一道正确率20%的案例,你也可以挑战?

2018-04-01 佚名 瑞金血液

病史 患者女,27岁。因突发的阴道大出血至急诊就诊。 既往史:曾因重度肥胖(BMI 70.8kg/m2)接受胃袖状切除术。最近一次术后随访(1个月前)恢复良好,复查无明显异常。


病史

患者女,27岁。因突发的阴道大出血至急诊就诊。

既往史:曾因重度肥胖(BMI 70.8kg/m2)接受胃袖状切除术。最近一次术后随访(1个月前)恢复良好,复查无明显异常。

查体:患者尽管已接受缩胃手术,体重较之前减轻63kg,但目前依然重度肥胖(BMI 50.7kg/m2)。无明显肝脾肿大。

实验室检查

血常规



生化免疫



血常规结果触发仪器报警,仪器自动推片,请观察外周血涂片并进行白细胞分类。






提问
1、上图中细胞①属于(  );细胞②属于(  );细胞③属于(  );细胞④属于(  );细胞⑤属于(  );细胞⑥属于(  );细胞⑦属于(  );细胞⑧属于(  );细胞⑨属于(  )
A.中性粒细胞分叶核
B. 淋巴细胞
C.单核细胞
D. 嗜酸性粒细胞
E.嗜碱性粒细胞
F.早幼粒细胞
G.中幼粒细胞 
H.晚幼粒细胞
I. 原始细胞
J.异型淋巴细胞
K.异常淋巴细胞 
L.浆细胞
M.幼淋巴细胞 
N.幼稚单核细胞
O.有核红细胞

2、上图中红细胞形态有何异常?(  )
A.红细胞大小不一 
B.口形红细胞 
C.红细胞碎片
D.椭圆形红细胞 
E.有核红细胞
 
3、根据临床症状及实验室检查,推测该患者可能的疾病为:(  )
A.传染性单核细胞增多症 
B.AML-M2b 
C.急性嗜碱性粒细胞白血病 
D.AML-M3 
E.再生障碍性贫血 
F.类白血病反应 
G.AML-M5
 
4、下一步的检查:(  )
A.抗EB病毒抗体检测          
B.骨髓细胞学检查
C.流式细胞免疫表型分析     
D.染色体核型分析
E.分子生物学检查     
F.凝血功能检查
G.FISH荧光原位杂交            
H.血小板功能检测
I.其他病毒血清学检测(流感、VZV等)  

关键时刻来了!你的正确率超过了20%吗?

【答案】

1、①F ②O ③F ④F ⑤A ⑥F ⑦B ⑧F ⑨F
2、A C E
3、F
4、B C D E F G

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    2018-04-03 海之蓝

    学习

    0

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    2018-04-03 yfjms

    学习

    0

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    2018-04-02 龙胆草

    学习谢谢分享

    0

  4. 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encodeId=931130199ec0, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Mon Apr 02 08:40:32 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301982, encodeId=26da30198237, content=了解了解.学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Mon Apr 02 07:38:53 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301980, encodeId=51d6301980f6, content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Mon Apr 02 07:38:35 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301973, encodeId=fb2c3019e3da, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Apr 02 07:32:04 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301963, encodeId=1205301963a0, content=值得学习借鉴, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/13/0e293a15a201ba87105050681af14e5d.jpg, createdBy=edf62290744, createdName=121e6640m66暂无昵称, createdTime=Mon Apr 02 07:09:03 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301957, encodeId=e21d30195e82, content=血液果然不是那么简单, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, 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createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:00:54 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 1dd8c52fm63(暂无匿称)

    了解了解.学习学习

    0

  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:00:54 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 lietome2

    好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛.

    0

  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:00:54 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 明月清辉

    谢谢分享.学习了

    0

  7. 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content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Mon Apr 02 07:38:35 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301973, encodeId=fb2c3019e3da, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Apr 02 07:32:04 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301963, encodeId=1205301963a0, content=值得学习借鉴, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/13/0e293a15a201ba87105050681af14e5d.jpg, createdBy=edf62290744, createdName=121e6640m66暂无昵称, createdTime=Mon Apr 02 07:09:03 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301957, encodeId=e21d30195e82, content=血液果然不是那么简单, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:01:13 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301956, encodeId=8bed30195637, content=我的天哪是这样, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:01:05 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301955, encodeId=2a8b301955b6, content=还有这种操作么, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:00:54 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 121e6640m66暂无昵称

    值得学习借鉴

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:00:54 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 雾夜芭蕾

    血液果然不是那么简单

    0

  9. 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content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Mon Apr 02 07:38:35 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301973, encodeId=fb2c3019e3da, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Apr 02 07:32:04 CST 2018, 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createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:00:54 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 雾夜芭蕾

    我的天哪是这样

    0

  10. 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content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Mon Apr 02 07:38:35 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301973, encodeId=fb2c3019e3da, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Mon Apr 02 07:32:04 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301963, encodeId=1205301963a0, content=值得学习借鉴, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/13/0e293a15a201ba87105050681af14e5d.jpg, createdBy=edf62290744, createdName=121e6640m66暂无昵称, createdTime=Mon Apr 02 07:09:03 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301957, encodeId=e21d30195e82, content=血液果然不是那么简单, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:01:13 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301956, encodeId=8bed30195637, content=我的天哪是这样, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:01:05 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=301955, encodeId=2a8b301955b6, content=还有这种操作么, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Mon Apr 02 07:00:54 CST 2018, time=2018-04-02, status=1, ipAttribution=)]
    2018-04-02 雾夜芭蕾

    还有这种操作么

    0

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