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(A) 1. ¤@¦ì30·³¨k©Ê±wªÌ¥D¶D­G»Ä°f¬y¡A¯Ý°©«á¤è¦³¨`¼ö·P¡A¤U¦C¦óªÌ¤£·|¼W¥[¦¹¯fªº­·ÀI©Î´c¤Æ¯f¤Hªº¯gª¬¡H
A.«ÕªùÁ³±Û±ìµß(Helicobacter pylori)·P¬V
B.©â·Ï
C.ªÎ­D
D.¶tÂ÷¤l³q¹DªýÂ_¾¯(calcium channel blocker)
E.§tÁ¡²üÃþ­¹ª«
 
(D) 2. ¤U¦C¦óªÌ»P­¹¹DÅ쪬¤W¥Ö²Ó­MÀù(esophageal squamous cell carcinoma)ªºµo¥ÍµLÃö¡H
A.©â·Ï
B.³Ü°s
C.ªø´Á³Ü¼ö¯ù
D.¤Ú¬¥¤ó­¹¹D(Barrett's esophagus)
E.­¹¹D¦¢½w¤£¯à(achalasia)
 
(D) 3. ¤U¦C¦óªÌ¤£·|«P¶i­G»Äªº¤Àªc
A.histamine
B.acetylcholine
C.gastrin
D.somatostatin
E.¨ë¿E°g¨«¯«¸g(vagus nerve)
 
(B) 4. ¤U¦C¦³Ãö«ÕªùÁ³±Û±ìµß(Helicobacter pylori)ªº±Ô­z¡A¦óªÌ¥¿½T? 1.80%·P¬VªÌ·|¦³®ø¤Æ©Ê¼ìºÅ¡A2.°£µß«á¬ù60-75%ªº­GÂH½¤¬ÛÃö²O¤Ú²Õ´²O¤ÚÀù(mucosa-associated lymphoid tissue lymploma)¥i¥H±o¨ì½w¸Ñ¡A3.»P­G¶NªùÀùµo¥Í¦³Ãö¡A4.ÄÝ©ó¨ã¦³§¿¯ÀúC(urease)¤§­²Äõ¤ó³±©Êµß(Gram-negative bacteria)
A.1+3
B.2+4
C.1+4
D.3+4
E.1+2
 
(B) 5. ¤@¦ì¤Q¤G«ü¸z¼ìºÅªº±wªÌ¦b±µ¨ü®Ú°£«ÕªùÁ³±Û±ìµß(Helicobacter pylori)ªº¤T¦X¤@Àøªk¤§«á¡A¤U¦C¦ó¶µÀˬd³Ì¾A¦X¥Î©ó½T©w±þµß¦¨¥\»P§_?
A.§Ö³t§¿¯ÀúC(rapid urease)´ú¸Õ
B.§¿¯À©I§lÀˬd(urea breath test)
C.¦å²M¾Ç(serology)ÀË´ú
D.¯f²z²Õ´Àˬd(histology)
E.ÁT«K§Ü­ì(stool antigen)Àˬd
 
(A) 6. ¤@¦ì®ø¤Æ©Ê¼ìºÅ±wªÌ¦]¥X¦å±µ¨ü³¡¥÷­G¤Á°£¦X¨Ö°g¨«¯«¸gºIÂ_³N(subtotal gastrectomy & vagotomy)«á¡A¦b¶i­¹90¤ÀÄÁ¦Ü180¤ÀÄÁ«á¦³®É·|¥X²{ÀYµh¡Bµs¦½¡B¤ß±ª¡A¬Æ¦Ü©ü­Ë±¡§Î¡C¤U¦C¦ó¶µ³B¸mµL¯q©ó´î»´¦¹±wªÌªº¯gª¬¡H
A.¤Ö¦Yªo¯×¦h¦Y´I§tºÒ¤ô¤Æ¦Xª«ªº­¹ª«
B.¤Ö¶q¦hÀ\
C.ÁקK¶i­¹¤Ó¦h¬y½è­¹ª«
D.µ¹¤©acarbose
E.­Y§ïÅܶ¼­¹¤è¦¡µL®ÄªÌ¡A«h¥iµ¹¤©octreotide
 
