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class="news_con"> <div id="ugj8i2h" class="jxbox clearfix"> <p>醫(yī)學(xué)教育網(wǎng)送福利啦，至考前會(huì)為大家梳理各科目考試重點(diǎn)和高頻出題點(diǎn)，這些知識點(diǎn)都是網(wǎng)校教研團(tuán)隊(duì)精心挑選，緊扣2019年新版考試大綱，此內(nèi)容為臨床醫(yī)師沖刺直播班的輔助學(xué)習(xí)資料，視頻課程內(nèi)容及重點(diǎn)知識梳理，建議大家購買沖刺備考班后系統(tǒng)學(xué)習(xí)，<a target="_blank" href="http://thedailypurge.net/xuanke/90143-901627/course-13352-9.shtml"><strong><font color="#ff0000">沖刺備考班詳情>></font></strong></a>接下來，今天為大家分享下臨床執(zhí)業(yè)助理醫(yī)師“兒科”高頻考點(diǎn)川崎病的內(nèi)容：</p> <p><strong><font color="#ff0000">麻疹病原：麻疹病毒。</font></strong></p> <p>傳染源：麻疹患者。</p> <p>傳染性：出疹前、后5天，并發(fā)肺炎則延至出疹后10天。</p> <p>傳播途徑：通過患者的呼吸、噴嚏、<a href="http://thedailypurge.net/jibing/kesou/" target="_blank" title="咳嗽" class="hotLink" >咳嗽</a>和說話等由飛沫傳播。病后可產(chǎn)生持久的免疫力，大多可獲終身免疫。</p> <p>臨床表現(xiàn)麻疹黏膜斑（Koplik斑）：見于下磨牙相對的頰黏膜上，為直徑約0.5～1mm灰白色小點(diǎn)，前期診斷重要依據(jù)。</p> <p>出疹期：3～4天：出疹時(shí)體溫更高（疹出熱盛），出疹順序：耳后、發(fā)際、前額、面部、頸部、軀干和四肢，最后達(dá)手掌和足底。</p> <p>并發(fā)癥：肺炎：是麻疹最常見的并發(fā)癥。</p> <p>預(yù)防</p> <p>1.控制傳染源：一般病人隔離至出疹后5天，合并肺炎者延長至10天。接觸麻疹易感者檢疫觀察3周，接受過被動(dòng)免疫者可延至4周。</p> <p>風(fēng)疹出疹期·發(fā)熱第2天出疹并在一天內(nèi)出齊·出疹順序：面→頸→軀干→四肢·疹退體溫恢復(fù)正常。</p> <p>·出疹3～4天后，耳后、兩側(cè)頸部淋巴結(jié)腫大。</p> <p>預(yù)防隔離患者至出疹后5～7天。孕婦（尤其早孕）避免與風(fēng)疹患者接觸。</p> <p><strong><font color="#ff0000">幼兒急疹（嬰兒玫瑰疹）</font></strong></p> <p>病原：人類皰疹病毒6型臨床特點(diǎn)潛伏期：7～15天，平均10天發(fā)熱期：急，體溫突然升高39～40℃，持續(xù)3～5天，可有驚厥，一般狀況良好。</p> <p>出疹期：熱退疹出，一天出齊，分布軀干、頸部、上肢，無色素沉著，也無脫皮。</p> <p>水痘病原：水痘-帶狀皰疹病毒典型水痘（四世同堂）</p> <p>瘙癢性斑疹→丘疹→水皰疹→結(jié)痂疹，可同時(shí)存在，向心性分布。</p> <p>皮疹的特點(diǎn)：皮膚上同時(shí)存在斑疹、丘疹、水皰疹和結(jié)痂疹，高峰時(shí)“四世同堂”。</p> <p>出疹順序：皮疹呈向心性，開始為頭皮、面部、軀干和腰部，四肢遠(yuǎn)端較少。有癢感。</p> <p>并發(fā)癥：繼發(fā)皮膚細(xì)菌感染：皮膚化膿性感染最為常見，嚴(yán)重時(shí)可播散為全身敗血癥。</p> <p>治療抗病毒治療：阿昔洛韋。</p> <p>預(yù)防</p> <p>1.隔離患者：隔離患者至全部皮疹結(jié)痂為止。對接觸的易感者檢疫3周。</p> <p>手足口病病原：多種腸道病毒（EV），常見的病原包括腸道病毒71型（EV71）、柯薩奇病毒A組16型以及?？刹《镜哪承┭逍汀?/p> <p>腸道病毒71型（EV71）常引起重癥病例。</p> <p>臨床特點(diǎn)普通病例·急性起病，“上感”癥狀。</p> <p>·出疹部位：手、足、口、臀。</p> <p>·出疹特點(diǎn)：斑丘疹和皰疹。</p> <p>“四不”——不痛、不癢、不結(jié)痂、不留疤。</p> <p><strong><font color="#ff0000">猩紅熱病原：A組β（乙型）溶血性鏈球菌。</font></strong></p> <p>臨床以發(fā)熱、<a href="http://thedailypurge.net/jibing/yanyan/" target="_blank" title="咽炎" class="hotLink" >咽炎</a>、草莓舌、全身鮮紅皮疹、疹退后片狀脫皮為特征。</p> <p>臨床表現(xiàn)前驅(qū)期：起病急，發(fā)熱38～39℃；咽痛、頭痛和<a href="http://thedailypurge.net/jibing/futong/" target="_blank" title="腹痛" class="hotLink" >腹痛</a>；咽部與扁桃體充血、水腫，可有膿性分泌物。</p> <p>舌被白苔→白苔脫落→舌乳頭紅腫突起→草莓舌。</p> <p>出疹期：起病24小時(shí)內(nèi)出疹，24小時(shí)內(nèi)遍布全身。</p> <p>皮疹特點(diǎn)：全身皮膚彌漫性充血發(fā)紅。</p> <p>順序：頸部、腋下、腹股溝→全身醫(yī)學(xué)教育網(wǎng)。</p> <p>“口周蒼白圈”、“帕氏線”</p> <p>恢復(fù)期：皮疹按出現(xiàn)順序消退，無色素沉著。</p> <p>并發(fā)癥：少數(shù)患兒發(fā)病后1～5周可發(fā)生急性腎小球腎炎或風(fēng)濕熱。</p> <p>治療：首選青霉素，肌注或靜滴7～10天；青霉素過敏可選紅霉素、頭孢類。</p> <p><font style="BACKGROUND-COLOR: #00ccff" color="#000000"><strong>編輯推薦：</strong></font></p> <p><a target="_blank" href="http://thedailypurge.net/linchuangzhuliyishi/jingyan/my1906288035.shtml"><font color="#0000ff" size="2">2019年臨床助理醫(yī)師筆試短期備考攻略！資料滿滿！</font></a></p> <p><a target="_blank" 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