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()
1. (deep branch)?
A. (middle cerebral artery)
B. (vertebral artery)
C. (posterior cerebral artery)
D. (anterior cerebral artery)
Ans(C)
Key

thalamus PCA
Middle Cerebral Artery basal ganglion MCA

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()
2. Corpus callosum?
A.(anterior cerebral artery)
B.(middle cerebral artery)
C.(basilar artery)
D.(anterior choroidal artery)
Ans(A)
Key

corpus collosum anterior cerebral artery

Middle Cerebral Artery
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()
3. (herniation),?
A.inferior vermis
B.flocculonodular lobe
C.(tonsil)
D.(inferior cerebellar peduncle)
Ans(C) (tonsil)
Key

(1) Uncal
(2) Central
(3) Cingulate
(4) Transcalvarial
(5) Upward
(6) Tonsilar tonsil

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()
4. ?
A.(superior salivatory nucleus)
B.(dorsal motor nucleus of vagus nerve)
C.(trigeminal motor nucleus)
D.Edinger-Westphal nucleus
Ans(C) (trigeminal motor nucleus)
Key

A. CN 7
B.
C. tensor tympanitensor veli palatinimylohyoid anterior belly of
the digastric
D. EW

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()
5. 1 2 3,(vertigo)?
A.12
B.23
C.2
D.123
Ans(D) 123
Key

(vestibule)(semicircular canal)
ampulla saccule utricle

vestibular ganglion vestibular nuclei

1. Medial longitudinal pathway

2. Vetibulospinal pathway
3. (inferior cerebellar peduncle)
4.
()

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()
6. ?
A.(glossopharyngeal nerve)
B.(internal laryngeal nerve)
C.(superior laryngeal artery)
D.(recurrent laryngeal nerve)
AnsA.(glossopharyngeal nerve)
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Key
C internal laryngeal nerve ( B ) hyothyroid membrane
external laryngeal nerve cricothyroid muscle
thyroid cartilage D recurrent laryngeal nerve
aortic arch subclavian artery
A

A. Glossopharyngeal nerve 9 stylopharyngeal

muscle
B. BCD
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(superior laryngeal nerve)(internal laryngeal nerve)(external

laryngeal nerve) hyothyroid membrane
subclavian
artery

()
7. (superior cervical ganglion),?
A.(carotid sheath)
B.(longus capitis)
C.CN IXCN X(pharyngeal plexus)
D.CN V

AnsB. (longus capitis)

Key QQ

B B

A. Carotid sheath common carotid arteryinternal jugular veinCN10

B.
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C. CN9CN10
D. CN5

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()
8. submandibular gland
A.muscular triangle
B.carotid triangle
C.digastric triangle
D.submental triangle
AnsC.
digastric triangle submental triangle

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()
9.
A.otic ganglion
B.vestibular ganglion
C.spiral ganglion
D. pterygopalatine ganglion
Ans()
Key
spiral ganglion= cochlear ganglion
Cochlea nerve bipolar neuron Organ of Corti
( CN8 :cochlear nerve)(cochlear nucleus)

* spiral ganglion cochlear ganglion spiral

ganglion = cochlear ganglion!

(A) otic ganglion CN9 (2012 12-72, d.)

(B) vestibular ganglionCN8(Vestibulocochlear nerve)(spiral ganglion)
(2012 12-93, e)
(C)
(D) pterygopalatine ganglion CN7
(2012 12-72, b.)

(conduction) 2012 12-91, b

()()
(
) ( ) (

)
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(pathway)2012 12-91, c
Corti organ ()(spiral ganglion=cochlea ganglion)
()()()(4142 )

http://what-when-how.com/wp-content/uploads/2012/04/tmp15F73.jpg

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()
10.nasal septum

A.
B.
C.
D.
Ans())
Key
*= =~
=+
argue
+
2012 8-1, c
(nasal septum)
(1)
(2) vomer
*~

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()
11.hyoid bone
A.facial nerve
B.glossopharyngeal nerve
C.hypoglossal nerve
D.
Ans()
Key
*
2012 15-16, VII
()()
(suprahyoid m.)(infrahyoid m.) C1~C3CN5-3(D )CN7(A )
B C
(1) C
(2)2012 15-13, IV(hyoglossus) CN12 (C )
B
2012 15-16, VII
*
I.
(1) (genioglossus)CN7
(2) (palatoglossus)CN10
(3) (styloglossus)CN12
(4) (hyoglossus)CN12
II. ()
(1) (geniohyoid)C1
(2) (mylohyoid)CN5-3
(3) CN5-3
(4) CN7
(5) (stylohyoid) CN7
(6) B4(thyrohyoid)C1
(7) B3(sternothyroid)()
(8) B2(sternohyoid)(C1-C3)
(9) B1(omohyoid)(C1-C3)

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()
12. 2
A.right ventricle
B.right atrium
C.superior vena cava
D.pulmonary trunk
Ans()
Key
BCS

2 !
D.

2
2
5

https://web.duke.edu/anatomy/Lab03/Lab4_preLab.html
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()
13.pulmonary veinsuperior vena cava
A.transverse pericardial sinus
B.oblique pericardial sinus
C.coronary sinus
D.diaphragmic surface of pericardial cavity
Ans()
Key
minor
!
*pulmonary vein
superior vena cava~
2012 5-3, C.3
(pericardial sinus)=(reflection)
I. (oblique pericardial sinus)()
(1) /
(2) /
II. (transverse pericardial sinus)
(1) /
(2)
/
*

Ao:
Pu:
R:
L:
SVC:
IVC:

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http://images.slideplayer.com/12/3558295/slides/slide_5.jpg

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()
14.fissure for ligamentum teres
A.
B.
C.quadrate lobe
D.caudate lobe
Ans()
Key
landmark (
~)
*fissure for ligamentum teresquadrate lobe
2012 9-20, 3
(1) ()

(2)

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quadrate lobe
(3)
()

http://geekymedics.com/hepatocellular-carcinoma/

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()
15.phrenic nerve
A.C35
B.C7T2
C.T35
D.T610
Ans()
Key C3~C5 C1~C3 !
2012 12-55, E

1. (phrenic n, C3~C5)()
@()

2. (ansa cervicalis, C1~C3)()

@C1
a. C1
b. C1
(C2~C3)

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()
16.
A.iliohypogastric nerve
B.ilioinguinal nerve
C.posterior femoral cutaneous nerve
D.obturator nerve
Ans()
Key2012 12-60, 5.
posterior femoral cutaneous nerve, S1~S3
C
2012 12-58, G.
(5 )
1. (femoral nerve, L2~4)
2. (obturator nerve, L2~4)
3. (iliohypogastric nerve, T12~L1)
4. (ilioinguinal nerve, T12~L1)
5. (genitofemoral nerve, L1~2)

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()
17.?
(A)
(B)
(C)
(D)
Ans(B)
Key

(A) , (B)(C)(D)<<
(B)

(X7)(X3)
1.
(1)
a.
b.
(2)
(3) (F)(M)
(4) (F)=(M)
(5)
(6)
a.
b.
i.
()
ii.
()
(7)
2.
(1)
(2)
(3)
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(A):
(B)..//(M).(F)
(C): 1/3 ..//(M).(F)
(D)
i.
1/3 . 1/3 .
ii.
.()

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*
1. :
(1) (<<)
(2) =(<)
2.
(1) (SMA)
(2) (IMA)
3.
(1) 1/3:(<IMA)
(2) 1/3:(<)
(3) 1/3:(<<)
4.
(1) 2/3:
(2) 1/3:

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()
18. (pelvic diaphragm)?
(A) (levator ani)
(B) (obturator internus)
(C) (deep transverse perineal muscle)
(D) (external urethral sphincter)
Ans(A)
Key

:()

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(Pelvic Diaphragm)

(pelvic diaphragm)
1.
(1)
(2)

(3)
2.

(urogenital diaphragm)
1.
2.

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()
19.(scrotum)?
(A) (cremasteric artery)
(B) (femoral artery)
(C) (artery of the bulb of penis)
(D) (internal iliac artery)
Ans(C)
Key

1.(<<)
2.(<<)

1.. 2 . 3 (<<)
4.(<)

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()
20. (lumbar plexus)?
(A) (superior gluteal nerve)
(B) (nerve to obturator internus)
(C) (obturator nerve)
(D) (pelvic splanchnic nerve)
Ans()
Key

(
)(D)

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(A)(B)(C)....

1.
2.(C)
3.
4.
5.

1.
2.
3.
4.(A) .
5.
6.
7. .
8.(B).
-------------------------------------------------------(D)

1.
2.
3.
4.
5.(D) S2-S4 Auerbach&Meissner (
)(.) ;

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()
21. (rectosigmoid junction)?
(A) (S1)
(B) (S2)
(C) (S3)
(D) (S4)
Ans(C)
Key
key.

()
22. (anteflexion)?
(A) (broad ligament)
(B) (cardinal ligament)

(C)(round ligament of the uterus)

(D) (uterosacral ligament)
Ans(C)
Key
5 1

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5 1
1.
2.
3.
4.
5.
6.

,
/

----------------------------------------------

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()
23. ?
(A) (sural nerve)
(B) (deep fibular nerve)
(C) (superficial fibular nerve)
(D) (tibial nerve)
Ans(C)
Key
N

( N)(V)(N)()()(V)()()

()

(<)
()
(<)

(A) (sural nerve)

(B) (deep fibular nerve)
(D) (tibia nerve)
(C) (superficial fibular nerve)

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()
24. (calcaneal tendon)?
(A) (gastrocnemius)
(B) (soleus)
(C) (popliteus)
(D) (plantaris)
Ans(C)
Key

1. ()
2. ()
3. ()
=(Achilles)

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()
25.hip jointknee joint
(A) sartorius
(B) adductor magnus
(C) vastus lateralis
(D) vastus medialis
Ans(A)
Keyhip jointknee joint

()
//

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()
26.adduction
(A) deep branch of radial nerve
(B) superficial branch of radial nerve
(C) deep branch of ulnar nerve
(D) superficial branch of ulnar nerve
Ans(C)
Key
1. ()
2. 5th -(hypothenar m.) &
(lumbricalis) & (interossei)

1.
(1)
(2) hypothenar, lumbricalis, interossei, adductor pollicis(),
Palmaris brevis()
2.
(1) 3+1/2
(2) lateral epicondyle cubital fossa

a.
b.
3.
(1)
(2) carpal tunnel
(3)

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()
27 axillary nerverotator cuff
(A)supraspinatus muscle
(B)infraspinatus muscle
(C)subscapularis muscle
(D)teres minor
Ans(D)
Key rotator cuff (~)

(A)supraspinatus muscle: suprascapular n.

(B)infraspinatus muscle: suprascapular n.
(C)subscapularis muscle: subscapular n.
(D)teres minor: axillary n.

()
28.ulnar nerve
(A)opponens pollicis
(B)abductor pollicis brevis
(C)flexor pollicis brevis
(D)adductor pollicis
Ans(D)
Key()

(A)opponens pollicis:
(B)abductor pollicis brevis:
(C)flexor pollicis brevis:
(D)adductor pollicis:
: (A)(B)(C)

(D)

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()
29. sacrococcygeal teratoma
(A).
(B).primitive streak
(C).
(D).
Ans B
Key!

(A)teratoma
(B) sacrococcygeal teratoma primitive streak

(C)
(D) 1:3-1:4

sacrococcygeal teratoma germ cell tumor Altman type

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extragonadal germ cell tumor

mediastinum( 3T1L), retroperitoneum, pineal and suprasellar regions
sacrococcygeal teratoma
Ref: Wikipedia, UpToDate, Larsen's Human Embryology, Fifth Edition, chapter Gametogenesis, Fertilization, and First Week (from ClinicalKey)

()
30. cleft lip and palate
(A).foramen cecum
(B).incisive fossa
(C). greater palatine canal
(D).foramen ovale
Ans(B)
Key incisive fossa
incisive fossa
Foramen cecum frontal
bone superior sagittal sinus
thyroglossal duct
thyroid

Incisive fossa

Greater palatine canal

Foramen ovale (CN V-3)

ASD

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(
) frontonasal prominence( medial nasal prominence lateral nasal
prominence) maxillary prominence

lateral nasal prominence medial nasal prominence nasal

pit

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medial nasal prominence intermaxillary segment primary palate

incisive fossa V maxillary prominence
lateral palatine process(palatal shelf) secondary palate

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()
31.ureteric bud
(A)Bowman's capsule
(B)proximal convoluted tubule
(C)glomerulus
(D)collecting tubule
Ans(D)
Key ureteric bud (collecting system) metanephric tissue cap
(excretory unit)

ureteric bud

metanephric mesoderm

metanephrogenic
diverticulum

metanephrogenic blastema

mesonephric duct
cloaca

ureter, renal pelvis, major and Bowman's capsule, proximal convoluted

minor renal calyces,
tubule, loop of Henle
collecting tubules

bud=

metanephric tissue cap

1. pronephros mesonephros metanephros

2.mesonephric duct(Woffian duct) paramesonephrci

duct(Mullerian duct)
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3.ureteric bud (collecting system) metanephric tissue cap

(excretory unit)

intermediate mesoderm pronephros mesonephros

metanephros urteteric bud metanephric tissue cap

WT1WT1 Wilam's Tumor

ref:

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()
32.hypaxial division of myotomes
(A).splenius capitis muscle
(B).middle scalene muscle
(C).intercostal muscle
(D).quadratus lumborum muscle
Ans(A)
Key....

myotome (dorsal) epaxial division (epimere)(ventral) hypaxial

division (hypomere) epaxial division (epimere)
extensor flexor A
!

