问题 问答题 案例分析题

关节痛病例:简要病史:患者,女性,58岁,左膝关节痛,逐渐加重3年。

答案

参考答案:

1本例老年妇女,慢性关节痛可能是骨关节病,病史采集内容如下:

1.现病史

(1)根据主诉及相关鉴别询问1)膝部疼痛的性质、程度、有无诱因,与活动的关系。

2)有无关节功能受限及程度。

3)有无关节僵硬,活动时是否伴有响声或摩擦感,以了解关节面情况及是否有半月板损伤等。

4)是否伴有低热盗汗,消瘦乏力等,以与关节结核相鉴别。

(2)诊疗经过

1)影像学检查和化验检查结果,如X线片或CT片以及血常规、血沉等情况。

2)全身或局部用药情况,如抗生素、抗结核药或局部封闭治疗及其效果。

3)局部理疗情况,是否有效。

2.相关病史

(1)膝关节外伤史,手术史。

(2)结核病史,与关节病变是否有关。

(3)风湿或类风湿病史,以便鉴别。

填空题

Most "unassertive" people are not confident and take no for an answer much too easily. There is a growing awareness in our society that this tendency (1) the rights of large numbers of people. For example, in recent years there has been an upsurge in (2) and pressure groups. This is a (3) as there will always be a need for such organizations to (4) individuals and minorities in a competitive society. The danger is that we (5) for our rights and lose the art of asserting ourselves. It is better for (6) with other people if you can learn (7) for yourself.
Now, we have to learn to ignore some of the (8) that may be ringing in our unconscious minds, such as: "If you ask once more, I’ll flatten you", and " (9) ".
The main technique that we use in (10) to practice the art of persistence is called Broken Record. (11) we hear one sentence over and over again until we reach screaming pitch and (12) .
Broken Record is the skill of being able to repeat over and over again, (13) , what it is you want or need, until the other person gives in or (14) .
Now, this technique is extremely useful for dealing with situations where your rights are clearly (15) , or coping with situations where you are likely to be diverted by clever, (16) .
The beauty of using Broken Record is that you (17) because you know exactly what you are going to say, however (18) the other person tries to be.
As with most assertive techniques, it must be used appropriately. It is (19) and is not designed to foster deep, interesting conversations and friendships with people! It is primarily of use in situations where (20) .

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