untitled

年 理 療 類 療 ˍˍˍˍˍˍˍ 不 80 1.25 2 不 1 列 percussion 肋 tympanic 度 hyperresonance 2 列 CXR reverse S sign pericardial effusion with cardiac tamponade right upper lobe atelectasis with hilar lymphadenopathy pneumothorax dullness resonance massive pleural effusion 3 ICU CXR deep sulcus sign pericardial effusion with cardiac tamponade pneumomediastinum pneumothorax massive pleural effusion 4 列 COPD 行 spirometry flow-volume curve 降 FEV 1 prognosis 0.8 L 不 行 bronchodilator test 5 列 restrictive lung FVC forced vital capacity FEV 1 forced expiratory volume in 1 second FEV 1 /FVC ratio TLC total lung capacity 6 restrictive lung 異 量 D LCO CO diffusion capacity TLC total lung capacity 7 列 diffusion capacity 量 行 行 行 RV TLC 10 度 不 量 FEV 1 forced expiratory volume in 1 second FVC forced vital capacity 來 alveolar membrane pulmonary capillary membrane CO 8 bronchoalveolar lavage fluid neutrophil lymphocyte macrophage basophil

9 列 bronchoalveolar lavage culture 量 10 2 CFU/mL CFU colony-forming units PSB protect-sheath brush 量 10 3 CFU/mL bronchial biopsy 3~4 specimens TBNA transbronchial needle aspiration 來 mediastinal mass 10 列 metabolic acidosis 烈 ketoacidosis 量利尿 量 11 hemothorax 肋 hematocrit 50% 數 X 來 量 量 500 ml 12 2003 GOLD severe COPD 塞 FEV 1 /FVC 70% FEV 1 FEV 1 80% 50% FEV 1 80% 30% FEV 1 50% FEV 1 30% 13 GOLD 塞 COPD 行 復 stage I 度 stage II 度 stage III 度 stage IV 度 14 塞 列 FEV 1 1 L PaCO 2 65 mmhg PaO 2 55 mmhg 路 15 暴露 塞 理 spirometry X 16 塞 療 列 惡 不 FEV 1 力 exercise capacity 不 nebulizer 療來 量 metered dose inhaler 了 類 療 17 chronic bronchitisemphysema 狀 productive cough 狀 arterial hypoxemia 更 易 cor pulmonale 18 COPD PaO 2 降 PaCO 2 diffusion impairment 流 ventilation perfusion mismatch 流 intrapulmonary shunting 降 mixed venous oxygen saturation diminished

19 列 lung volume 量 FRC body plethysmography 來 body plethysmography shutter 來 panting airflow body plethysmography shutter 來 lung volume FRC body plethysmography shutter 來 airway resistance 20 列 不 塞 COPD neutrophil T 淋 T lymphocyte eosinophil macrophage 21 bronchiectasis 異 trachea and large bronchi 2 mm medium-size bronchi terminal bronchiole acini 22 列 狀 葉 理 見 coarse crackles 23 列 度 high resolutional CT chest ultrasonography X bronchoscopy 24 National Institutes of Health 類 度 severe persistent asthma 狀 1 流 異度 peak expiratory flow variability 20% 狀 1 流 異度 20~30% 狀 1 流 異度 20~30% 狀 流 異度 30% 25 列 類 易 - -blocker - -blocker 離 calcium-channel antagonists anticholinergic agents 26 列 不 Bacteroides melaninogenicus, Peptostreptococcus species 見 middle lobe lingual lobe 易 lung abscess empyema 咽 泌 27 AIDS 見 Aspergillus Streptococcus pneumoniae Pneumocystis carinii Mycobacterium tuberculosis

28 rejection Pseudomonas aeruginosa Cytomegalovirus Aspergillus Klebsiella pneumoniae 29 列 Pontiac fever Legionella pneumonia 了 狀 狀 療 30 Acinetobacter baumannii Klebsiella pneumoniae Moraxella catarrhalis Staphylococcus aureus 31 洞 cavity 療 10 2 10 4 10 4 10 6 10 7 10 9 10 10 32 列 例 尿 糖尿 33 列 葉 upper lobe apical posterior segment 葉 middle lobe medial lateral segment 葉 upper lobe superior lingular inferior lingular segment 葉 lower lobe anterior basal posterior basal segment 34 chronic mediastinitis 見 臨 clinical manifestation 塞 cardiac tamponade superior vena cava syndrome pneumomediastinum 肋 pleural effusion 35 靈 aspirin 量 low-molecular-weight heparin oral anticoagulants unfractionated heparin 36 塞 pulmonary embolism venous thrombosis 惡 nephrotic syndrome 37 pulmonary hypertension mean pulmonary arterial pressure mmhg 25 15 30 20 38 atopy IgE Churg-Strauss 狀 polyarteritis nodosa Wegener s granulomatosis microscopic polyarteritis

