44. The major symptoms that define the state of shock include the following EXCEPT:
(A) Fever
(B) Oliguria
(C) Tachycardia
(D) Hypotension

40. 以下何者中心靜脈壓會下降？ (A) 心因性休克（Cardiogenic shock） (B) 神經性休克（Neurogenic shock） (C) 心包填塞（Cardiac tamponade） (D) 肺栓塞 (pulmonary embolism)

複選題41. Which statement of nutrition support in critical care patient is correct, EXCEPT: (A) When full nutrition support is not possible with enteral feedings, the intravenous delivery of nutrients can be used to replace enteral nutrition. (B) The daily calorie requirement will be 25Kcal/day. (C) The daily protein requirement will be 1.4 gm/day. (D) The carbohydrate supply approximately 50% of the daily calorie requirement.

42. About analgesia and sedation in ICU, which statement is not correct： (A) Benzodiazepines are popular sedations they can be safe to use, and accompanied by amnesia. (B) Therapeutic dose of benzodiazepines can cause respiratory depression in select ICU patients. (C) The elimination half-life of diazepam is 20-50 hours versus 2-8 hours of midazolam, the clinical recovery time is the same following a single interventions dose of each drug. (D) The infusion rate of midazolam should be determined using total body weight.

43. 一位 70 歲男性因敗血症休克, 引發急性腎衰竭(Acute renal failure). 醫師給予連 續性靜脈靜脈血液過濾(Continuous Venovenous Hemofiltration, CVVH). 治 療持續到 48 小時, 患者血壓 120/80mm Hg, 過濾速率由原本每小時 2400 mL 銳減為每小時 1500 mL. 以下處置動作, 何者不適當? (A) 診視過濾器及管路有無阻塞或彎折 (B) 提高血流速度 (C) 降低 heparin 的劑量 (D) 降低過濾收集液器皿

45. The initial therapy for patient in state of shock is: (A) IV dopamine (B) IV norepinephrine (C) IV fluid bolus (D) IV dobutamine

46. Regarding central venous pressure (CVP) catheters, all the following are correct, EXCEPT (A) In the absence of tricuspid disease, CVP mirrors right ventricular end diastolic pressure (B) In patients with normal cardiac function, adequate intravascular volume is considered when CVP is greater than 10mmHg (C) CVP catheters can be used for administration of hyperosmolar fluids and total parenteral nutrition (TPN) (D) CVP is decreased in patients with right ventricular infarction

47. APACHE III 計分法最高為: (A) 50 (B) 100 (C) 200 (D) 299

48. 下面圖形的正確肺動脈楔壓 (pulmonary arterial wedge pressure)應該是 (A) 30 mmHg (B) 20 mmHg (C) 0 mmHg (D) 7 mmHg

49. Which of the following is not the diagnostic criteria for the systemic inflammatory response syndrome (SIRS)? (A) Temperature ＞38℃ or ＜36℃ (B) Heart rate ＞ 90 beats/minute (C) Platelet count ＜80,000/mm3 or decreased more than 50% (D) WBC count ＞12,000/mm3 or ＜4000/mm3 or ＞10% immature(band) forms

50. Which of the following is not the goals for the first 6 hours of management for patients with severe sepsis and septic shock? (A) Central venous pressure 8-12 mmHg (B) Mean arterial pressure ＞ 65mmHg (C) Body temperature ＜38.5℃ (D) Urine output ＞0.5ml /kg per hour