Epaxial division

Hypaxial division

Epimere

Hypomere

myotome

extensor muscles of the

neck (A), vertebral
column, and lumbar
region

myotome: scalene (B),

prevertebral, infrahyoid, and
geniohyoid muscles.

extensor
sacrococcygeal
ligament

myotome: lateral and ventral

flexors of the vertebral column
myotome: quadratus
lumborum(D)

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myotome: muscles of the pelvic

diaphragm, anus, and sex organs
intercostal muscle hypomere
somite
somite 5
https://www.youtube.com/watch?v=9N-q7z2Zz4s
( youtube Somite patterns The Noted Anatomist)

ventromedial portion
sclerotome dorsolateral part dermomyotome dermatome epithelium
myotome epimere myomere

myotome

(Pharyngeal arch branchial arches)(CN V)(CN

VII)(CN IX)(CN X)
prochordal plate
occipital myotome
lateral plate mesoderm

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Ref: Review of MEDICAL EMBRYOLOGY Book by BEN PANSKY, Ph.D, M.D. ch63. Development of
The Muscular System
http://discovery.lifemapsc.com/library/review-of-medical-embryology/chapter-63-development-of-themuscular-system

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()
33. (freeze fracture technique)
(A) (inner leaflet)(outer leaflet) P (P-face) E (E-face)
(B)
(C) P (P-face)(outer leaflet)
(D) P (P-face) E (E-face)
Ans(C)
Key
1.
()
()
coating


2. E-face (extracellular) P-face
(protoplasm) P-face

(C) P-face inner leaflet

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()
34. (osteoclast)
(A) (Howship's lacunae)
(B)
(C) (lysosomes)
(D)
Ans(D)
Key

1. monocyte-macrophage
remodeling resorption bay (= Howship's lacunae)
2. acid phosphatase

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()
35. (matrix)(calcification)
(elastic cartilage) (hyaline cartilage) (fibrocartilage)
(A)
(B)
(C)
(D)
Ans(B)
Key

(perichondrium)

(calcification)

articular surface
(
) C

(
articular cartilage
)

(
endochondral bone
formation)

insertion of
tendons

(
callous
)

(
)

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()
36.
(A)
(B)
(C)
(D)
Ans(D)
Key
T
tubule

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Reference: Ross. Histology: A Text and Atlas, 6th edition. P.337

(D)
()
37.splenic sinuses
A.macrophages
B.rod-shaped endothelial cells
C.fibroblasts
D.reticular cells
Ans(B)
Key

Red Pulp splenic sinus pulp cords splenic sinus B

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()
38.fenestrated capillaries
A.
B.
C.
D.
Ans(C)
Key(A)(B)(D) Continuous capillaries

Ultrastructure Atlas of Human Tissues(2014)(google books

)Continuous capillaries connective tissues, muscle, nerve, lungs, and the CNS.
Fenestrated capillaries endocrine organs, GI tract, gallbladder, kidney
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()
39.cardiac portion
A.surface mucous cells
B.enteroendocrine cells
C.parietal cells
D.regenerative stem cells
Ans(A)
Key

Wheater's Functional Histology surface mucous cell( foveolar cell)

cardiac glands mucous A HCl intrinsic
factor parietal cell pepsinogen chief cell fundus enteroendocrine cells
G cell pylorus

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()
40.
A.pinealocytes
B.thyroid follicular cells
C.chromaffin cells
D.chief cells of parathyroid gland
Ans(D)
Key

(A) melatoninInhibiting reproductive functionProtecting damage by free radical

Setting circadian rhythms
(B) ATP (calcitonin) C
(C)adrenal medulla neuroendocrine cells epinephrine(80%) norepinephrine(20%)
(D)(PTH)

()
41.
A.Leydig cell tumors
B.spermatogenic cells
C.ductus deferens
D.benign prostatic hypertrophy, BPHperipheral zone
Ans(D)
Key(D) transitional zone

(A) 1 prognosis
(B) blood-testis barrier ~
(C) Vasectomy
(D) prostate 7 peripheral zone prostate CA central zone 2
transitional zone 1
()
42. edema factor
(A)
(B) cAMP
(C) phospholipase C
(D) diarrhea
Ans(B)
Key? B
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(Anthrax toxin)AB PALFEF

(Cholera toxin)AB Gs
(Pertussis toxin)AB Gi
cAMP

Bacillus anthracis
(protective antigen, PA)
(lethal factor, LF) (edema factor, EF) PA+EF
EF calmodulin cAMP

(Cholera toxin, CTX) AB

B subunit A1subunit
adenyl cyclase(AC)subunit A
protein(ARF) Gs (Gs)
ADP-ribose( ADP-ribosylation) GTPase
GTP GDP G protein
Adenylate cyclase(AC)
cAMP cAMP
watery
diarrhea()
: GM1 (GM1 ganglioside receptor); Gsa (G protein);
AC (adenylate cyclase); Gi (G protein); cAMP (cyclic AMP);
CFTR (cystic fibrosis transmembrane conductance regulator).
(Pertussis toxin, PTX) Gi (Gi) ADP ppt/

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ribose( ADP-ribosylation) GDP GTPGi protein AC

AC cAMP cAMP

(Cholera toxin, CTX)

(Pertussis toxin, PTX)
Gs 201
Gi Cys C

Arg

cAMP cAMP

Gs Gi protein adenylyl cyclase Gs cAMP Gi cAMP

()
43. Shigella
(A) bacillary dysentery
(B) Shigella dysenteriae Shiga toxin
(C)
(D) 108
Ans(D)
Key
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10 105 -108

/(Enterobacteriaceae)
(Shigella) Shigella dysenteriaeS. flexneriS. boydii
S. sonnei(bacillary dysentery)
S.dysenteriae S.flexneri S.boydii S.sonnei
, S.flexneri S.sonnei S.dysenteriae 1950

S. dysenteriae 1 Shiga
Shiga toxin() A 5 B A
B
(intestinal epithelium)(Hemolytic uremic
syndrome, HUS)
Exterotoxic()
Diarrhea()
Cytotoxic()
Hemorrhage()
Neurotoxic()
Cramping()
Peyer's patch M
cell macrophage

macrophage F
actin-tail

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()
44. typhoid fever
(A) Salmonella typhi
(B)
(C)
(D) Vi Vi capsular polysaccharides
Ans(B)
Key@@
Salmonella typhi rz

Salmonella typhi
6-48
72 3-7 1

HIV

Peyers patch ( 1.0)

10 3 2~5
() 8-14
( 3 60 ) 1
Vi (Vi capsular polysaccharides)
14 ( 2~3 ) 3

()

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()
45. Streptococcus pyogenes superantigen
(A) M-protein
(B) F-protein
(C) heat-labile toxinspeA
(D) Streptolysin S
Ans(C)
Key
Streptococcus pyogenes()

M protein C3b
F protein M protein
Streptococcal Pyrogenic Exotoxins
erythrogenic toxins ()
T cell
superantigen()

T T

Streptolysin SNonimmunogenic Serum

heat stable
Streptolysin Oimmunogenic
ASO test heat labile
Streptokinase

C5a peptidase

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()
46. Staphylococcal enterotoxin pseudomembranous enterocolitis
(A) Enterotoxin A
(B) Enterotoxin B
(C) Enterotoxin C
(D) Enterotoxin D
Ans(B)
Key
Staphylococcal enterotoxin B (SEB)

:
1.Cytotoxin()
2.Exfoliative toxins() SSSS()
3.Enterotoxins() T cell cytokines
superantigen Polyclonal Anti-SEB
4.Toxic shock syndrome toxin-1(TSST-1)
(Enterotoxin) AI8

PS. (pseudomembranous colitis)

(Clotridium difficile)
C. difficile -associated diarrhea
(CDAD) pseudomembranous colitis (PMC)

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()
47.
(A)
(B)
(C)
(D)
Ans(C)
Key
(Bacillus)(Clostridium)()(endospore)

(Bacillus)
1. (Bacillus subtitis)
2. (Bacillus megaterium)
3. (Bacillus cereus)106 /
4. (Bacillus anthracis)
(Clostridium)
(Cytochrome) catalase peroxidase
(CO2H2)
1.(C. tetani) (tetanospasmin)
2.(C. botulinum) ABE
3.(C. perfringens) ( / )
4.(C. difficile)
((pseudomembranous enterocolitis)

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()
48. Bacillus anthracis
(A)
(B) capsule
(C) gamma phage
(D) DFA test
Ans(B)
Key XD
(C)(D)@@

Bacillus anthracis()
Gram(+)spore(+)catalase(+)facultative anaerobe
Capsule(+)()(Anthrax toxin)
AB ( PALFEF)

1.cutaneous anthrax
2.gastrointestinal anthrax
3.inhalation anthrax
4.anthrax meningitis
(C)(D)
gamma phage DFA test(
)

the C-terminal region of gammaphage lysin protein (PlyG) binds

specifically to the cell wall of B.
anthracis and the recombinant
protein corresponding to this region,
PlyGB, is available as a bioprobe for
detection of B. anthracis.
Direct Fluorescent Antibody, DFA
test()

()
()

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()
49. heterophile antibody

(A) Epstein-Barr virus

(B) Human herpesvirus-6
(C) Human T-cell lymphotropic virus type 1
(D) Cytomegalovirus
Ans(A)(D)
Key
(Infectious mononucleosis) (EBV)

()

EB
EB
4 7
2 3
EB EB

(Heterophile Antibody)(Infectious mononucleosis,

IM) EB

IM 90% EB IM
CMVHSV
(Hodgkin`s disease)
EB
EB EB-VCA IgMEB-VCA IgGEBEA AbEBNA Ab

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()
50. HIVHuman immunodeficiency virus
(A) M-tropic CXCR4
(B) T-tropic
(C) Kaposis sarcoma
(D) CD4 T 200/L
Ans(A)
Key(A)M-tropic CCR5

A B http://www.aidsmap.com/Receptors-co-receptors-andimmunity-to-HIV/page/1391639/
(A)HIV receptor-mediated endocytosis receptor CD4co-receptor
M(Macrophage)-tropic strain CCR5( tropism R5)T(T cell)-tropic strain
CXCR4( tropism X4)
(B)T-tropic strain syncytium-inducing cell membrane
M-tropic
(C):) HIV 4 cancer 9 Kaposis
sarcoma HHV8
(D) AIDS CD4+ T cell 200/L HIV (
)
()
51.whitlow
(A) Cytomegalovirus
(B) Herpes simplex virus
(C) Human papillomavirus
(D) Human herpesvirus-6
Ans(B)
Key(B)FC ??Herpetic whilow

(A) Cytomegalovirus(CMV, HHV5) TORCH C

(B) Herpes simplex virus(HSV1&HSV2)FC HSV1 HSV2

herpetic whitlow
()self-limited
(C) Human papillomavirus(HPV)(warts)(cervical CA, HPV16&18)
(D) Human herpesvirus-6(HHV6)(Roseola/Exanthem subitum)

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()
52. Parvoviridae
(A) Adenovirus-associated virus
(B) DNA
(C) envelope
(D)
Ans(B)
Key(B)Parvoviridae DNA

104 DNA DNA

(A) Parvoviridae B19 AAV AAV mild immune reaction

(B) DNA !!
(C) envelope DNA (Adenoviridae)(Papovaviridae,
HPV polyomaviridae)
(D)(Pox virus)
DNA Parvovirus B19 (erythema
infectiosum)(aplastic anemia)
()
53.double-layered capsid ISVP
intermediate/infectious subviral particle
(A) Norovirus
(B) Rotavirus
(C) Parainfluenza virus
(D) Measles virus
Ans
Key(B)

Reovirus family Rotavirus

!!??
Rotavirus (triple-layers)
XD
(
https://drive.google.com/folderview?id=0B1_bEavrhpePMlVGOUZqaWUxRjA&usp=sharing&tid=0B1_bEavr
hpePdnY3LWlZQkdtZmM)

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()
54.subacute sclerosing
panencephalitis)
(A) Measles virus
(B) Mumps virus
(C) Nipah virus
(D) Hendra virus
Ans(A)
Key Measles virus 5-10

~
(A)Measles Virus( RubeolaRubella)4D(four-day fevers as high as 40)3C&P(Cough
ConjunctivitisCoryzaPhotophobia)Kopliks spotgeneralized red maculopapular rash
SSPE!
(B)Mumps Measles

(C)1999 () 21

(D)1994
Nipah virusHendra virus(rabies)(Ebola virus)
SARS-CoV

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()
55. Corynebacterium jeikeium
(A)
(B)
(C)
(D) Lipophilic Corynebacteria
Ans(C)
Key(C)

(C. diphtheriae)= =
(A) Corynebacterium systemic infection
(B)Corynebacterium (endogenous)(opportunity)
(C) C. diphtheriae (05
paperComparison of the antibiotic sensitivity of lipophilic Corynebacterium sp. isolated from patients on the
day of admission and during hospitalization 99%
2%)
(D) Lipophilic lipid C. jeikeium C. urealyticumC. diphtheriae
lipid-free
()
56. ,
(A) A E
(B) ACD E RNA, B (partially double-stranded cricular)DNA
(C) B C
(D) D A
Ans(D)
Key
(A) HAV HEV HBVHCV HDV /
(B)
(C) HBV HCV HBV- 10%HCV- 80%
(D) HBV HCV
=
1. 18th Harrison

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2.

