问题 问答题 案例分析题

女,28岁,已婚,G2P0,因停经9个多月,无痛性 * * 流血11小时,于2005年12月20日5AM急诊抬送入院。

病人LMP2005年3月23日,停经40天出现早孕反应,3个月后消失,妊娠4个多月感胎动,妊娠5个月首次产前检查,测血压90/60mmHg,尿蛋白(-)。妊娠6个月出现2次 * * 流血,量较月经量少,未予重视。妊娠7个月、8个月时分别又出现 * * 流血,量较以前稍增多,但仍少于月经量,在当地医院予以抗炎,止血处理后好转。20日早晨2AM突然出现 * * 大出血,如解小便样,无腹痛,曾昏倒1次,由家人用救护车急送至我院。起病以来,无头昏、头痛、眼花、畏寒、发热等。

体格检查:T36℃,P120次/分,R22次/分,BP80/50mmHg。急性重病容,面色苍白,神清合作,心率120次/分,律齐,有Ⅱ级收缩期吹风样杂音,双下肢水肿(++)。产科情况:腹隆起如孕足月大小,宫高34cm,腹围95cm,LSA,臀先露,未入盆,胎心音隐约可闻及166次/分,有不规则宫缩,子宫无压痛。外阴可见鲜红色血流出。

实验室检查:Hb60g/L,WBC11.6×109/L,N0.80,L0.20,PLT80×109/L。C02CP14mmol/L,尿蛋白(-)。

试述该病人的入院诊断和诊断依据。

答案

参考答案:

诊断:①宫内妊娠38周,LSA活胎;②前置胎盘;③胎儿宫内窘迫;④失血性休克;⑤失血性贫血(中度);⑥代谢性酸中毒。诊断依据:①停经9个多月,无痛性 * * 流血11小时。②体格检查示P120次/min,R22次/min,BP80/50mmHg,心率120次/min,律齐,有Ⅱ级收缩期吹风样杂音,双下肢水肿(++)。③产科情况示腹隆起如孕足月大小,宫高34cm,腹围95cm,LSA,臀先露,未入盆,胎心音隐约可闻及166次/min,有不规则宫缩,子宫无压痛。外阴可见鲜红色血流出。④实验室检查示HB60g/L,WBC11.6×109/L,N0.80,L0.20,PLT80×109/L,C02CP14mmol/L,尿蛋白(-)。

阅读理解

My grandmother often said to me, “You can count the number of your true friends on the fingers of one hand.” For a long time I thought this was true. However, I’ve now discovered my grandmother was only half right. Maybe we do only make a few “best” friends in our lifetime, but those aren’t the only people that we can call friends. There are many different types. Let me tell you about a few of them.

One type of friends is the type I call the “football mom friend”. My neighbor Sally is a good example. We both have kids who play football in a football club, and someone has to take them to practice and pick them up. Sally and I and two other mothers take turns to do this. We meet sometimes and have tea and talk about what our kids are doing, but those are the only times that we meet each other. I enjoy being with these women, but we don’t do anything else together.

Another type is called the “hobby friend”. That’s the person you share an interest or a hobby with. Michael and Cater, who are brothers, are a good example of this type. We’re all in a bird watching club. Every few weekends the members of the club go on a trip to watch different kinds of birds. There’s nothing romantic(浪漫的)about my relationship with Michael and Cater, of course. We just share interest in birds.

Then there’s the “other half of the couple” type of friends. Jim is married to Rose, a friend that I’ve known since college. When Rose married Jim, I realized that I would have to be Jim’s friend if I want to continue to be Rose’s. Jim and I don’t share so many interests, but we do have a friendly relationship.

小题1:What does the first paragraph tell us about?

A.We need true friends in our lifetime.

B.We have few best friends in our lifetime.

C.We should make new friends.

D.We must be friendly to all our friends.小题2:Many people are mentioned in this passage. Who is the writer’s true friend?

A.Sally.

B. Michael.

C. Jim.

D. Rose.小题3:Which of the following statements is RIGHT?

A.Finally the writer agrees with her grandmother.

B.Michael and Cater both fall in love with the writer.

C.The writer herself sometimes takes her kid to the football club.

D.Sally and the writer are close friends.小题4:How many types of friends are mentioned in the passage?

A.2.

B. 3.

C. 4.

D.5小题5:From the last paragraph we learn that ________.

A.the writer made friends with Jim only because of Rose

B.Jim was the writer’s good friend at college

C.Rose didn’t want the writer to be a friend of her husband

D.the writer made friends with Rose because of Jim

单项选择题