鼻腔的原发恶性肿瘤中，发病率最高的组织学类型为（） A.鳞癌 B.腺癌 C.未分化癌

青黛入药宜（）。

A.先煎

B.后下

C.包煎

D.另煎

E.冲服

患者女性，78岁，发热、腹痛、皮肤黄染2天，少尿1天。查体：神志不清，体温39℃，血压70∕40mmHg，心率130次∕分，全身湿冷。留置导尿见尿色深黄，尿量50ml。实验室检查：pH7.230，PaO₂68mmHg，PaCO₂24mmHg，BE－12mmol∕L，K5.0mmol∕L，血肌酐218μmol∕L，血尿素氮20mmol∕L，患者治疗过程中观察尿量是很重要且很有意义的指标，治疗目标是（）。

A.0.5ml（kg·h）

B.1.0ml（kg·h）

C.1.5ml（kg·h）

D.2.0ml（kg·h）

E.2.5ml（kg·h）

阅读下面短文，掌握其大意，然后从36—55各题所给的四个选项（A、B、C和D）中，选出最佳选项

My sister and I grew up in a little village in England. Our father was a struggling   36 , but I always knew he was   37  . He never criticized us, but used   38  to bring out our best. He’d say, “If you pour water on flowers, they flourish. If you don’t give them water, they die.”  I   39  as a child I said something   40  about somebody, and my father said, “   41  time you say something unpleasant about somebody else, it’s a reflection of you.” He explained that if I looked for the best   42  people, I would get the best   43  . From then on I’ve always tried to   44  the principle in my life and later  in running my company.

Dad’s also always been very   45 . At 15, I started a magazine. It was   46  a great deal of my time, and the headmaster of my school gave me a  47 ：stay in school or leave to work on my magazine.

I decided to leave, and Dad tried to sway me from my decision,   48  any good father would.  When he realized I had made up my mind,  he said, “Richard, when I was 23, my dad   49  me to go into law.  And I’ve   50  regretted it. I wanted to be a biologist,   51  I didn’t pursue my   52  . You know what you want. Go fulfill it.”

As   53  turned out, my little publication went on to become Student, a national   54 for young people in the U.K.  My wife and I have two children, and I’d like to think we are bringing them up in the same way Dad   55  me.

36. A. biologist             B. manager                   C. lawyer                            D. gardener

37. A. strict                      B. honest                       C. special                            D. learned

38. A. praise                        B. courage                         C. power                      D. warmth

39. A. think                         B. imagine                         C. remember                 D. guess

40. A. unnecessary         B. unkind                          C. unimportant              D. unusual

41. A. Another                 B. Some                          C. Any                           D. Other

42. A. on                          B. in                              C. at                                 D. about

43. A. in case                   B. by turns                     C. by chance                 D. in return

44. A. revise                    B. set                                    C. review                            D. follow

45. A. understanding             B. experienced                     C. serious                          D. demanding

46. A. taking up                   B. making up                 C. picking up                  D. keeping up

47. A. suggestion                  B. decision                         C. notice                            D. choice

48. A. and                           B. as                               C. even if                       D. as if

49. A. helped                B. allowed                     C. persuaded                   D. suggested

50. A. always                       B. never                         C. seldom                      D. almost

51. A. rather                        B. but                                C. for                                D. therefore

52. A. promise              B. task                            C. belief                        D. dream

53. A. this                           B. he                                 C. it                                  D. that

54. A. newspaper           B. magazine                       C. program                        D. project

55. A. controlled           B. comforted                      C. reminded                       D. raised

若疼痛剧烈，伴有自主神经功能紊乱，严重干扰睡眠，被动体位，必须依靠止痛治疗，按主诉分级法，属于（）

A.4级：严重疼痛

B.3级：重度疼痛

C.2级：中度疼痛

D.1级：轻度疼痛

E.0级：无痛

女性，39岁。双手、双膝关节肿痛3个月。患者3个月前开始无明显原因出现双手、双膝关节肿胀、疼痛。以双手指关节为主，伴有明显晨僵，时间大于1小时。2个月前曾因乏力，关节痛到医院检查，诊断为"关节炎，贫血"（具体不详），未予治疗。发病以来无发热，无皮疹，偶有口腔溃疡，无光过敏，无口干、眼干症状，大、小便及睡眠均正常。既往体健，无胃病和痔疮史，无银屑病病史，无外伤史。无烟酒嗜好，不偏食。无遗传病家族史。查体：T36℃，P96次／分．R19次／分，BP120/70mmHg。轻度贫血貌，皮肤未见出血点和皮疹，浅表淋巴结未触及肿大，睑结膜略苍白，巩膜无黄染，甲状腺无肿大。双肺未闻及干湿性啰音，心界不大，心率96次／分，律齐，未闻及杂音。腹平软，无压痛，肝脾肋下未触及，移动性浊音（-），双下肢无水肿。左腕关节肿胀，压痛阳性；双手2、3掌指关节肿胀，压痛阳性；双膝关节轻度肿胀，浮髌试验（-），余关节正常。实验室检查：血常规：Hb80g/L，WBC7.5×10⁹/L，Plt345×10⁹/L。尿常规（-），类风湿因子110IU/ml（正常值0~301U/ml）。抗环胍氨酸肽抗体58RU/ml（正常值0~5RU/ml）。抗核抗体1：20（正常值<1：40）。要求：根据以上病历摘要，请写出初步诊断、诊断依据（如有两个以上诊断，应分别写出各自诊断依据，未分别写出扣分）、鉴别诊断、进一步检查与治疗原则。