问题 单项选择题

女性,25岁。5年来劳累后心悸、气短,3天来间断咯血,无发热。查体:双颊紫红,颈静脉无怒张,双肺未闻及干、湿性啰音,心浊音界在胸骨左缘第三肋间向左扩大,心尖部可闻及舒张期隆隆样杂音,第一心音亢进,腹平软,肝脾肋下未能及,下肢无水月中。

该患者最紧急的治疗是

A.急诊手术

B.输液、输血

C.急诊胃镜止血

D.静脉给予质子泵抑制剂

答案

参考答案:B

解析:[考点] 食管胃底静脉曲张破裂出血的诊断和治疗

[分析]: 该中年男性患者突然大量呕血和黑便,血压已经下降,结合过去有“肝功能异常”史和目前查体有黄疸,最可能的出血原因是食管胃底静脉曲张破裂出血,其余三种病因均很少会突然发生这样大量出血;大量上消化道出血后应该腹部肠鸣音活跃,至少是正常,不会消失,因为肠鸣音代表活动性出血的程度;该患者有肝硬化,所以肝未触及和腹部移动性浊音阳性是会有的;应该有脾大,但因大出血后,脾可能摸不到。紧急治疗是输液和输血,纠正低血压,手术或内镜止血只能等血压控制后,可以静脉给予质子泵抑制剂,但不是最重要的紧急治疗。

完形填空
完形填空
     One of the main reasons that may stop us from reaching our goals and desires is our inability to be
flexible.
     This fact may be_1_to swallow, but it's true.We do everything to get rid of suffering in our lives, yet
challenges and pressures can_2_the best in us.
     If you have been burdened (负担)  by__3__in the past, learn from them, forget about them, and
move on.Some people_4_to focus on how bad their lives have been_5_these mistakes.As a result, they
remain_6_in their miserable lives.
     So what if you run a business and you lose a ton of money?In this_7_, some people would remain
deeply_8_for such a long time, and their personal lives are being affected_9_.If you're afraid to fail, then
you will_10_all your chances to achieve your goals in life._11_again;but this time, be more careful and
use your past mistakes as guide maps.
     But when you try, make sure you_12_.I've met so many people who accepted my suggestion, but
most of them would_13_right in the middle of their work.They have the drive to start, _14_they lack the
motivation to go through all the_15_.Yes, this is another fact of life.Those who persist (坚持) may have
a bad time at present, but they shall have the_16_laugh.
     Let's fast forward into the_17_.Let's say you did try, you followed through, and you succeeded.
Congratulations.So you became_18_by harvesting the fruits of your labor.This does not mean you'll stay
in that situation for good._19_may arise again, so always be ready to adjust to the present situation.The
only thing permanent in this world is_20_.
( ) 1. A. false          
( ) 2. A. center on      
( ) 3. A. mistakes      
( ) 4. A. fail          
( ) 5. A. except for    
( ) 6. A. stuck          
( ) 7. A. position      
( ) 8. A. discouraged    
( ) 9. A. slightly      
( ) 10. A. catch        
( ) 11. A. Finish        
( ) 12. A. follow through
( ) 13. A. interrupt    
( ) 14. A. for          
( ) 15. A. reports      
( ) 16. A. nervous      
( ) 17. A. past          
( ) 18. A. tired        
( ) 19. A. Problems      
( ) 20.  A. success      
B. hard              
B. ruin              
B. loads            
B. intend            
B. because of        
B. satisfied        
B. company          
B. touched          
B. negatively        
B. risk              
B. Lose              
B. give up          
B. stop              
B. as                
B. difficulties      
B. short            
B. future            
B. grateful          
B. Congratulations    
B. laugh            
C. able      
C. bring out  
C. debts    
C. hate      
C. as to    
C. unknown    
C. phenomenon  
C. seated    
C. immediately
C. take      
C. Refuse    
C. take off  
C. divide    
C. but      
C. lives    
C. small    
C. labor    
C. wealthy  
C. Goals    
C. love        
D. impossible        
D. exchange          
D. reasons          
D. tend              
D. but for          
D. interested        
D. situation        
D. scared            
D. usually          
D. increase          
D. Try              
D. end up            
D. recover          
D. though            
D. papers            
D. last              
D. truth            
D. generous          
D. Chances          
D. change            
单项选择题