{"id":1973,"date":"2022-07-05T00:30:32","date_gmt":"2022-07-04T17:30:32","guid":{"rendered":"https:\/\/ykhoataynguyen.com\/site\/?p=1973"},"modified":"2022-07-06T00:03:05","modified_gmt":"2022-07-05T17:03:05","slug":"duoc-ly-cuoi-ky-ii-2018-2019-yk16a1-yk16c","status":"publish","type":"post","link":"https:\/\/ykhoataynguyen.com\/site\/duoc-ly-cuoi-ky-ii-2018-2019-yk16a1-yk16c\/","title":{"rendered":"D\u01b0\u1ee3c L\u00fd ( cu\u1ed1i k\u1ef3 II 2018-2019) YK16A1-YK16C"},"content":{"rendered":"

Th\u1eddi gian 90 ph\u00fat<\/em><\/p>\n

C\u00e2u1 :<\/b>\u00a0B\u1ec7nh nh\u00e2n NVB, 81 tu\u1ed5i, n\u1eef gi\u1edbi, \u0111ang \u0111i\u1ec1u tr\u1ecb rung nh\u0129 m\u00e3n t\u00ednh, thu\u1ed1c \u0111ang \u0111i\u1ec1u tr\u1ecb l\u00e0:<\/p>\n

1. Acenocoumarol li\u1ec1u t\u00f9y theo INR<\/p>\n

2. Digoxin 0.125mg, u\u1ed1ng 1 l\u1ea7n\/ ng\u00e0y.<\/p>\n

B\u1ec7nh nh\u00e2n ph\u00e1t hi\u1ec7n th\u00eam b\u1ecb t\u0103ng huy\u1ebft \u00e1p n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh th\u00eam Indapamid 5mg, u\u1ed1ng 1 vi\u00ean \/ ng\u00e0y<\/p>\n

Sau 2 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n \u0111\u1ecdc t\u00ednh c\u1ee7a digoxin<\/p>\n

Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n

a. N\u00eau c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a digoxin?<\/p>\n

b. Acenocoumarol gi\u00fap \u00edch g\u00ec cho b\u1ec7nh nh\u00e2n n\u00e0y? N\u00eau c\u01a1 ch\u1ebf?<\/p>\n

c. N\u00eau 3 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Digoxin?<\/p>\n

d. Nguy\u00ean nh\u00e2n n\u00e0o d\u1eabn \u0111\u1ebfn \u0111\u1ed9c t\u00ednh digoxin. Gi\u1ea3i th\u00edch?<\/p>\n

C\u00e2u 2:<\/b>\u00a0B\u1ec7nh nh\u00e2n VNA, 76 tu\u1ed5i, n\u1eef gi\u1edbi, th\u1ec3 tr\u1ea1ng ph\u00f9 chi d\u01b0\u1edbi, ti\u1ec1u s\u1eed \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng typer II, huy\u1ebft \u00e1p 160\/84mmHg. C\u00e1c thu\u1ed1c \u0111ang \u0111i\u1ec1u tr\u1ecb:<\/p>\n

1. Metformin 850mg, u\u1ed1ng 1 vi\u00ean\/ l\u1ea7n x2 l\u1ea7n \/ ng\u00e0y<\/p>\n

2. Metoprolol XL 50 mg, u\u1ed1ng 1 vi\u00ean\/ l\u1ea7n x 2 l\u1ea7n \/ ng\u00e0y<\/p>\n

3. Furosemid 40mg, u\u1ed1ng 1 l\u1ea7n\/ ng\u00e0y<\/p>\n

4. Telmisartan 40mg, u\u1ed1ng 1 l\u1ea7n \/ ng\u00e0y<\/p>\n

5. Aspirin 81 mg, u\u1ed1ng 1 l\u1ea7n \/ ng\u00e0y<\/p>\n

6. Simvastartin 40mg, u\u1ed1ng 1 l\u1ea7ng \/ ng\u00e0y<\/p>\n

Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n

a. M\u1ee5c \u0111\u00edch s\u1eed d\u1ee5ng c\u1ee7a Telmisartan trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 g\u00ec? Gi\u1ea3i th\u00edch c\u01a1 ch\u1ebf?<\/p>\n

b. M\u1ee5c \u0111\u00edch c\u1ee7a Metoprolol s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 g\u00ec? Gi\u1ea3i th\u00edch c\u01a1 ch\u1ebf?<\/p>\n

c. N\u00eau 4 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Furosemid?<\/p>\n

d. N\u00eau 3 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Simvastatin?<\/p>\n

