2012

1. 1 ? 1. 2. 3. 4. 5.

) 2

2. ?1. Hot zone 2. Red zone 3. Warm zone 4. Blue zone 5. Cold zone

3. ?1. 2. 3. 95% 4. (-)5. (+), 17/min, pulse(+)

4. . . ?1. abdominal thrust .2. .3. .4. .5. 15:2 .

5. 60 . . BP 70/50, . ?1. X-ray check2. Lab W/U3. Fluid Tx4. Needle Rt.chest puncture5. ?

7. 8 . GCS?( ', ' .)1. 72. 83. 94. 105. 11

8. 24 5 3 , 2~3 . 4 1 . ?1. 2. 3. 4. 5.

9. ?1. 52. 103. 154. 205. 30

10. ? 1. 2. 3. 4. 5.

11. 38 , . . . ?1. .2. .3. .4. .5. .

12. 25 , . 3 . ?1. 2. 3. 4. 5.

13. 40 . , . . ?1. 2. 3. 4. 5.

14. 20 4 . . pH 7.0, pCO2 25, pO2 110, HCO3- 10, SaO2 99 . acetaminophen, aspirin, naproxen . ?1. 2. 3. 4. 5.

15. 60 Bp 180/130, high fever , 1 . WBC mild , CPK . Brain CT , . ?1. NaHCO32. Bromocriptin3. Benzodiazepine4. Naloxone5. Dantrolene flumazenil ..??

16. M/26 , , . . ?1. Fogarty .2. .3. .4. .5.

17. 72 Lt. flank pain . 30 . . v/s 90/50-111-28. ?1. Creatinine 2. 3. ammonia 4. 5. Hb18. ?1. CT 2. 3. (gr III)4. FAST 5. local wound exploration

: 2 relative indication

20. . ?1. . 2. .3. 4. ?5. ?

21. 26 HIV . ?1. .2. Zidobudine .3. 6 F/U .4. 2 -HIV 4 , 6 F/U .5. Zidobudine 6 F/U HIV (+) 2 -HIV .

22. 70 . 1 . 1. Td2. TIG3. Td, TIG4. 5. TIG penicillin 23. 56 . . ?1. .2. .3. .4. .5. .

24. 50 . . ?1. 2. 3. 2 4. 305. 119

25. BLS 2011 , , ?1. , 5cm , 1002. , 5~6cm, 100~1203. , 5~6cm, 100~120 4. 1/3, 5cm , 1005. 1/3, 5~6cm, 100~120

: 32011 PS) . 1/2, 5-6cm, 100-120/ 5 ?

27. - . ?1. 6cm, 120/2. PaCO2 60mmHg3. PETCO2 9mmHg4. 25mmHg5. ScvO2 40%28. 56 .BP 60/40, Pulse 180, 29, . ?1. 2. CCB 3. Beta Blocker 4. 50J 5.

29. 62 . 3 70/40mmHg . ?

( 4 . .)

30. 80/40, HR 130, FAST , . RSI ?1. 2. 3. 4. 5.

31. early goal-directed therapy ?1. (CVP) 903. ( Mixed venous oxygen saturation ) >65%4. Pulmonary capillary wedge pressure D-shape ?

:

33. brain CT indication ?1. 50 2. 20 3. 70 4. 50

34. . , , . ?1. 2. 3. 4. 5.

35. 43 1 . . check 200/120 . ?observation 50% .SBP < 185mmHg

36. 35 , . , . ?1. 2. brown-sequard syndrome3. 4. 5.

37. 25 . . ?1. 2. 3. 4. -hcg 5.

38. 50 . CT . ?

: Vancomycin + gentamycin( .)

: : Cefotaxime(2g IV every 6h) 3rd cefa. Trimethoprime-sulfamethoxazole + metronidazoleor chloramphenicol : high dose penicillin + metronidazole ( ) : vancomycin + nafcillin, G(-): cefatazidime : Cefotaxime 3rd cefa +metonidazole

39. 27 2 rib series 6 . ?1. 2. 3. 4. 5.

40. ?1. .2. 48 foley cath. .3. 4. x-ray .5. 2cm, 2cm .

