问题 问答题 案例分析题

简要病史:患者,男,62岁,间断咳嗽、咳痰11年,近5天加重。初步诊断:慢性支气管炎急性发作期。要求:你作为住院医师,请围绕以上简要病史,写出应该询问的患者现病史及相关病史的内容。

答案

参考答案:

(一)现病史

1.根据主诉及相关鉴别询问

(1)发病诱因:有无受凉感冒、过度劳累、吸入刺激性气体等。

(2)咳嗽的特点:有无刺激性咳嗽,有无鸡鸣样或金属音咳嗽。

(3)痰的性状(颜色、是否脓性、气味)及痰量,有无咯血及呼吸困难。

(4)伴随症状:有无寒战、发热、心悸、气短、下肢水肿,有无杵状指。

(5)二便、睡眠、食欲、体重变化等情况。

2.诊疗经过

(1)是否曾到医院就诊,做过哪些检查:如血常规、胸部X线片、肺功能、心电图等。

(2)治疗用药情况。

(二)相关病史

1.有无药物过敏史。

2.与该病有关的其他病史有无肺结核及其他系统疾病史。有无烟酒嗜好。工作性质及环境。

3.家族中有无类似疾病。

问答题
阅读理解

阅读理解。

     At a meeting, a well-known speaker lifted up a bill of 20 dollars before starting his speech.

     Facing 200 people, he asked, "Who wants this 20-dollar bill?" A great many hands were put up. Then he

continued to say, "I intended to give it to any one of you, but allow me to do a thing before giving it to you."

Suddenly he crumpled (揉) it into a round mass. Then he asked, "Who wants it?" Still some hands were lifted

up.

    He asked again, "Well, how could it be if I do it like this?" he threw the bill onto the ground, stepped on it

and twisted it. As he picked it up, the bill had become not only dirty but wrinkled.

    "Who still wants it?" Still a few people put up their hands.

    "My dear friends, you have had a meaningful class. No matter how I treated this bill, you still want it,

because it is worth 20 dollars. On your life road, you may be knocked down (击垮) or even broken into pieces

by your determination or unfavorable situations. We may feel ourselves worth nothing, but, my darling,

remember that whatever happens in the future, you should never lose your value (价值) in the God's heart.

You're particular-never forget it."

1. How many times did the speaker ask the people whether they wanted the bill? [ ]

A. Three times

B. Twice

C. Once

D. Four times

2. The underlined word "wrinkled" in the third paragraph probably means _____. [ ]

A. broken

B. flat

C. having small lines or folds in it

D. having holes in it

3. The speaker did this test in order to _____. [ ]

A. tell the audience that one should never lose one's own value

B. tell the audience that God values money most

C. test if some of the audience were extremely interested in money

D. play a trick on the audience

4. What would the speaker probably talk about next? [ ]

A. How money can make people crazy.

B. How to avoid being knocked down in one's life.

C. How to keep one's value of life.

D. How to give a meaningful class.