(D) | 1. | ¹ï¤@¦å²M¶u¿@«×110mEq/L¯f¤H«æ³t¿éª`°ª±i©m¹ÆQ¤ô(hypertonic saline),¦Óµo¥Í¤â¸}³Â·ô,»¡¸Ü¤£²M(dysarthria),¤Î§]Ã`§xÃø(dysphagia)µ¥¯gª¬,±zn½T©wµo¥Í¤F¤°¨Æ,À³¥Î¤U¦C¦óºØÀˬd³Ì¦n? |
A. | ¦å²Mº¯³zÀ£(serum osmolality) |
B. | ÀY³¡X¥ú |
C. | ¸£ªi |
D. | ®ÖºÏ¦@®¶(MRI) |
E. | ¸£¦åºÞÄá¼v |
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(C) | 2. | ¹ï¥[Å@¯f©Ð¯f¤H·Qª¾¹DÁ`Åé²G(total body fluid)¤§ÅܤÆ,¤U¦C¦óºØ¤èªk³Ì¨Î? |
A. | ´ú¤¤¤ßÀR¯ßÀ£(central venous pressure) |
B. | ´ú¨C¤Ñ§¿¶q |
C. | ´ú¨C¤ÑÅ髤§ÅÜ¤Æ |
D. | ¦ôºâ¶i¥X²GÅéÁ`¶q(intake output) |
E. | µû¦ô¤ß¸õ¤Î¦åÀ£¤§ÅÜ¤Æ |
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(D) | 3. | Ig AµÇ¯fÅÜ¡}Ig A nephropathy¡~¤§±Ôz¡A¦óªÌ¤£¹ï? |
A. | ¥¦¬O¥@¬É¤W³Ì±`¨£ªº¤@ºØµÇ¤p²y¯fÅÜ¡}glomerulopathy¡~ |
B. | ¦bµÇŦ¤§²§±`»PHenoch-Schonleinµµ´³¯g¡}purpura¡~Ãø¥H°Ï¤À |
C. | ºC©Ê¨x¯f¯f¤H¤]¥iµo¥Í¦¹ºØµÇŦ¯fÅÜ |
D. |
ªì¨B³Qµo²{¡}initial presentation¡~¥Dn¬O°ª¦åÀ£¤ÎµÇ¯f¯gÔ¸s |
E. | ¬ù20-50¢M¯f¤H¦b20¦~¤º¶i®i¨ì¥½´ÁµÇ¯fÅÜ¡}ESRD¡~
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(A) | 4. | ¦è¤è°ê®a§¿¬r¯gì¦]³Ì¦h¬°¿}§¿¯fµÇ¯fÅÜ¡A¤U¦C±Ôz¦³Ãö¦¹¯f¦óªÌ¤£¥¿½T¡H |
A. | µ´¤j¦h¼Æ¦³¥½´ÁµÇ¯fÅÜ¡}ESRD¡~¤§¿}§¿¯f¬°²Ä1«¬¡}type¢¹¡~ |
B. | ³Ì¦´Áªº¯f²zÅܤƬ°°ò©³½¤¡}GBM¡~¼W«p¤Î»J²ÓM°Ï¡}mesangium¡~ÂX¤j |
C. | ·L¥Õ³J¥Õ§¿¡}microalbuminuria¡~¥i¹w´úÅã©ÊµÇ¯fÅÜ¡}overt nephropathy¡~¤§µo¥Í |
D. | ¦åºÞ±i¤O¯À¨üÅéªýÂ_¾¯¡}ARB¡~¹ï²Ä¢º«¬¡}type ¢º¡~¤§µÇ¯fÅÜ¥i´î½w¨ä´c¤Æ |
E. | ¦b³zªR¯f¤H¤¤¡A¿}§¿¯f¨Öµo§¿¬r¯gªÌ¨ä¨C¦~¦º¤`²v³Ì°ª |
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(C) | 5. | ¨Ï¥Î¦åºÞ¤ÉÀ£¯ÀÂà¤ÆúC§í¨î¾¯¡}ACE inhibitor¡~®É¡A¥Dn¥i¯àµo¥Íþ¤@ºØ¹q¸Ñ½è²§±`¡H |
