{"id":2233,"date":"2022-07-08T23:37:52","date_gmt":"2022-07-08T16:37:52","guid":{"rendered":"https:\/\/ykhoataynguyen.com\/site\/?p=2233"},"modified":"2022-07-08T23:37:52","modified_gmt":"2022-07-08T16:37:52","slug":"de-thi-duoc-ly-khoa-yk19","status":"publish","type":"post","link":"https:\/\/ykhoataynguyen.com\/site\/de-thi-duoc-ly-khoa-yk19\/","title":{"rendered":"\u0110\u1ec1 thi D\u01b0\u1ee3c l\u00fd kh\u00f3a YK19"},"content":{"rendered":"

Th\u1eddi gian l\u00e0m b\u00e0i 90 ph\u00fat\u00a0<\/em><\/p>\n

\u0110\u1ec1 thi onl v\u1edbi c\u00e1c l\u1edbp YK19A1, YK19A2, YK19A3\u00a0<\/strong><\/p>\n

L\u1edbp YK19A1\u00a0<\/strong><\/em><\/p>\n

\n
C\u00e2u 1<\/strong>.B\u1ec7nh nh\u00e2n N.T.X, n\u1eef, 26 tu\u1ed5i, l\u00e0m vi\u1ec7c t\u1ea1i m\u1ed9t c\u1eeda h\u00e0ng b\u00e1n qu\u1ea7n \u00e1o, nh\u00e0 c\u00f3 nu\u00f4i m\u00e8o. Ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 m\u1eb9 b\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng. C\u00e1ch \u0111\u00e2y m\u1ed9t n\u0103m \u0111i kh\u00e1m v\u00ec th\u01b0\u1eddng xuy\u00ean kh\u00f2 kh\u00e8, kh\u00f3 th\u1edf, \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n b\u1eadc 2. \u0110\u01b0\u1ee3c k\u00ea \u0111\u01a1n g\u1ed3m:<\/div>\n
1.Ventolin inhaler (salbutamol 100 mcg), x\u1ecbt khi l\u00ean c\u01a1n kh\u00f3 th\u1edf<\/div>\n
2.Fluticasone propionat 125 mcg, x\u1ecbt ng\u00e0y 2 l\u1ea7n s\u00e1ng, t\u1ed1i, 1 l\u1ea7n 1 x\u1ecbt.<\/div>\n
B\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng thu\u1ed1c (2) trong 1 th\u00e1ng r\u1ed3i ng\u1eebng v\u00ec c\u1ea3m th\u1ea5y kh\u00f4ng c\u00f2n kh\u00f3 th\u1edf nhi\u1ec1u. Sau m\u1ed9t th\u1eddi gian, b\u1ec7nh nh\u00e2n th\u01b0\u1eddng l\u00ean c\u01a1n kh\u00f3 th\u1edf, s\u1eed d\u1ee5ng (1) v\u00e0 c\u1ea3m th\u1ea5y tri\u1ec7u ch\u1ee9ng c\u00f3 gi\u1ea3m. Tuy nhi\u00ean d\u1ea1o g\u1ea7n \u0111\u00e2y, b\u1ec7nh nh\u00e2n hay th\u1ee9c gi\u1ea5c v\u00e0o ban \u0111\u00eam do ho v\u00e0 kh\u00f3 th\u1edf, b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng c\u1ea3(1) v\u00e0 (2) m\u1ed7i khi l\u00ean c\u01a1n nh\u01b0ng kh\u00f4ng \u0111\u1ee1. B\u1ec7nh nh\u00e2n \u0111\u1ebfn b\u1ec7nh vi\u1ec7n do m\u1ed9t c\u01a1n kh\u00f3 th\u1edf n\u1eb7ng, th\u0103m kh\u00e1m th\u1ea5y ch\u1ee9c n\u0103ng ph\u1ed5i ch\u01b0a suy gi\u1ea3m. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n nh\u01b0 sau:<\/div>\n
1.Ventolin inhaler (salbutamol 100 mcg), x\u1ecbt 1-2 nh\u00e1t khi l\u00ean c\u01a1n kh\u00f3 th\u1edf<\/div>\n
2.Seretide 25\/250 mcg (salmeterol\/fluticasone propionat) x\u1ecbt ng\u00e0y 2 l\u1ea7n s\u00e1ng, t\u1ed1i, 1 l\u1ea7n 1 x\u1ecbt.<\/div>\n
3.Methylprednisolon 16 mg, u\u1ed1ng 1 vi\u00ean s\u00e1ng trong 5 ng\u00e0y<\/div>\n
Tr\u1ea3 l\u1eddi c\u00e1c c\u00e2u h\u1ecfi sau \u0111\u00e2y:<\/div>\n
a.N\u00eau nh\u1eefng y\u1ebfu t\u1ed1 nguy c\u01a1 d\u1eabn \u0111\u1ebfn b\u1ec7nh hen ph\u1ebf qu\u1ea3n c\u1ee7a b\u1ec7nh nh\u00e2n?<\/div>\n
b.D\u1ef1a v\u00e0o nh\u1eefng nguy\u00ean t\u1eafc chung trong \u0111i\u1ec1u tr\u1ecb hen theo GINA 2019, n\u00eau nh\u1eefng v\u1ea5n \u0111\u1ec1 trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb hen trong 1 n\u0103m v\u1eeba qua c\u1ee7a b\u1ec7nh nh\u00e2n.<\/div>\n
