高普考題庫
109 年 109年公務人員高等考試三級考試暨普通考試・調劑學與臨床藥學
申論 2請閱讀下述案例報告病程描述並回答下列問題:A 71-year-old woman with paroxysmal atrial fibrillation being treatedwith warfarin 3.75 mg/day presented at the hospital with a 5-day history ofincreasing swelling in her neck, sialorrhoea, and difficulty swallowing. Oneweek earlier, she had been started on fluconazole 200 mg once a day becauseof oral candidiasis. She was afebrile. Physical examination showed a large,soft, dark-red swelling on the floor of her mouth: her tongue was displacedsuperiorly. She had a sublingual haematoma. Laboratory testing showed aC-reactive protein level of 65 mg/L (reference value <5.0 mg/L), a white cellcount of 12.510per L with 83.3% neutrophils, and an internationalnormalised ratio of more than 9.0 (reference range 3.0). Coagulation wasrapidly corrected with prothrombin complex concentrate and intravenousvitamin K, leading to spontaneous resolution of haematoma over the courseof one week while the patient was under close surveillance.㈠列出文中所述及藥品與其用途。(3分)㈡說明該年長女士之病程概要與可能原因。(7分)㈢分析如何解決與監測此案例之臨床狀況,並闡述藥師角色。(10分)