问题 问答题 案例分析题

患者,26岁,女性,3天前淋雨后感咽喉部疼痛,自服"阿莫西林"后咽痛无缓解,1天前患者感咽痛加剧,说话含糊,吞咽困难,呼吸不畅,无张口困难。患者感烦躁不安,不能入睡,即来医院就诊。体检:痛苦面容,面色苍白,T36.8℃,P110次/分,四凹征明显,吸气性喉喘鸣,口咽部检查未见异常,急诊血常规:WBC10.1×109/L,N87%,L13%。试问:

(2)该疾病需与哪些疾病相鉴别?

答案

参考答案:

(2)鉴别诊断

①急性咽炎:有咽痛,吞咽疼痛,血象可以增高,但一般无呼吸困难,体检咽部急性充血,间接喉镜检查无异常可鉴别。

②急性扁桃体炎:有咽痛,吞咽疼痛,血象可以增高,但一般无呼吸困难,体检双侧扁桃体急性充血,间接喉镜检查无异常。

③扁桃体周脓肿:有咽痛,吞咽疼痛,血象可以增高,炎症向喉部蔓延可引起喉水肿导致呼吸困难,张口困难是扁桃体周脓肿的典型特征,体检可见一侧软腭充血,局部隆起。

阅读理解

How much sleep do we need? We are all different. Some people need only three hours of sleep a night. Others need ten hours of sleep a night. Most Americans sleep an average (平均值) of seven to eight hours a night. After the age of fifty the average sleep time goes down to 6.5 hours a night.

Most people have a bad night when they can not sleep. About one in three Americans has a problem with sleep. Many of these people can not fall sleep. This problem is called (叫做) insomnia. This is not a new problem. Many famous people in history had insomnia. Some of these people had special (特别的) ideas to another to make them sleep. Benjaming Franklin, the famous stateman (政治家) and inventor (发明家),had four beds. He moved from one to another to fall asleep. King Lousis XIV of France had 13 beds and hoped that he could fall asleep in one of them. Mark Twain, the famous American writer, had a different way. He lay on his side on the end of the bed!

小题1:.Most American people need________ hours of sleep a night.

A.3

B.10

C.7-8

D.5-6小题2:People need_________ sleep as they get older.

A.more

B.less(更少的)

C.no

D.little小题3:“The problem is called insomnia.” Here “insomnia” means_________.

A.going to sleep easily

B.sleep at daytime

C.the ways of sleep

D.not being able to(能够)go to sleep小题4:Mark Twain lay on his side on the end of the bed because he_________.

A.was an old man

B.thought it was easy to go sleep

C.was a famous writer

D.didn’t have much room to sleep in小题5:The passage is mainly (主要地) talking about_________.

A.sleep

B.insomnia

C.how to go to bed

D.the famous person

单项选择题