(C) 7. ¤@¦ì30·³¤k©Ê±wªÌ¦³©úÅ㸡Âm¡B¤ô¸~(edema)²{¶H¡A¦í°|Àˬdµo²{albumin¡G1.4 g/dL globulin¡G1.6 g/dL¡A¨x¥Í¤ÆÀËÅçµ²ªG¥¿±`¡A§¿²G¤¤¨ÃµL³J¥Õ¡A¤p¸z¥ÍÀˤ§¯f²z³ø§i¬°intestinal lymphangiectasia¡C½Ð°Ý¤U¦C¦óºØ¶¼­¹³B¤è¦³§Q©ó§ïµ½¦¹±wªÌªº¯gª¬¡H
A.§C¶u¶¼­¹
B.°ª³J¥Õ¶¼­¹
C.§t¤¤Ãì¯×ªÕ»Ä(medium-chain triglycerides)§C¯×¶¼­¹
D.µLgluten¶¼­¹(gluten-free diet)
E.°ª¶t¶¼­¹
 
(A) 8. µoª¢©Ê¤j¸z¯e¯f(inflammatory bowel disease)¥]§t¼ìºÅ©Ê¤j¸zª¢(ulcerative colitis)©M§J¶©¤ó¯g(Crohn's disease)¡A³oÃþ±wªÌ±`·|¦X¨Ö¸z¹D¥~ªí²{(extraintestinal manifestation)¡C¤U¦C¦ó¶µªí²{¦b¼ìºÅ©Ê¤j¸zª¢¸û§J¶©¤ó¯g§ó±`¨£¡H
A.pyoderma gangrenosum
B.ankylosing spondylitis
C.nephrolithiasis
D.cholelithiasis
E.episcleritis
 
(C) 9. ¤U¦C¦óªÌ¬°¤j¸zÀù(colon cancer)¤§¦MÀI¦]¤l? 1.°ª³J¥Õ¶¼­¹ 2.¯Ø®q¯Àªý§Ü(insulin resistance) 3.¤j¸z¿Eļ¯g(irritable bowel syndrome) 4.E. coli bacteremia 5.ureterosigmoidostomy
A.1+2
B.3+4
C.2+5
D.1+4
E.2+3
 
(E) 10. Ãö©ó«DÃþ©T¾J§Üµoª¢ßÓª«¡]NSAID¡^¾É­Pªº­G¸z¹D¨Öµo¯g¡A¤U¦C±Ô­z¦óªÌ¿ù»~¡H 1. ÄY­«ªºNSAID¾É­Pªº¨Öµo¯g¡A¤j¦h¼Æ¯f±w©ó¿©¯f«eÀ³¦³dyspepsia 2. §C¾¯¶q¡]<=75 mg/d¡^Aspirin¤£·|¾É­PÄY­«ªº¨Öµo¯g 3. ¦~¬ö¤j¡A¹L¥h¦³®ø¤Æ©Ê¼ìºÅ¡A¦P®ÉªA¥Î§tÃþ©T¾J¤§ßÓª«¡A¬Ò¬Oestablished risk factor 4. ­Y¦³risk factor¦Ó¤´»ÝªA¥ÎNSAID¡A¥i¥Hproton pump inhibitors©Îmisoprostol¹w¨¾­G¸z¹D¨Öµo¯g 5. ­YNSAID¤w³y¦¨­G¼ìºÅ¡A¦ý¤S¤£¯à°±¥Î¡A¥i¥ÎH2 blockerªvÀø
A.1 + 3 + 5
B.1 + 2 + 4
C.2 + 3 + 4
D.3 + 4 + 5
E.1 + 2 + 5
 
