患儿女，4岁，来自农村。7月份因发热、头痛4天，伴呕吐、抽搐住院。体检：神志欠清，压眶有反应，双侧瞳孔4mm，对光反射存在，颈有阻力，心、肺无异常，腹软，腹壁反射未引出，四肢肌张力较高，克氏征、布氏征、巴氏征均阳性。最可能的诊断是（）
A.中毒性菌痢
B.病毒性脑炎
C.结核性脑膜炎
D.流行性乙型脑炎
E.化脓性脑膜炎
参考答案：D
解析：7月下旬发病，起病急，病程3天后出现明显神经系统症状及病理反射阳性，结合脑脊液改变应考虑为乙脑。由于乙脑早期外周血象白细胞可升高，且以中性粒细胞为主，因此要排除细菌感染。化脓性脑膜炎脑脊液细胞数及蛋白应明显升高，糖、氯化物降低；流行性脑脊髓膜炎发病季节为冬春季，且临床特点为皮肤瘀点、瘀斑，脑脊液化脓性改变；结核性脑膜炎起病缓慢，脑脊液生化改变蛋白升高明显，糖、氯化物降低明显；细胞分类以单核细胞为主；中毒性痢疾起病更急，多伴有休克表现及消化道症状。
请阅读下列应用文及相关信息，并按照要求匹配信息。请在答题卡上将对应题号的相应选项字母涂黑。 首先阅读以下学校各社团的介绍。
阅读以下学生的相关信息。匹配适合他们的社团。 小题1:Cherry wants to join a club that will keep her fit and active but because she has a part-time job every workday evening she is only available to take part on the weekends. 小题2: David is a new student at the university, whose major is English literature. He is a little shy so is hoping to join a club that can help him get to know new people and build his confidence. 小题3:Bonnie is majoring in drama and wants to be a scriptwriter when she graduates. She is interested in discovering new stories that she may one day be able to turn into movies. As her home is far from the university she is only free during the day to take part. 小题4:Betty is studying film making and one day hopes to become a director. But she thinks her ability to create beautiful visual images is not strong enough so she has recently purchased a camera to help her practice. 小题5:Jack is a first year geography student who would like to learn more about the geography of the local area. He is also worried about passing the English test that all students must take at the end of their first year of study. He has to return to his home to help his parents every weekend so is only free during weekdays. |
