患者男，7岁，因“高热3d，抽搐、意识障碍1d”来诊。20d前有狗咬_爱下问搜题

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患者男，7岁，因“高热3d，抽搐、意识障碍1d”来诊。20d前有狗咬伤史，已深部清洗伤口并按要求注射狂犬病疫苗，目前伤口已愈合。查体：T40.3℃，P107次/min，R32次/min，BP150/90mmHg；昏迷；下肢见2cm×2cm瘢痕，全身皮肤未见皮疹；瞳孔左侧3mm，右侧4mm，对光反射迟钝；可疑颈强直；双肺可闻及痰鸣音；肝、脾未触及；克尼格征（＋），巴宾斯基征（＋）。血常规：WBC20.5×10⁹/L，N0.86。

正确的治疗是（）

A.一般治疗：隔离，支持疗法，注意水、电解质平衡等，加强护理

B.高热：以物理降温为主，药物降温为辅，如安乃近滴鼻，如效果不理想，可用亚冬眠疗法

C.惊厥或抽搐：应针对高热、缺氧、脑水肿、脑实质炎症等不同原因采用不同的对症治疗方法

D.患儿血压较高，双瞳孔不等大，要注意有脑水肿、脑疝的存在，故应先行退热、吸氧、脱水等治疗，如仍有抽搐，应尽早使用镇静药

E.患者呼吸较快，双肺可闻及痰鸣音，要注意防治呼吸衰竭：吸氧及吸痰以保持呼吸道通畅

F.如出现中枢性呼吸衰竭可用呼吸兴奋药，还可使用血管扩张药，以改善微循环，减轻脑水肿

G.患儿病情危重应积极快速补液以防止出现循环衰竭

H.中枢性呼吸衰竭必要时可机械通气辅助呼吸

答案

参考答案：A, B, C, D, E, F, H

单项选择题

腹部叩诊移动性浊音阳性提示腹腔内游离腹水在

A．1000ml以上

B．1200ml以上

C．1500ml以上

D．1800ml以上

E．2000ml以上

完形填空

After forty-three years I have forgotten the name of the old lady, who was a   16   on the newspaper route in my hometown when I was a twelve-year-old boy. Yet it remains in my memory that she taught me a lesson in     17   that I shall never forget.
On a winter afternoon, my fellows and I were throwing stones onto the slanted (倾斜的) roof of the old lady’s house to observe how the stones    18    off the roof’s edge and shot out like missiles. I found a   19   smooth rock and threw it out, but it 20  straight not for the roof but for a small window of the old lady’s house.   21   the sound of broken glass, we knew we were in trouble. We ran faster than any of our   22    flew off her roof.
I was so   23   about getting caught that first night   24   I was not concerned about the old lady with the broken window in winter.    25  , a few days later I started to feel guilty for her misfortune. She    26   greeted me with a smile when I gave her the newspaper, but I was no longer able to act    27   in her presence.
I    28   my mind that I would save my newspaper delivery money, and in three weeks I had seven dollars. I put the money in an envelop with a    29   explaining that I was sorry for breaking her window and hope that the seven dollars would    30   the cost for repairing it.
I waited until it was     31     to avoid being seen, and put the letter I didn’t    32   into her yard. To my relief, I could have the   33  of, once again, looking straight into the old lady’s kind eyes.
The next day, I handed the old lady her newspaper. She thanked me and gave me a bag of cookies she had made herself.   34  eating cookies, I felt an envelope and pulled it out of the bag. After opening it, I was shocked. Inside were the seven dollars and a short note    35  , “I’m proud of you.”

B．carelessness

C．forgiveness

B．disappointed

C．embarrassed

D．comfortably