(C) 11. ¦³Ãö­ìµo©ÊÁx¹D©Ê¨xµw¤Æ (primary biliary cirrhosis) ¤§±Ô­z¡A¦óªÌ¬°»~¡H(1) §Ü²É¸¢Åé§ÜÅé (AMA) ³q±`¶§©Ê(2) ¦nµo©ó¤k©Ê(3) ±`¦X¨Öµo¥Í©óºC©Ê¼ìºÅ©Êµ²¸zª¢±wªÌ(4) µoª¢©ÊÅÖºû¤Æ«I¥Ç¨x¤º¤Î¨x¥~ÁxºÞ(5) ERCP ©Î MRCP ¬°½T©w¶EÂ_¤è¦¡¡C(À³¿ï¥X¥þ³¡µª®×)
A.1 + 2 + 3
B. 2 + 3 + 4
C.3 + 4 + 5
D.3 + 4
E. 4 + 5
 
(E) 12. ¤@¦ì¯f¤H³QªB¤Í´£¿ô¥i¯à¦³¶À¯n²{¶H¡A´NÂå©â¦åÀËÅç¡Aµ²ªGBilirubin (Total) = 4.0 mg/dL¡C¤U¦C«áÄò³B¸m¡A¦óªÌ¨Ã«D³Ì­¢¤Á»Ý­n
A.¦A©â¦åÀËÅç Bilirubin (Direct)
B.¦A©â¦åÀËÅç Prothrombin time (PT)
C.¦A©â¦åÀËÅç Alkaline phosphatase (ALP)¤Îgamma-glutamyl transpeptidase (gamma-GT)
D.¦A©â¦åÀËÅç ALT (GPT)¤ÎAST (GOT)
E.¦A©â¦åÀËÅç Antinuclear antibody (ANA)
 
(E) 13. ¤U¦C¦³Ãö¨xª¢¬Ì­]ª`®g¤§´y­z¡A¦óªÌ¿ù»~¡H
A.·s¥Í¨à®É´Á±µ¨ü¢Ð«¬¨xª¢¬Ì­]ª`®g¥B²£¥Í¦³®Ä§ÜÅé (anti-HBs)¡A¬ù¦Ü²Ä¤Q¦~¥H«áÀ³ÀË´ú¨ä§ÜÅé¿@«×¬O§_¤w¤j´T­°§C
B.¦ÛµM·P¬V¦Ó²£¥Í¤§anti-HBs¡A40¦h·³®É­Yµo²{¤w®ø¥¢¡A¬é­n±µ¨ü¢Ð«¬¨xª¢¬Ì­]ª`®g1~2¦¸¡]¶¡¹j¬ù¤@­Ó¤ë¡^¡A§ÜÅé§Y¥i¦A«×¥X²{
C.¢Ï«¬¨xª¢¬Ì­]»Ý­nª`®g¨â¦¸¡A¶¡¹j¬ù¤»­Ó¤ë¡ã¤@¦~
D.¢Ð«¬¨xª¢¬Ì­]¦Ü¤Ö»Ýª`®g¤T¦¸¡A²Ä¤G¾¯»P²Ä¤@¾¯¬ù¶¡¹j¤@­Ó¤ë¡A²Ä¤T¾¯»P²Ä¤G¾¯¬ù¶¡¹j¤­­Ó¤ë
E.­Y«æ»Ý­u¦³¢Ó«¬¨xª¢¦s¦b¤§¦a°Ï¡A¥i¦b¤@­Ó¤ë¤§¤º±µ¨ü¨â¦¸¢Ó«¬¨xª¢¬Ì­]ª`®g
 
(A) 14. ¤U¦C¦U¶µ±Ô­z¡A¦óªÌ¿ù»~¡H
A.Wilson's disease±wªÌ¦å¤¤ceruloplasmin level·|²§±`¤É°ª
B.Wilson's disease±wªÌ§¿¤¤ªº»É±Æªn¶q·|²§±`¤É°ª
C.Wilson's disease©Ò¾É­P¤§¨x°IºÜ±wªÌ¡A±µ¨ü¨xŦ²¾´Ó«á¥i²¬Â¡
D.Hemochromatosis±wªÌ¦å¤¤fasting transferrin saturation³q±` > 100%
E.¦å¤¤Ferritin¿@«×¦b¤@¨Çinflammatory disorders©Îneoplastic diseases¥ç·|²§±`¤É°ª
 
