49、 於 Aneurysms 或蜘蛛網膜下腔出血(SAH)的病人，下列何種徵候/症狀出 現時最需要優先考慮 vasospasm 的可能性？
(A) Fever
(B) Headache
(C) Drowsiness
(D) Motor weakness
(E) Sensory impairment

50、 下列何者最不會增加老年病人（＞65 歲）腦部對藥物的敏感度（brain sensitivity）? (A) Thiopental (B) Inhaled agents (C) Propofol (D) Midazolam (E) Morphine

51、 有關休克(shock)的徵候，下列何者最不可能？ (A) Pallor (B) Agitation (C) Widen pulse pressure (D) Diminished urine output (E) Tachycardia

52、 頭部外傷合併股骨頭（femoral head）骨折的年輕（＜40 歲）病患，下列 何者為緊急建立靜脈通道（IV line）最適當的部位？ (A) Large-bore antecubital vein (B) Internal jugular vein (C) Subclavian vein (D) Femoral vein (E) Intraosseous

53、 手術中採下列何種姿勢，病患最容易發生 hypotension ？ (A) Prone position (B) Trendelenburg position (C) Lateral oblique position (D) Lithotomy position (E) Supine position

54、 有關 critical illness myopathy（CIM）及 critical illness polyneuropathy （CIP）之敘述，下列何者最不恰當？ (A) Status asthmaticus 病患用 steroids 治療，會發生 CIM (B) 敗血症病患未曾接受 steroids 或肌肉鬆弛劑治療，也會發生 CIM (C) ICU 病人，嚴格控制血糖控制（≤ 110 mg/ml），對降低 CIP 沒有助益 (D) 可藉由電生理檢查及血清 creatine kinase 濃度來區分 CIM 或 CIP (E) 兩者的臨床預後（clinical outcome）相近

55、 A 45-year-old male patient received laparoscopic cholecystectomy. After60-min CO2 insufflation, intra-abdominal pressure was 14 mmHg. End-tidal CO2 was found to increase from 30 to 50 mmHg. SpO2 was 80% with airway pressure soared up to 40 cm H2O. Physical examination showed a reduction of breathing sound with hyperresonance over the right lung. In addition, slight swelling and crepitus were noted over anterior chest wall. The most likely diagnosis is: (A) Endobronchial intubation (B) Massive CO2 embolism (C) Pneumothorax (D) Capnothorax (E) Subcutaneous emphysema

56、 Postoperative delirium in the elderly is common. Which statement is least appropriate? (A) Hemodynamic complications such as hypotension, dysrhythmia are associated with its occurrence (B) Hypoactive type is more common than hyperactive type (C) Incidence is 5-10 % (D) The type of anesthesia is not related to the occurrence of delirium (E) Routine preoperative testing is not necessary

57、 At the end of the operation, neuromuscular blockade was antagonized under monitoring with a nerve stimulator. Unfortunately, your stimulator does not have a recording function. You have to combine other clinical tests for your judgment. Which of the following clinical test is least reliable to exclude the residual neuromuscular blockade? (A) Sustained head-lift for 5 seconds (B) Sustained hand-grip for 5 seconds (C) Maximum inspiratory pressure ≧ 40-50 cmH2O (D) Normal tidal volume (E) Sustained “tongue depressor test”

58、 A 68-year-old businessman was scheduled for laparoscopic cholecystectomy under general anesthesia. He had history of coronary artery disease and rheumatic heart disease with moderate mitral regurgitation. Preoperative cardiac evaluation showed ejection fraction of 40%. In consideration of anesthnetic care, which one is least appropriate? (A) Pre-operative preload augmentation (B) Nitroglycerin can be chosen to correct the reduction of cardiac output secondary to an increase of systemic vascular resistance. (C) Increased afterload is a major contributor to the altered hemodynamics seen during pneumoperitoneum (D) Normalization of hemodynamic is immediate soon after operation was completed (E) Accentuated vagal stimulation should be considered in patient taking β-blockers.

59、 During spine surgery, which monitor is most reliable to avoid spinal cord injury secondary to distraction of the spine? (A) Wake-up test (B) Somatosensory evoked potential (SSEP) (C) Electromyogram (EMG) (D) Motor evoked potentials (MEP) (E) Auditory evoked potential (AEP)

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