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(D) 1. ¤@¦ì17·³¤k©Ê±wªÌ¡A¦]¦³©ü¯t¡A¦hµo©ÊÃö¸`¯kµh¤Î¤UªÏ¯B¸~¦Ó¦í°|¡CANA 1:320 speckled¡A¦å²G±`³W¡GRBC 2.87M/£gL¡AWBC 2.84K/£gL¡A platelet 124K¡C§¿²G±`³WÀˬdµo²{¡Gproteinuria ¡Ù300 mg/dL¡A§¿¨H´íRBC 40-50/HPF¡AWBC 20-30/HPF¡Ahyaline cast 3-5/HPF¡CµÇŦ¬¡ÅéÀˬdªºµ²ªG(¨£ ·Ó¤ùA©M ·Ó¤ùB)¬°¡G(A)¿Ã¥ú§ÜÅé¬V¦â (B)H&E¬V¦â¡C½Ð°Ý³o¦ì±wªÌªº³Ì¥i¯à¶EÂ_¬°¡G
A.Acute pyelonephritis
B.Amyloidosis
C.Multiple myeloma
D.Lupus nephritis
E.Post-streptococcal glomerulonephritis
 
(E) 2.¡]©Ó«eÃD¡^½Ð°Ý¤U¦Cªº¦óºØªvÀø¹ï¯f¤H³Ì¬°¾A·í¡H
A.Pencillin G IV injection
B.Oral melphalan
C.High dose oral glucocorticoids
D.Oral cyclosporine
E.Cyclophosphamide pulse therapy
 
(A) 3.¦³¤@¦ì33·³ªº¤k©Ê±wªÌ¡A¦b¤G¦~«e¶}©lµoı¥V¤Ñ¨â¤â«üºÝ·|¦³µo¥Õ¡Bµoµµ²{¶H¡C³Ìªñ¤@¦~¨Ó®É±`¦³¦hµo©ÊÃö¸`»Äµh¡AÅé­«´î»´¤Î¸z­G¤£¾A¡C³Ìªñ¥b¦~¨Ó¦³§]Ã`§xÃø¤ÎÁy³¡©M¤â«üªº¥Ö½§Á^ºò¤Î½§¦âÅܶ¡C¦b¨D¶E«e¤@­Ó¤ë¦³°®«y¤Î¹B°Ê©Ê©I§l§xÃø¡C½Ð°Ý³Ì¥i¯àªº¶EÂ_¬°¡G
A.Progressive systemic sclerosis
B.Systemic lupus erythematosus
C.Dermatomyositis
D.Rheumatoid arthritis
E.Idiopathic pulmonary fibrosis
 
(B) 4.¡]Äò«eÃD¡^¤W­z±wªÌ¦í°|¤§«áªºÀˬdµ²ªG¦p¤U¡GANA 1:1280 nucleolar pattern¡AIgG 2042 mg/dL¡AIgA 365 mg/dL¡AIgM 156 mg/dL¡FPFT¡Gmoderate restrictive ventilatory defect with 56% of predicted DLCO¡Fesophageal motility test Åã¥Ü­¹¹D¤U³¡ 2/3 ¦³¤£¥¿±`į°Ê¡C¸Õ°Ý¤U¦C¦óºØÃĪ«¹ï¦¹±wªÌ³Ì¦³À°§U¡H
A.Salazopyrine
B.D-penicillamine
C.Methotrexate
D.IVIG
E.Calcium channel blocker
 
(C) 5.¤@¦ì46·³ªºRA±wªÌ¡A¨â°¼¤â«ü¦³ulnar deviation¤Î¤âµÃ³¡©Tª½¡]ankylosis¡^¡A¨¬³k¥ç¦³ÅܧΤΨ¬½ï³¡¸~µÈ¡C¦³¤@¤Ñ¦­¤W¿ô¨Óµoı¥ª¤â²Ä¢¼¤Î¢½«ü¤U««µLªk¤WÁ|¡C¦Ó¥k¸}¤]µL¤O¤Î·Pı²§±`¡C©â¦åÀˬdµo²{RF 1810 IU/mL¡AC3 54.7 mg/dL¡AC4 8.4 mg/dL¡ACRP 11.7 mg/dL¡C½Ð°Ý³o¦ì±wªÌªº¥i¯à¶EÂ_¬°¡G
A.Entrapment syndrome
B.¥ª¤â²Ä¢¼¡B¢½«ü¶¡šj±a¤Î¥k¨¬ Achilles tendon Â_µõ
C.Mononeuritis multiplex
D.Atlanto-axial subluxation
E.Rheumatoid nodules formation in the above sites
 
