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(A) 1. ¤U¦C¼Æ«h¦³Ãö¤ß©Ð¼³°Ê(Atrial flutter) ªºÁ{§É»¡ªk¡A¦óªÌ¬O¤£¥¿½Tªº¡H
A. µo¥Í¤ß©Ð¼³°Êªº¤ß©Ð©Ê§Ö¸õ¾÷Âà³q±`¬O¥\¯à©Êªº (functional)¡A¦Ó¤£¬O¾¹½è©Ê(organic)
B.¨å«¬¤ß©Ð¼³°Ê¦h¨£"sawtooth" §Îª¬,¦bII,III,aVF¤ÎV1§e¥¿¦V©Î­t¦Vªi
C.¤ß©Ð¼³°Ê¥i¦b¨Ï¥Î§Ü¤ß«ß¤£¾ãÃĪvÀø¤ß©ÐÅÖºûŸ°Ê(Atrial fibrillation,AF)«áµo¥Í
D.¤ß©Ð¼³°Ê¤]¥i¦b¥ª¤ß©Ð¿N¨`¤â³NªvÀø¤ß©ÐÅÖºûŸ°Ê(AF)«á¥X²{
E.¹q¿E¤è¦¡(electric cardioversion)¬°ªvÀø¤ß©Ð¼³°Ê³Ì¦³®Äªº¤èªk
 
(D) 2. ¨Ì¾Ú¤µ¦~ACCF/AHA guideline for the management of heart failure¡A¨ä«ü¤Þ¾É¦V¤º¬ìÀøªk(Guideline-directed medical therapy)¦³½ÑÂI­«­n­×¥¿¡A½Ð°Ý¤U¦C¦óªÌ¤£¬O«ü¤Þ¥D±i?(1)ACE inhibitors, Angiotensin-II receptor blockers, ¤Î£]-blockers¤´Â¬O¦X©y¤º¬ìÀøªk (2)B-type naturetic peptide(BNP)¥i§@¬°¹w«á¤Î¯f¶Ë¤ÀÃþ¤§®Ú¾Ú¡A¤×¨äªvÀø«áBNPªº­°§C, §ó¥i§@¹w«áªº°Ñ¦Ò (3)¥u¦³¤ô¸~¯f¤H¤~»Ý­nÄY®æ­­¨îÆQ¤À (4)À³¸Ó¨Ï¥ÎInotropic therapy (5)Cardiac resynchronization therapy­­©w¦b¤ß°IºÜFunction class 3¥H¤W¤ÎLBBB >150msecªº¯f¤H¡A¤~¦³¸m©ñªº¾AÀ³(indications)±ø¥ó ¡C
A.(1)+(2)+(3)
B.(1)+(3)+(5)
C.(2)+(3)+(4)
D.(2)+(4)+(5)
E.(3)+(4)+(5)
 
(A) 3. ¤U¦C¦³ÃöDigoxinªvÀø¤ß°IºÜªº¹êÃÒÂå¾Ç»¡ªk¡A¦óªÌ¬O¿ù»~ªº?
A.Digoxin¥i§í¨î¤ß¦Ù²Ó­M½¤Na-K ATPase pump¡A¼W¥[²Ó­M¼ß²G(Cytosol)¤ºCa++¡A¦Ó¼W±j¤ß¦Ù¦¬ÁY¤O(Inotropism)¡A¦]¦¹¹¡©M¾¯¶q¬O«æª`­ì«h
B.¨Ì¾ÚDIGÁ{§É¸ÕÅç¡A¦b«D¤ß©ÐÅÖºûŸ°Ê¯f¤H¡A¸gDigoxin ªvÀø«á¡A¨Ã¥¼¯à§ïµ½¦º¤`²v©Î¦í°|¤é¼Æ
C.¦bÁ{§É¤WDigoxin¨Ã«DªvÀø¤ß°IºÜªº¥D¶b¡A¥u¯à»P£]-blocker, diuretic, Angiotensin converting enzyme inhibitor ©ÎAngiotensin receptor blockade¨Ö¥Î
D.Digoxin¥i¥Î©ó¤ß°IºÜ¨Ö¦³¤ß©ÐÅÖºûŸ°Ê¤Î¤ßÂX¤jªÌ
E.Digoxin ¤¤¬r¤§Á{§Éªí²{¡A¥H¤ß«ß¤Î¤ß¶Ç¾É²§±`³Ì¦h¨£¡A­G¸z¯gª¬¦¸¤§
 