FC

HAV
RNA
Picornavirus

RNA

HBV

Hepadnavirus

DNA

HCV

Flavivirus

RNA

HDV

Defective

RNA

ppt/

HEV

Calicivirus

RNA

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()
57. subcutaneous mycoses ,
(A) Sporotrichosis- Chaetomium spp.
(B) Chromoblastomycosis- Madurella spp.
(C) Eumycotic mycetoma- Aspergillus nidulans
(D) Subcutaneous zygomycosis- Sporothrix schenckii
Ans(C)
Key
(A) Sporotrichosis - Sporothrix spp.
(B) Chromoblastomycosis- Fonsecaea, Phialophora, Cladophialophora etc.
(C)
(D) Subcutaneous zygomycosis(Entomophthoromycosis) Basidiobolus ranarum, Conidiobolus coronatus
(Mucormycosis) Rhizopus, Mucor, Rhizomucor, Lichtheimia, Saksenaea etc

1. FC
(Superficial Mycoses)
(Cutaneous Mycoses)
(Subcutaneous Mycoses) !!!

(Systemic Mycoses)


2.

(Subcutaneous Mycoses)

Sporotrichosis

Chromoblastomycosis

Sporothrix spp.

Rose gardeners disease()

Fixed cutaneous(
)Lymphocutaneous(
)Pulmonary(
)Osterarticular()

Fonsecaea
Phialophora
Cladophialophora

(cigar-shaped)

(verrucous)
(scaly)

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etc.

Phaeohyphomycosis

Cladophialophora
Exophiala
Bipolaris
Exserohilum
Curvularia etc.

Mycotic mycetoma

Pseudallescheria
Madurella
Trematosphaeria
Acremonium
Exophiala etc.

Subcutaneous zygomycosis
(Entomophthoromycosis)
()

Basidiobolus
ranarum
Conidiobolus
coronatus

Subcutaneous zygomycosis
(Mucormycosis)
(/)

Rhizopus
Mucor
Rhizomucor,
Lichtheimia
Saksenaea etc

(cauliflower-like nodule)

(tinea nigra)
(cyst
) paranasal sinus
brain

2/3

viscous, purulent fluid containing grains(
hallmark)

Zygomycosis:

rhino-facial-cranial area

embolization
acidotic diabetes, starvation, severe
burns, intravenous drug abuse, leukemia and
lymphoma, immunosuppressive therapy

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-Rhinosporidiosis

Lobomycosis

3.

Rhinosporidium
seeberi

Loboa loboi

Amazon Valley in
Brasil

skeloids

()
http://www.mycology.adelaide.edu.au/Mycoses/Subcutaneous/

()
58. D-arabinitol
(A) Histoplasma capsulatum
(B) Penicillium marneffei
(C) Cryptococcus neoformans
(D) Candida albicans
Ans(D)
Key
(D) D- arabinitol invasive Candidiasis

1. D- arabinitol Candida
2. Candida spp. D- arabinitol L- arabinitol
3.
a. 80 D- arabinitol
b. invasive Candidiasis D-arabinitol/L-arabinitol ratios
D-arabinitol/creatinine ratios

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()
59.HIV-1 isolates
(A) env
(B) gag
(C) pol
(D) LTR
Ans(A)
Key HIV
Env envelope viral envelope protein
Gag
Pol polymerase HIV reverse transcription
LTR
HIV HIV
Pol
A

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Env(gp120, gp40) HIV bind CD4 T cell.

Gaggroup-specific antigen 55kD p55MA
p17 target of gag protein to plasma membraneCAp24 capsid proteinNCp9 viral
nucleocapsid p6
Pol protease, reverse transcriptase, integrase HIV

LTRLong terminal repeats (LTRs) LTR

viral reverse transcriptase HIV replication cycle
10 genomic base env gene (40% variation in the env gene, and 810%
variation in the pol/gag genes) env gene
Ref:
1. Saladin Osmanov, William L. Heyward, Jos Esparza. HIV-1 Genetic Variability: Implications for the
Development of HIV Vaccines.
2. Maria Mercedes Santoro 1 and Carlo Federico Perno. HIV-1 Genetic Variability and Clinical
Implications. ISRN Microbiol. 2013; 2013: 481314.

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()
60.52

(A) 20%
(B)
(C) 50%
(D) 5%
Ans(D)
Key(H. pylori)
H. pylori

H. pylori
H. pylori PH H. pylori H.
pylori NH3 CO2 PH

Helicobacter, Campylobacter
Helicobacter, Proteus

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()
61.
(A) protease
(B) urease
(C) nuclease
(D) coagulase
Ans(B)
KeyH. pylori
()
H. pylori
H. pylori PH H. pylori H.
pylori NH3 CO2 PH

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()
62. antigen-presenting cell, APC
(A) B
(B) CD4+ T
(C) macrophage
(D) Langerhans' cells
Ans(B)
Key
1. (Major Histocompatibility Complex, MHC)
MHC
(Human Leukocyte Antigens, HLA)
2. MHC
MHC I
i.

ii.
CD8+ T cell TCR
iii.
() MHC I
CD8+ T cell
MHC II(Antigen-Presenting Cells, APCs)
i.
APC
ii.
CD4+ T cell TCR
iii.
APC CD4+ T cell
MHC II
3. (APC)(dendritic cells)macrophage B

Langerhans' cells

APC B B

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()
63.variable domain V(D)J recombination

(A) V-J joining V-D joining

(B) V-J joining D-J joining
(C) D-J joining V-J joining
(D) V-D joining D-J joining
Ans(C)
Key
1.
(variable regions)
(constant region)
C and C ()
V-D-J
Heavy chain
(mu and delta)
)
Light chain
V-J ( D segment)
(kappa and lambda)
Variable (V), Diversity (D), Joining (J), Constant (C)
2. B
[(Stem cell)]
-1. DNA V-D-J-C-C
2. (VDJ) DJ joining VD joining
3. VDJ DNA primary transcript RNA
4. C poly-A tail mRNA
V-D-J-C
5. mRNA Ig heavy chain protein
B cell
pre-B cell
[Pre-B cell]
-6. DNA V-J V-J
V-J
7. (VJ) VJ joining
8. VJ DNA primary transcript RNA
9. mRNA
10. mRNA Ig
protein Ig
chain protein()
DNA

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Ig M B cell immature B cell

Reference: http://www.ncbi.nlm.nih.gov/books/NBK26860/
wiki VDJ

V(D)J DJVDVJ C

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()
64. B
(A) heavy chain
(B) heavy chain
(C) light chain
(D) light chain
Ans(B)
Key

B IgM
B

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()
65. T cytotoxic T lymphocyteCTLnatural killer cellNK

(A) CTL NK perforin granzyme

(B) NK MHC class I
(C) CTL MHC class I
(D) CTL NK
Ans(A)
Key
1. CTL NK (Cytotoxic Protein Pathway)
perforin granzyme (apoptosis)CTL Fas Ligand
Pathway
2. CTL NK MHC class I
CTL MHC class I MHC class I
CTL
NK NK MHC class I
MHC class I NK NK

(A)
(B) MHC class I NK MHC class I NK

(C) CTL (CD2, CD28)

(IL-1, IL-2, IL-12)

(D) CTL NK

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()
66. B mature naive B cell B
(A) B IgG
(B) B
(C) B
(D) B
Ans(D)
Key
(A) B cell IgG IgD
(B) nave !
(C) B cell
(D)

(A), (B) mature nave B cell

B cell bone marrow IgD mature nave B cell IgD B cell

IgM antigen-binding siteMature nave B cell peripheral antigen B cell
effector cell
antigen
(C) B cell bone marrowperipheral
T cell bone marrowperipheral
(E) B cell Th B cell geminal center( d)
somatic hypermutation immune complex-coated follicular dendritic cells (FDCs)
antigen-specific T follicular helper cells (TFH cells) affinity selection plasma
cell memory B cell antibody

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Antigen-activated B cells and T cells migrate towards the borders of the B cell follicles and the T cell zones
of secondary lymphoid organs, respectively, which leads to them establishing stable B cellT cell interactions
and enables B cells to receive helper signals from cognate CD4+ T cells. Activated B cells and T cells then
migrate to the outer follicles, where B cells undergo proliferation (part a). Some of the proliferating B cells
differentiate into short-lived plasma cells (part b), which give rise to the extrafollicular foci, and some
develop into memory B cells (part c; germinal centre-independent memory B cells). Alternatively, the
activated B cells can return to the follicle and can undergo rapid proliferation to form the germinal centre
(part d). In the dark zone of the germinal centre, the clonal expansion of antigen-specific B cells is
accompanied by B cell receptor (BCR) diversification through somatic hypermutation. The B cells that exit
the cell cycle relocate to the light zone, where affinity selection takes place through interaction with immune
complex-coated follicular dendritic cells (FDCs) and antigen-specific T follicular helper cells (TFH cells). The
affinity-matured germinal centre B cells can re-enter the germinal centre cycle. Alternatively, these germinal
centre B cells exit the germinal centre, either as memory B cells (parte; germinal centre-dependent memory B
cells) or as long-lived plasma cells (part f) that contribute to serological memory. The strength of signals that
B cells receive is likely to determine their fate; stronger signals (indicated by bold arrows) favour
development into plasma cells or germinal centre B cells, whereas weaker signals (indicated by narrow
arrows) determine memory B cell differentiation. TCR, T cell receptor.
[]
1. http://www.ncbi.nlm.nih.gov/books/NBK26884/
2. http://www.nature.com/nri/journal/v15/n3/full/nri3802.html
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()
67. T
(A) IL-10
(B) TGF-
(C) Indoleamine 2, 3 dioxygenaseIDO
(D) IL-6
Ans(D)
Key
regulatory T cell nave T
cell regulatory T cell cytokine AB cytokineC
D cytokine regulatory T cell D
~

DC Treg

DC Treg
1. DC TGF-b Foxp3 gene nave T cell Treg
2. DC AhR(aryl hydrocarbon receptor) TLR9 upregulate IDO tryptophan IDO
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induce TGF-b suppress IL-6 nave T cell Treg

3. DC apoptosis DC haptens, glucocorticoids, UV radiation Treg
4. Retinoic acid Treg cytokine signal
5. Treg signalsvitamin D (RANK/RANKL signaling), VIP(vasoactive intestinal peptide),
HGF(hepatocyte growth factor), PGD2(prostaglandin-D2)

Figure 2 DCs drive differentiation of foxp3+ inducible regulatory T cells. (iTregs). DCs secrete TGF-b,
which induces foxp3 in naive T cells, driving differentiation of naive T cells into iTregs. Activation of AhR
and TLR9 drives induction of IDO, which catalyzes tryptophan metabolism. Tryptophan metabolites promote
iTreg generation through induction of TGF-b production and suppression of Th17 inducing cytokine, IL-6.
Furthermore, uptake of apoptotic DCs by viable DCs along with exposure to haptens, glucocorticoids and UV
radiation also induces TGF-b production, which drives iTreg differentiation. Other signals such as
RANK/RANKL signalling by vitamin D treated keratinocytes and treatment of DCs with vasoactive
intestinal peptide (VIP), hepatocyte growth factor (HGF) and prostaglandin-D2 (PGD2) also promote iTreg
differentiation. Moreover, retinoic acid promotes iTreg differentiation by suppressing cytokines which are
inhibitory to iTreg differentiation and targeting of antigen to DEC205 drives iTreg differentiation through a
TGF-b dependent mechanism
[]
http://download.springer.com/static/pdf/751/art%253A10.1186%252F2045-3701-1-20.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1186%2F2045-3701-120&token2=exp=1465742417~acl=%2Fstatic%2Fpdf%2F751%2Fart%25253A10.1186%25252F2045-3701-1-20.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1186%252F2045-3701-120*~hmac=57e658cf3afe3b1ff33895c7b037abd43b871a1056c052b0432479e2864a32c6

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()
68.Fas gene knockout mice
(A) inflammatory bowel disease
(B) lymphoproliferative disease
(C) rheumatoid arthritis
(D) demyelinating disease
AnsB
Key
><

(B)ALPS(autoimmune lymphoproliferative disease) FAS gene

(C) RA type autoimmune

Organ specific
Type I
antibody against soluble factor
Pernicious anemia(IF)
Type II
antibody to cell-surface antigen Myasthenia gravis
Hashimotos thyroiditis
Goodpastures syndrome
Type IV T-cell mediated destruction
Experimental autoimmune encephalomyelitis
Insulin-dependent diabetes mellitus (IDDM)
Multiple sclerosis
Rheumatoid arthritis
Type V
Agonist Ab against receptor
Graves disease
Non-organ specific
Type III Deposition of immune complex SLE
Rheumatoid arthritis
Dermatomyositis
[]
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()
69. RNA
(A) Toll-like receptor 3
(B) Toll-like receptor 7
(C) Toll-like receptor 6
(D) Toll-like receptor 4
AnsA
Key

[]
ppt

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()
70.XSCID

(A)
(B)
(C) migration
(D)
AnsA
Key
SCID = severe combined immune deficiency the boy in the bubble

Primary immunodeficiency diseases

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[]
ppt

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()
71.
(A) IgE
(B) T
(C)
(D)
AnsB
Keyhypersensitivity ~~
TB delayed type hypersensitivity (=Type IV hypersensitivity)type IV type I~III
A
B T1
C 48~72 TB
D type IV macrophage (monocyte) lymphocyte type I eosinophil mast cell

antibody, antigen, response time, transferred with

Systemic

*penicillin

Serum

Contact

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anaphylaxis

allergy

sickness,
Arthus
reaction

dermatitis

type II type IV

mast cell mediators granules preformed

mediator Newly formed mediator
[]
http://www.microbiologybook.org/ghaffar/hyper00.htm

