【評論主題】39.根據使用呼吸器病人的脫離過程可將病人分類，下列敘述何者錯誤？(A)簡單脫離（simple weaning）病人在第 1 次嘗試自主呼吸測試時即順利拔管，且成功脫離 呼吸器 (B)困難脫離（dif
【評論內容】
Simple weaning
Wean to extubation on first attempt
Difficult weaning
Fail initial weaning and require up to 3 SBTs or ≤ 7 days from first SBT
Prolonged weaning
Fail 3 weaning SBTs and 7 days weaning from first SBT
【評論主題】78.臨床使用sellick maneuver的目的為：(A)壓迫上腹，咳出嗆入呼吸道的異物(B)壓迫頸部，避免胃內容物嗆入呼吸道(C)壓迫胸部，避免氣血胸加重(D)壓迫頸部，避免皮下氣腫擴大
【評論內容】
環狀軟骨壓迫法，或者稱作Sellick maneuver ，是用在氣管內管插管時降低胃食道逆流發生的一種技巧。施術者對頸部的環狀軟骨施予壓力，直接地壓迫並阻塞其後方的食道。[1]
值得注意的是，環狀軟骨壓迫法不應該與"BURP"(Backwards Upwards Rightwards Pressure) maneuver搞混，後者是用在氣管插管時幫助喉鏡能夠更容易地看到聲門所使用的技法，而非為了防止胃食道逆流。[2] 正如同BURP maneuver 其名所指示的，施術者將對患者的甲狀軟骨施以"向後"、"向上"、以及"向右"的力量，使得聲門更容易被看見。
【評論主題】67.母親與胎兒會有一些高危險因子，造成新生兒容易發生肺炎，下列何者最不容易發生新生兒肺炎？(A)週產期發燒(B)羊膜提早破水(C)羊水有異味與混濁(D)母親有糖尿病
【評論內容】
危險因子
母體因素
→羊水感染、母親懷孕期間發燒
→ prolonged rupture of the fetal membrane (18小時)
胎兒因素
→早產、呼吸道異常、嚴重underlying、住院時間長等
【評論主題】33.高碳酸血症時，周邊化學受體（peripheral chemoreceptors）參與通氣反應的調控約為多少%？ (A)5～10 (B)20～30 (C)50～60 (D)80～90
【評論內容】
For a given increase in PaCO2 or [H+], the carotid bodies are
less responsive than the central chemoreceptors. The peripheral
chemoreceptors account for only 20% to 30% of the ventilatory
response to hypercapnia.5 However, they respond to increased
arterial [H+] more rapidly than the central chemoreceptors. The
explanation is that, in contrast to the central chemoreceptors,
the carotid bodies are exposed directly to arterial blood. The
body’s initial ventilatory response to metabolic acidosis is fairly
quick, even though H+ crosses the blood-brain barrier with
difficulty...
【評論主題】39.根據使用呼吸器病人的脫離過程可將病人分類，下列敘述何者錯誤？(A)簡單脫離（simple weaning）病人在第 1 次嘗試自主呼吸測試時即順利拔管，且成功脫離 呼吸器 (B)困難脫離（dif
【評論內容】
Simple weaning
Wean to extubation on first attempt
Difficult weaning
Fail initial weaning and require up to 3 SBTs or ≤ 7 days from first SBT
Prolonged weaning
Fail 3 weaning SBTs and 7 days weaning from first SBT
【評論主題】18.穿孔型微血管（fenestrated capillary）最不常見於下列何處？(A)腦下垂體（pituitary gland）(B)大腦皮質（brain cortex）(C)腎臟（kidney）
【評論內容】
有孔毛細血管（fenestrated capillary）的特點是，內皮細胞不含核的部分很薄，有許多貫穿細胞的孔，孔的直徑一般為60～80nm。許多器官的毛細血管的孔有隔膜封閉，隔膜厚4～6nm，較一般的細胞膜薄。內皮細胞基底面有連續的基板。此型血管主要存在於胃腸粘膜(lamina propria)、某些內分泌腺(Endocrine gland)和腎血管球(Kidney’s glomerulus)等處。腎血管球的內皮細胞的孔沒有隔膜。
【評論主題】51.小容積噴霧器（SVN），裝置中的噴射出口（jet orifice）之功能為：(A)降低側壓（lateral pressure）(B)增加回壓（back pressure）(C)加快氣流速率（ve
【評論內容】
Basic components of an air-entrainment system.
Pressurized gas passes through a nozzle or jet, beyond which are
air-entrainment ports. Shear forces at the jet orifice entrain air into
the primary gas stream, diluting the O2 and increasing the total flow
output of the device.
【評論主題】3.高頻呼吸器（high frequency ventilation）治療急性呼吸窘迫症候群（acute respiratorydistress syndrome）的預後是：(A)比傳統呼吸器更能改善
【評論內容】
In contrast, the OSCAR trial showed no difference
between HFV and conventional modes of mechanical ventilation
in treating ARDS. At the current time, we do not
recommend HFV in routine ARDS management, and, when
being considered, its use should be reserved to referral centers
with established experience.