患者,女性,26岁,农民。因无明显诱因出现烦躁、焦虑、抑郁、怀疑被人议论和被害5个月

题型:单项选择题 A3/A4型题

问题:

患者,女性,26岁,农民。因无明显诱因出现烦躁、焦虑、抑郁、怀疑被人议论和被害5个月,2个月前出现四肢近端阵发性发绀,腕、足、踝关节红、肿、热、痛并指端发麻,进行性出现皮肤变黑、色素沉着、双侧颜面部呈对称性皮疹,口唇色素沉着并增厚,面部及四肢皮肤红斑、脱发,间歇性低热,全身乏力,食欲降低,体重下降5kg,于2008年5月30日入院。

入院体格检查:发育正常,营养一般,慢性病容,留男士发型,头发稀疏,有2处约2cm×3cm大小的圆形斑秃。面部及全身皮肤呈棕褐色色素沉着,双侧面颊呈黑红色,可见毛细血管扩张,四肢皮肤也可见红斑或网状青斑,呈不规则圆形,周围稍微凸起,红斑上附有鳞屑。精神状况检查:意识清晰,精神萎靡,接触交谈欠合作。谈话中未引出幻觉。情绪低落,存在关系妄想,被害妄想,无自知力。实验室检查:Hb10.5g/L,WBC3900/mm3,血沉65mm/h,肝、肾功能正常,抗链球菌"O"正常,CH5040U/ml,C30.87mg/L;抗核抗体(ANA)测定呈阳性反应,狼疮细胞阳性。该患者可能的诊断为()

A.类风湿性关节炎

B.系统性红斑狼疮(SLE.

C.风湿性关节炎

D.骨性关节炎

E.强直性脊柱炎

F.皮肤炎

G.多发性肌炎

H.系统性硬化症

I.结节性多动脉炎

考点:重庆住院医师内科I阶段精神科精神科题库
题型:单项选择题 A3/A4型题

It seems impossible to have an honest conversation about global warming. I say this after diligently perusing the British government’s huge report released last week by Sir Nicholas Stern, former chief economist of the World Bank and now a high civil servant. The report is a masterpiece of misleading public relations. It foresees dire consequences if global warming isn’t curbed: a worldwide depression and flooding of many coastal cities. Meanwhile, the costs of minimizing these awful outcomes are small: only 1 percent of world economic output in 2050.

No sane person could fail to conclude that we should conquer global warming instantly, if not sooner. Who could disagree Well, me. Stem’s headlined conclusions are intellectual fictions. They’re essentially fabrications to justify an aggressive anti-global-warming agenda. The danger of that is that we’d end up with the worst of both worlds: a program that harms the economy without much cutting of greenhouse gases.

Let me throw some messy realities onto Stern’s tidy picture. In the global-warming debate, there’s a big gap between public rhetoric and public behavior. Greenhouse emissions continue to rise despite many earnest pledges to control them. Just last week, the United Nations reported that of the 41 countries it monitors (not including most developing nations), 34 had increased greenhouse emissions from 2000 to 2004. These include most countries committed to reducing emissions under the Kyoto Protocol.

Why is this In rich democracies, policies that might curb greenhouse gases require politicians and the public to act in exceptionally "enlightened" ways. They have to accept "pain" now for benefits that won’t materialize for decades, probably after they’re dead. And even if rich countries cut emissions, it won’t make much difference unless poor countries do likewise and so far, they’ve refused because that might jeopardize their economic growth and poverty-reduction efforts.

The notion that there’s only a modest tension between suppressing greenhouse gases and sustaining economic growth is highly dubious. Stern arrives at his trivial costs—that 1 percent of world GDP in 2050—by essentially assuming them. His estimates presume that, with proper policies, technological improvements will automatically reconcile declining emissions with adequate economic growth. This is a heroic leap. To check warming, Stern wants annual emissions 25 percent below current levels by 2050. The IEA projects that economic growth by 2050 would more than double emissions. At present, we can’t bridge that gap.

The other great distortion in Stern’s report involves global warming’s effects. No one knows what these might be, because we don’t know how much warming might occur, when, where, or how easily people might adapt. Stern’s horrific specter distills many of the most terrifying guesses, including some imagined for the 22nd century, and implies they’re imminent. The idea is to scare people while reassuring them that policies to avert calamity, if started now, would be fairly easy and inexpensive.

The author agrees with Stern that()

A. global warming is something to fight with

B. curbing global warming will not affect economy

C. an aggressive anti-global-warming agenda is necessary

D. not much cost will be involved in conquering global warming

题型:单项选择题 A3/A4型题

八旬老妪,患"五更泻"两年未愈,近两月泻下不禁,完谷不化,形寒肢冷,腰酸膝软,舌淡胖,苔白,脉沉细。治疗宜选用()

A.附子理中汤

B.补中益气汤

C.桃花汤

D.四神丸

E.真人养脏汤

题型:单项选择题 A3/A4型题

关于腹膜解剖生理的叙述,正确的是

A.腹膜分为壁腹膜、脏腹膜、肠系膜和网膜四个部分

B.腹膜有很多皱襞,因此具有较大的表面积,相当于人体皮肤表面积的1.7~2倍

C.腹膜上具有丰富的腺体,在急性炎症时能够分泌大量的液体以稀释有害物质

D.正常情况下,腹腔内有75―100ml澄清液体和少量气体以润滑、间隔腹腔内的脏器

E.腹膜具有很强的吸收能力,能够吸收腹腔内的积液、血液和细菌毒素

题型:单项选择题 A3/A4型题

1609年,日本萨摩番岛津氏曾侵占琉球,逼迫琉球向其进贡,从此琉球处于一仆二主的地位。

题型:单项选择题 A3/A4型题

高压试验结束后,作业人员应检查哪些内容?

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