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'.$ TN'J'.-TiIO DIl Y D^UQC CAN THO v:- eQ iraox'rAu rHAN N.av thi:10/6/2014' iil;,.i rn ' ,-, ^ Bi ttri mdn: !T Tim Thin DOi tugng: \, v/ Trgrn: i MA DE: "'*vv ,\'1 Trieu ctlthng ndo sau dfry thuQc ,6i logn tw duy: S-r(Z' Wl.Yti,bflh ou' 6*! '(u u't 1.a* "i b) Tucrng nham "j mi, cangiruorg e*?"ir Y K25 't'r-'-'^$J- LAn thi: -)ro," ': +hbi gian lirm bai: B phtt/ I tr?m' qu:: hiit DA: 100 ': ?!'-/ stg vipc dd xiv vd thay ';;"fXl::['r'iri;f,';:;if,:;;:l;:r':r::t iuc nstdi a) Qu0n ccrn -bJ Nh6 gie chuvQn Y.;;;;;'uo rou ddv tluqc sft dvng *nAmi'thirc: @niu {; Ntto nttam a) Quan sit cim xirc ,t-agg BQnh nhftn trgng thtii,trdm cdm vdi ! tu'ottg b) Hdi f tuang hoang tu&ng, em anh t,{,ty, clro yin.l phdm chdt xdu, nhi'r'r kltuv€t ,,4 A,HAi r rur v *,,no ^sr5ouanh triQu chirng gi: Y ru']'r X; ttoi vA ao giac bi€u ndo sau ^3 Ptttit tIiry diam" ' ddy ld phit hqp vti cftm xrtc ciln Q?th,Ui" b) Am enh ^1- mon: f*ilinoi, nQi dung kh6ng phong phu Y) i;A >ttar, "i icictritrictr x,.jng quanh c) Hnnh vi di tsi iui nhiAu c) Ao tucmg d) Hoang tuctng B€ni ry:A" vdi, bi6u hiQn kdm tri nhd vd nh$n t tf; -th1t1' to.:f :ifS 9', nghbo,ndn vA crt'm gidc' nhitt ,r) Hrmg ph6n, vui vd hsn binh thucm g , bidu hiprt cfia r6i lottn gi: c6 stg it6u tranh cdch c6 lrtc biin aai- ta 4, Hitnlz vi xufrt ltign dQt ngQt kttbng v* tT":}tl vO nghia l) ItAT b€n ad *im'cltd lgi, n6 xdv io ua id' hav Olli,t-tl't311'$i', vd mdnlt iitt, ci xu hwong gAv isi ddn b&e'' tk6n phdn liQt QTam thin ) ntbi trwdng xung quanh,"nhi n iripu ch*ng ph6t trien tlm thin @c[am md ICD'10 v6i ki hiQu Fab't, clt'7n pl:'at -|L'-T'ong (B fianl vi xurrg d'ng, kich gi? flb;j ;;;;i"-,.e oO'e dQng Y,i*?irig?i3?i*sia; ddy clt*ng Tripu nd'o ts Korsakoff: a) Hnnh vi gia nho satt tdng Larls b) Ting c) Hoang tucrng, Ao gi6c tituQc 'Jf'{{!tr;,in,so.*an,k1^nh (s* {d\ l'[*u' !e$ 't.[*'* @,o 1? 1",1!'*" $w - -,.-.^ -di'l1si*be* phil bi6u niro sau day KFhNG yhit hzp klzi nai n.di ' ric,tinh thuic antlfia kinh: ItQi chrirng I u ie ihe 'nu? ':?"1""F cdp cuu a) LamOt noikhoa g vit;"d aavitril"tir}, =-A^,n , 4, ,_^: thAn kintr co' t[ng men CPKddi Ul p1C" hiei1t{ TriQu cltftng ndo sau dAy KIIANG thupc hQi a "",tri,nili^'ga*, c) DiQu tr! chu yeu nAng dd nutop.riaot mg ticm bip dd diau ui s;;di nghia a) Khi sdc tr'n ca.m g6c cila th.uQt.ngir Hi' lgp trottg -t-ir YZ' fn'o ffi\ ciam tii nhs t?Yl1Tll:'^i"^: u, (optiv, Qpsv) cd nghin [i: ,{^1 c; Tu ch4m ch+P -f1 schizophreiia,';phrenia" 1?r divin ci'6ng biuc cir€ '" Allil|;* \4 -: , c) Kol loa.n d) Phdn IY / c\,,, uc ' c[';r, "2"tL tte: lUu Tr4m: a)25 35 35 khin.phdt wj+q"mdi ram thin phdn IiQt "'";'.d ls b) @_0.t ndo: W.