id
string | choice_num
int64 | answer
string | level
int64 | en_question
string | en_A
string | en_B
string | en_C
string | en_D
string | zh_question
string | zh_A
string | zh_B
string | zh_C
string | zh_D
string | en_E
string | zh_E
string | en_F
string | zh_F
string | en_G
string | zh_G
string | en_H
string | zh_H
string | en_I
string | zh_I
string |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
9afc5c67-415c-598c-8e8e-4aed27c060cb
| 4 |
A
| 1 |
Which of the following is the most common cause of death associated with iatrogenic pulmonary artery rupture (PAR)?
|
Anoxia
|
Hemorrhagic shock
|
Cardiac tamponade
|
Myocardial infarction
|
以下哪项是与医源性肺动脉破裂（PAR）相关的最常见死亡原因？
|
缺氧
|
失血性休克
|
心脏压塞
|
心肌梗死
| null | null | null | null | null | null | null | null | null | null |
96139dc6-342c-5a5b-bbc0-f4840d343ab8
| 6 |
A
| 2 |
17. A 65-kg patient is receiving volume-controlled ventilation with a tidal volume of 400 mL and frequency of 14 breaths per minute. The measured peak airway pressure is 18 cm H2O, with a plateau pressure of 12 cm H2O, and the PEEP is 2 cm H2O. What is the static compliance of the patient's lung compliance?
|
40 mL/cm H2O
|
67 mL/cm H2O
|
25 mL/cm H2O
|
25 cm H2O/L
|
17. 一名65公斤的患者正在接受容量控制通气，潮气量为400毫升，呼吸频率为每分钟14次。测得的气道峰压为18 cm H2O，平台压为12 cm H2O，PEEP为2 cm H2O。患者的肺顺应性静态顺应性是多少？
|
40 mL/cm H2O
|
67 mL/cm H2O
|
25 mL/cm H2O
|
25 cm H2O/L
|
15 cm H2O/L
|
15 cm H2O/L
|
40 cm H2O/L
|
40 cm H2O/L
| null | null | null | null | null | null |
31e53e79-ac63-5544-92f0-5f2ce511382c
| 6 |
A
| 3 |
For a euvolemic patient with normal lung compliance and cardiac function, delivery of positive pressure ventilation (PPV) would be most likely to have which of the following hemodynamic effects?
|
Decreased preload, decreased afterload, and increased cardiac output
|
Decreased preload, increased afterload, and decreased cardiac output
|
Decreased preload, increased afterload, and increased cardiac output
|
Increased preload, decreased afterload, and decreased cardiac output
|
对于一个血容量正常、肺顺应性和心功能正常的患者，给予正压通气（PPV）最可能产生以下哪种血流动力学效应？
|
前负荷减少，后负荷减少，心输出量增加
|
前负荷减少，后负荷增加，心输出量减少
|
前负荷减少，后负荷增加，心输出量增加
|
前负荷增加，后负荷减少，心输出量减少
|
Increased preload, decreased afterload, and increased cardiac output
|
前负荷增加，后负荷减少，心输出量增加
|
Increased preload, increased afterload, and decreased cardiac output
|
前负荷增加，后负荷增加，心输出量减少
| null | null | null | null | null | null |
2b38ad39-1833-5b4c-8814-79704fafd75b
| 5 |
D
| 2 |
21. A patient is breathing steadily at a minute ventilation of 10 L/min while receiving supplemental oxygen via nasal cannula at a rate of 6 L/min. What is the approximate FiO2 delivered to the patient during inspiration?
|
0.15-0.21
|
0.21-0.28
|
0.28-0.38
|
0.38-0.46
|
21. 一名患者在每分钟通气量为10 L/min的情况下，通过鼻导管以6 L/min的速度吸入补充氧气。患者在吸气时接收到的FiO2大约是多少？
|
0.15-0.21
|
0.21-0.28
|
0.28-0.38
|
0.38-0.46
|
0.46-0.52
|
0.46-0.52
| null | null | null | null | null | null | null | null |
b3c2b78f-27e0-549f-aab5-700d595a52a3
| 4 |
A
| 1 |
Which of the following statements about the differences between a partial rebreather and a nonrebreather oxygen delivery mask is most correct?
|
A nonrebreather can theoretically reach an Fio2 of 1.0, whereas a partial rebreather can reach an FiO2 of 0.7-0.8.
|
A nonrebreather utilizes a large reservoir bag of 600-1000 mL, whereas a partial rebreather utilizes a smaller reservoir bag.
|
A nonrebreather allows expired gases to enter the reservoir bag, whereas a partial rebreather has a 1-way valve that inhibits expired gases from entering the reservoir bag.
|
A nonrebreather allows inhaled nebulized bronchodilator therapy to bedelivered, whereas a partial rebreather does not.
|
以下关于部分重呼吸面罩和非重呼吸面罩之间差异的陈述中，哪一项是最正确的？
|
非重呼吸面罩理论上可以达到1.0的吸入氧浓度（FiO2），而部分重呼吸面罩可以达到0.7-0.8的吸入氧浓度（FiO2）。
|
非重呼吸面罩使用600-1000毫升的大储气袋，而部分重呼吸面罩使用较小的储气袋。
|
非重呼吸面罩允许呼出的气体进入储气袋，而部分重呼吸面罩有一个单向阀，阻止呼出的气体进入储气袋。
|
非重呼吸面罩允许吸入雾化支气管扩张剂治疗，而部分重呼吸面罩不允许。
| null | null | null | null | null | null | null | null | null | null |
23e4eda4-8077-5840-ac46-55fcac2c360e
| 4 |
B
| 1 |
Which of the following statements is most correct regarding oxygen delivery to a patient wearing a Venturi mask?
|
A variable FiO2 is delivered depending on the patient's minute ventilation.
|
A fixed FiO2 is delivered based on the entrainment port size on the mask, independent of the patient's minute ventilation.
|
A fixed FiO2 is delivered to the patient based on the oxygen flow rate to the mask, independent of the patient's minute ventilation.
|
A variable FiO2 is delivered to the patient depending on the oxygen flow rate to the mask.
|
关于佩戴文丘里面罩的患者的氧气输送，下列哪项陈述最正确？
|
根据患者的每分钟通气量，提供可变的FiO2。
|
根据面罩上的引流口大小，提供固定的FiO2，与患者的每分钟通气量无关。
|
根据面罩的氧气流速，提供固定的FiO2，与患者的每分钟通气量无关。
|
根据面罩的氧气流速，提供可变的FiO2。
| null | null | null | null | null | null | null | null | null | null |
2f805ed4-432d-55c0-9c29-68adfb4eec36
| 4 |
D
| 1 |
Which of the following statements regarding the benefit of high-flow nasal cannula (HFNC) is/are most correct?
|
HFNC can provide PEEP.
|
HFNC can improve CO2 exchange.
|
HFNC can achieve an FiO2 between 0.21 and 1.0 that is independent of patient respiratory effort.
|
All of the above.
|
以下关于高流量鼻导管（HFNC）益处的说法中，哪一项是最正确的？
|
HFNC 可以提供呼气末正压（PEEP）。
|
HFNC 可以改善二氧化碳交换。
|
HFNC 可以实现 0.21 到 1.0 之间的吸入氧浓度（FiO2），且不依赖于患者的呼吸努力。
|
以上全部。
| null | null | null | null | null | null | null | null | null | null |
1f398851-394c-5ba1-876b-3a132c6e65a6
| 4 |
A
| 1 |
A delivery system that allows for nitric oxide (NO) to have a long residence time in the ventilator circuit can lead to high concentrations of which of the following toxic metabolites?
|
NO2
|
NO
|
N2O
|
N2O2
|
一种使一氧化氮（NO）在呼吸机回路中停留时间较长的输送系统可能导致以下哪种有毒代谢物的高浓度？
|
NO2
|
NO
|
N2O
|
N2O2
| null | null | null | null | null | null | null | null | null | null |
396f454e-998b-5be9-8b47-d29badfa466c
| 4 |
B
| 1 |
Which of the following best describes the method for calculating of mean arterial pressure (MAP) using a noninvasive blood pressure monitor?
|
Calculated from a proprietary algorithm based on systolic and diastolic blood pressure
|
Inflation pressure at which maximum oscillometric pulse amplitude is detected
|
Noninvasive blood pressure monitors do not give MAP
|
Calculated using the equation, MAP = diastolic blood pressure + 1/3 (systolicdiastolic blood pressure)
|
以下哪项最能描述使用无创血压监测仪计算平均动脉压（MAP）的方法？
|
根据收缩压和舒张压的专有算法计算
|
检测到最大示波脉搏幅度的充气压力
|
无创血压监测仪不提供MAP
|
使用公式计算，MAP = 舒张压 + 1/3 (收缩压-舒张压)
| null | null | null | null | null | null | null | null | null | null |
cee831b2-724d-5fdc-8bd1-57d28cee546e
| 4 |
B
| 2 |
A "square wave" test is performed to measure the dynamic response of a radial arterial line. Two oscillations are seen before the tracing returns to baseline. Which of the following best describes the state of the arterial pressure
|
Underdamped
|
Adequately damped
|
Overdamped
|
Cannot be determined
|
进行“方波”测试以测量桡动脉导管的动态响应。看到两个振荡后，波形回到基线。以下哪项最能描述动脉压力的状态？
|
欠阻尼
|
适度阻尼
|
过度阻尼
|
无法确定
| null | null | null | null | null | null | null | null | null | null |
7630e341-f885-5437-9b8a-76fee6e2fe4b
| 4 |
B
| 1 |
33. You are called to evaluate a patient in the ICU who has an indwelling pulmonary artery catheter. The nurse states that the waveform (below) appears markedly changed from 30 minutes ago. Which of the following best explains the portion of the waveform indicated by the arrow?
|
Pulmonary regurgitation
|
Right ventricular diastole
|
Right ventricular systole
|
Intermittent wedging of the pulmonary artery catheter
|
33. 你被叫去评估一名在ICU的病人，他有一个留置的肺动脉导管。护士说波形（如下）与30分钟前相比有显著变化。以下哪一项最能解释箭头所指的波形部分？
|
肺动脉返流
|
右心室舒张期
|
右心室收缩期
|
肺动脉导管的间歇性楔入
| null | null | null | null | null | null | null | null | null | null |
fc17c02b-a78a-5abe-bac4-ca098cd019c5
| 5 |
C
| 2 |
Which of the following conditions have the most insignificant effect on left ventricular end-diastolic pressure (LVEDP) estimation using a pulmonary artery catheter?
|
Severe mitral regurgitation
|
Tip of pulmonary artery catheter in West Zone I
|
Severe tricuspid regurgitation
|
Peak end-expiratory pressure at 15 cm H2O.
|
以下哪种情况对使用肺动脉导管估算左心室舒张末期压（LVEDP）的影响最不显著？
|
严重的二尖瓣返流
|
肺动脉导管尖端位于 West Zone I
|
严重的三尖瓣返流
|
呼气末正压为 15 cm H2O
|
Left atrial myxoma
|
左心房粘液瘤
| null | null | null | null | null | null | null | null |
dba08939-7f44-57e7-b847-b1034c180b6a
| 4 |
D
| 2 |
Using the following measurements obtained from a patient with a pulmonary artery catheter that are listed below, what is the systemic vascular resistance (SVR) (in dynes/cm5 )?
