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男,76歲。左下肢間歇性跛行3年,加重1個(gè)月。既往史:高血壓病史8年,冠心病病史5年,曾行冠脈支架植入術(shù)。查體:BP150/90mmHg,左足蒼白,左足及左下肢皮溫明顯降低,左足背動(dòng)脈、腘動(dòng)脈搏動(dòng)消失,左股動(dòng)脈可觸及搏動(dòng),做可能的診斷是左下肢

A、急性動(dòng)脈栓塞
B、深靜脈血栓形成
C、動(dòng)脈硬化性閉塞癥
D、血栓性淺靜脈炎
E、血栓閉塞性脈管炎
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C

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AsGilbertWhite,Darwin,andothersobservedlongago,allspeciesappeartohavetheinnatecapacitytoincreasetheirnumbersfromgenerationtogeneration.Thetaskforecologistsistountangletheenvironmentaandbiologicalfactorsthatholdthisintrinsiccapacityforpopulationgrowthincheckoverthelongrun.Thegreatvarietyofdynamicbehaviorsexhibitedbydifferentpopulationmakesthistaskmoredifficult:sompopulationsremainroughlyconstantfromyeartoyear;othersexhibitregularcyclesofabundanceandscarcity;stillothersvarywildly,withoutbreaksandcrashesthatareinsomecasesplainlycorrelatedwiththeweather,andinothercasesnot.Toimposesomeorderonthiskaleidoscopeofpatterns,oneschoolofthoughtproposesdividingpopulationsintotwogroups.Theseecologistspositthattherelativelysteadypopulationshavedensity-dependentgrowthparameters;thatis,ratesofbirth,death,andmigrationwhichdependstronglyonpopulationdensity.Thehighlyvaryingpopulationshavedensity-independentgrowthparameters,withvitalratesbuffetedbyenvironmentalevents;theseratesfluctuateinawaythatiswhollyindependentofpopulationdensity.Thisdichotomyhasitsuses,butitcancauseproblemsiftakentooliterally.Foronething,nopopulationcanbedrivenentirelybydensity-independentfactorsallthetime.Nomatterhowseverelyorunpredictablybirth,death,andmigrationratesmaybefluctuatingaroundtheirlong-termaverages,iftherewerenodensity-dependenteffects,thepopulationwould,inthelongrun,eitherincreaseordecreasewithoutbound(barringamiraclebywhichgainsandlossescanceledexactly)。Putanotherway,itmaybethatonaverage99percentofalldeathsinapopulationarisefromdensity-independentcauses,andonlyonepercentfromfactorsvaryingwithdensity.Thefactorsmakinguptheonepercentmayseemunimportant,andtheircausemaybecorrespondinglyhardtodetermine.Yet,whetherrecognizedornot,theywillusuallydeterminethelong-termaveragepopulationdensity.Inordertounderstandthenatureoftheecologist’sinvestigation,wemaythinkofthedensity-dependenteffectsongrowthparametersasthesignalecologistsaretryingtoisolateandinterpret,onethattendstomakethepopulationincreasefromrelativelylowvaluesordecreasefromrelativelyhighones,whilethedensity-independenteffectsacttoproducenoiseinthepopulationdynamics.Forpopulationsthatremainrelativelyconstant,orthatoscillatearoundrepeatedcycles,thesignalcanbefairlyeasilycharacterizedanditseffectsdescribed,eventhoughthecausativebiologicalmechanismmayremainunknown.Forirregularlyfluctuatingpopulations,wearelikelytohavetoofewobservationstohaveanyhopeofextractingthesignalfromtheoverwhelmingnoise.Butitnowseemsclearthatallpopulationsareregulatedbyamixtureofdensity-dependentanddensity-independenteffectsinvaryingproportions.

1.Theauthorofthetextisprimarilyconcernedwith

[A]Discussingtwocategoriesoffactorsthatcontrolpopulationgrowthandassessingtheirrelativeimportance.

[B]Describinghowgrowthratesinnaturalpopulationsfluctuateovertimeandexplainingwhythesechangesoccur.

[C]Proposingahypothesisconcerningpopulationsizeandsuggestingwaystotestit.

[D]Posingafundamentalquestionaboutenvironmentalfactorsinpopulationgrowthandpresentingsomecurrentlyacceptedanswer.

