问题 问答题

咳嗽与咳痰的临床表现

答案

参考答案:

(1)咳嗽的性质①干性咳嗽:指咳嗽时无痰或痰量甚少,可见于急性咽喉炎、支气管炎、早期肺结核等。②湿性咳嗽:指咳嗽时伴有痰液,可见于肺炎、慢性支气管炎、肺结核等。

(2)咳嗽的时间与节律①骤起咳嗽:刺激性气体、异物或上呼吸道急性炎症等。②慢性咳嗽:慢性支气管炎、支气管扩张症等。③发作性咳嗽:百日咳、肿瘤等。④夜间咳嗽:慢性心衰、肺结核等。⑤清晨或体位改变时咳嗽等:慢性支气管炎、支气管扩张症、肺脓肿等。

(3)咳嗽的音色:指咳嗽时声音的特性。①咳嗽声音嘶哑:声带炎症或肿瘤等。②犬吠样咳嗽:会厌、喉部病变或气管受压等。③金属音调样咳嗽:纵隔肿瘤、主动脉瘤、肺癌等。④咳嗽声音微弱:极度衰竭或声带麻痹等。

(4)痰液的性质和痰量:急性呼吸道炎症时痰量较少,而肺脓肿、支气管扩张症、支气管胸膜瘘时痰量较多,且排痰与体位有关。脓痰有恶臭气味者,提示有厌氧菌感染;黄绿色或翠绿色痰,提示铜绿假单胞菌(绿脓杆菌)感染;痰白黏稠、牵拉成丝难以咳出,提示有白色念珠菌感染;大量稀薄浆液性痰中含粉皮样物,提示棘球蚴病(包虫病)。每天可咳出数百至上千毫升泡沫浆液样痰,还应考虑弥漫性肺泡癌的可能。

单项选择题
填空题

[A] Look and listen and think about what the other person says, how they say it and what they do. Be aware of yourself as well If you recognize a pause in the wrong place or a phrasing that implies weakness then immediately look for a way to counter the impression produced. The game is not lost until the encounter is over. Many of these signals do not require a deep study of psychology. They require awareness, some common sense to recognize meaning and a readiness to do something about the signals that are sent and received.

[B] Recognition of body language also helps to understand our own feelings. If we feel irritated by someone, could it be because they are leaning back in their chair, with head slightly tilted back (looking down their noses at us), perhaps with hands together making a shape like a church steeple, or with hands behind their head We may both be standing up and the other person is holding their jacket lapels, waggling their thumbs at us. These are all gestures of superiority and might explain our annoyance. Understanding this, we may be able to handle it better.

[C] If we can interpret this involuntary commentary then our negotiating position will be per. We could recognize a lie, whether our arguments were being accepted or whether the other party was unreceptive and adjust our behaviour accordingly.

[D] Many studies claim to show that over 50 percent of the messages we convey are through gesture, expression and posture. This is in addition to the messages conveyed through tone of voice. Whether it be banging the table with our fists, directing an angry stare or looking puzzled, it is hard to deny the importance of this side of communication. The astute dealer is always alive to body language but don’t concentrate so much on it that you don’t pay attention to what is actually said.

[E] Signals don’t appear singly but in clusters of several that reinforce each other. Don’t rely upon just one gesture that may be misinterpreted but take the wider evidence available. We frequently say things we don’t mean and mean things we don’t say. How easy it is to imply things we don’t mean! Interpretation of the "sub-text" of communication is inaccurate. Don’t rely upon what you think is going on under the surface without checking you interpretation.

[F] Some expressions and gestures are particular to specific cultures, while others are common to the entire human race, such as smiling or the bared teeth of anger. A smile can be faked, it can mask anger and aggression. However, the way we stand and what we do with our hands is harder to control. There is another layer of body signals, of greater subtlety, such as the narrowing of eyes, the shape of the smile and even the contraction of the pupils of the eye, which may also betray the real feelings of the smiling negotiator. Most of those gestures are universal.

[G] Typically, someone who is lying will avoid your eye and may look downwards. They may touch their faces around the mouth and have the palms of their hands hidden from you. The other party may adopt a tone of voice of great sincerity and look you steadily in the eye in order to reinforce the deception of their words. If you look away from that gaze you may see signals they are unable to control, which give the game away.

[H] We all recognize a lot unconsciously, which is how we get a feeling that someone is lying or that they are bored. In lying, people’s expressions, postures and gestures convey contrary messages to their words and we intuitively recognize the disparity. To negotiate more effectively, be sensitive to these signals, whether by paying more attention to your feelings or by consciously observing and thinking about the gestures and expressions we see.

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