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(E) 1. ¨k©Ê74·³¦Ñ¤H¡A¦]©ü³Ö¡A¹B°Ê©Ê©I§l§xÃø¤ÎºÝ§¤©Ê©I§l§xÃø¡]orthopnea)¦³¤C¤Ñ¤§¤[¡A¨D¶E«æ¶E³¡¡A¨ä¤ß¹q¹Ï¦p¹Ï¥Ü¡A¨ä¥¿½T¤§¶EÂ_¬O¡G
A.¥¿±`
B.²Ä¤G«×Äuµ²¤ß©Ð¶Ç¾Éªýº¢
C.²Ä¤T«×Äuµ²¤ß©Ð¶Ç¾Éªýº¢
D.²Ä¤G«×©Ð«Ç¶Ç¾Éªýº¢
E.²Ä¤T«×©Ð«Ç¶Ç¾Éªýº¢
 
(E)
2. ¤W­z¯f¤H¤§³Ì¦X²z¤Î¦³®Äªº³B¸m¤è¦¡¡AÀ³¸Ó¬O
A.±Ä¥Î100µJ¦Õ¤§ª½¬y¹qÀ»¡]DC. cardioversion )
B.ª`®gAtropine 0.8 mg
C.ÀR¯ßª`®gAmiodarone 150mg
D.¤fªASotalol
E.¸Ë¸m¤H¤u¤ß«ß½Õ¸`¾¹
 
(D)
3. ¨k©Ê58·³¦]«æ©Ê¤ß¦Ù±ð¶ë¯g¦í¤J¥[Å@¯f©Ð¡A²Ä¤G¤Ñ©¿¦³¤ß±ª¡A§N¦½¤Î§C¦åÀ£¡A¨ä¤ß¹q¹Ï¦pÃD¡A¾ú®É¼Æ¤ÀÄÁ¡A¸g³B¸m«á¤~¼Èí©w¡A¨ä¥¿½T¤§¶EÂ_¬°
A.¥[³t«¬¦Û§Ú¤ß«Ç§Ö¸õ¡]Accelerated idioventricular rhythm )
B.Torsades de pointes
C.«D«ùÄò©Ê¤ß«Ç§Ö¸õ¡]Non-sustained ventricular tachycardia )
D.«ùÄò©Ê¤ß«Ç§Ö¸õ¡]Sustained ventricular tachycardia¡^
E.¤W¤ß«Ç§Ö¸õ(Supraventricular tachycardia)
 
(E)
4. ¤W­z¯f¤H³Ì¦X²z¤Î¦³®Äªº³B¸m¤è¦¡¡AÀ³¸Ó¬O
A.¤£¥²ªvÀø¥u»ÝÆ[¹î
B.¨Ï¥Î¤A«¬¥æ·P¯«¸gªýÂ_¾¯ ( £]-blocker )
C.ª`®gMagnesium sulfate
D.±Ä¥Î¾ÉºÞ¹q¨`( Catheter ablation )
E.±Ä¦æª½¬y¦¡¹qÀ» ( DC electric shock )
 
(C)
5. °Ê¯ßµ°ª¬µw¤Æ¤§¾÷Âत¡A¦³¥|ºØ²Ó­M¤§¼Wªø§ñÃö¨äµ°ª¬µw¤Æ¤§¯f²z¶i®i¡A¦óªÌ¨ÃµL°Ñ»P¯f²zÅܤơG
A.¦åºÞ¤º¥Ö²Ó­M( Endothelial cell )
B.¥­·Æ¦Ù²Ó­M( Smooth muscle cell )
C.B«¬²O¤Ú²y( B lymphocyte )
D.¢â«¬²O¤Ú²y( T lymphocyte )
E.¥¨¤j§]¾½²Ó­M( Macrophage )
 
(B)
6. ¯f¤H¨k©Ê¦~ÄÖ48·³¡A©ó8¤ë22¤é¤W¤È6®É¯Ý¯k¡A¤D©ó7®É18¤À¨D¶E¬YÂå°|¡A¤ß¹q¹Ï§e²{¤ß¸õ58¦¸/¤À¤Î«æ©Ê¤U¾À¤ß¦Ù±ð¶ëÅܤơB¦åÀ£128/82mmHg¡A¨ä¥L²z¾Ç¨ÃµL²§±`¡C­È¯Z¦í°|Âå®v¨M©w³]¸mÀR¯ß¾ÉºÞ¡A¨Ã¶}©l¨Ï¥Î (1) front-loaded tPA 100mg (2) IV verapamil 0.15mg/kg (3) Aspirin 100mg (4) IV nitroglycerin 100mcg/bolus (5) Captopril 6.25mg p.o. ¦óªÌªvÀø¸û¬°²Å¦X·í¤µªvÀø«ü¤Þ
A.1 , 2 , 3
B.1 , 3 , 5
C.1 , 4 , 5
D.2 , 3 , 4
E.3 , 4 , 5
 