(C) 15. ¤U¦C¦³Ãö¨xÅÖºû¤Æ¤§±Ô­z¡A¦óªÌ¿ù»~¡H
A.Hemochromatosis±wªÌ¦å¤¤ferritin > 1000 ug/L®É¡A¨ä¨x¤º±`¦³advanced fibrosis
B.¹ï°sºë©Ê¨x¯f±wªÌ¡A¥H¤âIJºN¨xŦ¤ñ¸¡³¡¶W­µªi±½´y¯à§óºë·Ç§PÂ_¨xµw¤Æ¤§¦³µL
C.Elastography (Fibro Scan)¥Ø«e¤w³Q¥Î¨Ó°»´ú¨x¤ºÅÖºû¤Æ¤§µ{«×¡A¦ý¤´¬Û·í¤£·Ç½T
D.¨x¬ï¨ë¡]liver biopsy¡^¥Ø«e¤´¬O§PÂ_¨x¤ºÅÖºû¤Æ¦s¦b»P§_¤Î¨äµ{«×¤§reference standard
E.¦å¤pªO¼Æ¶q¥i¥Î¨Ó§PÂ_ºC©Ê¨x¯f±wªÌ¬O§_¦³¨xÅÖºû¤Æ
 
(D) 16. ºC©Ê¯f¬r©Ê¨xª¢¬O¥xÆW¦a°Ï³Ì±`¨£¤§¨x¯f¡A¤U¦C¦³Ãö¨äªvÀø¤§±Ô­z¡A¦óªÌ¿ù»~¡H 1. ºC©Ê¢Ñ«¬¨xª¢¥D­nªvÀø¤è¦¡¬°Interferon + Ribavirin 2. ºC©Ê¢Ð«¬¨xª¢¤§ªvÀø¤è¦¡¦³Interferonª`®g¤Î¤fªA§Ü¢Ð«¬¨xª¢¯f¬rÃĪ«¨âºØ 3. Interferonª`®g¥i¯à²£¥Íµo¿N¡BÀYµh¡B¬Æ¦Ü¼~Æ{ (depression)¤§°Æ§@¥Î 4. Ribavirin¥i¯à¾É­P¥Õ¦å²y¼Æ¥Ø¤U­° 5. ³sÄòªA¥Î®É¡A¢Ð«¬¨xª¢¯f¬r¹ïEntecavir (¨©¼Ö§J¡ABaraclude)³Ì®e©ö²£¥Í§ÜÃÄ©Ê
A.1+2
B.2+3
C.3+4
D.4+5
E.5+1
 
(B) 17. ¤U¦C¦U¶µ±Ô­z¡A¦óªÌ¥¿½T¡H 1. ºC©Ê¢Ñ«¬¨xª¢±wªÌ¡A¨C¤Ñ³Ü°s¶W¹L20-50 g¡A¾É­P¨xµw¤Æ¤§­·ÀI·|¼W¥[ 2. ºC©Ê¢Ñ«¬¨xª¢±wªÌ¡A¨ä³Ü°s¶q»Pinterferon-based therapy¤§¦¨¥\²vµLÃö 3. ¨C¤Ñ³Ü°s¶W¹L20 g¡A¨k©Ê¸û©ö¿©±w°sºë©Ê¨x¯f 4. °sºë©Ê¨xª¢±wªÌ¤§¦å¤¤AST (GOT)/ALT (GPT)¤§¤ñ­È±` > 1¡A¦ÓºC©Ê¯f¬r©Ê¨xª¢±wªÌ«h±` < 1
A.1+2
B.1+4
C.2+3
D.3+4
E.1+3
 
