问题 单项选择题

患者,女性,28岁。孕9周,诊断为Graves病。

该患者经药物治疗控制甲亢症状后,可选择手术治疗,其最佳手术时机应在妊娠

A.2~3月

B.3~4月

C.4~6月

D.5~7月

答案

参考答案:C

解析:①妊娠全程都可以应用丙硫氧嘧啶进行治疗,因丙硫氧嘧啶不易通过胎盘,且经临床证实其维持量50~150mg/d对胎儿是安全的。甲硫氧嘧啶起效慢,目前临床上少用。131Ⅰ因有放射性,肯定不能用于妊娠甲亢的治疗。手术治疗多用于妊娠中期的甲亢。②抗甲状腺药物的不良反应包括:粒细胞减少(发生率10%)、皮疹(发生率2%~3%),胆汁淤积性黄疸、血管神经性水肿、中毒性肝炎、急性关节炎均罕见。③发生在妊娠初期的甲亢,经丙硫氧嘧啶治疗控制甲亢症状后,可选择在妊娠4~6月时做甲状腺次全切除。

多项选择题 案例分析题
单项选择题

Children start out as natural scientists, eager to look into the world around them. Helping them enjoy science can be easy; there’s no need for a lot of scientific terms or expensive lab equipment. You only have to share your children’s curiosity. Firstly, listen to their questions. I once visited a classroom of seven-year-olds to talk about science as a job. The children asked me "textbook questions" about schooling, salary and whether I liked my job. When I finished answering, we sat facing one another in silence. Finally I said, "Now that we’re finished with your lists, do you have questions of your own about science"

In which of the following paragraph(s) does the author tell us what to say to encourage children in a science discussion
A. The second and third.
B. The fourth and fifth.
C. The fifth and sixth.
D. The seventh.

After a long pause, a boy raised his hand, "Have you ever seen a grasshopper eat When I try eating leaves like that, I get a stomachache. Why"
This began a set of questions that lasted nearly two hours.
Secondly, give them time to think. Studies over the past 30 years have shown that, after asking a question, adults typically wait only one second or less for an answer, no time for a child to think. When adults increase their "wait time" to three seconds or more, children give more logical, complete and creative answers.
Thirdly, watch your language. Once you have a child involved in a science discussion, don’t jump in with "That’s right" or "Very good". These words work well when it comes to encouraging good behavior. But in talking about science, quick praise can signal that discussion is over. Instead, keep things going by saying "That’s interesting" or "I’d never thought of it that way before", or coming up with more questions or ideas.
Never push a child to "Think". It doesn’t make sense, children are always thinking, without your telling them to. What’s more, this can turn a conversation into a performance. The child will try to find the answer you want, in as few words as possible, so that he will be a smaller target for your disagreement.
Lastly, show; don’t just tell. Real-life impressions of nature are far more impressive than any lesson children can learn from a book or a television program. Let children look at their fingertips through a magnifying glass, and they’ll understand why you want them to wash before dinner. Rather than saying that water evaporates, set a pot of water to boil and let them watch the water level drop.