2.Itcanbeinferredfromthetextthattheauthorconsidersthedichotomydiscussedtobe

[A]Applicableonlytoerraticallyfluctuatingpopulations.

[B]instrumental,butonlyifitslimitationsarerecognized.

[C]Dangerouslymisleadinginmostcircumstances.

[D]Acompleteandsufficientwaytoaccountforobservedphenomena.

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[B]Regularcyclesofincreasesanddecreasesinnumbers.

[C]Erraticincreasesinnumberscorrelatedwiththeweather.

[D]Uncheckedincreasesinnumbersovermanygenerations.

4.Thediscussionconcerningpopulationinthethirdparagraphservesprimarilyto

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[B]Advocatemorerigorousstudyofdensity-dependentfactorsinpopulationgrowth.

[C]Provethatthedeathratesofanypopulationareneverentirelydensity-independent.

[D]underlinetheimportanceofevensmalldensity-dependentfactorsinregulatinglong-termpopulationdensities.

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[A]Citetheviewsofotherbiologists.

[B]Defineabasicproblemthatthetextaddresses.

[C]Presentconceptualcategoriesusedbyotherbiologists.

[D]Describetheresultsofaparticularstudy.

Themajorityofsuccessfulseniormanagersdonotcloselyfollowtheclassicalrationalmodeloffirstclarifyinggoals,assessingtheproblem,formulatingoptions,estimatinglikelihoodsofsuccess,makingadecision,andonlythentakingactiontoimplementthedecision.Rather,intheirday-by-daytacticalmaneuvers,theseseniorexecutivesrelyonwhatisvaguelytermedintuitiontomanageanetworkofinterrelatedproblemsthatrequirethemtodealwithambiguity,inconsistency,novelty,andsurprise;andtointegrateactionintotheprocessofthinking.Generationsofwritersonmanagementhaverecognizedthatsomepracticingmanagersrelyheavilyonintuition.Ingeneral,however,suchwritersdisplayapoorgraspofwhatintuitionis.Someseeitastheoppositeofrationality;othersviewitasanexcuseforcapriciousness.Isenberg'srecentresearchonthecognitiveprocessesofseniormanagersrevealsthatmanagers'intuitionisneitherofthese.Rather,seniormanagersuseintuitioninatleastfivedistinctways.First,theyintuitivelysensewhenaproblemexists.Second,managersrelyonintuitiontoperformwell-learnedbehaviorpatternsrapidly.Thisintuitionisnotarbitraryorirrational,butisbasedonyearsofpainstakingpracticeandhands-onexperiencethatbuildskills.Athirdfunctionofintuitionistosynthesizeisolatedbitsmofdataandpracticeintoanintegratedpicture,ofteninanAha!experience.Fourth,somemanagersuseintuitionasacheckontheresultsofmorerationalanalysis.Mostseniorexecutivesarefamiliarwiththeformaldecisionanalysismodelsandtools,andthosewhousesuchsystematicmethodsforreachingdecisionsareoccasionallyleeryofsolutionssuggestedbythesemethodswhichruncountertotheirsenseofthecorrectcourseofaction.Finally,managerscanuseintuitiontobypassin-depthanalysisandmoverapidlytoengenderaplausiblesolution.Usedinthisway,intuitionisanalmostinstantaneouscognitiveprocessinwhichamanagerrecognizesfamiliarpatterns.Oneoftheimplicationsoftheintuitivestyleofexecutivemanagementisthatthinkingisinseparablefromacting.Sincemanagersoftenknowwhatisrightbeforetheycananalyzeandexplainit,theyfrequentlyactfirstandexplainlater.Analysisisinextricablytiedtoactioninthinking/actingcycles,inwhichmanagersdevelopthoughtsabouttheircompaniesandorganizationsnotbyanalyzingaproblematicsituationandthenacting,butbyactingandanalyzingincloseconcert.Giventhegreatuncertaintyofmanyofthemanagementissuesthattheyface,seniormanagersofteninstigateacourseofactionsimplytolearnmoreaboutanissue.Theythenusetheresultsoftheactiontodevelopamorecompleteunderstandingoftheissue.Oneimplicationofthinking/actingcyclesisthatactionisoftenpartofdefiningtheproblem,notjustofimplementingthesolution.

1.Accordingtothetext,seniormanagersuseintuitioninallofthefollowingwaysEXCEPTto

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[B]Identifyaproblem.

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