A. | °ª¦å¶t¡}Hypercalcemia¡~ |
B. | §C¦å¶u¡}Hyponatremia¡~ |
C. | °ª¦å¹[¡}Hyperkalemia¡~ |
D. | °ª¦åÁC¡}Hyperphosphatemia¡~ |
E. | §C¦å¹[¡}Hypokalemia¡~ |
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(C) | 6. | ºC©ÊµÇ¥\¯à¤£¥þ¯f¤H¡}©|¥¼³zªR¡~¬°¦ÂI¨¾¤î°Æ¥Òª¬¸¢¼W¥Í¡}Hyperplasia¡~¡AÀ³±±¨î°Æ¥Òª¬¸¢²üº¸»X¡}PTH¡~¦bþ¤@Ó½d³ò¡H |
A. | ¥¿±`¤H¤Wªº3-5¿ |
B. | ¥¿±`¤H¤Wªº2.5-3¿ |
C. | ¥¿±`¤H¤Wªº1-2¿ |
D. | ¥¿±`¤Hªº¤@¥b¥H¤U |
E. | »P¥¿±`¤H¬Û¦P |
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(D) | 7. | ¦³¤@¤k©Ê¯f¤H¦~ÄÖ28·³¡A¨ì«æ¶E³B©I§l¨C¤À28-34¦¸¡A³Q¶EÂ_¬°«æ©Ê·²´µªº¨½¯g¡}hysteria¡~¤Þµo©I§l«æ«P¡A§A¬Ý¤U¦Cþ¤@ºØ°Ê¯ß¦å²G®ðÅé¤ÀªR·|µo¥Í¦b³oºØ±¡§Î¡H |
A. | pH 7.25¡AHCO3- 28mmol/L |
B. | pH 7.4¡AHCO3- 24mmol/L |
C. | pH 7.3¡AHCO3- 44mmol/L |
D. | pH 7.55¡AHCO3- 20mmol/L |
E. | pH 7.55¡AHCO3- 44mmol/L |
|
(E) | 8. | 38·³¤k©Ê¡A¦³¯T½H©ÊµÇª¢¡}Lupus nephropathy¡~¡AµÇ¬ï¨ëµ²ªGµo²{¦³»´«×§K¬Ì²y³J¥Õ¨I¿n©óµÇ¤p²y»J²ÓM°Ï¡}mesangial deposits of immunoglobulins ¡~¡A¨ä¥Lªñ¥G¥¿±`¡A¹ï¦¹¯f¤H¤§µÇŦ¤è±À³¤©¦óºØ¯S®íªvÀø¡H |
A. | ¤fªAÃþ©T¾J |
B. | ¯ß½Ä¦¡Ãþ©T¾J¡}pulse prednisolone¡~ |
C. | ¤fªA cyclophosphamide |
D. | ¯ß½Ä¦¡ cyclophosphamide |
E. | ¤£»Ýn¯S®íªvÀø |
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(D) | 9. | ¿}§¿¯f¯f¤H·L¥Õ³J¥Õ§¿¡}Micoralbuminuria¡~¬O¤@ºØ¤´¥i¯à«ì´_¡}potentially reversible¡~¤§ª¬ºA¡A·L¥Õ³J¥Õ§¿¬O«ü¨C¤Ñ±Æªn¥Õ³J¥Õ¡}Albumin¡~¤§¶q¬°¡H¡}¤U¦Cþ¤@¶µ³Ì¾A·í¡A½Ð¿ï¤@¶µ¡~ |
A. | §C©ó3¢U |
B. | §C©ó30¢U |
C. | §C©ó100¢U |
D. | §C©ó300¢U |
E. | §C©ó1000¢U |
