[2017醫師國考詳解-臨床醫學] 勘誤彙整區



  • 前言

    非常感謝大家使用2017的醫師國考詳解
    如果本書有任何不清楚或錯誤的地方
    還希望各位讀者能夠告訴我!
    我也會將這些勘誤修改的地方放於此處!

    勘誤內容

    (1) p1

    • 本題患者應該是constrictive pericarditis

    • 判斷原因:心臟無擴大、肝腎功能正常、回流不好

    • y descent和右心室的快速填充有關係,如果y很深,常見於constrictive pericarditis。若y不明顯,則常見於右心阻塞的狀況,如cardiac tamponade和tricuspid stenosis。

    • Constrictive pericarditis的特徵
      JVP升高、心搏過速、Pulsus paradoxus(不一定出現)、心包膜敲擊音(pericardial knock→心室填充在舒張早期突然停止所產生的聲音)、Kussmaul sign(吸氣時,系統靜脈壓升高)

    (2) p2 心搏過速的處置內容

    • 若患者沒有不穩定,則進入後續的流程

    • 規則+窄QRS

      • sinus tachycardia處理underlying
      • PSVT給adenosine (6mg-12mg-12mg)、vagal maneuver
    • 不規則+窄的QRS

      • 包括Atrial fibrillation、Multifocal atrial tachycardia、atrial flutter等
      • 可考慮給CCB、beta-blocker等
    • 規則+寬的QRS

      • 可能是Ventricular tachycardia或是SVT with aberrancy
      • 若為單型態、規則的QRS波,可以考慮給adenosine
      • 其他可考慮給amiodarone、sotalol、procainamide等
    • 不規則+寬的QRS

      • 可能是Afib with preexciatation、Afib with aberrancy、polymorphic VT
      • 若為Afib with preexciation,給了CCB/beta-blocker/digoxin,可能會誘發VT,造成患者死亡。因此看到不規則、寬的QRS,不能給這些藥物!可考慮給amiodarone、sotalol、procainamide等

    (3) p47.

    • 第三題的表格,第四列應該是『aldosterone antagonist』

    (4) p58.

    • 第五題詳解部分
      家族史中媽媽48歲死於"子宮頸癌" → 應改為"子宮內膜癌"

    (5) p76.

    • Syphilis是梅毒(內文的淋病為筆誤)

    (6) p131.

    • 阻塞的為智,應該是總肝管之下,總膽管之上

    (7) p.142

    • 詳解第二行
      但須小心和"盲腸"扭轉(cecal volvulus)產生的coffee-bean signs鑑別

    (8) p190.

    • VACTERAL的縮寫中,R應該為『renal』 and radius anomalies

    (9) p261.

    • misoprostol為人工合成的prostaglandin E1

    (10) p297.

    • Wegner是granulomatoiss with polyangitis;Churg-Strauss才是Eosinophilic granulomatosis with polyangitis

    (11) p312

    • 變色糠疹(汗斑)在Wood's lamp下應該是黃橘色

    (12) p363

    • 第8題,依照題幹的描述, 應該要懷疑家暴的可能性


  • P190.
    下方食道閉鎖合併的先天異常VACTERL的R
    應該是#Renal# or radius anomalies



  • P190.
    下方食道閉鎖合併的先天異常VACTERL的R
    應該是#Renal# or radius anomalies



  • P.261 第10題詳解
    (A) Misoprostol 應該是prostaglandin E1



  • P.131
    15題
    阻塞處應在總肝管之下 總膽管之上



  • P.76
    Syphilis 中文是梅毒 不是淋病



  • p.142 詳解第二行
    但須小心和"盲腸"扭轉(cecal volvulus)產生的coffee-bean signs鑑別



  • 雖然不是很重要
    不過p363 家醫科第8題 應該是懷疑家暴



  • p.58 第五題詳解部分
    家族史中媽媽48歲死於"子宮頸癌" → 應改為"子宮內膜癌"



  • p.118 第30題詳解第一行
    腦膜瘤由 "dura mater" → 應改為 "蜘蛛網膜的cap cell" 增生而來



  • P.167
    Parkland formula 後1/2的輸液應該是接續的「16」小時給完?



  • p.334 第六題詳解部分
    Type II: "缺氧型(ischemic)" → 應改為"椎弓解離型(isthmic)"



  • P.258 解析 Bishop score: station -3 -2 -1 嗎?



  • p.374 第五題詳解部分
    降低MAC: "低血壓" → 應改為"低血氧"
    血壓似乎對MAC無影響?



  • 不好意思..總共缺11題嗎?



  • 請問您的意思是?



  • P237 活菌疫苗應是間隔三個月後施打
    如果已打活菌疫苗要再打IVIG,才需間隔11個月



  • 不好意思看錯了,麻煩版主刪除><



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