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女性，30岁。发热伴牙龈出血三周。查体：贫血貌，脾肋下3em，胸骨压痛()，血红蛋白70g／L，白细胞14.0×lO9／L，血小板35×109/L，骨髓增生明显活跃，原始细胞占O．62，为进一步诊断，应首选哪项检查
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The ancient Sumerians began fermenting beer from barley at least 6,000 years ago.
A．reliefB．pieceC．scienceD．thief
M: Sure. What have you got there？
W: Well, it's some kind of shellfish. I thought it might be a brachiopod, but I am not sure. I found it when I went out hiking last weekend.
M: I think you might be right. It certainly appears to be a brachiopod. But it's easy to confuse them with the bivalve mollusks. Superficially they resemble one another. Both have two shells for example.
W: How can you tell them apart then？
M: Well, there are some minor differences in the shell. A lot of brachiopods have ridge shells like this one. There are other distinctions of course. Internally they are quite different. Mollusks and brachiopods belong to different animal groups, and they had been in competition with one another millions of years ago.
W: How old do you think this one is？
M: It's hard to tell. The earliest brachiopods were from the Paleozoic era, 300 to 500 million years ago. They were quite successful then in terms of the number of species. It's not out of the question that your fossil could be that old.
W: Wow, that's amazing. It makes paleontology seem more interesting when you can hold it in your hand.
M: You know, that gives me an idea. Would you mind bringing this to our next class？ The others might find it interesting too.
W: Well, I could. But if you don't already have one in your collection, I thought you might as well keep it.
M: That's very kind of you.
(20)
该患者下列哪项检查对诊断最重要
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