试题与答案

女性,30岁。腹胀半年,发热1个月。患者近半年感腹胀,未诊治。近1个月发热,多于午后

题型:问答题 案例分析题

题目:

女性,30岁。腹胀半年,发热1个月。患者近半年感腹胀,未诊治。近1个月发热,多于午后出现,体温在37.5℃~38.0℃之间,由门诊入院。发病以来,食欲欠佳,每日排黄软便3~5次,无脓血便,尿量正常,体重减轻5kg。3年前曾患"肠结核",因出现药物不良反应中断治疗。查体:T37.8℃,P100次/分,R16次/分,BP90/60mmHg。神志清楚,无力体型,贫血貌,皮肤、巩膜无黄染,双肺未闻及干、湿啰音,心界不大,心率100次/分,律齐,各瓣膜区未闻及杂音。腹部柔韧感,全腹压痛及反跳痛阳性,右下腹明显,肝脾肋下未触及,移动性浊音阳性,肠鸣音正常。双下肢无水肿。实验室检查:血WBC8.9×10/L,N0.46,L0.54,Hb95g/L,Plt280×10/L,粪常规:镜检(-),隐血(-),血沉54mm/h,肝、肾功能正常。腹部B超提示:腹腔积液,肝、胆、脾、胰、双肾未见异常。钡灌肠检查示:回盲部及升结肠缩短、变形,激惹征阳性。要求:根据以上病历摘要,请写出初步诊断及诊断依据、鉴别诊断、进一步检查与治疗原则。

答案:

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参考答案:A

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题型:单项选择题

In June 1985, two British mountaineers Joe Simpson and Simon Yates made the first-ever climb of the 21,000-foot snow-covered Siula Grande mountain in Peru. It was an exceptionally (26) job, but nothing compared to what was to (27) . Early in the process, Simpson (28) and broke his right knee. Yates could have (29) him but managed to find a way of (30) him down the mountains on a rope in a series of difficult drops. Then Simpson fell into a crevasse and Yates eventually had no (31) but to cut the (32) , completely convinced that his friend was now (33)

In his book on the (34) , Joe Simpson wrote:

(35) I looked at the distant moraines, I know that I must at least try I would probably (36) there among those rocks. If I died, well, that wasn’t so (37) , but I wouldn’t have (38) waited for it to happen. The (39) of dying no longer affected me as it had in the crevasse at first. I now had a chance to (40) it and struggle against it.

The survival of Yates himself was (41) . That Simpson somehow found a way of (42) out of the crevasse after 12 hours and then crawled and (43) himself six miles back to camp, (44) three days and might without food or drink, would be considered as a heroic fiction. But in fact it was so (45) .

33().

A. safe

B. dead

C. alive

D. hurt

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