问题 单项选择题 A1型题

关于肺炎链球菌肺炎的临床表现,下列哪项是错误的()

A.最常见的症状是突发的寒战、发热、咳嗽、咳痰与胸痛

B.咳痰呈红棕色胶冻状

C.可出现呕吐、腹痛、腹泻

D.严重者可出现昏迷

E.可出现发绀与口周疱疹

答案

参考答案:B

解析:肺炎链球菌肺炎的症状是发病前常有淋雨、受凉、醉酒、疲劳、病毒感染和生活在拥挤环境等诱因,可有数日上呼吸道感染的前驱症状。典型表现为起病急骤、畏寒或寒战、高热,体温可在数小时内达39~40℃,呈稽留热,或高峰在下午或傍晚。全身肌肉酸痛,患侧胸痛明显,可放射至肩部,深呼吸或咳嗽时加剧,病人常取患侧卧位。开始时痰少,可带血丝,24~48小时后可呈铁锈色,与肺泡内浆液渗出和红细胞、白细胞渗出有关。重症时有惊厥、谵妄及昏迷等中毒性脑病的表现,较大儿童可见唇部疱疹。故选B。解题关键:肺炎链球菌肺炎多起病急剧,表现为突发高热、咳嗽、胸痛、纳差、疲乏和烦躁不安,咳铁锈色痰。早期可有呕吐,腹痛,腹泻的症状。重症时有惊厥、谵妄及昏迷等中毒性脑病的表现,较大儿童可见唇部疱疹。【考点】:肺炎链球菌肺炎的特点

名词解释
单项选择题

When it comes to suing doctors, Philadelphia is hardly the city of brotherly love. A combination of sprightly lawyers and sympathetic juries has made Philadelphia a hotspot for medical-malpractice lawsuits. Since 1995, Pennsylvania state courts have awarded an average of $ 2m in such cases, according to Jury Verdict Research, a survey firm. Some medical specialists have seen their malpractice insurance premiums nearly double over the past year. Obstetricians are now paying up to $104,000 a year to protect themselves.

The insurance industry is largely to blame. Carol Golin, the Monitor’s editor, argues that in the 1990s insurers tried to grab market share by offering artificially low rates (betting that any losses would be covered by gains on their investments). The stock-market correction, coupled with the large legal awards, has eroded the insurers’ reserves. Three in Pennsylvania alone have gone bust.

A few doctors--particularly older ones--will quit. The rest are adapting. Some are abandoning litigation-prone procedures, such as delivering babies. Others are moving parts of their practice to neighboring states where insurance rates are lower. Some from Pennsylvania have opened offices in New Jersey. New doctors may also be deterred from setting up shop in litigation havens, however prestigious.

Despite a Republican president, tort reform has got nowhere at the federal level. Indeed doctors could get clobbered indirectly by a Patients’ Bill of Rights, which would further expose managed care companies to lawsuits. This prospect has fuelled interest among doctors in Pennsylvania’s new medical malpractice reform bill, which was signed into law on March 20th. It will, among other things, give doctors $ 40m of state funds to offset their insurance premiums, spread the payment of awards out over time and prohibit individuals from double dipping--that is, suing a doctor for damages that have already been paid by their health insurer.

But will it really help Randall Bovbjerg, a health policy expert at the Urban Institute, argues that the only proper way to slow down the litigation machine would be to limit the compensation for pain and suffering, so-called "non-monetary damages". Needless to say, a fixed cap on such awards is resisted by most trial lawyers. But Mr Bovbjerg reckons a more nuanced approach, with a sliding scale of payments based on well-defined measures of injury, is a better way forward. In the meantime, doctors and insurers are bracing themselves for a couple more rough years before the insurance cycle turns.

Nobody disputes that hospital staff make mistakes: a 1999 Institute of Medicine report claimed that errors kill at least 44,000 patients a year. But there is little evidence that malpractice lawsuits on their own will solve the problem.

To which of the following is the author most likely to agree()

A. The proper way is to slow down payments for injuries

B. Juries tended to find fault with the compensations paid

C.Low insurance rates are to blame for the potential trouble

D. Legal procedures alone may not solve the rough problem