Th\u1eddi gian: 90 ph\u00fat<\/b><\/p>\n
C\u00e2u 1<\/b>. (2\u0111) B\u1ec7nh nh\u00e2n NVC, 64 tu\u1ed5i, nam gi\u1edbi nh\u1eadp vi\u1ec7n c\u1ea5p c\u1ee9u v\u00ec b\u1ecb \u0111au v\u00e0 ph\u00f9 \u1edf ch\u00e2n. Ti\u1ec1n s\u1eed b\u1ec7nh nh\u00e2n b\u1ecb ung th\u01b0 ti\u00ean li\u1ec7t tuy\u1ebfn. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea7n \u0111o\u00e1n thuy\u00ean t\u0103c huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111inh enoxaparin 1mg\/kg, 2 l\u1ea7n\/ng\u00e0y. Sau 2 ng\u00e0y, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n v\u00e0 \u0111\u01b0\u1ee3c cho s\u1eed d\u1ee5ng enoxaparin t\u1ea1i nh\u00e0.<\/p>\n
Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u<\/p>\n
a. Tr\u00ecnh b\u00e0y 2 \u01b0u \u0111i\u1ec3m c\u1ee7a enoxaparin so v\u1edbi heparin?<\/p>\n
b. N\u00eau c\u01a1 ch\u1ebf c\u1ee7a enoxaparin?<\/p>\n
c. B\u1ec7nh nh\u00e2n t\u1eeb ch\u1ed1i s\u1eed d\u1ee5ng enoxaparin v\u00ec l\u00fd do b\u1ec7nh nh\u00e2n s\u1ed1ng m\u1ed9t m\u00ecnh v\u00e0 kh\u00f4ng ai c\u00f3 th\u1ec3 ti\u00eam cho \u00f4ng. N\u00eau 2 nh\u00f3m thu\u1ed1c kh\u00e1c c\u00f3 th\u1ec3 d\u00f9ng cho b\u1ec7nh nh\u00e2n n\u00e0y<\/p>\n
d. Ch\u1ecdn m\u1ed9t thu\u1ed1c \u0111\u01b0\u1eddng u\u1ed1ng s\u1eed d\u1ee5ng cho b\u1ec7nh nh\u00e2n. Gi\u1ea3i th\u00edch l\u00fd do ch\u1ecdn thu\u1ed1c<\/p>\n
C\u00e2u 2.<\/b>\u00a0(2\u0111) B\u00eanh nh\u00e2n NVB, 68 tu\u1ed5i, nam gi\u1edbi nh\u1eadp vi\u1ec7c v\u00ec vi\u00eam ph\u1ed5i. B\u1ec7nh nh\u00e2n c\u00f3 ti\u00ean s\u1eed COPD, t\u0103ng huy\u1ebft \u00e1p, thu\u1ed1c \u0111ang s\u1eed d\u1ee5ng:<\/p>\n
1.\u00a0<\/i>Lisinopril lOmg, u\u1ed1ng I l\u1ea7n\/ng\u00e0y<\/p>\n
2.\u00a0<\/i>Salmeterol\/Fluticason 25\/250 \u00b5g, 2 nh\u00e1t\/ng\u00e0y<\/p>\n
3.\u00a0<\/i>Tiotropium, 18 \u00b5g, b\u1ed9t h\u00edt 1 l\u1ea7n\/ng\u00e0y<\/p>\n
4.\u00a0<\/i>Atorvastatin 10mg, u\u1ed1ng 1 l\u1ea7n\/ng\u00e0y<\/p>\n
B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c cho d\u00f9ng th\u00eam Ceftriaxon 2g\/ng\u00e0y X 07 ng\u00e0y<\/p>\n
Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n
a. N\u00eau c\u01a1 ch\u1ebf c\u1ee7a Ceftriaxon<\/p>\n
b. N\u00eau 02 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Ceftriaxon<\/p>\n
c. Sau 03 ng\u00e0y, t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n, c\u00f3 th\u1ec3 chuy\u1ec3n sang Ceftriaxon \u0111\u01b0\u1eddng u\u1ed1ng \u0111\u01b0\u1ee3c kh\u00f4ng? V\u00ec sao?<\/p>\n
d. N\u00eau c\u01a1 ch\u1ebf c\u1ee7a Atorvastatin<\/p>\n
C\u00e2u 3<\/b>. (2\u0111) B\u1eb9nh nh\u00e2n NVB, 30 tu\u00f4i, v\u1edbi ti\u1ec1n s\u1eed t\u0103ng huy\u00eat \u00e1p. C\u00e1c thu\u1ed1c \u0111ang s\u1eed d\u1ee5ng l\u1ea3:<\/p>\n
