{"meta_info": "taiwanese_test_Q", "question": "在病人接受全身麻醉施行胸腰脊椎侧弯（scoliosis）矫正手术时，下列何方法对脊椎神经功能监测最可靠？", "answer_idx": "D", "answer": "wake-up test", "options": {"A": "motor evoked potentials", "B": "somato-sensory evoked potentials", "C": "electromyography", "D": "wake-up test"}}
{"meta_info": "taiwanese_test_Q", "question": "人体站立时，肺部那一区域的换气／灌流比（ventilation/perfusion）为最高？", "answer_idx": "B", "answer": "肺尖", "options": {"A": "肺底", "B": "肺尖", "C": "肺中央处", "D": "肺各处均有相若之换气／灌流比"}}
{"meta_info": "taiwanese_test_Q", "question": "一位75 岁的男性，主诉最近6 个月來快走会有心悸和胸闷的现象，身体检查时，血压140/50 mmHg，心跳规律，胸骨右侧上方可听到心舒期杂音，心脏超音波检查有严重的主动脉瓣逆流，但左心室收缩内径（left ventricular end systolic dimension）为58 mm，舒张内径为80 mm，此时最好的治療方式为何？", "answer_idx": "B", "answer": "用猪心瓣膜置换主动脉瓣", "options": {"A": "用金属性瓣膜置换主动脉瓣", "B": "用猪心瓣膜置换主动脉瓣", "C": "使用抗心律不整药剂", "D": "使用抗心衰竭药剂"}}
{"meta_info": "taiwanese_test_Q", "question": "关于停经后的荷尔蒙療法，下列叙述何者错误？", "answer_idx": "B", "answer": "女性荷尔蒙有降低 LDL 的效果，所以可用于预防心血管疾病", "options": {"A": "对于萎缩性阴道炎，可使用局部荷尔蒙療法", "B": "女性荷尔蒙有降低 LDL 的效果，所以可用于预防心血管疾病", "C": "荷尔蒙療法对于骨质疏松所造成的骨折有预防的效果", "D": "若子宫未切除，使用女性荷尔蒙者需合并服用黄体素"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是路易氏体失智症（dementia with Lewy bodies, DLB）的主要症狀？", "answer_idx": "C", "answer": "舞蹈症", "options": {"A": "认知功能时好时坏", "B": "视幻觉", "C": "舞蹈症", "D": "巴金森氏症狀"}}
{"meta_info": "taiwanese_test_Q", "question": "「动作单位（motor unit）」指的是：", "answer_idx": "A", "answer": "单一运动神经元加上它支配的所有肌肉纤维", "options": {"A": "单一运动神经元加上它支配的所有肌肉纤维", "B": "一条肌肉纤维加上所有支配它的动作神经元", "C": "供应单一肌肉的所有动作神经元", "D": "一组拮抗肌群"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者并非神经内分泌瘤的组织免疫标记？", "answer_idx": "D", "answer": "CD7", "options": {"A": "neuron-specific enolase", "B": "synaptophysin", "C": "chromogranin A", "D": "CD7"}}
{"meta_info": "taiwanese_test_Q", "question": "左侧第九到十一后肋间静脉血直接回流入下列何者？", "answer_idx": "B", "answer": "半奇静脉（hemiazygos vein）", "options": {"A": "奇静脉（azygos vein）", "B": "半奇静脉（hemiazygos vein）", "C": "左锁骨下静脉（left subclavian vein）", "D": "内胸静脉（internal thoracic vein）"}}
{"meta_info": "taiwanese_test_Q", "question": "利用配对方式选择病例对照研究，下列何者错误？", "answer_idx": "C", "answer": "无法控制配对因子之干扰作用", "options": {"A": "需事先决定干扰因子", "B": "可降低已知干扰因子的影响", "C": "无法控制配对因子之干扰作用", "D": "需做配对分析"}}
{"meta_info": "taiwanese_test_Q", "question": "24 此时下列那些治療方式对此男婴有帮助？ ①Blalock-Taussig 分流术 ②心房中隔气球造口术（balloon atrial septostomy） ③前列腺素静脉注射（PGE1 infusion） ④肺动脉环缩术（PA banding）", "answer_idx": "B", "answer": "②③", "options": {"A": "①②", "B": "②③", "C": "①③", "D": "①④"}}
{"meta_info": "taiwanese_test_Q", "question": "39 一位55 岁停经后女性，发现乳房右侧有一2.5 公分肿块，经详细检查后，接受改良型全乳房根除术（modified radical mastectomy），病理诊断为乳癌（T2N0M0）, ER(+), PR( +), Her2(-)。术后辅助治療何者适当？\n", "answer_idx": "B", "answer": "荷尔蒙拮抗治療", "options": {"A": "化学治療", "B": "荷尔蒙拮抗治療", "C": "化学治療合并放射治療", "D": "放射治療"}}
{"meta_info": "taiwanese_test_Q", "question": "73.32岁男性病人右下腹痛2天，来到急诊，身体检查有明显局部压痛，白血球在正常值内但略偏高，C-reactive protein上升。未注射显影剂的电脑断层如图示，下列何项诊断最有可能？\n", "answer_idx": "A", "answer": "epiploic appendagitis", "options": {"A": "epiploic appendagitis", "B": "acute ileus", "C": "ascending colon intusussception", "D": "colon cancer with perforation"}}
{"meta_info": "taiwanese_test_Q", "question": "一位60岁男性因突然大量吐血而被送至急诊，呈休克状态，经紧急输液治疗后，病情改进。发病前并未喝酒及呕吐，也没有服用非类固醇消炎止痛药（NSAID, non-steroidal anti-inflammatory drugs），最近也无特殊压力。他是B型肝炎病毒慢性感染者。这位病人最可能是下列那种病灶出血？", "answer_idx": "A", "answer": "食道静脉曲张破裂出血", "options": {"A": "食道静脉曲张破裂出血", "B": "胃癌出血", "C": "出血性胃炎", "D": "十二指肠第二部分出血"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 2 岁的小孩，2 天前出现轻度发烧及皮肤病灶，并注意到全身出现红斑，检查时 Nikolsky sign 呈阳性，下列叙述何者正确？", "answer_idx": "A", "answer": "葡萄球菌皮肤烫伤样症候群（staphylococcal scalded skin syndrome）为可能诊断", "options": {"A": "葡萄球菌皮肤烫伤样症候群（staphylococcal scalded skin syndrome）为可能诊断", "B": "一定会侵犯黏膜组织", "C": "使用類固醇治療有良好療效", "D": "会留下永远的皮肤病灶"}}
{"meta_info": "taiwanese_test_Q", "question": "一位50岁男性主诉胸部不适与行动时气促，无高血压病史，血压130/80 mmHg，心跳规则每分钟76次，听诊上有第四心音，但并无明显杂音，胸部X光片无明显异常，心电图呈现左心室肥厚合并ST-T波变化，而心脏超音波呈现严重左心尖部肥厚与正常左心室收缩功能。下列何种药物最不适当？", "answer_idx": "A", "answer": "digitalis", "options": {"A": "digitalis", "B": "beta blockers", "C": "diltiazem", "D": "verapamil"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 50 岁男性病人，因为皮肤出现红疹且有剧痒來诊，病人无发烧。三天前因为被诊断出有甲狀腺功能亢进，目前正服用抗甲狀腺药物中。病人之白血球數为 4,500/μL，最适当的处置为下列那一项？", "answer_idx": "B", "answer": "给予抗组织胺、换用另外一种抗甲狀腺药物", "options": {"A": "立即停用抗甲狀腺药物、建议开刀", "B": "给予抗组织胺、换用另外一种抗甲狀腺药物", "C": "加入大量類固醇、立即安排放射性碘治療", "D": "加入抗生素、给予 Lugol's solution"}}
{"meta_info": "taiwanese_test_Q", "question": "30.一位45岁自小罹患慢性B型肝炎的男性病患，主诉一个多月前觉得右上腹疼痛，有时疼痛会延伸到右边的肩 膀。最近一周至门诊追踪腹部超音波显示有多颗肝脏肿瘤，分别是一颗2.2公分大小在S2的位置，和另一颗6.6\n 公分大小在 S5的位置，有观察到低回音（hypoechoic）的肿块。进一步安排腹部电脑断层之后，发现在相同位置有同样大小的肿块，并且已经侵犯到右侧肝门静脉。其他部位的腹部超音波和电脑断层结果皆属正常。抽血结果发现胎儿蛋白值（AFP）为230 ng/mL，AST 53 U/L，ALT 68 U/L。则这位病人最可能的诊断为何？\n", "answer_idx": "B", "answer": "hepatocellular carcinoma with portal vein thrombosis", "options": {"A": "liver abscess with necrosis", "B": "hepatocellular carcinoma with portal vein thrombosis", "C": "multiple cavernous hemangioma", "D": "acute-on-chronic hepatitis"}}
{"meta_info": "taiwanese_test_Q", "question": "关于先天性肺部呼吸道畸形（congenital pulmonary airway malformation）的治疗，下列何者比较正确？", "answer_idx": "A", "answer": "新生儿胸部X光发现右上肺叶有大囊泡状病灶，出生后即因呼吸衰竭插管治疗，应紧急进行开胸手术", "options": {"A": "新生儿胸部X光发现右上肺叶有大囊泡状病灶，出生后即因呼吸衰竭插管治疗，应紧急进行开胸手术", "B": "新生儿产前怀疑右下肺叶有实质状病灶，出生后呼吸平稳，应立即接受肺部电脑断层检查", "C": "新生儿产前怀疑左上肺叶有小囊泡状病灶，于出生后6个月大时接受电脑断层确诊，应于2岁之后再手术", "D": "3个月大男婴因呼吸急促，经X光及电脑断层检查发现左下肺叶多囊泡状病灶，应安排磁振造影（MRI）确定血管走向"}}
{"meta_info": "taiwanese_test_Q", "question": "王先生，56 岁农夫，有长期吸烟与嚼槟榔习惯，近1 个月有喉咙异物感、吞咽不适、左耳疼痛、左前颈部肿大、双侧颈部中段各有一颗最大径超过2公分肿瘤，声音稍哑但无呼吸困难，经医师检查后可能的诊断是罹患下咽癌，王先生此时之临床分期应该是多少？", "answer_idx": "D", "answer": "T4N2c", "options": {"A": "T3N2a", "B": "T3N2b", "C": "T4N2b", "D": "T4N2c"}}
{"meta_info": "taiwanese_test_Q", "question": "36 26 岁不孕女性，主诉月经稀少，经检查如图 A、图 B、图 C 所示，欲治療图 A 所呈现疾患，下列药物何者最不适当？图 A：多毛 图 B：后颈黑色素棘皮症 图 C：阴道超音波\n", "answer_idx": "D", "answer": "danazol", "options": {"A": "medroxyprogesterone acetate", "B": "antiandrogen", "C": "5α-reductase inhibitor", "D": "danazol"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关人体寄生虫成虫形态的叙述，何者错误？", "answer_idx": "D", "answer": "广节裂头绦虫（Diphyllobothrium latum）具有圆形吸盘（sucker）", "options": {"A": "十二指肠钩虫（Ancylostoma duodenale）具有兩对齿钩", "B": "蛲虫（Enterobius vermicularis）具有头翼（cephalic alae）", "C": "牛羊肝吸虫（Fasciola hepatica）具有头锥（cephalic cone）", "D": "广节裂头绦虫（Diphyllobothrium latum）具有圆形吸盘（sucker）"}}
{"meta_info": "taiwanese_test_Q", "question": "传染登⾰热的病媒蚊是下列何者？", "answer_idx": "B", "answer": "埃及斑蚊、⽩线斑蚊", "options": {"A": "热带家蚊、⽩腹丛蚊", "B": "埃及斑蚊、⽩线斑蚊", "C": "⽩腹丛蚊、⼩⿊蚊", "D": "中华疟蚊、热带家蚊"}}
{"meta_info": "taiwanese_test_Q", "question": "核子医学 technetium pertechnetate scan 对诊断下列何种疾病有帮助？", "answer_idx": "A", "answer": "梅克耳憩室（Meckel's diverticulum）", "options": {"A": "梅克耳憩室（Meckel's diverticulum）", "B": "水肾", "C": "骨髓病变", "D": "肾上腺肿瘤"}}
{"meta_info": "taiwanese_test_Q", "question": "下列各病症与其病原虫之配对中，何者错误？", "answer_idx": "C", "answer": "Megaesophagus－杜氏利什曼原虫（Leishmania donovani）", "options": {"A": "Romaña's sign－枯西氏锥虫（Trypanosoma cruzi）", "B": "Winterbottom's sign－冈比亚锥虫（Trypanosoma brucei gambiense）", "C": "Megaesophagus－杜氏利什曼原虫（Leishmania donovani）", "D": "Espundia－巴西利什曼原虫（Leishmania braziliensis）"}}
{"meta_info": "taiwanese_test_Q", "question": "在blood coagulation pathway的最后一步，促使fibrinogen转化成fibrin的物质为何？", "answer_idx": "C", "answer": "thrombin", "options": {"A": "von Willebrand factor", "B": "factor V", "C": "thrombin", "D": "plasminogen"}}
{"meta_info": "taiwanese_test_Q", "question": "39.58岁男性，近半年感到腹部不适，某日就诊时发现有两侧颈部、腋下与腹股沟淋巴结肿大。病人体温38.8℃，血压90/50mmHg，并有畏寒与疲累的症状，血球检查数据如下（括弧内是正常参考数值）：RBC 4.12 M/μL（4～5.52），Hb 12.4 g/dL（13.2 ～17.2），Retic. 1.48%（0.5～2），PLT 261 k/μL（148～339）， WBC 9.74 k/μL（3.54～9.06），Blast 0% ，Promyel. 0%，Myelo. 0%， Meta 0%，Band 0%，Seg 5.0%，Eos. 3.0%，Baso. 1.0%，Mono. 8.0%，Lym. 83.0%，Aty.Lym. 0.0%，Plasma cell 0.0%，Normobl. 0.0/100 WBC 。以 下那个叙述错误？\n", "answer_idx": "A", "answer": "因为白血球总数正常，只需要症状治疗", "options": {"A": "因为白血球总数正常，只需要症状治疗", "B": "应该要做详细的身体检查，以找出可能的感染来源", "C": "应该要接受血液细菌培养", "D": "应该要尽早投与静脉注射的广效性抗生素"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 24 岁男性病人主诉下背疼痛已半年。症狀时好时坏。严重时，可能半夜或清晨会痛醒。该病人最不可能同时有下列那一种症狀或征兆？", "answer_idx": "C", "answer": "皮下结节（subcutaneous nodule）", "options": {"A": "虹彩炎（iritis）", "B": "香肠趾（sausage toe）", "C": "皮下结节（subcutaneous nodule）", "D": "足底筋膜炎（plantar fasciitis）"}}
{"meta_info": "taiwanese_test_Q", "question": "依据赫尔辛基宣言（Declaration of Helsinki），当使用可辨识之人体组织或资料进行研究时，须遵守的规定。下列何者错误？", "answer_idx": "B", "answer": "在不可能或无法取得同意之情况，或取得同意后将造成研究无效时，可在免除同意书之情况下进行", "options": {"A": "通常医师必须取得同意后，方可收集、分析、储存和再利用", "B": "在不可能或无法取得同意之情况，或取得同意后将造成研究无效时，可在免除同意书之情况下进行", "C": "在不可能或无法取得同意之情况，或取得同意后将造成研究无效时，此种研究需经研究伦理委员会审议和批准后，方可在免除同意书之情况下进行", "D": "医师应避免受试者在压力或胁迫下取得同意"}}
{"meta_info": "taiwanese_test_Q", "question": "根据世界卫生组织宣布，下列何种疾病因为病毒疫苗之使用而绝迹？", "answer_idx": "A", "answer": "天花（smallpox）", "options": {"A": "天花（smallpox）", "B": "流行性感冒", "C": "小儿麻痹", "D": "水痘"}}
{"meta_info": "taiwanese_test_Q", "question": "医师法所称之医师不包括下列那一项？", "answer_idx": "B", "answer": "兽医师", "options": {"A": "中医师", "B": "兽医师", "C": "医师", "D": "牙医师"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种组织结构不被外淋巴液（perilymph）所包围？", "answer_idx": "C", "answer": "锤骨（malleus）", "options": {"A": "椭圆囊（utricle）", "B": "耳蜗管（cochlea duct）", "C": "锤骨（malleus）", "D": "球囊（saccule）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是亚急性皮肤红斑性狼疮 （subacute cutaneous lupus erythematosus；SCLE）常见的皮肤表现形式？", "answer_idx": "B", "answer": "papulosquamous 与 annular lesions", "options": {"A": "malar rash 与 papulosquamous lesions", "B": "papulosquamous 与 annular lesions", "C": "malar rash 与 discoid rash", "D": "discoid rash 与 annular lesions"}}
{"meta_info": "taiwanese_test_Q", "question": "一位84 岁男性病患，过去曾在金矿坑内工作长达30 年，6 个星期前因为咳嗽加剧、黄痰，及下午发烧送医，痰液抹片检查发现AFB（Acid-fast bacilli） (+++)，医生当时开立第一线治療之标准四种抗结核药物。如今结核菌培养呈现 MDR（multidrug resistant）TB，检验结果显示对下列那些药物产生抗药性？", "answer_idx": "A", "answer": "Rifampin+Isoniazid", "options": {"A": "Rifampin+Isoniazid", "B": "Rifampin+Isoniazid+Ethambutol", "C": "Isoniazid+Ethambutol", "D": "Isoniazid+Pyrazinamide"}}
{"meta_info": "taiwanese_test_Q", "question": "感染下列何种病毒，若自行服用阿司匹灵（Aspirin）等水杨酸类（salicylates）退烧药物后，最易增加儿童罹患雷氏症候群（Reye syndrome）的风险？", "answer_idx": "C", "answer": "流感病毒（Influenza virus）", "options": {"A": "德国麻疹病毒（Rubella virus）", "B": "麻疹病毒（Measles virus）", "C": "流感病毒（Influenza virus）", "D": "狂犬病病毒（Rabies virus）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关治疗产后大量出血之血管内栓塞术的叙述，下列何者最正确？", "answer_idx": "B", "answer": "栓塞的目标是止血并尽量保存子宫", "options": {"A": "血管内栓塞术是唯一的治疗方法", "B": "栓塞的目标是止血并尽量保存子宫", "C": "栓塞两侧子宫静脉对止血的效果最好", "D": "栓塞两侧子宫动脉的后遗症是会造成卵巢坏死"}}
{"meta_info": "taiwanese_test_Q", "question": "高血压的预防和控制指引，不包括下列何者？", "answer_idx": "B", "answer": "增加钠盐摄取", "options": {"A": "体重控制", "B": "增加钠盐摄取", "C": "增加体能活动", "D": "饮酒适量"}}
{"meta_info": "taiwanese_test_Q", "question": "关于重积癫痫（status epilepticus）治疗，下列何者错误？", "answer_idx": "A", "answer": "癫痫发作时应立即给与抗癫痫药物如phenytoin，并避免给予苯二氮类药物（benzodiazepines）如", "options": {"A": "癫痫发作时应立即给与抗癫痫药物如phenytoin，并避免给予苯二氮类药物（benzodiazepines）如", "B": "抗癫痫药物应使用静脉注射类而不是口服类", "C": "若使用抗癫痫药物后仍持续发作，进入顽固性重积癫痫（refractory status epilepticus），应再加上麻醉类药物如propofol", "D": "脑波监控是必要检查"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者与味蕾感觉讯号的传递，较不相关？", "answer_idx": "A", "answer": "trigeminal nerve", "options": {"A": "trigeminal nerve", "B": "facial nerve", "C": "glossopharyngeal nerve", "D": "vagus nerve"}}
{"meta_info": "taiwanese_test_Q", "question": "有关骨骼肌和平滑肌的比较，下列叙述何者错误？", "answer_idx": "D", "answer": "骨骼肌可经有丝分裂增殖，平滑肌则否", "options": {"A": "骨骼肌是多核细胞，平滑肌是单核细胞", "B": "骨骼肌细胞核位在细胞的周边，平滑肌细胞核位在中央", "C": "骨骼肌具有横纹，平滑肌则无", "D": "骨骼肌可经有丝分裂增殖，平滑肌则否"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者为管理学 SWOT 分析中与外部环境相关之面向？", "answer_idx": "A", "answer": "机会（opportunity）和威胁（threat）", "options": {"A": "机会（opportunity）和威胁（threat）", "B": "优势（strength）和劣势（weakness）", "C": "机会（opportunity）和劣势（weakness）", "D": "优势（strength）和威胁（threat）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关白喉毒素（diphtheria toxin）的叙述，那一项错误？", "answer_idx": "A", "answer": "是一种endotoxin", "options": {"A": "是一种endotoxin", "B": "可结合至细胞表面之heparin-binding epidermal growth factor", "C": "可结合至心脏及神经细胞导致受损", "D": "A subunit会使细胞内的elongation factor 2（EF-2）失去活性"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 6 个月大的婴儿患有神经母细胞瘤，原肿瘤已完全切除，但肿瘤已转移到肝脏，则该疾病算是那一期？", "answer_idx": "D", "answer": "4S", "options": {"A": "2B", "B": "3", "C": "4", "D": "4S"}}
{"meta_info": "taiwanese_test_Q", "question": "一位25 岁喜好运动之男性，于三年前因車祸造成膝后十字韧带断裂，虽经积极復健，但走路膝关节内侧疼痛，理学检查呈现向后不稳定大于10 毫米，他应接受何种治療？", "answer_idx": "D", "answer": "手术重建（reconstruction）", "options": {"A": "继续復健（rehabilitation）", "B": "石膏固定（casting）", "C": "手术修补（direct repair）", "D": "手术重建（reconstruction）"}}
{"meta_info": "taiwanese_test_Q", "question": "临床上成功应用于breast cancer免疫疗法的单株抗体trastuzumab（Herceptin）是针对下列那一个分子？", "answer_idx": "A", "answer": "Her-2/neu", "options": {"A": "Her-2/neu", "B": "MAG-1", "C": "MUC-1", "D": "CD-20"}}
{"meta_info": "taiwanese_test_Q", "question": "足月产之婴儿，第一天血红素（Hb）浓度为 12 g/dL，平均红血球体积（MCV）为 110 fL，则下列判讀何者为真？", "answer_idx": "C", "answer": "正红血球性贫血（normocytic anemia）", "options": {"A": "完全正常", "B": "小红血球性贫血（microcytic anemia）", "C": "正红血球性贫血（normocytic anemia）", "D": "大红血球性贫血（macrocytic anemia）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者最有​​可能引起血压下降？", "answer_idx": "C", "answer": "增加小动脉一氧化氮（NO）的量", "options": {"A": "活化小动脉血管平滑肌β1 肾上腺素型受器（β1 adrenergic receptors）", "B": "开启小动脉血管平滑肌细胞上钙离子通道（calcium channel）", "C": "增加小动脉一氧化氮（NO）的量", "D": "活化血管张力素转换酶（angiotensin-converting enzyme）"}}
{"meta_info": "taiwanese_test_Q", "question": "在成年男性，下列何种病毒性疾病最易侵犯睪丸？", "answer_idx": "C", "answer": "腮腺炎（mumps）", "options": {"A": "麻疹（measles）", "B": "德国麻疹（rubella）", "C": "腮腺炎（mumps）", "D": "疱疹（herpes）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关Toxic shock syndrome的叙述，下列何者错误？", "answer_idx": "D", "answer": "主要致病机转为Pseudomonas 制造的exfoliative toxin所引起", "options": {"A": "临床上表现包括⼤⾯积⽪肤红肿疼痛或是脓疱、以及⽪肤广泛性脱屑现象", "B": "初期会出现⽪肤疼痛现象，⼤部分是因为术后伤⼝感染或是腹腔感染引起", "C": "病患会出现发烧、喉咙痛、肌⾁酸痛、呕吐或是腹泻，严重时会造成低⾎压以及多重器官衰竭", "D": "主要致病机转为Pseudomonas 制造的exfoliative toxin所引起"}}
{"meta_info": "taiwanese_test_Q", "question": "在静脉注射一个大剂量的短效胰岛素制剂造成低血糖时，下列何种状况最不会造成血糖回升延迟的现象？", "answer_idx": "D", "answer": "副甲状腺素分泌不足", "options": {"A": "肾上腺髓质发育不全", "B": "升血糖素（glucagon）分泌缺乏", "C": "甲状腺功能低下", "D": "副甲状腺素分泌不足"}}
{"meta_info": "taiwanese_test_Q", "question": "30 岁男性，數年來有反覆发作之全身银灰色鱗屑性红色斑块，3 个月前这些病灶集中在指（趾）尖及指（趾）甲周围，且合并脊椎及手指末端关节炎，又HLA -B27(+)。下列何者为首选口服治療药物？", "answer_idx": "B", "answer": "methotrexate", "options": {"A": "retinoids", "B": "methotrexate", "C": "cyclosporine", "D": "glucocorticoids"}}
{"meta_info": "taiwanese_test_Q", "question": "35.妇科手术后，若有 血症（septicemia）引起alveolar-capillary membrane的微血管侧受损，使肺部微血管通透 性增加，而造成肺部的并发症，称为：\n", "answer_idx": "D", "answer": "Acute respiratory distress syndrome", "options": {"A": "Pulmonary edema", "B": "Pulmonary hypertension", "C": "Respiratory permeability defect", "D": "Acute respiratory distress syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种周边视网膜变性与视网膜剥離关系最密切？", "answer_idx": "B", "answer": "格子狀变性（lattice degeneration）", "options": {"A": "囊狀视网膜变性（cystoid degeneration）", "B": "格子狀变性（lattice degeneration）", "C": "萎缩性视网膜裂孔（atrophic retinal hole）", "D": "卵石狀视网膜变性（paving stone degeneration）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种疾病不可使用 GnRH（gonadotropin-releasing hormone）agonist 治療？", "answer_idx": "D", "answer": "肢端肥大症（acromegaly）", "options": {"A": "无月经（amenorrhea）", "B": "前列腺癌症（prostate cancer）", "C": "乳癌（breast cancer）", "D": "肢端肥大症（acromegaly）"}}
{"meta_info": "taiwanese_test_Q", "question": "使用下列那一种麻醉剂时，最需要再合并给予肌肉松弛剂？", "answer_idx": "D", "answer": "Nitrous oxide", "options": {"A": "Halothane", "B": "Benzodiazepines", "C": "Isoflurane", "D": "Nitrous oxide"}}
{"meta_info": "taiwanese_test_Q", "question": "7 岁小男生因下肢及臀部出现红色点狀物（如附图），其血小板數目正常，同时有膝盖关节痛与阵发性腹痛之情形，尿液检查发现其同时有血尿的情形，请问最有可能之诊断为何？", "answer_idx": "A", "answer": "Henoch-Schönlein purpura", "options": {"A": "Henoch-Schönlein purpura", "B": "Ig A nephropathy", "C": "scarlet fever", "D": "juvenile rheumatoid arthritis"}}
{"meta_info": "taiwanese_test_Q", "question": "⿐咽癌的⾎液测试中，下列何者⽬前被认为准确度最好？", "answer_idx": "D", "answer": "Serum/Plasma free EBV DNA copies", "options": {"A": "EBV anti-VCA IgG", "B": "EBV anti-VCA IgA", "C": "EBV anti-EA IgA", "D": "Serum/Plasma free EBV DNA copies"}}
{"meta_info": "taiwanese_test_Q", "question": "有关头部神经或血管路径的叙述，下列何者正确？", "answer_idx": "B", "answer": "颜面神经（facial nerve）穿过茎乳孔（stylomastoid foramen）", "options": {"A": "眼动脉（ophthalmic artery）穿过眶上裂（superior orbital fissure）", "B": "颜面神经（facial nerve）穿过茎乳孔（stylomastoid foramen）", "C": "三叉神经上颌支（maxillary division of trigeminal nerve）穿过卵圆孔（foramen ovale）", "D": "前庭耳蜗神经（vestibulocochlear nerve）穿过颈静脉孔（jugular foramen）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于Noonan syndrome之叙述，下列何者错误？", "answer_idx": "D", "answer": "主动脉狭窄（aortic stenosis）为其最常见的心脏病变", "options": {"A": "身材矮小", "B": "蹼状颈（webbed neck）", "C": "正常染色体核型（normal karyotype）", "D": "主动脉狭窄（aortic stenosis）为其最常见的心脏病变"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 63 岁长期抽烟的男性喉癌病人（鱗狀上皮细胞）；手术一年后发现肺部广泛转移。于 cisplatin/5-FU 化学治療结束后第二天出院。但隔天其太太发现病人意識不清，于是送病人至急诊。呼吸及血压均正常，但心跳 112/分。何者是最适当之处置？", "answer_idx": "B", "answer": "检验血中 calcium", "options": {"A": "血液细菌培养，使用选择性抗綠脓杆菌之抗生素", "B": "检验血中 calcium", "C": "检验血液中NH3", "D": "脑部核磁共振"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 E. coli 修补 O6-methylguanine 的叙述，何者正确？", "answer_idx": "B", "answer": "利用甲基转移酶将甲基送到甲基转移酶本体", "options": {"A": "利用甲基转移酶（methyltransferase）将甲基送到四氢葉酸（tetrahydrofolate）", "B": "利用甲基转移酶将甲基送到甲基转移酶本体", "C": "利用 DNA 去甲基酶（DNA demethylase）送到四氢葉酸", "D": "利用 DNA 去甲基酶送到水中"}}
{"meta_info": "taiwanese_test_Q", "question": "一中年女性主诉手指会麻，下列那一部位的感觉缺失可使医师确认受伤的神经是尺神经（ulnar nerve）？", "answer_idx": "C", "answer": "小指的掌面（palmar surface of the 5th finger）", "options": {"A": "大拇指的掌面（palmar surface of thumb）", "B": "前臂掌面的尺侧（ulnar side of the volar surface of forearm）", "C": "小指的掌面（palmar surface of the 5th finger）", "D": "手背近虎口处（dorsum of hand between the thumb and the 2nd finger）"}}
{"meta_info": "taiwanese_test_Q", "question": "一名40多岁男性右眼红痛，经诊断为急性前部葡萄膜炎（acute anterior uveitis），并伴有多年下背痛病史，则下列何者错误？", "answer_idx": "C", "answer": "常双眼同时发作", "options": {"A": "好发于男性", "B": "X光可能发现竹状脊椎（bamboo spine）", "C": "常双眼同时发作", "D": "与HLA-B27相关"}}
{"meta_info": "taiwanese_test_Q", "question": "21 岁大学生准备前往某开发中国家旅游，该地是 A 型肝炎疫区，他没有免疫力，希望不要得到感染，下列叙述何者错误？", "answer_idx": "B", "answer": "A 型肝炎疫苗与免疫球蛋白不能同时施打", "options": {"A": "应接种 A 型肝炎疫苗或施打免疫球蛋白（immune serum globulin, ISG）", "B": "A 型肝炎疫苗与免疫球蛋白不能同时施打", "C": "如果 2 周内即将前往，应施打免疫球蛋白（ISG）较具保护力", "D": "如果计划多次到开发中国家旅游，施打 A 型肝炎疫苗较合成本效益"}}
{"meta_info": "taiwanese_test_Q", "question": "78.曼森裂头绦虫（Spirometra mansonoides）那些发育时期的虫体可以感染人？ ①六钩幼虫卵", "answer_idx": "D", "answer": "③④", "options": {"A": "①②", "B": "①③", "C": "②④", "D": "③④"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者会因胃扩张（Distension）之刺激而分泌？", "answer_idx": "C", "answer": "胃泌素（Gastrin）", "options": {"A": "胆囊收缩素（Cholecystokinin）", "B": "胃抑素（Gastric inhibitory peptide）", "C": "胃泌素（Gastrin）", "D": "体抑素（Somatostatin）"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，依Parkland formula，下列叙述何者正确？", "answer_idx": "C", "answer": "输液前8小时给crystalloid溶液2160 mL", "options": {"A": "输液前8小时给crystalloid溶液4320 mL", "B": "输液前12小时给crystalloid溶液4320 mL", "C": "输液前8小时给crystalloid溶液2160 mL", "D": "输液前12小时给crystalloid溶液2160 mL"}}
{"meta_info": "taiwanese_test_Q", "question": "腋神经（axillary nerve）受损时，会造成下列那一块旋转 （rotator cuff）肌肉无力？", "answer_idx": "D", "answer": "小圆肌（teres minor）", "options": {"A": "棘上肌（supraspinatus muscle）", "B": "棘下肌（infraspinatus muscle）", "C": "肩胛下肌（subscapularis muscle）", "D": "小圆肌（teres minor）"}}
{"meta_info": "taiwanese_test_Q", "question": "与大部分血管新生（angiogenesis）关系最密切的生长因子（growth factor）为何？", "answer_idx": "C", "answer": "VEGF（vascular endothelial growth factor）", "options": {"A": "PDGF（platelet-derived growth factor）", "B": "IGF-1（insulin-like growth factor-1）", "C": "VEGF（vascular endothelial growth factor）", "D": "TGF-β（transforming growth factor-β）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者与先天性白内障无关？", "answer_idx": "D", "answer": "丁气体；12", "options": {"A": "甲气体；2.4", "B": "乙气体；0.42", "C": "丙气体；1.9", "D": "丁气体；12"}}
{"meta_info": "taiwanese_test_Q", "question": "一名6 岁女孩因为手臂骨折而住院，身体诊查发现乳房已有发育，皮肤呈现咖啡牛奶斑（café-au-lait spots），甲狀腺机能亦有亢进现象，影像检查显示骨骼纤维性发育不良（ fibrous dysplasia），骨龄判讀为9 岁，最可能的诊断是：", "answer_idx": "B", "answer": "McCune-Albright syndrome", "options": {"A": "Fanconi syndrome", "B": "McCune-Albright syndrome", "C": "neurofibromatosis", "D": "Peutz-Jeghers syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是Bishop score的评分项目之一？", "answer_idx": "A", "answer": "生产次数（parity）", "options": {"A": "生产次数（parity）", "B": "子宫颈扩张程度（dilatation）", "C": "子宫颈软化程度（effacement）", "D": "胎头于骨盆的位置（station）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关骨髓（bone marrow）的叙述，何者正确？", "answer_idx": "A", "answer": "具有窦状系统（sinusoidal system），是一个封闭型的循环系统，新生的血球细胞必须穿透内皮（endothelium），才能进入循环", "options": {"A": "具有窦状系统（sinusoidal system），是一个封闭型的循环系统，新生的血球细胞必须穿透内皮（endothelium），才能进入循环", "B": "黄骨髓（yellow bone marrow）是活化的骨髓，负责制造各种血球细胞", "C": "在长骨（long bone）内的非造血空间，会被纤维母细胞（fibroblast）占据", "D": "巨核细胞（megakaryocyte）释放的血小板（platelet），必须藉由网状细胞（reticular cell）的协助，才能进入窦状系统（sinusoidal system）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位50 岁女性，发现右侧甲狀腺肿大1 个月，于门诊理学检查及超音波检查发现右侧甲狀腺有1 个3 公分肿瘤，无颈淋巴肿大，细针抽吸细胞学检查为乳突性甲狀腺癌，该病人接受甲狀腺全切除，手术后发生呼吸困难。关于病人发生呼吸困难之问题，下列叙述何者错误？", "answer_idx": "C", "answer": "手术后 2 小时发生呼吸困难，可能为副甲狀腺受损，导致低血钙进而全身麻木，呼吸不适", "options": {"A": "手术后一拔管立刻发生呼吸困难，可能为双侧喉返神经受损造成声带麻痹，导致呼吸道阻塞", "B": "手术后当天晚上发生呼吸困难，可能为颈部血肿压迫气管，造成气管软化及呼吸道阻塞", "C": "手术后 2 小时发生呼吸困难，可能为副甲狀腺受损，导致低血钙进而全身麻木，呼吸不适", "D": "可能因为伤口疼痛精神紧张造成过度换气症候"}}
{"meta_info": "taiwanese_test_Q", "question": "当疑有 submandibular duct 的结石时，下列何者为最恰当的影像诊断方式？", "answer_idx": "B", "answer": "dental occlusal view", "options": {"A": "skull basal view", "B": "dental occlusal view", "C": "skull lateral view", "D": "Caldwell view"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那种细菌以家禽、家畜为其贮存宿主（reservoir）？", "answer_idx": "A", "answer": "空肠弯曲菌（Campylobacter jejuni）", "options": {"A": "空肠弯曲菌（Campylobacter jejuni）", "B": "霍亂弧菌（Vibrio cholerae）", "C": "百日咳杆菌（Bordetella pertussis）", "D": "脑膜炎奈瑟氏菌（Neisseria meningitidis）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关low-molecular-weight heparin（LMWH）特点的叙述，何者错误？", "answer_idx": "B", "answer": "一般可以用凝血时间的检 做监测，维持约正常值的两倍左右", "options": {"A": "LMWH的使用剂量一般可依体重决定就好", "B": "一般可以用凝血时间的检 做监测，维持约正常值的两倍左右", "C": "必要时可以监测Factor Xa activity看LMWH的药量是否恰当", "D": "LMWH主要由肾脏代谢排出"}}
{"meta_info": "taiwanese_test_Q", "question": "一个2 岁8 个月大的女孩，来诊发现肝脾极度肿大，分别在肋骨下3 公分及8 公分摸到，其血色素（Hb）为6.5 g/dL，血小板（platelets）数目低为88,000 /mm3，检查无缺铁，血色素电泳分析（hemoglobin electrophoresis）Hb A 为93.0%，Hb A2 为5.1%，Hb F 为1.9%，骨髓检查无恶性细胞浸润，但有贮积细胞，周边血白血球测定之β-glucosidase 酵素活性甚低，下列何者为最可能诊断？", "answer_idx": "D", "answer": "高雪氏病（Gaucher disease）", "options": {"A": "重型乙型海洋性贫血（β-thalassemia）", "B": "重型甲型海洋性贫血（α-thalassemia）", "C": "重度再生不良性贫血（Severe aplastic anemia）", "D": "高雪氏病（Gaucher disease）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关肝细胞癌（hepatocellular carcinoma，即HCC）的临床评估及诊治，以下叙述何者错误？", "answer_idx": "D", "answer": "正子摄影（FDG-PET）已被证实是诊断HCC最敏感的影像检查方式", "options": {"A": "理学检查时，应注意是否有jaundice、ascites、spider angioma、palmar erythema等可能指出有chronic liver disease或liver cirrhosis的signs", "B": "血清AFP是常用的tumor marker；但并非所有的HCC患者，血清AFP皆会升高", "C": "ultrasound，triphasic CT及gadolinium-enhanced MRI皆是可应用来协助诊断HCC的影像检查方式", "D": "正子摄影（FDG-PET）已被证实是诊断HCC最敏感的影像检查方式"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列那项是该婴儿最可能之 blood gas 检查结果？", "answer_idx": "A", "answer": "metabolic alkalosis and respiratory acidosis", "options": {"A": "metabolic alkalosis and respiratory acidosis", "B": "metabolic acidosis and respiratory alkalosis", "C": "metabolic acidosis and respiratory acidosis", "D": "metabolic alkalosis and respiratory alkalosis"}}
{"meta_info": "taiwanese_test_Q", "question": "21 急诊常有受伤需缝合的伤口，关于拆线时间，下列叙述何者正确？ ①头皮 6～8 天 ②眼皮 10～14 天 ③背部 12～14 天 ④四肢 12～14 天\n", "answer_idx": "D", "answer": "①③④", "options": {"A": "①②④", "B": "①②③", "C": "②③④", "D": "①③④"}}
{"meta_info": "taiwanese_test_Q", "question": "29 岁女性经门诊医师诊断甲狀腺单边有一结节，有关诊断之叙述，下列何者错误？", "answer_idx": "D", "answer": "做 CT 及 MRI 检查", "options": {"A": "应有发生时间及症狀、家族史的资料", "B": "做超音波及 FNA（小针切片细胞学检查）", "C": "做 TSH 检查", "D": "做 CT 及 MRI 检查"}}
{"meta_info": "taiwanese_test_Q", "question": "心脏超音波检查是下列何种疾病的最佳诊断利器？", "answer_idx": "B", "answer": "心包囊积水", "options": {"A": "急性心肌梗塞", "B": "心包囊积水", "C": "心房中隔缺损", "D": "心室中隔缺损"}}
{"meta_info": "taiwanese_test_Q", "question": "54 岁女性失足从 3 公尺高度跌下，严重呼吸困难及右胸壁血肿。被送到急诊身体检查，意識昏昏欲睡，血压测不到，发绀、心动过速与右侧呼吸声减少。你是值班医生，你的及时处理为何？", "answer_idx": "C", "answer": "插胸管", "options": {"A": "胸部 X 光及电脑断层扫描", "B": "插 CVC 用全速静脉输液", "C": "插胸管", "D": "给予 inotropics"}}
{"meta_info": "taiwanese_test_Q", "question": "95 国民健康局想进行世代研究（cohort study），探讨运动是否可减少发生冠心症的危险。这个世代必 须是建立在：\n", "answer_idx": "B", "answer": "没有罹患冠心症的人", "options": {"A": "已经罹患了冠心症的人", "B": "没有罹患冠心症的人", "C": "已经有运动习惯的人", "D": "没有运动习惯的人"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关肺脏移植的叙述，何者错误？", "answer_idx": "D", "answer": "肺功能检查若是有 FVC 數据显著下滑的情形，可作为诊断排斥作用发生之 criteria", "options": {"A": "常見之 surgical indicatoins 为 COPD、pulmonary fibrosis 及 pneumoconiosis 等疾病所造成之肺部永久性伤害", "B": "prednisolone、cyclosporine 与 azathioprine 为常并用之免疫抑制药物", "C": "急性排斥发生时，病患常出现 dyspnea、leukocytosis 及 mild fever 等症狀", "D": "肺功能检查若是有 FVC 數据显著下滑的情形，可作为诊断排斥作用发生之 criteria"}}
{"meta_info": "taiwanese_test_Q", "question": "你的门诊诊间进來一位初诊病人，23 岁的阿凯是研究所一年级的学生。他的主诉为昨晚开始发烧、咳嗽、流鼻水，你问诊及做完身体检查，诊断他的问题为上呼吸道感染。正要开药时，他要求你为他开一张诊断证明书，因为学校后天要期末考，他担心感冒影响考试的准备，希望你在诊断证明书上注明他需要在家休息 3 天。下列何种作法最为恰当？", "answer_idx": "C", "answer": "经說明后，仅开给他当天之就医证明", "options": {"A": "打电话给他的父或母亲", "B": "问他是否得到老师的许可", "C": "经說明后，仅开给他当天之就医证明", "D": "转介给另一位门诊医师处理"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于美国精神医学会「精神疾患诊断及统计手册第四版」之焦虑性疾患（anxiety disorders）？", "answer_idx": "C", "answer": "适应障碍合并焦虑", "options": {"A": "创伤后压力疾患", "B": "恐慌症", "C": "适应障碍合并焦虑", "D": "社交畏惧症"}}
{"meta_info": "taiwanese_test_Q", "question": "有关病人在不同压力下所需的营养需求叙述，下列何者错误？", "answer_idx": "B", "answer": "烧伤病人每天所需的蛋白质摄取量为 2.0 g/kg/day", "options": {"A": "mild stress 下，病人所需的热量为 25～30 kcal/kg/day", "B": "烧伤病人每天所需的蛋白质摄取量为 2.0 g/kg/day", "C": "烧伤病人每天的热量摄取为 35～40 kcal/kg", "D": "moderate malnutrition 的病人，非蛋白质的热量摄取与氮素比为 150：1"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，关于乳癌的改良式根治性乳房切除手术（modified radical mastectomy）治疗，下列何者错误？", "answer_idx": "D", "answer": "前哨淋巴结切片（sentinel lymph node biopsy）无法避免腋下淋巴结清除手术的合并症，通常用于缩短手术时间", "options": {"A": "改良式根治性乳房切除包含清除腋下的淋巴结，通常清除level 1 与 level 2的范围", "B": "腋下淋巴结清除的解剖位置，上界为腋静脉（axillary vein），内界为胸壁，外界为背阔肌", "C": "腋下淋巴清除手术的合并症包括疼痛、减少关节活动范围、淋巴水肿等", "D": "前哨淋巴结切片（sentinel lymph node biopsy）无法避免腋下淋巴结清除手术的合并症，通常用于缩短手术时间"}}
{"meta_info": "taiwanese_test_Q", "question": "一糖尿病中年妇女，突然头部剧痛、左眼睑下垂、复视、瞳孔放大，来急诊求治，神智清楚，脑部电脑断层如附图，下列处置何者最恰当？", "answer_idx": "A", "answer": "住院，马上安排脑部血管摄影", "options": {"A": "住院，马上安排脑部血管摄影", "B": "抽血密切注意血糖的变化", "C": "住院，检 是否有重症肌无力（myasthenia gravis）", "D": "安排脑部核磁共振，再决定是否要住院"}}
{"meta_info": "taiwanese_test_Q", "question": "张太太的女儿现年 10 岁，自上学期中就开始经常口渴，有消瘦现象。有一天昏倒送医之后，诊断得到第一型糖尿病，胰脏之β（beta）细胞破坏严重，缺乏胰岛素，血糖过高。这个疾病的成因为何？", "answer_idx": "C", "answer": "产生自体免疫反应 T 细胞，破坏胰脏β（beta）细胞所致的自体免疫疾病", "options": {"A": "感染症破坏胰脏腺体，引起胰脏功能过高", "B": "摄取糖份过多，引起胰脏功能衰竭", "C": "产生自体免疫反应 T 细胞，破坏胰脏β（beta）细胞所致的自体免疫疾病", "D": "电解质代谢失常，引起胰脏功能衰竭"}}
{"meta_info": "taiwanese_test_Q", "question": "蛋白质最常经下列何种转译后修饰（post-translational modification），再送到溶酶体（lysosome）？", "answer_idx": "A", "answer": "糖基化（glycosylation）", "options": {"A": "糖基化（glycosylation）", "B": "磷酸化 （phosphorylation）", "C": "苏素化（sumoylation）", "D": "乙醯化（acetylation）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 28 岁 AIDS 患者，主诉为大腿内侧突然出现數颗 2-4 mm 的丘疹，其中心具有 umbilication 的现象。其皮肤切片如图示，最可能的诊断是：", "answer_idx": "C", "answer": "传染性软疣（molluscum contagiosum）", "options": {"A": "寻常疣（verruca vulgaris）", "B": "扁平疣（verruca plana）", "C": "传染性软疣（molluscum contagiosum）", "D": "尖端湿疣（condyloma acuminata）"}}
{"meta_info": "taiwanese_test_Q", "question": "1 一位五十岁病患术后小便减少，其小便的钠離子低于 20 mOs/L，小便和血浆的 creatinine 比值大于 40 ，则小便减少的原因是何种的问题？\n", "answer_idx": "A", "answer": "Prerenal", "options": {"A": "Prerenal", "B": "Renal", "C": "Postrenal", "D": "不一定"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，检查结果最可能合并的畸形为下列何者？", "answer_idx": "D", "answer": "Neural tube defect", "options": {"A": "Down syndrome", "B": "Trisomy 13", "C": "Trisomy 18", "D": "Neural tube defect"}}
{"meta_info": "taiwanese_test_Q", "question": "患者长期服用抗癫痫药物时，下列何种情况最不需要做血中药物浓度监测？", "answer_idx": "D", "answer": "合并使用无交互作用之药物", "options": {"A": "怀疑病人服药不确实", "B": "癫痫发作呈现重积狀态", "C": "病人本身有肝肾疾病", "D": "合并使用无交互作用之药物"}}
{"meta_info": "taiwanese_test_Q", "question": "75.⼀位46岁男性，胸部遭攻击造成⾎胸合并休克，胸管引流出700 ml⾎液后，⾎压为118/82 mmHg，⼼跳90 下/分，几分 后⾎压下降为84 /62 mmHg，⼼跳126下/分，下列处置何者最优先？\n", "answer_idx": "D", "answer": "重新评估病⼈", "options": {"A": "立即气管插管", "B": "紧急开胸", "C": "立即输⾎", "D": "重新评估病⼈"}}
{"meta_info": "taiwanese_test_Q", "question": "在光学显微镜下观察下列何种型式的血管，其内弹性板（internal elastic lamina）最明显且呈波浪狀？", "answer_idx": "B", "answer": "肌性动脉（muscular artery）", "options": {"A": "弹性动脉（elastic artery）", "B": "肌性动脉（muscular artery）", "C": "微血管（capillary）", "D": "小静脉（venule）"}}
{"meta_info": "taiwanese_test_Q", "question": "一鼻咽癌病患抱怨双侧手臂与大腿疼痛，下列何者是最适当的检查工具？", "answer_idx": "D", "answer": "同位素骨骼扫描", "options": {"A": "超音波", "B": "电脑断层扫描", "C": "核磁共振造影", "D": "同位素骨骼扫描"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 82 岁的骨癌末期并肺部移转的病人在安寧病房中，并已签署 DNR，主诉呼吸困难，下列何者是最不适宜的处置？", "answer_idx": "A", "answer": "安排胸部电脑断层摄影检查", "options": {"A": "安排胸部电脑断层摄影检查", "B": "给予 lorazepam", "C": "给予氧气治療", "D": "给予 codeine"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关使用心脏节律器（pacemaker）的病人，进行麻醉前评估与准备之叙述，何者错误？", "answer_idx": "B", "answer": "置放磁铁于麻醉中的病人之胸前pacemaker上，即可完全避免术中电烧的干扰与危害", "options": {"A": "进行非心脏常规手术前，应重新检查心脏节律器的功能", "B": "置放磁铁于麻醉中的病人之胸前pacemaker上，即可完全避免术中电烧的干扰与危害", "C": "术中应关闭心电图监视器上filter的功能，以免侦测不到节律放电波形（pacing spikes）", "D": "术中除使用心电图监视器外，应配合使用脉动式血氧饱和监测仪（pulse oximetry）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关脑部伪肿瘤（pseudotumor cerebri）的叙述，何者错误？", "answer_idx": "A", "answer": "常伴随脑室变大", "options": {"A": "常伴随脑室变大", "B": "脑压增高，作腰椎穿刺压力往往超过200 mmH2O", "C": "会有视乳突水肿（papilledema）", "D": "内科治疗以类固醇及利尿剂为主"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于功能性肠胃道疾患（functional gastrointestinal disorders）叙述，何者错误？", "answer_idx": "C", "answer": "在与功能性肠胃道疾患共病的焦虑疾患中，创伤后压力症候群（posttraumatic stress disorder）是最常出现的", "options": {"A": "具有肠胃道收缩异常以及功能性食道症状的病人经常合并有精神疾病", "B": "焦虑症为功能性肠胃道疾患常见的精神科共病", "C": "在与功能性肠胃道疾患共病的焦虑疾患中，创伤后压力症候群（posttraumatic stress disorder）是最常出现的", "D": "恐慌发作的症状亦包含了肠胃道症状"}}
{"meta_info": "taiwanese_test_Q", "question": "病理诊断狂⽝病（Rabies）的最主要依据是观察到：", "answer_idx": "C", "answer": "Negri body", "options": {"A": "Lewy body", "B": "Kuru plaque", "C": "Negri body", "D": "Stress granules"}}
{"meta_info": "taiwanese_test_Q", "question": "20 岁孕妇，G1P0，妊娠 31 周，主诉：头痛，视力模糊有一天之久。血压 200/140 mmHg，下肢水肿（+++），蛋白尿（++++），深部肌腱反射（+++），GOT 上升，血小板下降，有溶血现象。请问最可能的诊断为何？", "answer_idx": "D", "answer": "HELLP 症候群", "options": {"A": "肝昏迷", "B": "肾衰竭", "C": "子痫症", "D": "HELLP 症候群"}}
{"meta_info": "taiwanese_test_Q", "question": "结膜的杯狀细胞（goblet cells），可以分泌淚液的那一种成分？", "answer_idx": "C", "answer": "黏液（mucin）", "options": {"A": "脂肪（lipid）", "B": "水（aqueous）", "C": "黏液（mucin）", "D": "电解质（electrolytes）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位病人因为单纯性阑尾炎（simple appendicitis）接受阑尾切除术，术中并无肠内容物外漏，属于下列何种手术伤口分类？", "answer_idx": "B", "answer": "clean-contaminated", "options": {"A": "clean", "B": "clean-contaminated", "C": "contaminated", "D": "dirty and infected"}}
{"meta_info": "taiwanese_test_Q", "question": "有关于hiatal hernia之描述，下列何者正确？", "answer_idx": "A", "answer": "sliding hiatal hernia（type I）常伴随胃酸逆流之症状", "options": {"A": "sliding hiatal hernia（type I）常伴随胃酸逆流之症状", "B": "paraesophageal hiatal hernia指的是腹部的大肠、小肠等herniation to the chest", "C": "paraesophageal hiatal hernia与sliding hiatal hernia是不同的两种情形，不会同时出现", "D": "绝大部分的sliding hiatal hernia须接受手术治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "张小弟目前是小学六年级学生，大约 3 年前开始，他会不自主的皱眉头、眼睛亂飘、扮鬼脸以及发出声音等动作，因此常常被老师纠正。最近更加上时常口出秽语，自己无法控制。除此之外，身体理学以及神经学检查正常，也没有慢性疾病。下列臨床诊断何者最有可能？", "answer_idx": "C", "answer": "妥瑞氏症（Tourette's disorder）", "options": {"A": "过动儿（hyperkinetic child）", "B": "全肌张力不全症（generalized dystonia）", "C": "妥瑞氏症（Tourette's disorder）", "D": "亨丁顿氏舞蹈症（Huntington's chorea）"}}
{"meta_info": "taiwanese_test_Q", "question": "造成摄护腺手术中并发 TURP 症候群之可能原因，下列何者错误？", "answer_idx": "D", "answer": "失血过多", "options": {"A": "循环体液过多", "B": "水中毒", "C": "冲洗液内溶物毒性", "D": "失血过多"}}
{"meta_info": "taiwanese_test_Q", "question": "电脑断层检查发现广泛头骨增厚（diffuse skull thickening），下列何者最不会发生？", "answer_idx": "C", "answer": "水脑症（hydrocephalus）", "options": {"A": "肢端肥大症（acromegaly）", "B": "地中海型贫血（thalassemia）", "C": "水脑症（hydrocephalus）", "D": "小脑症（microcephaly）"}}
{"meta_info": "taiwanese_test_Q", "question": "免疫系统能够侦查出肿瘤细胞的存在，并且尽力消灭它。免疫系统与肿瘤互动的阶段依先后次序为何？", "answer_idx": "D", "answer": "消灭期→平衡期→逃避期", "options": {"A": "逃避期（escape phase）→平衡期（equilibrium phase）→肿瘤之免疫调节期（immunoediting）", "B": "逃避期→消灭期（elimination phase）→平衡期", "C": "平衡期→逃避期→消灭期", "D": "消灭期→平衡期→逃避期"}}
{"meta_info": "taiwanese_test_Q", "question": "与医療资源耗用和配置较有关系的健康指标为何？", "answer_idx": "A", "answer": "疾病盛行率", "options": {"A": "疾病盛行率", "B": "疾病发生率", "C": "有效接触率", "D": "平均余命"}}
{"meta_info": "taiwanese_test_Q", "question": "当一个病人被诊断出有右侧的输尿管结石合并右肾积水，同时又有左侧肾结石但无左肾积水；你觉得下列叙述中何者是最适当的治療步骤？", "answer_idx": "C", "answer": "先以体外震波碎石术或输尿管镜碎石术來治療右侧的输尿管结石，等结石廓清、肾积水消除后再处理左肾结石", "options": {"A": "先将左肾结石用体外震波碎石术來治療，等结石廓清后再处理右侧输尿管结石", "B": "同时为兩侧的结石施行体外震波碎石术治療", "C": "先以体外震波碎石术或输尿管镜碎石术來治療右侧的输尿管结石，等结石廓清、肾积水消除后再处理左肾结石", "D": "先将右侧输尿管结石推回肾脏，再施予兩侧的体外震波碎石术治療"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 55 岁男性糖尿病病患发生水肿及蛋白尿超过每日 6 克，该病患合并增生性视网膜病变，下列何种处置不需立即执行？", "answer_idx": "B", "answer": "肾脏组织切片", "options": {"A": "利尿剂", "B": "肾脏组织切片", "C": "限盐饮食", "D": "血管张力素接受体阻断剂（angiotensin receptor blocker）"}}
{"meta_info": "taiwanese_test_Q", "question": "Sulfonylureas类治疗糖尿病药物的主要作用机转为何？", "answer_idx": "D", "answer": "促进胰岛素的分泌", "options": {"A": "抑制胰岛素被肝脏代谢分解", "B": "促进胰岛素的生合成及敏感性", "C": "增加细胞的胰岛素受体数目", "D": "促进胰岛素的分泌"}}
{"meta_info": "taiwanese_test_Q", "question": "儿童严重型再生不良性贫血的治疗选项中，下列何种治疗方式之治愈率较高？", "answer_idx": "D", "answer": "血液干细胞移植", "options": {"A": "放射治疗", "B": "化疗", "C": "输血", "D": "血液干细胞移植"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种血浆蛋白不是以肝脏为主要的制造场所？", "answer_idx": "C", "answer": "γ 球蛋白（γ-globulin）", "options": {"A": "白蛋白（albumin）", "B": "β 球蛋白（β-globulin）", "C": "γ 球蛋白（γ-globulin）", "D": "纤维蛋白原（fibrinogen）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位脑中风（stroke）患者，其身体检查发现有一侧肢体的躯体感觉（somatosensory）功能缺损，而肌力（muscle power）正常。脑中风病灶最有可能位于：", "answer_idx": "C", "answer": "视丘（thalamus）", "options": {"A": "大脑额葉（frontal lobe）", "B": "大脑颞葉（temporal lobe）", "C": "视丘（thalamus）", "D": "大脑枕葉（occipital lobe）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关急性呼吸窘迫症（acute respiratory distress syndrome；ARDS）病人的临床处理原则的叙述，下列何者错误？", "answer_idx": "A", "answer": "在 ARDS 病人使用较高的呼吸末期正压（positive end-expiratory pressure，PEEP）提升血氧的临床策略，目前已经确认为最适当压力与方法，可有效改善 ARDS 病人死亡率", "options": {"A": "在 ARDS 病人使用较高的呼吸末期正压（positive end-expiratory pressure，PEEP）提升血氧的临床策略，目前已经确认为最适当压力与方法，可有效改善 ARDS 病人死亡率", "B": "趴姿（prone position）可以有效改善 ARDS 病人血氧，但没有影响死亡率", "C": "趴姿（prone position）目前建议应用在持续血氧过低 ARDS 病人", "D": "使用吸入性一氧化氮（Inhaled NO）目前可以应用在持续血氧过低 ARDS 病人，但对于死亡率没有影响 9 下列关于中心视网膜动脉阻塞（central retinal artery occlusion）之叙述，何者错误？"}}
{"meta_info": "taiwanese_test_Q", "question": "有关检查脊髓受伤病患之叙述，下列何者错误?", "answer_idx": "B", "answer": "患者仅下肢麻痹，上肢肌力正常，可完全排除颈椎受伤", "options": {"A": "患者若上、下肢完全麻痹，但脑神经系统正常，通常表示颈椎受伤", "B": "患者仅下肢麻痹，上肢肌力正常，可完全排除颈椎受伤", "C": "患者于外伤后 48～72 小时内还能保留肢体运动或感觉，通常表示有较佳之预后", "D": "对任何脊椎受伤之患者，首要考量为不可任意移动颈部"}}
{"meta_info": "taiwanese_test_Q", "question": "使用下类那一种治疗巴金森氏症药物时，尿液及唾液经常会呈现褐色的状况？", "answer_idx": "B", "answer": "levodopa", "options": {"A": "selegiline", "B": "levodopa", "C": "amantadine", "D": "bromocriptine"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 15 岁女童主诉过去几个月有间歇性的发烧、手腕及踝关节痛。尿液检查发现有血尿（hematuria）、蛋白尿（proteinuria）及脓尿（pyuria）。下列何种检验对诊断最有帮助？", "answer_idx": "A", "answer": "双股 DNA（dsDNA）抗体", "options": {"A": "双股 DNA（dsDNA）抗体", "B": "喉头 A 群 beta 溶血性链球菌（group A beta-hemolytic streptococcus）培养", "C": "小便培养", "D": "红血球沈淀速率（erythrocyte sedimentation rate）"}}
{"meta_info": "taiwanese_test_Q", "question": "第二颈髓完全损伤的患者，需要下列辅具，何者不包括在内？", "answer_idx": "C", "answer": "握柄加粗汤匙", "options": {"A": "口控电动輪椅", "B": "声控电脑", "C": "握柄加粗汤匙", "D": "呼吸器"}}
{"meta_info": "taiwanese_test_Q", "question": "35岁男性，家住山上，在台风之后清扫自家附近水沟，当时注意到有很多死老鼠，一周后因黄疸、茶色尿及发高烧被送到急诊，最可能的致病菌是：", "answer_idx": "A", "answer": "钩端螺旋体（Leptospira species）", "options": {"A": "钩端螺旋体（Leptospira species）", "B": "肠病毒（enterovirus）", "C": "流感病毒（influenza virus）", "D": "登革热病毒（dengue virus）"}}
{"meta_info": "taiwanese_test_Q", "question": "肾脏移植手术一个月之内比较少見的感染为何？", "answer_idx": "A", "answer": "BK virus（polyoma）", "options": {"A": "BK virus（polyoma）", "B": "泌尿道感染", "C": "oral candidiasis", "D": "herpesvirus"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种药物可作为堕胎药？", "answer_idx": "B", "answer": "Dinoprostone", "options": {"A": "Alprostadil", "B": "Dinoprostone", "C": "Epoprostenol", "D": "Iloprost"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，在治疗结束后，病人突然发生单侧下肢肿胀，肤色略为暗红，触压时没有凹陷（non-pitting），无局部发热现象，病人并无凝血功能异常也无栓塞的纪录，则下列诊断及治疗何者较正确？", "answer_idx": "C", "answer": "Trousseau's syndrome，给予抗凝血剂及抗癌药物", "options": {"A": "下肢静脉栓塞，给予抗凝血剂 heparin", "B": "下肢水肿，给予利尿剂", "C": "Trousseau's syndrome，给予抗凝血剂及抗癌药物", "D": "下肢静脉栓塞，给予血栓溶解剂 recombinant tissue plasminogen activator"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种症狀不是由克沙奇 A 型病毒（Coxsackie A virus）所引起的？", "answer_idx": "C", "answer": "胸膜痛（pleurodynia）", "options": {"A": "疹性咽峡炎（herpangina）", "B": "心脏炎（carditis）", "C": "胸膜痛（pleurodynia）", "D": "脑膜炎（meningitis）"}}
{"meta_info": "taiwanese_test_Q", "question": "76.7岁男童因突发性高烧、吞咽困难就医，在对比剂注射后，接受电脑断层扫描检查如图示，箭号所指病灶最可能诊断为何？", "answer_idx": "B", "answer": "咽喉后脓疡", "options": {"A": "扁桃腺炎", "B": "咽喉后脓疡", "C": "咽喉癌", "D": "甲状腺水囊"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种疾病引起的低血钠（hyponatremia）与血液稀释无关？", "answer_idx": "C", "answer": "抗利尿激素不适当分泌症候群（syndrome of inappropriate antidiuretic hormone secretion）", "options": {"A": "肝硬化（liver cirrhosis）", "B": "郁血性心脏衰竭（congestive heart failure）", "C": "抗利尿激素不适当分泌症候群（syndrome of inappropriate antidiuretic hormone secretion）", "D": "肾病症候群（nephrotic syndrome）"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，上述诊断之最佳手术治療方法为：", "answer_idx": "C", "answer": "下视丘刺激术（subthalamic stimulation）", "options": {"A": "苍白球切开术（pallidotomy）或烧灼术", "B": "视丘刺激术（thalamic stimulation）", "C": "下视丘刺激术（subthalamic stimulation）", "D": "大脑皮质刺激术（cortical stimulation）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关Clostridium difficile及其导致之腹泻疾病之叙述，何者错误？", "answer_idx": "D", "answer": "治疗后的复发率（recurrence rate）常低于5%", "options": {"A": "健康新生儿无症状肠道带菌（asymptomatic fecal carriage）并不罕见", "B": "通常为医疗照护相关之感染", "C": "抗微生物制剂的使用是诱发本疾病的主因", "D": "治疗后的复发率（recurrence rate）常低于5%"}}
{"meta_info": "taiwanese_test_Q", "question": "利用视网膜雷射（laser photocoagulation）治療糖尿病视网膜病变的功效，不包括下列何者？", "answer_idx": "A", "answer": "可防止微血管瘤（microaneurysms）之发生", "options": {"A": "可防止微血管瘤（microaneurysms）之发生", "B": "可促使视网膜新生血管（neovascularization）之消退", "C": "可减缓牵引型视网膜剥離（tractional retinal detachment）之惡化", "D": "可减少玻璃体出血（vitreous hemorrhage）之机会"}}
{"meta_info": "taiwanese_test_Q", "question": "21岁男性因上颈部硬块求诊，接受对比剂注射后的电脑断层扫描如图⽰，则最可能诊断为何？", "answer_idx": "A", "answer": "⿐咽癌", "options": {"A": "⿐咽癌", "B": "淋巴管瘤", "C": "上呼吸道感染", "D": "深颈部感染症"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种神经肌肉阻断剂的作用是直接抑制骨骼肌细胞内钙離子自肌浆网释出而使骨骼肌松弛？", "answer_idx": "B", "answer": "Dantrolene", "options": {"A": "Baclofen", "B": "Dantrolene", "C": "Pancuronium", "D": "Atracurium"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种疾病是性联遗传（sex-linked recessive）？", "answer_idx": "C", "answer": "裘馨氏肌肉失养症（Duchenne muscular dystrophy）", "options": {"A": "肢带型肌肉失养症（limb-girdle muscular dystrophy）", "B": "肌强直症（myotonic dystrophy）", "C": "裘馨氏肌肉失养症（Duchenne muscular dystrophy）", "D": "低钾周期性麻痹（hypokalemic periodic paralysis）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是 Framingham Heart Study 用來估算心血管疾病十年风险的指标？", "answer_idx": "C", "answer": "舒张压", "options": {"A": "总胆固醇", "B": "高密度脂蛋白胆固醇值（HDL）", "C": "舒张压", "D": "抽烟习惯"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种降血压药物的作用机转是经由 NO-cGMP pathway？", "answer_idx": "D", "answer": "Nitroprusside", "options": {"A": "Verapamil", "B": "Trimethaphan", "C": "Diazoxide", "D": "Nitroprusside"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一硬脑膜静脉窦（dural venous sinuses）的血液直接注入内颈静脉（internal jugular vein）？", "answer_idx": "A", "answer": "乙状窦（sigmoid sinus）", "options": {"A": "乙状窦（sigmoid sinus）", "B": "上岩窦（superior petrosal sinus）", "C": "横窦（transverse sinus）", "D": "枕窦（occipital sinus）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于眼睑恶性肿瘤的叙述，下列何者错误？", "answer_idx": "D", "answer": "⽪脂腺癌⼀般好发在下眼睑", "options": {"A": "基底细胞癌（basal cell carcinoma）发⽣率最⾼", "B": "鳞状细胞癌（squamous cell carcinoma）⼀般预后较基底细胞癌差", "C": "⽪脂腺癌（sebaceous gland carcinoma）临床上易被误诊为慢性眼睑炎或霰粒肿（chalazion）", "D": "⽪脂腺癌⼀般好发在下眼睑"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关出血性脑中风之叙述，何者错误？", "answer_idx": "D", "answer": "高血压所导致之出血性脑中风最常发生于顶葉之大脑皮质", "options": {"A": "不正常之脑内血管可以造成出血性脑中风", "B": "不正常之血液凝集功能可以造成出血性脑中风", "C": "出血性脑中风亦可发生于年轻人", "D": "高血压所导致之出血性脑中风最常发生于顶葉之大脑皮质"}}
{"meta_info": "taiwanese_test_Q", "question": "45.某劳工于甲、乙、丙场所分别工作2.5、3、2.5小时，若其甲苯浓度分别为40、150、20 ppm，其时量平均浓度 （TWA）为何？\n", "answer_idx": "C", "answer": "75 ppm", "options": {"A": "70 ppm", "B": "74 ppm", "C": "75 ppm", "D": "80 ppm"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 21 岁男性患者，因胸痛及呼吸困难前來就诊，胸部 X 光片如图所示，下列何种处置最为适当？", "answer_idx": "C", "answer": "插胸管引流", "options": {"A": "即时给予抗生素治療", "B": "给予支气管扩张剂吸入治療", "C": "插胸管引流", "D": "给予氧气治療，并观察病情"}}
{"meta_info": "taiwanese_test_Q", "question": "有关决定能力，下列叙述何者错误？", "answer_idx": "B", "answer": "根据「安寧缓和医療条例」，末期病人意識昏迷或无法清楚表达意愿时，由医护人员根据病患最大利益进行代理", "options": {"A": "一个人可能有能力决定住处的选择，却没有能力决定接受何种治療", "B": "根据「安寧缓和医療条例」，末期病人意識昏迷或无法清楚表达意愿时，由医护人员根据病患最大利益进行代理", "C": "「病患自主」和「尊重人格」的倫理原则要求让有决定能力的人对医療行使知情同意", "D": "一个人可能因为精神错亂而暂时失去决定能力，但之后又恢復这能力"}}
{"meta_info": "taiwanese_test_Q", "question": "法洛氏四合症（Tetralogy of Fallot）完全矫正后，长期追踪若有严重的肺动脉瓣逆流，右心室扩大，及右心室功能失效，此时最好的处理方式为何？", "answer_idx": "B", "answer": "肺动脉瓣置换", "options": {"A": "心房中隔造口（creation of atrial septal defect）", "B": "肺动脉瓣置换", "C": "三尖瓣置换", "D": "使用降肺高压药物"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是爱滋病毒（human immunodeficiency virus）传播的方式？", "answer_idx": "C", "answer": "共用餐具", "options": {"A": "性行为未全程使用保险套", "B": "共用针头施打毒品", "C": "共用餐具", "D": "被爱滋病毒感染的母亲哺喂母乳"}}
{"meta_info": "taiwanese_test_Q", "question": "16.3岁男童，因为咽喉疼痛伴随吞咽与呼吸困难送至急诊室，经医师检查，发现他在每次吸气时都出现明显阻塞的声音，侧颈X光（lateral neck x-ray）报告显示会厌软骨肿胀（swollen epiglottis），此最有可能是下列何种细菌感染所造成？\n", "answer_idx": "A", "answer": "b型流感嗜血杆菌（Haemophilus influenzae type b）", "options": {"A": "b型流感嗜血杆菌（Haemophilus influenzae type b）", "B": "无乳链球菌（Streptococcus agalactiae）", "C": "奈瑟氏脑膜炎球菌（Neisseria meningitidis）", "D": "单核球增多性李斯特菌（Listeria monocytogenes）"}}
{"meta_info": "taiwanese_test_Q", "question": "大部份血管瘤（hemangioma）在多少岁开始退化？", "answer_idx": "D", "answer": "12～18个月", "options": {"A": "1个月", "B": "3～6个月", "C": "6～9个月", "D": "12～18个月"}}
{"meta_info": "taiwanese_test_Q", "question": "19 一位 40 岁男性，曾经因肝功能異常接受血液检查，被告知结果为 anti-HDV 呈现阳性反应，这位病人最可能当时还有以下何种病毒感染？ （HDV 表示 D 型肝炎病毒）", "answer_idx": "B", "answer": "B 型肝炎病毒", "options": {"A": "A 型肝炎病毒", "B": "B 型肝炎病毒", "C": "C 型肝炎病毒", "D": "E 型肝炎病毒"}}
{"meta_info": "taiwanese_test_Q", "question": "Pyrazinamide 在酸性环境中可有效对抗结核杆菌的活性，故常与其他药物合并使用以治療结核病患，但该抗生素真正有活性的形式是必须被水解成 pyrazinoic acid。此水解反应需在何器官进行？", "answer_idx": "B", "answer": "肝脏", "options": {"A": "心脏", "B": "肝脏", "C": "肾脏", "D": "脾脏"}}
{"meta_info": "taiwanese_test_Q", "question": "1岁以上正常小孩应仍保有下列那一种反应或反射？", "answer_idx": "B", "answer": "parachute reaction", "options": {"A": "palmar grasp reflex", "B": "parachute reaction", "C": "rooting reflex", "D": "symmetric tonic neck reflex（STNR） 72."}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关迟发型性腺功能低下症（late onset hypogonadism）的叙述，何者正确？", "answer_idx": "C", "answer": "有臨床症狀时才须治療", "options": {"A": "睪固酮于晚上 8 至 10 点分泌达最高峰", "B": "睪固酮由睪丸内曲细精管内皮细胞分泌", "C": "有臨床症狀时才须治療", "D": "前列腺增生（BPH）病人可以补充睪固酮"}}
{"meta_info": "taiwanese_test_Q", "question": "不产芽孢厌氧菌（non-sporeforming anaerobes）感染人体，最常造成下列那种形式的病变？", "answer_idx": "C", "answer": "组织坏死和脓疡（abscess）", "options": {"A": "食物中毒（food poisoning）", "B": "溶血性贫血（hemolytic anemia）", "C": "组织坏死和脓疡（abscess）", "D": "自体免疫病（autoimmune diseases）"}}
{"meta_info": "taiwanese_test_Q", "question": "18 75 岁王先生，因高血压服药控制，血压为 130/70 mmHg。三天前因摄护腺肥大，并服泌尿科开予的 α-blocker，早上起床时发生昏厥（syncope），2 分钟后自然苏醒。家属并未发现有尿、粪失禁现象。病人昏厥最可能的原因为何？\n", "answer_idx": "A", "answer": "姿势性低血压（orthostatic hypotension）", "options": {"A": "姿势性低血压（orthostatic hypotension）", "B": "心室颤动（ventricular fibrillation）", "C": "心因性休克（cardiogenic shock）", "D": "癫痫发作（seizure）"}}
{"meta_info": "taiwanese_test_Q", "question": "⼀位61岁男性⻑期使⽤diazepam每天50～60毫克达15年，若立即停⽌服⽤后，下列何者为最正确的描述？", "answer_idx": "C", "answer": "抽搐发作为较严重之戒断症状", "options": {"A": "⼼搏变慢", "B": "戒断症状不会在停⽤5天后才出现", "C": "抽搐发作为较严重之戒断症状", "D": "戒断症状不致于产⽣谵妄"}}
{"meta_info": "taiwanese_test_Q", "question": "73.15岁车祸伤患主诉左上腹部剧痛，而且逐渐呈现休克状态。电脑断层检查如附图。箭头所指之异常最符合下列那一项诊断？", "answer_idx": "A", "answer": "spleen laceration", "options": {"A": "spleen laceration", "B": "pancreas laceration", "C": "kidney laceration", "D": "diaphragm laceration"}}
{"meta_info": "taiwanese_test_Q", "question": "免疫球蛋白重链（immunoglobulin heavy chain）基因之胚原序列（germline sequence）可存在于下列那种细胞中？", "answer_idx": "D", "answer": "T 细胞", "options": {"A": "成熟之 B 细胞", "B": "活化之 B 细胞", "C": "浆细胞（plasma cell）", "D": "T 细胞"}}
{"meta_info": "taiwanese_test_Q", "question": "Celiac disease及Crohn's disease是二种肠道发炎疾病，下列有关二者之比较何者正确？", "answer_idx": "C", "answer": "IFN-γ所引起的发炎反应，在这二种疾病都扮演重要角色", "options": {"A": "前者是对肠内共生菌有强烈发炎反应，后者是因为对麦类食物过敏所引起", "B": "前者可能与NOD-2分子失去功能有关，后者主要与HLA-DQ2分子的表现有关", "C": "IFN-γ所引起的发炎反应，在这二种疾病都扮演重要角色", "D": "利用广泛性抗生素去掉大部分共生菌，皆可治疗这二种疾病"}}
{"meta_info": "taiwanese_test_Q", "question": "77.下列有关单胞绦虫（Echinococcus granulosus）感染人体的叙述，共有几项叙述错误？ ①人为终宿主（final host） ②最容易在肌肉形成包生囊（hydatid cyst） ③因误食未熟带虫之牛肉而感染 ④感染后数周即迅速发病", "answer_idx": "D", "answer": "4项", "options": {"A": "1项", "B": "2项", "C": "3项", "D": "4项"}}
{"meta_info": "taiwanese_test_Q", "question": "58 35 岁之女性病人，主诉心悸，容易紧张，体重在半年内减轻 10 公斤。理学检查发现手易发抖、冒汗。颈部甲状腺吞咽时易见。甲促素（TSH）测不到。下列何者是确定本病例病因之最重要检查？\n", "answer_idx": "B", "answer": "甲状腺碘 131 摄取影像检查", "options": {"A": "甲状腺超音波", "B": "甲状腺碘 131 摄取影像检查", "C": "细针穿刺细胞学检查", "D": "颈部断层摄影"}}
{"meta_info": "taiwanese_test_Q", "question": "下列口服降血糖药物中，不会引起体重增加的是那一种？", "answer_idx": "B", "answer": "metformin", "options": {"A": "glyburide", "B": "metformin", "C": "pioglitazone", "D": "repaglinide"}}
{"meta_info": "taiwanese_test_Q", "question": "乳癌最常见转移部位为下列何者？", "answer_idx": "B", "answer": "骨骼", "options": {"A": "脑部", "B": "骨骼", "C": "肺部", "D": "肝脏"}}
{"meta_info": "taiwanese_test_Q", "question": "腰椎椎间盘突出，90%发生在那个地方？", "answer_idx": "D", "answer": "L4-5 and L5-S1", "options": {"A": "L1-2 and L2-3", "B": "L2-3 and L3-4", "C": "L3-4 and L4-5", "D": "L4-5 and L5-S1"}}
{"meta_info": "taiwanese_test_Q", "question": "单纯以加氯消毒饮用水，对下列那一种病原体效果不佳？", "answer_idx": "A", "answer": "梨型鞭毛虫（Giardia）", "options": {"A": "梨型鞭毛虫（Giardia）", "B": "沙门杆菌（Salmonella）", "C": "志贺杆菌（Shigella）", "D": "大肠杆菌（Esherichia Coli）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关白血病（leukemia）各器官病理变化之叙述，何者错误？", "answer_idx": "D", "answer": "慢性淋巴球性白血病（chronic lymphoid leukemia）之肝脏浸润在于肝窦状隙内", "options": {"A": "急性骨髓性白血病（acute myeloid leukemia）中单核球分化之亚型较可能浸润皮肤及其附属构造", "B": "急性淋巴球性白血病（acute lymphoid leukemia）比急性骨髓性白血病较常见有中枢神经", "C": "绿色瘤（chloroma）多会进展为急性骨髓性白血病", "D": "慢性淋巴球性白血病（chronic lymphoid leukemia）之肝脏浸润在于肝窦状隙内"}}
{"meta_info": "taiwanese_test_Q", "question": "有关心电图PR间距（PR interval），最不可能代表下列心跳周期的那一部分？", "answer_idx": "D", "answer": "心室去极化（ventricular depolarization）", "options": {"A": "心房去极化（atrial depolarization）", "B": "心房再极化（atrial repolarization）", "C": "房室间细胞延迟（atrioventricular delay）", "D": "心室去极化（ventricular depolarization）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者非葡萄球菌菌种（Staphylococcus species）所造成的主要疾病？", "answer_idx": "D", "answer": "胃溃疡（gastric ulcer）", "options": {"A": "食物中毒（food poisoning）", "B": "脓疱疮（impetigo）", "C": "皮肤烫伤样综合征状（scalded skin syndrome）", "D": "胃溃疡（gastric ulcer）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于梅毒的叙述，下列何者正确？", "answer_idx": "C", "answer": "二期梅毒皮疹典型发生在chancre出现的3~12周后，但在HIV病患出现的时间可能与chancre有所重叠", "options": {"A": "梅毒螺旋体（Treponema pallidum）可以利用镜检与其他nonvenereal diseases的treponemes做鉴别诊断", "B": "二期梅毒皮疹经治疗后，皮疹通常在4~12周后消褪", "C": "二期梅毒皮疹典型发生在chancre出现的3~12周后，但在HIV病患出现的时间可能与chancre有所重叠", "D": "血液专一性treponemal test是监测梅毒治疗效果的最佳指标"}}
{"meta_info": "taiwanese_test_Q", "question": "77 在治療注意力缺损过动疾患（attention-deficit/hyperactivity disorder）之患者，常使用中枢神经刺激剂 （central stimulants），下列何者不属此類药物？\n", "answer_idx": "C", "answer": "Nortriptyline", "options": {"A": "Dextroamphetamine", "B": "Methylphenidate", "C": "Nortriptyline", "D": "Pemoline"}}
{"meta_info": "taiwanese_test_Q", "question": "尘肺病中与惡性间皮瘤（malignant mesothelioma）最相关的物质是：", "answer_idx": "D", "answer": "石绵", "options": {"A": "碳", "B": "铅", "C": "矽", "D": "石绵"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那个现象最能显示 DNA 为遗传物质？", "answer_idx": "B", "answer": "DNA 的转化作用（transformation）能改变细菌的表型（phenotype）", "options": {"A": "RNA 的生物合成必须以单股 DNA 做为模版", "B": "DNA 的转化作用（transformation）能改变细菌的表型（phenotype）", "C": "DNA 存在于原核生物中", "D": "DNA 存在于所有的真核的细胞核中"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关抗癫痫药物oxcarbazepine的叙述，何者错误？", "answer_idx": "C", "answer": "其比carbamazepine具有较强的诱发肝脏细胞色素P450活性的作用", "options": {"A": "主要靠其代谢物10-hydroxy-carbazepine（MHD）来产生抗癫痫作用", "B": "其药理学作用方式与carbamazepine相似，但相对严重的副作用较少发生", "C": "其比carbamazepine具有较强的诱发肝脏细胞色素P450活性的作用", "D": "使用oxcarbazepine较carbamazepine容易发生低钠血症（hyponatremia）"}}
{"meta_info": "taiwanese_test_Q", "question": "老化过程中会发生许多生理变化，在 80 岁以上之正常老人，下列何种变化不正确或较罕见？", "answer_idx": "B", "answer": "肾素（renin）与肾上腺皮质醛固酮（aldosterone）分泌增加", "options": {"A": "心脏窦房结（sino-atrial node）之节律细胞（pacemaker cells）数量减少可达 90%", "B": "肾素（renin）与肾上腺皮质醛固酮（aldosterone）分泌增加", "C": "约有 50%可在肠道发现憩室（diverticula）", "D": "动脉血氧分压约 70-75 毫米汞柱 21 下列何者在老年病患最不常见？"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者会因小肠中出现酸性食糜而分泌？", "answer_idx": "D", "answer": "胰泌素（secretin）", "options": {"A": "胃抑素（gastric inhibitory polypeptide）", "B": "胃泌素（gastrin）", "C": "饥饿素（ghrelin）", "D": "胰泌素（secretin）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于深筋膜（deep fascia）的构造？", "answer_idx": "B", "answer": "半月板（meniscus）", "options": {"A": "阔筋膜（fascia lata）", "B": "半月板（meniscus）", "C": "髂胫束（iliotibial tract）", "D": "足底筋膜（plantar aponeurosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "S-D 序列（Shine-Dalgarno sequence）是位于 mRNA 转译起点（translation initiation site）上游的 AG 丰富序列（AG rich sequence），其功能为何？", "answer_idx": "D", "answer": "可与 16S 核糖体 RNA 的 3'端序列结合，使 mRNA 的转译起点作正确排列以利转译表现的进行", "options": {"A": "可与 23S 核糖体 RNA（ribosomal RNA）的 3'端序列结合，使 mRNA 上的启动子区域（promoter region）作正确排列以利转译表现的进行", "B": "可与 16S 核糖体 RNA 的 3'端序列结合，使 mRNA 上的启动子区域作正确排列以利转译表现的进行", "C": "可与 23S 核糖体 RNA 的 3'端序列结合，使 mRNA 的转译起点作正确排列以利转译表现的进行", "D": "可与 16S 核糖体 RNA 的 3'端序列结合，使 mRNA 的转译起点作正确排列以利转译表现的进行"}}
{"meta_info": "taiwanese_test_Q", "question": "34.以下有关hereditary nonpolyposis colon cancer（HNPCC；或称Lynch's syndrome）常见的临床病理及基因分子 变异，何者错误？\n", "answer_idx": "A", "answer": "HNPCC大肠直肠癌患者诊断的中位年龄，较其他一般民众大肠直肠癌诊断的中位年龄来得较年长", "options": {"A": "HNPCC大肠直肠癌患者诊断的中位年龄，较其他一般民众大肠直肠癌诊断的中位年龄来得较年长", "B": "HNPCC患者的家属也好发卵巢癌、子宫内膜癌或其他的肠胃道癌症", "C": "HNPCC与germline mutations of hMSH2或hMLH1相关", "D": "hMSH2或hMLH1之基因变异将导致细胞内DNA mismatch repair机制的缺损"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是腹膜（peritoneum）的衍生物？", "answer_idx": "C", "answer": "卵巢韧带", "options": {"A": "阔韧带", "B": "卵巢系膜", "C": "卵巢韧带", "D": "输卵管系膜"}}
