62 一位16歲患者，因發燒、喉嚨痛及全身倦怠來診，理學檢查顯示口腔黏膜水泡，另外於手掌及臀部亦發現相同水泡病灶，病史詢問後發現家中另一孩童亦有類似症狀被診斷為疱疹咽峽炎（herpangina）。關於此病症下列敘述何者錯誤？

此病症之潛伏期約為10-14天 重症者可發生腦炎、心肌炎

此病症家中之傳播率高達90%以上 死亡原因以肺水腫或肺出血為主要原因

ans A: Herpangina typically has an incubation period of 4-14 days.

Herpangina, also called mouth blisters, is the name of a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A (and the term "herpangina virus" refers to coxsackievirus A)^[1] but it can also be caused by coxsackievirus B or echoviruses.^[2] Most cases of herpangina occur in the summer,^[3] affecting mostly children. However, it occasionally occurs in adolescents and adults. It was first characterized in 1920.^[4]

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66 下列何者是有青少年子女的家庭（adolescent family）發展階段的課題（developmental issue）？

親密與自主（intimacy and autonomy） 性（sexuality）

依賴（dependency） 自我的完整性（ego integrity）

SEX

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69 一位64歲女性最近2年背痛逐漸嚴重而就診。疼痛位置在胸椎中間，為隱隱作痛。症狀從2年前在家中滑倒傷到背部即開始。身體移動時或脊椎側彎時會加重。理學檢查發現有駝背（kyphosis）現象，在第7、8胸椎處有明顯壓痛點。身高156公分，體重46公斤。其它理學檢查無特殊異常。胸椎X光檢查發現第8胸椎有壓迫性骨折。下列針對病人疼痛之起始治療（initial treatment）何者較適當？

Calcium gluconate Bisphosphonates

Estrogen replacement therapy Nasal spray calcitonin

ans D

Calcitonin is a 32-amino acid linear polypeptide hormone that is produced in humans primarily by theparafollicular cells (also known as C-cells) of the thyroid, and in many other animals in the ultimobranchial body.^[2] It acts to reduce blood calcium (Ca²⁺), opposing the effects of parathyroid hormone(PTH).^[3] It has been found in fish, reptiles, birds, and mammals. Its importance in humans has not been as well established as its importance in other animals, as its function is usually not significant in the regulation of normal calcium homeostasis

nasal spray calcitonin!

USES: This medication is used to treat brittle bone disease (osteoporosis) in women who are at least 5 years past "the change of life" (menopause). Calcitonin works by slowing bone loss to help maintain strong bones and reduce your risk of fractures.