| (C) | 1. |
下列何者不是國際上評估diffuse large B cell lymphoma病人預後的指標IPI (International Prognostic Index)?
|
| A. | Performance status |
| B. | Age |
| C. | Hb |
| D. | Stage |
| E. | LDH |
| |
| (B) | 2. |
目前Azacytidine以治療骨髓化生不良症候群(MDS)高危險之病患,已有健保給付。此藥作用的機轉為何?
|
| A. | Tyrosine kinase inhibitor |
| B. | DNA methylation inhibitor |
| C. | Proteosome inhibitor |
| D. | Immunomodulator |
| E. | Vascular endothelial growth factor inhibitor |
| |
| (E) | 3. |
一位37歲女性病患過去無特殊病史,最近因為疲倦、黃疸及深色尿應診,血液檢查顯示Hb 8.7 g/dL,reticulocyte 4.8%,白血球3560/uL,血小板145000/uL,血液抹片如圖所示;bilirubin全量3.7 mg/dL,直接型0.6 mg/dL,AST 75 U/L,ALT 31 U/L,LDH 2350 U/L,Coombs' test陰性;小便如圖所示,潛血反應呈陽性,沈澱物中RBC 0-2/HPF,WBC 1-3/HPF。下列何種檢查對診斷最有幫助?
|
| A. | Urine myoglobin |
| B. | Hb electrophoresis |
| C. | Bone marrow examination |
| D. | Hepatitis markers |
| E. | Flow cytometry for CD55 and CD59 expression |
| |
| (C) | 4. |
下列何種狀況造成iron deficiency anemia的機會最小?
|
| A. | Gastrectomy |
| B. | Paroxysmal nocturnal hemoglobinuria |
| C. | Thalassemia |
| D. | Pregnancy |
| E. | Colon Cancer |
| |
| (D) | 5. |
下列化學治療或標靶治療藥物中,何者造成神經學毒性的可能性最小?
|
| A. | Vincristine |
| B. | Cisplatin |
| C. | Thalidomide |
| D. | Etoposide |
| E. | Bortezomib |
| |
| (A) | 6. |
下列檢查為多發性骨髓瘤診斷或分期所必需,何者為例外?
|
| A. | Bone scan |
| B. | β2-microglobulin |
| C. | Albumin |
| D. | Daily urine light chain quantification |
| E. | Blood M-protein level |
| |
| (B) | 7. |
一位25歲急性白血病人周邊血中血紅素7.5 g/dL,白血球165000/uL,血小板13000/uL;尿酸10.5 mg/dL,Cr 1.7 mg/dL;為及早降低白血球的數目,化學治療必須儘快開始。在化學治療前,為快速達到預防及治療tumor lysis syndrome的目的,下列何種藥物最適當?
|
| A. | Allopurinol |
| B. | Rasburicase |
| C. | Benzbromarone |
| D. | Furosemide |
| E. | Magnexium oxide |
| |
| (A) | 8. |
一位31歲女性身體檢查顯示有輕微黃疸,皮膚少許淤青,無其他出血現象。血紅素9.2 g/dL,網狀紅血球(reticulocyte) 4.1%,白血球4750/uL,血小板23000/uL;PT及PTT正常,血液抹片如圖所示,此病人最可能的診斷為何?
|
| A. | Thrombotic thrombocytopenic purpura |
| B. | Disseminated intravascular coagulation |
| C. | G-6PD deficiency |
| D. | Evan syndrome |
| E. | Hypersplenism |
| |
| (C) | 9. |
一位35歲病患,被診斷得了費城染色體(Ph)陽性之acute lymphoblastic leukemia。除了化學治療外,下列何種治療可進一步改善病人的預後?(1)all-trans retinoic acid (2)dasatinib (3)allogeneic hematopoietic stem cell transplantation(必須選出所有正確答案)
|
| A. | (1) |
| B. | (3) |
| C. | (2)+(3) |
| D. | (1)+(3) |
| E. | (1)+(2)+(3) |
| |
| (E) | 10. |
一位72歲男性,有長期肺病病史,最近抽血檢驗發現Hb 18.6 g/dL,Hct 55%,被轉診到血液科門診。身體檢查發現其面色潮紅,嘴唇稍有發鉗現象,並有杵狀指。下列何種檢查對區分此病人是polycythemia vera或secondary erythrocytosis有幫助?(必須選出所有正確答案)
(1)arterial blood gas (2)JAK2 mutation (3)erythropoietin level
|
| A. | (1) |
| B. | (2) |
| C. | (1)+(2) |
| D. | (2)+(3) |
| E. | (1)+(2)+(3) |
| |