Monday, November 29, 2010

ANTI ARRHYTHMIA DRUGS

ALL CLASS I: FAST NA CHANNEL BLOCKER
ALL CLASS II: BETA BLOCKERS
ALL CLASS III: K CHANNEL BLOCKER
CLASS IV: SLOW CHANNEL CA BLOCKER
CLASS V: UKNOWN MECHANISM

NA
BETA
K
CA
UNKNOWN

Ia: quinidine, amide group
Ib: lido, pheny, mexilitine
Ic: fecainide, propafenone, moricizine

II: all the OLOL

III: A- amiodarone
I - ibutilide
D - dofetilide
S - sotalol

IV: diltiazem, verapamil
V: adenosine, digoxin


During the storage phase the internal urethral sphincter remains tense and the detrusor muscle relaxed by sympathetic stimulation. During micturition, parasympathetic stimulation causes the detrusor muscle to contract and the internal urethral sphincter to relax. The external urethral sphincter (sphincter urethrae) is under somatic control and is consciously relaxed during micturition.


SYMPATHETIC: STAY URINE
PARASYMPA: PEE URINE!


15
下列有關能量攝取與甲狀腺的關係,何者正確?
攝取過量的碳水化合物可抑制甲狀腺素(thyroxine)的分泌
來自脂肪組織的瘦體素(leptin)可促進甲釋素(thyrotropin releasing hormone)的分泌
瘦體素抑制甲狀腺素的分泌
甲狀腺素過多會抑制瘦體素的分泌
B

LEPTIN: STIMLUATE THYROID HOROMONE THUS GETTING THINNER!


16
腎上腺素(epinephrine)是由那一種胺基酸合成?
色胺酸(tryptophan) 酪胺酸(tyrosine) 半胱胺酸(cysteine) 胱胺酸(cystine)
TYROSINE!!!!!

18
卵的第二次減數分裂(second meiotic division)何時完成?
 排卵前 濾泡破裂排卵時
精子穿透卵的細胞膜時 著床後
C



19
神經學檢查中有關之神經反射,何者屬於單突觸反射(monosynaptic reflex)?
 瞳孔反射(pupillary light reflex) 回縮反射(withdrawal reflex)
膝腱反射(knee jerk) 交叉伸肌反射(crossed-extensor reflex)
C

monosynaptic reflex A simple reflex that involves transmission of information from a sensory neuron to the appropriate motor neuron across a single synapse in the spinal cord. The knee-jerk reflex action is an example of a monosynaptic reflex (see stretch reflex). Compare polysynaptic reflex.

polysynaptic reflex A reflex action that involves an electrical impulse being transferred from a sensory neuron to a motor neuron via at least one connecting neuron (interneuron) in the spinal cord. For example, stimulation of pain receptors in the skin initiates a withdrawal reflex, which involves several synapses with several motor neurons and results in the removal of the organism or part from the stimulus.
5
Limbic system中與恐懼情緒(fear)關係密切之結構為何?
thalamus hippocampus fornix amygdaloid nuclei
D

AMY=FEAR


7
移除骨骼肌細胞質液(cytosol)內的鈣離子,會產生下列何種現象?
肌動蛋白(actin)上的肌凝蛋白(myosin)連接處,經旋轉肌凝蛋白(tropomyosin)作用而暴露出來
旋轉肌凝蛋白會改變形態,使得旋轉子(troponin)從連接橋(cross-bridge)結合處離開
旋轉子會改變形態,使得連接橋結合處暴露出來
肌動蛋白上的肌凝蛋白連接處,被旋轉肌凝蛋白占據
D

RETWIST BACK TO ORIGINAL STATE!!!



