问题 单项选择题 案例分析题

患者男,18岁,因“反复心悸、呼吸困难1月余”入院。发病前有受凉史,曾在当地医院诊断为“急性病毒性心肌炎”,但疗效不佳。既往史无特殊。入院查体:T36.8℃,P76次/min,R26次/min,Bp82/62mmHg;神清,精神欠佳,双肺呼吸音清,心界左下扩大,HR76次/min,律齐,心尖部可闻及3/6级收缩期杂音。腹软,肝右肋下3指。双下肢无水肿。心脏彩色超声提示:全心扩大,LVEDd6.7mm,LVEF30%,左心室壁运动弥漫性减弱,二、三尖瓣中度关闭不全。

患者自发病以来多次检查肝、肾功能均正常,ECG显示为窦性心律、肢导联低电压、V1~V3导联R波递增不良、T波低平或倒置。虽积极配合治疗,但日常活动仍明显受限,目前需考虑的进一步治疗手段为()

A.免疫吸附抗心肌抗体

B.心脏再同步化治疗

C.植入ICD

D.心脏移植

E.射频消融

F.心脏瓣膜置换术

答案

参考答案:D

问答题
阅读理解

About one million years ago,the Ice Age began.The Ice Age was a long period of time in which four great glaciers(冰川) pushed southward to cover almost all the upper half of North America,and then melted away.Each glacier was a thick sheet of ice and snow that spread out from a center near what is now Hudson Bay in Canada.The winters were long,and the cool summers were too short to melt much of the ice and snow.The evergrowing sheet built up to a thickness of two miles at its center.

As all glaciers do,these great glaciers slid(滑动). They pushed down giant trees in their paths and scraped(刮削)the earth bare(光秃秃)of soil.Many animals moved farther south to escape.Others stayed and were destroyed.

When winters of little snow came,the summer suns into the edges to the ice sheets.As the glaciers melted,rocks,soil and other things that had mixed with the ice and snow were left.New hills,lakes and rivers were formed.

The last of the great glaciers began its melting about 11 000 years ago.Itsmelting formed the Great Lakes.These lakes are today little changed from their early sizes the glaciers.This is the Mississippi Missouri Ohio system.These rivers were miles wide at first.Through the years they settle into their present channels.

The main idea of this passage is  ________ .

A.the Ice Age was a long period of time        

B.great glaciers covered North America many years ago        

C.changes in climate helped to melt the glaciers        

D.how glaciers changed North America       

2.The author states that all glaciers ________.

A.are two miles thick           B.form frozen lakes        

C.are a million years old      D.move and slide   

3.From the information in this passage we know that  ________.

A.glaciers are destructive        

B.all glaciers in the world move southward        

C.the Mississippi Missouri Ohio systems is larger than it was before the Ice Age        

D.the Great Lakes are now smaller than they were before the Ice Age

4.The Ice Age lasted almost ____.

A.1 000 years      B.100 years      C.1 000 000 years      D.11 000 years  

5.In the last sentence,the word “their” refers to  ________ .

A.lakes            B.rivers         C.glaciers             D.systems