岚哥岚嫂说病例第2季第02期（病例部分）

A newborn girl is evaluated in the nursery by a pediatrician. She was born 6 hours ago at 37 weeks’ gestation via spontaneous vaginal delivery after an uncomplicated pregnancy to a 35-year-old woman who had good prenatal care.

On physical examination, her skin is pink with no rashes or lesions. Her eyes appear regularly shaped and spaced, and she has a red reflex present in both eyes. Her lips and nose are normal,and her palate has a high arch. She has a webbed neck that is flexible. Her chest is shield shaped with widely spaced nipples. Her lungs are clear to auscultation bilaterally, and her breathing is unlabored with a respiratory rate of 50/min. Her femoral pulses are delayed compared to her radial pulses. She is able to move all extremities equally but has edematous hands and feet. She is alert and has normal Moro and rooting reflexes.

1、Which of the following cardiac examination findings is most likely?

(A) Continuous machinery murmur at the left upper sternal border
(B) Harsh holosystolic murmur at the left lower sternal border
(C) Single loud S2
(D) Systolic murmur loudest below the left scapula
(E) Widely split fixed S2 and systolic ejection murmur at the left upper sternal border

2.Give the explanation.

译文：
本次病例的主人公是一名女性患儿。故事呢，是这样发生的……某天，一位儿科医生在婴儿室检查一名6小时前出生的女婴，该女婴是由一名产前状况良好、无任何并发症的35岁女性在妊娠37周后顺产的。

在体检中，女婴的皮肤呈现粉红色并未出现任何皮疹或皮损。她的双眼等大等圆且大小正常，均存在红光反射，鼻子和嘴唇也都正常，她的腭弓高，有柔韧的颈蹼。胸廓呈盾状，乳头间距较大。肺部听诊呼吸音清，频率为50次/分，且呼吸不费力。她的股动脉搏动相对于桡动脉搏动有所延迟。她的手和脚水肿，但可以活动。她非常警觉，而且拥有正常的拥抱反射和觅食反射。

1、如果医生对女婴的心脏进行听诊，他会听见什么呢？
A、上段胸骨左缘出现连续性杂音
B、下段胸骨左缘出现粗糙的全收缩期杂音
C、单一响亮的第二心音
D、左肩胛骨下缘出现的收缩期杂音最响
E、上段胸骨左缘出现固定分裂的第二心音和收缩期喷射性杂音

2、第一题为什么选这个选项呀？给出理由呗