患者，男性，65岁。肺癌患者，住院化学治疗期间渐起左下肢肿胀，疼痛。Doppler超声检查提示深静脉炎。予抗凝治疗后症状有所改善。今日早餐进食时突感气急、胸闷和心前区疼痛，呈进行性加重。检查见患者口唇明显发绀，坐位，心界扩大，心率120次／分，律齐，P2亢进，三尖瓣区闻及收缩期杂音及舒张期奔马律。右下肺呼吸音降低。既往有高血压病和冠心病史。
本例患者最可能的诊断是（）
A.肺栓塞和急性肺源性心脏病
B.急性右心衰竭
C.肺癌转移及压迫大气道
D.窒息
E.急性心肌梗死
参考答案：A
完形填空 (10分) Grandma was busy cooking in the kitchen and Sera was always to be here for dinner. There were many photographs of past and present 1 members and many other old things on her grandma’s table. Among them, she especially loved the large clay pot (陶壶). It was beautiful, painted in many colours. “May I hold it?” asked Sera. “Yes, but please be 2 . It is very old.” Grandma picked up the pot with gentle hands, gave it to Sera, and then went into the kitchen. Sera decided to sit on the sofa. The sofa was a few feet 3 her. She went backward. 4 a toy truck was there. The truck rolled (滚动) away when Sera stepped on it. She fell back onto the sofa. The clay pot 5 out of her hands and up into the air! It landed on the floor. Sera could hear the clay crack (裂痕). “No, no!” she cried. She heard grandma’s footsteps coming toward her. How could she face her grandma now? “It’s not so 6 , Sera,” Grandma said. “Come on. You can repair the pot.” “Let me tell you a story about that pot.” Grandma pointed to another crack in the pot. Sera had never 7 it before. “My grandma made this crack when she was about your age,” said grandma. “She was carrying it back to the village 8 it fell onto the road. It had been full of 9 , so she got all wet!” She pointed to another crack. “This crack came when I dropped the pot on a big boat that brought 10 here from Canada,” said grandma smiling. Sera laughed and held up the pot. She could see now how each crack had become part of the colourful design--and part of her family’s story.
|