问题 单项选择题 A2型题

2岁小儿,生后4个月出现发绀,哭吵甚时有抽搐史。查体:发育差,发绀明显,心前区可闻及Ⅲ级左右收缩期的喷射音,胸片示:肺血少,右心室增大,心腰凹陷,呈靴形心。此患儿的诊断应是()。

A.法洛四联症 

B.动脉导管未闭 

C.肺动脉狭窄 

D.室间隔缺损 

E.房间隔缺损

答案

参考答案:A

解析:

法洛四联症临床表现为稍活动,如哭闹、情绪激动、体力活动及寒冷刺激等,均可出现气急和青紫加重。体检:心前区隆起,胸骨左缘第2~4肋间可闻及Ⅱ~Ⅲ级喷射性级收缩期杂音,一般以第3肋间最响,其响度决定于肺动脉狭窄程度,狭窄严重者,杂音反而轻。漏斗部痉挛时,杂音还可暂时消失。肺动脉第二音减弱或消失。

单项选择题
单项选择题

It’s easy to get the sense these days that you’ve stumbled into a party with some powerful drug that dramatically alters identity. The faces are familiar, but the words coming out of them aren’t. Something has happened to a lot of people you used to think you knew. They’ve changed into something like their own opposite.

There’s Bill Gates, who these days is spending less time earning money than giving it away--and pulling other billionaires into the deep end of global philanthropy(慈善事业) with him. There’s historian Francis Fukuyama, leading a whole gang of disaffected fellow travelers away from neoconservatism. To flip-flopis human. It can still sometimes be a political liability, evidence of a flaky disposition or rank opportunism. But there are circumstances in which not to reverse course seems almost pathological(病态的). He’s a model of consistency, Stephen Colbert said last year of George W. Bush:" He believes the same thing Wednesday that he believed on Monday -- no matter what happened on Tuesday."

Over the past three years, I found people who had pulled a big U-turn in their lives. Often the insight came in a forehead-smiting moment in the middle of the night: I’ve got it all wrong.

It looked at first like a sprinkling of outliers beyond the curve of normal human experience. But when you stepped back, a pattern emerged. What these personal turns had in common was the apprehension that we’re all connected. Everything leans on something, is both dependent and depended on.

"The difference between you and me," a visiting Chinese student told University of Michigan psychologist Richard Nisbett not long ago," is that I think the world is a circle, and you think it’s a line." The remark prompted the professor to write a book, The Geography of Thought, about the differences between the Western and the Asian mind.

To Western thinking, the world is linear; you can chop it up and analyze it, and we can all work on our little part of the project independently until it’s solved. The classically Eastern mind, according to Nisbett, sees things differently: the world isn’t a length of rope but a vast, closed chain, incomprehensibly complex and ever changing. When you look at life from this second perspective, some unlikely connections reveal themselves.

I realized this was what almost all the U-turns had in common: people had swung around to face East. They had stopped thinking in a line and started thinking in a circle. Morality was looking less like a set of rules and more like a story, one in which they were part of an ensemble cast, no longer the star.

What can we infer from first two paragraphs()

A. Some people have changed into someone another

B. Rhere are some drugs that can change one’s identity

C. Some moneybags are pulled to act as philanthropist

D. francis Fukuyama has become a great traveler