临床技能考察题库(国外英文资料).doc

临床技能考核题库 The right temporal acute epidural hematoma [abstract] male, 23 years old, was knocked down by a car on a bicycle, and left the right temporalis on the ground for half an hour to visit the emergency room After the patient falls, there are about 5 minutes of coma, wake up, self-conscious headache, nausea. Physical examination: BP 139-80mmhg, P80 / min, general situation, the nervous system examination not seen positive signs. Skull slice tip: right temporal linear fracture. The patient was given an emergency care. In the next two hours, the patients headache gradually increased, accompanied by vomiting, restlessness and, in turn, an awareness disorder. Physical examination: T 38 ℃, BP 160/100 MMHG, P60 times/min, R18 times/min, shallow coma, the left pupil 3 mm, light reflex, right pupil 4 mm, slow to respond to light. The left nasal lip is shallow and the left side Babinskis Sign is positive. [analysis] Diagnostic and diagnostic criteria (8 points) (1) the diagnosis of external hematomas of the right temporomatic acute epidural (2) diagnosis There is a definite traumatic history 2. There is a typical middle period of wakefulness. There is a linear fracture in the head force Progressive intracranial pressure and cerebral hernia occur Differential diagnosis (5 points) Acute subdural hematoma and intracranial hematoma: a history of trauma; Hematomas occur in the hedged area; Awareness disorders persist; Definite diagnosis depends on CT 3, further examination (4) head CT scan Treatment principle (3 minutes) the treatment of the emergency department of the surgical removal of the cranial hematoma After the right hip [abstract] male, 40 years old, after right hip trauma, cant move for four hours With patients before four hours by bus, the left leg on the right lower limb, suddenly on the brakes, right knee against the seat back, before that feeling right hip pain, not activities. He came to the hospital. The patient is physically healthy. No special disease, no s