问题 单项选择题

患者,男,60岁,心前区阵发性疼痛1个月,多在夜间发作,与活动无关,每次发作15分钟,发作时心电图Ⅱ、Ⅲ、aVF导联ST段抬高。首选治疗的药物是()。

A.硝酸酯类

B.β受体阻滞剂

C.钙离子拮抗剂

D.洋地黄类

E.乙胺碘呋酮

答案

参考答案:C

解析:患者在夜间发作,与活动无关,考虑为变异型心绞痛,与卧位型心绞痛相似,一般在休息或熟睡时发生,常在半夜、偶在午睡时发作,不易为硝酸甘油缓解,但发作时心电图示有关导联的ST段抬高,与之相对应的导联则ST段可压低,为冠脉突然痉挛所致,迟早会心梗。其治疗以钙通道阻滞剂的疗效最好。故选C。

多项选择题
单项选择题

"You are not here to tell me what to do. You are here to tell me why I have done what I have already decided to do," Montagu Norman, the Bank of England’s longest-serving governor (1920-1944), is reputed to have once told his economic adviser. Today, thankfully, central banks aim to be more transparent in their decision making, as well as more rational. But achieving either of these things is not always easy. With the most laudable of intentions, the Federal Reserve, America’s central bank, may be about to take a step that could backfire.

Unlike the Fed, many other central banks have long declared explicit inflation targets and then set interest rates to try to meet these. Some economists have argued that the Fed should do the same. With Alan Greenspan, the Fed’s much-respected chairman, due to retire next year-after a mere 18 years in the job-some Fed officials want to adopt a target, presumably to maintain the central bank’s credibility in the scary new post-Greenspan era. The Fed discussed such a target at its February meeting, according to minutes published this week. This sounds encouraging. However, the Fed is considering the idea just when some other central banks are beginning to question whether strict inflation targeting really works.

At present centra1 banks focus almost exclusively on consumer-price indices. On this measure Mr. Greenspan can boast that inflation remains under control. But some central bankers now argue that the prices of assets, such as houses and shares, should also somehow be taken into account. A broad price index for America which includes house prices is currently running at 5.5%, its fastest pace since 1982. Inflation has simply taken a different form.

Should central banks also try to curb increases in such asset prices Mr. Greenspan continues to insist that monetary policy should not be used to prick asset-price bubbles. Identifying bubbles is difficult, except in retrospect, he says, and interest rates are a blunt weapon: an increase big enough to halt rising prices could trigger a recession. It is better, he says, to wait for a housing or stockmarket bubble to burst and then to cushion the economy by cutting interest rates-as he did in 2001-2002.

And yet the risk is not just that asset prices can go swiftly into reverse. As with traditional inflation, surging asset prices also distort price signals and so can cause a misallocation of resources-encouraging too little saving, for example, or too much investment in housing. Surging house prices may therefore argue for higher interest rates than conventional inflation would demand. In other words, strict inflation targeting-the fad of the 1990s-is too crude.

It is implied in the fourth paragraph that Mr. Greenspan is skeptical of ()

A. the stipulation of anti-monopoly rules and regulations

B. the intervention by central banks in asset prices

C. the prevention of economic recession

D. the countdown by the Federal Reserve of new economic upheavals