男性,44岁。咳嗽、咳痰伴发热1周。患者1周前受凉后出现阵发性咳嗽,咳黄色脓痰,伴畏

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问题:

男性,44岁。咳嗽、咳痰伴发热1周。患者1周前受凉后出现阵发性咳嗽,咳黄色脓痰,伴畏寒、发热、胸闷,体温最高达39.5℃,无咯血。院外自行口服复方乙酰氨基酚片、阿莫西林,症状无明显缓解,且逐渐出现气短。自发病以来,精神、食欲差,睡眠可,大小便未见异常,体重无明显变化。平素体健,否认传染病接触史。吸烟20余年,20支/日。偶有饮酒,无遗传病家族史。查体:T38.8℃,P99次/分,R30次/分,BP118/70mmHg。急性热病容,精神差。口唇轻度发绀,全身浅表淋巴结未触及肿大。扁桃体无肿大。双下肺叩诊稍浊,双肺呼吸音粗,双下肺可闻及细湿啰音,未闻及哮鸣音及胸膜摩擦音。叩诊心界不大,心率99次/分,律齐,心音有力,各瓣膜听诊区未闻及杂音。腹平软,无压痛及反跳痛,肝脾肋下未触及。双下肢无水肿。辅助检查:血常规:Hb128g/L,RBC4.68×1012/L,WBC10.0×109/L,N0.89,Plt291×109/L。肝肾功能无异常。胸部X线片:双肺纹理增多,双下肺可见斑片状阴影。要求:根据以上病历摘要,请写出初步诊断、诊断依据(如有两个以上诊断,应分别写出各自诊断依据,未分别写出扣分)、鉴别诊断、进一步检查与治疗原则。

考点:临床执业医师实践技能呼吸系统呼吸系统题库
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When Jennifer stepped in quietly, her mother, ____ on the bed, was sleeping sound.

A.laying

B.lain

C.laid

D.lying

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甲为其3岁儿子购买某品牌的奶粉,小孩喝后上吐下泻,住院7天才恢复健康。经鉴定,该品牌奶粉属劣质品,甲打算为此采取 * * 行动。下列是甲的一些 * * 措施,其中属于不当措施的是( )。

A.请媒体曝光,并要求工商管理机关严肃查处
B.向出售该奶粉的商场索赔,或向生产该奶粉的厂家索赔
C.直接提起诉讼,要求商场赔偿医疗费、护理费、误工费、交通费等
D.直接提起仲裁,要求商场和厂家连带赔偿甲全家所受的精神损害

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由于库存现金总额还不到M公司年末总资产的1‰,助理人员认为其金额远远低于报表的重要性水平而不必进行盘点。( )

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作用于壁细胞H2受体,抑制胃酸和胃蛋白酶的分泌

A.甲氰咪胍
B.阿托品
C.前列腺素
D.吗丁啉
E.奥美拉唑

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My dictionary defines subtle as "not immediately obvious; characterized by skill or ingenuity; clever; elusive; [even] insidious." Let us look at some concrete instances of this. (The very word itself is an example, as the letter" b" is silent in pronunciation.)"

Language can be straight-forward and directly to the point, but sometimes that takes the fun out of it. On occasion, at least, one appreciates subtleties—often as the mark of a quick wit. This particularly is true of jokes that generally have a double meaning. For example: Awaitress received only three pennies for a tip. Nonplussed, she told the customer that those three pennies told a lot about him. He took the bait and asked what they revealed. "The first penny," she said, "tells me you are thrifty." The patron agreed. "what does the second penny say" asked the customer. "It tells me you’re a bachelor." "Right again," he replied, "And what does the third penny tell you" "The third penny," responded the waitress, "tells me your daddy was a bachelor, too." How’s that for a subtle punishment

Subtleties also can be used on occasion for a good putdown. For instance, one can say a certain man was a big gun of industry. "Yes," is the counter, "he was fired several times." In this category was Mark Twain’ s caustic time bomb: "He was a good man—in the worst sense of the term."

In our day of political correctness (sometimes called the tyranny of the minority), police seldom talk about suspects, but only about" persons of interest." I guess law enforcement does not want another lawsuit on its hands. Then, too, with the campaign against fat and fried foods, Kentucky Fried Chicken calls itself KFC, figuring that few will think of "fried" that way.

The meaning of a word or phrase seems to change more rapidly today and unless one is "with it", a faux pas (失礼) can be committed. Such is the case with the term, "an exceptional child." Way back when, one would think that referred to an especially bright youngster, whereas today it indicates a handicapped youth. So, too, the word "primitive" virtually has been erased from our language and replaced with "earlier culture" and Indians are known as Native Americans.

The world of advertising is a master at subtleties with which it hopes to bamboozle (欺骗) the customer. For instance, when asked how much a gallon of gasoline costs, the reply might be something like $2.25. Yet, one must add a penny to that as a 9/10 follows the price, making it, in effect, $2.26. Cereal prices have skyrocketed over the years, but some companies claim to have held the line by keeping the price the same. What many do, however, is reduce the number of ounces in the package.

I leave the reader with the truism that subtlety, not brevity, is the soul of wit. Use it to win friends and influence people.

The underlined word "putdown" (Line 1, Paragraph 3) most probably means ()

A. a pun which can be interpreted in both positive and negative ways

B. a tone-twisting joke which intends to make the hearer puzzled

C. a response by understanding something deliberately in another way

D. an indirect way of saying something to make someone humiliated

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