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(D) | 10. | 37·³¨k©Ê¡Aµo¥Í«æ©ÊµÇ°IºÜ¡A¨ä§¿¶q¬°200¢W/¤Ñ¡A¤U¦Cþ¨Ç±¡§Î·|Åý§A·Q¨ì¬O¥F§¿©Ê«æ©ÊµÇ¤pºÞÃa¦º¡}oliguric ATN¡~¡H¡}1¡~§¿¶u¿@«×¡}urine Na¡~§C©ó20mEq/L ¡}2¡~§¿/¦å¼ß¤§¦Ù»ÄÓþ¤ñÈ¡}u/p Cr¡~¤j©ó40 ¡}3¡~§¿º¯³zÀ£¡}urine osmolality¡~§C©ó350mosmol/¢V H2O ¡}4¡~¶u±Æªn³¡¥÷¡}fractional excretion of Na¡AFENa¡~¤p©ó1 ¡}5¡~u/p Cr§C©ó20 ¡}6¡~FENa¤j©ó 1 ¡}7¡~urine Na¤j©ó40 mEq/L |
A. | 1¡Ï6 |
B. | 1¡Ï4 |
C. | 2¡Ï4 |
D. | 3¡Ï5 |
E. | 2¡Ï7 |
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(E) | 11. | 40·³¨k©Ê¡A¦å¹[¬°2.8mEq/L¡A§An¦Ò¼{þ¨Ç¥i¯à©Ê¡H¡}1¡~°§¾j ¡}2¡~µÇ°IºÜ¡}renal failure¡~¡}3¡~¨Ï¥Î«DÃþ©T¾J§Üµoª¢ÃĪ«¡}NSAID¡~¡}4¡~¦³©I§l©ÊÆP¤¤¬r¡}respiratory alkalosis¡~¡}5¡~µÇ¤W¸¢¥\¯à¤£¥þ¡}adrenal insufficiency¡~¡}6¡~§C¦åÁâ¡}hypomagnesemia¡~¡}7¡~¥þÀR¯ßÀç¾i¡}total parenteral nutrition¡~ |
A. | 2¡Ï5¡Ï6 |
B. | 1¡Ï2¡Ï3 |
C. | 3¡Ï5¡Ï7 |
D. | 2¡Ï3¡Ï4 |
E. | 1¡Ï6¡Ï7 |
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(D) | 12. | 25·³¨k©Ê¦]¤UªÏ¤ô¸~¦í°|¡A¯f¤H¹L¥h¥v¨ÃµL¯S®í¡C¦í°|Àˬd¦åÀ£¬°140/90¢PHg¡C§¿²G¤ÀªRµo²{500¢U/dL³J¥Õ§¿¡A¨I¾ýª«¤¤°ª¿Ãè¤U¦³5-10 RBC¡A¨ÃµLRBC cast¡C¥Í¤ÆÀˬd¶EÂ_¬°µÇ¯f¯gÔ¸s¡F¦å²M§K¬Ì¾ÇÀˬdµL¯S®íµo²{¡Cµ¹¤©°ª¾¯¶qÃþ©T¾J¡}prednisolone 1¢U/¢V/day¡~ªvÀø¨â¶g«á¡A¯f¤H¥X²{©I§l§xÃø¡C¯ß·i120¡A¦åÀ£120/88¡A©I§l25¡FµLµo¿N©Î«y¹Â¡CªÍ³¡Å¥¶EµL¯S®íµo²{¡C¯Ý³¡X¥ú¤ù¤ßŦ¥¿±`¡AªÍ³¡µL¯S®í®û¼í¡A¨â°¼costophrenic anglesµy¦³¿n¤ô¡C¤U¦C³B¸m¦óªÌ¸û¬°¥¿½T¡H |
A. | §Y¨Ï¯Ý³¡X¥ú¨SÅã¥ÜªÍ³¡²§±`¡A¯f¤HªA¥ÎÃþ©T¾JÀ³¸Ó¥ýµ¹¤©§Ü¥Í¯ÀªvÀø¡C |
B. | ¶·¦Ò¼{«D¨å«¬©ÊªÍª¢¡AÄ´¦p°h¥îx¤H¯gªÍª¢¡AÀ³¥ß§YÀˬd§¿²Glegionella antigen¡C |