41. BNP . ?1. 20%2. 30%3. 40%4. 50%5. 60%

42. 45 1 , 180/100, 100, X-ray , 20 , ?( , , , ) 1 ,,

43. 28 cardiac arrest . c/s ? 1. 22. 43. 64. 85. 10

) 4 Tint . 97p table 16-3)20 maternal arrest 5 perimortem c/s .

44. 10 DM, CRF 64 , . ?EKG : Junctional bradycardia, wide QRS .1. Diuretics2. Albuterol nebulizer3. Sodium bicarbonate4. Calcium gluconate5. Emergency hemodialysis

Tintinallis Emergency Medicine 7th edition, 123page, Table 21-13 hyperkalemia management . 123page hyperkalemia symptomatic hyperkalemia 3 phases . (1) membrane stabilization (2) Intracellular shift of [K+] (3) Removal/excretion of [K+] from the body , table onset of action, mechanism onset , membrane stablization calcium gluconate .( . )45. 3 . 150/80mmHg, 150/, 32/, 40.1 . ?

3 5 . Esmolol, Acetaminophen, Aspirin, propranolol, methimazole, Propylthiouracil .

) Antipyretics acetaminophen aspirin -blocker : esmolol selective 1-blocker -blocker Propylthiouracil, methimazole hormone synthesis

47. 81 . , , , . ?1. 2. 3. 4. 5.

48. ?1) 2) 3) 4) PT, PTT5) FBP

49. 40 1 . . ?

....50. FDA drug category .. ? 1. Category A2. Category B3. Category C 4. Category D5. Category X

: 4) The U.S. Food and Drug Administration lists five categories of labeling for drug use in pregnancy (Table 102-6)Table 102-6 U.S. Food and Drug Administration Categorization of Drug Risk in Pregnancy

Drug CategoryRisk during Pregnancy

AControlled studies have failed to demonstrate a fetal risk in the first trimester (and there is no evidence of risk in later trimesters), and the possibility of fetal harm is remote.

BEither animal studies have not demonstrated a fetal risk but there are no controlled human studies

or

Animal studies have demonstrated an adverse effect that was not confirmed in controlled human studies in women in the first trimester (and there is no evidence of risk in later trimesters).

CEither animal studies have revealed adverse effects on the fetus (teratogenic or embryocidal) and there are no controlled studies in humans

or

No human or animal studies are available. Drugs should only be used if the potential benefit justifies the potential fetal risk.

DEvidence of human fetal risk exists, but the benefits of use in pregnant women may be acceptable despite the risk.

XStudies in animals or humans have demonstrated fetal risk, or there is evidence of fetal risk based on human experience. The risk of use in pregnancy clearly outweighs any possible benefit. Drugs are contraindicated for use in women who are or may become pregnant.

51. 70 . V/S 70/40 pulse 100bpm X-ray .EKG ST elevation inferior lead, V1-4 Twave inversion () ?1. 2. 3. 4. 5.

52. 50 . 70/40-120-28-36.0 . ?1. 2. 3. 4. 5.

53. 78 100/70mmHg 100/ 18/ 37.8c ph 7.38 pco2 38mmHg po2 60mmHg CRP x ray ct ?(X-ray CT; air-fluid level of abscess cavity Lt lung abscess, Tin. Fig. 69-3 )

1. clindamycin + 2 cepha2. metronidazole3. 4. 5.

54. ?1. .2. .3. .4. .5. .56. R type) 39 35 . . 2 . .

) uterine rupture

57. R type) 70 3 , . . EF . EKG . EKG : A-fib

: 1. CCB 2. B-blocker 3. 4. 5. 6. 7. 8.

58. R type) 50 , dyspnea . CHF F/U BP 100/70, crakle XR pul.edema(+)ECG .( WPW ) ??

1. 2. 3. 4. 5. 6. 7. 8. DC cardioversion

59. R type) 60 3 . ( ) SPO2 90% ? ( ABGA/X ray/neck AP/Lat// )

60. R type) , . . . . ?1. 2. 3. 4. ABGA5. AP/Lat x-ray6. 7. ?8. ?