(D) 4. ¯f¤H78·³°h¥ðªº¨k¤½°È­û¡A¥D¶D¤ß±ª¦³¤K¤p®É¤§¤[¡A¨Ã¦³°_¥ñ¤£©w¤§°ª¦åÀ£ÅܤơA¤D«æ³t°eÂå°|¨D¶E¡C´N¶E®É¡A¯f¤Hªí²{·W±i¤£¦w¡C¾ÚºÙ¦³¤@¦~¤§°ª¦åÀ£¡A¤S¦³ªÍ®ð¸~¡A¨C¤ÑªA¥ÎTheophylline 200 mg¡F¸£³¡¦³Lacunar infarct¡A¨C¤ÑªA¥ÎClopidogrel 75 mg¡C²z¾ÇÀˬd¡G¦åÀ£166/86 mmHg¡F¤ß¸õ95/ min¡F¾lµL¤£¥¿±`¡C¤ß¹q¹Ï¦p¹Ï¥Ü¡C¦å²GÀˬd¡GSugar¡A165 mg/dL¡FCPK¡A74 IU/L¡FCK-MB¡A1.2U/L¤ÎTroponin I¡A0.02 ng/mL¡C½Ð°Ý¥»¯f¤H³Ì¥i¯àªº¶EÂ_¬O¡G
A.°ª¦åÀ£
B.STEMI(ST Elevation Myocardial Infarction)
C.NSTEMI(Non ST Elevation Myocardial Infarction)
D.Brugada syndrome
E.Long QT syndrome
 
(C) 5. ¯f¤H²{¦~68·³¨k©Ê¹A¤Ò¡A©ó¢µ¤ë¢¶¤é²M±á¬ð¦³¯Ý´e¡A¦P®É¦ñ¦³äú¤ß¡B¹Ã¦R¡B¤ß±ª¤Î§N¦½¡A¤D«æ©¹«æ¶E³¡¨D¶E¡C¯f¤H¨C¤Ñ©âµÒ¤G¥]¡A¤w¦³¤T¤Q¦h¦~¡AµL°ª¦åÀ£¡B°ª¯×¦å©Î¿}§¿¯f¯f¥v¡C²z¾ÇÀˬdTPR ¡G35.6/82/16¡FBP¡G146/93 mmHg¡A·NÃѲM·¡¡A¤ßŦ¤j¤p¤Î¤ß­µ¥¿±`¡AªÍ³¡µLÀãÅo­µ¡A¨ä¥L³¡¦ì¥çµL²§±`©Ò¨£¡CCKMB 35 U/L ¥¿±`­È[7-25] ¡ATroponin-T 0.009 ng/ml¡ACreatinine(¦å) 1.0 mg/dL¡AeGFR 79 mL/min/1.73M2¡C ¯Ý³¡¢æ¥ú¥¿±`¡A¨ä¤ß¹q¹Ï¦p¹Ï¥Ü¡A½Ð°Ý³Ì¥¿½T¯e¯f¶EÂ_¬O¡G
A.Angina pectoris
B.Non-ST Elevation Myocardial infarction
C.Right coronary artery occlusion with inferior ST-elevation infarction
D.Left circumflex artery occlusion with posterior ST-elevation infarction
E.Left anterior descending artery occlusion with anterior myocardial ischemic injury
 
(B) 6. 48·³¨k©Ê±q¬Q¤é¤U¤È4:30 pm¬ðµo¥ª¯Ýµh¡A¨Ã¦³«á­I¶Çµh¡A¦ñ¦³§N¦½¡B®ð«P¤Î©I§l§xÃøµ¥¯gª¬¡A¤w¾ú¸g¤@¤Ñ¥¼½w¸Ñ¡A¤D©ó7 PM°e¹FÂå°|¨Dªv¡C¯f¤H¤@¦V°·§§¡A¥¼¦³°ª¦åÀ£©Î¨ä¥L«a¤ß¯f¬ÛÃö¦MÀI¦]¯À¡C²z¾Ç©Ò¨£¡G«æ¯fª¬¡A¥ª¥k¨â¤â¦åÀ£¤À§O¬°182/126¤Î193/125 mmHg¡A¥ª¥k¨â»L¦åÀ£¬°211/112¤Î205/112 mmHg¡F¤ß¸õ71/min¡A¥¿±`«ß°Ê¡A¤ßŦ·L¤j¡AµL²§±`Âø­µ¥i»D¡C¨ä¤ß¹q¹Ï¤Î¯Ý³¡X¥ú¦p¹Ï¥Ü¡A¥Í¤ÆÀˬdCK¡BCK-MB¤ÎTroponin I³£¥¿±`¡FBNP,246 pg/mL·L°ª¡C¯f¤H¦¹¨è¤§¯e¯f¶EÂ_¤Î¨ä³B¸m¡A¥H¦óªÌ³Ì§´¾A?
A.Acute myocardial infarction, anteroseptal STEMI
B.Hypertensive cardiovascular disease complication
C.Acute pericarditis
D.Hyperkalemia
E.Myocarditis
 