|
1003
|
851
|
673
|
Cannot be calculated with the given information
|
使用从一位患者的肺动脉导管获得的以下测量值，系统血管阻力（SVR）（以dynes/cm5为单位）是多少？
|
1003
|
851
|
673
|
无法根据给定信息计算
| null | null | null | null | null | null | null | null | null | null |
87068bb2-34d3-5c75-978d-ec50fe32c0ea
| 4 |
C
| 2 |
A patient is being monitored in the ICU using a noninvasive cardiac output monitoring device attached to radial arterial line. It uses arterial pressure contour for estimating stroke volume and cardiac output. In which of the following clinical scenarios would stroke volume estimated by this cardiac output monitor be most accurate?
|
Rapid atrial fibrillation
|
Acute aortic regurgitation
|
During fluid resuscitation
|
End-stage liver disease
|
一名患者在ICU中使用连接到桡动脉导管的无创心输出量监测设备进行监测。该设备使用动脉压力波形来估算每搏量和心输出量。在以下哪种临床情境中，该心输出量监测器估算的每搏量最为准确？
|
快速心房颤动
|
急性主动脉瓣关闭不全
|
液体复苏期间
|
终末期肝病
| null | null | null | null | null | null | null | null | null | null |
9d7e0ca7-cec5-5c8a-afc1-7abea44b8d07
| 4 |
B
| 1 |
Based on the Stewart-Hamilton equation, the relationship between thermodilution-based cardiac output and area under the temperature curve is best characterized by which of the following?
|
Directly proportional
|
Inversely proportional
|
Varies based on body surface area
|
Not related
|
根据Stewart-Hamilton方程，基于热稀释的心输出量与温度曲线下面积之间的关系最好由以下哪一项描述？
|
成正比
|
成反比
|
根据体表面积变化
|
无关
| null | null | null | null | null | null | null | null | null | null |
1f51d995-5367-5e13-a279-a4976ecb1a70
| 4 |
B
| 1 |
Which of the following statements regarding the Bispectral index (BIS) for monitoring depth of anesthesia is most correct?
|
BIS is superior to end-tidal anesthetic gas monitoring in preventing awareness.
|
BIS correlates with probability of patient movement to noxious stimuli.
|
BIS is an American Society of Anesthesiology standard monitor.
|
BIS is unreliable during total intravenous anesthesia.
|
以下关于用于监测麻醉深度的双频谱指数（BIS）的陈述中，哪一项最正确？
|
BIS在防止意识清醒方面优于呼气末麻醉气体监测。
|
BIS与患者对有害刺激的运动概率相关。
|
BIS是美国麻醉医师学会的标准监测仪。
|
BIS在全静脉麻醉期间不可靠。
| null | null | null | null | null | null | null | null | null | null |
dc1d4d32-5993-5189-8ffc-5b97d75a3b1c
| 4 |
C
| 1 |
An EEG monitor is being used to measure the depth of anesthesia for a patient receiving total intravenous anesthesia with propofol. Which of the following best describes the characteristics of an EEG in an awake patient and in a patient under general anesthesia?
|
Awake: high frequency and high amplitude; general anesthesia: low frequency and low amplitude
|
Awake: low frequency and low amplitude; general anesthesia: high frequency and high amplitude
|
Awake: high frequency and low amplitude; general anesthesia: low frequency and high amplitude
|
Awake: low frequency and high amplitude; general anesthesia: high frequency and low amplitude
|
正在使用脑电图监测仪测量接受丙泊酚全静脉麻醉患者的麻醉深度。以下哪项最能描述清醒患者和全身麻醉患者的脑电图特征？
|
清醒：高频高幅；全身麻醉：低频低幅
|
清醒：低频低幅；全身麻醉：高频高幅
|
清醒：高频低幅；全身麻醉：低频高幅
|
清醒：低频高幅；全身麻醉：高频低幅
| null | null | null | null | null | null | null | null | null | null |
aa5eb5df-b929-5bb7-a9eb-f55496b0c312
| 4 |
B
| 3 |
The velocity of blood through the middle cerebral artery, measured using transcranial Doppler (TCD), is likely to be elevated in all the following scenarios, EXCEPT which one?
|
Increased cerebral perfusion pressure (CPP)
|
Increased intracranial pressure
|
Cerebral vasospasm
|
Carotid artery stenosis
|
使用经颅多普勒（TCD）测量的中脑动脉血流速度在以下所有情况下可能升高，除了哪一种？
|
脑灌注压（CPP）增加
|
颅内压增加
|
脑血管痉挛
|
颈动脉狭窄
| null | null | null | null | null | null | null | null | null | null |
faa9eb64-1dec-5a3d-84cd-0b01917fe83e
| 4 |
B
| 1 |
Which of the following BEST represents the degree of influence of anesthetic agents on somatosensory evoked potential (SSEP) monitoring? (Arranged from most deleterious to the least deleterious agents.)
|
Etomidate > isoflurane > propofol > opioids
|
Isoflurane > propofol > opioids > etomidate
|
Isoflurane > opioids > etomidate > propofol
|
Propofol > isoflurane > opioids > etomidate
|
以下哪一项最能代表麻醉药物对体感诱发电位（SSEP）监测的影响程度？（从最有害到最不有害的药物排列。）
|
依托咪酯 > 异氟醚 > 丙泊酚 > 阿片类药物
|
异氟醚 > 丙泊酚 > 阿片类药物 > 依托咪酯
|
异氟醚 > 阿片类药物 > 依托咪酯 > 丙泊酚
|
丙泊酚 > 异氟醚 > 阿片类药物 > 依托咪酯
| null | null | null | null | null | null | null | null | null | null |
07cc97b0-102a-59df-afac-85d79f47361e
| 4 |
D
| 1 |
Which of the following modalities for monitoring evoked potentials (EPs) is least affected by inhalational anesthetics?
|
Visual EP
|
Somatosensory EP
|
Motor EP
|
Brainstem auditory EP
|
以下哪种诱发电位（EPs）监测方式最不受吸入麻醉药的影响？
|
视觉诱发电位
|
体感诱发电位
|
运动诱发电位
|
脑干听觉诱发电位
| null | null | null | null | null | null | null | null | null | null |
7d198112-7f21-519a-9857-ae939c257f5c
| 4 |
C
| 1 |
A 67-year-old man is scheduled for a Whipple procedure and is offered an epidural for postoperative pain control. Which of the following is an absolute contraindication to placement of an epidural?
|
Aortic stenosis with a valve area of 1.2 cm2
|
Recent upper respiratory tract infection
|
Patient refusal
|
Scoliosis
|
一名67岁的男性计划进行胰十二指肠切除术，并被建议使用硬膜外麻醉进行术后疼痛控制。以下哪一项是硬膜外麻醉置入的绝对禁忌症？
|
主动脉瓣狭窄，瓣膜面积为1.2 cm²
|
近期上呼吸道感染
|
患者拒绝
|
脊柱侧弯
| null | null | null | null | null | null | null | null | null | null |
456258fb-2196-53d0-bea2-3fa5480c3501
| 4 |
A
| 2 |
You are called to the postanesthesia care unit because a patient with an epidural placed at T12-L1 is complaining of pain at the site of his lower abdominal incision but cannot move his legs. He was initially very comfortable. His motor examination has not changed since arrival in the postanesthesia care unit. Which of the following local anesthetics is most likely to have been used?
|
Etidocaine 1.5%
|
Lidocaine 2%
|
Bupivacaine 0.5%
|
Chloroprocaine 3%
|
你被叫到麻醉后护理单元，因为一名在T12-L1放置硬膜外导管的患者抱怨下腹部切口处疼痛，但无法移动双腿。他最初感觉很舒适。他的运动检查自到达麻醉后护理单元以来没有变化。以下哪种局部麻醉药最有可能被使用？
|
1.5% 依替卡因
|
2% 利多卡因
|
0.5% 布比卡因
|
3% 氯普鲁卡因
| null | null | null | null | null | null | null | null | null | null |
c1ea6d13-a4da-5366-aa5a-6ae430d5cc62
| 4 |
C
| 2 |
A 67-year-old woman is on the first postoperative day following a Whipple procedure. She has a thoracic epidural in place and is receiving a mix of bupivacaine and dilaudid. She reports good pain relief but states that she is incredibly itchy, especially in her face and on her nose. Which of the following is
|
Naloxone
|
Propofol
|
Diphenhydramine
|
Elimination of opioids from epidural mix
|
一名67岁的女性在Whipple手术后的第一天。她有一个胸段硬膜外导管，并正在接受布比卡因和氢吗啡酮的混合物。她报告疼痛缓解良好，但表示她感到非常痒，尤其是在脸上和鼻子上。以下哪项是
|
纳洛酮
|
丙泊酚
|
苯海拉明
|
去除硬膜外混合物中的阿片类药物
| null | null | null | null | null | null | null | null | null | null |
28e40994-7e57-5f91-bbe6-3080b23448bb
| 4 |
A
| 3 |
A 100-kg, 71-year-old man with a history of asthma, snoring, and emphysema undergoes thoracotomy and wedge resection for removal of a lung tumor. Which of the following treatments would be most effective to control his pain postoperatively while also maintaining adequate ventilation?
|
Thoracic epidural with a continuous infusion of bupivacaine and hydromorphone
|
As-needed doses of hydromorphone administered by the nurse
|
Patient-controlled analgesia (PCA) with hydromorphone
|
Lumbar epidural with a continuous infusion of bupivacaine and hydromorphone
|
一名100公斤、71岁的男性，有哮喘、打鼾和肺气肿病史，接受开胸手术和楔形切除以去除肺部肿瘤。以下哪种治疗方法最有效地控制他的术后疼痛，同时保持足够的通气？
|
胸段硬膜外麻醉，持续输注布比卡因和氢吗啡酮
|
由护士按需给予氢吗啡酮
|
患者自控镇痛（PCA）使用氢吗啡酮
|
腰段硬膜外麻醉，持续输注布比卡因和氢吗啡酮
| null | null | null | null | null | null | null | null | null | null |
a1d1d855-79b4-5ee2-8928-9ad4240eb1c8
| 4 |
A
| 1 |
5. A 67-year-old woman who is 9 hours status post gastrectomy is noted to have a respiratory rate of 6 and is also somewhat somnolent. Which of the following neuraxial medications or combinations of medications would be predicted to cause respiratory depression within 6-12 hours of exposure?
|
Morphine
|
Fentanyl
|
Bupivacaine
|
Bupivacaine plus sufentanil
|
5. 一名67岁的女性在胃切除术后9小时被发现呼吸频率为6，并且有些嗜睡。以下哪种神经轴药物或药物组合预计会在接触后6-12小时内导致呼吸抑制？
|
吗啡
|
芬太尼
|
布比卡因
|
布比卡因加舒芬太尼
| null | null | null | null | null | null | null | null | null | null |
2d48433e-3ccf-5f6b-808f-e59d1657edda
| 4 |
A
| 1 |
Compared with a single epidural dose of morphine, a single epidural dose of fentanyl has a longer half-time in the epidural space secondary to which of the following properties?
