84 Each of the following increases the risk of postoperative delirium, except
(A) Advanced age
(B) Preexisting cognitive impairment
(C) Alcohol abuse
(D) Chronic pain

80 下列有關Preeclampsia 的敘述何者錯誤? (A) MgSO4 經常用於預防seizure 的發生, 是比benzodiazepine 更常用的選擇, 腎功能不良之病人則需監控 patellar reflex and serum concentration. (B) Preeclampsia 合併hemolysis, elevated liver enzymes 及low platelet count 則稱為HELLP syndrome (C) 使用MgSO4的preeclampsia產婦若需緊急插管進行麻醉, 首選的肌肉鬆弛劑為succinylcholine, 並且應減 少劑量, rocuronium 也應減少劑量 (D) Preeclampsia產婦的剖腹產最佳麻醉方式目前仍有爭論, 應以個別病患進行評估全身麻醉或區域麻醉之 優缺點 (E) Preeclampsia產婦使用MgSO4當serum concentration達12 mg/dL時, patellar reflex也將消失, 但此時因 MgSO4僅少量通過胎盤, 對胎兒影響不大

81 使用呼吸器接受正壓呼吸治療之病患，可能會有心輸出量降低之現象。下列何項敘述並非正壓呼吸對血流動 力所造成的影響？ (A) 正壓呼吸降低靜脈回流。 (B) 右心室功能不佳 (RV dysfuction) 之病患較易發生心輸出量降低現象。 (C) 正壓呼吸可以降低右心室之後負荷 (RV afterload)。 (D) 正壓呼吸可以造成心室中隔左移。 (E) 左心室可張性 (distensibility) 受到限制。

82 A 47-year-old male has just undergone a Whipple procedure. He had been doing well, but as the nurses were preparing his transfer to the ICU for further monitoring, he suddenly became unresponsive. The medical team began CPR and reconnected this patient to the monitors. The respiratory therapist suggests end-tidal CO2 monitoring. During CPR, end-tidal CO2 correlates with which one of the following? Page (A) Arterial CO2 (B) Cardiac output (C) Minute ventilation (D) Arterial systolic blood pressure (E) Venous CO2

83 加護病房的照護中有關於 FAST HUG 整體性評估表的敘述，以下何者為非？ (A) F-餵食(Feeding) (B) T-預防血栓（Thromboprophylaxis） (C) H-維持血行動力學穩定（Hemodynamic） (D) U-預防潰瘍（Ulcer prophylaxis） (E) G-控制血糖（Glycemic）

85 A 25-year-old man is admitted to the intensive care unit after exploratory laparotomy and repair of multiple bowel injuries from several gunshot wounds. Several hours after admission, the respiratory therapist calls to alert you that his peak airway pressures have increased significantly. The bedside nurse also reports an increase in his vasopressor requirement, and a decrease in urine output. On examination, his abdomen is tense, with a midline dressing intact, and clear breath sounds bilaterally. The most likely diagnosis is (A) Acute myocardial infarction leading to pulmonary edema (B) Hypovolemia from inadequate fluid resuscitation (C) Hemorrhage from an unrecognized injury (D) Abdominal compartment syndrome from bowel edema or hemorrhage

86 下列關於postoperative visual loss (POVL) 之敘述何者為非? (A) 大部份spine surgery後發生的POVL為AION ( anterior ischemic optic neuropathy). (B) 多數POVL於術後24-48小時被發現，然而有些術後呼吸器合併鎮靜藥物使用之病患可能較晚被發現 (C) 通常POVL之症狀為視野缺損,視力消失及對光線無反應. (D) 少數病例可能於影像檢查中發現神經水腫情形,但通常orbital MRI對於POVL之診斷並沒有很大的幫助.

87 目前inhaled nitric oxide用於哪些臨床病患可能有幫助? (A) 患肺高壓且呼吸衰竭之新生兒 Page (B) 右心室心肌梗塞 (right ventricular myocardial infarction) 合併patent foramen ovale (PFO)之病患 (C) 可能發生bronchopulmonary dysplasia之早產兒 (D) 以上皆是

88 何者為處理頭部外傷(Traumatic head injury)所造成顱內高壓(IICP)的作法是不恰當的？ (A) 使用高劑量類固醇(corticosteroid)來消腫 (B) 避免發燒 (C) 使病人床頭抬高30 degree (D) 維持腦部灌流壓cerebral perfusion pressure 60-70mmHg

89 關於 Extracorporeal membrane oxygenation (ECMO) 之使用，下列?述何者正確？ (A) ECMO之使用目的在於維持病患足夠的 oxygen delivery (DO2)和CO2 clearance。其中， DO2 = stroke volume × arterial oxygen content (B) ECMO之使用希望可以提供病患DO2＞兩倍VO2(oxygen consumption)。其中，VO2 = cardiac output x (arterial – venous oxygen content) (C) 經ECMO氧合後的arterialized blood在VV mode ECMO是由動脈回到systemic circulation，相反的，在VA mode ECMO則由靜脈回到病人身上。 (D) 對於呼吸功能衰竭而心臟功能仍良好之患者，通常會使用VA Mode ECMO.

90 下列各病人群之postoperative cognitive dysfunction(POCD)發生率的比較，何者為非？ (A) 大於80歲的老人＞20-30歲的年輕人 (B) 開心手術中，接受體外循環５個小時的患者＞接受體外循環１個小時的患者 (C) 有previous cerebrovascular accident (CVA) history之患者＞無CVA病史之患者 (D) 教育程度高者＞教育程度低者