问题 多项选择题 案例分析题

患者女,58岁,因劳力性气促、腹胀、双下肢水肿3年,加重7d伴黒蒙1次入院。8年前因病态窦房结综合征行永久人工心脏起搏器置入治疗(VVI起搏器),当时UCG和胸部X线检查均无异常。无慢性咳嗽和原发性高血压史。查体:Bp120/70mmHg,颈静脉怒张,双肺呼吸音粗,无啰音。心率50次/min,律齐,P2不亢进,胸骨左下缘可闻及4/6级全收缩期杂音,吸气时增强。肝大,双下肢水肿。

最佳治疗方案为()(提示:食管超声发现三尖瓣间隔瓣穿孔,电极与瓣叶黏附牵连。)

A.利尿,纠正右心衰竭

B.使用降低肺动脉高压的药物

C.更换起搏器

D.外科手术三尖瓣修复或置换

E.心外膜永久起搏

F.拔出原心内膜电极

答案

参考答案:A, C, D, E, F

完形填空
完形填空
     I first met her on the beach near where I live.I drive to this beach a__1__of three or four miles,
whenever I'm feeling down.At that time she was__2__something.
     Looking__3__, she said, "Hello." I nodded, not wanting to__4__with a small child.
     "I'm Wendy and I'm building something, " she said.
    "I see.But what is it?" I asked, not__5__.
    "I don't know.I just like the__6__of sand."
     A sandpiper (矶鹞鸟) flew by.
     "That's a__7__.Mum says sandpipers come to bring us joy."
     "Goodbye, joy, "  I thought to myself, "hello, __8__." and  walked  away.My  life  then  seemed
completely out of__9__.
     "Come again, " she called, "and have another__10__day."
     But the days and weeks that followed__11__to other people:naughty boys and a__12__mother.
One morning I suddenly realized I needed my__13__and headed for the beach.The breeze was cool,
but I walked along, trying to recapture (捕捉) the inner peace I needed.I had almost__14__the child
so I was surprised when she appeared.
    "__15__do you live?" I asked.She pointed toward a summer cottage.
     Then one day, I rushed to my beach in great pain, even in no__16__to greet the girl."If you don't
mind,  " I said coldly, "I'd rather be__17__today." She seemed unusually__18__ and out of breath.
     "Why?" she asked.
     "My mother died!"
     "Did it hurt when she died?"
     "Of course it hurt!" I shouted, misunderstanding her.
     When I next went to the beach, she wasn't there.Feeling__19__, and admitting I__20__her, I went
up to the cottage.A woman answered the door."Wendy, my daughter, died last week.She had
leukemia (白血病). Maybe she didn't tell you."
( )1. A. length      
( )2. A. ob serving  
( )3. A. up    
( )4. A. work    
( )5. A. caring    
( )6. A. feel      
( )7. A. sorrow  
( )8. A. comfort  
( )9. A. balance  
( )10. A. sad    
( )11. A. added    
( )12. A. kind      
( )13. A. party    
( )14. A. searched  
( )15. A. How      
( )16. A. mood      
( )17. A. alone      
( )18. A. happy      
( )19. A. sorry      
( )20. A. cheated    
B. distance      
B. drawing      
B. out          
B. play          
B. seeing        
B. sense        
B. joy          
B. pleasure      
B. sight        
B. happy        
B. led          
B. poor          
B. sandpiper    
B. known        
B. What          
B. time          
B. lonely        
B. pale          
B. excited      
B. lost          
C. space      
C. building    
C. down      
C. say        
C. wanting    
C. smell      
C. pity      
C. kindness  
C. mind      
C. busy      
C. belonged    
C. lonely      
C. chance      
C. noticed        
C. Where      
C. way          
C. unique        
C. good          
C. cold          
C. troubled    
D. reach        
D. collecting  
D. over        
D. talk        
D. worrying    
D. comfort      
D. lie          
D. pain        
D. range        
D. fine        
D. related      
D. sick        
D. holiday      
D. forgotten    
D. Which        
D. place        
D. special      
D. powerful    
D. puzzled      
D. missed      
单项选择题