|
Lipid solubility
|
Ionization state
|
Molecular size
|
Molecular weight
|
与单次硬膜外注射吗啡相比，单次硬膜外注射芬太尼在硬膜外腔中的半衰期较长，这主要是由于以下哪种特性？
|
脂溶性
|
电离状态
|
分子大小
|
分子量
| null | null | null | null | null | null | null | null | null | null |
ebfa64d4-525a-5671-9c0e-b3bbb2cd446b
| 4 |
A
| 2 |
A 42-year-old woman undergoes total colectomy under general anesthesia with a thoracic epidural (T10-T11) in place. At the conclusion of the procedure, she receives an infusion of bupivacaine 0.1% and hydromorphone 20 μg/mL at 6 mL/h through her epidural catheter. You are called to see her 8 hours postoperatively and find that she is complaining of pain at the site of her incision. Her heart rate is 100 beats per minute and her blood pressure is 160/92 mm Hg. What is the most appropriate next step to manage this patient's pain?
|
Administer a bolus of 5 cc of 1.5% lidocaine with epinephrine 1:200 000 through her epidural catheter.
|
Add PCA with hydromorphone to her current regimen.
|
Add Toradol to her current regimen.
|
Check a serum bupivacaine level.
|
一名42岁的女性在全身麻醉下接受了全结肠切除术，并置入了胸段硬膜外导管（T10-T11）。手术结束时，她通过硬膜外导管接受了0.1%布比卡因和20 μg/mL氢吗啡酮以6 mL/h的速度输注。术后8小时，你被叫去看她，发现她抱怨切口处疼痛。她的心率为每分钟100次，血压为160/92 mm Hg。管理该患者疼痛的最合适的下一步措施是什么？
|
通过她的硬膜外导管给予5 cc 1.5%利多卡因和1:200 000肾上腺素的推注。
|
在她目前的方案中加入氢吗啡酮的PCA。
|
在她目前的方案中加入托拉塞米。
|
检查血清布比卡因水平。
| null | null | null | null | null | null | null | null | null | null |
6d35883d-ce9f-5fc3-8bf3-8d3eb44abc69
| 4 |
C
| 1 |
You are caring for a 77-year-old man with no significant medical history who underwent an L5-S1 fusion yesterday for spinal stenosis. He was taking oxycodone at home for his chronic back pain, and you decide to write him for a PCA. Which of the following medications should be avoided?
|
Hydromorphone
|
Morphine
|
Meperidine
|
Fentanyl
|
您正在照顾一位77岁的男性患者，他没有显著的病史，昨天因脊柱狭窄进行了L5-S1融合手术。他在家中因慢性背痛服用羟考酮，您决定为他开一个PCA。以下哪种药物应避免使用？
|
氢吗啡酮
|
吗啡
|
哌替啶
|
芬太尼
| null | null | null | null | null | null | null | null | null | null |
bd4d3267-d8af-5e47-b848-171d39c32f42
| 4 |
A
| 1 |
Which of the following settings is not recommended for a PCA pump using hydromorphone for an opioid-naive patient in the postoperative period?
|
Continuous background infusion
|
Initial lockout interval of 10 minutes
|
Initial hourly dose limit of 1-2 mg
|
Addition of opioid-sparing medications to the analgesic regimen
|
以下哪种设置不建议用于术后期间使用氢吗啡酮的PCA泵在阿片类药物初次使用患者中？
|
持续背景输注
|
初始锁定间隔为10分钟
|
初始每小时剂量限制为1-2毫克
|
在镇痛方案中添加阿片类药物节省药物
| null | null | null | null | null | null | null | null | null | null |
66dc6c0a-cb3b-589f-ab33-392d32a67739
| 4 |
A
| 2 |
A 65-year-old woman with Parkinson disease and esophageal cancer is receiving an intravenous PCA with hydromorphone after undergoing Ivor Lewis esophagectomy. She reports excellent pain control but is experiencing nausea. Which of the following antiemetics is the most appropriate selection for this patient?
|
Ondansetron
|
Haldol
|
Promethazine
|
Droperidol
|
一名65岁的女性患有帕金森病和食道癌，在接受Ivor Lewis食管切除术后，正在使用静脉PCA与氢吗啡酮。她报告疼痛控制良好，但出现了恶心。以下哪种止吐药是该患者最合适的选择？
|
昂丹司琼
|
氟哌啶醇
|
异丙嗪
|
氟哌利多
| null | null | null | null | null | null | null | null | null | null |
3be699df-499d-5bda-9411-a2a846c15c91
| 4 |
A
| 1 |
11. Which of the following best describes the mechanism of acetaminophen?
|
Central inhibition of cyclooxygenase (COX) activation
|
Inhibition of lipoxygenase activation
|
Activation of lipoxygenase central a2 receptors
|
Activation of GABA receptors
|
11. 以下哪项最能描述对乙酰氨基酚的作用机制？
|
中枢抑制环氧合酶（COX）激活
|
抑制脂氧合酶激活
|
激活脂氧合酶中枢α2受体
|
激活GABA受体
| null | null | null | null | null | null | null | null | null | null |
ca047e42-8f34-58b8-8f0d-33865c012b3b
| 4 |
C
| 2 |
You are consulted on a patient with a history of chronic back pain who is now on the first postoperative day from a L4-L5 fusion surgery. He tells you that he
|
Ketamine
|
Hydromorphone
|
Tizanidine
|
Tylenol
|
您被咨询了一位有慢性背痛病史的患者，他现在是L4-L5融合手术后的第一天。他告诉你他
|
氯胺酮
|
氢吗啡酮
|
替扎尼定
|
泰诺
| null | null | null | null | null | null | null | null | null | null |
9bd0b727-6186-5853-bfda-11551de0c271
| 4 |
B
| 1 |
Which of the following agents or drugs is most likely to have a similar mechanism of action to ketamine?
|
Sevoflurane
|
Nitrous oxide
|
Midazolam
|
Clonidine
|
以下哪种药物或药剂的作用机制最有可能与氯胺酮相似？
|
七氟醚
|
一氧化二氮
|
咪达唑仑
|
可乐定
| null | null | null | null | null | null | null | null | null | null |
d535a56b-3d41-5b90-9b6a-769430a16d53
| 4 |
B
| 2 |
A 60-year-old man with bilateral radicular pain in his legs presents 4 weeks after implantation of a spinal cord stimulator (SCS) with dual percutaneous leads. He had reported greater than 50% pain relief with his SCS trial and also reports feeling well after implantation of his SCS. He has therefore greatly increased his daily activity. He now complains of paresthesias in his lower abdominal region and worsening pain in his legs. His neurologic exam is unremarkable. There is no pain on palpation of his lower back. His incision site is clean, dry, and intact and he is afebrile. Which of the following most likely explains this presentation?
|
Epidural abscess
|
Migration of leads
|
Disc herniation
|
Infection of the SCS leads
|
一名60岁的男性在植入双经皮导线的脊髓刺激器（SCS）4周后出现双侧腿部根性疼痛。他在SCS试验中报告疼痛缓解超过50%，并且在植入SCS后感觉良好。因此，他大大增加了日常活动量。现在他抱怨下腹部区域有感觉异常，并且腿部疼痛加重。他的神经系统检查无异常。触诊下背部无疼痛。他的切口部位清洁、干燥且完整，并且无发热。以下哪项最可能解释这种表现？
|
硬膜外脓肿
|
导线移位
|
椎间盘突出
|
SCS导线感染
| null | null | null | null | null | null | null | null | null | null |
b28ca67d-279b-5348-b23d-3bf82681febf
| 4 |
A
| 1 |
Which of the following areas is targeted by SCSs?
|
Dorsal columns
|
Lateral corticospinal tract
|
Botzinger complex
|
Peripheral nerves
|
以下哪个区域是SCSs的目标？
|
背柱
|
侧皮质脊髓束
|
Botzinger复合体
|
周围神经
| null | null | null | null | null | null | null | null | null | null |
36d8e04b-0c78-5c3c-9db0-983be7440eb5
| 4 |
B
| 2 |
A patient with a history of unresectable pancreatic cancer presents to your office because his current pain control regimen, Tylenol and hydromorphone (2- 4 mg every 4 h as needed), is no longer sufficient. He reports that when he
|
Opioid-induced hyperalgesia (OIH)
|
Pseudotolerance
|
Drug-seeking behavior
|
Addiction
|
一名有不可切除胰腺癌病史的患者来到您的办公室，因为他目前的疼痛控制方案（泰诺和氢吗啡酮，每4小时2-4毫克按需服用）已不再足够。他报告说，当他
|
阿片类药物诱导的痛觉过敏（OIH）
|
假耐受性
|
药物寻求行为
|
成瘾
| null | null | null | null | null | null | null | null | null | null |
e5a9b617-9172-5863-a319-fa4a9b457973
| 4 |
B
| 2 |
17. A patient with a history of prostate cancer with metastases to his spine causing back pain presents to your office. You have been managing his opioid prescriptions for over a year, and during that time he has required increasing doses of hydromorphone to treat his back pain. He currently takes 8-10 mg of dilaudid every 3 hours. When questioned about his pain, he describes a diffuse pain that affects his arms and legs. His back pain is also present. Which of the following receptors or family of receptors is thought to be involved in this phenomenon?
|
GABA-A
|
NMDA
|
GABA-B
|
Dopamine-2
|
17. 一名有前列腺癌病史并转移至脊柱导致背痛的患者来到您的诊所。您已经管理他的阿片类药物处方超过一年，在此期间他需要增加氢吗啡酮的剂量来治疗背痛。他目前每3小时服用8-10毫克的氢吗啡酮。当被问及他的疼痛时，他描述了一种影响手臂和腿的弥漫性疼痛。他的背痛也存在。以下哪种受体或受体家族被认为与这种现象有关？
|
GABA-A
|
NMDA
|
GABA-B
|
多巴胺-2
| null | null | null | null | null | null | null | null | null | null |
79575af3-9282-5407-803f-38efd5384065
| 4 |
A
| 1 |
In the perioperative period, patients maintained on Suboxone will most likely experience which of the following?
|
Increased postoperative opioid requirements
|
Increased sensitivity to opioids
|
Withdrawal symptoms within 24 hours of discontinuing Suboxone
|
Increased risk of postoperative delirium
|
在围手术期，使用Suboxone维持的患者最有可能经历以下哪种情况？
|
术后阿片类药物需求增加
|
对阿片类药物的敏感性增加
|
停用Suboxone后24小时内出现戒断症状
|
术后谵妄风险增加
| null | null | null | null | null | null | null | null | null | null |
dc4195a9-9b9c-56dc-bf01-cd684b66df31
| 4 |
B
| 2 |
Which of the following effects would be likely to occur after parenteral injection of Suboxone in a patient actively taking heroin?
