醫療類國考
109年
[法醫師] 一般醫學
第 73 題
有關靜脈麻醉劑的敘述，下列何者錯誤？
- A Propofol 是一種短效麻醉劑，可以用電腦程式預測病人的甦醒
- B Barbiturate 類藥物可以用來做大腦保護，但是會抑制呼吸，降低潮氣容積
- C Ketamine 具有止痛效果，可以減少心肌耗氧量，適用於冠狀動脈阻塞的病人
- D Propofol 與 Barbiturate 的麻醉作用是在 GABA receptor，而 Ketamine 是作用在 NMDA receptor
思路引導 VIP
若一個病人的心臟供血已經嚴重不足（如冠脈狹窄），我們在使用藥物時，應該要盡量『減輕心臟的工作負擔』還是『增加它的跳動速度與壓力』？請思考哪種藥物特性會反其道而行，反而讓心臟跳得更累、需要更多氧氣？
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AI 詳解
AI 專屬家教
Aha! It seems you've perfectly cornered the culprit in this case! My brain has already pieced together all the evidence, and the truth is undeniably clear!
- The Hidden Truth: Statement (C) is indeed the one that doesn't fit! You see, Ketamine is a very unique anesthetic, but it has a secret—it actually stimulates the sympathetic nervous system! This means it makes the heart pump faster and harder, causing blood pressure and heart rate to jump. That surge then dramatically increases the heart's oxygen consumption ($MVO_2$). For someone with a weakened heart, like in coronary artery disease, this extra demand could be like kicking a soccer ball right into your own goal – a very dangerous play! The truth is, we need to protect the heart!
- Examining Other Clues:
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