患者女性，60岁，退休干部。该患者于7年前曾有过1次心前区疼痛，持续约5分钟，自行缓

发布时间：2018-02-27 17:56 │ 来源：www.tikuol.com

题型：问答题案例分析题

问题：

患者女性，60岁，退休干部。该患者于7年前曾有过1次心前区疼痛，持续约5分钟，自行缓解，一直未治疗，此后未再发生上述症状。3小时前无明显诱因突然发生胸骨后上中段闷痛，未向他处放散，伴气短，出汗及恶心，持续20分钟后缓解，2小时前又出现上述症状，约30分钟自行缓解。1小时前再次出现上述症状，并且疼痛加重，患者无法忍受，疼痛并向左肩部放散，伴有剧烈的恶心、呕吐，呕出物均为胃内容物。于是家人陪同打车来到医院急诊科，直至来医院时疼痛尚未缓解。体格检查：体温37.0℃，脉搏87次／分，呼吸15次／分，血压135／89mmHg，神志清楚，平卧位，大汗、无颈静脉怒张，双肺听诊呼吸音清，无干湿啰音。心率87次／分，心音低钝，节律整，心尖部或闻及2／6级收缩期吹风样杂音。全腹软，无压痛及反跳痛，肝脾朱触及，双下肢无水肿。

请问你作为急诊医生需要迅速做哪些必要的辅助检查？

该患者的临床初步诊断是什么？

如何进行急诊处理？

考点：广东住院医师急诊医学急诊医学科综合练习急诊医学科综合练习题库

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任务型阅读。阅读下列短文，根据短文中的信息完成文后表格。（每空一词)

       In the past, man did not have to think about the protection of his environment. There were not many people
on earth, and natural resources seemed to be unlimited.
       Today, things are different. The world has become too crowded. We are using up our natural resources too
quickly, and at the same time we are polluting our environment with dangerous chemicals. If we continue like
this, human life on earth will not survive.
       Everyone realizes today that if too many fish are taken from the sea, there will soon be none left. Yet, with
modern fishing methods, more and more fish are caught. We know that if too many trees are cut down, forests
will disappear and nothing will grow on the land. Yet, we continue to use bigger and more powerful machines to
cut down more and more trees.
       We realize that if rivers are polluted with waste products from factories, we will die. However, in most
countries waste products are still put into rivers or into the sea, and there are few laws to stop this.
       We know, too, that if the population of the world continues to rise at the present rate, in a few years, there
will not be enough food.
       What can we do to solve these problems?
       If we eat more vegetables and less meat, we will easily get more food. Land that is used to grow crops can
feed five times more people than land where animals are kept.
       The world population will not rise so quickly if people use modern methods of birth control.
       Finally, if we educate people to think about the problems, we shall have a better and cleaner living place in
the future.

The importance of protecting the environment

Problems	◆ More fish being caught. ◆ More 1 being cut down. ◆ More waste products being put into rivers. ◆ More 2 being born.
Causes	◆ The world is becoming too 3 . ◆ Modern methods make the situation worse .
Result	We human beings will not survive on the earth.
Solutions	◆ Eat more vegetables and less meat so that more food will be available for everyone. ◆ Use modern methods of 4 control so that the population will not grow too fast. ◆ Educate people so that the 5 will be better and cleaner.

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春分到夏至日，太阳直射点

A．从北回归线向赤道移动

B．从赤道向南回归线移动

C．从赤道向北回归线移动

D．从南回归线向赤道移动

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根据发生水域不同，淹溺可分为哪几类（）

A.干性淹溺

B.湿性淹溺

C.海水淹溺

D.淡水淹溺

E.近乎淹溺

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请从“独语体”的角度简述鲁迅散文集《野草》的艺术特点。

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“生命链”是指从“第一反应人”发现伤病员开始，到专业急救人员到达现场进行抢救的一个系列过程，它包括四个互相联系得环节序列，也叫链条。他们的正确顺序是（）。

A.早期通路、早期徒手心肺复苏、、早期心脏除颤、早期高级生命支持

B.早期通路、早期心脏除颤、早期高级生命支持、早期徒手心肺复苏

C.早期徒手心肺复苏、早期通路、早期高级生命支持、早期心脏除颤

D.早期高级生命支持、早期徒手心肺复苏、早期通路、早期心脏除颤

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