21、 Which of the following statement about recommendations for ventilator settings in acutely injuryed patients is least likely ：
(A) Tidal volumes of 8-10 ml/kg
(B) Limit peak/plateau pressure to ＜40/35 cmH2O for average patients
(C) Wean FIO2 to obtain a PaO2 of 80-100 mmHg or oxygenation saturation of 93 ％-97％
(D) Convert to pressure-controlled inverse-ratio ventilation if necessary
(E) Adjust the I:E ratio and respiratory rate a needed

17、 Which statement is least likely： (A) Administering morphine at the end of surgery (1 to 3 mg ,i.v., every 5 ~ 10 min improves pain relief with less respiratory depression (B) The presnce of pain prevent respiratory depression (C) Patient-controlled analgesia minimizes patient anxiety (D) NSAID can be part of an effective multimodal analgesia protocol (E) In general, thoracotomy appears to be the most painful operation

18、 Which of the following statement is most likely? (A) Propofol-based anesthetic are not consistently associated with a low incidence of postoperative nausea and vomiting (B) Patients undergoing laparoscopic surgery are not at increased risk for nausea and vomiting (C) The FDA recommendation of EKG for droperidol usage is practical for anesthesiologists (D) The serotonin antagonist ondansetron is useful as first-line drug for nausea and vomiting (E) Shivering increases the metabolic rate and decrease minute ventilation

19、 Which of the following is least appropriate for postanesthesia recovery score (Modified Aldrete Score) and Postanesthesia Discharge Scoring System? (A) 0 = BP+50mm of preanesthetic level (B) 2 = Arousable on calling (C) 2 = SpO2 ＞ 92 % on room air (D) 1 = 20 %-50 % of preoperative baseline (BP and pulse) (E) 2 = Minimal : treat with PO medications (nausea and vomiting)

20、 Which of the following is least likely the symptom of shock? (A) Diaphoresis (B) Agitation or obtundation (C) Hypotension (D) Diminished urine output (E) Widened pulse pressure

22、 Which of the following statement is least likely? (A) Laryngospasm is a reflex closure of the upper airway from spasm of the glottic musculature (B) Stridor is noisy inspiration from turbulent upper airway gas flow (C) The posterior cricoarytenoids abduct the vocal cords and widen the glottic chink during inspiration (D) The thyroarytenoids and lateral cricoarytenoids adduct the vocal fold (E) Intravenous fentayl can depress the protective airway cough reflex without affecting the laryngospasm reflex

23、 有關小兒心臟麻醉中 central nervous system 之監測，下列敘述何者最不 恰當？ (A) Jugular venous bulb saturation 監測屬於高度危險併發症的侵入性處置 (B) Transcranial doppler (TCD)可監測腦部的空氣 emboli (C) Deep hypothermic bypass 時病人的 EEG 需達到 isoelectric (D) Near-infrared spectroscopy 可監測腦部細胞的 mitrochondrial enzymes 活性 (E) TCD 監測易受病人頭部移動的干擾

24、 小兒心臟手術後常發生 pulmonary artery hypertension，下列處理原則何 者最不恰當? (A) 經靜脈給予 NaHCO3 維持血中 pH 值 7.6 (B) 經氣管給予 100%氧氣 (C) 呼吸器給予 PEEP(positive end-expiratory pressure)約 3-5 mmHg (D) 經靜脈給予 adenosine (E) 給予呼吸 tidal volume 10-15 ml/kg 及呼吸次數為 25-35/min

25、 有關 cardiac tamponade(CT)，下列敘述何者不正確？ (A) Gun shot 引致之 CT，pericardial volume (PV)達 150 ml 時，pericardial pressure(PP)可達 10 mmHg 或以上 (B) Stab wound 引致之 CT，PV 達 200 ml 時，PP 可達 25 mmHg 或以上 (C) Uremic pericarditis 引致之 CT，PV 達 400 ml 時，PP 可達 20 mmHg 或以 上 (D) Aortic dissection 引致之 CT，PV 達 150 ml 時，PP 可達 15 mmHg 或以上 (E) 放置 CVP 導致右心房穿孔引致之 CT，PV 達到 100 ml 時，PP 可達 5 mmHg 或以上

26、 有關小兒心臟手術於 cardiopulmonary bypass (CPB)後，ultrafiltration 的 使用，下列敘述何者最不適當？ (A) 減少 pulmonary edema 之發生 (B) 增加手術後的輸血量 (C) 改善左心室功能 (D) 增加 air embolism 的發生 (E) CPB 後，體溫回昇較慢

27、 Cardiopulmonary bypass(CPB)後，若沒有明顯 surgical bleeding，無 fibrinolysis 及 ACT 也沒有偏高，但手術部位有滲血(post-CPB bleeding) 現象。當考慮給予 FFP 或 platelets 時，下列何者最不適當? (A) Platelet count 75K，PT/aPTT = 2.5，給予 FFP (B) Platelet count 110K，PT/aPTT = 1.3，給予 platelets (C) Platelet count 60K，PT/aPTT = 1.5，給予 platelets (D) Platelet count 90K，PT/ aPTT = 2.0，給予 platelets (E) Platelet count 120K，PT/aPTT = 1.8，給予 FFP