37.為Geriatric Trauma, 今年沒上 38.ABCD都對,但是根據我查的資料我覺得E好像也沒錯,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 右臂右腿無力且右肩尚有痛覺--表示傷在spinal cord 右側,且位置介於支配右肩和右臂的神經 左臂左腿痛覺消失--也表示表示傷在spinal cord 右側 因此大約在C5 40.D 錯在methylprenisolone不能用在penetrating injuries,只能用在blunt spinal cord injury A Brown-Sequard syndrome就是指spinal cord側邊橫斷而導致運動或感覺喪失 --

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