9
下列那一個因子必須在血管內皮細胞與其受器(receptor)結合,活化蛋白質C以減低凝血效應?
凝血酶(thrombin) 血漿素(plasmin) 肝素(heparin) 維生素K
A

Negative feedback

Thrombin bound to thrombomodulin activates protein C, an inhibitor of the coagulation cascade. The activation of protein C is greatly enhanced following the binding of thrombin to thrombomodulin, an integral membrane protein expressed by endothelial cells. Activated protein C inactivates factors Va and VIIIa. Binding of activated protein C to protein S leads to a modest increase in its activity. Thrombin is also inactivated by antithrombin, a serine protease inhibitor




12

下列關於輔脂酶(colipase)之敘述,何者正確?

位於小腸上皮細胞膜上

負責消化三酸甘油酯(triglycerides)

可將脂肪酶原(prolipase)轉化成脂肪酶(lipase)

避免脂肪酶(lipase)受到膽鹽的影響而降低其活性

D




80
Eflornithine通常用以治療何種疾病?
弓蟲症(toxoplasmosis) 甘比亞睡眠病(Gambian sleeping sickness)
片山熱(Katayama fever) 旋毛蟲症(trichinosis)
B

Mode of Action

[edit]Hirsutism

Eflornithine topically applied is an irreversible inhibitor of ornithine decarboxylase (ODC), an enzyme that catalyses the conversion of ornithine to putrescine, which plays an important role in cell division and proliferation in the hair follicle.[11]


[edit]Sleeping sickness treatment

Eflornithine appears to kill trypanosomes by acting as a suicide inhibitor of the enzyme ornithine decarboxylase (EC 4.1.1.17). This enzyme regulates cell division by catalysing the first step in polyamine biosynthesis. As the inhibitor has a low half-life in humans, it is broken down rapidly while the parasite cannot metabolise it quickly enough. This means that it preferentially harms the parasite.

78
下列有關瘧疾的敘述,何者正確?
腦性瘧疾(cerebral malaria)是惡性瘧的併發症之一
間日瘧患者最常見的併發症為腎病症候群(nephrotic syndrome)
四種人類之瘧疾中,以惡性瘧的地理分布最廣
台灣於瘧疾根除後之四十年間,所發現之瘧疾病例均係境外移入
A

NEPHROTIC SYNDROME IS THE 三日瘧
P VIVAX : 地理分布最廣







57
下列關於小兒麻痺病毒(Poliovirus)之敘述,何者為錯?
分類上屬於小RNA病毒科(Picornaviridae),包括三種血清型
其疫苗有沙克疫苗及沙賓疫苗,均為包含三種血清型之混合疫苗
感染後大部分人出現中樞神經症狀,少部分人為無症狀感染
麻痺性脊髓灰白質炎(paralytic poliomyelitis)主要是因為此病毒感染脊髓前角細胞(anterior horn cell)所致
C

In 95% of cases only a primary, transient presence of viremia (virus in the bloodstream) occurs, and the poliovirus infection isasymptomatic.

59
真菌細胞壁特有的成分是:
麥角醇 幾丁質 角質 醣苷類
B

幾丁質 CHITIN
麥角醇 ERGOSTEROL
醣苷類 GLYCOSIDE


63
下列何種自體免疫疾病,主要是由於自體免疫反應性T細胞所引起?
 自體免疫胰島素-依賴性糖尿病(autoimmune insulin-dependent diabetes mellitus)
全身性紅斑狼瘡(systemic lupus erythematosus)
重症肌無力(myasthenia gravis)
Grave氏病(Grave’s disease)
A


64
下列何者為器官特異性的自體免疫疾病?
 全身性紅斑狼瘡(systemic lupus erythematosus)
類風溼性關節炎(rheumatoid arthritis)
多發性硬化症(multiple sclerosis)
硬皮症(scleroderma)
C

66
下列何分子之缺陷不會影響到淋巴球的基因重組,但會使淋巴球的成熟受到阻礙?
IL-2 receptor γc chain RAG 1
RAG 2 DNA-dependent protein kinase
A

The Recombination Activating proteins RAG -1 and RAG-2 act together as a heterodimer in the initiation of the process of antigen receptor gene segment assembly. (Spanopoulou, 1996). These proteins are encoded by the Recombination Activating genes, which are found on human chromosome 11 (Shigeoka, 2002). The RAG genes are in very close proximity and consist of one exon (Janeway, 2001). These proteins are essential for proper formation and function of B cell and T cell receptors. (Janeway, 2001)These proteins are active only in the very early stages of lymphoid development as part of the V(D)J recombinase. These enzymes act together to effect somatic recombination. The RAG complex is responsible for initiating the recombination of the variable (V), diversity (D) and joining (J) gene segments of the receptor (Janeway 2001).




