感染科題目一項是考試的常考項目,相關適應症,副作用,藥物藥理作用等等.......因此對於感染科懼怕的人閱讀此份講義後相信會有功力上的精進喔!!因此努力地學習起來吧!!!

 

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內分泌急症是很不易診斷出來,但又是會致死的急症。因此對於疑似的病患都因針對危險因子,實驗室檢查,誘發因素,及身體評估加以診斷,進而予以適當的治療。

 Thyroid storm 甲狀腺風暴

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對於血中酸鹼不平衡也須找出其致病原因, 才能根本解決問題!!

圖片1.jpg 

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骨科一向是外科專師考題的重點,因此這份講義主要針對歷年考題的主題做一複習~~~~相當仔細喔!!

 

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國境之南

 

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 Recently an old female patient admitted to our hospital due to CHF and acute on CRF.Previously she ever accepted left hip replacement twice and bilateral knee replacemnt nearly 2 decades ago.Infection work-up was also performed.We excluded lung infection and UTI via a series of tests/lab but to gall bladder and left knee.At last we consider the infection source coming from left knee.According to PE,erythema and swollen of left knee was noted and arthrocentesis was performed post consultiing orthologist.Synovial analysis disclosed WBC greater than 50000/cumm with PMN predominantly(>75%) and sugar is lower(30mg/dl).This result is compatible with septic knee.Therefore I post up synovial fluid analysis to differentiate from different types of knee disease.

 

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Indications   1.Suspected CNS Infection : Meningitis /Encephalitis 2.Evaluate for Hemorrhagic CVA (Subarachnoid Hemorrhage): Hemorrhage suspected despite negative Head CT /Head CT not available 3.Diagnostic Chemistry Evaluation :CSF Gamma Globulin (Multiple Sclerosis) 4.CSF Dynamics :Spinal block diagnosis (Queckenstedt test) /Normal Pressure Hydrocephalus evaluation :Katzman infusion/Radionucleotide cisternography 5.CSF Cytology :Carcinomatous Meningitis /Lymphomatous Meningitis 6.Therapeutic lumbar puncture:Methotrexate infusion (CNS Leukemia)/ Amphotericin B infusion (fungal Meningitis)/ Removal of fluid to decrease Intracranial Pressure: Pseudotumor Cerebri /Headache associated with Subarachnoid Hemorrhage

Contraindications   1.Local infection at lumbar puncture site 2.Cerebral mass lesion (risk of herniation) :Large brain abscess/ Brain Tumor (especially posterior fossa)/ Subdural Hematoma /Intracranial Hemorrhage 3.Papilledema 4.Uncorrected Bleeding Disorder :Severe Thrombocytopenia

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針對過去兩年胸腔科考題作一整理,如:CAP,asthma,COPD,常用藥物.........

 

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 未命名2.JPG 

 

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 Purpose of review
Hospitalization and mortality rates associated with heart failure are persistently high.

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