问题 问答题 案例分析题

女童,2岁。主诉:口腔黏膜起疱并发溃疡2天。(病例题)

答案

参考答案:

1.初步诊断

急性疱疹性龈口炎。

2.问诊内容

(1)现病史

①根据主诉及相关鉴别询问

A.有无接触疱疹病损患者病史。

B.病损症状及病程。

C.伴随症状:其他部位有无伴发表现。

D.全身情况:食欲、睡眠、体重变化等一般情况。

②诊疗经过

A.是否到医院就诊,有否做过相应检查和治疗等。

B.治疗用药及效果如何。

(2)相关病史

①是否有药物过敏史。

②与该疾病有关的其他病史:皮肤有无类似病史。

3.问诊技巧

(1)条理性强、能抓住重点。

(2)能够围绕病情询问。

4.需要鉴别的疾病

(1)口炎型口疮(疱疹样口疮)散在分布的单个小溃疡,病程反复发作,无发疱期,溃疡数目较多,分布在口腔黏膜角化程度较差的部位,多见于成年人。

(2)三叉神经带状疱疹水疱较大,聚集成簇。沿三叉神经的分支排列成带状,但不超过中线。疼痛剧烈,甚至在起疱前和愈合后仍有疼痛。可发生于任何年龄,但老年人多见。

(3)手足口病口腔黏膜、手掌、足底出现散在水疱、丘疹与斑疹。

(4)疱疹性咽峡炎临床表现似急性疱疹性龈口炎,病损仅限于口腔的后面,为丛集成簇的小水疱。损害很少发生于口腔前部,牙龈不受损害,7d左右愈合。

阅读理解

Beyond Baby Mozart, Students Who Rock

Music education hasn’t changed much since the 1970s. Students are still taught to read notation(乐谱) so they can recite compositions that they would never listen to on their MP3 players or play with friends. Playing music enriches life. The question is: Why do schools teach music in a way that turns off so many young people rather than catch their imagination? Can we do a better job of using the power of music to get kids excited about school?

The experience of an organization called Little Kids Rock suggests the answer is yes — if we change the way music is taught. Little Kids Rock has helped music programs in over a thousand public schools and served 150,000 children. The organization has given 30,000 free instruments out, mainly guitars, and trained 1,500 teachers to run music classes in which students quickly experience the joys of playing their favorite songs, performing in bands(乐队), and writing their own music.

The key to Little Kids Rock is that it teaches children to play music the way many musicians learn to play it — not by notation, but by listening, imitation(模仿) and meaningful experimentation. “The knowledge you need to get started playing rock music is very limited,” explains Dave Wish, the founder of Little Kids Rock. “In high school, my friend Paul taught me a couple of chords(和弦) and my life was changed forever. On the first day of class, Little Kids Rock teachers place guitars in the hands of their students and get them practicing chords that will enable them to play thousands of songs. The kids decide what songs they want to learn and the class is off and running. Their progress is surprising. Within a year, eight and nine-year-olds are playing musical instruments, and giving concerts, even performing their own songs.

One of the biggest advantages that music offers is the ability to encourage students who are otherwise bored by school. “I’ve had students start coming back to school because of this program,” said Adkison Thomas, who heads up music for the Dallas Independent School District. He added, “One of the best things is that the teachers discover a new side of their students. They see kids become successful who weren’t before.”

小题1:The expression “turn off” in Paragraph 1 means “______”.

A.make kids feel cool

B.make kids feel bored

C.make kids feel confident

D.make kids feel nervous小题2:How did Little Kids Rock help the school?

A.By writing music for kids.

B.By playing kids’ favorite songs.

C.By making instruments for school.

D.By training teachers for music classes.小题3:Little Kids Rock is successful because ______.

A.it encourages kids to experience music

B.it helps kids learn from great musicians

C.it allows kids to decide how to learn music

D.it offers musical programs all over the country小题4:What does the writer want to tell us?

A.Learning music is a good way to become successful.

B.Teaching in a proper way benefits students’ development.

C.It’s necessary for students to practice a lot in learning music.

D.It’s important for teachers to discover the new sides of students.

单项选择题