2003年卒业测验(国外英文资料).docVIP

2003年毕业考试 Graduated from clinical medicine at hebei medical university Medical case summary (1) (20 points) The patient wang mou, male 68 years old, the farmer, the main reason cough, cough and sputum 30 years, the gas short five years, the mind is not clear 2 days, on May 15, 99, be admitted to the hospital. The patient was due to cough and sputum in the winter for about 30 years, lasting about 3 to 4 months, and the summer was relieved. Nearly five to six years of cough and sputum have been increased, and have a short, suffocating appearance, especially when active, with discontinuous lower limb swelling, and relief after taking the drug. A week ago because of the cold, cough, shortness of breath, yellow purulent sputum, chest pain, lower extremity edema, not half a lie, in local green, streptomycin and double hydrogen grams of urine therapy, edema, reduced the volume of sputum, but patients with anorexia, breathing becomes shallow, delirious and come to our hospital. In the past 40 years, the history of hepatitis, tuberculosis, coronary heart disease, hypertension and diabetes has been denied. Physical examination: T38.2 ℃, P110 times/min, the R26 times/min, BP120/70 MMHG, delirious, half supine position, lip, refers to the light purple purple, palpebral conjunctiva congestion, sclera, no yellow dye, jugular vein engorgement, trachea center, thyroid, barrel chest, two lung knocking sounds, double lung song audible and dispersed in the business, both lungs audible and wet rale. Percussion is not a big deal, the heart rate is 110 times, the law is not, can be heard and the early beat, not smell and noise, P2 A2. Stomach is a bit of peng, liver in rib under 4.5 cm, qualitative hard, edge blunt, light tenderness, liver jugular vein regurgitation) positive, spleen untouched, ascites sign (-), refers to the pitting edema of lower limbs. The physiological reflex is weakened and the pathologic reflex is not introduced. Chemical and auxiliary examination, routine blood