再次提醒 1.个人资料ppt 内容要包括照片 姓名 学校 run过的course 现在只有三个人交 记得有空赶快弄一弄寄给我喔 [email protected] 2.考试 考试时间：9/1(五) 14:00 考试地点：3F临床技能中心 考试内容：分笔试和slide两部分 笔试共有33题选择 (包括intern seminar同学出的题目学姊有挑几题) 一大题问答 考试时间50分钟 Slide题三题 每题五分钟 一次三个人进去考 会有slide(比如说skin lesion或是x-ray)提示 再从假父母问病史 提问可以三个人一起合作 最後答案卷则是各自分开写 要写出诊断及治疗 评分重点跟妇产科不太一样 请大家多注意 3.聚餐 8/30 (三) 晚上六点半 欣叶日本料理 馆前店(灿坤楼上） 地址：台北市馆前路12号(Future Center 6楼) 电话：(02)2371-3311 Intern seminar题目整理 Atopic dermatitis 1. Which one of the following is the most important Ab in the pathogenesis of atopic dermatitis? 1. IgE 2.IgG 3.IgM 4.IgA ans1 2. What is the immune cell that plays the most important role in acute phase of atopic dermatitis? 1. Th2 2.Th1 3.macrophage 4.eosinophil ans1 3. which one of the following diseases is associated with atopic dermatitis? 1. asthma 2. allergic rhinitis 3.both 4. none ans3 4. What are the immune cells that play important roles in chronic phase of atopic dermatitis? 1. macrophage 2. eosinophil 3.both 1+2 4.mast cell ans3 C 1. 下列叙述皆有助於Atopic dermatitis 的诊断，何者除外？ a) itchy skin. b)family history of asthma. c) Skin biopsy d) Onset age <2y/o. D 2. Atopic dermatitis的治疗何者有误？a)首选药物是topical steroid. b) topical steroid无效时可以试用tacrolimus类药物. c)antihistamine可以减少痒感以及帮助 入睡. d)UV light可以长期照射，不必担心副作用. A 3. Tacrolimus的作用机制是？ a)calcineurin inhibitor. b) anti-oxidant. c)anti-coagulant. d)leukotriene inhibitor. A 4. 关於Atopic dermatitis何者正确？ a)皮肤表现和irritant dermatitis很相似， 宜从history上加以区别. b)常并发S. aeurus感染宜长期使用预防性抗生素. c)high social classes的盛行率较低. d)有food allergy的小小孩不需要避免食用奶蛋. Aplastic anemia (E) 1. Which of the following is the possible cause of aplastic anemia? (A) quantitative and qualitative defects in stem cells (B) blocks in differentiation (C) inadequate cytokine production (D) the effects of a chemical poison (E) all of the above (E) 2. About aplastic anemia, which of the following is true? (A) Incidence is higher in Asia than in the West (B) Associated with genetic mutation (C) immune-mediated disease (D) the drug chloramphenicol may cause aplastic anemia (E) All of the above (E) 3. Aplastic anemia responds to (A) antithymocyte globulin(ATG) (B) Steroid (C) Cyclosporin (D) Cyclophosphamide (E) All of the above (C) 4. In aplastic anemia, which cytokine do activated cytotoxic T cells especially expressed? (A) IFN-α (B) IFN-β (C) IFN-γ (E) 5. Which of the following is the possible cause of T cell activation in aplastic anemia? (A) HLA-DR2 over-expression (B) Polymorphisms in cytokine genes (C) Constitutive expression of Tbet (D) SAP protein level decreased (E) All of the above D 1. What is not the treatment of aplastic anemia? (a) ATG (b) Cyclosporine (c) transplant (d) iron D 2. What is the source of hematopoietic Stem Cell Transplantation for aplastic anemia? (a) Allogeneic HLA-matched sibling donor transplant (b) Matched unrelated donor transplant (c) umbilical cord transplants (d) all of the above D 3. What does not the conditioning we currently use when allogeneic HLA-matched sibling donor transplant is prepared to perform? (a)irradiation (b)cyclophosphamide (c)cyclophosphamide plus ATG (d)none of the above D 4. What is the prognosis factor of aplastic anemia with matched unrelated donor transplant? (a) age (b) the closeness of the class I HLA match (c) the length of time from diagnosis (d) all of the above Kawasaki disease 1.下列哪个徵象不符合Kawasaki disease的Principle clinical criteria？ (a) Erythema of palms or soles (b) Fever ≧ 5 days (c) Strawberry tongue (d) Cervical lymphadenopathy (e) Arthritis Ans: e 2.关於Kawasaki disease，下列何者为非？ (a) 男多於女 (b) Generalized systemic vasculitis (c) Duration of fever是coronary arteries aneurysm良好的 risk predicting factor (d) Coronary artery z scores是此病评估与治疗的一项有用的指标 (e) Coronary aneurysms的位置以distal RCA最为常见 Ans: e 3.关於Kawasaki disease的cardiac catheterization和angiography，何者为非？ (a)可侦测coronary artery stenosis、thrombotic occlusion以及collateral artery formation的范围。 (b)对於有mild ectasia or small fusiform coronary artery aneurysms的病人， angiography并不建议施行。 (c)对於接受过surgical revascularization 的病人，再次心导管可以评估 治疗效果。 (d)对於初次开始评估coronary aneurysms的病人，abdominal aortography和 subclavian arteriography也被建议施行。 (e)以上皆正确。 Ans: e 4. Echocardiography在评估Kawasaki disease病人coronary artery aneurysms的角色， 何者为非？ (a) 诊断之初可提供coronary artery morphology, LV and left valvular function 的baseline. (b) 可定量地量测血管内径、测得aneurysms的位置和数量，以及thrombus的有无 (c) 根据AHA最新定义，内径大於8mm的aneurysm为giant aneurysm (d) 在处理病人的原则上，echocardiography的评估优先於任何治疗上的处理。 (e) 随着小病人的成长，体表面积的增加，会提高侦测aneurysm的困难，这是 echocardiography的limitation之一。 Ans: d (a) 1. About long-term management of Kawasaki disease with transient coronary artery dilatation (disappearing within the initial 6 to 8 weeks after the onset of illness): (a) No antiplatelet therapy is needed (b) Long-term antiplatelet therapy solely is recommended (c) Long-term antiplatelet therapy with warfarin is recommended (d) Long-term thrombolytic therapy is recommeded (c) 2. About long-term management of Kawasaki disease with persistent giant aneurysms (a) No antiplatelet therapy is needed (b) Long-term antiplatelet therapy solely is recommended (c) Long-term antiplatelet therapy with warfarin is recommended, target INR 2.0:2.5 (d) Long-term thrombolytic therapy is recommeded (d) 3. What is initial treatment of Kawasaki disease (a) Steroid solely (b) Steroid + high dose Aspirin (c) Steroid + lose dose Aspirin (d) IVIG + high dose Aspirin (d) 4. About long-term management of Kawasaki disease with coronary artery obstruction confirmed by angiography (a) Monitoring for risk factors of atherosclerosis is unnecessary (b) No antiplatelet therapy is needed (c) Beta-adrenergic-blocking drugs should be avoided (d) Cardiology evaluation with an echocardiogram and ECG should be obtained at 6-month intervals --

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