男性，25岁。踢足球后淋雨，晚上突然寒战，高热，伴全身肌肉酸痛

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问题单项选择题 A3型题

男性，25岁。踢足球后淋雨，晚上突然寒战，高热，伴全身肌肉酸痛，右胸痛，深呼吸时加重，咳嗽，咳少量铁锈色痰。查体：急性病容，口角有疱疹，体温39.5℃，脉搏100次／分，右肺触觉语颤增强，叩诊呈浊音，可闻及支气管呼吸音。实验室检查：WBC21×10⁹／1，中性粒细胞0.90，核左移。

该患者最可能的诊断是（）

A.肺炎链球菌肺炎

B.肺脓肿

C.葡萄球菌肺炎

D.克雷伯杆菌肺炎

E.支原体肺炎

答案

参考答案：A

解析：患者为年轻男性，淋雨后出现高热，急性起病，咳铁锈色痰。查体可见口角疱疹，右肺实变体征，伴有血象明显增高，考虑为肺炎链球菌肺炎。

阅读理解

阅读理解。

	When you cough or sneeze, you'd better turn your head away from others and cover your mouth with the full part of your hand. And then, you should say, "Excuse me". This seems so simple, but it is surprising how many kids have never been told to do this. Actually, I notice adults all the time who cough and sneeze in public without placing a hand over the mouth. One important thing I point out to the kids is that after they sneeze or cough on their hands, they should wash their hands as soon as possible. If not, they will be passing those germs (细菌) along to everything and everyone they touch.
	If you come to a door and someone is following you, hold the door. If the door opens by pulling, pull it open, stand to the side, and allow the other person to pass through first, thenyou can walk through. If the door opens by pushing, hold the door after you pass through. After a few weeks of seeing kids try to get through doors in the school and watching them enter restaurants as the door hit other people, I knew I had to discuss the problem with my students. Teaching them small acts of kindness, such as letting someone else go through a door first as they hold it open, may seem unimportant, but it can go a long way toward helping students realize how to be polite and thank others. Once they've been told, they're halfway there.
	When we have to go up moving stairs,we will stand to the right. That will give others who are in a hurry a choice of walking up the left-hand side of the moving stais. When we are going to entera lift,the underground,or a doorway, we will wait for others to exit before we enter. After college when I moved to London, I was surprised at how polite everyone was in the subways. I was even more touched when I traveled to Japan. In both places, people made effort to make way for others. On moving stairs, everyone stood to the right and walked to the left. On lifts, everyone would stand over to the side and allow others to exit before they would begin to enter.