女性患者,45岁,以“双手、双腕、双踝及左膝关节肿痛4个月”来诊。无明显关节活动受限,晨僵1.5h,曾有发热和咳嗽,无皮疹和指端变色。查体:体温 36.2℃,脉搏80/min,皮肤、淋巴结及脊柱无异常,双手示指及右手中指和小指的近端指间关节、左手示指和中指。右手拇指和小指掌指关节、双腕、右膝和踝关节均有肿胀和压痛。双膝关节活动时有骨擦音,双手可见He- berden结节。 该患者化验ESR 14mm/1h,RF 25kU/L, CRP 12mg/L,抗核抗体阴性,血尿酸正常,胸CT无异常。为进一步明确诊断需进行的检查不考虑的是
A. 血清免疫球蛋白和补体测定
B. 血、尿常规
C. 双手和膝关节X线检查
D. HLA-DR4基因检测
E. 血清抗环瓜氨酸肽(CCP)抗体检测
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女患者,45岁,以“双手近端指间关节、掌指关节、腕关节肿痛3个月”来诊,无发热、皮疹及脱发,有晨僵,关节无畸形。化验ESR 62mm/1h,RF 460kU/L,ANA阴性,血常规、尿常规正常。 对该患者的治疗原则是
A. 单独应用非甾体抗炎药
B. 单独应用慢作用抗风湿药
C. 单独应用小剂量激素
D. 联合应用非甾体抗炎药和小剂量激素
E. 联合应用非甾体抗炎药和慢作用抗风湿药
男性,30岁。因与人争吵被人用刀刺伤右胸部半小时入院。查体:血压90/45mmHg,呼吸32/min,脉搏110/min,烦躁不安,颜面苍白,口唇发绀,右前胸靠外侧可见2~3cm长刀伤破裂口,随患者呼吸闻及气体从破裂口出入的声响。胸部透视右肺压缩70%,右侧肋脯角消失。 正确的诊断是
A. 右胸刀伤
B. 右侧外伤性血气胸
C. 右侧大量胸腔积液
D. 右侧胸部贯通伤
E. 右侧闭合性气胸
The purpose of the requirements definition phase is to produce a clear, complete, consistent, and testable (71) of the technical requirements for the software product. During the requirements definition phase, the requirements definition team uses an iterative process to expand a broad statement of the system requirements into a complete and detailed specification of each function that the software must perform and each (72) that it must meet. The starting point is usually a set of high-level requirements from the (73) that describe the project or problem. In either case, the requirements definition team formulates an overall concept for the system and the defines (74) showing how the system will be operated, publishes the system and operation concept documents, and conducts a system concept review (SCR). Following the SCR, the team derives (75) requirements for the system from the highlevel requirements and the system operations concept. Using structured or object-oriented analysis,the team specifies the software functions and algorithms needed to satisfy each detailed requirements.
A. detailed
B. outlined
C. total
D. complete
女性患者,60岁,糖尿病病史15年,长期口服优降糖(格列本脲)治疗,现诊断为糖尿病肾病,血肌酐升高,迭尿毒症期。首选何种治疗
A. 维持原治疗
B. 改用其他磺脲类降糖药
C. 改用胰岛素
D. 双胍类药物
E. 胰岛素增敏剂