1. Perindopril 5mg, u\u00f4ng 1 l\u1ea7n\/ng\u00e0y<\/p>\n
2. Rosuvastatin 10 mg, u\u1ed1ng 1 l\u1ea7n\/ng\u00e0y<\/p>\n
H\u00f4m nay b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n v\u1edbi c\u00e1c bi\u00eau hi\u1ec7n \u0111\u1ed9t ng\u1ed9t t\u00e9 ng\u00e3, y\u1ebfu v\u00e0 gi\u1ea3m \u00fd th\u1ee9c.<\/p>\n
K\u00e9t qu\u1ea3 CT cho th\u1ea5yxu\u1ea5t hi\u1ec7n huy\u1ebft kh\u1ed1i \u0111\u1ed9ng m\u1ea1ch n\u00e3o gi\u1eefa. B\u1eb9nh nh\u00e2n\u0111\u01b0\u1ee3c thi \u0111\u1ecbnh d\u00f9ng ngay: r-tPA, IV.<\/p>\n
Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n
a. N\u00eau c\u01a1 ch\u1ebf c\u1ee7a r-tPA?<\/p>\n
b. N\u00eau 2 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Perindopril?<\/p>\n
c. N\u00eau c\u01a1 ch\u1ebf c\u1ee7a Rosuvastatin?<\/p>\n
d. K\u1ec3 c\u00e1c \u0111\u01b0\u1eddng d\u00f9ng c\u1ee7a tPA?<\/p>\n
C\u00e2u 4.<\/b>\u00a0(2\u0111) B\u1ec7nh nh\u00e2n T.V.X., 60 tu\u1ed5i, ti\u1ec1n s\u1eed \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u0103ng c\u00e1c thu\u1ed1c Metformin 850mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean, chi\u1ec1u 1 vi\u00ean sau b\u1eefa \u0103n. 2 th\u00e1ng nay b\u1ec7nh nh\u00e2n th\u1ea5y \u0111\u01b0\u1eddng huy\u1ebft kh\u00f4ng \u1ed5n \u0111\u1ecbnh n\u00ean \u0111i kh\u00e1m l\u1ea1i v\u00e0 ph\u00e1t hi\u1ec7n th\u00eam b\u1ec7nh t\u0103ng huy\u1ebft \u00e1p (HA: 160\/90 mmHg), c\u00e1c x\u00e9t nghi\u1ec7m: Glucose m\u00e1u (l\u00fac \u0111\u00f3i): 8.0 mmol\/1, HbAlc: 7%, ch\u1ee9c n\u0103ng gan, th\u1eadn b\u00ecnh th\u01b0\u1eddng. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c chi \u0111\u1ecbnh d\u00f9ng th\u00eam:<\/p>\n
1.\u00a0<\/i>Dapagliflozin 5mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean sau \u0103n.<\/p>\n
2.\u00a0<\/i>Telmisartan 40 mg, u\u1ed5ng s\u00e1ng 1 vi\u00ean sau \u0103n.<\/p>\n
Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u00f2i sau (m\u1ed7i c\u00e2u 0,5 \u0111):<\/p>\n
a. N\u00eau t\u00e1c d\u1ee5ng c\u1ee7a Metformin?<\/p>\n
b. Ke 2 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Metformin?<\/p>\n
c. N\u00eau c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a Dapagliflozin?<\/p>\n
d. L\u1ee3i \u00edch c\u1ee7a Dapagliflozin trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y?<\/p>\n
C\u00e2u 5.<\/b>\u00a0(2\u0111) B\u1ec7nh nhi N. N. A., nam gi\u1edbi, 6 tu\u1ed5i, 25 kg, ti\u1ec1n s\u1eed hen ph\u1ebf qu\u1ea3n \u0111ang \u0111\u01b0\u1ee3c d\u00f9ng Salbutamol 2mg, u\u1ed1ng s\u00e1ng 1\/2 vi\u00ean, chi\u1ec1u 1\/2 vi\u00ean ,\u0111\u01b0\u1ee3c \u0111\u01b0a \u0111\u1ebfn b\u1ec7nh vi\u1ec7n kh\u00e1m v\u1edbi tri\u1ec7u ch\u1ee9ng kh\u00f2 kh\u00e8, kh\u00f3 th\u1edf li\u00ean t\u1ee5c 3 ng\u00e0y nay, s\u1ed1t cao 39 \u0111\u1ed9, ch\u1ea9n \u0111o\u00e1n l\u00e0 hen ph\u1ebf qu\u1ea3n b\u1ed9i nhi\u1ec5m. Thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh:<\/p>\n