69
下列有關寄生蟲逃避寄主免疫反應的機制之描述,那一項不正確?
瘧疾原蟲(Plasmodium species)脫去circumsporozoite(CS)抗原
利什曼蟲(Leishmania species)引發寄主體內較高的Th1反應
錐型蟲(Trypanosomes)外表有變異醣蛋白(variant surface glycoprotein)
血吸蟲(Schistosomes)外表包覆著人類的ABO血型抗原
B


70
下列何者不是B細胞表面分子?
Igα和Igβ CD3 CD19和CD21 CD40
B

B LYMPHOCYTES, NO 3!!!!! B=2 NO 3




71
Lipopolysaccharide(LPS)是革蘭氏陰性細菌細胞壁的成分,會和白血球上的那個分子結合?
CD1 CD5 CD14 CD25
C


73
下列那種分子的配對組合(內皮細胞上的分子/白血球上的分子)會在發炎反應細胞遷移(cell migration)時發生?
MadCAM/α4β1
E-selectin/CD15s(sialyl-Lewis-X carbohydrate of CD15)
IL-8/CCR2
VCAM-1/LFA-1
B

74
下列那一種細胞不能呈獻(presenting)胜肽(peptide)抗原給輔助型T細胞(helper T cells)?
B細胞 嗜中性白血球(neutrophils)
巨噬細胞(macrophages) 樹狀突出細胞(dendritic cells
B

NEURTAL NGA SYA, NO PRESENTING !!!!

77
下列關於薑片蟲(Fasciolopsis buski)的敘述,何者正確?
為寄生在人體肝臟的巨大吸蟲
因食入淡水魚中的囊狀幼蟲(metacercaria)感染
嚴重感染時可能發生水腫和腹水現象
可以用「免疫診斷」來確認診斷
C
Fasciolopsiasis results from an infection by the trematode Fasciolopsis buski. [1] The largest intestinal fluke ofhumans (

AUQATIC PLANT: NOT FISH
INTESTINAL:NOT LIVER
Microscopic identification of eggs, or more rarely of the adult flukes, in the stool or vomitus is the basis of specific diagnosis.






Sunday, November 28, 2010

31
下列那一項構造的胚胎起源與第二對咽弓(pharyngeal arch)無關?
砧骨 莖突 莖突舌骨韌帶 舌骨之小角部
A

砧骨: INCUS
莖突l STYOID
莖突舌骨韌帶: STYLOHYOID LIGAMENT
舌骨之小角部: CORNUS OF HYOID BONE


33
在眼球中,下列何者不屬於葡萄膜(uvea or tunica vasculosa)?
虹膜(iris) 網膜色素層(pigment epithelium)
睫狀體(ciliary body) 脈絡膜(choroid)
B

Anatomy

[edit]Regions

The vascular middle layer of the eye. It is traditionally divided into 3 areas, from front to back, the iris, ciliary body, and choroid.



36

具有「膠質原纖維酸性蛋白(glial fibrillar acidic protein, GFAP)」的細胞是:

星狀膠細胞(astrocyte) 腦室襯裏細胞(ependymal cell)

寡突膠細胞(oligodendrocyte) 微膠細胞(microglia)

A



37

下列有關牙齒的敘述,何者正確?

