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[] A 35-year-old white man with spina bifida is admitted to the hospital for a urologic procedure. | 一名患有脊柱裂的 35 岁白人男子因泌尿外科手术入院。
[] He has been functionally independent in activities of daily living | 他在日常生活活动中一直能够功能性自理，
[] and is employed doing inventory control in a local sporting goods store. | 并在当地一家体育用品商店从事库存控制工作。
[] He has maintained continence through periodic self-catheterization. | 他通过定期的自我导尿来维持排尿自制。
[] The patient is paraplegic, has recurrent calcium oxalate kidney stones, | 该患者截瘫，患有复发性草酸钙肾结石，
[] and recent onset of incontinence secondary to detrusor and bladder neck dysfunction. | 近期出现继发于逼尿肌和膀胱颈功能障碍的尿失禁。
[] Vital signs are normal. | 生命体征正常。
[] Physical examination shows a well-developed, well-nourished man in no acute distress. | 体格检查显示一名发育良好、营养良好、无急性病容的男子。
[] Aside from paraplegia, lower extremity muscle atrophy, and lower abdominal surgical scars, | 除截瘫、下肢肌肉萎缩和下腹部手术瘢痕外，
[] the physical examination discloses no abnormalities. | 体格检查未发现异常。
[] He had an episode of anaphylaxis secondary to latex allergy | 他曾在一次利用肠道吻合术
[] during a previous operation for functional expansion of his bladder. | 进行的膀胱功能性扩大手术中，发生过继发于乳胶过敏的过敏性休克。
[] Through a bowel anastomosis. | （通过肠道吻合术）。
[] Which of the following is most important to consider in the care of this patient? | 在护理该患者时，以下哪项是最重要的考虑因素？
[] A. Administration of injectable medications with disposable syringes. | A. 使用一次性注射器注射药物。
[] B. Preparation of food by outside contractors. | B. 由外部承包商准备食物。
[] C. Type of cleaning agents used to sterilize bed linens. | C. 用于消毒床单的清洁剂类型。
[] D. Use of rubber urethral catheters. | D. 使用橡胶导尿管。
[] E. Use of topical moisturizing agents for skin care. | E. 使用局部保湿剂进行皮肤护理。
[] For this, I'm going to go ahead and say D, right? | 对于这题，我会选 D，对吧？
[] And again, that makes sense. | 这显然是合理的。
[] Why? | 为什么？
[] Because this person, they've had anaphylaxis with, | 因为这个人，他们曾发生过过敏性休克，
[] the person has latex allergy. | 该患者有乳胶过敏。
[.79] And remember, latex allergy can absolutely positively cause anaphylaxis, right? | 记住，乳胶过敏绝对会引起过敏性休克，对吧？
[] So, you don't want to be exposed to latex ever again. | 所以，你不想再让他接触乳胶。
[] And I wouldn't be surprised that this guy developed his sensitivity to latex | 我对他产生乳胶敏感并不感到意外，
[] because he's been heavily involved with the healthcare system, right? | 因为他一直频繁地接触医疗系统，对吧？
[] When people have these like neurological disorders, | 当人们患有这些神经系统疾病，
[] or they were born preterm or whatever, right? | 或者是早产儿之类的，
[] They tend to be in the hospital for a while. | 他们往往会在医院待很长时间。
[] They tend to be in and out of the hospital a lot, right? | 他们往往会经常进出医院，对吧？
[] So, those people may develop a sensitivity to latex | 所以，由于接触了这么多医护人员（戴乳胶手套），
[] because so many healthcare workers have touched them | 这些人可能会产生乳胶过敏。
[] and they've developed a latex sensitivity. | 从而产生了乳胶敏感性。
[] All right. | 好的。
[] Question 38. | 第 38 题。
[] A 14-year-old boy is brought to the walk-in clinic by his father | 一名 14 岁男孩在周六下午晚些时候
[] late on a Saturday afternoon | 由他的父亲带到急诊诊所，
[] because his left ear is swollen and painful. | 因为他的左耳又肿又痛。
[] The ear has been black and blue | 自从三天前在摔跤比赛中受伤后，
[] since he injured it in a wrestling match three days ago. | 耳朵就一直青一块紫一块的。
[] Symptoms have increased significantly | 在三小时前的一场比赛中再次受伤后，
[] following a repeat injury during a match three hours ago. | 症状显著加重。
[] Vital signs are normal. | 生命体征正常。
[] The left ear is markedly swollen and tender to palpation. | 左耳明显肿胀，触痛明显。
[] Which of the following is the most appropriate next step in management? | 以下哪项是最合适的下一步处理措施？
[] A, reassure him and start aspirin. | A，安抚他并开始服用阿司匹林。
[] B, reassure him and start codeine. | B，安抚他并开始服用可待因。
[] C, recommend that he apply cold packs to the ear | C，建议他在接下来的 12 小时内
[] for the next 12 hours. | 对耳朵进行冷敷。
[] D, recommend that he apply hot packs to the ear | D，建议他在接下来的 12 小时内
[] for the next 12 hours. | 对耳朵进行热敷。
[] E, refer him to a surgeon for immediate drainage of the lesion. | E，转诊给外科医生立即对病变进行引流。
[] Hmm. | 嗯。
[] Okay. | 好的。
[] So, look at what's going on here, right? | 看看这里发生了什么，对吧？
[] So, this kid seems to have like a problem with the ear, right? | 这个孩子的耳朵似乎出了问题，对吧？
