【評論主題】6.下列何者是治療麻醉氣體引起的惡性高溫（malignant hyperthermia）最主要的藥物？(A)propranolol(B)dantrolene(C)doxazosin(D)nifedip
【評論內容】
惡性高溫的發生都在麻醉手術中或剛結束，所以診斷要靠臨床條件，這包括1呼吸性酸中毒:End Tidal CO2 55mmHg; PaCO2 60mmHg 。2心臟受影響:無法解釋 的心搏過速或心室顫動。3代謝性酸中毒:缺 鹼超過 8m/Eql 或 pH<7.25 。4肌肉僵硬:包 括全身僵硬或嚼肌僵硬。5肌肉崩潰:包括血 清肌酸酐激酉每大於 20000/L;尿液呈可樂色; 血清或尿液肌球蛋白過高;K+6mEq/L 6體 溫升高:快速升過 38.8°C。7對 Dantrolene 的 治療有快速正面反應。8家族中有相關遺傳病 史。符合上述六個條件以上就可確定惡性高溫的診斷。
惡性高溫的治療愈快愈好，原則包括移除 所有可能引發惡性高溫的物質，針對徵兆症狀治療及儘速使用特效藥 Dantrolene
【評論主題】4.下列何者不是脫離呼吸器（weaning from ventilator）的條件？(A)呼吸速率 < 25 / minute(B)動脈血氧氣分壓（ PaO2）＞ 70 mmHg（FiO240%
【評論內容】
Discontinuation of mechanical ventilation is a two-step process, consisting of readiness testing and weaning:
●Readinessn testing – Readiness testing is the evaluation of objective criteria to ndetermine whether a patient might be able to successfully and safely nwean from mechanical ventilation.
●Weaningn – Weaning is the process of decreasing the amount of support that the npatient receives from the mechanical ventilator, so the patient assumes an greater proportion of the ventilatory effort. The purpose is to assess nthe probability that mechanical ventilation can be successfully ndiscont...
【評論主題】1.下列與腹部腔室症候群（abdominal compartment syndrome）相關的症狀，何者錯誤？(A)腹內壓突然增加(B)小便量減少(C)缺氧（hypoxia）(D)血壓正常
【評論內容】n
Gastrointestinal
nn↓ Celiac blood flow
nn↓ SMA blood flow
nn↓ Mucosal blood flow
nn↓ pHi
nnRenal
nn↓ Urinary output
nn↓ Renal blood flow
nn↓ GFR
nnHepatic
nn↓ Portal blood flow
nn↓ Mitochondrial function
nn↓ Lactate clearance
nnAbdominal wall
nn↓ Compliance
nn↓ Rectus sheath blood
flownCentral nervous system
nn↑ Intracranial pressure
nn↓ Cerebral perfusion pressure
nnCardiac
nnHypovolemia
nn↓ Cardiac output
nn↓ Venous return
nn↑ PCWP and CVP
nn↑ SVR
nnPulmonary
nn↑ Intrathoracic pressure
nn↑ Peak inspiratory pressure
nn↑ Airway pressures
nn↓ Compliance
nn↓ PaO2
nn↑ PaCO2
nn↑ Shunt fraction
nn↑ Vd/V...