C. | À³¸Ó¦Ò¼{Åé²G¹L¦h¤Þ°_ªºªÍ¤ô¸~¡Aµ¹¤©ÀR¯ßª`®g¥Õ³J¥Õ¨Ã¥[±j§K¬Ì§í¨î¾¯¡C |
D. | À³¸Ó¦Ò¼{ªÍ³¡ªºÄé¬y±½´y¡A¨ÃÀˬd¦å¤¤ªº antithrombin ¢»¡C |
E. | ´î¤ÖÃþ©T¾J¾¯¶q¡A¥i¯à¬OÃþ©T¾Jªº°Æ§@¥Î¡C |
|
(C) | 13. | 38·³¤k©Ê¤w±B¯f¤H¡A¨|¦³¤@¤l¤@¤k¡A¦]°ª¦åÀ£±±¨î¤£©ö¨D¶E¡A¯f¤H¦åÀ£170/112¢PHg¡C§¿²G¤ÀªR¥¿±`¡A¥Í¤ÆÀˬd¡ABUN 15¢U/dL¡ANa+ 145 mmol/L¡AK+ 3.0mmol/L¡ACl- 97mmol/L¡ACa++ 2.38mmol/L¡C¯f¤H°±ÃĤ@¶g«á©â¦å¡A±oPRA¡}plasma renin activity¡~¬°0.25ng/ml/hr¡}¥¿±`1-3.5¡~¡APAC¡}plasma aldosterone concentration¡~¬°27ng/dL¡}¥¿±`12-28¡~¡C¦³Ãö¶EÂ_¤U¦C¦óªÌ¥¿½T¡H |
A. | À³¸Ó°µcaptopril renogram¨Ó½T©w¶EÂ_¡C |
B. | ¯f¤H¥i¯à¬Oªø´ÁªA¥Î¥Ì¯ó¡}licorice¡~¤Þ°_°ª¦åÀ£¡C |
C. | À³¸Óµ¹¤©¤T¤Ñ°ªÆQ¶¼¹«á¦AÀˬd½T©w¶EÂ_¡C |
D. | ¯f¤H¥i¯à¬OµÇŦªº11-beta-hydroxysteroid dehydrogenase°ò¦]¥X²{¬ðÅÜ¡C |
E. | À³¸Ó¯d¤@¤Ñªº§¿²G´ú©w17-ketosteroid¨Ó½T©w¶EÂ_¡C |
|
(B) | 14. | ¤U¦Cþ¤@Ó¯f¨Ò¸û²Å¦X©Ò¦C¤§°Ê¯ß¦å®ðÅé¤ÀªR©M¦å²M¹q¸Ñ½èªºÀˬdµ²ªG¡HpH 7.32¡APO2 110 ¢PHg¡APCO2 33 ¢PHg¡AHCO3- 18¡FNa+ 138¡AK+ 5.9¡ACl- 109¡}¹q¸Ñ½èªº³æ¦ì¬O mmol/L¡~ |
A. | 65·³¯f¤H³Ü°s«á¡A¥X²{©I§l«æ«P¡C |
B. | 55·³¿}§¿¯f¤H¯f¥v12¦~¡A¦å¿}±±¨î¤£¨Î¡AµL°ª¦åÀ£¡C¦å²M¦Ù»ÄÓþ 3.2¢U/dL¡F¦å¼ßµÇ¯À¬¡©Ê¬° 0.34ng/ml/hr¡}¥¿±`Ȭ°1.0-3.5¡~¡C |
C. | 40·³¯f¤H¶EÂ_ìµo©Ê¥Ö½èîÇଯg¡}primary aldosteronism¡~ªA¥Îspironolactone¡C |
D. | 18·³¯f¤H¦³¿}§¿¯f¡A¥H¯Ø®q¯À±±¨î¦å¿}¡A¦Ò¸Õ«e¤@¤Ñ¥X²{©I§l«æ«P¡C |
E. | 28·³¯f¤H¶EÂ_¼~Æ{¯gªA¥Î¤j¶qbenzodiazepam¡C |
|
(A) | 15. | ¦³ÃöºC©Ê¥½´ÁµÇŦ¯f¤H¶tÁC¥¿Åªº±Ôz¦óªÌ¤£¥¿½T¡H |
A. | ¨Ï¥Î§t¾TªºÁCµ²¦X¾¯¥i¯à¤Þ°_°Æ¥Òª¬¸¢¯À¤É°ª¡A³y¦¨³n°©¯g¡}osteomalacia¡~¡C |
B. | Sevelamer¬O²Ä¤G¥NªºÁCµ²¦X¾¯¡A¤£§t¶t©Î¾T¡A¥B¥i¥H¤É°ª°ª±K«×Áx©T¾J¡C |
