儿科期末考intern seminar六题，请大家参考~ 1. Regarding stepwise management of asthma, which of the following is correct? (A) SABA PRN for mild intermittent asthma (B) adding inhaled glucocorticoid for mild persistent asthma (C) adding montelukast, theophylline or LABA for moderate persistent asthma (D) all of the above Ans: (D) 2. 下列何者不是Vitamine D deficiency的 risk factor? (A) Lack of sunlight exposure (B) White ethnicity (C) Obesity (D) Liver disease Ans: (B) 3. Which statement is not true? (A) infants with biliary atresia who have evidence of persistent cholestasis, remain at high risk for fat soluble vitamin insufficiency (B) Early after hepatoenterostomy, a total serum bilirubin .2 mg/dL, a marker of poor bile flow, has been found to be associated with poorer short-term outcome (C) Current strategies that can successfully correct fat soluble vitamin deficiency include adding large supplements of individual vitamins,switching to more water-soluble forms . (D) All of above are true Ans: (C) 4. Which Fat-Soluble Vitamin insufficiency were more common in children with biliary atresia even after supplementation ? (A) vitamin A and D (B) vitamin A and E (C) vitamin A and K (D) vitamin E and K Ans: (A) 5. 关於Infantile hemangiomas，何者为是？ (A) 大部分的Infantile hemangiomas会自行消退。 (B) Facial hemangiomas大於五公分时，可考虑眼科检查，脑部、颈部及上胸部的血管检 查，来排除PHACE syndrome。 (C) 较大较严重的infantile hemangioma，若长在lumbosacral or perineal area，要注 意spinal cord, anogenital, and renal anomalies。 (D) cutaneous hemangioma若大於5个，可先考虑从头到脚全身听诊，初步检查体内血管 畸形。 (E) 以上皆对 Ans: (E) 6. 下列关於婴儿血管瘤(infantile hemangioma)叙述何者错误? (A) 可以考虑使用口服Prednisone，以每公斤每日1-3 mg剂量给予，须注意可能之副作用 ，包括hypertension，stomach irritation，容易infection甚至cardiomyopathy等 (B) Propranolol 现在是许多医师的首选，其效果卓越，但须注意hypoglycemia， hypotension以及可能出现之便秘情况。对於某些可能出现bronchial hypersensitivity 或者是伴随有cerebral vascular anomaly 之患者禁用。 (C) Sirolimus (Rapamycin) 是一种mTOR inhibitor，可以抑制mTORC1所诱导之mRNA转译 等作用，进而抑制细胞之生长。目前上市之产品效果有效、安全，没有任何可能的安全疑 虑。 (D) 雷射也是一个可以考虑使用的治疗方式，目前有较多证据有效的依然是一般的 pulsed dye laser (585 nm – 595 nm)，每2-4 周施行一次，疼痛度不高，施行时也不 需要深度麻醉，对於ulcerating lesion, residual erythema, telangiectasia效果不错 。近来有人研究ND: Yag发现对於refractroy lesion似乎也有一定之疗效。 (E) 以上皆是 ANS: (C) Sirolimus 对於IH 仍在trial 中，有organ growth suppress 之安全考量 --

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