{"meta_info": "taiwanese_test_Q", "question": "有关溺水病人之急救，下列何者正确？", "answer_idx": "A", "answer": "最重要的病理性结果是缺氧", "options": {"A": "最重要的病理性结果是缺氧", "B": "应尽早清除呼吸道的水分，尽速实施哈姆立克急救", "C": "应使用提下巴法打开呼吸道，且常规使用颈圈于每位溺水病患", "D": "急救溺水的病人，应从水中就开始做 CPR，然后一面游向岸边"}}
{"meta_info": "taiwanese_test_Q", "question": "抑制单纯疹病毒之药物 acyclovir，其标的为何？", "answer_idx": "C", "answer": "病毒胸腺激酶（thymidine kinase）", "options": {"A": "直接破坏病毒的组成，造成病毒结构解離", "B": "阻止病毒从寄主细胞中释放出來", "C": "病毒胸腺激酶（thymidine kinase）", "D": "抑制病毒 RNA 合成酶（RNA polymerase）的作用"}}
{"meta_info": "taiwanese_test_Q", "question": "下列甲状腺结节（thyroid nodule）的检查，应不优先考虑何者？", "answer_idx": "C", "answer": "正子摄影检查", "options": {"A": "超音波及细针穿刺细胞检查", "B": "胸骨下甲状腺瘤作CT或 MRI", "C": "正子摄影检查", "D": "甲状腺核医扫描（scanning）用于滤泡瘤且甲状腺刺激素（TSH）低者"}}
{"meta_info": "taiwanese_test_Q", "question": "比较第一型和第二型骨骼肌纤维时，下列何者错误？", "answer_idx": "B", "answer": "第一型纤维较易疲乏", "options": {"A": "第一型纤维的粒线体含量较丰富", "B": "第一型纤维较易疲乏", "C": "第一型纤维的肌球蛋白含量较丰富", "D": "第一型纤维的微血管含量较丰富"}}
{"meta_info": "taiwanese_test_Q", "question": "这位病人可能是因下列何构造被血块挤压，进而压迫脑干而引起上述症狀？", "answer_idx": "B", "answer": "钩（uncus）", "options": {"A": "小脑扁桃体（cerebellar tonsil）", "B": "钩（uncus）", "C": "胼胝体（corpus callosum）", "D": "下视丘（hypothalamus）"}}
{"meta_info": "taiwanese_test_Q", "question": "78 一位 72 岁男性在周边血液出现有核红血球。病人之直接及间接抗球蛋白测试（direct and indirect Coombs test）均为阴性。下列何者为最可能之原因？\n", "answer_idx": "A", "answer": "癌症骨髓转移", "options": {"A": "癌症骨髓转移", "B": "慢性酒精中毒", "C": "肠胃吸收不良", "D": "慢性失血"}}
{"meta_info": "taiwanese_test_Q", "question": "23 一位 15 岁女孩來到门诊，主诉发烧 3 周、体重减轻、全身倦怠，身体诊查发现双侧脸颊红斑。在怀疑 systemic lupus erythematosus 情形下，下列何种检查结果符合美国风湿病学院（ACR）公布的十一 项诊断准则之一？\n", "answer_idx": "C", "answer": "positive anticardiolipin IgG and IgM", "options": {"A": "淋巴球 2200/mm3", "B": "24 小时肌酐廓清率（creatinine clearance rate）45 ml/min/1.73 m2", "C": "positive anticardiolipin IgG and IgM", "D": "补体 C3：60 mg/dL, C4：9.87 mg/dL"}}
{"meta_info": "taiwanese_test_Q", "question": "下列对于「脾脏之红髓（red pulp）」的叙述，何者正确？", "answer_idx": "C", "answer": "富含血液", "options": {"A": "由淋巴小结（lymphatic nodule）组成", "B": "位于皮质区", "C": "富含血液", "D": "主要功能是过濾淋巴液"}}
{"meta_info": "taiwanese_test_Q", "question": "病人发生代谢性酸血症（Metabolic acidosis）合并下列何种临床情境，则可能为Inborn errors of metabolism 的机率最高？", "answer_idx": "A", "answer": "3周大新生儿，一直呕吐、无法进食、活力差。血液Anion gap与Lactic acid增加；尿液Ketones 4+", "options": {"A": "3周大新生儿，一直呕吐、无法进食、活力差。血液Anion gap与Lactic acid增加；尿液Ketones 4+", "B": "10个月大男婴持续腹泻3天。血液呈现氯高而Anion gap正常", "C": "3岁大男童高烧5天且食欲差。血液白血球增高", "D": "8岁女童多吃、多喝、多尿但体重下降。血糖410 mg/dL，血液呈现Anion gap增加"}}
{"meta_info": "taiwanese_test_Q", "question": "45岁孕妇，G5P4，妊娠周数不明，接受产科超音波检查，正在测量标的的名称（双十 之间）为何？", "answer_idx": "C", "answer": "FL（femur length）", "options": {"A": "BPD（biparietal diameter）", "B": "AC（abdominal circumference）", "C": "FL（femur length）", "D": "NT（nuchal translucency）"}}
{"meta_info": "taiwanese_test_Q", "question": "⼤部分⼈体内成熟T细胞上之TCR为α-chain及β-chain所组成，故称为αβ T cells。当比对TCR α-chain及βchain的DNA序列时，发现β-chain比α-chain多出了下列何种基因片段？", "answer_idx": "B", "answer": "D", "options": {"A": "V", "B": "D", "C": "J", "D": "C"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者直接位于子宫的后方？", "answer_idx": "D", "answer": "输卵管", "options": {"A": "卵巢", "B": "膀胱", "C": "直肠", "D": "输卵管"}}
{"meta_info": "taiwanese_test_Q", "question": "65 下列何者为心脏复健的目的？ ①治疗心脏病 ②增进心脏功能 ③减少残障发生 ④找出并改善危 险因子\n", "answer_idx": "D", "answer": "①②③④", "options": {"A": "只有①和②", "B": "只有③和④", "C": "只有①②③", "D": "①②③④"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关房水（aqueous humour）之叙述，何者错误？", "answer_idx": "D", "answer": "房水在前房形成，经瞳孔，流入后房排出", "options": {"A": "房水是血浆在睫状体（cilicary body）处分泌（secretion）形成", "B": "大约90%的房水经小梁网（trabecular meshwork）排出眼睛", "C": "大约10%的房水经葡萄膜巩膜路径（uveoscleral route）排出眼睛", "D": "房水在前房形成，经瞳孔，流入后房排出"}}
{"meta_info": "taiwanese_test_Q", "question": "α-胺基酸中的胺基（-NH2）与羧基（-COOH），其pKa 值分别为10 和2，当pH 接近中性时，胺基会接受一个质子（proton），而羧基则失去一个质子，这种狀态或现象称为：", "answer_idx": "C", "answer": "兩性離子（zwitterions）", "options": {"A": "異构现象（isomerization）", "B": "中和现象（neutralization）", "C": "兩性離子（zwitterions）", "D": "立体異构现象（stereoisomerization）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于儿童失神癫痫 （childhood absence epilepsy）的叙述，下列何者正确？", "answer_idx": "D", "answer": "属于良性的原发性全面性癫痫（idiopathic generalized epilepsy）之一", "options": {"A": "好发于1至3岁", "B": "常伴有智力损伤或神经学检查异常", "C": "每秒4到6次的棘波-慢波复合波（4-to 6-Hz spike-and-wave complexes）为其特征性之脑电图（EEG）表现", "D": "属于良性的原发性全面性癫痫（idiopathic generalized epilepsy）之一"}}
{"meta_info": "taiwanese_test_Q", "question": "铁硫蛋白（iron-sulfur protein）为一种电子传递蛋白质，下列相关叙述何者不正确？", "answer_idx": "D", "answer": "有 3Fe-3S cluster", "options": {"A": "属于 non-heme iron protein", "B": "其铁硫簇（iron-sulfur cluster）的配体（ligand）大多是 cysteine", "C": "Rieske protein 属于此類的蛋白", "D": "有 3Fe-3S cluster"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是食道異物（esophageal foreign body）最容易卡住的部位？", "answer_idx": "A", "answer": "环咽括约肌（cricopharyngeal sphincter）狭窄区", "options": {"A": "环咽括约肌（cricopharyngeal sphincter）狭窄区", "B": "主动脉跨过食道造成狭窄区", "C": "食道中三分之一处", "D": "下食道括约肌（lower esophageal sphincter）狭窄区"}}
{"meta_info": "taiwanese_test_Q", "question": "73.13岁女性病患，月经未来且下腹痛，故接受电脑断层检查，结果如下图。其最有可能的诊断为何？", "answer_idx": "D", "answer": "子宫融合异常合并处女膜未穿孔（uterine fusion abnormality with imperforated hymen）", "options": {"A": "子宫肌瘤（uterine myoma）", "B": "子宫内膜癌（endometrial cancer）", "C": "输卵管卵巢脓疡（tubo-ovarian abscess）", "D": "子宫融合异常合并处女膜未穿孔（uterine fusion abnormality with imperforated hymen）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关肝糖合成酶（glycogen synthase）参与肝糖合成之叙述，下列何者正确？", "answer_idx": "D", "answer": "将葡萄糖残基以（α1→4）键结⾄肝糖链（glycogen chain）之非还原端", "options": {"A": "此酵素被磷酸化后可被活化", "B": "此酵素只存在于肝脏", "C": "利⽤glucose-6-phosphate做为葡萄糖单元的供给者", "D": "将葡萄糖残基以（α1→4）键结⾄肝糖链（glycogen chain）之非还原端"}}
{"meta_info": "taiwanese_test_Q", "question": "处理急性胸痛病患时，下列何项应为第一优先执行？", "answer_idx": "A", "answer": "呼吸、脉搏、血压", "options": {"A": "呼吸、脉搏、血压", "B": "病史", "C": "身体检查", "D": "心电图"}}
{"meta_info": "taiwanese_test_Q", "question": "48 如图示，未施打显影剂之电脑断层横切面影像，于右大脑半球额顶葉处，有一大范围之低密度病灶 ，并使中线构造左移，最可能的诊断为下列何者？\n", "answer_idx": "B", "answer": "脑梗塞（cerebral infarct）", "options": {"A": "脑炎（encephalitis）", "B": "脑梗塞（cerebral infarct）", "C": "脑挫伤（brain contusion）", "D": "脑瘤（brain tumor）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一项不是影响子宫内膜癌的不良预后因子？", "answer_idx": "C", "answer": "年轻", "options": {"A": "深部子宫肌肉层侵袭", "B": "grade 3 肿瘤", "C": "年轻", "D": "淋巴血管空间侵袭（lymph-vascular space invasion）"}}
{"meta_info": "taiwanese_test_Q", "question": "依照卫生福利部国民健康署的乳癌筛检建议，健康年龄 55 岁的停经女性，定期追踪项目为下列何者？", "answer_idx": "D", "answer": "每两年乳房 X 光摄影", "options": {"A": "每半年执行乳房超音波检查", "B": "每年乳房 X 光摄影", "C": "每一年乳房超音波检查", "D": "每两年乳房 X 光摄影"}}
{"meta_info": "taiwanese_test_Q", "question": "治疗慢性肾病（chronic kidney disease）合并之高血压时，首选药物为：", "answer_idx": "D", "answer": "血管张力素转化酶阻断剂（angiotensin-converting enzyme inhibitors）或血管张力素接受器阻断剂（angiotensin receptor blockers）", "options": {"A": "利尿剂（diuretics）", "B": "钙离子阻断剂（calcium channel blockers）", "C": "β-阻断剂（β-blockers）", "D": "血管张力素转化酶阻断剂（angiotensin-converting enzyme inhibitors）或血管张力素接受器阻断剂（angiotensin receptor blockers）"}}
{"meta_info": "taiwanese_test_Q", "question": "急性胆管炎指的是胆道系统细菌性感染，临床症状从轻微自愈到危及生命都有可能，何者非Charcot's triad？", "answer_idx": "D", "answer": "意识谵妄（delirium）", "options": {"A": "发烧（fever）", "B": "黄疸（jaundice）", "C": "腹痛（abdominal pain）", "D": "意识谵妄（delirium）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于肾小管对于肾小球过滤液中钠离子再吸收的描述，下列何者错误？", "answer_idx": "B", "answer": "亨氏管上行段粗枝的基底外侧细胞膜会利用钠-钾-氯协同转运蛋白（Na-K​​-2Cl cotransporter）再吸收 30%肾小球过滤液中的钠离子", "options": {"A": "60%肾小球过滤液中的钠离子在近曲小管被再吸收", "B": "亨氏管上行段粗枝的基底外侧细胞膜会利用钠-钾-氯协同转运蛋白（Na-K​​-2Cl cotransporter）再吸收 30%肾小球过滤液中的钠离子", "C": "远曲小管（distal convoluted tubule）会利用顶膜（apical membrane）的钠-氯协同转运蛋白（Na-Cl cotransporter）再吸收 7%肾小球过滤液中的钠离子", "D": "集尿管（collecting duct）会利用顶膜的上皮钠离子通道（epithelial sodium channel）再吸收 3%肾小球过滤液中的钠离子"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一个胺基酸可以代谢成α-ketoglutarate，然后进入 citric acid cycle？", "answer_idx": "B", "answer": "Proline", "options": {"A": "Glycine", "B": "Proline", "C": "Alanine", "D": "Tyrosine"}}
{"meta_info": "taiwanese_test_Q", "question": "神经传递中下列那一项可能最直接促使神经末梢之乙醯胆碱（acetylcholine）释放？", "answer_idx": "C", "answer": "电压门控钙離子通道（voltage-gated calcium ion channel）打开", "options": {"A": "电压门控钠離子通道（voltage-gated sodium ion channel）打开", "B": "电压门控钾離子通道（voltage-gated potassium ion channel）打开", "C": "电压门控钙離子通道（voltage-gated calcium ion channel）打开", "D": "电压门控镁離子通道（voltage-gated magnesium ion channel）打开 50 请指出何者不是核糖核酸（ribonucleic acid, RNA）的特性？"}}
{"meta_info": "taiwanese_test_Q", "question": "根据世界医学会所制定的赫尔辛基宣言（Declaration of Helsinki），对兼顾医療照护的医学研究，下列建议何者最为适当？", "answer_idx": "C", "answer": "医师可以结合医学研究与医療照护，但此情况仅止于此研究有潜在的预防、诊断或治療的价值", "options": {"A": "应清楚区分医療照护与医学研究，以避免责任不清，确保病患权益", "B": "研究是提升医療照护水准所必需，因此在教学医院，所有的医療照护都应包含某种程度之医学研究", "C": "医师可以结合医学研究与医療照护，但此情况仅止于此研究有潜在的预防、诊断或治療的价值", "D": "无相关建议"}}
{"meta_info": "taiwanese_test_Q", "question": "如果以员工「对工作的自主控制」（control）及「工作负荷」（demand）來分類，以下何种组合的职业压力最高？", "answer_idx": "D", "answer": "低控制、高负荷", "options": {"A": "高控制、高负荷", "B": "高控制、低负荷", "C": "低控制、低负荷", "D": "低控制、高负荷"}}
{"meta_info": "taiwanese_test_Q", "question": "甲状腺上皮细胞内将碘化甲状腺球蛋白（iodinated thyroglobulin）分解成甲状腺素的胞器是：", "answer_idx": "A", "answer": "溶酶体（lysosomes）", "options": {"A": "溶酶体（lysosomes）", "B": "过氧化酶体（peroxisomes）", "C": "粒线体（mitochondria）", "D": "高尔基氏体（Golgi complex）"}}
{"meta_info": "taiwanese_test_Q", "question": "22 一位16 岁男性，体检时发现胸部X 光肺动脉血管阴影扩大，心脏大小正常，理学检查听诊在左边第肋间有2/6 度收缩期心杂音，第2 心音呈固定分裂音（fixed splitting） ，则最可能的诊断是：", "answer_idx": "D", "answer": "心房中隔缺损", "options": {"A": "肺动脉瓣狭窄", "B": "主动脉瓣狭窄", "C": "心室中隔缺损", "D": "心房中隔缺损"}}
{"meta_info": "taiwanese_test_Q", "question": "77.一位56岁女性，由美国纽约返回台北的飞机途中发生晕厥（syncope），下了飞机后因呼吸不顺至急诊就诊，她以前不曾发生类似状况，平常亦无特殊疾病，身体检查发现血压120/70 mmHg，心跳126次/分，呼吸28次/分，体温37.2℃，呼吸音及心音皆正常，四肢活动自如，无肿胀现象，在给予40％氧气五分钟后，动脉气体分析为pH =7.48，PaO2 =70mmHg，PaCO2 =28mmHg，O2 saturation=92%，此时应安排下列那一项检查最适当？\n", "answer_idx": "C", "answer": "注射显影剂的螺旋快速胸部电脑断层检查", "options": {"A": "心脏超音波检查", "B": "静脉杜卜勒超音波检查", "C": "注射显影剂的螺旋快速胸部电脑断层检查", "D": "主动脉血管摄影"}}
{"meta_info": "taiwanese_test_Q", "question": "外伤评分系统（Injury Severity Score, ISS）是对外伤病患严重度评估常⽤的评分⽅式；下列对于外伤评分系统的叙述何者错误？", "answer_idx": "B", "answer": "Injury Severity Score（ISS）是⼀种⽣理性评分系统（physiological scoring system）", "options": {"A": "Abbreviated Injury Scale（AIS），于1971年提出，将受伤部位严重程度，分为从第1级（minimal severity）⾄第6级（presumably fatal）", "B": "Injury Severity Score（ISS）是⼀种⽣理性评分系统（physiological scoring system）", "C": "ISS分数区域为1分⾄75分，minor injury是指ISS<9分", "D": "Glasgow Coma Scale（GCS）能评量外伤病患意识状态，分数区域为3分⾄15分"}}
{"meta_info": "taiwanese_test_Q", "question": "有关气喘病患呼吸道过度反应性（airway hyperresponsiveness）之叙述，下列何者错误？", "answer_idx": "C", "answer": "某病患methacholine PC20<8 mg/mL即可诊断为气喘", "options": {"A": "常以支气管激发试 中使FEV1下降20%之methacholine浓度（PC20）或剂量（PD20）来表示", "B": "如果某病患methacholine剂量-反应曲线在高剂量时未出现平原（plateau）现象也代表呼吸道高反应性之存在", "C": "某病患methacholine PC20<8 mg/mL即可诊断为气喘", "D": "methacholine PC20值越低代表呼吸道高反应性越高"}}
{"meta_info": "taiwanese_test_Q", "question": "主动脉瓣狭窄的病患容易发生心绞痛（angina pectoris）的原因为何？", "answer_idx": "B", "answer": "左心室压增加但是主动脉压却下降", "options": {"A": "左心室压增加而且主动脉压也增加", "B": "左心室压增加但是主动脉压却下降", "C": "左心室压下降而且主动脉压也下降", "D": "左心室压下降但是主动脉压却增加"}}
{"meta_info": "taiwanese_test_Q", "question": "对于肝硬化的叙述，下列何者错误？", "answer_idx": "B", "answer": "预防肝硬化所引起的食道静脉瘤的首选药物为非选择性α-blockers", "options": {"A": "经颈静脉肝内门体静脉分流术TIPS（transjugular intrahepatic portosystemic shunt） 会使得肝性脑病变", "B": "预防肝硬化所引起的食道静脉瘤的首选药物为非选择性α-blockers", "C": "不论是否伴随 出血，末期肝衰竭病患都需考虑肝脏移植", "D": "食道静脉瘤出血处置需要外科介入的情况，包含内视镜处理失 ，胃静脉瘤出血和TIPS治疗失"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是綠脓杆菌（Pseudomonas aeruginosa）的特征？", "answer_idx": "B", "answer": "会发酵葡萄糖和乳糖", "options": {"A": "好栖息于潮湿的环境中", "B": "会发酵葡萄糖和乳糖", "C": "生长时会发出葡萄般的香味", "D": "对大部分的抗生素具抗药性"}}
{"meta_info": "taiwanese_test_Q", "question": "当偏头痛患者出现恶⼼、呕吐等症状时，下列何者是最佳的治疗药物？", "answer_idx": "C", "answer": "sumatriptan", "options": {"A": "acetaminophen", "B": "allopurinol", "C": "sumatriptan", "D": "sulindac"}}
{"meta_info": "taiwanese_test_Q", "question": "肺炎退伍军人杆菌（Legionella pneumophila）初次分离培养（primary culture）时，需要添加下列那种成分？", "answer_idx": "C", "answer": "L-半胱胺酸（L-cysteine）", "options": {"A": "甘油（glycerol）", "B": "橄榄油（olive oil）", "C": "L-半胱胺酸（L-cysteine）", "D": "烟碱酸（nicotinic acid）"}}
{"meta_info": "taiwanese_test_Q", "question": "相较于年轻人，老年人之甲狀腺机能亢进，比较容易以下列何种征象來表现？", "answer_idx": "B", "answer": "心房纤维颤动（atrial fibrillation）", "options": {"A": "凸眼（exophthalmos）", "B": "心房纤维颤动（atrial fibrillation）", "C": "甲狀腺肿（goiter）", "D": "震颤（tremor）"}}
{"meta_info": "taiwanese_test_Q", "question": "色素性视网膜炎（retinitis pigmentosa）的典型三特征（classical triad）不包含：", "answer_idx": "D", "answer": "黄斑部水肿（macular edema）", "options": {"A": "骨刺状黑色素沉积（retinal bone-spicule pigmentation）", "B": "视神经苍白化（waxy pallor of the optic disc）", "C": "小动脉变细（arteriolar attenuation）", "D": "黄斑部水肿（macular edema）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何项是分辨高位无肛病（high type imperforate anus）或低位无肛病（low type imperforate anus）最重要的方法？", "answer_idx": "D", "answer": "肉眼观察", "options": {"A": "倒位摄影（invertogram）", "B": "电脑断层", "C": "核磁造影", "D": "肉眼观察"}}
{"meta_info": "taiwanese_test_Q", "question": "有关免疫抑制剂的叙述，下列何者错误？", "answer_idx": "C", "answer": "Sirolimus（Rapamycin）和 Cyclosporine 都属于 Calcineurin inhibitors", "options": {"A": "Tacrolimus 造成的 PTDM（Post-transplant diabetes mellitus）机会比 Cyclosporine 高", "B": "Cyclosporine 会有牙龈增生（Gingival hyperplasia）和多毛症（Hirsutism）的副作用", "C": "Sirolimus（Rapamycin）和 Cyclosporine 都属于 Calcineurin inhibitors", "D": "Tacrolimus 和 Cyclosporine 都是常用于肾脏移植术后的药物，但是同时也具有肾毒性的副作用"}}
{"meta_info": "taiwanese_test_Q", "question": "关于荨麻疹（urticaria）的叙述，下列何者错误？", "answer_idx": "D", "answer": "病灶的组织病理变化主要是血管炎", "options": {"A": "肥胖细胞（mast cell） 是主要作用细胞", "B": "特定病灶存在时间通常小于24小时", "C": "部分慢性荨麻疹患者的病因是自体免疫（autoimmunity）", "D": "病灶的组织病理变化主要是血管炎"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 55 岁男性主诉解黑便 3 天，内视镜检查发现为十二指肠溃疡，除了制酸药剂 Omeprazole 外，有医师建议给予口服 Clarithromycin 250 mg 及 Amoxicillin 1000 mg 每天兩次。服用几天是最佳选择？", "answer_idx": "B", "answer": "14 天", "options": {"A": "3 天", "B": "14 天", "C": "30 天", "D": "90 天"}}
{"meta_info": "taiwanese_test_Q", "question": "上颌 Le Fort 式骨折一共有几种？", "answer_idx": "C", "answer": "三", "options": {"A": "一", "B": "二", "C": "三", "D": "四"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是臨床上已广泛用來抑制摄护腺肥大及治療雄性秃之 5α-reductase type 2 inhibitor？", "answer_idx": "A", "answer": "Finasteride", "options": {"A": "Finasteride", "B": "Dutasteride", "C": "Megestrol acetate", "D": "Leuprolide"}}
{"meta_info": "taiwanese_test_Q", "question": "在昏暗的环境下，视网膜杆状细胞（rod cell）外部区段（outer segment）产生的钠离子内流（influx）电流主要是因为下列那一物质的作用？", "answer_idx": "B", "answer": "cGMP", "options": {"A": "cAMP", "B": "cGMP", "C": "传导素（transducin）", "D": "all-trans retinal"}}
{"meta_info": "taiwanese_test_Q", "question": "颈脊髓空洞症（cervical syringomyelia）最典型的临床症状是：", "answer_idx": "A", "answer": "区段分离性的感觉异常症候群（segmental sensory dissociation）", "options": {"A": "区段分离性的感觉异常症候群（segmental sensory dissociation）", "B": "分离性感觉与运动障碍症候群（sensory motor dissociation deficit）", "C": "联合性后柱及侧柱障碍症候群（combined posterior and lateral column deficit）", "D": "联合性前柱及侧柱障碍症候群（combined anterior and lateral column deficit）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关肾脏（kidney）组织结构之叙述，何者错误？", "answer_idx": "B", "answer": "致密斑（macula densa）是由近直小管（proximal straight tubule）的上皮细胞所特化", "options": {"A": "肾丝球微血管（glomerular capillary）之内皮细胞（endothelial cell）属于穿孔型（fenestrated type）", "B": "致密斑（macula densa）是由近直小管（proximal straight tubule）的上皮细胞所特化", "C": "近肾丝球细胞（juxtaglomerular cell）主要是由入球小动脉（afferent arteriole）之管壁平滑肌细胞（smooth muscle cell）所特化", "D": "皮质和髓质交接处有弓形动脉（arcuate artery）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于 calcitonin 的叙述，何者错误？", "answer_idx": "C", "answer": "和血浆蛋白（plasma protein）结合能力强，所以在肝脏以及肾脏代谢缓慢", "options": {"A": "由 32 个胺基酸组成", "B": "主要由甲狀腺（thyroid）分泌", "C": "和血浆蛋白（plasma protein）结合能力强，所以在肝脏以及肾脏代谢缓慢", "D": "可用來治療 Paget 氏疾病（Paget's disease of bone）"}}
{"meta_info": "taiwanese_test_Q", "question": "如何辨識位于颈部的颈内动脉与颈外动脉？", "answer_idx": "C", "answer": "颈内动脉无分支，颈外动脉有分支", "options": {"A": "颈内动脉有分支，颈外动脉无分支", "B": "颈内动脉与颈外动脉皆有分支，但分支數目不同", "C": "颈内动脉无分支，颈外动脉有分支", "D": "由兩者之口径不同判别"}}
{"meta_info": "taiwanese_test_Q", "question": "35 岁的吴先生担任警卫，这兩周因为感冒没有上班；3 天前开始下肢无力，并逐渐加重到今天已全身无力、呼吸困难，并且兩侧手脚发麻。理学检查发现肌腱反射（tendon reflex）消失，脚趾对音叉震动及关节角度变化没有感觉。神经传导检查发现传导速度变慢；脑脊髓液中蛋白质升高，但白血球數目正常。下列那一项诊断有可能？", "answer_idx": "C", "answer": "急性发炎性多发性周边神经病变（Guillain-Barré syndrome）", "options": {"A": "脑膜炎（meningitis）", "B": "运动神经元疾病（motor neuron disease）", "C": "急性发炎性多发性周边神经病变（Guillain-Barré syndrome）", "D": "多发性硬化症（multiple sclerosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "小明平常偶尔吃一点花生后就会很不舒服，有一天不小心吃了以花生油炸过的芝麻球，几分钟后就喘不过气來。小明体内对花生的特異性抗体，最可能是那一种？", "answer_idx": "C", "answer": "IgE", "options": {"A": "IgM", "B": "IgG", "C": "IgE", "D": "IgA"}}
{"meta_info": "taiwanese_test_Q", "question": "有关转译之叙述，下列何者错误？", "answer_idx": "A", "answer": "每一种 t-RNA 均只能辨认一种 codon", "options": {"A": "每一种 t-RNA 均只能辨认一种 codon", "B": "ATG 是一种起始 codon", "C": "UAA 是一种终止 codon", "D": "不需透过特定之 t-RNA 终止转译 35 有关真核细胞之 mRNA 之转錄后修饰，下列叙述何者错误？"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关人类唾液腺结构之叙述，何者错误？", "answer_idx": "C", "answer": "颌下腺（submandibular gland）的分泌腺泡主要为黏液性，舌下腺（sublingual gland）则主要为浆液性", "options": {"A": "耳下腺（parotid gland）为纯浆液腺，而颌下腺（submandibular gland）与舌下腺（sublingual gland）则是混合腺体", "B": "耳下腺（parotid gland）内的闰管（interealated duct）长度，在三大唾液腺中最长", "C": "颌下腺（submandibular gland）的分泌腺泡主要为黏液性，舌下腺（sublingual gland）则主要为浆液性", "D": "唾液腺之叶间泌管（interlobar duct）上皮主要为伪复层柱状上皮（pseudostratified columnar epithelium）或复层立方上皮"}}
{"meta_info": "taiwanese_test_Q", "question": "何种感染后最容易造成急性肾丝球肾炎（Glomerulonephritis）？", "answer_idx": "C", "answer": "链球菌", "options": {"A": "大肠杆菌", "B": "葡萄球菌", "C": "链球菌", "D": "綠脓杆菌"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关糖尿病肾病变之叙述，何者错误？", "answer_idx": "A", "answer": "蛋白尿或微蛋白尿不会出现于新诊断第二型糖尿病病人", "options": {"A": "蛋白尿或微蛋白尿不会出现于新诊断第二型糖尿病病人", "B": "病理上的变化如肾丝球基底膜变厚及肾小球内基质（mesangium）扩张是常见的", "C": "使用肾素－血管张力素系统（renin-angiotensin system）阻断剂", "D": "国内目前每年进入透析的新病人其原发病因以糖尿病肾病变占第一位"}}
{"meta_info": "taiwanese_test_Q", "question": "下列胸部影像中的病变最可能为：", "answer_idx": "A", "answer": "左肺下葉塌陷（left lower lobe collapse）", "options": {"A": "左肺下葉塌陷（left lower lobe collapse）", "B": "局限性左肋膜积水（localized left pleural effusion）", "C": "左横膈膜赫尼亚（left diaphragmatic hernia）", "D": "纵膈腔肿瘤（mediastinal tumor）"}}
{"meta_info": "taiwanese_test_Q", "question": "39 一位 50 岁女性最近一个月胃口不佳、比较累、且有恶心，晚上小便次数增加，血压为 175/100 mmHg。血液生化检查：BUN 40 mg/dL，creatinine 2.3 mg/dL，Na+ 142 mmol/L，K+ 3.5 mmol/L，Cl- 91 mmol/L， free Ca 3.0 mmol/L。在询问病史时，下列何者对于鉴别诊断上较无帮助？\n", "answer_idx": "D", "answer": "有无使用类固醇", "options": {"A": "有无服用 thiazide 类利尿剂", "B": "有无尿道结石病史", "C": "有无使用维生素 D", "D": "有无使用类固醇"}}
{"meta_info": "taiwanese_test_Q", "question": "肩难产最容易发生的问题是：", "answer_idx": "B", "answer": "臂神经丛受伤", "options": {"A": "膈神经受伤", "B": "臂神经丛受伤", "C": "锁骨骨折", "D": "肱骨骨折"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种形式之核酸重复（nucleotide repeat），与遗传疾病如 fragile X syndrome, Huntington's disease 等有关？", "answer_idx": "B", "answer": "三核酸重复（triple nucleotide repeat）", "options": {"A": "双核酸重复（double nucleotide repeat）", "B": "三核酸重复（triple nucleotide repeat）", "C": "四核酸重复（quadruple nucleotide repeat）", "D": "随意核酸重复（random nucleotide repeat）"}}
{"meta_info": "taiwanese_test_Q", "question": "右眼外展神经（abducens nerve）麻痹病人，以右眼固视（fixation）时，斜视角度会呈现下列何种情况？", "answer_idx": "A", "answer": "内斜视角度大于用左眼固视", "options": {"A": "内斜视角度大于用左眼固视", "B": "内斜视角度小于用左眼固视", "C": "外斜视角度大于用左眼固视", "D": "外斜视角度小于用左眼固视"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者最可能是癌前病变？", "answer_idx": "B", "answer": "日照性角化症（actinic keratosis）", "options": {"A": "化脓性肉芽肿（pyogenic granuloma）", "B": "日照性角化症（actinic keratosis）", "C": "脂漏性角质化（seborrheic keratosis）", "D": "皮纤维瘤（dermatofibroma）"}}
{"meta_info": "taiwanese_test_Q", "question": "UDP-glucose 參与下列那个代谢路径？", "answer_idx": "D", "answer": "半乳糖转变为葡萄糖（epimerization of galactose to glucose）", "options": {"A": "五碳糖磷酸途径（pentose phosphate pathway）", "B": "肝糖分解（glycogen degradation）", "C": "糖解作用（glycolysis）", "D": "半乳糖转变为葡萄糖（epimerization of galactose to glucose）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一个分子在嘌呤代谢中直接水解成尿酸？", "answer_idx": "A", "answer": "xanthine", "options": {"A": "xanthine", "B": "hypoxanthine", "C": "inosine", "D": "IMP"}}
{"meta_info": "taiwanese_test_Q", "question": "一位50 岁男性，肝功能异常有15 年，GOT 值及GPT 值都维持150 U/L 左右（两项正常值均为0-35 U/L），C 型肝炎抗体阳性，B 型肝炎表面抗原阴性反应，表面抗体阳性反应，核心抗体阳性反应，接受肝穿刺检查，病理报告显示中等度纤维化及发炎。请问以下之治疗药物何者是最佳选择？", "answer_idx": "A", "answer": "Interferon + Ribavirin", "options": {"A": "Interferon + Ribavirin", "B": "Interferon + Lamivudine", "C": "Interferon + Adefovir", "D": "Interferon + Entecavir"}}
{"meta_info": "taiwanese_test_Q", "question": "与淋病球菌（gonococci）異性带菌者一次性接触后，得到感染的危险性程度为何？", "answer_idx": "A", "answer": "女高于男", "options": {"A": "女高于男", "B": "男高于女", "C": "男女均为 0％", "D": "男女均为 100％"}}
{"meta_info": "taiwanese_test_Q", "question": "72.57岁女士主诉下楼梯时，突然左脚后跟剧烈疼痛，隔天至骨科门诊，接受脚后跟超音波检查矢状切面如图，最可能之诊断为何？", "answer_idx": "C", "answer": "Achilles tendon rupture", "options": {"A": "Achilles tendinitis", "B": "Achilles tendon fibroma", "C": "Achilles tendon rupture", "D": "retro-calcaneal bursitis"}}
{"meta_info": "taiwanese_test_Q", "question": "11 一位56 岁的男性病人因半夜发生端坐呼吸至急诊就诊，理学检查发现血压为164/98 mmHg，不规则心跳120/min，兩侧肺部有啰音，心尖部有III/VI之全收缩期杂音及S3奔马音，抽血检查Na+: 120 mEq/L, 5 mEq/L, Cl- : 92 mEq/L。下列何种处置最不适当？", "answer_idx": "B", "answer": "立即给予静脉滴注 3% saline以矫正其血中Na+浓度", "options": {"A": "再验其尿中Na+浓度以厘清病因", "B": "立即给予静脉滴注 3% saline以矫正其血中Na+浓度", "C": "立即给予静脉注射 furosemide", "D": "立即给予静脉注射 digoxin"}}
{"meta_info": "taiwanese_test_Q", "question": "下列叙述何者错误？", "answer_idx": "A", "answer": "Flumazenil 是苯二氮平（benzodiazepine）的拮抗剂，可维持作用达数十小时", "options": {"A": "Flumazenil 是苯二氮平（benzodiazepine）的拮抗剂，可维持作用达数十小时", "B": "苯二氮平戒断症状有焦虑及激躁，也可能引起幻觉", "C": "苯二氮平缓解焦虑症状快速，当其为治疗泛焦虑症时，使用时间宜越短越好", "D": "苯二氮平使用会影响记忆力及专注力"}}
{"meta_info": "taiwanese_test_Q", "question": "52岁男性主诉双手渐进性肌肉萎缩及无力，之后伴随言语及吞咽困难，神经学检查发现舌头及手脚肌肉萎缩、肌束震颤（fasciculation）和深部肌腱反射增强，但感觉系统并无异常。下列何者为最可能之诊断？", "answer_idx": "A", "answer": "肌萎缩性侧索硬化（amyotrophic lateral sclerosis）", "options": {"A": "肌萎缩性侧索硬化（amyotrophic lateral sclerosis）", "B": "多发性硬化症（multiple sclerosis）", "C": "多发性神经病变（polyneuropathy）", "D": "肌肉性失养症（muscular dystrophy）"}}
{"meta_info": "taiwanese_test_Q", "question": "除 Barrett's esophagus 外，食道癌病理绝大部分为：", "answer_idx": "A", "answer": "鱗狀上皮癌（Squamous cell carcinoma）", "options": {"A": "鱗狀上皮癌（Squamous cell carcinoma）", "B": "類表皮癌（Carcinoid）", "C": "腺癌（Adenocarcinoma）", "D": "小细胞癌（Small cell carcinoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "白血球的附着分子（adhesion molecule）缺乏时，最可能导致下列何种情形？", "answer_idx": "D", "answer": "白血球的趋化作用（chemotaxis）会出现问题", "options": {"A": "白血球附着缺乏（leukocyte adhesion deficiency; LAD）的患者会出现明显的中性白血球降低", "B": "白血球的骨髓氧化酶（myeloperoxidase）出现缺损", "C": "这類患者容易得到病毒感染", "D": "白血球的趋化作用（chemotaxis）会出现问题"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列何者为该女性最可能之诊断？", "answer_idx": "B", "answer": "乳腺囊肿（breast cyst）", "options": {"A": "乳腺癌（breast carcinoma）", "B": "乳腺囊肿（breast cyst）", "C": "良性纤维腺瘤（fibroadenoma）", "D": "乳腺脓疡（breast abscess）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位35岁的病人接受子宫肌瘤切除手术，术后6周回诊时发现骨盆腔脓疡而再次手术，取出一块大纱布，术后医师的处理方式，下列那一个的方式是最不适当的？", "answer_idx": "A", "answer": "要求开刀房的护理长负起责任", "options": {"A": "要求开刀房的护理长负起责任", "B": "主动通报院内病人安全委员会", "C": "诚恳与病人讨论当时开刀的实况", "D": "争取减免第2次手术的费用"}}
{"meta_info": "taiwanese_test_Q", "question": "王太太某日在果园工作时被一只蜜蜂叮咬，约10几分钟后，出现全身荨麻疹（urticaria），接 呼吸困难，家人连忙将她送到急诊室求诊。抵达急诊室时血压为88/54 mmHg，心跳110 BPM。对王太太目前的状况，应以下列何项优先给药？", "answer_idx": "D", "answer": "epinephrine 0.5 mg肌肉注射", "options": {"A": "methylprednisolone 60 mg静脉注射", "B": "diphenhydramine 50～100 mg静脉注射", "C": "albuterol 5 mg吸入", "D": "epinephrine 0.5 mg肌肉注射"}}
{"meta_info": "taiwanese_test_Q", "question": "50岁健康男性，因牙结石进行相关治疗，过去病史有penicillin过敏，下列建议何者最恰当？", "answer_idx": "D", "answer": "不需给与预防性抗生素", "options": {"A": "给与clindamycin预防心内膜炎", "B": "给与vancomycin预防心内膜炎", "C": "给与tetracycline预防心内膜炎", "D": "不需给与预防性抗生素"}}
{"meta_info": "taiwanese_test_Q", "question": "52", "answer_idx": "A", "answer": "慢性胰脏炎并胰脏钙化及胰管内结石", "options": {"A": "慢性胰脏炎并胰脏钙化及胰管内结石", "B": "急性胰脏炎", "C": "胰脏癌", "D": "胆结石"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于心脏复健的有氧训练方式？", "answer_idx": "D", "answer": "举重", "options": {"A": "踩固定式脚踏车", "B": "跑步机运动", "C": "游泳", "D": "举重"}}
{"meta_info": "taiwanese_test_Q", "question": "下列丘脑内之何结构跟边缘系统没有直接的聯系？", "answer_idx": "D", "answer": "前腹侧核（Ventral anterior nucleus）", "options": {"A": "背外侧核（Lateral dorsal nucleus）", "B": "前核（Anterior nucleus）", "C": "中线核（Midline nucleus）", "D": "前腹侧核（Ventral anterior nucleus）"}}
{"meta_info": "taiwanese_test_Q", "question": "取卵的时机一般是在绒毛性腺激素（human chorionic gonadotropin）注射后几小时？", "answer_idx": "B", "answer": "34～36", "options": {"A": "20～24", "B": "34～36", "C": "40～44", "D": "48～52"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种病患不宜使用可倾斜靠背（recline back support）輪椅？", "answer_idx": "C", "answer": "荐椎部患有压疮（pressure sore）的病人", "options": {"A": "不能独立移动身体重量（shift weight）的病人", "B": "长时间坐立造成腰痛或臀痛的病人", "C": "荐椎部患有压疮（pressure sore）的病人", "D": "常发生姿势性低血压（postural hypotension）的病人"}}
{"meta_info": "taiwanese_test_Q", "question": "一位70岁男性，意识清楚，因咳嗽、黄痰和发烧来医院就诊，胸腔科门诊的胸部X光片显示右上叶肺炎，患者的vital signs：", "answer_idx": "B", "answer": "一般病房住院治疗", "options": {"A": "门诊治疗", "B": "一般病房住院治疗", "C": "加护病房住院治疗", "D": "立即施打肺炎疫苗"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 32 岁女性，有静脉注射毒品的习惯，因发烧及寒颤 3 天至急诊求诊。理学检查有贫血、口腔有溃疡、心脏听诊有心杂音。下列叙述何者最不恰当？", "answer_idx": "D", "answer": "安排胸前心脏超音波（transthoracic echocardiography），检查结果为阴性即可排除感染性心内膜炎的诊断", "options": {"A": "应做三套血液培养，每次抽血时间至少相隔 1 小时", "B": "最可能的致病菌为金黄色葡萄球菌（Staphylococcus aureus）", "C": "眼底镜检查可能会发现有 Roth's spots，而病患四肢可能会出现疼痛的 Osler's node", "D": "安排胸前心脏超音波（transthoracic echocardiography），检查结果为阴性即可排除感染性心内膜炎的诊断"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者为糖尿病多发性神经病变（diabetic polyneuropathy）病患的特征之一？", "answer_idx": "B", "answer": "Areflexia", "options": {"A": "Babinski sign", "B": "Areflexia", "C": "Grasp reflex", "D": "Exaggerated stretch reflex 21 造成耳蜗（cochlea）内 hair cell 去极化的机转为何？"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者位于心脏的隔缘肉柱（septomarginal trabecula, moderator band）中？", "answer_idx": "B", "answer": "房室束右支（right branch of atrioventricular bundle）", "options": {"A": "发出左右分支前的房室束（atrioventricular bundle）", "B": "房室束右支（right branch of atrioventricular bundle）", "C": "房室束左支（left branch of atrioventricular bundle）", "D": "普金斯纤维（Purkinje fibers）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关疝气（hernia）的叙述，何者错误？", "answer_idx": "C", "answer": "以腹股沟疝气发生率而言，女性多于男性", "options": {"A": "75%的疝气发生在腹股沟区域（inguinal region）", "B": "以腹股沟疝气（inguinal hernia）而言，三分之二属于间接型疝气（indirect hernia）", "C": "以腹股沟疝气发生率而言，女性多于男性", "D": "以股疝气（femoral hernia）发生率而言，女性多于男性"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种情况，导致遗传疾病半乳糖血症（galactosemia）的发生？", "answer_idx": "B", "answer": "缺少 UDP-glucose:galactose 1-phosphate uridylyltransferase", "options": {"A": "缺少 fructokinase", "B": "缺少 UDP-glucose:galactose 1-phosphate uridylyltransferase", "C": "无法分解 lactose", "D": "过度摄取 galactose"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 20 岁女性，过去因蝴蝶斑被怀疑是全身性红斑性狼疮，病患现因发烧及下肢水肿住院。尿液检验显示血尿与严重之蛋白尿，下列何者自体抗体检查与病患目前之症狀最有相关性？", "answer_idx": "C", "answer": "anti-double strand DNA", "options": {"A": "anti-Sm", "B": "anti-RNP", "C": "anti-double strand DNA", "D": "anti-histone"}}
{"meta_info": "taiwanese_test_Q", "question": "有关疾病筛检之叙述，下列何者正确？", "answer_idx": "D", "answer": "选取一个切点（cut-off point）来决定标准值所在时，若增加敏感度（sensitivity），则特异度（specificity）常会下降", "options": {"A": "鉴别力好的 Receiver Operating Characteristics（ROC）曲线应该是接近对角线", "B": "诊断糖尿病的饭前血糖值标准若由 110 降到 105，伪阳性个案数会减少", "C": "若以系列性检查（tests in series），筛检一种疾病，则第一个检查通常会使用特异度（specificity）较高者", "D": "选取一个切点（cut-off point）来决定标准值所在时，若增加敏感度（sensitivity），则特异度（specificity）常会下降"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列何种处置方式可行？", "answer_idx": "D", "answer": "剖腹探查", "options": {"A": "经 性抗生素治疗", "B": "血管摄影检查", "C": "胃镜检查", "D": "剖腹探查"}}
{"meta_info": "taiwanese_test_Q", "question": "59 杨小姐今年 27 岁，最近每天晚上服用巴比妥盐類药物（Barbiturate）帮助睡觉，几天之后开始肚子剧痛，且偶尔会有幻觉产生，今天因为癫痫发作而被送至急诊。她的血压 172/116 mmHg、心跳每分钟 134 次，一直喊肚子痛；兩脚不断的踢來踢去挣扎，但兩手却垂在床缘不太会动。杨小姐接受了腹部超音波、腹部电脑断层、脑脊髓液检查都完全正常，但神经传导速度检查显示周边神经有明显之轴突病变（axonopathy）。家属表示杨小姐的妈妈也曾经因为吃巴比妥盐類药物而产生類似的症狀。下列何者诊断最有可能？\n", "answer_idx": "D", "answer": "紫质症（porphyria）", "options": {"A": "蜱麻痹（tick paralysis）", "B": "混合型冷凝蛋白血症（mixed cryoproteinemia）", "C": "急性发炎性脱髓鞘型多发神经病变（acute inflammatory demyelinating polyneuropathy）", "D": "紫质症（porphyria）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种药物最常用于预防早产？", "answer_idx": "D", "answer": "Ritodrine", "options": {"A": "Isoproterenol", "B": "Albuterol", "C": "Salmeterol", "D": "Ritodrine"}}
{"meta_info": "taiwanese_test_Q", "question": "77.一位28岁已婚女性病人，性生活正常，有左侧输卵管发炎的病史，平常月经相当不规则，有时候两至三个月才来一次，上次月经来已经是九周前的事了。此病人从昨天早上开始，下腹疼痛合并阴道有少许出血，另外还有冒冷 、头晕、心悸的症状，故来求诊。到达急诊时意识清楚，脸色苍白，无外伤。生命征象如下：呼吸22次/min、心跳 102次/min、体温", "answer_idx": "C", "answer": "腹部X光检查", "options": {"A": "给予静脉输液（fluid hydration）", "B": "持续性监测血压", "C": "腹部X光检查", "D": "怀孕测试（pregnancy test）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关降血糖药物作用机转的描述，何者错误？", "answer_idx": "C", "answer": "rosiglitazone 具有减少胰岛素抗性（insulin resistance）的作用，主要针对第一型糖尿病使用", "options": {"A": "glipizide 具有促进胰岛素分泌的作用", "B": "metformin 具有抑制肝脏制造过多葡萄糖的作用", "C": "rosiglitazone 具有减少胰岛素抗性（insulin resistance）的作用，主要针对第一型糖尿病使用", "D": "acarbose 具有抑制肠道内负责分解双糖、寡糖及多糖的酵素，进而延迟及减少糖類的分解吸收"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于復发性短期忧郁性疾患（Recurrent brief depressive disorder）之治療？", "answer_idx": "B", "answer": "激素治療", "options": {"A": "心理治療", "B": "激素治療", "C": "抗忧郁剂治療", "D": "情绪稳定剂治療"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种视神经盘凹杯与视神经盘直径比例（cup-disk ratio），比较不会被怀疑有青光眼：", "answer_idx": "A", "answer": "0.2", "options": {"A": "0.2", "B": "0.5", "C": "0.8", "D": "两眼视神经盘凹杯与视神经盘直径比例（cup-disk ratio）极不对称"}}
{"meta_info": "taiwanese_test_Q", "question": "89 一位60 岁男性因上腹闷痛來求诊，内视镜发现溃疡性病灶，病理切片发现在黏膜层有大量单形性（monomorphous）淋巴球浸润，且有淋巴上皮性病灶（lymphoepithelial lesion ），则下列何者是最有可能的致病原？\n", "answer_idx": "D", "answer": "幽门螺旋杆菌", "options": {"A": "巨细胞病毒", "B": "葡萄球菌", "C": "沙门氏杆菌", "D": "幽门螺旋杆菌"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，此时会选择何种药物治療？", "answer_idx": "D", "answer": "口服 metronidazole 或 vancomycin", "options": {"A": "注射 clindamycin", "B": "口服 asacol", "C": "注射 ampicillin", "D": "口服 metronidazole 或 vancomycin"}}
{"meta_info": "taiwanese_test_Q", "question": "许多药物的合成乃是结合分子生物学与合成化学而得，抗爱滋病的药物 3'-Azido-2',3'-dideoxythymidine （AZT）即为其中一项，下列关于 AZT 的叙述，何者错误？", "answer_idx": "D", "answer": "人類 T 淋巴球的 DNA 复制酶对 AZT triphosphate 有高亲和力，所以会带來许多副作用", "options": {"A": "AZT 由易被 HIV 病毒感染的 T 淋巴球所吸收而转变为三磷酸根 AZT（AZT triphosphate）", "B": "HIV 病毒的反转錄酶对于 AZT triphosphate 有极高的亲和力", "C": "HIV 病毒的 DNA 进行复制时若 3'端加入 AZT triphosphate 则会终止复制反应", "D": "人類 T 淋巴球的 DNA 复制酶对 AZT triphosphate 有高亲和力，所以会带來许多副作用"}}
{"meta_info": "taiwanese_test_Q", "question": "催产素（oxytocin）的主要作用为何？", "answer_idx": "B", "answer": "促进排乳作用（milk ejection）", "options": {"A": "促进子宫松弛（uterine relaxation）", "B": "促进排乳作用（milk ejection）", "C": "抑制黄体分解（luteolysis）", "D": "抑制前列腺素 F2α（PGF2α）的分泌"}}
{"meta_info": "taiwanese_test_Q", "question": "判别食道闭锁的病婴有无食道气管瘘管，可由一般胸部 X 光片那一种变化看出？", "answer_idx": "A", "answer": "有无肠胃空气的影像", "options": {"A": "有无肠胃空气的影像", "B": "横膈膜位置", "C": "食道盲端的位置", "D": "气管分支的位置"}}
{"meta_info": "taiwanese_test_Q", "question": "三个月大的婴儿，患有右侧斜颈症（torticollis），下列的医療建议何者正确？", "answer_idx": "D", "answer": "应该教导向右侧上方注视的姿势", "options": {"A": "如果没有治療，左脸会有扁平化的现象", "B": "容易合并左侧髋关节发育不良（hip dysplasia）", "C": "应该加强右侧颈部的肌力训練", "D": "应该教导向右侧上方注视的姿势"}}
{"meta_info": "taiwanese_test_Q", "question": "当吸入过敏原后，过敏原经由抗原呈现细胞（antigen presenting cell, APC），将其处理后呈现给 T 细胞而引起一連串的过敏反应。以下何者不属于抗原呈现细胞？", "answer_idx": "A", "answer": "嗜伊红性细胞（eosinophil）", "options": {"A": "嗜伊红性细胞（eosinophil）", "B": "树突细胞（dendritic cell）", "C": "单核球（monocyte）", "D": "巨噬细胞（macrophage）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关前列腺癌之叙述，下列何者错误？", "answer_idx": "D", "answer": "肿瘤侵犯至贮精囊时属T3a期", "options": {"A": "每年PSA升高超过0.75 ng/mL者，潜伏癌症之机率增高", "B": "经直肠超音波检查比指诊更能精确定出局部肿瘤期别", "C": "格里森分数（Gleason score）高于7分者较易发生癌症进展", "D": "肿瘤侵犯至贮精囊时属T3a期"}}
{"meta_info": "taiwanese_test_Q", "question": "当我们为病患进行麻醉诱导时，下列何项因子并不会增加麻醉气体的诱导速率？", "answer_idx": "B", "answer": "高麻醉机通路气体容量（high anesthetic-circuit volume）", "options": {"A": "减少再吸入（rebreathing）", "B": "高麻醉机通路气体容量（high anesthetic-circuit volume）", "C": "高脑血流量（cerebral blood flow）", "D": "肺泡中的溶解度（solubility）降低"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关急性发炎性脱髓鞘多发性神经病变症候群（Guillain-Barré syndrome）之叙述，何者错误？", "answer_idx": "D", "answer": "糖尿病病人大部分会发生此病", "options": {"A": "可能引起颜面神经病变", "B": "呼吸困难常是致命的主因", "C": "会有自主神经功能異常（autonomic dysfunction）的症狀", "D": "糖尿病病人大部分会发生此病"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那种酶在肌细胞中含量较低，无法有效进行糖合成作用（gluconeogenesis）？", "answer_idx": "D", "answer": "葡萄糖6-磷酸酶（glucose 6-phosphatase）", "options": {"A": "丙酮酸脱氢酶（pyruvate dehydrogenase）", "B": "磷酸果糖磷激酶-1（phosphofructokinase-1）", "C": "肝糖合成酶（glycogen synthase）", "D": "葡萄糖6-磷酸酶（glucose 6-phosphatase）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是分辨肌⾁病变与神经病变最有⽤的电学诊断⽅法？", "answer_idx": "B", "answer": "肌电图检查（EMG study）", "options": {"A": "神经传导检查（nerve conduction study）", "B": "肌电图检查（EMG study）", "C": "连续电刺激神经检查（repetitive nerve stimulation test）", "D": "肌⾁激发电刺激检查（muscle excitability test）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 60 岁心肌梗塞患者，经运动功能测试后，有关其心脏復健之有氧运动的处方，下列叙述何者最正确？", "answer_idx": "A", "answer": "每周运动 3 次以上", "options": {"A": "每周运动 3 次以上", "B": "每次持续运动时间应超过 60 分钟", "C": "以上肢运动为主", "D": "运动强度不得低于心跳每分钟 130 次"}}
{"meta_info": "taiwanese_test_Q", "question": "单精细胞质内注射术（ICSI）其遗传物质不可由何处取得？", "answer_idx": "D", "answer": "原精细胞（Spermatogonia）", "options": {"A": "活动精虫（Spermatozoon）", "B": "副睪（Epididymis）的精虫（Spermatozoon）", "C": "精小管（Seminiferous tubules）的精细胞（Spermatids）", "D": "原精细胞（Spermatogonia）"}}
{"meta_info": "taiwanese_test_Q", "question": "为避免早产儿于出生后发生玻璃腺样病（hyaline membrane disease），可于产前给予孕妇下列何种药物？", "answer_idx": "B", "answer": "glucocorticoids", "options": {"A": "aspirin", "B": "glucocorticoids", "C": "magnesium sulfate", "D": "thyrotropin"}}
{"meta_info": "taiwanese_test_Q", "question": "关于嗜伊红性白血球和嗜中性白血球的异同，下列叙述何者正确？", "answer_idx": "B", "answer": "IL-5主要促进嗜伊红性白血球的生成", "options": {"A": "嗜中性白血球含有过氧化酶，但嗜伊红性白血球不含此酶", "B": "IL-5主要促进嗜伊红性白血球的生成", "C": "真核寄生虫感染时嗜中性白血球反应较强", "D": "CCR3在嗜中性白血球表现较多"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 45 岁红斑性狼疮女性患者，近半年来数度因为突发性眼皮与嘴唇皮下组织水肿合并有呼吸困难，前往急诊就医。下列何者与患者的急性症状最为相关？", "answer_idx": "B", "answer": "补体系统", "options": {"A": "抗核抗体", "B": "补体系统", "C": "免疫球蛋白", "D": "血中白蛋白"}}
{"meta_info": "taiwanese_test_Q", "question": "下列气管（trachea）和支气管（bronchus）管壁构造之比较，何项正确？", "answer_idx": "A", "answer": "两者都有弹性纤维（elastic fiber）", "options": {"A": "两者都有弹性纤维（elastic fiber）", "B": "两者的上皮（epithelium）高度相同", "C": "两者都有纤维软骨（fibrous cartilage）", "D": "两者都没有平滑肌细胞（smooth muscle cells）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位7 岁男孩，3 星期以來，下肢出现很多脓疖（furunculosis），2 天前出现红色血尿及蛋白尿，因此至门诊就诊；血压明显升高（160/105 mmHg），并发现全身水肿，体重比平时重了3 kg，血清白蛋白/球蛋白比值（A/G）为3.2/3.1 mg/dL。下列何者最不可能出现？", "answer_idx": "D", "answer": "尿液培养常长出 A 群链球菌", "options": {"A": "经检验，此病童血中C3补体降低", "B": "疖内脓（pus）培养，长出 A 群链球菌，但 ASO（antistreptolysin O）titer 正常", "C": "肾丝球基底膜可发现免疫复合体（immune complex）沈淀", "D": "尿液培养常长出 A 群链球菌"}}
{"meta_info": "taiwanese_test_Q", "question": "下颌下腺（submandibular gland）位于下列何处？", "answer_idx": "C", "answer": "二腹肌三角（digastric triangle）", "options": {"A": "肌三角（muscular triangle）", "B": "颈动脉三角（carotid triangle）", "C": "二腹肌三角（digastric triangle）", "D": "颏下三角（submental triangle）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关抗癫痫药物作用的叙述，下列何者错误？", "answer_idx": "C", "answer": "topiramate透过阻断glutamate转运子（transporter）的作用来产生抗癫痫作用", "options": {"A": "ethosuximide主要透过阻断T-type钙离子通道来产生抗癫痫作用", "B": "tiagabine主要透过阻断GABA转运子（transporter）的作用来产生抗癫痫作用", "C": "topiramate透过阻断glutamate转运子（transporter）的作用来产生抗癫痫作用", "D": "valproic acid可透过阻断钠离子通道来产生抗癫痫作用"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 23 岁女性病人主诉心悸，心跳每分钟 160 下，血压为 110/80 mmHg，心电图为 paroxysmal supra- ventricular tachycardia（PSVT），可优先考虑下列何种治療？", "answer_idx": "D", "answer": "颈动脉窦按摩", "options": {"A": "Adenosine 静脉快速注射", "B": "Lidocaine 静脉注射", "C": "Verapamil 静脉缓慢注射", "D": "颈动脉窦按摩"}}
{"meta_info": "taiwanese_test_Q", "question": "关于Zollinger-Ellison syndrome的叙述，下列何者错误？", "answer_idx": "B", "answer": "70～90%的肿瘤会分布于总胆管、胃与胰脏颈及胰脏体之间", "options": {"A": "病因为胃泌细胞瘤（gastrinoma）⼤量分泌胃泌激素后，造成胃酸分泌过量", "B": "70～90%的肿瘤会分布于总胆管、胃与胰脏颈及胰脏体之间", "C": "必须排除有无第⼀型多发性内分泌肿瘤症候群（MEN I）的可能，因为有四分之⼀的患者会合并有MEN I，", "D": "病⼈会有淋巴及肝脏转移之风险，所以应将这个肿瘤视为恶性肿瘤"}}
{"meta_info": "taiwanese_test_Q", "question": "最常见的偏头痛预兆是：", "answer_idx": "B", "answer": "视觉症状", "options": {"A": "感觉异常", "B": "视觉症状", "C": "半侧偏瘫", "D": "语言障碍"}}
{"meta_info": "taiwanese_test_Q", "question": "23 一位 50 岁男性患者有高血压病史约 5 年，20 分钟前发生未曾经歷过的剧烈头痛，接着出现兩下肢无 力，最可能的病变为：\n", "answer_idx": "A", "answer": "前交通动脉（anterior communicating artery）之动脉瘤破裂", "options": {"A": "前交通动脉（anterior communicating artery）之动脉瘤破裂", "B": "后交通动脉（posterior communicating artery）之动脉瘤破裂", "C": "脊髓梗塞（spinal cord infarct）", "D": "兩侧前大脑动脉阻塞"}}
{"meta_info": "taiwanese_test_Q", "question": "臨床上有关不同類型休克（shock）的成因，下列何者正确？", "answer_idx": "D", "answer": "Hypovolemic shock 可出现于大量失血（hemorrhage）时", "options": {"A": "烧烫伤（burns）可造成 distributing shock", "B": "心包膜填塞（cardiac tamponade）会造成 cardiogenic shock", "C": "Obstructive shock 常出现于外科手术（surgery）后", "D": "Hypovolemic shock 可出现于大量失血（hemorrhage）时"}}
{"meta_info": "taiwanese_test_Q", "question": "5 岁男孩，并无发烧或高血压病史，突然发生右侧肢体无力，经脑部电脑断层检查，发现左侧前脑动脉供应区呈现缺血性梗塞，核磁共振动脉摄影（MRA）及脑血管摄影显示兩侧前脑动脉及中脑动脉供应区出现不正常毛玻璃样血管丛。下列四项诊断中，那一项最符合？", "answer_idx": "C", "answer": "毛毛样脑血管症（Moyamoya Disease）", "options": {"A": "左侧前脑动脉瘤破裂，并发血管收缩", "B": "基底核区之动静脉畸形", "C": "毛毛样脑血管症（Moyamoya Disease）", "D": "脑动脉炎并发血管阻塞"}}
{"meta_info": "taiwanese_test_Q", "question": "与子宫颈腺癌相关性最强的人類乳突病毒是：", "answer_idx": "B", "answer": "HPV 18", "options": {"A": "HPV 16", "B": "HPV 18", "C": "HPV 31", "D": "HPV 33"}}
{"meta_info": "taiwanese_test_Q", "question": "关于原发性肺癌的叙述，何者错误？", "answer_idx": "A", "answer": "鳞状上⽪癌（squamous cell carcinoma）是⽬前最常⾒的组织型态", "options": {"A": "鳞状上⽪癌（squamous cell carcinoma）是⽬前最常⾒的组织型态", "B": "腺癌（adenocarcinoma）会有腺泡（acinar）、乳突（papillary）、⿂鳞（lepidic）、固态（solid）等的型态", "C": "跟吸烟相关性⾼的是鳞状上⽪癌、⼩细胞癌（small-cell carcinoma）", "D": "表⽪⽣⻑因⼦受体（epidermal growth factor receptor）突变常出现于腺癌"}}
{"meta_info": "taiwanese_test_Q", "question": "21 承上题，如果你采用带茎横式腹直肌肌皮瓣（pedicled transverse rectus abdominis myocutaneous （TRAM）flaps）来重建，最大的缺点为何？\n", "answer_idx": "B", "answer": "腹肌无力，甚至出现腹部疝气", "options": {"A": "腹部疤痕不美观", "B": "腹肌无力，甚至出现腹部疝气", "C": "重建的乳房不自然", "D": "皮瓣体积不够"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关疖（furuncle）的叙述，何者正确？", "answer_idx": "C", "answer": "较常发生于年轻人", "options": {"A": "疖是一种急性的汗腺感染症", "B": "外用抗生素是治療首选", "C": "较常发生于年轻人", "D": "常見的病原菌是 haemolytic streptococci"}}
{"meta_info": "taiwanese_test_Q", "question": "软斑（malacoplakia）是一种什么样的病灶？", "answer_idx": "D", "answer": "细菌性感染", "options": {"A": "良性的膀胱肿瘤", "B": "膀胱上皮的癌前病灶", "C": "病毒性感染", "D": "细菌性感染"}}
{"meta_info": "taiwanese_test_Q", "question": "过量neostigmine中毒，不会产生下列何种作用？", "answer_idx": "C", "answer": "散瞳", "options": {"A": "腹泻", "B": "流", "C": "散瞳", "D": "排尿"}}
{"meta_info": "taiwanese_test_Q", "question": "新生儿室一位新生儿的右侧足踝部有明显变形如下图，图片显示的足踝先天畸形，不包括下列何者？", "answer_idx": "B", "answer": "扁平足（pes planus）", "options": {"A": "前足内翻（metatarsal adductus）", "B": "扁平足（pes planus）", "C": "足跟内翻（heel varus）", "D": "马蹄足（ankle equinus）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种尿路结石，其成分含镁？", "answer_idx": "A", "answer": "struvite", "options": {"A": "struvite", "B": "whewellite", "C": "weddellite", "D": "hydroxyapatite"}}
{"meta_info": "taiwanese_test_Q", "question": "有关老人 hip fracture 的叙述，下列何者错误？", "answer_idx": "D", "answer": "术后应尽量不要让病人下床活动", "options": {"A": "常見于骨质疏松的病人", "B": "一般而言，手术是较好的处理方式", "C": "骨折手术后一年内 mortality rate 仍会上升", "D": "术后应尽量不要让病人下床活动"}}
{"meta_info": "taiwanese_test_Q", "question": "一名个9个月大婴儿因突发性右侧阴囊肿大来急诊，经臆断可能是嵌闭性腹股沟疝气、睪丸扭转、睪丸或副睪发炎、或急性阴囊水肿。下列叙述何者错误？", "answer_idx": "C", "answer": "如果是嵌闭性腹股沟疝气，无论多久，应尽速在急诊就徒手复位", "options": {"A": "可做阴囊超音波检查帮助鉴别诊断", "B": "如果是睪丸扭转，应尽速在扭转后6小时内手术，约有90%可成功恢复血流", "C": "如果是嵌闭性腹股沟疝气，无论多久，应尽速在急诊就徒手复位", "D": "急性阴囊水肿可以观察，不用急 手术"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 16 岁重型地中海型贫血病患，长期输血且排铁剂使用不足，致罹患铁质沈积症。下列那一种情况与其病情无关？", "answer_idx": "C", "answer": "智力测验显示重度智障", "options": {"A": "肝脏切片有纤维化的现象", "B": "心脏超音波检查舒张功能有缺陷", "C": "智力测验显示重度智障", "D": "葡萄糖耐受试验（glucose tolerance test）異常"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于新生儿淋病性结膜炎（neonatal gonococcal conjunctivitis）的叙述，何者错误？", "answer_idx": "C", "answer": "脓状分泌物大约在出生后第三周至第四周间开始出现", "options": {"A": "常是由母亲经产道感染给新生儿", "B": "须同时给予局部及全身抗生素治疗", "C": "脓状分泌物大约在出生后第三周至第四周间开始出现", "D": "最好要对其分泌物作抹片及细菌培养等检查"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 35 岁女性主诉：畏寒、水肿、无月经、且时有乳汁分泌。血液分析发现甲狀腺激素數值过低，则此病患之无月经及泌乳现象最可能由于下列何种激素之影响？", "answer_idx": "C", "answer": "下视丘所分泌之甲释素（TRH）刺激脑下垂体分泌泌乳素", "options": {"A": "下视丘所分泌之多巴胺（dopamine）刺激脑下垂体分泌泌乳素（prolactin）", "B": "下视丘所分泌之性释素（GnRH）刺激脑下垂体分泌促黄体素（LH）", "C": "下视丘所分泌之甲释素（TRH）刺激脑下垂体分泌泌乳素", "D": "下视丘所分泌之多巴胺刺激脑下垂体分泌促黄体素"}}
{"meta_info": "taiwanese_test_Q", "question": "副交感神经之节后纤维与下列何者伴行？", "answer_idx": "B", "answer": "腭大神经（Greater palatine nerve）", "options": {"A": "岩小神经（Lesser petrosal nerve）", "B": "腭大神经（Greater palatine nerve）", "C": "岩大神经（Greater petrosal nerve）", "D": "鼓索神经（Chorda tympani nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于medullary thyroid carcinoma的叙述，何者错误？", "answer_idx": "B", "answer": "约80%的medullary carcinoma与MEN 2A或MEN 2B有关", "options": {"A": "源⾃于parafollicular或C cells", "B": "约80%的medullary carcinoma与MEN 2A或MEN 2B有关", "C": "可分泌calcitonin，亦可能分泌carcinoembryonic antigen（CEA）", "D": "若同时合并pheochromocytoma，则必须先处理pheochromocytoma"}}
{"meta_info": "taiwanese_test_Q", "question": "士兵参与战争后，最可能产生的精神疾病为何？", "answer_idx": "A", "answer": "创伤后压力症（post traumatic stress disorder）", "options": {"A": "创伤后压力症（post traumatic stress disorder）", "B": "强迫症（obsessive compulsive disorder）", "C": "妄想症（delusional disorder）", "D": "恐慌症（panic disorder）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是诊断糖尿病神经病变（diabetic neuropathy）最有用的电学诊断方法？", "answer_idx": "A", "answer": "神经传导（nerve conduction）检查", "options": {"A": "神经传导（nerve conduction）检查", "B": "肌电图（electromyography）检查", "C": "肌肉激发电刺激（muscle excitability）检查", "D": "神经连续电刺激（repetitive nerve stimulation）检查"}}
{"meta_info": "taiwanese_test_Q", "question": "55 下列何种药物应在病人感染疟疾數天之后给予，以便清除病人肝脏中裂殖虫（schizonts）及静止虫体 （hypnozoites）？\n", "answer_idx": "A", "answer": "primaquine", "options": {"A": "primaquine", "B": "artemisinin", "C": "proguanil", "D": "sulfadoxine"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，电脑断层显示如下图，抽血检 睪固酮（testosterone）为250 ng/dL，DHEAS为800 µg/dL，则诊断最有可能为：", "answer_idx": "C", "answer": "肾上腺肿瘤", "options": {"A": "分泌男性素的卵巢肿瘤", "B": "多囊性卵巢肿瘤", "C": "肾上腺肿瘤", "D": "库欣氏症（Cushing syndrome）"}}
{"meta_info": "taiwanese_test_Q", "question": "台湾常見的贝他型海洋性贫血症（β thalassemia），其致病基因是位于第几对染色体上？", "answer_idx": "B", "answer": "11", "options": {"A": "9", "B": "11", "C": "13", "D": "15"}}
{"meta_info": "taiwanese_test_Q", "question": "一位45 岁男性病人，曾有高尿酸血症及血脂異常之病史，求诊时主诉最近兩周体重急遽下降8 公斤，有口渴频尿之现象，理学检查发现病人身高165 公分，体重80公斤，血压160/90 mmHg，呼吸每分钟15 次，脉搏每分钟100 次，颈部有黑色素沈积之现象，病人最可能的诊断为何？", "answer_idx": "C", "answer": "糖尿病", "options": {"A": "甲狀腺功能亢进", "B": "嗜铬细胞瘤", "C": "糖尿病", "D": "尿崩症"}}
{"meta_info": "taiwanese_test_Q", "question": "对于血液与消化系统之间的关系叙述，下列何者错误？", "answer_idx": "B", "answer": "肝脏合成之免疫球蛋白（immunoglobulin）在血液中具杀菌作用", "options": {"A": "红血球被摧毁之后，血基质（heme）被分解成胆红素（bilirubin）进入肝脏成为胆汁的一部分", "B": "肝脏合成之免疫球蛋白（immunoglobulin）在血液中具杀菌作用", "C": "大肠常生菌（normal flora）合成之维他命K对凝血因子的生成很重要", "D": "消化道吸收的铁可供给红血球进行氧气携带"}}
{"meta_info": "taiwanese_test_Q", "question": "42.产妇生产会阴部裂伤（perineal laceration）共分四度，第四度裂伤最为严重。第四度裂伤代表深度到达下列何 种解剖位置？\n", "answer_idx": "D", "answer": "直肠黏膜层（rectal mucosa）", "options": {"A": "阴道黏膜层（vaginal mucosa）", "B": "外层肛门括约肌（external anal sphincter）", "C": "内层肛门括约肌（internal anal sphincter）", "D": "直肠黏膜层（rectal mucosa）"}}
{"meta_info": "taiwanese_test_Q", "question": "构成手腕（wrist）的骨头中，那两块骨头会直接与桡骨远端（distal end of radius）相关节？", "answer_idx": "C", "answer": "舟状骨（scaphoid）与月状骨（lunate）", "options": {"A": "大多角骨（trapezium）与小多角骨（trapezoid）", "B": "头状骨（capitate）与钩状骨（hamate）", "C": "舟状骨（scaphoid）与月状骨（lunate）", "D": "三角骨（triquetrum）与豆状骨（pisiform）"}}
{"meta_info": "taiwanese_test_Q", "question": "RU-486（mifepristone）可以用在人工流产，是因为其主要拮抗下列何种受体？", "answer_idx": "D", "answer": "progesterone", "options": {"A": "glucocorticoid", "B": "androgen", "C": "estrogen", "D": "progesterone"}}
{"meta_info": "taiwanese_test_Q", "question": "70岁女性，左侧耳后有如左图之肿瘤，数年之久，病理组织切片结果如右图；下列何者为最适当的诊断？", "answer_idx": "B", "answer": "基底细胞癌（basal cell carcinoma ）", "options": {"A": "状细胞癌（squamous cell carcinoma）", "B": "基底细胞癌（basal cell carcinoma ）", "C": "恶性黑色素细胞癌（malignant melanoma）", "D": "脂漏性角化症（seborrheic keratosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "16 35 岁男性主诉发烧五天，发病前三天从印尼旅游一周回来，其他症状包括：眼窝后酸痛、背部肌肉酸痛、食欲减退、软便及下肢和腹部红疹（如图所示）。血压 130/85 mmＨg；额温 38.9℃；脉搏 88/分；呼吸 18/分；血液检验：白血球 2,350/mm3；血球容积比（hematocrit）49%；血小板：43,000/mm3；\n GOT/GPT: 84/67 U/L。病人最可能是那种感染症？\n", "answer_idx": "C", "answer": "登革热（Dengue fever）", "options": {"A": "流行性感冒（influenza）", "B": "梅毒（Syphilis）", "C": "登革热（Dengue fever）", "D": "肺炎霉浆菌（Mycoplasma pneumoniae）感染 17 下列有关肺水肿的叙述，何者正确？"}}
{"meta_info": "taiwanese_test_Q", "question": "关于婴儿异位性皮肤炎的叙述，下列何者正确？", "answer_idx": "A", "answer": "分布范围主要为脸部、头皮以及四肢的伸侧（extensor side）", "options": {"A": "分布范围主要为脸部、头皮以及四肢的伸侧（extensor side）", "B": "若患者合并thrombocytopenia以及免疫功能异常，需怀疑是hyper-IgE syndrome", "C": "临床上不须与脂漏性皮肤炎做鉴别诊断", "D": "为避免局部类固醇造成的副作用，FDA建议首选外用药物为0.03% tacrolimus或1% pimecrolimus"}}
{"meta_info": "taiwanese_test_Q", "question": "74.61岁男性突发性的胸痛、呼吸困难，其胸部X光如图示，最主要的诊断为何？", "answer_idx": "C", "answer": "气胸", "options": {"A": "肺气肿", "B": "肺挫伤出血", "C": "气胸", "D": "肺炎"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于操纵子（operon）的叙述，何者错误？", "answer_idx": "A", "answer": "只在真核生物上发现", "options": {"A": "只在真核生物上发现", "B": "包含promoter", "C": "包含operator", "D": "包含structural genes"}}
{"meta_info": "taiwanese_test_Q", "question": "尺神经（ulnar nerve）受损时，拇指无法进行何种动作？", "answer_idx": "C", "answer": "内收（adduction）", "options": {"A": "屈曲（flexion）", "B": "伸直（extension）", "C": "内收（adduction）", "D": "外展（abduction）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关内脏型利什曼症（visceral leishmaniasis）之叙述，何者错误？", "answer_idx": "C", "answer": "此類病人脾脏穿刺是禁忌", "options": {"A": "臨床上易误诊为再生不能性贫血（aplastic anemia）", "B": "病人以药物治療后，可能产生黑热病后皮肤利什曼症（post kala-azar dermal leishmaniasis）", "C": "此類病人脾脏穿刺是禁忌", "D": "病人会出现高球蛋白血症（hyperglobulinemia）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 Crohn's 大肠炎及溃疡性大肠炎（Ulcerative colitis）的鉴别之叙述，何者错误？", "answer_idx": "C", "answer": "溃疡性大肠炎有较高比率之肛裂，肛门溃疡、管及脓疡", "options": {"A": "臨床症狀 Crohn's 大肠炎比溃疡性大肠炎有较高比率可摸到腹部肿块及较多肛门问题", "B": "放射线学检查，Crohn's 大肠炎较多回肠疾病，且较多跳跃式病灶", "C": "溃疡性大肠炎有较高比率之肛裂，肛门溃疡、管及脓疡", "D": "溃疡性大肠炎的溃疡较表浅及普遍化，而 Crohn's 大肠炎较多直线性、深且散在性的溃疡"}}
{"meta_info": "taiwanese_test_Q", "question": "68.酮酸中毒患者体内酮体（ketone body）是由下列那些物质构成？ ①乙醯乙酸（acetoacetate） ②β-羟丁酸 （β-hydroxybutyrate） ③丙酮（acetone） ④α-酮戊二酸（α-ketoglutarate）\n", "answer_idx": "C", "answer": "仅①②③", "options": {"A": "①②③④", "B": "仅①②④", "C": "仅①②③", "D": "仅③④"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种碱基不存于一般 RNA 分子？", "answer_idx": "C", "answer": "胸腺嘧啶（thymine）", "options": {"A": "腺嘌呤（adenine）", "B": "尿嘧啶（uracil）", "C": "胸腺嘧啶（thymine）", "D": "胞嘧啶（cytosine）"}}
{"meta_info": "taiwanese_test_Q", "question": "64.怀孕妇女因输尿管结石产生腰痛求医处理时，下列何者较不合适？", "answer_idx": "A", "answer": "必须立即以IVU（intravenous urography）找出石头位置，加以碎石处理免得继续妊娠时症状加剧", "options": {"A": "必须立即以IVU（intravenous urography）找出石头位置，加以碎石处理免得继续妊娠时症状加剧", "B": "利用双J输尿管导管（double-J ureter stent）以解除输尿管之阻塞", "C": "局部麻醉下超音波定位置放经皮肾造廔管（percutaneous nephrostomy tube insertion）", "D": "在怀孕的第一个trimester时应该尽量避免X光照射"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种霉菌为主要病原菌（primary pathogen）？", "answer_idx": "D", "answer": "Paracoccidioides brasiliensis", "options": {"A": "Aspergillus niger", "B": "Cryptococcus neoformans", "C": "Candida albicans", "D": "Paracoccidioides brasiliensis"}}
{"meta_info": "taiwanese_test_Q", "question": "成熟的B细胞可以同时表现IgD与IgM两种免疫球蛋白于细胞表面上，其主要的分子机制为何？", "answer_idx": "A", "answer": "RNA多样裁接（alternative splicing）", "options": {"A": "RNA多样裁接（alternative splicing）", "B": "对偶基因排除（allelic exclusion）", "C": "V", "D": "J片段重组（recombination）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位50 岁女性，因为发烧、腹泻、脱水，在一家医院注射点滴治療，病患突然意識障碍、烦躁，而且陷入半昏迷狀态，转到医学中心紧急做了MRI 检查，根据此二张MRI T2WI及DWI 影像，最适当的诊断是：", "answer_idx": "A", "answer": "Pontine myelinolysis", "options": {"A": "Pontine myelinolysis", "B": "Acute pontine infarction", "C": "Japanese encephalitis", "D": "Pontine glioma"}}
{"meta_info": "taiwanese_test_Q", "question": "胆固醇是下列何种维生素（Vitamin）合成的前驱物？", "answer_idx": "B", "answer": "D", "options": {"A": "A", "B": "D", "C": "E", "D": "K"}}
{"meta_info": "taiwanese_test_Q", "question": "一位55 岁男性，因黄疸转诊，在检验所初步血清生化检查显示Bilirubin total/direct＝7.8/4.0 mg/dL（normal ＜1.0/0.3），GOT 247 U/L（normal＜35），GPT 176 U/L（normal＜35），血浆prothrombin time 延长，转诊医师注意到注射vitamin K 可明显改善prothrombin time，以下那一诊断方向最可能？", "answer_idx": "C", "answer": "阻塞性黄疸", "options": {"A": "慢性肝炎加急性发作", "B": "肝硬化", "C": "阻塞性黄疸", "D": "急性肝衰竭"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是视网膜黄斑部中央小凹（foveola）之结构特征？", "answer_idx": "B", "answer": "仅含有神经节细胞（ganglion cells）及锥狀细胞（cones）", "options": {"A": "完全无杆狀细胞（rods）之分布", "B": "仅含有神经节细胞（ganglion cells）及锥狀细胞（cones）", "C": "是视网膜最薄之处", "D": "完全无视网膜血管之分布"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是罹患乳癌的危险因子？", "answer_idx": "D", "answer": "婶婶罹患乳癌", "options": {"A": "一等亲姊妹罹患乳癌", "B": "40岁怀孕生第一胎", "C": "停经后服用10年的女性荷尔蒙取代剂", "D": "婶婶罹患乳癌"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关治疗甲状腺功能低下症（hypothyroidism）药物levothyroxine的药理作用描述，何者错误？", "answer_idx": "B", "answer": "Levothyroxine对于药物如amiodarone所引起的甲状腺功能低下症治疗效果不佳", "options": {"A": "Levothyroxine不能同时与钙和含铝类的制酸剂合并使用", "B": "Levothyroxine对于药物如amiodarone所引起的甲状腺功能低下症治疗效果不佳", "C": "Levothyroxine可以使用于怀孕的甲状腺功能低下症妇女", "D": "黏液性水肿昏迷（myxedema coma）可以利用levothyroxine来治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "有关乳房 X 光摄影（mammography）检查的叙述，何者正确？", "answer_idx": "C", "answer": "乳房脂肪比例会影响 mammography sensitivity", "options": {"A": "小于 30 岁的年轻妇女怀疑乳房有硬块，应先排乳房 X 光摄影", "B": "50 岁以上妇女 mammography sensitivity 较 50 岁以下妇女差", "C": "乳房脂肪比例会影响 mammography sensitivity", "D": "mammography 会因不同检查者而影响检查结果，亦即 operator-dependent"}}
{"meta_info": "taiwanese_test_Q", "question": "19岁女性，因为脚扭伤而贴敷酸痛药布，两天后，出现如图所示会痒之皮肤病变，下列何种检查最有助于诊断？", "answer_idx": "B", "answer": "贴肤试 （patch test）", "options": {"A": "KOH镜检（KOH examination）", "B": "贴肤试 （patch test）", "C": "针刺试 （prick test）", "D": "Tzanck抹片检查（Tzanck test）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关遗传学与基因检测在肝脏疾病的研究，下列叙述何者错误？", "answer_idx": "D", "answer": "在威尔森症（Wilson's disease）方面，最常见突变点发生在ATP7B基因，且只有一种突变会发生", "options": {"A": "在肝脏酒精代谢方面，酒精氧化代谢成乙醛（acetaldehyde）后，藉由乙醛脱氢酶（aldehyde", "B": "在自体免疫性肝炎（autoimmune hepatitis）方面，遗传背景与HLA-B1, -B8, -DR3和-DR4有相关", "C": "在遗传性铁质沉 症（hereditary hemochromatosis）方面，以HFE基因相关C282Y与H63D突变最常见", "D": "在威尔森症（Wilson's disease）方面，最常见突变点发生在ATP7B基因，且只有一种突变会发生"}}
{"meta_info": "taiwanese_test_Q", "question": "一位渔夫出海捕鱼时，不慎足背被鱼鳍刺伤，數小时后因小腿肿胀、疼痛并有深紫色水泡浮现，请问下列那一种致病菌最有可能？", "answer_idx": "C", "answer": "Vibrio vulnificus", "options": {"A": "Aeromonas hydrophilia", "B": "Staphylococcus aureus", "C": "Vibrio vulnificus", "D": "Streptococcus pyogenes"}}
{"meta_info": "taiwanese_test_Q", "question": "14 岁女孩出现恶性高血压（200/130 mmHg），腹部影像学检查显示一肾上腺肿瘤，尿中儿茶酚胺（catecholamine）以及血清肾素（serum renin）均升高。下列肾脏血管变化中，何者与此肿瘤有最密切的关系？", "answer_idx": "B", "answer": "Hyperplastic arteriolosclerosis", "options": {"A": "Hyaline arteriolosclerosis", "B": "Hyperplastic arteriolosclerosis", "C": "Atherosclerosis", "D": "Thromboembolism"}}
