问题 问答题 案例分析题

病历摘要:男性,21岁,餐饮业职工。发热、皮肤潮红5天,伴全身酸痛、头痛4天。

患者5天前开始发热及颜面、颈、胸部皮肤潮红,体温在39~40℃之间,无寒战、咳嗽、咳痰等。4天前开始出现全身酸痛、头痛,为胀痛,偶感肾区酸痛。发病以来,精神差,食欲减退,伴间断恶心、呕吐,睡眠较差,尿量减少,大便无明显异常。

体格检查:T39.2℃,P90次/分,R19次/分,BP80/60mmHg。自主体位,急性热病容。颜面、胸、颈部皮肤充血,腋下及胸背部尚可见条索点状瘀点。结膜充血,软腭部可见针尖样出血点。心肺部无明显异常。腹部平坦,无压痛及反跳痛,肝脾不大,肾区有叩击痛,移动性浊音(-),肠鸣音正常。神经系统无阳性体征。

实验室检查:WBC21×109/L,N0.45,L0.55,Hb135g/L,RBC6.5×1012/L,PLT72×109/L。尿常规,蛋白(+++);粪常规正常。

请简述该病症的诊断依据?

答案

参考答案:诊断依据

1)发热,呈稽留热,无咳嗽、咳痰等上呼吸道感染症状;

2)结膜充血、皮肤潮红,局部皮肤黏膜有出血点等毛细血管损害表现;

3)全身酸痛、头痛等全身中毒症状,尚伴有食欲减退等胃肠道症状;

4)血压较低,尿量减少,考虑有进入低血压休克期可能;

5)实验室检查白细胞很高,淋巴细胞为主(可进一步检查异形淋巴细胞);

6)偶感腰痛,肾区叩击痛、尿常规蛋白很高,提示肾脏损害。

7)有鼠类接触史。

完形填空

第二节 完形填空(共20小题;每小题1.5分,满分30分)

阅读下面短文,从短文后所给各题的四个选项(A、B、C和D)中,选出可以填入空白处的最佳选项,并在答题卡上将该项涂黑。

When I began my high school years, I was quite interested in biology. I read lots of books of my father’s about animals, and I was   36   much educated about such matters as a 16-year-old could be.

One Sunday afternoon, I was   37  with friends about animals. I said the whale(鲸鱼)was  __38  a mammal animal. They disagreed. Finally, I called a   39  over to help settle the matter. I knew I was  40 , so I was looking forward to the teacher  41   I was right. My friends were eager for an opposite answer. We asked her   42 the whale was a mammal. “No, the whale is a fish,” she said without a moment’s   43  .

You could have knocked me over with a feather. My   44   was hurt because I lost the argument, but that wasn’t the main reason I was too  45 to speak. I still knew I was right, which   __46  the teacher was wrong. Not only was she wrong,   47  she was completely ignorant(无知的) about something I thought was   48   knowledge. But she was a teacher who had taught a long time. Everyone   49   her and no one else thought she could be wrong.

__50  that, I hadn’t known grown-ups could be wrong. This   51  shaped the way I viewed people as I grew up.   52   I found anyone treated another person with too much respect and admiration, I thought——and still think——“   53  silly.” From that point on, I had no  54__ for authority(权威). To earn my respect, you have to be smart or  55   . I’ll never respect you just because you happen to be in charge or have a degree.

36. A. as  B. so       C. too          D. very

37. A. meeting       B. working     C. arguing      D. staying

38. A. about    B. like         C. beside      D. above

39. A. professor     B. biologist     C. librarian     D. teacher

40. A. clever   B. fight       C. creative    D. silly

41. A. proving       B. finding       C. promising   D. hoping

42. A. how     B. why        C. if      D. when

43. A. doubt   B. silence       C. regret  D. hesitation

44. A. heart    B. mind   C. pride   D. feeling

45. A. foolish  B. anxious      C. serious       D. astonished

46. A. meant   B. suggested   C. admitted     D. concluded

47. A. and         B. but     C. for           D. or

48. A. special  B. normal       C. regular       D. common

49. A. pleased B. admired     C. believed     D. loved

50. A. Before  B. After   C. Until   D. Since

51. A. fairly    B. properly     C. nearly D. greatly

52. A. Whenever    B. Although    C. While D. Whether

53. A. I’m         B. that’s  C. he’s    D. you’re

54. A. idea      B. respect       C. choice D. question

55. A. energetic      B. patient       C. talented      D. diligent

判断题