问题 单项选择题 A型题

患者男性,46岁,反复发作胸痛3天,胸痛持续数分钟,可自行缓解。此次就诊时再次发作胸痛,胸痛发作到胸痛消失的心电图记录如图3-2-4所示,应诊断为()。

A.急性下壁心肌梗死

B.急性心包炎

C.变异型心绞痛

D.早期复极综合征

E.加速性室性心动过速

答案

参考答案:C

解析:

图3-2-4A为患者胸痛发作时的心电图,可见Ⅱ、Ⅲ导联ST段显著抬高呈巨R型,Ⅰ导联ST段呈对应性下移,PR间期明显延长,提示发生房室传导阻滞。图3-2-4B为患者胸痛减轻时的心电图,Ⅱ、Ⅲ导联ST段抬高开始回落,伴随PR间期开始缩短。图3-2-4C为数分钟后患者胸痛消失的心电图记录,Ⅰ、Ⅱ、Ⅲ导联ST段偏移恢复至正常,PR间期也恢复正常。根据此心电图动态变化可诊断为变异型心绞痛。该患者ST段抬高发生在下壁导联,伴随出现房室传导阻滞,提示冠状动脉痉挛的部位为右冠状动脉。

阅读理解

根据短文内容,判断下列句子的正误,正确的用"T",错误的用"F"。

       A farmer's dog, Dolly, had puppies (小狗), and the farmer needed to sell them. He painted a sign and

   put it in his yard. As he was putting up the sign, a little boy walked up to him.

       "Sir," he said, "I want to buy one of your dogs. "

       "Well, " said the farmer, "these dogs are very expensive. "

       "Can I just look.'?" asked the boy.

       "Sure," said the farmer and whistled (吹口哨). "Here, Dolly !" he called.

       Dolly ran out from the doghouse and four little dogs followed her. The boy became excited.

       Then, the little boy noticed another dog. This one was smaller. It moved slowly and tried to catch up

  with the others.

       "I want that one," the boy said, pointing to the little dog.

       The farmer said, "Son, you don't want that dog. He will never be able to run and play with you like

  these other dogs. "

       The little boy reached down and rolled up (卷起) one leg of his trousers. He showed a cast (石膏)

  on his leg and a specially made shoe. He said, "You see, sir, I don't run too well myself, and he will need

  someone who understands. "

       The world is full of people who need someone who understands.

( ) 1. Dolly was a mother dog which bad four baby dogs.

(     ) 2. One of the dogs moved slowly probably because its legs were weak.

(     ) 3. The farmer advised the boy not to choose the smaller dog.

(     ) 4. Nothing was wrong with the boy's leg.

(     ) 5. We learn from the story that one should show love and understanding for the weak.

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