(E) 7. ¯f¤H¨k©Ê65·³¥Í·N¤H¡A¦³¤@¤Ñªº¯Ý°©¤U¯Ý´e¡A³vº¥¥[¼@¡A¦P®É¤S¦³§N¦½¡B¯t·w¤Î©I§l§xÃø¡A¤D©¹«æ¶E¨DÂå¡C¯f¤HµL¥ô¦ó¯e¯f¡A¶È¥u©âµÒ¨C¤Ñ¤@¥]¦³20¦~¡A§ÙµÒ¤w10¦~¡C²z¾ÇÀˬd¡G¦åÀ£110/67¡F¤ß¸õ45/min¡F¤ßŦ³W«h«ß¸õ¡AµL¤ßÂø­µ¡F¨ä¥L©Ò¨£¨ÃµL¥ô¦ó¤£¥¿±`¡C¨ä¥Í¤ÆÀˬd¡GCK,622 IU/L¡FCKMB, 32.6IU/L¡FTroponin I, 2.30 ng/ml¡FSugar,105 mg/dL¡FCholesterol,161 mg/dL¡FLDL-C,93 mg/dL¡FHDL-C,37 mg/dL¡A¨ä¤ß¹q¹Ï¤Î¯Ý³¡X¥ú¦p¹Ï¥Ü¡C¦b«æ©Ê¤ß¦Ù±ð¶ë¯g¶EÂ_¡A¯f¤H±µ¨ü¤U¦C³B¸m¡A½Ð°Ý¤U¦C¦óªÌ¬O¤£¥¿½Tªº¡H
A.iv Atropine, 0.5 mg¤Î Aspirin,100 mg qd p o
B.Atorvastatin 10 mg qd / hs
C.Clopidogrel 300 mg followed by 75 mg qd
D.Enoxaparin 60 mg subcutaneous injection
E.Carvedilol (6.25 mg),1# bid po
 
(C) 8. ¯f¤H¤k©Ê²{¦~44·³¡A¦³¥þ¨­¯B¸~2­Ó¤ë¡C¦Û2010¦~´N¦]Âù¸}¤ô¸~¨DÂå¡A¨ä«á¨â¦~¶¡¥ý«á¦]¸¡¤ô¡B¥þ¨­¤ô¸~¤ÎÅé­«11¤½¤çªº«æ¼@¼W¥[¡A¦í°|Àˬdµo²{¨xµw¤Æ¤Î§C¦å²M¥Õ³J¥Õ(1.2-1.6 g/dL)¡C³Ìªñ¥b¦~§ó¦³¤ô©Ê¸¡Âm¡B¸¡µh©M©]¶¡©I§l§xÃø¡A¬O¤D¦í°|¶EÀø¡C²z¾ÇÀˬd¡G¦åÀ£¡A108/71 mmHg¡F¤ß¸õ¡A88/min¡A¤£³W«h¡FÀVÀR¯ß«ã±i¡FÂù°¼ªÍ³¡¦³Àã¿B©I§lÁn¡F¤ßŦÂX¤j¡A¦b¤ß¦y¤Î¥ª¤U¯Ý½t(LLSB)¦³¤T«×¤ßÁY©ÊÂø­µ¤ÎS3¥i»D¡F¸¡³¡¦³·L¶q¸¡¤ô¤Î»´«×¨x¸~¡FÂù¸}¤¤«×¤ô¸~¡A¦ý¨ä°Ê¯ß¯ß¸õ©|ÄÝ¥¿±`¡C¸z¤ºµøÃè¥i¨£²O¤ÚºÞ¯B¸~(lymphangiectasia)¡C¨ä¤ß¹q¹Ï¤Î¯Ý³¡X¥ú¦p¹Ï¥Ü¡C½Ð°Ý¥»¯f¤H³Ì¥i¯à¤§¶EÂ_¬O¡G
A.¤ß¤º½¤ª¢(Endocarditis)
B.¤ß¦Ùª¢(Myocarditis)
C.¯¶ÁY©Ê¤ß¥]½¤ª¢(Constrictive pericarditis)
D.«a¤ß¯f(Coronary artery syndrome)
E.¹¬´U䳬Âꤣ¥þ(Mitral regurgitation)
 
