CNG N TP THIT B IN T Y SINH Chng 1: Tng quan, thut ng 1. Theo mc ch s dng thit b in t y t c phn thnh 3 loi : -Cc thit b chn on: thit b chn on chc nng( ECG,EEG,in c EMG; thit b chn thit b xt nghim ( huyt hc,sinh ha,nc tiu..) -Cc thit b iu tr: my thn nhn to,my to nhp,my x tr,my iu tr bng dng i -Cc thit b chm sc bnh nhn: my theo di bnh nhn, my h hp nhn to, my sc tim. 41. ECG l vit tt ca t : ElectroCardioGraph (my in tim) o v hin th tn hiu dng R 42.EEG l vit tt ca t ElectroEncephaloGraph (my in no) o v hin th tn hiu dng 43.EMG l vit tt ca t ElectroMyoGraph (my in c ) 50. Nhm cc thit b chm sc c bit c bn bao gm: my theo di bnh nhn patient moni ator, my sc tim defibrillator. 51. Nhm cc thit b chn on chc nng c bn bao gm : my in tim ECG, my in no E 52. Nhm cc thit b chn on hnh nh c bn gm cc thit b: my X quang( CR, DR); my lp in ton CT;my cng hng t MRI; my chp mch angiography; my chp ngc mammograp clear medicine ( PET,SPECT); ni soi Endoscopy; knh hin vi in t electronic microscope. 53. Nhm cc thit b iu tr c bn gm nhng loi my chy thn nhn to hemodialysis; m radiation thearapy; my iu tr bng dng in electronic therapy; my iu tr bng siu py; my iu tr bng laser therapy; my phc hi chc nng rehabilitation. 54. Nhm cc thit b xt nghim c bn gm nhng loi : my phn tch huyt hc hematology inh ha biochemistryanalyzer; my xt nghim nc tiu urine analyzer; my phn tch kh m nalyzer; my in di electropherogram analyzer; my in gii electrolyte analyzer; sc k ography; quang ph k spectrometer 75. Nheo c ch vn hnh v nguyn l hot ng thit b in t y t gm nhng loi: Thit hit b iu tr, Thit b phn tch Lab 77. Theo v tr t trong bnh vin thit b y t gm nhng loi: -Cc phng ban chc nng: my hp tit trng, my ra dng c -Khi iu tr: khoa ni (my siu m, my in tim), khoa ngoi (my gy m, my ph rung -Khi phi lm sng: khoa sinh ho (my xt nghim sinh ho, my ly tm), khoa huyt hc tr huyt hc) 78. Thut ng dng cho my in di trong y t l electropherogram analyzer 79. Thut ng dng cho my gy m km th l anesthesia 80. Thut ng cho my phn tch huyt hc: hematology analyzer 81. Thut ng dng cho my sc k l chromatography 82. Thut ng dng cho my sc tim defibrillator 83. Thut ng dng cho my to nhp : pacemarker 84.Thut ng dng cho my thn nhn to l hemodialysis 85. Thut ng dng cho my xt nghim nc tiu l urine analyzer 86. Thut ng dng cho my xt nghim quang ph k trong y t l spectrometer 87. Thut ng dng cho my xt nghim sinh ha l biochemistry analyzer 88. Thut ng dng cho thit b h hp nhn to ventilator 89. Thut ng dng cho my theo di bnh nhn l patient monotor

Chng 2: My theo di bnh nhn 18. Cc thng s c trng khi o thng s thng s NIBP trong monitor l: n v o ( mmHg u systolic l gi tr cao nht ( Cao) ; huyt p tm trng diastolic l gi tr thp nht g bnh. 19. Cc thng s c trng khi o SpO2 trong monitor: dng sng : th hin s thay i th thi gian; bo ha oxy SpO2 (%); nhp mch ( nhp/ pht) 20. Cc thng s c trng khi o tn hiu ECG trong monitor: o trnh; phc b QRS : mt rnh kh cc cc tm tht ca tim; on ST: l mt phn ca sng ECG th hin khong thi g tm tht ca tm tht ny v bt u qu trnh kh cc ca tm tht kia; nhp tim HR=60/RR( 21. Cc thng s c bn m thit b theo di bnh nhn theo di l: -o tn hiu in tim ECG hoc EKG : o nhp tim HR, on ST, phc b QRS ( t ECG) -o nhp th -o nng oxy bo ha trong mu SpO2: o nhp mch PR ( t SpO2) -o nhit TEMP -o huyt p khng can thip NIBP : o nhp mch PR t NIBP 37. o tn hiu nhp th, trong chun in cc AAMI, ngi ta dng 2 in cc: RA, LL.