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()
72. .somatic hypermutationgerminal center B
B

(A) B

(B) B
(C) B
(D) B T
Ans(D)
Key
FC
Negative selection Immature B cell
Immature B cell
negative selection
(apoptosis) D

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()
73.
(A) self-antigens
(B)
(C)
(D)
Ans(D)
Key

( tumor antigen )

Tumor antigen
1.
2.
3.
4.
5.
6. ()

(A) self-antigens
B-RAF (), BCR-ABL()
(B)
alpha-fetoprotein (HCC tumor marker)
(C)
EGFR(epidermal growth factor receptor) (EGFR
)
abnormal products of ras, p53

(D)
MUC-1 ( mucin )

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()
74. corticosteroids
(A) leukocytesapoptosis
(B) cytokines
(C) leukocytesmigration
(D) prostaglandins
Ans(B)
Key
A, C, D
B cytokine

()
75.Enterobius vermicularis
(A)
(B)
(C)chronic pelvic peritonitis
(D)
Ans(D)
Key

(D)

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()
76.tropical pulmonary eosinophilia

(A)
(B)
(C)microfilaria
(D) diethylcarbamazine
Ans(C)
Key(A)
(C)

(A) An elevation in serum immunoglobulin E level is frequently observed, often above 1000 units/mL.
[UpToDate]
(B) The cardinal laboratory finding in tropical pulmonary eosinophilia (TPE) is blood eosinophilia, usually
above 3000/microL [UpToDate]
(C) Microfilariae are generally not detectable in peripheral blood, and circulating filarial antigen is
undetectable in up to 50 percent of cases [UpToDate]
tropical pulmonary eosinophilia

(Tropical pulmonary eosinophilia)

(D) Standard treatment consists of diethylcarbamazine (DEC) given at 6 mg/kg/day in three doses for 12 to
21 days [UpToDate]

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()
77.
jaundice

(A)Clonorchis sinensis
(B)Opisthorchis felineus
(C)Opisthorchis viverrini
(D)Dicrocoelium dendriticum
Ans(D)
Key(D)

(A)

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(B) (C)
(D)

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()
78.Diphyllobothrium latum
(A)operculum
(B)plerocercoid
(C)
(D)
Ans(C)
Key

(C)

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()
79.cyst stage
(A)Chilomastix mesniliTrichomonas vaginalis
(B)Dientamoeba fragilisTrichomonasPentatrichomonashominis
(C)Balantidium coliEntamoeba gingivalis
(D)Iodamoeba btschliiTrichomonas tenax
Ans(B)
Key

cyst stage

( Cyst stage)

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cyst stage

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cyst stage

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cyst stage

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cyst stage

cyst stage

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() cyst stage

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()
80.
(A)Naegleria fowleri
(B)primary amebic meningoencephalitis
36
(C)trophozoitescysts
Acanthamoebaspp.
(D)Acanthamoebaspp.
Ans(A)
Key(B)(D)(A)(C)(A)

(A)
()
81.allergen
(A)head louse
(B)flea
(C)dust mite
(D)dog tick
Ans(C)
Key C
()
82.tick
(A)babesiosis
(B)ehrlichiosis
(C)Lyme disease
(D)trench fever
Ans(D)
Key(D)(A)(B)(C)

(D)

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()
83. survival time
A.Chi-square test
B.Student's t test
C.Mann-Whitney test
D.Log rank test
Ans:
()
84. 95% -0.142, 0.102
0.05 0.01

(A)
(B)
(C)
(D) type I error
Ans(B)
Key
0

1. 0relative risk 1
2.

a.
b.

c.

(hypothesis test)
p-value[]
(statistically significant)
() alpha
(significance level)

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()
85. hormone replacement therapy

(A)
(B)
(C)
(D)
Ans(C)

(A)
(B) HRT
(C)(D) Cohort study case-control study()(
)
()
86. 150 15
(A) 0
(B) 1
(C) 10
(D) 15
Ans(B)
Key

0 1

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()
87. mean
(A) Chi-square test
(B) t Student's t test
(C) Mann-Whitney test
(D) Sign test
Ans(B)
Key

T Test(B)

A.

:
I.

II.

I.
!!
II.
!!

I.

II.

III.

B.
T (T Test)
group ()
()

[]
Paired T Test
[: ]

(
0~100 )() T Test

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C.
Mann-Whitney test
nonparametric statistics T T Test
I.

II.

III.

(<30) 10
T Test
(A B A
B ) A B
>/////<

D.
Sign test

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()
88. specificityspecificity
(A)
(B)
(C)
(D)
Ans(D)
Key
A. ().
B. ()
C. Sensitivity ()
D. Specificity ()
D

a, b, c, d
Disease (+) Disease (-)
Test Result(+) a

a+b

Test Result(-) c

c+d

a+c

b+d

Sensitivity ()
== / = a / a+c
Specificity ()
== / = d / b+d
Positive Predictive Value, PPV ()

= / = a / a+b
Negative Predictive Value, NPV ()

= / = d / c+d
()(
/)

(Sensitivity)
(Specificity)
()
()
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A. ().
B. ()
C. Sensitivity ()
D. Specificity ()
()
89. 5

(A) simple regression

(B) multivariate analysis
(C) analysis of variance
(D) Fishers exact test
Ans(D)
Key
30 (Cell)
5( 10)(D)

A. simple regression

B. multivariate analysis

C. analysis of variance
Analysis of variance ANOVA
ContinuousDependent variable
Independent variable
D. Fishers exact test
<30<5
: --- Fishers Exact Test
http://math.nsysu.edu.tw/ezfiles/87/1087/img/495/h.pdf

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()
90. PAH
(A) benz[a]anthraceneBaA
(B) benzo[a]pyreneBaP
(C) benzo[k]fluorantheneBkF
(D) benzo[ghi]peryleneBghiP
Ans(B)
Key
XDDD

86 PAH
Bad Boy
?
(Polynuclear Aromatic Hydrocarbons, PAHs)
Benzo[a]pyrene (B(a)P)
B(a)P PAHs PAHs
- (GC/FID) (GC/MS) (HPLC)

(B) google ()

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()
91.
(A)
(B)
(C)
(D)
Ans(D)
Key(D)

(A)FC Chimney sweeps' carcinoma

squamous cell carcinoma of the skin of the scrotum wikipedia
(B) 100()92()91() First Choice
Raynauds syndrome
(contact dermatitis)(Cr)
(C)
(D)(International Agency for Research on Cancer, IARC)
dye workers urinary bladder cancer ! thyroid
cancer radiation

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()
92.

(A) NO2
(B) CO
(C) O3
(D) CFCl3
Ans(C)
Key(D)(CFC-11)
CO

(
http://www.epa.gov.tw/ct.asp?xItem=42821&ctNode=34550&mp=ghgact)
H2OO3CO2
N2OCH4CFCsHFCsHCFCs
PFCsSF6
1997

CO2CH4N2OHFCs
PFCsSF6
55%

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()
93.?
(A) UV-A
(B) UV-B
(C) UV-C
(D) UV-D
Ans
Key UV-A~D
UV-A UV-B
UV-A UV-C UV-D

(Ref. http://www.kmuh.org.tw/www/kmcj/data/9007/4744.htm)

UV-A (320 400nm)UV-B (280 320nm) UV-C (100 280nm)

UV-C
UV-C UV-B
UV-A UV-A
UV-D 100nm

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()
94.?
(A)
(B)
(C)
(D)
Ans(B)
Key

(Ref. http://www.stm.org.tw/omc/pg_03_a4.htm)

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()

X
X

(Pneumoconiosis)

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()
95.?
(A)
(B)
(C)
(D)
Ans(B)
Key 94

(carpal tunnel syndrome)(median nerve)

(De Quervain's disease; stenosing tenosynovitis)

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()
96.,,
,?
(A)
(B)
(C)
(D)
Ans(A)
Key
(insight)

1993 12
(total community construction)

(community building)
(community design)

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()
97.

(A)
(B)
(C)
(D)
Ans(C)
Key

(_)

()
98.
(A)
(B)
(C)
(D)
Ans: (C)
Key:
:

http://www.tagg.org.tw/DOWN///1-4-P198-215.pdf

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()
98.
(A)
(B)
(C)
(D)
Ans: (C)
Key:
:

http://www.tagg.org.tw/DOWN///1-4-P198-215.pdf
()
99. Donabedian

(A) (Process)
(B) (Structure)
(C) (Outcome)
(D) (Performance)
Ans: (D)
Key: Donabedian
:
Outcome
PerformanceOutcome

Google Donabedian(1998)(Structure)(Process)
(Outcome)

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()
100.
(A)
(B)
(C)
(D)
Ans: (C)
Key:
:

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()
1.ouabainNa+-K+ ATPase
Na+-Ca2+ exchanger
A.
B.
C.
D.
Ans(A)
Key

Ouabain Cardiac glycolsidesNa+-K+ ATPase

Na+-Ca2+ exchanger Ca

() 63~68
2.
A.cochlear nuclei inferior colliculusmedial geniculate bodyauditory cortex
B.cochlear nucleisuperior colliculusmedial geniculate bodyauditory cortex
C.cochlear nucleiinferior colliculuslateral geniculate bodyauditory cortex
D.cochlear nucleisuperior colliculuslateral geniculate bodyauditory cortex
Ans(A)
KeyCP

> superior colliculus inferior colliculus

L ight lateral geniculate body M ono medial
geniculate body
Bonus
Ventroposterior nu.
mindVPM (medial)limbVPL (lateral)

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()
3.
(A) frequency of action potential
(B) amplitude of action potential
(C) duration of each action potential
(D) latency of receptor potential
Ans(A)
Key~

1. ()
2.
3.
()

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()
4.dorsal column-medial lemniscal system first-order neuron secondorder neuron third-order neuron neurons

(A) first-order neuron dorsal horn of the spinal cord

(B) second-order neuron brain stem
(C) third-order neuron hypothalamus
(D) third-order neuron substantial nigra
Ans(B)
Keysecond-order neuron medulla oblongata brain stem (B)
~ XD

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(a) first-order neuron pseudounipolar () receptors

dorsal root ganglion dorsal columns (fasciculus gracilis / fasciculus cuneatus)
medulla oblongata dorsal column nuclei (nucleus gracilis / nucleus cuneatus) secondorder neuron thalamus third-order neuron
(b) spinothalamic tract~

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()
5.
(A) primary motor cortex
(B) supplementary motor area
(C) premotor cortex
(D) posterior parietal cortex
Ans(A)(B)(C)(D)
Key
(A) primary motor cortex (B)(C)(D)

(A) primary motor cortex

(B)(C)(D) several subcortical brain regions

(B) supplementary motor area

spinal cord

(C) premotor cortex

spinal cord
()
(D) posterior parietal cortex

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()
6.
(A)
(B)
(C)
(D) primary motor cortex
Ans(A)
Key.

google motion
XD
4th level motor neuron

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()
7.stretch
(A)
(B)
(C)
(D)
Ans(C)
Key
stretch (C)

stretch
@@

(A)
stretch spinal cord
stretch
activation
(B)
stretch-activated
(Ca2+) channels preload
stretch stretch

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151494/http://www.ncbi.nlm.nih.gov/books/NBK7490/
(C)(D)
stretch stretch
stretch Ca2+ RYR sarcoplasmic reticulum Ca2+

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http://physiologyonline.physiology.org/content/25/3/155
stretch-induced calcium release (from sarcoplasmic reticulum)(SICR)
calcium-induced calcium release Ca2+ sarcoplasmic reticulum
ryanodine receptor (RYR) Ca2+ stretch Ca2+ RYR
SICR
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233869/
pulmonary arterial smooth muscle cells (PASMCs)
stretch-induced calcium release
http://cardiovascres.oxfordjournals.org/content/103/2/313 (
)

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()
8. A hemophilia A
(A) tissue factor pathway inhibitor
(B) prothrombinfactor II
(C) factor X
(D) factor VIII
Ans(D)
Keyhemophilia A factor VIII (D)
A ~((A)(B)(C))

Hemophilia A X-linked X factor VIII (70%30%

by wiki) hemophilia 80%Hemophilia B X-linked
factor IX heterozygous females (
X )
Hemophilia C autosomal genetic disorder factor XI
X
hemophilia AB von Willebrand's disease

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()
9.depolarization
rapid repolarizationplateaufinal
repolarizationresting membrane potential

(A)
(B)
(C)
(D)
Ans(D)
Key

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(pace maker ~)
Phase 0Na+(Na+)()
fast Na+ channels Na++ 25 mV()
Phase 1Na+(Na+)K+(K+)()
fast Na+ channels voltage-gated (Ca2+-independent)K+
( Cardiac transient outward potassium current, Ito1)(
Cl-) (Ito1 )
phase 2
Phase 2Ca2+(Ca2+)K+(K+)
Phase 1 L-type calcium channels Ca2+(
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10 )voltage-gated ( the slow delayed rectifier K+

channel phase 1 ) Ca2+ K+
phase 2()
Phase 3Ca2+(Ca2+)K+(K+)()
L-type calcium channels K+
()( wiki)
sodium-calcium exchanger Na+K+Ca2+
Phase 4K+sodium-calcium exchanger
Na+Ca2+ K+( K+ leak channels)
K+sodium-calcium exchanger ATP

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()
10.
(A) L-L-type Ca2+ channels
(B) ryanodine receptors
(C) troponin
(D) Ca2+ ATPase
Ans(D)
Key(SR Ca2+-ATPase, SERCA) Ca2+ sarcoplasmic reticulum
(SR)

~Contraction~
1 Active potential

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2 L-L-type Ca2+ channels(A)Ca2+

3
4 sarcoplasmic reticulum ryanodine receptors(B) Ca2+

ryanodine receptorsCa2+ sparks

5
6 Ca2+ sparks Ca2+troponin(C)

~Relaxtion~
7 Ca2+ troponin

8
9 Ca2+Ca2+ ATPase(D) sarcoplasmic reticulum

sodium-calcium exchanger Na+ ECF

10
Na+

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()
11.cardiac cycleaortic pressure
dicrotic notch
(A) isovolumetric ventricular relaxation
(B) ventricular filling
(C) isovolumetric ventricular contraction
(D) ventricular ejection
Ans(A)
Keydicrotic notchisovolumetric ventricular relaxation

ejection isovolumetric (ventricular) relaxation

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()
aortic root ( aortic pressure
) dicrotic notch

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()
12.
hemoglobin oxygen saturation
(A) 90%
(B) 75%
(C) 50%
(D) 25%
Ans(B)
Key

Ganong 22th ed. P.667

97%(19.8mL O2/100mL )
75%(15.1mL O2/100mL )
()
13. systemic arterial blood(ventilation

(A) central chemoreceptor

(B)
central chemoreceptor
(C)
central chemoreceptor
(D) peripheral
chemoreceptor
Ans(B)
Key

Ganong 22th ed. P.671

(corticospinal tract)
(pacemaker cells)

PCO2
PCO2 H+ PCO2
CSF H+ CO2
CSF H2O H2CO3

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()
14. 55mmHg
61 mmHg 7.16 24.5 mEq/L
(A)
(B)
(C)
(D)
Ans(A)
Key
FC!!