(E) 9. ¯f¤H53·³¨k©Ê¡A¦³©I§l§xÃø¨Ö¦³¦h·ð¡B©]¶¡«y¹Â¤Î©]¶¡©I§l§xÃø¡B¯Ý´e¤Î¸}¸~µ¥¾ú®É¤@­Ó¦h¤ë¤£¸Ñ¡C¯f¤H¦³¦h¦~¤ß´¼¿ð¶w¡A¨Ã¦³¿}§¿¯f¤Î°ª¦åÀ£ªº¦Ü¤Ö¤@¦~¡C²z¾ÇÀˬd¡G¦åÀ£103/56 mmHg¡F¤ß¸õ98/min;©I§l18/min¡FÀVÀR¯ß¥¿±`¡F¤ßŦ·L¤j¡A¤ß­µ¥¿±`¡AµLÂø­µ¡F¯Ý³¡¥ª«á°¼Àã¿B©I§l­µ¡A¨x¨ÃµL¸~¤j¡A¦ýÂù¸}¯B¸~¡C¥Í¤ÆÀËÅç¡GCK,204 U/L¡FCK-MB,35 U/L¡FTroponin I,0.655 mg/L¡FSugar,216 mg/dl¡FHbA1C,8.0%¡FBUN,18 mg/dL¡Fcreatinine,0.84mg/dL¡FALT,90 IU/L¡FTriglyceride,100 mg/dL¡FHDL-C,58.5 mg/dL¡FLDL-C,178.1 mg/dL¡C¨ä¤ß¹q¹Ï¡B¯Ý³¡X¥ú¤Î«a¯ßÄá¼v¦p¹Ï¥Ü¡C½Ð°Ý¦¹¯f¤H¦b²{¶¥¬q¡A±q¦~ÄÖ¡B©Ê§O¡B«a¤ß¯f¦MÀI¦]¯À¤ÎÁ{§É¯gª¬µ¥¦Ò¶q¡A³Ì¨ãÂå¾Ç¹êÃÒªºªvÀø¤è¦¡¬O¡G
A.±Ä¥Î³Ì¦X¾Aªº¤º¬ìÀøªk(Optimal medical therapy)
B.±Ä¥Î¸g«a¯ßªý¤¶(PCI),¸m©ñ¤ä¬[(Coronary stent)
C.±Ä¥Î¥~¬ì¶¹D¤â³N(CABGS)
D.¥ý¥H³Ì¦X¾A¤º¬ìÀøªk¡Aº¸«á¨Ì¯f±¡¦A±Ä¦æPCI
E.¥ý¥H³Ì¦X¾A¤º¬ìÀøªk¡Aº¸«á¨Ì¯f±¡¦A±Ä¦æCABGS
 
(C) 10. WPW syndrome¦³¤ß±ª¡B¯t·w¡B©ü³Ö¤ÎÖ`¦º¦MÀI¡A¦³Ãö¾ÉºÞ¿N¨`¤â³N(Catheter ablation)ªvÀøªº¾AÀ³¯g¡A¦³½Ñ¦h¬ã¨s¹êÃÒ¡G(1)¦³¤ß§Ö¸õ¯gª¬ªÌ (2) µL¯gª¬¡A¦ýÂ_Â_ÄòÄò¥X²{preexcitation(short PR & delta wave) (3)WPW syndrome ¯f¤H¦ñ¦³Ãøªvªº¤ß©ÐÅÖºûŸ°Ê(atrial fibrillation) (4)WPW syndrome ¯f¤H¸g¹q¥Í²z¾ÇÀË»¤µo¤ß§Ö¸õªÌ (5)µL¯gª¬¡Apreexcitation µo¥Í¦b¹B°Ê­û¡B­¸¦æ­û¤Î¥®«Ä¡C ¤U¦C¦ó¶µ¤~¬O¥¿½T¤§¿ï¾Ü?
A.(1)+(2)+(3)
B.(1)+(2)+(4)
C.(1)+(3)+(4)
D.(1)+(2)+(5)
E.(2)+(3)+(4)
 
