32 關於膽道疾病的敘述，下列何者錯誤？

超音波掃描是優先考慮的診斷工具

無症狀膽囊結石，不一定要手術

急性無石性膽囊炎（acute acalculous cholecystitis）常發生於年輕病患

治療左側的肝內結石（intrahepatic stone）有時須將肝臟左葉切除

ANS C

Age

The condition can occur in persons of any age, although a higher frequency is reported in persons in their fourth and eighth decades of life.

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33 病患因消化性潰瘍術後，引流管發現大量（每天大於500毫升）的腸胃道內容物，腹痛、發燒，但血壓、生命現象仍穩定，則下列處置何者錯誤？

給予適量水分補充

抗生素及全靜脈營養補充

先接受腹部超音波或電腦斷層檢查，並予以恰當腹腔積液引流

應立即執行剖腹探查，修補滲漏的穿孔

ANS D

NOTE vital signs stable. ex lap is not necessary.

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38 上喉神經損傷（superior laryngeal nerve injury）會有以下何種機能喪失？

呼吸困難（dyspnea） 聲音沙啞（hoarseness）

流涎（salivation） 高音調（high pitch）異常

ans D

SUPERIOR LARYNGEAL NERVE = SUPER HIGH PITCH FUNCITION

it is the damage of the recurrent laryngeal nerve that will:

• If the damage is unilateral, the patient may present with voice changes including hoarseness.
• Bilateral nerve damage can result in breathing difficulties and aphonia, the inability to speak.
• The right recurrent laryngeal nerve is more susceptible to damage during thyroid surgery due to its relatively medial location.

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