{"meta_info": "taiwanese_test_Q", "question": "下视丘（hypothalamus）的那一个核区为人体生物时钟（biological clock）之主要节律点（pacemaker）？", "answer_idx": "D", "answer": "suprachiasmatic nucleus", "options": {"A": "paraventricular nucleus", "B": "preoptic nucleus", "C": "ventromedial nucleus", "D": "suprachiasmatic nucleus"}}
{"meta_info": "taiwanese_test_Q", "question": "一位病人因肺部肿瘤，施行经支气管切片，其组织学变化如图二所示，下列何者为最合适的描述？", "answer_idx": "C", "answer": "具腺体样结构（glandular structure）", "options": {"A": "呈现干酪狀坏死（caseous necrosis）变化", "B": "有角质珠（keratin pearl）的存在", "C": "具腺体样结构（glandular structure）", "D": "以神经性上皮（neuroepithelium）为主"}}
{"meta_info": "taiwanese_test_Q", "question": "在临床上有一部分的小孩因类胰岛素成长因子（insulin-like growth factor; IGF-1）的缺乏，因此造成生长发育迟缓的现象，下列何种药物可以用来促进其生长发育？", "answer_idx": "C", "answer": "Mecasermin", "options": {"A": "重组人类生长激素（recombinant human growth hormone）", "B": "Octreotide", "C": "Mecasermin", "D": "Pegvisomant"}}
{"meta_info": "taiwanese_test_Q", "question": "一位63 岁糖尿病患者因大葉性肺炎伴随败血症及肾衰竭住院，接受抗生素治療3 周后出现腹胀拉肚子，粪便有少许血丝以及黏液，大肠镜检查发现大肠黏膜上覆盖黄色膜样的斑块，粪便Clostridium difficile toxin 呈阳性反应，下列何者为最有可能之诊断？", "answer_idx": "B", "answer": "伪膜性结肠炎（pseudomembranous colitis）", "options": {"A": "毒性巨结肠症（toxic megacolon）", "B": "伪膜性结肠炎（pseudomembranous colitis）", "C": "輻射小肠结肠炎（radiation enterocolitis）", "D": "肠套叠（intussusception）"}}
{"meta_info": "taiwanese_test_Q", "question": "胃贲门部（cardiac portion）上皮那类细胞最多？", "answer_idx": "A", "answer": "表面黏膜细胞（surface mucous cells）", "options": {"A": "表面黏膜细胞（surface mucous cells）", "B": "肠内分泌细胞（enteroendocrine cells）", "C": "壁细胞（parietal cells）", "D": "再生干细胞（regenerative stem cells）"}}
{"meta_info": "taiwanese_test_Q", "question": "王君，男性25 岁，第一次搭摩天大樓的电梯时，恐慌发作，以后王君不敢再搭任何密闭式电梯，但王君搭飞机來往国内外多趟，并未发生恐慌发作，也可胜任密闭式实验室的工作，逛百货公司搭扶手电梯也都没有问题。王君最适合的诊断是什么？", "answer_idx": "C", "answer": "电梯畏惧症（specific phobia of elevator）", "options": {"A": "恐慌症（panic disorder）", "B": "惧高症（acrophobia）", "C": "电梯畏惧症（specific phobia of elevator）", "D": "惧旷症（agoraphobia）"}}
{"meta_info": "taiwanese_test_Q", "question": "原始致癌基因（proto-oncogenes）能够透过下列机制转变为致癌基因（oncogenes），何者除外？", "answer_idx": "D", "answer": "其启动区（promoter region）发生突变导致该蛋白质合成量下降", "options": {"A": "化学性诱导突变（chemical-induced mutation）", "B": "染色体重组", "C": "病毒感染", "D": "其启动区（promoter region）发生突变导致该蛋白质合成量下降"}}
{"meta_info": "taiwanese_test_Q", "question": "一位患有寻常天疮（Pemphigus vulgaris）的孕妇，刚刚平安产下3000 公克的小男婴，但是随即发现小男婴身上及四肢分布有红斑，有些红斑上有小水，因此迅速被送入新生儿加护病房治療。他的病因为何？", "answer_idx": "A", "answer": "母亲的自体免疫疾病之抗体，抗 desmoglein 3 抗体（anti-desmoglein 3 antibody）通过胎盘，暂时引起之病征", "options": {"A": "母亲的自体免疫疾病之抗体，抗 desmoglein 3 抗体（anti-desmoglein 3 antibody）通过胎盘，暂时引起之病征", "B": "母亲的自体免疫疾病之抗体，抗 dsDNA 抗体（anti-dsDNA antibody）通过胎盘，引起之胎儿皮肤系统之自体免疫病", "C": "母亲治療自体免疫疾病的用药，在他身上引起不良反应", "D": "母亲的自体免疫疾病之遗传，而且他一出生即发病"}}
{"meta_info": "taiwanese_test_Q", "question": "Rotenone 会抑制粒线体电子传递链的那一个步骤？", "answer_idx": "A", "answer": "NADH→coenzyme Q", "options": {"A": "NADH→coenzyme Q", "B": "Cyt b→Cyt c1", "C": "Cyt c1→Cyt c", "D": "Cyt c→Cyt (a+a3)"}}
{"meta_info": "taiwanese_test_Q", "question": "第三颅神经受损，最可能影响下列何种动作？", "answer_idx": "D", "answer": "上眼睑上抬", "options": {"A": "咀嚼", "B": "脸庞流汗", "C": "紧闭眼睛", "D": "上眼睑上抬"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一位脑死病患，最不适合成为肾脏移植的捐赠者？", "answer_idx": "D", "answer": "20 岁，HIV 阳性", "options": {"A": "43 岁，糖尿病病患", "B": "35 岁，肾结石病史者", "C": "37 岁，十二指肠溃疡病史", "D": "20 岁，HIV 阳性"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，有关上述病人在缝合后的应注意事项，下列何者错误？", "answer_idx": "A", "answer": "给予灌肠", "options": {"A": "给予灌肠", "B": "给予软便剂", "C": "给予冰敷", "D": "给予抗生素"}}
{"meta_info": "taiwanese_test_Q", "question": "44 52 岁女性病患，因左侧腰痛到泌尿科求诊，经身体检查只发现以前因子宫肌瘤行子宫切除术及胆囊结石接受腹腔镜手术的伤痕，尿液分析RBC：2-5/HPF ，WBC：2-5/HPF，Sugar(- )，Protein(- )， BUN：19.1 mg/dL，Cr：0.58 mg/dL，Uric acid：5.1 mg/dL，安排IVU（静脉注射尿路摄影）检查（如图），可能的诊断是：\n", "answer_idx": "B", "answer": "左肾盏结石", "options": {"A": "肾外的钙化", "B": "左肾盏结石", "C": "左肾血管钙化", "D": "兩侧输尿管结石"}}
{"meta_info": "taiwanese_test_Q", "question": "47 25 岁女性，G1P0，月经规则，周期 42 天，产前超音波呈现胎儿头臀径（CRL, crown-rump length） 1 公分，请问怀孕周數为：", "answer_idx": "D", "answer": "12 周", "options": {"A": "6 周", "B": "8 周", "C": "10 周", "D": "12 周"}}
{"meta_info": "taiwanese_test_Q", "question": "Beckwith-Wiedemann syndrome 可能合并何种肿瘤？", "answer_idx": "C", "answer": "Wilms' tumor", "options": {"A": "lymphoma", "B": "neuroblastoma", "C": "Wilms' tumor", "D": "hepatoblastoma"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关背部的叙述，何者错误？", "answer_idx": "C", "answer": "位在枕下三角内的动脉为枕下动脉（suboccipital artery）", "options": {"A": "竖脊肌（erector spinae）为脊柱的主要伸肌群", "B": "背部菱形肌（rhomboid muscle）的外型在上臂平举时方为易見", "C": "位在枕下三角内的动脉为枕下动脉（suboccipital artery）", "D": "构成枕下三角顶部的肌肉为头半脊肌（semispinalis capitis）"}}
{"meta_info": "taiwanese_test_Q", "question": "82 下列叙述中，何者是神经母细胞（Neuroblast）相关肿瘤之特点？", "answer_idx": "A", "answer": "有可能自行消退（Spontaneous regression）", "options": {"A": "有可能自行消退（Spontaneous regression）", "B": "神经节神经细胞瘤（Ganglioneuroma）中会有不少神经母细胞之存在", "C": "婴儿罹患神经母细胞瘤（Neuroblastoma）一旦有皮肤之转移，预后极差", "D": "所有神经节神经母细胞瘤（Ganglioneuroblastomas）都属良性肿瘤"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是雄性素（androgen）过度刺激所引起之可能副作用？", "answer_idx": "D", "answer": "Weight loss", "options": {"A": "Priapism", "B": "Polycythemia", "C": "Prostate enlargement", "D": "Weight loss"}}
{"meta_info": "taiwanese_test_Q", "question": "下图所示婴儿头部经常维持在向右倾斜的姿势，并在右侧颈部摸到一个鸽蛋大的硬块，则下列何种方向的头部活动会受限？", "answer_idx": "C", "answer": "头部转向右侧", "options": {"A": "头部前屈", "B": "头部后仰", "C": "头部转向右侧", "D": "头部转向左侧"}}
{"meta_info": "taiwanese_test_Q", "question": "25 岁机車骑士遭到时速 60 公里汽車撞击后被送入急诊，到院时意識清楚，下列情境对于颈部 X 光检查之叙述何者错误？", "answer_idx": "C", "answer": "外伤病人若侧面颈椎 X 光片正常，就可以将颈圈取下", "options": {"A": "无神经理学症狀者，仍可能有颈椎损伤", "B": "侧面颈椎 X 光片须包括 7 节颈椎及第一节胸椎", "C": "外伤病人若侧面颈椎 X 光片正常，就可以将颈圈取下", "D": "若侧面颈椎 X 光片无法看到第 7 颈椎，就要加照 swimmer's view"}}
{"meta_info": "taiwanese_test_Q", "question": "一位罹患惡性肿瘤的 5 岁男童在作完第五次化療后发现尿中有蛋白。单次小便的 protein/creatinine<1.0。同时尿液中发现有糖分、磷酸及碳酸（glycosuria，phosphaturia，bicarbonate loss）。下列何种组织构造是其受伤部位？", "answer_idx": "B", "answer": "近端肾小管（proximal tubules）", "options": {"A": "肾丝球（glomerulus）", "B": "近端肾小管（proximal tubules）", "C": "亨利氏环（Henle's loop）", "D": "远端肾小管（distal tubules）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种抗结核菌用药不适合使用于孕妇？", "answer_idx": "B", "answer": "streptomycin", "options": {"A": "isoniazid", "B": "streptomycin", "C": "rifampin", "D": "ethambutol"}}
{"meta_info": "taiwanese_test_Q", "question": "以下何者不属于水银（汞）中毒最常見的症狀？", "answer_idx": "C", "answer": "腕垂症", "options": {"A": "性情变化，暴躁易怒", "B": "步履不稳", "C": "腕垂症", "D": "颤抖"}}
{"meta_info": "taiwanese_test_Q", "question": "使用成人呼吸器 \"volume-cycled\" 通气模式时，降低吸气流量（flow rate）之设定，而维持其他设定，会产生下列何种现象？", "answer_idx": "A", "answer": "延长吸气时间（Ti）", "options": {"A": "延长吸气时间（Ti）", "B": "增加潮气容积（VT）", "C": "增加尖峰吸气压（PIP）", "D": "增加呼吸次数（RR）"}}
{"meta_info": "taiwanese_test_Q", "question": "根据American Society for Reproductive Medicine Revised Classification of Endometriosis，若病患手术中评估之score为28 分，其子宫内膜异位严重度为那一个stage？", "answer_idx": "C", "answer": "Stage III", "options": {"A": "Stage I", "B": "Stage II", "C": "Stage III", "D": "Stage IV"}}
{"meta_info": "taiwanese_test_Q", "question": "关于人工生殖技术（assisted reproductive technology）之叙述，下列何者正确？", "answer_idx": "B", "answer": "所谓人工生殖技术是指经过取卵过程之相关治疗", "options": {"A": "为增加怀孕率，植入的胚胎数越多越好", "B": "所谓人工生殖技术是指经过取卵过程之相关治疗", "C": "预防FSH surge是人工生殖技术中很重要的一环", "D": "诱导排卵时，GnRH-antagonist可抑制FSH surge"}}
{"meta_info": "taiwanese_test_Q", "question": "带有下列何种染色体或基因異常的急性骨髓性白血病之预后最坏？", "answer_idx": "A", "answer": "FLT3 internal tandem duplication", "options": {"A": "FLT3 internal tandem duplication", "B": "NPM1 mutation", "C": "t(15;17)", "D": "inv(16)"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，该患者在手术前发现血中β-HCG 值为1,050 1U/L（正常＜2.5），α-fetoprotein（AFP）值为330 ng/mL（正常＜6），手术后五天再追踪一次，假使病人现在已经完全没有肿瘤存在，则下列何种结果最有可能？", "answer_idx": "D", "answer": "β-HCG：25；AFP：160", "options": {"A": "β-HCG：＜2.5；AFP＜6", "B": "β-HCG：800；AFP：80", "C": "β-HCG：30；AFP：10", "D": "β-HCG：25；AFP：160"}}
{"meta_info": "taiwanese_test_Q", "question": "Bowen's disease是那一个部位的疾病？", "answer_idx": "D", "answer": "外阴", "options": {"A": "子宫体", "B": "子宫颈", "C": "阴道", "D": "外阴"}}
{"meta_info": "taiwanese_test_Q", "question": "一名妈妈发现她10个月大，一向很健康的女婴腹部肿胀且一整天未解便而就医。身体检查发现女婴腹部有明显压痛且肠音几乎消失。腹部X光检查发现小肠明显扩张，但无游离空气的存在。下列何种情况最可能发生在女婴身上？", "answer_idx": "C", "answer": "肠 叠（intussusception）", "options": {"A": "十二指肠闭锁（duodenal atresia）", "B": "赫希普氏病（Hirschsprung disease）", "C": "肠 叠（intussusception）", "D": "梅克尔氏憩室（Meckel diverticulum）"}}
{"meta_info": "taiwanese_test_Q", "question": "乳暈皮肤在哺乳时能分泌润滑液保护乳暈及乳头，其腺体的属性是：", "answer_idx": "A", "answer": "皮脂腺", "options": {"A": "皮脂腺", "B": "汗腺", "C": "乳腺", "D": "毛囊腺"}}
{"meta_info": "taiwanese_test_Q", "question": "51.有关儿童腹股沟疝气（inguinal hernia）的叙述，下列何者正确？ ①早产儿发生率较高 ②多为直接型疝气（direct type） ③ 手术以疝气袋高位结扎为主 ④手术年龄需大于一岁", "answer_idx": "B", "answer": "仅①③", "options": {"A": "②④", "B": "仅①③", "C": "①③④", "D": "①②③"}}
{"meta_info": "taiwanese_test_Q", "question": "一人因胃部疼痛而求诊，内视镜检查发现是胃溃疡，经采胃部切片检验后发现为幽门杆菌感染，因此医师开了三种抗生素给患者服用，其一是 clarithromycin。此抗生素之主要作用机转为何？", "answer_idx": "C", "answer": "抑制该菌之蛋白质合成", "options": {"A": "抑制该菌之细胞壁合成", "B": "抑制该菌之核酸合成", "C": "抑制该菌之蛋白质合成", "D": "抑制该菌之细胞膜合成"}}
{"meta_info": "taiwanese_test_Q", "question": "佩佩第一次产检抽血结果发现她的红血球比较小，MCV 67 fL，MCH 21 pg，血红素 Hb 12.3 g/dL，产前咨询时，下列叙述何者错误？", "answer_idx": "D", "answer": "如果夫妻双方一个是甲型带因，一个是乙型带因，可能会生下重症的小孩，须靠终生输血", "options": {"A": "佩佩有可能是地中海型贫血带因（carrier）或者是缺铁性贫血", "B": "应该请佩佩的先生也回门诊抽血验全血球计數（CBC），如果先生的 MCV 也小于 80 fL，要请夫妻双方一起作地中海型贫血的基因检测", "C": "地中海型贫血分为 thalassemia major, thalassemia minor 以及 thalassemia intermedia", "D": "如果夫妻双方一个是甲型带因，一个是乙型带因，可能会生下重症的小孩，须靠终生输血"}}
{"meta_info": "taiwanese_test_Q", "question": "勃起功能障碍（erectile dysfunction）最常见的原因是？", "answer_idx": "D", "answer": "混合因素（mixed factors）", "options": {"A": "精神因素（psychogenic factor）", "B": "荷尔蒙因素（hormonal factor）", "C": "动脉因素（arterial factor）", "D": "混合因素（mixed factors）"}}
{"meta_info": "taiwanese_test_Q", "question": "新药上市前，在临床试 阶段，其受试对象在1000～3000名，属于第几阶段的临床试 ？", "answer_idx": "B", "answer": "第三阶段", "options": {"A": "第四阶段", "B": "第三阶段", "C": "第二阶段", "D": "第一阶段"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是因胚胎发育异常造成的甲状腺组织位置变异？", "answer_idx": "C", "answer": "迷路甲状腺（lateral aberrant thyroid）", "options": {"A": "舌后甲状腺（lingual thyroid）", "B": "异位性甲状腺（ectopic thyroid）", "C": "迷路甲状腺（lateral aberrant thyroid）", "D": "甲状腺舌骨囊肿（thyroglossal duct cyst）"}}
{"meta_info": "taiwanese_test_Q", "question": "自动吐气末正压现象（Auto-PEEP），最容易出现于下列何种病患身上？", "answer_idx": "C", "answer": "重度慢性阻塞性肺疾", "options": {"A": "迷漫性大脑病变", "B": "兩侧广泛性肺炎", "C": "重度慢性阻塞性肺疾", "D": "严重呼吸肌无力"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 Basal ganglia 的神经讯息传导之叙述，何者正确？", "answer_idx": "A", "answer": "Corpus striatum（包含 caudate 与 putamen）为接收來自 cerebral cortex 的运动计画讯息之主要结构", "options": {"A": "Corpus striatum（包含 caudate 与 putamen）为接收來自 cerebral cortex 的运动计画讯息之主要结构", "B": "Substantia nigra 为接收來自 cerebral cortex 的运动计画讯息之主要结构", "C": "Globus pallidus 为接收來自 cerebral cortex 的运动计画讯息之主要结构", "D": "Basal ganglia 的传出讯息由 caudate 发出，传入 thalamus，再由 thalamus 传至 cerebral cortex 的运动区"}}
{"meta_info": "taiwanese_test_Q", "question": "发生急性心肌梗塞的患者，其心肌梗塞区的心肌细胞出现带狀收缩（contraction band）及心肌间质出血所代表的意义为：", "answer_idx": "B", "answer": "血栓溶解治療导致梗塞区血液再灌流", "options": {"A": "血栓扩展造成冠狀动脉完全阻塞及梗塞区扩大", "B": "血栓溶解治療导致梗塞区血液再灌流", "C": "非血栓性冠狀动脉阻塞所导致的心肌梗塞", "D": "非完全阻塞性冠狀动脉狭窄所导致的心内膜下心肌梗塞"}}
{"meta_info": "taiwanese_test_Q", "question": "有关脑下垂体细胞（pituicytes），下列叙述何项正确？", "answer_idx": "D", "answer": "此细胞属神经胶细胞（neuroglial cell）", "options": {"A": "此细胞位于脑下垂体前叶（pars distalis）", "B": "此细胞分泌催产素（oxytocin）与抗利尿激素（ADH/vasopressin）", "C": "此细胞具有 Herring 小体（Herring bodies）", "D": "此细胞属神经胶细胞（neuroglial cell）"}}
{"meta_info": "taiwanese_test_Q", "question": "女性骨盆腔最小的径线为何？", "answer_idx": "C", "answer": "中骨盆腔横径", "options": {"A": "骨盆腔入口前后径", "B": "中骨盆腔前后径", "C": "中骨盆腔横径", "D": "骨盆腔出口横径"}}
{"meta_info": "taiwanese_test_Q", "question": "72 岁女性由其女儿陪同就诊。女儿告诉医师她母亲罹患失智症已五年，无法跟人沟通，平日由她照顾。三个小时前母亲跌倒致右肩肿痛。理学检查发现手臂、脚、腹部及背部有多处深浅不一之瘀青，头及右上臂有压痛点。 X 光检查显示右肱骨头骨折。下列处置何者较适当？", "answer_idx": "D", "answer": "需怀疑是老人虐待，必要时寻求资源予以安置", "options": {"A": "安排全血球计數（CBC），凝血时间（clotting time）及其它检查以排除血液疾病", "B": "打石膏，固定止痛后，请女儿带回家，并请他们要注意跌倒的预防", "C": "照会骨科，做完内固定后，回家療养即可", "D": "需怀疑是老人虐待，必要时寻求资源予以安置"}}
{"meta_info": "taiwanese_test_Q", "question": "29.治疗发绀性先天性心脏病常用的外科Blalock-Taussig分流术式（Blalock-Taussig shunt），主要是连接下列那二 条血管，以达到改善缺氧的效果？\n", "answer_idx": "D", "answer": "锁骨下动脉和同侧肺动脉（Subclavian artery and pulmonary artery of the same side）", "options": {"A": "锁骨下动脉和同侧肺静脉（Subclavian artery and pulmonary vein of the same side）", "B": "升主动脉和肺动脉（Ascending aorta and main pulmonary artery）", "C": "颈动脉和同侧肺动脉（Carotid artery and subclavian artery of the same side）", "D": "锁骨下动脉和同侧肺动脉（Subclavian artery and pulmonary artery of the same side）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关情感性疾患混合发作（mixed episode），系指躁症与郁症之混合症狀迅速交替出现，时间至少持续多少天？", "answer_idx": "C", "answer": "七", "options": {"A": "一", "B": "四", "C": "七", "D": "十四"}}
{"meta_info": "taiwanese_test_Q", "question": "声音由空气传经人体中耳，依锤骨与钻骨之杠杆原理，声音增加了几分贝？", "answer_idx": "A", "answer": "3", "options": {"A": "3", "B": "10", "C": "15", "D": "20"}}
{"meta_info": "taiwanese_test_Q", "question": "62.在下背痛的筛选中，下列何种症状代表病人可能是罹患一种严重的病变（所谓 red flag），须转介至相关科别", "answer_idx": "A", "answer": "夜间疼痛且愈来愈严重", "options": {"A": "夜间疼痛且愈来愈严重", "B": "病人身体质量指数（BMI）高", "C": "合并下肢疼痛", "D": "曾有腰椎手术病史"}}
{"meta_info": "taiwanese_test_Q", "question": "Penicillamine常用来治疗下列何种结石？", "answer_idx": "D", "answer": "胱氨酸结石（cystine stone）", "options": {"A": "草酸钙结石（calcium oxalate stone）", "B": "尿酸结石（uric acid stone）", "C": "肾石灰沉 症（nephrocalcinosis）", "D": "胱氨酸结石（cystine stone）"}}
{"meta_info": "taiwanese_test_Q", "question": "一名38 岁女性，最近1 个月來黄疸现象愈來愈明显，过去几年來，她曾有过几次右上腹绞痛的经验，她接受肝脏切片检查，显微镜检查可見明显胆管增生及胆管内胆汁滞留的现象，但肝脏细胞没有发炎或坏死的变化。下列何者是引起她黄疸最可能的原因？", "answer_idx": "C", "answer": "肝外胆管阻塞（Extrahepatic biliary obstruction）", "options": {"A": "急性 C 型病毒性肝炎（Acute viral hepatitis C）", "B": "原发性胆道性肝硬化（Primary biliary cirrhosis）", "C": "肝外胆管阻塞（Extrahepatic biliary obstruction）", "D": "威尔森氏症（Wilson disease）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 55 岁男性，有长年抽烟、嚼槟榔与酗酒习惯。因口腔鱗狀上皮细胞癌接受手术前合并化学与放射线治療，之后发生吞咽疼痛现象。内视镜检查发现食道下三分之一处有一直径约 1.5 公分不规则形溃疡，病理切片检查如图所示。最可能的诊断为：", "answer_idx": "D", "answer": "单纯疱疹病毒（herpes simplex virus）感染", "options": {"A": "念珠菌（Candida）感染", "B": "口腔鱗狀上皮细胞癌转移至食道", "C": "合并食道鱗狀上皮细胞癌", "D": "单纯疱疹病毒（herpes simplex virus）感染"}}
{"meta_info": "taiwanese_test_Q", "question": "72.病人主诉右下腹逐渐闷痛、腹胀、反胃一整天。腹部电脑断层检查呈现如附图。箭号所指之异常最符合下列那一项初诊断？", "answer_idx": "B", "answer": "acute appendicitis", "options": {"A": "cecal diverticulitis", "B": "acute appendicitis", "C": "mesenteric adenitis", "D": "colon cancer"}}
{"meta_info": "taiwanese_test_Q", "question": "一位36岁女性因车祸跌倒时，右臂受到直接撞击，造成右前臂肿痛及变形，经X光检查发现远端桡骨骨折并远端桡尺骨关节脱位，此病患最可能的诊断为何？", "answer_idx": "A", "answer": "Galeazzi氏骨折", "options": {"A": "Galeazzi氏骨折", "B": "Smith氏骨折", "C": "Monteggia氏骨折", "D": "Essex-Lopresti氏骨折"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关慢性心衰竭的叙述，何者错误？", "answer_idx": "B", "answer": "内颈静脉的压力能完全反应左心室的功能", "options": {"A": "在听诊方面，收缩性左心衰竭病患可听到第三心音，在舒张性左心衰竭常听到第四心音", "B": "内颈静脉的压力能完全反应左心室的功能", "C": "身体诊察（physical examination）可发现最大心尖搏动点（point of maximal impulse）由原本位置（第5肋间及左锁骨中线）向左及向下偏离", "D": "左心室射出分量（left ventricular ejection fraction）为评估心脏收缩功能的指标"}}
{"meta_info": "taiwanese_test_Q", "question": "viridans streptococci 感染所造成之心内膜炎，不能单独使用 aminoglycosides 類的药物，而必须合并 penicillin 的使用才能发挥其殺菌的效果，其主要原因为何？", "answer_idx": "A", "answer": "aminoglycosides 類的药物无法穿过 viridans streptococci 之细胞壁", "options": {"A": "aminoglycosides 類的药物无法穿过 viridans streptococci 之细胞壁", "B": "aminoglycosides 无法与 viridans streptococci 的核糖体结合", "C": "viridans streptococci 没有细胞壁结构", "D": "aminoglycosides 類的药物无法穿过 viridans streptococci 之细胞膜"}}
{"meta_info": "taiwanese_test_Q", "question": "心脏细胞的休息膜电位（resting membrane potential）主要是因为细胞膜内外的什么離子浓度差所导致？", "answer_idx": "B", "answer": "钾", "options": {"A": "钠", "B": "钾", "C": "钙", "D": "镁"}}
{"meta_info": "taiwanese_test_Q", "question": "关于下列四种疾病的主要致病机转，那两种疾病的免疫过度反应（hypersensitivity reaction）最为接近？", "answer_idx": "C", "answer": "①④", "options": {"A": "①②", "B": "②④", "C": "①④", "D": "②③"}}
{"meta_info": "taiwanese_test_Q", "question": "当酸性食糜（pH＜3）进入十二指肠内产生之生理反应，下列叙述何者正确？", "answer_idx": "C", "answer": "增加富含碳酸氢根（bicarbonate）的胰液分泌", "options": {"A": "增加胃酸分泌", "B": "降低胆汁的生成", "C": "增加富含碳酸氢根（bicarbonate）的胰液分泌", "D": "抑制富含酵素之胰液分泌"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那种分子组合属于调节 T 细胞（regulatory T cell）的标记？", "answer_idx": "B", "answer": "CD4/CD25", "options": {"A": "CD3/CD28", "B": "CD4/CD25", "C": "CD3/CD8", "D": "CD16/CD56"}}
{"meta_info": "taiwanese_test_Q", "question": "33 岁女性，G4P2A1，妊娠 33 周，依胎儿生物生理计分法（biophysical profile, BPP）得分为 4 分，最佳处置为何？", "answer_idx": "B", "answer": "当天重复 BPP 试验，若是小于或等于 6，立即分娩", "options": {"A": "立即分娩", "B": "当天重复 BPP 试验，若是小于或等于 6，立即分娩", "C": "三天后重复 BPP 试验，若是小于或等于 8，立即分娩", "D": "七天后重复 BPP 试验，若是小于或等于 8，立即分娩"}}
{"meta_info": "taiwanese_test_Q", "question": "一位12 岁男童因阴茎太短而就诊，身体检查发现阴茎3 公分长，阴囊较小，未摸到睪丸，无尿道下裂且无阴毛发育，血液检查显示血清濾泡促素（FSH）及黄体促素（LH）值均高于正常范围，睪固酮（testosterone）值＜0.2 ng/mL。下列那一项检查对诊断的帮助最少？", "answer_idx": "B", "answer": "脑垂体功能检查", "options": {"A": "染色体检查", "B": "脑垂体功能检查", "C": "hCG 刺激试验", "D": "血清 antimüllerian hormone 浓度"}}
{"meta_info": "taiwanese_test_Q", "question": "一位52岁男性病患因长期胃痛至某医学中心求诊。医师安排做胃镜检查，发现该病人在胃幽门处有溃疡，并采取若干胃黏膜组织，送细菌室培养。针对这些检体，最适合的气体培养环境为何？", "answer_idx": "D", "answer": "低氧环境（含约5%氧气）", "options": {"A": "大气环境（含约20%氧气）", "B": "无氧环境", "C": "高氧环境（含约50%氧气）", "D": "低氧环境（含约5%氧气）"}}
{"meta_info": "taiwanese_test_Q", "question": "78.张先⽣是⼀位⽊⼯，和妻⼦住在⼀起，每天都会抽⼀包烟且下班后会喝⼀点酒。有⼀次晕倒⼜很快醒来，检查后发现他有左侧颈动脉明显狭窄，脑⾎管摄影发现狭窄⾼达90%。 ⾎管外科主治医师建议他做颈动脉内膜刮除术或置放⽀架等治疗，但告知张先⽣接受⼿术有立即死亡或中风的风险，张先⽣对⼿术感到迟疑，并说", "answer_idx": "A", "answer": "和张先⽣充分讨论后，先给予内科药物治疗，并安排戒烟计画及定期追踪", "options": {"A": "和张先⽣充分讨论后，先给予内科药物治疗，并安排戒烟计画及定期追踪", "B": "临床不需考虑治疗疾病以外的事，张先⽣的退休⾦不该影响你的医疗决策", "C": "张先⽣可能受到疾病的压⼒无法做正确的判断，应联络其家属讨论治疗⽅向", "D": "先安排⼿术争取治疗时效性，进开⼑房再向张先⽣解释此⼿术的风险即可"}}
{"meta_info": "taiwanese_test_Q", "question": "对 chronic ulcerative colitis 的病人而言，下列何者非促成其形成癌症的因素之一？", "answer_idx": "A", "answer": "溃疡之深度", "options": {"A": "溃疡之深度", "B": "发病年龄", "C": "罹病之期限", "D": "病变范围"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是大麻的药理作用？", "answer_idx": "B", "answer": "降低食欲", "options": {"A": "缓解疼痛", "B": "降低食欲", "C": "欣快感（euphoria）和放松", "D": "减少恶心"}}
{"meta_info": "taiwanese_test_Q", "question": "39 一位 41 岁健康女士，公司提供年度健康检查发现血中 CA 19-9 數值为 42.6 U/mL，高于正常值（＜ U/mL），因此到医院求助；其它项目皆无異狀。下列何者是比较合理的做法？", "answer_idx": "A", "answer": "解释并安慰", "options": {"A": "解释并安慰", "B": "安排大便潜血，胃镜、大肠镜", "C": "安排腹部超音波", "D": "直接做电脑断层摄影"}}
{"meta_info": "taiwanese_test_Q", "question": "在DNA复制中，下列何酵素功能主要是用以增加DNA复制之准确度？", "answer_idx": "B", "answer": "3'→5'外切核酸酶", "options": {"A": "单股DNA结合蛋白", "B": "3'→5'外切核酸酶", "C": "DNA连接酶", "D": "DNA解螺旋酶"}}
{"meta_info": "taiwanese_test_Q", "question": "周全性老年评估可以发现老年人之潜在性可治疗的健康问题，使老年人获得较好的健康照顾。下列何种状况最不适合作周全性老年评估？", "answer_idx": "A", "answer": "疾病末期病人或有严重失智者", "options": {"A": "疾病末期病人或有严重失智者", "B": "有多重疾病、服用多种药物的老年人", "C": "日常生活活动功能不全的老年人，尤其在最近有恶化的情形者", "D": "最近多次住院，且原因未明确者"}}
{"meta_info": "taiwanese_test_Q", "question": "74.\n 病人主诉胸骨后和上腹部疼痛且食欲不佳，胸部X光检查呈现如图，下列那一项诊断最正确？\n", "answer_idx": "A", "answer": "hiatal hernia", "options": {"A": "hiatal hernia", "B": "aortic dissection", "C": "myocardial infarction", "D": "pneumomediastinum"}}
{"meta_info": "taiwanese_test_Q", "question": "有关糖尿病慢性并发症的叙述，下列何者错误？", "answer_idx": "D", "answer": "糖尿病的肾脏病变在早期就会有肌酸酐上升的现象", "options": {"A": "糖尿病慢性并发症的发生与糖尿病的罹病期及血糖控制有关", "B": "病人最好能定期接受糖尿病慢性并发症的筛检", "C": "病人可能有腹泻或便秘的现象", "D": "糖尿病的肾脏病变在早期就会有肌酸酐上升的现象"}}
{"meta_info": "taiwanese_test_Q", "question": "一位21 岁大学女生出现不断检查门窗，认为家中桌椅不干净，不断擦拭，碰过桌椅的手需以水及肥皂反覆冲洗，且其脑中常有挥之不去「明知不可能是事实」的意念。请问此患者最有可能之臨床诊断为何？", "answer_idx": "C", "answer": "强迫症（obsessive compulsive disorder）", "options": {"A": "虑病症（hypochondriasis）", "B": "妄想症（delusional disorder）", "C": "强迫症（obsessive compulsive disorder）", "D": "恐慌症（panic disorder）"}}
{"meta_info": "taiwanese_test_Q", "question": "6 台湾地区肾病比率偏高，王先生为肾功能受损（GFR 25～40 mL/min）的病人，将进行全髋关节置换 手术，下列有关麻醉的考量，何者错误？\n", "answer_idx": "B", "answer": "肾功能不佳，故应绝对限制水分给予", "options": {"A": "术中低血容为手术后肾衰竭的重要因素", "B": "肾功能不佳，故应绝对限制水分给予", "C": "mannitol 与利尿剂（furosemide）对急性肾衰竭病人之帮助不大", "D": "应放置导尿管，并监测术中尿输出，使之大于 0.5 mL/kg/h"}}
{"meta_info": "taiwanese_test_Q", "question": "26 六岁女童到儿科急诊求诊，主诉为尿液呈现红色。急诊室医师帮女童安排尿液检查，没有看到红血球。下列何者最不可能是致病的原因？\n", "answer_idx": "C", "answer": "尿路外伤（urinary tract trauma）", "options": {"A": "肌球蛋白尿（myoglobinuria）", "B": "血红素尿（hemoglobinuria）", "C": "尿路外伤（urinary tract trauma）", "D": "药物（如 rifampin，sulfasalazine）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位70岁老先生没系妥安全带，开小轿车撞上电线杆，颜面直接撞击前面挡风玻璃，到达急诊时颜面严重肿胀，口腔内有血丝，主诉头部疼痛，下列叙述何者错误？", "answer_idx": "D", "answer": "老年人外伤的预后，与罹患之慢性病无关", "options": {"A": "治疗老年外伤的伤患，病患的评估顺序与一般外伤病患相同", "B": "老年人如有头部外伤，症状常延迟出现", "C": "随 年龄增加，老年人的生理代偿功能降低", "D": "老年人外伤的预后，与罹患之慢性病无关"}}
{"meta_info": "taiwanese_test_Q", "question": "一位年轻人因车祸受伤被送到急诊，病人意识不清但亟需立即开刀，不过一时之间又找不到他的家人来签同意书，医师应该如何处理？", "answer_idx": "C", "answer": "虽然没有病人同意，医师仍应进行开刀", "options": {"A": "没有病人同意、因此医师不应开刀", "B": "先找一找有没有护理人员愿意代理决定，再进行开刀", "C": "虽然没有病人同意，医师仍应进行开刀", "D": "通报警局再决定是否开刀"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关胃肠药之服用方式，何者错误？", "answer_idx": "B", "answer": "omeprazole 和制酸剂一起同时给与", "options": {"A": "制酸剂（antacid）于饭后 1 小时口服", "B": "omeprazole 和制酸剂一起同时给与", "C": "sucralfate 在饭前给与", "D": "H2 blocker 在睡前给与"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 40 周出生体重 4100 公克经自然生产出生之男婴，于出生后 8 小时发现他有间歇性兩侧手脚抽动与眼神直视的现象。在怀疑新生儿抽搐（neonatal seizure）的考虑下，下列那一项措施错误？", "answer_idx": "A", "answer": "先安排 EEG 检查再给予抗癫痫药物", "options": {"A": "先安排 EEG 检查再给予抗癫痫药物", "B": "立即抽血检查血糖值及血钙值", "C": "检查是否有颅内出血", "D": "确定母亲是否有 gestational diabetes"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于粒线体脑病变？", "answer_idx": "B", "answer": "雷特氏症候群（Rett syndrome）", "options": {"A": "Leigh 氏病", "B": "雷特氏症候群（Rett syndrome）", "C": "雷氏症候群（Reye syndrome）", "D": "具 ragged-red fiber 之肌跃性癫痫（MERRF）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关毛地黄使用于治療儿童心脏衰竭之叙述，何者不正确？", "answer_idx": "C", "answer": "心电图上 PR interval 延长就要停药", "options": {"A": "口服后 30 分钟有初步效果，2~6 小时达最高效果", "B": "60~85%能从胃肠道吸收", "C": "心电图上 PR interval 延长就要停药", "D": "低血钾病人会加剧毛地黄中毒"}}
{"meta_info": "taiwanese_test_Q", "question": "39岁女性经诊断有十二指肠溃疡及幽门螺旋杆菌感染，接受第一线杀菌药物治疗后，评估是否杀菌成功，下列何种检查最简便正确？", "answer_idx": "A", "answer": "C13-urea breath test", "options": {"A": "C13-urea breath test", "B": "血清幽门螺旋杆菌抗体检查", "C": "经胃镜切片组织学检查", "D": "尿液幽门螺旋杆菌抗体检查"}}
{"meta_info": "taiwanese_test_Q", "question": "一位28 岁未曾怀孕的病人主诉，在兩次月经间有出血，而且月经量增大，在过去9 个月间，她接受了兩次子宫内膜刮搔术，但症狀并未缓解，口服避孕药和抑前列腺素（antiprostaglandins）也没有减少異常出血。下列何种处置最恰当？", "answer_idx": "B", "answer": "子宫镜检查", "options": {"A": "子宫切除", "B": "子宫镜检查", "C": "子宫内膜破坏术（endometrial ablation）", "D": "给予促性腺释放激素刺激剂（GnRH agonist）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列抗心律不整药物中，何者较不会引起 Torsade de pointes 的副作用？", "answer_idx": "A", "answer": "Amiodarone", "options": {"A": "Amiodarone", "B": "Sotalol", "C": "Dofetilide", "D": "Quinidine"}}
{"meta_info": "taiwanese_test_Q", "question": "乳房根除手术（Radical mastectomy）后有翼狀肩（Winged scapula）之现象，是因那一条神经损伤之故？", "answer_idx": "A", "answer": "长胸神经（Long thoracic nerve）", "options": {"A": "长胸神经（Long thoracic nerve）", "B": "胸背神经（Thoracodorsal nerve）", "C": "肋间神经（Intercostal nerve）", "D": "桡神经（Radial nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者能外展手臂？", "answer_idx": "B", "answer": "棘上肌（supraspinatus）", "options": {"A": "棘下肌（infraspinatus）", "B": "棘上肌（supraspinatus）", "C": "肩胛下肌（subscapularis）", "D": "小圆肌（teres minor）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者最容易造成代谢性酸中毒（metabolic acidosis）？", "answer_idx": "B", "answer": "严重腹泻（severe diarrhea）", "options": {"A": "严重呕吐（severe vomiting）", "B": "严重腹泻（severe diarrhea）", "C": "过度换气（hyperventilation）", "D": "消化性溃疡（peptic ulcer）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于总胆管囊肿（choledochal cyst）的叙述，下列何者错误？", "answer_idx": "C", "answer": "很少有黄疸（jaundice）的现象", "options": {"A": "女性的比例较高", "B": "手术的方法以囊肿全切除并Roux-en-Y胆管空肠吻合", "C": "很少有黄疸（jaundice）的现象", "D": "若不全切除囊肿，日后有恶性变化的可能"}}
{"meta_info": "taiwanese_test_Q", "question": "导管烧灼术（catheter ablation）对于下列那一种不整脉，往往没有良好的治療效果？", "answer_idx": "A", "answer": "冠心症导致的心室频脉", "options": {"A": "冠心症导致的心室频脉", "B": "房室结再进入之上心室性频脉（atrioventricular nodal reentrant supraventricular tachycardia）", "C": "心房扑动（atrial flutter）", "D": "WPW 症候群相关之上心室性频脉"}}
{"meta_info": "taiwanese_test_Q", "question": "下列对于情感性疾患（mood disorders）之叙述，何者错误？", "answer_idx": "B", "answer": "第一型双极性疾患（bipolar I disorder）之盛行率，男性与女性差不多，但女性比男性会有较多躁症之发作", "options": {"A": "重度忧郁症之盛行率，女性通常是男性的兩倍", "B": "第一型双极性疾患（bipolar I disorder）之盛行率，男性与女性差不多，但女性比男性会有较多躁症之发作", "C": "第一型双极性疾患之发作年龄较重度忧郁症早", "D": "重度忧郁症之平均发作年龄约为 40 岁"}}
{"meta_info": "taiwanese_test_Q", "question": "我国全民健康保险之预防保健服务不包括：", "answer_idx": "B", "answer": "预防职业病健康检查", "options": {"A": "成人预防保健服务", "B": "预防职业病健康检查", "C": "孕妇产前检查", "D": "儿童预防保健服务"}}
{"meta_info": "taiwanese_test_Q", "question": "关于胆色素（bile pigment）之叙述，下列何者正确？", "answer_idx": "A", "answer": "为血红素分解之产物", "options": {"A": "为血红素分解之产物", "B": "參与脂肪的消化作用", "C": "全部由粪便排出", "D": "在肝细胞中与白蛋白（albumin）结合"}}
{"meta_info": "taiwanese_test_Q", "question": "一位24岁病人被发现有血红蛋白H疾病（hemoglobin H disease），下列何种血红蛋白在此病人特别多？", "answer_idx": "C", "answer": "β4", "options": {"A": "α2γ2", "B": "α2δ2", "C": "β4", "D": "γ4"}}
{"meta_info": "taiwanese_test_Q", "question": "有关梅氏神经丛（Meissner's plexus）的叙述，何者正确？", "answer_idx": "A", "answer": "调节黏膜层蠕动与腺体之分泌", "options": {"A": "调节黏膜层蠕动与腺体之分泌", "B": "分布在消化道肌肉层中", "C": "類似交感神经有刺激括约肌的功能", "D": "在浆膜层常見"}}
{"meta_info": "taiwanese_test_Q", "question": "苏先生，65 岁，过去两年来由于重症肌无力一直在神经内科接受药物治疗。最近一星期来呼吸逐渐急促，因而至急诊就医，理学检查并无发烧，呼吸速率 32/分钟，胸部听诊并无杂音。胸部 X 光并无异常，且动脉血氧气饱和度为 98%，则下列何者为最适当处置步骤？", "answer_idx": "A", "answer": "肺功能检查（FVC 和 Pimax）", "options": {"A": "肺功能检查（FVC 和 Pimax）", "B": "动脉血气体分析", "C": "追踪胸部 X 光摄影", "D": "肺部电脑断层摄影"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 70 岁男性过去有糖尿病、高血压、高血脂及常年抽烟的病史。 4 周前因冠狀动脉狭窄，接受经 femoral artery 之 PTCA（percutaneous transluminal coronary angioplasty）治療。目前主诉尿量减少，全身倦怠，轻微发烧住院。检查结果显示血压偏高 180/100 mmHg，下肢有网狀斑（livedo reticularis）及水肿，血中 creatinine 由 4 周前之 1.2 mg/dL 上升到 5.7 mg/dL。则其初步诊断是：", "answer_idx": "C", "answer": "atheroembolic renal disease（cholesterol emboli syndrome）", "options": {"A": "contrast nephropathy", "B": "systemic vasculitis", "C": "atheroembolic renal disease（cholesterol emboli syndrome）", "D": "acute interstitial nephritis"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者进入肾上腺髓质（suprarenal medulla），与嗜铬细胞（chromaffin cell）形成突触?", "answer_idx": "A", "answer": "经小内脏神经（lesser splanchnic nerve）来的节前神经纤维（preganglionic fiber）", "options": {"A": "经小内脏神经（lesser splanchnic nerve）来的节前神经纤维（preganglionic fiber）", "B": "经腹腔神经节（celiac ganglion）来的节后神经纤维（postganglionic fiber）", "C": "经主动脉肾神经节（aorticorenal ganglion）来的节后神经纤维（postganglionic fiber）", "D": "经下腹下神经丛（inferior hypogastric plexus）来的节前神经纤维（preganglionic fiber）"}}
{"meta_info": "taiwanese_test_Q", "question": "解剖病例在基底核发现 Alzheimer 第二型星狀细胞，病人多半是罹患了：", "answer_idx": "C", "answer": "肝性昏迷", "options": {"A": "Alzheimer 氏病", "B": "脑脱疝", "C": "肝性昏迷", "D": "Prion 引发的疾病"}}
{"meta_info": "taiwanese_test_Q", "question": "北洛尼氏病症（Peyronie's disease）经常和下列那一种病有相关？", "answer_idx": "A", "answer": "手肌腱的 Dupuytren's contracture", "options": {"A": "手肌腱的 Dupuytren's contracture", "B": "多发性硬化症（multiple sclerosis）", "C": "骨骼系统的 von Recklinghausen's disease", "D": "纤维性囊肿（cystic fibrosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "缺乏抗体及补体时，容易遭受下列何者感染？", "answer_idx": "C", "answer": "Pyogenic bacteria", "options": {"A": "Mycobacterium species", "B": "Herpes virus", "C": "Pyogenic bacteria", "D": "Pneumocystis carinii"}}
{"meta_info": "taiwanese_test_Q", "question": "根据下述听力图，则下列叙述何者正确？", "answer_idx": "B", "answer": "右耳传导性重听，左耳感音性重听", "options": {"A": "右耳传导性重听，左耳传导性重听", "B": "右耳传导性重听，左耳感音性重听", "C": "右耳感音性重听，左耳传导性重听", "D": "右耳感音性重听，左耳感音性重听"}}
{"meta_info": "taiwanese_test_Q", "question": "73.56岁女性，15个月前被诊断为卵巢癌接受化学治疗，最近主诉有恶心、呕吐及食欲不振 （anorexia）。半年前开始体重逐渐下降，已减轻20公斤，感觉越来越虚弱。检查发现呼吸每分钟约25次，结膜苍白，腹部鼓胀，有腹水且有一10×30 cm之肿块。治疗此病人之恶病质（cachexia）与食欲不振，下列那一种药物较适当？\n", "answer_idx": "A", "answer": "corticosteroid", "options": {"A": "corticosteroid", "B": "prochlorperazine", "C": "morphine sulfate", "D": "cyproheptadine"}}
{"meta_info": "taiwanese_test_Q", "question": "伤口重建的原则及方法有①skin graft ②myocutaneous flap ③free flap ④linear closure ⑤skin flap，重建的思考顺序是：", "answer_idx": "C", "answer": "④①⑤②③", "options": {"A": "①②③④⑤", "B": "④⑤①③②", "C": "④①⑤②③", "D": "④⑤③①②"}}
{"meta_info": "taiwanese_test_Q", "question": "有关 arginine vasopressin（AVP）之叙述，下列何者错误？", "answer_idx": "B", "answer": "AVP 的抗利尿（antidiuretic）作用主要是经由凝血因子 VI 的受体（receptor）", "options": {"A": "AVP 又称为抗利尿激素（antidiuretic hormone）", "B": "AVP 的抗利尿（antidiuretic）作用主要是经由凝血因子 VI 的受体（receptor）", "C": "AVP 会增加循环中凝血因子Ⅷ（Factor Ⅷ）的浓度", "D": "AVP 具有血管收缩（vasoconstriction）的作用"}}
{"meta_info": "taiwanese_test_Q", "question": "三尖瓣置换时，在那一部分下针时，必须很注意以免伤及传导组织，造成术后传导阻滞（heart block）？", "answer_idx": "C", "answer": "中隔葉（septal leaflet）环部", "options": {"A": "前葉与后葉交界处", "B": "前葉环部", "C": "中隔葉（septal leaflet）环部", "D": "后葉环部"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 62 岁的男性患有轻微重症肌无力，经电脑断层检查发现有约 2 公分大小的前纵膈腔肿瘤，如果你要向家属解释病情，开刀前预测术后病理报告最可能是什么？", "answer_idx": "B", "answer": "胸腺瘤（Thymoma）", "options": {"A": "畸形瘤（Teratoma）", "B": "胸腺瘤（Thymoma）", "C": "淋巴瘤（Lymphoma）", "D": "神经原性肿瘤（Neurogenic tumor）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于梅克尔憩室（Meckel diverticulum），下列叙述何者错误？", "answer_idx": "D", "answer": "年纪小的幼童比年纪大的孩童，更易发生憩室炎（diverticulitis）", "options": {"A": "最常见的临床表现为无痛性出血，其次为肠阻塞", "B": "通常位于离回盲瓣（ileocecal valve）50～75公分内的回肠端", "C": "可能含有异位性组织（ectopic tissue），胃组织比胰组织常见", "D": "年纪小的幼童比年纪大的孩童，更易发生憩室炎（diverticulitis）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关焦虑性疾患（anxiety disorders）的叙述，何者错误？", "answer_idx": "A", "answer": "针对特定畏惧症（specific phobia）的治療，目前被认为最有效者仍是药物治療", "options": {"A": "针对特定畏惧症（specific phobia）的治療，目前被认为最有效者仍是药物治療", "B": "焦虑症常并有物质使用疾患，必须小心厘清焦虑症狀是否和物质有关", "C": "广泛性焦虑症（generalized anxiety disorder）患者以女性较多", "D": "近期酒精过度饮用及支持系统不佳，均为创伤后压力症候群的危险因子"}}
{"meta_info": "taiwanese_test_Q", "question": "10.一位52岁在鱼市场送货的张先生，之前每周一到周六清晨5时载货到某鱼市场工作时，能扛10公斤为一箱的海鲜穿梭于市场约10来趟，胜任愉快。上周日参加喜宴，多喝了一些酒，第二天在同一鱼市场进行相同工作时发觉走了5趟就觉得喘，需要休息10分钟才能再搬货。他原以为前一晚没睡好，只要回家休息就可恢复，没想\n 到接下来3天皆是如此，因此前来医院就医。医师的初步诊断为心衰竭。请问根据纽约心脏协会的功能分类\n （NYHA functional classification），应属于：\n", "answer_idx": "B", "answer": "第二级", "options": {"A": "第一级", "B": "第二级", "C": "第三级", "D": "第四级"}}
{"meta_info": "taiwanese_test_Q", "question": "75.一位体重50公斤有C型肝炎及忧郁症病史之中年妇人，与丈夫吵架后服用36颗", "answer_idx": "D", "answer": "保守观察，不需进一步处理", "options": {"A": "考虑给予acetylcysteine", "B": "口服活性碳（activated charcoal）", "C": "检测血中钾离子浓度", "D": "保守观察，不需进一步处理"}}
{"meta_info": "taiwanese_test_Q", "question": "97 一位 18 岁女性，因为这几个月來觉得下腹部不适而就医。骨盆腔检查发现她左侧卵巢有一个 10 公分大的肿瘤，右侧卵巢及子宫大小正常。她接受肿瘤切除手术。肉眼观察发现这是一个实体灰白色的肿瘤。显微镜下可見肿瘤大多數是由不分化的间质细胞组成，部分细胞有软骨或神经上皮分化。有关此肿瘤的叙述，下列何者正确？\n", "answer_idx": "A", "answer": "是一种惡性肿瘤", "options": {"A": "是一种惡性肿瘤", "B": "肿瘤细胞源自卵巢的间质细胞", "C": "此肿瘤常伴随子宫内膜增生", "D": "此肿瘤与 BRCA1 基因異常有关"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者没有发出分支构成膝关节动脉吻合网（genicular anastomosis）？", "answer_idx": "C", "answer": "腓动脉（fibular artery）", "options": {"A": "股动脉（femoral artery）", "B": "腘动脉（popliteal artery）", "C": "腓动脉（fibular artery）", "D": "胫前动脉（anterior tibial artery）"}}
{"meta_info": "taiwanese_test_Q", "question": "人体试验开始进行前，计画书须先通过人体试验委员会（IRB）之审查。若需变更计画书内容，需经人体试验委员会通过，方可改变作业方式。但在什么情况下，不需经人体试验委员会通过，可直接不照计画书内容执行？", "answer_idx": "C", "answer": "为及时避免受试者遭受伤害者", "options": {"A": "仅修正受试者同意书之文字，未变更作业内容", "B": "经人体试验委员会以简易审查（expedited procedures）的程序审查通过之计画书", "C": "为及时避免受试者遭受伤害者", "D": "降低受试者的药物剂量，使得风险改变"}}
{"meta_info": "taiwanese_test_Q", "question": "在职业肺部疾病之检查中，一氧化碳扩散速率（DLco）的異常下降，较常見于下列何者？", "answer_idx": "A", "answer": "矽肺症", "options": {"A": "矽肺症", "B": "棉花肺症", "C": "职业性气喘", "D": "慢性阻塞性肺病"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于精神分裂症患者所出现之思考「内容」障碍？", "answer_idx": "D", "answer": "思考聯结松弛（loosening of associations）", "options": {"A": "被害妄想（delusion of persecution）", "B": "关系意念（idea of​​ reference）", "C": "被跟踪妄想（delusion of being followed）", "D": "思考聯结松弛（loosening of associations）"}}
{"meta_info": "taiwanese_test_Q", "question": "一段抗原蛋白片段被 T 细胞辨识时，不会与下列那一个分子直接接触？", "answer_idx": "A", "answer": "CD3 复合体分子", "options": {"A": "CD3 复合体分子", "B": "主要组织相容性复合体（MHC）分子", "C": "T 细胞受体（TCR）α 链", "D": "T 细胞受体（TCR）β 链"}}
{"meta_info": "taiwanese_test_Q", "question": "依照International Continence Society所提出Pelvic Organ Prolapse Quantification system（POP-Q）不同部位缺陷之定量测量，其数值之呈现可用另一种方式：以一条直线数串方式来表示，如-3, -4, -8 , -10, -3, -3, 11, 4, 3。但是，此列数值于何测量部位是不合情理？", "answer_idx": "B", "answer": "Point Ba", "options": {"A": "Point Aa", "B": "Point Ba", "C": "Point C", "D": "Point D"}}
{"meta_info": "taiwanese_test_Q", "question": "在下列四种神经元受损情况下，那一种最容易产生痉挛型构音障碍（spastic dysarthria）？", "answer_idx": "C", "answer": "双侧上运动神经元（bilateral upper motor neuron）", "options": {"A": "单侧上运动神经元（unilateral upper motor neuron）", "B": "单侧下运动神经元（unilateral lower motor neuron）", "C": "双侧上运动神经元（bilateral upper motor neuron）", "D": "双侧下运动神经元（bilateral lower motor neuron）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关麻疯的叙述，何者错误？", "answer_idx": "B", "answer": "在癞瘤型麻疯，是由于细胞性及体液性（humoral）免疫反应两者均有缺失的缘故", "options": {"A": "癞瘤型麻疯（lepromatous leprosy）病变组织中可以发现有极多的麻疯杆菌", "B": "在癞瘤型麻疯，是由于细胞性及体液性（humoral）免疫反应两者均有缺失的缘故", "C": "在类结核型麻疯（tuberculoid leprosy），是由于细胞性免疫反应太强的缘故，其肉芽肿中较难发现细菌", "D": "麻疯杆菌经由人与人之间散布，可能由呼吸传染"}}
{"meta_info": "taiwanese_test_Q", "question": "有关⼼脏⾎管系统的⾝体检查与评估，下列何者错误？", "answer_idx": "C", "answer": "⾺凡⽒症（Marfan's syndrome）除了⾝形瘦⻑之外，在牙龈上的表现常常是有较低的牙腭⼸（low-arched", "options": {"A": "所谓differential cyanosis指的是发绀现象单独出现在下肢，要考虑有从右到左的⾎液分流（shunting）病态", "B": "当⽪肤看起来有点像青铜⾊的⾊素沉积之际，⼼衰竭的鉴别诊断要考量⾎⾊素沉着病（hemochromatosis）", "C": "⾺凡⽒症（Marfan's syndrome）除了⾝形瘦⻑之外，在牙龈上的表现常常是有较低的牙腭⼸（low-arched", "D": "所谓的杵状指（clubbing finger）是暗⽰着病患可能有从右到左的⾎液分流（shunting）病态⽣理现象"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，阻塞性位置最常发生在：", "answer_idx": "C", "answer": "回肠", "options": {"A": "十二指肠", "B": "空肠", "C": "回肠", "D": "升结肠"}}
{"meta_info": "taiwanese_test_Q", "question": "威尔逊氏病（Wilson's disease）是一种铜代谢的先天性異常，角膜会有 Kayser-Fleischer ring，下列叙述何者正确？", "answer_idx": "D", "answer": "色素沈积于 Descemet's membrane 该层", "options": {"A": "该环狀铜质色素沈积于角膜中心", "B": "该色素沈积位于角膜上皮层", "C": "相同的环狀铜质色素，也会出现于圆锥角膜（keratoconus）的病人", "D": "色素沈积于 Descemet's membrane 该层"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关失语症的相关叙述，何者错误？", "answer_idx": "B", "answer": "全面性失语症的病患其听說能力異常，但讀写能力是正常的", "options": {"A": "如中风发生位置在优势大脑中脑动脉的主干（middle cerebral artery main stem），病患有可能呈现全面性失语症（global aphasia）", "B": "全面性失语症的病患其听說能力異常，但讀写能力是正常的", "C": "交叉性失语症（crossed aphasia）系指惯用手为右手的病患，当右侧脑部有病变时产生典型失语症之症狀", "D": "命名性失语症（anomic aphasia）常由其他類型失语症转变而來"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 19 岁大学女生，因骨盆腔巨大肿瘤接受手术治療，发现是左侧卵巢不成熟型畸胎瘤（immature teratoma），有关她的治療预后因子为：", "answer_idx": "A", "answer": "amount of undifferentiated neural tissue", "options": {"A": "amount of undifferentiated neural tissue", "B": "degree of glandular differentiation", "C": "presence of solid parts more than cystic parts", "D": "presence of sexual pseudoprecocity"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 30 岁男性因車祸造成颈椎损伤，右侧肢体无力但左侧温痛觉異常。这最可能是何种脊髓损伤？", "answer_idx": "B", "answer": "Brown-Séquard syndrome", "options": {"A": "anterior cord syndrome", "B": "Brown-Séquard syndrome", "C": "central cord syndrome", "D": "complete spinal cord injury"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种情形最不适合接种注射型非活性流感疫苗？", "answer_idx": "C", "answer": "罹患轻度心室中隔缺损的 3 个月婴儿", "options": {"A": "罹患糖尿病的 70 岁老人", "B": "怀孕 32 周的孕妇", "C": "罹患轻度心室中隔缺损的 3 个月婴儿", "D": "罹患发绀性心脏病的 6 岁儿童"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 28 岁女性抱怨說做了流产手术后，月经不來。她最可能的诊断是：", "answer_idx": "D", "answer": "Asherman's syndrome", "options": {"A": "Gonadal dysgenesis", "B": "Sheehan syndrome", "C": "Kallmann syndrome", "D": "Asherman's syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "将检体贮存于 4℃兩周以上，再进行细菌分離的冷藏增殖法（cold enrichment），适用于下列何种菌属的病菌？", "answer_idx": "B", "answer": "亚辛氏菌属（Yersinia）", "options": {"A": "沙门氏菌属（Salmonella）", "B": "亚辛氏菌属（Yersinia）", "C": "幽门杆菌属（Helicobacter）", "D": "霍亂弧菌属（Vibrio）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是属于补体的 C3 转化酶（C3 convertase）？", "answer_idx": "D", "answer": "C3bBb", "options": {"A": "C5b67", "B": "C3a", "C": "C3b", "D": "C3bBb"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于小儿麻痹病毒（Poliovirus）之叙述，何者为错？", "answer_idx": "C", "answer": "感染后大部分人出现中枢神经症狀，少部分人为无症狀感染", "options": {"A": "分類上属于小 RNA 病毒科（Picornaviridae），包括三种血清型", "B": "其疫苗有沙克疫苗及沙宾疫苗，均为包含三种血清型之混合疫苗", "C": "感染后大部分人出现中枢神经症狀，少部分人为无症狀感染", "D": "麻痹性脊髓灰白质炎（paralytic poliomyelitis）主要是因为此病毒感染脊髓前角细胞（anterior horn cell）所致"}}
{"meta_info": "taiwanese_test_Q", "question": "小学3 年级的李小弟最近功课退步，老师說他上课时常常发呆，有时嘴巴还动來动去，不知在吃什么；事后问他，他总是很无辜的說：「没有啊！」在门诊时请李小弟連续深呼吸3 分钟，结果做了一半他又开始发呆。下列那一个检查最能诊断出李小弟的病？", "answer_idx": "C", "answer": "脑电图", "options": {"A": "心理测验", "B": "24 小时心电图", "C": "脑电图", "D": "生长激素测定"}}
{"meta_info": "taiwanese_test_Q", "question": "59 某病患发生车祸造成脊髓损伤，肚脐以下完全没有感觉，下肢肌肉力量也完全丧失。根据美国脊髓 损伤协会（ASIA）的分类标准，其状况应表示为下列何者？\n", "answer_idx": "C", "answer": "ASIA：A, level：T10", "options": {"A": "ASIA：A, level：T4", "B": "ASIA：E, level：T4", "C": "ASIA：A, level：T10", "D": "ASIA：E, level：T10"}}
{"meta_info": "taiwanese_test_Q", "question": "15 一位25 岁男性病人，平日身体健康，喜欢野外旅游，10 天前刚从澎湖旅游回到台中，2 天前开始出现发烧、倦怠感及头痛，前往某诊所就诊后，服用一些感冒药但并未退烧，于是到某医院就诊，血液检查发现白血球：3600/μL、AST：120 IU/L、ALT：80 IU/L，于右侧腋窝附近发现有一焦痂（eschar）。请问最有可能的致病原为何？\n", "answer_idx": "A", "answer": "Orientia tsutsugamushi", "options": {"A": "Orientia tsutsugamushi", "B": "Hantavirus", "C": "Burkholderia pseudomallei", "D": "Coxiella burnetii"}}
{"meta_info": "taiwanese_test_Q", "question": "肾脏髓质的高渗透度环境主要是因为氯化钠与下列那一种物质累积所造成？", "answer_idx": "C", "answer": "尿素", "options": {"A": "尿酸", "B": "铵離子", "C": "尿素", "D": "蛋白质"}}
{"meta_info": "taiwanese_test_Q", "question": "34岁妇女，不孕症5年，经检查发现双侧输卵管水肿（hydrosalpinx），卵巢功能正常，先生精液检查正常，下一步应建议她做何治疗？", "answer_idx": "D", "answer": "腹腔镜输卵管整型、造口或切除手术", "options": {"A": "人工授精", "B": "打排卵针增加怀孕机会", "C": "吃排卵药增加怀孕机会", "D": "腹腔镜输卵管整型、造口或切除手术"}}
{"meta_info": "taiwanese_test_Q", "question": "脊髓刺激（spinal cord stimulation）可以有效降低慢性神经性疼痛，下列何者并非常见的适应症？", "answer_idx": "C", "answer": "癌症痛（cancer pain）", "options": {"A": "脊椎术后症候群（failed back syndrome）", "B": "脊髓损伤相关疼痛（pain associated spinal cord injury）", "C": "癌症痛（cancer pain）", "D": "截肢后疼痛（postamputation limb pain）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于台湾之 B 型肝炎疫苗注射，下列何者错误？", "answer_idx": "D", "answer": "若母亲为 e 抗原阳性的 B 型肝炎带原者，新生儿除接受疫苗注射外，需于出生 24 小时内注射 B 型肝炎免疫球蛋白", "options": {"A": "台湾已施行新生儿全面 B 型肝炎疫苗注射", "B": "青少年之带原率已由疫苗接种前 15%，降低到目前之 5%", "C": "儿童肝癌的年发生率已有显著下降", "D": "若母亲为 e 抗原阳性的 B 型肝炎带原者，新生儿除接受疫苗注射外，需于出生 24 小时内注射 B 型肝炎免疫球蛋白"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于细胞周期蛋白质（cyclin）之叙述何者错误？", "answer_idx": "D", "answer": "能直接催化蛋白质的磷酸化的一种激酶（kinase）", "options": {"A": "在细胞周期中能被活化和分解", "B": "是催化蛋白质磷酸化酵素的调控因子", "C": "能与泛肽素（ubiquitin）连结", "D": "能直接催化蛋白质的磷酸化的一种激酶（kinase）"}}
{"meta_info": "taiwanese_test_Q", "question": "当某种离子在细胞膜两侧达成电化学平衡（electrochemical equilibrium）时，下列叙述何者正确？", "answer_idx": "D", "answer": "此时之膜电位即为该种离子之平衡电位（equilibrium potential） 2 下列关于阶梯电位（graded potentials）的叙述，何者正确？", "options": {"A": "细胞膜电位（membrane potential）等于 0", "B": "该种离子在细胞膜两侧之浓度相等", "C": "细胞膜内侧之正电荷总数等于细胞膜外侧之负电荷总数", "D": "此时之膜电位即为该种离子之平衡电位（equilibrium potential） 2 下列关于阶梯电位（graded potentials）的叙述，何者正确？"}}
{"meta_info": "taiwanese_test_Q", "question": "人类与小鼠的肠道中，寄生有上千种的共生菌，但是正常个体并不会对这些共生菌产生免疫反应，下列叙述何者错误？", "answer_idx": "C", "answer": "肠道的免疫系统主要会产生IgA与共生菌结合，而后引起补体的活化清除共生菌", "options": {"A": "共生菌不像致病菌会利用毒性因子，破坏上皮细胞或是引起发炎细胞激素之分泌", "B": "与共生菌存在的上皮细胞会分泌TGF-β等细胞激素", "C": "肠道的免疫系统主要会产生IgA与共生菌结合，而后引起补体的活化清除共生菌", "D": "肠道的上皮细胞在接触共生菌的表面，并不会表现Toll-like receptors及CD14，因此较不易产生发炎反应"}}
{"meta_info": "taiwanese_test_Q", "question": "关于21-羟酶缺乏（21-hydroxylase deficiency）所致之先天性肾上腺增生（congenital adrenal hyperplasia）的叙述，下列何者正确？", "answer_idx": "B", "answer": "大多数患儿会出现电解质失调（electrolyte disturbance）", "options": {"A": "男婴的外阴部会出现性器混淆（ambiguous genitalia）", "B": "大多数患儿会出现电解质失调（electrolyte disturbance）", "C": "男童比女童易罹患此症", "D": "临床上常以21-羟酶酵素活性（enzyme activity）的测定作为诊断的依据"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 DNA 复制（DNA replication）的叙述，何者错误？", "answer_idx": "C", "answer": "DNA 合成（DNA synthesis）由 3'往 5'端进行", "options": {"A": "DNA 复制以半保留（semiconservative）模式进行", "B": "DNA 复制过程中会产生引导股（leading strand）与落后股（lagging strand）", "C": "DNA 合成（DNA synthesis）由 3'往 5'端进行", "D": "DNA 复制后，原始模版（parental strand）与新合成模版（newly synthesized strand）兩股以反向平行（antiparallel）形成双股结构"}}
{"meta_info": "taiwanese_test_Q", "question": "戴奥辛在各项环境介质中的污染及其对国人健康造成的影响深受关注。下列何者为国内戴奥辛排放量最高之污染來源？", "answer_idx": "B", "answer": "金属冶煉业", "options": {"A": "废弃物焚化爐", "B": "金属冶煉业", "C": "农田露天燃烧", "D": "有机氯农药制造"}}
{"meta_info": "taiwanese_test_Q", "question": "年轻的主动脉瓣狭窄的病人接受 Ross 手术式时，其主动脉瓣用下列何种瓣膜來置换？", "answer_idx": "D", "answer": "自体之肺动脉瓣（autograft）", "options": {"A": "机械性人工瓣膜（mechanical prosthesis）", "B": "生物性人工瓣膜（bioprosthesis）", "C": "同种之生物瓣膜（homograft）", "D": "自体之肺动脉瓣（autograft）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位27岁的男性，因手肘关节部位疼痛而来求诊，经病史询问及身体检查发现，怀疑为肱骨外上髁炎（lateral epicondylitis），下列何者错误？", "answer_idx": "B", "answer": "肱骨外上髁炎又称为高尔夫球肘（golfer's elbow）", "options": {"A": "肱骨外上髁是前臂、手腕、以及手指的伸肌（extensor）肌腱附 处（origin）", "B": "肱骨外上髁炎又称为高尔夫球肘（golfer's elbow）", "C": "身体检查可以发现肱骨外上髁处有压痛", "D": "病患作前臂伸展（extension）及外旋（supination）抗阻力的动作时会有疼痛"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是 gene transfer 所使用的 vectors？", "answer_idx": "D", "answer": "naked RNA", "options": {"A": "adenovirus", "B": "retrovirus", "C": "liposome-DNA", "D": "naked RNA"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 24 岁女性至急诊主诉突然发作之左下腹剧烈疼痛且有盗汗及呕吐情形，正常月经刚结束十天，怀孕检测为阴性，下列何者是最可能之臨床诊断？", "answer_idx": "D", "answer": "卵巢扭转（ovarian torsion）", "options": {"A": "阑尾炎（appendicitis）", "B": "子宫内膜異位（endometriosis）", "C": "子宫外孕（ectopic pregnancy）", "D": "卵巢扭转（ovarian torsion）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一个胺基酸在蛋白质的α螺旋（α-helix）结构中很少出现？", "answer_idx": "A", "answer": "脯胺酸（proline）", "options": {"A": "脯胺酸（proline）", "B": "甲硫胺酸（methionine）", "C": "色胺酸（tryptophan）", "D": "组胺酸（histidine）"}}
{"meta_info": "taiwanese_test_Q", "question": "1 岁小女生被带至急诊，家属陈述 4 天前即开始有鼻塞、流鼻涕，今日开始出现如「狗吠」般的咳嗽，偶尔会仰头呼吸且有喘鸣，下列​​叙述何者错误？", "answer_idx": "A", "answer": "立刻以压舌板检查喉咙是否有感染的征象", "options": {"A": "立刻以压舌板检查喉咙是否有感染的征象", "B": "主要病变处应在声门下区，而声门上区与声门区可能正常", "C": "胸部 X 光片可见气管影像成尖塔状（steeple sign）", "D": "较可能为病毒感染，不建议立即使用抗生素"}}
{"meta_info": "taiwanese_test_Q", "question": "71 一位 74 岁患有摄护腺癌并且已经发生转移，兩年前他已接受睪丸切除手术，此外他未曾接受其他治療，而且一直都保持很健康。直到最近他发现右侧髋关节剧痛，全身性骨头扫描发现弥漫性多处骨 头转移，骨盆 X 光检查显示右侧髋关节被肿瘤所浸润破坏，试问接下來应如何处理？\n", "answer_idx": "D", "answer": "局部放射治療右侧髋关节", "options": {"A": "给予男性荷尔蒙", "B": "给予 LH-RH analog", "C": "以止痛剂控制疼痛", "D": "局部放射治療右侧髋关节"}}
{"meta_info": "taiwanese_test_Q", "question": "评估医療品质，常用 Donabedian 所提出的三个构面來检视，其中，落实医事人员证照制度，是在改善那一个构面？", "answer_idx": "B", "answer": "结构", "options": {"A": "背景", "B": "结构", "C": "过程", "D": "结果"}}
{"meta_info": "taiwanese_test_Q", "question": "77.一位35岁女性癫痫患者，近5日来出现全身倦怠、食欲不佳和发烧症状，至急诊时生命征象如下：血压95/60 mmHg，心跳125次/分钟，呼吸20次/分钟，体温39.5℃，全身多处皮肤疼痛异常且出现如图的病灶。下列叙述何者错误？", "answer_idx": "C", "answer": "Nikolsky Sign为阴性", "options": {"A": "可能的诊断为toxic epidermal necrolysis 或是 Stevens-Johnson syndrome", "B": "药物史必须详尽，将药物不良反应列入考虑", "C": "Nikolsky Sign为阴性", "D": "比照烧伤病患的处理原则，大量给予输液，避免低血容性休克"}}
{"meta_info": "taiwanese_test_Q", "question": "50 岁男性，因右肩持续疼痛至復健科求诊。检查时发现：右肩肌力减弱，右眼眼皮下垂，瞳孔较左眼为小。下列叙述何者正确？", "answer_idx": "B", "answer": "需进行胸部 X 光检查", "options": {"A": "身体诊查时，应发现右眼眼球外突", "B": "需进行胸部 X 光检查", "C": "仅需进行右肩膀 X 光检查", "D": "为颈椎病变，需进行颈椎 X 光检查"}}
{"meta_info": "taiwanese_test_Q", "question": "50岁男性，无明显症状，影像检查如图所示，请选出最合适的描述：", "answer_idx": "D", "answer": "需考虑手术的可能", "options": {"A": "肝脏有一囊肿，位于肝门附近", "B": "有一肿瘤位于后纵膈腔", "C": "超音波抽吸可改善其压迫症状", "D": "需考虑手术的可能"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不会导致非感染性角膜炎？", "answer_idx": "B", "answer": "第二条脑神经麻痹", "options": {"A": "類风湿性关节炎", "B": "第二条脑神经麻痹", "C": "第五条脑神经麻痹", "D": "第七条脑神经麻痹"}}
{"meta_info": "taiwanese_test_Q", "question": "有关手术中输血的叙述，下列何者错误？", "answer_idx": "C", "answer": "输血反应在手术麻醉下，不会发生", "options": {"A": "血液成分输血治疗（blood component therapy）原则于手术中仍适用", "B": "大量输血（massive transfusion）时，必须适量补充新鲜冷冻血浆", "C": "输血反应在手术麻醉下，不会发生", "D": "耶和华见证人（Jehovah's Witnesses）病患在术前应与他们讨论输血问题"}}
{"meta_info": "taiwanese_test_Q", "question": "根据Hunt and Hess SAH classification，一个蜘蛛膜下腔出血（SAH）病人，临床上只有轻微头痛及轻微颈部僵硬，且无其他神经学检查异常（focal neurological deficit），其grade应为下列何者？", "answer_idx": "A", "answer": "1", "options": {"A": "1", "B": "2", "C": "3", "D": "4"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 paleospinothalamic system 之叙述，何者错误？", "answer_idx": "C", "answer": "传导路径不经过网狀系统（reticular formation）", "options": {"A": "与意識狀态有关", "B": "可传导痛觉", "C": "传导路径不经过网狀系统（reticular formation）", "D": "此体感觉传导系统较缺乏定位功能"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关谵妄（delirium）的叙述，何者最适当？", "answer_idx": "B", "answer": "失智症（dementia）是谵妄最主要的前置因子（predisposing factor）", "options": {"A": "老年人住院时谵妄的发生率，平均约为1.0～5.0 %", "B": "失智症（dementia）是谵妄最主要的前置因子（predisposing factor）", "C": "鸦片类药物（opioids）或是抗胆碱剂（anti-cholinergics）的使用，可有效帮助患者减少谵妄的发生", "D": "身体约束（physical restraint）及benzodiazepines注射，目前被建议用于谵妄的治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "位于下视丘（hypothalamus）之 osmoreceptor 为：", "answer_idx": "B", "answer": "Chemoreceptor", "options": {"A": "Mechanoreceptor", "B": "Chemoreceptor", "C": "Nociceptor", "D": "Stress receptor"}}
{"meta_info": "taiwanese_test_Q", "question": "37.⼀位46岁女性因为常常头晕，爬楼梯时感到很喘⽽来医院求诊。 ⾝体检查除脸⾊与结膜苍⽩之外，并无其他明显异常。患者⾎压106/76 mmHg，脉搏每分 72次，规则⼼跳，无发烧，亦无体重减轻或是食欲降低的现象。 ⾎液数据显⽰⾎红素7.6 g/dL，⽩⾎球4,030/μL，无异常分类，⾎⼩板418,000/μL，MCV 74.8 fL（参考区间80～100），ferritin 3.84 ng/mL（参考区间28～365），serum iron 10 μg/dL（参考区间51～209）， TIBC（total iron binding capacity）459 μg/dL（参考区间268～593）。 ⾎液抹片如下图所⽰。有关这位病⼈最可能的疾病之描述，下列何者错误？\n", "answer_idx": "C", "answer": "此类病⼈的红⾎球中的protoporphyrin 量常是降低的", "options": {"A": "此类病⼈的⾎液中的reticulocyte counts常是降低的", "B": "此类病⼈的骨髓中的sideroblast比例常是降低的", "C": "此类病⼈的红⾎球中的protoporphyrin 量常是降低的", "D": "此类病⼈的red cell distribution width（RDW）index常是增加的"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关乳房发炎或脓疡（abscess）之叙述，何者错误？", "answer_idx": "D", "answer": "在严重慢性乳房感染，单纯乳房切除（simple mastectomy）是绝对禁止的", "options": {"A": "脓疡通常发生在刚喂母奶时的前几周", "B": "葡萄球菌感染（Staphylococcus infection）较容易引起乳房局部性、深部之脓疡", "C": "链球菌感染（Streptococcus infection）较容易引起乳房全面性蜂窝组织炎（cellulitis）", "D": "在严重慢性乳房感染，单纯乳房切除（simple mastectomy）是绝对禁止的"}}
{"meta_info": "taiwanese_test_Q", "question": "1.2个月大女婴，咳嗽已有3个星期之久，近几天甚至偶尔咳至唇色发紫，这阵子并无发烧现象。血液检查WBC为", "answer_idx": "B", "answer": "Bordetella pertussis", "options": {"A": "adenovirus", "B": "Bordetella pertussis", "C": "enterovirus", "D": "Streptococcus pneumoniae"}}
{"meta_info": "taiwanese_test_Q", "question": "做视⼒检测时，只能看到蓝道尔（Landolt）⽒视⼒表上的0.4视标，表⽰：", "answer_idx": "D", "answer": "相当于史奈伦（Snellen）⽒视⼒表检查的20/50视⼒", "options": {"A": "要向前⾛到距离视⼒表四公尺处，才能看到1.0的视标", "B": "对应之最⼩视⾓（minimal angle of resolution）为五分之⼆分⾓（minute of arc）", "C": "该眼只剩下40%的视觉效能（visual efficiency）", "D": "相当于史奈伦（Snellen）⽒视⼒表检查的20/50视⼒"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者最容易造成 photosensitivity 的副作用？", "answer_idx": "C", "answer": "Promethazine", "options": {"A": "Hydralazine", "B": "Diphenhydramine", "C": "Promethazine", "D": "Penicillin"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者细菌不是急性鼻窦炎常見菌种？", "answer_idx": "A", "answer": "Staphylococcus aureus", "options": {"A": "Staphylococcus aureus", "B": "Streptococcus pneumoniae", "C": "Haemophilus influenzae", "D": "Moraxella catarrhalis"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 24 岁男性，准备出国旅游而至门诊咨询，他担心旅游期间在国外生病的问题。下列何者是国际旅游者最常見的疾病？", "answer_idx": "A", "answer": "旅游者腹泻", "options": {"A": "旅游者腹泻", "B": "性传染病", "C": "寄生虫感染", "D": "疟疾"}}
{"meta_info": "taiwanese_test_Q", "question": "生产时第一产程后期及第二产程的疼痛传导是经由：", "answer_idx": "A", "answer": "T10-L1", "options": {"A": "T10-L1", "B": "T12-S2", "C": "S2-S4", "D": "L1-L5"}}
{"meta_info": "taiwanese_test_Q", "question": "关于心包填塞（cardiac tamponade），下列叙述何者错误？", "answer_idx": "D", "answer": "常有 Kussmaul's sign", "options": {"A": "颈静脉鼓胀", "B": "低血压", "C": "奇脉（paradoxical pulse）", "D": "常有 Kussmaul's sign"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关血红素（hemoglobin）与氧气的结合与释放之叙述，何者正确？", "answer_idx": "A", "answer": "高浓度的 2,3-二磷酸甘油酸（2,3-bisphosphoglycerate）能降低血红素对氧气的亲和力", "options": {"A": "高浓度的 2,3-二磷酸甘油酸（2,3-bisphosphoglycerate）能降低血红素对氧气的亲和力", "B": "pH 值的下降可增强血红素对氧气的亲和力", "C": "当血红素中铁与氧气结合时会被氧化成三价铁離子", "D": "氧气结合在任何一个血基质（heme）皆不会受另外其他三个血基质的影响"}}
{"meta_info": "taiwanese_test_Q", "question": "一位25 岁的妇人来到门诊，她罹患系统性红斑性狼疮（systemic lupus erythematosus, SLE）已有五年，控制良好，最近她怀孕三个月，很怕胎儿会受SLE 的影响发生新生儿狼疮（neonatal lupus erythematosus, NLE），请问若此妈妈血中测得下列何种物质，则胎儿容易发生NLE？", "answer_idx": "B", "answer": "Anti-Ro antibodies", "options": {"A": "A low C4 concentration", "B": "Anti-Ro antibodies", "C": "Anti-Smith antibodies", "D": "Thrombocytopenia"}}
{"meta_info": "taiwanese_test_Q", "question": "右图为何种胞器（organelle）？", "answer_idx": "B", "answer": "粗糙内质网（Rough endoplasmic reticulum）", "options": {"A": "高基氏体（Golgi apparatus）", "B": "粗糙内质网（Rough endoplasmic reticulum）", "C": "平滑内质网（Smooth endoplasmic reticulum）", "D": "粒线体（Mitochondria）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位40岁病患突发心悸、脸色苍白、冒冷 、意识模糊，血压70/30 mmHg，其心电图如下，应做何处置较适当？", "answer_idx": "C", "answer": "同步心脏整流（cardioversion）", "options": {"A": "施予颈动脉窦按摩", "B": "注射atropine", "C": "同步心脏整流（cardioversion）", "D": "注射adenosine"}}
{"meta_info": "taiwanese_test_Q", "question": "补体 C5-C9 形成之胞膜破坏结构体（membrane attack complex）有缺乏时，会产生下列何种现象？", "answer_idx": "D", "answer": "无法防范细胞内细菌如 Neisseria meningitidis 之感染", "options": {"A": "易有免疫复合体疾病（immune complex disease）", "B": "易有自体免疫疾病（autoimmune disease）", "C": "对于传统补体路径（classical complement pathways）之活化大有影响，因此凋亡细胞之清除受到影响", "D": "无法防范细胞内细菌如 Neisseria meningitidis 之感染"}}
{"meta_info": "taiwanese_test_Q", "question": "18个月大的男孩，因昏迷被送到急诊室，脑部电脑断层摄影发现右颞部有硬脑膜下出血，身体诊察无外伤。据母亲叙述此男孩从小头围比正常小孩大，曾有医师怀疑有水脑。下列那种先天性代谢疾病最为可能的诊断？", "answer_idx": "C", "answer": "戊二酸尿症第一型（glutaric aciduria type I）", "options": {"A": "苯酮尿症（phenylketonuria）", "B": "中链脂肪酸去氢酶缺乏症（medium chain acyl CoA dehydrogenase deficiency）", "C": "戊二酸尿症第一型（glutaric aciduria type I）", "D": "异戊酸血症（isovaleric acidemia）"}}
{"meta_info": "taiwanese_test_Q", "question": "6 一位 43 岁男性病人因工作关系，7 天前发生烧伤达全身 35%表面积，外科医师安排常规清创与植皮手 术，下列叙述何者错误？\n", "answer_idx": "C", "answer": "烧伤病人进行手术时，手术室室温应尽量降低，以避免伤口术后感染", "options": {"A": "若有吸入性烧伤时，需仔细评估病人之气道情形，必要时须让病人在清醒狀况下进行光纤内视镜插入气管内管", "B": "切除坏死组织有时会伴随大量失血，大管径的静脉导管置入是必要的", "C": "烧伤病人进行手术时，手术室室温应尽量降低，以避免伤口术后感染", "D": "烧伤 24 小时后，使用肌肉松弛剂 succinylcholine 会使体内钾離子浓度上升，应避免使用"}}
{"meta_info": "taiwanese_test_Q", "question": "80 A 君在求诊时被诊断有 AIDS。基于个人因素，A 君希望主治医师不要将他的病情透露给其配偶知道。下列主治医师的处置何者不适当？\n", "answer_idx": "C", "answer": "若 A 君拒绝向配偶說明病情，可私下将实情告知 A 君的亲友", "options": {"A": "依法通报卫生主管单位", "B": "与 A 君沟通，說服他向他的配偶說明病情", "C": "若 A 君拒绝向配偶說明病情，可私下将实情告知 A 君的亲友", "D": "可请社工或心理师对 A 君提供咨询或辅导"}}
{"meta_info": "taiwanese_test_Q", "question": "有关狂犬病（rabies）之叙述，下列何者正确？", "answer_idx": "C", "answer": "最好的预防策略是对动物施打疫苗", "options": {"A": "是被感染了狂犬病细菌的病狗咬伤所引起的", "B": "最初的入侵部位为肌肉；最终之感染部位为心脏", "C": "最好的预防策略是对动物施打疫苗", "D": "病原细菌入侵仅数天即严重发病"}}
{"meta_info": "taiwanese_test_Q", "question": "何种生殖细胞肿瘤（germ cell tumor）对放射线治疗效果之反应最好且可能根治？", "answer_idx": "C", "answer": "胚组织瘤（germinoma）", "options": {"A": "绒毛膜癌（choriocarcinoma）", "B": "胚胎癌（embryonal carcinoma）", "C": "胚组织瘤（germinoma）", "D": "内胚层窦肿瘤（endodermal sinus tumor）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于钠-钾离子唧筒（Na+-K+pump）的机制，下列叙述何者错误？", "answer_idx": "D", "answer": "磷酸化的钠-钾离子唧筒对钾离子的亲和力低于对钠离子的亲和力", "options": {"A": "每运送三莫耳（moles）钠离子至细胞外需水解一莫耳ATP", "B": "与钠离子结合后会导致钠-钾离子唧筒的磷酸化", "C": "Cardiotonic steroid，如洋地黄（digitalis）会结合并抑制心脏细胞之钠-钾离子唧筒的功能", "D": "磷酸化的钠-钾离子唧筒对钾离子的亲和力低于对钠离子的亲和力"}}