(C) 11. ¯f¤H46·³¥d¨®¥q¾÷¡A¦]«æµo¯Ý¯k¤T¤p®É¨DÂå¡C¯f¤HµL­«¤j¯e¯f¡C¦­±áµn¤s¤¤¬ðµM¯Ýµh¦ñ¦³¥ªªÓ»Äµh»Pª~¦½¡C´NªñÂå°|¨D¶E¡A¤ß¹q¹Ï¦p¹Ï¥Ü¡A¦å²MCPK=240¡A ¤@¤Ñ«á¤W¤É¦Ü4224IU/L¡ACK-MB=9.8U/L¡A¤@¤Ñ«á¤W¤É¦Ü172.5U/L¡C¦åÀ£¡A117/76 mmHg¡F¤ß¸õ,56/min¡A¨ä¥L²z¾ÇÀˬd¨ÃµL­«¤j²§±`¡A³B¸m«áÂà°eÂå¾Ç¤¤¤ß¡C½Ð°Ý¦¹Âå°|ªº¦ó²Õ³B¸m¡A¤~²Å¦X«ü¤Þ³W©w¤§ªì©l³B¸m(Initial management)¡H(1)Carvedilol 3.125 mg qd / po (2)Atorvastatin 20 mg qd (3)Aspirin 80 mg qd and Clopidogrel 300 mg loading followed by 75 mg qd (4)IV nitroglycerin (5)IV Heparin 5000 u bolus followed by 1000u/hr (6)rTissue plasminogen activator IV, 15mg bolus followed by 85 mg / 90 min
A.(1)+(2)+(3)
B.(2)+(3)+(4)
C.(2)+(3)+(5)
D.(3)+(4)+(5)
E.(4)+(5)+(6)
 
(D) 12. ¤U¦C¦³Ãö·P¬V©Ê¤ß¤º½¤ª¢(Infective endocarditis)ªº»¡ªk¡A¦óªÌ¬O¤£¥¿½Tªº¡H
A.¦~»´ªº¤ß¤º½¤ª¢¯f¤H¥H¤k©Ê¬°¦h
B.ÂåÅ@·ÓÅU¬ÛÃöªº¤ß¤º½¤ª¢(healthcare-associated)¥HS. aureus ¬°³Ì¡CªÀ°Ï©Ê¤ß¤º½¤ª¢(community-acquired endocarditis)«h¥HStreptococcal species ³Ì±`¨£
C.¹¬´U佤¤ß¤º½¤ª¢±q¨Ó³Ì¦h¨£
D.佤¸m´«³N«á>12¤ëªº¤H¤u¤ß佤¤ß¤º½¤ª¢¡A¥HS aureus³Ì¦h¨£
E.Enterococcal septicemia¥i¦bªÀ°Ï©Ê¤ÎÂåÅ@·ÓÅU¬ÛÃö¤ß¤º½¤ª¢¥X²{
 
(B) 13. °ü²£¬ìÂà¨Ó¤@¦ì²£°ü¡A¦b¦o¶¶§Q¦a¥Î¦ÛµM²£¥Í¤U²Ä¤G­ÓÄ_Ä_¤§«á¤@­Ó¤ë¡A¦o¥X²{¤F®e©ö¯h¥F©M»´«×¹B°Ê´N·|«Ü³Ýªº±¡ªp¡C¨­ÅéÀˬdµo²{ÀVÀR¯ßÂX±i¡AÂù°¼¤UªÏ¦³¤ô¸~¡A³Ì¤j¤ß·iÂI(PMI)¤]¦V¥~¡A¦V¤U¦ì²¾¡C¤ßŦ¶W­µªiÀˬd¥ª¤ß«Ç·i¥X²v¬O30%¡A¤ß«Ç¦³ÂX¤j¡CÃö©ó¦oªº±¡ªp¡A¤U¦C­þ¤@¶µ´y­z³Ì«ê·í¡H
A.³oºØ±¡ªp¥i¥H¦b¥Í²£¼Æ¦~¤§«á¤~¬ðµM¥X²{
B.¤j¬ù¤@¥bªºÃþ¦ü±wªÌ·|²¬Â¡
C.³oºØ±¡§Î¤@¥¹¥X²{¡A¨Ã¤£·|¼W¥[¤U¤@­LÃh¥¥©Î¬O¥Í²£¶g´Áªº¤ß°IºÜ­·ÀI
D.¦¹±¡ªpªºªvÀø¤è¦¡¤£¦P©ó¨ä¥LÂX±i©Ê¤ß¦Ù¯fÅܱwªÌ
E.¶EÂ_¦¹±¡ªp¤@©w­n¶i¦æ¤ß¦Ù±Ä¼Ë(Endomyocardial biopsy)
 