1. Augmentin 500 mg, u\u1ed1ng s\u00e1ng 1 g\u00f3i, chi\u1ec1u 1 g\u00f3i<\/p>\n
2. Prednisolon 5 mg, u\u1ed1ng s\u00e1ng 4 vi\u00ean<\/p>\n
3. Combivent (Ipratropium + Albuterol), x\u1ecbt khi kh\u00f3 th\u1edd<\/p>\n
4. Seretide 25\/125 mcg evohaler (Salmeterol\/ Fluticasone), x\u1ecbt s\u00e1ng 1 nh\u00e1t, chi\u1ec1u 1 nh\u00e1t.<\/p>\n
5. Paracetamol 250 mg, u\u1ed1ng 1 g\u00f3i khi s\u1ed1t, c\u00e1ch nhau \u00edt nh\u1ea5t 4 gi\u1edd.<\/p>\n
Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n
a. N\u00eau c\u01a1 ch\u00ea t\u00e1c d\u1ee5ng c\u1ee7a Ipratropium v\u00e0 Albuterol?<\/p>\n
b. Salmeterol thu\u1ed9c nh\u00f3m thu\u1ed1c n\u00e0o? Gi\u1ea3i th\u00edch c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng?<\/p>\n
c. Vai tr\u1ecf c\u1ee7a Predniso\u1ec9on trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y?<\/p>\n
d. N\u00eau 2 \u0111\u1ed9c t\u00ednh c\u1ee7a Prednisolon khi d\u00f9ng cho tr\u1ebb em k\u00e9o d\u00e0i?<\/p>\n
H\u1ebft<\/p>\n
Ghi ch\u00fa: C\u00e1n b\u1ed9 coi thi kh\u00f4ng gi\u1ea3i th\u00edch g\u00ec th\u00eam<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" Th\u1eddi gian: 90 ph\u00fat C\u00e2u 1. (2\u0111) B\u1ec7nh nh\u00e2n NVC, 64 tu\u1ed5i, nam gi\u1edbi nh\u1eadp vi\u1ec7n c\u1ea5p c\u1ee9u v\u00ec b\u1ecb \u0111au v\u00e0 ph\u00f9 \u1edf ch\u00e2n. Ti\u1ec1n s\u1eed b\u1ec7nh nh\u00e2n b\u1ecb ung th\u01b0 ti\u00ean li\u1ec7t tuy\u1ebfn. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea7n \u0111o\u00e1n thuy\u00ean t\u0103c huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111inh enoxaparin 1mg\/kg, 2 l\u1ea7n\/ng\u00e0y. Sau …<\/p>\n","protected":false},"author":17,"featured_media":1578,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[117],"tags":[],"class_list":["post-1789","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-de-thi"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1789","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=1789"}],"version-history":[{"count":1,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1789\/revisions"}],"predecessor-version":[{"id":1790,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1789\/revisions\/1790"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/1578"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=1789"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=1789"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=1789"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}