(C) | 1. | 下列的疾病其臨床表現皆為典型的過敏症狀。請問那一種疾病其致病機轉中,Ig E抗體扮演關鍵性的角色? |
A. | Hereditary angioedema |
B. | Cholinergic urticaria |
C. | Symptomatic dermatographism |
D. | Radio-contrast dye-induced anaphylaxis |
E. | Hypocomplementemic urticarial vasculitis |
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(E) | 2. | 下列那一組風濕疾病,以侵犯手指distal interphalangeal( DIP)關節為其臨床之特徵? |
A. | Osteoarthritis and rheumatoid arthritis |
B. | Gonococcal arthritis and pseudogout |
C. | Rheumatoid arthritis and SLE |
D. | Septic arthritis and gouty arthritis |
E. | Psoriatic arthritis and osteoarthritis |
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(D) | 3. | 一個30歲的女性病人罹患全身性紅斑狼瘡症,已經三年多了,近年來病情穩定,無內臟器官侵犯之跡象。最近發現懷孕了。請問檢驗下列那組自抗抗體是否存在相當重要,因為其與懷孕成功及胎兒正常有著密切關係。 |
A. | Anti-Sm及anti-DNA |
B. | Anti-Sm及anti-ribosomal P. |
C. | Anti-DNA及anti-cardiolipin |
D. | Anti-cardiolipin及anti-SSA ( Ro ) |
E. | Anti-histone及anti-ribosomal P |
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(B) | 4. | 76歲的女性病人主訴右膝關節突然大痛起來已二天。理學檢查發現該關節紅腫熱痛相當明顯。抽取關節液檢查發現為黃色混濁狀,其中WBC 32000 cells/mm3,其細菌培養為陰性。在顯微鏡下,發現甚多棒狀(rod shape)結晶物被白血球吞噬。請問該病人之膝關節X光,最可能看到什麼變化? |
A. | Marginal erosion |
B. | Chondrocalcinosis |
C. | Periarticular calcific spot |
D. | Punched-out lesion with overhanging bony edge |
E. | Juxta-articular osteoporosis |
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(A) | 5. | 自體免疫疾病的發生,可能經由不同的機轉造成。請問風濕熱(rheumatic fever)所造成的心臟病最可能經由下列那一種機轉產生的? |
A. | Molecular mimicry |
B. | Superantigen stimulation |
C. | Microbial adjuvanticity |
D. | Increased T cell help by costimulatory molecules |
E. | Alteration of self-antigen |
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(D) | 6. | 細胞激素(cytokine)在類風濕性關節炎扮演重要的致病角色。截至目前為止,在臨床上已証明具有良好療效之兩種anti-cytokine therapy為下列那一組? |
A. | Anti-IL-10 and anti-TNF |
B. | Anti-IL-2 and anti-IFN-α |
C. | Anti-IL-1 and anti-IL-10 |
D. | Anti-TNF and anti-IL-1 |
E. | Anti-IFN-α and anti-IL-10 |
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(A) | 7. | 關節週邊疾病(periarticular disorder)或稱軟組織風濕症(soft tissue rheumatism)是最為常見的風濕疾病。請問下列那一種的發生與過度提抱小孩最有密切關聯? |
A. | De Quervains' tenosynovitis |
B. | Adhesive capsulitis |
C. | Lateral epicondylitis |
D. | Rotator cuff tendinitis |
E. | Olecranon bursitis |
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(B) | 8. | 干擾素α(Interferon-α)合併ribavirin之治療,最可能對下列那一種全身性血管炎(systemic vasculitis)具有良好的療效? |
A. | Churg-Strauss syndrome |
B. | Essential mixed cryoglobulinemia |
C. | Wegener's granulomatosis |
D. | Microscopic polyangitis |
E. | Takayasu's arteritis |
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(D) | 9. | 下列之細菌感染,皆有可能造成臨床上的所謂“反應性關節炎”(reactive arthritis)。其中那一些細菌造成的關節炎與病人具有HLA-B27基因有密切關係。1. β-hemolytic streptococci2. Chlamydia trachomatis3. Borrelia burgdorferi4. Yersinia enterocolitica5. Shigella flexneri |
A. | 1+ 2 + 5 |
B. | 1 + 3 + 4 |
C. | 2 + 3 + 5 |
D. | 2 + 4 + 5 |
E. | 3 + 4 + 5 |
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(C) | 10. | 一個24歲女性病人主訴兩側手指關節腫痛及臉頰出現紅斑皮疹已三星期,其他無任何症狀。實驗室檢查發現ANA 1:2560(+),RF(-),輕微補體C3下降,血小板減少(85K),其餘檢驗皆在正常範圍。此時,最合理的治療包括:1. Hydroxychloroquine 400 mg/day2. Pulse methylprednisolone 1 gm x 3days3. Topical glucocorticoid4. Pulse cyclophosphamide 1000 mg5. Prednisolone 10 mg/day |
A. | 1 + 2 + 4 |
B. | 1 + 3 + 4 |
C. | 1 + 3 + 5 |
D. | 2 + 3 + 4 |
E. | 1 + 2 + 3 |
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