38. o tn hiu nhp th, trong chun in cc EASI, ngi ta dng 2 in cc: I,A. 40. Thng s SpO2 trong thit b theo di bnh nhn ) nng bo ha oxy trong mu ) c rn tng s Hb c trong mu SpO2 %=100%x HbO2/( Hb+ HbO2) 63. Theo chc nng s dng thit b theo di bnh nhn gm nhng loi: -My theo di cm tay handheld pulse oximeter -My theo di ti ging bedside patient monitor -My theo di xch tay potable patient monitor -My theo di mang theo ngi handset monitor -My theo di thai nhi fatal maternal monitor -H thng theo di bnh nhn hu tuyn wired monitor system -H thng theo di bnh nhn v tuyn trn wireless monitor system. 68. Qu trnh o SpO2 trong thit b theo di bnh nhn hin nay ng dng nh lut Lambert I=Ioe-cd, trong : Io, I: l cng chm sng ban u v sau khi qua mi trng hp th : h s hp th quang, c: nng mtr (mol/l), d: dy mi trng nu mi trng hp th gm n thnh phn vi nng c1, c2,,cn ti bc sng th: A= n( bc sng. Vy cui cng ta c biu thc: SpO2= {((R)Hb- (IR)Hb)/ [((R)Hb- (R)HbO2)-( (IR)Hb- (IR)HbO2)}(R/ IR) vi R, IR l hp th ca nh sng v hng ngoi. 92. Phng php o SpO2 trong thit b theo di bnh nhn hin nay: -o p sut ring phn ca oxy trong mu thng qua my o kh mu. Phng php ny c nhc cch lin tc. -o khng can thit bng phng php hp th quang ( pulse oxymeter). Phng php ny o can thip vo c th bnh nhn, tin dng. o bng cch ng dng nh lut lambert beer v 98. Trong thit b monitor hin nay dng nhng chun in cc l: - Theo AAMI: RA, LA,LL, RL,V,V1-V6 - Theo EASI: I, S, A, N,E - Theo IEC: R,L,F,N,C,C1-C6 99. Trong vic thu nhn tn hiu ECG thit b theo di bnh nhn thng thu nhn nhng - 3 o trnh mu: I,II,III. - 3 o trnh n cc cc chi: aVR, aVF, aVL. - 6 o trnh trc tim: V1-V6.

Chng 3: My xt nghim 9. Cc lnh vc chnh ca xt nghim bao gm nhng xt nghim: XN sinh ha,XN huyt hc, vi t, XN ngn hng mu 11. Cc loi ha cht dng trong phn tch huyt hc hin nay gm c : cht Lytic, cht p 14. Cc phng php phn tch dng trong my my xt nghim sinh ha l: : p2 phn tch i hn tch ng hc 2 im; p2 o mu; p2 phn tch quang ph. 64. Phn loi theo chc nng trong xt nghm mu bch cu c 3 loi l : -To khng th lymphocyte -Truyn thng tin monocyte -Thc bo : Monocyte, Eosinophil, Neutrophil( thc bo sau cht), Basophil( thc bo sau 65. Phn loi theo kch thc bch cu c 3 loi : -LYM: lymphocyte ( 35-90 fl) -MID: monocyte ( 90-400fl) -GRAN: eosinophil, neutrophil, basophil ( 90-135fl) 74. Theo chc nng my xt nghim gm nhng loi: XN sinh ha; my m huyt hc; my phn h; my m gamma dng trong min dch; my o chc nng tiu cu. 76. Theo nguyn l hot ng my xt nghim gm nhng loi: -Da theo nguyn l o quang : my xt nghim sinh ha, nc tiu -Da theo nguyn l in: my m huyt hc -Da theo nguyn l bc x photon: my m gamma dng trong min dch. 91. Nguyn l m cc t bo mu dng trong phn tch huyt hc: -Dng knh hin vi : dng mt thng m s t bo qua knh hin vi, cc t bo mu phi -Phng php in t: cc t bo l lng trong mu khi chuyn qua khe m lm cn tr dng m cc. khi tr khng thay i kch thc ca t bo c xc nh bi cc xung ,chiu cao xun -Phng php laser :da trn s tn x ca nh sang khi t bo i qua ,gc tn x thay i 93. Trong cc t bo mu loi c kch thc nh nht l tiu cu( ng knh 1-4 micromet,

