繼續教育考題
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1.
(C) |
Which of the following
descriptions of fat embolism syndrome is WRONG? |
A | It is most likely to occur in
patients with multiple long bone and pelvic fractures. It may also
be associated with nontraumatic disorders. |
B | Patients with fractures
involving the middle and proximal parts of the femoral shaft are
more likely to experience fat embolism. |
C | Symptoms usually become evident
within 46 hours after the trauma |
D | Symptoms usually become evident
within 24-48 hours after trauma |
2.
(B) |
Which symptoms/signs
below are common manifestations of fat embolism syndrome? (1)
Hypoxemia (2) elevated temperature (3) jaundice (4) neurological
symptoms (5) hemorrhagic petechiae |
A | (2), (3), (4) |
B | (1), (2), (4), (5) |
C | (1), (3), (4), (5) |
D | (1), (2), (3), (4), (5) |
3.
(D) |
Which of the following
descriptions of fat embolism syndrome is true? |
A | Initial symptoms are probably
caused by mechanical occlusion of multiple blood vessels with fat
globules that are too large to pass through the capillaries. |
B | The late presentation is
thought to be a result of hydrolysis of the fat to more irritating
free fatty acids which then migrate to other organs |
C | Unlike other embolic events,
the vascular occlusion in fat embolism is often temporary or
incomplete since fat globules do not completely obstruct capillary
blood flow |
D | All of the above |
4.
(C) |
Which of the following
descriptions of the pulmonary manifestations of fat embolism
syndrome is WRONG?. |
A | Chest X-ray may show evenly
distributed, fleck-like pulmonary shadows (Snow Storm appearance),
and dilatation of the right side of the heart. |
B | Hypoxemia is present in nearly
all patients |
C | Hypoxemia in these patients
has been attributed to impairment of diffusion and can be easily
reversed by O2 supplement |
D | Acute cor pulmonale is
manifested by respiratory distress, hypoxemia, hypotension and
elevated central venous pressure |
5.
(D) |
Which of the following
CNS signs of fat embolism syndrome is true? |
A | Change in level of
consciousness is common |
B | Usually nonspecific and have
the features of diffuse encephalopathy: acute confusion, stupor,
coma, rigidity, or convulsions. |
C | Cerebral edema may contributes
to the neurologic deterioration |
D | All of the above |
6.
(C) |
Which of the following
description about the hematological manifestations of fat embolism
syndrome is WRONG? |
A | DIC with thrombocytopenia and
bleeding tendency are commonly |
B | A petechial rash that appears
on the upper anterior portion of the body, including the chest,
neck, upper arm, axilla, shoulder, oral mucous membranes and
conjunctivae is considered to be a pathognomonic sign of fat
embolism syndrome |
C | Petechiae may appear late in
the course and often disappears within hours (may result from
occlusion of dermal capillaries by fat) |
D | None of the above |
7.
(C) |
Which of the following
description about the laboratory findings of fat embolism syndrome
is CORRECT? |
A | Serum lipase is often elevated
in these patients during acute stage can be used as a marker of
disease severity |
B | Blood lipid level is helpful
for monitoring of the severity of the syndrome. |
C | Examination of urine, blood
and sputum with Sudan III staining may detect fat globules that are
either free or in macrophages. |
D | The presence of fat-containing
macrophages in the BAL is specific for the diagnosis of fat
embolism |
8.
(D) |
Which of the following
description about the management of fat embolism syndrome is
WRONG? |
A | Treatment of fat embolism
syndrome is mainly supportive |
B | Oxygen delivery by O2
mask |
C | Mechanical ventilation is
required for severe cases |
D | The use of PEEP is not
recommended in fat embolism syndrome |
9.
(D) |
Which kind of drug has
been shown to be effective for most patients with fat embolism
syndrome? |
A | Inhaled corticosteroid |
B | Intravenous heparin |
C | Antibiotics |
D | None of the above |
10.
(A) |
About the prognosis of
fat embolism syndrome, which statement below is WRONG? |
A | Prognosis is worse than that
of acute respiratory distress syndrome secondary to sepsis or
pneumonia |
B | Prognosis improved after the
introduction of mechanical ventilator after 1970s |
C | The current mortality rate is
about 10% |
D | Improvements in the surgical
technique and post-op care of the fracture may reduce the incidence
of fat embolism
syndrome |