女性,35岁。腹痛、腹胀、呕吐,停止排便、排气1天。患者于1天前无明显诱因出现阵发性

题型:问答题 案例分析题

问题:

女性,35岁。腹痛、腹胀、呕吐,停止排便、排气1天。

患者于1天前无明显诱因出现阵发性腹痛,呈绞痛,以右下腹为重,同时腹胀,停止肛门排便、排气。腹痛逐渐加重,伴恶心、呕吐,呕吐物初为胃液及胆汁,以后呕吐物有粪臭味。共呕吐5~6次,量约1000~1500ml,尿量约500ml/天,对症治疗未见明显好转。既往大小便正常,2年前曾因化脓性阑尾炎穿孔行阑尾切除术。

查体:T137℃,P105次/分,R20次/分,BP130/80mmHg。急性病容,神志清,全身皮肤未见黄染,皮肤黏膜干燥,弹性稍差。双肺未闻及干湿性啰音,心界不大,心率102次/分,律齐,腹膨隆,右下腹有手术瘀痕,可见肠型及蠕动波,全腹柔软,轻压痛,无反跳痛,未触及明确肿块,肝脾肋下未触及,肠鸣音高亢。直肠指诊:腔内空虚,未触及明确肿物,指套无血迹。实验室检查:血常规:Hb160g/L,WBC11.5×109/L,血K+3.0mmol/L,血Na+135mmol/L,血C1105mmol/L。立位腹部X线平片如图。

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消化系统消化系统题库
题型:问答题 案例分析题

阅读理解。

     An old woman opens her windows and looks out. What a sunny day! But she is surprised there is a

 man in the front garden. The old woman looks at him and says, "He is eating grass, why?" She goes out

 into her garden and says to him, "Are you very hungry? Why don't you go to work and get some food?"

 The man looks at her and says, "I don't like working, I just like eating. Now I'm hungry, I have nothing for

 my breakfast. You see, I'm eating grass. Can you give me some food?"

     The old woman says, "Come to the back door of my house." The man is very pleased (高兴的). He

 thinks he can get food from the old woman. So he goes with her. The old woman opens the back door

 and says to the man. " Look, the grass here is longer (更长的) than that in the garden. Just enjoy it here!"

1. What's the man doing in the garden?   He is ______ there.

    A. working hard

    B. opening the windows

    C. eating some food

    D. eating the grass

2. What does the man have for breakfast?

    A. Some food

    B. Nothing

    C. Vegetables

    D. Fruits

3. How does the man feel (感觉) when the old woman asks him to the back door?

    A. sad

    B. sorry

    C. interesting

    D. pleased

4. What does the woman ask him to do?

    A. She asks him to work for her

    B. She asks him to the back door and eat food

    C. She asks him to the back door and eat the grass there

    D. She gives him some food at the back door

5. What do you think of the man?     He is _____.

    A. pleased

    B. sad

    C. lazy

    D. sorry

题型:问答题 案例分析题

《期货交易管理条例》的施行时间是()。

A.2007年2月7日

B.2007年4月15日

C.2008年2月7日

D.2008年4月15日

题型:问答题 案例分析题

本病例诊断为

A.暑湿伤表证
B.气虚感冒
C.风寒束表证
D.风寒夹湿证
E.表寒里热证

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为什么扬压力对重力坝的应力及稳定均不利?

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数字图书馆信息资源建设应遵循哪些原则?

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