquid calories shipped to schools by almost 90 percent in the past five years.

But new research suggests that interventions(干预) aimed at school-aged children may be, if not too little, too late.

More and more evidence points to essential events very early in life — during the child years, babyhood and even before birth, in the womb(胎) — that can set young children on a fatness path that is hard to change by the time they’re in kindergarten. The evidence is not ironclad, but it suggests that prevention efforts should start very early.

Among the findings are these:

The fat angel-like baby who is growing so nicely may be growing too much for his or her own good, research suggests.

Babies whose mothers smoked during pregnancy are at risk of becoming fat, even though the babies are usually small at birth.

Babies who sleep less than 12 hours are at increased risk for fatness later. If they don’t sleep enough and also watch two hours or more of TV a day, they are at even greater risk.

Some early interventions are already widely practiced. Doctors recommend that overweight women lose weight before pregnancy rather than after, to cut the risk of fatness and diabetes in their children; breast-feeding is also recommended to lower the obesity risk.

Like children and teenagers, babies and toddlers have been getting fatter. One in 10 children under age 2 is overweight. The percentage of children ages 2 to 5 who are fat increased to 12.4 percent in 2006 from 5 percent in 1980. But most prevention programs have avioded intervening at very young ages, partly because the school system offers an efficient way to reach large numbers of children, and partly because the rate of fat teenagers is even higher than that of younger children — 18 percent.

Scientists like Dr. Birch worry about what are called epigenetic changes. The genes taken over from mother and father may be turned on and off and the strength of their effects changed by environmental conditions in early development. Many doctors are concerned about women being fat and unhealthy before pregnancy because the womb is the baby’s first environment.

Experts say change may require abandoning some treasured cultural attitudes. “The idea that a big baby is a healthy baby, and a crying baby is probably a hungry baby who should be fed, are things we really need to rethink,” Dr. Birch said.

61. What is NOT included in Michelle Obama’s campaign?

A. To restore school lunch.

B. To get young people moving more.

C. To issue fatness report cards.

D. To end childhood fatness.

62. Why should fatness prevention efforts start very early?

A. Because children now are growing too much for their own good.

B. Because there is too much liquid calories in drinks for children.

C. Because experiences even when in the womb can affect a child.

D. Because fat children cannot be healthy ones when they grow up.

63. Which of the following is closest in meaning to the word “ironclad” in paragraph three?

A. right       B. protective       C. objective      D. positive

64. Which of the following is NOT right?

A. 18% of the younger children are fatter than fat teenagers.

B. 10 % of the children under age 2 gain too much weight.

C. 12.4% of the children ages 2-5 were overweight in 2006.

D. In 1980, only 5% of the children ages 2-5 were too fat.

65. What does Dr. Birch’s statement mean in the last paragraph?

A. Feeding the baby when it is crying is not right.

B. Fat babies may not be so healthy as people think.

C. Parents should take responsibility for fat babies.

D. Lovely babies shouldn’t be so fat as people think.

不定项选择