*ot loq'n d4ng phan ller :q." Tl h4A uts: fl;i^ 761 Qm*ru*n'fiil*'*T* iii"ii"t, t# t$,f 53 io ini d 'n6' n*A Tr \ l - rlan1 'sfi''j f€.r trd ":,?5 70 bQnh phdn li€j cd citc thin phdn tdm ftdn cia fim iito crta iao cltric: vd Toong tuhttg vd gidc rd rQt, hdnh vi v6 tit vlt kh6'i bQnh muQn hott' ndi \!':it^!::*::::iwsc, l'olt biEu nito sau itfty KHilNI.phiyhrp fhi ThA xuln ,,iT.s.tdm thin phdn^ tiQt: ,a) ^n, ,i nWrcrynaoiJt qll]? 1=Ti:-1^ l" 'tr a) Th€ tram cd.m sau phin liQt ,.'-''-' '" :iffll{*trfrTixf:;,1;,Sxu6n ffiili?iiltlijft^"'.'-'{"f", liet' fi logn vdi tinh nai phdn , ,lot, i,4.Q+ r,,t tftm thfrn @-o:.h5s-sau 1r"" "'a'hav gdo nhdt uur&6 twons nw s*Pry 75 Logi hoang'twhng *fi",i;i;;;-t @?ilul" E; i-ienlQ , cl lic!_nnoi i+cc''it''t;a-rrPL :phil hsp ndi vi ao 40 Phtit u,i "a') '"'iu, ch'dt c'fia'cdc hoang tw6'ng ndo npi dung kh6ng kr qu-di tro!_s ir;;;";oi;r'i;;aia ',!;#r;J;:r;#rc!I.f,iuiulf,,,Y;X'i;;,'f;',iii, -i tian quon, hdni vi vo fi chil'c g:rtr','tr ttuyinais iqtc ciing nhw crlc tri(tt rd"rpt'ho(c idng - inmrg cttirns amfinh d)Tgcao 1'6 Jk;1.#7""'' ;ffi;iffi;"iran'et BfiH;Hf.lilt;Lti t+ loan tim tlqtt : '!J'{!ifJu;ui dusc benh nhan.nghy thay tu m6i rrucrng "dfrat thAn thuc the t [""-(+''at llR-t-:t:?i.tT phin ftat' b€n ngoiri co thA cua bQnh nhan 1; r n6i vi ltguyun'tilc diiu tr! tdm thin zlz, phan tha b nrrar, bgnh md b) Tiene noi rafro rang ! ngchpn-'!" Y.ONG phil din ) rj'frruv th'oc biQt dusc d6 Ia giqng din 6ng hay di€u tri cic trit:'t xac-ai*r ptrii ,i,an'giai ao* gioo cua tim ,oc) Ao that c6 d iie; c6c thu6c khac so v6i nhrng rin iro gi6c vir n bir'"' d6 "Biiu1*iJ**t**rei;.;ir l lu:le nAo | ttdy td pttit hgp ndi vt Phdt Uiei /- Ti'"qg vA aiAu vi $,}3;jit"ng sau 17 hgp: :j ffiigian cua t6i,thi6u cho mot li?u trinh diAu tri mOtthu6cli4dan6tuin' nguy,Ennnan'r'io-rinqtr,iorls,ti,'qt'^.urt i,*ch6ng loan tb2 e4?^q tdi ;i;G" ;i1a a*ng phr; cua thu6c rganthL yeuto co xirc c,m rop a) R6i ^L bing trihexyphenidvl' tn*l tfiuE.rnhcim b) R6i loan ;5-d6ng su dUrffiffic 'u'u" 'u oti ,i ti'ua, ch6ng loq'n thftn thi hg c*' n*rr.-Khi ' t'u benzodiazepin 6m anh:"0' cfru phit ht' p: t*-^ dofa4r'r'r"' sg' c) R6i lo.an hirnh vi cuongchO dopamir''* 'l'gn gil;il Jo ta a*g a6i van s'er\ine -tinh (Elrcac t.n thuong thgc th nao nhiiu nio, viam nio ^ cua'ogn-h tr.n cac trieu chtmg driong y cni cdn I tri(u ctu*ng tnia,c tiau_cfujy I aa ffira au"g n,u , Y"t thin phdn liQt cttdn dorttt t6m tttdn pttdn^Ugiiiro DSM-IV c) it tic