问题 多项选择题 案例分析题

患者女性,46岁,对称性多关节肿痛1年,加重3月入院。患者1年前无明显原因出现双手近端指间关节、掌指关节、双腕关节肿痛,伴有晨僵,每天可持续>1小时,自行口服"双氯芬酸片、泼尼松片"症状可好转,未规律治疗。近3月,出现双肘关节,双足跖趾关节肿痛,以上关节肿痛加重,并出现双肘、枕部皮下结节。为进一步诊治来我院。起病以来,伴有口干、眼干,精神食欲差,睡眠差。既往史、个人史、月经婚育史无特殊。家族史中其母患有类风湿关节炎。体格检查:血压130/76mmHg心肺腹无特殊阳性体征。双肘、枕部皮肤可触及皮下结节,质硬,无压痛。左手第2、3、4近端指间关节、右手第3、5近端指间关节呈梭形肿胀,左2、3、4掌指关节、右3、4、5掌指关节、双腕关节肿胀,压痛(+),双肘关节活动受限,左足第二跖趾关节肿胀,双下肢无水肿。辅助检查血常规:白细胞5.1×109/L,血红蛋白96g/L,血小板538×109/L;血沉76mm/h,CRP0.27mg/dl。

适宜的治疗措施有()。

A.应用非甾体抗炎药,如美洛昔康、赛来昔布等

B.活动期应注意休息,缓解期应加强关节锻炼

C.小剂量的皮质类固醇,如泼尼松10~20mg/d

D.注意建立长期治疗的观念,定期去医院检查

E.单独或联合应用免疫抑制剂如甲氨蝶呤、羟氯喹、柳氮磺吡啶、CTX等。

答案

参考答案:A, B, C, D, E

阅读理解
阅读下面短文,根据短文内容,从短文后的选项中选出适当的选项补全短文。选项中一项为多余选项。
     Victor's hobby was collecting stamps. He had stamps from many countries, like
England, Canada and China. Can you guess what people gave him as gifts? That's right-
stamps. Victor's favorite stamps came from France. 61 He only needed one. That was
a 1974 special edition. It was very hard to find.
     He looked for it everywhere. He asked his friends and relatives to help him. 62 It made Victor very sad.
     "Don't worry," his father said to him. "If you have enough patience, you'll find it one day."
     "I hope so," Victor said.
     Victor also liked writing. He had a penfriend in France. 63 Victor's pen-friend, Phillip,usually used new
stamps to send letters. Sometimes, his mother gave him stamps to use. Once Phillip's mother gave him a big,
green stamp. It looked old. When Victor received the letter, he was very surprised. On the envelope, he looked
carefully at the stamp. 64 Victor was so happy. He told his sister, his mother and his father.
     "You see," his father said. "You did find your stamp. So, it's good to have two things in life."
     "What are they?" Victor asked.
     "Friends and patience," he answered.
A. They wrote to each other every month.
B. But nobody could find the stamp.
C. It was the 1974 special edition stamp.
D. His mother helped him to collect stamps.
E. He had almost every stamp from 1954 to 2004.
选择题