8 二尖瓣（僧帽瓣）脫垂（mitral valve prolapse）是常見的瓣膜性心臟病，下列何者不是二尖瓣脫垂的正確敘述？

易發生於一些結締組織遺傳病病患如Marfan syndrome，osteogenesis imperfecta，Ehler-Danlos syndrome

二尖瓣病理變化為myxomatous degeneration，而且basic mucopolysaccharide的濃度增加

女性較常見，大多數病患不會有任何症狀，且大多數病患終生不會發生心血管不幸事件（如急性心肌梗塞或猝死）

在合併有二尖瓣閉鎖不全的二尖瓣脫垂病患，必須留意感染性心內膜炎的預防

b/d

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11 根據The 7th Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure（The JNC 7 Report）的高血壓定義，有關18歲以上成人之血壓（blood pressure）的敘述，下列何者錯誤？

正常血壓定義為＜120/80 mmHg

高血壓前期（prehypertension）為135-139/86-89 mmHg

第一期高血壓（stage I hypertension）為140-159/90-99 mmHg

第二期高血壓（stage II hypertension）為 ≥ 160/100 mmHg

B

Individuals with a systolic blood pressure of 120–139 mmHg or a

diastolic blood pressure of 80–89 mmHg should be considered as

prehypertensive and require health-promoting lifestyle modifications

to prevent CVD.

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13 下列何者與脂肪肝（fatty liver）無關？

肥胖症 糖尿病 C型肝炎 B型肝炎

D

• Having a certain strain or genotype of hepatitis

C – genotype 3: THIS CAUSE FATTY LIVER

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14 下列有關胰臟癌（carcinoma of the pancreas）的敘述，何者錯誤？

壺腹周圍癌（periampullary carcinoma）以胰臟頭部癌佔最多

胰臟癌病人血清中癌胚抗原（CEA）及鎖糖抗原（CA19-9）都會上升，是早期診斷的重要依據

電腦斷層掃描（CT scan）及內視鏡超音波（EUS）比一般超音波（ultrasonography）診斷率好

胰頭部癌之外科治療，可採用Whipple procedure（radical pancreatico-duodenal resection）

B

TUMOR MARKER NOT FOR DIAGNOSIS, BUT FOR EVALUATION OF PRE AND POST TREATMENT COMPARISON. FOR TRACING OF THE DISEASE

CA19-9 (carbohydrate antigen 19.9) is a tumor marker that is frequently elevated in pancreatic cancer. However, it lacks sensitivity and specificity. When a cutoff above 37 U/mL is used, this marker has a sensitivity of 77% and specificity of 87% in discerning benign from malignant disease. CA 19-9 might be normal early in the course, and could be elevated because of benign causes of biliary obstruction.^[

^{Carcinoembryonic antigen (CEA) is a glycoprotein involved in cell adhesion}

^{It was found that serum from individuals with colorectal carcinoma,[5] gastric carcinoma, pancreatic carcinoma, lung carcinoma and breast carcinoma, as well as individuals with medullary thyroid carcinoma, had higher levels of CEA than healthy individuals. Regions of high CEA levels in the body can be detected with the monoclonal antibody arcitumomab.}