91 一位69歲男性病患呈現嚴重的高血壓。影像學檢查發現他右腎臟的動脈進口處發生狹窄。下列疾病中那一個是造成這類腎臟動脈狹窄最常見的原因？

Fibromuscular dysplasia Takayasu arteritis

Polyarteritis nodosa Atherosclerosis

D

Fibromuscular dysplasia is an autosomal dominant^[4] disorder. It tends to occur between 14 and 50 years of age, but it has also been found in children younger than age 14. In one study, women were found to be affected more often than men

Polyarteritis nodosa (also known as "Panarteritis nodosa,"^[1] and "Periarteritis nodosa"^[1]) is a vasculitis of medium-sized arteries, which become swollen and damaged from attack by rogue immune cells. Polyarteritis nodosa is also called Kussmaul disease or Kussmaul-Maier disease.^[2] Infantile polyarteritis nodosa is a type of PAN restricted to infants.

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92 下列何者所併發的栓塞（embolic complications）可在肺部微血管循環中發現鱗狀細胞（squamous cell）？

分娩 嚴重骨折 胸壁傷害 血管導管檢查

A

Amniotic fluid embolism is entrance of amniotic fluid and fetal cells into the maternal circulation initiating an abnormal response.

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93 關於腸道血管結構不良（angiodysplasia）的敘述，何者錯誤？

好發年紀為60幾歲 常見部位為盲腸（cecum）及右結腸

在腸黏膜下層可見許多擴張的小血管 有血管內皮細胞異生

D

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94 一位4歲小男孩洗澡時，媽媽發現其右腹部有凸出的腫塊，經超音波檢查確定是約8公分大的腫瘤，手術後病理診斷為腎上腺惡性腫瘤，下列何種基因變異最可能？

N-myc基因增幅變異 p53基因點狀突變 c-myc基因轉位 RB基因刪除

A

N myc: Neuroblastoma

C myc: Burkitt lymphoma, chrom 8

Neuroblastoma is the most common extracranial solid cancer in childhood and the most common cancer in infancy, with an annual incidence of about 650 new cases per year in the US.^[1] Close to 50 percent of neuroblastoma cases occur in children younger than two years old.^[2] It is a neuroendocrine tumor, arising from any neural crest element of the sympathetic nervous system or SNS. It most frequently originates in one of theadrenal glands, but can also develop in nerve tissues in the neck, chest, abdomen, or pelvis.