94. Trong cc t bo mu loi c s lng t nht l bch cu (7000/mm3 i vi nam; 6800/m 95. Trong cc t bo mu loi c s lng nhiu nht l hng cu (4.5-5 triu/mm3 i vi n 97. Trong phn tch mu phi pha long trc khi phn tch v : Th nht, pha long mu trnh hin tng ng mu nhanh. Th hai, do s lng cc phn t hng cu, tiu cu v bch cu trong mu rt ln nn cn p v khng b nhm ln. < Th 3, do trong my m thng chia ra m tiu cu, bch cu ring, hng cu v SpO2 ri thnh 2 nhnh m do khi m hng cu v o SpO2 cn phi ph v hng cu> 100. Trong xt nghim dch no ty hin nay ngi ta thng xc nh cc thng s: nh l

101. Trong xt nghim mu hin nay ngi ta thng xc nh cc thng s: -Cc thng s v hng cu : s lng hng cu RBC; th tch trung bnh ca hng cu MCV; ph )-PCV ( packed cell volume); lng huyt sc t hemoglobin HGB; lng huyt sc t trung b ; nng MCH (MCHC) -Cc thng ss v tiu cu: s lng tiu cu PLT; th tch trung bnh tiu cu MPV; PCT( p cu; LPCR t s tp trung tiu cu ln -Cc thng s v bch cu: bch cu loi LYM; bch cu loi MID; bch cu loi GRA. 102. Trong xt nghim nc tiu hin nay ngi ta thng xc nh cc thng s nh lng p 103. Trong xt nghim fl l n v o th tch hng cu, bch cu v tiu cu. Fl- Femoliter ( Cubic Micrometer ) = 10E -15 lt 105. Vic xt nghim cc thng s trong my xt nghim huyt hc ngi ta thng dng cc p i ; phng php so mu ; phng php in t ; phng php laser 106. Vic xc nh cc thng s trong my xt nghim sinh ha ngi ta thng s dng cc ouguer-lambert) ; cc phng php : phng php phn tch im cui, phng php phn tch im, phng php o mu, phng php phn tch quang ph. 107. Vi my xt nghim huyt hc hin nay ngi ta thng phn ra gm 2 loi : my xt ngh logy analyzer ; my xt nghim huyt hc bn t ng semiauto hematology analyzer. 108. Vi my xt nghim sinh ha hin nay ngi ta phn ra thnh 2 loi : my xt nghim si emistry analyzer ; my xt nghim sinh ha bn t ng semiauto biochemistry analyzer.

Chng 4 : My chy thn nhn to 13. Cc phng php iu tr bnh thn hin nay l: chy my thn nhn to; chy my lc m 26. Nhng loi my chy thn nhn to hin ang c s dng l: 28,31. CVVH l vit tt ca nhng t continuous veno venous hemofiltration ( siu lc lin mch ) trong my chy thn nhn to : loi b lng nc t mu bng siu lc, nhng cht sung nc vo mu trc khi quay v bnh nhn. 29,32. CVVHD l vit tt ca t continuous veno venous hemodialysis ( khuych tn lin tc h) trong my chy thn nhn to : cht rn c loi b bng vic khuch tn vo dch lc,c 30,33. CVVHDF l vit tt ca t continuous veno venous hemodiafiltration ( khuch tn siu tc tnh tnh mch) trong my chy thn nhn to: kt hp gia CVVH v CVVHD 34. c im ca phng php lc SCUF ( slow continuous ultrafiltration Siu lc chm lin tc) trong thn nhn to l loi b nc t mu bng siu lc, khng lo 48. Cc c im ca mng bng : mng bng c tc dng lc mu tng t thn; mng bng c bng 1.5-2m3; cc c ch khuch tn v siu lc t nhin. 55. Cc hin tng xy ra trong qua trnh lc mu thn nhn to l: hin tng khuch tn lc. 69. SCUF l vit tt ca t slow continuous ultrafiltration Siu lc chm lin tc) trong thn nhn to l loi b nc t mu bng siu lc, khng lo 112. ngha ca t ng tnh mch v tnh tnh mch trong chy thn nhn to ngha l ng mch ti nt tht khi m mng ngn gia ng mch v tnh mch ko cn nguyn vn. Tnh t nhn.

