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学习笔记2.26

  • 2026-02-27 00:43:59
学习笔记2.26
前天FIM的Case中了嘿嘿，读研期间发表的第三篇文章
接下来就是交钱，然后等待出版了
昨天没有阅读涂老师的书，但是昨天把CCID返修的Case给弄完了。接下来就是继续等了。大胆预测一下，3月末才会有信儿。
继续阅读涂老师的临床思维书
Case49：头皮不规则脱发伴萎缩
我觉得先看是瘢痕性脱发还是非瘢痕性脱发。
头癣真的非常少见了，必要时查个真菌也可以排除。而且头癣确实儿童更常见，成人多少有基础病。
斑秃雄秃就更不是了。斑秃的特点是没头皮炎症，光滑。典型表现是突然出现的圆形或椭圆形，数量不等，边界清楚的脱发区，患处皮肤光滑，无炎症，无鳞屑，无瘢痕。
拔毛癖也肯定不是，因为没有原发性皮疹。所以接下来就要考虑瘢痕性脱发了。常见的狼疮，扁平苔藓，硬皮病。
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Case50：头皮断发
啊不是，怎么把上个Case鉴别头癣的图拿来了hhh。一眼诊断白癣了。
皮疹特点头顶部片状断发，有明显白色发鞘，头皮鳞屑明显，符合典型白癣。
治疗方面服，擦，剃，洗，消五字方针。
——————————————————————————
Case51：甲板增厚，发黄
看这个病史描述像是银屑病甲。有银屑病家族史，然后关节疼，如果有PSO皮疹就更能说明问题了。但是查个真菌也很有必要。
涂老师说的就是我，上来就查真菌。但是u1s1真菌镜检查出来阳性率有限
银屑病甲一般多对称分布于双手或双足，多个指甲短期内同时受累，而不是从1个趾甲逐渐发展到其他趾甲。
————————————————————————————
Case52：单一甲下黑条带
看这个样就像恶性的。和甲黑线还不一样。
确实，甲癣一般是黄色的，变黑了就不太好了。
终于看完涂老师的临床思维书了。嗯，接下来复习着前面的。然后再开始看新的书！
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  1. CONNECT:[ UseTime:0.001051s ] mysql:host=127.0.0.1;port=3306;dbname=no_67808;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.001533s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000712s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000684s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.001341s ]
  6. SELECT * FROM `set` [ RunTime:0.000600s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.001469s ]
  8. SELECT * FROM `article` WHERE `id` = 470702 LIMIT 1 [ RunTime:0.003325s ]
  9. UPDATE `article` SET `lasttime` = 1772310794 WHERE `id` = 470702 [ RunTime:0.001919s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.000582s ]
  11. SELECT * FROM `article` WHERE `id` < 470702 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.001188s ]
  12. SELECT * FROM `article` WHERE `id` > 470702 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.001237s ]
  13. SELECT * FROM `article` WHERE `id` < 470702 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.001499s ]
  14. SELECT * FROM `article` WHERE `id` < 470702 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.001807s ]
  15. SELECT * FROM `article` WHERE `id` < 470702 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.003969s ]
0.187519s