59 某女士患有退化性骨關節炎數年，檢查時並無關節腫脹（swelling）或局部發熱。上下樓梯時膝關節疼痛程度增加，且最近走路耐力逐漸減少。最適合接受下列何種復健治療？

冷敷＋電療＋爬階梯訓練（cold packing＋electrotherapy＋climbing steps exercise）

冷熱交替治療（alternate cold and heat therapy）

熱敷＋電療＋水療（hot packing＋electrotherapy＋hydrotherapy）

熱敷＋電療＋腳踏車訓練（hot packing＋electrotherapy＋cycling exercise）

D

61 下列有關頸椎脊髓病變（cervical myelopathy）臨床症狀之敘述，何者最正確？

膝肌腱反射（knee jerk）消失

下肢痙攣性無力（spastic weakness of lower limbs）

僅有單側神經性疼痛（unilateral neurogenic pain）出現

本體感受與震動感覺（proprioceptive and vibration）改變為最早的臨床症狀

B

77 產後2週正在哺育母乳的30歲女性，因為發燒和右側乳房疼痛至急診處就醫，理學檢查發現右側乳房紅腫且有壓痛的情形，體溫為38℃，其他生命徵象與理學檢查並無異常，下列敘述何者錯誤？

高度懷疑是產後的乳腺炎（puerperal mastitis）

最常見的致病菌為Staphylococcus aureus

應全面停止餵母乳

給予口服的抗生素

C

Puerperal mastitis is the inflammation of breast in connection with pregnancy, breastfeeding or weaning. It is caused by blocked milk ducts or milk excess. It is relatively common, estimates range depending on methodology between 5-33%. However only about 0.4-0.5% of breastfeeding mothers develop an abscess.

Some predisposing factors are known but their predictive value is minimal. It appears that proper breastfeeding technique, frequent breastfeeding and avoidance of stress are the most important factors that can be influenced.