患者女,24岁,因“发热、畏寒、寒战3d”来诊。无咳嗽、咳痰、腹痛、腹泻、尿频、尿急

题型:单项选择题 案例分析题

问题:

患者女,24岁,因“发热、畏寒、寒战3d”来诊。无咳嗽、咳痰、腹痛、腹泻、尿频、尿急等。既往有中耳炎病史。查体:T39.5℃,P130次/min,R28次/min,BP80/40mmHg;全身皮肤可见大量类圆形皮疹,无明显瘙痒,四肢末端湿冷,皮肤苍白,无明显花斑;腹部平软,无压痛及反跳痛,肝肋下未及,脾肋下1cm,质软,表面光滑,无压痛,墨菲征(-),肠鸣音4次/min。

最可能的诊断为()

A.结核杆菌感染

B.病毒感染

C.布氏杆菌病

D.多形性红斑

E.败血症,感染性休克

F.肾综合征出血热(流行性出血热)

G.猩红热

考点:内科学(医学高级)传染病传染病题库
题型:单项选择题 案例分析题

采用超额累进税率计算税额时,速算扣除数的作用主要是( )。

A.解决累进临界点税负不合理问题

B.使计算更准确

C.减缓税率累进的速度

D.简化计算

题型:单项选择题 案例分析题

用于治疗风热外袭,火毒内结,痈肿疮毒,兼有便秘者()

A.薄荷

B.牛蒡子

C.桑叶

D.蝉蜕

E.浮萍

题型:单项选择题 案例分析题

下列叙述中正确的是[ ]

A.铁丝在空气中燃烧火星四射

B.把生石灰放入稀盐酸,产生大量气泡

C.将碳酸钠放入滴有酚酞试液的水中,溶液变红

D.氯化铁溶液中加入氢氧化钠溶液,生成蓝色沉淀

题型:单项选择题 案例分析题

在前景、中景和背景中,主景一般是前景。

题型:单项选择题 案例分析题

(46) It is known that the brain shrinks as the body ages, but the effects on mental ability are different from person to person. Interestingly, in a study of elderly men and women, those who had more education actually had more brain shrinkage.
"That may seem like bad news," said study author Dr. Edward Coffey, a professor of psychiatry and of neurology at Henry Ford Health System in Detroit. (47) However, he explained, the finding suggests that education allows people to withstand more brain tissue loss before their mental functioning begins to break down.
The study, published in the July issue of Neurology, is the first to provide biological evidence to support a concept called the "reserve" hypothesis, according to the researchers. In recent years, investigators have developed the idea that people who are more educated have greater cognitive reserves to draw upon as the brain ages; in essence, they have more brain tissue to spare.
(48) Examining brain scans of 320 healthy men and women aged 66 to 90, researchers found that for each year of education the subjects had, there was greater shrink age of the outer layer of the brain known as the cortex. Yet on tests of cognition and memory, all participants scored in the range indicating normal.
"Everyone has some degree of brain shrinkage," Coffey said. "People lose (on average) 2.5 percent per decade starting in adulthood."
There is, however, a "remarkable range "of shrinkage among people who show no signs of mental decline, Coffey noted. Overall health, he said, accounts for some differences in brain size. Alcohol or drug use, as well as medical conditions such as diabetes and high blood pressure, contribute to brain tissue loss throughout adulthood.
In the absence of such medical conditions, Coffey said, education level helps explain the range of brain shrinkage exhibited among the mentally-fit elderly. The more-educated can withstand greater loss.
(49) Coffey and colleagues gauged shrinkage of the cortex by measuring the cerebrospinal fluid surrounding the brain. The greater the amount of fluid, the greater the cortical shrinkage.
Controlling for the health factors that contribute to brain injury, the researchers found that education was related to the severity of brain shrinkage. For each year of education from first grade on, subjects had an average of 1.77 milliliters 11 more cerebrospinal fluid around the brain.
Just how education might affect brain cells is unknown. (50) In their report, the researchers speculated that in people with more education, certain brain structures deeper than the cortex may stay intact to compensate for cortical shrinkage.

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