A19粟粒性结核病这个类目的主要分类轴心是临床表现的()。
A.症状及体征
B.性别及年龄
C.急及慢性
D.分期及分型
E.发病时间
参考答案:C
患者男,56岁,因“全身皮肤黄染3年,口干、眼干伴腮腺及泪腺肿大2年”入院。3年前,患者巩膜及全身皮肤黄染,腹部CT示“胰头癌”,行胰腺十二指肠切除术。病理示:慢性纤维化胰腺炎、胆管炎。出院后,患者碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)水平持续升高,伴双眼突出、泪腺及腮腺肿大。给予熊去氧胆酸及泼尼松治疗3个月后,症状缓解,但ALP、GGT水平仍轻度升高。2年前,患者出现口干、眼干、哭时无泪,伴反复发作的双侧腮腺无痛性肿大、夜尿增多。抗核抗体(ANA)阳性,类风湿因子(RF)、CRP及ESR均升高。抗SSA及抗SSB抗体阴性。外院唇腺活检示:淋巴细胞灶性浸润,考虑为“干燥综合征”。近半年来,患者于着凉后反复发热,体温波动范围为37.5~39℃,使用退热药及抗生素后体温降至正常。发热时,患者有全身多关节疼痛,伴尿急、尿频、尿痛,尿中泡沫增多,口腔溃疡多发。患者精神、食欲可,睡眠欠佳。7年前被确诊为2型糖尿病;5年前,因颌下淋巴结肿大行双侧颌下淋巴结及右侧颌下腺切除术。
为了进一步完善检查,以下哪些特殊辅助检查或针对性检查是需要的?()
A.自身免疫性疾病谱指标
B.蛋白电泳
C.免疫电泳
D.血清IgG4
E.唇腺活检+免疫组化
F.腮腺超声
G.甲状腺彩超
H.甲状腺功能
What’s your earliest childhood memory Can you remember learning to walk Or talk The first time you heard thunder or watched a television program Adults seldom (1) events much earlier than the year or so before entering school, (2) children younger than three or four (3) retain any specific, personal experiences.
A variety of explanations have been (4) by psychologists for this "childhood amnesia". One argues that the hippo-campus; the region of the brain which is (5) for forming memories, does not mature until about the age of two. But the most popular theory (6) that, since adults don’t think like children, they cannot (7) childhood memories. Adults think in words, and their life memories are like stories or (8) one event follows (9) as in a novel or film. But when they search through their mental (10) for early childhood memories to add to this verbal life story, they don’t find any that fit the (11) . It’s like trying to find a Chinese word in an English dictionary.
Now psychologist Annette Simms of the New York State University offers a new (12) for childhood amnesia. She argues that there simply aren’t any early childhood memories to (13) . According to Dr. Simms, children need to learn to use someone else’s spoken description of their personal (14) in order to turn their own short-term, quickly forgotten (15) of them into long-term memories. In other (16) , children have to talk about their experiences and hear others talk about (17) --Mother talking about the afternoon (18) looking for seashells at the beach or Dad asking them about their day at Ocean Park. Without this (19) reinforcement, says Dr. Simms, children cannot form (20) memories of their personal experiences.
Notes: childhood amnesia 儿童失忆症。
19()
A.habitual
B.verbal
C.unique
D.particular