dung tren trieu chtmg im tinh cltgn triQu cltdrng ndo KHING pltit hqp: d]19:I tf dilnc phr; ngoqi th6p dung ki.quai' I losn thdn c'5 di\n' choi't vi ;t;i; 'itaig hgn: , i a t - rL.' ih€ thu *ul chu vAu tran ciic vin 'Dcdupltit ue"r'*al, dsa, gi6t.hav gav hai t-i::,":;ltr::' " 'o'de2 hay nhi€u ft,it'z gtn-g n6i tro ifuq$lt eo edm rnil ycu trSn tri.u th*aN$vd d'r'q a) Hoang tu6mg c.6 nOi qrc b) Ao ralieng n6i binir oohli'i,u,, , L.-L -LA6 vi hdnh vi 6i:*H*1t X Av chuyQn voi \ ;:td;;'irirln, pttdn ti(t theo zt xni ndi f,401"***) @5Fui ? ,, iinh tdm.thdn Id docin ^.,.hsp duqc chdn ICD - I0 ntrnns ,;-,i.U ,'*Ml,Tt'{,;:f;hdng a) ROi loan tAm thAn cdP Siian sd itusc b!.rdi chdn ff*-.tnu6t dai diQn; oianzapin' d$tfil!;*a*tdc risperi'Jcn dung ngoqithap nhibu hun ?- Ei,: ltltl Tr4m: ,ii'J MA DE: bidu hiQn thu rit,.-xa l6nh' vQ sinh th6n thi kdm' chi.dinh ituqc it6y sau tltdn logn ch6ng 25, Thu6c ;;;"s- A!:JaY yielr" Chdn dodn tric ndv m *e si iriiu tr!cho cd,c ie'ni nnantam *dn pii'n- uryl*nang d gay iiary tqch cfia tfr.m thfrn phdn IiQt? tr!, nhrns bft"':;';"";'"i"i iia 'rt*rts -[-.rt n, ut: -r t'tt z:"-et" :-ni.".riaon b) Th€ cang trucrng lgc raDUlozaplne \K c) ritq di.chung @ vdt cirm sau Haloperidol ?r:y;f;;f#'ftoono orrithqp voi ti6n rwqng xiiu ier, it' d b€nh nhdnffi;;;dtiia, *df : ff,[ff,':;;;;;{n r gla dinh lo4n thin $Co tiAn su c) Kh6ng c6 yeu d) Bat thrro'g ul rne trAm Phdn ligt i;ruc _,sau ndm bpntt ;i.^ nhr,n td tsi tdi *ndTn',a-i; ;;d, wn tinh.tiqne, t:.',ni: cftn.g nhai nhw tttd kh6ng kiam ctft ryie's aisi chdn dodn th€m ndo Id phit h.op d th6'i di6m h'#?u;'iir'ui 1'' ,ndY? *,i"a" iqi @ R6i lo4n vin dQng musn UOi chrmg Parkinsondo thu6c * nao c) Loan trucrnq ru9 9o.caq , zl in-iffie ;;; ;iils;rsc horr.l al HQi chtmg dctinh thu.c MOt benh ** ,Llilrai, prral bqnh kholng knAi nifm "dimg nhiiu rugu.Igp !t' Iftn lgi 'lLa , ngt, ti6ng-noi trong:tai xui SZ' thang voi ;il "gt ru duong,';; dil;rui ttai' ngiry din nai gay fic hgi tdn thd chit' tinh thfrtt"' gisc, bdt benh nhnnti minh; gpild:BQnh nhnn cim thAy c6 ludn theo d6i T{53 i* nhu trudc, c6 nhimg a) Nhi6m dQc rugu dinh nguoi than v6 cd' AP:lg l?p ruqu 1ic lim nhim i-,qt thuQc rugu Tham kh6rn khac khdng phdt hien benh 19 noi ngo4i bQnh nhdn f.frOng lim vigc ftir '*inh, ql9 khoaquantrong,kh6ngti€nsusfrdpngchttmaniy'd)Lamoungrugu dt+ I; TiruOc chong ) ) f) " ll-9 giiilc trim iu "i'liii7'"rblnghisr'rwsudaodottgtir: *R;:? ::: l:? cirm yl,ilZll,i rrou, ,,ru ttito ,!u6., r'a rynq-:!