tgkuo1 Kuo's List: clinic

• oseltamivir

  • 流感治療及預防的藥物
• influenza A/New Caledonia (H1N1)

  • 流行的病毒株 Influenza A/New Caledonia H1N1
• This increase, as well as an increase over time in deaths from any cause attributed to influenza,⁶ occurred despite

  • 即使疫苗注射，發病、流行、住院率仍年年增加。
• One reason is that many older persons and persons with debilitating chronic conditions have a reduced ability to respond immunologically to the currently available influenza vaccines.¹

  • 疫苗注射失敗的原因。
• According to the Advisory Committee on Immunization Practices (ACIP),¹³ influenza vaccination is currently recommended for all persons 50 years of age or older, all children between 6 months and 18 years of age, and persons 19 to 49 years of age who have underlying medical conditions, are pregnant, are employed as health care workers, or are household contacts of high-risk persons (a group that includes all children in the household who are younger than 5 years of age)

  • 疫苗注射建議的對象。達85%。
• The province of Ontario, Canada

  • 安大略省成功的原因。
• In the past 5 years, a new variant that was not contained in the vaccine has been the major virus involved in 80% of the epidemics.

  • 疫苗因南北半球因素，導致新病毒株未被包括。
• For maximum effectiveness, the vaccine should be administered before influenza viruses begin to spread; structured programs for the delivery of the vaccine are needed.

  • 疫苗注射的時間及方式。
• Both the trivalent inactivated vaccine and the live attenuated influenza vaccine are well tolerated; the most common side effects are tenderness at the site of injection in the case of the trivalent inactivated vaccine and transient sore throat or nasal stuffiness in the case of the live attenuated influenza vaccine.

  • 常見的副作用。
• the live attenuated influenza vaccine

  • 減活性 效果較佳。
• real-time regional or community surveillance of influenza virus activity

  • 即時社區病毒活性監測系統

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• Jugular venous distention was 10 cm, measured at a 45-degree angle.

  • 頸動脈擴張的測量方式及意義
• A chest radiograph showed perihilar opacities and blurring of the pulmonary vasculature, findings that were consistent with interstitial edema.

  • Interstitial edema的意義及X光判讀。
• Vancomycin and clindamycin

  • 為何要使用這兩個藥物？
• This patient has severe sepsis, a diagnosis based on a temperature greater than 38.0°C, a heart rate of more than 90 beats per minute, respirations of more than 20 breaths per minute, a white-cell count of more than 12,000 per cubic millimeter, and evidence of organ dysfunction; the organ dysfunction places him at increased risk for death

  • 嚴重敗血症的定義。
• Septic shock is associated with a mortality rate of 30 to 50%

  • 敗血症的嚴重性及治療
• pulmonary capillary dysfunction

  • 新名詞 -> acute respiratory distress syndrome
• The third objective is to achieve adequate tissue perfusion, as measured by central venous oxygen saturation.

  • 第三目標導向治療：超加組識灌血量。
• timely and appropriate antibiotic administration has been shown to reduce the mortality rate significantly.

  • 抗生素治療也是很重要的。
• simple cellulitis

  • 手術的indication, 何謂Simple Cellulitis.
• Necrotizing fasciitis

  • Necrotizing fasciitis 的定義及病理發現。
• spontaneous, traumatic, or surgical disruption of bowel integrity

  • Necrotizing fasciitis 病源及好發位置。
• unfavorable prognostic sign

  • 預後不佳的sign.
• streptococcal toxic shock syndrome

  • Streptococcal Toxic Shock Syndrome的定義。
• those with low levels of specific antibodies against the infecting strain and against streptococcal superantigens produced by that strain

  • 好發的危險因子：MHC class II. Cytokines
• Clindamycin,

  • 治療應考慮Clindamycin的原因。
• Intravenous immune globulin

  • 免疫球蛋白
• hyperimmunoglobulinemia E syndrome

  • 病患免疫系統有問題。
• rattlesnakes

  • 響尾蛇鑑別。

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