(D) 6.¡]Äò«eÃD¡^¬°¤F¶i¤@¨B½T©w¶EÂ_¡A½Ð°ÝÀ³¸Ó§@¤U¦Cªº¨º¤@ºØÀˬd³Ì¦³À°§U¡H
A.¦å¤¤¦Ù¦×»Ã¯ÀªºÀˬd
B.ÀV´ÕX-¥ú·Ó¬Û¡]¥]¬Ahyperextension¤Îhyperflexion¡^
C.·Æ²G½¤ªº¥ÍÀˤÁ¤ù
D.¦Ù¹q¹Ï¤Î¯«¸g¹ï¾É³t«×´ú©w
E.¿©±w³¡¦ìªº¶W­µªiÀˬd
 
(C) 7.¤U¦C¦óºØ¦Ù¦×»Ã¯À¹ïµû¦ô¦hµo©Ê¦Ùª¢±wªÌªº¦Ù¦×µoª¢µ{«×³Ì¬°±Ó·P¡H
A.Aldolase
B.Lactic dehydrogenase
C.Creatine kinase
D.Glutamate pyruvate transaminase
E.Glutamic-oxaloacetic transaminase
 
(E) 8.¤U¦C¦³Ãö rheumatoid arthritis¡]RA¡^ÃĪ«ªvÀøªº´y­z¡A¦óªÌ¥¿½T¡H
A.NSAIDs ¥i¥H¨¾¤î°©ÀYªº«I»k
B.TNF-£\ neutralizing agents¥i¥H§@¬°²Ä¤@½uÃĪ«¨Ó¨Ï¥Î
C.Ãþ©T¾J¹ïRAªº¯gª¬½w¸Ñ¬Û·í¦³®Ä¡A°ß¨Ï¥Î¾¯¶q¥²¶·¤j©ó0.5 mg/kg/day
D.·í¨Öµo¦³rheumatoid interstitial lung fibrosis®É¡Amethylprednisolone pulse therapy¦³¬Û·íªºÀø®Ä
E.DMARDs¤¤¥Hmethotrexateªº¨Ï¥Î§@¬°°ò¥Û
 
(A) 9.¸Õ°Ý¤U¦Cªº¦ÛÅé§ÜÅé»P¦ÛÅé§K¬Ì¯e¯fªº°t¹ï¤¤¡A¦óªÌ¤£¥¿½T¡H
A.Anti-Jo-1---PSS
B.Anti-centromere ---CREST syndrome
C.cANCA---Wegener's garnulomatosis
D.Anti-ds DNA --- SLE
E.Anti-U1 RNA --- MCTD
 
(B) 10.¦³¤@¦ì23·³ªº¤k©Ê±wªÌ¿©±wSLE¤w¦³¥|¦~¤§¤[¡C¤T¤Ñ«e®a¤Hµo²{¦oªº¤f¾¦¤£²M¡A¦Ó¥B¥ª¤â¦³©âÝzµo¥Í¡A¦ýµL·NÃѳॢ¡C¦í°|¤§«á©â¦åÀˬdªºµ²ªG¦p¤U¡GANA 1:160 speckled¡Aanti-ds DNA 43.7 IU/mL¡AC3/C4=68.5/7.6 mg/dL¡AWBC 4700/£gL¡C½Ð°Ý¤U¦Cªº¨º¤TºØÀˬd³Ì¦³À°§U¡H(1)CSF (2) EEG (3) brain CT scan (4) MRI with contrast medium (5) anti-ENA (6) anti-cardiolipin antibodies
A.1 + 2 + 3
B.1 + 4 + 6
C.2 + 3 + 5
D.3 + 4 + 6
E.4 + 5 + 6
 


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