c.N\u00eau c\u01a1 ch\u1ebf, t\u00e1c d\u1ee5ng c\u1ee7a salbutamol, nh\u1eefng \u01b0u \u0111i\u1ec3m c\u1ee7a salbutamol khi d\u00f9ng d\u01b0\u1edbi d\u1ea1ng b\u00e0o ch\u1ebf trong ch\u1ebf ph\u1ea9m Ventolin inhaler?<\/div>\n
d. So s\u00e1nh vai tr\u00f2 c\u1ee7a fluticasone propionat v\u00e0 methylprednisolon trong \u0111\u01a1n thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea l\u1ea7n 2. N\u00eau t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a m\u1ed7i lo\u1ea1i trong \u0111\u01a1n thu\u1ed1c.<\/div>\n
<\/div>\n
C\u00e2u 2.<\/strong>B\u1ec7nh nh\u00e2n NTY, 35 tu\u1ed5i, n\u1eef gi\u1edbi, \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 F0 v\u00e0 \u0111ang \u0111i\u1ec1u tr\u1ecb t\u1ea1i nh\u00e0 theo \u0111\u01a1n thu\u1ed1c \u0111i\u1ec1u tr\u1ecb Covid-19 t\u1ea1i nh\u00e0 d\u00e0nh cho ng\u01b0\u1eddi l\u1edbn (S\u1edf Y t\u1ebf Th\u00e0nh Ph\u1ed1 H\u1ed3 Ch\u00ed Minh). Tr\u1ea3 l\u1eddi c\u00e1c c\u00e2u h\u1ecfi ng\u1eafn sau:<\/div>\n
a. H\u00e3y k\u1ec3 t\u00ean c\u00e1c thu\u1ed1c kh\u00e1ng vi\u00eam \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111\u01a1n thu\u1ed1c.<\/div>\n
b. H\u00e3y tra c\u1ee9u d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a 1 thu\u1ed1c kh\u00e1ng vi\u00eam \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111\u01a1n thu\u1ed1c.<\/div>\n
c. N\u00eau t\u00e1c d\u1ee5ng ph\u1ee5 chung c\u1ee7a nh\u00f3m kh\u00e1ng vi\u00eam steroids.<\/div>\n
d. N\u00eau l\u01b0u \u00fd khi s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng vi\u00eam steroids<\/div>\n
<\/div>\n
C\u00e2u 3<\/strong>.M\u1ed9t b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ung th\u01b0 ph\u1ed5i giai \u0111o\u1ea1n cu\u1ed1i di c\u0103n x\u01b0\u01a1ng, \u0111i\u1ec1u tr\u1ecb \u1edf khoa ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh d\u00f9ng Morphin 10% ti\u00eam b\u1eafp ng\u00e0y 2 \u1ed1ng. Tuy nhi\u00ean, \u1edf giai \u0111o\u1ea1n sau b\u1ec7nh nh\u00e2n than \u0111au nhi\u1ec1u v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho d\u00f9ng th\u00eam Buprenorphin 8mg ng\u1eadm d\u01b0\u1edbi l\u01b0\u1ee1i nh\u01b0ng b\u1ec7nh nh\u00e2n v\u1eabn kh\u00f4ng th\u1ea5y c\u1ea3i thi\u1ec7n.<\/div>\n
Tr\u1ea3 l\u1eddi c\u00e1c c\u00e2u h\u1ecfi ng\u1eafn sau:<\/div>\n
a.D\u1ef1a v\u00e0o c\u00f4ng c\u1ee5 tra c\u1ee9u t\u01b0\u01a1ng t\u00e1c thu\u1ed1c, h\u00e3y cho bi\u1ebft t\u01b0\u01a1ng t\u00e1c c\u1ee7a hai thu\u1ed1c n\u00f3i tr\u00ean? N\u00eau c\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c thu\u1ed1c?<\/div>\n
b.N\u00eau \u0111\u1ed9c t\u00ednh c\u1ea5p c\u1ee7a Morphin?<\/div>\n
c.N\u00eau c\u00e1ch x\u1eed tr\u00ed khi ng\u1ed9 \u0111\u1ed9c Morphin?<\/div>\n
d.Gi\u1ea3i th\u00edch t\u00e1c d\u1ee5ng tr\u00ean h\u00f4 h\u1ea5p c\u1ee7a Morphin?<\/div>\n
<\/div>\n
C\u00e2u 4.<\/strong>B\u1ec7nh nh\u00e2n NVB, 40 tu\u1ed5i, nam gi\u1edbi, \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n lo\u00e9t d\u1ea1 d\u00e0y, c\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh:<\/div>\n
1.Amoxicillin 500mg, u\u1ed1ng s\u00e1ng 2 vi\u00ean, chi\u1ec1u 2 vi\u00ean<\/div>\n
2.Levofloxacin 500mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean<\/div>\n
