九十八年度內科專科醫師考試筆試題 -- 血液科

(C) 1. 一位25歲女性因為貧血、深色尿求診,血液相如下:血紅素9.5 g/dL,MCV 95fL,網狀紅血球7.8%,白血球及血小板無異樣,血清AST 85 U/L,ALT 30 U/L,bilirubin全量3.1 mg/dL,直接型0.8 mg/dL,LDH 1,560 U/L,小便潛血陽性,但沈澱物中無明顯白血球及紅血球,下列各項檢查中何者對診斷最不需要?
A.Flow cytometry for CD55, CD59
B.Coombs' test
C.Osmotic fragility test
D.Cold agglutinin
E.G6PD
 
(B) 2. 一位45歲男性,無其他全身性疾病,因為皮膚瘀青應診,但其他部位無出血現象。血液檢查顯示血紅素13.1 g/dL,白血球9,550/uL,血小板16,000/uL,骨髓檢查無特殊異常。下列何者為對此病人最適當的處置?
A.Glucocorticoid plus platelet concentrate transfusion
B.Glucocorticoid alone
C.Intravenous immunoglobulin plus platelet concentrate transfusion
D.Intravenous immunoglobulin alone
E.Glucocorticoid, intravenous immunoglobulin and platelet concentrate transfusion
 
(C) 3. 下列容易引發栓塞之遺傳性缺陷中,何者在台灣最常見?
A.Antithrombin III deficiency
B.Protein C deficiency
C.Protein S deficiency
D.FactorV Leiden mutation
E.Prothrombin 20210A mutation
 
(A) 4. 為預防發熱性非溶血性輸血反應(febrile nonhemolytic transfusion reaction),在輸血前先給予何種處置?
A.Antipyretic agent
B.Antihistamine
C.Glucocorticoid
D.Antibiotics
E.Irradiation of blood cellular components
 
(B) 5. 一位26歲女孩因經血過多應診,身體無其他異狀。血液檢查顯示血紅素10.2 g/dL,白血球5,850/uL,分類正常,血小板187,000/uL;出血時間稍長,PT正常,PTT延長。下列何者是此病人最可能的診斷?
A.Hemophilia
B.von Willebrand disease
C.Uremia
D.Disseminated intravascular coagulation
E.Hepatitis
 
(E) 6. 下列各微生物感染及其相關之淋巴瘤對應中,何者是錯誤的?
A.Helicobacter pylori: gastric MALT lymphoma
B.HTLV-1: adult T-cell leukemia/lymphoma
C.Epstein-Barr virus: nasal NK/T cell lymphoma
D.HIV: diffuse large B cell lymphoma
E.Human herpes virus 8: Burkitt lymphoma
 
(D) 7. 下列何種狀況最不可能造成erythrocytosis?
A.Chronic obstructive pulmonary disease
B.Right-to-left shunts
C.Penal cell carcinoma
D.Hyperthyroidism
E.Smoking
 
(E) 8. 下列何者為不明原因之thrombotic thrombocytopenic purpura常見的變化? (應選出全部答案) 1. Schistocytes 2. ADAMTS13 deficiency 3. High LDH level 4. Reticulocytosis
A.1+3
B.2+3
C.1+2+3
D.1+3+4
E.1+2+3+4
 
(C) 9. 目前已知下列何種藥物可有效的治療多發性骨髓瘤? 1. Bevacizumab 2. Bortezomib 3. Thalidomide 4. Steroids (應選出全部答案)
A.1+4
B.2+3
C.2+3+4
D.1+2+3
E.1+2+3+4
 
(C) 10. 缺鐵性貧血病人可出現下列種異常? 1. Microcytic anemia 2. Reticulocytosis 3. Mild thrombocytosis 4. Eosinophilia (應選出全部答案)
A.1
B.1, 2
C.1, 3
D.1, 2, 3
E.1, 2, 3, 4
 


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