{"meta_info": "taiwanese_test_Q", "question": "50岁男性，患有高血压与寻常性干癣，下列那一类抗高血压药物会恶化干癣，宜避免处方？", "answer_idx": "B", "answer": "β-blocker", "options": {"A": "diuretics", "B": "β-blocker", "C": "calcium channel blocker", "D": "α-blocker 42."}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一類型胶原蛋白（collagen）纤维是弹性（elastic）软骨与透明（hyaline）软骨的基质中都有的？", "answer_idx": "B", "answer": "Type II", "options": {"A": "Type I", "B": "Type II", "C": "Type III", "D": "Type IV"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 8 岁小男孩，因为牙龈发黑，检查发现 cortisol 下降，ACTH 上升，诊断为 Addison 病。患童定时补充 cortisone acetate，但是在治療一年半后，发现学习上有退步的现象，而且走路也不太稳。下列的后续诊断发现，何者最不合理？", "answer_idx": "D", "answer": "家族史分析中发现父系亲属中也有一位男孩发病", "options": {"A": "脑部核磁共振检查发现有白质退化的现象", "B": "血液超长链脂肪酸分析结果不正常", "C": "小男孩 4 岁的弟弟也罹病", "D": "家族史分析中发现父系亲属中也有一位男孩发病"}}
{"meta_info": "taiwanese_test_Q", "question": "有关肺传导区（conducting zone）之功能，下列叙述何者错误？", "answer_idx": "C", "answer": "分泌表面作用素（surfactant）", "options": {"A": "分泌黏液（mucus）", "B": "形成无效腔（dead space）", "C": "分泌表面作用素（surfactant）", "D": "调控呼吸道阻力（airway resistance）"}}
{"meta_info": "taiwanese_test_Q", "question": "Nitric oxide（NO）可以直接活化下列何种酵素？", "answer_idx": "C", "answer": "Cytosolic guanylyl cyclase", "options": {"A": "Adenylate cyclase", "B": "Membrane-bound guanylyl cyclase", "C": "Cytosolic guanylyl cyclase", "D": "Protein kinase C"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于阿兹海默症（Alzheimer disease）的叙述，何者正确？", "answer_idx": "C", "answer": "病理特征为老年斑（senile plaques）和神经纤维纠结（neurofibrillary tangles）", "options": {"A": "意识障碍是首发症状", "B": "为持续性、进行性、可逆性病程", "C": "病理特征为老年斑（senile plaques）和神经纤维纠结（neurofibrillary tangles）", "D": "疾病早期不会有人格改变"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关静脉窦型（sinus venosus）心房中隔缺损（atrial septal defect，ASD）之叙述，何者错误？", "answer_idx": "D", "answer": "可以使用导管手术来关闭缺损", "options": {"A": "常合并肺静脉回流异常", "B": "缺损的位置，有时是在心房中隔底部接近下腔静脉开口", "C": "手术修补时，一般需使用布块（patch）修补", "D": "可以使用导管手术来关闭缺损"}}
{"meta_info": "taiwanese_test_Q", "question": "格雷夫斯病（Graves' disease）可以选择下列何种药物来治疗？", "answer_idx": "B", "answer": "Methimazole", "options": {"A": "Levothyroxine", "B": "Methimazole", "C": "Propranolol", "D": "Octreotide"}}
{"meta_info": "taiwanese_test_Q", "question": "在处理⼀个困难的伤⼝时，我们常以肌⾁⽪瓣（muscle flap）来重建缺损，根据 Mathes & Nahai 的分类，以下叙述何者正确？", "answer_idx": "C", "answer": "适合取较⼤肌⾁来重建缺损的是属于type I、III、V", "options": {"A": "臀⼤肌（gluteus maximus）和腹直肌（rectus abdominis）⽪瓣都属于type II", "B": "阔背肌（latissimus dorsi）由单⼀⾎管茎供应，属于type I", "C": "适合取较⼤肌⾁来重建缺损的是属于type I、III、V", "D": "股薄肌（gracilis）是属于type IV，所以只能取⼀⼩部分肌⾁来重建缺损"}}
{"meta_info": "taiwanese_test_Q", "question": "切除腮腺后，颜面神经主干可追溯至颅底何处？", "answer_idx": "C", "answer": "茎乳突孔（stylomastoid foramen）", "options": {"A": "卵圆孔（foramen ovale）", "B": "蝶腭孔（sphenopalatine foramen）", "C": "茎乳突孔（stylomastoid foramen）", "D": "眼眶下裂（infraorbital fissure）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 85 岁男性，三个月来发生运动时严重呼吸困难，一周前昏厥来门诊就医，听诊发现收缩期射出型心杂音（systolic ejection murmur）并延伸至右颈部，下列叙述何者正确？", "answer_idx": "C", "answer": "本病人如未积极治疗，存活率大约一年半至两年", "options": {"A": "本病人发生此疾病的原因，最常见的是风湿性心脏病", "B": "心脏超音波测量二尖瓣开口面积，可评估本病人心脏疾病的严重程度", "C": "本病人如未积极治疗，存活率大约一年半至两年", "D": "心脏瓣膜气球扩张术是本病人治疗的首选方法"}}
{"meta_info": "taiwanese_test_Q", "question": "在⼤肠杆菌中，下列何者为Dam甲基化酶（Dam methylase）所扮演的功能？", "answer_idx": "B", "answer": "对DNA模板股（template strand）的修饰，以便DNA修复系统的辨认", "options": {"A": "甲基化尿嘧啶（uracil），使之转化为胸腺嘧啶（thymine）", "B": "对DNA模板股（template strand）的修饰，以便DNA修复系统的辨认", "C": "去除模板股（template strand）上的错误配对", "D": "修复编码股（coding strand）上的错误配对"}}
{"meta_info": "taiwanese_test_Q", "question": "有关 aphasia 之病征与可能受损部位的叙述，何者正确？", "answer_idx": "A", "answer": "语言理解能力正常，說话困难，慢且不流畅，可能受损部位是 Broca's area", "options": {"A": "语言理解能力正常，說话困难，慢且不流畅，可能受损部位是 Broca's area", "B": "语言理解能力正常，說话困难，慢且不流畅，可能受损部位是 angular gyrus", "C": "语言理解能力正常，說话流畅，但无意义，可能受损部位是 angular gyrus", "D": "语言理解能力正常，說话流畅，但无意义，可能受损部位是 Wernicke's area"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者对于预防外伤病人发生破伤风（tetanus）和气性坏疽（gas gangrene）均极重要？", "answer_idx": "C", "answer": "清除坏死组织", "options": {"A": "给予抗毒素", "B": "送入高压氧舱", "C": "清除坏死组织", "D": "给予疫苗"}}
{"meta_info": "taiwanese_test_Q", "question": "关于此疾病的治療，下列何者具有最佳療效？", "answer_idx": "D", "answer": "波长694 nm的雷射", "options": {"A": "涂抹hydroquinone", "B": "涂抹tretinoin", "C": "波长532 nm的雷射", "D": "波长694 nm的雷射"}}
{"meta_info": "taiwanese_test_Q", "question": "有一位研究者想了解抽烟和肥胖间的相关，肥胖程度用身体质量指數测量，身体质量指數（BMI）＝体重（公斤）÷身高2（公尺），此研究者想描述抽烟者和非抽烟者的BMI集中趋势，下列何者统计量最适合？", "answer_idx": "A", "answer": "平均值", "options": {"A": "平均值", "B": "全距", "C": "百分比", "D": "众數"}}
{"meta_info": "taiwanese_test_Q", "question": "55 一名护士被感染爱滋病人血液的针头刺到，这名病人血液中含有 viral RNA 浓度（107 copies/mL）。下列何者为治療该名护士之首选方法？\n", "answer_idx": "C", "answer": "連续性给予 zidovudine 和 lamivudine 四星期", "options": {"A": "诊测护士的血液是否含有 HIV", "B": "連续性给予 zidovudine 四星期", "C": "連续性给予 zidovudine 和 lamivudine 四星期", "D": "連续性给予 acyclovir 和 zidovudine 四星期"}}
{"meta_info": "taiwanese_test_Q", "question": "一位足月男婴出生时很顺利，但是第三天大时开始出现黄疸，下列那一项最不可能是此婴儿的黄疸原因？", "answer_idx": "B", "answer": "Rh 血型不合", "options": {"A": "生理性黄疸", "B": "Rh 血型不合", "C": "哺育母乳黄疸", "D": "泌尿道感染"}}
{"meta_info": "taiwanese_test_Q", "question": "在 Tetralogy of Fallot 病患的正面胸部 X 光中，下列何者为误？", "answer_idx": "D", "answer": "心尖朝下", "options": {"A": "心脏的大小（size）可为正常", "B": "J 左心上缘可呈凹面狀（concavity）", "C": "肺的血管分布狀态可减少", "D": "心尖朝下"}}
{"meta_info": "taiwanese_test_Q", "question": "胺醯-tRNA合成酶（aminoacyl-tRNA synthetases）是一种活化胺基酸的酵素，其特征为何？", "answer_idx": "A", "answer": "能辨认特定的tRNA及胺基酸，促进胺醯-tRNA的合成", "options": {"A": "能辨认特定的tRNA及胺基酸，促进胺醯-tRNA的合成", "B": "需要会同其他酵素将胺基酸结合到特定的tRNA上", "C": "需要以GTP活化胺基酸后，始能进行胺醯-tRNA的合成", "D": "可以将胺基酸直接与tRNA 3'-端结合而形成胺醯-tRNA"}}
{"meta_info": "taiwanese_test_Q", "question": "细胞被病毒感染后，在短时间内会分泌何种物质，來防止病毒进一步感染其他细胞？", "answer_idx": "C", "answer": "干扰素（Interferons）", "options": {"A": "抗体（Antibodies）", "B": "化学介质（Chemokines）", "C": "干扰素（Interferons）", "D": "肿瘤坏死因子（Tumor necrosis factor）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列因素当中，那一项影响受孕的程度最小？", "answer_idx": "B", "answer": "肌层内子宫肌瘤（intramural myoma）", "options": {"A": "输卵管阻塞（tubal obstruction）", "B": "肌层内子宫肌瘤（intramural myoma）", "C": "子宫腔中隔（septum）", "D": "子宫内沾黏（intrauterine synechiae）"}}
{"meta_info": "taiwanese_test_Q", "question": "51.梅克耳憩室（Meckel's diverticulum）所造成的下消化道出血，可利用下列何者做诊断？ ①99mTc-pertechnetate放射线同位素检查 ②腹部超音波检查 ③腹腔镜探查 ④下消化道钡剂摄影 ⑤大肠镜检查", "answer_idx": "A", "answer": "①③", "options": {"A": "①③", "B": "②⑤", "C": "④⑤", "D": "②④"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那种阴道感染与早产的关聯性最高？", "answer_idx": "A", "answer": "Bacterial vaginosis", "options": {"A": "Bacterial vaginosis", "B": "Trichomonas vaginalis", "C": "Candidiasis", "D": "Herpes simplex infection"}}
{"meta_info": "taiwanese_test_Q", "question": "罕見遗传疾病 Medium-chain acyl-CoA dehydrogenase 基因突变，可能造成脂肪肝、低血糖、Octanoic acid 在血液中堆积、嗜睡、呕吐及昏迷。下列有关该酶之功能叙述，何者正确？", "answer_idx": "D", "answer": "该酶之作用是将脂肪酸逐步转化为 Acetyl-CoA 31 下列关于 Lesch-Nyhan syndrome 的叙述，何者错误？", "options": {"A": "该酶之作用是将脂肪酸运入粒线体", "B": "该酶作用于 ω-oxidation", "C": "该酶之作用是将脂肪酸逐步转化为 Pyruvate", "D": "该酶之作用是将脂肪酸逐步转化为 Acetyl-CoA 31 下列关于 Lesch-Nyhan syndrome 的叙述，何者错误？"}}
{"meta_info": "taiwanese_test_Q", "question": "在因全⾝性免疫疾病造成的⾓膜边缘溃疡（marginal ulcer）病患中，最常⾒的全⾝性免疫疾病是：", "answer_idx": "B", "answer": "類风湿性关节炎（rheumatoid arthritis）", "options": {"A": "全⾝性红斑性狼疮（systemic lupus erythematosus）", "B": "類风湿性关节炎（rheumatoid arthritis）", "C": "结节性多动脉炎（polyarteritis nodosa）", "D": "Wegener⽒⾁芽肿（Wegener granulomatosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "请在下列各原核细胞 RNA 聚合酶（RNA polymerase）次单元（subunit）中配对出其专一的功能？", "answer_idx": "D", "answer": "a-II, b-III, c-I", "options": {"A": "a-I, b-II, c-III", "B": "a-III, b-II, c-I", "C": "a-III, b-I, c-II", "D": "a-II, b-III, c-I"}}
{"meta_info": "taiwanese_test_Q", "question": "如图所示之皮疹，下列叙述何者错误？", "answer_idx": "D", "answer": "勤于用热水及肥皂洗澡，才能避免其发生", "options": {"A": "是缺脂性湿疹（asteatotic eczema）", "B": "常在秋冬季发生", "C": "主要发生于老人", "D": "勤于用热水及肥皂洗澡，才能避免其发生"}}
{"meta_info": "taiwanese_test_Q", "question": "55 岁甲狀腺功能低下病人，主诉呼吸困难，胸部 X 光如附图，则最正确的诊断应为：", "answer_idx": "C", "answer": "大量心包膜积液（massive pericardial effusion）", "options": {"A": "郁血性心衰竭（congestive heart failure）", "B": "二尖瓣闭锁不全（mitral regurgitation）", "C": "大量心包膜积液（massive pericardial effusion）", "D": "主动脉瓣闭锁不全（aortic regurgitation）"}}
{"meta_info": "taiwanese_test_Q", "question": "依据DSM-IV-TR诊断标准，下列有关自闭症的叙述何者正确？", "answer_idx": "A", "answer": "与典型自闭症比较，亚斯柏格症也有社交互动困难和局限且重复的行为与兴趣，但语言沟通常无困难", "options": {"A": "与典型自闭症比较，亚斯柏格症也有社交互动困难和局限且重复的行为与兴趣，但语言沟通常无困难", "B": "半数以上的自闭症儿童具有别人没有的特殊才能（例如记忆超凡），而少数具有智能障碍", "C": "半数以上的自闭症患者一生中会癫痫发作", "D": "抗精神病药物能改善其核心症状"}}
{"meta_info": "taiwanese_test_Q", "question": "一位怀孕 25 周的年轻孕妇，骑机車不慎撞击前方小轿車而到急诊就医。她有兩侧手掌及膝盖擦伤，她很担心的请问急诊室王医师有关她胎儿的情况。请问王医师针对胎儿的检查中，何者最为恰当？", "answer_idx": "D", "answer": "胎儿心跳监测", "options": {"A": "腹部电脑断层扫描", "B": "Kleihauer-Betke 试验", "C": "骨盆腔内诊", "D": "胎儿心跳监测"}}
{"meta_info": "taiwanese_test_Q", "question": "鼻毛囊炎（folliculitis）最常見的致病菌为：", "answer_idx": "C", "answer": "金黄色葡萄球菌", "options": {"A": "链球菌", "B": "綠脓杆菌", "C": "金黄色葡萄球菌", "D": "大肠杆菌"}}
{"meta_info": "taiwanese_test_Q", "question": "玻尿酸（hyaluronic acid）是关节滑液的组成之一，是下列何种双糖分子（disaccharide unit）的聚合物？", "answer_idx": "D", "answer": "D-glucuronic acid及N-acetylglucosamine", "options": {"A": "galactose及glucose", "B": "glucose及N-acetylglucosamine", "C": "D-glucuronic acid及fructose", "D": "D-glucuronic acid及N-acetylglucosamine"}}
{"meta_info": "taiwanese_test_Q", "question": "锥鼻虫（Triatoma / kissing bug）可以传播下列何种寄生虫？", "answer_idx": "D", "answer": "枯西氏锥虫（Trypanosoma cruzi）", "options": {"A": "杜氏利什曼原虫（Leishmania donovani）", "B": "热带利什曼原虫（Leishmania tropica）", "C": "冈比亚锥虫（Trypanosoma brucei gambiense）", "D": "枯西氏锥虫（Trypanosoma cruzi）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于介白素（interleukins）之讯息传递何者正确？", "answer_idx": "B", "answer": "活化转录因子STATs（signal transducers and activators of transcription）", "options": {"A": "其受体主要是丝胺酸激酶型受器（receptor serine kinase）", "B": "活化转录因子STATs（signal transducers and activators of transcription）", "C": "主要是活化cAMP", "D": "主要由G protein参与反应"}}
{"meta_info": "taiwanese_test_Q", "question": "腹股沟管（Inguinal canal）的前壁由下列何者组成？", "answer_idx": "A", "answer": "腹外斜肌腱膜（Aponeurosis）", "options": {"A": "腹外斜肌腱膜（Aponeurosis）", "B": "腹横肌膜（Fascia transversalis）", "C": "腹内斜肌", "D": "腹横肌"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是配体管制型離子通道（ligand-gated ion channel）如烟碱性乙醯胆碱受体（nicotinic acetylcholine receptor）的特性？", "answer_idx": "C", "answer": "碰到特定的配体时才允许離子通过细胞膜", "options": {"A": "在脂双层中允许離子通透的带电脂质", "B": "碰到特定的離子时才允许配体通过细胞膜", "C": "碰到特定的配体时才允许離子通过细胞膜", "D": "配体与细胞膜上相对应受体结合需依赖特定離子存在"}}
{"meta_info": "taiwanese_test_Q", "question": "造成早发性（early-onset）新生儿感染的细菌中，最常见的格兰氏阳性菌为：", "answer_idx": "B", "answer": "B群链球菌", "options": {"A": "金黄色葡萄球菌", "B": "B群链球菌", "C": "肺炎双球菌", "D": "大肠杆菌"}}
{"meta_info": "taiwanese_test_Q", "question": "抗甲狀腺药物之副作用，下列何者最常見？", "answer_idx": "C", "answer": "皮疹（rash）", "options": {"A": "肝炎（hepatitis）", "B": "白血球过低（agranulocytosis）", "C": "皮疹（rash）", "D": "類红斑狼疮（SLE-like syndrome）"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，那位病人给予生理食盐水后可以矫正其电解质和酸碱的不平衡？", "answer_idx": "B", "answer": "乙病人", "options": {"A": "甲病人", "B": "乙病人", "C": "丙病人", "D": "丁病人"}}
{"meta_info": "taiwanese_test_Q", "question": "一位51 岁的女病人因罹患下1/3 的直肠癌而直接进行低前位切除术治療，术后病理报告为Dukes' C2，术后第5 天排气，且小便自解无碍，逐步开始恢復进食，术后第7 天顺利排放大便，术后第9 天出院。出院后隔天晚上，病人在家发现有多量的黄浊具臭味之液体自阴道口排出，病人又回医院急诊室就医，则最可能是何种诊断？", "answer_idx": "C", "answer": "直肠阴道瘘管", "options": {"A": "尿路感染", "B": "月经周期來了", "C": "直肠阴道瘘管", "D": "伪膜性结肠炎"}}
{"meta_info": "taiwanese_test_Q", "question": "常見的 glycogen storage disease 是因为病人缺乏 glucose-6-phosphatase 所造成，下列叙述何者正确？", "answer_idx": "C", "answer": "病人血中 glucose 浓度可能偏低", "options": {"A": "glycogen synthesis 增加", "B": "glucose-6-phosphate 无法转化成 glucose-1-phosphate", "C": "病人血中 glucose 浓度可能偏低", "D": "glycolysis 異常"}}
{"meta_info": "taiwanese_test_Q", "question": "因尿路阻塞产生肾水肿（hydronephrosis）变化时，最早期的变化通常可見于下列何者？", "answer_idx": "C", "answer": "renal calices", "options": {"A": "renal pelvis", "B": "ureter", "C": "renal calices", "D": "renal papillae"}}
{"meta_info": "taiwanese_test_Q", "question": "有关 C 型肝炎病毒的叙述，何者错误？", "answer_idx": "C", "answer": "已经有疫苗可以预防感染", "options": {"A": "属于 Flaviviridae", "B": "具有 envelope", "C": "已经有疫苗可以预防感染", "D": "与肝癌有关"}}
{"meta_info": "taiwanese_test_Q", "question": "下列血清学诊断项目中，何者对于全身性红斑性狼疮（SLE）诊断的特異性最高？", "answer_idx": "D", "answer": "抗双链去氧核糖核酸抗体（anti-ds DNA）", "options": {"A": "红斑性狼疮细胞（LE cell）", "B": "類风湿因子（rheumatoid factor）", "C": "抗单链去氧核糖核酸抗体（anti-ss DNA）", "D": "抗双链去氧核糖核酸抗体（anti-ds DNA）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关「利他主义」（Altruism）、「公平」（Equity）、「正义」（Justice）、「效率」（Efficiency）的叙述，何者错误？", "answer_idx": "C", "answer": "有「效率」的医療体系运作结果，自然会导致「公平」的资源配置", "options": {"A": "「利他主义」的思考邏辑和个人偏好有关，因为具有利他思想的人会偏好生病者可以获得适当的医療服务", "B": "「公平」与「正义」的思考邏辑和个人偏好无关，因为公平正义的概念來自于一套特定价值标准的推导", "C": "有「效率」的医療体系运作结果，自然会导致「公平」的资源配置", "D": "「利他主义」的思考邏辑和「效率」的概念均与个人偏好有关"}}
{"meta_info": "taiwanese_test_Q", "question": "24岁女性，主诉半年无月经，双侧乳房有白色分泌物，病患主诉无性经 。下列检查何者最不适当？", "answer_idx": "D", "answer": "FSH（follicle stimulating hormone）", "options": {"A": "TSH（thyroid stimulating hormone）", "B": "prolactin", "C": "详细的药物史", "D": "FSH（follicle stimulating hormone）"}}
{"meta_info": "taiwanese_test_Q", "question": "原本健康的 20 岁原住民小华，十年前随家人迁往台北，已 5 年没到山上。清晨坐車由台北出发，早上10 点就到达合欢山，白天无明显不舒服，晚餐胃口不佳，晚上10 点后在山上（高度3050 公尺）有头痛、头暈、呕吐、虚弱等症狀，下列叙述何者正确？", "answer_idx": "B", "answer": "坐車快速上山，比慢慢走路上山，更容易发生高山症", "options": {"A": "原住民对高度适应良好，不会得高山症", "B": "坐車快速上山，比慢慢走路上山，更容易发生高山症", "C": "给小华氧气治療，通常无法改善症狀", "D": "小华晚上失眠，有坐着睡比躺着睡舒服现象时，建议给予 Benzodiazepam 治療以帮助睡眠"}}
{"meta_info": "taiwanese_test_Q", "question": "Neuraminidase 是某些流感病毒的重要酵素之一，此酵素可以切除宿主细胞膜上糖复合物上的那一种糖基？", "answer_idx": "C", "answer": "galactose", "options": {"A": "N-acetylglucosamine", "B": "gluconic acid", "C": "galactose", "D": "sialic acid"}}
{"meta_info": "taiwanese_test_Q", "question": "对于单纯头部外伤病人，当你发现下列何者时应怀疑颅内压力（ICP）異常升高？", "answer_idx": "C", "answer": "呼吸和脉搏变慢，且血压上升时", "options": {"A": "呼吸和脉搏变慢，且血压下降时", "B": "呼吸和脉搏是不规则的，且血压上升时", "C": "呼吸和脉搏变慢，且血压上升时", "D": "呼吸是快速与浅的，脉搏是快速的，且血压下降时"}}
{"meta_info": "taiwanese_test_Q", "question": "45.一名5岁大的女童因为颈部中线肿块，经检查为甲状舌骨囊肿（thyroglossal duct cyst）。有关其手术方式 （Sistrunk procedure）之描述，下列何者最正确？\n", "answer_idx": "B", "answer": "切除囊肿、舌骨中段及相连至舌底部之管道", "options": {"A": "切除囊肿及舌骨中段", "B": "切除囊肿、舌骨中段及相连至舌底部之管道", "C": "切除囊肿、甲状腺及相连至舌底部之管道", "D": "切除囊肿、舌骨中段及甲状腺"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是周边型眩暈症（peripheral vertigo）发生时，最可能的臨床征象？", "answer_idx": "D", "answer": "耳鸣", "options": {"A": "吞咽困难", "B": "复视", "C": "脸麻", "D": "耳鸣"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者收缩，可使舌头变窄？", "answer_idx": "A", "answer": "舌内在横肌（intrinsic transverse muscle）", "options": {"A": "舌内在横肌（intrinsic transverse muscle）", "B": "舌内在垂直肌（intrinsic vertical muscle）", "C": "颏舌肌（genioglossus muscle）", "D": "舌骨舌肌（hyoglossus muscle）"}}
{"meta_info": "taiwanese_test_Q", "question": "当病患使用tetracycline治疗时，并用下列何种药物最会干扰其吸收？", "answer_idx": "B", "answer": "Al(OH)3", "options": {"A": "CaCO3", "B": "Al(OH)3", "C": "Mg(OH)2", "D": "NaHCO3"}}
{"meta_info": "taiwanese_test_Q", "question": "当尿液排空，下列何者最可能紧贴于膀胱的上方？", "answer_idx": "A", "answer": "子宫", "options": {"A": "子宫", "B": "阴道", "C": "直肠", "D": "输精管"}}
{"meta_info": "taiwanese_test_Q", "question": "子宫颈锥狀切除后的病理检查，发现癌细胞侵袭深度介于 3~5 mm 之间，宽度小于 7 mm，则此病人属于子宫颈癌的那一期？", "answer_idx": "B", "answer": "stage Ia2", "options": {"A": "stage Ia1", "B": "stage Ia2", "C": "stage Ib1", "D": "stage Ib2"}}
{"meta_info": "taiwanese_test_Q", "question": "有关人类截肢后所发生的幻痛（phantom pain）现象，下列何者叙述最为正确？", "answer_idx": "D", "answer": "拍打残肢端（stump）或使用经皮神经刺激（TENS）是相当有效的止痛方式", "options": {"A": "截肢后延迟装置义肢可减轻幻痛", "B": "成人发生率比儿童低", "C": "幻痛与冷天气和情绪有关，入睡后仍会存在", "D": "拍打残肢端（stump）或使用经皮神经刺激（TENS）是相当有效的止痛方式"}}
{"meta_info": "taiwanese_test_Q", "question": "对于⾁毒杆菌（Clostridium botulinum）的叙述，下列何者错误？", "answer_idx": "A", "answer": "⾁毒素（Botulinum toxin）主要使细胞内的Rho-GTPase失去活性", "options": {"A": "⾁毒素（Botulinum toxin）主要使细胞内的Rho-GTPase失去活性", "B": "食入受此菌污染的罐头食品会造成⾁毒症", "C": "婴儿食入受到此菌芽胞污染的食物会造成⾁毒症", "D": "⾁毒素可做为⽣化武器，造成吸入性⾁毒症（inhalation botulism）"}}
{"meta_info": "taiwanese_test_Q", "question": "45 一位 25 岁的男子因感觉胸部有压迫感求诊。胸部 X 光检查显示纵隔肿块，血清肿瘤标志包括 AFP （alpha fetoprotein）、β- HCG 及 LDH 均显著升高。最可能的诊断是：\n", "answer_idx": "A", "answer": "生殖细胞肿瘤", "options": {"A": "生殖细胞肿瘤", "B": "肝癌", "C": "何杰金氏淋巴瘤（Hodgkin's lymphoma）", "D": "淋巴母细胞淋巴瘤（lymphoplasmacytic lymphoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "若在为病患抽血时不慎发生针扎事件，并且发现病患的爱滋病毒（HIV）抗体为阳性时，被针扎的医护人员，应在发生针扎后尽快开始服用抗病毒药物，以预防HIV 感染（post-exposure prophylaxis），一般建议服用多久？", "answer_idx": "C", "answer": "4 周", "options": {"A": "24 小时", "B": "7 天", "C": "4 周", "D": "6 个月"}}
{"meta_info": "taiwanese_test_Q", "question": "77 一位怀孕 32 周的 40 岁妇女，因严重头痛与视力模糊而至急诊就医，來急诊时，血压 165/115 mmHg， 身体诊查发现下肢严重水肿，下列处理何者不适当？\n", "answer_idx": "B", "answer": "可给予 ACE inhibitor 处理高血压的问题", "options": {"A": "处理方式比照子癎症（eclampsia），需紧急会诊妇产科医师", "B": "可给予 ACE inhibitor 处理高血压的问题", "C": "可给予MgSO4（magnesium sulfate）", "D": "考虑将胎儿生出來是治療的重要关键"}}
{"meta_info": "taiwanese_test_Q", "question": "精子（spermatozoa）具有粒线体鞘（mitochondria sheath）的部位是：", "answer_idx": "C", "answer": "尾部中节（middle piece）", "options": {"A": "头部（head）", "B": "尾部主节（principal piece）", "C": "尾部中节（middle piece）", "D": "尾部终节（end piece）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者有助于减少卵巢癌的发生？", "answer_idx": "A", "answer": "口服避孕药", "options": {"A": "口服避孕药", "B": "素食", "C": "装置子宫内避孕器", "D": "初经早（early menarche）"}}
{"meta_info": "taiwanese_test_Q", "question": "64 一位到复健科门诊求诊的脑中风病人，发病已经 1 个月，但仍有患侧肩关节脱位（subluxation）现象。下列复健处置，何者最为重要？\n", "answer_idx": "B", "answer": "维持被动性肩关节活动与加强肩外展运动", "options": {"A": "以肩带（shoulder sling）固定", "B": "维持被动性肩关节活动与加强肩外展运动", "C": "腋下放置软垫，增加肩外展角度", "D": "肩关节以胶布贴扎（taping）固定"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关人類禽流感（avian flu）之叙述，何者错误？", "answer_idx": "B", "answer": "病毒通常为H3亚型（hemagglutinin type）", "options": {"A": "目前发生在一些东南亚国家，死亡率极高", "B": "病毒通常为H3亚型（hemagglutinin type）", "C": "早期使用 oseltamivir 可能有效", "D": "有发生全球大流行（pandemic）之可能"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是steroidogenic acute regulatory protein的主要功能？", "answer_idx": "C", "answer": "促使胆固醇送入粒线体内", "options": {"A": "促使胆固醇转变成妊烯醇酮（pregnenolone）", "B": "促使胆固醇进入细胞内", "C": "促使胆固醇送入粒线体内", "D": "促使胆固醇转变成低密度脂蛋⽩（low density lipoprotein）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关磺胺剂之叙述，何者错误？", "answer_idx": "C", "answer": "单独使用可抑制人体 folic acid 之生合成，因此有贫血（anemia）之不良作用", "options": {"A": "可抑制细菌 folic acid 之生合成", "B": "可与 trimethoprim 合用产生加乘（synergistic）抑菌作用", "C": "单独使用可抑制人体 folic acid 之生合成，因此有贫血（anemia）之不良作用", "D": "不良作用有过敏反应，Stevens-Johnson syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "关于消化道壁内神经丛myenteric plexus（Auerbach's plexus）的叙述，下列何者正确？", "answer_idx": "B", "answer": "迷走神经（vagus nerve）为主要的刺激性讯息提供者", "options": {"A": "位于消化道的黏膜下层", "B": "迷走神经（vagus nerve）为主要的刺激性讯息提供者", "C": "除接受交感神经和副交感神经支配外，本身功能无法自行运作", "D": "主要功能为局部消化道的分泌、吸收和血流供应"}}
{"meta_info": "taiwanese_test_Q", "question": "一位65 岁因陈旧性脑中风卧病在床之养护机构女性住民，她长期放置导尿管，过去有几次无症狀菌尿症（asymptomatic bacteriuria）病史，例行性尿液检查发现有白血球及细菌，此时她未有发烧及泌尿道感染症狀，最合适之处理为下列何者？", "answer_idx": "D", "answer": "先行观察，若有发烧或泌尿道感染症狀再处理", "options": {"A": "马上给予口服抗生素治療", "B": "马上送至医院急诊室做进一步诊治", "C": "尿液送细菌培养，如果阳性给予静脉抗生素治療", "D": "先行观察，若有发烧或泌尿道感染症狀再处理"}}
{"meta_info": "taiwanese_test_Q", "question": "阵发性夜间血色素尿（paroxysmal nocturnal hemoglobinuria）的病人发生溶血的原因，是因为红血球上缺乏何种抗原？", "answer_idx": "A", "answer": "CD55, CD59", "options": {"A": "CD55, CD59", "B": "CD16, CD66", "C": "CD15, CD25", "D": "CD11, CD14"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何构造不会出现在肝门管区（portal area）？", "answer_idx": "B", "answer": "中央静脉（central vein）", "options": {"A": "门小静脉（portal venule）", "B": "中央静脉（central vein）", "C": "肝小动脉（hepatic arteriole）", "D": "胆管（bile duct）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列对慢性阻塞性肺病（COPD）治療的叙述，何者错误？", "answer_idx": "A", "answer": "以降阶（step down）方式：先用上多种药物，然后视情况逐渐减少种類", "options": {"A": "以降阶（step down）方式：先用上多种药物，然后视情况逐渐减少种類", "B": "若仍有抽烟习惯，必须戒烟", "C": "以升阶（step up）方式：先从单一或少量药物开始，然后视情况逐渐增加药物种類", "D": "肺的復健可改善 COPD 患者的生活品质"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者为屈戌（枢紐）关节？", "answer_idx": "B", "answer": "肘关节", "options": {"A": "肩关节", "B": "肘关节", "C": "近端尺桡关节", "D": "远端尺桡关节"}}
{"meta_info": "taiwanese_test_Q", "question": "多发性骨髓瘤病患出现高钙血症时，下列何种药物治疗不能达到治疗目的？", "answer_idx": "B", "answer": "fluoride", "options": {"A": "bisphosphonate", "B": "fluoride", "C": "corticosteroid", "D": "calcitonin"}}
{"meta_info": "taiwanese_test_Q", "question": "关于儿童次发性消化性溃疡（Secondary peptic ulcers），下列叙述何者错误？", "answer_idx": "B", "answer": "Nonsteroidal anti-inflammatory drugs（NSAIDs）造成的溃疡位置，最常见于十二指肠（duodenum）", "options": {"A": "Nonsteroidal anti-inflammatory drugs（NSAIDs）藉由抑制prostaglandin，而造成黏膜损伤", "B": "Nonsteroidal anti-inflammatory drugs（NSAIDs）造成的溃疡位置，最常见于十二指肠（duodenum）", "C": "压力性溃疡（Stress ulcer）通常在事件开始后的24小时内发生", "D": "氢离子帮浦抑制剂（Proton pump inhibitors），可用于治疗严重溃疡出血的病患"}}
{"meta_info": "taiwanese_test_Q", "question": "下面有关假说检定之型一错误（type I error）与型二错误（type II error）的叙述何者正确？", "answer_idx": "D", "answer": "固定型一错误的机率，增加样本数可以降低型二错误发生的机率", "options": {"A": "型一错误发生的机率加上型二错误发生的机率等于 1", "B": "检定力（power）= 1-型一错误的机率", "C": "型一错误与型二错误有可能会同时发生", "D": "固定型一错误的机率，增加样本数可以降低型二错误发生的机率"}}
{"meta_info": "taiwanese_test_Q", "question": "有一位 27 岁男子，因有轻度胸痛接受胸部 X 光检查，发现前纵膈腔有 15 公分大的肿瘤，而血清检查发现α-fetoprotein 有異常升高，试问此病人最好之治療为何？", "answer_idx": "C", "answer": "先化学治療后，看情况再追加手术切除", "options": {"A": "手术切除肿瘤，再追加化学治療", "B": "手术切除肿瘤，再追加放射线治療", "C": "先化学治療后，看情况再追加手术切除", "D": "先放射线治療后，看情况再追加化学治療或手术切除"}}
{"meta_info": "taiwanese_test_Q", "question": "一位25岁之健康男性，以潮气容积（tidal volume）1,500毫升，呼吸频率25次／分的方式持续呼吸30秒，下列叙述何者错误？", "answer_idx": "C", "answer": "血液中的氧气总量（total oxygen content）大幅增加", "options": {"A": "( Paco )", "B": "血红素氧饱和度（hemoglobin saturation;Sa 。2 ）变化不大", "C": "血液中的氧气总量（total oxygen content）大幅增加", "D": "呈现呼吸性碱中毒（respiratory alkalosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关睪丸之 Immature teratoma 的叙述，何者是正确的？", "answer_idx": "A", "answer": "为一种惡性肿瘤", "options": {"A": "为一种惡性肿瘤", "B": "通常只含一种胚胎层的组织", "C": "通常出现成熟的骨头组织", "D": "通常出现明显的 Trophoblast"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关下颌齿（mandibular teeth）根管中之感觉神经纤维的叙述，何者正确？", "answer_idx": "B", "answer": "穿过下颌孔（mandibular foramen）", "options": {"A": "其细胞本体（cell body）位于下颌下神经节（submandibular ganglion）", "B": "穿过下颌孔（mandibular foramen）", "C": "穿过圆孔（foramen rotundum）", "D": "与舌神经（lingual nerve）伴行"}}
{"meta_info": "taiwanese_test_Q", "question": "使⽤以下何种食物材质刺激最易促进吞咽反射？", "answer_idx": "A", "answer": "较冰的食物", "options": {"A": "较冰的食物", "B": "较甜的食物", "C": "温度适中的食物", "D": "较为坚硬的食物"}}
{"meta_info": "taiwanese_test_Q", "question": "儿童的肾丝球滤过速率（glomerular filtration rate, GFR）何时可以达到和成人一般的数值？", "answer_idx": "A", "answer": "出生后第二年至第三年", "options": {"A": "出生后第二年至第三年", "B": "出生后第四年至第五年", "C": "出生后第七年至第八年", "D": "青春期"}}
{"meta_info": "taiwanese_test_Q", "question": "46 一位58 岁男性，过去无全身性疾病之病史，最近在例行之健康检查中发现其血液相如下：血红素14.7 g/dL，血比容46%，白血球數12,350/μL，血小板數725,000/μL。其他生化、心电图及胸部 X 光 检查均无異常，病人亦无自述症狀。下列何者是目前对此病人最适当的治療？\n", "answer_idx": "D", "answer": "Observation", "options": {"A": "Plateletpheresis", "B": "Hydroxyurea", "C": "Anagrelide", "D": "Observation"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关治療類精神疾病药物所产生之副作用及其作用可能机制的配对，何者错误？", "answer_idx": "B", "answer": "直立型低血压：乙型肾上腺素性受体阻断作用", "options": {"A": "体重增加：组织胺及血清素受体阻断作用", "B": "直立型低血压：乙型肾上腺素性受体阻断作用", "C": "锥体外毒性症狀：多巴胺受体阻断作用", "D": "口干及尿液滞留：毒蕈素性受体阻断作用"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种 Staphylococcal enterotoxin 型最易引发食物中毒？", "answer_idx": "A", "answer": "Staphylococcal enterotoxin A", "options": {"A": "Staphylococcal enterotoxin A", "B": "Staphylococcal enterotoxin B", "C": "Staphylococcal enterotoxin C", "D": "Staphylococcal enterotoxin D"}}
{"meta_info": "taiwanese_test_Q", "question": "依据「安宁缓和医疗条例」之规定，末期病人无签署意愿书且意识昏迷或无法清楚表达意愿时，由其最近亲属出具同意书代替之。有①配偶 ②成年孙女 ③父 ④弟弟，四位最近亲属，意见不一时，优先次序为：", "answer_idx": "D", "answer": "①②③④", "options": {"A": "①③②④", "B": "①④③②", "C": "①③④②", "D": "①②③④"}}
{"meta_info": "taiwanese_test_Q", "question": "一位52岁停经后的妇女，除了主诉频尿、尿急和急迫性尿失禁外，看起来身体状况还算健康，针对她的主诉你会建议她接受何种治疗最适合？", "answer_idx": "D", "answer": "膀胱训练（bladder training）", "options": {"A": "放松的技巧（relaxation techniques）", "B": "抗乙醯胆碱药物（anticholinergic medication）", "C": "白天每小时解小便一次", "D": "膀胱训练（bladder training）"}}
{"meta_info": "taiwanese_test_Q", "question": "60 岁男性，主诉近几个月來痰中带血，左耳听力下降，MRI 影像如下，最有可能的诊断是：", "answer_idx": "C", "answer": "鼻咽癌（nasopharyngeal carcinoma）", "options": {"A": "咽喉血管瘤（hemangioma in nasopharynx）", "B": "口腔癌（oral cancer）", "C": "鼻咽癌（nasopharyngeal carcinoma）", "D": "听神经瘤（acoustic schwannoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "40.38岁女性，主诉在最近6个月运动时有愈来愈严重的呼吸困难（exertional dyspnea）。血球检查数据如下（括弧内是正常参考数值）：RBC 3.91 M/µL（3.78～4.99），HB 7.0 g/dL（10.8～14.9），HCT 26.2% （35.6～45.4），MCV 67.0 fL（80～ 100），MCH 17.9 pg（26～34），MCHC 26.7 g/dL（31～37），\n k/µL（150～361），WBC 6.07 k/µL（3.54～9.06）。以下那个检查对这个病人之诊断较无相关？", "answer_idx": "D", "answer": "血清中铜的浓度", "options": {"A": "血清中铁蛋白（ferritin）", "B": "粪便潜血检查", "C": "血清中铁的浓度", "D": "血清中铜的浓度"}}
{"meta_info": "taiwanese_test_Q", "question": "有关单独二尖瓣狭窄（isolated mitral stenosis）之叙述，何者正确？", "answer_idx": "D", "answer": "临床症状除运动时呼吸困难外，有时会出现咳血、肺栓塞或肺炎等", "options": {"A": "大多数病患狭窄愈严重，第一心音（S1）愈弱", "B": "opening snap如果听得见，是在心收缩期", "C": "感染性心内膜炎在单独二尖瓣狭窄病患的机率与合并二尖瓣闭锁不全病患相同", "D": "临床症状除运动时呼吸困难外，有时会出现咳血、肺栓塞或肺炎等"}}
{"meta_info": "taiwanese_test_Q", "question": "关于penicillins之药物动力学的叙述，下列何者正确？", "answer_idx": "C", "answer": "benzathine penicillin相对其他penicillin药物有较长的半衰期，约可长达 14 天", "options": {"A": "ticarcillin可以经肠胃道吸收，因此可以口服方式治疗感染", "B": "probenecid可以抑制 penicillins由肾小管过滤方式排至尿中", "C": "benzathine penicillin相对其他penicillin药物有较长的半衰期，约可长达 14 天", "D": "amoxicillin口服吸收效果易受食物干扰而降低药效"}}
{"meta_info": "taiwanese_test_Q", "question": "55岁女性，长期有搔痒，疲倦和腹部不适。身体检查发现病人有黄疸，皮肤有黄色瘤（xanthoma），肝脏切片检查发现肝内小胆管被破坏，并在门脉区发现有非干酪性肉芽肿（noncaseating granuloma），她血清中最可能出现下列何种抗体？", "answer_idx": "B", "answer": "抗粒线体抗体（anti-mitochondrial antibody）", "options": {"A": "抗平滑肌抗体（anti-smooth muscle antibody）", "B": "抗粒线体抗体（anti-mitochondrial antibody）", "C": "抗可溶性肝抗原／肝胰抗体（anti-soluable liver antigen/liver pancreas antigen antibody）", "D": "抗肝肾微小体-1抗体（anti-liver kidney microsome-1 antibody）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位70 岁女性，有高血压、糖尿病病史，早上起床时，突然发生口语不清，右侧肢体无力，在急诊室神经学检查发现：意識清楚，语言表达尚可，右侧上下肢肌力皆约2 分，感觉功能皆正常，下列叙述之病灶，何者最不可能？", "answer_idx": "C", "answer": "左侧丘脑外侧（lateral thalamus）", "options": {"A": "左侧内囊（internal capsule）附近", "B": "左侧放射冠（corona radiata）附近", "C": "左侧丘脑外侧（lateral thalamus）", "D": "左侧桥脑（pons）附近"}}
{"meta_info": "taiwanese_test_Q", "question": "使用年龄标准化死亡率（Age-adjusted death rates）的目的在：", "answer_idx": "D", "answer": "比较不同年龄结构族群间的死亡水准", "options": {"A": "控制因年龄登记错误所造成的误差", "B": "精确计算某特定年龄层的死亡人數", "C": "校正因年龄讯息遗漏所造成死亡率计算的误差", "D": "比较不同年龄结构族群间的死亡水准"}}
{"meta_info": "taiwanese_test_Q", "question": "42 一位 25 岁年轻女性，因脸上蝴蝶斑、颈部淋巴腺肿大及时有高烧而求诊。以往常会头痛，冬季时兩手有Raynaud's现象及手指关节疼痛。血液检查所見：血色素 9.8 g/dL，白血球 3,100/mm3，血小板", "answer_idx": "A", "answer": "anti-double-stranded DNA antibodies 阳性", "options": {"A": "anti-double-stranded DNA antibodies 阳性", "B": "elevated complement level", "C": "eosinophilia", "D": "depressed γ-globulin level"}}
{"meta_info": "taiwanese_test_Q", "question": "28 10 岁女童过去身体狀况良好，最近发现眼皮浮肿，下肢水肿，体重急速增加而住院。入院后之实验室检查呈现serum albumin 2.5 g/dL（正常4.0 - 5.3 g/dL），cholesterol 290 mg/dL（正常125 - 240 mg/dL）， triglyceride 350 mg/dL（正常15 - 114 mg/ dL），BUN 14 mg/dL（正常7 - 18 mg/dL），creatinine 0.7 mg/dL 5 - 1.0 mg/dL），24 小时尿蛋白为80 mg/m2/hr，下列那一项叙述最不正确？", "answer_idx": "D", "answer": "此病人有 90 %以上的机会是微小变化型肾病变（minimal-change nephropathy）", "options": {"A": "诊断为肾病症候群", "B": "需检测抗核抗体（ANA）及补体（C3, C4）", "C": "臨床上常合并有易凝血倾向（hypercoagulation status）", "D": "此病人有 90 %以上的机会是微小变化型肾病变（minimal-change nephropathy）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关眼球运动的叙述，何者错误？", "answer_idx": "D", "answer": "调节性会聚（accommodative convergence）属于一种强直性会聚（tonic convergence）", "options": {"A": "duction是指单眼的运动，包括眼球的内旋（intorsion）和外旋（exotorsion）", "B": "version是指双眼的同向运动，包括看右上（dextro-elevation）或左下（levo-depression）等", "C": "vergence是指双眼的异向运动，包括会聚（convergence）或散开（divergence）等", "D": "调节性会聚（accommodative convergence）属于一种强直性会聚（tonic convergence）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何项构造位于枕下三角内？", "answer_idx": "B", "answer": "枕下神经", "options": {"A": "颈内动脉", "B": "枕下神经", "C": "枕大神经", "D": "枕动脉"}}
{"meta_info": "taiwanese_test_Q", "question": "有关儿童白血病的叙述，下列何者错误？", "answer_idx": "D", "answer": "和慢性骨髓性白血病（CML）相反，急性淋巴性白血病（acute lymphoblastic leukemia, ALL）患童，若有 t（9；22） 的染色体易位，会有较佳的预后", "options": {"A": "慢性骨髓性白血病（chronic myelogenous leukemia，CML）在儿童发生的比率，相对于成人是非常低的", "B": "儿童慢性骨髓性白血病（CML）大部分都有 t（9；22）（q34；q11）的染色体易位，因而产生了费城染色体（Philadelphia chromosome）", "C": "过去儿童慢性骨髓性白血病（CML）的预后并不好，必需尽早接受干细胞移植，但自从有了基利克（imatinib, gleevec(r)）的问世，预后已显 改善", "D": "和慢性骨髓性白血病（CML）相反，急性淋巴性白血病（acute lymphoblastic leukemia, ALL）患童，若有 t（9；22） 的染色体易位，会有较佳的预后"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 25 岁罹患 AIDS 的男性呼吸衰竭致死。解剖时在肺脏見到的变化如图所示。则其病理诊断应是：", "answer_idx": "B", "answer": "病毒包涵体（viral inclusion body）", "options": {"A": "類淀粉病（amyloidosis）", "B": "病毒包涵体（viral inclusion body）", "C": "弥漫性肺泡伤害（diffuse alveolar damage）", "D": "霉菌感染（fungal infection）"}}
{"meta_info": "taiwanese_test_Q", "question": "有一位住加护病房之10 岁男童，昏迷但有自发性呼吸，医师叫他没反应，理学检查四肢松软无力，痛刺激手部时眼睛会张开、手会缩回，此时之葛式昏迷指數（Glasgow Coma Scale）为多少分？", "answer_idx": "B", "answer": "7 分", "options": {"A": "6 分", "B": "7 分", "C": "8 分", "D": "9 分"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关抗癫痫药物的描述，何者正确？", "answer_idx": "D", "answer": "孕妇于怀孕期间服用抗癫痫药物如 Phenytoin，其胎儿常会发现 Vitamin K-dependent 的凝血因子减少的现象", "options": {"A": "Oxcarbazepine 的体内半衰期较 Carbamazepine 短", "B": "Felbamate 具有阻断 GABAA型受体之功能", "C": "Tiagabine 具有促进神经元或神经胶细胞 GABA 再回收的作用", "D": "孕妇于怀孕期间服用抗癫痫药物如 Phenytoin，其胎儿常会发现 Vitamin K-dependent 的凝血因子减少的现象"}}
{"meta_info": "taiwanese_test_Q", "question": "关于脑垂体的发育，下列叙述何者正确？", "answer_idx": "D", "answer": "腺垂体（adenohypophysis）來自口腔外胚层", "options": {"A": "垂体漏斗（infundibulum）属于腺体部分", "B": "神经垂体（neurohypophysis）为中脑衍生而來", "C": "神经外胚层发育为脑垂体前葉（anterior lobe）", "D": "腺垂体（adenohypophysis）來自口腔外胚层"}}
{"meta_info": "taiwanese_test_Q", "question": "下列胞器，何者不具有膜（membrane）的构造？", "answer_idx": "A", "answer": "核仁（nucleolus）", "options": {"A": "核仁（nucleolus）", "B": "胞内体（endosome）", "C": "过氧化质体（peroxisome）", "D": "内质网（endoplasmic reticulum）"}}
{"meta_info": "taiwanese_test_Q", "question": "34岁的吴先生因多话，三天三夜没睡，觉得自己能力很好可以选总统，一个月花了50万买电视购物的产品，被家人送至急诊室，医师诊断为躁症发作（manic episode），此时不应给予何种药物？", "answer_idx": "A", "answer": "fluoxetine", "options": {"A": "fluoxetine", "B": "olanzapine", "C": "lithium", "D": "aripiprazole"}}
{"meta_info": "taiwanese_test_Q", "question": "20岁男性因急性腹痛、⾼烧求诊，接受对比剂注射后之电脑断层扫描检查如图，最可能之诊断为何？", "answer_idx": "A", "answer": "急性阑尾炎", "options": {"A": "急性阑尾炎", "B": "⼤肠憩室炎", "C": "尿路结⽯", "D": "胰脏炎"}}
{"meta_info": "taiwanese_test_Q", "question": "关于过敏性支气管肺麴霉菌病（allergic bronchopulmonary aspergillosis），下列何种影像学征象最少见？", "answer_idx": "D", "answer": "明显的肋膜积液 （pleural effusion）", "options": {"A": "肺扩张不全（atelectasis）", "B": "支气管囊肿（bronchocele）", "C": "肺实质化（consolidation）", "D": "明显的肋膜积液 （pleural effusion）"}}
{"meta_info": "taiwanese_test_Q", "question": "41 一位 45 岁女士，20 年前即发现有慢性 B 型肝炎，最近体检发现血红素 11.5 gm/dL，白血球 3,350/μL，血小板 95,000/μL。病人无自觉症狀。回顾过去五年來的抽血检查，血红素多在 11.5 gm/dL 至 12.5 gm/dL 之间，白血球數目多在 3,500/μL 至 4,000/μL 之间，血小板 100,000/μL 至 120,000/μL 之间。下列何项 是最可能的诊断？\n", "answer_idx": "D", "answer": "脾脏功能过旺", "options": {"A": "再生不良性贫血", "B": "自体免疫性疾病造成的血球低下症", "C": "药物造成的血球低下", "D": "脾脏功能过旺"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，若经过一天之静脉营养和输液、注射抗生素及大肠减压等療法后，病况仍未見改善，则该如何紧急处理较好？", "answer_idx": "B", "answer": "全大肠切除及回肠造口术，加上 Hartmann's pouch", "options": {"A": "全大肠切除及回肠直肠吻合术", "B": "全大肠切除及回肠造口术，加上 Hartmann's pouch", "C": "大肠直肠肛门全切除及回肠造口术", "D": "全大肠切除及回肠袋肛门吻合术（Ileal pouch-anal anastomosis）一次完成"}}
{"meta_info": "taiwanese_test_Q", "question": "64.40岁病⼈因剧烈头痛发烧来到急诊，之前没有⽤过抗⽣素，脑脊髓液检查发现脑压（opening pressure） 300 mmH2O，⽩⾎球100/mL（Lymphocyte：Neutrophil＝90：10），Protein level：45 mg/dL，最不可能的致病菌为何？\n", "answer_idx": "D", "answer": "Klebsiella pneumoniae", "options": {"A": "herpes simplex virus", "B": "Mycobacterium tuberculosis", "C": "Cryptococcus neoformans", "D": "Klebsiella pneumoniae"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者为膀胱过动症最合理的药物治療？", "answer_idx": "B", "answer": "抗胆碱激性剂（anticholinergic agent）", "options": {"A": "胆碱激性剂（cholinergic agent）", "B": "抗胆碱激性剂（anticholinergic agent）", "C": "肾上腺性剂（adrenergic agent）", "D": "抗肾上腺性剂（antiadrenergic agent）"}}
{"meta_info": "taiwanese_test_Q", "question": "视丘性疼痛症候群（thalamic pain syndrome）不常伴随下列何症狀？", "answer_idx": "C", "answer": "偏瘫（hemiplegia）", "options": {"A": "半侧偏盲（homonymous hemianopia）", "B": "分離性感觉丧失（dissociated sensory loss）", "C": "偏瘫（hemiplegia）", "D": "半侧感觉丧失（hemihypesthesia）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关肺脏移植后使用免疫抑制药物之叙述，何者正确？", "answer_idx": "D", "answer": "Cyclosporine 无 myelosuppression 的副作用，常与 prednisolone 并用，以减少 cyclosporine 所引起之肾毒性", "options": {"A": "Prednisolone 属于 adrenal corticosteroid 類，长期使用会有高血压（hypertension）与低血糖（hypoglycemia）之副作用", "B": "Azathioprine 属于 antiproliferative agents，最常見之副作用为白血球过多症（leukocytosis）", "C": "Mycophenolate mofetil（MMF）为 calcineurin inhibitor，在体内由肝脏之 cytochrome p450 enzymes 负责代谢", "D": "Cyclosporine 无 myelosuppression 的副作用，常与 prednisolone 并用，以减少 cyclosporine 所引起之肾毒性"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种情况最容易导致下肢水肿（Edema）？", "answer_idx": "D", "answer": "血中蛋白浓度下降（Decreased plasma protein concentration）", "options": {"A": "细小动脉收缩（Arteriolar constriction）", "B": "小静脉扩张（Venular dilatation）", "C": "静脉压下降（Decreased venous pressure）", "D": "血中蛋白浓度下降（Decreased plasma protein concentration）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关于甲状舌管囊肿（thyroglossal duct cyst）之叙述，何者错误？", "answer_idx": "D", "answer": "治疗方式主要是将囊肿切除即可，少有复发情形", "options": {"A": "是最常见的先天性颈部肿瘤，也是儿童第二常见的颈部肿瘤", "B": "理学检查可发现此囊肿随伸舌与吞咽动作而移动", "C": "甲状腺扫描及功能测定是治疗前的必要检查项目", "D": "治疗方式主要是将囊肿切除即可，少有复发情形"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者最不可能是卵巢过度刺激症候群（ovarian hyperstimulation syndrome）的危险因子？", "answer_idx": "C", "answer": "Antral follicle count小于4", "options": {"A": "年轻病患", "B": "BMI小于18.5", "C": "Antral follicle count小于4", "D": "当次周期成功怀孕"}}
{"meta_info": "taiwanese_test_Q", "question": "36 一位 70 岁男性病人，皮肤有超过体表面积 90%以上的脱屑及泛红，经诊断为红皮症（erythroderma）。下列相关叙述何者错误？\n", "answer_idx": "D", "answer": "应注意是否有低心输出量（low cardiac output）心脏衰竭之征候", "options": {"A": "干癣（psoriasis）惡化为常見病因之一", "B": "易导致血中低白蛋白（low serum albumin）及电解质不平衡", "C": "药物之不良反应亦可能导致此症", "D": "应注意是否有低心输出量（low cardiac output）心脏衰竭之征候"}}
{"meta_info": "taiwanese_test_Q", "question": "37.一位女性体检时，意外发现有高血钙，进一步检查证实为原发性副甲状腺功能亢进（primary hyperparathyroidism），根据目前的治疗指引，有些原发性副甲状腺功能亢进患者即使无临床症状亦建议应接受手术，但下列何者除外？\n", "answer_idx": "D", "answer": "年龄大于60岁", "options": {"A": "骨密度检查T-score小于-2.5", "B": "肌酸酐廓清率（creatinine clearance）小于60 mL/min", "C": "血钙超过正常值上限1.0 mg/dL以上", "D": "年龄大于60岁"}}
{"meta_info": "taiwanese_test_Q", "question": "人類乳头狀瘤病毒（Human Papillomavirus）分型方法是利用：", "answer_idx": "B", "answer": "基因体 DNA 序列相似度（sequence homology）", "options": {"A": "抗体辨識", "B": "基因体 DNA 序列相似度（sequence homology）", "C": "病毒颗粒之大小", "D": "病毒基因之表现"}}
{"meta_info": "taiwanese_test_Q", "question": "关于缺铁性贫血（iron-deficiency anemia, IDA）的叙述，下列何者错误？", "answer_idx": "D", "answer": "足月儿的缺铁性贫血常发生在出生后前3个月", "options": {"A": "低体重早产儿为好发族群", "B": "青春期后的女性罹患慢性缺铁性贫血应考虑月经过多", "C": "患者血清中（serum）ferritin 是下降的", "D": "足月儿的缺铁性贫血常发生在出生后前3个月"}}
{"meta_info": "taiwanese_test_Q", "question": "25 枫糖尿症是一种支链胺基酸代谢異常疾病。患者因为支链胺基酸以及其副产物堆积而引起脑病变。台湾发现这一项疾病在原住民发生率特别的高，后续的研究发现，下列那一项叙述最不合理？\n", "answer_idx": "B", "answer": "在蒙古可以看到和台湾原住民相同的突变", "options": {"A": "大部分的原住民患者可以看到一个相同的突变，称作 founder effect", "B": "在蒙古可以看到和台湾原住民相同的突变", "C": "台湾汉人患者的突变种類变異性比原住民大", "D": "台湾原住民表兄妹结婚相当普遍"}}
{"meta_info": "taiwanese_test_Q", "question": "用以治療广泛性焦虑症（generalized anxiety disorder）之抗焦虑药物中，buspirone 之主要药理作用机转为下列何者？", "answer_idx": "A", "answer": "血清素 1A受体部分作用剂（5HT1A receptor partial agonist）", "options": {"A": "血清素 1A受体部分作用剂（5HT1A receptor partial agonist）", "B": "血清素 1A受体拮抗剂（5HT1A receptor antagonist）", "C": "血清素 2A受体部分作用剂（5HT2A receptor partial agonist）", "D": "血清素 2A受体拮抗剂（5HT2A receptor antagonist）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种药物，可用来治疗思觉失调症（schizophrenia）？", "answer_idx": "B", "answer": "serotonin dopamine antagonists", "options": {"A": "serotonin dopamine agonists", "B": "serotonin dopamine antagonists", "C": "serotonin norepinephrine reuptake inhibitors", "D": "serotonin dopamine reuptake inhibitors"}}
{"meta_info": "taiwanese_test_Q", "question": "医疗费⽤的成⻑率跟下列那⼀个因素关​​联性较⼩？", "answer_idx": "D", "answer": "医病资讯不对称", "options": {"A": "⼈⼝老化", "B": "所得增加", "C": "医疗科技进步", "D": "医病资讯不对称"}}
{"meta_info": "taiwanese_test_Q", "question": "有关桡骨神经之叙述，下列何者错误？", "answer_idx": "C", "answer": "如果posterior interosseous nerve受伤，只会侵犯到手臂之伸肌", "options": {"A": "主要支配triceps、brachioradialis、supinator及extensors of the fingers等肌肉", "B": "神经主要源自颈椎第6～8节神经根", "C": "如果posterior interosseous nerve受伤，只会侵犯到手臂之伸肌", "D": "在铅中毒患者常见本神经之侵犯"}}
{"meta_info": "taiwanese_test_Q", "question": "产生肠毒素的大肠杆菌，其对热稳定的毒素，有下列何种作用机制？", "answer_idx": "D", "answer": "活化次级信号分子", "options": {"A": "溶解脂肪，打破细胞膜", "B": "抑制蛋白质的合成", "C": "活化发炎反应（inflammation）", "D": "活化次级信号分子"}}
{"meta_info": "taiwanese_test_Q", "question": "6.56岁的男性，肾病症候群病史，最近2天呕吐因此没有吃利尿剂。身体诊察有中度的全身水肿，动脉血气体pH 7.48，PaCO2 47 mmHg，HCO3- 34 mEq/L，血液osmolality 255 mOsmol/kg H2O，BUN 30 mg/dL，肌酸酐1.5 mg/dL，Na 120 mmol/ L。尿液Na+ 30 mmol/L，尿液Cl- 8 mmol/L。下列叙述何者错误？\n", "answer_idx": "C", "answer": "病人的有效血液容量增加", "options": {"A": "病人的细胞外液量增加", "B": "病人的细胞内液量增加", "C": "病人的有效血液容量增加", "D": "病人的有效血液容量减少"}}
{"meta_info": "taiwanese_test_Q", "question": "下 何者药物不会有引起急性尿滞留（acute urinary retention）的副作用？", "answer_idx": "D", "answer": "胆碱作用剂（cholinergic agents）", "options": {"A": "α-肾上腺素作用剂（α- adrenergic agents）", "B": "抗组织胺（antihistamines）", "C": "治疗鼻塞的感冒药", "D": "胆碱作用剂（cholinergic agents）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关医疗错误的告知，下列叙述何者错误？", "answer_idx": "D", "answer": "只要承认医疗错误，就等于有医疗过失", "options": {"A": "通常对医师而言，坦承自己的医疗错误是一件困难的事", "B": "最好是率先告知医疗错误，不要等病人问了再说", "C": "对于病人或家属强烈的情绪反应，要有心理准备", "D": "只要承认医疗错误，就等于有医疗过失"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是胰脏癌（carcinoma of the pancreas）的臨床表现？", "answer_idx": "B", "answer": "胆囊萎缩变小", "options": {"A": "阻塞性黄疸、灰白色粪便", "B": "胆囊萎缩变小", "C": "上腹部疼痛、后背痛", "D": "体重减轻"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种药物为一种选择性高之 antithrombin-dependent factor Xa 抑制剂？", "answer_idx": "C", "answer": "Fondaparinux", "options": {"A": "Heparin", "B": "Clopidogrel", "C": "Fondaparinux", "D": "Aspirin"}}
{"meta_info": "taiwanese_test_Q", "question": "28.会阴体（perineal body）受伤后，下列何者的作用最可能不受影响？ ①球海绵体肌（bulbospongiosus muscle） ②会阴深横肌（deep transverse perineal muscle） ③会阴浅横肌（superficical transverse perineal muscle） ④坐骨海绵体肌（ischiocavernosus muscle） ⑤尿道外括约肌（external urethral sphincter muscle）\n", "answer_idx": "D", "answer": "④⑤", "options": {"A": "①③", "B": "②④", "C": "①⑤", "D": "④⑤"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关神经性梅毒（neurosyphilis）之叙述，何者错误？", "answer_idx": "D", "answer": "治疗方法为经肌肉注射盘尼西林（penicillin）每周一次共三次", "options": {"A": "10%没有接受治疗的早期梅毒的患者会罹病", "B": "因为AIDS的盛行，神经性梅毒的发生率增高", "C": "脑脊髓液的螺旋菌抗体（treponemal antibody）阳性反应有助于诊断", "D": "治疗方法为经肌肉注射盘尼西林（penicillin）每周一次共三次"}}
{"meta_info": "taiwanese_test_Q", "question": "以下方法均可减少植体抗宿主疾病（graft-versus-host disease, GVHD），下列何者除外？", "answer_idx": "B", "answer": "将预植入的造血干细胞实行淋巴球混合作用（mixed lymphocyte reaction），以减低T淋巴球的数目", "options": {"A": "以alemtuzumab处理预植入的造血干细胞，经由拮抗CD52的作用，使得成熟的T淋巴球数目减少", "B": "将预植入的造血干细胞实行淋巴球混合作用（mixed lymphocyte reaction），以减低T淋巴球的数目", "C": "选择MHC class I及MHC class II配合的植体，以降低植入后成熟T淋巴球的抗宿主反应", "D": "使用抗胸腺球蛋白（anti-thymoglobulin）预处理植入的细胞，减低T淋巴球及白血球的数目"}}
{"meta_info": "taiwanese_test_Q", "question": "19 一位肝硬化患者因为大量吐血至急诊处接受紧急上消化道内视镜检查，发现胃及食道静脉曲张（varices）出血，此患者之门脉压（portal pressure，以wedge-to-free gradient测量）最有可能为：\n", "answer_idx": "D", "answer": "13～15 mmHg", "options": {"A": "5～7 mmHg", "B": "8～10 mmHg", "C": "10～12 mmHg", "D": "13～15 mmHg"}}
{"meta_info": "taiwanese_test_Q", "question": "4 一位 10 岁男孩，主诉 1 星期前感冒，來诊前 1 天相当疲倦，今天突然暈倒，苍白盗汗，心跳约 多次/分，心电图如附图，最可能的诊断为何？", "answer_idx": "D", "answer": "Wolff-Parkinson-White 症候群", "options": {"A": "感冒药副作用", "B": "心肌炎合并完全房室传导障碍", "C": "先天性心脏病", "D": "Wolff-Parkinson-White 症候群"}}
{"meta_info": "taiwanese_test_Q", "question": "那一种荷尔蒙经由 JAK-STAT 讯号途径产生作用？", "answer_idx": "C", "answer": "泌乳素（prolactin）", "options": {"A": "性释素（GnRH）", "B": "促濾泡素（FSH）", "C": "泌乳素（prolactin）", "D": "动情素（estrogen）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关心律不整之机转（mechanism），何者正确？", "answer_idx": "B", "answer": "Early afterdepolarization（EAD）主要之原因为动作电位间期（action potential duration）过长", "options": {"A": "Delayed afterdepolarization（DAD）主要原因为细胞内钾離子过多", "B": "Early afterdepolarization（EAD）主要之原因为动作电位间期（action potential duration）过长", "C": "Torsades des pointes 之主要原因为 delayed afterdepolarization", "D": "细胞外钾離子过高，易引起 early afterdepolarization"}}
{"meta_info": "taiwanese_test_Q", "question": "73 依据 DSM-IV-TR 诊断标准，下列何者会出现在典型自闭症但不在亚斯柏格症（Asperger's disorder） 的核心症状之中？\n", "answer_idx": "C", "answer": "语言能力与认知发展迟缓", "options": {"A": "社交互动缺损", "B": "智能障碍", "C": "语言能力与认知发展迟缓", "D": "局限、反覆、固着的行为／兴趣／活动"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关肾⼩管葡萄糖再吸收的描述，何者正确？", "answer_idx": "C", "answer": "近端肾⼩管顶膜（apical membrane）主要利⽤第⼆型钠依赖性葡萄糖运输蛋⽩（sodium-dependent glucose transporter 2）再吸收葡萄糖", "options": {"A": "远端肾⼩管顶膜（apical membrane）利⽤第⼀型葡萄糖运输蛋⽩（glucose transporter 1）再吸收葡萄糖", "B": "远端肾⼩管基底外侧膜（basolateral membrane）利⽤第⼀型钠依赖性葡萄糖运输蛋⽩（sodiumdependent glucose transporter 1）再吸收葡萄糖", "C": "近端肾⼩管顶膜（apical membrane）主要利⽤第⼆型钠依赖性葡萄糖运输蛋⽩（sodium-dependent glucose transporter 2）再吸收葡萄糖", "D": "近端肾⼩管基底外侧膜（basolateral membrane）主要利⽤第⼀型葡萄糖运输蛋⽩（glucose transporter"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关各种血管炎临床特征的描述，何者最为正确？", "answer_idx": "C", "answer": "Churg-Strauss syndrome-asthmatic attack", "options": {"A": "granulomatosis with polyangiitis-urticaria", "B": "microscopic polyangiitis-chronic sinusitis", "C": "Churg-Strauss syndrome-asthmatic attack", "D": "polyarteritis nodosa-severe migraine"}}
{"meta_info": "taiwanese_test_Q", "question": "开心手术后的病人，在加护病房照顾时，发现心包腔引流管出血量相当多，第1 个小时约300 毫升（病人体重60 公斤），第2 个小时约400 毫升，医护人员会依流出之量给予静脉输血及血小板或新鲜血浆。会造成这么厉害出血的原因，下列何者最不可能？", "answer_idx": "B", "answer": "体外循环会造成溶血", "options": {"A": "体外循环会破坏血小板", "B": "体外循环会造成溶血", "C": "体外循环时，残余之肝素", "D": "可能有出血点没有查到"}}
{"meta_info": "taiwanese_test_Q", "question": "威而刚（Viagra）主要是藉由何种作用促进勃起（erection）？", "answer_idx": "A", "answer": "抑制磷酸双酯酶（phosphodiesterase）的活性", "options": {"A": "抑制磷酸双酯酶（phosphodiesterase）的活性", "B": "促进磷酸双酯酶（phosphodiesterase）的活性", "C": "抑制一氧化氮合成酶（NO synthase）的活性", "D": "抑制腺苷酸环化酶（adenylate cyclase）的活性"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者最少見于 Klinefelter syndrome？", "answer_idx": "D", "answer": "身材矮小", "options": {"A": "最常見的核型（karyotype）为 47,XXY", "B": "很少在青春期以前被诊断", "C": "青春期发育可能迟延", "D": "身材矮小"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于肩难产（shoulder dystocia）的叙述，何者错误？", "answer_idx": "C", "answer": "西元 2002 年美国妇产科医学会（ACOG）建议非糖尿病产妇之胎儿预估体重大于 4000 克时，施行预防性剖腹生产手术是适当的", "options": {"A": "胎儿出生体重的增加会提高肩难产的发生", "B": "母体常会出现因子宫乏力或产道裂伤造成的产后大出血", "C": "西元 2002 年美国妇产科医学会（ACOG）建议非糖尿病产妇之胎儿预估体重大于 4000 克时，施行预防性剖腹生产手术是适当的", "D": "自然生产时可利用 McRoberts maneuver 或 Woods corkscrew maneuver 來协助胎儿娩出"}}
{"meta_info": "taiwanese_test_Q", "question": "8.⼀个G1P1 / 39周出⽣体重3,200公克的新⽣儿，出⽣后哺喂全⺟乳。第19个⼩时⼤时检测总胆红素值为12 mg/dL、直接型胆红素值为0.22 mg/dL。 ⺟亲为O型Rh阳性、⽗亲B型Rh阳性⾎型。 ⺟亲之前未曾接受过任何\n ⾎品输注。 ⽗亲有⼄型海洋性贫⾎、⺟亲则无海洋性贫⾎。下列何者为最可能之诊断？\n", "answer_idx": "B", "answer": "ABO⾎型不合（ABO incompatibility）", "options": {"A": "Rh其他⾎型不合（Rh minor group incompatibility）", "B": "ABO⾎型不合（ABO incompatibility）", "C": "⺟乳性黄疸（Breast milk jaundice）", "D": "⼄型海洋性贫⾎（ß-Thalassemia）"}}
{"meta_info": "taiwanese_test_Q", "question": "恙（Leptotrombidium spp.）能传染人類致病的时期是：", "answer_idx": "A", "answer": "幼虫", "options": {"A": "幼虫", "B": "前稚虫期", "C": "稚虫期", "D": "成虫期"}}
{"meta_info": "taiwanese_test_Q", "question": "Model for End-Stage Liver Disease（MELD）scale是评估hepatic functional reserve的好方法，其内容不包括下列何者？", "answer_idx": "A", "answer": "serum albumin level", "options": {"A": "serum albumin level", "B": "INR（international normalized ratio）", "C": "serum bilirubin level", "D": "serum creatinine level"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关内侧纵束（medial longitudinal fasciculus）之叙述，何者错误？", "answer_idx": "B", "answer": "參与瞳孔光反射之传导", "options": {"A": "含有由内侧前庭神经核（medial vestibular nucleus）发出之神经纤维", "B": "參与瞳孔光反射之传导", "C": "位于第四脑室或大脑导水管之腹面靠中线处", "D": "与眼球上下垂直共轭运动（vertical conjugate movement）有关"}}
{"meta_info": "taiwanese_test_Q", "question": "68 60 岁女性病人就诊前三个月因子宫颈癌切除子宫，手术后曾经发生急性尿滞留。其后，须用力排尿， 且常发生膀胱炎及耻骨上方疼痛。什么检查可给予诊断或治療最大之帮助？\n", "answer_idx": "B", "answer": "尿路动力学检查", "options": {"A": "核子医学检查", "B": "尿路动力学检查", "C": "膀胱放射摄影", "D": "静脉注射尿路摄影"}}
{"meta_info": "taiwanese_test_Q", "question": "77.一位35岁怀孕28周妇女，因血压过高至急诊就诊，经评估后怀疑是子癫前症（pre-eclampsia）。下 列何者不是此病之临床表现？\n", "answer_idx": "D", "answer": "癫痫（seizure）", "options": {"A": "高血压（hypertension）", "B": "蛋白尿（proteinuria）", "C": "寡尿（oliguria）", "D": "癫痫（seizure）"}}
{"meta_info": "taiwanese_test_Q", "question": "49 李小姐今年 36 岁，已婚，育有 2 个各为 7 岁与 5 岁小孩。李小姐于一周前开始有左侧乳房下方，接近乳暈处的疼痛现象，这兩天疼痛部位可摸到一约兩公分大小的硬块，硬块表面皮肤并且出现红肿 的现象。李小姐曾经自行服用止痛药，但是情况未能改善。下列何者是最适当的进一步处置？\n", "answer_idx": "B", "answer": "乳房超音波检查", "options": {"A": "乳房超音波粗针（core needle）穿刺检查", "B": "乳房超音波检查", "C": "乳房 X 光摄影检查", "D": "乳房肿瘤切除术"}}
{"meta_info": "taiwanese_test_Q", "question": "病毒感染引起发炎时，下列那一种发炎细胞最多？", "answer_idx": "C", "answer": "淋巴球", "options": {"A": "嗜中性球", "B": "嗜酸性球", "C": "淋巴球", "D": "浆细胞"}}
{"meta_info": "taiwanese_test_Q", "question": "3.48岁女性主诉胸闷，偶有眩晕并有运动时呼吸困难，身体诊察脉搏64/min, 心脏大小正常，有S4 gallop，在胸骨右缘第三及四肋间有Grade IV/VI射出型心缩期杂音, 向颈部放散\n （radiation to neck）。血行动力学压力（mmHg）如下：右心房平均压：6；右心室43/8；肺动脉：43/18（平均压28）；肺动脉楔压：平均压22；左心室227/33；主动脉139 /72（平均压98），病人之心脏病为：\n", "answer_idx": "C", "answer": "主动脉瓣狭窄", "options": {"A": "僧帽瓣狭窄", "B": "僧帽瓣闭锁不全", "C": "主动脉瓣狭窄", "D": "主动脉瓣闭锁不全"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何项危险因子不会影响阴茎海绵体血流量（penile blood flow，PBF）？", "answer_idx": "D", "answer": "心因性（psychogenic）勃起功能障碍", "options": {"A": "抽烟", "B": "糖尿病", "C": "高血压", "D": "心因性（psychogenic）勃起功能障碍"}}
{"meta_info": "taiwanese_test_Q", "question": "关于老人自杀相关的叙述，下列何者错误？", "answer_idx": "C", "answer": "和其他族群相较之下，老人自杀者较常合并酒精滥用", "options": {"A": "65岁以上之老年族群自杀风险性比其他族群高", "B": "老人往往采取较激烈的自杀方式，而且男性自杀身亡者比例较高", "C": "和其他族群相较之下，老人自杀者较常合并酒精滥用", "D": "失落和身体疾病缠身是老人自杀最常见的促使因素（precipitants）"}}
{"meta_info": "taiwanese_test_Q", "question": "横纹肌裡的 T 小管是下列何者形成的？", "answer_idx": "A", "answer": "细胞膜内陷形成", "options": {"A": "细胞膜内陷形成", "B": "平滑内质网特化形成", "C": "微小管特化形成", "D": "神经末梢特化形成"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关肾脏的逆流机制（countercurrent mechanism）的叙述，何者错误？", "answer_idx": "C", "answer": "亨氏管上升段粗枝会利用钠-氯协同运输蛋白（Na+-Cl+ cotransporter）将钠、氯离子分泌至肾小管管腔", "options": {"A": "主要是为了形成并维持肾脏髓质垂直性的渗透压梯度", "B": "所需要的能量由亨氏管上升段粗枝（thick ascending limb of loop of Henle）的钠-钾腺苷三磷酸酶（Na+-K+ ATPase）提供", "C": "亨氏管上升段粗枝会利用钠-氯协同运输蛋白（Na+-Cl+ cotransporter）将钠、氯离子分泌至肾小管管腔", "D": "直管（vasa recta）利用逆流交换（countercurrent exchange）的作用维持肾脏髓质垂直性的渗透压梯度"}}
{"meta_info": "taiwanese_test_Q", "question": "一位30 岁原本健康狀况良好的年轻人，三天内产生步态不稳，双下肢无力，病情逐渐加重，无力范围往上升到胸腹部，神经学检查显示胸部以下肌力减退为1-2分（5 分为正常），感觉功能正常，肌腱反射无反应，则最可能的诊断是：", "answer_idx": "B", "answer": "急性周边神经或神经根炎（Guillain-Barré syndrome）", "options": {"A": "重症肌无力（myasthenia gravis）", "B": "急性周边神经或神经根炎（Guillain-Barré syndrome）", "C": "颈脊髓肿瘤（cervical cord tumor）", "D": "多发性肌炎（polymyositis）"}}
{"meta_info": "taiwanese_test_Q", "question": "会制造睪固酮（testosterone）的细胞是：", "answer_idx": "A", "answer": "莱迪氏细胞（Leydig cell）", "options": {"A": "莱迪氏细胞（Leydig cell）", "B": "塞托利氏细胞（Sertoli cell）", "C": "管周边细胞（peritubular cell）", "D": "产精细胞（spermatogenic cell）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列叙述，何者较为正确？", "answer_idx": "A", "answer": "高度近视患者比正常人容易得青光眼、白内障、视网膜剥離、黄斑部出血等眼疾", "options": {"A": "高度近视患者比正常人容易得青光眼、白内障、视网膜剥離、黄斑部出血等眼疾", "B": "小朋友睡前点阿托品（atropine）眼药水，可以治好近视眼", "C": "近视度數七、八百度，用雷射屈光手术即可治愈近视所导致的眼球病变", "D": "给小朋友角膜塑形术，可以使近视眼球变化不再进行"}}
{"meta_info": "taiwanese_test_Q", "question": "34.下列那一个病例最不符合所列之动脉血气体分析和血清电解质的检查结果［pH：7.49，PaO2：90 mmHg， mmHg，HCO3-：28；Na+ 139，K+ 3.0，Cl- 89（电解质的单位是mmol/L）］？", "answer_idx": "B", "answer": "急性腹泻三天", "options": {"A": "长期使用利尿剂", "B": "急性腹泻三天", "C": "原发性皮质醛酮症", "D": "恶心呕吐两天"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 colon motility 之叙述何者为非？", "answer_idx": "D", "answer": "right colon 的 motility 以 peristaltic wave 为主", "options": {"A": "left colon 的 motility 型式以 tonic contraction 为主", "B": "进食后会有 gastrocolic reflex 之产生", "C": "一次 mass peristalsis 之收缩，将大肠内容物推进的长度约占整条大肠的三分之一", "D": "right colon 的 motility 以 peristaltic wave 为主"}}
{"meta_info": "taiwanese_test_Q", "question": "有关巩膜炎（scleritis）的处理，下列叙述何者错误？", "answer_idx": "B", "answer": "使用 10% phenylephrine 点眼，依照巩膜血管的收缩与否，可与上巩膜炎（episcleritis）鉴别诊断", "options": {"A": "常需照会风湿次专科医师，评估潜在的病因（underlying disease）", "B": "使用 10% phenylephrine 点眼，依照巩膜血管的收缩与否，可与上巩膜炎（episcleritis）鉴别诊断", "C": "应给予大量广效性抗生素作第一线治療", "D": "当巩膜炎有导致眼球破裂之虞时，可予缝补性移植片（patch graft）治療"}}
{"meta_info": "taiwanese_test_Q", "question": "何小姐，56 岁女姓，微胖。最近兩个月在深夜有偶发性的上腹剧痛，疼痛发作时痛的感觉会传导到右后背，尤其是肩胛骨下方的地方。疼痛经常持续 4~5 小时即自动缓解，何小姐注意到发作的当日往往是吃的很丰盛、油腻或很饱。综合上述的病史，您认为腹痛最可能的诊断是：", "answer_idx": "D", "answer": "胆结石并胆绞痛", "options": {"A": "急性胃炎", "B": "十二指肠溃疡", "C": "急性胰脏炎", "D": "胆结石并胆绞痛"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者主要是负责细胞还原生合成（reductive biosynthesis）反应之辅？", "answer_idx": "B", "answer": "NADPH", "options": {"A": "NADH", "B": "NADPH", "C": "FADH2", "D": "FMNH2"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关glutathione（GSH）的叙述，何者错误 ？", "answer_idx": "D", "answer": "glutathione reductase利⽤ATP可直接将GSSG还原成2个GSH", "options": {"A": "由Glu、Cys及Gly三种胺基酸组成", "B": "某些种类的leukotriene的⽣合成需要glutathione的参与", "C": "GSH被氧化时，经由双硫键的形成产⽣glutathione disulfide（GSSG）", "D": "glutathione reductase利⽤ATP可直接将GSSG还原成2个GSH"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种疾病常合并下肢无力、感觉異常及大小便失禁？", "answer_idx": "B", "answer": "脊神经管闭合不全（spinal dysraphism）", "options": {"A": "脊髓肌肉萎缩症（spinal muscular atrophy）", "B": "脊神经管闭合不全（spinal dysraphism）", "C": "恰克-马利-杜斯氏症（Charcot-Marie-Tooth disease）", "D": "裘馨氏肌失养症（Duchenne muscular dystrophy）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何处损伤最可能导致病人有異常高的肌肉张力（hypertonia）？", "answer_idx": "C", "answer": "upper motor neurons", "options": {"A": "α motor neurons", "B": "γ motor neurons", "C": "upper motor neurons", "D": "skeletal muscles"}}
{"meta_info": "taiwanese_test_Q", "question": "23.一名30岁女性，近2个月血清肌酸酐从1.0升至3.0 mg/dL，其血清anti-neutrophil cytoplasmic抗体呈阴性反应，血清C3降低，C4正常，经肾脏切片检查确定为新月型肾丝球肾炎，电镜检查发现有subepithelial electron-dense 沉积，glomerular basement membrane厚度正常，下列诊断何者正确？\n", "answer_idx": "D", "answer": "poststreptococcal glomerulonephritis", "options": {"A": "membranous nephropathy", "B": "membranoproliferative glomerulonephritis, type II", "C": "lupus nephritis", "D": "poststreptococcal glomerulonephritis"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者位于会阴浅隙（superficial perineal pouch）？", "answer_idx": "A", "answer": "阴茎脚", "options": {"A": "阴茎脚", "B": "膜部尿道", "C": "会阴深横肌", "D": "阴茎背侧神经"}}
{"meta_info": "taiwanese_test_Q", "question": "有关二尖瓣严重狭窄（severe mitral stenosis）之治疗，下列何者错误？", "answer_idx": "A", "answer": "有无征状的严重二尖瓣狭窄（mitral stenosis）都应该接受介入性的手术治疗", "options": {"A": "有无征状的严重二尖瓣狭窄（mitral stenosis）都应该接受介入性的手术治疗", "B": "严重的二尖瓣狭窄大都以风湿性心脏病（rheumatic heart disease）为主", "C": "利用体外循环之下行二尖瓣膜连合处切开术（open mitral commissurotomy, OMC）是手术选项之一", "D": "当无法实行二尖瓣膜连合处切开术时，二尖瓣膜置换手术（mitral valve replacement）也是外科治疗选项之一"}}
{"meta_info": "taiwanese_test_Q", "question": "P 先生对虾蟹过敏，每次吃了海鲜大餐都会产生荨麻疹。在K 先生的主动提议下，K 先生将P 先生的血清注射到自己的皮下后1 周，K 先生吃了海鲜大餐后半小时也在注射的皮肤出现明显的皮肤疹，但吃其他的食物并不会出现反应，身体其他地方也无特别病狀。下列叙述何者正确？", "answer_idx": "B", "answer": "血清中具抗原特異性的 IgE 已经黏附在皮下的过敏细胞", "options": {"A": "P 先生的反应是被动免疫，K 先生的反应是主动免疫", "B": "血清中具抗原特異性的 IgE 已经黏附在皮下的过敏细胞", "C": "P 先生的血清已经在 K 先生的身上引起免疫容忍", "D": "P 先生和 K 先生的反应都是被动免疫"}}
{"meta_info": "taiwanese_test_Q", "question": "下图为一孩童之 X 光素片，下列相关叙述何者错误？", "answer_idx": "C", "answer": "为确立诊断，必须进一步做小肠钡剂摄影", "options": {"A": "有呈现肠道異常之征象", "B": "要考虑左侧腹股沟疝气（left inguinal hernia）", "C": "为确立诊断，必须进一步做小肠钡剂摄影", "D": "应以外科手术治療"}}
