[國考申覆] 醫學(二) 61題 73題 96題
61. 下列何者非vitamin D及其衍生物的臨床適應症？
(A)骨質疏鬆（osteoporosis）
(B)骨軟化症（osteomalacia）
(C)腎功能衰竭（renal failure）
(D)副甲狀腺功能亢進症（hyperparathyroidism）
答案給D，不過覺得D和VitD相關臨床症狀也有關係...以下節錄至Harrison
出處：
Harrison's Online > Part 16. Endocrinology and Metabolism > Section 2.
Disorders of Bone and Mineral Metabolism >
Chapter 352. Bone and Mineral Metabolism in Health and Disease
內文：
Investigations in murine models demonstrate that hypophosphatemia, which in
vitamin D deficiency is a consequence of secondary hyperparathyroidism, is a
key etiologic factor in the development of the rachitic growth plate.
73. 下列有關治療巴金森氏症的藥物levodopa的描述，何者正確？
(A)levodopa口服效果差，需以靜脈注射的方式投藥
(B)levodopa通常不可以與selegiline（deprenyl）併用
(C)levodopa經常與bromocriptine併用，以延長其作用的時間
(D)levodopa會導致食慾下降
答案給D，但覺得C也正確，以下節錄
出處：
Harrison's Online > Part 17. Neurologic Disorders > Section 2. Diseases of
the Central Nervous System >
Chapter 372. Parkinson's Disease and Other Movement Disorders
內文：
Dopamine agonists are a diverse group of drugs that act directly on dopamine
receptors. Unlike levodopa, they do not require metabolism to an active
product and do not undergo oxidative metabolism. Initial dopamine agonists
were ergot derivatives (e.g., bromocriptine, pergolide, cabergoline) and were
associated with ergot-related side effects, including cardiac valvular
damage. They have largely been replaced by a second generation of non-ergot
dopamine agonists (e.g., pramipexole, ropinirole, rotigotine). In general,
dopamine agonists do not have comparable efficacy to levodopa. They were
initially introduced as adjuncts to levodopa to enhance motor function and
reduce "off" time in fluctuating patients.
96. 一位56歲女性，最近幾個月來腹圍逐漸變大。身體診查發現兩側卵巢有囊狀腫瘤及腹
水存在。細胞學檢查發現腹水中有惡性細胞。她接受腫瘤切除手術，標本的腫瘤囊壁表面
可見許多乳突樣突起。下列有關此病變的敘述，何者最正確？
(A)血中β-human chorionic gonadotropin濃度增加
(B)很可能出現腹腔偽黏液瘤（pseudomyxoma peritonei）
(C)卵巢腫瘤最可能是顆粒細胞瘤（granulosa cell tumor）
(D)顯微鏡下觀察卵巢腫瘤，常可見砂礫小體（psammoma bodies）
答案給D，但覺得B也可以，以下節錄
出處：
The MD Anderson Manual of Medical Oncology, 2e > Part VI. Gastrointestinal
Carcinomas >
Chapter 20. Small Bowel Cancer and Appendiceal Tumors
內文：
Pseudomyxoma peritonei (PMP), or false mucinous tumor, is a term originally
described by Werth in 1884, who described the pathological findings in a
patient with a ruptured ovarian cystadenoma who had copious gelatinous
intraperitoneal ascites. This term has been applied broadly to include any mucinous tumor-type involving the peritoneal cavity with any
histologic grade of differentiation.
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