临床技能考核题库（Clinical skills examination question bank）.docVIP

临床技能考核题库（Clinical skills examination question bank） 1 right fronto temporal acute epidural hematoma [Abstract] men, aged 23, have been knocked down by a car while riding, and have been in the right eye for half an hour to see the emergency department The patient has been unconscious for about 5 minutes after falling, and has a headache and nausea after waking up. Physical examination: BP 139-80mmHg, P80 / min, in general, the neurological examination revealed no positive signs. The head radiograph showed a linear fracture of the right fronto temporal line. Then stay in emergency patients. In the subsequent 2 hours in patients with headaches, progressive, vomiting, restlessness, and disturbance of consciousness. Physical examination: 38 C T, BP 160/100mmHg, P60 / min, R18 / min, light coma, the left pupil 3mm, light reflex, right pupil 4mm, unresponsive to light. Left nasolabial fold was shallow, and left Babinskis Sign positive. [analysis] Diagnosis and diagnosis (8 points) (I) diagnosis of right frontotemporal acute epidural hematoma (two) diagnosis basis; 1. had definite history of trauma 2. middle awake period typical 3. point linear fracture at the head 4. progressive intracranial hypertension and cerebral hernia occurred Two, differential diagnosis (5 points) 1. acute subdural hematoma and intracranial hematoma: the same history of trauma; hematoma occurs mostly at the site of the hedge; the disturbance of consciousness continues to increase; the definite diagnosis is based on CT Three, further examination (4 points) CT scan of the head Four 、 treatment principle (3 points) emergency evacuation of hematoma by craniotomy 2 posterior dislocation of right hip joint [Case Abstract] male, 40 years old, has pain in the right hip and can not move for four hours In four hours by bus, take the left lower extremity in right lower extremity, suddenly brakes, front seat back on his right knee contradict, that sense of right hip pain, unable to move. Go to hospital for medi