(C) 14. 68·³¨k©Ê±wªÌ¦³¿}§¿¯f©M¤ß°IºÜªº¾ú¥v¡A³Ìªñ±`¦]©]¶¡´e»P³Ý¦Ó¿ô¨Ó¡A¥L¥­®É¦]¬°·|³Ý¦ÓµLªk³sÄò¦æ¨«50¤½¤Ø¥H¤W¡A­Yª¦¼Ó±è¶W¹L¤@¼h¼Ó¤]·|«Ü³Ý¡CÀˬd®Éµo²{¦åÀ£¥¿±`¡AÂù°¼ªÍ©³¦³Åo­µ¡AÀVÀR¯ß¹ªµÈ¡C¤W­Ó¤ë¥L­è±µ¨ü¤F¤ßŦ¶W­µªiÀˬd¡Aµo²{¥ª¤ß«Ç®g¥X²v¬O30%¡A¥Ø«e¥LªA¥Î¤A«¬ªýÂ_¾¯¡B§Q§¿¾¯¡BÂà¤ÆúC§í¨î¾¯(Angiotensin Coverting enzyme inhibitor)©M¤fªA­°¦å¿}ÃĪ«¡C¨Ì¾Ú¯f±wªº¯S©Ê»P¥Ø«eªºª¬ªp¡A¤U¦C­þ¤@¶µ³Ì¥i¯à¬O³y¦¨³o¦ì±wªÌ¤ß°IºÜªº­ì¦]¡H
A.¬r©Êª«½è©ÎÃĪ«
B.®û¼í©Ê¯e¯f
C.«aª¬°Ê¯ß¯e¯f
D.佤©Ê¤ßŦ¯f
E.·P¬V©Ê¯e¯f
 
(E) 15. ¤@¦ì48·³¦³»´·L°ª¦åÀ£©M©âµÒªº¨k©Ê±wªÌ¡A¦]¬°²M±á¬ðµo©Ê¯Ý¤fÀ£­¢¯kµh¦X¨Öäú¤ß»P«_¦½¡A©I§lÅܳݡA¸g¥Ñ«æ¶E¤J°|¡C¦b­è¨ì¹F«æ¶Eªº¤ß¹q¹Ï¦³¯Ý«e·¥¾É(precordial leads)ªºST¸`¬q¤W¤É¡A¨t¦C©â¦åªº¤ßŦ»Ã¯À­È¥¿±`¡A¯f¤H±µ¨ü¤ß¾ÉºÞÀˬdµo²{¥ª«e¤U­°ªK«aª¬°Ê¯ß25%¯U¯¶¡A¯f¤H¨S¦³¶i¦æ¤ä¬[©ñ¸m©Î®ð²yÂX±iªvÀø¡A«áÄòªº¦í°|¹Lµ{¤¤¤]¨S¦³¥X²{¦MÀI©Êªº¤ß«ß¤£¾ã¡C¤U¦Cªº³B¸m¡A­þ¤@¶µ¬O¾A¦X¤]¥i¥H´î¤Ö¥¼¨Ó¤ÏÂеo¥ÍÃþ¦ü¯Ýµhªº±¡ªp¡H
A.©ñ¸m¶îÃĤä¬[(drug-eluting coronary artery stent)¦b«aª¬°Ê¯ß¤W
B.©ñ¸m«D¶îÃĤä¬[¦b«aª¬°Ê¯ß
C.¶}©l¨Ï¥ÎÂà¤ÆúC§í¨î¾¯(ACEI)ÃÄ«~ªvÀø
D.¶}©l¨Ï¥Î¤A«¬ªýÂ_¾¯ªvÀø
E.¶}©l¨Ï¥Î¶tÂ÷¤lªýÂ_¾¯ªvÀø
 