{"meta_info": "taiwanese_test_Q", "question": "71 32 岁女性曾做兩次流产手术，主诉痛经，经血量减少，经子宫输卵管摄影检查（見图 A）及子宫镜检（見图 B），下列诊断何者最适当？图 A 图 B", "answer_idx": "B", "answer": "Asherman's Syndrome", "options": {"A": "Sheehan's Syndrome", "B": "Asherman's Syndrome", "C": "Swyer's Syndrome", "D": "Klinefelter Syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是视网膜最前端的组织构造？", "answer_idx": "B", "answer": "锯齿缘（ora serrata）", "options": {"A": "玻璃体基底部（vitreous base）", "B": "锯齿缘（ora serrata）", "C": "皱折部（pars plicata）", "D": "平坦部（pars plana）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 18 岁男性病患兩年來有渐行性的动作性手抖、僵硬、手指徐动症（athetosis），說话有点不清晰，并无家族史。其肝功能不正常，腹部超音波显示有肝硬化。目前对诊断最有帮忙的检查为：", "answer_idx": "A", "answer": "血液中铜及藍胞浆素（ceruloplasmin）之浓度", "options": {"A": "血液中铜及藍胞浆素（ceruloplasmin）之浓度", "B": "血液中维他命 B12浓度", "C": "基因测试", "D": "血液中阿摩尼亚（ammonia）的浓度"}}
{"meta_info": "taiwanese_test_Q", "question": "小王由于白血病必须进行骨髓移植，他只有一位亲弟弟，他这位弟弟进行 HLA 检验，则 HLA 完全与他符合的机会大约为多少%？", "answer_idx": "D", "answer": "25", "options": {"A": "100", "B": "75", "C": "50", "D": "25"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于荨麻疹（urticaria）的叙述，何者错误？", "answer_idx": "C", "answer": "急性和慢性荨麻疹的定义，臨床上以是否持续 6 个月当分界", "options": {"A": "个别病灶通常在 24 小时内会消失，但可能会有新的病灶产生", "B": "dermographism 是因机械刺激造成 mast cell degranulation 而产生皮肤浮肿", "C": "急性和慢性荨麻疹的定义，臨床上以是否持续 6 个月当分界", "D": "阳光或冷热刺激亦可能会造成荨麻疹"}}
{"meta_info": "taiwanese_test_Q", "question": "关于tetracyclines类抗生素之叙述，下列何者正确？", "answer_idx": "C", "answer": "治疗立克次体感染的首选药物", "options": {"A": "可结合至细菌之50S核糖体，而干扰蛋白质合成", "B": "常与制酸剂并用，以预防胃部不适", "C": "治疗立克次体感染的首选药物", "D": "doxycycline口服时，易受食物干扰吸收"}}
{"meta_info": "taiwanese_test_Q", "question": "子宫内膜（Endometrium）的发育，与卵泡的逐渐成熟相一致并受卵巢雌性素（estrogen）分泌影响的是那一时期？", "answer_idx": "A", "answer": "增殖期（Proliferative phase）", "options": {"A": "增殖期（Proliferative phase）", "B": "分泌期（Secretory phase）", "C": "缺血期（Ischemic phase）", "D": "月经期（Menstrual phase）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不直接与子宫相連？", "answer_idx": "B", "answer": "悬韧带（suspensory ligament of ovary）", "options": {"A": "阔韧带（broad ligament）", "B": "悬韧带（suspensory ligament of ovary）", "C": "卵巢韧带（ligament of ovary）", "D": "子宫圆韧带（round ligament of uterus）"}}
{"meta_info": "taiwanese_test_Q", "question": "直肠癌最常見的症狀是那一项？", "answer_idx": "B", "answer": "便血（hematochezia）", "options": {"A": "裡急后重感（tenesmus）", "B": "便血（hematochezia）", "C": "解粘液便（mucus discharge）", "D": "大便习惯改变（change in bowel habit）"}}
{"meta_info": "taiwanese_test_Q", "question": "酶具有高效率的化学反应催化作用（catalysis），原因为何？", "answer_idx": "C", "answer": "可降低化学反应的活化能（activation energy, ΔG‡）", "options": {"A": "可抑制酶促反应（enzymatic catalytic reaction）的逆反应", "B": "可增加催化反应的平衡常数（equilibrium constant）", "C": "可降低化学反应的活化能（activation energy, ΔG‡）", "D": "可增加化学反应的活化能（activation energy, ΔG‡）"}}
{"meta_info": "taiwanese_test_Q", "question": "慢性心房振颤（Atrial fibrillation）的病人，可以用下列那一种手术术式來治療，使其恢復窦律（Sinus rhythm）？", "answer_idx": "C", "answer": "迷宫手术（Maze operation）", "options": {"A": "植入式心室振颤自动去除器（Automatic internal cardioverter defibrillator）", "B": "心律调整器（VVI pacemaker）", "C": "迷宫手术（Maze operation）", "D": "心房转换手术（Atrial switch）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关血液中二氧化碳之运输，下列叙述何者正确？", "answer_idx": "B", "answer": "在周边微血管（peripheral capillary）中，碳酸氢根离子（HCO3-）自红血球流出（efflux）", "options": {"A": "在肺泡微血管（alveolar capillary）中，碳酸氢根离子（HCO3-）自红血球流出（efflux）", "B": "在周边微血管（peripheral capillary）中，碳酸氢根离子（HCO3-）自红血球流出（efflux）", "C": "主要依赖氯-碳酸氢根共同转运蛋白（Cl-- HCO3- cotransporter）之协助", "D": "血液中二氧化碳主要以碳酸根离子（CO32-）之形式存在"}}
{"meta_info": "taiwanese_test_Q", "question": "霍亂弧菌（Vibrio cholerae）之血清型别是依据下列何者的抗原性予以区分？", "answer_idx": "C", "answer": "脂多糖体（lipopolysaccharides）", "options": {"A": "鞭毛蛋白（flagellin）", "B": "荚膜多糖体（capsular polysaccharides）", "C": "脂多糖体（lipopolysaccharides）", "D": "外膜蛋白（outer membrane proteins）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关犬心丝虫（Dirofilaria immitis）感染的叙述，何者错误？", "answer_idx": "B", "answer": "人体被狗身上的虱子及跳蚤叮咬而感染", "options": {"A": "狗是该虫的终宿主（final host）", "B": "人体被狗身上的虱子及跳蚤叮咬而感染", "C": "在人体感染很少能发育为成虫", "D": "大多數被感染的病人都在肺脏或皮下组织形成结节（nodules）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于肾病症候群（nephrotic syndrome）的叙述，下列何者错误？", "answer_idx": "B", "answer": "高蛋白饮食为治療肾病症候群的必要方式之一", "options": {"A": "肾病症候群的特点为重度蛋白尿，低白蛋白血症，高脂血症和水肿", "B": "高蛋白饮食为治療肾病症候群的必要方式之一", "C": "膜性肾病变（membranous glomerulonephritis）肾丝球肾炎容易发生肾静脉血栓", "D": "肾病症候群患者其血浆渗透压降低，可刺激肝脏脂蛋白合成而造成高脂血症，其中以低密度脂蛋白及胆固醇之增加为最常見"}}
{"meta_info": "taiwanese_test_Q", "question": "接合霉菌纲（zygomycetes）通常不具下列那一种构造？", "answer_idx": "C", "answer": "phialides", "options": {"A": "columella", "B": "sporangium", "C": "phialides", "D": "coenocytic hyphae 59 下列有关新型隐球菌（Cryptococcus neoformans）黑色素（melanin）之叙述何者错误？"}}
{"meta_info": "taiwanese_test_Q", "question": "42 一位 38 岁男性过去未曾关节腔出血，但因拔牙后流血不止而就医。抽血检查发现血小板數目 2 秒，aPTT 75.3 秒。下列诊断何者最应优先考虑？", "answer_idx": "D", "answer": "第十一凝血因子缺乏（Factor XI deficiency）", "options": {"A": "严重型類血友病（type 3 von Willebrand disease）", "B": "血小板无力症（Glanzmann's thrombasthenia）", "C": "第十凝血因子缺乏（Factor X deficiency）", "D": "第十一凝血因子缺乏（Factor XI deficiency）"}}
{"meta_info": "taiwanese_test_Q", "question": "当妊娠期间的妇女出现有異食症（pica syndrome）时，应该怀疑与下列何种情况最有相关性？", "answer_idx": "C", "answer": "缺铁性贫血（iron deficiency anemia）", "options": {"A": "家暴、暴力虐待（domestic abuse）", "B": "蛔虫感染（ascariasis）", "C": "缺铁性贫血（iron deficiency anemia）", "D": "精神分裂症（schizophrenia）"}}
{"meta_info": "taiwanese_test_Q", "question": "49 一位 48 岁妇女，主诉不正常子宫出血，子宫内膜搔刮手术报告为 atypical complex hyperplasia，下列 何者为最适当之治疗？\n", "answer_idx": "A", "answer": "子宫切除", "options": {"A": "子宫切除", "B": "黄体素给予", "C": "雌激素给予", "D": "子宫镜指引下，再次切除病灶"}}
{"meta_info": "taiwanese_test_Q", "question": "巴拉松属于那一种农药？", "answer_idx": "B", "answer": "有机磷", "options": {"A": "有机氯", "B": "有机磷", "C": "氨基甲酸盐", "D": "天然产物"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 38 岁女性，过去无重大疾病史，至门诊要求减重。理学检查发现其血压 138/94 mmHg，心跳 78 次/分，体重 68 公斤，腰围 88 公分，身体质量指數（BMI）为 26.6 kg/m2。家族病史显示母亲有糖尿病。下列处置何者最适当？", "answer_idx": "D", "answer": "病人属体重过重，先以饮食与运动治療即可", "options": {"A": "因合并有高血压，应立即使用 sibutramine 或 orlistat 等药物减重", "B": "家族病史有糖尿病，因此应给予 metformin 以减重并降血糖", "C": "腰围大于 80 公分，属中央型肥胖（central obesity），应进行腹部脂肪之抽脂手术", "D": "病人属体重过重，先以饮食与运动治療即可"}}
{"meta_info": "taiwanese_test_Q", "question": "某病毒可引起孩童之急性下呼吸道疾病，经由鼻腔分泌物分离出该病毒，发觉其不具血球凝集作用，但可使感染之细胞融合（syncytia）。该病毒可能为下列何者？", "answer_idx": "C", "answer": "呼吸道细胞融合病毒（Respiratory syncytial virus）", "options": {"A": "流行性感冒病毒A型（Influenza virus A）", "B": "副流行性感冒病毒（Parainfluenza virus）", "C": "呼吸道细胞融合病毒（Respiratory syncytial virus）", "D": "麻疹病毒（Measles virus）"}}
{"meta_info": "taiwanese_test_Q", "question": "48岁男性B型肝炎患者，腹部超音波发现一大型肝脏肿瘤，且主要肝门静脉也有肿瘤栓塞，显微镜下肿瘤细胞含有胆色素，则下列叙述何者为最有可能的诊断？", "answer_idx": "C", "answer": "肝细胞癌", "options": {"A": "胆管癌", "B": "肝脏血管瘤", "C": "肝细胞癌", "D": "转移性胆囊癌"}}
{"meta_info": "taiwanese_test_Q", "question": "B 群链球菌（GBS）常菌集落（colonization）于健康妇女之阴道，易造成新生儿之感染，如败血症、肺炎及脑膜炎等。新生儿 GBS 感染可分早期（early onset，出生后 7 天内）及晚期（late onset，出生后 7~90 天），则下列叙述何者错误？", "answer_idx": "D", "answer": "生产期间给予母亲抗生素或疫苗接种，兩种方法均可预防早期及晚期新生儿 GBS 感染", "options": {"A": "在生产开始前（before labor）使用抗生素（penicillin）无法可靠地清除阴道之 GBS 菌落，因此无法预防新生儿 GBS 感染", "B": "生产期间（intrapartum）给予母亲抗生素可阻断新生儿 GBS 之 colonization，预防新生儿 GBS 感染", "C": "在怀孕前或怀孕期间给予母亲 GBS 疫苗，产生之保护性抗体可通过胎盘，保护新生儿不受 GBS 感染", "D": "生产期间给予母亲抗生素或疫苗接种，兩种方法均可预防早期及晚期新生儿 GBS 感染"}}
{"meta_info": "taiwanese_test_Q", "question": "39 岁男性，一个月前开始出现严重搔痒性皮疹，皮疹主要分布于指间、手腕及肘窝屈侧、肚脐周围、外阴部、臀部等处。病灶处 KOH 法显微镜检查如图所示，下列问诊项目中，何者与本症之诊断较无关系？", "answer_idx": "B", "answer": "糖尿病的病史", "options": {"A": "严重搔痒的时间", "B": "糖尿病的病史", "C": "家人是否有類似症狀", "D": "最近的婚外性行为"}}
{"meta_info": "taiwanese_test_Q", "question": "57.一位79岁女性两星期前不慎滑倒，造成下背痛，无法起立。现在背痛已渐改善，且可用四脚拐杖辅助走路。 X光检查显示第二腰椎压迫性骨折（compression fracture），椎体高度丧失约20%，腰椎前凸（lordosis）仍保持，没有椎茎破坏（pedicle destruction）。下列何者是病患现在最适当的治疗？\n", "answer_idx": "A", "answer": "背架保护加止痛药物保守治疗", "options": {"A": "背架保护加止痛药物保守治疗", "B": "经皮椎体成型手术（percutaneous vertebroplasty）治疗", "C": "第一腰椎至第三腰椎后位骨钉固定骨融合手术治疗", "D": "椎板切除（laminectomy）神经减压，加第一腰椎至第三腰椎骨钉固定治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "热带肺部嗜酸性白血球增多症（tropical pulmonary eosinophilia）的病患常呈现下列特征，何者除外？", "answer_idx": "C", "answer": "大量微丝虫（microfilaria）会出现在末梢血液中", "options": {"A": "血清中呈现高效价抗丝虫抗体", "B": "除肺部外，末梢血液中之嗜酸性白血球也增多", "C": "大量微丝虫（microfilaria）会出现在末梢血液中", "D": "用diethylcarbamazine治疗有效"}}
{"meta_info": "taiwanese_test_Q", "question": "有关巴金森氏症（Parkinson's disease），下列叙述何者错误？", "answer_idx": "C", "answer": "通常会直接投予（口服或注射）多巴胺（dopamine）治疗", "options": {"A": "为大脑黑质（substantia nigra）及基底核（basal ganglia）中神经元的多巴胺（dopamine）分泌不足所造成", "B": "患者脑中之退化神经元中常含有由神经丝（neurofilaments）与特定蛋白质交织而成的内含体（Lewy bodies）", "C": "通常会直接投予（口服或注射）多巴胺（dopamine）治疗", "D": "脑神经元退化后，通常会有明显的神经胶样变性（gliosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关钙離子阻断剂（calcium channel blocker）治療高血压，下列叙述何者错误？", "answer_idx": "D", "answer": "短效的 dihydropyridines 比长效的 dihydropyridines 治療高血压，更能达到保护心血管效果 15 有关胆管癌（cholangiocarcinoma）的叙述，下列何者错误？", "options": {"A": "dihydropyridines（如 nifedipine）易造成 reflex tachycardia", "B": "diltiazem 或 verapamil 可造成房室传导时间（atrioventricular conduction）延长", "C": "dihydropyridines 易造成下肢水肿", "D": "短效的 dihydropyridines 比长效的 dihydropyridines 治療高血压，更能达到保护心血管效果 15 有关胆管癌（cholangiocarcinoma）的叙述，下列何者错误？"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列关于王女士所需医療照顾之叙述，何者错误？", "answer_idx": "B", "answer": "如王女士在急诊时仍持续有睡眠障碍，可用长效之 benzodiazepines 治療", "options": {"A": "王女士之精神病症狀可投与 haloperidol 治療", "B": "如王女士在急诊时仍持续有睡眠障碍，可用长效之 benzodiazepines 治療", "C": "应避免时常更换不同之照顾者", "D": "王女士于此病改善后，不需长期住院"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不适于断指重接（replantation）？", "answer_idx": "C", "answer": "多层（multiple levels）截断", "options": {"A": "全手掌（complete plam）截断", "B": "部份大拇指（partial thumb）截断", "C": "多层（multiple levels）截断", "D": "多指（multiple digits）截断"}}
{"meta_info": "taiwanese_test_Q", "question": "臀部肌肉注射时，外上四分之一象限（upper lateral quadrant）是安全部位，下列何者位于此部位？", "answer_idx": "B", "answer": "臀中肌（gluteus medius）", "options": {"A": "股四方肌（quadratus femoris）", "B": "臀中肌（gluteus medius）", "C": "阔筋膜张肌（tensor fasciae latae）", "D": "髂腰肌（iliopsoas）"}}
{"meta_info": "taiwanese_test_Q", "question": "根据American Burn Association所订，须到灼伤中心住院的情况，下列叙述何者错误？", "answer_idx": "D", "answer": "5岁以下，50岁以上，二及三度烧伤大于5% TBSA", "options": {"A": "二及三度烧伤大于10% TBSA", "B": "三度烧伤", "C": "inhalation injury", "D": "5岁以下，50岁以上，二及三度烧伤大于5% TBSA"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 28 岁女性因为长时间杵狀指与肢端发绀到院求治。动脉血气体分析为：pH 7.45，PaO2 50 mmHg， PaCO2 35 mmHg，HCO3- 24 mmol/L（未使用氧气），血比容为 65%。给予纯氧呼吸 30 分钟后，再分析动脉血气体结果为：pH 7.4，PaO2 195 mmHg，PaCO2 39 mmHg，HCO3- 24 mmol/L，胸部X光与肺功能检验都正常。最可能造成此病人低血氧的机制为何？", "answer_idx": "C", "answer": "血液分流", "options": {"A": "通气不足", "B": "通气灌流比異常", "C": "血液分流", "D": "肺部弥散障碍"}}
{"meta_info": "taiwanese_test_Q", "question": "50 20 岁年轻男性有严重头痛 1 天，身体检查发现颈部僵硬，体温 38.8℃，呼吸 26，脉搏 98，血压 95/45 。脑的肉眼变化如附图。最可能造成该变化的微生物是：\n", "answer_idx": "D", "answer": "Neisseria meningitidis", "options": {"A": "Cryptococcus neoformans", "B": "Mycobacterium tuberculosis", "C": "Toxoplasma gondii", "D": "Neisseria meningitidis"}}
{"meta_info": "taiwanese_test_Q", "question": "使用 lamivudine 治療慢性 B 型肝炎，容易使 B 型肝炎病毒产生何种基因之突变？", "answer_idx": "D", "answer": "DNA 聚合酶（polymerase）", "options": {"A": "B 型肝炎病毒抗原 HBxAg", "B": "B 型肝炎病毒抗原 HBsAg", "C": "B 型肝炎病毒抗原 HBcAg", "D": "DNA 聚合酶（polymerase）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 70 岁男性，因咳嗽而至门诊就诊时，发现痰液 acid-fast stain 为阳性。下列的致病菌何者不会呈现 acid-fast stain 阳性？", "answer_idx": "B", "answer": "Legionella pneumophila", "options": {"A": "Mycobacterium avium complex", "B": "Legionella pneumophila", "C": "Mycobacterium tuberculosis", "D": "Nocardia asteroides"}}
{"meta_info": "taiwanese_test_Q", "question": "关于先天性免疫力（innate immunity）相关的基因突变会导致严重的原发性免疫缺损疾病的叙述，下列何者正确？", "answer_idx": "C", "answer": "白血球黏着分子缺损可能会导致新生儿脐带伤口延迟愈合", "options": {"A": "NEMO 的突变不会影响先天性免疫力", "B": "慢性肉芽肿病的病患易受肝炎病毒感染", "C": "白血球黏着分子缺损可能会导致新生儿脐带伤口延迟愈合", "D": "Toll-like receptor 的缺损不会导致对病毒的免疫缺损"}}
{"meta_info": "taiwanese_test_Q", "question": "倒生性乳头瘤（inverted papilloma）最常发生于鼻腔之何处？", "answer_idx": "C", "answer": "鼻侧壁", "options": {"A": "鼻中隔", "B": "鼻前庭", "C": "鼻侧壁", "D": "鼻底部"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种材料是目前最常被用來修补耳膜破孔？", "answer_idx": "A", "answer": "自体颞肌膜（temporalis fascia）", "options": {"A": "自体颞肌膜（temporalis fascia）", "B": "自体皮瓣（pedicle flap）", "C": "自体全层皮肤移植片（full thickness skin graft）", "D": "自体分层皮肤移植片（split thickness skin graft）"}}
{"meta_info": "taiwanese_test_Q", "question": "27 下列关于粒线体（mitochondria）的叙述，何者错误？", "answer_idx": "D", "answer": "mitochondrial genome mutation 通常遗传自母亲", "options": {"A": "含有自己的 genome", "B": "电子传递鍊（electron transport system）之基因，全位于 mitochondrial genome", "C": "mitochondrial genome mutation 常造成先天神经肌肉或内分泌疾病", "D": "mitochondrial genome mutation 通常遗传自母亲"}}
{"meta_info": "taiwanese_test_Q", "question": "目前所订定的铅中毒标准，对小孩族群之保护远比对成人严格，主要來自下列那一系统或器官的毒性效应？", "answer_idx": "C", "answer": "造血系统", "options": {"A": "呼吸系统", "B": "周围神经系统", "C": "造血系统", "D": "肝"}}
{"meta_info": "taiwanese_test_Q", "question": "輪狀病毒（Rotavirus）和挪瓦克病毒（Norwalk virus）属于不同病毒，但它们共同具有下列何种特性？", "answer_idx": "A", "answer": "可经由粪-口传播", "options": {"A": "可经由粪-口传播", "B": "均是双股 RNA", "C": "均是单股 RNA", "D": "可经由游泳传播"}}
{"meta_info": "taiwanese_test_Q", "question": "被下列那一种人体寄生虫严重感染后，患者会出现肠阻塞（bowel obstruction）的臨床症狀？", "answer_idx": "C", "answer": "蛔虫（Ascaris lumbricoides）", "options": {"A": "横川氏吸虫（Metagonimus yokogawai）", "B": "旋毛虫（Trichinella spiralis）", "C": "蛔虫（Ascaris lumbricoides）", "D": "棘颚口线虫（Gnathostoma spinigerum）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种麻醉剂，在可产生外科麻醉的浓度下，所需要的诱导时间最短？", "answer_idx": "A", "answer": "nitrous oxide", "options": {"A": "nitrous oxide", "B": "benzodiazepines", "C": "methoxyflurane", "D": "halothane"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关头痛的现象之中，何者最需要让病人接受脑部磁振造影或电脑断层摄影？", "answer_idx": "C", "answer": "最近常在凌晨因头痛而醒过來，且常伴随恶心呕吐", "options": {"A": "头痛通常发生在单侧", "B": "头痛已经十年，型态及严重度都没有变化", "C": "最近常在凌晨因头痛而醒过來，且常伴随恶心呕吐", "D": "头痛之前常有闪光性的视野缺损（scintillating scotoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "乳房X光摄影之筛检报告为breast imaging reporting and data system（BI-RADS）category 0，下列的处置何者最适当？", "answer_idx": "D", "answer": "加做乳房超音波", "options": {"A": "一年后再追踪", "B": "直接手术切片", "C": "细胞针刺检查", "D": "加做乳房超音波"}}
{"meta_info": "taiwanese_test_Q", "question": "朱女士，45 岁，20 年前因开刀输血感染 C 型肝炎，目前 AST 60 U/L，ALT 85 U/L，肝生检（biopsy）显示为第二期（Metavir F2）之肝纤维化。下列叙述何者错误？", "answer_idx": "B", "answer": "朱女士可接受抗病毒治療", "options": {"A": "朱女士应定期接受肝癌筛检，包括腹部超音波和甲型胎儿蛋白", "B": "朱女士可接受抗病毒治療", "C": "目前 C 型肝炎之标准治療为长效型干扰素（pegylated interferon）合并雷巴威林（ribavirin）和蛋白酵素抑制剂（protease inhibitor）", "D": "若能清除 C 型肝炎病毒，可减少肝硬化和肝癌之风险"}}
{"meta_info": "taiwanese_test_Q", "question": "有关Trisomy18（Edwards syndrome）的叙述，下列何者错误？", "answer_idx": "C", "answer": "经过良好治疗，90%可存活至成年", "options": {"A": "容易早产", "B": "窄及外展受限的髋关节（Narrow hips with limited abduction）", "C": "经过良好治疗，90%可存活至成年", "D": "存活者有严重的神经学发展迟缓"}}
{"meta_info": "taiwanese_test_Q", "question": "60 岁女性病人，20 年前有右侧乳癌做过 irradiation，发现右侧甲狀腺硬块约二个月，则应建议做何检查？", "answer_idx": "B", "answer": "超音波定位细胞学检查", "options": {"A": "T3, T4, TSH", "B": "超音波定位细胞学检查", "C": "核磁共振", "D": "血管摄影"}}
{"meta_info": "taiwanese_test_Q", "question": "咖啡因（caffeine）戒断之最常见症状为何？", "answer_idx": "B", "answer": "头痛", "options": {"A": "入睡困难", "B": "头痛", "C": "心搏过速", "D": "手抖"}}
{"meta_info": "taiwanese_test_Q", "question": "有关脂漏性⽪肤炎（seborrheic dermatitis）的叙述，下列何者错误？", "answer_idx": "C", "answer": "外⽤抗霉菌药物不能有效治疗脂漏性⽪肤炎", "options": {"A": "好发在头⽪、眉⽑、⿐⼦两侧、⽿朵后⾯", "B": "常发于婴儿和成⼈", "C": "外⽤抗霉菌药物不能有效治疗脂漏性⽪肤炎", "D": "若是病程顽固且临床表现不寻常，需留意HIV感染"}}
{"meta_info": "taiwanese_test_Q", "question": "能引起体内产生较强抗体反应的蛋白质抗原，一般具有何特性？", "answer_idx": "C", "answer": "与反应个体的体内分子差異大", "options": {"A": "分子量很小（MW < 2500）", "B": "结构简单、复杂度不高", "C": "与反应个体的体内分子差異大", "D": "进入体内可以很快完全释放"}}
{"meta_info": "taiwanese_test_Q", "question": "老化过程中会发生许多生理变化，下列何种变化在正常老人最常見？", "answer_idx": "C", "answer": "心房利钠激素（atrial natriuretic hormone）分泌增加", "options": {"A": "肾素（renin）分泌增加", "B": "肾上腺皮质醛酮（aldosterone）分泌增加", "C": "心房利钠激素（atrial natriuretic hormone）分泌增加", "D": "抗利尿激素（antidiuretic hormone）分泌减少"}}
{"meta_info": "taiwanese_test_Q", "question": "有关精索静脉曲张（varicocele）的叙述，下列何者错误？", "answer_idx": "B", "answer": "精子的浓度和运动力可不受影响", "options": {"A": "年纪大的人突然发生精索静脉曲张，有时是肾脏肿瘤的表现", "B": "精子的浓度和运动力可不受影响", "C": "进行 valsalva maneuver 时精索静脉曲张会更明显", "D": "外科手术是结扎 internal spermatic veins"}}
{"meta_info": "taiwanese_test_Q", "question": "⼦宫外孕病患选择内科单⼀化学药物methotrexate（叶酸拮抗剂）治疗后，第4天⾄第7天抽⾎检验⾎清⼈类绒⽑膜性腺激素值（human chorionic gonadotropin），根据美国⽣殖医学会2013年建议，若下降幅度没有达到多少百分比，可以考虑接受追加第⼆剂methotrexate治疗？", "answer_idx": "D", "answer": "15%", "options": {"A": "45%", "B": "35%", "C": "25%", "D": "15%"}}
{"meta_info": "taiwanese_test_Q", "question": "有关长期照护与医疗照护之比较，下列叙述何者错误？", "answer_idx": "C", "answer": "长期照护以机构式照顾为主", "options": {"A": "长期照护主要的对象为慢性病患或身心障碍之失能或失智者", "B": "医疗照护对象包括急性病患与慢性病患", "C": "长期照护以机构式照顾为主", "D": "医疗照护之照顾概念主要为治 疾病"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于大肠的特征？", "answer_idx": "A", "answer": "环狀皱襞（plicae circulares）", "options": {"A": "环狀皱襞（plicae circulares）", "B": "结肠袋（haustrae coli）", "C": "肠脂垂（appendices epiploicae）", "D": "结肠带（taeniae coli）"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，经过一系列臨床检查后，发现她患有子宫颈癌第 Ib 期，她住院检查并接受根除性子宫切除手术及骨盆腔淋巴结摘除手术。但是手术后病患自觉大腿无法内收，大腿内侧感觉变差，且症狀并没有慢慢好转。请问最有可能的原因为何？", "answer_idx": "D", "answer": "手术中伤到 obturator nerve", "options": {"A": "手术后淋巴水肿，压迫骨盆神经", "B": "手术中伤到 pudendal nerve", "C": "手术中下肢使用弹性绷带过久，导致神经压迫损伤", "D": "手术中伤到 obturator nerve"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 23 岁男性，主诉下背疼痛且传导至右下肢已數月之久。理学检查发现兩侧肌力 5 分，straight leg raising test（SLRT）右侧 20°，左侧 70°；双侧深部肌腱反射（DTR）正常，疼痛位置约在第五腰椎神经根支配处。则最有可能的诊断是：", "answer_idx": "B", "answer": "腰椎椎间盘突出", "options": {"A": "腰椎肿瘤", "B": "腰椎椎间盘突出", "C": "腰椎滑脱", "D": "腰椎肌肉肌腱炎"}}
{"meta_info": "taiwanese_test_Q", "question": "陈先生，60 岁，每天均要喝酒，尤其晚餐还常不吃饭，由媳妇预备小菜下酒，同时吹吹年轻时的英雄故事，三天前腹痛住院，医生怀疑肠胃有问题，因此一切饮食均由医院严格管制，陈先生刚开始出现失眠、发抖的症狀，从昨天开始出现视幻觉，看到满身爬满虫子，不停大叫并往外冲。陈先生最可能的诊断为：", "answer_idx": "B", "answer": "酒精戒断", "options": {"A": "镇静剂服用过量中毒", "B": "酒精戒断", "C": "妄想症", "D": "老年性痴呆"}}
{"meta_info": "taiwanese_test_Q", "question": "医療法规定下列何种医療机构应提拨年度结余的百分之二十以上作为营运基金？", "answer_idx": "C", "answer": "社团法人医療机构", "options": {"A": "公立医療机构", "B": "财团法人医療机构", "C": "社团法人医療机构", "D": "教学医院"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 60 岁矿工，主诉干咳及胸痛，组织切片显示有黑色的色素沈积在肺、肋膜及淋巴结，其最可能的病理诊断为：", "answer_idx": "A", "answer": "碳沈积症", "options": {"A": "碳沈积症", "B": "矽沈积症", "C": "肺癌", "D": "黑色素癌"}}
{"meta_info": "taiwanese_test_Q", "question": "在长期使用類精神疾病治療药物时，常会伴随着锥体外症狀（extrapyramidal syndrome）的发生，其主要的原因系下列那种受体被阻断所产生的结果？", "answer_idx": "B", "answer": "dopamine", "options": {"A": "muscarinic", "B": "dopamine", "C": "α-adrenergic", "D": "serotonin"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于竖脊肌（erector spinae）？", "answer_idx": "A", "answer": "半棘肌（semispinalis）", "options": {"A": "半棘肌（semispinalis）", "B": "棘肌（spinalis）", "C": "最长肌（longissimus）", "D": "髂肋肌（iliocostalis）"}}
{"meta_info": "taiwanese_test_Q", "question": "门诊来了一位52岁男性进行体检，身高167公分，体重87公斤，平日没有不适。身体诊察发现血压132/84毫米汞柱，心跳每分钟72次，身体质量指数（BMI）31 kg/m2，其他身体检查正常。在目前的血压值所处的范围，考虑前面的叙述，下列那一种生活型态修正对于降低血压数值的效果最明显？", "answer_idx": "C", "answer": "减重大约九公斤", "options": {"A": "每天慢走十分钟，每周四次", "B": "每天作息正常", "C": "减重大约九公斤", "D": "每日限盐小于六公克"}}
{"meta_info": "taiwanese_test_Q", "question": "57 岁男性，由其女儿送至急诊室，外观衣衫褴褛、步态不稳，面无表情不回答问题。据其女儿所述，病患每天酗酒不太进食，最近视力渐差，急诊的第一步处置应为：", "answer_idx": "D", "answer": "静脉注射 thiamine，再给予静脉输液", "options": {"A": "静脉注射含葡萄糖输液", "B": "会诊神经内科医师", "C": "静脉注射 MgSO4", "D": "静脉注射 thiamine，再给予静脉输液"}}
{"meta_info": "taiwanese_test_Q", "question": "关于糖尿病（diabetes mellitus）诊断之叙述，下列何者错误？", "answer_idx": "B", "answer": "餐后两小时血浆葡萄糖浓度大于等于 180 mg/dL", "options": {"A": "空腹血浆葡萄糖浓度大于等于 126 mg/dL", "B": "餐后两小时血浆葡萄糖浓度大于等于 180 mg/dL", "C": "糖化血红素（hemoglobin A1c）大于 6.5%", "D": "有口渴多尿及不明原因体重减轻时，随机血浆葡萄糖浓度大于等于 200 mg/dL"}}
{"meta_info": "taiwanese_test_Q", "question": "李先生參加农耕队服务于巴西，回国后脚部皮肤有出疹现象，诊断为泳者之痒（swimmer's itch），请问下列叙述何者正确？", "answer_idx": "A", "answer": "止痒剂（antipruritic）及抗组织胺（antihistamine）可舒缓症狀", "options": {"A": "止痒剂（antipruritic）及抗组织胺（antihistamine）可舒缓症狀", "B": "使用 mebendazole 可治療痊愈", "C": "在皮下组织一段时间后会在骨骼肌中形成包囊", "D": "是因人類血吸虫尾动幼虫（cercaria）感染而引起"}}
{"meta_info": "taiwanese_test_Q", "question": "物理治療常常使用热療來治療疼痛或是肌肉骨骼的问题。下列有关热療的叙述，何者错误？", "answer_idx": "B", "answer": "降低代谢", "options": {"A": "增加血流量", "B": "降低代谢", "C": "减少关节僵直程度", "D": "增加神经传导速度"}}
{"meta_info": "taiwanese_test_Q", "question": "一个40周出生2,000公克的新生儿，在出生后第2小时出现呼吸喘快、有肋骨下凹陷、全身发红但嘴唇为紫红色的现象，体温脉博正常，检测血糖值为30 mg/dL 。接下来应做何种检 最为重要？", "answer_idx": "B", "answer": "血球血比容（Hematocrit）", "options": {"A": "C反应蛋白（CRP）", "B": "血球血比容（Hematocrit）", "C": "心脏超音波（Heart ultrasound）", "D": "血液钠离子浓度（Serum sodium concentration）"}}
{"meta_info": "taiwanese_test_Q", "question": "如图所示之皮疹发生于头皮、躯干、手肘及膝盖处，下列叙述何者正确？", "answer_idx": "B", "answer": "311 nm 窄波紫外线 B 光是有效的治療方法", "options": {"A": "是一种霉菌感染", "B": "311 nm 窄波紫外线 B 光是有效的治療方法", "C": "无同形现象（isomorphic phenomenon）", "D": "口服類固醇是最佳处置"}}
{"meta_info": "taiwanese_test_Q", "question": "37岁孕妇，G1P0，妊娠39周，生产后如图所示：", "answer_idx": "D", "answer": "fourth-degree laceration", "options": {"A": "first-degree laceration", "B": "second-degree laceration", "C": "third-degree laceration", "D": "fourth-degree laceration"}}
{"meta_info": "taiwanese_test_Q", "question": "病人双眼颞侧偏盲（bitemporal hemianopia），其病灶位于何处？", "answer_idx": "D", "answer": "视交叉（optic chiasma）", "options": {"A": "视神经（optic nerve）", "B": "眼窝（orbital fossa）", "C": "视神经管（optic canal）", "D": "视交叉（optic chiasma）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关儿童生长与儿童发展的描述，何者最为完整？", "answer_idx": "C", "answer": "儿童的发展涵盖了动作发展、语言发展、认知发展、社会情绪发展及自我照顾发展", "options": {"A": "生长（growth）是指一些技巧的成熟与功能的获得", "B": "发展（development）是指儿童生理性的变化，如身高、体重及头围的变化", "C": "儿童的发展涵盖了动作发展、语言发展、认知发展、社会情绪发展及自我照顾发展", "D": "丹佛发展筛检量表（Denver II）是评估 6 岁以上儿童的发展"}}
{"meta_info": "taiwanese_test_Q", "question": "当抗原侵入血液循环时，B 及 T 细胞免疫反应在何处发生？", "answer_idx": "C", "answer": "脾脏", "options": {"A": "血液", "B": "肝脏", "C": "脾脏", "D": "淋巴结"}}
{"meta_info": "taiwanese_test_Q", "question": "maple syrup urine disease 是因为下列那个胺基酸无法代谢，造成 α-keto acids 在血液裡累积？", "answer_idx": "A", "answer": "leucine", "options": {"A": "leucine", "B": "alanine", "C": "glycine", "D": "histidine"}}
{"meta_info": "taiwanese_test_Q", "question": "股动脉闭塞一段时间后将导致血管舒张之代谢产物生成，其原因为何？", "answer_idx": "B", "answer": "氧供应低于氧需求", "options": {"A": "氧供应高于氧需求", "B": "氧供应低于氧需求", "C": "氧供应与氧需求达到新平衡", "D": "与氧供应对氧需求之比值无关"}}
{"meta_info": "taiwanese_test_Q", "question": "李小姐习惯长时间于电脑前工作，她有双眼近视，右眼约一千五百度，左眼一千九百度，日常生活和近距離工作时配戴一般眼镜。她注意到有些漂浮物在视线周边已有一段时间。一周前，李小姐开始觉得左眼的视野裡漂浮物越來越多，偶尔还伴有闪光。三天前，她的左眼在下鼻侧渐渐变成像窗簾一般遮住她的视线。今天早上，她觉得症狀越來越严重，到医院求诊后住院做进一步的检查和处置。住院当时，她的右眼以一千五百度镜片矫正后的最佳矫正视力为6/12，左眼以一千三百度镜片矫正后的最佳矫正视力为6/12，她的角膜狀态，瞳孔光反射，水晶体及眼压都是正常的。视网膜检查较可能的发现为何？", "answer_idx": "B", "answer": "左眼外上侧视网膜剥離", "options": {"A": "兩眼外上侧视网膜下出血", "B": "左眼外上侧视网膜剥離", "C": "兩眼内下侧之脉络膜肿瘤", "D": "左眼内下侧视网膜静脉血管阻塞"}}
{"meta_info": "taiwanese_test_Q", "question": "一个一岁6 个月的男童，刚出生时，在胸骨左侧上缘可以听到心缩期杂音，慢慢地嘴唇及指端有发绀的现象，发育尚称良好，但在玩耍至某一程度，发绀会更厉害，无法继续玩下去，必须在旁边蹲坐一阵子再回去玩，胸部X 光检查及心电图如图示，则此病童最可能有何种疾病？", "answer_idx": "B", "answer": "一定是有肺动脉血流不足的先天性心脏病", "options": {"A": "大动脉血管转位症，体动脉接受缺氧血所造成的", "B": "一定是有肺动脉血流不足的先天性心脏病", "C": "可能是肺囊狀纤维化（Cystic fibrosis）之疾病", "D": "可能是先天性肺动脉高压症"}}
{"meta_info": "taiwanese_test_Q", "question": "一位6 岁的女生，罹患弥漫增生型狼疮性肾炎（diffuse proliferative lupus nephritis），已接受每天30 mg 口服prednisolone 2 个月，最近学校通知要施打疫苗（vaccination），下列何者易发生严重副作用，不宜施打？", "answer_idx": "C", "answer": "Measles, mumps 及 rubella vaccine", "options": {"A": "Haemophilus influenza type b conjugate vaccine", "B": "Influenza vaccine", "C": "Measles, mumps 及 rubella vaccine", "D": "Tetanus 及 diphtheria toxoid vaccine"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 61 岁男性主诉倦怠，四个月以來逐渐严重。病人血清肌酸酐及尿素氮明显增加，尿液试纸检验，无血尿、尿蛋白或尿糖情形，但本斯琼司氏蛋白（Bence Jones proteins）测试阳性。肾切片检查如下图所示。病人之基本病因为何？", "answer_idx": "B", "answer": "多发性骨髓瘤（Multiple myeloma）", "options": {"A": "风湿热（Rheumatic fever）", "B": "多发性骨髓瘤（Multiple myeloma）", "C": "僵直性脊椎炎（Ankylosing spondylitis）", "D": "系统性硬化症（Systemic sclerosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "舌癌最容易发生在那一部位？", "answer_idx": "C", "answer": "舌头侧边", "options": {"A": "舌头前端", "B": "舌根部", "C": "舌头侧边", "D": "舌头中间部位"}}
{"meta_info": "taiwanese_test_Q", "question": "一位2 岁大的男童，自出生6 个月后反覆有中耳炎、细菌性鼻窦炎及肺炎，虽然施打卡介苗，直至目前并无任何关于卡介苗的并发症，除了一般常规的CBC/DC 检查之外，你认为下列何种检测最能查出病因？", "answer_idx": "B", "answer": "Immunoglobulins level（IgG, A, M, E）& lymphocyte subsets", "options": {"A": "Lymphocyte proliferation test including antigens and mitogens stimulation", "B": "Immunoglobulins level（IgG, A, M, E）& lymphocyte subsets", "C": "PMN function tests, including chemotaxis, nitroblue tetrazolium test, CD11/CD18 expression及phagocytosis", "D": "HIV 1+2 Ab"}}
{"meta_info": "taiwanese_test_Q", "question": "16.一35岁过去无特殊病史之已婚女性，因两天的发烧、频尿、左腰痛求诊。急诊所做血液培养：Staphylococcus epidermidis （只在一瓶需氧血液培养瓶长出；另一瓶厌氧瓶及另一 血液培养，则无细菌生长）; 尿液常规有脓尿症，尿液培养：\n", "answer_idx": "C", "answer": "依尿液培养报告选择抗生素，治疗E. coli泌尿道感染", "options": {"A": "安排心脏超音波，寻找感染性心内膜炎之证据", "B": "依血液培养报告选择抗生素，积极治疗S. epidermidis菌血症", "C": "依尿液培养报告选择抗生素，治疗E. coli泌尿道感染", "D": "依血液与尿液培养报告选择抗生素，同时治疗S. epidermidis菌血症与E. coli泌尿道感染"}}
{"meta_info": "taiwanese_test_Q", "question": "49 一位 39 岁男性，因为持续 3 周的血痰与呼吸喘促到院求治。胸部 X 光与胸部电脑断层显示兩侧多发性实质化与毛玻璃样浸润。尿液检查有许多红血球。理学检查发现后鼻腔有黏膜增厚，疑似肿块。下列那种检验对于确立诊断效益最低？\n", "answer_idx": "C", "answer": "anti-cardiolipin antibody", "options": {"A": "cytoplasmic antineutrophil cytoplasmic antibody（c-ANCA）", "B": "anti-glomerular basement membrane（GBM）antibody", "C": "anti-cardiolipin antibody", "D": "鼻腔肿块活体切片"}}
{"meta_info": "taiwanese_test_Q", "question": "46岁生过四胎之妇女，于第四胎生产时接受输卵管结扎手术。现因不正常阴道出血而就医，经阴道诊视发现子宫颈表面平滑，血液自子宫颈口处流出，触诊发现子宫大小正常无触痛之情形。经阴道超音波扫瞄子宫大小正常无内膜增生之情形，然而于子宫附属物区发现有香肠般水囊状物，最长部位为9.5公分而最宽部位为3.9公分，此水囊状物最适合之诊断为：", "answer_idx": "D", "answer": "输卵管水肿（hydrosalpinx）", "options": {"A": "尿道憩室（urethral diverticulum）", "B": "盲肠炎（appendicitis）", "C": "输尿管水肿（hydroureter）", "D": "输卵管水肿（hydrosalpinx）"}}
{"meta_info": "taiwanese_test_Q", "question": "40岁女性，患蜘蛛膜下腔出血（subarachnoid hemorrhage），检查发现囊状动脉瘤出血，下列叙述何者正确？", "answer_idx": "D", "answer": "若该血管瘤为剥离性动脉瘤（dissecting aneurysm）而非囊状动脉瘤，它的临床表现通常是大脑梗塞（cerebral infarct）而非出血", "options": {"A": "该血管瘤在病人出生时即已存在", "B": "主要的缺损是血管的内膜（intima）", "C": "病人的一等亲患此病的机率与一般人相同", "D": "若该血管瘤为剥离性动脉瘤（dissecting aneurysm）而非囊状动脉瘤，它的临床表现通常是大脑梗塞（cerebral infarct）而非出血"}}
{"meta_info": "taiwanese_test_Q", "question": "一名 13 岁 9 个月男童因为身材矮小而就诊，他出生时体重 3 公斤。他的父亲身高 162 公分，第二性征发育始于 14 岁；母亲身高 152 公分，初经年龄为 13 岁。此孩童身体检查显示身高 137 公分（低于第三百分位），体重 32 公斤（第十百分位），左右睪丸均为 2 毫升，无阴毛发育，其他器官亦未发现異常。下列那一项检查就此个案言最不适切？", "answer_idx": "B", "answer": "单次空腹抽血测生长激素（growth hormone）值", "options": {"A": "骨龄（bone age）X 光检查", "B": "单次空腹抽血测生长激素（growth hormone）值", "C": "单次空腹抽血测第一型似胰岛素生长因子（insulin-like growth factor）值", "D": "脑部影像医学检查（image study）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者引起血小板增加的可能性最小？", "answer_idx": "B", "answer": "肝硬化", "options": {"A": "慢性骨髓性白血病", "B": "肝硬化", "C": "脾脏切除", "D": "缺铁性贫血"}}
{"meta_info": "taiwanese_test_Q", "question": "阻塞性肥厚型心肌病症患者之听诊，所听到的收缩期心杂音，可因下列何项操作而减轻甚至消失？", "answer_idx": "A", "answer": "蹲踞", "options": {"A": "蹲踞", "B": "站立", "C": "使用毛地黄", "D": "含舌下硝化甘油含片"}}
{"meta_info": "taiwanese_test_Q", "question": "关于腕隧道症候群（carpal tunnel syndrome），下列何者错误？", "answer_idx": "A", "answer": "在小指（第五指）有麻痹感", "options": {"A": "在小指（第五指）有麻痹感", "B": "在晚上（或不工作）时，大拇指和第二、第三指有痛感", "C": "严重时手部的肌肉萎缩", "D": "患者中女性较男性为多"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是造成新生儿先天性感染之重要病原体？", "answer_idx": "D", "answer": "麻疹病毒", "options": {"A": "巨细胞病毒", "B": "梅毒螺旋体", "C": "弓虫症", "D": "麻疹病毒"}}
{"meta_info": "taiwanese_test_Q", "question": "cyclosporine-A（CsA）是异体造血干细胞移植（allogeneic hematopoietic stem cell tr​​ansplantation）用来预防移植物反宿主疾病（graft-versus-host disease）的重要免疫抑制剂，下列何者不是CsA常见的副作用？", "answer_idx": "C", "answer": "hyperglycemia", "options": {"A": "hypertension", "B": "hyperlipidemia", "C": "hyperglycemia", "D": "nephrotoxicity"}}
{"meta_info": "taiwanese_test_Q", "question": "一位长期喝酒之40 岁男性患者因急性胰脏炎住院治療，不料第二天开始出现颤抖、流汗、血压增高、心跳变快、焦虑不安、烦躁失眠、有视幻觉及被害妄想，之后并出现癫痫发作及意識混亂，亂拔点滴，下列叙述何者正确？", "answer_idx": "B", "answer": "应给予大剂量苯二氮平類（benzodiazepines）的抗焦虑剂，但不需给予抗癫痫药", "options": {"A": "应立即予以肢体约束，并注射镇静效果强的传统抗精神病药物", "B": "应给予大剂量苯二氮平類（benzodiazepines）的抗焦虑剂，但不需给予抗癫痫药", "C": "胰脏炎与酒精性谵妄（alcohol withdrawal delirium）的产生没有关聯", "D": "正子断层造影（positron emission tomography）可能显示左顶葉及右额葉代谢明显增加"}}
{"meta_info": "taiwanese_test_Q", "question": "风湿性心脏病（rheumatic heart disease）最常侵犯：", "answer_idx": "B", "answer": "二尖瓣膜（mitral valve）", "options": {"A": "主动脉瓣膜（aortic valve）", "B": "二尖瓣膜（mitral valve）", "C": "肺动脉瓣膜（pulmonary valve）", "D": "三尖瓣膜（tricuspid valve）"}}
{"meta_info": "taiwanese_test_Q", "question": "林先生主诉看东西影像会晃动，经检查为双侧对称性水晶体上颞侧脱位（supero-temporal subluxation），会建议他作何种遗传性疾病检查？", "answer_idx": "C", "answer": "马凡氏症候群（Marfan syndrome）", "options": {"A": "半乳糖血症（galactosemia）", "B": "威尔逊氏病（Wilson's disease）", "C": "马凡氏症候群（Marfan syndrome）", "D": "爱伯氏症候群（Alport syndrome）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是 cAMP 媒介之药理作用？", "answer_idx": "B", "answer": "norepinephrine 促进血管收缩", "options": {"A": "vasopressin 促进肾脏对水分之再吸收", "B": "norepinephrine 促进血管收缩", "C": "epinephrine 促进肝糖分解", "D": "epinephrine 促进脂肪细胞分解三酸甘油酯"}}
{"meta_info": "taiwanese_test_Q", "question": "对于细菌荚膜（capsule）之叙述，下列何者正确？", "answer_idx": "D", "answer": "能帮助细菌抵抗吞噬作⽤（phagocytosis）", "options": {"A": "主要成分为胜肽聚糖（peptidoglycan）", "B": "所有细菌皆有多糖类荚膜", "C": "导致⾰兰⽒染⾊（Gram stain）反应的主要原因", "D": "能帮助细菌抵抗吞噬作⽤（phagocytosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "FAP（Familial adenomatous polyposis）病人之形成大肠直肠癌与下列何者有关？", "answer_idx": "A", "answer": "Tumor suppressor gene mutation", "options": {"A": "Tumor suppressor gene mutation", "B": "DNA mismatch repair gene mutations", "C": "myc oncogene", "D": "erb B2 oncogene"}}
{"meta_info": "taiwanese_test_Q", "question": "38 在有慢性溶血疾病的病人，下列何种病毒感染会导致暂时性的再生不良性贫血（transient aplastic crisis）？\n", "answer_idx": "B", "answer": "Parvovirus B19", "options": {"A": "human immunodeficiency virus（HIV）", "B": "Parvovirus B19", "C": "Coxsackievirus", "D": "Enterovirus 39 下列何种药物会使 Lambert-Eaton 肌无力症候群症狀惡化？"}}
{"meta_info": "taiwanese_test_Q", "question": "79 大维因車祸昏迷不醒至今已三年多，其同卵双胞胎弟弟国明因上星期发生猛爆性肝炎而危在旦夕。虽然大维的肝功能正常且与国明有相同基因，但医师并没有提出要摘取大维肝脏來救国明的建议。在倫理上，下列各项中何者是医师不提这项建议最为重要的理由？\n", "answer_idx": "D", "answer": "大维无法同意捐赠肝脏给国明", "options": {"A": "国明并未同意接受大维的捐赠", "B": "为免大维的父母陷入兩难选择", "C": "成功机率过低而不应贸然提出", "D": "大维无法同意捐赠肝脏给国明"}}
{"meta_info": "taiwanese_test_Q", "question": "食用未熟之海水鱼類，会感染下列何种寄生虫？", "answer_idx": "A", "answer": "海兽胃线虫（Anisakis simplex）", "options": {"A": "海兽胃线虫（Anisakis simplex）", "B": "美洲钩虫（Necator americanus）", "C": "广东住血线虫（Angiostrongylus cantonensis）", "D": "中华肝吸虫（Clonorchis sinensis）"}}
{"meta_info": "taiwanese_test_Q", "question": "下运动神经元（lower motor neurons）的损伤会导致下列那一种疾病？", "answer_idx": "C", "answer": "amyotrophic lateral sclerosis", "options": {"A": "Parkinson's disease", "B": "Huntington's disease", "C": "amyotrophic lateral sclerosis", "D": "myasthenia gravis"}}
{"meta_info": "taiwanese_test_Q", "question": "踝关节受伤机转以下列何者最多？", "answer_idx": "D", "answer": "旋后外转（Supination-External rotation）", "options": {"A": "旋前外转（Pronation-External rotation）", "B": "旋前外展（Pronation-Abduction）", "C": "旋后内收（Supination-Adduction）", "D": "旋后外转（Supination-External rotation）"}}
{"meta_info": "taiwanese_test_Q", "question": "针对卫生教育计画本身执行过程给予评核，如教学活动安排时间是否合适、教学者能否熟用教学法、学习者是否全程参与教学活动等，是属于下列那一种卫生教育的评价？", "answer_idx": "B", "answer": "过程评价", "options": {"A": "结果评价", "B": "过程评价", "C": "冲击评价", "D": "成效评价"}}
{"meta_info": "taiwanese_test_Q", "question": "所谓「健康工人效应（healthy worker effect）」是指会造成何种偏差（bias）？", "answer_idx": "A", "answer": "选样上偏差（selection bias）", "options": {"A": "选样上偏差（selection bias）", "B": "资料上偏差（information bias）", "C": "干扰（confounding）", "D": "测量上偏差（measurement error）"}}
{"meta_info": "taiwanese_test_Q", "question": "瘦素（leptin）会抑制食欲，使得体重得以维持恒定，是因为其促进下列何种传导物质，进而抑制进食中枢所致？", "answer_idx": "A", "answer": "α-melanocyte stimulating hormone（α-MSH）", "options": {"A": "α-melanocyte stimulating hormone（α-MSH）", "B": "neuropeptide Y（NPY）", "C": "orexin", "D": "agouti-related peptide（AgRP）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是不可改善的心脏疾病危险因子？", "answer_idx": "B", "answer": "家族史", "options": {"A": "高血压", "B": "家族史", "C": "吸烟", "D": "静态（sedentary）生活"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者非 schizophrenia 病人到急诊的常見原因？", "answer_idx": "D", "answer": "失眠", "options": {"A": "药物未按时服用", "B": "服药产生之副作用", "C": "自殺行为", "D": "失眠"}}
{"meta_info": "taiwanese_test_Q", "question": "16 岁男孩，主诉鼻塞、浓稠鼻涕已经超过一年。根据此张 plain CT 片，最可能的诊断是：", "answer_idx": "B", "answer": "Chronic paranasal sinusitis", "options": {"A": "Chronic rhinitis", "B": "Chronic paranasal sinusitis", "C": "Fungal infection in the paranasal sinuses", "D": "Tumors in the paranasal sinuses"}}
{"meta_info": "taiwanese_test_Q", "question": "关于转化症（conversion disorder〔functional neurological symptom disorder〕）的叙述，何者错误？", "answer_idx": "D", "answer": "最佳的治疗方式为告知患者其症状是想像出来的", "options": {"A": "常见于戏剧型人格（histrionic personality disorder）", "B": "瘫痪（paralysis）、视盲（blindness）、不语（mutism）是最常见的症状", "C": "在男性患者中，与反社会型人格障碍症（antisocial personality disorder）相关", "D": "最佳的治疗方式为告知患者其症状是想像出来的"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是蕈毒碱受体阻断剂（muscarinic receptor-blocking drugs）之临床用途？", "answer_idx": "A", "answer": "青光眼（glaucoma）", "options": {"A": "青光眼（glaucoma）", "B": "动晕症（motion sickness）", "C": "支气管扩张（bronchodilation）", "D": "帕金森氏症（Parkinson's disease）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关发绀（cyanosis）之叙述，下列何者错误？", "answer_idx": "C", "answer": "血红素蛋白（hemoglobin）異常或病变会造成贫血，但不会引起 central cyanosis", "options": {"A": "周边血管收缩是造成 peripheral cyanosis 最常見的原因", "B": "动脉血氧浓度过低，是造成 central cyanosis 的原因", "C": "血红素蛋白（hemoglobin）異常或病变会造成贫血，但不会引起 central cyanosis", "D": "central cyanosis 有时会造成杵狀指（clubbing fingers）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是人工膝关节置换手术后復健计画的重点？", "answer_idx": "D", "answer": "卧床休息以预防人工关节过早磨损", "options": {"A": "减少疼痛", "B": "恢復关节活动度", "C": "恢復及增加肌力", "D": "卧床休息以预防人工关节过早磨损"}}
{"meta_info": "taiwanese_test_Q", "question": "李女士在健康检查时血液中的 antinuclear antibody（ANA）价數达到 1：8（titer 1：8），她没有身体不适，也没有其他的检验值異常。出现 ANA 自体抗体的意义为何？", "answer_idx": "D", "answer": "某种低程度的自体免疫性是身体正常免疫功能运作的一部分", "options": {"A": "应是检验错误，需重新抽血再测一次", "B": "李女士已得到红斑性狼疮", "C": "李女士即将于近期发病，得到红斑性狼疮", "D": "某种低程度的自体免疫性是身体正常免疫功能运作的一部分"}}
{"meta_info": "taiwanese_test_Q", "question": "评估支气管哮喘病患急性发作时，下列何种理学检查结果不能作为哮喘严重度指标？", "answer_idx": "B", "answer": "使用噘嘴呼吸（pursed-lip breathing）", "options": {"A": "使用辅助肌吸气（accessory muscle）", "B": "使用噘嘴呼吸（pursed-lip breathing）", "C": "胸腔过度充气（hyperinflation）", "D": "有奇异脉（paradoxical pulse）"}}
{"meta_info": "taiwanese_test_Q", "question": "在⼼脏无异常的病⼈置放flow-directed pulmonary artery catheter录肺动脉楔压（wedge pressure）时，其肺动脉楔压最接近下列何种⾎压？", "answer_idx": "C", "answer": "left ventricular end-diastolic pressure", "options": {"A": "aortic diastolic pressure", "B": "central venous pressure", "C": "left ventricular end-diastolic pressure", "D": "pulmonary artery systolic pressure"}}
{"meta_info": "taiwanese_test_Q", "question": "有关嗜铬细胞瘤（Pheochromocytoma）的治療，下列那一项叙述正确？", "answer_idx": "C", "answer": "病人虽然血压高低不定，仍应给予 alpha adrenergic blocker", "options": {"A": "病人已有高血压，应避免给予输液", "B": "需首先给予 beta adrenergic blocker，以改善流汗头痛等症狀", "C": "病人虽然血压高低不定，仍应给予 alpha adrenergic blocker", "D": "绝对禁用 calcium-channel blocker 以避免血压变化太大"}}
{"meta_info": "taiwanese_test_Q", "question": "有关中耳（middle ear）的叙述，下列何者正确？", "answer_idx": "C", "answer": "中耳腔又称鼓室（tympanic cavity）", "options": {"A": "听管（auditory or Eustachian tube）平时是开的，仅在吞咽或喊叫才关闭", "B": "三块听骨为透明软骨", "C": "中耳腔又称鼓室（tympanic cavity）", "D": "听小骨间藉由韧带聯合而形成关节"}}
{"meta_info": "taiwanese_test_Q", "question": "目前治疗晚期（advanced）上皮性卵巢癌化学疗法的第一线药物为何？", "answer_idx": "B", "answer": "carboplatin＋paclitaxel", "options": {"A": "cisplatin＋5FU", "B": "carboplatin＋paclitaxel", "C": "cisplatin＋cyclophosphamide", "D": "carboplatin＋cyclophosphamide"}}
{"meta_info": "taiwanese_test_Q", "question": "小脑天幕（cerebellar tentorium）不附着于：", "answer_idx": "D", "answer": "颧骨（zygomatic bone）", "options": {"A": "蝶骨（sphenoid bone）", "B": "枕骨（occipital bone）", "C": "颞骨（temporal bone）", "D": "颧骨（zygomatic bone）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种病原体通常引起非典型肺炎（atypical pneumonia）？", "answer_idx": "C", "answer": "Mycoplasma pneumoniae", "options": {"A": "Streptococcus pneumoniae", "B": "Mycobacterium avium-intracellulare", "C": "Mycoplasma pneumoniae", "D": "Nocardia"}}
{"meta_info": "taiwanese_test_Q", "question": "⼀研究想比较抽烟者与非抽烟者的⾎胆固醇浓度，下列叙述何者错误？", "answer_idx": "D", "answer": "型⼀错误加型⼆错误的机率和为1", "options": {"A": "检定时犯下型⼀错误（type I error）的机率，即为研究者设定的显著⽔准", "B": "若显著⽔准不变，欲增加统计检定⼒，可以增加样本数", "C": "型⼀错误是抽烟者与非抽烟者的⾎胆固醇浓度没差异，但检定时却误判有差异的情形", "D": "型⼀错误加型⼆错误的机率和为1"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关矽肺症（silicosis）的叙述，何者错误？", "answer_idx": "C", "answer": "患者感染结核病的机率与一般人相近", "options": {"A": "盛行率最高的尘肺症", "B": "即使患者停止接触二氧化矽疾病仍可以持续进展", "C": "患者感染结核病的机率与一般人相近", "D": "疾病晚期可见进展性大量纤维化（progressive massive fibrosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "在产前染⾊体检查分析的20个⽺⽔细胞中，发现5个细胞有46条正常染⾊体，15个细胞多了⼀条第21号染⾊体。下列何者为最可能的诊断？", "answer_idx": "D", "answer": "异常细胞镶嵌（mosaicism）型唐⽒症候群（Down syndrome）", "options": {"A": "无分离（nondisjunction）型唐⽒症候群（Down syndrome）", "B": "无分离（nondisjunction）型爱德华⽒症候群（Edwards syndrome）", "C": "转位（translocation）型爱德华⽒症候群（Edwards syndrome）", "D": "异常细胞镶嵌（mosaicism）型唐⽒症候群（Down syndrome）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那些麻醉相关监视器对静脉空气栓塞（venous air embolism）侦测之敏感度（sensitivity），由高至低排列顺序为何？", "answer_idx": "D", "answer": "④②①③", "options": {"A": "①②③④", "B": "②①③④", "C": "②③①④", "D": "④②①③"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种降血压药物最适合用于妊娠性高血压的病人？", "answer_idx": "B", "answer": "α-Methyldopa", "options": {"A": "Clonidine", "B": "α-Methyldopa", "C": "Captopril", "D": "Propranolol"}}
{"meta_info": "taiwanese_test_Q", "question": "目前在医疗上常使用肉毒杆菌毒素（botulinum toxin）注射来治疗肌肉痉挛，主要作用的机转为下列何者？", "answer_idx": "C", "answer": "让乙醯胆碱无法由终板（end plate）释出，阻断神经肌肉交接处的功能", "options": {"A": "让肌肉细胞膜钙离子阻断作用，导致肌肉无法收缩", "B": "破坏乙醯胆碱接受器（acetylcholine receptor）", "C": "让乙醯胆碱无法由终板（end plate）释出，阻断神经肌肉交接处的功能", "D": "使神经轴细胞质（axon plasma）流动停止，造成神经传导异常"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关HDV的描述，何者错误？", "answer_idx": "D", "answer": "interferon（或pegylated interferon）是目前唯一被证实有效治疗HDV的药物，根治率极高（＞80%）且不容易复发", "options": {"A": "HDV可以与HBV急性共同感染（coinfection），或是重覆感染（superinfection）于HBV带原者", "B": "重覆感染HDV，对原本慢性HBV带原者有不好的影响，可能促使肝脏疾病快速恶化或造成猛爆性肝衰竭", "C": "HDV与HBV急性共同感染之后演变成慢性D型肝炎的机会较低", "D": "interferon（或pegylated interferon）是目前唯一被证实有效治疗HDV的药物，根治率极高（＞80%）且不容易复发"}}
{"meta_info": "taiwanese_test_Q", "question": "成年人的踝关节急性创伤，可以根据 Ottawa ankle rules 来判断是否需要接受 X 光检查。下列何者不是 Ottawa ankle rules 的判断准则？", "answer_idx": "D", "answer": "受伤后足踝背屈活动受限（limited dorsiflexion of ankle）", "options": {"A": "受伤后内踝有压痛（tenderness at tip of medial malleolus）", "B": "受伤后外踝有压痛（tenderness at tip of lateral malleolus）", "C": "受伤后无法负重（inability to bear weight）", "D": "受伤后足踝背屈活动受限（limited dorsiflexion of ankle）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于预防院内泌尿道感染之原则，何者错误？", "answer_idx": "A", "answer": "尿液中本来就有细菌，因此放置留置型导尿管不须采取无菌技术", "options": {"A": "尿液中本来就有细菌，因此放置留置型导尿管不须采取无菌技术", "B": "放置留置型导尿管须采取无菌技术，以预防泌尿道感染", "C": "不应该为了照顾者之方便而放置留置型导尿管", "D": "留置型导尿管不需要时应尽早拔除"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，如果病患是原发性副甲狀腺高能症（Primary Hyperparathyroidism），则那一项描述最正确？", "answer_idx": "D", "answer": "手术切除副甲狀腺病灶", "options": {"A": "肝脏肿瘤绝不是惡性的", "B": "異位性副甲狀腺腺瘤，颈部超音波 100%可以侦测", "C": "T1-201-Tc99m subtraction scan 定位优于 Tc99m sestamibi scan", "D": "手术切除副甲狀腺病灶"}}
{"meta_info": "taiwanese_test_Q", "question": "活体肝移植捐赠者于部分肝切除后剩下的肝脏变化，下列叙述何者正确？", "answer_idx": "C", "answer": "肝细胞与库弗氏细胞（Kupffer's cells）及内皮细胞同步复制", "options": {"A": "被切除的肝叶重新长出", "B": "剩下的肝脏至少需半年以上才能长大一倍", "C": "肝细胞与库弗氏细胞（Kupffer's cells）及内皮细胞同步复制", "D": "肝脏切除后的代偿性生长主要是由于肝内干细胞（intrahepatic stem cells）之生长 77 下列有关细胞凋亡（apoptosis）的叙述，何者正确？"}}
{"meta_info": "taiwanese_test_Q", "question": "关于儿童肠 叠（intussusception）的叙述，下列何者错误？", "answer_idx": "B", "answer": "大多数病人都需要手术治疗", "options": {"A": "好发的年龄为三个月到两岁", "B": "大多数病人都需要手术治疗", "C": "好发部位在回肠盲肠部（ileocecal region）", "D": "若诊断时已有腹膜炎的现象，则以手术治疗较为恰当"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 danazol 的药理学作用描述，何者错误？", "answer_idx": "C", "answer": "具有抑制芳香环转化酶（aromatase）的活性，进而抑制雌激素的合成", "options": {"A": "一种经人工合成的睪固酮（testerone）", "B": "主要用于子宫内膜异位症（endometriosis）及良性乳房纤维囊肿（fibrocystic breast", "C": "具有抑制芳香环转化酶（aromatase）的活性，进而抑制雌激素的合成", "D": "具有肝毒性"}}
{"meta_info": "taiwanese_test_Q", "question": "手肘弯曲时，尺骨头（head of ulna）与下列何者接触？", "answer_idx": "A", "answer": "尺骨切迹（ulnar notch）", "options": {"A": "尺骨切迹（ulnar notch）", "B": "冠狀窝（coronoid fossa）", "C": "桡骨窝（radial fossa）", "D": "鹰嘴窝（olecranon fossa）"}}
{"meta_info": "taiwanese_test_Q", "question": "下图为一位 41 岁女性腰椎之磁振造影矢狀面 T1 及 T2 影像。第四及第五腰椎体内中央部分有横向之高讯号变化。请问此高讯号的骨髓变化为何？", "answer_idx": "D", "answer": "fatty replacement of central aspect of vertebral bodies", "options": {"A": "infectious spondylitis", "B": "transverse fracture of vertebral bodies", "C": "metastases", "D": "fatty replacement of central aspect of vertebral bodies"}}
{"meta_info": "taiwanese_test_Q", "question": "75 岁男性病人腹痛兩天至急诊，体温38.5℃、血压80/60 mmHg、脉搏120/min，理学检查发现上腹压痛及僵硬有反弹痛（rebound pain）怀疑有消化性溃疡并穿孔，此时最适宜之X 光检查为：", "answer_idx": "A", "answer": "胸部 X 光（chest X-ray）", "options": {"A": "胸部 X 光（chest X-ray）", "B": "KUB X-ray", "C": "上消化道 X 光（upper G-I series）", "D": "腹部电脑断层（abdominal CT scan）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关胱胺酸结石（cystine stone）的叙述，何者错误？", "answer_idx": "B", "answer": "尿中的镁離子是胱胺酸结石的 inhibitor", "options": {"A": "典型的 cystinuria 是 autosomal recessive 遗传", "B": "尿中的镁離子是胱胺酸结石的 inhibitor", "C": "内科療法包括每天喝水超过 3 公升，和尿液的碱性化", "D": "penicillamine 可以降低尿中胱胺酸的 level"}}
{"meta_info": "taiwanese_test_Q", "question": "许多蛋白质须与金属離子结合后才能展现正确的功能，下列何种胺基酸的侧链具备与金属離子直接结合的能力？", "answer_idx": "A", "answer": "半胱胺酸（cysteine）", "options": {"A": "半胱胺酸（cysteine）", "B": "丙胺酸（alanine）", "C": "苯丙胺酸（phenylalanine）", "D": "脯胺酸（proline） 27 维生素 lipoic acid 及 biotin 是与酶分子中那个胺基酸结合？"}}
{"meta_info": "taiwanese_test_Q", "question": "21.67岁男性本身有糖尿病，目前以口服降血糖药物控制，前一天晚上11点左右喝了2瓶啤酒后，忽然发生心悸，一直到今日上午5℃，心跳每分钟140次，血压150/80毫米汞柱，呼吸每分钟24次。心电图如下。下列处置何者最恰当？", "answer_idx": "C", "answer": "给予amiodarone静脉注射治疗", "options": {"A": "给予coumadin口服", "B": "立即胸前电击100J", "C": "给予amiodarone静脉注射治疗", "D": "给予heparin静脉注射治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "当巴金森氏病病人在晚期开始出现运动阻滞（motor block）时，进行下列何种运动比较不受影响？", "answer_idx": "A", "answer": "上楼梯", "options": {"A": "上楼梯", "B": "在狭窄的走廊步行", "C": "过马路", "D": "进出电梯门"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是造成产妇出血（obstetrical hemorrhage）致死的常見原因？", "answer_idx": "D", "answer": "子痫症（eclampsia）", "options": {"A": "胎盘早期剥離（abruption of placenta）和前置胎盘（placenta praevia）", "B": "植入性胎盘（placenta accreta/increta）和胎盘存留", "C": "子宫破裂和子宫无力（uterine atony）", "D": "子痫症（eclampsia）"}}
{"meta_info": "taiwanese_test_Q", "question": "43.一位35岁女性因为月经流量太大应诊，抽血检查发现血红素为11.2 gm/dL，白血球7550/µL，血小板196500/µL，前凝血酵素时间（PT）INR 1.0，活化之部分凝血激素时间\n （aPTT）56秒（control:28\"-35\"），下列何种检查对此病人的诊断不是必要的？\n", "answer_idx": "C", "answer": "factor XIII activity", "options": {"A": "factor VIII activity", "B": "factor IX activity", "C": "factor XIII activity", "D": "von Willebrand factor activity"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关阴道滴虫及其病症的叙述，何者正确？", "answer_idx": "C", "answer": "人是其唯一的宿主", "options": {"A": "患者之白带呈白色乳酪狀", "B": "夫妻中男性通常没有症狀，只需治療出现症狀的妻子即可", "C": "人是其唯一的宿主", "D": "感染型（infective form）为囊体"}}
{"meta_info": "taiwanese_test_Q", "question": "34 某位39 岁孕妇，G6P2A3，妊娠35 周，产科史前二次妊娠皆因骨盆狭窄行剖腹产，此次妊娠采人工受孕，主诉突然阴道大出血，然而并无下腹痛或其他疼痛，急诊送院后行紧急剖腹产。胎儿娩出后 ，胎盘无法完全剥離，子宫收缩疲软出血不止，不得已行子宫全切除术。则上述病例最可能的诊断是：\n", "answer_idx": "C", "answer": "植入性胎盘", "options": {"A": "胎盘早期剥離", "B": "双角子宫", "C": "植入性胎盘", "D": "双葉胎盘"}}
{"meta_info": "taiwanese_test_Q", "question": "33 28 岁女性最近半年來脸颊部有红斑（如附图）及手指、手腕和肩膀有偶发性疼痛。曾经被医师怀疑为红斑性狼疮。请问下列那些检查对疾病的诊断最有帮助？  skin biopsy  anti-nuclear antibodies serum complements C3 and C4 level rheumatoid factors complete\n blood routine  anti-dsDNA antibodies  anti-SS-A/anti-SS-B\n", "answer_idx": "C", "answer": "", "options": {"A": " - -", "B": "", "C": "", "D": ""}}
{"meta_info": "taiwanese_test_Q", "question": "陈小妹是一位国中2 年级学生，7 天前，左手突然发生不自主的亂动，她无法拿碗吃饭，尤其是双手平举时，整只手臂一直舞动不停无法控制，但是左手力量不减，感觉也无異常，理学及神经学检查无其他異常。另外她的心脏超音波也显示瓣膜不正常，红血球沉降速率（ESR）也升高。最有可能的臨床臆断是：", "answer_idx": "B", "answer": "辛登南氏舞蹈症（Sydenham's chorea）", "options": {"A": "亨丁顿氏舞蹈症（Huntington's chorea）", "B": "辛登南氏舞蹈症（Sydenham's chorea）", "C": "高甲狀腺性舞蹈症", "D": "中风性半边舞蹈症"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种副作用与长期使用抗心律不整药物 amiodarone 最无关？", "answer_idx": "C", "answer": "Depression", "options": {"A": "Hyperthyroidism", "B": "Pulmonary fibrosis", "C": "Depression", "D": "Photosensitivity"}}
{"meta_info": "taiwanese_test_Q", "question": "64.一位55岁男性这两天意识变化被送至急诊处。病人一个月前诊断为肺癌，但他拒绝任何进一步治疗。家人叙述病人这个月情绪低落，但进食情况尚可，无呕吐或发烧。身体检查：体温36.8℃，血压130/78 mmHg，脉搏每分80次，呼吸每分19次。病人对时空有错乱情形，以及嗜睡；其他神经学检查无异常；右上锁骨窝有一拇指大的淋巴结，下肢无水肿。初步检查血比容 mg/dL，ALT 30 U/L，血糖156 mg/dL。血清电解质，Na+ 122，K+ 5.5，Cl- 86（电解质单位mmol/L）。有关此病人的可能诊断，下列那一个最适当？", "answer_idx": "D", "answer": "肺癌并发抗利尿激素分泌不当", "options": {"A": "肺癌并发阻塞性肺炎", "B": "肺癌并发脑部转移", "C": "肺癌并发厌食", "D": "肺癌并发抗利尿激素分泌不当"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是真核细胞组蛋⽩去⼄醯酶（histone deacetylase）之主要功能？", "answer_idx": "A", "answer": "调节基因之转录", "options": {"A": "调节基因之转录", "B": "增加组蛋⽩之浓度", "C": "减少mRNA转译之作⽤", "D": "增加真核起始因⼦2（eIF2）蛋⽩质之稳定性"}}
{"meta_info": "taiwanese_test_Q", "question": "一个正在接受手术后放射线治疗的病人，发生呕吐、食欲不佳、腹泻及轻微腹痛之症状。下列何者为最有可能之诊断？", "answer_idx": "B", "answer": "放射线后肠炎（radiation enteritis）", "options": {"A": "放射线后膀胱炎（radiation cystitis）", "B": "放射线后肠炎（radiation enteritis）", "C": "放射线后直肠炎（radiation proctitis）", "D": "肠道阴道瘘管（enterovaginal fistula）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于小孩子外伤，下列叙述何者错误？", "answer_idx": "C", "answer": "小孩子急救时之优先顺序与成人不相同", "options": {"A": "小孩子胸部外伤虽未見肋骨骨折，但已有肺部挫伤现象", "B": "小孩子较常見脊椎没有骨折但有脊髓受伤（spinal cord injury without radiologic abnormality）之现象", "C": "小孩子急救时之优先顺序与成人不相同", "D": "小孩子因皮下脂肪（subcutaneous tissue）较少，急救时易导致低体温（hypothermia）"}}
{"meta_info": "taiwanese_test_Q", "question": "28 王女士 38 岁，接受机械性僧帽瓣置换手术后，术后使用 warfarin sodium，则下列何者正确？ ①若王女士须服用thyroxine，应定期监测prothrombin time，适当减少warfarin 的剂量②若王女士须服用当归、银杏等中药，应定期监测aPTT，适当减少warfarin 的剂量③若王女士须服用口服避孕药，应定期监测prothrombin time，适当增加warfarin 的剂量④若王女士嗜食菠菜，应定期监测aPTT，适当增加warfarin 的剂量", "answer_idx": "B", "answer": "①③", "options": {"A": "①②", "B": "①③", "C": "②④", "D": "④"}}
{"meta_info": "taiwanese_test_Q", "question": "对于急性胰脏炎（acute pancreatitis）的可能并发症（complications），下列叙述何者错误?", "answer_idx": "C", "answer": "高钙血症合并抽搐（hypercalcemia with seizure）", "options": {"A": "低血容合并急性肾衰竭（hypovolemia with acute renal failure）", "B": "低血氧合并成人呼吸窘迫症（hypoxemia with adult respiratory distress syndrome）", "C": "高钙血症合并抽搐（hypercalcemia with seizure）", "D": "血管栓塞合并小肠缺血症（vascular thrombosis with ischemic bowel disease）"}}
{"meta_info": "taiwanese_test_Q", "question": "1.1岁女童高烧3天并有轻微咳嗽，悬壅垂与舌颚交界处（Uvulopalatoglossal junction）有红色小斑或出血点（Nagayama spots），第4天开始出现红疹后不再发烧，同时出现轻微腹泻，此女童最可能是被下列何种病原体感染？\n", "answer_idx": "C", "answer": "人类疱疹病毒第六型（Human Herpesviruses 6）", "options": {"A": "麻疹病毒（Measles）", "B": "呼吸道融合病毒（Respiratory syncytial virus）", "C": "人类疱疹病毒第六型（Human Herpesviruses 6）", "D": "轮状病毒（Rotavirus）"}}
{"meta_info": "taiwanese_test_Q", "question": "对于痘科病毒（Poxvirus）的叙述，下列何者正确？", "answer_idx": "D", "answer": "痘科病毒感染细胞后的复制过程在细胞质内进⾏，不需要宿主的DNA复制系统协助", "options": {"A": "天花的扑灭，是因为全⾯接种猴痘科（monkeypox）病毒的死毒疫苗", "B": "天花的扑灭，是因为全⾯接种天花病毒（variola virus）的减毒疫苗", "C": "猴痘科病毒对动物的感染⽬前仍然流传于非洲，但不会感染⼈类", "D": "痘科病毒感染细胞后的复制过程在细胞质内进⾏，不需要宿主的DNA复制系统协助"}}
{"meta_info": "taiwanese_test_Q", "question": "下图为一个颜面部创伤来急诊的病人，急诊医师安排脸部电脑断层，颜面骨有骨折的状况，其受伤的情形分类为：", "answer_idx": "C", "answer": "右侧Le Fort I + III，左侧Le Fort II", "options": {"A": "右侧Le Fort I + II，左侧Le Fort III", "B": "右侧Le Fort II + III，左侧Le Fort I", "C": "右侧Le Fort I + III，左侧Le Fort II", "D": "右侧Le Fort I + II，左侧Le Fort IV"}}
{"meta_info": "taiwanese_test_Q", "question": "为了解决家庭医学常見的急慢性疾病、未分化问题及身心疾病达到全人照顾的目的，臨床诊治宜采用何种模式？", "answer_idx": "D", "answer": "生物心理社会模式", "options": {"A": "生物医学模式", "B": "心理医学模式", "C": "社会医学模式", "D": "生物心理社会模式"}}
{"meta_info": "taiwanese_test_Q", "question": "酸性药物中毒时，给与NaHCO3的主要原因为何？", "answer_idx": "D", "answer": "减少药物在肾小管的再回收", "options": {"A": "增加酸性药物在肝脏代谢的速率", "B": "改变酸性药物在血液中的稳定度", "C": "增加药物在血液中的free form，利于肾丝球的过滤", "D": "减少药物在肾小管的再回收"}}
{"meta_info": "taiwanese_test_Q", "question": "一位25 岁年轻女性來到门诊，主诉2 天前即觉得解小便时，尿道口有疼痛及烧灼的感觉，随后并有频尿和尿急之现象，今天早上则发现尿液呈粉红色，兩天來下腹部偶有不适，但是并没有发烧或寒颤之情形。最适当之臆断（Impression）会是什么？", "answer_idx": "B", "answer": "急性膀胱炎", "options": {"A": "泌尿道结石", "B": "急性膀胱炎", "C": "膀胱肿瘤", "D": "急性肾盂肾炎"}}
{"meta_info": "taiwanese_test_Q", "question": "丛林斑疹伤寒（scrub typhus）的病媒是：", "answer_idx": "B", "answer": "红（red mite）", "options": {"A": "跳蚤（flea）", "B": "红（red mite）", "C": "体虱（louse）", "D": "硬蜱（hard tick）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 5 岁男童，因为先天性之双侧膀胱输尿管逆流导致慢性肾病变。身体检查发现：男童身高 100 公分，体重 20 公斤。抽血测得之血中尿素氮（BUN）值为 56 mg/dL；血清肌酸酐值 1.2 mg/dL。请估算其肾丝球过濾率，并根据慢性肾病之分期，判断目前男童的肾功能属于慢性肾病第几期？", "answer_idx": "C", "answer": "第三期", "options": {"A": "第一期", "B": "第二期", "C": "第三期", "D": "第四期"}}
{"meta_info": "taiwanese_test_Q", "question": "下列叙述何者错误？", "answer_idx": "D", "answer": "对于大多数轻度智能障碍的儿童来说，5 岁之前常常无法发展出社交和沟通技能", "options": {"A": "评估儿童青少年的发展，须评估已具有的能力和生理年龄应有的发展程度之间的差距", "B": "大多数轻度智能障碍的成年人，能发展出自我支持（self-support）的社交和职业技能", "C": "大多数儿童在 1 岁时已会发出近似语言但不若语言清楚的声音", "D": "对于大多数轻度智能障碍的儿童来说，5 岁之前常常无法发展出社交和沟通技能"}}
{"meta_info": "taiwanese_test_Q", "question": "水中那一个物质的存在最能代表最近刚受到粪便的污染？", "answer_idx": "A", "answer": "NH3-N", "options": {"A": "NH3-N", "B": "NO2--N", "C": "NO3--N", "D": "N2O5-N"}}
{"meta_info": "taiwanese_test_Q", "question": "王小姐是子宫颈癌患者，理学检查发现她的子宫颈癌病灶大小约 3 公分，且有侵犯到上 1/3 的阴道和右侧子宫旁组织（parametrium），但未达到骨盆壁。其他检查像是膀胱镜检查、下消化道摄影以及泌尿道摄影等均无发现肿瘤组织，则王小姐的子宫颈癌分期为：", "answer_idx": "C", "answer": "Stage IIb", "options": {"A": "子宫颈癌采用手术分期，须手术完才能确定", "B": "Stage IIa", "C": "Stage IIb", "D": "Stage IIIb"}}
{"meta_info": "taiwanese_test_Q", "question": "脂肪栓塞症候群（Fat embolism syndrome）是长骨或骨盆骨折的并发症，死亡率高。手术中及手术后如果有下列变化，要怀疑可能发生脂肪栓塞症候群，下列叙述何者错误？", "answer_idx": "A", "answer": "潮气容积末二氧化碳（ETCO2）上升", "options": {"A": "潮气容积末二氧化碳（ETCO2）上升", "B": "动脉血氧浓度下降", "C": "肺动脉压上升", "D": "心电图可能显现類似缺血般的 ST-segment 变化"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种癫痫发作时，病人的意識是清醒的？", "answer_idx": "C", "answer": "单纯型部分发作（simple partial seizures）", "options": {"A": "全身强直阵挛型发作（generalized tonic-clonic seizures）", "B": "复杂型部分发作（complex partial seizures）", "C": "单纯型部分发作（simple partial seizures）", "D": "热痉挛（febrile convul​​sion）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于硬皮症（morphea）的叙述，下列何者错误？", "answer_idx": "C", "answer": "常有雷诺氏现象（Raynaud phenomenon）", "options": {"A": "硬皮症之皮肤病灶和全身性硬化症（systemic sclerosis）的皮肤病灶可明显区分", "B": "极少见影响内脏器官，预后良好", "C": "常有雷诺氏现象（Raynaud phenomenon）", "D": "线形硬皮症（linear morphea）好犯于儿童之四肢"}}
{"meta_info": "taiwanese_test_Q", "question": "最常見的先天性心脏病为：", "answer_idx": "A", "answer": "心室中隔缺损", "options": {"A": "心室中隔缺损", "B": "心房中隔缺损", "C": "法洛氏四合症", "D": "肺动脉瓣闭锁"}}
{"meta_info": "taiwanese_test_Q", "question": "停经后妇女的卵巢肿瘤多半來自？", "answer_idx": "A", "answer": "卵巢表皮（ovarian epithelium）", "options": {"A": "卵巢表皮（ovarian epithelium）", "B": "卵巢实质（ovarian stroma）", "C": "卵巢生​​殖细胞（ovarian germ cell）", "D": "他处转移而來"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关双极性疾患（bipolar disorder）的叙述，何者错误？", "answer_idx": "C", "answer": "第1次发病（onset）大部分是躁症", "options": {"A": "多數个案会再復发", "B": "可能合并妄想或幻觉", "C": "第1次发病（onset）大部分是躁症", "D": "2次发病间可完全缓解（full remission）"}}