|
Respiratory depression
|
Withdrawal
|
Euphoria
|
Miosis
|
在正在服用海洛因的患者中，注射Suboxone后可能会出现以下哪种效果？
|
呼吸抑制
|
戒断反应
|
欣快感
|
瞳孔缩小
| null | null | null | null | null | null | null | null | null | null |
f0845d9b-300d-5502-9249-c79d2e76f557
| 4 |
B
| 2 |
A 76-year-old man with pancreatic cancer and chronic abdominal pain admits to his pain specialist that he has been giving his son, who has chronic back pain, some of his oxycodone pills. Which of the following terms best characterizes
|
Abuse
|
Misuse
|
Pseudoaddiction
|
Addiction
|
一名76岁的男性患有胰腺癌和慢性腹痛，他向他的疼痛专科医生承认，他一直在给患有慢性背痛的儿子一些他的羟考酮药片。以下哪个术语最能描述这种行为？
|
滥用
|
误用
|
伪成瘾
|
成瘾
| null | null | null | null | null | null | null | null | null | null |
6f3ba33d-56eb-53e3-8e46-e28d6fef4bae
| 4 |
C
| 2 |
A patient with metastatic prostate cancer complains of back pain. He is found to have metastases to his vertebral bodies. He has no neurologic deficits. Which of the following is the first-line definitive treatment for this pain?
|
Physical therapy
|
Glucocorticoids
|
Radiation therapy
|
Surgical decompression
|
一名患有转移性前列腺癌的患者抱怨背痛。他被发现椎体有转移。他没有神经功能缺损。以下哪项是这种疼痛的一线根本治疗方法？
|
物理治疗
|
糖皮质激素
|
放射治疗
|
外科减压
| null | null | null | null | null | null | null | null | null | null |
59d5f9af-f03c-5751-a624-22acfcc80c2d
| 4 |
A
| 2 |
Which of the following would you expect to see in a patient receiving continuous thoracic epidural analgesia as compared with one receiving PCA with morphine after undergoing open nephrectomy?
|
Faster return of bowel function
|
Comparable requirements for antiemetic medications
|
Inferior pain control at the surgical site
|
Similar patient satisfaction
|
与接受吗啡PCA的患者相比，接受连续胸段硬膜外镇痛的患者在开放性肾切除术后，您预计会看到以下哪种情况？
|
肠功能更快恢复
|
对止吐药物的需求相当
|
手术部位的疼痛控制较差
|
患者满意度相似
| null | null | null | null | null | null | null | null | null | null |
1821b106-2db3-53f1-80c8-3ae17810686d
| 4 |
C
| 3 |
23. An immunocompromised patient undergoing treatment for lymphoma presents to the emergency department with altered mental status. He has recently tested positive for coccidiomycosis, and there is a concern that he has a disseminated infection. He undergoes a lumbar puncture, which is negative. His mental status clears later that night, but 2 days later he returns to the emergency department with a positional headache, consistent with a postdural puncture headache (PDPH). Every time he sits up, he reports severe pain and nausea. He fails treatment with rest, intravenous fluids, and medications. Which of the following epidural injections is most appropriate?
|
Normal saline
|
Autologous blood
|
Allogeneic blood
|
Autologous blood with fibrin glue
|
23. 一名免疫功能低下的患者正在接受淋巴瘤治疗，他因精神状态改变来到急诊科。他最近被检测出球孢子菌病阳性，担心他有播散性感染。他接受了腰椎穿刺，结果为阴性。当天晚上他的精神状态恢复正常，但两天后他因体位性头痛再次来到急诊科，这与硬膜穿刺后头痛（PDPH）一致。每次他坐起来时，他都报告有剧烈的疼痛和恶心。他在休息、静脉输液和药物治疗后无效。以下哪种硬膜外注射最合适？
|
生理盐水
|
自体血
|
异体血
|
自体血与纤维蛋白胶
| null | null | null | null | null | null | null | null | null | null |
13b35c56-d551-56b7-8df4-3162aa1c6562
| 4 |
C
| 1 |
A patient with unresectable pancreatic cancer presents for a celiac plexus block. Which of the following organs or structures does not receive innervation from the celiac plexus?
|
Biliary tract
|
Mesentery
|
Descending colon
|
Adrenal glands
|
一名无法切除的胰腺癌患者前来进行腹腔神经丛阻滞。以下哪个器官或结构不接受腹腔神经丛的支配？
|
胆道
|
肠系膜
|
降结肠
|
肾上腺
| null | null | null | null | null | null | null | null | null | null |
8ffcf6d7-8375-5e6d-a59c-1864ea4b81d7
| 4 |
D
| 1 |
A patient with unresectable pancreatic cancer presents for celiac plexus neurolysis via a posterior approach. He asks what the risks of the procedure are. Which of the following is the most common complications?
|
Constipation
|
Lower-extremity paralysis
|
Anterior abdominal pain
|
Orthostatic hypotension
|
一名无法切除的胰腺癌患者前来接受通过后路进行的腹腔神经丛神经溶解术。他询问该手术的风险是什么。以下哪项是最常见的并发症？
|
便秘
|
下肢瘫痪
|
前腹痛
|
体位性低血压
| null | null | null | null | null | null | null | null | null | null |
cf79ad7e-e318-51d8-8a7e-42b58cbbd8e2
| 4 |
A
| 1 |
When used for neurolytic blocks, compared with ethanol, which of the following is true about phenol?
|
Painless on injection
|
More effective
|
Provides a longer duration of block
|
More likely to cause hypotension
|
在用于神经溶解阻滞时，与乙醇相比，关于苯酚以下哪项是正确的？
|
注射时无痛
|
更有效
|
提供更长时间的阻滞
|
更可能导致低血压
| null | null | null | null | null | null | null | null | null | null |
3d0fe68e-b6d2-5e57-994b-b8f60b7ce900
| 4 |
C
| 2 |
According to the World Health Organization (WHO) pain ladder, what is the next treatment step for a patient who has inadequate pain control for back pain secondary to metastatic prostate cancer after trying Tylenol, ibuprofen, aspirin as well as multiple nonnarcotic adjuvant pain medications such as gabapentin, tizanidine, and lidocaine patches?
|
Paracetamol
|
Fentanyl patch
|
Tramadol
|
Morphine
|
根据世界卫生组织（WHO）疼痛阶梯，对于一名在尝试了泰诺、布洛芬、阿司匹林以及多种非麻醉性辅助止痛药如加巴喷丁、替扎尼定和利多卡因贴片后，仍然无法有效控制因前列腺癌转移引起的背痛的患者，下一步的治疗措施是什么？
|
对乙酰氨基酚
|
芬太尼贴片
|
曲马多
|
吗啡
| null | null | null | null | null | null | null | null | null | null |
3d317223-0b00-59dc-81a7-72d0e1de4267
| 4 |
A
| 1 |
Which of the following statements is most consistent with the WHO pain ladder?
|
The oral form of analgesics should be used over other forms whenever possible.
|
Analgesics should be given only as needed.
|
Standardized dosing of opioids should be used for adult patients.
|
Treatment of cancer pain should begin with an opioid medication.
|
以下哪项陈述最符合WHO疼痛阶梯？
|
应尽可能使用口服形式的镇痛药，而不是其他形式。
|
镇痛药应仅在需要时给予。
|
成人患者应使用标准化的阿片类药物剂量。
|
癌痛治疗应从阿片类药物开始。
| null | null | null | null | null | null | null | null | null | null |
094663f7-8328-53ee-b206-413d78293c2f
| 4 |
D
| 1 |
29. All of the following are part of the diagnostic criteria for fibromyalgia EXCEPT which one?
|
Allodynia to digital pressure at 11 or more of 18 anatomically defined tender points
|
A history of widespread pain for at least 3 months
|
A history of sleep disturbance
|
A history of radicular pain in both arms and legs
|
29. 以下哪一项不属于纤维肌痛的诊断标准？
|
在18个解剖学定义的压痛点中，11个或更多点对数字压力的异常痛觉
|
至少3个月的广泛疼痛史
|
睡眠障碍史
|
双臂和双腿的根性疼痛史
| null | null | null | null | null | null | null | null | null | null |
b5adba46-2e7d-5265-85c4-bc935af52943
| 4 |
A
| 1 |
Which of the following medications has been shown to be efficacious in the treatment of fibromyalgia?
|
Duloxetine
|
Amitriptyline
|
Pregabalin
|
Hydrocodone
|
以下哪种药物已被证明对治疗纤维肌痛有效？
|
度洛西汀
|
阿米替林
|
普瑞巴林
|
氢可酮
| null | null | null | null | null | null | null | null | null | null |
ec4db7a2-6149-5db7-9ee5-c0555176302f
| 4 |
D
| 2 |
Which of the following scenarios is suggestive of complex regional pain syndrome (CRPS) type II?
|
A patient burns his right foot and develops pain, hyperalgesia, and allodynia in his right lower leg that continues more than 6 months after his burn. His right foot is noted to be shiny and without hair.
|
A patient's right forearm is crushed by a falling object. She reports pain, hyperalgesia, and allodynia of the forearm more than a year later. Her forearm is noted to be shiny and without hair.
|
A patient's left forearm is crushed by a falling object. She reports pain, hyperalgesia, and allodynia of the forearm more than a year later. Atrophy of the muscles of the forearm is noted.
|
After surgery, a patient develops numbness over his right lateral thigh. He reports pain, hyperalgesia, and allodynia of the lateral thigh more than a year later. The area is noted to be shiny and without hair.
|
以下哪种情况提示复杂性区域疼痛综合征（CRPS）II型？
|
一名患者右脚被烧伤，出现疼痛、痛觉过敏和异常痛觉，持续超过6个月。其右脚被观察到发亮且无毛发。
|
一名患者的右前臂被坠落物体压伤。她报告前臂的疼痛、痛觉过敏和异常痛觉超过一年。其前臂被观察到发亮且无毛发。
|
一名患者的左前臂被坠落物体压伤。她报告前臂的疼痛、痛觉过敏和异常痛觉超过一年。观察到前臂肌肉萎缩。
|
手术后，一名患者右侧大腿外侧出现麻木。他报告大腿外侧的疼痛、痛觉过敏和异常痛觉超过一年。该区域被观察到发亮且无毛发。
| null | null | null | null | null | null | null | null | null | null |
f2144623-db6d-5262-8a59-56fd9842f1ae
| 4 |
A
| 1 |
What is the greatest risk factor for the development of postherpetic neuralgia (PHN)?
|
Increasing age
|
Male sex
|
Lack of a prodrome
|
Use of antiviral agents during acute herpes zoster infection
|
带状疱疹后神经痛（PHN）发展的最大风险因素是什么？
|
年龄增加
|
男性
|
缺乏前驱症状
|
在急性带状疱疹感染期间使用抗病毒药物
| null | null | null | null | null | null | null | null | null | null |
5b1207ed-673c-5753-bd89-239ab967a3a9
| 4 |
C
| 1 |
All of the following are risk factors for the development of phantom limb pain EXCEPT which one?