C. | ªA¥Î¹L¦hªº¶t¤ù©Î¬¡©Êºû¥Í¯ÀD¡}vitamin D3¡~¨Ï¥Î¡A·|¤Þ°_µL¦A¥Í©Êªº°©½è²§±`¡}aplastic renal osteodystrophy¡~¡C |
D. | ³o¨Ç¯f¤Hªº¦å²M°Æ¥Òª¬¸¢¯À¤£¶·nªvÀø¦Ü¥¿±`ªº½d³ò¡}10-60ng/L¡~¡C |
E. | ¹w¨¾¦¸µo©Ê°Æ¥Òª¬¸¢¹L¦h¯g¡}secondary hyperparathyroidism¡~ªº³Ì¨Î¤èªk¬O¡A¨îÁCªºÄá¨ú©M¨Ï¥ÎÁCµ²¦X¾¯¡C |
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(B) | 16. | 25·³¤k¯f¤H§¿²G¦³¼ç¦å¥H¤ÎÅܧΪº¡}dysmorphic¡~¬õ¦å²y¡A°µ¤FµÇŦ¤Á¤ù¡A²Õ´Àˬd¦³mesangial cell proliferation¥H¤ÎIgA§ÜÅé¨I¿n¡C¹L¥h¦o¦³¨â¦¸¦b·P«_«á¥X²{¦×²´¥i¨£¦å§¿¡A¨C¦¸¬ùºû«ù¨â¤Ñ¡C¤U¦C¦³Ãö¦¹¯f¤Hªº±Ôz¦óªÌ¤£¥¿½T¡H |
A. | ¥Ø«eµL¯S®íÃĪ«¥i¥HªvÀø¯f¤Hªº¦å§¿¡C |
B. | µo¥Í¦×²´¦å§¿¦¸¼Æ¦hªº¯f¤H¹w«á¸û®t¡C |
C. | ¥X²{§¿³J¥Õªº¯f¤H¹w«á¸û®t¡C |
D. | ¦b¥½´ÁµÇ°IºÜ¤¤¡A³oÓ¯f¬OµÇµ·²yª¢¤¤³Ì±`¨£ªº¡C |
E. | ¦pªG¯f¤Hµo¥Í§¿¬r¯g¡A±µ¨üµÇŦ²¾´Ó¡A²¾´ÓªºµÇŦ¥i¯à¥X²{¬Û¦P¯f¨_¡C |
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(B) | 17. | Ãö©ó¦hµo©Ê°©Åè½F¡}multiple myeloma¡~³y¦¨µÇŦªºÁ{§Éªí¼x¡A¤U¦C¦óªÌ¬°«D¡H |
A. | °ª¶t¦å¯g |
B. | ³±Â÷¤l»Ø¡}anion gap¡~¼W¥[ |
C. | ³J¥Õ§¿ |
D. | ¦¨¤H«¬ Fanconi¤ó¯gÔ¸s |
E. | µÇ¥\¯à¤£¥þ |
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(B) | 18. | ¤U¦Cþ¤@Ó¯f¨Ò¤£²Å¦X©Ò¦C¤§°Ê¯ß¦å®ðÅé¤ÀªR©M¦å²M¹q¸Ñ½èªºÀˬdµ²ªG¡HpH 7.49¡APO2 90 mmHg¡APCO2 48 mmHg¡AHCO3- 32¡FNa+ 140¡AK+ 2.7¡ACl- 92¡}¹q¸Ñ½èªº³æ¦ì¬O mmol/L¡~ |
A. | 40·³a¯f¤H¡A¦åÀ£160/102 mmHg¡Aªø´Á¹¥Î¥Ì¯ó¡}licorice¡~ |
B. | 40·³b¤k©Ê¡A¨Ï¥Î§Q§¿¾¯¡}acetazolamide¡~ªvÀø«C¥ú²´ |
C. | 18·³c¯f¤H¡A¦åÀ£105/70 mmHg¡A§¿²Gªºprostaglndin E¤ñ¥¿±`¤H°ª¥X³\¦h¡CµÇ¶WµªiÀˬdµo²{¦³µÇ¶t¤Æ¡}nephrocalcionsis¡~ |
