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      胡女士,50歲,漢族,重慶人,某高校教師.身高160厘米,體重70公斤,血壓120/80 mmlHg,總膽固醇5.1mmol/L,餐后兩小時血糖10mmol/L,空腹血糖6.5mmol/L,喜愛吃火鍋,特別愛吃動物內臟.因教學任務重,沒有時間參加體育鍛煉.父親有高血壓及糖尿病史.請回答以下問題:

      一、多選題(共30分,每題6分.每題答案數目不定,多選或少選均不得分)

      1.根據資料分析,你認為胡女士患何種疾病的危險性較高? 答案:AB

      A、肥胖 B、糖尿病 c、痛風 D,高脂血癥 E、冠心病

      2.如果進一步收集胡女士的健康危險因素資料,可采用的收集方法有哪些? 答案:ABCDE

      A、膳食問卷調查 B,體格檢查 c、實驗室檢查 D、體力活動問卷調查

      E、生活方式問卷調查

      3.糖尿病的主要危險因素是什么? 答案: ACDE

      A、遺傳因素 B、高脂血癥 C.超重和肥胖 D、體力活動不足 E、膳食不平衡

      4.如果要對胡女士進行糖尿病的篩檢,下列哪幾項符合篩檢條件? 答案:ABCD

      A.空腹血糖6.5mmol/L B.BMI>24kg/m2 C.父親患糖尿病 D.年齡50歲,不愛運動

      E.總膽固醇5.1mmol/L

      5.在糖尿病篩檢中檢測血糖的目的是 答案: ABD

      A.查出隱性的糖尿病患者

      B.查出糖耐量減低者(IGT)

      C.查出有糖尿病并發癥的患者

      D查出空腹血糖受損者(IFG)

      E.預測糖尿病病情進展情況

      二、計算題(每題1O分,共20分)

      1.請根據所給內容計算胡女士的組合危險因素,寫出計算規則并列出計算過程及結果。

      收縮壓120mmHg,危險分數0 8;舒張壓80 mmHg,危險分數0.8;體重超重1 0%,危險分數1.0;血糖偏高,危險分數1.6;有糖尿病家族史,危險分數1.5;體力活動不足,危險分數1.2;飲食結構不合理,危險分數1.1。

      答題要點:

      將大于1. 0的危險分數減去1.0后作為相加項,小于或等于1.的分數相乘作為相乘項,相加項與相乘項合計就是組合危險因素。 (5分)

      (0.8)*(0.8)*(1.O)+《(1.6-1)+(1.5-1)+(1.2-1)+(1.1-1))》=2.04

      (算式正確3分。計算結果正確2分)

      2.請根據下表計算胡女士每天所需的熱量,請列出計算過程及結果

      表1:不同體形成人每公斤理想體重日所需總熱量(Kcal/kg)

      消瘦正常體重肥胖

      輕體力勞動353025

      答題要點:

      計算公式:理想體重=身高-105

      胡女士的理想體重=160-105=55kg

      體型判定:實際體重在理想體重±10%為正常范圍;超過理想體重10%為超

      重或肥胖;低于理想體重:10%為體重不足。

      胡女士的體重超重。

      每天所需的熱量=55kg*25kcal/kg=1375Kca1

      (算式正確6分,計算結果正確3分,單位正確1分)

      三、問答題(共50分)

      (一)健康管理的基本策略是什么?如果請你管理胡女士屬于哪一種策略?(10分)

      答題要點:

      健康管理的基本策略是通過評估和控制健康風險,達到維護健康的目的。(3分)

      包括6種基本策略:生活方式管理、需求管理、疾病管理、災難性病傷管理、殘疾管理和綜合的群體健康管理。(4分)

      管理胡女士屬于疾病管理(或生活方式管理)。(答對任何一個都得3分)

      (二)要對胡女士進行分析評估和健康管理,需要收集和了解哪些信息?(10分)

      答題要點:

      ①一般情況調查,包括年齡(0.5分)、性別(0.5分)、身高(0.5分)、體重(0.5分)、腰圍(0.5分)、臀圍(0.5分)、血壓(0.5分)等。

      ②糖尿病相關檢查,包括血糖(0.5分)、糖化血紅蛋白(0.5分)、尿糖(0.5分)、口服葡萄糖耐量試驗(0.5分)、胰島素抵抗(0.5分)等。

      ③基本資料收集,包括血脂、血壓檢查(0.5分),既往史、家族史調查(0.5分),吸煙情況(0.5分),身體活動和體育運動情況(0.5分),飲食習慣及營養調查(0.5分),飲酒習慣(0.5分),腎功能、眼底及末梢神經檢測(0.5分)等。

      結合年齡、性別、體重指數,對血壓、血脂、血糖的檢查結果,進行心血管疾病綜合風險評估;對生活習慣進行評估,發現主要的問題,開展相應的指導;對糖尿病患者,結合腎功能、眼底及末梢神經監測結果,進行并發癥的風險預測與評估(0.5分)。

      (三)請根據胡女士的情況制定健康干預方案,并簡要敘述具體措施。(20分)

      答題要點:

      1、合理的營養與膳食指導

      (1)合理控制總能量(1分) (2)合理分配碳水化合物、脂肪和蛋白質的比例(1分) (3)每日進食充足的蔬菜和適量的水果,補充足量的維生素和礦物質(1分) (4)高纖維素與低鹽飲食(1分) (5)合理分配熱能(1分) (6)限制飲酒(1分)

      2、減肥

      飲食過量和缺乏體育運動是造成肥胖的主要原因,(2分)減輕體重的方法是減少能量的攝入和增加運動量(2分)。每月以減輕體重1—2KG為宜(3分)

      3、增加體力活動及運動

      每周活動至少3次,(2分)每次至少持續30分鐘,(2分)養成習慣,活動方式包括跳舞、散步、爬樓梯、游泳、太極拳(劍)等。(3分)

      (四)作為一名健康管理師,你認為胡女士的心身特點是什么?胡女士在心理發展中會遇到哪些問題?(10分)

      答題要點:

      心身特點

      (1)生理上從成熟走向衰退(2分)

      (2)智力發展到最佳狀態(2分)

      (3)個性的成熟與穩定(2分)

      心理問題

      (1)反應速度與記憶能力下降;(1分)

      (2)渴望健康與追求成就的矛盾;(1分)

      (3)人際關系錯綜復雜;(1分)

      (4)家庭與事業的雙趨沖突。(1分)

      分享到: 編輯:潘雪

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