|
Preamputation pain
|
Depression
|
Distal amputation
|
Proximal amputation
|
以下哪一项不是幻肢痛发展的风险因素？
|
截肢前疼痛
|
抑郁
|
远端截肢
|
近端截肢
| null | null | null | null | null | null | null | null | null | null |
7b49ee47-4064-5909-b992-b3588e8521ff
| 4 |
A
| 1 |
Which of the following is most characteristic with facetogenic back pain?
|
Pain in the low back that radiates to the ipsilateral posterior thigh
|
Nonradiating pain in the low back
|
Pain in the ipsilateral buttocks
|
Numbness over the lower back
|
以下哪项最能表征关节突源性背痛？
|
下背部疼痛放射至同侧后大腿
|
下背部非放射性疼痛
|
同侧臀部疼痛
|
下背部麻木
| null | null | null | null | null | null | null | null | null | null |
6d569186-da48-5cda-8c82-c646487f6d0f
| 4 |
A
| 1 |
A patient with a history of pain in the lower back that radiates to his ipsilateral thigh presents to a pain clinic for a facet joint injection. Which nerve fibers innervate the facet joints?
|
Medial branch of the dorsal ramus of spinal nerve
|
Lateral branch of the dorsal ramus of spinal nerve
|
Lateral branch of the posterior cutaneous branch of the dorsal ramus
|
Medial branch of the posterior cutaneous branch of the dorsal ramus
|
一名有下背部疼痛病史的患者，疼痛放射至同侧大腿，来到疼痛诊所进行小关节注射。哪些神经纤维支配小关节？
|
脊神经背支的内侧支
|
脊神经背支的外侧支
|
背支后皮神经支的外侧支
|
背支后皮神经支的内侧支
| null | null | null | null | null | null | null | null | null | null |
0f4f642e-de0f-5fa9-aee3-a54447857675
| 4 |
A
| 1 |
36. Which of the following would you expect to find in a patient who presents with pain originating from the sacroiliac joint?
|
Back pain that radiates to the ipsilateral buttocks
|
Back pain accompanied by pain extending down the ipsilateral leg when the ipsilateral leg is passively raised straight in the air up to 60°
|
Numbness of the anterolateral thigh
|
Back pain accompanied by a leg length discrepancy
|
36. 患者出现来源于骶髂关节的疼痛时，您期望发现以下哪种情况？
|
放射至同侧臀部的背部疼痛
|
伴随疼痛的背部疼痛，当同侧腿被动抬高至60°时疼痛延伸至同侧腿
|
前外侧大腿的麻木
|
伴随腿长差异的背部疼痛
| null | null | null | null | null | null | null | null | null | null |
9f883f21-29c0-588d-96cd-c12594340b28
| 4 |
A
| 1 |
A patient presents with pain in the left buttock. He reports that he frequently carries his wallet in the left pocket and that his wallet is quite large. Furthermore, he sits on the wallet throughout most of the day at a desk job. You suspect piriformis syndrome and plan to inject a combination of local anesthetic and steroid. Which anatomic relationship between the piriformis muscle and the sciatic nerve is most common?
|
The undivided sciatic nerve passes below the piriformis muscle.
|
The divided sciatic nerve passes through and below the piriformis muscle.
|
The divided sciatic nerve passes through and above the piriformis muscle.
|
The undivided nerve passes through the piriformis muscle.
|
一名患者出现左侧臀部疼痛。他报告说经常把钱包放在左边口袋里，而且钱包很大。此外，他在办公桌工作时大部分时间都坐在钱包上。你怀疑是梨状肌综合征，并计划注射局部麻醉剂和类固醇的组合。梨状肌与坐骨神经之间最常见的解剖关系是什么？
|
未分开的坐骨神经经过梨状肌下方。
|
分开的坐骨神经穿过并经过梨状肌下方。
|
分开的坐骨神经穿过并经过梨状肌上方。
|
未分开的神经穿过梨状肌。
| null | null | null | null | null | null | null | null | null | null |
af21ea2e-c242-5b01-8790-e3fcc1417539
| 4 |
D
| 1 |
A 56-year-old man with a history of hypertension, chronic obstructive pulmonary disease, and diabetes presents for a lumbar epidural steroid injection (ESI) for lower-back pain that radiates into his right leg. He receives an injection of methylprednisone and lidocaine. Which of the following is most likely to occur after he receives this injection?
|
Arachnoiditis
|
Headache
|
Infection
|
Hyperglycemia
|
一名56岁的男性，有高血压、慢性阻塞性肺病和糖尿病病史，因下背部疼痛放射至右腿而接受腰椎硬膜外类固醇注射（ESI）。他接受了甲基泼尼松龙和利多卡因的注射。在他接受注射后，以下哪种情况最有可能发生？
|
蛛网膜炎
|
头痛
|
感染
|
高血糖
| null | null | null | null | null | null | null | null | null | null |
0ea3218a-2cd3-5223-b99b-28bcf73cf77d
| 4 |
B
| 1 |
Which of the following statements about new, acute onset low-back pain is most accurate?
|
Bed rest is recommended for up to 1 week.
|
In the absence of "red flag" symptoms, imaging is not indicated in the acute setting.
|
Opioids are the first-line therapy for this type of pain.
|
A short course of oral steroids may be helpful in treating this pain.
|
以下关于新发急性下背痛的陈述中哪一项最准确？
|
建议卧床休息长达1周。
|
如果没有“红旗”症状，急性情况下不需要影像检查。
|
阿片类药物是这种疼痛的一线治疗。
|
短期口服类固醇可能有助于治疗这种疼痛。
| null | null | null | null | null | null | null | null | null | null |
15705985-4e9b-5052-83ad-4226def8b51d
| 4 |
B
| 1 |
A patient presents to you with pain on the left side of her face. She states that the pain began a month ago and that chewing food is excruciating. She also notes the sensation of "shooting" pain on the left side of her face. Which of the following statements about this condition is most likely true?
|
Pain on the left side of the face is more common than the right side.
|
Involvement of the V1 distribution is uncommon.
|
Autonomic symptoms such as tearing or nasal discharge are common.
|
The most common first-line drug is oxycodone.
|
一名患者向您诉说左侧面部疼痛。她表示疼痛始于一个月前，咀嚼食物时疼痛难忍。她还注意到左侧面部有“电击”样疼痛感。关于这种情况，下列哪项陈述最有可能是正确的？
|
左侧面部疼痛比右侧更常见。
|
V1分布的受累不常见。
|
自主神经症状如流泪或流鼻涕很常见。
|
最常用的一线药物是羟考酮。
| null | null | null | null | null | null | null | null | null | null |
57420f6d-1618-5dd8-8d2c-fa431ca5a1cc
| 4 |
A
| 2 |
A 38-year-old man with a history of HIV well managed on antiretroviral agents presents with painful neuropathy in both feet. He describes the pain as burning and constant. It gets worse when he does his job as a postal carrier. Initially he responded to tramadol but no longer finds it helpful. Which of the following is the next most appropriate step to manage this patient's foot pain?
|
Further evaluate the patient's antiviral regimen.
|
Initiate antiepileptic therapy.
|
Perform an ESI.
|
Initiate oxycontin.
|
一名38岁的男性患者，既往有HIV病史，抗逆转录病毒药物控制良好，现出现双足疼痛性神经病变。他描述疼痛为烧灼感且持续存在。在从事邮递员工作时疼痛加重。最初他对曲马多有反应，但现在不再觉得有帮助。以下哪一项是管理该患者足部疼痛的下一个最合适的步骤？
|
进一步评估患者的抗病毒方案。
|
开始抗癫痫治疗。
|
进行硬膜外类固醇注射。
|
开始使用奥施康定。
| null | null | null | null | null | null | null | null | null | null |
f64f766d-abaf-5ac7-b306-cf6f0c39e490
| 4 |
B
| 2 |
42. In a patient taking methadone, which of the following is most likely to contribute to development of torsades de pointes?
|
Methadone dose of 10 mg a day
|
HIV
|
Male sex
|
Obesity
|
42. 在服用美沙酮的患者中，下列哪项最有可能导致尖端扭转型室性心动过速的发展？
|
每天10毫克的美沙酮剂量
|
艾滋病毒
|
男性
|
肥胖
| null | null | null | null | null | null | null | null | null | null |
549f1e72-f698-5e64-b18b-ad6f96ab6053
| 4 |
D
| 1 |
A lumbar sympathetic block is appropriate for diagnosis and/or treatment of all the following conditions EXCEPT which one?
|
CRPS type I of the right calf
|
Phantom limb pain of the left lower extremity
|
PHN of the right thigh
|
Coccydynia
|
腰交感神经阻滞适用于诊断和/或治疗以下所有情况，除了哪一种？
|
右小腿的CRPS I型
|
左下肢的幻肢痛
|
右大腿的PHN
|
尾骨痛
| null | null | null | null | null | null | null | null | null | null |
4626a62e-c709-588f-ac8f-35c085126cd6
| 4 |
B
| 1 |
Which of the following is the most likely cause of a "failed" spinal?
|
Resistance to local anesthetics
|
Displacement of the tip of a pencil-point needle
|
Dural ectasia
|
Use of lidocaine instead of bupivacaine
|
以下哪项最有可能导致“失败”的脊髓麻醉？
|
对局部麻醉药的抵抗
|
铅笔尖针头的尖端移位
|
硬膜外膨出
|
使用利多卡因代替布比卡因
| null | null | null | null | null | null | null | null | null | null |
702bbfa5-8a77-585e-bbc2-604af4c81492
| 4 |
B
| 2 |
An otherwise healthy 42-year-old patient who has received a spinal anesthetic for outpatient total knee arthroplasty reports severe pain in his legs and buttocks. The pain began a few hours after surgery and has persisted on the first postoperative day. Which medication was most likely used for the spinal anesthetic?
|
Bupivacaine
|
Lidocaine
|
Bupivacaine and fentanyl
|
2-Chloroprocaine
|
一名42岁健康患者在门诊全膝关节置换术中接受了脊髓麻醉，术后报告腿部和臀部剧烈疼痛。疼痛在手术后几小时开始，并持续到术后第一天。最有可能用于脊髓麻醉的药物是哪种？
|
布比卡因
|
利多卡因
|
布比卡因和芬太尼
|
2-氯普鲁卡因
| null | null | null | null | null | null | null | null | null | null |
69732d9c-fea6-5958-8ecc-7b326d8fd40d
| 4 |
A
| 1 |
Six months after undergoing a right inguinal hernia repair, a 27-year-old man presents to your office with continuing pain in the groin. He describes the pain as a constant burning sensation that is also occasionally sharp. He has seen his surgeon and does not have a recurrence of his hernia. Which of the following nerve blocks might be helpful in diagnosing this condition?