Chng 5 : Thit b vt l tr liu 8. Cc ch iu tr s dng trong thit b siu m iu tr l: tip xc trc tip gia iu tr kt hp dng thuc. 10. Cc loi dng iu tr thng dng trong iu tr in hin nay: Dng in mt chiu u, Dng xung hnh ch nht, Dng xung hnh tam gic- faradic, Dng xu h sin, Dng xung 2-5 trabert, ultrareiz, Dng xung giao thoa- interferential, Nemec, Dng TENS, Dng kch thch Nga, Dng cao tn 16. Cc thit b vt l tr liu hin nay gm nhng nhm thit b:

iu tr bng in, iu tr bng t, iu tr bng siu m, iu tr bng laser, iu tr 27. Cng chm tia siu m dng trong iu tr thng s dng trong khong: 0.3 n 3W/c 39. trnh vic quen trong my iu tr in ngi ta dng mt s bim php: lin tc tn dng in) ; gii hn thi gian iu tr. 56. Nhng hiu qu khng tch cc ca chm tia siu m ln c th l : h hi m, tc t da.. 57. Nhng hiu qu tch cc ca chm siu m ln c th l: kch thch tun hon mu; th g g ti sinh cho m; gim au.. 58. Nhng tc ng c hc ca chm tia siu m ln c th l: lm thay i th tch cc t thm ca mng t bo v m; kch thch qu trnh trao i cht. 59. Nhng tc ng nhit ca chm siu m trn c th l : siu m lm tng nhit ti c ..; vic tng nhit l mt yu t quan trng trong s pht trin ca mt s qu trnh si 66. Phn ng chung ca c th khi cho dng in trong my iu tr chy qua gm nhng giai on co c; giai on au;hin tng thch nghi 96. Trong my siu m iu tr ngi ta thng s dng loi tn s 1Mhz v 3 Mhz

Chng 6: My h hp nhn to 4. AMV l vit tt ca t assist mandatory ventilation ( h hp nhn to h tr) trong my hc ny ngh l bnh nhn t mnh to nhp th cn my lm nhim v h tr. Tuy nhin khi b uyn sang phng thc iu khin. 6. APRV l vit tt ca t airway pressure release ventilation ( h hp nhn to vi p lc k) l mt phng thc mi c a vo s dng kim sot lc trung bnh ng dn kh. ra nhng thay i thang p lc dng cui k th ra. 7. BIPAP l vit tt ca t Biphasic positive airway pressure ( h hp nhn to vi p lc trong my h hp nhn to. 17. Cc thng s k thut c bn ca my h hp nhn to thng dng hin nay: th tch lu s th( nhp th); nng oxy; nhy ; gii hn p lc; h thng bo ng; to nhitk v 23. CFV l vit tt ca t continuous flow ventilation ( h hp nhn to vi dng chy lin h hp nhn to) 24. CMV l vit tt ca t controlled mandatory ventilation ( h hp nhn to iu khin) t to: y l phng thc h hp nhn to bt buc ngi bnh th di s iu khin ca my 44. Hn hp kh gy m trong my gy m km th hin nay dng nhng cht : N2OH2O->N2O->OH 2-O-CH2-CH3; clorofoc CH3Cl3; halothan CF3-CHClB3. cc loi cht gy m ny chuyn ha tron rt phc tp, chng tc ng ln mng t bo v thn kinh,km hm s trao i cht lm bnh 45. IMV l vit tt ca nhng t intermittent mandatory ventilation ( h hp nhn to ngt my h hp nhn to : l phng thc kt hp gia iu khin vi h hp t nhin, nhm lm bnh nhn. 46. IPPB l vit tt ca intermittent positive pressure breathing ( h hp nhn to vi p g) trong my h hp nhn to 61. PC l vit tt ca t Pressure Controlled c ngha l qu trnh cung cp kh h hp c p sut. 67. PSV l vit tt ca nhng t: pressure support ventilation ( h hp nhn to h tr p hn to PSV l thng kh h tr p lc dng dng kh, trong bnh nhn t to nn nhp th 70. SIMV l vit tt ca t pressure intermittent mandatory ventilation ( h hp nhn to ) trong my h hp nhn to : ci tin ca IMV khi nhp th iu khin khp vi nhp th sn v ch bt u th th vo khi bnh c s n lc th vo. 71. Theo cch phn loi hin nay my gy m km th gm nhng loi: -Kiu h: l kiu kh th ra c thi ra ngoi hon ton, kh vo l kh mi -Kiu kn: kh th ra c a vo bnh hp th CO2 sau a tr li phn th vo -Kiu na kn na h: l kiu c lp thm mt s van iu chnh p lc trn ng th ra 72. Theo chc nng iu khin thng dng hin nay my h hp nhn to gm nhng loi: my to iu khin th tch. 73. Theo chc nng s dng my h hp nhn to gm 2 loi: my h hp nhn to dng trong ic gy m. 90. Cc phng thic h hp nhn to thng dng trong cc my th hin nay: -H hp nhn to iu khin CMV (Controlled Mandatory Ventilation) -H hp nhn to h tr AMV (Assist MV) -H hp nhn to h tr /iu khin A/CMV -H hp nhn to ngt qung IMV ( Intermittent MV) -H hp nhn to ng b ngt qung SIMV (synchronized IMV)