2014FC p.227~228
Ph<7.38 Ph>7.44 7.16
PCO2 40[HCO3-] 24
PCO2
A (O2 CO2 )
()
15. exopeptidase
(A) aminopeptidase
(B) chymotrypsin
(C) elastase
(D) trypsin
Ans(A)
Key

Ganong 22th ed. P.471

(pepsin)
(trypsin)(chymotrypsin)
(elastase)(endopeptidase)
(exopeptidase)
(exopeptidase)!!!!aminopeptidase

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()
16.
(A) .peristaltic wave
(B) .segmentation contraction
(C) .tonic contraction
(D) .mass action contraction
Ans(D)
Key
mass action contraction: Mass movement 1~3 ~

FC p244
A. Peristaltic wave ~~ ~ primary
Peristaltic constriction secondary Peristaltic constriction
B. segmentation contraction ~
Peristaltic wave ~
C. tonic contraction ~

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()
17.
(A) secondary active transport
(B) Fe2+-mediated conversion
(C) .phagocytosis
(D) .oxidative phosphorylation
Ans(A)

Key

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()
18. X 36 mg/mL X 0.25 mg/mL 1 mL/min
hematocrit 50% X clearance mL/min
(A)9
(B)18
(C)144
(D)288
Ans(C)
Key
C x P= V x U
C= Clearance
P= Plasma concentration
V=Urine volume
U= Urine concentration
C x 0.25 = 1 x 36
C=144
()
19.
(A) . 2
(B) .aquaporin-1
(C) . 6070%
(D) .
Ans(A)
Key~

~
66
~

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()
24.

(A)
(B)
(C)
(D)
Ans(C)
Key 23
23 A , B
Growth hormone deficiency
Hypothyroidism in children 1,2,3

growth hormone deficiency in children hypothyroidism in children

23 A.growth hormone B.thyroxine C.cortisol

D.prolactin
Growth hormone
Thyroid hormone Cortisol
Prolactin
Def ciency Children:
Children: Gastrointestinal symptoms
Fatigue, weakness
Adult:
Failure to thrive
hypothyroidism
Morning headache
Fasting hypoglycemia
Increased insulin sensitivity
Decreased gastric acidity
Decreased free water clearance
Children:
gigantism
Thyrotoxicosis
Hypogonadism

Adult: acromegaly
galactorrhea
Major side effects associated with glucocorticoid therapy
Dermatologic and soft tissue
Renal
Skin thinning and purpura; Cushingoid appearance
Hypokalemia, Fluid volume shifts
Alopecia; Acne; Hirsutism; Striae; Hyp rtrichosis
Genitourinary and reproductive
Eye
Amenorrhea/infertility,
Intrauterine growth retardation
Posterior subcapsular cataract
Elevated intraocular pressure/glaucoma
Bone
Exophthalmos
Osteoporosis, Avascular necrosis
Cardiovascular
Muscle
Myopathy
Neuropsychiatric
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Arrhythmias (with intravenous pulse therapy)

Hypertension
Perturbations of serum lipoproteins
Premature atherosclerotic disease
Gastrointestinal
Gastritis, Peptic ulcer disease, Pancreatitis,
Steatohepatitis, Visceral perforation

Euphoria, Dysphoria/depression, Insomnia/akathisia

Mania/psychosis, Pseudotumor cerebri
Endocrine
Diabetes mellitus
Hypothalamic-pituitary-adrenal insufficiency
Infectious disease
Heightened risk of typical infections
Opportunistic infections, Herpes zoster

Hypothyroidism
Mechanism
Symptoms
Slowing of
Fatigue and weakness
metabolic
Cold intolerance
processes
Dyspnea on exertion
Weight gain
Cognitive dysfunction
Mental retardation (infantile onset)
Constipation
Growth failure
Accumulation of
Dry skin
matrix substances
Hoarseness
Edema
Other

Decreased hearing
Myalgia and paresthesia
Depression
Menorrhagia
Arthralgia
Pubertal delay

Signs
Slow movement and slow speech
Delayed relaxation of tendon reflexes
Bradycardia
Carotenemia

Coarse skin
Puffy facies and loss of eyebrows
Periorbital edema
Enlargement of the tongue
Diastolic hypertension
Pleural and pericardial effusions
Ascites
Galactorrhea

congenital growth hormone deficiency congenital hypothyroidism

1.
(1) birth length breech presentation perinatal asphyxia
hypoglycemia Prolonged jaundice
(2) ACTH deficiency
(3) gonadotropin deficiency(microphallus)(cryptorchidism)
hypoplasia of scrotum
(4) 6~12 growth rate bone age delay height age

2.
prolonged jaundicefeeding deficulty
[]
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1.
2.
3.
4.
5.

https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-5-17
http://www.uptodate.com/contents/diagnosis-of-growth-hormone-deficiency-in-children#H5
http://www.uptodate.com/contents/clinical-manifestations-of-hypothyroidism
http://www.uptodate.com/contents/diagnosis-of-adrenal-insufficiency-in-children
http://www.uptodate.com/contents/major-side-effects-of-systemic-glucocorticoids

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()
25.
(A)cretinism
(B)congenital adrenal hyperplasia
(C)dwarfism
(D)Prader-Willi syndrome
Ans(A)
Key 24

24
Congenital adrenal hyperplasia (21-hydroxylase deficiency)

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aldosterone

3/4

Prader-Willi syndrome
1. etiology:
(1) 15 (15q11-q13) (deletion) 70~75%
(2) 15 (maternal uniparental disomy) 20~25%
(3) (imprinting center mutation ) 2~5%
(4) (balanced translocation) 1%
2.
(1)
(2) (DTR)
(failure to thrive)
(hypoplasia)
(3) 12~18

(4) (Hyperphagia)
() (IQ 60 90 )

[]
http://www.genes-at-taiwan.com.tw/genehelp/database/case/record_39.htm
http://www.genes-at-taiwan.com.tw/genehelp/database/disease/PWS_940706.htm

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()
26. parallel -strandedantiparallel -stranded

(A)
(B) disulfide bond
(C) stacking --sheet
(D) -protein-protein binding domain
Ans(A)
Key

https://smallcollation.blogspot.tw/2013/03/beta-sheet.html#gsc.tab=0
(beta sheets)
a.
b. -
7
c. 0.65nm 0.70nm

d. parallel 5 antiparallel

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wikipedia

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()
27.penicillin
(A) -lactamase
(B) transpeptidase
(C) ligase
(D) aldolase
Ans(B)
Key
-lactam

Penicillin -lactam transpeptidase

A !!!!.!

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()
28. pH pI
(A)
(B)
(C)
(D)
Ans(B)
Key

https://smallcollation.blogspot.tw/2013/03/isoelectric-pointpi.html#gsc.tab=0
pI pH (Isoelectric point(pI))

pH pI H+ H+H+
-NH2 -NH3+-COO--COOH

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()
29. 30

(A) B1
(B) B12
(C) C
(D) A
Ans(C)
Key

FC

https://smallcollation.blogspot.tw/2014/11/navigation-of-vitamin.html#gsc.tab=0
Vitamin A Nyctalopia or Night BlindnessXerophthalmia
Vitamin B1(thiamin)Beriberi
Vitamin B12(cobalamin)pernicious anemia
Vitamin C(ascorbic acid)scurvy
C

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()
30.RNA CMP UMP
(A) -aminoisobutyrate
(B) .thymine
(C) .uracil
(D) .hypoxanthine
Ans(C)
KeySalvage pathway p162~

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()
31 .base residues ribose

(A) hydrogen bond

(B) N--glycosyl bond
(C) .phosphodiester bond
(D) .amide bond
Ans(B)
Key

(A) 2
(B)
(C) 2

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()
32.Ames test
(A) .
(B) .DNA
(C) .
(D) .
Ans(D)
Key~
Ames test~ Ames test
1964

DNA

1967 12

S9
S9
S9

1973 PNAS
Carcinogens are mutagens S9
174 8090

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1994 Pauline Gee 2 Ames II test

6
DNA

()
33 . Okazaki
(A) endonuclease DNA
(B) 30S ribosomal subunit RNA
(C) . DNA lagging strand
(D) . 3' 5' DNA
Ans(C)
KeyOkazaki DNA lagging strand ~
~

(A) Okazaki DNA polymerase DNA~

(B) Okazaki DNA30S RNA rRNA
(D)DNA 5' 3'

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()
34. mRNA
(A) mRNA 5' 3'
(B) mRNA mRNA
(C) mRNA 10
(D) mRNA 5'cap 3'poly(A) tail
Ans(D)
Key
mRNA

(A) mRNA Deadenylation-dependent mRNA decay

deadenylase poly-A tail

poly-A tail
a 3'5' 3'-5' exosome complex mRNA
3'5' exosome complex
b 5'3' Lsm1-7( RNA binding protein) 3' DCP1-2( mRNA
decapping complex) XRN1( exoribonuclease) 5'-3'
5'3' decapping complex
mRNA 3' 5' A
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http://www.nature.com/nrm/journal/v8/n2/fig_tab/nrm2104_F1.html
(B) mRNA
a mRNA polycistronic mRNA
mRNA monocistronic mRNA
b mRNA (lack of processing of mRNA) 5' capping 3'
poly-A tail
c 5' capping 3' poly-A tail mRNA

d mRNA mRNA

Translation of the mRNA begins when mRNA is still being transcribed from the DNA molecule.
mRNA B
(C) mRNA orz
(D)

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()
35. translation
(A) silent mutation
(B) missense mutation
(C) suppressor mutation
(D) nonsense mutation
Ans(D)
Key

Silent mutations
Missense mutations
Nonsense mutations(codon)(stop codon)

(D) nonsense mutation

(C) suppressor mutation
DNA

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()
36. -tRNA aminoacyl-tRNA synthetases
(A) tRNA -tRNA
(B) tRNA
(C) GTP -tRNA
(D) tRNA 3'--tRNA
Ans(A)
Key
-tRNA aminoacyl-tRNA synthetases tRNA
aminoacyl-tRNA (aa-tRNA, -tRNA)tRNA -tRNA
-tRNA -tRNA
(ribosome)

(1) ()amino acid + ATP aminoacyl-AMP + PPi

(2) tRNA aminoacyl-AMP + tRNA aminoacyl-tRNA + AMP

(A)
(B)
(C) ATP
(D) ATP tRNA 3'-

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()
37. apoptosis
(A) Bak
(B) Bax
(C) Bcl-2
(D) FASL
Ans(C)
Key
()

1.

