问题 问答题 案例分析题

男性,47岁,上腹部不适、呕血1天。请针对该案例,说明问诊内容与技巧。

答案

参考答案:

1.问诊内容(13分)

(1)现病史(10分)①根据主诉及相关鉴别询问(8分)有无服药物、食用粗糙食物、大量酗酒或精神打击等诱因。(1分)呕血的量及颜色,如鲜红、咖啡样、暗红色、有无血块,是否混有食物。(2分)周围循环衰竭的表现,如口渴,尿少、头晕、心悸、意识障碍。(2分)伴随症状,有无咳嗽、胸痛、规律性上腹部疼痛,有无黄疸。(2分)大便情况,是否有黑便,尿量及尿色情况。(1分)②诊疗经过(2分)是否到医院就诊过,做过哪些检查。(1分)治疗用药情况。(1分)

(2)相关病史(3分)是否有药物过敏史、饮酒史。(1分)与该病有关的其他病史,有无肝病、全身出血性疾病、糖尿病病史。(2分)

2.问诊技巧(2分)条理性强、能抓住重点。(1分)能够围绕病情询问。(1分)

填空题
阅读理解

阅读理解。

     Cities with high levels of homeownership-in the range of 75%, like Detroit and St. Lous -had on

average considerably lower levels of economic activity and much lower wages and incomes. Far too

many people in financial problems are trapped in homes they can't sell, unable to move on to new centers

of opportunity.

     The cities and regions with the lowest levels of homeownership-in the range of 55% to 60% like Los

Angeles and New York-had healthier economies and higher incomes. They also had higher levels of

happiness and well-being.

     I was shocked to read these interesting points that Richard Florida made in his recent article. Let

me try to understand. The people in Detroit and St. Louis are less happy than the people in New York,

and Los Angeles. And, the reason is because of home ownership rates?

First, to compare them to New York City (the economic capital of the world), Los Angeles (the entertainment capital of the world) seems unfair. Most people in almost any other city in the world might be less

happy!

     Next, let's try a different way of determining whether renters are happier than homeowners. Why

don't we ask them? Fannie Mae's National Housing Survey 2010 reported:

     75% of current renters believe owning a home makes more sense.

     67% plan to buy a home at some point in the future.

    When they asked current renters for the major reason to buy a house, these were their answers (they

could pick several answers):

     78% said it was a good place to raise children.

     75% said because they would feel safe.

     70% said because you have control your own space.

     If you believe renters are happier, you would also have to believe the majority enjoy living in a less

safe environment, which wouldn't be a good place to raise children and would be a place where they

have less control of their space.

1.Which of the following is a fact?

A. People in Los Angeles earn high incomes because of its low homeownership rate.

B. New York's low homeownership rate increases people's happiness levels.

C. Detroit's high level of homeownership causes its economic problems.

D. St. Louis has a higher level of homeownership than Los Angeles.

2. In his article, Richard Florida tried to express that ________.

A. people in Los Angeles are happier than those in St. Louis

B. Renting a house is better than owning a house

C. Detroit's economy is healthier than New York's economy

D. New York and Los Angeles are happiest cities

3.The writer believes that New York Cities and Los Angeles________.

A. pay employee highest wages in America

B. benefit from low levels of homeownership

C. are leading cities across the globe

D. are best American cities to live in

4. From Fannie Mae's survey report, we can know that________.

A. paying rent makes more sense

B. most homeowners plan to sell their houses

C. most renters prefer to become homeowners

D. parents need to buy a house for their children

5.According to the passage, current renters' reasons to buy a house are the follows except _______. 

A. to have a good place to raise children 

B. to live in a safer environment

C. to make money

D. to have control of their own space