-H -H -H -H -H -H

hp hp hp hp hp hp

nhn nhn nhn nhn nhn nhn

to to to to to to

h tr p lc PSV (Pressure support ventilation) vi p lc gim theo chu k APRV (Airway pressure release ventilation) iu khin p lc PC (Pressure controlled) vi p lc dng tnh 2 pha BIPAP (Biphasic Positive Airway Pressure) vi p lc dng ngt qung IPPB (Intermittent Positive Pressure Breathing vi dng chy lin tc CFV (Continuous Flow Ventilation)

Chng 7: My sc tim 60. Nhng xung dng trong sc tim bn ngoi hin nay gm : xung hnh sin; xung hnh thang. 62. My sc tim chia lm 4 loi : my sc in xoay chiu ( AC defibrillator); my sc in ibrillator); my sc in ng b ( synchronozized defibrillator); my sc in km monitor 82. Thut ng dng cho my sc tim trong y t l : Defibrillator Chng 8: My to nhp 2. AAI c ngha l to nhp nh theo yu cu. trong my to nhp 3. AICD l vit tt ca t automatic implantable cardioverter defibrillator( my chuyn nh rung t ng) l loi my kt hp gia my sc v my to nhp tr ri lon nhp tim, n au t ng sc in phc hi li nhp xoang. 5. Trong my to nhp AOO ngha l ch to nhp nh c nh. 12. Cc m hiu dng cho my to nhp hin nay l: -V: ventricle( tht) -A: atrium (nh) -I: inhibit( c ch) -T: triggered ( khi kch) -D: dual ( hai bung) -S: single ( mt bung) -R: responsive( p ng tn s) -O: khng c chc nng. 15. Cc phng php to nhp trong my to nhp: -To nhp mt bung tim ( tht hoc nh) : to nhp tht c nh VOO, to nhp tht theo nh dng khi kch VVT, to nhp tht theo tn s nh VDD, to nhp nh c nh AOO, to nhp -To nhp hai bun tim ( c tht v nh): to nhp nh tht ng b DDD, to nhp nh tht -To nhp p ng tn s DDDR 22. Cc v tr c th t my chuyn nhp v ph rung t ng ( AICD) trn c th l t 25. Nhng loi my to nhp thng c dng hin nay l: my to nhp mt bung tim tht my to nhp hai bung tim DDD, my to nhp p ng tn s tht VVIR, my to nhp p tim p ng tn s DDDR, my to nhp kch thch tht nhn cm nh v tht theo dng tn s VDDR 35. DDD ngha l phng php to nhp nh tht ng b ( trong to nhp hai bung tim) ca 36. DDI c ngha l phng php to nhp nh tht ng b dng c ch ( trong to nhp hai 47. M hiu ca my to nhp hin nay c dng theo tiu chun NASPE/BPEG (NBG)- north ame f pacing and electrophysiology/ Britishpacing and electrophysiology group. 49. My to nhp v ph rung t ng hin nay gm 2 loi : my to nhp ph rung t ng m bung. 104. VDD trong my to nhp ngha l to nhp tht theo tn s nh. 109. VVI trong my to nhp ngha l to nhp tht theo nhu cu. 110. VVO trong my to nhp c ngha l to nhp tht c nh 111. VVT trong my to nhp c ngha l to nhp tht theo dng khi kch Cu 120. Theo mc ch s dng ngnh in t y t, thit b in t y sinh phn thnh nhng ay. -Thit b chn on, thit b iu tr, thit b chm sc c bit -Thit b chn on: + Chn on chc nng nh my in tim, in no, in c.. + Chn on hnh nh: X_quang, Siu m, ct lp in ton (CT), + Thit b xt nghim: Xt nghim sinh ha, xt nghim huyt hc, -Thit b iu tr: iu tr bng dng in, iu tr bng siu m, my thn nhn to, my -Thit b chm sc c bit: theo di bnh nhn, my h hp nhn to, my sc tim Cu 121: nu cc lnh vc xt nghim chnh trong ngnh y t hin nay v c im ca tng l -Xt nghim sinh ha,xt nghim huyt hc, xt nghim vi sinh, sinh hc phn t v xt nghi -c im: + Xt nghim sinh ha: thc hin phn tch kh mu, nc tiu, dch no ty v mt s dch

