9 下列何者和調控凝血無關？
fibrinogen protein C C-reactive protein kallikrein
ANS c
acute phase reactant protein!!!
PROTEIN C【Protein C】：是一種Vitamin-K-dependent蛋白，由肝臟製造。平常為酵素原，當被凝固因子V和
VIII切斷一段胜肽鏈後成為活化態的Protein C。當activated Protein C和Protein S結合後，會接著和thrombin-thrombomodulin complex結合，進行抗凝血反應。
12 一位54歲高血壓病患，於聽診時發現其心尖位置之第一心音（first heart sound）前有一低頻短音，此時病人常會伴隨有下列何種現象？
心電圖出現心房顫動（atrial fibrillation） 胸部X光出現右心室擴大
心臟超音波發現左心室肥厚 左側胸骨下緣出現收縮期心雜音
ANS VENTRICULAR HYPERTROPHY!
15 急性胰臟炎發作時，最先被活化的酵素為何？
胰澱粉酶（pancreatic amylase） 胰蛋白酶（trypsin）
胰糜蛋白酶（chymotrypsin） 胰脂肪酶（pancreatic lipase）
TRYPSIN!
17 下列何種狀況會發生發紺（cyanosis）？
動脈血缺氧血紅素含量大於5 g/dL 一氧化碳中毒
組織毒性缺氧 嚴重貧血缺氧
ANS a
Approximately 5 g/dL of 缺氧血紅素unoxygenated hemoglobin in the capillaries generates the dark blue color appreciated clinically as cyanosis. For this reason, patients who are anemic may be hypoxemic without showing any cyanosis.
18 當血中之鉀離子濃度上升時，體內那一個激素分泌增加？
抗利尿激素（anti-diuretic hormone; ADH） angiotensinogen
aldosterone atrial natriuretic peptide（ANP）
ALDOSTERONE
21 因應血中葡萄糖濃度上升於第二階段（phase II）中緩慢釋出胰島素之細胞內關鍵分子為下列何者？
鈣離子（calcium ion） 麩胺酸鹽（glutamate）
丙酮酸鹽（pyruvate） 鎂離子（magnesium ion）
GLUTAMATE
Beta cells in the islets of Langerhans release insulin in two phases. The first phase release is rapidly triggered in response to increased blood glucose levels. The second phase is a sustained, slow release of newly formed vesicles triggered independently of sugar.
26 一位男童特別高大，主訴關節鬆動、視網膜剝離病變。檢查發現他的第二型膠原蛋白（type II collagen）於三胜肽重複單位（tripeptide repeat）產生突變，以致影響它的四級結構。這個突變最可能發生在那個胺基酸？
羥離胺酸（hydroxylysine） 羥脯胺酸（hydroxyproline）
甘胺酸（glycine） 色胺酸（tryptophan）
GLYCINE!!!
A child with tall stature, loose joints, and detached retinas is found to have a mutation in type II collagen. Recall that collagen consists of a repeating tripeptide motif where the first amino acid of each tripeptide is the same. Which of the following amino acids is the recurring amino acid most likely to be altered in mutations that distort collagen molecules?
a. Glycine
b. Hydroxyproline
c. Hydroxylysine
d. Tyrosine
e. Tryptophan
a. Glycine
b. Hydroxyproline
c. Hydroxylysine
d. Tyrosine
e. Tryptophan
The primary structure of collagen peptides consists of repeating tripeptides with a gly-X-Y motif, where gly is glycine and X and Y are any amino acid. The small CH2 group connecting the amino and carboxyl groups of glycine contrasts with the larger connecting groups and side chains of other amino acids. The small volume of glycine molecules is crucial for the α helix secondary structure of collagen peptides. This in turn is necessary for their tertiary helical structure and their assembly into quaternary tripeptide, triple-helix structures. The most severe clinical phenotypes caused by amino acid substitutions in collagen peptides are those affecting glycine that prevent α helix formation. The child has a disorder called Stickler syndrome (108300) that exhibits autosomal dominant inheritance.
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