星形網(stellate reticulum)是由間葉(mesenchyme)衍生而來

琺瑯質(enamel)是由外胚層(ectoderm)衍生而來

齒質(dentine)是人體中最硬的構造

琺瑯質先形成之後,齒質再形成

B


38

破骨細胞(osteoclast)較常出現的區域是:

骺板細胞增殖區(zone of cell proliferation)

骺板細胞肥大和軟骨鈣化區(zone of hypertrophy and calcification)

骺板軟骨儲備區(zone of reserve cartilage)

骺板骨化區(osteogenic zone)

D





39

下列那一細胞層,僅出現在手掌或腳掌之厚皮膚?

角質層(stratum corneum) 透明層(stratum lucidum)

顆粒層(stratum granulosum) 棘狀層(stratum spinosum)

B


THICK SKIN: LUCIDUM!!!


43

下列何者無法培養在一般的大氣中?

霍亂弧菌(Vibrio cholerae) 綠膿桿菌(Pseudomonas aeruginosa)

志賀氏赤痢菌(Shigella dysenteriae) 幽門桿菌(Helicobacter pylori)

D




47

梭狀芽孢桿菌屬(Clostridium)病菌生存時不會產生下列何種毒素?

腸毒素(enterotoxins) 神經毒素(neurotoxins)

溶組織毒素(histolytic toxins) 內毒素(endotoxins)

D



54

輪狀病毒(Rotavirus)和挪瓦克病毒(Norwalk virus)屬於不同病毒,但它們共同具有下列何種特性?

可經由糞-口傳播 均是雙股RNA 均是單股RNA 可經由游泳傳播

A


56

下列關於病毒與其引起之疾病的敘述,何者為錯?

狂犬病毒(Rabies virus)可引起恐水症(hydrophobia)

B型克沙奇病毒(Coxsackie B virus)可引起胸膜痛(pleurodynia)

輪狀病毒(Rotavirus)可引起嬰兒腹瀉(infantile diarrhea)

A型克沙奇病毒(Coxsackie A virus)可引起出血熱併腎症候群(hemorrhagic fever with renal

syndrome)

D


COX B: BLEURODYNIA!!!!

The most well known Coxsackie A disease is Hand, foot and mouth disease (unrelated to foot and mouth disease),


What is hemorrhagic fever with renal syndrome?Go to top of page

Hemorrhagic fever with renal syndrome (HFRS) is a group of clinically similar illnesses caused by hantaviruses from the family Bunyaviridae. HFRS includes diseases such as Korean hemorrhagic fever, epidemic hemorrhagic fever, and nephropathis epidemica. The viruses that cause HFRS include Hantaan, Dobrava-Belgrade, Seoul, and Puumala.



21
胸管(thoracic duct)和下列那一構造一起穿過橫膈膜進入胸腔?
下腔靜脈 食道 主動脈 迷走神經
C


22
下列有關顏面神經的敘述,何者正確?
運動根(motor root)含有副交感神經纖維
中間神經(nerve intermedius)含有支配軟腭的感覺神經纖維
岩大神經(greater petrosal nerve)含有支配骨骼肌的運動神經纖維
味覺纖維的細胞本體位於膝狀神經節(geniculate ganglion)
D

The nervus intermedius, or intermediate nerve, is the part of the facial nerve (cranial nerve VII) located between the motor component of the facial nerve and the vestibulocochlear nerve (cranial nerve VIII). It contains the sensory and parasympathetic fibers of the facial nerve. Upon reaching the facial canal, it joins with the motor root of the facial nerve at the geniculate ganglion.

The greater (superficial) petrosal nerve is a nerve in the skull that branches from the facial nerve; it forms part of a chain of nerves that innervates the lacrimal gland. The fibres have synapses in the pterygopalatine ganglion.



