问题 多项选择题 A3/A4型题

患者男,64岁。间断右上腹疼痛4个月。患者4个月前无明显诱因出现间断右上腹部绞痛,无恶心呕吐,无腹泻,无发热,数小时后腹痛自行缓解。发病以来食欲尚可,大小便正常,体重减轻3kg。查体:一般状态尚可,睑结膜苍白,浅表淋巴结无肿大,心肺查体未见异常,腹平软,肝脾肋下未触及,肝区无叩痛,全腹元压痛,右上腹可触及-鸡蛋大小的包块,质硬,表面光滑,无压痛,活动度好。

该患者体格检查:面色晦暗,眼睑无水肿,巩膜中度黄染,结膜苍白,颈静脉无怒张,胸前有4枚蜘蛛痣,有肝掌,听诊右肺下呼吸音减弱,双肺未闻及干湿啰音,心脏查体正常。腹膨隆,脐膨出,腹壁静脉显露,全腹压痛、反跳痛,以左侧腹为著,肝肋下未触及,肝颈静脉回流征阴性,脾肋下2cm,移动性浊音阳性。肠鸣音正常,双下肢水肿。为进一步确诊,需完善哪些相关检查()。

A.肝胆脾超声或CT

B.肝肾功

C.腹水常规、生化

D.尿细菌培养

E.腹水病原学检查

F.腹水ADA

答案

参考答案:A, B, C, E, F

阅读理解

IMAGINE that you are in school, giving a speech to your class.

Now think what it feels like when stammering(口吃)makes it a struggle to communicate your thoughts and feelings to other people.

The King’s Speech, which won the best picture at

the Academy Awards, highlights(突出) stammering along with other speech-related problems. The movie tells the story of Britain’s King George Ⅵ, who became king after his brother Edward Ⅷ gave up the crown to marry an American woman.

As a result of British actor Colin Firth’s performance, people are starting to realize that stammering can damage a person’s self-confidence and cause him/her to escape from life.

“The problem is unseen and unheard,” said Norbert Lieckfeldt, an expert at the British Stammering Association, in an interview with The Guardian newspaper.

“Stammering masks(遮盖) your ability,” he said, “It's a serious disability(残疾).”

Most stammerers face bullying(欺负) in school, something that is “usually carried over into the workplace”.

George Ⅵ’s stammer took away his confidence as a speaker. But Samantha Mesango, a speech coach based in the UK, believes that speech problems are more common than most people realize. “Some simply don't like the sound of their own voice; others are scared of speaking in public,” she said.

Travis Treats from Saint Louis University’s department of communication sciences in the US, praised The King’s Speech. He said it shows that “how one’s speech does not mean what one is inside”.

He also added that people who stammer need to be heard and our society should recognize that they have a lot to give to the world.

小题1: What is the point of the first two paragraphs?

A.To tell readers about speech speaking.

B.To show how harmful a stammer is.

C.To draw the attention of readers to the problem of a stammer.

D.To show how a stammer makes a person popular小题2: According to the article, King George Ⅵ _____.

A.was a hero during World War Ⅱ

B.took the place of his brother

C.married a divorced American woman

D.was a failure because of his stammer小题3: What is Norbert Lieckfeldt’s view of the challenge of a stammer?

A.A stammer can destroy a person’s self-confidence.

B.A stammer is a serious problem for many people but it is often ignored.

C.People who stammer need to have their own voice.

D.People who stammer do better in work than in school.

问答题 简答题