{"meta_info": "taiwanese_test_Q", "question": "对于慢性不愈合伤口的叙述，下列何者错误？", "answer_idx": "C", "answer": "Vitamin B12缺乏会妨碍单核细胞的活化和fibronectin沉积，然后影响细胞的黏 和妨碍TGF-β receptors", "options": {"A": "最常见的原因是伤口感染", "B": "放射线的暴露会造成内皮细胞（endothelial cell）的伤害和endarteritis，导致组织萎缩，纤维化和愈合延缓", "C": "Vitamin B12缺乏会妨碍单核细胞的活化和fibronectin沉积，然后影响细胞的黏 和妨碍TGF-β receptors", "D": "糖尿病会影响伤口愈合的每一个步骤"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 77 岁女性因为最近 8 个月來体重减轻 7 公斤而就诊。她在 2 年前先生过世后就一个人独居。最近一年因为心脏衰竭及膝关节炎，无法自我照料而住在长期照护机构。照顾者表示：她最近记忆力变差且情绪低落。下列叙述何者错误？", "answer_idx": "D", "answer": "社会网络（social network）对个人健康的影响是间接的", "options": {"A": "根据 Holmes & Rahe 的社会再适应量表，配偶死亡比父母亲死亡的压力更大", "B": "人口统计资料显示鳏寡者的死亡率比有配偶者高", "C": "评估社会心理对健康的影响时，社会资源（social resource）是很重要的项目", "D": "社会网络（social network）对个人健康的影响是间接的"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关肝脏解剖学之叙述，何者错误？", "answer_idx": "D", "answer": "即使在门脉高压的情况底下，门脉循环与系统静脉循环彼此之间仍然没有联系（connection）", "options": {"A": "通常胆囊动脉源自于右肝动脉", "B": "最常见的胆道构造为右前枝与右后枝胆管会合后，再与左胆管会合成总肝管（common hepatic duct）", "C": "尾状叶（caudate lobe）指的是Couinaud分类中的第一节叶（segment 1）", "D": "即使在门脉高压的情况底下，门脉循环与系统静脉循环彼此之间仍然没有联系（connection）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者非松脆类杆菌（Bacteroides fragilis）之特征？", "answer_idx": "C", "answer": "能产生芽胞（spore）", "options": {"A": "能水解七叶苷（esculin）", "B": "能生长于含20%胆盐（bile salt）的培养基", "C": "能产生芽胞（spore）", "D": "属革兰氏阴性杆菌"}}
{"meta_info": "taiwanese_test_Q", "question": "15 有关世界卫生组织（WHO）与台湾卫生福利部疾病管制署目前在推动之手部卫生运动中，所谓洗手 5 时机，包括下列那些情形？ ①帮病人做身体检查前②只接触病人身体体表之一般检查之后③预期接触到病人血液或体液才须洗手④执行侵入性检查戴无菌手套之前⑤进入病人房间，只触碰到床栏杆就离开病人房间", "answer_idx": "B", "answer": "仅①①①①", "options": {"A": "①①①①①", "B": "仅①①①①", "C": "仅①①①", "D": "仅①①①"}}
{"meta_info": "taiwanese_test_Q", "question": "使用传统抗精神病药物的个案若出现锥体外症候群（extrapyramidal syndrome）的副作用时，下列处理何者错误？", "answer_idx": "B", "answer": "并用锂盐（lithium）來降低锥体外症候群", "options": {"A": "降低传统抗精神病药物的剂量", "B": "并用锂盐（lithium）來降低锥体外症候群", "C": "并用抗胆碱性药物（anticholinergics）", "D": "考虑换成​​新一代的抗精神病药物"}}
{"meta_info": "taiwanese_test_Q", "question": "幼儿罹患「先天性鼻淚管阻塞」的原因及处理原则，何者错误？", "answer_idx": "C", "answer": "十二个月以内的幼儿，可施以淚囊鼻腔吻合术來治療", "options": {"A": "此病是由于鼻淚管的末端薄膜（valve of Hasner）未完全打开", "B": "六个月以内的幼儿，可施以局部按摩合并点抗生素眼药水", "C": "十二个月以内的幼儿，可施以淚囊鼻腔吻合术來治療", "D": "在保守療法治療一段时间后仍无法成功的患者，可施以淚囊灌洗术及探针术"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，上述病人若术前怀疑髓质癌（Medullary cancer）淋巴未转移，最好之手术方法是：", "answer_idx": "A", "answer": "双侧甲狀腺全切除术及中央淋巴廓清术（total thyroidectomy＋central lymph node dissection）", "options": {"A": "双侧甲狀腺全切除术及中央淋巴廓清术（total thyroidectomy＋central lymph node dissection）", "B": "双侧甲狀腺全切除术及双侧广泛性颈淋巴廓清术（total thyroidectomy＋bilateral radical neck dissection）", "C": "甲狀腺次全切术（subtotal thyroidectomy）", "D": "患侧甲狀腺全葉切除术（one side lobectomy）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是颈动脉海绵窦管（Carotid-cavernous fistula）的典型征候？", "answer_idx": "B", "answer": "结膜血管曲张", "options": {"A": "眼压降低", "B": "结膜血管曲张", "C": "眼球内陷", "D": "水晶体混浊"}}
{"meta_info": "taiwanese_test_Q", "question": "一位70 岁有肝硬化病史的老先生，近几周因生蚝盛产，自己剥生蚝來吃，到急诊时，主诉发烧已兩天，今天皮肤出现下图之水泡，到急诊时血压90/50 mmHg，老先生最可能感染的病原菌为下列何者？", "answer_idx": "B", "answer": "Vibrio vulnificus", "options": {"A": "Staphylococcus aureus", "B": "Vibrio vulnificus", "C": "group A streptococcus", "D": "Klebsiella pneumoniae"}}
{"meta_info": "taiwanese_test_Q", "question": "输卵管及副睪丸之 adenomatoid tumor 之细胞的來源是：", "answer_idx": "C", "answer": "mesothelial cell", "options": {"A": "epithelial cell", "B": "squamous cell", "C": "mesothelial cell", "D": "endothelial cell"}}
{"meta_info": "taiwanese_test_Q", "question": "32 35 岁 70 公斤男性被高压电电伤，烧伤面积占总体表面积 40%，以 Parkland Formula 來计算，伤后前 小时每小时应输入体液多少 mL？", "answer_idx": "C", "answer": "700", "options": {"A": "350", "B": "460", "C": "700", "D": "1050"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种雷射适用于治療血管扩张？", "answer_idx": "A", "answer": "染料雷射（Dye laser）", "options": {"A": "染料雷射（Dye laser）", "B": "铒雅铬雷射（Er-YAG laser）", "C": "红宝石雷射（Ruby laser）", "D": "铷雅铬雷射（Nd-YAG laser）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关sevoflurane的叙述，何者错误？", "answer_idx": "A", "answer": "遇到瓶子或麻醉机管路中的杂质会降解出HCl，也叫做路易士酸", "options": {"A": "遇到瓶子或麻醉机管路中的杂质会降解出HCl，也叫做路易士酸", "B": "需要特殊塑胶瓶来包装", "C": "如果降解出酸性物质，则有可能灼伤病患的呼吸黏膜", "D": "通常制造的成品中会加一些水以防降解"}}
{"meta_info": "taiwanese_test_Q", "question": "人类免疫不全病毒（HIV）感染的孕妇服用合并抗反转录病毒治疗，若侦测不到血浆HIV病毒量（＜20 copies/mL），则生下婴儿感染HIV机会大约多少？", "answer_idx": "D", "answer": "＜1%", "options": {"A": "25%", "B": "15%", "C": "7%", "D": "＜1%"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种惡性增生最不常見于儿童接受骨髓移植后的次发性惡性疾病（secondary malignancy）？", "answer_idx": "C", "answer": "肾癌（renal cell cancer）", "options": {"A": "脑瘤（brain tumor）", "B": "甲狀腺瘤（thyroid tumor）", "C": "肾癌（renal cell cancer）", "D": "非何杰金氏淋巴瘤（non-Hodgkin lymphoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关胆固醇合成之叙述，何者错误？", "answer_idx": "C", "answer": "从饮食中摄取的胆固醇是不会影响到肝细胞中胆固醇的合成", "options": {"A": "胰岛素可刺激 HMG-CoA reductase", "B": "细胞内高浓胆固醇可以刺激胆固醇脂（cholesterol ester）的形成", "C": "从饮食中摄取的胆固醇是不会影响到肝细胞中胆固醇的合成", "D": "一些胆固醇的中间代谢产物会抑制 HMG-CoA reductase"}}
{"meta_info": "taiwanese_test_Q", "question": "79.下列疾病中，何者致病机转主要跟自体抗体（autoantibody）的产生有关？ ①寻常型天疱疮（pemphigus vulgaris） ②多发性结节性动脉炎（polyarteritis nodosa） ③恶性贫血（pernicious anemia）\n", "answer_idx": "D", "answer": "仅①③", "options": {"A": "①②③", "B": "仅①②", "C": "仅②③", "D": "仅①③"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于腺病毒（adenovirus）的叙述，何者错误？", "answer_idx": "D", "answer": "具有外套（envelope）", "options": {"A": "为 DNA 病毒", "B": "引起结膜炎（conjunctivitis）", "C": "可以潜伏于淋巴组织中", "D": "具有外套（envelope）"}}
{"meta_info": "taiwanese_test_Q", "question": "医师为一位过重的糖尿病患开立 1500 Kcal 饮食，下列营养师所列之处方何者较接近？", "answer_idx": "B", "answer": "190 公克碳水化合物、50 公克脂肪、75 公克蛋白质", "options": {"A": "210 公克碳水化合物、60 公克脂肪、100 公克蛋白质", "B": "190 公克碳水化合物、50 公克脂肪、75 公克蛋白质", "C": "250 公克碳水化合物、70 公克脂肪、90 公克蛋白质、6 公克 NaCl", "D": "300 公克碳水化合物、80 公克脂肪、75 公克蛋白质、8 公克综合维他命丸"}}
{"meta_info": "taiwanese_test_Q", "question": "一位64岁男性，突然发生右半身瘫痪，无法言语，意識不清，此CT影像是症狀发生后第7天所照，最可能的诊断是：", "answer_idx": "C", "answer": "hemorrhagic infarction", "options": {"A": "contusion hemorrhage", "B": "hypertensive hemorrhage", "C": "hemorrhagic infarction", "D": "hemorrhage due to bleeding tendency"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关主动脉闭锁不全身体诊察的叙述，何者错误？", "answer_idx": "D", "answer": "听诊主动脉闭锁不全的心杂音，请病人左侧卧姿（left decubitus position）最清楚", "options": {"A": "可听到 Austin Flint murmur", "B": "可听到 mid-systolic murmur", "C": "可听到 decrescendo diastolic murmur", "D": "听诊主动脉闭锁不全的心杂音，请病人左侧卧姿（left decubitus position）最清楚"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关潜在性器官捐赠者（potential donor）的照顾之叙述，何者错误？", "answer_idx": "C", "answer": "尿崩症（diabetes insipidus）并不常見，故尿量变多时，只须减少给予的水分即可", "options": {"A": "平均动脉血压（mean arterial blood pressure）须大于 60 mmHg", "B": "每小时尿量最好大于 1.0 mL/kg", "C": "尿崩症（diabetes insipidus）并不常見，故尿量变多时，只须减少给予的水分即可", "D": "高血钠症是常見的电解质不平衡"}}
{"meta_info": "taiwanese_test_Q", "question": "王先生因为急性胰脏炎入院，下列何者最不像是他该有的症状或检查结果？", "answer_idx": "C", "answer": "血钙上升", "options": {"A": "腹痛位于上腹并且辐射到背部", "B": "持续性呕吐", "C": "血钙上升", "D": "发烧"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关慢性发炎性脱髓鞘型多发性神经病变（chronic inflammatory demyelinating polyneuropathy）之陈述，何者错误？", "answer_idx": "D", "answer": "類固醇（prednisolone）治療常无效", "options": {"A": "慢慢出现", "B": "可以逐渐（progressive）也可以阶梯式（step-wise）进行", "C": "早期可以有不对称性", "D": "類固醇（prednisolone）治療常无效"}}
{"meta_info": "taiwanese_test_Q", "question": "关于Q热（Q fever）致病菌之相改变（phase transition）现象的叙述，下列何者正确？", "answer_idx": "D", "answer": "急性期时，病人体内产生的IgM及IgG抗体主要是对抗第二相的抗原", "options": {"A": "相改变是因为此菌的鞭毛（flagellum）基因发生突变所造成", "B": "当此菌处于第一相（phase I）时，其细胞壁（cell wall）不含O抗原糖（O-antigen sugars）", "C": "当此菌处于第二相（phase II）时，能抑制吞噬体（phagosome）与溶小体（lysosome）的融合", "D": "急性期时，病人体内产生的IgM及IgG抗体主要是对抗第二相的抗原"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种血管炎，c-ANCA（c-antineutrophil cytoplasmic autoantibodies）呈阳性的比例最高？", "answer_idx": "B", "answer": "Wegener granulomatosis", "options": {"A": "microscopic polyangiitis", "B": "Wegener granulomatosis", "C": "Henoch-Schönlein purpura", "D": "Churg-Strauss syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关脊髓白质（white matter）的叙述，何者正确？", "answer_idx": "A", "answer": "前外侧系统（anterolateral system）传递痛、温和粗触觉", "options": {"A": "前外侧系统（anterolateral system）传递痛、温和粗触觉", "B": "腹侧皮质脊髓径（ventral corticospinal tract）为已交叉的神经纤维", "C": "薄束（fasciculus gracilis）存在于前索（anterior funiculus）中", "D": "楔狀束（fasciculus cuneatus）存在于全段脊髓白质"}}
{"meta_info": "taiwanese_test_Q", "question": "发生賈克森氏癫痫（jacksonian seizure），最可能的病灶位在何处？", "answer_idx": "C", "answer": "额葉", "options": {"A": "颞葉", "B": "枕葉", "C": "额葉", "D": "顶葉"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 52 岁男性病患因为車祸大量出血，有关此时的生理现象之描述，下列何者错误？", "answer_idx": "A", "answer": "会刺激副交感神经系统导致心跳加速", "options": {"A": "会刺激副交感神经系统导致心跳加速", "B": "心输出量（cardiac output）会下降", "C": "四肢会冰冷同时冒冷汗", "D": "回到右心房之体静脉血量会降低"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 80 岁男性，1 周來在脸部、四肢末端长出如图所示的暗褐色斑、水、合并糜爛。患者发疹前几天曾服用过磺胺類（sulphonamide）药物，几年前也曾在服用類似药物后在身体同样的部位也会发出類似的疹子。最可能诊断为：", "answer_idx": "C", "answer": "固定性药物疹（fixed drug eruption）", "options": {"A": "多形性红斑（erythema multiforme）", "B": "麻疹样药物疹（morbilliform drug eruption）", "C": "固定性药物疹（fixed drug eruption）", "D": "单纯性疹（herpes simplex）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关直肠癌的术前放射线治療之叙述，何者错误？", "answer_idx": "D", "answer": "无法减轻对小肠之伤害", "options": {"A": "可以增加 Resectability rate", "B": "可以减少术中之 Tumor seeding", "C": "可增加保留肛门的机会", "D": "无法减轻对小肠之伤害"}}
{"meta_info": "taiwanese_test_Q", "question": "上斜肌（superior oblique muscle）本身的作用，并不会使眼球做下列何种运动？", "answer_idx": "C", "answer": "内转（adduction）", "options": {"A": "看下（depression）", "B": "内旋（intorsion）", "C": "内转（adduction）", "D": "外转（abduction）"}}
{"meta_info": "taiwanese_test_Q", "question": "腹膜覆盖下腹壁动脉（inferior epigastric artery）会形成下列何结构？", "answer_idx": "C", "answer": "脐外侧襞（lateral umbilical fold）", "options": {"A": "脐正中襞（median umbilical fold）", "B": "脐内侧襞（medial umbilical fold）", "C": "脐外侧襞（lateral umbilical fold）", "D": "脐旁襞（paraumbilical fold）"}}
{"meta_info": "taiwanese_test_Q", "question": "41.胎心无压力试 （non-stress test）20分钟检查结果，有二次胎心加速大于基线胎心搏（baseline）15 bpm （beat per minute）以上，且持续15秒以上，可以判读为：\n", "answer_idx": "A", "answer": "正常反应（reactive）", "options": {"A": "正常反应（reactive）", "B": "不正常反应（nonreactive）", "C": "争议性（equivocal）", "D": "无法判读（unsatisfactory）"}}
{"meta_info": "taiwanese_test_Q", "question": "心尖相对于第几个肋间？", "answer_idx": "B", "answer": "五", "options": {"A": "三", "B": "五", "C": "七", "D": "九"}}
{"meta_info": "taiwanese_test_Q", "question": "71.78岁陈先生由亲人陪同就诊，主诉最近一周有尿失禁及倦怠无力。病人长期失眠，经常服用安眠药。最近失眠加重，增加剂量仍未见效，而且血压也上升。病人又自行购买高血压药物服用。身体检查病人生命征象稳 定，意识清楚，行动正常且无局部神经异常症状。对该病人的处置方式，下列何者最为适当？\n", "answer_idx": "C", "answer": "作老人周全性评估", "options": {"A": "安排病人入住护理之家接受照顾", "B": "转介精神神经专科检查及调整安眠药", "C": "作老人周全性评估", "D": "即刻安排病人住院治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种情形，可以不用得到病人的告知后同意？", "answer_idx": "C", "answer": "病人在诊间似乎语多保留，调阅该病人五年前在本院由 A 医师主治时的住院病歷，看是否曾经罹患性病，以确认本次处方药物的正确性", "options": {"A": "开立我国行政院卫生署已经核准上市的处方药物给一个非仿单所载适应症的病人，因为国外最知名的期刊刚刚才登载了这种标签外使用对这類病人有非常好的療效", "B": "在病人例行回诊验血时，顺便多抽 5 ml 的血，來作一项国科会所赞助的研究计画", "C": "病人在诊间似乎语多保留，调阅该病人五年前在本院由 A 医师主治时的住院病歷，看是否曾经罹患性病，以确认本次处方药物的正确性", "D": "为了保护新生儿免于垂直感染，在产妇例行产检时，作 AIDS 的筛检"}}
{"meta_info": "taiwanese_test_Q", "question": "下表为三种不同双螺旋 DNA 结构（A form; B form; Z form）的特性，请指出代号 W、X、Y 的结构型式（structural form）名称：", "answer_idx": "A", "answer": "W = Z form DNA; X = A form DNA; Y = B form DNA", "options": {"A": "W = Z form DNA; X = A form DNA; Y = B form DNA", "B": "W = Z form DNA; X = B form DNA; Y = A form DNA", "C": "W = A form DNA; X = Z form DNA; Y = B form DNA", "D": "W = A form DNA; X = B form DNA; Y = Z form DNA"}}
{"meta_info": "taiwanese_test_Q", "question": "粒线体疾病（mitochondrial disease）的遗传是：", "answer_idx": "B", "answer": "母系遗传", "options": {"A": "父系遗传", "B": "母系遗传", "C": "孟德尔定律", "D": "无定律可循"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关眼部病变之叙述，何者错误？", "answer_idx": "B", "answer": "葛雷氏症（Graves' disease）是突眼症最常見的原因", "options": {"A": "突眼症（Exorbitism）是眼窝体积减少（Decreased bony orbital volume）造成", "B": "葛雷氏症（Graves' disease）是突眼症最常見的原因", "C": "赫特氏眼外测量计（Hertel exophthalmometer）是用來量侧眼缘（Lateral orbital rim）到角膜顶端（Corneal apex）的距離", "D": "外科治療外伤后眼球内陷（Post-traumatic enophthalmos）并不能完全解决复视（Diplopia）的问题"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者在下视丘分泌减少时会引起泌乳激素（prolactin）分泌增加？", "answer_idx": "C", "answer": "多巴胺（dopamine）", "options": {"A": "乙醯胆碱（acetylcholine）", "B": "肾上腺素（epinephrine）", "C": "多巴胺（dopamine）", "D": "血清素（serotonin）"}}
{"meta_info": "taiwanese_test_Q", "question": "伤寒沙门氏菌（Salmonella typhi）菌体的何种成分可以作为疫苗抗原，以产生保护性免疫力？", "answer_idx": "B", "answer": "荚膜多糖体（capsular polysaccharides）", "options": {"A": "鞭毛蛋白（flagellin）", "B": "荚膜多糖体（capsular polysaccharides）", "C": "菌毛蛋白（pilin）", "D": "脂多糖体（lipopolysaccharides）"}}
{"meta_info": "taiwanese_test_Q", "question": "Stridor 最常見于下列何种患者？", "answer_idx": "C", "answer": "上呼吸道阻塞", "options": {"A": "气喘症", "B": "慢性阻塞性肺疾", "C": "上呼吸道阻塞", "D": "肺结核"}}
{"meta_info": "taiwanese_test_Q", "question": "想了解台湾地区有多少比率的小朋友最近几年曾经被肠病毒感染过，应该检查：", "answer_idx": "C", "answer": "血清中的抗体力价（titer）", "options": {"A": "血清中的病毒培养（virus culture）", "B": "血清中的病毒抗原浓度", "C": "血清中的抗体力价（titer）", "D": "血清中具有特異性的聚合链反应（polymerase chain reaction, PCR）"}}
{"meta_info": "taiwanese_test_Q", "question": "有位曾患肾盂肾炎的孕妇，因细菌引起严重上呼吸道感染，下列何者为治療该孕妇的首选药物？", "answer_idx": "C", "answer": "Azithromycin", "options": {"A": "Clarithromycin", "B": "Erythromycin", "C": "Azithromycin", "D": "Tetracycline"}}
{"meta_info": "taiwanese_test_Q", "question": "王老先生于2 年前因罹患中风后即长期卧床，近日家属发现其臀部有一个4 公分伤口，经整形外科医师诊断为褥疮，建议手术治療；术中发现伤口坏死范围深及骨头，则此褥疮的深度分级为何？最好的重建方法是清创（debridement）后再作何种处置？", "answer_idx": "D", "answer": "Grade IV；局部臀大肌皮瓣重建术（local gluteal maximus flap reconstruction）", "options": {"A": "Grade III；换药即可（dressing change）", "B": "Grade III；植皮（skin grafting）", "C": "Grade IV；显微皮瓣重建术（microsurgical free flap reconstruction）", "D": "Grade IV；局部臀大肌皮瓣重建术（local gluteal maximus flap reconstruction）"}}
{"meta_info": "taiwanese_test_Q", "question": "尿路感染最常見的菌种是下列何者？", "answer_idx": "C", "answer": "E. Coli", "options": {"A": "Klebsiella spp.", "B": "Proteus spp.", "C": "E. Coli", "D": "Enterobacter spp."}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种药物口服可治疗铁中毒？", "answer_idx": "B", "answer": "deferasirox", "options": {"A": "deferoxamine", "B": "deferasirox", "C": "D-dimethylcysteine", "D": "Prussian blue"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是上皮性卵巢癌？", "answer_idx": "D", "answer": "Granulosa cell tumor", "options": {"A": "Mucinous adenocarcinoma", "B": "Serous adenocarcinoma", "C": "Endometrioid adenocarcinoma", "D": "Granulosa cell tumor"}}
{"meta_info": "taiwanese_test_Q", "question": "下咽癌病患接受根除性手术治疗后，下列何者不是常使用之音声复健方式？", "answer_idx": "C", "answer": "腹语（abdominal voice）", "options": {"A": "气动式人造喉（pneumatic artificial larynges）", "B": "食道语（esophageal voice）", "C": "腹语（abdominal voice）", "D": "气管食道语（tracheo-esophageal speech）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关一氧化氮（nitric oxide）之叙述，何者正确？", "answer_idx": "B", "answer": "由 L-arginine 与氧分子作用形成", "options": {"A": "是化学性（chemical）传递物质（messenger）可活化 adenylate cyclase", "B": "由 L-arginine 与氧分子作用形成", "C": "可导致血管壁收缩（constriction of blood vessels）", "D": "是极安定之气体分子"}}
{"meta_info": "taiwanese_test_Q", "question": "78.65岁男性长期有高血压，持续用药控制中，几天前门诊医师帮他换药，这几天就常感觉腹胀，而且 有便秘现象，病人最可能用了下列何种药？\n", "answer_idx": "D", "answer": "Amlodipine", "options": {"A": "Valsartan", "B": "Renitec", "C": "Labetalol", "D": "Amlodipine"}}
{"meta_info": "taiwanese_test_Q", "question": "尿路结石的发生和下列何种狀况较少有关連？", "answer_idx": "A", "answer": "肾移植", "options": {"A": "肾移植", "B": "怀孕", "C": "肥胖", "D": "马蹄肾"}}
{"meta_info": "taiwanese_test_Q", "question": "有关体内钙质的描述何者错误?", "answer_idx": "C", "answer": "98%的钙会被肾脏再吸收，主要是在远端肾小管", "options": {"A": "骨骼系统储存体内99%的钙，血钙则占略少于1%", "B": "钙质的来源主要为饮食摄取，大多于十二指肠（duodenum）及空肠（jejunum）吸收", "C": "98%的钙会被肾脏再吸收，主要是在远端肾小管", "D": "1,25-(OH)2 vitamin D可增加肠道的钙结合蛋白（calcium binding protein）来增进钙质吸收"}}
{"meta_info": "taiwanese_test_Q", "question": "李小姐，50岁已婚的台湾人，体重96公斤，目前还有性生活。在三年前时，因为有子宫肌瘤而接受经腹部全子宫切除术（total abdominal hysterectomy）。她没有抽烟，在某一所护理之家当护理助手，并且此份工作和提重物有关。她本身因为有气喘（asthma）的病史而有慢性咳嗽（chronic cough）。她目前有两位小孩，年纪为20及23岁，两位都是经由阴道生产，其中出生体重最重的为4.0公斤。最近10个月来，她感觉到腹部有下坠感以及头痛的症状，当她站立整天，下坠感越大，她也抱怨尿的流量不好以及感觉膀胱无法完全排空，而她自述并没有小便失禁或是肠道症状。下列关于造成她形成阴道脱垂（prolapse）的危险因子，何者最不相关？", "answer_idx": "D", "answer": "目前还有性生活", "options": {"A": "经阴道生产的过大胎儿", "B": "肥胖", "C": "曾经接受子宫切除", "D": "目前还有性生活"}}
{"meta_info": "taiwanese_test_Q", "question": "正常情况下，心脏后方大都由下列何者构成？", "answer_idx": "D", "answer": "左心房（left atrium）", "options": {"A": "右心室（right ventricle）", "B": "左心室（left ventricle）", "C": "右心房（right atrium）", "D": "左心房（left atrium）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于人类免疫缺陷病毒（Human immunodeficiency virus, HIV）致病机转之叙述，下列何者错误？", "answer_idx": "C", "answer": "感染B淋巴球，造成免疫功能下降", "options": {"A": "可造成巨噬细胞（macrophage）功能变差", "B": "会引起CD4 T淋巴球（lymphocyte）减少", "C": "感染B淋巴球，造成免疫功能下降", "D": "CD8 T淋巴球/CD4 T淋巴球比例上升"}}
{"meta_info": "taiwanese_test_Q", "question": "31.\n 一位62岁女性于50岁时停经，这一年多来常有频尿、夜尿、尿急及急迫性尿失禁之情形，因此造成日常生活困扰而就医。理学检查发现有第三度膀胱脱垂之现象，尿液分析无菌尿、血尿或尿路感染之情形。解尿日记发现白天解尿次数超过八次以上，晚上夜尿（nocturia）情\n 形超过3至5次以上。尿路动力学检查于膀胱灌注期发现如下图之情形，其初次解尿感觉\n （first desire to void）之容积为116 c.c.、膀胱最大容积（maximum bladder capacity）为\n c.c.。据此尿动力学之发现，此患者最适合之诊断为：", "answer_idx": "A", "answer": "逼尿肌不稳定（detrusor instability）", "options": {"A": "逼尿肌不稳定（detrusor instability）", "B": "间质性膀胱炎（interstitial cystitis）", "C": "尿道症候群（urethral syndrome）", "D": "尿动力学应力性尿失禁（urodynamic stress incontinence）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 68 岁男性COPD病患，去年已有兩次因为acute exacerbation住院放置气管内管使用呼吸器治療。最近一星期明显咳嗽加剧，痰量增加，颜色变黄，伴有轻微发烧及严重呼吸困难，急诊室的血液检查呈现轻度leukocytosis，动脉血检查PaO2 = 58 mmHg，PaCO2 = 68 mmHg，胸部X光片并未出现新的浸润。下列叙述何者错误？", "answer_idx": "B", "answer": "应该给予oxygen，并且尽量维持PaO2在 90 mmHg，以避免加重heart failure", "options": {"A": "应该给予 empirical intravenous antibiotics 治療，antibiotics 应该要能 cover Gram(-) bacilli", "B": "应该给予oxygen，并且尽量维持PaO2在 90 mmHg，以避免加重heart failure", "C": "应该要小心排除合并 left side heart failure 的情形，必要时要安排 echocardiography", "D": "病人稳定后出院给予口服 prednisolone，会减少 relapse rate"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是食物引起的肉毒杆菌毒素中毒（food-born botulism）的症状？", "answer_idx": "D", "answer": "角弓反张（opisthotonus）", "options": {"A": "瞳孔放大（pupil dilatation）", "B": "吞咽困难（dysphagia）", "C": "构音障碍（dysarthria）", "D": "角弓反张（opisthotonus）"}}
{"meta_info": "taiwanese_test_Q", "question": "注意力缺失过动症（attention-deficit/hyperactivity disorder）所使用之治療药物中，下列何者不是中枢神经刺激剂？", "answer_idx": "D", "answer": "Wellbutrin", "options": {"A": "methylphenidate", "B": "dextroamphetamine", "C": "dexmethylphenidate", "D": "Wellbutrin"}}
{"meta_info": "taiwanese_test_Q", "question": "有一肺肿瘤病人，并有腹部绞痛、腹泻、气管痉挛及皮肤潮红，其组织诊断最有可能是：", "answer_idx": "A", "answer": "支气管類癌（bronchial carcinoid）", "options": {"A": "支气管類癌（bronchial carcinoid）", "B": "乳癌肺转移（metastatic breast cancer）", "C": "肺非小细胞癌（non-small cell lung carcinoma）", "D": "大肠癌肺转移（metastatic colon cancer）"}}
{"meta_info": "taiwanese_test_Q", "question": "48 岁女性因倦怠、肤色变黑來诊。病人主诉食欲不振，3 个月來已减轻 4 公斤。病人年轻时曾患甲狀腺机能亢进症，接受 131I 治療，现已甲狀腺机能低下，规则服用甲狀腺素。抽血检查：Na+ 125 mmol/L， K+ 5.0 mmol/L，Ca2+ 2.7 mmol/L，Hb 10.5 g/dL，WBC 8000/mm3。请问下一步最有诊断价值的检查是：", "answer_idx": "C", "answer": "ACTH，cortisol", "options": {"A": "free T4，hsTSH", "B": "anti-dsDNA，ANA", "C": "ACTH，cortisol", "D": "PET（正子扫描）"}}
{"meta_info": "taiwanese_test_Q", "question": "糖蛋白（N-linked glycoprotein）的生成中，携带寡糖（oligosaccharide moiety）的分子为下列何者？", "answer_idx": "B", "answer": "dolichol phosphate", "options": {"A": "isoprene", "B": "dolichol phosphate", "C": "Coenzyme A", "D": "thiamine pyrophosphate"}}
{"meta_info": "taiwanese_test_Q", "question": "具有前期B细胞抗原接受器（pre-B cell receptor）之B型细胞具有下列那一项生物特性？", "answer_idx": "C", "answer": "快速细胞分裂", "options": {"A": "轻链基因重组（light chain gene rearrangement）", "B": "细胞表面具IgM分子", "C": "快速细胞分裂", "D": "接受专一性抗原刺激"}}
{"meta_info": "taiwanese_test_Q", "question": "10.8岁气喘男童，最近3个月内，于白天出现气喘症状的次数平均一星期少于1次，一个月内半夜因咳嗽而醒来也少于2次，其", "answer_idx": "A", "answer": "吸入型短效支气管扩张剂（inhaled short-acting β2 agonist）", "options": {"A": "吸入型短效支气管扩张剂（inhaled short-acting β2 agonist）", "B": "吸入型长效支气管扩张剂（inhaled long-acting β2 agonist）", "C": "吸入型类固醇（inhaled corticosteroid）", "D": "吸入型类固醇倂用口服白三烯素受体结抗剂（inhaled corticosteroid + oral leukotriene receptor antagonist）"}}
{"meta_info": "taiwanese_test_Q", "question": "翼腭窝（pterygopalatine fossa）与其周边之連通经由：", "answer_idx": "C", "answer": "圆孔（foramen rotundum）接受第五颅神经之第二支", "options": {"A": "上颌孔（maxillay foramen）进入硬腭黏膜", "B": "翼管（pterygoid canal）接受交感神经节前纤维", "C": "圆孔（foramen rotundum）接受第五颅神经之第二支", "D": "翼腭孔（pterygopalatine foramen）进入鼻腔"}}
{"meta_info": "taiwanese_test_Q", "question": "具有毒性的有机危害性物质大部分可在燃烧过程中分解或减量，但也有在燃烧过程中产生新的有害物质，其中最引人注意的就是毒性高，具致癌作用，在环境中可持久不易分解的焚化后新生物是：", "answer_idx": "B", "answer": "多氯戴奥辛（polychlorinated dioxins）", "options": {"A": "多氯聯苯（polychlorinated biphenyls）", "B": "多氯戴奥辛（polychlorinated dioxins）", "C": "滴滴涕（dichlorodiphenyl-trichloroethane, DDT）", "D": "氯仿（chloroform）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一条肌肉不是由正中神经（median nerve）所支配？", "answer_idx": "D", "answer": "尺侧屈腕肌（Flexor carpi ulnaris）", "options": {"A": "桡侧屈腕肌（Flexor carpi radialis）", "B": "掌长肌（Palmaris longus）", "C": "屈拇长肌（Flexor pollicis longus）", "D": "尺侧屈腕肌（Flexor carpi ulnaris）"}}
{"meta_info": "taiwanese_test_Q", "question": "以下何者不属于构成鼻中隔的部分？", "answer_idx": "B", "answer": "鼻骨", "options": {"A": "中隔软骨", "B": "鼻骨", "C": "犁骨", "D": "垂直板"}}
{"meta_info": "taiwanese_test_Q", "question": "一个曾经被流感病毒感染过的人，其体内最具中和性保护力的抗体，应具有辨識那一种病毒蛋白质的能力？", "answer_idx": "A", "answer": "血球凝集素（hemagglutinin, HA）", "options": {"A": "血球凝集素（hemagglutinin, HA）", "B": "基质（matrix, M）蛋白", "C": "核套蛋白（nucleocapsid, NP）", "D": "非结构（nonstructural, NS）蛋白"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关使用经心肌雷射血管再造术（Transmyocardial laser revascularization）治療无法以传统冠狀动脉绕道手术治療的末期冠狀动脉疾病病人之叙述，何者错误？", "answer_idx": "D", "answer": "其作用机转，乃经由心肌打洞，使带氧血能直接由左心室流入心肌，供应氧气及养份", "options": {"A": "6 个月后之追踪，约有 60~80%病人症狀有改善", "B": "其作用机转可能和心脏神经被去除作用（Cardiac denervation）有关", "C": "其作用机转可能是心肌局部血管新生（Local neovascularization）有关", "D": "其作用机转，乃经由心肌打洞，使带氧血能直接由左心室流入心肌，供应氧气及养份"}}
{"meta_info": "taiwanese_test_Q", "question": "有关痘病毒（Poxvirus）的叙述，下列何者错误？", "answer_idx": "D", "answer": "动物的痘病毒不会传给人", "options": {"A": "是最大的人类DNA病毒", "B": "完全在细胞质中复制", "C": "自己携带核糖核酸聚合酶（RNA polymerase），供基因转录", "D": "动物的痘病毒不会传给人"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，病患寻求另類医学治療，约三个月后双腿几乎瘫痪，故又來接受外科治療，经手术将脊椎前后的肿瘤切除，并植入自体骨移植，再用钛合金属内固定，病理报告是aneurysmal bone cyst，病理组织是：", "answer_idx": "A", "answer": "良性（benign）", "options": {"A": "良性（benign）", "B": "低度惡性（low malignancy）", "C": "高度惡性（high malignancy）", "D": "非典型骨瘤（atypical bone tumor）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 25 岁男性晚餐后酒后驾車，发生車祸被送入急诊室，诊断腹腔内出血，需紧急进行剖腹探查手术。車祸后二小时，病患送入手术室，此时血压为 80/46 mmHg，心跳每分钟 120 下。下列叙述何者错误？", "answer_idx": "B", "answer": "麻醉诱导时应持续压住 thyroid cartilage，直到气管内管的气囊充完气，以防止胃内容物吐出", "options": {"A": "麻醉诱导时，应进行 rapid sequence induction", "B": "麻醉诱导时应持续压住 thyroid cartilage，直到气管内管的气囊充完气，以防止胃内容物吐出", "C": "可考虑使用 ketamine 做为 induction agent，以防止血压再下降", "D": "麻醉诱导前，必须做足够时间的 preoxygenation"}}
{"meta_info": "taiwanese_test_Q", "question": "有关骨盆横膈（pelvic diaphragm）的叙述，下列何者错误？", "answer_idx": "D", "answer": "排便时其肌肉收缩，帮助排出粪便", "options": {"A": "外形呈现漏斗状", "B": "位于会阴（perineum）的顶部", "C": "由提肛肌（levator ani muscle）和尾骨肌（coccygeus）及其筋膜组成", "D": "排便时其肌肉收缩，帮助排出粪便"}}
{"meta_info": "taiwanese_test_Q", "question": "常有癌症患者家属不愿病人知道病情，要求医师不要告诉病人，但基于「尊重自主」的原则医师却应该告知病人真相，因而产生进退两难的困境。这种临床上常见的伦理两难，通常经由下列何种方法或步骤，可以获得妥善解决？", "answer_idx": "C", "answer": "沟通技巧", "options": {"A": "医疗法律", "B": "道德良知", "C": "沟通技巧", "D": "卫生教育"}}
{"meta_info": "taiwanese_test_Q", "question": "66 岁男性，已知高血压多年但未控制，突发头痛、意识不清与癫痫，至急诊时血压为240/130 mmHg，神经学检查意识混沌，但无局部肢体无力现象，脑部磁振照影检查最可能的发现为何？", "answer_idx": "C", "answer": "大脑枕叶部（occipital lobe）水肿", "options": {"A": "小脑（cerebellum）出血", "B": "视丘（thalamus）出血", "C": "大脑枕叶部（occipital lobe）水肿", "D": "中脑（midbrain）梗塞"}}
{"meta_info": "taiwanese_test_Q", "question": "有一新生儿出生后有呕吐，呕吐液为黄色。腹部 X 光显示\"double-bubble sign＂，远端肠道无肠气。则下一步处置为何？", "answer_idx": "A", "answer": "腹部超音波检查是否有幽门肥厚情形", "options": {"A": "腹部超音波检查是否有幽门肥厚情形", "B": "上消化道摄影，以确定阻塞位置及程度", "C": "下消化道摄影，看是否有 microcolon", "D": "安排开腹手术"}}
{"meta_info": "taiwanese_test_Q", "question": "钠離子（Na）以不同浓度分布于细胞膜兩侧，此时驱使钠離子依单纯扩散（simple diffusion）作用由高浓度之一侧向低浓度之一侧移动之能量梯度是属于一种：", "answer_idx": "B", "answer": "化学能（chemical potential energy）", "options": {"A": "热能（thermal energy）", "B": "化学能（chemical potential energy）", "C": "电位能（electrical potential energy）", "D": "机械能（mechanical energy）"}}
{"meta_info": "taiwanese_test_Q", "question": "58岁妇女，停经2年，无妇科开刀病史，无热潮红，心悸症状，但会有阴部干涩，性交疼痛的困扰，其最适当的治疗为：", "answer_idx": "D", "answer": "阴部雌激素局部使用", "options": {"A": "口服大豆异黄酮", "B": "口服雌激素与黄体素", "C": "口服雌激素", "D": "阴部雌激素局部使用"}}
{"meta_info": "taiwanese_test_Q", "question": "一般细菌中能产生芽胞的杆菌，革兰氏染色结果为：", "answer_idx": "C", "answer": "深紫色", "options": {"A": "红色", "B": "绿色", "C": "深紫色", "D": "黄色"}}
{"meta_info": "taiwanese_test_Q", "question": "有关 Fluconazole，下列叙述何者正确？", "answer_idx": "B", "answer": "抑制 lanosterol 的去甲基化", "options": {"A": "有效治療 Aspergillosis", "B": "抑制 lanosterol 的去甲基化", "C": "无法通过脑部血管", "D": "易诱发肝脏药物代谢酵素的合成"}}
{"meta_info": "taiwanese_test_Q", "question": "在手腕处，正中神经（median nerve）位于下列何者肌腱的深层？", "answer_idx": "C", "answer": "尺侧屈腕肌（flexor carpi ulnaris）", "options": {"A": "掌长肌（palmaris longus）", "B": "桡侧屈腕肌（flexor carpi radialis）", "C": "尺侧屈腕肌（flexor carpi ulnaris）", "D": "屈指浅肌（flexor digitorum superficialis） 15 下列何者不支配肘关节（elbow joint）的运动？"}}
{"meta_info": "taiwanese_test_Q", "question": "自从SARS之后，医护人员的职业性感染问题受到很大的关注。请依院内感染控制的观念，对于职业性肺结核的认定，下列何者正确？", "answer_idx": "A", "answer": "员工就职时的肺部X光检查是职业性肺结核认定的重要比较资料之一", "options": {"A": "员工就职时的肺部X光检查是职业性肺结核认定的重要比较资料之一", "B": "由于肺结核也属于法定传染病，因此依据劳工保险条例，不得同时加以认定为职业病，因此也得不到劳保给付", "C": "由于患者四处走动，医院中各部门员工感染肺结核的危险性皆相同", "D": "医护人员得到肺结核都是职业病"}}
{"meta_info": "taiwanese_test_Q", "question": "16.25岁男性病人因骑机车车祸而颜面部受伤，主要症状为右侧鼻翼撕裂伤（avulsion injury）、流鼻血 （epistaxis）和肿痛，送至急诊室，下列叙述何者错误？\n", "answer_idx": "B", "answer": "经会诊耳鼻喉科医师，发现右侧鼻中膈有血肿情形（septal hematoma），应保守治疗，待其自行吸收", "options": {"A": "要高度怀疑可能有鼻骨骨折的发生，可安排X-ray检查", "B": "经会诊耳鼻喉科医师，发现右侧鼻中膈有血肿情形（septal hematoma），应保守治疗，待其自行吸收", "C": "鼻部主要组成可分为皮肤覆盖（skin cover）、结构支撑（structural support）及黏膜内衬（mucosal lining），治疗时可以根据缺损的范围，做不同的重建考量", "D": "鼻唇皮瓣（nasolabial flaps）和前额旁正中皮瓣（paramedian forehead flaps）为鼻部重建时，最常用的两种局部皮瓣"}}
{"meta_info": "taiwanese_test_Q", "question": "3 岁小孩在定期健康检查时，听到心杂音，强度 II/VI，位于胸骨缘左侧中间之短暂收缩期杂音。该杂音并未輻射至颈部，没有震颤（thrill），小孩过去无重大病史，身高及体重在五十百分位，生长发育正常，血压 90/70 mmHg。脉搏 84 次/分，且规律，其它理学检查均正常。接下來该如何处置？", "answer_idx": "C", "answer": "告诉小孩的母亲，这种心杂音在小孩很常見，定期观察追踪即可", "options": {"A": "立即照会小儿心脏科医师", "B": "不要告诉小孩的母亲有关心杂音的事，以免引起紧张", "C": "告诉小孩的母亲，这种心杂音在小孩很常見，定期观察追踪即可", "D": "告诉小孩的母亲，所有的心杂音都必须进一步做心脏超音波检查"}}
{"meta_info": "taiwanese_test_Q", "question": "14.28岁妇女产下健康男婴2个月后，因体重增加、倦怠、怕冷、便秘来就诊，目前仍哺乳中。病人自诉产前体检皆为正常，但产后感觉力不从心，身体检查除脸部圆大、皮肤略微干燥外并无特殊发现。血压150/100 mmHg mmHg），脉搏60/min 规则，抽血检查Na：132 mM，K：3.5 mM，Ca：2.3 mM。下列那项检查最具诊断价值：", "answer_idx": "C", "answer": "freeT4，hsTSH", "options": {"A": "ACTH，cortisol", "B": "Blood glucose", "C": "freeT4，hsTSH", "D": "忧郁量表"}}
{"meta_info": "taiwanese_test_Q", "question": "人类免疫缺乏病毒（HIV）经由 CD4 分子进入白血球时，经常利用下列何者当作共同接受体？", "answer_idx": "C", "answer": "CXCR4", "options": {"A": "CD40", "B": "CD40 ligand", "C": "CXCR4", "D": "CCR4"}}
{"meta_info": "taiwanese_test_Q", "question": "B细胞发育过程中第一个表现之抗体蛋白是：", "answer_idx": "B", "answer": "µ重链（µ heavy chain）", "options": {"A": "δ重链（δ heavy chain）", "B": "µ重链（µ heavy chain）", "C": "κ轻链（κ light chain）", "D": "λ轻链（λ light chain）"}}
{"meta_info": "taiwanese_test_Q", "question": "一个小于 1 公分的 colorectal tubular adenoma，其 risk of cancer 约有多少？", "answer_idx": "B", "answer": "<5%", "options": {"A": "绝对不可能有 cancer", "B": "<5%", "C": "5-10%", "D": "10-20%"}}
{"meta_info": "taiwanese_test_Q", "question": "凝血蛋白之麸胺酸基之γ-羧化（γ-carboxylation）修饰，需要何种维生素參与？", "answer_idx": "D", "answer": "Vitamin K", "options": {"A": "Vitamin A", "B": "Vitamin D", "C": "Vitamin E", "D": "Vitamin K"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者連接股骨与髋臼窝？", "answer_idx": "C", "answer": "内收大肌（adductor magnus）", "options": {"A": "内收长肌（adductor longus）", "B": "内收短肌（adductor brevis）", "C": "内收大肌（adductor magnus）", "D": "耻骨肌（pectineus）"}}
{"meta_info": "taiwanese_test_Q", "question": "最常用來重建下颔骨的骨皮瓣包括腓骨（fibula）、髂骨（iliac）、肩胛骨（scapula），下列叙述何者错误？", "answer_idx": "B", "answer": "髂骨皮瓣（iliac osteocutaneous flap）对皮瓣提供处的后遗症最小，所能带的血管根蒂（pedicle）较短", "options": {"A": "腓骨皮瓣（fibula osteocutaneous flap）由腓动脉（peroneal artery）供应血流，对皮瓣提供处的后遗症最小", "B": "髂骨皮瓣（iliac osteocutaneous flap）对皮瓣提供处的后遗症最小，所能带的血管根蒂（pedicle）较短", "C": "肩胛骨皮瓣（scapula osteocutaneous flap）由肩胛下动脉（subscapular artery）供应血流，可以連同周围的骨头、肌肉和皮肤一起取，形成复合式皮瓣", "D": "对良性的下颔骨缺损，腓骨皮瓣（fibula osteocutaneous flap）可以合并牙科植体手术（osseointegrated implantation for dentition or prosthetic anchors）"}}
{"meta_info": "taiwanese_test_Q", "question": "肱骨外科颈（surgical neck of humerus）骨折，最可能伤及那⼀条神经？", "answer_idx": "D", "answer": "腋神经（axillary nerve）", "options": {"A": "肌⽪神经（musculocutaneous nerve）", "B": "正中神经（median nerve）", "C": "尺神经（ulnar nerve）", "D": "腋神经（axillary nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "90 一名 61 岁男性病人主诉骨骼疼痛，并有肾衰竭及肺炎球菌感染导致之肺炎（Pneumococcal pneumonia）。骨髓活检切片中最可能并且最重要的发现为：\n", "answer_idx": "B", "answer": "浆细胞（Plasma cell）之病变", "options": {"A": "肉芽肿（Granuloma）", "B": "浆细胞（Plasma cell）之病变", "C": "淋巴球（Lymphocyte）之病变", "D": "立德-史登堡氏细胞（Reed-Sternberg cell）"}}
{"meta_info": "taiwanese_test_Q", "question": "抗利尿激素（anti-diuretic hormone）不适当分泌症候群（SIADH），会造成下列何种电解质异常？", "answer_idx": "B", "answer": "低钠血症", "options": {"A": "高钠血症", "B": "低钠血症", "C": "高钾血症", "D": "低钾血症"}}
{"meta_info": "taiwanese_test_Q", "question": "77.⼀位66岁糖尿病合并肾病变病⼈，有胸闷、咳嗽无痰、呼吸急促、意识昏睡，⽣命征象显⽰⾎压80/40 mmHg，⼼跳每分40下，呼吸每分26次，体温36℃。经抽⾎检查发现钾离⼦7.7 mmol/L、⾎糖300 mg/dL、动脉⾎：pH=7.20，HCO3- =12 mEq/L，BE= -12 mEq/L。下列何者治疗不适当？\n", "answer_idx": "C", "answer": "经静脉快速灌注⽣理食盐⽔1000 mL，治疗低⾎压及稀释钾离⼦", "options": {"A": "经静脉给予碳酸氢钠，可将钾离⼦由细胞外移入细胞内", "B": "经静脉给予葡萄糖⽔及胰岛素，可将钾离⼦由细胞外移入细胞内", "C": "经静脉快速灌注⽣理食盐⽔1000 mL，治疗低⾎压及稀释钾离⼦", "D": "经静脉给予氯化钙，以拮抗钾离⼦对⼼脏细胞膜电位的影响"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一个临床症状与心电图变化的配对是最相符合的？", "answer_idx": "B", "answer": "普金杰系统阻断（Purkinje system block）：延长的 QRS 综合波", "options": {"A": "第一级心阻断（first-degree heart block）：QT 延长症候群（long QT syndrome）", "B": "普金杰系统阻断（Purkinje system block）：延长的 QRS 综合波", "C": "心肌钾离子通道突变，功能降低：PR（或 PQ）间期异常的延长", "D": "左心室肥大或扩张：高而尖的T波"}}
{"meta_info": "taiwanese_test_Q", "question": "有关简单型热痉挛（simple febrile seizure）的描述，下列何者正确？", "answer_idx": "A", "answer": "常有家族病史", "options": {"A": "常有家族病史", "B": "通常到成人阶段仍会发生", "C": "脑波检查常发现不正常", "D": "常伴随脑部病变"}}
{"meta_info": "taiwanese_test_Q", "question": "茎突咽肌（stylopharyngeal muscle）由下列何者支配？", "answer_idx": "A", "answer": "第九颅神经", "options": {"A": "第九颅神经", "B": "第七颅神经", "C": "下颌神经（mandibular nerve）", "D": "交感神经（sympathetic nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者受损会影响肱骨（humerus）的内收（adduct）、内旋（medially rotate）及屈曲（flex）功能？", "answer_idx": "A", "answer": "胸大肌（pectoralis major）", "options": {"A": "胸大肌（pectoralis major）", "B": "胸小肌（pectoralis minor）", "C": "锁骨下肌（subclavius）", "D": "前锯肌（serratus anterior）"}}
{"meta_info": "taiwanese_test_Q", "question": "7 岁男孩，三天前开始发高烧、倦怠，同时在脸部、躯干及四肢出现网狀红斑，脸部的病灶如图所示，则男孩最可能之诊断为：", "answer_idx": "D", "answer": "传染性红斑（erythema infectiosum）", "options": {"A": "麻疹（measles）", "B": "川崎氏症（Kawasaki's disease）", "C": "猩红热（scarlet fever）", "D": "传染性红斑（erythema infectiosum）"}}
{"meta_info": "taiwanese_test_Q", "question": "70岁男性，机械性人工二尖瓣瓣膜置换手术后，术后三小时，胸腔引流管之流量逐渐减少，但是中心静脉压逐渐上升，尿量逐渐减少，心跳逐渐加快，动脉压逐渐下降。此时要鉴别诊断是心包填塞（cardiac tamponade）或是术后心脏失能（myocardial dysfunction），最好的诊断工具为下列何者？", "answer_idx": "A", "answer": "心脏超音波", "options": {"A": "心脏超音波", "B": "胸部X光", "C": "胸动脉导管（swan ganz catheter）", "D": "动脉血气体分析"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何症狀与 achalasia 无关？", "answer_idx": "A", "answer": "胃酸逆流", "options": {"A": "胃酸逆流", "B": "吞咽困难", "C": "体重减轻", "D": "吸入性肺炎"}}
{"meta_info": "taiwanese_test_Q", "question": "反转錄病毒嵌入宿主的染色体中，其基因上那一个片段具有启动子（promoter）序列可以调控病毒的转錄（transcription）？", "answer_idx": "A", "answer": "LTR", "options": {"A": "LTR", "B": "gag", "C": "pol", "D": "env"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关Meckel's diverticulum之叙述，何者错误？", "answer_idx": "C", "answer": "通常长在mesenteric border", "options": {"A": "通常是由vitelline duct退化而成", "B": "是造成小孩下消化道出血的原因之一", "C": "通常长在mesenteric border", "D": "掉入腹股沟疝气袋内时，又称为Littre's hernia"}}
{"meta_info": "taiwanese_test_Q", "question": "忧郁症患者常见的快速动眼期睡眠（rapid eye movement sleep）之潜期（latency）变化为何？", "answer_idx": "B", "answer": "缩短", "options": {"A": "不变", "B": "缩短", "C": "延长", "D": "不会出现潜期"}}
{"meta_info": "taiwanese_test_Q", "question": "A 型主动脉剥離症，须紧急手术，手术死亡率相当高，最常見的死亡原因为：", "answer_idx": "C", "answer": "血管吻合处出血不止", "options": {"A": "心脏衰竭", "B": "呼吸衰竭", "C": "血管吻合处出血不止", "D": "脑中风"}}
{"meta_info": "taiwanese_test_Q", "question": "陈先生，19 岁，最近到南美洲游学兩星期，回国后出现類流感症狀，愈后仍出现关节痛达數十天之久。请问最可能感染下列何种病毒？", "answer_idx": "D", "answer": "基孔肯雅病毒（Chikungunya virus）", "options": {"A": "登革热病毒（dengue virus）", "B": "塞姆利基森林病毒（Semliki Forest virus）", "C": "黄热病毒（yellow fever virus）", "D": "基孔肯雅病毒（Chikungunya virus）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是掌控与维持姿势相关的中轴肌肉（axial muscles）收缩的最主要运动路径？", "answer_idx": "C", "answer": "网状脊髓路径（reticulospinal tract）", "options": {"A": "侧皮质脊髓路径（lateral corticospinal tract）", "B": "腹皮质脊髓路径（ventral corticospinal tract）", "C": "网状脊髓路径（reticulospinal tract）", "D": "红核脊髓路径（rubrospinal tract）"}}
{"meta_info": "taiwanese_test_Q", "question": "52 下列那些疾病发生呼吸衰竭时，会以高二氧化碳性（hypercarbic）而非低血氧性（hypoxemic）呼吸衰竭为主？ ①极重度慢性阻塞性肺病 ②肺炎并急性肺损伤 ③原发性肺纤维化（idiopathic pulmonary fibrosis） ④心脏衰竭并肺水肿 ⑤重症肌无力（myasthenia gravis） ⑥颈椎外伤", "answer_idx": "C", "answer": "①⑤⑥", "options": {"A": "①③④", "B": "②③④", "C": "①⑤⑥", "D": "③⑤⑥"}}
{"meta_info": "taiwanese_test_Q", "question": "蛋白质结构中的β-折板（β-sheet）与α-螺旋（α-helix）在结构分类上属于：", "answer_idx": "B", "answer": "二级结构（secondary structure）", "options": {"A": "一级结构（primary structure）", "B": "二级结构（secondary structure）", "C": "三级结构（tertiary structure）", "D": "四级结构（quaternary structure）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种检查，最无法确定目前胃中有幽门杆菌（Helicobacter pylori）感染？", "answer_idx": "B", "answer": "血中抗幽门杆菌抗体阳性", "options": {"A": "胃切片组织培养阳性", "B": "血中抗幽门杆菌抗体阳性", "C": "碳-13尿素吹气检查阳性", "D": "粪便幽门杆菌抗原检 阳性"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种抗癫痫药物在达到其治療上需要之浓度（therapeutic concentration）后，在人体内之排除是属于非​​线性排除（nonlinear elimination）？", "answer_idx": "A", "answer": "Phenytoin", "options": {"A": "Phenytoin", "B": "Carbamazepine", "C": "Valproate", "D": "Gabapentin"}}
{"meta_info": "taiwanese_test_Q", "question": "日本血吸虫（Schistosoma japonicum）那一发育时期的虫体会感染人？", "answer_idx": "C", "answer": "尾动幼虫（cercaria）", "options": {"A": "虫卵", "B": "纤毛幼虫（miracidium）", "C": "尾动幼虫（cercaria）", "D": "囊狀幼虫（metacercaria）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种药物广泛地使用于抑制细胞免疫的反应，也会抑制 prostaglandins 及 leukotrienes 的合成及促进 IgG 的合成作用？", "answer_idx": "B", "answer": "Prednisone", "options": {"A": "Cyclosporine", "B": "Prednisone", "C": "Cyclophosphamide", "D": "Mercaptopurine"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关如何培养婴幼儿及儿童良好饮食习惯的叙述，何者最为适当？", "answer_idx": "B", "answer": "3岁后可以开始规定一些简单的餐桌礼仪", "options": {"A": "2岁半到3岁之间为黄金训练期", "B": "3岁后可以开始规定一些简单的餐桌礼仪", "C": "2至4岁可以使用脱脂鲜奶", "D": "少喝含糖饮料，补充水分以稀释果汁为宜"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关 Arthus 反应的描述，何者错误？", "answer_idx": "A", "answer": "这种过敏免疫反应常是全身性反应", "options": {"A": "这种过敏免疫反应常是全身性反应", "B": "抗体和补体系统活化都是重要的致病因子", "C": "嗜碱性球（basophils）的活化是重要的致病因子", "D": "属于第三型的过敏免疫（hypersensitivity）反应"}}
{"meta_info": "taiwanese_test_Q", "question": "依据2005年Starfield等人的研究报告，美国地区每10,000人口多增加一位家庭医师，对死亡人数的影响为何？", "answer_idx": "C", "answer": "每100,000人口减少70人死亡", "options": {"A": "每100,000人口增加700人死亡", "B": "每100,000人口增加70人死亡", "C": "每100,000人口减少70人死亡", "D": "每100,000人口减少700人死亡"}}
{"meta_info": "taiwanese_test_Q", "question": "在医院工作时发现有不符合医学伦理但不违法的事情，如果想采取行动，下列那一项最不适当？", "answer_idx": "D", "answer": "向检察官告发", "options": {"A": "提报到医学伦理委员会讨论", "B": "向上级报告", "C": "寻求同侪意见", "D": "向检察官告发"}}
{"meta_info": "taiwanese_test_Q", "question": "人类是下列何种病毒中，最明确的天然宿主？", "answer_idx": "D", "answer": "基孔肯雅病毒（Chikungunya virus）", "options": {"A": "辛德毕斯病毒（Sindbis virus）", "B": "塞姆利基森林病毒（Semliki Forest virus）", "C": "西尼罗脑炎病毒（West Nile encephalitis virus）", "D": "基孔肯雅病毒（Chikungunya virus）"}}
{"meta_info": "taiwanese_test_Q", "question": "张先生目前 50 余岁，最近出现多个关节肿胀、疼痛，主要在双手近端指间关节、双手腕关节、膝关节等，检查结果为類风湿性关节炎（rheumatoid arthritis）。医师表示目前张先生体内的類风湿性因子（rheumatoid factor）价數颇高，需积极治療。此因子是下列那一项？", "answer_idx": "B", "answer": "自体抗体（autoantibody）", "options": {"A": "细胞激素（cytokine）", "B": "自体抗体（autoantibody）", "C": "调节性T细胞（Treg细胞）产生之调控因子", "D": "补体复合体（complement complex）"}}
{"meta_info": "taiwanese_test_Q", "question": "气喘病人应避免使用 aspirin，是因为使用 aspirin 后下列何种物质产生可能增加，而易导致气管收缩？", "answer_idx": "C", "answer": "leukotriene", "options": {"A": "thromboxane", "B": "prostaglandin D2", "C": "leukotriene", "D": "PAF（platelet-activating factor）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者非目前国内所推动本土化家庭医师制度的特色？", "answer_idx": "A", "answer": "由基层医​​师组织聯合门诊", "options": {"A": "由基层医​​师组织聯合门诊", "B": "建置家庭档案的资讯管理系统", "C": "合作医院成立共同照护门诊", "D": "提供 24 小时的咨询服务专线"}}
{"meta_info": "taiwanese_test_Q", "question": "65 岁男性病患，长期患有下足疼痛及肿胀，其足部之 X 光素片如图，呈现软组织肿大及邻近骨骼变化，最可能的臨床诊断为？", "answer_idx": "C", "answer": "痛风关节炎（gouty arthritis）及痛风石沉淀（tophi）", "options": {"A": "退化性关节炎（degenerative arthritis）并发囊膜积水", "B": "感染性（infection）骨骼及软组织病变", "C": "痛风关节炎（gouty arthritis）及痛风石沉淀（tophi）", "D": "外伤性之骨骼软组织病变"}}
{"meta_info": "taiwanese_test_Q", "question": "7.26岁女性病人，最近一周有多喝和多尿。体重50公斤，血液osmolality 290 mOsmol/kg H2O，Na 140 mmol/L，K 3.8 mmol/L。尿液osmolality 200 mOsmol/kg H2O，限水试 2小时之体重47公斤，尿液osmolality 290 mOsmol/kg H2O，给予\n ADH（DDAVP）后2小时内最高的尿液osmolality 320 mOsmol/kg H2O。下列叙述何者最正确？\n", "answer_idx": "C", "answer": "治疗使用thiazides", "options": {"A": "最可能的诊断是原发性多饮症（primary polydipsia）", "B": "治疗使用限水", "C": "治疗使用thiazides", "D": "最可能的诊断是中枢型尿崩症（central diabetes insipidus）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 60 岁先生骑車車祸受伤前额着地，送至急诊室时仍可自行步行进入急诊。双手疼痛无力抬起，经双手 X 光检查后并无任何手部骨折情形。则这位先生最可能是何种脊椎损伤？", "answer_idx": "C", "answer": "中央脊髓症候群（central cord syndrome）", "options": {"A": "前脊髓症候群（anterior cord syndrome）", "B": "布朗塞卡氏症候群（Brown-Séquard syndrome）", "C": "中央脊髓症候群（central cord syndrome）", "D": "马尾束症候群（cauda equina syndrome）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者属耳蜗内淋巴液（endolymph）组成成分的特色，以便产生动作电位？", "answer_idx": "C", "answer": "低钠離子，高钾離子", "options": {"A": "高钠離子，高钾離子", "B": "高钠離子，低钾離子", "C": "低钠離子，高钾離子", "D": "低钠離子，低钾離子"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，引发上述现象的解释，有一种学說是有关左肾静脉的胡桃钳效应（nutcracker effect）；请问这个胡桃钳指的是那兩条血管？", "answer_idx": "B", "answer": "superior mesenteric artery and aorta", "options": {"A": "celiac trunk and aorta", "B": "superior mesenteric artery and aorta", "C": "inferior mesenteric artery and aorta", "D": "right renal artery and aorta"}}
{"meta_info": "taiwanese_test_Q", "question": "某研究为分析降血压药的效果，采用病例对照设计（case-control study），欲分析病例对照两组样本服降血压药3 个月前后测量之血压值差异是否有明显不同，研究者应该使用何种统计方法最合适？", "answer_idx": "D", "answer": "独立样本 t 检定（Independent t-test）", "options": {"A": "配对 t 检定（Paired t-test）", "B": "单一样本 Z 检定（One sample Z-test）", "C": "Pearson 卡方检定（Pearson Chi-square test）", "D": "独立样本 t 检定（Independent t-test）"}}
{"meta_info": "taiwanese_test_Q", "question": "一个8个月大的男童因第一次尿道感染住院，膀胱尿道摄影检查（voiding cystourethrogram）显示如附图，你会如何给父母亲建议？", "answer_idx": "C", "answer": "建议使用抗生素预防感染", "options": {"A": "接受外科手术治疗", "B": "建议接受局部玻尿酸注射治疗", "C": "建议使用抗生素预防感染", "D": "建议只要观察有无复发性感染，暂不需任何治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是治療慢性淚囊炎（chronic dacryocystitis）的最佳方法？", "answer_idx": "C", "answer": "淚囊鼻腔吻合术", "options": {"A": "淚囊切除", "B": "淚囊切开排脓", "C": "淚囊鼻腔吻合术", "D": "结膜淚囊鼻腔吻合术"}}
{"meta_info": "taiwanese_test_Q", "question": "有关儿童急性阑尾炎（appendicitis）的叙述，下列何者最恰当？", "answer_idx": "A", "answer": "小于 2 岁其常见的症状为腹痛、呕吐、腹泻、发烧", "options": {"A": "小于 2 岁其常见的症状为腹痛、呕吐、腹泻、发烧", "B": "大于 2 岁其临床表现与大人相似", "C": "白血球上升是诊断的重要指标", "D": "超音波检查诊断率较电脑断层高"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 19 岁少女，來门诊求诊，主诉下腹痛合并阴道点狀出血。她叙述 1 个禮拜前曾在家裡自行验孕，验孕试剂呈现阳性反应。医师安排阴道超音波检查并没有发现子宫腔内的妊娠囊。抽血检查血清 beta-hCG 數值为 1800 mIU/mL。相隔 4 天之后，再次检查血清 beta-hCG 數值为 2100 mIU/mL。这位少女的臨床症狀及实验室數据最符合下列那一个臨床诊断？", "answer_idx": "C", "answer": "子宫外孕（ectopic pregnancy）", "options": {"A": "自然流产（spontaneous abortion）", "B": "多重怀孕（multiple gestation）", "C": "子宫外孕（ectopic pregnancy）", "D": "不完全流产（incomplete abortion）"}}
{"meta_info": "taiwanese_test_Q", "question": "可以用手术矫正之男性不孕症病因最常見的（the most common correctable cause of male infertility）为何？", "answer_idx": "A", "answer": "Varicocele", "options": {"A": "Varicocele", "B": "Testicular torsion", "C": "Testicular tumor", "D": "Hydrocele"}}
{"meta_info": "taiwanese_test_Q", "question": "民国 94 年间国军 A 上尉于军事操練中意外死亡，其未婚妻要求妇产科医师进行尸体取精以作人工生殖，在当时引起社会很大争议，下列何者非为本案医学倫理上的主要争议？", "answer_idx": "D", "answer": "抚恤金公平分配的问题", "options": {"A": "死者意愿的问题", "B": "家属权利的问题", "C": "未來儿女权利的问题", "D": "抚恤金公平分配的问题"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是给予全静脉营养治療（Total Parenteral Nutrition）的并发症？", "answer_idx": "A", "answer": "Non-essential fatty acid deficiency", "options": {"A": "Non-essential fatty acid deficiency", "B": "Iron deficiency anemia", "C": "Hyperglycemia", "D": "Pancreatitis"}}
{"meta_info": "taiwanese_test_Q", "question": "陈姓老翁1个月前因为罹患胰脏癌末期而签署了安宁缓和医疗意愿书，希望病危的时候可以放弃急救。 3天前，陈老先生出现发烧、频尿的情况，而被送往医院救治，经过医师的诊察确认陈老先生为尿路感染合并 血症，陈老先生于住院中因为血压不稳，经过输液治疗而导致肺水肿，医师建议进行气管插管并用呼吸器治疗，以缓解其肺水肿。此时是否应同意陈老先生接受插管？", "answer_idx": "C", "answer": "赞成，虽然陈老先生为胰脏癌末期，也签署了安宁缓和医疗意愿书，但本次住院的原因为 泌尿道感染合并 血症，并非不可治愈的疾病，医师应该为其插管治疗", "options": {"A": "反对，因为陈老先生已经签署了安宁缓和医疗意愿书，不应该违反其意愿而为其插管", "B": "反对，因为陈老先生为胰脏癌末期，不要再进行过于侵入性的治疗，免得增加其痛苦", "C": "赞成，虽然陈老先生为胰脏癌末期，也签署了安宁缓和医疗意愿书，但本次住院的原因为 泌尿道感染合并 血症，并非不可治愈的疾病，医师应该为其插管治疗", "D": "赞成，虽然陈老先生为胰脏癌末期，也签署了安宁缓和医疗意愿书，但只要属于病危的患者，均应该依医师法定急救义务而加以急救"}}
{"meta_info": "taiwanese_test_Q", "question": "化脓性肝脓疡在台湾地区，以下列何种致病菌为最常見？", "answer_idx": "B", "answer": "Klebsiella pneumoniae", "options": {"A": "Escherichia coli", "B": "Klebsiella pneumoniae", "C": "Anaerobic bacteria", "D": "Streptococci"}}
{"meta_info": "taiwanese_test_Q", "question": "有关心脏血管系统的身体诊查（physical examination），下列叙述何者错误？", "answer_idx": "A", "answer": "正常右内颈动脉的压力应小于 12 cm H2O", "options": {"A": "正常右内颈动脉的压力应小于 12 cm H2O", "B": "第三心音可在正常儿童或年轻人听到", "C": "第三心音与心室的血容量增加有关（volume overload）", "D": "第四心音与心室的顺应性（compliance）下降有关"}}
{"meta_info": "taiwanese_test_Q", "question": "保险的基本原理有三个要件，下列何者不是要件之一？", "answer_idx": "C", "answer": "供需平衡", "options": {"A": "危险共同分摊", "B": "大多數法则", "C": "供需平衡", "D": "避免引导道德危险"}}
{"meta_info": "taiwanese_test_Q", "question": "一位12岁女孩因身材矮小就诊，父亲身高160公分，母亲身高152公分。去年曾发生一次全身性痉挛（generalized convul​​sion），身体检查显示身高133公分（低于第3百分位），体重47公斤（第90百分位），圆脸、轻微智障，实验室检查显示血清钙值1.53 nmol/L，血清磷值6.4 mg/dL，血清镁1.1 mmol/L，血清副甲狀腺素（intact PTH）值245 pg/mL（正常值12-72 pg/mL），此女童最可能的诊断为：", "answer_idx": "C", "answer": "pseudohypoparathyroidism", "options": {"A": "hyperparathyroidism", "B": "hypoparathyroidism", "C": "pseudohypoparathyroidism", "D": "pseudopseudohypoparathyroidism"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关蛋白质激酶 C（protein kinase C）的叙述，何者正确？", "answer_idx": "A", "answer": "可在细胞膜上被二醯甘油（diacylglycerol）活化", "options": {"A": "可在细胞膜上被二醯甘油（diacylglycerol）活化", "B": "可对二醯甘油进行磷酸化", "C": "可活化 p53 抑癌基因", "D": "可被 cylic AMP 活化"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种人体寄生虫感染需要全家集体投药治療？", "answer_idx": "A", "answer": "蛲虫（Enterobius vermicularis）", "options": {"A": "蛲虫（Enterobius vermicularis）", "B": "有钩绦虫（Taenia solium）", "C": "旋毛虫（Trichinella spiralis）", "D": "中华肝吸虫（Clonorchis sinensis）"}}
{"meta_info": "taiwanese_test_Q", "question": "復健病房值班时，有颈椎损伤患者，头痛、冒汗、起鸡皮疙瘩，下列处置何者最适当？", "answer_idx": "C", "answer": "检查是否有膀胱过涨现象，必要时紧急导尿", "options": {"A": "检查喉咙是否发红，是否发烧，给予感冒、退烧药", "B": "询问是否有习惯性偏头痛，给予止痛药", "C": "检查是否有膀胱过涨现象，必要时紧急导尿", "D": "可能是紧张过度，给予镇定剂"}}
{"meta_info": "taiwanese_test_Q", "question": "鉴定皮癣菌（Dermophyton）的主要依据，不包括下列那一特性？", "answer_idx": "A", "answer": "生化特性", "options": {"A": "生化特性", "B": "菌落特性", "C": "菌丝特性", "D": "孢子特性"}}
{"meta_info": "taiwanese_test_Q", "question": "臀皱褶（Gluteal fold）附近的皮肤感觉主要由下列何者支配？", "answer_idx": "D", "answer": "股后皮神经（Posterior femoral cutaneous nerve）", "options": {"A": "臀下神经（Inferior gluteal nerve）", "B": "坐骨神经（Sciatic nerve）", "C": "股外侧皮神经（Lateral femoral cutaneous nerve）", "D": "股后皮神经（Posterior femoral cutaneous nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "社区健康营造不鼓勵的做法是：", "answer_idx": "C", "answer": "由上而下（top-down）", "options": {"A": "充能或增能（empowerment）", "B": "伙伴关系（partnership）", "C": "由上而下（top-down）", "D": "合作或结盟（alliance）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者非为透纳氏症候群Turner syndrome之特征？", "answer_idx": "D", "answer": "青春痘增生", "options": {"A": "身材短小", "B": "无月经", "C": "不孕症", "D": "青春痘增生"}}
{"meta_info": "taiwanese_test_Q", "question": "耳下腺管（parotid duct）开口处口腔黏膜的痛觉，由下列何者传导？", "answer_idx": "B", "answer": "颊神经（buccal nerve）", "options": {"A": "舌神经（lingual nerve）", "B": "颊神经（buccal nerve）", "C": "颧面神经（zygomaticofacial nerve）", "D": "面神经（facial nerve）之颊支（buccal branch）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是目前市场上的抗胆碱药物（anti-cholinergic medications）治療尿急性失禁（urge incontinence）时，最常見的副作用（adverse effect）？", "answer_idx": "C", "answer": "口干（dry mouth）", "options": {"A": "肌肉无力（muscle weakness）", "B": "尿液滞留（urinary retention）", "C": "口干（dry mouth）", "D": "频尿（urinary frequency）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位男童于 9 个月大因罹患川崎病接受 2 gm/kg 的静脉注射免疫球蛋白治療，现已痊愈。 15 个月大來诊要求注射麻疹-腮腺炎-德国麻疹疫苗与第一剂日本脑炎疫苗，下列那一种处置最适当？", "answer_idx": "B", "answer": "可接种日本脑炎疫苗，麻疹-腮腺炎-德国麻疹疫苗必须延后接种", "options": {"A": "可立即接种注射麻疹-腮腺炎-德国麻疹疫苗与日本脑炎疫苗", "B": "可接种日本脑炎疫苗，麻疹-腮腺炎-德国麻疹疫苗必须延后接种", "C": "可接种麻疹-腮腺炎-德国麻疹疫苗，日本脑炎疫苗必须延后接种", "D": "日本脑炎疫苗与麻疹-腮腺炎-德国麻疹疫苗均必须延后接种"}}
{"meta_info": "taiwanese_test_Q", "question": "关于胃酸（gastric acid) 分泌之叙述，何者错误？", "answer_idx": "D", "answer": "D细胞（D cell）所分泌的somatostatin会增加组织胺（histamine）及胃泌素（gastrin）的分泌，进而增加胃酸的分泌", "options": {"A": "受到乙醯胆碱（acetylcholine），胃泌素（gastrin）及组织胺（histamine）的调控", "B": "胃酸的分泌可分为头期（cephalic phase），胃期（gastric phase）及肠期（intestinal", "C": "胃期（gastric phase）所分泌的胃酸占所有胃酸分泌的 60%～70%", "D": "D细胞（D cell）所分泌的somatostatin会增加组织胺（histamine）及胃泌素（gastrin）的分泌，进而增加胃酸的分泌"}}
{"meta_info": "taiwanese_test_Q", "question": "从遭到爱滋病毒感染，到以检测试剂可侦测到感染的这一个月左右的时间内，检测结果可能出现伪阴性。这段期间称为什么期？", "answer_idx": "A", "answer": "空窗期（window period）", "options": {"A": "空窗期（window period）", "B": "潜伏期（incubation period）", "C": "恢復期（recovery period）", "D": "发病期（developing period）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关足底筋膜炎（plantar fasciitis）的叙述，何者错误？", "answer_idx": "C", "answer": "足部 X 光片常可見到骨刺（spur），此为诊断最重要的根据", "options": {"A": "足底筋膜可帮助维持内侧足弓（plantar arch）", "B": "当大脚趾做过度背屈动作（hyper-dorsiflexion）时可引发疼痛", "C": "足部 X 光片常可見到骨刺（spur），此为诊断最重要的根据", "D": "很少需要以手术方式治療"}}
{"meta_info": "taiwanese_test_Q", "question": "91 气喘筛检计画调查兩所国中的学生，共检出气喘学生人數如下： 男生 女生金城国中 315 270 山城国中 480 420 合 计 795 690 试问下列叙述何者正确？\n", "answer_idx": "D", "answer": "这些數字无法进行任何推論", "options": {"A": "这项调查显示男生有气喘的危险性高", "B": "山城国中的气喘盛行率较高", "C": "山城国中的气喘发生率较高", "D": "这些數字无法进行任何推論"}}
{"meta_info": "taiwanese_test_Q", "question": "外展声带，打开声门最主要的是下列何种肌肉之作用？", "answer_idx": "D", "answer": "后环杓肌", "options": {"A": "侧环杓肌", "B": "环甲肌", "C": "杓间肌", "D": "后环杓肌"}}
{"meta_info": "taiwanese_test_Q", "question": "使用 ACE 抑制剂（angiotensin converting enzyme inhibitor）要注意那一种副作用？", "answer_idx": "C", "answer": "高血钾（Hyperkalemia）", "options": {"A": "高血钠（Hypernatremia）", "B": "低血钙（Hypocalcemia）", "C": "高血钾（Hyperkalemia）", "D": "低血钠（Hyponatremia）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关稳定型心绞痛（stable angina）之药物治療，下列何者最不适当？", "answer_idx": "D", "answer": "合并使用 aspirin 及 warfarin 优于单独使用 aspirin", "options": {"A": "使用交感神经乙型阻断剂，除非病人有该药物之禁忌症", "B": "若病人有使用交感神经乙型阻断剂之禁忌症，则建议使用钙離子阻断剂", "C": "若合并糖尿病或左心室收缩功能不良，则建议使用血管张力素转换酶抑制剂（angiotensin-converting", "D": "合并使用 aspirin 及 warfarin 优于单独使用 aspirin"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 70 岁抽烟患者，其肺功能显示 FEV1/FVC = 60%，FEV1 只有预期值的 56%；下列何者非长期治療的处方？", "answer_idx": "B", "answer": "口服低剂量類固醇", "options": {"A": "吸入长效型支气管扩张剂", "B": "口服低剂量類固醇", "C": "戒烟", "D": "肺部復健"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关骶尾畸胎瘤（sacrococcygeal teratoma）之叙述，何者正确？", "answer_idx": "B", "answer": "原条（primitive streak）闭锁不全所造成", "options": {"A": "由外胚层和中胚层的细胞组成", "B": "原条（primitive streak）闭锁不全所造成", "C": "产前的超音波检查不易发现", "D": "常发生于男性新生儿"}}
{"meta_info": "taiwanese_test_Q", "question": "透明膜（hyaline membrane）这种疾病与胎儿肺部在下列何时期发育不良有关？", "answer_idx": "C", "answer": "末囊期（terminal sac period）", "options": {"A": "伪腺期（pseudoglandular period）", "B": "小管期（canalicular period）", "C": "末囊期（terminal sac period）", "D": "肺泡期（alveolar period）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者较不可能是因为上运动神经元（upper motor neuron）损伤所呈现的病征？", "answer_idx": "B", "answer": "肌束抽搐（Fascicular twitching）", "options": {"A": "肌无力（Weakness）", "B": "肌束抽搐（Fascicular twitching）", "C": "深部腱反射（Deep tendon reflex）增加", "D": "伸跖反射（Extensor plantar reflex） 61 巨细胞动脉炎（Giant cell arteritis）的主要治療是："}}
{"meta_info": "taiwanese_test_Q", "question": "一位 52 岁女性，主诉咳嗽痰多，胸部 X 光片和 CT 影像如下图，则最可能的诊断为下列何者？", "answer_idx": "A", "answer": "囊状支气管扩张（cystic bronchiectasis）", "options": {"A": "囊状支气管扩张（cystic bronchiectasis）", "B": "脓胸（empyema）", "C": "横膈疝脱（diaphragmatic hernia）", "D": "空洞性肺癌（cystic lung carcinoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 43 岁病人，偶然间摸到颈部淋巴结肿大，但无其他不适。经淋巴结切片及病理检查证实为 B 细胞弥漫型大细胞淋巴瘤，CD20 抗原阳性。电脑断层摄影显示腹部大动脉旁及鼠蹊部淋巴结肿大。对这位病人最适当的治疗为何？", "answer_idx": "D", "answer": "给予化学治疗 CHOP 加 rituximab", "options": {"A": "密切观察待有症状时再治疗", "B": "给予化学治疗 COP（cyclophosphamide, vincristine 及 prednisolone）", "C": "给予化学治疗 CHOP（COP 加 adriamycin）", "D": "给予化学治疗 CHOP 加 rituximab"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不会引起脂肪肝？", "answer_idx": "D", "answer": "胃食道逆流", "options": {"A": "肥胖", "B": "糖尿病", "C": "高血脂症", "D": "胃食道逆流"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，在急诊处对该病人的处置，下列何者最为适当？", "answer_idx": "B", "answer": "尿液渗透压测定，并给予0.9% NaCl", "options": {"A": "脑部电脑断层摄影，并给予口服kayexalate 60 mg", "B": "尿液渗透压测定，并给予0.9% NaCl", "C": "动脉血气体分析，并作血液的细菌培养", "D": "脑脊髓液检查，并给予5%葡萄糖溶液，加入5单位的短效胰岛素"}}
{"meta_info": "taiwanese_test_Q", "question": "下列狀况何者为最可能的诊断？", "answer_idx": "B", "answer": "排卵期的子宫颈黏液", "options": {"A": "使用口服排卵药", "B": "排卵期的子宫颈黏液", "C": "早发性停经", "D": "接受子宫颈锥狀切除术后"}}
{"meta_info": "taiwanese_test_Q", "question": "一男婴足月出生活动力正常，但产后 4 天发现脐带结扎处有渗出血水，背部有局部瘀血斑，婴儿最有可能缺乏下列何种营养素？", "answer_idx": "A", "answer": "维生素 K", "options": {"A": "维生素 K", "B": "维生素 B12", "C": "葉酸", "D": "铁"}}
{"meta_info": "taiwanese_test_Q", "question": "9 张先生56 岁，因严重心脏衰竭至急诊处，胸部X 光及臨床诊察变化为：肺充血（lung congestion）  Kerley B line 腹水、肝肿大下肢水肿（edema），则下列何者是最确切的右心衰竭特点？\n", "answer_idx": "C", "answer": "", "options": {"A": "", "B": "", "C": "", "D": ""}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关肉毒杆菌毒素（botulinum neurotoxin）局部肌肉注射以治療脑性麻痹肌肉痉挛的叙述，何者最正确？", "answer_idx": "C", "answer": "有效期间 3 至 6 个月，需要重复注射", "options": {"A": "其作用是使周边神经去髓鞘（demyelination），造成肌肉无力", "B": "作用快速，注射后 20 分钟就出现肌肉无力及痉挛消失", "C": "有效期间 3 至 6 个月，需要重复注射", "D": "其缺点是可能造成局部感觉異常"}}
{"meta_info": "taiwanese_test_Q", "question": "一般标准之纯音听力检查（pure tone audiometry）所测 之最高音频为下列何者？", "answer_idx": "C", "answer": "8000 Hz", "options": {"A": "4000 Hz", "B": "6000 Hz", "C": "8000 Hz", "D": "10000 Hz"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种细胞是专业化的抗原呈现细胞（professional antigen-presenting cell）？", "answer_idx": "C", "answer": "巨噬细胞（macrophage）", "options": {"A": "CD4+ T 细胞", "B": "嗜中性白血球（neutrophil）", "C": "巨噬细胞（macrophage）", "D": "肥胖细胞（mast cell）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列细胞中，何者的主要功能是产生抗体？", "answer_idx": "C", "answer": "浆细胞（plasma cells）", "options": {"A": "巨噬细胞（macrophages）", "B": "肥大细胞（mast cells）", "C": "浆细胞（plasma cells）", "D": "T淋巴细胞（T lymphocytes）"}}
{"meta_info": "taiwanese_test_Q", "question": "在急性心肌梗塞后，会发生各种并发症，下列何种并发症发生后必须考虑尽速手术治療，以免病人病情惡化而死亡？", "answer_idx": "B", "answer": "坏死性心室中隔缺损", "options": {"A": "呼吸窘迫症候群（Acute Respiratory Distress Syndrome）", "B": "坏死性心室中隔缺损", "C": "低心输出量合并寡尿（Oliguria）", "D": "细菌性心内膜炎"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关平滑肌收缩时之 cross-bridge activation 的叙述，何者错误？", "answer_idx": "A", "answer": "该激活作用是因肌动蛋白（actin）磷酸化所致", "options": {"A": "该激活作用是因肌动蛋白（actin）磷酸化所致", "B": "troponin 不參与此激活作用", "C": "细胞质内之钙離子（cytosolic calcium）与调钙蛋白（calmodulin）结合，參与此激活作用", "D": "在平滑肌内的 ATPase 酵素活性速率比在骨骼肌内來的慢"}}
{"meta_info": "taiwanese_test_Q", "question": "84 有关医療社会化（medical socialization）之可能结果，请由下列选项中选出最适当的组合关系？ ①造成医療价格高涨 ②非医療需求者亦需负担医療费用 ③易引起医療供给者之反弹 ④易引起高所得者之不满与不安", "answer_idx": "B", "answer": "②③④", "options": {"A": "①②③④", "B": "②③④", "C": "①②③", "D": "①②④"}}
