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病例摘要:女性,48岁。牡丹江人,长途车押运员。已婚,左利手。右侧肢体麻伴不认识物品2天。患者2天前长途卧床到南京停车场休息,觉头昏、乏力和恶心。次晨下车去厕所时被人发现右足未穿鞋,提醒后才恍然大悟。此时觉右侧下肢麻。上厕所小便后无法找到自己的卧车。由别人找回到长途车。3小时后付过路费时无法分出各人民币的币值;反复拉手提包拉链,找不出和不认识包中的手机;最后均由别人代理完成。入病房后一直认为在牡丹江的医院病房。一天来面色苍白、嗜睡。既往史:3年前9月某日晨起曾发生左手无力,继而手指活动不能,洗脸时无法拧毛巾,行走下肢拖行。当地医院CT扫描示脑血栓形成。据说当时血常规、肝和肾功能正常。经治疗1个月后完全好转。从40岁以后碰撞处皮肤会出现浅紫斑片。无药物过敏史、未服避孕药和任何药物。无腹泻等胃肠病。无关节痛等慢性病。无冶游史。个人史:生有一女,月经史:月经周期准、量中等。从未去过农牧区。父母健在,高血压、糖尿病和脑血栓形成。查体:T36.5℃,P70次/分,R18次/分,BP120/76mmHg,皮肤无瘀斑,黏膜无贫血貌,浅表淋巴结未肿大,两肺呼吸,心率70次/分,律齐,无杂音,肝脾肋下未触及。神经系统检查:神志清,对答切题。无偏盲等脑神经异常。左侧肢体痛、温、触觉减退,左侧肢体振动觉减退,左手对钱币、钥匙等物体觉差。四肢肌力均为5级。四肢腱反射对称。Babinski征阴性。辅助检查:血白细胞8.9×10 /L、其中中性粒细胞69.4%、淋巴细胞21.2%、单核细胞5.6%、嗜酸性粒细胞3.8%、红细胞4.8×10 /L、血红蛋白140g/L、血细胞比容42.1%、血小板837×10 /L。血糖5.0mmol/L。脑MR示右侧顶叶、枕前区T 加权低信号、T 加权高信号(图6-16)。骨髓组织学检查:呈轻度增生性骨髓象。粒系细胞增生略活跃,部分细胞退行性变,NAP78%阳性,积分168。有2%异型淋巴细胞。红系细胞比例正常。巨核细胞明显增多。原始和幼稚巨核细胞增加,有成簇的血小板。用AS-PCR基因测定发现有JAK 基因且有V617F点突变。
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举一反三
【简答题】A: What is their relationship? B : I think ______________.
【简答题】 Complete the following sentences with the words or phrases given below. Change the form if necessary. visionary highlight survive leave aside work out At the beginning, I was confused about those si...
【简答题】I think helping people learn to work at their relationships to make their relationship work would be a __________ thing that I ’ d like to see happening.
【单选题】在知识产权中,既包括人身权利,又包括财产权利的是?
A.
商业秘密权
B.
商标权
C.
著作权
D.
地理标记权
【简答题】A: What is their relationship ? B: I think they are__________.
【简答题】My father was poor in expressing his feelings. I knew that my dad loved me, but he showed me his love in unusual ways. There was one particular time in my life when this became real to me. I always be...
【判断题】做梦时通过神经递质和脑桥,抑制运动系统,使人的运动系统和肌肉处于抑制状态,所以人在做梦时不会有动作。
A.
正确
B.
错误
【单选题】My friend has been seeing a woman off and on but I do not think that their relationship is very serious. The underlined part means ______.
A.
occasionally
B.
frequently
C.
successively
D.
unexpectedly
【简答题】下列属于主板品牌标识的是
【单选题】接腰式连衣裙裙片的后臀围大公式是( )。
A.
H/4-1cm
B.
H/4-0.5cm
C.
H/4+0.5cm
D.
H/4+1cm
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