(A)
7. ¤ß¥]Ån¶ñ¶ë( Cardiac tamponade )¤§­«­nÁ{§Éªí¼x¦³¡@ (1) ÀV°Ê¯ßÀ£ª@°ª (2) ¥æ¤e©Ê¯ßÀ£( Paradoxical pulse pressure ) > 10mmHg (3) §C¦åÀ£©Î¥ð§J (4) ²Ä¤@¤ß­µ¥[±j (5) ªÍ¤ô¸~
A.1 , 2 , 3
B.1 , 2 , 5
C.1 , 4 , 5
D.2 , 3 , 4
E.3 , 4 , 5
 
(B)
8. ¤U¦C¤ßŦ佤¯fÅܤ§¶EÂ_©ÊÅ¥­µ²§±`¡A¦³¥¿½T¤Î¤£¥¿½T¤§°t¹ï¡A¦ó¸s¬O¥¿½T¡H (1) Mitral stenosis - Presystolic murmur (2) aortic stenosis - Paradoxical splitting of S2 (3) Mitral regurgitation - S1 accentuation (4) Aortic regurgitation - S3 (5) Tricuspid regurgitation - Inspiratory accentuation
A.1 , 2 , 3
B.1 , 2 , 5
C.1 , 4 , 5
D.2 , 3 , 4
E.3 , 4 , 5
 
(E)
9. ¤U¦C¤§¥ý¤Ñ©Ê¤ßŦ¯f»PÁ{§Éªí¼x¦³¥¿½T¤Î¤£¥¿½T¤§°t¹ï¡A¦ó¸s¬O¥¿½T¡H (1) ¶}ºZ©Ê°Ê¯ßúPºÞ( Patent ductus arteriosus ) - ¥k¤ß«Ç¦å®ñ¹¡©M¶q¼W¥[ (2) ¤ß©Ð¤¤¹j¯Ê·l( Atrial septal defect ) - ¥ª¤ß«ÇÂX¤j (3) ¤ß¤º½¤¹Ô¯Ê·l¯g( Endocardial cushion defect ) - ¹¬´U䳬Âꤣ¥þ (4) ªk¬¥¤ó¥|¦X¸s¯g( Tetralogy of Fallot ) - ¥k¤ß«Ç¥X¸ô¯¶ (5) Ebstein·î«¬ - ¤ß©Ð¤Æ¥k¤ß«Ç
A.1 , 2 , 3
B.1 , 2 , 5
C.1 , 4 , 5
D.2 , 3 , 4
E.3 , 4 , 5
 
(D)
10. ¦³Ãö¤ßµÎ©Ê¥ª¤ß«Ç°IºÜ ( Diastolic left ventricular failure ) ¦³³\¦hÁ{§Éªí¼x¡A¦ó¸s¬O¥¿½T (1) ¦]¤ß°IºÜ¯gª¬¨Ó´N¶Eªº±wªÌ¤¤¡A¤ßÁY©Ê°IºÜ¤ñ¤ßµÎ©Ê°IºÜ¦h (2) ¦h¨£¤UªÏ¯B¸~ (3) ¤£»ÝªvÀø (4) ¦h¦]¤ß¦Ù¯Ê®ñ¡A¤ß¦Ù«I¼í¯fÅܩદåÀ£¦Óµo¥Í (5) ¦h¨£©I§l§xÃø¡A¤ß±ª¤ÎªÍ¤ô¸~
A.1 , 2 , 3
B.1 , 2 , 5
C.1 , 3 , 5
D.1 , 4 , 5
E.3 , 4 , 5
 
(B)
11. ¦å¹[¹L°ª( Hyperkalemia ) ±`¦X¨Öªº¤ß¹q¹ÏÅܤơA¦óªÌ°£¥~¡G
A.°ªªºTªi¡C
B.ST segment ©µªø¡C
C.P ªi´î¤p¬Æ¦Ü®ø¥¢¡C
D.QRS ªiÅܼe¡C
E.Sine wave¡C
 
(E)
12. ¦b¤U¦C¦óºØ±¡ªp,¤£©y¨Ï¥ÎÂà¤ÆúC§í¨î¾¯ ( angiotensin converting enzyme inhibitor )
A.¨â°¼µÇ°Ê¯ß¯U¯¶¡C
B.¦³¤ß°IºÜ¥B¹ï¦å¬y¦³ÄY­«ªý¤O ( ¦pÄY­«¤§¥D°Ê¯ßä©Î¤G¦yä¯U¯¶) ¡C
C.¤w¦³©ÎÃhºÃ¦³preload¥i¯à¤£¨¬±¡ªpªÌ ( ¦p¾É¦]©ó¨Ï¥ÎÀR¯ßÂX±i¾¯¡B¤j¶q§Q§¿¾¯¡B¹Ã¦R¡B¸¡Âm¤Î¥X¦åµ¥ ) ¡C
D.¦³°_§¤©Ê§C¦åÀ£ªÌ ¡C
E.¥H¤W±¡ªp¬Ò¤£©y¨Ï¥Î¦¹ÃĪ«¡C
 
