问题 单项选择题 A1/A2型题

患者男,17岁,学生。少语少动半月,病前有感冒史,体温达39℃,在当地医院住院治疗,4天后恢复正常,之后患者渐出现少语少动,进食少,神经系统检查未见异常,脑电图和头颅MRI检查正常,无大小便失禁。精神状况检查:患者静卧于床,百问不答,皱眉头。据家属反映,患者病前期中考试成绩不理想,曾说自己脑子不好使。此患者最可能的诊断是()

A.病毒性脑炎所致精神障碍

B.反应性精神病

C.抑郁发作

D.双相情感障碍

E.分裂样精神病

答案

参考答案:C

解析:此患者病前有感冒史,出现了亚木僵的表现,因此需要先排除器质性疾病如脑炎。题干的信息指出患者神经系统检查正常,脑电图和头颅MRI检查正常,也无大小便失禁等情况,精神状况检查时发现皱眉头,因此可以推测患者的意识没有明显障碍,而且患者曾经说过自己脑子不好使,当时可能已经出现了抑郁情绪、思维迟缓和记忆力下降,所以患者觉得脑子不好使,只是当时家属和患者没有察觉而没有带患者就医,而感冒只是病程中的一个巧合而已。病史中没有提到患者有过躁狂发作或者混合性发作等,因此不考虑双相障碍的诊断,同时该患者没有精神病性症状的出现,也不考虑分裂样精神病的诊断,考试成绩的不理想可能是抑郁发作的结果,而不是原因,因此也不考虑反应性精神病的诊断。故此患者最可能的诊断是抑郁发作。

阅读理解

Here is an interview with a painter. Read and choose the best.

Reporter:Mr Shum, you were one of Taiwan’s most outstanding youths last year. Why was that?

Mr Shum:Well, I can tell you that there are two reasons.First, I am a painter. Second, and more important reason is I am handicapped﹙残疾的﹚。I have no arms and only one leg.

Reporter:Well, how do you paint then if you’ve got no arms? Do you use your foot?

Mr Shum:Hah! For some handicapped people, it’s true and they are able to use their feet.No,I use my mouth. I put my paintbrush or my crayons or pencils or whatever I am using in my mouth. I hold it firmly in my teeth and paint or draw like that. It was a little strange for me at first, but it quickly became very easy.

Reporter:I know you feel that you are first a painter and only secondly that you are a disablbed person, but can we talk first about your handicap?

Mr Shum:Well,in fact I think of myself firstly as a person, secondly as a painter and thirdly as someone with a physical handicap. Can I say that I am not happy with the word “handicapped”?

I am a popular painter because my paintings are good, not because they were painted by a handicapped person. “handicapped”means you can’t do anything. It is difficult for me to do some things like getting dressed.

Reporter: Were you born with your handicap?

Mr Shum:No. An accident happened to me when I was 15 years old.After that I became depressed﹙沮丧﹚and even tried to end my life, but my mother was always there for me.

小题1:Mr Shum is a painter who has no ____.

A.mouth

B.teeth

C.feet

D.arms小题2:Mr Shum thinks himself first as ____.

A.a person

B.a painter

C.a hit

D.a star小题3:He doesn’t like the word“handicapped”because it suggests ______.

A.he can do anything

B.there are some things he can’t do

C.there are somethings he can do very well

D.he doesn’t want others to look him down小题4:What does the underlined word“firmly”in this passage mean?

A.紧紧地

B.随意地

C.缓缓地

D.轻轻地小题5:What can we learn from Mr Shum’s story?

A.Comfort in living by painting

B.Pleasure of living with a brave mother

C.Help gives people happiness.

D.What really matters is how you face it.

单项选择题