D. | 55·³d¯f¤H¦³®ø¤Æ©Ê¼ìºÅ¡A¨C¤Ñ³Ü¨î»Ä¾¯¨Ã¦YG¨Å¤ù¡}§tAl(OH)3¡ACaCO3¡ANaHCO3µ¥¡~¡C |
E. | 35·³e¯f¤H¡A¦åÀ£170/110 mmHg¡A¸¡³¡¾aªñ¨{ÂÀ¥ª°¼¦³§nÂøÁn¡}bruits¡~¡AµÇŦ¶Wµªi¥ª°¼µÇŦ¤ñ¥k°¼µÇŦ¤p1.5¢Q |
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(C) | 19. | ©Ó¤WÃD¡AYµ¹¤©¥Í²z¹ÆQ¤ô¡A°£¤F¤£²Å¦X¤WÃDªº¯f¤H¡Aþ¨Ç¯f¤Hªº¹q¸Ñ½è©M»ÄÆP°ÝÃDµLªkÀò±oÁB¥¿¡H |
A. | a¡Ïb¡Ïc |
B. | a¡Ïe |
C. | a¡Ïc¡Ïe |
D. | b¡Ïc¡Ïd |
E. | d |
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(C) | 20. | ¦³Ãö¸¡½¤³zªRªvÀø§¿¬r¯g¯f¤H¡A¤U¦C±Ôz¦óªÌ¥¿½T¡Ha. ¸¡½¤³zªR¯f¤Hªº´Ý¾lµÇ¥\¯à©M¦s¬¡²v¤Î¥Í¬¡«~½è¬ÛÃö¡Cb. ¸¡½¤³zªR¤ñ¦å²G³zªR¯f¤H¸û±`µo¥Í§C¹[¦å¯g¡Cc. ¸¡½¤³zªRªvÀøµLªkÄ~Äò¶i¦æªº³Ì¥Dnì¦]¬O¸¡½¤ª¢¡Cd. ¸¡½¤³zªRªvÀøªº¯×ªÕ¥NÁ²§±`¸û¦å²G³zªR±`¨£¡Ce. ¸¡½¤³zªRªvÀø¹ï¿}§¿¯f¤H¬O¸T§Ò¡C |
A. | a¡Ïb |
B. | a¡Ïb¡Ïc |
C. | a¡Ïb¡Ïc¡Ïd |
D. | b¡Ïc¡Ïd |
E. | c¡Ïd¡Ïe |
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(E) | 21. | ´ú¶q¯f¤Hbicarbonate¤§±Æªn¤À²v¡}fractional excretion of HCO3-¡A²ºÙFEHCO3-¡~¤§¥Øªº¦b¨ó§U¶EÂ_þ¤@ºØª¬ªp¡H |
A. | ଻Ĥ¤¬r¡}ketoacidosis¡~ |
B. | µÇ°IºÜ»Ä¤¤¬r¡}uremic acidosis¡~ |
C. | Bartter's¯gÔ¸s¡}Bartter's syndrome¡~ |
D. | Áâ¯Ê¥F |
E. | µÇ¤pºÞ©Ê»Ä¤¤¬r¡}renal tubular acidosis¡~ |
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(C) | 22. | °ª¦å¶u¯g¡}Hypernatremia¡~¤§ì¦]¦³þ¨Ç¡H1.§Ü§Q§¿²üº¸»X¤Àªc¤£·í¯g¡}SIADH¡~¡C2.¥Òª¬¸¢¾÷¯à§C¤U¡}Hypothyroidism¡~¡C3.¥Ö½èîÇତÀªc¹L¦h¯g¡}Hyperaldosteronism¡~¡C4.®wªY¤ó¯g¡}Cushing's Syndrome¡~¡C |
A. | 1¡A2¡C |
B. | 1¡A3¡C |
C. | 3¡A4¡C |
D. | 2¡A4¡C |
E. | 1¡A2¡A3¡A4¡C |
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