(extrinsic)(intrinsic)
(1) Fas ligand (FASL) Fas Fas ligand

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death-inducing signaling complex (DISC) DISC caspase 8caspase 8

caspase 3, 6, 7
T cell induced apoptosis
(2) caspase-dependent pathway
(DNA damage ) mitochondrial
permeability transition (MPT)()
cytochrome c cytochrome c Apaf-1 procaspase 9 apoptosome
caspase 9 caspase 3, 6, 7
2. caspase 3, 6, 7 common
pathway DNA
3. mitochondrial permeability transition (MPT)

(1) (pro-apoptotic)BAK, BAX, BAD, BID

(2) (anti-apoptotic)Bcl-2, Bcl-xL
MPT

(A) BAD
(B) BAD
(C) Bcl-xL
(D) T cell FASL

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()
38.
(A) glycolysis ATP
(B) glycolysis
(C) TCA cycle
(D) pentose phosphate pathway
Ans(A)
Key
BCD,B CD ~
A

+TCA cycle

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()
39.glycogen

(A) glucose 1-phosphate

(B) glucose 6-phosphate
(C) CMP-glucose
(D) UDP-glucose
Ans
Key D
Pathway

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()
40 glycolysis NADH
NAD+
(A) -ketoglutarate succinyl-CoA
(B) pyruvate lactate
(C) coenzyme Q cytochrome b
(D) pyruvate acetyl-CoA
Ans(B)
Key B

AD TCA cycle ,C complexIII

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()
41.
insulin
(A) glycogen synthase
(B) glucokinase hexokinase IV
(C) phosphorylase kinase
(D) glycogen phosphorylase
Ans(B)
Key A ()
glucose K+ channel Ca2+
insulin

glucose

HKIV

insulin

F2,6BP
PFK-1
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()

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()
42.
(A).Apo B-100
(B).Apo C-I
(C).Apo C-II
(D).lipoprotein lipase
Ans(A)
Key (1) LDL
(2)Apo B-100 LDL apolipoprotein
LDL-receptor apo B-100 Apo E
QQ

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(A)
(B) (C) apo C HDL
chylomicrons VLDL apo C-II lipoprotein lipase (TG)
(FFA)
(D) lipoprotein lipase
!! protein apolipoprotein
()

: wiki

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()
43.-bacteriorhodopsin
(A). 7 -
(B). -
(C). retinal
(D).light-driven proton transport

Ans(B)
Key A B 50%
! alpha-helix B ya~

bacteriorhodopsin Halobacteria()

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bacteriorhodopsin 7 alpha-helix (
rhodopsin G-Protein Coupled Receptor ) Retinal
bacteriorhodopsin
light-driven proton pump
ACD

ref: wiki

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()
44.autosomal dominant familial hyper-cholesterolemia
low density lipoproteinLDLreceptor LDL
(A).LDL receptor
(B).LDL LDL receptor bile salts
(C).LDL triglyceride
(D).LDL

Ans(B)
KeyLDL
ACD statins bile acid binding resins
(statin / resin LDL receptor LDL)
B

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(A) LDL A LDL receptor

(B) LDLreceptor
(C)(&) 50%
(D)VLDL LDL VLDL lipoprotein lipase TG()

!!(@@)
42
: wiki

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()
45.phenylalanine hydroxylase
phenylketonuria
(A).tyrosine
(B).tryptophan
(C).phenylalanine
(D).phenylalanine
Ans(A)
Key phenylalanine tyrosin (
phenylalanin tyrosin )
phenylalanine hydroxylase phenylalanine keton
( tryptophan tryptophanouria ...)
phenylalanine CD
phenylalanine
phenylalanine phenylalanine phenylalanine hydroxylase
tyrosine ( 46. tyrosin catecholamine )
PKU phenylalanine
phenylpyruvate phenyllactate& phenylacetate

phenylalanine hydroxylase Tetrahydrobiopterin(BH4)

phenylalanine hydroxylase Tetrahydrobiopterin

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Nelson Textbook of PediatricsDefects in Metabolism of Amino Acidsclinicalkey

phenylalanine tyrosine
enzyme: (1) Phenylalanine hydroxylase, (2) pterin-carbinolamine dehydratase,
(3) dihydrobiopterin reductase, (4) guanosine triphosphate (GTP) cyclohydrolase, (5) 6pyruvoyltetrahydropterin synthase, (6) sepiapterin reductase, (7) carbonyl reductase, (8) aldolase reductase, (9)
dihydrofolate reductase, (10) tyrosine aminotransferase, (11) 4-hydroxyphenylpyruvate dioxygenase, (12)
homogentisic acid dioxygenase, (13) maleylacetoacetate isomerase, (14) fumarylacetoacetate hydrolase, (NE)
nonenzymatic.
BH4

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1.PKU phenylalanine tyrosin

2.phenylalanine hydroxylase Tetrahydrobiopterin
3. phenylalanine CNS
hypopigmentation BH4 PKU
CNS BH4
4. phenylalanine tyrosin BH4 BH4 LDOPA5-HTP
5.PKU ( phenylalanine)
6.

ref: Nelson

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()
46.epinephrinenorepinephrine

(A).arginine
(B).histidine
(C).tyrosine
(D).tryptophan

Ans(C)
Key catecholamine cheese
syndrome catecholamine tyrosine
catecholamine

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catecholamine !

(1) catecholamine

(2)

Tyr DOPA DopamineDopamine DBH

norepinephrine voltage gated calcium channel
norepinephrine

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()
47.
(A).cytochrome c1
(B).NADH
(C).FADH2
(D).coenzyme Q
Ans(A) & (D) (D )
Key= =

(A) cytochrome c cytochrome "Cytochrome c is highly watersoluble, unlike other cytochromes, " Wikipedia, "Cytochrome c"@@
(B) NADH "all forms of this coenzyme are white amorphous powders that are
hygroscopic and highly water-soluble Wikipedia, Nicotinamide adenine dinucleotide
(C) FADH2 "fully reduced form, FADH2 has high
polarizability, " Wikipedia, Flavin adenine dinucleotide
(D) Co Q
Q10 "This fat-soluble substance, which resembles a vitamin, is
present in most eukaryotic cells," Wikipedia, Coenzyme Q10

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()
48.proto-oncogenesoncogenes
(A)chemical-induced mutation
(B)
(C)
(D)promoter region
Ans(D)
Key

proto-oncogenes oncogenes
tumor suppressor genes
()
49.insulinpreprohormone
(A) endoplasmic reticulum
(B) A B
(C) proteolytic cleavage
(D)
Ans(B)
Key

preproinsulin
signal sequencesecretory vesicles
proinsulindisulfide bond

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()
50.
(A) DNA microarray analysis
(B) Northern blotting
(C) Southern blotting
(D) Two-hybrid analysis
Ans(D)
Key

(A)DNA microarray analysis DNA DNA chipPCR

hybridization
(B)(C)Southern blotting DNA DNA
restriction endonuclease DNA probe
northern blotting Southern blotting RNA

(D)two-hybrid analysis yeast two-hybrid analysis Gal4p

reporter gene Gal4p domain
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X Y Gal4P X Y
Gal4p X Y Gal4p

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()
51. Phase I
(A) Oxidation
(B) Hydrolysis
(C) Conjugation
(D) Reduction
Ans(C)
Key conjugation phase II(Glucuronidation, Acetylation, Glutathione conjugation,
Glycine conjugation, Sulfate conjugation, Methylation, Water conjugation)

1. (Biotransformation) pH
pH
(metabolism)

2.
phase1 phase2
(1) Phase I parent drug
a. Oxidation Cytochrome P450-dependent oxidations, deamination, dealkylation,
desulfuration
b. Reduction Azo reductions, Nitro reductions, Carbonyl reductions
c. Hydrolyses Ester, Amides
(2) Phase II phase 1
(glucuronic acid)(sulfonic acid)(acetic acid)
Glucuronidation, Acetylation, Glutathione
conjugation, Glycine conjugation, Sulfate conjugation, Methylation, Water conjugation
(3)
isoniazid phase II N-acetyl conjugate phase I
isonicotonic acidphase II phase I

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()
52. blood flow-limited
(A) Alprenolol
(B) Lidocaine
(C) Isoniazid
(D) Aspirin
Ans(D)
KeyAspirin

1. Alprenolol(-lol) non-selective beta blocker 5-HT1A receptor antagonist

Atenolol
2. Lidocaine class IB Lidocaine 3%

propanolol, cimetidine
lidocaine

Class

IA: quinidine, procainamide, disopyramide

IA:
IB: lidocaine, mexiletine, phenytoin
IB:
IC: flecainide
IC:
Class II
Esmolol, Sotalol
blocker
Class III Bretylium, Sotalol, Ibuti ide

Class IV
Verapamil, Diltiazem
(Nifedipine dihydropyridine CCB

3. Isoniazid(INH) mycolic acid TB

INH N-acetyltransferase INH
1/3 1/2
4. Aspirin non-selective COX inhibitor COX( NSAID )Aspirin

Aspirin

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()
53. ketoconazole fluconazole
(A) Ketoconazole cortisol fluconazole
(B) Ketoconazole fluconazole
(C) Ketoconazole fluconazole
(D) Ketoconazole cytochrome P450 fluconazole
Ans(B)
Key BBB Azole Fluconazole

1. Azole CYP450 azole N

imidazoles(ketokonazole, miconazole, clotrimazole) triazoles(itraconazole,
fluconazole, voriconazole)
2. Ketoconazole azole fluconazole, itraconazole
CYP450()
ketaconazole CYP450
cyclosporine cisapride
ketaconazole cimetidine H2 blocker pH
ketoconazole rifamycin (rifampin, rifabutin, rifapentine) ketaconazole

3. FluconazoleFluconazole azole BBB

BBB fluconazole
azole
4. Fluconazole

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()
54.

(A) Griseofulvin
(B) Miconazole
(C) Terbinafine
(D) Nystatin
Ans(D)
Key Nystatin

1.
(1) Griseofulvin(fungistatic)

2-6
(serum sickness)
Griseofulvin (itraconazole, terbinafine)
(2) Terbinafine
a. Terbinafine Griseofulvin (keratophilic) Terbinafine
fungicidal
b. Terbinafine Azole squalene
epoxidase) CYP450
2.
(1) NystatinNystatin Amphotericin B (poreforming)Nystatin

(oropharyngeal thrush)
(2) Azole (Topical Azoles)
a. azole clotrimazole miconazole
(vulvovaginal candidiasis)Cotrimazole
nystatin azole

b. Ketaconazole ()
(3) Allylamine (Topical Allylamines)terbinafine naftidine
(tinea cruris)(tinea corporis)

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()
55.
(A) Ribavirin
(B) Adefovir
(C) Enfuvirtide
(D) Abacavir
Ans(C)
Key Enfuvirtide

1.
(1) Anti-herpes & anti-cytomegalovirus agentsAcyclovir, Ganciclovir, Cidofovir, Forscanet
(2) NRTIs(Nucleoside reverse transcriptase inhibitors,)Zidovudine, Lamivudine,
Abacavir
(3) NNRTIs(Nonnucleoside reverse transcriptase inhibitors,Nevirapine, Delavirdine,
Efavirenz
(4) Protease inhibitorsIndinavir, Rotonavir
(5) Anti-influenza agentsAmantadine&Rimantadine, Zanamivir&Oseltamivir, Interferons, Ribavirin,
Palivizumab
2. Abacavir NRTIsAbacavir Guanine
glucuronosyltransferase
3. RibarivinGuanine GTP
mRNA cappingRibarivin DNA RNA influenza A&B,
parainfluenza, RSV, HCV, HIV-1
4. Adefovir(deoxyadenosinetriphosphate) DNA
DNA B (HBV) DNA (polymerase)
B
5. EnfuvirtideT4 CD4 HIV gp120 T4
CD4 Tcell Enfuvirtide transmembrane glycoprotein
gp41 subunit HR1

6. HIV
(1) CCR5 co-receptor antagonist (maraviroc)Fusion inhibitor (enfuvirtide)
(2) NNRTIsNRTIs
(3) (integrase)Integrase strand-transfer inhibitors (INSTIs)
(4) (budding)Protease inhibitors (PIs)

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()
56.Clopidogrel ()
(A) c-AMP
(B) ADP receptor
(C) Fibrinogen receptor IIb/IIIa
(D) Thromboxane receptor
Ans(B)
KeyClopidogrel Ticlopidine ADP

1.
(1) ()
(2) () ()vWF
collagen
a. ( ADP/TXA2/serotonin) cAMP Ca2+
b. granules factors(ThrombinADP)
Arachidonic acid prostaglandin2TXA2
GP IIb-IIIa receptors fibrinogen vWF
(3) () ()
a. 12-11-9-10
b. 7-10
c. 10-2-1 Prothrombin(II)Thrombin(IIa) Fibrinogenfibrin(I)
2.
(1) Antiplatelet drugs
a. COX inhibitorAspirin
b. GP IIb/IIIa inhibitorAbciximabEptifibatideTirofiban Integrilin
c. ADP receptor antagonistClopidogrelTiclopidine
d. PDE/adenosine uptake inhibitorDipyridamolCilostazol
(2) Anticoagulants() Thrombin
a. IndirectHeparin(UFH)LMWH()Fondaparinux
b. DirectLepirudinHirudinDabigatranRivaroxabanApixaban
c. Warfarin(Coumadin)
(3) Thrombolytic AlteplaseStreptokinaseUrokinaset-PA(Tissue plasminogen
activator)
3. Clopidogrel Ticlopidine ADP Aspirin
prostaglandin Clopidogrel Ticlopidine

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()
57. Fibrinolysis
(A)Hirudin
(B)Aminocaproic acid
(C)Tranexamic acid
(D)Aprotinin
Ans(A)
Key
Fibrinolysis complex
: ?

(A) Hirudin Thrombina

(B) Aminocaproic acid Antifibrinolysin profibrinolysin
Plasminogen Plasmin(Plasmin Fibrinolysis)
(C) Tranexamic acid (B)!
(D) Aprotinin Serine protease inhibitor profibrinolysin
Plasminogen Plasmin
()
58. tamoxifen
(A)
(B)
(C)
(D)
Ans(C)
Key tamoxifen tamoxifen
tamoxifen
( tamoxifen genital tract
viginal discharge )

(A) tamoxifen SERM(Selective Estrogen Receptor Modulators) steroid(A)

(B)
(C)~ LDL
(D) tamoxifen

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()
59.5
growth hormone

(A)somatostatin
(B)
(C)secondary hypothyroidism
(D)
Ans(C)
Key growth hormone therapy T4 T3 deiodination
secondary hypothyroidism

(A) somatostatin growth hormone

(B)

(D)(B)
(C) growth hormone therapy T4 T3 deiodination
secondary hypothyroidism

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()
60.hypothyroidism levothyroxine

(A)Levothyroxine
(B)Levothyroxine amiodarone
(C)Levothyroxine
(D)myxedema coma levothyroxine
Ans(B)
Key~

(A)Levothyroxine interaction interaction

Levothyroxine :
(B)Levothyroxine amiodarone
induce thyroid dysfunction
(C)Levothyroxine pregnancy risk A
(D)myxedema coma

(= = )

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()
61.Graves' disease
(A)Levothyroxine
(B)Methimazole
(C)Propranolol
(D)Octreotide
Ans(B)(C)
Key Graves' disease
~

(A)Levothyroxine :
(B)Methimazole : !
Propylthiouracil !
(C)Propranolol : lol beta blocker

beta blocker ~(beta blocker

beta blocker
BZD SSRI SSRI
beta blocker)
(D)Octreotide : ! Somatostatin analogue
Somatostatin

Somatostatin TSH Graves' disease B cell TSH

receptor antibody receptor TSH
~

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()
62.pituitary diabetes insipidus
(A)Atosiban
(B)Desmopressin
(C)Conivaptan
(D)Oxytocin
Ans(B)
Key central DI
dDAVP Desmopressin( 4-9 )
!

