31案例:A full-term weighing 3500g boy presents mildly jaundice with a total serum bilirubin of 205μmol/L(0.12g/L) at 48 hours of age.The baby is born to a 27-year-old primigravida with blood type O at 2 hours after membranes rupture. Breast-feeding has been wellThe most appropriate additional diagnostic studies to evaluate the cause of this infant jaundice are( )
A.Direct serum bilirubin,complete blood count,liver ultrasound,transaminases
B.Direct serum bilirubin,complete blood count, red blood cell glucose-6-phosphate dehydrogenase levels (G-6-PD),baby blood type
C.Complete blood count, direct serum bilirubin, baby blood type and Coombs, peripheral smear
D.Blood cultures,transaminases,red blood cell osmotic fragility,direct serum bilirubin
E.Abdominal radiograph,urine bilirubin,complete blood count,direct serum Bilirubin
开始考试练习点击查看答案32案例:A full-term weighing 3500g boy presents mildly jaundice with a total serum bilirubin of 205μmol/L(0.12g/L) at 48 hours of age.The baby is born to a 27-year-old primigravida with blood type O at 2 hours after membranes rupture. Breast-feeding has been wellThe nurse calls to inform you that the infant studies are back.The baby has O-positive blood. His direct serum bilirubin is 3. 4μmol/L(0.002g/L) with a repeat total serum bilirubin of 201 μmol/L(0.12g/L). The white count is 13×109/L with a di
A.Rh or ABO hemolytic disease
B.Physiologic jaundice
C.Sepsis
D.Congenital spherocytic anemia
E.Biliary atresia
开始考试练习点击查看答案33案例:女婴,26小时,孕36周,自然分娩,出生体重3200g。患儿出生后18小时出现呻吟,颜面青紫,偶有呼吸暂停。查体:T 35.5℃,P 156次/分,吸气性三凹征(+),双侧呼吸音减低,可闻及较多细湿啰音,律齐,未闻及杂音。四肢肢端发凉发花,下肢双侧硬肿。根据患儿情况,最不可能的临床诊断是( )
A.感染性肺炎
B.特发性呼吸窘迫综合征
C.败血症合并感染性休克
D.新生儿败血症
E.新生儿肺出血
开始考试练习点击查看答案34案例:女婴,26小时,孕36周,自然分娩,出生体重3200g。患儿出生后18小时出现呻吟,颜面青紫,偶有呼吸暂停。查体:T 35.5℃,P 156次/分,吸气性三凹征(+),双侧呼吸音减低,可闻及较多细湿啰音,律齐,未闻及杂音。四肢肢端发凉发花,下肢双侧硬肿。进一步的检查不包括( )
A.胸部X线
B.血培养
C.血常规+CRP
D.腰穿脑脊液检查
E.胸腔穿刺
开始考试练习点击查看答案35案例:女婴,26小时,孕36周,自然分娩,出生体重3200g。患儿出生后18小时出现呻吟,颜面青紫,偶有呼吸暂停。查体:T 35.5℃,P 156次/分,吸气性三凹征(+),双侧呼吸音减低,可闻及较多细湿啰音,律齐,未闻及杂音。四肢肢端发凉发花,下肢双侧硬肿。血培养证实为B组溶血性链球菌(GBS)感染,应选用的合适抗生素为( )
A.红霉素
B.青霉素
C.万古霉素
D.头孢他啶
E.美洛培南
开始考试练习点击查看答案36案例:一足月女婴,生后3天出现黄疸,近2天食欲缺乏,黄疸明显加重。查体:脐部红肿,有脓性分泌物,T 35.5℃。以下哪项检查对明确诊断很重要( )
A.血培养
B.查尿中巨细胞病毒
C.红细胞G-6-PD活性测定
D.血常规及血小板计数
E.检查母、婴血型
开始考试练习点击查看答案37案例:一足月女婴,生后3天出现黄疸,近2天食欲缺乏,黄疸明显加重。查体:脐部红肿,有脓性分泌物,T 35.5℃。关于抗生素的选择,配伍最合理的是( )
A.静脉滴注甲硝唑
B.肌内注射庆大霉素+青霉素
C.静脉滴注甲硝唑+头孢曲松钠
D.静脉滴注SIZ+青霉素
E.静脉滴注红霉素+氯霉素
开始考试练习点击查看答案38案例:天女婴,足月顺产,母乳喂养,生后第3天出现黄疸。近2天皮肤黄染加深,拒奶,查体:面色灰暗、易激惹、前囟张力稍高、四肢稍凉、脐部红肿、有脓性分泌物,肝肋下3cm,肛温 34.5℃。最可能的诊断是( )
A.新生儿脐炎,生理性黄疸
B.新生儿脐炎,母乳性黄疸
C.新生儿脐炎,新生儿肝炎
D.新生儿脐炎,新生溶血病
E.新生儿脐炎,新生儿败血症
开始考试练习点击查看答案39案例:天女婴,足月顺产,母乳喂养,生后第3天出现黄疸。近2天皮肤黄染加深,拒奶,查体:面色灰暗、易激惹、前囟张力稍高、四肢稍凉、脐部红肿、有脓性分泌物,肝肋下3cm,肛温 34.5℃。下列哪项检查对明确诊断最重要( )
A.血ALT测定
B.检查母婴血型
C.血常规和血小板
D.血培养
E.检查尿中巨细胞病毒
开始考试练习点击查看答案40案例:天女婴,足月顺产,母乳喂养,生后第3天出现黄疸。近2天皮肤黄染加深,拒奶,查体:面色灰暗、易激惹、前囟张力稍高、四肢稍凉、脐部红肿、有脓性分泌物,肝肋下3cm,肛温 34.5℃。该患儿最可能的并发症是( )
A.脑膜炎
B.核黄疸
C.肝硬化
D.骨髓炎
E.腹膜炎
开始考试练习点击查看答案