|
Genitofemoral nerve block
|
Pudendal nerve block
|
Transversus abdominus plane (TAP) block
|
Lateral femoral cutaneous nerve (LFCN) block
|
在接受右侧腹股沟疝修补术六个月后，一名27岁的男性来到您的诊所，抱怨腹股沟持续疼痛。他描述这种疼痛为持续的烧灼感，有时也会感到尖锐疼痛。他已经看过他的外科医生，并没有疝气复发。以下哪种神经阻滞可能有助于诊断这种情况？
|
生殖股神经阻滞
|
阴部神经阻滞
|
腹横肌平面（TAP）阻滞
|
股外侧皮神经（LFCN）阻滞
| null | null | null | null | null | null | null | null | null | null |
ea295afb-f89c-5889-9e3a-dd7498446130
| 4 |
D
| 1 |
The pudendal nerve can become entrapped at all the following locations EXCEPT which one?
|
Inside the Alcock canal
|
Between the sacrospinous and sacrotuberous ligaments
|
Across the inner margin of the falciform process of the sacrotuberous ligament
|
Inside the deep inguinal ring
|
阴部神经可能在以下所有位置受压，除了哪一个？
|
在Alcock管内
|
在骶棘韧带和骶结节韧带之间
|
跨过骶结节韧带的镰状突内缘
|
在深腹股沟环内
| null | null | null | null | null | null | null | null | null | null |
e7200a91-dcae-555a-b288-d3c14a0edd8e
| 4 |
A
| 1 |
Which of the following nerve blocks is associated with a nearly 100% chance of ipsilateral diaphragmatic palsy?
|
Superficial cervical plexus block
|
Infraclavicular block
|
Greater auricular nerve block
|
Axillary nerve block
|
以下哪种神经阻滞与几乎100%的同侧膈肌麻痹有关？
|
浅颈丛阻滞
|
锁骨下阻滞
|
大耳神经阻滞
|
腋神经阻滞
| null | null | null | null | null | null | null | null | null | null |
44c53a0b-b837-5e63-afa7-a9aaa745f040
| 4 |
A
| 1 |
49. Which one of the following is the benefit of transcutaneous electrical stimulation (TENS)?
|
It can be applied by the patient at home.
|
It has shown to be effective for chronic pain management.
|
It is cost-effective.
|
It improves the level of disability due to back pain.
|
49. 以下哪一项是经皮电刺激（TENS）的好处？
|
患者可以在家中自行使用。
|
已被证明对慢性疼痛管理有效。
|
具有成本效益。
|
改善因背痛导致的残疾程度。
| null | null | null | null | null | null | null | null | null | null |
cc880b64-ca00-5e77-ad82-bd6d7611b8ba
| 4 |
C
| 1 |
A 56-year-old type 1 diabetic man comes to your office to complaining of bilateral "stocking distribution" neuropathy. When questioned about his glucose control, the patient states that he normally maintains tight glucose control and he follows a strict low-carbohydrate diet. Which of the following is not a risk factor for development of peripheral neuropathy?
|
Poorly controlled blood glucose
|
Duration of diabetes
|
Gender
|
Patient age
|
一名56岁的1型糖尿病男性来到您的诊所，抱怨双侧“袜子分布”型神经病变。当询问他的血糖控制情况时，患者表示他通常保持严格的血糖控制，并遵循严格的低碳水化合物饮食。以下哪一项不是周围神经病变发展的风险因素？
|
血糖控制不佳
|
糖尿病病程
|
性别
|
患者年龄
| null | null | null | null | null | null | null | null | null | null |
2a963f14-08c2-57f0-a04a-394fa0e4583c
| 5 |
B
| 2 |
A 42-day-old infant is brought to the operating room (OR) for repair of hypertrophic pyloric stenosis. After appropriate rapid sequence induction and intubation of the trachea, the surgeons begin the procedure. One hour into the procedure you notice that the infant's body temperature has dropped from 37°C to 35.5°C. Which of the following is the LEAST effective method of maintaining thermal homeostasis in an infant?
|
Raising the room temperature from 24°C to 29°C
|
Running maintenance IV fluids through a fluid warmer
|
Wrapping the infant's head in plastic
|
Applying a forced-air warming device to exposed body areas
|
一名42天大的婴儿被送到手术室进行肥厚性幽门狭窄的修复手术。在适当的快速序贯诱导和气管插管后，外科医生开始手术。手术进行一小时后，你注意到婴儿的体温从37°C下降到35.5°C。以下哪种方法是维持婴儿热平衡最不有效的方法？
|
将室温从24°C提高到29°C
|
通过液体加温器加热维持静脉输液
|
用塑料包裹婴儿的头部
|
在暴露的身体部位使用强制空气加热装置
|
Using a circulating warm-water mattress
|
使用循环温水床垫
| null | null | null | null | null | null | null | null |
671ebcfb-737e-5c8c-913d-0a801b24b412
| 5 |
A
| 1 |
When considering premedication with midazolam in the pediatric patient, all of the following are true EXCEPT which one?
|
Midazolam's fast onset of action is due to its water insolubility.
|
Midazolam can be administered via the oral, nasal, intramuscular (IM), buccal, intravenous (IV), and rectal routes.
|
As age decreases, required midazolam dose in mg/kg for effective anxiolysis increases.
|
Oral midazolam has a bioavailability of 30% compared with IV administration.
|
在考虑对儿科患者使用咪达唑仑作为术前用药时，以下哪一项是错误的？
|
咪达唑仑的快速起效是由于其不溶于水。
|
咪达唑仑可以通过口服、鼻腔、肌肉注射（IM）、颊部、静脉注射（IV）和直肠途径给药。
|
随着年龄的减小，为达到有效的抗焦虑效果所需的咪达唑仑剂量（mg/kg）增加。
|
口服咪达唑仑的生物利用度为静脉注射的30%。
|
Time to peak plasma concentration of rectally administered midazolam is 15-20 minutes.
|
直肠给药的咪达唑仑达到血浆峰浓度的时间为15-20分钟。
| null | null | null | null | null | null | null | null |
e381e427-f640-59b2-b905-b9ababa26d5b
| 5 |
A
| 1 |
Of the various types of Mapleson circuits, which one has the fresh gas inflow furthest from the patient/T-piece?
|
Mapleson A
|
Mapleson B
|
Mapleson C
|
Mapleson D
|
在各种类型的Mapleson回路中，哪一种的新鲜气体流入点距离患者/T型管最远？
|
Mapleson A
|
Mapleson B
|
Mapleson C
|
Mapleson D
|
Mapleson E
|
Mapleson E
| null | null | null | null | null | null | null | null |
3e5f393d-c1e2-5e90-951b-3b50eceaac8b
| 5 |
D
| 1 |
Of the various types of Mapleson circuits, which has a spring-loaded pop-off valve located at the distal end of the circuit (furthest from the patient/Tpiece?)
|
Mapleson A
|
Mapleson B
|
Mapleson C
|
Mapleson D
|
在各种类型的Mapleson回路中，哪一种在回路的远端（离患者/T型管最远处）有一个弹簧加载的排气阀？
|
Mapleson A
|
Mapleson B
|
Mapleson C
|
Mapleson D
|
Mapleson E
|
Mapleson E
| null | null | null | null | null | null | null | null |
e53f568e-d77c-5d97-b666-be967cf74f30
| 5 |
D
| 1 |
5. The Bain modification is a coaxial circuit where fresh gas flows through an inner tube through the corrugated reservoir tubing of which Mapleson circuit?
|
Mapleson A
|
Mapleson B
|
Mapleson C
|
Mapleson D
|
5. Bain改良型是一种同轴回路，其中新鲜气体通过内管流经哪种Mapleson回路的波纹储气管？
|
Mapleson A
|
Mapleson B
|
Mapleson C
|
Mapleson D
|
Mapleson E
|
Mapleson E
| null | null | null | null | null | null | null | null |
a0f4806b-c919-584b-834e-71bacdfcdde6
| 5 |
D
| 1 |
All of the following are acceptable agents for induction of anesthesia in children EXCEPT which one?
|
Sevoflurane
|
Ketamine
|
Halothane
|
Desflurane
|
以下哪一种不是儿童麻醉诱导的可接受药物？
|
七氟醚
|
氯胺酮
|
氟烷
|
地氟醚
|
Methohexital
|
甲氧己妥
| null | null | null | null | null | null | null | null |
e71f8351-55a7-5521-8f3f-dd4a859784e1
| 5 |
C
| 2 |
When evaluating a 4-month-old for elective circumcision revision in the preoperative area, the patient's mother tells you that she fed the child expressed breastmilk fortified with formula powder 3.5 hours ago. According to the ASA NPO status guidelines, how many hours must pass between this feeding and the induction of general anesthesia?
|
2 hours
|
4 hours
|
6 hours
|
8 hours
|
在术前区域为一名4个月大的婴儿评估择期包皮环切术修正时，患者的母亲告诉你，她在3.5小时前给孩子喂了用配方奶粉强化的母乳。根据ASA禁食状态指南，从这次喂食到全身麻醉诱导之间必须间隔多少小时？
|
2小时
|
4小时
|
6小时
|
8小时
|
12 hours# The following vignette applies to questions 8, 9, and 10.A 2-year-old, 12.5-kg girl with history of a ventriculoperitoneal shunt that was placed in infancy for congenital aqueductal stenosis presents to your OR for emergent shunt revision in the setting of lethargy, vomiting, and irritability. Her parents tell you she "ate some crackers" 2 hours ago. The patient is otherwise healthy with no known drug allergies.
|
12小时# 以下情境适用于问题8、9和10。一名2岁、12.5公斤的女孩有婴儿期因先天性导水管狭窄而放置脑室腹腔分流管的病史，因嗜睡、呕吐和易怒的情况来到你的手术室进行紧急分流管修正。她的父母告诉你，她在2小时前“吃了一些饼干”。患者其他方面健康，无已知药物过敏。
| null | null | null | null | null | null | null | null |
3a3c9610-7da0-5c19-b581-6729697733a4
| 5 |
D
| 2 |
The MOST appropriate medication and dosage for neuromuscular blockade for rapid sequence intubation in this patient is which of the following?
|
Rocuronium 10 mg IV
|
Rocuronium 25 mg IV
|
Succinylcholine 12.5 mg IV
|
Succinylcholine 25 mg IV
|
在该患者的快速序贯插管中，最合适的神经肌肉阻滞药物及剂量是以下哪一项？
|
罗库溴铵 10 mg 静脉注射
|
罗库溴铵 25 mg 静脉注射
|
琥珀胆碱 12.5 mg 静脉注射
|
琥珀胆碱 25 mg 静脉注射
|
Succinylcholine 25 mg IM
|
琥珀胆碱 25 mg 肌肉注射
| null | null | null | null | null | null | null | null |
664227d1-ec09-5093-bb43-b1f461b45da8
| 5 |
D
| 2 |
The MOST appropriate blade and endotracheal tube for this patient would be which of the following?
