Microsoft Word - 平成24年度医学部卒業試験問題-2.docx
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- えりか くまじ
- 9 years ago
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1 :
2 /kg :2 AED 3 1
3
4 2 X X SpO 90% 60mmHg Primary Survey FAST CT 90% 100mmHg FAST 1 2L FAST(Focused assessment with sonography for trauma) 3
5 HUS CRT:1s CRT:4s START 30 4
6 2 SIRS SIRS SIRS SIRS 20 5
7 SIRS G 2 6
8 Fowler PAM 2 7
9 3 8
10 ARDS 18 Hg PaO2 FiO2 400 Hg ARDS 95 PaO2 A-aDO 2 COPD ACS) VF ACS AED ACS BLS AED CK-MB H-FABP T avf ST 9
11 Q V1 3 V2 V3 V4 V5 18g/ COPD CO-Hb 10
12 6Gy 4Gy 1 1Gy Japan Coma Scale early CT sign 11
13 12
14 Hb 20.2g/dl /40 mmhg SpO2 90% 25 / 13
15
16 29 159cm 81kg 32/ 106bpm 98/76 mmhg CT D-Dimer /68 mmhg 60 / SpO2 92% 9 / 36.1 JCS PAM
17 , ( ) CRP 2.8mg/dl / / SpO2 99% E4V4M6 CT 21cmH2O MRI CT , 23 16
18 cm 70 kg 24/ 116/ 116/92 mmhg 500 ml ml 750 1,500 ml 1,500 2,000 ml 2,000 ml / 17
19 / SpO2 100%( 10L) ml 1L CHDF HCO3 - CK AST(GOT) LDH T /65 mmhg 40 / SpO2 92% 9 / 33.1 JCS 20 SpO2 18
20 SpO2 E3V3M5 88/ SpO2 86%( 10L) 3 2 X CT 19
21 80 50Kg % 37% 39% 41 45% Baxter 1 120ml/h 230ml/h 370ml/h 460ml/h 510ml/h 20
22 cm 55 kg 24/ 86/ 142/92 mmhg 21
23 63 :160/96 :48 SpO2:98% 6mm 4mm GCS 4 Secondary survey CT CT 2 22
24 mmHg 23
25 45 SpO2:100% :80/60 :140 Primary Survey FAST CT X X Primary Survey TAE( ) / / mmhg mmhg Hb g/dl Hb g/dl ml Hb g/dl 12 24
26 80 2 JCS 30 JCS100 JCS300 GCS 7 GCS 8 40 CT
27 NSAIDs 3 118/64mmHg 45 SpO2 100 CT X ECG 26
28 25 170cm 65kg / 80/ 100/80mmHg CT 24 27
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1 FEV1.0 FEV1.0 30 80% NIH FEV1.0 50 80% FEV1.0 50% FEV1.0 cyanosis PaO2 PaCO2 PaO2 PaCO2 40mmHg FEV1.0 25% 2 1 1 2
15 1 12 1 2 2 2 2.1.............................. 3 2.2........................... 3 2.3 β........................ 6 2.4............................ 7 3 8 3.1....................... 8 3.2....................
6 12 10661 93100 227213202 222208197 85kg cm 20 64.521 106856142 2 1 4 3 9767 100 35 cm 7747 208198 90kg 23 5828 10661 93100 cm 227213202 10639 61 64.521 85kg 78kg 70kg 61 100 197204.5 cm 15 61
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1 2 (90cm 70cm 2015) 3 (68cm 28cm 30cm 12kg 2015) (77.5 109.5cm 2015) 4 (22cm 50cm 50cm 4.6kg 2015) (45cm 62.5cm 2015) (47.4cm 62.5cm 2014) 5 (28.5cm 23.5cm) (45cm 62cm 2015) (97cm 107cm 2015) 6 7 8 9
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21 180 140 22 23 25 50 1 3 350 140 500cm 600 140 24 25 26 27 28 29 30 31 1/12 8.3 1/15 6.7 10 1/8 12.5 1/20 140 90 75 150 60 150 10 30 15 35 2,000 30 32 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 % 100 50 33.3
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24 11 10 24 12 10 30 1 0.45m1.00m 1.00m 1.00m 0.33m 0.33m 0.33m 0.45m 1.00m 2 23% 29% 71% 67% 6% 4% n=1525 n=1137 6% +6% -4% -2% 21% 30% 5% 35% 6% 6% 11% 40% 37% 36 172 166 371 213 226 177 54 382 704 216
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表 1 入院時検査所見 11,500L 471 L 17.0 gdl.3 L ph 7.49 PaCO 37.8 mmhg PaO 67.4 mmhg HCO 3.6 meql B E 1. meql 141 meql K 3.9 meql Cl 108 meql Ca 8.4 mgdl P 4.5
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17 2005/12/28 UP 3+, TP 4.2g/dl, Alb 1.9g/dl PSL 50mg/day 1/17 PSL 45mg/day PSL 2006/4/4 PSL 30mg/day mpsl mpsl1000mg 32 5/8 36.1 :90 /:114/64 mmhg 166.2 cm64.3 kg 3.9 g/dl 1.6 g/dl 382 mg/dl 408 mg/dl
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本文／一般演題＿吉田
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