1岁半男孩，因发热、咳嗽3天，诉右耳痛1天就诊，五官科诊断为急性卡他性中耳炎。其发病机制为(     )

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• 1A 2 year-old previously healthy boy presents fever for 5 days and cough and tachypnea for 2 days with highest body temperature of 40°C， inspiratory retraction (three depression sign) and fine crackles in both lungs. What is the most likely cause for his condition(     )

  A.Streptococcus pneumoniae

  B.Chlamydia pneumoniae

  C.Respiratory syncytial virus

  D.Haemophilus influenzae

  E.Mycoplasma pneumoniae

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• 2A 4-year-old boy with Staphylococcus pneumonia suddenly develops increasing respiratory distress. If you are called to see this child， what should be your order(     )

  A.A second chest radiograph to evaluate for pneumatocele formation

  B.A large-bore needle and chest tube kit for aspiration of a probable tension pneumothorax

  C.A change in antibiotics to include gentamicin

  D.A sedative to treat the childs attack of severe anxiety

  E.A thoracentesis kit to drain his probable pleural effusion

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• 3Which of the following is NOT the characteristic of staphylococci aureus pneumonia(     )

  A.high fever，most of them are remittent fever

  B.Scarlatinoid rash or urticaria

  C.physical signs of the lungs appear late

  D.formation of subcutaneous emphysema

  E.patchy shadows in x-ray film

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• 4关于呼吸道合胞病毒肺炎的特点，应除外的是(     )

  A.多见于2岁以内，尤其是6个月以内的婴儿

  B.肺部体征出现早

  C.常有呼吸困难

  D.高热、双肺细湿啰音为主

  E.X线改变主要是间质性肺炎，肺泡病变及肺气肿

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• 5不符合呼吸道合胞病毒性肺炎的是(     )

  A.呼吸困难、喘憋

  B.双肺满布喘鸣音

  C.严重缺氧可发生呼吸衰竭

  D.胸部X线示小点片状、斑片状，部分有不同程度肺气肿

  E.多有持续高热

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• 62岁患儿，发热1天，食欲缺乏，咽痛，检查时可见咽部充血，在咽弓、悬雍垂黏膜上可见数个2〜4mm大小的灰白色小疱疹，周围有红晕，血常规WBC4.0×109/L，中心粒细胞45%，淋巴细胞55%，则患儿诊断为(     )

  A.咽结膜炎

  B.疱疹性咽峡炎

  C.溃疡性口腔炎

  D.手足口病

  E.球菌性口炎

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• 78个月男婴，发热3天，体温最高39℃，伴咳嗽、流涕，查体:精神反应好，咽部充血，扁桃体不大，双肺呼吸音粗，未闻及干湿性啰音，心音有力，律齐，腹平软，肝脾不大。根据患儿表现，下一步最需要的检查是(     )

  A.血常规+CRP

  B.胸部X线

  C.咽拭子细菌培养

  D.呼吸道病毒抗原检测

  E.支原体抗体

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• 83岁女孩，高热3天，T39.5℃，诉咽痛和眼部刺痛，恶心、呕吐伴腹泻、腹痛，查体:咽部充血明显，双眼滤泡性结膜炎，颈部和耳后淋巴结肿大，心肺腹检查无特殊。可能的诊断为(     )

  A.流行性感冒

  B.麻疹早期

  C.猩红热早期

  D.咽结合膜热

  E.急性阑尾炎

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• 92岁男孩，急起高热，流涎，厌食。查体:咽部充血，咽腭弓、软腭等处可见2〜4mm大小的疱疹，牙龈和颊黏膜无异常，心、肺未见异常。最可能的诊断是(     )

  A.疱疹性口炎

  B.鹅口疮

  C.疱疹性咽峡炎

  D.猩红热

  E.咽结合膜热

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