(D) 18. ¤@¦ì¨xµw¤Æ¯f¤H¦]´NÂå¤è«K©Ê¡A§Æ±æ¦b§Aªºªù¶E°lÂÜ¡C¥L¬OºC©Ê¢Ð«¬¨xª¢±wªÌ¡A¦b°lÂܹLµ{¤¤¡A§AÀ³¸Ó¬°¥L¦w±Æ¤U¦C¦U¶µÀËÅç©ÎÀˬd¡A¦óªÌ¿ù»~¡H
A.©w´Á©â¦åÀËÅçGOT (AST)¤ÎGPT (ALT)
B.©w´Á©â¦åÀËÅç CBC¡A¥]§tPlatelet count
C.©w´Á©â¦åÀËÅçProthrombin time (PT)
D.¨C¨â¦~¦w±Æ¤@¦¸¸¡³¡¶W­µªiÀˬd
E.­Y¸¡³¡¶W­µªiÀˬdµo²{¦³µÊ¸~¤j¡AÀ³«Øij¯f¤H±µ¨ü¤W®ø¤Æ¹D¤ºµøÃèÀˬd
 
(E) 19. ¤U¦C¦U¶µ¬°­±Á{¹x©TÃøªv¸¡¤ô (refractory ascite)®É¥²»Ý¦Ò¼{¤§¥i¯à³B¸m¡A°£¤F¡G
A.TIPS (Transjugular Intrahepatic Porto-Systemic Shunt)
B.LVP (Large Volume Paracentesis) + albumin supply
C.¨xŦ²¾´Ó
D.­­¨îÆQ¤ÀÄá¨ú + §Q§¿¾¯
E.Phlebotomy
 
(C) 20. Ãö©ó¨x²Ó­MÀù¤§ªvÀø¡A¤U¦C¦óªÌ¥Ø«e©|«D¥D¬y¤è¦¡¡G
A.¶}¤M¤Á°£ (resection)
B.¨x°Ê¯ß®ê¶ë (transhepatic arterial embolization, TAE)
C.¼Ð¹vªvÀø (molecularly target therapy)
D.°sºëª`®g (percutaneous ethanol injection therapy)
E.®gÀW¿N¨`ªvÀø (radiofrequency ablation)
 
(A) 21. Ãö©ó¨xŦ²¾´Ó¡A¤U¦C±Ô­z¦óªÌ¿ù»~¡H
A.¤â³N§¹¦¨3­Ó¤ë¥H«á¡A¥¢±Ñªº¥D¦]¬°·P¬V¤Î¥X¦å¡C
B.¬é¦³³¡¤Àªº¨x­MÀù±wªÌ¯à±µ¨ü¨xŦ²¾´ÓªvÀø¡C
C.ÁxºÞ²Ó­MÀù±wªÌµ´¹ï¤£¯à¥H¨xŦ²¾´Ó¤â³NªvÀø¤§¡C
D.¢Ñ«¬¨xª¢¯f¬r¾É­P¤§¨xµw¤Æ ±wªÌ¡A±µ¨ü¨xŦ²¾´Ó«á¡A¨ä¢Ñ«¬¨xª¢¤j¦h·|´_µo¡C
E.­ìµo©ÊÁx¥Äº¢¯d©Ê¨xµw¤Æ (primary biliary cirrhosis) ±wªÌ¡A¨xŦ²¾´Ó¤§¦¨¥\²v«Ü°ª¡C
 
(A) 22. ¯f¤H¦]­Â«å¦Ó©â¦å¡A¨äµ²ªG¦p¤U¡GGOT=33 (< 37 IU/L)¡AGPT=37 (< 41 IU/L)¡ABil (T)=0.7 (< 1 mg/dL)¡AAlb=3.8 ( >3.5 g/dL)¡AGlobulin=8.0(< 3.5 g/dL)¡AALP=200 ( < 240 IU/L)¡Ar-GT=48 (< 50 IU/L)¡C¤U¦C¦U¶µ«áÄòÀˬd©ÎÀËÅç¡A¨º¨Ç¬O¦X²zªº¡H 1. abdominal ultrasound 2. MRI (magnetic resonance image) 3. serum protein electrophoresis 4. antimitochondrial antibody (AMA) 5. urine protein electrophoriesis 6. bone scan
A.1+3+5
B.2+3+4
C.3+4+6
D.2+4+5
E.1+5+6
 


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