{"meta_info": "taiwanese_test_Q", "question": "一位病人于理学检查时被发现有肩膀外展（abduction）无力，下列那一部分的神经损伤不会造成此种现象？", "answer_idx": "C", "answer": "肌皮神经（musculocutaneous nerve）", "options": {"A": "腋窝神经（axillary nerve）", "B": "臂神经丛上干（upper trunk）", "C": "肌皮神经（musculocutaneous nerve）", "D": "臂神经丛后索（posterior cord）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于人类单核细胞艾利希体症（human monocytic ehrlichiosis）的叙述，下列何者错误？", "answer_idx": "A", "answer": "以青霉素（penicillin）、氨基糖苷（aminoglycosides）、大环内酯（macrolides）等类药物治疗有效", "options": {"A": "以青霉素（penicillin）、氨基糖苷（aminoglycosides）、大环内酯（macrolides）等类药物治疗有效", "B": "其致病菌可在血液单核球（monocyte）和巨噬细胞（macrophage）内进行繁殖", "C": "多数病患会有血清转胺酶（serum transaminase）升高及血小板减少（thrombocytopenia）的情况", "D": "临床主要以核酸增幅法（nucleic acid amplification）或血清学检 （serological test）确认此疾病"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者非会厌炎（epiglottitis）典型之症状？", "answer_idx": "C", "answer": "哮鸣（wheezing）", "options": {"A": "喘鸣（stridor）", "B": "吞咽困难（dysphagia）", "C": "哮鸣（wheezing）", "D": "流涎（drooling）"}}
{"meta_info": "taiwanese_test_Q", "question": "脑中核酸分解所形成之氨（ammonia），主要转化为下列何种物质，再经由血液运送至肝脏或肾脏？", "answer_idx": "D", "answer": "麸胺醯胺（glutamine）", "options": {"A": "尿酸（uric acid）", "B": "尿素（urea）", "C": "天冬醯胺（asparagine）", "D": "麸胺醯胺（glutamine）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者受损时最可能影响提睪肌（cremasteric muscle）的收缩？", "answer_idx": "C", "answer": "生殖股神经（genitofemoral nerve）", "options": {"A": "股神经（femoral nerve）", "B": "阴部神经（pudendal nerve）", "C": "生殖股神经（genitofemoral nerve）", "D": "髂腹股沟神经（ilioinguinal nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "此时昏迷指數最可能为几分？", "answer_idx": "B", "answer": "3", "options": {"A": "1", "B": "3", "C": "5", "D": "7"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种细胞不属于永久性组织（nondividing or permanent tissues）?", "answer_idx": "C", "answer": "平滑肌细胞（smooth muscle cells）", "options": {"A": "神经元（neurons）", "B": "骨骼肌细胞（skeletal muscle cells）", "C": "平滑肌细胞（smooth muscle cells）", "D": "心肌细胞（cardiac muscle cells）"}}
{"meta_info": "taiwanese_test_Q", "question": "儿童总胆管囊肿（choledochal cyst）的症狀，下列何者最少見？", "answer_idx": "C", "answer": "胆道结石（gallstone）", "options": {"A": "腹痛（abdominal pain）", "B": "黄疸（jaundice）", "C": "胆道结石（gallstone）", "D": "腹部肿块（abdominal mass）"}}
{"meta_info": "taiwanese_test_Q", "question": "34岁男性，因中枢神经系统症状住院，脑部切片显示多个髓鞘脱失（demyelination）病灶，其内之神经轴索（axons）数目略减，病灶边缘之寡树突胶质细胞核呈玻璃状双染的包涵物（glassy amphophilic inclusions），亦见到奇异且巨大的星状胶原细胞（bizarre giant astrocytes），其诊断为何？", "answer_idx": "B", "answer": "进行性多病灶脑白质病（progressive multifocal leukoencephalopathy）", "options": {"A": "人类免疫力不足病毒脑炎（human immunodeficiency virus encephalitis）", "B": "进行性多病灶脑白质病（progressive multifocal leukoencephalopathy）", "C": "亚急性硬化性全脑炎（subacute sclerosing panencephalitis）", "D": "第二型单纯疱疹病毒脑炎（herpes simplex virus type 2 encephalitis）"}}
{"meta_info": "taiwanese_test_Q", "question": "50 岁妇女上门求诊，因左侧腋下有肿块 3 周，经医师检查发现，左侧腋下淋巴结肿大且硬，但不痛，请问该妇女最有可能罹患下列何种疾病？", "answer_idx": "B", "answer": "乳房腺管癌", "options": {"A": "急性乳腺炎合并化脓", "B": "乳房腺管癌", "C": "乳房恶性淋巴瘤", "D": "肺部小细胞癌"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 16 岁的高中生打篮球后左膝盖一直疼痛不愈。国术馆推拿后反而渐渐肿胀。骨科检查，X 光发现远端股骨有異常；切片诊断为惡性骨肉瘤。下列叙述何者错误？", "answer_idx": "B", "answer": "胸部 X 光检查发现有一个可能是转移的肿瘤，此阶段已无法治療", "options": {"A": "X 光检查可能发现 Codman's triangle", "B": "胸部 X 光检查发现有一个可能是转移的肿瘤，此阶段已无法治療", "C": "胸部电脑断层检查是必要的", "D": "化学治療是不可缺少的"}}
{"meta_info": "taiwanese_test_Q", "question": "控制下列心血管因子，何者对缺血性心脏病之预后影响最不显著？", "answer_idx": "D", "answer": "控制血糖", "options": {"A": "戒烟", "B": "控制血压", "C": "控制血脂異常（dyslipidemia）", "D": "控制血糖"}}
{"meta_info": "taiwanese_test_Q", "question": "肺炎霉浆菌（Mycoplasma pneumoniae）感染会引起原发性非典型肺炎（primary atypical pneumonia），在鉴定培养时通常会加入下列何种抗生素于培养基中，以利霉浆菌的分離与生长？", "answer_idx": "A", "answer": "青霉素（penicillin）", "options": {"A": "青霉素（penicillin）", "B": "红霉素（erythromycin）", "C": "四环素（tetracycline）", "D": "磺胺剂（sulfonamide）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种真核细胞调控蛋白质（eukaryotic regulatory proteins）会与增强子（enhancer）结合，以促进基因转录？", "answer_idx": "A", "answer": "转录活化子（transcription activators）", "options": {"A": "转录活化子（transcription activators）", "B": "辅活化子（coactivators）", "C": "TATA-结合蛋白（TATA-binding proteins; TBP）", "D": "基准转录因子（basal transcription factors）"}}
{"meta_info": "taiwanese_test_Q", "question": "胚胎发育时，下列那一咽沟（pharyngeal groove）会持续存在，并且衍生形成外听道（external acoustic meatus）？", "answer_idx": "A", "answer": "第一", "options": {"A": "第一", "B": "第二", "C": "第三", "D": "第四"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 5 岁大 20 kg 的儿童送医途中，身体评估显示儿童无反应、无脉搏，且无自发性呼吸。护送儿童的紧急救护员叙述护送途中持续给予正压呼吸及胸部按压，贴上自动体外电击器贴片，心电图显示如下，此时，下列何种治療对小朋友最合适？", "answer_idx": "C", "answer": "使用儿童电击贴片，给予 50 焦耳双相电击一次", "options": {"A": "建立血管通路，给予 Amiodarone 100 mg 注射", "B": "建立血管通路，给予 Adenosine 2 mg 注射", "C": "使用儿童电击贴片，给予 50 焦耳双相电击一次", "D": "建立血管通路，给予 Epinephrine 0.2 mg 注射，并继续 CPR"}}
{"meta_info": "taiwanese_test_Q", "question": "胰脏之腺泡中央细胞（centroacinar cells）的來源是什么？", "answer_idx": "D", "answer": "闰管（intercalated duct）细胞", "options": {"A": "产酵素细胞（zymogenic cells）", "B": "蘭氏小岛（islet of Langerhans）细胞", "C": "小葉间管（interlobular duct）细胞", "D": "闰管（intercalated duct）细胞"}}
{"meta_info": "taiwanese_test_Q", "question": "20岁男性，因右膝受伤接受X光摄影。附图为X光摄影影像，最可能的诊断为何？", "answer_idx": "B", "answer": "hereditary multiple exostoses", "options": {"A": "fibrous dysplasia", "B": "hereditary multiple exostoses", "C": "osteogenic sarcoma", "D": "eosinophilic granuloma"}}
{"meta_info": "taiwanese_test_Q", "question": "年轻女性引起急性输卵管炎之最常見的致病原因为何？", "answer_idx": "B", "answer": "Chlamydia trachomatis", "options": {"A": "gonorrhea", "B": "Chlamydia trachomatis", "C": "Ureaplasma urealyticum", "D": "bacterial vaginitis"}}
{"meta_info": "taiwanese_test_Q", "question": "有关幼儿異物吞食之叙述，下列何者错误？", "answer_idx": "D", "answer": "即使病人无臨床症狀，blunt objects and coins lodged in the esophagus 也必须尽早取出，以避免食道破裂", "options": {"A": "至少 30% of children with esophageal foreign bodies 无症狀", "B": "误食 foreign body 者，大部分（约 80%）为 6 个月到 3 岁之间的婴幼儿", "C": "若有 sharp objects in the esophagus, disc button batteries 或異物合并呼吸道症狀者，应立即取出", "D": "即使病人无臨床症狀，blunt objects and coins lodged in the esophagus 也必须尽早取出，以避免食道破裂"}}
{"meta_info": "taiwanese_test_Q", "question": "35岁女性主述于2年前，手部遇冷会出现指端变紫黑色的情形，另外也抱怨颜面红斑及多发性关节痛。最近1 年，工作时容易疲劳，实 室检查Anti-U1 RNP抗体为1:1280。最可能的诊断为：", "answer_idx": "D", "answer": "混合性结缔组织病（mixed connective tissue disease）", "options": {"A": "全身性硬化症（systemic sclerosis）", "B": "系统性红斑狼疮（systemic lupus erythematosus）", "C": "皮肤肌炎（dermatomyositis）", "D": "混合性结缔组织病（mixed connective tissue disease）"}}
{"meta_info": "taiwanese_test_Q", "question": "出生体重低于1000公克的早产儿发生脑性麻痹（cerebral palsy）机率较高，是因为这类婴儿较易有何种脑部病变发生？", "answer_idx": "D", "answer": "peri-ventricular leukomalacia", "options": {"A": "brain malformation", "B": "subdural hematoma", "C": "congenital meningitis", "D": "peri-ventricular leukomalacia"}}
{"meta_info": "taiwanese_test_Q", "question": "因感染结核分枝杆菌（Mycobacterium tuberculosis）而在肺部形成的肉芽肿（granuloma）中，主要可以观察到下列那一种细胞？", "answer_idx": "D", "answer": "兰氏巨细胞（Langhans giant cell）", "options": {"A": "滋养细胞（trophocyte）", "B": "小胶质细胞（microglial cell）", "C": "空泡细胞（koilocyte）", "D": "兰氏巨细胞（Langhans giant cell）"}}
{"meta_info": "taiwanese_test_Q", "question": "左胃网膜动脉（left gastro-omental artery）源自下列何者？", "answer_idx": "D", "answer": "脾动脉（splenic artery）", "options": {"A": "右胃网膜动脉", "B": "肝动脉（hepatic artery）", "C": "胃十二指肠动脉（gastroduodenal artery）", "D": "脾动脉（splenic artery）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位72 岁病患，服用口服降血糖药物多年，最近五天因\"感冒\"变得嗜睡，由家人送來急诊求医，抵院时，血压为120/80 mmHg，神经学检查无異常所見，实验室數据如下：WBC：14,500/mm3、尿酮：", "answer_idx": "B", "answer": "0.9% NaCl 3000 mL 静脉输注", "options": {"A": "NPH insulin 20 单位皮下注射", "B": "0.9% NaCl 3000 mL 静脉输注", "C": "抗生素治療", "D": "7% sodium bicarbonate 40 mL 静脉注射"}}
{"meta_info": "taiwanese_test_Q", "question": "克流感（oseltamivir）主要藉由干扰流感病毒的那种蛋白的功能，以达到抑制病毒的功效？", "answer_idx": "D", "answer": "Neuraminidase", "options": {"A": "M1 protein", "B": "Hemagglutinin", "C": "M2 protein", "D": "Neuraminidase"}}
{"meta_info": "taiwanese_test_Q", "question": "附图为描述糖尿病发病过程的一些生理变化，甲、乙及丙三条曲线分别描述那些变化？", "answer_idx": "A", "answer": "甲：血糖变化；乙：胰岛素分泌量；丙：胰岛素敏感度", "options": {"A": "甲：血糖变化；乙：胰岛素分泌量；丙：胰岛素敏感度", "B": "甲：胰岛素分泌量；乙：胰岛素敏感度；丙：血糖变化", "C": "甲：血糖变化；乙：胰岛素敏感度；丙：胰岛素分泌量", "D": "甲：胰岛素敏感度；乙：胰岛素分泌量；丙：血糖变化"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关马尾症候群（cauda equina syndrome）的叙述，何者正确？", "answer_idx": "D", "answer": "球海绵体肌反射（bulbocavernosus reflex）消失", "options": {"A": "以上运动神经元（upper motor neuron）表征为主", "B": "通常临床症状是左右两侧对称", "C": "深部肌腱反射增强", "D": "球海绵体肌反射（bulbocavernosus reflex）消失"}}
{"meta_info": "taiwanese_test_Q", "question": "五个月大男婴，因哭闹不停及出现粉红色果冻样大便（currant jelly stool）就医，影像学检查发现有肠套叠。病人最可能出现下列何种病理变化？", "answer_idx": "A", "answer": "肠道坏死", "options": {"A": "肠道坏死", "B": "肠壁平滑肌肥厚", "C": "肠黏膜细胞增生", "D": "肠道血管增生"}}
{"meta_info": "taiwanese_test_Q", "question": "左肺门（hilum）正上方的沟（或切迹）是由何结构造成的？", "answer_idx": "B", "answer": "动脉弓", "options": {"A": "食道", "B": "动脉弓", "C": "奇静脉", "D": "上腔静脉"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关第一型神经纤维瘤（type 1 neurofibromatosis）的描述，何者错误？", "answer_idx": "A", "answer": "此病为体染色体隐性遗传（autosomal recessive）", "options": {"A": "此病为体染色体隐性遗传（autosomal recessive）", "B": "有将近一半的病人均是因为新的基因突变造成（de novo mutation）", "C": "有可能会伴发视神经瘤（optic glioma）", "D": "身上有六个以上之咖啡斑（café-au-lait spots）"}}
{"meta_info": "taiwanese_test_Q", "question": "48 岁男性，連续发生胸痛并延伸至左肩之情形已持续 3 天。來到急诊时表现为呼吸困难、头暈与冒冷汗持续 1 小时；病人一到急诊血压无法测得，而心电图呈现如下变化。下列处置何者正确？", "answer_idx": "D", "answer": "直流电电击整流术（direct current cardioversion）", "options": {"A": "舌下甘油片可缓解此病人之疼痛", "B": "可针对病人之呼吸困难使用 morphine 肌肉注射", "C": "以静脉注射 amiodarone 速效剂量，再以静脉連续输注维持剂量", "D": "直流电电击整流术（direct current cardioversion）"}}
{"meta_info": "taiwanese_test_Q", "question": "患者因肛门严重搔痒就诊，并出现脱肛（rectal prolapse）症狀时，你应怀疑受到下列何种寄生虫感染？", "answer_idx": "C", "answer": "鞭虫（Trichuris trichiura）", "options": {"A": "蛔虫（Ascaris lumbricoides）", "B": "美洲钩虫（Necator americanus）", "C": "鞭虫（Trichuris trichiura）", "D": "蛲虫（Enterobius vermicularis）"}}
{"meta_info": "taiwanese_test_Q", "question": "单一静脉注射thiopental在人体内的作用时间非常短暂，其主要原因是具有下列何项性质？", "answer_idx": "C", "answer": "易由大脑再到脂肪组织重新分布", "options": {"A": "在肠胃道之吸收缓慢", "B": "不经由肝脏代谢而直接由肾脏排出", "C": "易由大脑再到脂肪组织重新分布", "D": "在肝脏很快被代谢成不活性物质"}}
{"meta_info": "taiwanese_test_Q", "question": "下列低血钾之成因何者不是因钾離子移入细胞内？", "answer_idx": "C", "answer": "库欣氏症（Cushing's syndrome）", "options": {"A": "代谢性碱中毒（metabolic alkalosis）", "B": "合成代谢阶段（anabolic state）", "C": "库欣氏症（Cushing's syndrome）", "D": "低血钾周期性无力症（hypokalemic periodic paralysis）"}}
{"meta_info": "taiwanese_test_Q", "question": "健康行为改变的PRECEDE-PROCEED模式中，下列那一项是属于增强因素（reinforcing factor）？", "answer_idx": "B", "answer": "重要他人支持", "options": {"A": "资源整合运用", "B": "重要他人支持", "C": "态度信念改变", "D": "支持环境的重建"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者属于衍生性空气污染物？", "answer_idx": "D", "answer": "臭氧", "options": {"A": "二氧化硫", "B": "一氧化碳", "C": "一氧化氮", "D": "臭氧"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列有关这類患者之药物治療，何者错误？", "answer_idx": "A", "answer": "使用 hydroxychloroquine 主要是抑制发炎细胞的增生", "options": {"A": "使用 hydroxychloroquine 主要是抑制发炎细胞的增生", "B": "急性期可以使用類固醇來缓解症狀", "C": "Sulfasalazine 主要是抑制发炎性细胞激素之表现", "D": "Methotrexate 是有效之第二线药物"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，若此男童骨龄检查结果为 12 岁 9 个月，优先考虑下列那一项诊断？", "answer_idx": "C", "answer": "体质性生长迟延（constitutional growth delay）", "options": {"A": "家族性身材矮小（genetic short stature）", "B": "营养不良（malnutrition）", "C": "体质性生长迟延（constitutional growth delay）", "D": "脑垂体低能症（hypopituitarism）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 21 岁双极性疾患（bipolar disorder）急性躁症发作（acute manic episode）的患者，被送到医院急诊室时，下列那一种症狀应较不会出现？", "answer_idx": "D", "answer": "罪惡妄想", "options": {"A": "情绪高亢", "B": "精力旺盛", "C": "意念飞跃", "D": "罪惡妄想"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于自发性气胸（spontaneous pneumothorax）的手术适应症叙述，何者错误？", "answer_idx": "D", "answer": "细针穿刺引流无效者", "options": {"A": "第一次发作经插胸管引流后仍持续漏气超过 72 小时", "B": "同侧气胸第二次或以上之復发", "C": "并发血胸、脓胸或慢性气胸者", "D": "细针穿刺引流无效者"}}
{"meta_info": "taiwanese_test_Q", "question": "45 岁男性病人在接受心脏移植 10 年后发生冠狀动脉狭窄，最可能的冠狀动脉病变是：", "answer_idx": "A", "answer": "Intimal fibrosis", "options": {"A": "Intimal fibrosis", "B": "Medial fibrosis", "C": "Periarterial fibrosis", "D": "Medial calcification"}}
{"meta_info": "taiwanese_test_Q", "question": "目前国内接种的 B 型肝炎疫苗是属于：", "answer_idx": "D", "answer": "基因重组次单位疫苗（subunit vaccine）", "options": {"A": "死病毒（Killed virus）", "B": "活减毒疫苗（Live attenuated virus）", "C": "活病毒（Live virus）", "D": "基因重组次单位疫苗（subunit vaccine）"}}
{"meta_info": "taiwanese_test_Q", "question": "30 岁少妇，已婚，婚后6 年來并无节育计画，但并未生小孩，月经时有时无，最近因乳房分泌乳汁，至一般外科看诊，再转诊至妇科，经抽血检查，发现血中某數值增高，医师随即安排脑部核磁共振造影，结果在颅底鞍凹（sella turcica）处，发现约1 公分大小之脑瘤。请问此患者抽血检查數值偏高的是下列那一项？", "answer_idx": "C", "answer": "prolactin", "options": {"A": "HCG（human chorionic gonadotropin）", "B": "growth hormone", "C": "prolactin", "D": "α-fetoprotein"}}
{"meta_info": "taiwanese_test_Q", "question": "3.2 g/dL", "answer_idx": "A", "answer": "因急性十二指肠溃疡穿孔接受腹腔镜十二指肠修补缝合术，术后第三天，鼻胃管仍留置，每日引流量约为六百毫升", "options": {"A": "因急性十二指肠溃疡穿孔接受腹腔镜十二指肠修补缝合术，术后第三天，鼻胃管仍留置，每日引流量约为六百毫升", "B": "因胃癌住院准备接受手术，手术后体重由七十公斤降为六十五公斤，抽血检查血清白蛋白浓度为", "C": "因上肠系膜动脉血栓并腹膜炎切除大部分小肠，术后第八天", "D": "因胃及小肠胃肠间质瘤（gastrointestinal stroma tumor, GIST）接受半胃切除术及小肠部分切除术，约切除二十公分小肠，术后第三天仍未排气，持续禁食中"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种激素扮演促进胎儿时期中枢神经发育的关键角色？", "answer_idx": "B", "answer": "甲状腺素（thyroxine）", "options": {"A": "生长激素（growth hormone）", "B": "甲状腺素（thyroxine）", "C": "肾上腺皮质醇（cortisol）", "D": "泌乳素（prolactin）"}}
{"meta_info": "taiwanese_test_Q", "question": "23.65岁女性病⼈因⻑期糖尿病肾病变，接受规则⾎液透析治疗已5年，透析前⾎中磷（PO43-）6.8 mg/dL、钙", "answer_idx": "A", "answer": "使⽤磷结合剂（phosphate binder）", "options": {"A": "使⽤磷结合剂（phosphate binder）", "B": "使⽤维他命D3（vitamin D3）", "C": "使⽤拟钙剂（calcimimetic）", "D": "使⽤钙浓度3.0 mEq/L透析液"}}
{"meta_info": "taiwanese_test_Q", "question": "43.有一 32岁男性主诉两三个月来易倦，腹胀。理学检查发现体温正常，结膜苍白，脾脏在左肋下沿可触诊；血液常规检查：WBC 120,000/uL， blast/promyelocyte/myelocyte/metamyelocyte/neutrophil/monocyte/eosinophil/ basophil/lymphocyte =\n metaphases 。目前学界共识第一线治疗为何？", "answer_idx": "C", "answer": "tyrosine kinase inhibitor", "options": {"A": "hydroxyurea", "B": "interferon-alpha", "C": "tyrosine kinase inhibitor", "D": "allogeneic hematopoietic stem cell tr​​ansplantation"}}
{"meta_info": "taiwanese_test_Q", "question": "大脑大静脉（great cerebral vein of Galen）注入：", "answer_idx": "C", "answer": "直窦（straight sinus）", "options": {"A": "岩上窦（superior petrosal sinus）", "B": "横窦（transverse sinus）", "C": "直窦（straight sinus）", "D": "上矢狀窦（superior sagittal sinus）"}}
{"meta_info": "taiwanese_test_Q", "question": "62.张先生到医院进行各项肺容积之测量，测量结果显示总肺容量（total lung capacity）为5000毫升，肺余容积（residual volume）为300毫升，两者之间的差值称之为何？\n", "answer_idx": "A", "answer": "肺活量（vital capacity）", "options": {"A": "肺活量（vital capacity）", "B": "吸气储备容积（inspiratory reserve volume）", "C": "潮气容积（tidal volume）", "D": "功能性肺余容量（functional residual capacity）"}}
{"meta_info": "taiwanese_test_Q", "question": "52 一位 60 岁男性，病人主诉便秘，大便有血，并有痔疮。病人要求手术治疗痔疮以改善便秘，下列有 关临床医师之应对处置何者错误？\n", "answer_idx": "D", "answer": "改善便秘需切除痔疮", "options": {"A": "检查痔疮严重度", "B": "安排大肠镜检查", "C": "肛门收缩力检查", "D": "改善便秘需切除痔疮"}}
{"meta_info": "taiwanese_test_Q", "question": "復苏后的照护，有关体温部分之叙述，下列何者正确？", "answer_idx": "D", "answer": "復苏后体温若高于正常，要积极降温", "options": {"A": "復苏后体温于略低狀态（33-35℃），则要小心的回温至正常", "B": "復苏后将体温控制于 32-34℃，维持 12-24 小时，于原始为 ventricular fibrillation（VF）心律者，为 classⅡb 位阶", "C": "復苏后将体温控制于 32-34℃，维持 12-24 小时，于原始为 Asystole 心律者，为 classⅡa 位阶", "D": "復苏后体温若高于正常，要积极降温"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 50 岁中年妇女到门诊主诉右手食指、中指、无名指麻痹，理学检查鱼际肌（thenar muscle）有明显萎缩，她最可能发生下列那条神经的病变？", "answer_idx": "B", "answer": "正中神经（median nerve）", "options": {"A": "桡神经（radial nerve）", "B": "正中神经（median nerve）", "C": "尺神经（ulnar nerve）", "D": "后骨间神经（posterior interosseous nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "结核病及類肉瘤病（sarcoidosis）的共同特征是：", "answer_idx": "C", "answer": "都有肉芽肿", "options": {"A": "都是传染性疾病", "B": "都有干酪狀坏死", "C": "都有肉芽肿", "D": "常引起肺脏的弥漫性间质纤维化"}}
{"meta_info": "taiwanese_test_Q", "question": "有一位12岁的男童因两边淋巴腺肿大到医院求诊，经血液及切片检查，发现有细胞型态正常的组织球增生与血液细胞吞噬现象。细胞免疫检 发现CD1a阴性，而有CD8阳性之T细胞。下列何者为最正确诊断？", "answer_idx": "B", "answer": "infection-associated hemophagocytic syndrome", "options": {"A": "Langerhans cell histiocytosis", "B": "infection-associated hemophagocytic syndrome", "C": "malignant histiocytosis", "D": "acute monocytic leukemia"}}
{"meta_info": "taiwanese_test_Q", "question": "以下何者容易出现病毒相关性肿瘤？", "answer_idx": "D", "answer": "AIDS 患者", "options": {"A": "Leishmaniasis 患者", "B": "Legionella pneumonia 患者", "C": "IgA nephropathy 患者", "D": "AIDS 患者"}}
{"meta_info": "taiwanese_test_Q", "question": "⼈⼯⽿蜗（cochlear implants）是利⽤电极，刺激极重度听损病⼈内⽿中之何种细胞？", "answer_idx": "D", "answer": "螺旋神经节细胞（spiral ganglion cells）", "options": {"A": "外⽑细胞（outer hair cells）", "B": "内⽑细胞（inner hair cells）", "C": "⾎管纹细胞（striae vascularis cells）", "D": "螺旋神经节细胞（spiral ganglion cells）"}}
{"meta_info": "taiwanese_test_Q", "question": "62.假设其它条件不变，慢性阻塞性肺脏疾病（chronic obstructive pulmonary disease）患者若要达到与正常人相同之通气量（ventilation），则其每次呼吸时肋膜内压（intrapleural pressure, Pip）的变化与正常人相比较应为下列何者？\n", "answer_idx": "A", "answer": "较大", "options": {"A": "较大", "B": "较小", "C": "相等", "D": "可能较大也可能较小，视病情而定"}}
{"meta_info": "taiwanese_test_Q", "question": "一位37 岁女性因为容易疲倦应诊，血液相检查显示血红素8.0 gm/dL，红血球數3.65×106 /µL，血比容（Hct）24%，白血球數8,150 /µL，血小板385,000 /µL，网狀红血球2.5%。此病人之网狀红血球生成指數（reticulocyte production index）最接近多少 %？", "answer_idx": "D", "answer": "0.7", "options": {"A": "2.5", "B": "2", "C": "1.25", "D": "0.7"}}
{"meta_info": "taiwanese_test_Q", "question": "一位25 岁女性，无特殊过去病史，因右腋下有一硬块以及一个月内体重减轻5 公斤而至医院求诊，自述并无发烧、盗汗、咳嗽、呼吸困难或腹痛等症状，理学检查除了右侧腋下有一5×6 cm、固定、无痛性硬块以外其余皆正常，亦无可触性的乳房肿块。切片报告（incisional biopsy）为 poorly differentiated carcinoma，下一步该如何处理最适当？", "answer_idx": "B", "answer": "针对病理切片和病理科医师讨论，并安排进一步相关免疫染色基因检测之检查", "options": {"A": "抽血检验 CEA、CA-125、AFP 及 PSA", "B": "针对病理切片和病理科医师讨论，并安排进一步相关免疫染色基因检测之检查", "C": "尽快安排右侧乳房切除术及腋下淋巴结切除术", "D": "立即给予 cyclophosphamide、adriamycin 及 5-fluorouracil"}}
{"meta_info": "taiwanese_test_Q", "question": "有关甲狀腺功能调节之叙述中，下列何者错误？", "answer_idx": "D", "answer": "甲狀腺释放之荷尔蒙，大部份是三碘甲狀腺素（T3）", "options": {"A": "脑下垂体分泌的 TSH，可刺激甲狀腺荷尔蒙之合成", "B": "甲狀腺可自动调节其对碘離子的回收", "C": "甲狀腺荷尔蒙之合成，会受本身的负回馈调节", "D": "甲狀腺释放之荷尔蒙，大部份是三碘甲狀腺素（T3）"}}
{"meta_info": "taiwanese_test_Q", "question": "正常生理范围下，preload 与 afterload 对于心搏量（stroke volume）之影响分别为何？", "answer_idx": "A", "answer": "preload 增加心搏量；afterload 降低心搏量", "options": {"A": "preload 增加心搏量；afterload 降低心搏量", "B": "preload 降低心搏量；afterload 增加心搏量", "C": "皆增加心搏量", "D": "皆降低心搏量"}}
{"meta_info": "taiwanese_test_Q", "question": "33.60岁何女士有高血压10年，每日服用losartan 50 mg与hydrochlorothiazide 12.5 mg，血压一直控制在理想范围。 2个月前因为肺结核开始服用四合一抗结核药物，一周前何女士开始出现发烧及手部多发性小关节肿痛现象，\n 抽血检 发现抗核抗体（ANA）1：1280阳性，anti-histone antibody阳性，但anti-dsDNA antibodies为阴性。下\n 列处置何者最为适当？\n", "answer_idx": "B", "answer": "停掉isoniazid", "options": {"A": "停掉losartan", "B": "停掉isoniazid", "C": "停掉hydrochlorothiazide", "D": "原有用药都不停，加上prednisolone 0.5 mg/kg/day"}}
{"meta_info": "taiwanese_test_Q", "question": "多发性内分泌肿瘤第Ⅰ型（MENⅠ），不包括下列何者？", "answer_idx": "C", "answer": "甲狀腺髓质瘤", "options": {"A": "副甲狀腺增生", "B": "胰岛素瘤", "C": "甲狀腺髓质瘤", "D": "胃泌素瘤"}}
{"meta_info": "taiwanese_test_Q", "question": "右侧视神经束（optic tract）受损的患者，下列有关其视野（visual field）检查结果的叙述，何者正确？", "answer_idx": "B", "answer": "患者无法侦测投射在右眼右半视网膜（retina）的物体影像", "options": {"A": "左眼视觉功能缺失，而右眼正常", "B": "患者无法侦测投射在右眼右半视网膜（retina）的物体影像", "C": "患者可以侦测投射在左眼右半视网膜（retina）的物体影像", "D": "兩眼均无法侦测右侧视野（visual field）的物体"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关破骨细胞（osteoclasts）的叙述何者正确？", "answer_idx": "A", "answer": "是多核细胞", "options": {"A": "是多核细胞", "B": "位于骨膜内（periosteum）", "C": "分泌骨基质", "D": "细胞质为强嗜碱性"}}
{"meta_info": "taiwanese_test_Q", "question": "派亚氏斑（Peyer's patch）具有下列何种特征？", "answer_idx": "C", "answer": "是淋巴球聚集形成的构造", "options": {"A": "是微血管聚集形成的构造", "B": "是内分泌细胞聚集形成的构造", "C": "是淋巴球聚集形成的构造", "D": "是神经细胞聚集形成的构造"}}
{"meta_info": "taiwanese_test_Q", "question": "因⾞祸⽽急需输⾎患者的⾎型为AB型，在场三⼈中，⼩李⾎型是A型，⼩吴是B型，⼩何是O型，下列叙述何者正确？", "answer_idx": "C", "answer": "三⼈均可捐⾎给患者", "options": {"A": "只有⼩李及⼩吴可捐⾎给患者", "B": "只有⼩何可捐⾎给患者", "C": "三⼈均可捐⾎给患者", "D": "三⼈均不可捐⾎给患者"}}
{"meta_info": "taiwanese_test_Q", "question": "陈小姐被发现有意识不清及黄疸而被送到急诊就医，检查结果为total bilirubin：7.2 mg/dL（正常值：0.2～1.6 mg/dL）、direct bilirubin：4 mg/dL（正常值： 0～0.3 mg/dL）、AST：478 U/L（正常值：5～45 U/L）、 ALT：356 U/L（正常值：0～40 U/L）、alkaline phosphatase：102 U/ L（正常值：10～100 U/L）、 prothrombin time（INR）：3.1、albumin：3.6 g/dL（正常值：4.3～5.4 g/dL），下列之叙述何者错误？", "answer_idx": "D", "answer": "此病人之最可能病因为急性胆管炎", "options": {"A": "此病患可能发生hepatocellular jaundice", "B": "腹部超音波检查胆管应无异常", "C": "此病患黄疸的病因，可能包括virus, autoimmune, toxin and metabolic disorder等", "D": "此病人之最可能病因为急性胆管炎"}}
{"meta_info": "taiwanese_test_Q", "question": "41 一位肾脏病患经異体肾脏移植后服用免疫抑制剂控制排斥反应。最近发现在左侧足背皮肤有一些不 痛、不规则之斑块（如图），病理切片下呈现许多梭狀细胞（spindle cell）和血管样间隙（slit-like vascular space）。有关此病的叙述何者错误？\n", "answer_idx": "B", "answer": "免疫抑制剂中，glucocorticoid 比 cyclosporine A 更易导致此病发生", "options": {"A": "此为卡波西氏肉瘤（Kaposi's sarcoma）", "B": "免疫抑制剂中，glucocorticoid 比 cyclosporine A 更易导致此病发生", "C": "Human immunodeficiency virus（HIV）感染可能与此病之发生有关", "D": "Human herpesvirus-8 与此病相关"}}
{"meta_info": "taiwanese_test_Q", "question": "有位病人因下肢趾头关节处肿胀疼痛无法行走，被送至医院急诊室，经抽血检查发现是xanthine oxidase活性极高所引起的痛风，医师做了紧急处理缓解后，建议病人服用下列何种药物控制尿酸浓度最为合适？", "answer_idx": "C", "answer": "allopurinol", "options": {"A": "ibuprofen", "B": "indomethacin", "C": "allopurinol", "D": "aspirin"}}
{"meta_info": "taiwanese_test_Q", "question": "12.一位50岁女性肺结核病患，已服第一线4种抗结核药物一个月，病人主诉食欲较差，稍微倦怠，但小便更深黄，肝功能检查发现bilirubin T/D 15/8 mg/ dL，AST：68 U/L，ALT：70 U/L。最不可能是那一种抗结核药物引起？\n", "answer_idx": "C", "answer": "ethambutol", "options": {"A": "isoniazid", "B": "rifampin", "C": "ethambutol", "D": "pyrazinamide"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种胺基酸为合成甲狀腺素T3 & T4的前驱物？", "answer_idx": "A", "answer": "arginine", "options": {"A": "arginine", "B": "tryptophan", "C": "lysine", "D": "tyrosine"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 53 岁男性，主诉腹部疼痛及呕吐。患者于 3 年前曾因大肠肿瘤接受右侧结肠切除术，半年前病患亦有一次相似的腹部疼痛，于急诊室处理后症狀改善而出院。此次病患仰卧腹部X 光片显示于左上腹部及左下腹部出现充满气体之胀大空肠肠管，6 小时后追踪之腹部X 光片仍显示胀大的肠管，但是肠管内之气体消失明显，被肠腔内液体所取代。身体诊查发现病患肠音静止，患者无排气无排便。下列何者与患者的病情变化最不相符？", "answer_idx": "A", "answer": "小肠阻塞转变为部分性（small bowel partial obstruction）", "options": {"A": "小肠阻塞转变为部分性（small bowel partial obstruction）", "B": "电脑断层显示肠壁变厚，出现气体", "C": "血中白血球數可能无升高", "D": "体温可能无上升"}}
{"meta_info": "taiwanese_test_Q", "question": "颅内脑动脉瘤（cerebral aneurysm），破裂后第几天，血管痉挛为最严重？", "answer_idx": "B", "answer": "3~10 天", "options": {"A": "1~3 天", "B": "3~10 天", "C": "10~15 天", "D": "15~21 天"}}
{"meta_info": "taiwanese_test_Q", "question": "在人体中，胺基酸不能作为下列何种生物分子生合成的前驱物？", "answer_idx": "D", "answer": "氰钴胺（cobalamin）", "options": {"A": "肾上腺素（epinephrine）", "B": "紫质（porphyrin）", "C": "腺嘌呤（adenine）", "D": "氰钴胺（cobalamin）"}}
{"meta_info": "taiwanese_test_Q", "question": "甲医师受邀到药厂所赞助的研讨会担任讲师，支领钟点费5,000元，担心有利益冲突的问题。有关利益冲突的叙述与处理，下列何者错误？", "answer_idx": "D", "answer": "利益冲突本身就不道德，应全面禁止", "options": {"A": "有效处理利益冲突第一个要件，就是察觉其存在", "B": "公开是处理利益冲突的金科玉律", "C": "核准与审核，也是处理利益冲突的方式之一", "D": "利益冲突本身就不道德，应全面禁止"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种抗生素不经由肝脏代谢或胆汁排出，因此不会干扰其他药物的代谢作用？", "answer_idx": "C", "answer": "gentamicin", "options": {"A": "chloramphenicol", "B": "erythromycin", "C": "gentamicin", "D": "rifampin"}}
{"meta_info": "taiwanese_test_Q", "question": "57 一位 75 岁女性有高血压病史一直用药物控制，主诉心悸、呼吸困难來诊。身体检查发现心跳 108 次/min 而且不规则，有轻微心脏叩音变大，心跳呈心房颤动、心室搏动快速；心脏超音波呈 ejection fraction", "answer_idx": "C", "answer": "测定free T4、TSH", "options": {"A": "使用 amiodarone 控制心跳", "B": "测定 troponin", "C": "测定free T4、TSH", "D": "以cardioversion治療心房颤动"}}
{"meta_info": "taiwanese_test_Q", "question": "Jacob 和 Monod 在研究大肠杆菌中乳糖代谢时发现：一些突变株不管有没有诱导物（乳糖等）的存在下，皆 可 表现 大 量半 乳 糖 苷酶（β-galactosidase），是因为：", "answer_idx": "C", "answer": "此 突 变 株 的 半 乳 糖 苷酶操 纵 子 （operon）无法受其抑止子（Lac repressor）所调控", "options": {"A": "此突变株影响到半乳糖苷酶 mRNA 的转译表现", "B": "此突变株影响到半乳糖苷酶 mRNA 的转录后修饰表现", "C": "此 突 变 株 的 半 乳 糖 苷酶操 纵 子 （operon）无法受其抑止子（Lac repressor）所调控", "D": "此突变造成 Lac repressor 的 DNA 结合能力变强"}}
{"meta_info": "taiwanese_test_Q", "question": "影响台湾地区民众死亡的因素中，何者最为重要？", "answer_idx": "D", "answer": "生活型态的因素", "options": {"A": "医療体系的因素", "B": "生物的因素", "C": "环境的因素", "D": "生活型态的因素"}}
{"meta_info": "taiwanese_test_Q", "question": "某32岁女子，离开勒戒所不久，又施打来路不明的海洛因，因纯度提高导致中毒出现意识不清，送至医院后处置之原则，下列何者正确？", "answer_idx": "C", "answer": "若瞳孔放大与呼吸速率增加，显示中毒程度正逐渐改善", "options": {"A": "因个案体温会下降，所以保温是海洛因中毒最重要的救护措施", "B": "以静脉注射methadone为主要药物治疗", "C": "若瞳孔放大与呼吸速率增加，显示中毒程度正逐渐改善", "D": "因鸦片类拮抗剂（opioid antagonist）多为长效，所以通常给予单次剂量即可"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是脑部病变造成的下半身瘫痪（cerebral paraplegia）最常见的原因？", "answer_idx": "D", "answer": "大脑镰脑膜瘤（falx meningioma）", "options": {"A": "前脑动脉梗塞性脑中风（stroke）", "B": "一氧化碳中毒脑病变（encephalopathy）", "C": "脑膜炎（meningoencephalitis）", "D": "大脑镰脑膜瘤（falx meningioma）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关人工关节的叙述，何者正确？", "answer_idx": "C", "answer": "人工关节垫片及内衬磨损的问题直接关系其使用年限，目前髋关节陶瓷内衬及陶瓷股骨头问世，大大减少磨损率", "options": {"A": "人工关节最大的问题在于与人体组织相容性，装入人体内日积月累，容易产生異物反应（foreign body reaction），故要定期翻修", "B": "糖尿病或免疫力差的病人不是人工关节感染的高危险群", "C": "人工关节垫片及内衬磨损的问题直接关系其使用年限，目前髋关节陶瓷内衬及陶瓷股骨头问世，大大减少磨损率", "D": "人工关节感染最常見菌种为綠脓杆菌（Pseudomonas aeruginosa）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列细菌何者与食入受污染的米饭而引起的食物中毒最为相关？", "answer_idx": "C", "answer": "腊状杆菌（Bacillus cereus）", "options": {"A": "肠炎沙门氏菌（Salmonella enterica）", "B": "创伤弧菌（Vibrio vulnificus）", "C": "腊状杆菌（Bacillus cereus）", "D": "大肠杆菌（Escherichia coli）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关掌内肌群（intrinsic muscles）之叙述，何者错误？", "answer_idx": "B", "answer": "掌短肌（palmaris brevis）是由正中神经（median nerve）所支配的", "options": {"A": "外展拇肌（abductor pollicis）是由正中神经（median nerve）所支配的", "B": "掌短肌（palmaris brevis）是由正中神经（median nerve）所支配的", "C": "背侧掌骨间肌（dorsal interossei）是由尺神经（ulnar nerve）所支配的", "D": "蚓状肌（lumbricals）是由正中神经（median nerve）和尺神经（ulnar nerve）共同支配的"}}
{"meta_info": "taiwanese_test_Q", "question": "19.有关肺癌的描述，下列何者正确？ ①adenocarcinoma是最常见的细胞型 ②squamous cell carcinoma 的发生与抽烟最有关联 ③squamous cell carcinoma常位于靠近肺门中央的位置 ④小细胞肺癌常可以经由手术切除得到治疗", "answer_idx": "B", "answer": "①②③", "options": {"A": "①③④", "B": "①②③", "C": "①②④", "D": "②③④"}}
{"meta_info": "taiwanese_test_Q", "question": "26.6岁大的儿童因为突然晕倒被送到医院，心电图显示如图，心跳频率约为200/min。病童的血压经测量为50/25 mmHg，可以摸到微弱的脉搏但周边循环不佳，接下来应做的处置为何？\n", "answer_idx": "C", "answer": "使用同步整流术（Synchronized DC cardioversion）治疗", "options": {"A": "静脉快速给与Adenosine治疗", "B": "使用冰袋轻轻压迫前额（Valsalva maneuver）", "C": "使用同步整流术（Synchronized DC cardioversion）治疗", "D": "静脉给与Amiodarone治疗"}}
{"meta_info": "taiwanese_test_Q", "question": "遗传性非息肉症大肠癌（hereditary nonpolyposis colon cancer-HNPCC）可由 hMSH2 或 hMLH1 基因变异，而影响下列何种 DNA 修复途径所造成？", "answer_idx": "A", "answer": "错误配对修复（mismatch repair）", "options": {"A": "错误配对修复（mismatch repair）", "B": "碱基切除修复（base excision repair）", "C": "核酸切除修复（nucleotide excision repair）", "D": "双股断裂修复（double strand break repair）"}}
{"meta_info": "taiwanese_test_Q", "question": "胎盘对于胎儿之生长发育极为重要，此乃由于其能提供犹如成人除了下列何者以外重要器官之功能？", "answer_idx": "D", "answer": "外分泌腺体", "options": {"A": "肾脏", "B": "肠胃道", "C": "肺脏", "D": "外分泌腺体"}}
{"meta_info": "taiwanese_test_Q", "question": "在美国精神医学会之精神疾患诊断及统计手册中，下列那一种人格疾患所属的族类（cluster）与其他三者不同？", "answer_idx": "C", "answer": "妄想型", "options": {"A": "边缘型", "B": "反社会型", "C": "妄想型", "D": "戏剧型"}}
{"meta_info": "taiwanese_test_Q", "question": "下列眼振图所代表的临床意义，最可能的诊断是：", "answer_idx": "C", "answer": "右侧小脑桥脑角肿瘤（cerebellopontine angle tumor）", "options": {"A": "右侧美尼尔病（Ménière's disease）", "B": "左侧美尼尔病（Ménière's disease）", "C": "右侧小脑桥脑角肿瘤（cerebellopontine angle tumor）", "D": "左侧小脑桥脑角肿瘤（cerebellopontine angle tumor）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者为 ampicillin 与 piperacillin 合并治療 Pseudomonas aeruginosa 感染时诱发抗药性的原因？", "answer_idx": "B", "answer": "ampicillin 诱发 beta-lactamase 的产生", "options": {"A": "piperacillin 抑制 ampicillin 与 penicillin 结合蛋白接触", "B": "ampicillin 诱发 beta-lactamase 的产生", "C": "piperacillin 抑制 autolytic enzyme 的活性", "D": "ampicillin 系一种 bacteriostatic 作用剂"}}
{"meta_info": "taiwanese_test_Q", "question": "有关呼吸系统，下列叙述何者错误？", "answer_idx": "C", "answer": "鼻腔内之上皮组织属于过渡性上皮（transitional epithelium）", "options": {"A": "鼻腔内之黏膜（mucosa）可以温暖，湿润及过濾吸入之空气", "B": "Bowman's 腺可分泌浆液（serous），以去除已被侦测过之残余气味物质", "C": "鼻腔内之上皮组织属于过渡性上皮（transitional epithelium）", "D": "嗅上皮（olfactory epithelium）是伪复层柱狀上皮"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种激素主要是由肾脏所生成？", "answer_idx": "D", "answer": "红血球生成素（erythropoietin）", "options": {"A": "降钙素（calcitonin）", "B": "血管张力素原（angiotensinogen）", "C": "醛酮素（aldosterone）", "D": "红血球生成素（erythropoietin）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 24 岁女性，因排尿困难合并外生殖器有疼痛性病灶，臨床诊断为疱疹，这些病灶已融合成皮肤溃疡。同时有发烧、倦怠、肌肉酸痛及头痛等症狀。过去并无類似的症狀。下列有关此病人之叙述，何者错误？", "answer_idx": "B", "answer": "此疾病预后良好，以后不会復发", "options": {"A": "最有可能之诊断是第二型单纯疱疹（herpes simplex）", "B": "此疾病预后良好，以后不会復发", "C": "以 acyclovir 治療可以缩短愈合所需时间", "D": "以 acyclovir 治療可以减少復发的严重度与频率"}}
{"meta_info": "taiwanese_test_Q", "question": "当微血管前小动脉（precapillary arterioles）收缩时，会产生下列何种显 变化？", "answer_idx": "B", "answer": "微血管的滤过速率（filtration rate）下降", "options": {"A": "微血管的静水压（hydrostatic pressure）增加", "B": "微血管的滤过速率（filtration rate）下降", "C": "微血管的血浆胶体渗透压（colloid osmotic pressure）增加", "D": "组织间液胶体渗透压（colloid osmotic pressure）上升"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关单纯性疱疹角膜炎（Herpes simplex keratitis）的叙述，何者较正确？", "answer_idx": "C", "answer": "病情缓解后，未來仍可能復发", "options": {"A": "大多因植物性外伤所造成", "B": "与配戴隐形眼镜有关", "C": "病情缓解后，未來仍可能復发", "D": "抹片检查，可以看見有革蘭氏染色（Gram's stain）阴性之杆菌"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一条神经常在穿过鼠蹊韧带（inguinal ligament）时受到压迫，造成病患大腿外侧感觉麻痛？", "answer_idx": "B", "answer": "股骨侧皮表神经（lateral femoral cutaneous nerve）", "options": {"A": "股神经（femoral nerve）", "B": "股骨侧皮表神经（lateral femoral cutaneous nerve）", "C": "闭孔神经（obturator nerve）", "D": "阴部神经（pudendal nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那三块肌肉的肌腱一起附 于胫骨粗隆的内侧（medial side of tibial tuberosity）？", "answer_idx": "B", "answer": "股薄肌（gracilis）、缝匠肌（sartorius）、半腱肌（semitendinosus）", "options": {"A": "股薄肌（gracilis）、缝匠肌（sartorius）、半膜肌（semimembranosus）", "B": "股薄肌（gracilis）、缝匠肌（sartorius）、半腱肌（semitendinosus）", "C": "股二头肌（biceps femoris）、半膜肌（semimembranosus）、半腱肌（semitendinosus）", "D": "内收长肌（adductor longus）、内收短肌（adductor brevis）、内收大肌（adductor magnus）"}}
{"meta_info": "taiwanese_test_Q", "question": "根据统计，全球仅次于 Candida albicans 造成念珠菌菌血症（candidemia）之病原菌为何？", "answer_idx": "B", "answer": "Candida glabrata", "options": {"A": "Candida krusei", "B": "Candida glabrata", "C": "Candida parapsilosis", "D": "Candida tropicalis"}}
{"meta_info": "taiwanese_test_Q", "question": "86 下列有关补体系统的凝集路径（lectin pathway）中的关键分子 mannan-binding lectin（MBL）的描述 ，何者错误？\n", "answer_idx": "D", "answer": "其所參与的凝集路径和替代路径（alternative pathway）的作用机制较相似", "options": {"A": "可和细菌表面的糖蛋白或碳水化合物结合", "B": "是发炎反应中产生的一种急性蛋白（acute phase protein）", "C": "其功能在补体系统中和 Clq 分子相似", "D": "其所參与的凝集路径和替代路径（alternative pathway）的作用机制较相似"}}
{"meta_info": "taiwanese_test_Q", "question": "其诊断为何？", "answer_idx": "B", "answer": "腹部主动脉瘤", "options": {"A": "肠系膜囊肿", "B": "腹部主动脉瘤", "C": "胰脏尾部肿瘤", "D": "下腔静脉血栓"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，再经心导管检查，确定了诊断，对此病患，下列何种手术治療最不适合？", "answer_idx": "D", "answer": "肺动脉环缩术", "options": {"A": "体动脉至肺动脉分流术", "B": "肺动脉瓣气球扩张术", "C": "在体外循环下，作直视下心内修补手术", "D": "肺动脉环缩术"}}
{"meta_info": "taiwanese_test_Q", "question": "有关海马系统（hippocampal formation）之最主要传出纤维（efferent fiber），可形成下列何构造？", "answer_idx": "A", "answer": "穹束（fornix）", "options": {"A": "穹束（fornix）", "B": "胼胝体（corpus callosum）", "C": "终纹（stria terminalis）", "D": "丘脑髓纹（stria medullaris thalami）"}}
{"meta_info": "taiwanese_test_Q", "question": "与人類子宫颈癌相关性最强的病毒为人類乳头瘤病毒（human papillomavirus）第几型？", "answer_idx": "A", "answer": "16 及 18", "options": {"A": "16 及 18", "B": "1 及 2", "C": "6 及 2", "D": "25 及 38"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种作用与低剂量 Aspirin 预防栓塞型中风（Stroke）有关？", "answer_idx": "C", "answer": "抑制血小板的 COX-1", "options": {"A": "抑制血管内皮细胞的 COX-2", "B": "抑制血球细胞的 Lipoxygenase", "C": "抑制血小板的 COX-1", "D": "抑制血小板的 Thromboxane A2 受体"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 21 岁大学女生，兩侧小腿红疹、痛感，已有 3 天。检查看似红疹，触诊则为结节、稍热如下图所示。最可能的臨床诊断为：", "answer_idx": "B", "answer": "结节性红斑（Erythema nodosum）", "options": {"A": "多型性红斑（Erythema multiforme）", "B": "结节性红斑（Erythema nodosum）", "C": "蜂窝性组织炎（Cellulitis）", "D": "游走性红斑（Erythema migrans）"}}
{"meta_info": "taiwanese_test_Q", "question": "细胞缺氧时，最不可能出现下列何种变化？", "answer_idx": "C", "answer": "钙离子由细胞内流出", "options": {"A": "钠和水进入细胞", "B": "细胞内pH值下降", "C": "钙离子由细胞内流出", "D": "细胞内ATP下降"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 65 岁女性病人，主诉 3 年來右膝关节日益疼痛，以致行动困难，本次就诊之右膝关节 X 光摄影及 MRI 影像如图，最可能的诊断为何？", "answer_idx": "B", "answer": "自发性骨坏死并膝关节炎（spontaneous osteonecrosis with arthritis）", "options": {"A": "類风湿关节炎并骨囊肿（rheumatoid arthritis with bone cyst）", "B": "自发性骨坏死并膝关节炎（spontaneous osteonecrosis with arthritis）", "C": "感染性关节炎并骨囊肿（septic arthritis with bone cyst）", "D": "痛风性关节炎并骨囊肿（gouty arthritis with bone cyst）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是脑中风病患使用足踝部副木（splints）的最主要目的？", "answer_idx": "C", "answer": "矫正步态", "options": {"A": "促进足踝部功能的恢復", "B": "防止踝关节肿痛", "C": "矫正步态", "D": "动态副木可以取代瘫痪无力的肌肉"}}
{"meta_info": "taiwanese_test_Q", "question": "下列①⾄④项中那些物质运输⽅向是由⾼浓度到低浓度？", "answer_idx": "C", "answer": "②④", "options": {"A": "①③", "B": "②③", "C": "②④", "D": "①②"}}
{"meta_info": "taiwanese_test_Q", "question": "有关家族性高胆固醇症（familial hypercholesterolemia）最主要的致病原因为何？", "answer_idx": "D", "answer": "LDL receptor 基因变異", "options": {"A": "饮食中过度高油脂食物的摄取", "B": "HMG-CoA reductase 基因变異", "C": "正常 LDL receptor 蛋白表现量过高", "D": "LDL receptor 基因变異"}}
{"meta_info": "taiwanese_test_Q", "question": "Dexmedetomidine可提供镇静、安眠及止痛作用，其作用机转为何？", "answer_idx": "B", "answer": "α2-adrenergic agonist", "options": {"A": "γ-amino-butyric acid inhibition", "B": "α2-adrenergic agonist", "C": "µ receptor agonist", "D": "N-methyl-D-aspartate receptor inhibition"}}
{"meta_info": "taiwanese_test_Q", "question": "出生三日之婴儿发生结膜充血、分泌物剧增，且其父母曾有性病史，下列叙述何者错误？", "answer_idx": "C", "answer": "由于仅为结膜炎，无失明之虞", "options": {"A": "分泌物的抹片检查，可能有革蘭氏阴性双球菌", "B": "与产道感染有关", "C": "由于仅为结膜炎，无失明之虞", "D": "治療方针应予 Penicillin G，局部点眼及肌肉注射"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关前哨淋巴结切片术（sentinel lymph node biopsy）的叙述，何者错误？", "answer_idx": "B", "answer": "外科医师执行前哨淋巴结切片术之经 中，前百例若有伪阴性，不应再执行前哨淋巴结切片术", "options": {"A": "可减少腋下淋巴廓清（axillary lymph node dissection）造成手臂淋巴水肿的发生", "B": "外科医师执行前哨淋巴结切片术之经 中，前百例若有伪阴性，不应再执行前哨淋巴结切片术", "C": "乳房全切除（total mastectomy）者亦可做前哨淋巴结切片术", "D": "理学检查若摸到腋下淋巴结者，不适合做前哨淋巴结切片术"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关器官移植之分配原则，何者最不适宜？", "answer_idx": "C", "answer": "受赠病患生活型态或行为", "options": {"A": "受赠病患医療需求的迫切程度", "B": "受赠病患于名单上的等候时间", "C": "受赠病患生活型态或行为", "D": "受赠病患与捐赠者组织配对相容性"}}
{"meta_info": "taiwanese_test_Q", "question": "腹式呼吸通常要配合节奏性的呼吸速率（paced breathing），下列何者是最理想的呼吸节奏？", "answer_idx": "A", "answer": "吐气：吸气＝4秒：2秒", "options": {"A": "吐气：吸气＝4秒：2秒", "B": "吐气：吸气＝1秒：2秒", "C": "吐气：吸气＝1秒：1秒", "D": "吐气：吸气＝2秒：4秒"}}
{"meta_info": "taiwanese_test_Q", "question": "老年病人发生吸入性肺炎最不可能之病原菌为：", "answer_idx": "D", "answer": "Legionella pneumophila", "options": {"A": "Entoerobacteriaceae", "B": "Staphylococcus aureus", "C": "Anaerobic bacteria", "D": "Legionella pneumophila"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一项不是世代追踪研究偏差的來源？", "answer_idx": "C", "answer": "稀有暴露", "options": {"A": "追踪漏失率", "B": "暴露组与非暴露组资料搜集的完整性不同", "C": "稀有暴露", "D": "研究对象不回应者"}}
{"meta_info": "taiwanese_test_Q", "question": "那两个克氏循环（TCA cycle）的中间产物皆可直接经由一次转胺反应（transamination）合成胺基酸？", "answer_idx": "A", "answer": "草醯乙酸（oxaloacetate）与α-酮基戊二酸（α-ketoglutarate）", "options": {"A": "草醯乙酸（oxaloacetate）与α-酮基戊二酸（α-ketoglutarate）", "B": "柠檬酸（citrate）与琥珀酸（succinate）", "C": "琥珀酸（succinate）与苹果酸（malate）", "D": "α-酮基戊二酸（α-ketoglutarate）与异柠檬酸（isocitrate）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何病症是早产儿出生數日内特有的脑部病变？", "answer_idx": "B", "answer": "核黄疸（Kernicterus）", "options": {"A": "玻璃质膜病（Hyaline membrane disease）", "B": "核黄疸（Kernicterus）", "C": "Hirschsprung 氏病", "D": "Pick 氏病"}}
{"meta_info": "taiwanese_test_Q", "question": "48岁男性，患有multiple endocrine neoplasia type 1（MEN type 1） 合并hyperparathyroidism，于10年前接受副甲状腺切除⼿术，之后⾎钙及iPTH皆正常，惟最近追踪抽⾎检查显⽰：iPTH为132 pg/mL，⾎钙为10.8 mg/dL，则最适宜的诊断为：", "answer_idx": "D", "answer": "recurrent hyperparathyroidism", "options": {"A": "secondary hyperparathyroidism", "B": "tertiary hyperparathyroidism", "C": "persistent hyperparathyroidism", "D": "recurrent hyperparathyroidism"}}
{"meta_info": "taiwanese_test_Q", "question": "消化道中那一部分其黏膜下层具有分泌黏液的腺体？", "answer_idx": "A", "answer": "十二指肠", "options": {"A": "十二指肠", "B": "直肠", "C": "胃", "D": "结肠"}}
{"meta_info": "taiwanese_test_Q", "question": "上颈神经节（superior cervical ganglion）相对于下列何脊椎骨高度？", "answer_idx": "A", "answer": "第一、二颈椎", "options": {"A": "第一、二颈椎", "B": "第四颈椎", "C": "第六颈椎", "D": "第一胸椎"}}
{"meta_info": "taiwanese_test_Q", "question": "一位再生不良性贫血病人，虽经过多种治療，病情仍无法改善，经常需要输注浓缩红血球，最近抽血检查发现血铁质（ferritin）为 3,750 ng/mL，肝功能变差。下列何者是最适当的治療药物？", "answer_idx": "C", "answer": "Deferoxamine", "options": {"A": "Dimercaprol", "B": "Penicillamine", "C": "Deferoxamine", "D": "Charcoal"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种病媒，性喜产卵于流水中，且其卵呈三角形？", "answer_idx": "B", "answer": "蚋（blackfly）", "options": {"A": "虻（deer fly）", "B": "蚋（blackfly）", "C": "采采蝇（tsetse fly）", "D": "蠓（biting midges）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于肺腺癌基因突变及标靶治疗，下列叙述何者正确？", "answer_idx": "C", "answer": "ALK translocation的肺腺癌病⼈年纪中位数（median age），较整体肺腺癌患者的年纪中位数年轻", "options": {"A": "在东亚肺腺癌，EGFR突变率约10～20%", "B": "有EGFR突变的第四期肺腺癌，可⽤EGFR tyrosine kinase inhibitor治愈（cure）", "C": "ALK translocation的肺腺癌病⼈年纪中位数（median age），较整体肺腺癌患者的年纪中位数年轻", "D": "ALK translocation之肺腺癌，经标靶治疗产⽣抗药性后，约50～60%产⽣exon 20 T790M突变"}}
{"meta_info": "taiwanese_test_Q", "question": "锥鼻虫（reduviid bug）可以媒介下列何种寄生虫病？", "answer_idx": "A", "answer": "查加斯氏病（Chagas' disease）", "options": {"A": "查加斯氏病（Chagas' disease）", "B": "利什曼症（Leishmaniasis）", "C": "睡眠病（Sleeping sickness）", "D": "黑热病（Kala-azar）"}}
{"meta_info": "taiwanese_test_Q", "question": "旋股内侧动脉（medial circumflex femoral artery）穿过下列何者，至大腿后面？", "answer_idx": "A", "answer": "髂腰肌（iliopsoas）和耻骨肌（pectineus）", "options": {"A": "髂腰肌（iliopsoas）和耻骨肌（pectineus）", "B": "耻骨肌和内收短肌（adductor brevis）", "C": "内收短肌和内收长肌（adductor longus）", "D": "内收长肌和内收大肌（adductor magnus）"}}
{"meta_info": "taiwanese_test_Q", "question": "此病人若接受外科手术治療，下列何项步骤不正确？", "answer_idx": "A", "answer": "股动脉至膝动脉绕道手术", "options": {"A": "股动脉至膝动脉绕道手术", "B": "经皮下血管扩张整形术合并血管内人工弥补物（endovascular prosthesis）之置换", "C": "主动脉至兩侧股动脉绕道手术", "D": "腋动脉至股动脉绕道手术"}}
{"meta_info": "taiwanese_test_Q", "question": "有关血栓性栓塞（thromboembolism）于怀孕妇女的叙述，下列何者错误？", "answer_idx": "D", "answer": "对于怀孕妇女深部静脉栓塞或肺栓塞，建议使用 warfarin 治療，以维护胎儿安全", "options": {"A": "年龄大（尤其是 35 岁以上）的怀孕妇女发生静脉栓塞较高", "B": "深部静脉栓塞与肺栓塞在怀孕及刚生产后的妇女，发生率比未怀孕妇女高", "C": "Technetium-99m 肺灌注和肺换气检查（V/Q scan），一般而言，对胎儿是安全的", "D": "对于怀孕妇女深部静脉栓塞或肺栓塞，建议使用 warfarin 治療，以维护胎儿安全"}}
{"meta_info": "taiwanese_test_Q", "question": "升结肠（ascending colon）部位之大肠癌病人最常表现下列何种臨床症狀？", "answer_idx": "D", "answer": "贫血", "options": {"A": "便血（hematochezia）", "B": "大便习惯改变", "C": "里急后重（tenesmus）", "D": "贫血"}}
{"meta_info": "taiwanese_test_Q", "question": "新生儿红斑性狼疮（Neonatal lupus erythematous）由母体内何种自体抗体，经胎盘传给胎儿所引起？", "answer_idx": "D", "answer": "anti-Ro/SS-A", "options": {"A": "ANA", "B": "anti-ds-DNA", "C": "anti-Sm", "D": "anti-Ro/SS-A"}}
{"meta_info": "taiwanese_test_Q", "question": "先天性遗传代谢疾病患童常散发出特异性体味，下列之对应组合中何者最不正确？", "answer_idx": "C", "answer": "酪胺酸血症（tyrosinemia）- 泳池消毒水味（swimming pool odor）", "options": {"A": "苯酮尿症（phenylketonuria）- 霉臭味（musty odor）", "B": "异戊酸血症（isovaleric acidemia）- 脚 臭味（sweaty feet odor）", "C": "酪胺酸血症（tyrosinemia）- 泳池消毒水味（swimming pool odor）", "D": "三甲基胺尿症（trimethylaminuria）- 腐鱼味（rotten fish odor）"}}
{"meta_info": "taiwanese_test_Q", "question": "腹部受伤机转不同，可能有不同器官伤害，且受伤频率不一，路人甲发生车祸造成腹部钝伤（blunt injury）和路人乙腹部遭受枪击伤（gunshot injury）时，他们最常受伤的器官分别是：", "answer_idx": "C", "answer": "钝伤时为脾脏；枪击伤时是小肠", "options": {"A": "钝伤时为脾脏；枪击伤时是肝脏", "B": "钝伤时为肝脏；枪击伤时是脾脏", "C": "钝伤时为脾脏；枪击伤时是小肠", "D": "钝伤时为小肠；枪击伤时是胰脏"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是诊断卵黄囊瘤（yolk sac tumor）最常用的血清标记？", "answer_idx": "A", "answer": "甲型胎儿蛋白（alpha-fetoprotein）", "options": {"A": "甲型胎儿蛋白（alpha-fetoprotein）", "B": "癌胚抗原（carcinoembryonic antigen）", "C": "人类绒毛膜促性腺激素（ human chorionic gonadotropin）", "D": "胎盘碱性磷酸酶（ placental alkaline phosphatase）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位20岁的陈姓大学生，参加露营活动，平日健康状况良好。在搬一箱20公斤重的饮料，突然觉得腰痛，当天晚上腰痛加剧，且蔓延至右脚也呈现酸麻、无力，隔天他到门诊求助。其最可能的诊断为何？", "answer_idx": "D", "answer": "右侧腰椎神经根病变", "options": {"A": "右胫骨神经（tibial nerve）病变", "B": "右腓骨神经（peroneal nerve）病变", "C": "右股神经（femoral nerve）病变", "D": "右侧腰椎神经根病变"}}
{"meta_info": "taiwanese_test_Q", "question": "下列药物可用于治疗急性无机汞盐（inorganic mercury salts）中毒，何者错误？", "answer_idx": "D", "answer": "D-dimethylcysteine", "options": {"A": "unithiol", "B": "dimercaprol", "C": "succimer", "D": "D-dimethylcysteine"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，检查报告诊断为胃食道逆流（GERD）合并裂孔疝气（Hiatal hernia），以下何种治療不会考虑在内？", "answer_idx": "D", "answer": "螺旋杆菌治療（H.P. eradication）", "options": {"A": "减重", "B": "床头垫高 15 度", "C": "投与 PPI（Proton pump inhibitor）治療", "D": "螺旋杆菌治療（H.P. eradication）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种肿瘤最少见于前纵隔腔？", "answer_idx": "D", "answer": "节细胞神经母细胞瘤（ganglioneuroblastoma）", "options": {"A": "何杰金氏淋巴瘤（Hodgkin lymphoma）", "B": "生殖细胞肿瘤（germ cell tumor）", "C": "副甲状腺瘤（parathyroid adenoma）", "D": "节细胞神经母细胞瘤（ganglioneuroblastoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "HIV-1 经由黏膜感染进入人体时，主要藉由何种细胞携带进入淋巴结？", "answer_idx": "C", "answer": "Dendritic cell", "options": {"A": "NK cell", "B": "CD8 T cell", "C": "Dendritic cell", "D": "CD4 T cell"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 30 岁女性，胰脏尾部有一个 7 公分大的囊狀肿瘤而接受肿瘤切除手术。手术时发现肿瘤并未与胰管相通。切除标本切面外观可見其为一个多囊狀肿瘤，内含黏稠液体。显微镜下可見肿瘤囊壁由一单层柱狀上皮覆盖，在上皮下有一层致密的间质细胞存在。上皮细胞的细胞核位于细胞底部并不浓染，且无明显多形性存在。下列何者是最可能的诊断？", "answer_idx": "C", "answer": "Mucinous cystadenoma", "options": {"A": "Pseudocyst", "B": "Serous cystadenoma", "C": "Mucinous cystadenoma", "D": "Intraductal papillary mucinous neoplasm"}}
{"meta_info": "taiwanese_test_Q", "question": "下列药物之主要作用为降低血浆 triglyceride，何者除外？", "answer_idx": "C", "answer": "cholestyramine", "options": {"A": "niacin", "B": "fenofibrate", "C": "cholestyramine", "D": "gemfibrozil"}}
{"meta_info": "taiwanese_test_Q", "question": "32 24 岁男性的右手腕关节疼痛肿胀有二个月之久。他本人不记得右手有受伤过，经服用消炎片虽有止痛效果，但是该关节越來越惡化而无法弯曲。 X 光检查如附图。抽取关节液检查发现：WBC mg/dL，显微镜观察无结晶物发现。最适切的诊断为何？", "answer_idx": "C", "answer": "Infectious arthritis", "options": {"A": "Rheumatoid arthritis", "B": "Calcium pyrophosphate dihydrate deposition disease", "C": "Infectious arthritis", "D": "Complex regional pain syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是热療（heat therapy）的治療效果？", "answer_idx": "D", "answer": "疼痛阈值降低", "options": {"A": "血管扩张", "B": "肌肉韧带松弛", "C": "代谢率增加", "D": "疼痛阈值降低"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 42 岁妇女主诉头痛，喉咙痛和鼻充血带有綠色黏狀分泌液已三天。但否认有发烧，胃肠症狀以及季节性过敏，或与病人接触史。身体检查：体温36.8℃，脉搏82 次/分，呼吸16 次/分，血压124/76 毫米汞柱，后口咽部呈现轻度发红及肿胀，颈部柔软，无淋巴节肿大，呼吸声正常。被诊断为鼻窦炎（rhinosinusitis），其最常見的原因为何？", "answer_idx": "A", "answer": "鼻病毒（rhinovirus）", "options": {"A": "鼻病毒（rhinovirus）", "B": "肺炎链球菌（Streptococcus pneumoniae）", "C": "流行感冒嗜血杆菌（Haemophilus influenzae）", "D": "卡他莫拉克氏菌（Moraxella catarrhalis）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种 DNA 病毒可在感染人体之后，建立\"潜伏性感染＂（latent infection）？", "answer_idx": "A", "answer": "EB 病毒（Epstein-Barr virus）", "options": {"A": "EB 病毒（Epstein-Barr virus）", "B": "反转錄病毒（Retrovirus）", "C": "冠狀病毒（Coronavirus）", "D": "呼吸道肠道病毒（Reovirus）"}}
{"meta_info": "taiwanese_test_Q", "question": "小威的妈妈问医生小威的气喘病那时候才会好，医生回答气喘病是呼吸道组织持续的发炎反应，临床不一定会有明显症状，但组织的发炎反应可能持续几天甚至好几年。下列何者不是造成慢性持续发炎的原因？", "answer_idx": "C", "answer": "介白质-5（IL-5）会诱使肥大细胞（mast cell）前驱物分化，而使肥大细胞增生，进而破坏局部组织", "options": {"A": "反覆的过敏原接触刺激过敏反应细胞如肥大细胞（mast cell），嗜伊红性细胞（eosinophil）产生反应", "B": "第二型辅助T细胞（Th2）分泌细胞素如介白质-13（interleukin-13, IL-13），IL-5等而使上述的过敏反应细胞存活更久", "C": "介白质-5（IL-5）会诱使肥大细胞（mast cell）前驱物分化，而使肥大细胞增生，进而破坏局部组织", "D": "组织的重模组化（remodeling）造成气管不可逆的组织变化而使疾病成慢性且持续"}}
{"meta_info": "taiwanese_test_Q", "question": "关于化学性灼伤（chemical burn），下列叙述何者错误？", "answer_idx": "D", "answer": "水泥灼伤是酸性化学灼伤", "options": {"A": "所有的化学性灼伤都应该立即除去患处衣物并大量冲水", "B": "严重酸性化学灼伤若引起血中酸碱值异常及呼吸困难，可能需要气管内插管及使用呼吸机（ventilator）协助呼吸", "C": "氢氟酸（hydrofluoric acid）灼伤应立即以2.5%葡萄糖酸钙凝胶（calcium gluconate gel）局部患处治疗", "D": "水泥灼伤是酸性化学灼伤"}}
{"meta_info": "taiwanese_test_Q", "question": "6.75岁男性病人，抽烟10年以上，使用calcium channel blocker 治疗高血压10年，胸痛接受显影剂注射冠状动脉摄影，检查前血液肌酸酐1.0 mg/dL，检查结果发现严重冠状动脉硬化，3 天后的血液肌酸酐1.1 mg/dL，7天后发生加速型的高血压（accelerated hypertension）及少尿而住院。住院当天的理学检查，高血压视网膜病变、心脏扩大、下肢脉搏正常，但有皮肤网状青斑（livedo reticularis），血液嗜伊红性白血球增加、补体下降、肌酸酐3.0 mg/dL，尿液红血球6～10/HPF，蛋白质1+。最可能的诊断是：\n", "answer_idx": "B", "answer": "肾脏粥状样栓塞（atheroembolic renal disease）", "options": {"A": "显影剂肾病变（contrast nephropathy）", "B": "肾脏粥状样栓塞（atheroembolic renal disease）", "C": "肾动脉狭窄（renal artery stenosis）", "D": "肾静脉栓塞（renal vein thrombosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关胆汁中之菌落的叙述，下列何者为误？", "answer_idx": "B", "answer": "慢性胆囊炎的患者胆汁中培养出细菌的比率较急性胆囊炎者高", "options": {"A": "在没有胆结石或其他病灶存在的情况下，胆囊中的胆汁一般是无菌的", "B": "慢性胆囊炎的患者胆汁中培养出细菌的比率较急性胆囊炎者高", "C": "有症狀之胆结石患者，胆汁中最常培养出之细菌为 E. coli 及 Klebsiella 等格蘭氏阴性菌", "D": "胆结石合并总胆管结石者，胆汁中培养出细菌的比率较不合并总胆管结石者高"}}
{"meta_info": "taiwanese_test_Q", "question": "维持喉部气道功能最重要之肌肉为何？", "answer_idx": "B", "answer": "后环杓肌（Posterior cricoarytenoid muscle）", "options": {"A": "甲狀杓骨肌（Thyroarytenoid muscle）", "B": "后环杓肌（Posterior cricoarytenoid muscle）", "C": "外环杓肌（Lateral cricoarytenoid muscle）", "D": "环甲肌（Cricothyroid muscle）"}}
{"meta_info": "taiwanese_test_Q", "question": "一对夫妇來看不孕症门诊，检查结果唯一不正常的是精液；精虫數 14,000,000/mL，活动力 25%，正常形态 23%。你会建议先做什么治療？", "answer_idx": "C", "answer": "intrauterine insemination with washed husband's sperm", "options": {"A": "clomiphene citrate", "B": "in vitro fertilization（IVF）", "C": "intrauterine insemination with washed husband's sperm", "D": "insemination with donor sperm"}}
{"meta_info": "taiwanese_test_Q", "question": "40 岁女性罹患混合型尿失禁（mixed incontinence），病人主诉急迫性尿失禁的程度比应力性尿失禁严重，初步的治療选择应该是：", "answer_idx": "D", "answer": "修正饮水习惯，并教导与鼓勵做骨盆底肌运动", "options": {"A": "使用甲型交感神经拮抗剂（α-adrenergic antagonist）", "B": "胶原蛋白（collagen）注射于尿道", "C": "施行耻骨阴道吊带术（pubovaginal sling），因为此手术是治療混合型尿失禁最理想的手术方法", "D": "修正饮水习惯，并教导与鼓勵做骨盆底肌运动"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一项对足月新生儿清醒时是不正常的？", "answer_idx": "A", "answer": "心跳每分钟72下", "options": {"A": "心跳每分钟72下", "B": "呼吸每分钟40次", "C": "体温37.5℃", "D": "前囟门平坦"}}
{"meta_info": "taiwanese_test_Q", "question": "42 岁女性，G5P4，妊娠 18 周，其胎儿脑部超音波检查发现「香蕉征」（banana sign），请问下列诊断中何者最为可能？", "answer_idx": "B", "answer": "神经管缺损", "options": {"A": "唐氏症", "B": "神经管缺损", "C": "无脑儿", "D": "透纳氏征候群（45, X）"}}
{"meta_info": "taiwanese_test_Q", "question": "当最大的光线强度刺激时，会使视网膜上的光感受细胞（photoreceptor cells）膜电位趋近于下列何者？", "answer_idx": "B", "answer": "钾离子的平衡电位", "options": {"A": "钠离子的平衡电位", "B": "钾离子的平衡电位", "C": "钙离子的平衡电位", "D": "0 mV"}}
{"meta_info": "taiwanese_test_Q", "question": "依现行身心障碍者权益保护法，下列叙述何者错误？", "answer_idx": "C", "answer": "身心障碍者进入收费之公营风景区、康乐场所或文教设施，凭身心障碍证明应予半价优待", "options": {"A": "各级政府机关及公营事业机构员工总人数在34人以上者，进用具有就业能力之身心障碍者人数，不得低于员工总人数3%", "B": "公共停车场应保留2%停车位，作为行动不便之身心障碍者专用停车位", "C": "身心障碍者进入收费之公营风景区、康乐场所或文教设施，凭身心障碍证明应予半价优待", "D": "各级政府应至少每五年举办身心障碍者之生活状况、保健医疗、特殊教育、就业与训练等需求评估及服务调查研究"}}
{"meta_info": "taiwanese_test_Q", "question": "一位45 岁女性，G3P2，妊娠30 周，急诊就医，主诉突然大量阴道出血合并剧烈下腹部疼痛，无任何内外科疾病史，血压180/110 mmHg，子宫剧痛硬如木板，最可能的诊断为：", "answer_idx": "B", "answer": "胎盘早期剥離", "options": {"A": "葡萄胎", "B": "胎盘早期剥離", "C": "植入性胎盘", "D": "子宫外孕"}}
{"meta_info": "taiwanese_test_Q", "question": "下列关于真核生物 RNA 的叙述，何者错误？", "answer_idx": "C", "answer": "mRNA 之 3' poly（A）序列是依循模板（template）DNA 上 poly（T）而來", "options": {"A": "5'-cap 可保护 mRNA 的端点，增加其稳定性", "B": "rRNA 及 tRNA 均无 5'-cap", "C": "mRNA 之 3' poly（A）序列是依循模板（template）DNA 上 poly（T）而來", "D": "histone 的 mRNA 没有 3' poly（A）序列"}}
{"meta_info": "taiwanese_test_Q", "question": "有关以公权力推动强制性的卫生政策之伦理原则，下列叙述何者错误？", "answer_idx": "D", "answer": "即使某些卫生政策可能牺牲个人自由，但为了当事人的健康，也为了国民健康，卫生主管机关仍然应该毫无例外地推动这些政策", "options": {"A": "所采用的手段必须能够达到政策目的", "B": "所要达成的公共利益与所牺牲的个人利益之间要符合比例", "C": "即使必须牺牲个人利益，仍应采取最小侵害手段", "D": "即使某些卫生政策可能牺牲个人自由，但为了当事人的健康，也为了国民健康，卫生主管机关仍然应该毫无例外地推动这些政策"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种反应条件，酵素可达到其催化之最高速度？", "answer_idx": "C", "answer": "所有酵素均与反应物结合", "options": {"A": "反应物浓度＜Km", "B": "反应物浓度＝Km", "C": "所有酵素均与反应物结合", "D": "温度达到 100℃"}}
{"meta_info": "taiwanese_test_Q", "question": "桡神经（radial nerve）在大圆肌（teres major）下方处受到伤害，通常也会伤及与其伴行的那一条血管？", "answer_idx": "B", "answer": "深肱动脉（deep brachial artery）", "options": {"A": "肱动脉（brachial artery）", "B": "深肱动脉（deep brachial artery）", "C": "前回旋肱动脉（anterior circumflex humeral artery）", "D": "后回旋肱动脉（posterior circumflex humeral artery）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于中央静脉导管置放术（central venous catheterization）的叙述，下列何者错误？", "answer_idx": "A", "answer": "一般就成功率而言，经外颈静脉置放的成功率远比经内颈静脉置放的成功率高", "options": {"A": "一般就成功率而言，经外颈静脉置放的成功率远比经内颈静脉置放的成功率高", "B": "若需要长期使用考量，则经锁骨下静脉置放中央静脉导管比经由股静脉置放要來的适当", "C": "置放中央静脉导管时，以头低脚高的姿势（Trendelenburg position），可使内颈静脉血管较易鼓胀、较易成功置放，且可以减少发生空气栓塞的机会", "D": "中央静脉导管置放术可能产生气胸（pneumothorax）、乳糜胸（chylothorax）等并发症"}}
{"meta_info": "taiwanese_test_Q", "question": "关于非小细胞肺癌之治疗叙述，下列何者错误？", "answer_idx": "D", "answer": "bronchoalveolar cell carcinoma 不适合手术", "options": {"A": "Stage I 之肺癌以外科手术为主", "B": "Stage II 之肺癌以外科手术为主，可考虑化学及放射治疗为辅", "C": "Stage IIIb 之肺癌以化学及放射治疗为主", "D": "bronchoalveolar cell carcinoma 不适合手术"}}
{"meta_info": "taiwanese_test_Q", "question": "一位24 岁女性月经不规则来门诊求诊，怀孕试验呈阴性反应，荷尔蒙检查发现甲状腺、泌乳激素正常，但是黄体激素大于滤泡激素2 倍，超音波发现为多囊性卵巢，要如何治疗？", "answer_idx": "A", "answer": "服用避孕药", "options": {"A": "服用避孕药", "B": "给予性腺刺激素（gonadotropin）", "C": "给予皮下注射降血糖药物", "D": "做子宫扩刮术（D & C）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列早期胰脏腺癌症狀之叙述，何者最常見？", "answer_idx": "A", "answer": "无症狀", "options": {"A": "无症狀", "B": "腹痛", "C": "发烧", "D": "黄疸"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关胃部分切除（partial gastrectomy）病人之叙述，何者正确？", "answer_idx": "B", "answer": "餐后易发生虚弱、晕眩及盗 现象", "options": {"A": "餐后四小时易引起血糖过高现象", "B": "餐后易发生虚弱、晕眩及盗 现象", "C": "餐后易发生血压上升现象", "D": "甜食可避免餐后的不适"}}
{"meta_info": "taiwanese_test_Q", "question": "正常情况下，水分的通透性（permeability）在下列何处最大？", "answer_idx": "A", "answer": "亨利氏弯管的细下降枝（thin descending limb）", "options": {"A": "亨利氏弯管的细下降枝（thin descending limb）", "B": "亨利氏弯管的细上升枝（thin ascending limb）", "C": "亨利氏弯管的粗上升枝（thick ascending limb）", "D": "集尿管（collecting duct）的髓质部（inner medullary portion）"}}
{"meta_info": "taiwanese_test_Q", "question": "80 李先生因为家人有癌症病史，所以到A 医院的健康检查中心作全身健康检查，检查项目除了抽血之外还有胃镜和大肠镜的检查，依照医疗法规定，李先生需不需要写同意书？\n", "answer_idx": "B", "answer": "需要，侵入性检查需要书面同意", "options": {"A": "不需要，只有在手术和麻醉时才要", "B": "需要，侵入性检查需要书面同意", "C": "不需要，侵入性检查只需要口头同意即可", "D": "不需要，侵入性检查只需要事后同意即可"}}
{"meta_info": "taiwanese_test_Q", "question": "有关慢性肾脏病的治疗，下列何者正确？", "answer_idx": "D", "answer": "患有蛋白尿之第4期慢性肾脏病患者，应采用低蛋白饮食疗法", "options": {"A": "若患者合并高血压，其降血压药物首选为乙型阻断剂（β-blocker）", "B": "若患者合并退化关节炎，可使用非类固醇类抗发炎药物（NSAID）来止痛", "C": "患有重度蛋白尿之糖尿病慢性肾脏病患，最好合并使用血管张力素转化酶抑制剂（ACEi）和血管张力素II型受体拮抗剂（ARB）来治疗", "D": "患有蛋白尿之第4期慢性肾脏病患者，应采用低蛋白饮食疗法"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 56 岁女性，躯干及四肢出现靶心狀病灶（target lesions），口腔糜爛、眼结膜红肿、会阴部糜爛、身体发烧，最有可能之诊断为何？", "answer_idx": "B", "answer": "史蒂芬-强森症候群（Stevens-Johnson syndrome）", "options": {"A": "疱疹性皮肤炎（dermatitis herpetiformis）", "B": "史蒂芬-强森症候群（Stevens-Johnson syndrome）", "C": "寻常性天疱疮（pemphigus vulgaris）", "D": "脓疱性干癣（pustular psoriasis）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是骨盆底（pelvic floor）最主要的支撑（support）构造？", "answer_idx": "B", "answer": "提肛肌（levator ani muscle）", "options": {"A": "子宫荐骨韧带（uterosacral ligaments）", "B": "提肛肌（levator ani muscle）", "C": "骨盆（bony pelvis）", "D": "圆韧带（round ligaments）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关小胖威利症候群（Prader-Willi Syndrome）的叙述，下列何者错误？", "answer_idx": "A", "answer": "母源性（maternal）染色体15q11-q13缺失", "options": {"A": "母源性（maternal）染色体15q11-q13缺失", "B": "新生儿及婴儿期会有严重低张力与喂食困难", "C": "小手与小脚（small hands and feet）", "D": "性腺机能不足（hypogonadism）"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列对霍亂弧菌的叙述，何者正确？", "answer_idx": "C", "answer": "人類是此菌唯一的天然宿主", "options": {"A": "对酸的耐受性高", "B": "所产生的神经毒素会刺激肠道的蠕动", "C": "人類是此菌唯一的天然宿主", "D": "无法生长于未添加盐的培养基"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种细胞表面辨識抗原的受体（receptor）为免疫球蛋白？", "answer_idx": "B", "answer": "B 淋巴细胞", "options": {"A": "T 淋巴细胞", "B": "B 淋巴细胞", "C": "巨噬细胞", "D": "自然殺手细胞"}}
