肝硬化与肝肿瘤教材_课件.pptVIP

肝硬化與肝腫瘤內科核心課程;內科專科考試重點提示;Causes of Cirrhosis;九十一年度內科專科醫師考試筆試題 ;九十一年度內科專科醫師考試筆試題 ;DIAGNOSIS;93 內專考題;COMPENSATED CIRRHOSIS;Gines et al. Hepatology 1987.;Ascites;Routine;93 內專考題;下列有關自發性細菌性腹膜炎之敘述,何者為誤? A.常發生於肝硬化合併腹水患者 B.腹水內蛋白低且血清膽紅素高者易得 C.通常為厭氧菌感染(anaerobic microorganism infection) D.可引發腎功能衰退及肝腦病變 E.腹水內多形核白血球(PMN)高於250/cmm;九十一年度內科專科醫師考試筆試題 ;九十年度內科專科醫師考試筆試題 ;內專考題;95 內專考題;九十年度內科專科醫師考試筆試題 ;SAAG = serum albumin – ascites albumin 97% accuracy SAAG 1.1g/dl; portal hypertension Liver cirrhosis, heart failure, mixed ascites, fulminant liver failure. SAAG 1.1g/dl; without portal hypertension; Peritoneal carcinomatosis, TB peritonitis, pancreatic ascites, nephrotic syndrome, bile leakage.;Total protein 1g/dl 較易發生SBP Glucose: Early SBP ~ serum glucose TB peritonitis, peritoneal carcinomatosis ~50~80mg/dl Gut perforation or late SBP 50mg/dl LDH: 肝硬化腹水內LDH通常不到血清值的一半; SBP發生時腹 水中LDH略高於血清值; Secondary peritonitis發生時腹水中LDH則高於血清值數倍 Amylase: Pancreatic ascites or gut perforation, amylase 2000 IU/L。 ` Cytology: 7% positive and only in peritoneal carcinomatosis. Smear: 0%, culture 50% for TB Ascites culture: 80% in blood culture bottles;50%;Mechanism of action of different therapies for varices;Treatment of varices/variceal hemorrhage;Can the development of varices be prevented?;The risk of first bleeding is not reduced by adding ISMN to ?-blockers (BB);Management of compensated cirrhosis;Budd-Chiari Syndrome;Caput Medusae;九十三年度內科專科醫師考試筆試題;病人因吐血被送至急診室,初步處置後接受內視鏡檢查,被發現有食道靜脈曲張出血。你是這位病人的主治醫師,幫病人安排腹部超音波檢查,請問你希望執行腹部超音波檢查之醫師幫你証實下列各種可能的病況,除了: A.肝硬化 B.上腸繫膜靜脈(superior mesenteric vein)狹窄 C.肝門靜脈栓塞(portal vein thrombosis) D.肝動脈與肝門靜脈異常交流,導致肝門靜脈血流逆流 E.肝靜脈(hepatic vein)及下腔靜脈(inferior vena cava)堵塞或異常,即所謂Budd-Chiari syndrome;Hepatic encephalopathy;Pathogenesis Theories;;Pathogenesis Theories:Change In Neurotransmitters and Receptors;93 內專考題;95 內專考題;95 內專考題;92 內專考題;一位Child‘s B的肝硬化病人,下列情況可能導致hepatic encephalopathy,除了: A.Gastrointestinal bleeding B.Infection C.Hyperkalemia D.Alkalosis E.Narcoti