山东大学医学院出科考试儿科基础Word文档格式.docx

山东大学医学院出科考试儿科基础Word文档格式.docx

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onepatientintheoutpatientarm（0.6%butnoneinthehospitalgroupsufferednon-fatalrecurrentVTE.217Inameta-analysisof14（mostlycohort-studies,thepooledincidencesofrecurrentVTE,majorbleedingandtotalmortal-itydidnotdiffersignificantlybetweenoutpatients,patientsdis-chargedearly,andthosetreatedasinpatients.351

5.8Therapeuticstrategies

AnalgorithmoftherecommendedtherapeuticstrategiesforacutePEisshowninFigure5.

5.8.1Pulmonaryembolismwithshockorhypotension（high-riskpulmonaryembolism

PatientswithPEpresentingwithshockorhypotensionareathighriskofin-hospitaldeath,particularlyduringthefirstfewhoursafterad-mission.Besideshaemodynamicandrespiratorysupport,intraven-ousUFHshouldbeadministeredtothesepatientsasthepreferredmodeofinitialanticoagulation,asLMWHorfondaparinuxhavenotbeentestedinthesettingofhypotensionandshock.

Primaryreperfusiontreatment,particularlysystemicthromboly-sis,isthetreatmentofchoiceforpatientswithhigh-riskPE.Inpatientswithcontraindicationstothrombolysis—andinthoseinwhomthrombolysishasfailedtoimprovethehaemodynamicstatus—surgi-

calembolectomyisrecommendedifsurgicalexpertiseandresources

areavailable.Asanalternativetosurgery,percutaneouscatheter-directedtreatmentshouldbeconsideredifexpertisewiththis

methodandtheappropriateresourcesareavailableonsite.In

thesecases,treatmentdecisionsshouldbemadebyaninterdisciplin-

aryteaminvolvingathoracicsurgeonorinterventionalcardiologist,

47.佝偻病后遗症期,主要表现是（

5.8.2Pulmonaryembolismwithoutshockorhypotension（intermediate-orlow-riskpulmonaryembolism

B.睡眠不安及多汗

C.X线长骨骼端呈毛刷状改变

D.骨骼畸形

E.肌肉韧带松弛

正确答案:

D

48.早期诊断佝偻病的可靠指标是（

A.钙磷乘积下降

B.血磷增高

C.血浆中cAMP水平降低

sPESIof0（Table9,shouldbeconsideredforearlydischargeandoutpatienttreatment,ifthisappearsfeasiblebasedonthepatient’santicipatedcomplianceaswellashis/herfamilyandsocialback-ground.Forallotherpatients,assessmentofRVfunctionbyecho-cardiography（orCTangiographyandcardiactroponintesting

E.骨骼X线改变

49.维生素D治疗佝偻病的剂量应为（

A.依病情不同而剂量不同

B.不同病期,剂量相同

C.先用小剂量,逐渐加大剂量

D.剂量越大越好

E.剂量越小越安全

A

50.口服大剂量（1万单位维生素D治疗佝偻病激期。

需要（A.用至痊愈

B.用至3岁

C.用至血生化完全正常

D.用3~6个月

E.用1个月

E

51.维生素D缺乏性手足搐

搦症。

主要是由于（

A.血钙迅速转移至骨骼

B.血浆蛋白浓度降低

C.骨钙不能游离入血

D.血磷增加

E.血中钙离子降低

52.当血钙低于哪个数值时

可引起手足搐搦（

A.血总钙<

2.2~2.35mmol/L

B.血总钙<

2.0~2.45mmol/L

C.血离子钙<

1.88~

2.2mmol/L

D.血离子钙<

1.75~

1.88mmol/L

E.血总钙<

1.75~1.88mmol/L

53.维生素D缺乏性手足搐

indefiniteanticoagulanttreatmentafterafirstunprovokedVTE.Noevidenceoftheclinicalbenefitofextendedanticoagulanttreatment

iscurrentlyavailableforcarriersofheterozygousfactorVLeiden