問題詳情

83. 一位65歲女性，因尿毒症，9個月前開始長期接受腹膜透析(CAPD)治療。最近兩天因為發燒、腹痛，透析引流液(effluent)混濁而被送至急診。身體檢查: 體溫37.6℃, 腹部tenderness (+). 您會優先安排做以下何種評估(initial evaluation)？
(A) Abdominal CT
(B) PD effluent: for culture, cytology and Gram staining
(C) 照會外科，更換 PD catheter
(D) Empirical antibiotics and stopping PD, shift to HD
(E) 測量 CAPD Kt/V, 並安排腹膜功能測試 (peritoneal equilibration test, PET)

參考答案

答案：B
難度：計算中-1
書單：沒有書單，新增

用户評論

【用戶】.

【年級】大三上

【評論內容】先區分peritoneal dialysis related peritonitis / secondary peritonitis,因此peritoneal fluid analysis是最先需要評估的,一般leukocyte count > 100 cells/mm3 , > 50%leukocyte屬於neutrophil懷疑bacterial peritonitis; gram stain和culture is positive in approximately 80 to 95 percent of peritonitis,在peritoneal dialysis-related peritonitis之中 gram-positive organism最常見 (usually coagulase-negative Staphylococcus species)