女性，46岁，既往有哮喘反复发作史。1小时前上楼时，突然发作呼吸困难及左侧胸痛。查体：烦躁，大汗。明显的呼吸困难，口唇发绀，端坐呼吸，颈静脉充盈，气管轻度右偏，桶状胸，双肺叩诊过清音，左侧略带鼓音，左肺呼吸音低，右肺可闻及哮鸣音。
本病例最可能的诊断是（）
A.支气管哮喘发作
B.支气管哮喘并发肺感染
C.支气管哮喘并发自发性气胸
D.哮喘持续状态
E.支气管哮喘并发心衰
参考答案：C
| Nine states and the District of Columbia are doing away with the sales tax on items such as clothes, shoes and even notebooks over the next few weeks, just in time for back-to- school shopping. Most of the promotions last only a few days, so shoppers will have to act quickly to get a tax break. The tax holidays, which have already expired in two other states, apply to small and large items. For example, the tax break applies to any school supply that costs $15 or less in New Mexico. In Massachusetts, it covers most retail purchases of $2,500 or less. Stores may offer additional savings because these events "give retailers an opportunity to have a sale on top of what the state is doing," says Verenda Smith, government affairs associate at the Federation of Tax Administrators. No industry-wide figures are available about how much consumers save annually from these tax breaks. But Texas estimates that shoppers will save $47.4 million in taxes this year, nearly a 3 percent increase from the previous year. Massachusetts says shoppers saved roughly $10 million in taxes during its 2005 event. States that cast aside these promotions when a slow economy pinched state budgets are now reviving them in hopes of stimulating local economies. Some states also believe the gain in consumer goodwill helps balance out the loss in tax revenue. In some cases, tax losses are minimal because serious shoppers don’t stop at clothes and books. "While states give up sales tax, they usually break even on sales-tax collection," says J. Craig Shearman, a vice-president at the National Retail Federation. Sophie Beckmann, a certified public accountant at A. G. Edwards in St. Louis, says she’ll avoid that temptation by making a list of necessities. On the Missouri resident’s shopping list: notebooks, pencils, glue and three or four outfits for her son, who is entering the fifth grade this month. She plans to pocket any tax savings. "When you start buying more and spending more just because of the savings, then you’re not doing yourself a favor," Beckmann says. |
Mr. Verenda Smith is most probably a ______ .
A．governmental employee working at the Federation of Tax Administrators
B．free-lance PR officer representing the Federation of Tax Administrators
C．Federation of Tax Administrators employee dealing with the government
D．PR officer running between the government and the Federation of Tax Administrators