24、 小兒心臟手術後常發生 pulmonary artery hypertension，下列處理原則何 者最不恰當?
(A) 經靜脈給予 NaHCO3 維持血中 pH 值 7.6
(B) 經氣管給予 100%氧氣
(C) 呼吸器給予 PEEP(positive end-expiratory pressure)約 3-5 mmHg
(D) 經靜脈給予 adenosine
(E) 給予呼吸 tidal volume 10-15 ml/kg 及呼吸次數為 25-35/min

60、 To prevent vasovagal reaction secondary to interscalene nerve block in arthroscopic shoulder surgery, which one is least appropriate? (A) Fluid loading (B) Intravenous atropine (C) Intravenons β-blocker (D) Intravenous glycopyrrolate (E) Abort the procedure

61、 Which one is least likely to be the systemic effects of tourniquet release in total knee replacement(TKR)? (A) Transient metabolic acidosis (B) Transient fall in central venous oxygen tension (C) Increased oxygen consumption (D) Release of acid metabolites into central circulation (E) Transient rise in core temperature

62、 In performing axillary plexus block, which of the following is the most likely structure marked “X” in the picture on the right : (A) Ulnar nerve (B) Radial nerve (C) Median nerve (D) Musculocutaneous nerve (E) Coracobrachialis muscle

63、 Which one is least likely to be the independent predictor of postoperative pulmonary complications in elective non-cardiac surgery? (A) Longer duration of general anesthesia (B) Age (C) Obesity (D) Surgical procedure (E) Postoperative nasogastric intubation

64、 Which of the following best describes the antagonization of non-depolarizing muscle relaxants? (A) Prolonged administration of cholinesterase inhibitors can lead to a myasthenia-like state (B) There is only one class of drug to reverse non-depolarizer-induced paralysis (C) Neostigmine has prejunctional effect to enhance the release of acetylcholine (D) An atropine-like drug is not necessarily administered (E) Mechanisms of all acetylcholinesterase inhibitors are identical

65、 A 3-year-old patient, body weight 12 kg, received right inguinal hernioplasty. The surgeon request that the anesthesiologist should use laryngeal mask airway (LMA) for anesthesia . Which one is the most appropriate size of LMA for this patient? (A) 1 (B) 1.5 (C) 2 (D) 2.5 (E) 3

66、 Which of the following statement most likely describes the physiologic and anatomical differences in pediatric patients? (A) Complete maturation of glomerular filtration occurred approximately 20 weeks after birth (B) Drug binding to albumin will not alter in the presence of hyperbilirubinemia (C) Shivering is the principal mechanism of thermogenesis (D) Coordination of swallowing with respiration occurred immediately since birth (E) The larynx is located lower in the neck compared with adults

67、 有關自然生產時產婦疼痛的描述，下列何者最不恰當？ (A) 產痛可藉由訓練而有效降低 (B) 經產婦(multiparous)的疼痛比初產婦高，但兩者都比 post-herpetic neuralgia 的疼痛大 (C) 第一產程的疼痛主要來自 T10-12和 L1 神經支配 (D) 第二產程的疼痛來自 S2-4 (E) 產痛是神經組織的相互作用，跟產婦的情緒無關

68、 有關產婦使用 opioids，下列描述何者最恰當？ (A) Fentanyl 是最常用的 opioids (B) Meperidine 最不易造成胎兒呼吸抑制(respiratory depression) (C) 靜脈給予 Fentanyl 後，此藥物不易穿過 placenta 造成胎兒的 sedation (D) Fentanyl 易造成 ominous sinusoidal FHR (Fetal Heart Rate)，影響婦產科醫 師的判謮 (E) Fentanyl 的止痛效果(作用在 μ-receptors)有 ceiling effect

69、 有關子癲前症(pre-eclampsia)病患的麻醉，下列敘述何者最不恰當？ (A) Airway 容易水腫，造成插管困難度提高 (B) 若患者已有 DIC (disseminated intravascular coagulation)時，避免使用 epidural 或 spinal 麻醉 (C) Fluid volume expansion 要非常小心，以免造成肺水腫 (D) Pulmonary wedge catheter 是必需的 monitor，可用於 fluid status 的評估 (E) Neuraxial anesthesia 比 general anesthesia 安全

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