^:t:j thuvEn,hda Ii* :oy fi}l?TiF"tgH;Y^ys4r{c rdi sau rythNc iluqc chuv*n hda sd gdv hiprt, L" iiie aai , i#.',ri tr trwung uur' u'Ee sau itfty;uIY;r;;{; :do rcqn "wt'6 nsy: Haroperidol Ir ru &zusperidone itfrv cho fuwg-buin non, non 6i, nhthc cldu, nrtng ltttt c6 tha gidrc vd caii cimg gfty ch6.t do Iifi q dy ia"g, &o Gt T) hftt:' oranzapine @+':l:i*l* b) Acettc rt acto c) Aldehvde dehvdrogenase d) Chlorpromazine e1161 )ls Ti'ioN-c- iiqp LAM sriNc sau z ngdy diiutri, dQt nnrci Wh- nhfrn.cuttg hitm, trgn *i7' y^o '.6 llAl::1"\dehvdrogenase 3'5, Ndit'i sry phdn chia theo nhintg r,i logn fiAn vd cltdy nw6c cldi Tltudc oao tt,ict iW Ai diiu yn a'1y1t' chqn c.fru drtng: , lr{ ,Aitog" mi phdt " quan ruo-ti u; Nitqlg toito+n su dgng rugu gom: lam dgng a) piracetam V L 1";'t* ' #' r a b) vatproate nhiem'ruo-Lt gdm: rusu gay loan (u)*t*g r6i ['p {d -hn\'tx., "' ' -' -i'r c,ai ruou Yl ci*g.biioba t_ s _ _r r6i ioan su dirng ruou gdrn: cai ruou i,a i3 phtl rtsng tdc Do SiryC tApf 30 TRUN;^rq, S\O*t thuQc rueu l , ,a ,il-riiyiriiii,ri, bQnh nhdn u6ng thu6c kh6ng, ruo-r-' d) Nhrnig r6i 1o4n gay rusu g6m: 1€ thuoc id nam + nnia1s gian jt trtdi diu, ty b6 trtu6c, Trong ;i;,;{ri, nttd.n tdi pttdt b(nit nhiiu tiii, aan ain vd nhi6m ddc rusu dac uttg tri ;#.i]ri ndy: sodium l'-"'*[ *t*ftTw x Eb: 108 Tr4rn:4 sir tit d) Lo?n s6c chu ki hon viQc ddnh gid nhitng rdi togn 42 Ti luu hdnh cfia trilm crtm chil ydu ngu'iti ctvng rwou, tac gii niing^(l9ia1 lwa chwvidt trwdng thdnh Id: c.eEt, insn j, ighia xn-hNc p.hil a) c6 fuo'gid anh (chi) carn !b"v miott nOn oit giirm R?; fl-f4 ' (but downfviQc u6ng rus,r i9 zox ts phiin pi (chi) cim thAv C6 bao gid an[ q>24% (Annoyed) boi mQt vi chi trich viQc udng nrEr cua 36 Di AE hqp: t?'1:, q '!2v: ! ctrult fl bnn chua? co bao sio anh (chi) cam th6y tg cao (Grandiose) trdm cdm chrtyau: (9*;ie."ilf;;*cuabpchua? " -, - -.' ) vspLl\ "c d) C6 bao g'iA th (chi) u6ng rusu vdo bu6i sang simr 9:i ll chung,.nam = nt T Z4 ni€n, nam < nt thi€u (iv op.nrt) chua? @luoi ;; i,,, ,: ; :i*i:';,!l"i!,ifil !! f iTi{; ::;;: ;#;!,1;ffi iy ^" u,,, a)Tilechung,nam>nt ffi r, d u r ri c plzrit ildm b6a chfrc ndng sinh tin, cdn bii sung vitamin, nh6m nh6n cdclt co ch| bQnh sinh, clipn , dpc bipt Id vitamin ind* ndo sau -,i,*j.c lrytphdn r.i{ A6-yl!t"c4c1r paranoid' cdih lv'Afih-in a) ryran b) Nhdn c6ch ranh gi6i > nhdn c6c'h phAn ly' r€r B ddy: r A I ^ ;^d#*n \X; c) Nhdn cdch 6m,anh > nh&n cdch ranh gioi u/ \d) Nhdn c6ch chgng AOi xa h6i > nhdn c6ch ranh gioi d) D Rii logn gi6c ngrt diin hinh trdm cdm chti |s| luat vd cdc giai dogn cai rugu, giai ilogn *do^n,,i7 'yo'("-t!i*np hipn: q16)thwdng tdt eii1Sfrl -co silt: lieu *d{'1ipi