(A) Atosiban : Oxytocin-inhibitor

()?
Progesterone beta agonistMgSO4CCB (
)
(D)Oxytocin : (A)(D)(
? ADH
Oxytocin plasma level
)
(B)Desmopressin : collecting ductvasopressin receptoraquaporin channels translocation
lumen side()~
(C)Conivaptan : vasopressin receptor blockerDesmopressin
?!
(4-7)

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() 63~68
63. Carbonic anhydrase
A.Amiloride
B.Dorzolamide
C.Torsemide
D.Bumetanide
Ans(B)
Key
Carbonic anhydrase inhibitors
Amiloride potassium-sparing
Dorzolamide Carbonic anhydrase inhibitors Acetazolamide
Torsemide loop diuretics FurosemideLasix
Bumetanide Furosemide
Bumetanide loop diuretics
FC
() 63~68
64.phosphodiesterase cGMP

A.Misoprostol
B.Nitroglycerine
C.Sildenafil
D.Theophylline
Ans(C)
Key nitrite NO pathway

Misoprostol (PDE1)
Nitroglycerine Guanylyl cyclaseSildenafil Phosphodiesterase cGMP

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Theophylline (PDEi)

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() 63~68
65.renin angiotensin II
A.Aliskiren
B.Hydrochlorothiazide
C.Losartan
D.Ramipril
Ans(A)
Key
RAAS

Aliskiren
Hydrochlorothiazide thiazide
Losartan ARB Angiotensin receptor blocker Ramipril ACEi

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() 63~68
66.
A.2
B.2
C.Dopamine D2
D.Muscarinic M2
Ans(B)
Key

presynaptic
modulation of norepinephrine release norepinephrine
norepinephrine

Wendell S. Akers, Lisa A. Cassis (2003) , Presynaptic modulation of evoked NE release

contributes to sympathetic activation after pressure overload

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() 63~68
67.
A.Atropine
B.Bethanechol
C.Pilocarpine
D.Rivastigmine
Ans(B)
Key

Atropine Muscarinic antagonist bradycardia

Bethanechol Muscarinic agonist
Pilocarpine Muscarinic agonist
Rivastigmine Cholinesterase inhibitors Ach Parkinson

() 63~68
68.EIB
A.Cromolyn
B.Terbutaline
C.Salmeterol
D.Theophylline
Ans(D)
Key

FC Cromolyn EIB Theophylline

EIB b-agonist Cromolyn

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()
69. xanthine oxidase
(A) Febuxostat
(B) Probenecid
(C) Sulfinpyrazone
(D) Colchicine
Ans(A)
Key

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1. XO(xanthine oxidase) allopurinolfeboxustat (Feburic)feboxustat

allopurinol ( HLA-B*5801 )
2. benzbromaronesulfinpyrazoneprobenecid
3. (uricase)
(FDA) pegloticase

4. (corticosteroid) (NSAID)
(colchicine) MSU (antigen-presenting cell APC)

()
70.
(A) Alprostadil
(B) Dinoprostone
(C) Epoprostenol
(D) Iloprost
Ans(B)
KeyDinoprostone Prostaglandin E2

prostaglandins
:
PGE PGF
PGE1 PGE2 PGA

PGI2
(A) Alprostadil (PGE1)
(B) Dinoprostone (PGE2)
()
(C) Epoprostenol (prostacyclin)

(D) Iloprost ( prostanoid prostacyclin )

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()
71. CarbidopaLevodopa
(A) Dopa decarboxylase
(B) 3-O-Methyldopa
(C) Tyrosine hydroxylase
(D) COMT
Ans(A)
KeyParkinsons disease Nigrotriatal neuron()
dopamine dopamine Acetylcholine(Ach)
dopamine Ach

[]
Dopamine
Dopamine
Dopamine agonist
MAOB ( dopamine )
COMT( levodopa 3-o-methyldopa
levodopa )
Ach receptor( tremor rigidity)

Amantadine(
Levodopa+Carbidopa
ErgotBromocriptine, Pergolide/
Non-ergotPramipexole, Ropinirole
Selegiline, rasagiline
Entacapone(), tolcapone(+
)
Benztropine, Trihexyphenidyl,
Biperiden

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(A) Levodopa+Carbidopa Dopamine BBB Dopamine

Levodopa dopa decarboxylase dopamine
Levodopa dopa decarboxylase dopamine
Carbidopa
dopa decarboxylase Levodopa dopamine

(1)Pyridoxine(Vitamin B6) decarboxylase cofactor Levodopa dopamine

(2)MAOA inhibitor Norepinephrine hypertensive crisis
(B)(D)3-O-Methyldopa Levodopa COMT Levodopa
COMT inhibitor Entacapone, tolcapone COMT Levodopa 3-OMethyldopa
(2014 First Choice p.135 p.96-99)
()
72.
(A)
(B)
(C) zero-order kinetics
(D) Acetaldehyde
Ans(B)
Key( XD)
XD
Ethanol()
()
Acetate()

(A) 20%80%
(Volume of Distribution)
(B)
(C) (D)(Zero-order
kinetics)
acetaldehyde()
Disulfiram
Alcohol dehydrogenase

[](Alcohol withdrawal syndrome)

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6-8 1-3
BZD(Diazepam.lorazepam,chloridiazepoxid )Carbamazepine

( p.1142014First Choice p.161)

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()
73. arsenic advanced African trypanosomiasis
(A) Dimercaprol
(B) Succimer
(C) Melarsoprol
(D) Ferroxamine
Ans(C)
Key(African trypanosomiasis)
(A)(B)(D)(C)

[](2014 p.370)

Deferoxamine
Penicillamine
EDTA
BAL(Dimercaprol)
Succimer
DMPS(Dimaval)

penicillin

BAL

(C) ()
WHO human African trypanosomiasis Pentamidine
SuraminMelarsoproleflornithine
1. Pentamidine first early stage T.b.gambiense
2. Suramin first early stage T.b. rhodesiense
3. Melarsoprol second /advanced stage human African trypanosomiasis
4. Eflornithine second stages T.b.gambiens ( T.b rhodesiense late stage )
(D) Deferoxamine(hemochromatosis)

ferroxamine ( Deferoxamine
desferoxamine ferrioxamine)
(2014First Choice p.370http://www.who.int/mediacentre/factsheets/fs259/en/)

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()
74. 6
spike-wave

(A) Carbamazepine
(B) Valproic acid
(C) Phenytoin
(D) Diazepam
Ans(B)
Key()
( XD)
(Generalized seizure)(Abscence)
(B)
valproic acid( Depakin) Ethosuximide

[]
Partial
Cabamazepine
Simple

Phenytoin

Complex
Generalized
GTCS ()

Ethosuximide

Absence ()
Static epilepticus
30 Diazepam

[] (2014 First Choice p.143-145 p.173)

Na Carbamazepine Partial

GTCS
Steven-John syndrome
Absence
Phenytoin

(gingival hyperplasia) D
( Osteomalacia)
( megaloblastic anemia)
SJS syndrome
Ca Ethosuximide
absence
Valproic acid
Na,Ca
Absence

Lamotrigine

UGT
Zonisamide
Sulfonamide
Status epilepticus
GABA BZD

Diazepam

Barbiturate
Partial GTCS

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GABA

GABA

glutamate

Tiagabine
Valproic acid
Gabapentin
Vigabatrin
Topiramate
Felbamate

Partial

GABA aminotransferase-1

Partial GTCS

GABA GABA

GABA transaminase
NMDA
AMDA

Partial GTCS

()
75.
(A) Valproic acid
(B) Lamotrigine
(C) Phenytoin
(D) Ethosuximide
Ans(C)
Key(A)(B)(D) Absence seizures(C)Phenytoin partial GTCS
phenytoin absence seizure = =
()
(C) Phenytoin Carbamazepine absence seizures Carbamazepine
GABAA vigabatrin tiagabine GABA Agonist

()
76.nondividing or permanent tissues?
(A)neurons
(B)skeletal muscle cells
(C)smooth muscle cells
(D)cardiac muscle cells
Ans(C)
Key

1.labile cells

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2.(stable cells)
G0 DNA G1

,
3.permanent cells
,

Rubins pathology, 2005

https://smallcollation.blogspot.tw/2014/01/tissue-regeneration-capacity.html#gsc.tab=0

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()
77.mediator
(A)vasodilationTNF, IL-1
(B)C3aC5a
(C)feverprostaglandins
(D)painbradykinin
Ans(A)
Key

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http://www.pro2services.com/Lectures/Fall/InfMeds/
Rubins pathology

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()
78.
(A)lymphocyte
(B)neutrophil
(C)plasma cell
(D)eosinophil
Ans(C)
Key
:
:

The pathognomonic microscopic lesion of syphilis is a proliferative endarteritis with an

accompanying inflammatory infiltrate rich in plasma cells.

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A, Syphilitic chancre of the scrotum. Such lesions typically are painless despite the presence of ulceration, and
they heal spontaneously. B, Histologic features of the chancre include a diffuse plasma cell infiltrate beneath
squamous epithelium of skin.
Robbins Basic Pathology, Ninth Edition
()
79.
(A)
(B)
(C)
(D)
Ans(A)
Key

Typical Mumps Complications

Meningitis, Meningoencephalitis, and Encephalitis
Meningitis and mild meningoencephalitis are the most frequent complications of mumps in children.
Gonadal Infection (Epididymo-Orchitis and Oophoritis)
Epididymo-orchitis and oophoritis almost never occur before puberty. 164 However, in adolescent boys and
adult men, epididymo-orchitis is second only to parotitis as a manifestation of mumps virus infection.
Pancreatitis
In a retrospective survey of 2482 hospitalized patients with mumps, pancreatitis was noted in 75 (3%)
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Diabetes Mellitus
Diabetes mellitus long has been suspected to be associated with antecedent mumps.
Nephritis
Viruria is a common occurrence in uncomplicated mumps, and mild abnormalities in renal function occur.
Deafness
Deafness is an important but rare complication of mumps virus infection. 2167105 Its incidence has been
estimated at 0.5 to 5.0 per 100,000 cases of mumps.
Feigin and Cherry's Textbook of Pediatric Infectious Diseases, Seventh Edition

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()
80.

(A)
(B)
(C)
(D)
Ans(C)
Key

()
81.
(A)Asbestos
(B)Cadmium compounds
(C)Vinyl chloride
(D)Benzene
Ans(D)
Key

Occupational Cancers
Agent/Group of
Agents

Human Cancer Site and Type

for Which Reasonable
Evidence Is Available

Typical Use/Occurrence

Arsenic and
arsenic
compounds

Lung, skin, hemangiosarcoma Byproduct of metal smelting

Asbestos

Lung, mesothelioma;
gastrointestinal tract
(esophagus, stomach, large
intestine)

Component of alloys, electrical and semiconductor

devices, medications and herbicides, fungicides, and
animal dips
Formerly used for many applications because of fire,
heat, and friction resistance; still found in existing
construction as well as fire-resistant textiles, friction
materials (e.g., brake linings), underlayment and roofing
papers, and floor tiles

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Benzene

Leukemia

Principal component of light oil

Many applications exist in printing and lithography,
paint, rubber, dry cleaning, adhesives and coatings, and
detergents
Formerly widely used as solvent and fumigant

Beryllium and
beryllium
compounds

Lung

Cadmium and
cadmium
compounds

Prostate

Missile fuel and space vehicles

Hardener for lightweight compounds metal alloys,
particularly in aerospace applications and nuclear
reactors
Uses include yellow pigments and phosphors
Found in solders
Used in batteries and as alloy and in metal platings and
coatings

Chromium
compounds

Lung

Component of metal alloys, paints, pigments, and

preservatives

Ethylene oxide

Leukemia

Ripening agent for fruits and nuts

Used in rocket propellant and chemical synthesis, in
fumigants for foodstuffs and textiles, and in sterilants for
hospital equipment

Nickel
compounds

Nose, lung

Nickel plating
Component of ferrous alloys, ceramics, and batteries
Byproduct of stainless steel arc welding

Radon and its

decay products

Lung

Vinyl chloride

Angiosarcoma, liver

From decay of minerals containing uranium

Can be serious hazard in quarries and mines
Refrigerant
Monomer for vinyl polymers
Adhesive for plastics
Formerly used as inert aerosol propellant in pressurized
containers

Robbins Basic Pathology, Ninth Edition

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(
82.cor pulmonale
(A)
(B)
(C)
(D)
Ans(A)
Key

In acute cor pulmonale, the right ventricle usually shows only dilation; if an embolism causes sudden
death, the heart may even be of normal size.
Chronic cor pulmonale is characterized by right ventricular (and often right atrial) hypertrophy. In
extreme cases, the thickness of the right ventricular wall may be comparable with or even exceed that of the
left ventricle. When ventricular failure develops, the right ventricle and atrium often are dilated. Because
chronic cor pulmonale occurs in the setting of pulmonary hypertension, the pulmonary arteries often contain
atheromatous plaques and other lesions, reflecting long-standing pressure elevations.

