问题 单项选择题 A1/A2型题

男性,16岁,时有酱油色尿而来就诊。红细胞形态正常,血红蛋白90g/L,网织红细胞3.8%;Coombs试验(-),酸化血清试验阳性,冷热溶血试验(-)。本例应诊断为()

A.运动性血红蛋白尿

B.自身免疫性溶血性贫血

C.阵发性冷性血红蛋白尿

D.冷凝集素血症

E.PNH

答案

参考答案:E

解析:阵发性睡眠性血红蛋白尿症是一种后天获得性造血干细胞基因突变引起的溶血病。多为慢性血管内溶血。患者体内存在对补体敏感的红细胞。Ham试验阳性主要见于PNH。

单项选择题

Passage OneA recent study indicates that the “short sleepers” had been more or less average in their sleep needs until the men were in their teens. But at about age 15 or so, the men voluntarily began cutting down their nightly sleep time because of pressures from school, work, and other activities. These men tended to view their nightly periods of unconsciousness as bothersome interruptions in their daily routines.In general, these “short sleepers” appeared ambitious, active, energetic, cheerful, conformist in their opinions, and very sure about their career choices. They often held several jobs at once, or work fullor parttime while going to school. And many of them had a p urge to appear “normal” or “acceptable” to their friends and associates.When asked to recall their dreams, the “short sleepers” did poorly. More than this, they seemed to prefer not remembering. In similar fashion, their usual way of dealing with psychological problems was to deny that the problem existed, and then to keep busy in the hope that the trouble would go away.The sleep patterns of the “short sleepers” were similar to, but less extreme than, sleep patterns shown by many mental patients categorized as manic.The “long sleepers” were quite different indeed. According to the study, these young men had lengthy sleeps since childhood. They seemed to enjoy their sleep, protected it, and were quite concerned when they were occasionally deprived of their desired 9 hours of nightly bed rest. They tended to recall their dreams much better than did the “short sleepers”.Many of the “long sleepers” were shy, anxious, introverted, inhibited, passive, mildly depressed, and unsure of themselves (particularly in social situations). Several openly state that sleep was an escape from their daily problems.

Many “short sleepers” are likely to hold the view that ().

A.sleep is a withdrawal from the reality

B.sleep interferes with their sound judgment

C.sleep is the least expensive item on their routine program

D.sleep is the best way to deal with psychological troubles

判断题