问题 问答题 案例分析题

患者,女,9岁。

病史摘要:患儿1周前发现面部轻度浮肿,渐累及全身,伴血尿。近日尿量减少。拟诊急性肾炎入院。患者半个多月前曾有咽喉炎病史。

主要阳性体征及实验室检查:全身浮肿,血压升高(154/100mmHg)。尿液检查:蛋白(++),红细胞(+++),伴管型尿。肾穿刺活检:光镜:大部分肾小球体积增大,肾小球内细胞数目显著增多,偶见中性粒细胞浸润。球丛毛细血管腔狭窄,少数毛细血管袢有节段性纤维素样坏死。

住院治疗1月余,痊愈出院。

临床病理联系:解释本例出现尿液改变、水肿及高血压的病变基础。

答案

参考答案:

临床病理联系:

尿液改变:血尿、轻度蛋白尿伴少量管型——肾小球毛细血管壁损伤所致;少尿——肾小球内细胞增生、肿胀,导致毛细血管腔狭窄,血流量减低,滤出减少。

水肿:肾小球滤过率降低→水钠潴留;超敏反应→全身毛细血管通透性增高→水肿加重。

高血压:由水钠潴留,血容量增加所致。

阅读理解

I grew up in Jamaica Plain. My best friend Rose and I used to dream about raising a family of our own someday and living next door to one another.

Our dream remained alive through school and beyond. Rose was my maid of honor when I married Dick. Later, Dick was stationed in Alaska and we moved. Rose was sad to see me leave, but wished me the best of luck. We remained in touch for a few years before we lost track. 

  I thought of her several times over the years. All of my children now have families of their own, and Dick passed away a few years ago. Basically, a lifetime has passed. Then one day, near my 80th birthday, I received a phone call “Hi Natalie, it’s Rose,” the voice on the other end said, “ I don’t know if you remember me, but we used to be best friends in Jamaica Plain when we were kids.” 

  We have spent hours on the phone catching up. Even after 52 years of separation our personalities and interests are still extremely similar. We both share a passion for several hobbies that we each picked up independently several years after we lost touch with one another. It almost feels like we are picking up right where we left off.

Her husband died a few years ago as well, but she mailed me several photographs of her family that were taken over the years. It’s so crazy, just looking at the photos and listening to her description of her family reminds me of my own: a reasonably large, healthy family. Part of me feels like we led fairly similar lives.

I don’t think the similarities between our two lives are a coincidence either. I think it shows that we didn’t just call each other best friend; we truly were best friends and even now we can be best friends again. Real friends have two things in common: a compatible(相容的)personality and a strong-willed character. The compatible personality is what starts the connection between two people. A strong-willed character at both ends is what maintains the connection. If those two ingredients are present in a friendship, the friendship is for real, It can pass the tests of time and long distance between one another and will never disappear

小题1:From the passage we may know that the author       .

A.lived next door to Rose in her childhood

B.was Rose’s maid of honor when she was married

C.lost touch of Rose since she moved to Alaska

D.missed her friend although they lost contact小题2:After 52 years of separation, they       .

A.had a lot to talk on the phone

B.sent each other photographs of their family

C.they lived the same life

D.developed different personalities and hobbies小题3:The underlined word “it” in Paragraph 6 refers to       .

A.Rose’s description

B.coincidence

C.best friend

D.the similarities between our two lives小题4:The author thinks that       .

A.the similarities between their lives are coincident

B.although they’re not best friends, they have much in commom.

C.they both have a compatible personality and a strong-willed character

D.only those who have similar characters can be real friends

多项选择题