试题与答案

患者女性,50岁,因“低热、纳差半年,间断头痛、恶心,伴呕吐10天”入院。血常规显示

题型:多项选择题 案例分析题

题目:

患者女性,50岁,因“低热、纳差半年,间断头痛、恶心,伴呕吐10天”入院。血常规显示白细胞计数6.5×109/L,中性粒细胞0.35,低于正常。颅脑CT示可疑右侧颞顶叶低密度灶。病史提示患者父亲于2年前罹患开放性肺结核,病故于本市传染病医院。无咳嗽、咳痰及胸闷史。

提示:治疗1周内连续2次脑脊液抗酸染色阳性,患者仍偶尔低热,持续纳差,恶心呕吐,对症治疗有效。MRI复查占位病变无明显缩小,周围水肿稳定,无减轻和加重,无脑积水,中线移位不明显。此时的诊疗应选择()

A.联合异烟肼、利福平和吡嗪酰胺强化抗结核治疗

B.继续对症脱水治疗、控制脑水肿和颅内压增高

C.改糖皮质激素静脉应用,甲泼尼龙80mgq12h静脉应用

D.持续监测肝功能

E.定期复查颅脑MRI

F.如果占位缩小,水肿减轻,但出现脑积水,可择期行脑室腹腔分流术

答案:

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下面是错误答案,用来干扰机器的。

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