(D)
13. ¤U¦C¦³Ãö«æ©Ê¤ß¥]ª¢ ( acute pericarditis )¤§´y­z¡A¦óªÌ¬°«D¡H
A.«æ©Ê¤ß¥]ª¢¤Þ°_¤§¨å«¬¯Ý³¡¯kµh¡A¦b§l®ð¤Î¥­½ö®É´c¤Æ¡C
B.12¾Éµ{¤§¤ß¹q¹Ï°£¤FV1¤ÎaVR¥~±`¦³ST¬q©ï°ª¡C
C.ÀR¯ßÀ£¶}©l¤Wª@¡A«hÀ³¦Ò¼{¶}©leffusive - constrictive pericarditis ©Îcardiac tamponade¡C
D.¦bÄu©Ê¸`«ß ( sinus rhythm ) ®É¡A¨å«¬¤§¤ß¥]¼¯À¿­µ¥Ñ¤G­Ó¦¨¤À²Õ¦¨¡A¦¹¤G­Ó¦¨¤À¬Û·í©ó¤ß«Ç¤§¦¬ÁY»PµÎ±i¡C
E.¤ß¹q¹Ï¥X²{QRSªiTªi¡APªiµ¥¤§¡¨¹q®ð¥æ´À¡¨²{¶H ( electrical alternans )®É»Ý¦Ò¼{¤ßŦÀ£¶ë ( cardiac tamponade )¡C
 
(B)
14. ¦³Ãö§Q§¿¾¯¦b¥ª¤ß°IºÜ ( Left - side heart failure )±wªÌ¨Ï¥Î®É¡A¤U¦C¦ó¶µ±Ô­z¤£¥¿½T¡H
A.¦]­°§C«e­t²ü ( preload ) ¦Ó§ïµ½ªÍ¥R¦åªº±¡§Î ( pulmonary congestion )¡C
B.¥i¥H¼W¥[¤ß·i¥X¶q ( stroke volume )¡C
C.¦bªÍ¥R¦å ( pulmonary congestion ) ±wªÌ¡A¥i§ïµ½°Ê¯ß¦å®ñ¤ÀÀ£ ( PaO2)¡C
D.¥i¯à¤Þ°_¹q¸Ñ½è¤£¥­¿Å¡C
E.¥H¤W¬Ò¥¿½T¡C
 
(A)
15. ¹ï©ó¥D°Ê¯ßäÄY­«¯U¯¶¡A¤U¦C±Ô­z¦óªÌ¬°«D¡H
A.µL¯gª¬©Î¤ß¹q¹ÏµL¥ª¤ß«ÇªÎ¤j²{¶H«h¥i±Æ°£¥D°Ê¯ßäÄY­«¯U¯¶¡C
B.¨å«¬¤§¯gª¬¥]¬A©I§l§xÃø¡B·w³Ö¤Î¯U¤ß¯g¡C
C.¦p¥X²{¥H¤W¯gª¬«h¹w«á¤£¨Î¡A©Ò¥HÀ³«Øij¤ß¾ÉºÞÀˬd ( ¥]¬A«aª¬°Ê¯ßÄá¼v )¡A½T©w¶EÂ_«á§@¥~¬ì¤â³NªvÀø¡C
D.µo¥ÍÄY­«¤ß°IºÜ®É¨ä¤ßÂø­µ¤£©úÅã¡C
E.¥H¤W¬Ò¥¿½T¡C
 
(E)
16. ¤ß¦Ù±ð¶ë«áªºÃĪ«ªvÀø¡A¤U¦C¦óªÌÀ³ÁקK¨Ï¥Î¡H
A.£] blockers¡C
B.§Ü¦å¤pªO¾¯¡C
C.Nitrates ( ¦pisosorbide dinitrate )¡C
D.Captopril¡C
E.Nifedipine¡C
 