s cc xt nghim u da trn c s ca phn ng ha hc to mu t xc nh nng s hp cht ha hc khi phn ng vi nhng dung dch xc nh. + Xt nghim huyt hc: Thc hin xc nh s lng v c tnh ca cc yu t to nn mu trng thiu mu, nhim trng ung th, xut huyt Tnh t phn trm t bo mu, kch th + Xt nghim vi sinh: thc hin nghin cu cc mu m hoc dch xc nh cc vi sinh vt nui cy vi khun a kh v k kh, khng sinh , min dch hunh quang. + Xt nghim sinh hc phn t: Cc xt nghim lin quan n cu trc gen, k thut PCR- Ph ut R-PCR, k thut RT-PCR + Xt nghim ngn hng mu: Nhm thc hin phn loi mu theo cc nhm mu khc nhau, cc h mu nh nhm A, B,AB, O vn ang c pht trin mnh m. Cu 122: Nhng c ch no xy ra trong qu trnh lc mu my thn nhn to v c im c iu tr thn nhn to? C ch: thm thu, khuch tn, i lu, hp ph Khuch tn: Loi b tt cc cht tan trong mu. Khng loi b c cc cht gn kt i lu (siu lc) loi b tt cc cht tan trong c trng lng nh v trung bnh. ein. Thm thu: vi tc nh loi b nc ra khi mu, vi tc ln tin ti c ch Hp ph: Loi b cc cht tan nh c ch bm dnh vo b mt cht hp ph. Cc cht ht nha ion mang in tch Xu hng pht trin trong iu tr thn nhn to: -Thi k sng cn-> thi k cc thng s-> thi k ca cht lng. Nh vy xu hng pht tr ca cht lng: Gim chi ph iu tr, nng cao hiu qu iu tr, trnh s c gy t vong,