C\u00e2u 3:<\/b>\u00a0B\u1ec7nh nh\u00e2n M.T.C, 70 tu\u1ed5i, n\u1eef gi\u1edbi, ti\u1ec1n s\u1eed hen ph\u1ebf qu\u1ea3n \u1ed5n \u0111\u1ecbnh, t\u0103ng huy\u1ebft \u00e1p. B\u1ec7nh nh\u00e2n b\u1ecb t\u00e9 g\u00e3y x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt. Thu\u1ed1c \u0111ang d\u00f9ng.<\/p>\n

1. Telmisartan 40mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean<\/p>\n

2. Salbutamol 100 mcg, h\u00edt khi kh\u00f3 th\u1edf<\/p>\n

3. Bambuterol 10mg, u\u1ed1ng t\u1ed1i 1 vi\u00ean<\/p>\n

Sau ph\u1eabu thu\u1eadt, b\u1ec7nh nh\u00e2n v\u1eabn than \u0111au nhi\u1ec1u n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ti\u00eam Morphin 10mg\/ml, ti\u00eam b\u1eafm. Tuy nhi\u00ean, b\u1ec7nh nh\u00e2n v\u1eabn than \u0111au nhi\u1ec1u n\u00ean li\u1ec1u th\u1ee9 hai \u0111\u01b0\u1ee3c ti\u00eam sau \u0111\u00f3 3 gi\u1edd. sau \u0111\u00f3 c\u01a1n \u0111au c\u00f3 d\u1ecbu d\u1ea7n nh\u01b0ng 10 ph\u00fat sau, b\u1ec7nh nh\u00e2n c\u00f3 d\u1ea5u hi\u1ec7u kh\u00f3 th\u1edf, m\u1ec7t, n\u00f4n m\u1eeda, nhip th\u1edf ch\u1eadm, \u0111\u1ed3ng t\u1eed co nh\u1ecf. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 ng\u1ed9 \u0111\u1ed9c Morphin.<\/p>\n

Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n

a. Nh\u1eefng d\u1ea5u hi\u1ec7u n\u00e0o g\u1ee3i \u00fd b\u1ec7nh nh\u00e2n b\u1ecb ng\u1ed9 \u0111\u1ed9c Morphin? Gi\u1ea3i th\u00edch?<\/p>\n

b. Thu\u1ed1c n\u00e0o \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3i \u0111\u1ed9c Morphin? N\u00eau c\u01a1 ch\u1ebf gi\u1ea3i \u0111\u1ed9c<\/p>\n

c. K\u1ec3 3 y\u1ebfu t\u1ed1 \u1edf b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 th\u1ec3 d\u1ec5 d\u1eabn \u0111\u1ebfn t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a Morphin?<\/p>\n

d. N\u00eau c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Bambuterol?<\/p>\n

C\u00e2u 4:<\/b>\u00a0B\u1ec7nh nh\u00e2n N.T.A, n\u1eef gi\u1edbi, 30 tu\u1ed5i \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 lo\u00e9t d\u1ea1 d\u00e0y sau d\u00f9ng Nsaids. Thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh l\u00e0:<\/p>\n

1. Esomeprazol 40mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean, chi\u1ec1u 1 vi\u00ean, tr\u01b0\u1edbc b\u1eefa \u0103n 30 ph\u00fat<\/p>\n

2. Misoprotol 200mcg, u\u1ed1ng s\u00e1ng 1 vi\u00ean, chi\u1ec1u 1 vi\u00ean sau b\u1eefa \u0103n<\/p>\n

Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n

a. N\u00eau c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a Esomeprazol?<\/p>\n

b. V\u00ec sao Esomeprazol \u0111\u01b0\u1ee3c b\u00e0o ch\u1ebf d\u01b0\u1edbi d\u1ea1ng vi\u00ean bao tan trong ru\u1ed9t? h\u01b0\u1edbng d\u1eabn c\u00e1ch s\u1eed d\u1ee5ng cho b\u1ec7nh nh\u00e2n A nh\u01b0 th\u1ebf n\u00e0o?<\/p>\n

c. N\u00eau c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a Misoprotol?<\/p>\n

d. T\u1ea1i sao Misoprotol ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi ph\u1ee5 n\u1eef c\u00f3 thai?<\/p>\n