(D)
17. ¤@±w¦³ªø´Á°ª¦åÀ£¤§¤¤¦~¨k©Ê¬ðµMµo¥Í¼@¯P¤§«ùÄò©Ê¯Ý«e¯kµh¨Ã©ñ®g¨ì­I³¡¡A¥ª¤WªÏ¤§¯ß·iÅÜ®z¡A¯Ý«e¨Ã¥iÅ¥¨ìGrade II/VI ¤ßµÎÂø­µ¡A§A»{¬°¤U¦C¦óªÌ¬°³Ì¾A·í¤§Àˬd¡H (1) ¤ß¹q¹Ï¤Î¯Ý³¡X¥ú¡C (2) ¯Ý³¡¹q¸£Â_¼hÄá¼v¡C (3) ªÍ³¡Äéª`®Ö¤l±½ºË¡C (4) «aª¬°Ê¯ßÄá¼v¡C (5) ¶W­µªi¤ß¹Ï¡C
A.1, 3
B.1, 2, 3
C.1, 4, 5
D.1, 2, 5
E.1, 2, 3, 4, 5
 
(D)
18. ¤ß«Ç©Ê¤ß·i¹L³t ( ventricular tachycardia ) ªº¯S²§«¬ Torsades de pointes ±`»P¤U¦C¦óªÌ¦³Ãö³s? (1) §C¦åÁâ¡C (2) §C¦å¹[¡C (3) ¨Ï¥Î type Ia §Ü¤ß«ß¤£¾ãÃĪ« ( ¦pquinidine )¡C (4) §ÜÅðµßÃÄ ( ketoconazole )
A.1, 2
B.2, 3
C.2, 3, 4
D.1, 2, 3, 4
E.1, 2, 4
 
(C)
19. ¦³Ãö¤U¦C¤ßŦºc³y¤§¬Û¹ï¦ì¸mÃö«Y¤§±Ô­z¡A¦óªÌ¬°«D¡H
A.¥k¤ß©Ð¦ì©ó¥ª¤ß©Ð¤§«e¤è¡B¥k¤è¤Î¤U¤è¡C
B.¥k¤ß«Ç¦ì©ó¥ª¤ß«Ç¤§«e¤è¤Î¥k¤è¡C
C.ªÍ°Ê¯ßä¦ì©ó¥D°Ê¯ß䤧«e¤è¡B¥k¤è¤Î¤W¤è¡C
D.¤T¦yä¦ì©ó¤G¦y䤧«e¤è¡B¥k¤è¤Î¤U¤è¡C
E.¥H¤W¬Ò¥¿½T¡C
 
(E)
20. ¤@¦ì46·³¦³°ª¦åÀ£¯f¥v¤§¨k©Ê¦b¼@¯P¯Ýµhµo¥Í«á7¤p®É¦Ü«æ¶E«Ç¨D¶E¡A¤ß¹q¹ÏÅã¥Ü«æ©Ê«e¾À¤ß¦Ù±ð¶ë¤§ÅܤơA¦åÀ£¬°120/84mmHg ¡A¤ß³t²v¨C¤À90¡A©I§l¨C¤À20¤U¡A¯Ý³¡¦³¨Ç·LÅo­µ¡C¦¹¯f¤H¥H©¹µL¯gª¬¡A¦ý´¿©ó¤@¶g«e§@½ñªO¹B°Ê¤ß¹q¹Ï ( ¤ß³t²v¹F¨ì¹w¦ô³Ì°ª­È¤§90% )¦Ó³Q§P©w¬°¥¿±`¡CÃö©ó¦¹¯f¨Ò¤§±Ô­z¡A¦óªÌ¬°«D¡H
A.³y¦¨«æ©Ê¤ß¦Ù±ð¶ë³Ì¦³¥i¯à¤§¾÷Âର¥ª«e¤UªK«aª¬°Ê¯ß¤§µ°ª¬µw¤Æª« ( atheroma ) ¯}µõ¡A»¤µo¦å¤pªO¤§¾®»E¤Î¦å®ê¤§§Î¦¨¡A¾É­P¦åºÞªý¶ë¡C
B.¯}µõ«e¤§ atheroma ¹ï¦åºÞ©|¥¼³y¦¨ÄY­«¤§¯U¯¶¡A¦]¦¹¯f¤H¥H©¹µL¯U¤ß¯g¥B¹B°Ê¤ß¹q¹Ï¥¿±`¡C
C.¦¹¯f¤H¥H¦å®ê·»¸Ñ¾¯©Îºò«æ®ð²y¾ÉºÞÂX±i³N (PTCA ) ªvÀø¡A¦]¦b¯Ýµhµo¥Í«á12¤p®É¥H¤º¨Ï¦åºÞ¦AºZ³q ( recanalization ) ¡A¹ï¨ä¯f±¡¤Î¹w«á¦³§U¯q¡C
D.¦pµL¸T§Ò¡A¨Ï¥Î¥æ·P¯«¸g¤A«¬ªýÂ_¾¯ ( beta - blocker ) ¤ÎÂà¤ÆúC§í¨î¾¯ ( Angiotensin converting enzyme inhibitor ) ¹ï¨ä¯f±¡¤§¹w«á¦³§U¯q¡C
E.¥H¤W¬Ò¥¿½T¡C
 


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