问题 多项选择题 案例分析题

患者男,24岁,因“四肢肌肉萎缩无力20年,胸闷、气促4个月”来诊。患者于4岁时不明原因出现走路不稳,易摔跤。近5年来,症状明显加重。脊柱侧弯,四肢肌肉明显萎缩,以近端为重,并出现双下肢假性肥大。近4个月来,出现呼吸困难,咳嗽力弱,痰咳不出。肢无力更加明显,排粪无力,饮食量减少。查体:呼吸力弱,口唇及指端发绀;双肺呼吸动度小,双肺叩诊呈清音,听诊双肺呼吸音低,闻及明显干、湿性啰音;心脏(-);四肢肌张力降低,肌力减退,腱反射消失;深、浅感觉正常;Hoffman征(-),Babinski征(-)。

应尽快做的处理包括(提示患者入院后感冒、发热,出现咳嗽、喘憋、呼吸困难。血气分析:pH7.273,PO259.7mmHg,PCO250.9mmHg。)()。

A.吸氧

B.营养支持疗法

C.静脉应用抗生素

D.无创呼吸机辅助通气

E.静脉应用地塞米松

F.痰培养、药敏

答案

参考答案:A, B, C, D, F

阅读理解

The year is 2094. It has been announced that a comet (彗星)is heading towards the earth. Most of it will miss our planet, but two pieces will probably hit the southern half of the earth.

On 17 July, a piece of 4 kilometers wide comet enters the Earth’s atmosphere with a massive explosion(爆炸). About half of the piece is destroyed, but the remaining part hits the South Atlantic at 200 times the speed of sound. The sea boils and a huge hole is made in the seabed. Huge waves are created and spread outwards form the hole. The wall of water, a kilometer high, rushes towards southern Africa at 800 kilometers an hour. Cities on the African coast are totally destroyed and millions of people are drowned(淹死).

Before the waves reach South America, the second piece of the comet lands in Argentina. Earthquakes and volcanoes ash set off in the Andes Mountains. The shock waves move north into California and all around the Pacific Ocean. The cities of Los Angeles, San Francisco and Tokyo are completely destroyed by earthquakes. Millions of people in the southern half of the earth are already dead, but the north won’t escape for long. Because of the explosions, the sun is hidden by clouds of dust, temperatures around the world fall to almost zero. Crops are ruined. The sun won’t be seen again for many years. Wars break out as countries fight for food. A year later, no more than 10 million people remain alive.

Could it really happen? In fact, it has already happened more than once in the history of the earth. The dinosaurs were on the Earth for over 160 million years. Then 65 million years ago they suddenly disappeared. Many scientists believe that the Earth was hit by a piece of object in space. The dinosaurs couldn’t live through the cold climate that followed and they died out. Will we meet the same end?

小题1:What is mainly described in the passage?

A.A historic discovery.

B.An event in imagination.

C.A research on space.

D.A scientific adventure.小题2:When the first piece hits the South Atlantic, it causes________.

A.an earthquake

B.hunger

C.an Earth explosion

D.huge waves小题3:Why can’t the northern half of the earth escape for long?

A.Because the land is covered with water.

B.Because the light and heat form the sun cannot reach the earth.

C.Because people there cannot live at the temperature of zero.

D.Because wars break out among countries.小题4:By giving the example of dinosaurs, the author tries to prove_________.

A.animals could not live in the cold climate

B.what happened 65 million years ago was an invented story

C.the human beings will die out in 2094

D.the Earth could be hit by other objects in space

填空题