某男，60岁。头晕、乏力半年，近1个月症状加重，间有低热，四肢酸痛来诊。体检：体温38℃，重度贫血貌，下肢皮肤散在出血点，颈部可扪及花生仁大小淋巴结2枚，脾肋下2 cm。化验：Hb 50 g／L，WBC 2．3×10／L，血小板45×10／L，血片中有核红细胞3／100 WBC，并见巨大红细胞及巨大血小板。

［假设信息］假如患者通过上述治疗症状消失，体检无异常发现，三系细胞均升至正常范围内，骨髓涂片原始细胞占0．02(2％)，患者出院门诊治疗。半年后骨髓涂片增生明显 活跃，原粒细胞占0． 42(42％)，红系细胞及巨核细胞受抑。此时诊断是

A:原来疾病复发 B:急性粒细胞白血病未分化型(M1) C:急性粒细胞性白血病部分分化型(M2) D:继发性急性粒细胞性白血病(M2型) E:转化中原始细胞过多性难治性贫血

某男性患者，46岁，缺失，设置联合卡环，设置RPI卡环组，舌杆大连接体连接

设计的邻面板其最佳宽度为

A:小于基牙颊舌径的1／3 B:小于基牙颊舌径的2／3 C:大于基牙颊舌径的1／3 D:大于基牙颊舌径的2／3 E:大于基牙颊舌径的1／4

某男性患者，39岁，缺失，近远中大面积银汞合金充填物，无松动，X线显示已行完善的根管治疗；未见明显的牙体牙髓及牙周病变

如果患者要求固定义齿修复，但5牙冠剩余牙体薄弱，最佳的处理措施是

A:烤瓷固定桥 B:烤瓷固定桥 C:行桩核恢复后，烤瓷固定桥 D:金属固定桥 E:行桩核恢复后，金属固定桥

某女性患者，35岁，右颈部结节一周。无畏寒、发热，无咳嗽、咳痰，饮食可。否认结核病史。PE:右颈部可触及一约1.5cm×2cm的结节，质地中等，无压痛，随吞咽动作上下活动。血清FT、FT、TSH、TGAb及TMAb均正常。TcO甲状腺静态显像示右叶甲状腺可见一"冷"结节。

Tc-MIBI甲状腺血流显像及甲状腺肿瘤阳性显像示右叶"冷"结节血流灌注增加10分钟早期相及2小时延迟显像均可见放射性分布异常浓聚，上述征象提示最可能的诊断是

A:亚急性甲状腺炎 B:甲状腺癌 C:结节性甲状腺肿 D:甲状腺出血 E:甲状腺囊肿 F:慢性淋巴细胞甲状腺炎

某女性患者，35岁，右颈部结节一周。无畏寒、发热，无咳嗽、咳痰，饮食可。否认结核病史。PE:右颈部可触及一约1.5cm×2cm的结节，质地中等，无压痛，随吞咽动作上下活动。血清FT、FT、TSH、TGAb及TMAb均正常。TcO甲状腺静态显像示右叶甲状腺可见一"冷"结节。

行右叶甲状腺全切和左叶甲状腺大部分切除，右颈淋巴结清扫术，术后病理：分化良好乳头状甲状腺癌（右叶）伴右颈部淋巴结(5／7)转移。随后，行三次I治疗。近期因血甲状腺球蛋白(Tg)进行性升高，最高达648mg,/L，行I显像，结果阴性。F-FDGPET／CT示胸骨柄代谢局灶性异常增高，F-FDG显像阳性结果提示

A:癌细胞分化程度高，预后相对好 B:癌细胞分化程度低，预后相对差 C:癌细胞乏氧 D:癌细胞碘代谢活跃 E:癌细胞糖代谢降低 F:癌组织血流灌注增加

某男性患者，16岁，右膝X线平片和CT检查见下图。

病变发生部位是

A:骨端 B:干骺端 C:骨骺 D:骨干 E:关节腔

某男性患者，16岁，右膝X线平片和CT检查见下图。

对于此病变的征象，描述不正确的是

A:右胫骨内侧平台近关节面下不规则溶骨性破坏 B:边缘可见硬化缘 C:病灶内可见多发细小点状钙化 D:可见骨膜反应 E:病变为偏心性生长

某男性患者，16岁，右膝X线平片和CT检查见下图。

根据此病灶内部多发钙化，对其定性诊断的提示是

A:良性 B:骨源性 C:软骨源性 D:纤维源性 E:恶性

某男性患者，16岁，右膝X线平片和CT检查见下图。

此病变最可能的诊断是

A:骨巨细胞瘤 B:内生软骨瘤 C:骨结核 D:成软骨细胞瘤 E:软骨黏液样纤维瘤

Across the Deserts

　　The SaharaDesertis the largest desert in the world. It stretches across Africa fromSenegaltoEgypt. TheSaharaDesertis an unfriendly environment. During the day it"s very hot, and at night it’s sometimes very cold. It is also difficult to find water in theSahara.

　　In 2006, Kevin Lin, Ray Zahab, and Charlie Engle decided to do something very difficult. They made the decision to run across the Sahara Desert 4,300 miles (6,920km). It seemed impossible to do, but they wanted to try. The three men liked to test themselves, and this would be a very big test.

　　On the morning of November 2, Kevin, Ray, and Charlie started their trip across theSahara. Every morning they began running at 5:00. At11 a.m. they stopped and rested until 5 p.m. Then they ran again until 9:30 in the evening. Each day they ran about 40 miles (64 km). Every day it was the same thing. They got up and ran. They listened to music on their iPods, and they ran and ran.

　　Kevin, Ray, and Charlie needed to eat a lot of food during their trip. Most people need about 2,000 calories of food each day. Kevin, Ray, and Charlie needed between 6,000 and 9,000 calories every day. That"s a lot of food! They also needed to drink a lot of water.

　　The three men had some problems on their trip, and many times they wanted to quit and go home. It was often very hot (140°F/60°C) during the day, and the heat made them sick. Their legs and feet hurt. Sometimes it was very windy, and they couldn"t see. One time they got lost. But they didn"t quit. After 111 days, Kevin, Ray; and Charlie successfully finished their trip across theSaharaDesert. They hugged each other and put their hands in the water of theRed Sea. Then they ran to a hotel to take a long shower.

　　词汇：

　　Stretch / strɛtʃ / v. 延伸，伸展

　　Calorie / "kælərɪ / n. 卡(路里)，小卡，大卡

　　Quit / kwɪt / v. 停止，放

　　注释：

They sometimes felt sick because it was so hot.

A:Right B:Wrong C:mentioned