2015心麻考题.doc

下列哪一項最不可能造成activated clotting time (ACT)的延長 Heparin Warfarin Platelet dysfunction Hyperthermia Hemodilution 下列何者為處理hypertrophic cardiomyopathy with dynamic LV outflow tract obstruction時之重要血行動力學目標? Increased myocardial contractility Decreased myocardial contractility Increased heart rate Decreased preload Decreased afterload 下列何種揮發性麻醉氣體對於正常baroreceptor response之抑制最為明顯? Sevoflurane Desflurane Isoflurane Enflurane Halothane 一個70歲病患接受冠狀動脈繞道手術，於開始體外心肺循環時，平均動脈血壓由76 mmHg 降至56 mmHg，最可能的原因是? Hypothermia-induced vasodilation Reduced left ventricular preload Reduced right ventricular preload Myocardial ischemia with reduced cardiac output Hemodilution from crystalloid pump prime 下列有關在 congestive heart failure時心肌氧氣之供給與需求之敘述，何者為真? Decreased myocardial oxygen supply and demand Increased myocardial oxygen supply and demand Decreased myocardial oxygen supply and increased demand Increased myocardial oxygen supply and decreased demand No change 下列何種藥物並不會造成coronary steal? Isoflurane Nitroprusside Dipyridamole Adenosine Sildenafil 一個70歲女性接受冠狀動脈繞道手術以及二尖瓣修補，在脫離體外心肺循環40分鐘且關胸2分鐘後，心電圖之inferior lead有2mm ST segment elevation，接著突發ventricular fibrillation，下列何者為可能之原因? Atrial pacing during repolarization Intracoronary air embolism Hyperthermia Hyperkalemia All of the above 一個50歲女性接受心房中膈缺損手術，於體外心肺循環中發現混合靜脈血氧氣飽和度為50%，最不可能是下列何種原因? Malfunction of membrane oxygenator Pump flow too low Inadequate hemoglobin level Left to right shunt through atrial septal defect None of the above 一個1歲男孩接受法洛四重症(Tetralogy of Fallot)手術時，血氧濃度突然由95%下降至65%，下列何種處理方法最不適當? Intravenous fluid bolus Epinephrine Esmolol Norepinephrine or phenylephrine Increased FiO2 下列有關先天性心臟病之敘述，何者正確？ 慢性缺氧會造成紅血球增生，使血液黏滯度增加 慢性缺氧會影響凝血功能，而使得手術中失血增加 肺血流量增加會造成呼吸道阻力增加 先天性心臟病病患常會合併呼吸道之異常 以上皆是 先天性心臟病之病患可能有慢性缺氧之現象，下列何者不是慢性缺氧時合併之問題？ 內臟（Splanchnic）循環血流降低 生長速率變慢 代謝速率變慢 血紅素濃度增加 呼吸作功能增加 Miller Ch.83, P.2606-2607 關於pacemaker何者錯誤？ DDD代表dual-chamber pacing and sensing, both triggered and inhibited mode VVI代表single-chamber, ventricular pacin