3.Omeprazol 20mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean, chi\u1ec1u 1 vi\u00ean<\/div>\n
4.Phospalugel 20g, u\u1ed1ng s\u00e1ng 1 g\u00f3i, chi\u1ec1u 1 g\u00f3i U\u1ed1ng trong 10 ng\u00e0y<\/div>\n
Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/div>\n
a.N\u00eau nh\u00f3m thu\u1ed1c v\u00e0 c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a amoxicillin?<\/div>\n
b.N\u00eau nh\u00f3m thu\u1ed1c v\u00e0 c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a levofloxacin?<\/div>\n
c.N\u00eau t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a levofloxacin? N\u00eau 3 thu\u1ed1c c\u00f9ng nh\u00f3m v\u1edbi levofloxacin?<\/div>\n
d.N\u00eau ph\u1ed5 kh\u00e1ng khu\u1ea9n c\u1ee7a 2 nh\u00f3m kh\u00e1ng sinh n\u00f3i tr\u00ean?<\/div>\n
<\/div>\n
C\u00e2u 5<\/strong>.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\u1eb1ng 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\/l, HbA1c: 7%, ch\u1ee9c n\u0103ng gan, th\u1eadn b\u00ecnh th\u01b0\u1eddng. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9\u0111\u1ecbnh d\u00f9ng th\u00eam:1.Empagliflozin 25mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean sau \u0103n.2.Perindopril 5mg, u\u1ed1ng s\u00e1ng 1 vi\u00ean sau \u0103n.<\/div>\n
Tr\u1ea3 l\u1eddi ng\u1eafn c\u00e1c c\u00e2u h\u1ecfi sau:<\/div>\n
a.N\u00eau l\u1ee3i \u00edch c\u1ee7a Metfomin?<\/div>\n
b.K\u1ec3 3 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Metformin?<\/div>\n
c.N\u00eau nh\u00f3m thu\u1ed1c v\u00e0 c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a Empagliflozin?<\/div>\n
d.N\u00eau nh\u00f3m thu\u1ed1c v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Perindopril?<\/div>\n<\/div>\n
<\/div>\n
L\u1edbp YK19A2\u00a0<\/strong><\/em><\/div>\n
<\/div>\n
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<\/div>\n<\/div>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Th\u1eddi gian l\u00e0m b\u00e0i 90 ph\u00fat\u00a0 \u0110\u1ec1 thi onl v\u1edbi c\u00e1c l\u1edbp YK19A1, YK19A2, YK19A3\u00a0 L\u1edbp YK19A1\u00a0 C\u00e2u 1.B\u1ec7nh nh\u00e2n N.T.X, n\u1eef, 26 tu\u1ed5i, l\u00e0m vi\u1ec7c t\u1ea1i m\u1ed9t c\u1eeda h\u00e0ng b\u00e1n qu\u1ea7n \u00e1o, nh\u00e0 c\u00f3 nu\u00f4i m\u00e8o. Ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 m\u1eb9 b\u1ecb vi\u00eam m\u0169i d\u1ecb \u1ee9ng. C\u00e1ch \u0111\u00e2y m\u1ed9t n\u0103m \u0111i kh\u00e1m v\u00ec …<\/p>\n","protected":false},"author":17,"featured_media":1581,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[117,113],"tags":[],"class_list":["post-2233","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-de-thi","category-de-thi-y-da-khoa-nam-3"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2233","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=2233"}],"version-history":[{"count":1,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2233\/revisions"}],"predecessor-version":[{"id":2234,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2233\/revisions\/2234"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/1581"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=2233"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=2233"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=2233"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}