问题 问答题 案例分析题

张某,男,71岁,因下肢水肿,胸闷,气短就诊,诊断为慢性心功能不全,大夫应用处方为地高辛片每次0.25mg,每天3次,氢氯噻嗪片每次25mg,每天3次,泼尼松片每次10mg,每天3次。治疗数天不见好转,请分析原因。

答案

参考答案:

此处方不合理原因是:(1)氢氯噻嗪能促进钠、水的排泄,减少血容量,降低心脏的前、后负荷,消除和缓解静脉淤血及其所引起的肺水肿和外周水肿,但其可引起血钾降低。(2)泼尼松具有保钠排钾作用,可引起水钠潴留而加重患者的水肿,同时降低血钾。(3)氢氯噻嗪与泼尼松合用可明显降低血钾,地高辛在低血钾的时候易引起中毒。所以说此处方不合理。

阅读理解

阅读理解

     If this 13year old American boy succeeds in climbing Mount Everest,he has modest ambitions-pick a

small piece of rock from the top as a memento (纪念品) and wear it in a necklace.

     "It is something for myself to say 'this is a rock from the top',"Jordan Romero from California,told

reporters in Kathmandu.He left for the mountain on Sunday.

     If he succeeds,Romero will become the youngest climber to climb the 8,850 meters Everest Summit.

Currently a 16yearold Nepali boy,Temba Tsheri Sherpa,holds the record of being the world's youngest

climber of Mount Everest.

     But Romero,sitting over lunch with his climbing father and stepmother in Kathmandu's tourist district

of   Thamel,said he was not after setting climbing records.

     Romero said Mount Qomolangma,that runs across NepalChina border,was part of his goal to climb

the highest mountains on all seven continents.

     "It is just a goal," he said confidently."If I don't succeed I am okay.I will try again."

     Romero has already climbed Mount Kilimanjaro in Africa and Mount McKinley in Alaska among

others.

     Romero's father Paul said the boy was ready to take on the climb and understood the risk of climbing

the giant mountain.

     "I know it requires a lot of patience.I will remain patient.I want to stay safe and make right choice,"

Romero said of his climb using the northeast ridge (山脊) route on the Chinese side of the mountain.

     Over 4,000 climbers have reached the top of Mount Qomolangma since it was first climbed by New

Zealander Sir Edmund Hillary and Nepal's Tenzing Norgay Sherpa in 1953.Romero said he wanted to

climb the highest mountains in all 50 states in the US next."It does not need to be after Qomolangma and

could be in between."

1. According to the passage,at present________keeps the record of being the world's youngest

    climber of Mount Everest.

A. Jordan Romero  

B. Temba Tsheri Sherpa

C. Tenzing Norgay Sherpa  

D. Sir Edmund Hillary

2. From the passage we can learn that Romero's goal is________.

A. to break the record of the youngest climber to climb Everest Summit

B. to pick a small piece of rock from the top of Everest Summit

C. to climb the highest mountains on all seven continents

D. to climb the highest mountains in all 50 states in the US

3. We can infer from the passage that________.

A. Romero has made a promise that he must climb up the top of Mount Qomolangma

B. the highest mountain in America is Mount Kilimanjaro

C. Sir Edmund Hillary and Tenzing Norgay Sherpa come from different countries

D. there is no risk climbing Mount Qomolangma

4. The following statements are true EXCEPT________.

A. Romero is to use the northwest ridge route on the Chinese side of the mountain

B. Romero has his patience and understands the risk of climbing the giant mountain

C. Romero has made a safe climbing plan

D. Romero is fond of climbing

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