(A) 16. ªù¶E¨Ó¤F¤@¦ì15·³ªº¨k¾Ç¥Í¡A³­¦Pªº±Ð½mªí¥Ü¥L¦b¬Q¤Ñªº¨Ò¦æ±Æ²y®Õ¶¤°V½m¤¤¥ý¬O·PıÀY·w¡AµM«á·w­Ë¨Ã¶^¸¨¦a­±¡A¦P®É³à¥¢·NÃѤj¬ù1¤ÀÄÁ¡A¨S¦³¥þ¨­©âÝz©Î¬O¤f¦R¥Õªj¡C¤µ¦~¬O¥L¥[¤J®Õ¶¤ªº²Ä¤@¦~¡A¥L¤§«e¨Ã¤£´¿·w­Ë¡A¦]¬°¥L¨ü¤H»â¾i¡A®a±Ú¥v¨S¦³¶i¤@¨Bªº¸ê°T¡C¨­ÅéÀˬd¤¤§Aµo²{¤F¥ª¯Ý°©½t¨ì¤ß¦y¦³¦¬ÁY´Á¤ßÂø­µ¡A¤ß¹q¹ÏÀˬd¬OÄu©Ê¤ß«ß¡A¦ý¦³¥ª¤ß«ÇªÎ¤j¡C¨Ì¾Ú«e­zª¬ªp§PÂ_¡A¤U¦C­þ¤@¶µ²z¾ÇÀˬd·|¬O¤ñ¸û¦X²zªº¤è¦¡¨Ó¶i¤@¨BÂç²M³o­Ó¹B°Ê­û¦b¹B°Ê°V½m¤¤·w­Ë©M¤ßÂø­µ¥X²{ªº¥i¯à­ì¦]¡H
A.¤ß¦y°Ï°ìªº¦¬ÁY´Á¤ßÂø­µÀHµÛÃÛ¤U©Î¥Î¤O´¤®±¦Ó´î¤Ö¡AÀHµÛ¯¸¥ß°_¨Ó©Î¶i¦æValsalva maneuver¦Ó¼W¥[
B.¦¬ÁY¤¤´Áªººwµª­µ(systolic click)©M¦¬ÁYÂø­µ¡AÀHµÛÃÛ¤U©Î¥Î¤O´¤®±¦Ó´£¦­¡AÀHµÛ¯¸¥ß°_¨Ó©Î¶i¦æValsalva maneuver¦Ó©µ«á
C.¦¬ÁY¥þ®É´ÁªºÂø­µ¦b¤ß¦yÅ¥±o³Ì²M·¡¡A·|¶Ç¨ì¥ªµÅ¤U¡AÀHµÛÃÛ¤U©Î¥Î¤O´¤®±¦Ó¼W±j¡AÀHµÛ¯¸¥ß°_¨Ó©Î¶i¦æValsalva maneuver¦Ó´î¤Ö
D.§j®ð«¬¦¬ÁY´ÁÂø­µ(Blowing systolic murmur)¥X²{¦b¥ª¤U¯Ý°©½t¡AÀHµÛÃÛ¤U©Î¥Î¤O´¤®±¦Ó¼W±j¡AÀHµÛ¯¸¥ß°_¨Ó©ÎValsalva maneuver¦Ó´î¤Ö
E.¥X²{§CÀW¦¬ÁY¤¤´Á¤ßÂø­µ·|¶Ç¨ìÀV°Ê¯ß°Ï°ì
 
(E) 17. ªù¶E¦³¤@¦ì®e©ö¤ß±ªªº36·³¤k©Ê±wªÌ¡A¦o­è±µ¨ü¤F±Æ©wªº24¤p®É¤ß¹q¹ÏÀˬd¡A³ø§i§e²{¦o¦³¤Ö¶qªº¤ß«Ç´Á¥~¦¬ÁY©M¤ß©Ð´Á¥~¦¬ÁY¡A¨S¦³¨ä¥Lªº¤ß«ß¤£¾ã¡C¤ßŦ¶W­µªi¥ª¤ß«Ç·i¥X²v¤j©ó60%¡A¨S¦³¨ä¥L佤©Î§½³¡¦¬ÁY¥\¯à²§±`¡A¯f¤H¨S¦³¨ä¥Lªº¨t²Î©Ê¯e¯f¡A¤]¤£´¿·w­Ë¡C°w¹ï¦oªºª¬ªp¡A¤U¦C­þ¤@ºØªvÀø¤ñ¸û¦X¾A¡H
A.µ¹¤©§ÜµJ¼{ÃÄ«~
B.µ¹¤©¤A«¬ªýÂ_¾¯
C.µ¹¤©¤ò¦a¶À(Digoxin)
D.µ¹¤©«¶¹ç(Quinidine)
E.µ¹¤©¦A«OÃÒ¡A«ØijÆ[¹î¡A¥Ø«e¤£¥Îµ¹ÃÄ¡C
 
(E) 18. ¤@¦ì80·³¦³ªø´Á¯Ê¦å©Ê¤ßŦ°IºÜªº¨k©Ê±wªÌ¦]¬°¥¢¥NÀvªº¤ß°IºÜ¡]Decompensated congestive heart failure¡^¦í¶i¥[Å@¯f©Ð¡A¤ß¹q¹Ï¦³¤ß©ÐÅÖºûŸ°Ê»P¥ª°¼§ôªK¶Ç¾ÉªýÂ_¡C¯Ý³¡X¥ú¦³§J¹p¤óB½u(Kerley's B-lines)©MÂù°¼ªÍªw®û¼íÅܤÆ(Alveolar infiltrates)¡C¦b²z¾ÇÀˬd¤WÀ³¸Ó¥i¥Hµo²{¤U¦C­þ¤@­Ó²Õ¦X¡H(1)²Ä¤G¤ß­µ¤Àµõ­µ (2)²Ä¥|¤ß­µ (3)²Ä¤T¤ß­µ (4)¤£³W«hªº¯ß·i (5)ÀVÀR¯ß¥X²{³W«hªºaªi
A.(1)+(2)+(4)
B.(3)+(4)+(5)
C.(1)+(2)+(3)
D.(2)+(3)+(5)
E.(1)+(3)+(4)
 