Cu 123: trong thit b xt nghim huyt hc, ti sao chng ta cn pha long mu trc khi chia ra thnh hai ng xc nh s lng t bo mu? Ti sao li phi dng ha cht phn bch cu v 5 thnh phn bch cu, tng s c thng s m my c th phn tch ti th Cn pha long mu trc khi phn tch v: mt t bo trong mu l ln, pha long gim ra cn trnh hin tng ng mu nhanh. -Phi chia ra lm 2 ng xc nh s lng t bo mu v: kch thc ca cc t bo mu 30fl, bch cu 35-400 fl) do phi chia lm hai ng: ng 1 xc nh hng cu v ti khc l phn ln kch thc ca hng cu nm trn trong bch cu nh vy s khng o c . Pha long cn tit kim ha cht v o theo ng bch cu ch cn pha long 1:400, c . -Phi dng ha cht ph v hng cu v : phn ln kch thc ca hng cu nm trn trong ph v hng cu mi c th o c bch cu -Trong my xt nghim huyt hc 3 thnh phn bch cu v 5 thnh phn bch cu tng s cc ln lt l 18 v 22 thng s. Cu 124: Thit b theo di bnh nhn 5 thng s dng trong y t bao gm cc thng s no? N g loi thng s no? -5 thng s: Nhp tim, nhp th (RESP), nng bo ha oxy trong mu SPO2, nhit (TEMP) ip (NIBP) -7 thng s : th chn 2 thng s o thm trong cc thng s sau: nng CO2, EtCO2;huyt lng tim CO, o kh mu Cu 125: Thit b in xung dng trong vt l tr liu thng s dng nhng loi dng in ham s xung in trong khi iu tr? Cc loi dng in: dng 1 chiu u, xung hnh ch nht, xung hnh tam gic, xung hnh l 2-5, dng kch thch NGA, dng cao tn, dng TENS,dng giao thoa -Thay i cc tham s xung in trong iu tr v: trnh hin tng quen (hin tng thc bin xung(thay i dng dng in iu tr), gii hn thi gian iu tr Cu 126: xc nh cc thng s trong my xt nghim sinh ha, hin nay ngi ta thng s -S dng nh lut: Beer-Bouguer-Lembert -Phng php: s dng 5 phng php: phn tch im cui, ng hc, ng hc hai im, o m Cu 127. Khi nim v thng s nng bo ha oxy trong mu SpO2? Cm bin o thng s SpO bng bao nhiu? Ti sao? Khi nim: bo ha oxy trong mu SpO2 (%) l t lng HbO2 trn tng lng Hb c tron -Cm bin o s dng hai loi nh sng. nh sng bc sng 660nm, nh sng hng ngoi b ph thuc vo bc sng v nh sng chiu ti v chng khc nhau r rt ti di nh sng c th tnh c lng Hb v HbO2 Cu 128. Trong thit b siu m iu tr, hin nay ngi ta s dng cc ch no? Nhng l g m thng c s dng kt hp vi nhng tc nhn no?

-S dng 2 ch : siu m sng xung v siu m lin tc -Tn s 1MHz, 3MHz -Kt hp vi: u iu tr tip xc trc tip vi bnh nhn, iu tr di nc, iu tr k Cu 129. Anh(ch) hy trnh by chc nng ca my to nhp? cc phng php to nhp ang nhp trong c th cn lu g trong khi khm bnh? Chc nng: -To nhp l mt phng php hin i dng iu tr cc ri lon nhp tim bng cch cy -T nhng bc u ng dng ca my to nhp ch to ra cc tn hiu nhp tim cu sn -Ngy nay my to nhp c nhiu chc nng mi ph hp vi tnh trng sinh l ca tim. Cc phng php to nhp: -To nhp mt bung tim (nh hoc tht) -To nhp hai bung tim (c nh v tht) -To nhp p ng tn s DDDR Cn ch : trnh i li ni c t trng ln, khng chp nh cng hng t Cu 130. Trong phng php iu tr suy thn bng my chy thn nhn to hin nay, nhng th -Tn sut lc (ln/tun) -Thi gian lc (h) -Lu lng mu(tc bm mu QB ml/pht) -Lu lng dch siu lc QF (ml/pht) -Lu lng dch thi QD(ml/pht) -H s lm sch K (l/24 gi) Vi nng trc khi lc mu l nng sau khi lc mu thanh thi tng phn ure (liu lc) Vi : K l lc ca Ure ca my lc t: thi gian lc mu V: khi lng nc ton th ca bnh nhn(=60% trng lng c th, kg->lit) : nng Ure trong mu trc lc : nng Ure trong mu sau lc T gim ure trc v sau khi lc Trong : : nng Ure trong mu trc lc : nng Ure trong mu sau lc

