普通外科(国外英文资料).docVIP

普通外科(国外英文资料) Patient: male, 44 years old. Vomiting blood three days, emergency hospital admission. For half a year, the patient is constantly bloating, losing his appetite, and he is wasting away with oil, nausea and acid. Three days ago, after drinking more hard, eat cold food, hematemesis, a total of three times, the first two is fresh, about 400 ml, a coffee after sample, volume of about 150 ml. Physical examination: blood pressure 14/12kpa. Thin, anemic, with five spider veins on his cheek and front chest, no abnormal liver, no liver, the spleen can be reached, and the edge is tough. Question: according to the history, physical signs, the patient should be admitted after admission, which major examination should be done first? A. routine blood B. Liver function examination C. serum hepatitis antigen examination D. B is a super check E.X on barium check F. T scan G. Liver puncture test H.A FP I. Radionuclide liver and spleen scan Tip: Hb90g/L, RBC3.2 x 10 ~ 12. GIF/L, WBC3.6 x 10 ~ 9. GIF/L, platelet 40 x 10 ~ 9. GIF/L, liver function test: zinc sulfate turbidity 16 units, albumin 28 g/L, globulin 32 g/L, GPT160 unit, bilirubin quantitative is 25 mu mol/L, HbsAg (+). B hyperexamination: the liver shrinks, the portal vein thickens, the inner diameter is 15mm, the spleen is slightly swollen. Esophageal barium X ray examination: when the barium is filling, the insect alteration is visible, and the varicose veins in the air are beaded in a beaded form. Question: what should be done to further clarify the causes and parts of the gastrointestinal bleeding? A. the air balloon inflates the stomach and the esophagus in the lower part of the esophagus B. After the compression of the capsule, the bleeding of the stomach, the duodenal ulcer and the esophageal stomach of the esophagus may be at the same time C. Fibre stomach, duodenoscopy D. selective arteriography T scan of e.c. with our fabrication: F. radionuclide scanning G. vomit blood sample, color, taste, residue check