每日一题_2022.12.09

A medical student is asked to perform a cardiovascular examination on a patient. After 10 minutes of auscultation with no success, the medical student gives up and asks his resident for help. The resident puts up the patient’s anteroposterior chest radiograph (see image) and begins to explain the molecular etiology of this patient’s condition. What is one respiratory complication that this patient is at increased risk of developing as a result of his condition?

要求医学生对患者进行心血管检查。听诊 10 min 没有成功，医学生就放弃了，请住院医师帮忙。住院医师摆正患者的前后位胸片（见图），并开始解释该患者疾病的分子病因学。该患者因其疾病发生风险增加的呼吸系统并发症是什么？

(A) Acute respiratory distress syndrome 急性呼吸窘迫综合征

(B) Bronchiectasis支气管扩张

(C) Carcinoma of the lung肺癌

(D) Exercise-induced asthma运动性哮喘

(E) Idiopathic pulmonary fibrosis特发性肺纤维化

答案解析：

被压倒的医学生听不到左边任何心音的原因是因为这个患者有完全的内脏反位。从正位胸片可以看出，心脏轮廓在右侧，胃泡也是如此。如果内脏完全逆转，这种情况通常无害，但如果逆转仅限于心脏，则相当使人虚弱。内脏转位通常与 Kartagener 综合征相关，Kartagener综合征是一种由分子运动蛋白动力蛋白常染色体隐性缺陷引起的疾病。这种遗传缺陷导致纤毛不动，损害许多重要过程。重要的发现是：精子不动导致的男性不育，输卵管纤毛不动导致的女性不育，细菌和颗粒清除失败导致的复发性鼻窦炎，无功能的粘膜纤毛剥离器导致的支气管扩张。

正确答案：B