24
下列何者不發生於近距離之調焦作用(accommodation)?
第三對顱神經副交感節前纖維興奮
睫狀肌(ciliary muscle)收縮
水晶體懸韌帶(suspensory ligaments of lens)被拉緊
水晶體變凸變厚
C


27
下列有關翼腭窩(pterygopalatine fossa)之敘述,何者錯誤?
上頜動脈(maxillary artery)之第三部分進入此窩
由翼腭窩向內經鼻腭孔(nasopalatine foramen)進入鼻腔
上頜神經(maxillary nerve)經過此窩
此窩中之副交感神經節前纖維來自翼管(pterygoid canal)
B

Passages

The following passages connect the fossa with other parts of the skull:

Direction↓Passage↓Connection↓
Posteriorlyforamen rotundummiddle cranial fossa
Posteriorlypterygoid canal (Vidian)middle cranial fossa, foramen lacerum
Posteriorlypalatovaginal canal (pharyngeal)nasal cavity/nasopharynx
Anteriorlyinferior orbital fissureorbit
Mediallysphenopalatine foramennasal cavity
Laterallypterygomaxillary fissureinfratemporal fossa
Inferiorlygreater palatine canal (pterygopalatine)oral cavity, lesser palatine canals
17
陰囊的dartos肌所在之位置相當於下列何結構?
腹外斜肌 腹內斜肌 腹部淺肌膜層 潤肌膜(fascia lata)
C

18
第十一肋間的動脈供應來自:
前肋間動脈(anterior intercostal artery) 後肋間動脈(posterior intercostal artery)
肌膈動脈(musculophrenic artery) 肋下動脈(subcostal artery)
B/C

20
左肺門(hilum)正上方的溝(或切跡)是由何結構造成的?
食道 動脈弓 奇靜脈 上腔靜脈
B


12
下列何者位於會陰深隙(deep perineal pouch)?
會陰淺橫肌 球海綿體肌 陰莖背側神經 坐骨海綿體肌
C

會陰淺橫肌: Superficial transverse perineal muscle
球海綿體肌:Bulbospongiosus muscle
陰莖背側神經 Dorsal penile nerve
坐骨海綿體肌Ischial cavernous muscle

Contents

The deep perineal pouch contains:



13
下列何者為提睪肌(cremaster muscle)的主要支配神經?
股神經 陰部神經 生殖股神經 髂腹股溝神經
C

Innervation and vascular supply

The cremaster muscle is innervated from the genital branch of the genitofemoral nerve and supplied by the cremasteric artery.

It receives distinctly different innervation and vascular supply in comparison to the internal oblique.

11
下列何者有子宮動脈經過?
闊韌帶(broad ligament) 懸韌帶(suspensory ligament)
子宮圓韌帶(round ligament of uterus) 子宮薦韌帶(uterosacral ligament)
A

broad ligament

The suspensory ligament of the ovary, also infundibulopelvic ligament (commonly abbreviated IP ligament or simply IP), is a fold of peritoneum[1] that extends out from the ovary to the wall of the pelvis.

Some sources consider it a part of the broad ligament of uterus[2] while other sources just consider it a "termination" of the ligament.[3]

The suspensory ligament is directed upward over the iliac vessels.

8
下列何者伴行足背動脈(dorsalis pedis artery)?
 腓深神經(deep peroneal nerve) 腓淺神經(superficial peroneal nerve)
脛神經(tibial nerve) 足底內側神經(medial plantar nerve)
A


左右對齊5
切除腮腺後,顏面神經主幹可追溯至顱底何處?
卵圓孔(foramen ovale) 蝶腭孔(sphenopalatine foramen)
莖乳突孔(stylomastoid foramen) 眼眶下裂(infraorbital fissure)
C

STYLOMASTOID FORAMEN:

Between the styloid and mastoid processes of the temporal bone is the stylomastoid foramen

It is the termination of the facial canal, and transmits the facial nerve and stylomastoid artery.



FORAMEN OVALE

Contents

Several nerves, arteries and veins pass through the foramen ovale. They are as follows:

  • The otic ganglion is situated directly under the foramen, but is also transmitted through the foramen ovale.

The contents of this foramen neatly form the mnemonic 'OVALE' (otic ganglion, V3, accessory meningeal artery, lesser petrosal nerve, emissary veins)