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Medscape > Fast Five Quizzes Quiz: Are You Able to Confront Clostridium Difficile Infections? Michael Stuart Bronze, MD January 04, 2016   Clostridium difficile is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile infection commonly manifests as mild to moderate diarrhea, occasionally with abdominal cramping. In rare cases, patients with C difficile infection can pr...
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Teachable Moment | December 2015 The Importance of Clinical Context When Interpreting Serum Ammonia Levels A Teachable Moment Joseph W. Howells; Patricia A. Short JAMA Intern Med. 2015;175(12):1902-1903. doi:10.1001/jamainternmed.2015.5772. Story From The Front Lines病历摘要 A man in his early 40s presented to his primary care physician with intermittent anxiety attacks and progressive fatigue. An active duty service member, the patient had a history of panic disorder sinc...
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Teachable Moment | December 2015 LESS IS MORE The Value of the History and Physical Examination—Sailing Through Medicine With Modern Tools A Teachable Moment Maen D. Abou Ziki; David N. Podell; Danise M. Schiliro JAMA Intern Med. 2015;175(12):1901-1902. doi:10.1001/jamainternmed.2015.5768. Story From The Front Lines病历摘要 A middle-aged woman presented to the emergency department with severe ankle pain, generalized body aches, malaise, and petechial rash over her extremit...
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JAMA Diagnostic Test Interpretation Hyperkalemia Biff F. Palmer, MD; Deborah J. Clegg, PhD JAMA 2015; 314: 2405-2406 一名64岁男性患者患有2型糖尿病,高血压和慢性肾病(CKD)。患者因新发无力就诊。6个月前患者发生心肌梗塞合并心功能衰竭,射血分数35%。使用药物包括赖诺普利(lisinopril)、美托洛尔(metoprolol)、胰岛素和呋塞米。一周前,患者被诊断为右下肢蜂窝织炎,使用了7天的复方新诺明。2天前患者出现全身无力,且在过去24小时内进行性加重。体格检查发现右下肢蜂窝织炎缓解。患者上肢及下肢肌...
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JAMA Diagnostic Test Interpretation Hyperkalemia Biff F. Palmer, MD; Deborah J. Clegg, PhD JAMA 2015; 314: 2405-2406 A 64-year-old man with type 2 diabetes, hypertension, and chronic kidney disease (CKD) presented with new weakness. Six months ago he had a myocardial infarction complicated by heart failure with an ejection fraction of 35%. His medications were lisinopril, metoprolol succinate, insulin, and furosemide. One week ago, he was diagnosed with cellulitis ...
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Medscape > Fast Five Quizzes Quiz: How Much Do You Know About Systemic Lupus Erythematosus? Herbert S. Diamond, MD November 03, 2015 系统性红斑狼疮(SLE)是一种慢性炎性疾病,病情可反复发作及缓解。SLE可以影响任何器官系统,但主要累及皮肤、关节、血液系统及神经系统。SLE的自然病程从相对良性表现到迅速进展甚至致死性疾病。 你对这种疾病的了解有多少? 问题1:已知以下哪种疾病能够增加SLE罹患率及病死率? 答案:骨质疏松 解答: European League Against Rheumatism (EULAR) task force 认为...
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Medscape > Fast Five Quizzes Quiz: How Much Do You Know About Systemic Lupus Erythematosus? Herbert S. Diamond, MD November 03, 2015 系统性红斑狼疮(SLE)是一种慢性炎性疾病,病情可反复发作及缓解。SLE可以影响任何器官系统,但主要累及皮肤、关节、血液系统及神经系统。SLE的自然病程从相对良性表现到迅速进展甚至致死性疾病。 你对这种疾病的了解有多少? 已知以下哪种疾病能够增加SLE罹患率及病死率? 炎性肠病 骨质疏松 心房纤颤 妊娠 View Results  Loading ...
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[编者按]:在刚刚结束的中国危重病医学大会2015中,组委会安排了形式新颖的“图霸争锋”竞赛环节。希望通过这种形式加强与会者的参与度,同时传播相关知识。 我们将陆续刊出本次竞赛的题目及答案,希望对同道们的临床工作有所裨益。 题目6:女性79岁患者因休克及呼吸功能衰竭入ICU。ABG (FiO2 0.7, PEEP 10 cmH2O): pH 7.36, PaCO2 34 mmHg, PaO2 65 mmHg。经右侧锁骨下静脉留置肺动脉导管(PAC),但无法嵌顿。CXR如图所示。此时,经PAC远端留取血标本进行血气分析。 问题:以下哪个结果最符合PAC远端管腔留取血标本...
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[编者按]:在刚刚结束的中国危重病医学大会2015中,组委会安排了形式新颖的“图霸争锋”竞赛环节。希望通过这种形式加强与会者的参与度,同时传播相关知识。 我们将陆续刊出本次竞赛的题目及答案,希望对同道们的临床工作有所裨益。 题目6:女性79岁患者因休克及呼吸功能衰竭入ICU。ABG (FiO2 0.7, PEEP 10 cmH2O): pH 7.36, PaCO2 34 mmHg, PaO2 65 mmHg。经右侧锁骨下静脉留置肺动脉导管(PAC),但无法嵌顿。CXR如图所示。此时,经PAC远端留取血标本进行血气分析。 以下哪个结果最符合PAC远端管腔留取...
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[编者按]:在刚刚结束的中国危重病医学大会2015中,组委会安排了形式新颖的“图霸争锋”竞赛环节。希望通过这种形式加强与会者的参与度,同时传播相关知识。 我们将陆续刊出本次竞赛的题目及答案,希望对同道们的临床工作有所裨益。 题目5:以下是一名男性社区获得性肺炎患者气管插管后2小时的呼吸机波形 问题:以上呼吸机波形提示? 问题选项: A. 吸气流量不足 B. 吸气触发灵敏度不恰当 C. 气道阻力增加 D. 呼吸频率与呼吸机设置频率不匹配 E. 顺应性降低 答案:B. 吸气触发灵敏度不恰当
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