问题 问答题 案例分析题

恶心、尿色黄伴多年肝功能异常和乙肝表面抗原阳性。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)发病诱因,有无与肝炎病人接触。(2分)尿量颜色,发病急缓,有无变化,皮肤有无黄疸。(2分)伴随症状,是否伴有发热、乏力等全身症状。有无腹痛、腹泻。(2分)大便、睡眠。(2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。(1分)与该病有关的其他病史,有无与肝炎病人接触史,有无胆道疾病史、肝炎病史。(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)

单项选择题 A1/A2型题
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During the twentieth-century there has been a great change in the lives of women. A woman marrying at the end of the nineteenth century would probably have been in her middle twenties, and would be likely to have seven or eight children, of whom four or five lived till they were five years old. By the time the youngest was fifteen, the mother would have been in her early fifties and would expect to live a further twenty years, during which chance and health made it unusual for her to get paid work. Today women marry younger and have fewer children. Usually a woman's youngest child will be fifteen when she is forty-five and can be expected to live another thirty-five years and is likely to take paid work until sixty.

This important change in women's life has only recently begun to have its full effect on women's economic position. Even a few years ago most girls left school and took a full-time job. However, when they married, they usually left work at once and never returned to it. Today the school-leaving age is sixteen, many girls stay at school after that age, and though women marry younger, more married women stay at work at least until shortly before their first child is born. Very many more afterwards return to full or part-time work. Such changes have led to a new relationship in marriage, with the husband accepting a greater share of the duties and satisfactions of family life.

46. We are told that in a family in about 1900        .

A. few children died before they were five

B. seven or eight children lived to be more than five

C. the youngest child would be fifteen

D. four or five children died when they were five

47.One reason why the woman of today may take a job is that she         .

A. is younger when her children are old enough to look after themselves

B. does not like children herself

C. needn't worry about food for her children

D. can be free from family duties when she reaches sixty

48. According to the passage, it is now quite usual for women to        .

A. stay at home after leaving school         

B. marry men younger than themselves

C. start working again later in life          

D. marry while still at school

49.Many girls are now likely to       .

A. give up their jobs for good after they are married

B. leave school as soon as they can

C. marry so that they can get a job

D. continue working until they are going to have a baby

50. Now a husband probably        .

A. plays a greater part in looking after the children

B. helps his wife by doing more of the housework

C. feels dissatisfied with his part in the family

D. takes a part-time job so that he can help in the home