39 silicosis 暴露 不 惡 療 行 progressive massive fibrosis low lung field 見 40 塞 pulmonary embolism 見 sign hemoptysis tachypnea fever edema 41 primary pulmonary hypertension angiotensin converting enzyme inhibitors - 離 calcium channel antagonists nitroglycerin 42 asbestosis 列 肋 mesothelioma 43 列 來 狀 pulmonary alveolar proteinosis hypersensitivity pneumonitis bronchiolitis obliterans drug-induced interstitial lung disease 44 interstitial lung disease gold standard X 切 45 列 酪 noncaseating granuloma idiopathic pulmonary fibrosis systemic lupus erythematosus pulmonary tuberculosis sarcoidosis 46 列 acute pulmonary edema 量 narcotics overdose Guillain-Barre syndrome 勞 respiratory muscle fatigue pulmonary fibrosis 塞 pulmonary embolism 47 列 IPF idiopathic pulmonary fibrosis 不 40 70 惡 狀 clubbing fingercor pulmonale 療 類 neutrophil lymphocyte prognosis 48 列 ARDS 理 理 alveolar-capillary membrane permeability hyaline membrane macrophage 泌 cytokine hypoxemia vasodilatation

49 見 pneumomediastinum esophageal perforation 力 裂 alveolar rupture 刺 tracheobronchial perforation 50 連 flail chest 了 肋 2 3 4 6 51 連 列 paradoxical motion 泌 FRC functional residual capacity 52 了 理 inhalation injury X 53 列 inhalation injury 了 塞 量 療 -agonist 來 bronchospasm 來 30~50% 54 度 hyperventilation 療 PCO 2 28~30 mmhg 量 降 55 c-anca cytoplasmic antineutrophil cytoplasmic antibody Churg-Strauss 狀 polyarteritis nodosa Wegener s granulomatosis microscopic polyarteritis 56 肋 LDH 12 U/L total protein 1.3 gm/dl LDH 40 U/L total protein 5.0 gm/dl 塞 肋 57 列 chylothorax 惡 triglyceride 110 mg/dl 58 列 肋 mesothelioma 見 肋 肋 惡 來 惡 肋 切 肋

59 列 力 myasthenia gravis 10% myasthenia gravis 療 anticholinesterase agent thymoma 切 率 60 mediastinal tumors anterior middle posterior 率 列 61 mediastinum 神 neurogenic tumor 見 pheochromocytoma 神 ganglioneuroma 神 neuroblastoma 神 Schwannoma and neurofibroma 62 mediastinal tumors 見 狀 intrathoracic goiter 淋 lymphoma thymoma teratoma 63 行 TNM T 2 N 2 M 1 鱗狀 squamous cell lung cancer IV IIIB IIIA IIB 64 列 hypercalcemia adenocarcinoma small cell carcinoma 鱗狀 squamous cell carcinoma large cell carcinoma 65 葉 2 adenocarcinoma 肋 列 淋 臨 IV IIIB IIIA IIB 66 列 異 ectopic Cushing s syndrome ectopic corticotropin syndrome adenocarcinoma small cell carcinoma 鱗狀 squamous cell carcinoma large cell carcinoma 67 列 mediastinum germ-cell tumor 類 human chorionic gonadotrophin - alpha-fetoprotein 卵 yolk sac tumor teratoma choriocarcinoma embryonic cell carcinoma 68 mediastinal tumors 力 myasthenia gravis 類 thymic carcinoid thymic hyperplasia thymic carcinoma thymoma 69 mediastinum 見 germ-cell tumor choriocarcinoma 精 seminoma teratoma embryonic cell carcinoma

70 塞 obstructive sleep apnea syndrome 年 女 裂 狀 71 不 狀 snoring 尿 降 72 列 來 療 切 切 雷 73 列 REM intercostal muscle EMG intercostal muscle EMG 度 率都 律 率 降 度不 律 率不 律 74 hepatic vein portal vein inferior vena cava superior vena cava 75 respiratory syncytial virus, RSV 列 留 1 力 年 3~5 泌 留 10 力 76 列 oral appliance 療 long soft palate retruded mandible high mandibular plan angle 列 不 77 lung abscess E. coli 金 S. aureus -streptococci hemolyticus 都 etiology 療 療 數 2~3 4~8 thoracotomy 療 不 78 PPHN 列 hypoxia 糖 hyperglycemia lower ph shock 79 chest pain 見 塞 pulmonary embolism viral myocarditis musculoskeletal problems asthma 80 列 Guillain-Barre syndrome Guillain-Barre syndrome 狀 量 數量 異 plasmapheresis 復