医药3（Medicine 3）.docVIP

医药3（Medicine 3） Summarize the principles of differential diagnosis and treatment in case analysis (Western medicine practice skills guidance) 2010-5-25 9:45 [big and small] [I want error correction] 1. epidemic cerebrospinal meningitis Differential diagnosis: purulent meningitis caused by other bacteria. Tuberculous meningitis. Viral meningitis. Lumbar puncture: test pressure, the appearance of cerebrospinal fluid. Convention. Biochemistry. Bacteriological examination (culture and smear). Blood culture or skin petechia smear. Chest radiograph excluding pneumonia and tuberculosis. Principle of treatment: pathogen treatment: the early application of antibiotic sensitive drugs and blood brain barrier drugs, medical education / network collection, selection of large doses of penicillin, and the use of chloramphenicol and three generation cephalosporin. Symptomatic treatment: mannitol lowering intracranial pressure and physical cooling or using antipyretic. 2. right upper lung lesions of unknown origin. Differential diagnosis: pulmonary tuberculosis. Pulmonary inflammatory mass. Benign tumor of lung. Further examination: bronchoscopy and / or fine-needle aspiration biopsy. Chest CT., abdominal B ultrasound, to understand whether there is metastasis. Sputum cytology. Principle of treatment: surgical treatment. Right pneumonectomy. According to pathological type. Postoperative chemotherapy. Radiotherapy. 3. left pneumonia. Differential diagnosis: other types of pneumonia: staphylococcal pneumonia, caseous pneumonia, gram negative pneumonia. Pulmonary abscess。 Lung cancer. Further examination: chest x-ray. Sputum culture + drug susceptibility test. 4. gastric cancer. Hemorrhagic anemia. Differential diagnosis: peptic ulcer. Gastritis. Further examination: gastroscopy, histopathological examination. Radiographic examination: CT. medical education / Web collection, chest X film. Treatment principle: radical gastrectomy plus chemotherapy. Supportive therapy, symptomatic treatm