问题 问答题 简答题

简述类风湿关节炎的鉴别诊断

答案

参考答案:

1.骨关节炎:其特点包括:①中、老年人多发,起病缓慢;②膝、髋、手及脊柱关节易受累,而掌指、腕和其他关节较少受累;③活动后疼痛加重;④晨僵小于半小时。⑤无皮下结节及血管炎等关节外表现;⑥RF阴性。

2.反应性关节炎:其特点为:①青年男性多见;②起病急,发病前常有肠道或泌 * * 感染史;③以外周大关节(尤其下肢关节)非对称性受累为主;④关节外表现为眼炎、 * * 炎、龟头炎、溢脓性皮肤角化病及发热等;⑤HLA-B27多阳性;⑥RF阴性。

3.强直性脊柱炎:主要特点为:①青年男性多发,起病缓慢;②以骶髂及脊柱关节受累为主;③常伴有肌腱病的表现;④关节外表现多为虹膜睫状体炎、心脏传导阻滞及主动脉瓣关闭不全等;⑤X线可见骶髂关节侵蚀、破坏或融合;⑥HLA-B27阳性;⑦RF阴性;⑧有家族发病倾向。

4.银屑病关节炎:本病患者RF阴性,关节受累比类风湿关节炎少,有特征性银屑疹和指甲病变。

5.系统性红斑狼疮:SLE关节外的系统性表现如蝶形红斑、脱发、蛋白尿等较突出。血清抗核抗体、抗双链DNA抗体多阳性,补体降低。

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"The imperative to self-knowledge has always been at the heart of philosophical inquiry," wrote MIT professor Sherry Turkle in the insightful book about the web and the self, Life on the Screen: Identity in the Age of the Internet. Published in 1995 as the second part of a trilogy that examined our relationships with technology, it looked at how we are who we are in online spaces. And what that means for us offline.

The good news is that the results are positive: "Play has always been an important aspect of our individual efforts to build identity," she said, referencing developmental psychologist Erik Erikson, and nodding to the theories of psychoanalysts Freud, Lacan and Jung. "In terms of our views of the self," she wrote, "new images of multiplicity, heterogeneity, flexibility, and fragmentation dominate current thinking about human identity. "

At the time Life on the Screen was released, most of the visitors were college students and their professors from a remarkably small talent pool, and a surprisingly small geography. They were tech-savvy, and generically open-minded about the new fields of virtual exploration that lay within the networks of this new communication platform. They were, in other words, liberal, enlightened types who were more willing to embrace the unprecedented fluidity of self-expression that this new technology uniquely afforded.

As a psychoanalyst and a web user herself, Turkle spent much of the book explaining why the articulation of multiple personalities wasn’t pathological. Contrary to its Latin root, identity need not mean "the same", she argued. "No one aspect can be claimed as the absolute, true self", she wrote, maintaining that the web allowed us the opportunity to get to know our "inner diversity". In the great psychoanalytic tradition, she said that self-actualisation meant coming to terms with who we are, and integrating each aspect of it into a coherent and well-integrated us.

Almost everyone has experienced this kind of identity play. Even if you’ve never ventured into an online game or been a signed-up member of a web community, you’ve probably developed a profile for a social network, written a blog, styled a website, commented on an article. But things are different from the time when Turkle was writing Life on the Screen. Nowadays, our virtual social lives are increasingly integrated. with our offline social lives. The freedom of expression is curtailed by the threat of offline consequences from online actions. Today, your reputation offline is far more closely tied to your reputation online than before. In fact, our experience of contemporary identity online is disarmingly similar to offline.

However, I still subscribe to the old Turkle. Consequence-free online environments allow us to practise and play without fear of offline effect, and offer an extraordinary place to experience the fluidity of our selves: I can be anyone, even a dog. As Tom MacMaster found, there still are places online where this is possible.

From the first sentence we know that()

A. inquiry into online identity has become a philosophical concern

B. philosophers put high premium on the nature of knowledge

C. the search for identity is an eternal theme of philosophical inquiry

D. philosophers are exploring our relationships with the Internet