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%。

该疾病需与哪些疾病相鉴别?

答案

参考答案:

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。

完形填空
完形填空。

     It was on a winter morning, near Oxford, Maryland, that I set the breakfast table beside the huge window,
which   1   the Tred Avon River. The snow decorated the shore in white. For a moment I stood quietly against
the bookcase, appreciating what the night's snow had   2 
      3    I leaned forward and peered (盯着看) close to the frosted window. "It really is!" I cried out loud.
"There is a goose out there!"  I   4   to the bookcase and pulled out a pair of binoculars (望远镜). Into their
sights came the   5    of a large Canada goose, very still, its wings folded tight to its sides, it s  6   frozen to
the ice.
     Then from the dark sides, I saw a line of swans.They crossed   7   the west of the broad river, moving
   8   to the east.
     As I   9  , the leader swung to the right, and then the white  10  of birds become a white circle. It floated
from the top of the sky downward. At last, as easy as feathers coming to earth, the circle  11   the ice.The
swans
  12   the frozen goose! Amazingly, those bills (啄) began to work on  13 . The long necks were lifted and
curved down,   14  . It went on for a long time.At last, the goose was free and  15  its big webbed (有蹼的)
feet slowly. The goose  16   its wings as far as they would go. The swans took off and  17  their eastward
journey, in perfect formation, to their secret destination.  18   them, rising with incredible speed and joy, the
goose moved into the sky.
     I watched them  19    they disappeared over the tips of the farthest trees. Only then did I realize that tears
were running down my cheeks.
     This is a true story.I do not try to interpret it here.I just often  20   it in the bad moments, and tell myself,
"If so for birds, why not for man?"

( )1. A. undertook       
( )2. A. destroyed       
( )3. A. Finally         
( )4. A. rushed         
( )5. A. figure         
( )6. A. head            
( )7. A. along           
( )8. A. steadily       
( )9. A. watched         
( )10. A. block         
( )11. A. skated on     
( )12. A. threatened     
( )13. A. the ice       
( )14. A. one after another 
( )15. A. washing       
( )16. A. enlarged       
( )17. A. started       
( )18. A. Behind         
( )19. A. after         
( )20. A. write about    
B. overlooked    
B. covered        
B. Unwillingly    
B. returned       
B. shadow         
B. body         
B. from          
B. smoothly     
B. expected                 
B. mass           
B. landed on      
B. attacked       
B. their feather  
B. side by side   
B. protecting    
B. spread       
B. carried on    
B. In front of    
B. although     
B. keep      
C. overshadowed        
C. painted            
C. Disappointedly    
C. advanced            
C. cry                
C. feet                
C. around              
C. in the snow        
C. predicted          
C. dot              
C. fell down to      
C. surrounded        
C. the river       
C. now and then      
C. moving             
C. lifted          
C. repeated         
C. Along with          
C. unless             
C. think of         
D. evaluated          
D. hidden             
D. Suddenly           
D. reached            
D. baby               
D. beak               
D. in                 
D. closely            
D. feared             
D. st  ring           
D. broke into         
D. killed             
D. the shore          
D. again and again    
D. warming            
D. threw              
D. stopped            
D. Including          
D. until              
D. retell             
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