问题 单项选择题


女性,56岁,诊断肺心病3年,2天前受凉后发热,咳嗽、咳痰加重,黄痰,呼吸困难不能平卧。查体明显发绀,颈静脉怒张,双肺广泛散在干湿性啰音,心率110次/分,三尖瓣区可闻及收缩期杂音,肝肋下3cm,下肢水肿。

该患者最重要的治疗措施是

A.利尿剂

B.强心剂

C.呼吸兴奋剂

D.有效抗生素

E.血管扩张剂

答案

参考答案:D

解析:肺心病病人最常见的加重因素是感染。此患者2天前发热、咳嗽、咳黄痰,并伴有明显心衰的症状和体征,所以病情加重的主要原因是呼吸道感染;由于此病人近期加重,病程较短,易产生呼吸性酸中毒,此时肾脏的调节和代偿尚不充分,此时最重要的治疗是去除诱因。

判断题
单项选择题

Randy Kraus was paralyzed. His left side was useless. But his right hand was (1) enough to lift a bucket to his forehead. Once, he’d been a police officer and owned a private-eye agency. Once, he’d been p and able. Now, he felt he was nothing.

His (2) started with Parkinson’s disease, but it didn’t (3) there. In July 2002, the 60 year old Kraus went into the hospital for an operation to control the shaking. (4) , during the operation, he had a stroke. He was paralyzed. The (5) man, who loved golf, could think, but couldn’t (6) . Kraus wanted the doctors to (7) it to him straight. "You may never walk again, " they told him. "Maybe you won’t (8) be able to talk. "

Once at home, he (9) he couldn’t lift a fork or take a drink by himself. Physical treatment was so painful and slow. What did he have to (10) for So now Kraus held the gun against his head. (11) the cold metal on his skin, he began to consider not his pain, but the pain he (12) cause his wife, daughters and grandchildren. He didn’t pull the trigger.

"You are where you are", his exercise physiologist, Andrew Garud told him. "The pace would be slow; the pain would be (13) . But as long as you are (14) , you have the ability to get better. " After three months of (15) with Garud, Kraus wanted to see if he could (16) . He could. Then he took three steps, sat down and cried like a baby. One step (17) to another. Next he managed a short walk. It was the hardest (18) of Kraus’s life.

Garud kept saying he could (19) more. Now, Kraus can brush his teeth, shave himself and get around the house with a walker. Little success only the paralyzed can (20) understand.

13().

A.sharp

B.dull

C.familiar

D.real