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

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.

91 Which one of the following is true regarding seizures as one of the multiple side effects from the use of opioids? (A) Morphine and related opioids can cause seizure activity when moderate doses are given. (B) Seizure activity is more likely with meperidine, especially in the elderly and with renal dysfunction. (C) Seizure activity is mediated through stimulation of N-methyl-D-aspartate (NMDA) receptors. (D) Naloxone is very effective in treating seizures produced by morphine and related drugs including meperidine. (E) Seizure activity is most likely related to the fact that opioids stimulate the production of γ-aminobutyric acid (GABA).

92 A spinal neuraxial anesthetic was given 20 minutes earlier to a 28-year-old G3P2 parturient scheduled for repeat cesarean section. Alcohol swab exam revealed that she has lost temperature sensation up to T2 level. At what level do you anticipate the block will reach to provide adequate pain control? Page (A) T2 (B) T3 (C) T4 (D) T5

93 Following successful performance of a right interscalene block for surgical rotator cuff repair in a 27-yearold patient with no other medical issues, you are called to the recovery room (post–anesthesia care unit) 3 hours later to evaluate the patient. The patient’s symptoms include drooping of the right eyelid, redness of the conjunctiva, and pupillary constriction. The most likely diagnosis is (A) Spinal anesthesia (B) Subdural injection of local anesthetic (C) Horner syndrome (D) Cerebrovascular accident (CVA)

94 A 56-year-old patient with a past medical history of hypertension, diabetes, and alcohol abuse presents to the operating room for a right-elbow open reduction internal fixation, secondary to a motor vehicle accident that occurred 24 hours ago. On postoperative day 1, the patient complains of right fourth and fifth digit numbness and minor pain. A diagnosis of cubital tunnel syndrome has been made. The nerve most likely to be involved is (A) Median nerve (B) Ulnar nerve (C) Radial nerve (D) Musculocutaneous nerve

95 A 92-year-old man is undergoing total knee arthroplasty for severe painful osteoarthritis. After struggling in the placement of a lumbar spinal anesthetic, you decide to use the Taylor approach. What best characterizes the Taylor approach to performing spinal anesthesia? (A) Uses image guidance to facilitate bony landmarks (B) Uses a midline and steep angled approach (C) Uses microcatheters to produce long-lasting blocks (D) Uses a loss of resistance technique with air (E) Uses a paramedian approach at L5-S

96 A patient receives a lumbar epidural block with 2% lidocaine for a vaginal hysterectomy. Three hours after surgery the patient reports a dense motor block. An MRI demonstrates a lumbar epidural hematoma. For the best neurologic outcome, it is recommended that a surgical evacuation of the hematoma occurs within (A) 6-8 h (B) 8-10 h (C) 10-12 h (D) 12-14 h (E) 14-16 h