(D) 19. ¦³¤@¦ì75·³¨k©Ê§Y±N±µ¨ü±`³W°lÂܪº«aª¬°Ê¯ß¾ÉºÞÀˬd¡A¥Øªº¬Oµû¦ô¥L¹ï©ó¤fªAÃÄ«~¤ÏÀ³¤£¤Ó¦nªº¯U¤ß¯g¡C¥L°Ý¨ì¦³Ãö©ó«aª¬°Ê¯ßÄá¼vÀˬd³Ì±`¨£¨ìªº¨Öµo¯g¡A¨Ì¾Ú¤W­z±¡ªp¡A§A»{¬°¤U¦C­þ¤@¶µªº¤ñ¨Ò³Ì°ª¡H
A.«æ©ÊµÇ°IºÜ
B.½wºC©Ê¤ß«ß¤£¾ã(Bradyarrhythmias)
C.¤ß¦Ù±ð¶ë
D.¦åºÞª`®g³¡¦ì(vascular access site)¥X¦å
E.§Ö³t©Ê¤ß«ß¤£¾ã
 
(A) 20. ¤U¦C­þ¤@¶µ¥Ø±¡ªp¡A¦b¤ß©ÐÅÖºûŸ°Êªº±wªÌ¡A¥Ø«e¤´¤£´¶¹M³Q·í§@¬O¸£¦åºÞ¤¤­·ªº¦MÀI¦]¤l¡H
A.¥ª¤ß©Ð¤j¤p4.0¤½¤À
B.¿}§¿¯f
C.´¿¦³Æ{¦å©Ê¤ß°IºÜ
D.¦³°ª¦åÀ£
E.´¿¸g¦³¸£¦åºÞ¤¤­·
 
(B) 21. ¤ß©ÐÅÖºûŸ°Ê¦b¨C¦ì±wªÌ¨­¤WªºÁ{§Éªí²{®t²§«Ü¤j¡A¦b¨ã¦³¤U¦C´XºØÁ{§É±¡ªpªº±wªÌ¡A¦pªG¥L­Ì¨­¤W¦pªG¥X²{¤F·sªº«ùÄò©Ê¤ß©ÐÅÖºûŸ°Ê¡A­þ¤@ºØ·|¦³¬Û¹ï§ó©úÅ㪺¯gª¬(¨Ò¦p¡G³Ý)¡H
A.«æ©Ê°sºë¤¤¬r
B.ªÎ«p©Ê¤ß¦Ù¯fÅÜ
C.¥Òª¬¸¢¾÷¯à¤®¶i
D.§CÅé·Å
E.¶}¯Ý¤â³N«áªº¯f¤H
 
(C) 22. ¦³Ãö¤ßŦ佤¯e¯f»Ý±µ¨ü佤¸m´«¤â³Nªº±¡ªp¡A¤U¦C»¡©ú­þ¨Ç¬O¥¿½Tªº¡H(1)»P¾÷±ñ佤¤ñ¸û¡A¥Íª«Ã¤½¤(Bioprosthetic valve) ¤ñ¸û¤£·|²£¥Í¦å®ê (2)¦P¼Ë¨Ï¥Î¾÷±ñ佤¡A©ñ¸m¦b¥D°Ê¯ßä¦ì¸mªºÃ¤½¤¤ñ©ñ¸m¦b¤G¦y䪺佤¦å®ê²£¥Í¾÷·|§ó°ª (3)¦pªG±wªÌ·Q­nÃh¥¥¥Í¤l¡A¾ãÅ骺¨­Å骬ªp¥i¥H±µ¨ü¡A¨Ï¥Î¾÷±ñ佤·|¤ñ¥Íª«Ã¤½¤§ó¦n (4)¦Ò¼{¨Ï¥Î­@¤[©Ê¡A¦b¦~»´¤H¨­¤WÀ³¨Ï¥Î¥Íª«Ã¤½¤·|¤ñ¾÷±ñ佤§ó¦n (5)Âù½L¦¡ªº¾÷±ñ佤(Double-disk valves)¤ñ²yª¬Ã¤½¤(Ball valve)¦³¤ñ¸û¦nªº¦å¦æ°Ê¤O¾Çªí²{(Hemodynamic parameters)
A.(1)+(4)
B.(2)+(5)
C.(1)+(5)
D.(3)+(4)
E.(2)+(3)
 


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