|
Miller 1 blade, size 4.0 uncuffed endotracheal tube
|
Miller 1 blade, size 4.0 cuffed endotracheal tube
|
Miller 1 blade, size 4.5 cuffed endotracheal tube
|
Wis-Hipple 1.5 blade, size 4.0 cuffed endotracheal tube
|
对于该患者，最合适的喉镜片和气管导管是以下哪一种？
|
Miller 1号喉镜片，4.0号无袖套气管导管
|
Miller 1号喉镜片，4.0号有袖套气管导管
|
Miller 1号喉镜片，4.5号有袖套气管导管
|
Wis-Hipple 1.5号喉镜片，4.0号有袖套气管导管
|
Wis-Hipple 1.5 blade, size 5.0 uncuffed endotracheal tube
|
Wis-Hipple 1.5号喉镜片，5.0号无袖套气管导管
| null | null | null | null | null | null | null | null |
de9b812a-8b70-51d9-aaa1-dcd49045d801
| 5 |
C
| 2 |
After successful intubation and initiation of general anesthesia, you decide you would like to attempt to decrease the patient's chance of emergence excitation. With that in mind, which of the following would be the least appropriate choice for maintenance anesthesia?
|
Desflurane at 0.5 minimum alveolar concentration (MAC), dexmedetomidine infusion at 0.5 μg/kg/h
|
Propofol and fentanyl total IV anesthesia
|
Sevoflurane at 1.0 MAC, oxygen, and air
|
Isoflurane at 1.0 MAC, oxygen, and air
|
在成功插管并开始全身麻醉后，你决定尝试减少患者出现苏醒激动的几率。考虑到这一点，以下哪种维持麻醉的选择最不合适？
|
0.5最低肺泡浓度（MAC）的地氟醚，0.5 μg/kg/h的右美托咪定输注
|
丙泊酚和芬太尼全静脉麻醉
|
1.0 MAC的七氟醚、氧气和空气
|
1.0 MAC的异氟醚、氧气和空气
|
Ketamine infusion, 50% nitrous oxide/50% oxygen
|
氯胺酮输注，50%一氧化二氮/50%氧气
| null | null | null | null | null | null | null | null |
76ad2271-407e-530e-94ae-6137ab60861d
| 5 |
B
| 1 |
At what age is MAC of isoflurane the highest?
|
Newborn
|
6 months of age
|
12 months of age
|
2 years of age
|
异氟醚的最低肺泡浓度（MAC）在什么年龄最高？
|
新生儿
|
6个月大
|
12个月大
|
2岁大
|
5 years of age
|
5岁大
| null | null | null | null | null | null | null | null |
1ad7d2a8-7aa5-521b-bbfe-cc1df4271fab
| 5 |
D
| 1 |
One MAC of isoflurane in a neonate equates to what percentage of end-tidal isoflurane concentration?
|
0.9
|
1.1
|
1.3
|
1.6
|
新生儿中一MAC的异氟醚相当于多少百分比的呼气末异氟醚浓度？
|
0.9
|
1.1
|
1.3
|
1.6
|
2.2
|
2.2
| null | null | null | null | null | null | null | null |
23fcaf3d-b966-55b2-b14b-7d667b8e784e
| 4 |
D
| 1 |
When considering the relative ED95 in μg/kg of nondepolarizing neuromuscular blocking drugs (NMBDs), the impact of age on relative pharmacodynamics is which of the following?
|
Neonates require less than children who require less than adults.
|
Neonates require more than children who require more than adults.
|
Neonates require more than children, but children require less than adults.
|
Neonates require less than children, but children require more than adults.
|
在考虑非去极化神经肌肉阻滞药（NMBDs）相对ED95（μg/kg）时，年龄对相对药效学的影响是以下哪项？
|
新生儿所需剂量小于儿童，儿童所需剂量小于成人。
|
新生儿所需剂量大于儿童，儿童所需剂量大于成人。
|
新生儿所需剂量大于儿童，但儿童所需剂量小于成人。
|
新生儿所需剂量小于儿童，但儿童所需剂量大于成人。
| null | null | null | null | null | null | null | null | null | null |
53dd6d04-80a2-5a8a-8fa0-10063b96f01d
| 5 |
C
| 2 |
The estimated circulating blood volume of a 4-kg, full-term neonate is which of the following?
|
200 mL
|
240 mL
|
340 mL
|
420 mL
|
4公斤足月新生儿的估计循环血容量是以下哪一项？
|
200毫升
|
240毫升
|
340毫升
|
420毫升
|
480 mL
|
480毫升
| null | null | null | null | null | null | null | null |
6a087fa5-28a3-5012-ab0b-4351f9baecf3
| 4 |
C
| 1 |
The benefits of leukoreduction of donor blood products include all of the following EXCEPT which one?
|
Prevention of cytomegalovirus transmission
|
Prevention of nonhemolytic febrile transfusion reactions
|
Prevention of graft-versus-host disease
|
Prevention of human leukocyte antigen alloimmunization
|
供体血液产品的白细胞去除的好处包括以下所有选项，除了哪一个？
|
预防巨细胞病毒传播
|
预防非溶血性发热性输血反应
|
预防移植物抗宿主病
|
预防人类白细胞抗原同种免疫
| null | null | null | null | null | null | null | null | null | null |
cc965c1c-6450-51d5-b4e0-c9c9d87c18b9
| 5 |
D
| 2 |
A 2500-g infant is born at approximately 35 weeks' gestation to a woman who had received minimal prenatal care. Shortly after birth, the infant is noted to be tachypneic with respiratory rates in the 60s, an SpO2 of 85%, and a heart rate
|
Application of continuous positive airway pressure (CPAP), with ventilation goals titrated to an ETCO2 of 35-40 mm Hg
|
Application of CPAP, with ventilation goals titrated to an ET CO2 of 40-45 mm Hg
|
Intubation and pressure control ventilation, with ventilation goals titrated to ETCO2 of 40-45 mm Hg
|
Intubation and pressure support ventilation with permissive hypercapnia and peak inspiratory pressures <25 cm H20
|
一名2500克的婴儿在大约35周的妊娠期出生，其母亲接受的产前护理很少。出生后不久，婴儿被发现呼吸急促，呼吸频率在60次左右，SpO2为85%，心率
|
应用持续气道正压通气（CPAP），通气目标调整为ETCO2 35-40 mm Hg
|
应用CPAP，通气目标调整为ETCO2 40-45 mm Hg
|
插管和压力控制通气，通气目标调整为ETCO2 40-45 mm Hg
|
插管和压力支持通气，允许性高碳酸血症，峰值吸气压<25 cm H2O
|
Spontaneous ventilation with high-flow oxygen therapy via nasal cannula#### The following vignette applies to questions 17, 18, and 19.A 37-week infant is born uneventfully to a 39-year-old G3P2002 mother via normal spontaneous vaginal delivery. He is noted to have small palpebral fissures and mild hypotonia. 24 hours after birth, the infant has repeated vomiting of bilious emesis.
|
通过鼻导管进行高流量氧疗的自发通气
| null | null | null | null | null | null | null | null |
72155fef-1b52-58cf-95a0-24003eb9027d
| 5 |
B
| 1 |
17. Which of the following is the most likely cause of the emesis?
|
Pyloric stenosis
|
Duodenal atresia
|
Choanal atresia
|
Necrotizing enterocolitis
|
17. 以下哪一项最有可能是呕吐的原因？
|
幽门狭窄
|
十二指肠闭锁
|
后鼻孔闭锁
|
坏死性小肠结肠炎
|
Intussusception
|
肠套叠
| null | null | null | null | null | null | null | null |
5bd10b71-3dda-5346-8225-e8121694f394
| 5 |
D
| 1 |
Which of the following is the most common radiologic finding that would be seen in this infant during workup for bilious emesis?
|
Gastric bubble above the diaphragm
|
Multiple dilated loops of bowel
|
Pneumatosis
|
"Double-bubble" sign on X-ray
|
在对该婴儿进行胆汁性呕吐的检查中，以下哪项是最常见的放射学发现？
|
膈肌上方的胃泡
|
多处肠管扩张
|
肠壁积气
|
X光片上的“双泡”征
|
Target sign on abdominal ultrasonography
|
腹部超声上的靶征
| null | null | null | null | null | null | null | null |
8bc9fcb7-9320-5516-95d1-aa254d4f7541
| 5 |
C
| 2 |
The patient undergoes successful surgical repair in the neonatal period. At 6 months of age he returns for an esophagogastroduodenoscopy. He has appropriately fasted, and an inhalational induction is planned. While your resident is managing the airway, you attempt to place an IV. The patient slightly withdraws to the needle, so your resident increases the inhaled sevoflurane concentration from 4% to 8% to aid with depth of anesthesia. The
|
Hypotension
|
Tachycardia
|
Bradycardia
|
Decreased respiratory rate
|
患者在新生儿期成功接受了手术修复。在6个月大时，他返回进行食管胃十二指肠镜检查。他已适当禁食，计划进行吸入诱导。当您的住院医生管理气道时，您尝试放置静脉注射。患者对针头稍微退缩，因此您的住院医生将吸入的七氟醚浓度从4%增加到8%以帮助加深麻醉深度。
|
低血压
|
心动过速
|
心动过缓
|
呼吸频率降低
|
Increased tidal volume
|
潮气量增加
| null | null | null | null | null | null | null | null |
36d3e605-7377-5e69-a804-6134489c7316
| 5 |
E
| 1 |
Compared with adults, infants desaturate more quickly during induction of anesthesia because of which of the following?
|
Increased respiratory rate
|
Increased cardiac output in mL/kg/min
|
Decreased O2 consumption in mL/kg/min compared with adults
|
Decreased closing capacity
|
与成人相比，婴儿在麻醉诱导期间更快脱饱和是由于以下哪一项？
|
呼吸频率增加
|
每公斤体重每分钟的心输出量增加
|
与成人相比，每公斤体重每分钟的氧气消耗减少
|
闭合容量减少
|
Decreased functional residual capacity (FRC) in mL/kg
|
每公斤体重的功能残气量（FRC）减少
| null | null | null | null | null | null | null | null |
295c1a77-a534-5cbe-bfc9-e2eddad416e5
| 5 |
D
| 2 |
A 14-week-old infant, who was born at 36 weeks' gestational age, presents for elective repair of a right-sided inguinal hernia. He is otherwise healthy and does not have any known allergies, and his parents have not noted any symptoms that would indicate a recent upper respiratory tract infection. The infant did not spend any time in the NICU and has never had an apneic or bradycardic spell. The surgeon asks you about the patient's disposition after surgery. Which of the following is true?
|
Preterm infants who are less than 60 weeks' postconceptual age (PCA) need to undergo extended apnea monitoring after general anesthesia but not after light sedation with a natural airway.
|
This patient does not have a history of apnea or bradycardia and therefore does not meet criteria for postanesthetic admission for apnea monitoring.
|
This patient will need to be admitted for apnea monitoring after general anesthesia with the requirement that 24 hours of apnea-free time elapse before discharge.
|
Spinal and regional anesthesia without supplemental sedation does not abolish the need for postoperative apnea monitoring in former preterm infants less than 60 weeks' PCA.