Cu 131. pht hin bt kh trong vng tun hon ngoi c th trong chy thn nhn to s hin bt kh? Khi pht hin bt kh th quy trnh s l ca my l nh th no? -Phng php: quang, quang in t, quang siu m -Pht hin bt kh v nu khng pht hin c bt kh, bt khi i vo mch mu gy phnh m -Quy trnh x l: trong thit b chy thn nhn to c khoang x l bt kh. Khi c bt kh v bt kh c loi b ti khoang ny Cu 132. c th thu nhn ng thi 12 o trnh ca tn hiu, ngi ta phi s dng cp G no ang ang c s dng? c th o c cc o trnh trc ngc th phi dng loi -12 o trnh:S dng cp o loi in cc AAMI 10 in cc, EASI 5 in cc, IEC 10 in c -Nhng loi in cc o ECG: +AAMI: RA, LA, LL,RL, V, V1->V6 +EASI: I,S,A,N,E +IEC:R,L,F,N,C,C1->C6 - o c cc o trnh trc ngc th dng loi in cc: AAMI,EASI Cu 133. Khi thc hin o thng s huyt p khng can thip NIBP bng phng php Krotkoff, no ca huyt p, ti sao? Khi thc hin bng phng php giao ng k, mch in c th t Ngi ta c th o c huyt p tm thu v huyt p tm trng v y l phng php o th i p sut ti kh ln hn p sut ng mch th khng c mu chy trong ng mch-> khng n ng mch th ng mch m c mu chy-> nghe thy c m thanh (m thanh Max). Khi ng in) nh vy vi phng php Korotkoff ta ch phn bit c hai m thanh max v min tng trng. Do ch c th o c huyt p tm thu v huyt p tm trng -Khi thc hin bng phng php dao ng k, mch in c th tnh ton cc gi tr: huyt a, p lc ti a.

Cu 134. Vic thu nhn tn hiu ECG thit b theo di bnh nhn, thng thu nhn nhng dng 2 in cc no ca tn hiu ECG o thng s h hp? Cc o trnh c bn: -3 o trnh mu: I,II,III -3 o trnh n cc cc chi: AVR,AVL,AVF -6 o trnh trc tim: V1-V6 Hai in cc ca tn hiu ECG o thng s h hp l: RA, LL(i vi chun 3 AAMI); I v

Cu 135. Anh(ch) hy trnh by nguyn l dng xc nh cc t bo mu trong my phn t ? Vi phng php ny, ti sao li ch phn bit c 3 thnh phn bch cu. Mun pht hin hp no, ti sao? Nguyn l: trong my o 3 thnh phn bch cu ngi ta tch thnh hai ng m s lng Khi cc t bo l lng trong mu khi chuyn qua khe m s lm cn tr dng mt chiu v tha i tr khng thay i kch thc ca t bo c xc nh bi cc xung, chiu cao ca xung x kch thc hng cu nm trn trong bch cu nn phi ph v cu trc hng cu ri mi o -Phng php ny ch phn bit c 3 thnh phn bch cu v: theo kch thc th bch cu , MYD (monocyte):90-400fl; GRA (Eosinophil,Neutrophil, Basophil): 90-135fl. Do cc t bo c th tch ging nhau s to ra cc xung c chiu cao ging nhau. Nh vy ch xc th tch nh trn - xc nh c 5 thnh phn bch cu th s dng phng php laser: da trn s tn x c h thc v cu to ca t bo. Phng php ny c u im l phn bit c cu to ca t eutrophil, Basophil (90-135fl). Do c th phn bit c 5 thnh phn bch cu Cu 136. Anh(ch) hy trnh by v cc li my th hin nay? Cc phng thc h hp nhn t ng my gy m km th, hin nay ngi ta thng dng li kiu kn Cc loi my th hin nay: -Theo chc nng s dng: my th dng trong iu tr v my th dng trong gy m. -Theo chc nng iu khin: my th iu khin p lc, my th iu khin th tch Cc phng thc h hp nhn to: -H hp nhn to iu khin CMV -H hp nhn to h tr AMV -H hp nhn to h tr/ iu khin A/CMV -H hp nhn to ngt qung IMV -H hp nhn to ng b ngt qung SIMV -H hp nhn to h tr p lc PSV Dng kiu kn v: kiu ny tn kh, cht gy m t, t gy i nhim, ngi bnh khng b th