37.为Geriatric Trauma, 今年没上 38.ABCD都对,但是根据我查的资料我觉得E好像也没错,以下附上查到Tintinalli's Emergency Medicine的原文 B Leaking fluid can also be tested for a specific CSF protein, transferrin C In the first 72 h after a head injury, pneumococcus is generally the cause. After that, gram-negative organisms and Staphylococcus aureus become more common D Administration of antibiotics should be done in consultation with a neurosurgeon who will be following the patient E 1.patients with signs of herniation may need emergency decompression by trephination ("burr holes"). 2.The high-pressure arterial bleeding of an epidural hematoma can lead to herniation within hours after an injury. Therefore, early recognition and evacuation is key to reduce morbidity and mortality. Bilateral emergency department trephination (burr holes) is only indicated if definitive neurosurgical care is not available. 39.D 右臂右腿无力且右肩尚有痛觉--表示伤在spinal cord 右侧,且位置介於支配右肩和右臂的神经 左臂左腿痛觉消失--也表示表示伤在spinal cord 右侧 因此大约在C5 40.D 错在methylprenisolone不能用在penetrating injuries,只能用在blunt spinal cord injury A Brown-Sequard syndrome就是指spinal cord侧边横断而导致运动或感觉丧失 --

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