问题 多项选择题 案例分析题

患者男,42岁。因“左跖趾关节划伤11天,突发疼痛4天”前来就诊。5天前,患者搬家时左跖趾关节被门框底边划伤,立即到当地医院就诊,门诊注射“破伤风疫苗”,清洁伤处,予“抗生素抗感染治疗”(具体不详)后返家。4天前大量饮酒后突发左跖趾关节肿胀、疼痛,活动受限,到当地医院就诊,门诊予“抗生素抗感染治疗”(具体不详)后症状无缓解。今日为进一步诊治来我院。查体:T36.7℃,BP126/80mmHg,P87次/分。营养好。左跖趾关节红肿明显、皮温稍高,有压痛,皮肤表面可见一约1cm×0.15cm×0.05cm伤口,愈合良好。有“血脂紊乱”史。平素血压及血糖正常。父亲患痛风。

(提示患者进行滑囊液细菌培养后,结果为阴性。)患者滑囊液的检查结果最可能为()

A.有脓性渗出物

B.白细胞计数>50000~100000/mm

C.多为中性粒细胞

D.白细胞计数约为5000~75000/mm

E.含有二羟焦磷酸钙结晶

F.含有尿酸钠结晶

答案

参考答案:C, D, F

解析:

1.A和B选项提示化脓性关节炎的可能,但根据提示可以排除。C项为化脓性关节炎和痛风急性发作时共有的特点。D项为痛风和假性痛风共有的特点。E项二羟焦磷酸钙是假性痛风的特征。F项尿酸钠盐是痛风的特征。

2.该患者血压、血糖正常,不考虑选用他汀类降LDL-C。TG>2.3mmol/L,可考虑贝特类。结合其为痛风患者可选择可降低血尿酸的药,其中非诺贝特有促尿酸排泄作用,尽管目前还没有资料证明它可以降低血脂紊乱患者发生痛风的风险,但在临床上仍然可以考虑将它优先用于伴发TG升高为主的血脂紊乱的痛风患者。

选择题
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阅读理解

     The Ivy League is an athletic conference comprising eight private institutions of higher education in the

Northeastern United States.The term is most commonly used to refer to those eight schools considered as

a group.The term is also connected with academic excellence,selectivity in admissions,and social elitism

(精英主义).

     The term became official,especially in sports terminology,after the formation of the NCAA Division I

athletic conference in 1954,when much of the nation polarized around favorite college teams."IV" was used

because originally the league consisted only of four members.The use of the phrase is no longer limited to a

thletics,and now represents an educational philosophy inherent to the nation's oldest schools.In addition,Ivy

League schools are often viewed by the public as some of the most prestigious universities worldwide and

are often ranked amongst the best universities in the United States and worldwide.The eight institutions are

Brown University,Columbia University,Cornell University,Dartmouth College,Harvard University,Princeton

University,the University of Pennsylvania,and Yale University.

     All of the Ivy League's institutions place near the top in the US News & World Report college and

university rankings and rank within the top one percent of the world's academic institutions in terms of

financial endowment (捐助).Seven of the eight schools were founded during America's colonial period;

the exception is Cornell,which was founded in 1865.Ivy League institutions,therefore,account for seven of

the nine Colonial Colleges chartered before the American Revolution.The Ivies are all in the Northeast

geographic region of the United States.All eight schools receive millions of dollars in research grants and

other subsidies from federal and state government.

      Undergraduate enrollments among the Ivy League schools range from about 4,000 to 14,000,making

them  larger than those of  a typical private liberal arts college and smaller than a  typical public state

university.Ivy League university financial endowments range from Brown's $2.01 billion to Harvard's $26

billion,the largest financial endowment of any academic institution in the world.

1.From the passage,we know the word "Ivy" in "the Ivy League" was first chosen to refer to________.

A.a plant  

B.a number  

C.a sport  

D.a spirit

2.What is special about Cornell University in the League?

A.It is the oldest one.

B.It was founded by colonists.

C.It has the smallest endowment.

D.It is the youngest one.

3.Which meaning can the term "the Ivy League" convey today?

A.The largest enrollment.

B.The strongest government support.

C.The most expensive schools.

D.Firstclass education.

4.Which of the following statements is true?

A.There is no longer sports competition in the Ivy League.

B.Seven colleges were set up before the USA was founded.

C.Brown University has the smallest number of students.

D.Typical public state universities are larger than the Ivies.

5.Which of the following can be the best title of the passage?

A.The ABC of "The Ivy League"

B.Best Universities in the USA

C.The Financial Income of American Universities

D.How to Apply to an Ivy League University