Robbins Basic Pathology, Ninth Edition

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()
83.45evanescent phlebothrombosis

(A)non-bacterial thrombotic endocarditis

(B)Libman-SacksLibman-Sacks endocarditis
(C)acute infective endocarditis
(D)acute myocardial infarction
Ans(A)
Key
A
BC D

Libman-Sacks Endocarditis
Libman-Sacks endocarditis is characterized by the presence of sterile vegetations on the valves of patients
with systemic lupus erythematosus.
The lesions probably develop as a consequence of immune complex deposition and thus exhibit associated
inflammation, often with fibrinoid necrosis of the valve substance adjacent to the vegetation; subsequent
fibrosis and serious deformity can result in lesions that resemble chronic rheumatic heart disease.
Thrombi on heart valves are called vegetations.
Bacterial or fungal blood-borne infections can cause valve damage, leading to the development of large
thrombotic masses (infective endocarditis).
Sterile vegetations also can develop on noninfected valves in hypercoagulable statesthe lesions of socalled nonbacterial thrombotic endocarditis . Less commonly, sterile, verrucous endocarditis (LibmanSacks endocarditis) can occur in the setting of systemic lupus erythematosus
Robbins Basic Pathology, Ninth Edition

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()
84.
polycythemia vera
essential thrombocythemia
systemic mastocytosis
acute lymphoblastic leukemia
(A)
(B)
(C)
(D)
Ans(A)
Key

Acute myeloid leukemia [M3-APL: PML-RAR t(15;17)]

Chronic myelogenous leukemia [BCR-ABL]
Chronic eosinophilic leukemia [FIP1/PDGFRA]
Polycythemia vera [JAK2]
Essential thrombocythemia [JAK2VALRMPLCALR]
Primary myelofibrosis [JAK2VALRMPLCALR]
Follicular lymphoma (grade I and II) (follicle) [BCL-2][t(14;18)]
Marginal zone B-cell lymphoma (follicle) [trisomy 3]
Mantle cell lymphoma (follicle) [t(11;14) (q13;q32)]
Primary mediastinal (thymic) large B-cell lymphoma [SOCS1JAK2]
Germinal center B-cell-like DLBCL [CD10BCL6]
Activated B-celllike DLBCL [BCL2]
Anaplastic large cell lymphoma (sinus) [ALK]
Burkitt lymphoma (follicle) [8, c-myc][t(8;14) or t(8;22)]
Systemic mastocytosis [KIT]
Acute lymphoblastic leukemia [t(12;21)t(9;22)(q34;q11.2)/BCR-ABL19pt(4;11)(q21;q23)/MLLAFF1(AF4)]

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()
85. 5 terminal deoxynucleotidyl transferase
TdTCD10CD19 blast cells t12;21

(A) T T-cell chronic lymphoblastic leukemia

(B) T T-cell acute lymphoblastic leukemia
(C) B B-cell acute lymphoblastic leukemia
(D) B B-cell chronic lymphoblastic leukemia
Ans(C)
Key
1. CD19CD20CD22 B cell surface markerCD3 T cell surface marker CD19
B cell
2. Acute chronic
a.

b.
()
c. 97

1.
//

2. Terminal deoxynucleotidyl transferase DNA

3. t12;21 ALL

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()
86.
(A)
(B)
(C)
(D)
Ans(C)
CMV

1. (Obliterative
bronchiolitis) FEV1

3~4 43~80%
2. submucosa mucosa
fibroblasts/myofibroblasts
3. obliterative bronchiolitis

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()
88.?
(A) amiodarone
(B) acetaminophen
(C) phenothiazine
(D) methotrexate
Ans(B)
KeyAcetaminophen overdose hepatocellular injury centrilobular
hepatic necrosis NAC

(A) Amiodarone
Liver biopsy variable micro- and macrovesicular fatballooning
degeneration mild inflammation moderate inflammation ( granulomatous)
fibrosis Mallory bodies steatosis Amiodarone
centrilobular necrosis pattern (Ref: http://livertox.nlm.nih.gov/Amiodarone.htm#insert)
(B) Acetaminophen overdose hepatocellular injury centrilobular hepatic
necrosis Acetaminophen conjugation
overdose conjugation
Acetaminophen CYP (CYP2E1, 1A2, 2A6, 3A4)
N-acetyl-p -benzoquinoneimine (NAPQI)NAPQI glutathione
conjugation NAPQI glutathione
NAPQI hepatocellular proteins cysteinyl sulfhydryl groups oxidative
damage mitochondrial dysfunction(Ref:
http://emedicine.medscape.com/article/820200-overview#a3)

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(C) Phenothiazine case report

cholestatic injury hypersensitivity (Ref:
http://catbull.com/alamut/Bibliothek/1999_selim_135_1.pdf)
(D) Methotrexate fatty liver diseasefibrosis cirrhosis
(Ref: http://livertox.nlm.nih.gov/Methotrexate.htm)

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()
89. 24 ,,
,;
?
(A) (crypt abscess)
(B) (adenocarcinoma)
(C) (necrotizing vasculitis)
(D) (non-caseating granulomas)
Ans(D)
Key Inflammatory bowel disease Ulcerative colitis
rectum proximal colonCrohn's disease
skip lesion Crohn's disease
non-caseating granulomas

(A) Crypt abscess ulcerative colitis

(B) (C)
(D) 60% Crohn's disease non-caseating granulomas Ulcerative colitis

()(crypt abscess)
(mucosal ulceration)(
)(lamina
propria)(rectum)
(pancolitis) 10%
(barium enema)

()
()
()
(sarcoid-type epithelioid granulation)
() 20%
()(
90%)

(tenesmus)
(bloody diarrhea)

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()
90. 4 ,
,(bile ductule),,
(cholestasis)?
(A) (choledochal cyst)
(B) (cholangitis)
(C) (biliary atresia)
(D) (cholangiocarcinoma)
Ans(C)
Key 60
(acholic
stool)

150 microns
C

(A)

(Ref: http://www.uho.com.tw/sick.asp?aid=418)
(B)
( Charcots triad)
( Charcots triad Reynolds pentad)
(C)
(acholic stool)

150 microns
(Ref:
http://wwwu.tsgh.ndmctsgh.edu.tw/pgs/D_BiliaryAtresia.htm)
(D) (cholangiocarcinoma, CCA)
10-15% 95% 60-70
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(Ref: http://www.tma.tw/ltk/102560404.pdf)

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()
91.(Shiga-like toxin)?
(A) (thrombotic thrombocytopenic purpura)
(B) (idiopathic thrombocytopenic purpura)
(C) (typical hemolytic-uremic syndrome)
(D) (atypical hemolytic-uremic syndrome)
Ans(C)
KeyO157 (Shiga-like toxin) typical HUS
TTP ITP
Atypical HUS

(A) TTP 20 ~ 50

20 ~ 50
AIDS 4/100000(Ref:
http://wan811018.weebly.com/348802356726495281872356930151.html)
(B) ITP

ITP
70% 1 ~ 3 (Ref:
http://wan811018.weebly.com/348802356726495281872356930151.html)
(C) O157 (hemolytic uremic syndrome)

O157
(Shiga-like toxin)

(Ref:
https://www.ntuh.gov.tw/Ped/health/DocLib/O157%E5%9E%8B%E5%A4%A7%E8%85%B8%E6%A1%BF%
E8%8F%8C%E8%88%87%E5%8D%B1%E9%9A%AA%E7%9A%84%E6%BA%B6%E8%A1%80%E5%B0
%BF%E6%AF%92%E7%97%87%E5%80%99%E7%BE%A4.aspx)
(D) aHUS

aHUS
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CFHCD46CFICFBC3THBDCFHR3CFHR1CFHR1CFHR4

(Ref:
http://www.tfrd.org.tw/tfrd/rare_b/view/id/252)

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()
92. medullary carcinoma
(A) RAS
(B) RET
(C) BRAF
(D) PTEN
Ans(B)
Key
1.
a. follicular adenoma
b.
i. Papillary carcinoma: > 85%
ii. Follicular carcinoma: 5~15%
iii. Medullary carcinoma: 5%
iv. Poorly differentiated thyroid carcinoma/ anaplastic carcinoma: < 5%
2. ()

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3. Medullary carcinoma parafollicular C cells medullary

carcinoma (MEN)
MEN I
MEN II (IIa) MEN III (IIb)

3P (pituitaryparathyroid

pancreas)
(pheochromocytoma)
(medullary carcinoma)
11q13
RET

()
93. sporadic
(A) cyclin D1
(B) calcium-sensing receptor
(C) vitamin D receptor
(D) parathyroid hormone
Ans(A)
Key
1. cyclin D1 calciumsensing receptor familial hypocalciuric hypercalcemia vitamin D receptor
parathyroid hormone

2.
a. CDK (Cyclin-dependent Protein Kinase) kinase CKI Cyclins

b. CKI (Inhibitor of CDK) CDK CDK

c. Cyclins CDK
CDK

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3. PARD1PARD1 cyclin D1 cyclin D1

(inversion) cyclin D1

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()
94. 3 26 28

0.8
(A) 69, XXY
(B) 46, XX
(C) 23, Y
(D) 47, XXY
Ans(A)
Key
()
1. (trophoblast)

(hydatidiform mole)
2.
a. Complete mole*2 ()
46XX
b. Partial mole*2 + *1 () 69XXX
69XXY 69XYY ( Y)

partial mole 3 XXX XXY XYY

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()
95. 40 Erythroplasia of Queyrat

(A)
(B) condyloma acuminatum
(C)
(D)
Ans(C)
Key

Bowens disease
Erythroplasia of Queyrat Bowenoid Papulosis

>35
>35

()

Gross

(invasive risk)

()

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()
97. aspirin

(A) kernicterus
(B) petechial hemorrhage
(C) brain edema
(D) lenticular degeneration

Ans(C)
Key
aspirin
Reyes syndrome()(Influenza)
(Varicella)

()
Reyes syndrome

(A) kernicterus
bilirubin

(B) petechial hemorrhage

()(Haemorrhagic transformation of an ischaemic
infarct)
(C) lenticular degeneration
lenticular degeneration (hepato-lenticular degeneration)
Wilsons disease

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()
98. transtentorial herniation

(A)
(B)
(C)
(D)
Ans(C)
Key

PCA CN3

brain herniation ()
1. Transtentorial herniation (Uncal herniaiton)
2. Central
3. Cingulate (subfalcine)
4. Transcalvarial
5. Upward
6. Tonsillar

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()
99.

(A)
(B)
(C)
(D)
Ans(C)
Key

farmers lung

https://www.tafm.org.tw/ehc-tafm/s/viewDocument?documentId=998990cd34274521ba8b13982f629680

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()
100.
(A)
(B)
(C)
(D)
Ans(A)
Key
hypersensitivity reaction type FC

farmers lung
immune complex

(foamy
cytoplasm)

(B)

(C)

(D)

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()
20. D
(A) 1,25-dihydroxycholecalciferol
(B) 7-dehydrocholesterol
(C) 25-hydroxycholecalciferol
(D) cholecalciferol
Ans: (A)
Key: Vitamin D
:

(B)7-dehydrocholesterolVitamin DUV
Cholecalciferol (Vitamin D3)25C-OH(C)
25-hydroxycholecalciferol1C-OHactive form1,25dihydroxycholecalciferol(A)

()
21. (rickets)
(A)
(B)
(C)
(D)
Ans: (B)
Key: Rickets
:
Vitamin D deficiency Calcium deficiency Bone
tendernessDental problemsMuscle weakness (rickety myopathy)Skeletal deformityGrowth
disturbanceHypocalcemia

()
22.
(A) (luteinizing hormone)
(B) (progesterone)
(C) (estrogen)
(D) (follicle)(granulosa cell)(estrogen)
Ans: (C)
Key:
:

Estrogen pick pick

progesterone

()
23.
(A) (growth hormone)
(B) (thyroxine)
(C) (cortisol)
(D) (prolactin)
Ans: (A)(B)
Key:
:
Thyroid hormones and fetal brain development.
(A)QQ
Thyroid hormones and fetal brain development.http://www.ncbi.nlm.nih.gov/pubmed/16170282
()
87.
(A)
(B)
(C)
(D)
Ans(D)
Key
Lobar
Interstitial

()
96. chondrosarcoma
A. 20
B.
C.grade 1 10%
D.grade 3
chondroblastic osteosarcoma
AnsD

A: chondrosarcoma
Chondrosarcoma Male-to-Female Ratio

Age of Peak Incidence

Conventional

Almost 1:1 (slight male

predominance)

50-70 y (most common > 50 y, gradual increase

with age)

Dedifferentiated

Similar to the ratio above

> 50 y

Clear cell

2.4:1

20-40 y (common 10-90 y)

Mesenchymal

1:1

20-30 y (common in teenagers and young adults)

Juxtacortical

1:1

20-40 y

B primary secondaryPrimary chondrosarcomas arise de novo, whereas

secondary chondrosarcomas arise from preexisting lesions of the cartilage.

C
Grade I:
Grade II10-15%
Grade III>50%

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