C\u00e2u 5:<\/b>\u00a0B\u1ec7nh nh\u00e2n NVT, 55 tu\u1ed5i, ch\u1ee9c n\u0103ng gan th\u1eadn b\u00ecnh th\u01b0\u1eddng, th\u1ec3 tr\u1ea1ng kh\u00f4ng ph\u00f9 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p, suy tim \u0111\u1ed9 II, thi\u1ebfu m\u00e1u c\u01a1 tim c\u1ee5c b\u1ed9. Ti\u1ec1n s\u1eed nh\u1ed3i m\u00e1u c\u01a1 tim 3 th\u00e1ng tr\u01b0\u1edbc, lo\u00e9t d\u1ea1 d\u00e0y c\u00e1ch 2 tu\u1ea7n, \u0111ang d\u00f9ng c\u00e1c thu\u1ed1c:<\/p>\n

1. Aspirin 81 mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean sau \u0103n<\/p>\n

2. Atorvastatin 20mg, u\u1ed1ng t\u1ed1i 1 vi\u00ean sau \u0103n<\/p>\n

3. Lisinopril 20mg, u\u1ed1ng t\u1ed1i 1 vi\u00ean sau \u0103n<\/p>\n

4. Esomeprazol 40mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean tr\u01b0\u1edbc \u0103n 30 ph\u00fat<\/p>\n

5. Bisoprololn 2,5mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean sau \u0103n.<\/p>\n

Th\u00e1ng tr\u01b0\u1edbc b\u1ec7nh nh\u00e2n th\u1ea5y \u0111au \u0111\u1ea7u g\u1ed1i 2 b\u00ean nhi\u1ec1u n\u00ean \u0111i kh\u00e1m ph\u00e1t hi\u1ec7n th\u00eam b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 v\u00e0 tho\u00e1i h\u00f3a kh\u1edbp, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh d\u00f9ng th\u00eam:<\/p>\n

1. Etoricoxib 90mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean, t\u1ed1i 1 vi\u00ean, sau \u0103n<\/p>\n

2. Glipizide 5mg, u\u1ed1ng sang 1 vi\u00ean tr\u01b0\u1edbc \u0103n 30 ph\u00fat<\/p>\n

Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n

a. T\u00e1c d\u1ee5ng c\u1ee7a Aspirin 81 mg trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y?<\/p>\n

b. Ch\u1ec9 \u0111\u1ecbnh Aspirin 81 mg c\u00f3 ph\u00f9 h\u1ee3p cho b\u1ec7nh nh\u00e2n T. kh\u00f4ng? T\u1ea1i sao?<\/p>\n

c. \u00dd ki\u1ebfn c\u1ee7a anh ch\u1ecb v\u1ec1 s\u1eed d\u1ee5ng Etoricoxib trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y?<\/p>\n","protected":false},"excerpt":{"rendered":"

Th\u1eddi gian 90 ph\u00fat C\u00e2u1 :\u00a0B\u1ec7nh nh\u00e2n NVB, 81 tu\u1ed5i, n\u1eef gi\u1edbi, \u0111ang \u0111i\u1ec1u tr\u1ecb rung nh\u0129 m\u00e3n t\u00ednh, thu\u1ed1c \u0111ang \u0111i\u1ec1u tr\u1ecb l\u00e0: 1. Acenocoumarol li\u1ec1u t\u00f9y theo INR 2. Digoxin 0.125mg, u\u1ed1ng 1 l\u1ea7n\/ ng\u00e0y. B\u1ec7nh nh\u00e2n ph\u00e1t hi\u1ec7n th\u00eam b\u1ecb t\u0103ng huy\u1ebft \u00e1p n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh th\u00eam Indapamid 5mg, u\u1ed1ng 1 …<\/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-1973","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\/1973","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=1973"}],"version-history":[{"count":1,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1973\/revisions"}],"predecessor-version":[{"id":1974,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1973\/revisions\/1974"}],"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=1973"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=1973"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=1973"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}