|
一名14周大的婴儿，出生时孕龄为36周，现准备进行右侧腹股沟疝的择期修复手术。婴儿身体健康，无已知过敏，其父母未注意到任何表明近期上呼吸道感染的症状。婴儿未曾在新生儿重症监护室（NICU）停留过，也从未有过呼吸暂停或心动过缓的发作。外科医生询问您关于患者术后处理的意见。以下哪项是正确的？
|
胎龄小于60周的早产婴儿在全身麻醉后需要进行延长的呼吸暂停监测，但在自然气道的轻度镇静后则不需要。
|
该患者没有呼吸暂停或心动过缓的病史，因此不符合术后入院进行呼吸暂停监测的标准。
|
该患者在全身麻醉后需要入院进行呼吸暂停监测，并要求在出院前有24小时无呼吸暂停的时间。
|
在胎龄小于60周的早产婴儿中，单纯使用脊髓和区域麻醉而不辅以镇静并不能免除术后呼吸暂停监测的需要。
|
Prophylactic administration of caffeine is recommended for this patient after general anesthesia to prevent apnea.
|
建议在全身麻醉后为该患者预防性使用咖啡因以防止呼吸暂停。
| null | null | null | null | null | null | null | null |
c846e5f9-1434-57c2-ad29-7e10184e012c
| 5 |
A
| 2 |
Of the following pediatric surgical patients, which one would have the lowest risk of postoperative nausea and vomiting (PONV)?
|
A 3-year-old undergoing open reduction of a radial fracture
|
A 16-year-old undergoing hernia repair
|
A 5-year-old undergoing strabismus repair
|
An 8-year-old undergoing tonsillectomy
|
在以下小儿外科手术患者中，哪一位的术后恶心呕吐（PONV）风险最低？
|
3岁儿童接受桡骨骨折切开复位术
|
16岁青少年接受疝修补术
|
5岁儿童接受斜视矫正术
|
8岁儿童接受扁桃体切除术
|
A 12-year-old undergoing orchiopexy
|
12岁儿童接受隐睾固定术
| null | null | null | null | null | null | null | null |
a8a5b497-2309-51f3-8cc7-00efad9cc289
| 5 |
A
| 1 |
All of the following are efficacious in preventing and managing PONV in children EXCEPT which one?
|
Intraoperative fluid restriction
|
Ondansetron
|
Dexamethasone
|
Total IV anesthesia with propofol
|
以下哪一项在预防和管理儿童术后恶心呕吐（PONV）方面无效？
|
术中限制液体摄入
|
昂丹司琼
|
地塞米松
|
丙泊酚全静脉麻醉
|
Postoperative oral fluid restriction
|
术后限制口服液体摄入
| null | null | null | null | null | null | null | null |
1bc479c5-c92b-5020-86a8-0362582e7607
| 5 |
C
| 1 |
Considerations in anesthetizing a neonate with meningomyelocele include which of the following?
|
It is necessary to avoid succinylcholine because these patients are at higher risk for hyperkalemia.
|
There is high likelihood of a difficult airway.
|
Evaporative heat and fluid loss through the defect results in hypothermia and hypovolemia.
|
Defect should be repaired within 12 hours of birth to avoid infection and worsening neurologic damage.
|
在对患有脊髓脊膜膨出的新生儿进行麻醉时需要考虑以下哪些因素？
|
有必要避免使用琥珀胆碱，因为这些患者有较高的高钾血症风险。
|
很可能会遇到困难的气道。
|
通过缺损的蒸发性热量和液体损失会导致体温过低和低血容量。
|
为了避免感染和神经损伤恶化，缺损应在出生后12小时内修复。
|
Cardiac anomalies are commonly present.
|
常见心脏异常。
| null | null | null | null | null | null | null | null |
d5b1846d-23a7-528a-9e20-3ac4fdbb5101
| 5 |
A
| 1 |
A 12-day-old, 875-g infant born at 25 weeks' gestational age is brought to the OR for exploratory laparotomy for concern for necrotizing enterocolitis. The patient's vital signs on entry to the OR are notable for HR 160, RR 40, SPO2 of 98%, and BP 70/40. The patient has appropriate IV access, and the decision is made to do an awake intubation after administration of 1 µg/kg of fentanyl. The laryngoscopy is more difficult than anticipated, but successful tracheal intubation occurs within 60 seconds. Despite this, the infant desaturates during laryngoscopy from 98% to 65%. The SpO2 recovers with gentle positive pressure ventilation. With regard to the respiratory mechanics and anatomy of the newborn as compared with adults, which of the following is false?
|
Tidal volumes in mL/kg are decreased compared with adults.
|
FRC is equal in neonates and adults.
|
Neonates have a higher rate of O2 consumption in mL/kg/min.
|
Neonates have a higher closing capacity than adults.
|
一名12天大的婴儿，体重875克，出生时胎龄为25周，被送到手术室进行探查性剖腹手术，因担心坏死性小肠结肠炎。患者进入手术室时的生命体征显示心率160次/分，呼吸频率40次/分，血氧饱和度98%，血压70/40。患者有合适的静脉通路，决定在给予1 µg/kg芬太尼后进行清醒插管。喉镜检查比预期更困难，但在60秒内成功进行了气管插管。尽管如此，婴儿在喉镜检查期间血氧饱和度从98%下降到65%。通过轻柔的正压通气，血氧饱和度恢复。关于新生儿与成人相比的呼吸力学和解剖结构，下列哪项是错误的？
|
与成人相比，潮气量（mL/kg）减少。
|
新生儿和成人的功能残气量（FRC）相等。
|
新生儿的氧气消耗率（mL/kg/min）更高。
|
新生儿的闭合容量比成人高。
|
Neonates have a decreased total lung capacity (TLC) in mL/kg compared withadults.# The following vignette pertains to questions 26 and 27.A 3-year-old, 16-kg unvaccinated child presents to the emergency department with fever, dysphagia, and drooling. His parents attempted herbal remedies for his fever and sought medical evaluation once he started drooling out of fear that he had been accidentally poisoned by the herbs. Vital signs include HR 120, BP 90/50, RR 40, SpO2 98%, and T 39.8°C. On examination the patient is in visible respiratory distress, drooling, and sitting leaning forward on one arm.
|
与成人相比，新生儿的总肺容量（TLC，mL/kg）减少。
| null | null | null | null | null | null | null | null |
f2731419-9b20-57e3-9393-46091f83a013
| 5 |
D
| 1 |
26. Which of the following is the most likely diagnosis?
|
Fifth disease
|
Pneumonia
|
Foreign body ingestion
|
Epiglottitis
|
26. 以下哪一项是最可能的诊断？
|
第五病
|
肺炎
|
异物吞咽
|
会厌炎
|
Coxsackie virus
|
柯萨奇病毒
| null | null | null | null | null | null | null | null |
159c9ce3-8c5c-59b2-b780-02aeac60a4fa
| 4 |
D
| 3 |
27. The emergency department physicians decide that the child needs a secure airway, given that he is rapidly decompensating from a respiratory standpoint. The best strategy for airway management in this patient would be which of the following?
|
Immediate placement of an IV in the emergency department followed by rapid sequence intubation with pediatric anesthesia on standby
|
IM ketamine and glycopyrrolate, followed by IV placement and intubation in the emergency department with pediatric anesthesiology on standby
|
Expedited transfer to the OR with pediatric anesthesiologists followed by rapid sequence intubation with succinylcholine, propofol, and fentanyl
|
Expedited transfer to the OR, inhalational induction, and direct laryngoscopy with rigid bronchoscope and surgical personnel present on standby
|
27. 急诊科医生决定，由于孩子的呼吸状况迅速恶化，需要确保气道安全。对于该患者，气道管理的最佳策略是哪一项？
|
在急诊科立即放置静脉通路，然后在儿科麻醉师待命的情况下进行快速序贯插管
|
肌肉注射氯胺酮和东莨菪碱，然后在急诊科放置静脉通路并在儿科麻醉师待命的情况下进行插管
|
快速转移到手术室，由儿科麻醉师进行快速序贯插管，使用琥珀胆碱、丙泊酚和芬太尼
|
快速转移到手术室，进行吸入诱导，并在硬质支气管镜和外科人员待命的情况下进行直接喉镜检查
| null | null | null | null | null | null | null | null | null | null |
7868657c-40bc-5013-8e72-c3969930699a
| 4 |
A
| 2 |
A 7-day-old, 3.5-kg neonate with severe coarctation of the aorta has failed percutaneously repair in the catheterization laboratory and comes to the OR for an open repair. In addition to placing noninvasive blood pressure cuffs on both upper and lower extremities to monitor precoarctation and postcoarctation blood pressures, where should the pulse oximeter probe be placed in this patient?
|
Right upper extremity
|
Right lower extremity
|
Left upper extremity
|
Left lower extremity
|
一名7天大的3.5公斤新生儿患有严重的主动脉缩窄，在导管室的经皮修复失败后，来到手术室进行开放修复。除了在上下肢放置无创血压袖带以监测缩窄前和缩窄后的血压外，该患者的脉搏血氧仪探头应放置在哪里？
|
右上肢
|
右下肢
|
左上肢
|
左下肢
| null | null | null | null | null | null | null | null | null | null |
3f6aceb3-ea06-5a68-bd20-03f33122f62c
| 4 |
D
| 3 |
An 18-month-old, 12-kg child with hypoplastic left heart syndrome is following a
|
10 mL/kg crystalloid bolus
|
Hypoventilation, 100% oxygen
|
Transfusion of whole blood to achieve hematocrit of 39% from 33%
|
Hyperventilation with 100% oxygen
|
一名18个月大、12公斤的患有左心发育不全综合征的儿童正在接受以下哪种治疗？
|
10 mL/kg的晶体液推注
|
低通气，100%氧气
|
输注全血以将血细胞比容从33%提高到39%
|
用100%氧气进行过度通气
| null | null | null | null | null | null | null | null | null | null |
2ce7f3dd-d4a3-58b3-a8cc-8b4bebd5dcbe
| 4 |
A
| 3 |
A 3-year-old, 16-kg boy with unrepaired tetralogy of Fallot is presenting to the OR for repair. Preinduction vitals are BP 88/52, HR 100, and SpO2 90%. He receives sevoflurane and nitrous oxide for induction of anesthesia, followed by IV placement and rocuronium. Airway placement is unexpectedly difficult, and the patient's vitals after successful intubation are BP 69/40, HR 135, and SpO2 60% and falling, despite confirmation of ETCO2 and bilateral breath sounds. Which of the following would be an appropriate pharmacologic intervention?
|
Phenylephrine
|
Ephedrine
|
Lasix
|
Epinephrine
|
一名3岁、16公斤的男孩患有未修复的法洛四联症，现准备在手术室进行修复手术。诱导前生命体征为血压88/52，心率100，血氧饱和度90%。他接受了七氟醚和氧化亚氮进行麻醉诱导，随后进行静脉置管和注射罗库溴铵。气道置管意外困难，成功插管后患者的生命体征为血压69/40，心率135，血氧饱和度60%并下降，尽管已确认ETCO2和双侧呼吸音。以下哪种药物干预是合适的？
|
去氧肾上腺素
|
麻黄碱
|
呋塞米
|
肾上腺素
| null | null | null | null | null | null | null | null | null | null |
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