a)MAtngudnuh0m "-'a)6-8'gib ;) ; lf gi" NLi vL- tLau,r 4(ii D Kl6ng tri dusc giAc ngu lan t6a g\d ^ , , &l'i4, "gY cudi dern Vl;; -1fii, nri ,ulnt Jrr c',ri r tl-u @4ingu nhdn vdi biiu ttign cdng thdng nbi tfrn, dodn phdn bit.lt voi sgng tlo V ne"i 6i;rz - zi Ktti ndi vi c,ic chin nianh, cdn cdo h;to cai rwqu d nh6m bQ-nh c6 td"g h;;;;iirg ttriin"ktot ltil n.ip, itdnh tring ngtrc,.iych gi crta ffftm cdrn: v1t vd thay dii trgng thtii tdm thin, chpn cdu tir, , p6y li tri(u chtittg , ^ thwc "xiOie'ini 0+ g.lv{it sinh iuc,-,_, 39 r'^ nw, f'-7) GDtq* l) loan hoat co th€ d";#['#*u' cholinergic lteO dqc thudc klt6ng c) Su dgng c6c thu6c nf,u amph.Lmine, cocain d)Tangrroatao.rqt"yC"giap { 40 Trong cdc r6i logn bdi mQt-haY nhiiu n nhirni giai itogn trffi ^a'r sdc, r6i logn,dqc dQng ROi d) MAt hrmg thri trwny 47 DA chin tlodn trdm cdm (theo DSM-IV), Isanlt nhdn phdi itdp ftng it nhdt'| triQu ch*ng ! \ @ryi ca^-Ati hinh, dwqc ch6'n,.oul'!'?: sic trdm vir giAm sp rp docin Id: fry-;i'ioun lu6'g csc I H,pA; lnen luemg cuc Z ;';;;r" ffiil'" sic di Si 4x:6) V tuong buQc tQi va nhin tucrng lai bi quan rc tri*vi mAt,moi quan tdm thich thir T) Y tucmg.tg s{tvi mAt.sinh lgc @yt f ftheo DSt'ttrl:-!' .'shie.' ,'.!:dt,*n,tnv V-TR), chn thdi gian tii thiAu bao lftu: Loqn togn khf sdc,,,6i loqh dqc trwng a)01 thang 4tr Trong cdc bhi milt ltay nhiiu g:ioi dogt,t trdm cd'm,l' khbng tnQt R 9! tl:"g giai itogn hwng cdm, lu.rng cdm nhg ho(c hin hap, $) IZ thang -, ^n d)24 th6ng nN Vno, citin dodn rii !d: a) Roi lo4n lucmg cr,rc b) ROi loqn lu&ng cuc 6),Tram cAm chu y6u \/ !! 'if' f:(' I ram: ] P nnA od: Dii: ,iLy(i 1oo pnt'-!{l:16:1i.au @.or':::0.:l 4e Pttcit biiu ndo sau itdv xn.fuxe Xni lqtJns.amphetamin.sau mQt thdi gim sir DSil-tVrry1t (the; cttudn chdn itotin Ig thuQc,chAt d,ng,seti7.:uitp",innyiiuvim$tfrmthi'nndo: a) Giirm hen hiQu quA n6u "t',i ,o d\r;g mqt luqng a) Hrmg cim' tusng tg sau *Ot titOi gian diing' Tr 0) de trdnh 51Tta'* b) St dqng cirng ch6t hoac chit tuong t'u YLo4n than' ^ hoac lirm gilm hOi chimg d) Roi 1o4n nhan cdch' fic) MAt nhigu tl,oi gi*.tt:ong hoqt dQng 9\ th'i6t dA dikhoic6ct6c s6 sft d4ng methadon itiiu tri cni ngliQn Ti' , cai' rt r , r , ; -.co -: tt;' j;d;atdoioacph dgngphgcuachAt.'; !!,nhdmchdtmufiyndosaudfry: thu6c phiqn' vi mic cAc duqcchat,rr] @ S: dfi genh nrran ,,i|eu lirc phiri ngung chAt ampnelamrn b] x5o (xio chat dung su va",'a* ly, sric khoe xiy lg Cin sa' gir dil,;t'a* cim hay tlet aa div,';)' -,-A,.^ c) 5i, Trong nhirng chdt sau dfry, tltikc Pttign: nguin g6c tir r',uuc rj::::: ' chfu Pr"er" ndo KHONG cd