问题 问答题 简答题

特发性血小板减少性紫癜的主要鉴别诊断是什么?

答案

参考答案:

(1)再生障碍性贫血:表现为发热、贫血、出血三大症状,肝、脾、淋巴结不大,与特发性血小板减少性紫癜伴有贫血者相似。但一般贫血较重,白细胞总数及中性粒细胞多减少,网织红细胞不高,骨髓红粒系统生血功能减低,巨核细胞减少或极难查见。

(2)急性白血病:ITP特别需要与白细胞不增高的白血病鉴别。通过血涂片中可见各期幼稚白细胞及骨髓检查,即可确诊。

(3)过敏性紫癜:为对称性出血,斑丘疹以下肢为多见,血小板不少,一般易于鉴别。

(4)红斑性狼疮:早期可表现为血小板减少性紫癜,有怀疑时应检查抗核抗体及狼疮细胞(LEC.可助鉴别。

(5)继发性血小板减少性紫癜:严重细菌感染和病毒血症均可引起血小板减少,各种脾大疾病、骨髓受侵犯疾病、化学和药物过敏或中毒(药物可直接破坏血小板或抑制其功能或与血浆成分合并形成抗原复合物,继而产生抗体,再由抗原抗体发生过敏反应,破坏血小板。过敏反应开始时,可见寒战、发热、头痛及呕吐等)、溶血性贫血均可伴有血小板减少。应仔细检查,找出病因,以与特发性血小板减少性紫癜鉴别。

单项选择题
填空题

The following is a text about the perpetual motion machine. In the paragraphs with numbers, the supporting details, data or facts have been omitted and are listed following the text in random order. Match each of the details with the statement it supports.
Perpetual Motion Machine is a fascinating and long-discussed topic that moves well beyond the scope of physics. In short, a perpetual motion machine can be likened to a magic cow that continues to live and breathe and yet needs no sustenance. A perpetual motion engine installed in a car would continue to run indefinitely but would need neither gas tank nor petrol. Of course, as a perpetual motion machine is in violation of natural laws, it will likely never move out of the realm of imagination and into reality. When the phrase " perpetual motion machine " is entered into Google’s search engine, 34,400 items are returned. Of these 34,400 items, the forty-first to the forty-fifth hold reasonable interest and will be further discussed herein.
41. Myths and legends
Long before the advent of the steam engine, human beings have ruminated on the possibility of a perpetual motion machine. Throughout history, many have attempted to invent such a device, though none have thus far been successful.
42. Fame and glory
Some people hold that any inventor attempting to create a perpetual motion machine must only be in it for credit and accolades, wishing to be the first in his field to discover the much-coveted secret.
43. Wealth and riches
It is also suspected by some that those seeking to unlock the mystery of perpetual motion machine must be motivated by the monetary rewards. If such a device were to fall into popular use, the inventor would be a wealthy man indeed.
44. Antics and capers
Even some of those who are aware of the impossibility of perpetual motion machine have invented something similar under the guise of perpetual motion machine in order to tease us.
45. Deception and trickery
Some people, though fully aware that they are incapable of inventing a perpetual motion machine, persist in arguing that they can with the intention of scamming us.
Though the perpetual motion machine is a dream long-sought after by the scientific community, it is improbable that it will ever be realized. We can, however, pour our resources into researching more practical energy conserving forms of power such as geothermal, hydro-electric, and solar power solutions.
[A] Inventor K declared, " The experiments with perpetual motion are on the verge of success. My products will soon be distributed throughout the world and used in a wide range of industrial applications. When that happens, my company will expand exponentially. I’ll make a fortune! "
[B] Inventor F told me excitedly, " Some complex details are currently under discussion to unearth the key to perpetual motion. If my experiment proves to be effectual, I will become a Nobel Prize winner. You know, the ceremony is held annually in Sweden and is broadcasted live to every corner of the globe. " It is no great wonder that Inventor F espoused enthusiasm. A functional perpetual motion machine is a wonder that would be marveled at for generations to come.
[C] In ancient China there was an extremely adroit man by the name of Zhu Geliang. It is said that he constructed a wooden horse which could walk unaided and could be used in the transportation of military supplies. As no records of this occurrence have been found, this tale has passed into legend.
[D] One of the closest things to a perpetual motion engine was the one installed on the Traveler 1 spacecraft, the first spaceship in human history to fly beyond the edges of our solar system. Though Traveler’s engine is able to Fun without maintenance for many years, it still requires energy—nuclear energy. So, strictly speaking, Traveler 1 does not run on a perpetual motion engine, but in fact needs energy as do all other machines.
[E] Mr, Goofy announced that he had effectively diagrammed the first perpetual motion machine. When a private corporate party purchased the patent, they found to their dismay that manufacturing it according to the design layout was technically infeasible. Furious, they sued Mr. Goofy for fraud, but even in the courtroom, Mr. Goofy would not be shamed. He simply retorted, " I’m just joking around. "
[F] Tom, proudly proclaiming that he had invented a clock that ran on perpetual motion, and had it placed in the central square of his town. The clock, he said, would work perfectly despite a lack of springs in the internal mechanism. A scientist later ascertained the secret and revealed it to the townspeople: the clock had been cleverly devised to run on temperature differentials.