问题 问答题 案例分析题

简要病史:腰痛2年,加重伴右下肢放射痛1年。

答案

参考答案:

初步诊断(仅供考官参考,不计分):腰椎间盘突出。评分标准:(总分15分)

1.问诊内容(共13分)(1)现病史(10分)①根据主诉及相关鉴别询问(8分)腰部疼痛的性质、程度、有无诱因,与活动的关系。(2分)有无关节功能受限及程度。(2分)有无关节僵硬,活动时是否伴有响声或摩擦感。(2分)是否伴有低热、盗汗、消瘦、乏力等,以与关节结核鉴别。(2分)②诊疗经过(2分)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。(1分)全身或局部用药情况,如抗生素、消炎止痛药或局部封闭治疗及其效果。(0.5分)局部理疗情况,是否有效。(0.5分)(2)相关病史(3分)腰部外伤史,手术史。(1分)结核病史,与腰部病变是否有关。(1分)风湿或类风湿病史,以便鉴别。(1分)

2.问诊技巧(2分)条理性强、能抓住重点。(1分)能够围绕病情询问。(1分)

阅读理解

阅读理解。

     After Mr. and Ms. Smith spent a happy morning at the zoo with Joe,their four-year-old grandson, they

stopped at a restaurant and then went into it for lunch. When the waiter passed them some menus, Mr. Smith

reached into his pocket for his glasses. He was disappointed (失望的) to find that they were lost. "I know

where your glasses are,Grandpa," said the grandson.

     "Where?" asked Mr. Smith happily.

     "They are at the zoo." Joe answered. "When you took me off the train near the elephants, they fell out of

your pocket."

     Mr. Smith was a little angry and he asked, "Joe, if you saw my glasses fall out of my shirt, why didn't you

tell me?"

    "Well, Grandpa," said Joe, "after you put your foot on them, I didn't think you wanted them any more."

1. Mr.and Ms. Smith with Joe went to the zoo ______.

A. in the afternoon

B. before they came to a restaurant

C. to 1ook after the elephant

D. to 1ook for the lost glasses

2. Mr. Smith put his hand into his pocket for his ______.

A. glasses

B. money

C. food

D. menu

3. The glasses fell out of the pocket when ______.

A. Mr. Smith got into the zoo

B. Mr. Smith hurried into the restaurant

C. Joe was taken off the train near the elephants

D. they were getting on the train

4. At first Mr Smith was ______ to hear Joe's words.

A. sad

B. angry

C. sorry

D. happy

5. Which of the following is TRUE?

A. Joe didn't know where his grandpa's glasses were.

B. Mr.Smith got his glasses back at last.

C. Mr.Smith didn't get his glasses back at last.

D. Mr. Smith was glad with what his grandson did.

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