诊断实验答案（Diagnostic test answer）.docVIP

诊断实验答案（Diagnostic test answer） (I) diagnosis Obstruction jaundice: common bile duct stone 4 points (two) diagnosis basis; 1., intermittent paroxysmal abdominal pain, accompanied by jaundice, fever 1 points 2. postprandial attacks of abdominal pain, back and shoulder radiation, for the performance of biliary colic 1 points 3., a history of gallstones 1 minutes 4. laboratory examination with mild jaundice, 0.5 points 5. B ultrasound showed that the bile duct was suspected to expand by 0.5 points Two, differential diagnosis (5 points) 1., the cause of internal medicine jaundice, such as liver cells, hemolytic, drug jaundice 2 points 2. tumor: pancreatic head cancer, periampullary cancer, with progressive painless yellow based 3 points Three, further examination (4 points) 1. episodes of repeated urine routine examination of bilirubin and liver function, 2 2. imaging examination: CT, barium meal 1 points 3. assist 1 points with ERCP or endoscopic ultrasound when necessary Four, treatment principles (3 points) 1. laparotomy, common bile duct exploration, drainage 2 minutes 2. or EPT surgery, 1 points Case 6 1. diagnosis and diagnosis Initial diagnosis: chronic glomerulonephritis. Diagnosis basis: (1) the chronic course of middle-aged women. (2) patients with intermittent face and lower extremity edema 2 years, with oliguria, fatigue, anorexia, hypertension, proteinuria, edema after 1 weeks of cold. (3) past physical rehabilitation. (4) physical examination, BP, L60 / 100mmHg, double eyelid edema, slight sunken edema of lower extremity. (5) urine protein (+ +), WBC 0-1 / HP RBC l0-20 / HP, 0-1 / HP particles, 24 hour urinary protein quantitative 3.0g; blood BUN 8.3mmol / L Cr L56 / L mol. 2. differential diagnosis (1) hypertensive patients suffer from kidney damage, first of all have a history of hypertension, followed by renal damage. The urine changes slightly, often has the renal tubule function damage first, often simultaneously has the hypertension heart and brain co