{"meta_info": "taiwanese_test_Q", "question": "有关老年病人的评估，下列叙述何者正确？", "answer_idx": "C", "answer": "Timed up-and-go test用于评估行走与平衡能力", "options": {"A": "Mini-Mental State Examination主要用来筛检忧郁症（depression）", "B": "Mini-Cog test包括「倒背数 」与「系列减法」两部分", "C": "Timed up-and-go test用于评估行走与平衡能力", "D": "备餐、沐浴、移位、服药等能力皆是基本日常生活活动功能（basic activities of daily living）的评估项目"}}
{"meta_info": "taiwanese_test_Q", "question": "运动测试可以用來评估心肌梗塞后病患能否回到工作岗位。如果受试者想重回办公室工作、不须负重或频繁走动，则运动测试时其最大摄氧量至少须达多少代谢当量（Metabolic Equivalents, METs）？", "answer_idx": "B", "answer": "5-7", "options": {"A": "3-4", "B": "5-7", "C": "8-10", "D": "11-13"}}
{"meta_info": "taiwanese_test_Q", "question": "40岁男性，在右大脚趾出现如图所示之表征，有一年之久，最适切之诊断为：", "answer_idx": "B", "answer": "subungual melanoma", "options": {"A": "subungual hematoma", "B": "subungual melanoma", "C": "subungual pigmented nevus", "D": "friction induced melanonychia"}}
{"meta_info": "taiwanese_test_Q", "question": "3 岁右撇子男孩，刚学自己用餐，家人却发现他左手固定于轻度内旋而无法外旋捧碗就口，右前臂却活动自如，于医院照左前臂X 光如下图，最可能的诊断是：", "answer_idx": "C", "answer": "先天性桡尺骨黏合（congenital radioulnar synostosis）", "options": {"A": "先天性桡骨头脱臼（congenital radial head dislocation）", "B": "先天性尺骨杵狀手（congenital ulnar club hand）", "C": "先天性桡尺骨黏合（congenital radioulnar synostosis）", "D": "创伤后肘内翻（post-traumatic cubitus varus deformity）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列各种感觉及其受器，何者最不容易因持续刺激而发生传导适应现象（adaptation）？", "answer_idx": "B", "answer": "本体感觉；muscle spindles", "options": {"A": "压觉；pacinian corpuscles", "B": "本体感觉；muscle spindles", "C": "嗅觉；olfactory receptor cells", "D": "听觉；hair cell receptors"}}
{"meta_info": "taiwanese_test_Q", "question": "Limbic system 中与恐惧情绪（fear）关系密切之结构为何？", "answer_idx": "D", "answer": "amygdaloid nuclei", "options": {"A": "thalamus", "B": "hippocampus", "C": "fornix", "D": "amygdaloid nuclei"}}
{"meta_info": "taiwanese_test_Q", "question": "77.一位30岁的男性工人从6公尺高的鹰架坠落，身体检查显示收缩压120 mmHg，右胸有明显的连迦胸（flail chest），严重的呼吸窘迫（severe respiratory distress），右胸呼吸声音稍微降低，叩诊时则左右两侧类似。给予非再呼吸型面罩氧气15 L/min后，其动脉气体分析为pH：7.47，PaO2：65 mmHg，PaCO2：28 mmHg；下列何者最可能解释他的异常动脉气体分析之原因？\n", "answer_idx": "D", "answer": "肺挫伤", "options": {"A": "疼痛", "B": "合并腹部创伤", "C": "心包膜积血", "D": "肺挫伤"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何构造损伤，最可能导致感觉型失语症（sensory aphasia）？", "answer_idx": "C", "answer": "渥尼克区(Wernicke area)", "options": {"A": "上丘（superior colliculus）", "B": "弓状束（arcuate fasciculus）", "C": "渥尼克区(Wernicke area)", "D": "前联合（anterior commissure）"}}
{"meta_info": "taiwanese_test_Q", "question": "13 一位 73 岁纤瘦妇女，腹部反覆绞痛 3 个月，最近 3 天逐渐腹胀及无排气、无大便。过去病史：多年前子宫颈癌根治性子宫卵巢切除术及化放療后。住院生命征象：血压 110 / 70 mmHg、心跳 130/分、寡尿。理学检查：脱水、腹胀、肠蠕动加剧且听诊发现有金属音（metallic sound），腹部呈弥漫性压痛。实验室數据：Hb 13.2 gm/dL、WBC 12000/mm3、血清 amylase 600 U/L、Na 127 mEq/L。腹部 X 光显示小肠扩大且无大肠气。则其最可能的诊断为何？\n", "answer_idx": "A", "answer": "机械性肠阻塞（mechanical obstruction）", "options": {"A": "机械性肠阻塞（mechanical obstruction）", "B": "麻痹性肠阻塞（paralytic ileus）", "C": "急性胰脏炎（acute pancreatitis）", "D": "上肠系动脉阻塞（SMA occlusion）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位三个月大男婴因为咳嗽一周住院，呼吸道分泌物检验出有砂眼披衣菌（Chlamydia trachomatis）抗原，这位男婴最可能也有下列那一种臨床表现？", "answer_idx": "B", "answer": "曾有新生儿结膜炎", "options": {"A": "肝脾肿大", "B": "曾有新生儿结膜炎", "C": "持续高烧七天", "D": "胸部 X 光有实质化（consolidation）变化"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是骨重新塑形过程后残存的构造？", "answer_idx": "C", "answer": "间骨板（Interstitial lamellae）", "options": {"A": "外环周骨板（Outer circum ferential lamellae）", "B": "哈维氏管（Haversian canal）", "C": "间骨板（Interstitial lamellae）", "D": "内环周骨板（Inner circum ferential lamellae）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不会抑制甲促素（TSH）之分泌？", "answer_idx": "C", "answer": "乳促素", "options": {"A": "糖皮素", "B": "体抑素", "C": "乳促素", "D": "多巴胺"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 74 岁女性由家人陪同入急诊求医。主诉为一天前开始腹泻，约有 10 次，黏液狀（mucoid）粪便。家人无同样症狀。腹部偶尔会有绞痛感，无呕吐，无发烧。病人 10 天前因为肺炎住院，前二天才出院，带回家口服使用的药物有 Augmentin（amoxicillin with clavulanic acid）与 acetaminophen，除此以外无使用其他药物。依以上病史，你认为以下何者是最有可能造成此次腹泻的病原？", "answer_idx": "B", "answer": "Clostridium difficile", "options": {"A": "Staphylococcus aureus", "B": "Clostridium difficile", "C": "Pseudomonas aeruginosa", "D": "Norwalk virus"}}
{"meta_info": "taiwanese_test_Q", "question": "Infliximab 单株抗体可用于 Crohn's disease 之缓解，其主要作用之标的为何？", "answer_idx": "C", "answer": "TNF-α", "options": {"A": "interferon", "B": "IL-2", "C": "TNF-α", "D": "LTB4"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，如第一步检查是正常，肛门指诊带有暗红色的血便，接下來要作：", "answer_idx": "B", "answer": "直肠镜", "options": {"A": "血管摄影", "B": "直肠镜", "C": "大肠钡剂摄影", "D": "插鼻胃管"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是活化态维生素D的分子结构？", "answer_idx": "A", "answer": "1, 25-dihydroxycholecalciferol", "options": {"A": "1, 25-dihydroxycholecalciferol", "B": "7-dehydrocholesterol", "C": "25-hydroxycholecalciferol", "D": "cholecalciferol"}}
{"meta_info": "taiwanese_test_Q", "question": "关于药物动力学的叙述，下列何者错误？", "answer_idx": "B", "answer": "药物可藉由细胞与细胞之间的水性孔（aqueous pores）进行被动渗透，可容许的最大分子量为不超过", "options": {"A": "亲脂性药物较亲水性药物容易被身体快速吸收", "B": "药物可藉由细胞与细胞之间的水性孔（aqueous pores）进行被动渗透，可容许的最大分子量为不超过", "C": "药物可藉由与细胞膜上特定载体结合而通过细胞膜进入细胞", "D": "药物可以藉由胞吞作用（endocytosis）进入细胞"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关「肿瘤细胞逃避宿主CD8淋巴细胞攻击」的叙述，那一项错误？", "answer_idx": "A", "answer": "肿瘤细胞抑制本身MHC（major histocompatibility complex）class II分子的表现", "options": {"A": "肿瘤细胞抑制本身MHC（major histocompatibility complex）class II分子的表现", "B": "肿瘤细胞不表现可引发免疫反应的抗原", "C": "肿瘤细胞可分泌抑制T细胞活化的细胞激素", "D": "肿瘤细胞群能形成特殊环境不让CD8淋巴细胞浸润"}}
{"meta_info": "taiwanese_test_Q", "question": "44\n 3\n 阴性\n 0\n 98\n", "answer_idx": "B", "answer": "94%", "options": {"A": "84%", "B": "94%", "C": "97%", "D": "100%"}}
{"meta_info": "taiwanese_test_Q", "question": "下列情况使用angiotensin-converting enzyme inhibitor（ACEI）比较容易发生急性肾衰竭，但何者例外？", "answer_idx": "B", "answer": "合并使用钙离子阻断剂", "options": {"A": "双侧肾动脉狭窄", "B": "合并使用钙离子阻断剂", "C": "使用大量利尿剂治疗郁血性心衰竭", "D": "合并使用非类固醇消炎剂"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是学者Jonsen等⼈⽤来解决临床医学个案问题的四主题法或四象限法（four topics or four boxes method）的内容？", "answer_idx": "A", "answer": "不伤害原则（nonmaleficience）", "options": {"A": "不伤害原则（nonmaleficience）", "B": "医疗适应症（medical indications）", "C": "病⼈偏好（patient preferences）", "D": "⽣活品质（quality of life）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一项处置最不会增加住院病人医疗照护相关感染肺炎（healthcare-associated pneumonia）的风险？", "answer_idx": "D", "answer": "使用口服sucralfate药物治疗胃炎", "options": {"A": "尽量让病人平躺以维持住院的舒适度", "B": "给与麻醉药物（na​​rcotics）全天止痛", "C": "为方便抽痰延长使用气管内插管（endotracheal intubation）", "D": "使用口服sucralfate药物治疗胃炎"}}
{"meta_info": "taiwanese_test_Q", "question": "Methenamine 被用于预防尿道细菌感染之药剂，但其缺乏全身性抗菌作用，原因为何？", "answer_idx": "C", "answer": "在低 pH 值尿液中才能转化成 formaldehyde", "options": {"A": "口服无法吸收进入血液循环", "B": "迅速被肝脏酵素代谢", "C": "在低 pH 值尿液中才能转化成 formaldehyde", "D": "大量与血浆蛋白结合"}}
{"meta_info": "taiwanese_test_Q", "question": "下列对于透纳氏症（Turner syndrome）的叙述，何者错误？", "answer_idx": "D", "answer": "透纳氏症女性的特征为蹼颈、盾狀胸、主动脉瓣膜缺损以及严重智力障碍", "options": {"A": "透纳氏症女性身材矮小，成人身高一般不超过 150 公分", "B": "透纳氏症女性于 1959 年被证实为细胞染色体核型（karyotype）45X，或嵌合型（mosaic）", "C": "透纳氏症的发生率为 1/2500", "D": "透纳氏症女性的特征为蹼颈、盾狀胸、主动脉瓣膜缺损以及严重智力障碍"}}
{"meta_info": "taiwanese_test_Q", "question": "有关葡萄胎（hydatidiform mole）的叙述，下列何者错误？", "answer_idx": "D", "answer": "完全性葡萄胎因转为绒毛膜癌机会很高，治疗应以全子宫切除手术为佳", "options": {"A": "在超音波检查下，常见子宫腔内呈暴风雪（snow storm）样影像", "B": "母亲年龄较大怀孕是危险因子", "C": "患者有时会有严重恶心、呕吐现象，血液中 hCG 值很高", "D": "完全性葡萄胎因转为绒毛膜癌机会很高，治疗应以全子宫切除手术为佳"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是氧气治疗（oxygen therapy）引起的并发症？", "answer_idx": "B", "answer": "在COPD的病人容易引起hyperventilation", "options": {"A": "absorption atelectasis", "B": "在COPD的病人容易引起hyperventilation", "C": "bronchopulmonary dysplasia", "D": "在新生儿常引起retinopathy of prematurity（ROP）"}}
{"meta_info": "taiwanese_test_Q", "question": "67 面对一位外籍勞工因病來诊，在医病间之认知及沟通有所困难时，Berlin 及 Fowker 提出有用之沟通 方式\"LEARN＂Model，有关 LEARN Model 之叙述，下列何者错误？\n", "answer_idx": "C", "answer": "A 代表 ask，要求病人多提供资料", "options": {"A": "L 代表 listen，倾听病人之叙述", "B": "E 代表 explain，解释给病人听", "C": "A 代表 ask，要求病人多提供资料", "D": "R 代表 recommend，综合病人叙述及医师意見提出建议"}}
{"meta_info": "taiwanese_test_Q", "question": "一位微生物实验室助理吴小姐 25 岁，右手食指指甲发展成類似灰指甲（Onychomycosis）症狀有 6 个月，但感染指甲周边皮肤并没有脱皮、起水泡或搔痒。吴小姐自小学起就有咬指甲之习惯，最近发现指甲变得很丑，于是到医院皮肤科就诊。皮肤科医师以指甲剪取样，其中一部分在门诊以 10% KOH 处理并且以显微镜观察，结果显示指甲中有酵母菌（Yeast）、及长短不一之菌丝（Hyphae）。兩星期后指甲培养之结果出來，感染之病原菌很可能是一种平滑（Smooth）菌落、乳白色（Creamy）、出芽型酵母菌（Budding yeast）；有假菌丝（Pseudohyphae）及芽管（Germ tube）产生，PCR 分析也证明该菌之种類。于是医师就开 Terbinafine 口服处方，兩个月后吴小姐的指甲也就復原。该菌最可能是下列那一病原？", "answer_idx": "D", "answer": "Candida albicans", "options": {"A": "Trichophyton rubrum", "B": "Epidermophyton floccosum", "C": "Microsporum canis", "D": "Candida albicans"}}
{"meta_info": "taiwanese_test_Q", "question": "29.下列选项中，心脏科医师会优先选择，由何处进入施行心脏冠状动脉的气球扩张术（percutaneous transluminal coronary angioplasty）？\n", "answer_idx": "A", "answer": "股动脉（femoral artery）", "options": {"A": "股动脉（femoral artery）", "B": "股静脉（femoral vein）", "C": "大隐静脉（great saphenous vein）", "D": "小隐静脉（small saphenous vein）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者受坐骨神经（sciatic nerve）支配？", "answer_idx": "D", "answer": "内收大肌（adductor magnus）", "options": {"A": "内收长肌（adductor longus）", "B": "耻骨肌（pectineus）", "C": "股薄肌（gracilis）", "D": "内收大肌（adductor magnus）"}}
{"meta_info": "taiwanese_test_Q", "question": "在台湾引起肝脓疡最常见的细菌为何？", "answer_idx": "D", "answer": "克雷白氏肺炎杆菌（K. pneumoniae）", "options": {"A": "幽门螺旋杆菌（H. pylori）", "B": "大肠杆菌（E. coli）", "C": "金黄色葡萄球菌（S. aureus）", "D": "克雷白氏肺炎杆菌（K. pneumoniae）"}}
{"meta_info": "taiwanese_test_Q", "question": "无精虫症是男性不孕症原因之一，如精液检 发现无精虫症时，下列何者为最佳做法？", "answer_idx": "A", "answer": "解释无精虫症可能原因之后，休息数星期后再次检 精液或抽血检查", "options": {"A": "解释无精虫症可能原因之后，休息数星期后再次检 精液或抽血检查", "B": "安排睪丸切片，用以分析阻塞性或非阻塞性无精虫症", "C": "安排单一精虫注射试管婴儿", "D": "告知领养小孩是唯一选择"}}
{"meta_info": "taiwanese_test_Q", "question": "大部分小儿外科医师建议隐睪症儿童在什么年龄接受手术？", "answer_idx": "C", "answer": "1 岁", "options": {"A": "1 个月", "B": "6 个月", "C": "1 岁", "D": "3 岁"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种毒物，会阻断钠离子通道而抑制神经动作电位之传导？", "answer_idx": "D", "answer": "tetrodotoxin", "options": {"A": "botulinum toxin", "B": "ω-conotoxin GVIA", "C": "α-latrotoxin", "D": "tetrodotoxin"}}
{"meta_info": "taiwanese_test_Q", "question": "B细胞被抗原刺激后，细胞膜上之免疫球蛋白可转变成分泌型抗体，其机制为何？", "answer_idx": "B", "answer": "RNA剪接（RNA splicing）", "options": {"A": "DNA重组（DNA recombination）", "B": "RNA剪接（RNA splicing）", "C": "蛋白分解酶（protease）切割", "D": "蛋白激酶（protein kinase）修饰"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种狀况可促进周边组织中氧气和血红素的解離？", "answer_idx": "A", "answer": "运动", "options": {"A": "运动", "B": "pH 值 7.6", "C": "二氧化碳分压降低", "D": "温度下降"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一项是最能证明爱滋病预防教育执行成功的指标？", "answer_idx": "A", "answer": "民众从事安全性行为（使用保险套）的比率提高", "options": {"A": "民众从事安全性行为（使用保险套）的比率提高", "B": "爱滋病患的病情在臨床上获得有效控制", "C": "医院发出爱滋病预防教育单张的數量增加", "D": "參加爱滋病卫生教育活动的人數增多"}}
{"meta_info": "taiwanese_test_Q", "question": "单内醯胺（monobactam）属于β-内醯胺類的抗生素，但与其他同類药物相较，其抗菌范围较为狭窄只可对抗何類细菌？", "answer_idx": "C", "answer": "革蘭氏阴性嗜氧菌", "options": {"A": "革蘭氏阴性厌氧菌", "B": "革蘭氏阳性厌氧菌", "C": "革蘭氏阴性嗜氧菌", "D": "革蘭氏阳性嗜氧菌"}}
{"meta_info": "taiwanese_test_Q", "question": "77 一位 55 岁男性至急诊就医，主诉 3 天來感觉头暈，站立时较严重，躺卧时可缓解。除此以外无任何不适。平日偶尔会服用非類固醇類消炎止痛药治療关节酸痛。理学检查无明显腹部压痛，肠音蠕动正常。肛门检查发现有血便，在急诊安排胃灌洗（gastric lavage）、胃镜以及大肠镜检查皆无发现異 常。住院后进行血管摄影也无異常。然而病人的血便仍持续。以下何者为最适合的下一步检查？\n", "answer_idx": "A", "answer": "核医闪烁造影术（scintigraphy）", "options": {"A": "核医闪烁造影术（scintigraphy）", "B": "钡剂对比检查（barium contrast study）", "C": "超音波（sonography）", "D": "电脑断层（computed tomography）"}}
{"meta_info": "taiwanese_test_Q", "question": "女孩进入青春期，一般最先开始发育的部位为：", "answer_idx": "B", "answer": "乳房（breast）", "options": {"A": "阴毛（pubic hair）", "B": "乳房（breast）", "C": "快速生长（height spurt）", "D": "初经（menarche）"}}
{"meta_info": "taiwanese_test_Q", "question": "在肝脏细胞膜（plasma membrane）中，下列何种脂质含量最低？", "answer_idx": "C", "answer": "心磷脂（cardiolipin）", "options": {"A": "胆碱磷脂（phosphatidylcholine）", "B": "鞘磷脂（sphingolipids）", "C": "心磷脂（cardiolipin）", "D": "胆固醇（cholesterol）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是高阴离子间隙代谢性酸中毒（high-anion-gap metabolic acidosis）的原因？", "answer_idx": "C", "answer": "diarrhea", "options": {"A": "lactic acidosis", "B": "ketoacidosis", "C": "diarrhea", "D": "salicylate intoxication"}}
{"meta_info": "taiwanese_test_Q", "question": "幼稚园中班的小恩，前年和去年皆施打过流行性感冒疫苗，半个月前被诊断得了流行性感冒，而服用了克流感（oseltamivir）治疗。有关小恩后续的流感防范措施，下列何者是最佳的选择？", "answer_idx": "A", "answer": "今年施打一剂流感疫苗", "options": {"A": "今年施打一剂流感疫苗", "B": "年龄未达8岁且打过疫苗又得病，今年应施打两剂流感疫苗", "C": "已服用过克流感，今年不必施打流感疫苗", "D": "流感疫苗无效，明年不要施打"}}
{"meta_info": "taiwanese_test_Q", "question": "鉴于青少年忧郁症的重要，有研究人员想要发展一份简易的筛检问卷。为了检验该筛检问卷的效度，他一共邀请某一学校之 500 位学生填写筛检问卷。其中 50 人被判定为阳性，其余为阴性。然后他请精神科医师亲自对这 500 人问诊，结果发现在 50 名阳性者当中，只有 35 人真正有病，但是 450 名阴性者当中，却还有 10 人有病。请问筛选问卷的敏感度（sensitivity）为何？", "answer_idx": "C", "answer": "35／45", "options": {"A": "50／500", "B": "35／50", "C": "35／45", "D": "40／450"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 68 岁病人因为深颈部严重感染引起败血性休克，他的呼吸道受到脓疡压迫而变狭窄，耳鼻喉科医师判断需要插呼吸管以抢救生命，下列何者考量正确？", "answer_idx": "C", "answer": "紧急狀态，应径行插管抢救", "options": {"A": "若病人意識不清楚，须经家属同意再进行插管", "B": "即使病人意識清楚，仍应等候家属到來再决定", "C": "紧急狀态，应径行插管抢救", "D": "依病况决定要不要救"}}
{"meta_info": "taiwanese_test_Q", "question": "病患的左眼可以看向左方但无法同时上抬，下列何者最可能损伤？", "answer_idx": "B", "answer": "左眼之上直肌", "options": {"A": "左眼之上斜肌", "B": "左眼之上直肌", "C": "左眼之内直肌", "D": "左眼之下斜肌"}}
{"meta_info": "taiwanese_test_Q", "question": "由于体超突变机转（somatic hypermutation）使得在发育中心（germinal center）的B淋巴球能产生出对抗原结合性更高的抗体，但是此过程之中也偶而会有产生自体抗体的B淋巴球，这时免疫系统如何处理？", "answer_idx": "D", "answer": "这些产生自体抗体的B淋巴球，在缺乏T细胞帮助之下凋亡，因而被清除", "options": {"A": "这些产生自体抗体的B淋巴球，停留于发育中心并不离开，以便于将来遇到自体抗原时再产生自体抗体", "B": "这些产生自体抗体的B淋巴球，因与补体结合而活化增生", "C": "这些产生自体抗体的B淋巴球，会遇到巨噬细胞而被清除", "D": "这些产生自体抗体的B淋巴球，在缺乏T细胞帮助之下凋亡，因而被清除"}}
{"meta_info": "taiwanese_test_Q", "question": "2.麻醉药物的效应可以大致分为催眠（hypnotic）以及止痛（analgesic）两大方面来独立考量，前者是麻醉深度监测 （monitoring of the depth of anesthesia）的主要范畴。下列关于麻醉深度监测的叙述，何者错误？\n", "answer_idx": "B", "answer": "手术过程中麻醉深度不足，可能导致病患术中清醒（intraoperative awareness） ，低体温时，其发生率较高", "options": {"A": "麻醉的深度可以用脑波图（electroencephalogram, EEG）或由脑波图计算出来的相关指标进行监测，主要是因为这些指标和", "B": "手术过程中麻醉深度不足，可能导致病患术中清醒（intraoperative awareness） ，低体温时，其发生率较高", "C": "越来越多的证据显示，术中进行麻醉深度监测，有助于降低病患术中清醒的发生率。但是，进行此项监测，并不能保证病患完全不会发生术中清醒", "D": "在病患可以承受的范围内，尽量维持适当而且稳定的吸入性麻醉气体浓度，有助于减少病患术中清醒的发生"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种致癌物最容易引起白血病及恶性淋巴瘤？", "answer_idx": "D", "answer": "Benzene", "options": {"A": "Asbestos", "B": "Cadmium compounds", "C": "Vinyl chloride", "D": "Benzene"}}
{"meta_info": "taiwanese_test_Q", "question": "治療幽门杆菌引起之消化性溃疡，下列叙述何者错误？", "answer_idx": "B", "answer": "Clarithromycin 于酸性环境相当稳定，所以单独使用 clarithromycin 之效果极佳", "options": {"A": "目前标准治療为 proton pump inhibitor，加上 clarithromycin 及 amoxicillin", "B": "Clarithromycin 于酸性环境相当稳定，所以单独使用 clarithromycin 之效果极佳", "C": "若有抗药性产生可以使用其他抗菌剂取代，如 metronidazole 或 tetracycline", "D": "对于十二指肠溃疡患者，将幽门杆菌清除，可以降低一年之溃疡復发率"}}
{"meta_info": "taiwanese_test_Q", "question": "8.⻑期禁食后再重新给与营养时，为避免造成再喂食症后群（refeeding syndrome），于早期喂食时，应注意下 列那些离⼦的补充？\n", "answer_idx": "A", "answer": "钾、磷、镁", "options": {"A": "钾、磷、镁", "B": "钠、磷、钙", "C": "钾、磷、钙", "D": "钾、钠、镁"}}
{"meta_info": "taiwanese_test_Q", "question": "主胰管（major pancreatic duct）与胆管（common bile duct）共同开口于十二指肠何处？", "answer_idx": "B", "answer": "下行段（descending part）", "options": {"A": "上段（superior part）", "B": "下行段（descending part）", "C": "下段（inferior part）", "D": "上行段（ascending part）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位48 岁男性病患发生一侧上肢肢体乏力症狀，接着同侧下肢肢体乏力，随后再发生異侧下肢肢体乏力，脑部电脑断层扫描发现有一个脑膜瘤（meningioma），该脑膜瘤最有可能长在那个位置？", "answer_idx": "C", "answer": "枕骨大孔（foramen magnum）", "options": {"A": "枕骨斜坡（clivus）", "B": "大脑镰（falx）", "C": "枕骨大孔（foramen magnum）", "D": "嗅沟（olfactory groove）"}}
{"meta_info": "taiwanese_test_Q", "question": "有一病人因久咳且痰中带有血丝及脓液而就诊，经医师采集其痰液进行细菌培养检测后，发现其痰检体中出现结核分枝杆菌，是为肺结核之患者。下列那一种抗生素不会出现在医师的处方笺中？", "answer_idx": "D", "answer": "Vancomycin", "options": {"A": "Isoniazid", "B": "Ethambutol", "C": "Rifampin", "D": "Vancomycin"}}
{"meta_info": "taiwanese_test_Q", "question": "最常見儿童急性淋巴性白血病的白血病细胞免疫表现型（immunophenotype）为：", "answer_idx": "A", "answer": "early pre-B cell, CD10+", "options": {"A": "early pre-B cell, CD10+", "B": "pro-B cell, CD10-", "C": "pre-B cell", "D": "T cell"}}
{"meta_info": "taiwanese_test_Q", "question": "当胃内胃酸分泌 pH 值＜3 时，会分泌下列何种胜肽至胃腔中，抑制胃泌素（gastrin）之分泌？", "answer_idx": "D", "answer": "体抑素（somatostatin）", "options": {"A": "胆囊收缩素（cholecystokinin）", "B": "胃抑素（gastric inhibitory polypeptide）", "C": "胰泌素（secretin）", "D": "体抑素（somatostatin）"}}
{"meta_info": "taiwanese_test_Q", "question": "23 一位 50 岁乳癌病患，她同时患有慢性 B 型肝炎及肝硬化。于五年前接受右侧乳房切除后，健康情况一直稳定。最近一星期有咳嗽及右胸疼痛现象，胸部 X 光检查显示右侧有中等程度肋膜腔积水。经安排胸腔超音波及抽水（thoracentesis），共抽出500 mL 黄褐色之液体，送实验室检查获得以下结果：glucose：105 mg/dL、LDH：350 U/L、total protein：4.5 g/dL、 WBC：1,000/uL。\n 请问下列叙述何者错误？\n", "answer_idx": "D", "answer": "应直接注入黏連剂至病患的肋膜腔内，以减少肋膜腔积水", "options": {"A": "肝硬化是引起肋膜腔积水的原因之一，静脉补充白蛋白（albumin）可以改善肋膜腔积水", "B": "病患肋膜腔积水可能來自于乳癌肋膜转移，必须检验肋膜腔积水是否有乳癌细胞", "C": "病患肋膜腔积水可能來自于肺部感染，必须进行肋膜腔积水及痰液之细菌培养", "D": "应直接注入黏連剂至病患的肋膜腔内，以减少肋膜腔积水"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者伴行小隐静脉（small saphenous vein），且传递小腿后外侧与小脚趾的皮肤感觉？", "answer_idx": "B", "answer": "腓肠神经（sural nerve）", "options": {"A": "隐神经（saphenous nerve）", "B": "腓肠神经（sural nerve）", "C": "腓深神经（deep fibular nerve）", "D": "腓浅神经（superficial fibular nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "74岁男性，发烧咳嗽，右下肺叶有⼀个圆形病灶，内含很多中性球、坏死细胞的黏稠液，此病灶最可能为：", "answer_idx": "B", "answer": "脓疡（abscess）", "options": {"A": "肥厚性瘢痕（hypertrophic scar）", "B": "脓疡（abscess）", "C": "⾎肿（hematoma）", "D": "结核（tuberculosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列构造何者不经过superior orbital fissure？", "answer_idx": "D", "answer": "maxillary branch of trigeminal nerve", "options": {"A": "trochlear nerve", "B": "abducens nerve", "C": "superior ophthalmic vein", "D": "maxillary branch of trigeminal nerve"}}
{"meta_info": "taiwanese_test_Q", "question": "在右上腹触摸到长形（香肠狀）硬块是那一疾病的特征？", "answer_idx": "D", "answer": "肠套叠", "options": {"A": "水肾", "B": "胆管囊肿", "C": "肥大性幽门狭窄", "D": "肠套叠"}}
{"meta_info": "taiwanese_test_Q", "question": "80 下列何种疾病可以出现有脂质或蛋白质等物质过度储积于神经元（neuron）细胞内？ ①尼曼－匹克症 （Niemann-Pick disease） ②黏多糖储积症（mucopolysaccharidoses） ③戴－萨克斯症（Tay-Sachs\n disease）\n", "answer_idx": "D", "answer": "①②③", "options": {"A": "仅①②", "B": "仅②③", "C": "仅①③", "D": "①②③"}}
{"meta_info": "taiwanese_test_Q", "question": "正常人对下列何种味觉具有最低的感受阈值（the lowest stimulation threshold）？", "answer_idx": "C", "answer": "苦", "options": {"A": "酸", "B": "甜", "C": "苦", "D": "咸"}}
{"meta_info": "taiwanese_test_Q", "question": "8.5，尿液通常会培养出变形杆菌属细菌，如Proteus mirabilis 下列有关Wegener's granulomatosis之叙述，何者最正确？", "answer_idx": "B", "answer": "黑人较白人常见", "options": {"A": "血中可测到antiproteinase-3抗体", "B": "黑人较白人常见", "C": "肾切片＞50%组织，可见到肉芽组织（granuloma）", "D": "此病在眼部不会造成结膜炎及巩膜炎（scleritis）"}}
{"meta_info": "taiwanese_test_Q", "question": "16 个月男婴，因排便后突然发生呼吸急促，发绀加剧而送至急诊。此孩童以往即被发现有发绀及心杂音，其胸部 X 光片显示肺血管减少，心脏形状似\"马靴\"（boot-shaped）。下列何种处理较不适当？", "answer_idx": "C", "answer": "避免孩童躁动而更消耗氧气，给予 benzodiazepam 镇静", "options": {"A": "马上将孩童置膝抱胸（knee-chest）姿势，并给予氧气", "B": "给予碳酸氢钠（NaHCO3）以矫正酸血症", "C": "避免孩童躁动而更消耗氧气，给予 benzodiazepam 镇静", "D": "给予静脉注射 propranolol，减缓肺动脉下漏斗体（infundibulum）之收缩"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 2 岁男孩，被家属发现四肢冰冷、意識不清及发作（seizure）。当时血压为 62/44 mmHg，其心电图（EKG）如下图所示。下列何者为最适当之处理？", "answer_idx": "D", "answer": "电击休克（DC shock）", "options": {"A": "给与静脉注射 amiodarone", "B": "给与静脉注射 lidocaine", "C": "放置暂时性心律调节器（temporary pacemaker）", "D": "电击休克（DC shock）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何项治療可以减轻慢性阻塞性肺病之惡化？", "answer_idx": "C", "answer": "戒烟与氧气治療", "options": {"A": "支气管扩张剂", "B": "類固醇", "C": "戒烟与氧气治療", "D": "復健"}}
{"meta_info": "taiwanese_test_Q", "question": "引起蛛网膜下出血最多的动脉瘤是那一种？", "answer_idx": "D", "answer": "Berry", "options": {"A": "Atherosclerotic", "B": "Mycotic", "C": "Traumatic", "D": "Berry"}}
{"meta_info": "taiwanese_test_Q", "question": "一位机車骑士，車祸撞击造成右膝受伤，身体检查发现右膝正前方有撞击伤，合并轻微膝关节肿胀，膝后拉测试（posterior drawer test）呈阳性，X 光显示无骨折，表示他何处韧带损伤？", "answer_idx": "D", "answer": "膝后十字韧带", "options": {"A": "膝内侧韧带", "B": "膝外侧韧带", "C": "膝前十字韧带", "D": "膝后十字韧带"}}
{"meta_info": "taiwanese_test_Q", "question": "心脏传导系统的蒲金氏纤维（Purkinje fibers）为下列何者特化而成？", "answer_idx": "A", "answer": "心肌细胞（cardiac muscle cell）", "options": {"A": "心肌细胞（cardiac muscle cell）", "B": "神经细胞（nerve cell）", "C": "纤维母细胞（fibroblast）", "D": "内皮细胞（endothelial cell）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者是原发性副甲状腺功能亢进的患者，最可能出现的电解质变化？", "answer_idx": "A", "answer": "高血钙、低血磷", "options": {"A": "高血钙、低血磷", "B": "低血钙、高血磷", "C": "低血钙、低血磷", "D": "高血钙、高血磷"}}
{"meta_info": "taiwanese_test_Q", "question": "在下列何种疾病会听到全收缩期杂音（holo-systolic murmur）？", "answer_idx": "B", "answer": "心室中隔缺损（ventricular septal defect）", "options": {"A": "心房中隔缺损（atrial septal defect）", "B": "心室中隔缺损（ventricular septal defect）", "C": "肺动脉瓣狭窄（pulmonary stenosis）", "D": "开放性动脉导管（patent ductus arteriosus）"}}
{"meta_info": "taiwanese_test_Q", "question": "霍亂弧菌毒素会刺激小肠绒毛分泌细胞产生 cyclic AMP，接着引发下列何种離子大量释出，导致分泌性腹泻？", "answer_idx": "B", "answer": "氯離子", "options": {"A": "钠離子", "B": "氯離子", "C": "钙離子", "D": "镁離子"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列何者是最适当优先安排的检查工具？", "answer_idx": "C", "answer": "腹部电脑断层摄影", "options": {"A": "大肠钡剂灌肠摄影", "B": "大肠镜", "C": "腹部电脑断层摄影", "D": "腹部超音波"}}
{"meta_info": "taiwanese_test_Q", "question": "侦测自然殺手细胞（NK cells）可以下列那种分子组合作为标记？", "answer_idx": "C", "answer": "CD16/CD56", "options": {"A": "CD3/CD4", "B": "CD4/CD25", "C": "CD16/CD56", "D": "CD19/CD21"}}
{"meta_info": "taiwanese_test_Q", "question": "非典型胸痛的年轻女子接受运动心电图检查，下列叙述何者最正确？", "answer_idx": "C", "answer": "若呈阴性反应，则最终诊断为冠狀动脉疾病的机率极低", "options": {"A": "若呈阳性反应，则最终诊断为冠狀动脉疾病（coronary heart disease）的机率高", "B": "若呈阳性反应，则最终诊断为二尖瓣脱垂（mitral valve prolapse）的机率高", "C": "若呈阴性反应，则最终诊断为冠狀动脉疾病的机率极低", "D": "若呈阴性反应，则最终诊断为二尖瓣脱垂的机率极低"}}
{"meta_info": "taiwanese_test_Q", "question": "梦游症（sleepwalking disorder）通常发生在睡眠脑波图（EEG）的那一个时期？", "answer_idx": "C", "answer": "stage III & IV", "options": {"A": "stage I", "B": "stage II", "C": "stage III & IV", "D": "REM（rapid eye movement）sleep"}}
{"meta_info": "taiwanese_test_Q", "question": "糖尿病诊断标准之一为空腹血浆糖 ≥ 126 mg/dL，此处空腹之定义为没有摄取热量达至少多少小时？", "answer_idx": "B", "answer": "8", "options": {"A": "6", "B": "8", "C": "12", "D": "16"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那种细胞最不可能与维持 oral tolerance 有关？", "answer_idx": "C", "answer": "第十七型辅助性 T 细胞（TH17）", "options": {"A": "第三型辅助性 T 细胞（TH3）", "B": "调节性 T 细胞（regulatory T cell）", "C": "第十七型辅助性 T 细胞（TH17）", "D": "第二型辅助性 T 细胞（TH2）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者现在臨床上适合用來治療严重败血症？", "answer_idx": "D", "answer": "Activated protein C", "options": {"A": "Interleukin-1 receptor antagonist", "B": "Soluble receptor for tumor necrosis factor-α", "C": "Lipopolysaccharide antagonist", "D": "Activated protein C"}}
{"meta_info": "taiwanese_test_Q", "question": "关于配对的描述，下列何者错误？", "answer_idx": "B", "answer": "配对主要有频率配对（frequency matching）与个人配对（individual matching）兩种，频率配对需要较大的成本", "options": {"A": "在病例对照研究中，若采用配对，是避免研究所关注的危险因子外的暴露在病例组与对照组的分布有差異", "B": "配对主要有频率配对（frequency matching）与个人配对（individual matching）兩种，频率配对需要较大的成本", "C": "假设对性别与年龄进行配对，则无法再探讨这兩个变项对疾病的影响", "D": "以病例对照研究为例，一个病例可配对多个对照，以增加检力（power）"}}
{"meta_info": "taiwanese_test_Q", "question": "抗癌药合并疗法ABVD治疗何杰金氏淋巴瘤（Hodgkin's lymphoma），其中何者可以明显抑制癌细胞之topoisomerase II，而产生细胞毒杀作用？", "answer_idx": "B", "answer": "doxorubicin", "options": {"A": "bleomycin", "B": "doxorubicin", "C": "vincristine", "D": "dacarbozine"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种病毒具有E1A与E1B这两种促进细胞生长的活化因子？", "answer_idx": "A", "answer": "Adenovirus", "options": {"A": "Adenovirus", "B": "Papillomavirus", "C": "Epstein-Barr virus", "D": "Cytomegalovirus"}}
{"meta_info": "taiwanese_test_Q", "question": "葡萄糖分子在肾小管近端上皮细胞的再吸收，最主要是透过何种机制进行？", "answer_idx": "A", "answer": "次级主动运输（secondary active transport）", "options": {"A": "次级主动运输（secondary active transport）", "B": "二价铁离子媒介之转化作用（Fe2+-mediated conversion）", "C": "胞噬作用（phagocytosis）", "D": "氧化磷酸化作用（oxidative phosphorylation）"}}
{"meta_info": "taiwanese_test_Q", "question": "在某些例外的情况下，无需病患的同意即可进行医療行为，惟下列何者不属于这些例外的情况？", "answer_idx": "B", "answer": "有利于患者的人体试验", "options": {"A": "紧急开刀或紧急侵入性检查", "B": "有利于患者的人体试验", "C": "精神疾病患者的强制治療", "D": "法定传染病患者的隔離治療"}}
{"meta_info": "taiwanese_test_Q", "question": "4 岁男孩，母亲主诉4 天前开始出现轻微咳嗽，3 天前开始发烧，温度皆在39℃以上，且合并有寒颤（chill），入院前2 天咳嗽更加剧烈，且有腹痛现象，身体检查显示一急性病容的小孩，右侧胸部呼吸音下降且有啰音，胸部X 光片如附图，血液检查显示无贫血，但WBC = 24,000/μL。则此病人最可能的致病菌为：", "answer_idx": "C", "answer": "Streptococcus pneumoniae", "options": {"A": "Haemophilus influenzae type b", "B": "Staphylococcus aureus", "C": "Streptococcus pneumoniae", "D": "Mycoplasma pneumoniae"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是听觉传导路径中的构造？", "answer_idx": "C", "answer": "内侧蹄系（medial lemniscus）", "options": {"A": "斜方体（trapezoid body）", "B": "上橄榄核群（superior olivary complex）", "C": "内侧蹄系（medial lemniscus）", "D": "下丘（inferior colliculus）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关胸管的叙述，何者错误？", "answer_idx": "D", "answer": "胸管直接汇入上腔静脉", "options": {"A": "乳糜池（chyle cistern）的大小、外型是不固定的", "B": "下六对肋间的淋巴亦下行汇入乳糜池（chyle cistern）", "C": "胸管位在后纵隔腔（posterior mediastinum）", "D": "胸管直接汇入上腔静脉"}}
{"meta_info": "taiwanese_test_Q", "question": "红斑性狼疮（lupus erythematosus）之皮肤盘狀病灶（discoid lesion），较不会出现在下列那一部位之皮肤？", "answer_idx": "C", "answer": "腹部（abdomen）", "options": {"A": "颜面（face）", "B": "头部（scalp）", "C": "腹部（abdomen）", "D": "手前臂（forearm）"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，下列何者不是检查胸腔出口症候群的方法？", "answer_idx": "D", "answer": "Breath test", "options": {"A": "Adson（scalene）test", "B": "Halsted（costoclavicular） test", "C": "Wright（hyperabduction）test", "D": "Breath test"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 69 岁男性病患呈现严重的高血压。影像学检查发现他右肾脏的动脉进口处发生狭窄。下列疾病中那一个是造成这類肾脏动脉狭窄最常見的原因？", "answer_idx": "D", "answer": "Atherosclerosis", "options": {"A": "Fibromuscular dysplasia", "B": "Takayasu arteritis", "C": "Polyarteritis nodosa", "D": "Atherosclerosis"}}
{"meta_info": "taiwanese_test_Q", "question": "平静吸气（quiet inspiration）过程中，不会发生下列何种现象？", "answer_idx": "B", "answer": "内肋间肌（internal intercostal muscle）收缩", "options": {"A": "膈神经（phrenic nerve）兴奋", "B": "内肋间肌（internal intercostal muscle）收缩", "C": "肋膜内压（intrapleural pressure, Pip）下降", "D": "肺脏之弹性回复力（elastic recoil）增加"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关非特异性间质肺炎（non-specific interstitial pneumonia）的叙述，何者正确？", "answer_idx": "A", "answer": "可分细胞性（cellular）和纤维化（fibrosing）两种型态", "options": {"A": "可分细胞性（cellular）和纤维化（fibrosing）两种型态", "B": "时间异质性（temporal heterogeneity）明显", "C": "可见纤维母细胞增生病灶（fibroblastic focus）", "D": "可见蜂巢状纤维化（honeycomb fibrosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，若病患请教医师对其该肾脏肿瘤处置之見解时，则会建议：", "answer_idx": "B", "answer": "应为良性肿瘤，但当有症狀或体积超过 4 公分时再进行手术", "options": {"A": "应为良性肿瘤，不論大小都不必理会", "B": "应为良性肿瘤，但当有症狀或体积超过 4 公分时再进行手术", "C": "应为惡性肿瘤，并建议立刻行肾脏切除手术", "D": "应为惡性肿瘤，但可行肾脏部分切除手术（nephron sparing surgery）即可"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 19 岁大学男生，自小即患有突发性心悸。住院当中，病患突感心悸，你立即作了心电图，从此心电图的结果中，你认为病人的不整脉最可能为何？", "answer_idx": "C", "answer": "paroxysmal supraventricular tachycardia（PSVT）", "options": {"A": "sinus tachycardia", "B": "atrial fibrillation with rapid ventricular response", "C": "paroxysmal supraventricular tachycardia（PSVT）", "D": "ventricular tachycardia（VT）"}}
{"meta_info": "taiwanese_test_Q", "question": "80.老王是退休的单身男性，78岁，有心脏病、高血压、糖尿病，只有间断服药，在一家工厂担任仓库管理员，最近一年半来走路容易跌倒，因此住院检查，发现罹患了小脑萎缩症，医师也告之此病症的预后不佳，因此曾拜托老板，如果有什么重病突发时，不要再急救。他并且留下书面的不予急救（DNR）意愿书。某日晚上，在大门值班时突然昏迷，紧急送往医院急救，发现有左前脑及中脑动脉阻塞之大片梗塞，又病人的实 室检查发现有慢性肾功能衰竭，宜进行透析治疗。病人在急诊处呼吸逐渐不规则，血中二氧化碳分压升高。\n 如果不施行气管插管，可能危及生命，则下列的处理何者最适切？\n", "answer_idx": "D", "answer": "只进行一般之支持疗法，但不安排透析，也不进行气管插管，以尊重病人的意愿", "options": {"A": "请工厂负责人代为签署同意书，进行气管插管，因医师以救命为第一职责", "B": "请医院之警卫或社工人员当见证人签同意书，进行气管插管，因医师以救命为第一职责", "C": "直接进行气管插管，并安排腹膜透析", "D": "只进行一般之支持疗法，但不安排透析，也不进行气管插管，以尊重病人的意愿"}}
{"meta_info": "taiwanese_test_Q", "question": "药物在血浆中的浓度以\"一次级的动力学＂下降，则表示：", "answer_idx": "D", "answer": "大约等于其半衰期", "options": {"A": "只经由一种药物的代谢途径", "B": "大部份在肝脏中代谢", "C": "药物只存在血液循环内", "D": "大约等于其半衰期"}}
{"meta_info": "taiwanese_test_Q", "question": "安非他命所引起的激动不安，要使用何种药物治療？", "answer_idx": "A", "answer": "安神药（benzodiazepines）", "options": {"A": "安神药（benzodiazepines）", "B": "抗精神病药物（antipsychotics）", "C": "抗忧郁剂（antidepressants）", "D": "情绪稳定剂（mood stablizers）"}}
{"meta_info": "taiwanese_test_Q", "question": "急性期的脑动脉瘤破裂合并蜘蛛网膜下腔出血，则下述何者是快速及确定诊断的检查？", "answer_idx": "B", "answer": "电脑断层血管扫描（CT angiography）", "options": {"A": "核磁共振血管扫描（MR angiography）", "B": "电脑断层血管扫描（CT angiography）", "C": "电脑断层扫描（CT brain）", "D": "腰椎穿刺（lumbar puncture）"}}
{"meta_info": "taiwanese_test_Q", "question": "医院策略性管理（strategic management）的意义，是在导引医院依据内外在环境的变动，做出重大的变革。其首要工作是要确认医院的：", "answer_idx": "B", "answer": "使命与目标", "options": {"A": "处境", "B": "使命与目标", "C": "策略选择", "D": "策略执行评估"}}
{"meta_info": "taiwanese_test_Q", "question": "根据卫生福利部民国95年公告之「研究用人体检体采集与使用注意事项」，有关「去连结」之定义，下列何者正确？", "answer_idx": "D", "answer": "于检体编码后，将代码与检体提供者可供辨识个人资讯之对照资料完全永久消除之作业方式", "options": {"A": "将检体编码，以代码取代姓名或其他可供辨识个人资讯，致无法辨识检体提供者之作业方式", "B": "于检体编码后，将代码与检体提供者可供辨识个人资讯之对照资料，和检体分开保存之作业方式", "C": "于检体编码后，将代码与检体提供者可供辨识个人资讯之对照资料再编码方式处理之作业方式", "D": "于检体编码后，将代码与检体提供者可供辨识个人资讯之对照资料完全永久消除之作业方式"}}
{"meta_info": "taiwanese_test_Q", "question": "当你接收到一位严重创伤已插有气管内管插管（endotracheal tube）的转诊病人时，于下列所有情况都需怀疑有气管插管误入食道（esophageal intubation），那项除外？", "answer_idx": "D", "answer": "可见到气管内管内有雾气进出", "options": {"A": "end-tidal CO2值近乎零", "B": "挤苏醒球(bag-valve-mask)时听不到呼吸声", "C": "听得见胃有杂声（borborygmus）", "D": "可见到气管内管内有雾气进出"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，为了要确定诊断，有各种方式可用，但下列何者错误？", "answer_idx": "A", "answer": "人工关节手术后第三天，其 d-dimer test 结果若为阳性，有百分之九十的机会可以排除此诊断", "options": {"A": "人工关节手术后第三天，其 d-dimer test 结果若为阳性，有百分之九十的机会可以排除此诊断", "B": "人工关节手术后第三天，Homans' sign 阴性，也不能排除此诊断", "C": "血管摄影虽比较具侵袭性，但却是最正确的诊断方式", "D": "超音波及都卜勒（duplex）检查最方便且无侵袭性，但正确度和操作者经验有关"}}
{"meta_info": "taiwanese_test_Q", "question": "承上题，为防止这类病人的肌肉萎缩，下列何种复健治疗最合适？", "answer_idx": "A", "answer": "功能性电刺激（functional electrical stimulation）", "options": {"A": "功能性电刺激（functional electrical stimulation）", "B": "经皮神经电刺激（transcutaneous electrical nerve stimulation）", "C": "低能量雷射治疗（low level laser therapy）", "D": "超音波热疗法（ultrasound diathermy）"}}
{"meta_info": "taiwanese_test_Q", "question": "如眼底视网膜照片所示，此位患者最可能之诊断为何？", "answer_idx": "A", "answer": "糖尿病视网膜病变", "options": {"A": "糖尿病视网膜病变", "B": "急性视网膜中心动脉阻塞", "C": "急性视网膜中心静脉阻塞", "D": "早产儿视网膜病变"}}
{"meta_info": "taiwanese_test_Q", "question": "使用下列那一類治療忧郁症的药物时，必须限制含乳酪食品的摄取，否则会引起血压上升的危险？", "answer_idx": "D", "answer": "Tranylcypromine", "options": {"A": "Fluoxetine", "B": "Imipramine", "C": "Bupropion", "D": "Tranylcypromine"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是引起术后 Hypoventilation 常見的原因？", "answer_idx": "A", "answer": "Hyperkalemia", "options": {"A": "Hyperkalemia", "B": "Hypothermia", "C": "使用 Opioids", "D": "使用 Neuromuscular blocking agents"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关脓胸（empyema thoracis）之叙述，何者错误？", "answer_idx": "A", "answer": "诊断依据为胸水检验中，白血球數目超过 2500/mm3", "options": {"A": "诊断依据为胸水检验中，白血球數目超过 2500/mm3", "B": "常見的致病菌包括 Streptococcus、Anaerobes、Klebsiella spp.", "C": "常見的症狀为胸痛、发烧", "D": "胸管引流与合宜的抗生素使用，为主要的治療方式"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不属于椎前交感神经节？", "answer_idx": "D", "answer": "腰交感神经节（Lumbar sympathetic ganglia）", "options": {"A": "腹腔神经节（Celiac ganglia）", "B": "肠系膜上神经节（Superior mesenteric ganglia）", "C": "肠系膜下神经节（Inferior mesenteric ganglia）", "D": "腰交感神经节（Lumbar sympathetic ganglia）"}}
{"meta_info": "taiwanese_test_Q", "question": "在长期无法进食之受伤病人，其体内营养之补充途径，已经证明以肠道营养（enteral nutrition）优于非肠道营养（parenteral nutrition），下列原因何者错误？", "answer_idx": "D", "answer": "易引发吸入性肺炎（aspiration pneumonia）", "options": {"A": "价格较低", "B": "合并症较少", "C": "肠道黏膜（intestinal mucosa）较不易萎缩", "D": "易引发吸入性肺炎（aspiration pneumonia）"}}
{"meta_info": "taiwanese_test_Q", "question": "1 岁5 个月的男童因为高烧不退5 天，躁动不安及不爱动左脚，被带至急诊室评估，身体诊察发现左膝红肿合并压痛及关节活动受限，下列何者是最重要的检查来确诊败血性关节炎（septic arthritis）？", "answer_idx": "C", "answer": "左膝关节液检查（Gram stain and culture）", "options": {"A": "左膝关节 X 光", "B": "红血球沉降速率（ESR）", "C": "左膝关节液检查（Gram stain and culture）", "D": "血球计数及分类"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者为已开发国家，50 岁以上造成不可逆视力丧失最常見之原因？", "answer_idx": "A", "answer": "视网膜黄斑部退化", "options": {"A": "视网膜黄斑部退化", "B": "白内障", "C": "青光眼", "D": "视网膜剥離"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者未矫正，是引起所谓的经线性（Meridional）弱视的原因？", "answer_idx": "B", "answer": "散光（Astigmatism）", "options": {"A": "不等视（Anisometropic）", "B": "散光（Astigmatism）", "C": "远视（Hypermetropia）", "D": "上斜视（Hypertropia）"}}
{"meta_info": "taiwanese_test_Q", "question": "臀上动脉（superior gluteal artery）发生阻塞，下列何者最不受影响？", "answer_idx": "D", "answer": "上孖肌（superior gemellus muscle）", "options": {"A": "臀大肌（gluteus maximus muscle）", "B": "臀小肌（gluteus minimus muscle）", "C": "梨狀肌（piriformis muscle）", "D": "上孖肌（superior gemellus muscle）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种指标与脑伤（traumatic brain injury）病人的预后关联性最低？", "answer_idx": "A", "answer": "脑伤后癫痫（seizure）发生频率", "options": {"A": "脑伤后癫痫（seizure）发生频率", "B": "格拉司哥昏迷指数（Glasgow coma scale）", "C": "脑伤后失忆症（amnesia）时间的长短", "D": "脑伤造成意识失常（comatose）时间的长短"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关药品安全监视的项目，属于我国独有而一般医药先进国家比较不常监视者？", "answer_idx": "A", "answer": "中药掺西药的监视", "options": {"A": "中药掺西药的监视", "B": "疫苗副作用的监视", "C": "新药安全的监视", "D": "偶发药品品质安全副作用事件的监视"}}
{"meta_info": "taiwanese_test_Q", "question": "你正面对一位刚被诊断有第二型糖尿病的62岁女性，她怀疑自己也有骨质健康的问题，下列何者最能正确说明糖尿病和骨松症的相关性？", "answer_idx": "A", "answer": "第二型糖尿病患者相对于第一型糖尿病患者有较高的骨质密度", "options": {"A": "第二型糖尿病患者相对于第一型糖尿病患者有较高的骨质密度", "B": "第二型糖尿病患相对于一般人较少发生骨折", "C": "第二型糖尿病患相对于第一型糖尿病患有较高的骨折风险", "D": "血糖控制不良会降低骨质密度"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关惡性高温（malignant hyperthermia）的叙述，何者错误？", "answer_idx": "D", "answer": "主要因为肌肉无法进行收缩作用", "options": {"A": "与钙離子的 homeostasis 失调有关", "B": "可能与 ryanodine receptor 蛋白的基因缺损有关", "C": "可能与肌浆网（sarcoplasmic reticulum）受器蛋白的基因缺损有关", "D": "主要因为肌肉无法进行收缩作用"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那项肺脏疾病，最有可能出现嗜中性白血球渗出物？", "answer_idx": "C", "answer": "细菌性肺炎", "options": {"A": "病毒性肺炎", "B": "肺气喘", "C": "细菌性肺炎", "D": "肺癌"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者为婴儿感染先天性德国麻疹（congenital rubella）后，最常合并之心脏病？", "answer_idx": "D", "answer": "开放性动脉导管（patent ductus arteriosus）", "options": {"A": "心室中隔缺损（ventricular septal defect）", "B": "心房中隔缺损（atrial septal defect）", "C": "法洛式四合症（tetralogy of Fallot）", "D": "开放性动脉导管（patent ductus arteriosus）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关 Achalasia 与 Pseudoachalasia 之叙述，何者错误？", "answer_idx": "C", "answer": "大部分 Achalasia 于内视镜下，可发现食道黏膜之破坏与病变", "options": {"A": "Achalasia 起于食道蠕动功能不足", "B": "Pseudoachalasia 起于 GE junction 附近的肿瘤压迫", "C": "大部分 Achalasia 于内视镜下，可发现食道黏膜之破坏与病变", "D": "兩者皆可发现食道扩张的现象"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关注意力缺损过动症（attention-deficit/hyperactivity disorder, ADHD）的叙述，何者错误？", "answer_idx": "A", "answer": "第一线治療为行为治療", "options": {"A": "第一线治療为行为治療", "B": "3 岁之前很难诊断注意力缺损过动症，因正常小孩也可能有相同行为", "C": "约一半的人到青春期或成人仍有症狀", "D": "第一线药物治療为中枢神经刺激剂（stimulant），其主要副作用为食欲降低及失眠"}}
{"meta_info": "taiwanese_test_Q", "question": "38岁女性，到妇产门诊就诊，主诉有下列典型症状 dysuria、dribbling、dyspareunia，同时临床骨盆检查发现前阴道壁有一肿块，下列何者被公认为最佳诊断之影像工具？", "answer_idx": "D", "answer": "核磁共振（magnetic resonance imaging）", "options": {"A": "静脉肾盂摄影（intravenous pyelography）", "B": "解尿膀胱尿道摄影（voiding cystourethrography）", "C": "肾脏输尿管膀胱摄影（kidney, ureter, bladder, KUB）", "D": "核磁共振（magnetic resonance imaging）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是评估健康服务的指标？", "answer_idx": "B", "answer": "ethnicity", "options": {"A": "efficacy", "B": "ethnicity", "C": "effectiveness", "D": "efficiency"}}
{"meta_info": "taiwanese_test_Q", "question": "有关「失用症」（apraxia）的叙述，下列何者最为正确？", "answer_idx": "A", "answer": "言语功能也可能发生失用症", "options": {"A": "言语功能也可能发生失用症", "B": "病人因不了解指令所以无法执行动作", "C": "病人多伴有感觉神经功能缺失", "D": "多因小脑受伤引起"}}
{"meta_info": "taiwanese_test_Q", "question": "EB病毒（Epstein-Barr virus）主要感染B淋巴球；它是以该细胞表面的何种分子为受体（receptor）？", "answer_idx": "A", "answer": "CR2", "options": {"A": "CR2", "B": "CD4", "C": "CD8", "D": "糖蛋白（glycoprotein）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于真核细胞蛋白质合成的启始阶段（initiation stage），下列叙述何者错误？", "answer_idx": "C", "answer": "核糖体的大与小两个次单元（large and small subunits）必须形成完整的核糖体（ribosome）才能与mRNA结", "options": {"A": "需要mRNA、核糖体（ribosome）与aminoacyl-tRNA的参与", "B": "mRNA必须具有5'端帽结构（5'cap structure）或internal ribosome entry site（IRES）才能参与启始作用", "C": "核糖体的大与小两个次单元（large and small subunits）必须形成完整的核糖体（ribosome）才能与mRNA结", "D": "启始阶段需要的aminoacyl-tRNA是Met-tRNAiMet"}}
{"meta_info": "taiwanese_test_Q", "question": "T细胞受器多样化（T cell receptor diversity）之原因很多，但不包含下列那一项？", "answer_idx": "D", "answer": "N-核苷酸添加（N-nucleotides addition）", "options": {"A": "V", "B": "J基因片段连接[V", "C": "J gene segments joining]", "D": "N-核苷酸添加（N-nucleotides addition）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 28 岁女性，已婚但多年未生育，最近月经疼痛惡化，超音波检查发现卵巢附近有一个囊肿，最可能的原因是：", "answer_idx": "B", "answer": "子宫内膜異位症", "options": {"A": "骨盆腔发炎", "B": "子宫内膜異位症", "C": "子宫肌瘤", "D": "子宫内膜癌"}}
{"meta_info": "taiwanese_test_Q", "question": "张先生因罹患大肠癌而來找此方面权威的邢主任看诊，邢主任决定为张先生开刀治療。在手术前邢主任和张先生一番寒暄鼓勵，在麻醉生效后邢主任便将手术交给资深住院医师执行，自己先行離去，直到最后才进开刀房将大肠癌段摘除，病患完全不知情，只听邢主任說手术过程顺利。有关邢主任的作为，下列那一个叙述最为恰当？", "answer_idx": "D", "answer": "应于术前向张先生說明參与手术的是那一些人，并告知他在适当的情况下会教导资深住院医师开刀的技术", "options": {"A": "是一位好的老师，给予年轻医师如此的磨練机会以获取更多的经验，用心良苦", "B": "工作负荷重，需要用这段时间做行政、教学及研究工作，情有可原", "C": "应全程參与开刀并亲自执刀，只让资深住院医师缝合皮肤", "D": "应于术前向张先生說明參与手术的是那一些人，并告知他在适当的情况下会教导资深住院医师开刀的技术"}}
{"meta_info": "taiwanese_test_Q", "question": "下列风湿病主要侵犯的组织之解剖构造（anatomic structures）之配对中，那一项错误？", "answer_idx": "B", "answer": "Ankylosing spondylitis；bony end plate", "options": {"A": "Rheumatoid arthritis；synovium", "B": "Ankylosing spondylitis；bony end plate", "C": "Osteoarthritis；cartilage", "D": "Gout；joint space 31 下列有关 Henoch-Schönlein purpura 的叙述，何者最不正确？"}}
{"meta_info": "taiwanese_test_Q", "question": "49 某日，一位 69 岁女性 A 在健身俱樂部被游泳池员工带往服务台，建议 A 的先生带 A 到医院检查。原來，A 不断地问同样的问题「我现在在那裡？我在做什么？」很快地，他们來到医学中心急诊部，病人血压偏高，意識清楚，手脚活动与感觉正常，步态平稳。 54 小时后安排了 Brain MRI 结果如下， A 有可能的狀况为：\n", "answer_idx": "A", "answer": "暂时性失忆症（transient global amnesia）", "options": {"A": "暂时性失忆症（transient global amnesia）", "B": "阿兹海默症（Alzheimer disease）", "C": "失忆性中风（amnestic stroke）", "D": "癫痫发作（epileptic seizures）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位50 岁已婚女性，主诉1 个月以來，有失眠、疲倦、胃口不佳、便秘、体重下降、胸闷等症狀，怀疑自己可能有重大身体疾病，曾看过胃肠科、心脏科、家医科。检查均属正常，最后被转介到精神科治療，经询问病史发现：病患有严重情绪低落及毫无生活情趣并有自殺想法。以上这些症狀在过去二年以來均持续存在，只是过去程度较轻，此次发作乃因股票暴跌所导致。您的诊断最可能是：", "answer_idx": "C", "answer": "重叠性忧郁症（double depression）", "options": {"A": "轻郁症（dysthymic disorder）", "B": "重郁症（major depression disorder）", "C": "重叠性忧郁症（double depression）", "D": "双极型情感性疾病（bipolar disorder）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位36 岁妇女因发烧倦怠及手部多处关节炎而住院，理学检查有贫血、口腔有溃疡、背部有多处红斑、兩手关节有多处肿胀及压痛感觉，实验室检查白血球2,100/mm3 （淋巴球占40%、中性白血球占57%）、血红素（Hgb）10.5 gm/dL、红血球沈降速度（ESR）92 mm/hr、24 小时尿蛋白为1.2 gm，下列那一项检查对诊断此病最重要？", "answer_idx": "B", "answer": "抗核抗体（ANA）", "options": {"A": "C-反应蛋白（CRP）", "B": "抗核抗体（ANA）", "C": "血清免疫球蛋白", "D": "全身电脑断层扫描检查"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是正常老年人在泌尿功能上因老化造成的影响？", "answer_idx": "D", "answer": "未抑制之膀胱逼尿肌收缩（uninhibited detrusor contraction）增加", "options": {"A": "膀胱容量变小", "B": "尿流速率变慢", "C": "最大尿道闭锁压（maximal urethral closure pressure）降低", "D": "未抑制之膀胱逼尿肌收缩（uninhibited detrusor contraction）增加"}}
{"meta_info": "taiwanese_test_Q", "question": "压力（stress）会促使内分泌系统那一个轴线（axis）活化？", "answer_idx": "D", "answer": "下视丘－脑下腺－肾上腺皮质", "options": {"A": "下视丘－脑下腺－睪丸", "B": "下视丘－脑下腺－卵巢", "C": "下视丘－脑下腺－甲狀腺", "D": "下视丘－脑下腺－肾上腺皮质"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是脱离呼吸器（weaning from ventilator）的条件？", "answer_idx": "D", "answer": "每分钟通气量（minute ventilation）> 9 L / minute", "options": {"A": "呼吸速率 < 25 / minute", "B": "动脉血氧气分压（ PaO2）> 70 mmHg（FiO2 40%）", "C": "潮气量（tidal volume）5～6 mL/kg", "D": "每分钟通气量（minute ventilation）> 9 L / minute"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种寄生虫曾经广泛流行于我国離岛之金门及澎湖地区？", "answer_idx": "A", "answer": "班氏丝虫（Wuchereria bancrofti）", "options": {"A": "班氏丝虫（Wuchereria bancrofti）", "B": "马來亚丝虫（Brugia malayi）", "C": "蟠尾丝虫（Onchocerca volvulus）", "D": "羅阿丝虫（Loa loa）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何项与胃幽门杆菌感染无关？", "answer_idx": "B", "answer": "胃贲门癌", "options": {"A": "胃炎", "B": "胃贲门癌", "C": "十二指肠溃疡", "D": "胃 MALToma"}}
{"meta_info": "taiwanese_test_Q", "question": "一位58 岁的女性病患每日规律运动，最近一个月注意到每天傍晚下肢就会出现水肿，早上起床时水肿会消失，门诊的身体检查发现颈静脉压力正常，心脏大小正常，心跳规律无杂音，兩侧肺野呼吸音正常，兩侧下肢有可凹陷水肿（pitting edema），则以下的检查，对鉴别诊断价值最低的是：", "answer_idx": "D", "answer": "核子医学左心室射出率（ejection fraction）", "options": {"A": "BUN, creatinine", "B": "serum albumin", "C": "肝功能检查（ALT, AST）", "D": "核子医学左心室射出率（ejection fraction）"}}
{"meta_info": "taiwanese_test_Q", "question": "某抑制剂会使酵素反应的 Km上升，但是不影响 高反应速率（即 Vmax不变），此抑制剂应属于下列何者？", "answer_idx": "A", "answer": "竞争型抑制剂（competitive inhibitor）", "options": {"A": "竞争型抑制剂（competitive inhibitor）", "B": "不竞争型抑制剂（uncompetitive inhibitor）", "C": "非竞争型抑制剂（noncompetitive inhibitor）", "D": "混合型抑制剂（mixed inhibitor）"}}
{"meta_info": "taiwanese_test_Q", "question": "91 李先生是一退休农耕队队员，早年曾派驻中南美洲等地。近日因胸闷、心悸、吞咽困难及胃肠不适就医。李先生陈述当年驻外住在茅草房时，半夜常被小虫叮咬，以致睡眠品质不好，曾引发心脏病。依此病史，叮咬李先生最可能的是下列何者？\n", "answer_idx": "C", "answer": "锥鼻虫（reduviid bug）", "options": {"A": "白蛉子（sandfly）", "B": "采采蝇（tsetse fly）", "C": "锥鼻虫（reduviid bug）", "D": "臭虫（bedbug）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位病人被发现有白血病，他的周边血液及骨髓抹片中可看到很多不成熟的细胞（如图所示）。这位病人的血球细胞内最可能出现那种染色体異常？", "answer_idx": "A", "answer": "t(15;17)", "options": {"A": "t(15;17)", "B": "t(9;22)", "C": "t(8;21)", "D": "t(4;11)"}}
{"meta_info": "taiwanese_test_Q", "question": "52 岁家庭主妇，主诉双手指末端关节痛有1 年，常在使用手工作后疼痛加剧，休息后会改善，理学检查发现手指远端指间关节（distal interphalangeal joints）皆有小结节，具压痛感，此病人最有可能罹患的疾病为何？", "answer_idx": "A", "answer": "退化性关节炎", "options": {"A": "退化性关节炎", "B": "類风湿性关节炎", "C": "结晶沈积引发关节炎", "D": "感染性关节炎"}}
{"meta_info": "taiwanese_test_Q", "question": "细胞内DNA复制过程中，为何需要RNA引子（primer）？", "answer_idx": "B", "answer": "提供DNA聚合酶合成反应所需要的3'-端羟基（OH）", "options": {"A": "提供DNA聚合酶合成反应所需要的3'-端磷酸基", "B": "提供DNA聚合酶合成反应所需要的3'-端羟基（OH）", "C": "提供DNA聚合酶合成反应所需要的5'-端羟基（OH）", "D": "提供DNA聚合酶合成反应所需要的5'-端磷酸基"}}
{"meta_info": "taiwanese_test_Q", "question": "80.34岁的叶小姐是位老师，身体健康无特殊病史，近日因为右侧鼠蹊部肿胀来门诊，经诊断为腹股沟疝气，医师向叶小姐建议进行疝气修补术治疗，在解释病情及手术细节后，叶小姐却要求术后要补充白蛋白，因为她听说白蛋白对腹部手术术后恢复有帮助，但医师的专业判断认为并不需要，此情境下，如何处理较适当？\n", "answer_idx": "A", "answer": "经过专业判断不需要补充白蛋白，与病人多沟通后婉拒病人的要求，不给与术后白蛋白补充", "options": {"A": "经过专业判断不需要补充白蛋白，与病人多沟通后婉拒病人的要求，不给与术后白蛋白补充", "B": "答应病人补充白蛋白，且以健保支付", "C": "即使判断补充白蛋白不是恰当的医疗处置，但是病人要求了，补充之也无伤大雅", "D": "补充白蛋白是医疗专业判断，由医师决定即可，不需再与病人沟通"}}
{"meta_info": "taiwanese_test_Q", "question": "5 下列何种先天构造异常之新生儿会在安静时呈现呼吸窘迫及发绀（cyanosis）的症状，而张口大哭之 后发绀情况则得以缓解？\n", "answer_idx": "D", "answer": "双侧后鼻孔闭锁（bilateral choanal atresia）", "options": {"A": "先天性横膈疝气（congenital diaphragmatic hernia）", "B": "气管食道瘘管（tracheo-esophageal fistula）", "C": "皮耳罗宾症候群（Piérre-Robin syndrome）", "D": "双侧后鼻孔闭锁（bilateral choanal atresia）"}}
{"meta_info": "taiwanese_test_Q", "question": "大多数先天性代谢异常疾病（Inborn errors of metabolism）的遗传模式（Mode of inheritance）为Autosomal recessive，下列何种代谢异常除外？", "answer_idx": "B", "answer": "Ornithine transcarbamylase deficiency（OTC deficiency）", "options": {"A": "Phenylketonuria（PKU）", "B": "Ornithine transcarbamylase deficiency（OTC deficiency）", "C": "Methylmalonic acidemia（MMA）", "D": "Maple syrup urine disease（MSUD）"}}
{"meta_info": "taiwanese_test_Q", "question": "有关nesiritide用于治疗急性代偿性功能失常之心衰竭病人之药理作用叙述，下列何者错误？", "answer_idx": "A", "answer": "使cyclic AMP增加", "options": {"A": "使cyclic AMP增加", "B": "活化brain natriuretic peptide（BNP）receptor", "C": "使血管放松", "D": "产生利尿作用"}}
{"meta_info": "taiwanese_test_Q", "question": "何种功能性脑下垂体肿瘤，对口服药物治疗反应最好，包括激素降低及脑瘤体积缩小？", "answer_idx": "C", "answer": "泌乳素瘤（prolactinoma）", "options": {"A": "肢端肥大症（acromegaly）", "B": "库欣氏症（Cushing's disease）", "C": "泌乳素瘤（prolactinoma）", "D": "甲促素分泌瘤（TSH-secreting adenoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "双眼外侧视野二分之一缺损（bilateral temporal hemianopia），最可能的损伤部位是：", "answer_idx": "D", "answer": "视交叉（optic chiasm）", "options": {"A": "视神经（optic nerve）", "B": "外侧膝狀体（lateral geniculate body）", "C": "视径（optic tract）", "D": "视交叉（optic chiasm）"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一种感染症最易于组织中见到厚壁、棕色之硬化体（sclerotic bodies）？", "answer_idx": "C", "answer": "产色芽生霉菌症（Chromoblastomycosis）", "options": {"A": "黑癣（Tinea nigra）", "B": "孢子丝菌病（Sporotrichosis）", "C": "产色芽生霉菌症（Chromoblastomycosis）", "D": "皮下黑化真菌病（Subcutaneous phaeohyphomycosis）"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 18 岁男孩，患有肾病症候群，双手掌心被发现有 discoid-like 的皮疹并有脱皮如下图，肾脏切片检查结果为 membranous nephropathy，下列那一项感染是最可能的诊断？", "answer_idx": "D", "answer": "梅毒（syphilis）", "options": {"A": "B 型肝炎（hepatitis B）", "B": "巨细胞病毒（cytomegalovirus）感染", "C": "钩端螺旋体症（Leptospirosis）", "D": "梅毒（syphilis）"}}
{"meta_info": "taiwanese_test_Q", "question": "麻醉风险之评估系统，现行的方法叫：", "answer_idx": "B", "answer": "ASA physical status classification", "options": {"A": "APACHE", "B": "ASA physical status classification", "C": "Apgar score", "D": "RISK"}}
{"meta_info": "taiwanese_test_Q", "question": "大肠内容物中最常見的 aerobic bacteria 是下列何者？", "answer_idx": "C", "answer": "Escherichia coli", "options": {"A": "Enterococcus", "B": "Proteus", "C": "Escherichia coli", "D": "Pseudomonas"}}
{"meta_info": "taiwanese_test_Q", "question": "喉返神经（recurrent laryngeal nerve）受伤切断时，何者错误？", "answer_idx": "C", "answer": "不宜缝补受伤之神经", "options": {"A": "声带麻痹，处于近中央位置（paramedian）", "B": "声音沙哑", "C": "不宜缝补受伤之神经", "D": "环状甲状腺肌肉（cricothyroid muscle）不会麻痹"}}
{"meta_info": "taiwanese_test_Q", "question": "一位 20 岁的年轻人发生車祸，造成肩胛骨翼狀外翻（scapular winging），下列叙述何者错误？", "answer_idx": "C", "answer": "大多为肩胛下肌（subscapularis）无力所致", "options": {"A": "可能因背肩胛神经（dorsal scapular nerve）受损所致", "B": "大多为前锯肌（serratus anterior muscle）无力所致", "C": "大多为肩胛下肌（subscapularis）无力所致", "D": "大多为长胸神经（long thoracic nerve）受损所致"}}
{"meta_info": "taiwanese_test_Q", "question": "10 一位28 岁男性病人的血压值为：右上肢血压200/120 mmHg，左上肢血压190/115 mmHg，下肢膝窝动脉（popliteal artery）血压110/60 mmHg，上背部有收缩期杂音，下列何者为最可能的诊断？\n", "answer_idx": "B", "answer": "原发性高血压（essential hypertension）", "options": {"A": "肾动脉狭窄（renal artery stenosis）", "B": "原发性高血压（essential hypertension）", "C": "主动脉缩窄（coarctation of aorta）", "D": "嗜铬细胞瘤（pheochromocytoma）"}}
{"meta_info": "taiwanese_test_Q", "question": "18.巨噬细胞（macrophage）和嗜中性球（neutrophil）是体内最主要的吞噬细胞，它们都具有吞噬 （phagocytosis）并杀死病原的能⼒，有关这两群细胞的叙述何者错误？\n", "answer_idx": "B", "answer": "这两群细胞在受到细菌刺激后都会进⾏所谓的呼吸爆发（respiratory burst）的现象，这是因为胞内酵素的", "options": {"A": "当嗜中性球被细菌活化后，会进⾏⼀种特殊的细胞死亡的过程，把核内的染⾊质（chromatin）释放到细胞", "B": "这两群细胞在受到细菌刺激后都会进⾏所谓的呼吸爆发（respiratory burst）的现象，这是因为胞内酵素的", "C": "巨噬细胞在各个器官及组织都存在，比如在肝脏的库⽒细胞（Kupffer cell）及神经组织中的⼩神经胶质细", "D": "如果NADPH氧化酶（oxidase）的基因发⽣突变⽽失去功能，会导致这两群主要的吞噬细胞不能有效地杀"}}
{"meta_info": "taiwanese_test_Q", "question": "下列那一類坏死最常見于心脏的缺血性伤害？", "answer_idx": "B", "answer": "凝固性坏死", "options": {"A": "液化性坏死", "B": "凝固性坏死", "C": "干酪狀坏死", "D": "脂肪坏死"}}
{"meta_info": "taiwanese_test_Q", "question": "您至隔壁病房协助一位猝死病患的急救，根据2010年心肺复苏术指引，下列何者错误？", "answer_idx": "C", "answer": "使用进阶呼吸道（advanced airway）装置人工通气（ventilation）时，成人每6至8秒吹气一次，与胸部按压同步进行", "options": {"A": "若需检查脉搏，不超过10秒钟", "B": "避免中断胸部按压，如有需要中断，不超过10秒钟", "C": "使用进阶呼吸道（advanced airway）装置人工通气（ventilation）时，成人每6至8秒吹气一次，与胸部按压同步进行", "D": "若需实施去颤电击，在每次电击后立即实施胸部按压"}}
{"meta_info": "taiwanese_test_Q", "question": "下列女性均为 35 岁，何者最容易罹患子宫内膜癌？", "answer_idx": "D", "answer": "患有多囊性卵巢症候群（polycystic ovarian syndrome）", "options": {"A": "青少年期卵巢便已切除", "B": "卵巢发育不全（ovarian agenesis）", "C": "曾经多次生育", "D": "患有多囊性卵巢症候群（polycystic ovarian syndrome）"}}
{"meta_info": "taiwanese_test_Q", "question": "病人车祸濒临死亡，他已签署器官捐赠同意书，其所捐赠的器官该分配给那位受赠者，是应依据下列何医学伦理原则？", "answer_idx": "D", "answer": "正义原则（justice）", "options": {"A": "行善原则（beneficence）", "B": "尊重自主原则（respect for autonomy）", "C": "不伤害原则（non-maleficence）", "D": "正义原则（justice）"}}
{"meta_info": "taiwanese_test_Q", "question": "2个月大的女婴，因为最近一个月喂食越来越困难而住院，身体诊察发现神智清楚，低肌肉张力，四肢无力，无深部肌腱反应，腹式呼吸以及舌头颤动（fasciculation）。最可能的诊断是：", "answer_idx": "B", "answer": "脊髓肌肉萎缩症（spinal muscular atrophy）", "options": {"A": "缺氧缺血性脑病变（hypoxic ischemic encephalopathy）", "B": "脊髓肌肉萎缩症（spinal muscular atrophy）", "C": "先天性重症肌无力（congenital myasthenia gravis）", "D": "先天性肌肉失养症（congenital muscular dystrophy）"}}
{"meta_info": "taiwanese_test_Q", "question": "一名 72 岁男性因猝死接受病理解剖。显微镜下检查发现在胃部黏膜、肾脏间质、肺脏肺泡壁及动脉旁皆有形态不一、非结晶性钙盐沈积。下列何种情况最能解释上述变化？", "answer_idx": "B", "answer": "末期肾疾病", "options": {"A": "正常老化过程", "B": "末期肾疾病", "C": "全身性结核菌感染", "D": "动脉硬化症"}}
{"meta_info": "taiwanese_test_Q", "question": "primary hyperparathyroidism造成的并发症中，下列何者无关？", "answer_idx": "B", "answer": "tetany", "options": {"A": "osteoporosis, osteopenia", "B": "tetany", "C": "depression, anxiety", "D": "kidney stone"}}
{"meta_info": "taiwanese_test_Q", "question": "林医师最近亟需发表学术論文，于是想找高中同学陈教授合作，陈教授任职医学院的基础医学学科，林医师說他作癌症手术时，会取下病人的组织，而且为了有安全范围，都会多取一些周边的正常组织，他可以提供这些组织來作研究，陈教授很有意愿合作，不过担心是否要取得病人同意，林医师說又不会有人知道，不用取得病人同意，这样的說法对吗？", "answer_idx": "C", "answer": "不对，因为我国目前对于以剩余检体供研究使用规定需要取得病人同意", "options": {"A": "对，因为我国目前对于以剩余检体供研究使用并无特殊规定", "B": "对，因为这是促进科学进步", "C": "不对，因为我国目前对于以剩余检体供研究使用规定需要取得病人同意", "D": "不对，因为我国目前规定不能以剩余检体供研究使用"}}
{"meta_info": "taiwanese_test_Q", "question": "Cardiac tropnin T，α-tropomyosin，myosin-binding protein C，β-myosin heavy chain 等基因突变与下列何种心肌症（cardiomyopathy）最有关？", "answer_idx": "B", "answer": "hypertrophic type", "options": {"A": "restrictive type", "B": "hypertrophic type", "C": "dilated type", "D": "mixed type"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者受损，最可能造成前臂（forearm）无法伸直（extension）？", "answer_idx": "D", "answer": "桡神经（radial nerve）", "options": {"A": "肌皮神经（musculocutaneous nerve）", "B": "正中神经（median nerve）", "C": "尺神经（ulnar nerve）", "D": "桡神经（radial nerve）"}}
{"meta_info": "taiwanese_test_Q", "question": "关于细菌基因传递的叙述，下列何者错误？", "answer_idx": "B", "answer": "Plasmid 不能经由 conjugation 传递", "options": {"A": "Conjugation 是由细菌与细菌接触进行", "B": "Plasmid 不能经由 conjugation 传递", "C": "在某些细菌是可直接将外來 DNA 带入菌体内", "D": "Transduction 通常由噬菌体造成"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何种non-steroidal anti-inflammatory drugs (NSAIDs)药物，同时具有抑制cyclooxygenase和lipoxygenase的作用？", "answer_idx": "C", "answer": "ketoprofen", "options": {"A": "aspirin", "B": "etodolac", "C": "ketoprofen", "D": "naproxen"}}
{"meta_info": "taiwanese_test_Q", "question": "大多數女童，最先出现的青春期发育表征（visible sign of puberty）为：", "answer_idx": "A", "answer": "乳房发育", "options": {"A": "乳房发育", "B": "阴毛发育", "C": "腋毛发育", "D": "初经"}}
{"meta_info": "taiwanese_test_Q", "question": "下列何者不是妄想症（delusional disorder）发病之危险因子？", "answer_idx": "C", "answer": "移民经过數代后", "options": {"A": "耳聾或视力衰退", "B": "社会孤立", "C": "移民经过數代后", "D": "社会经济剥夺"}}
{"meta_info": "taiwanese_test_Q", "question": "以帕金森氏病症狀与自主神经障碍为主要表现的神经症候群为：", "answer_idx": "B", "answer": "Shy-Drager syndrome", "options": {"A": "Wernicke-Korsakoff syndrome", "B": "Shy-Drager syndrome", "C": "acquired immunodeficiency syndrome", "D": "Guillain-Barré syndrome"}}
{"meta_info": "taiwanese_test_Q", "question": "位于肠道底层免疫组织中之M细胞的主要免疫功能为：", "answer_idx": "C", "answer": "捕捉及转运肠道中的抗原至下层的淋巴组织", "options": {"A": "直接杀菌", "B": "制造抗体", "C": "捕捉及转运肠道中的抗原至下层的淋巴组织", "D": "保护周边的肠道表皮细胞"}}
{"meta_info": "taiwanese_test_Q", "question": "谢小姐，25 岁​​，至门诊主诉最近体重增加，希望能减重。经理学检查及病史询问后，资料如下：身高 160 cm，体重 64 kg，腰围 76.5 cm，臀围 80.5 cm，最近一年体重增加约 5 kg，月经规则。血压 138/88 mmHg，心跳 76/min，其他无明显異常。依行政院卫生署之体位标准，请问下列的评估及治療方式何者较适当？", "answer_idx": "D", "answer": "属体重过重，并无中央性肥胖，应先予以饮食指导及运动咨询", "options": {"A": "属重度肥胖，应马上予以减重手术治療", "B": "属中度肥胖，且为中央性肥胖，应马上给予药物治療", "C": "属轻度肥胖，应给予适当的饮食控制及运动治療，并辅以药物治療", "D": "属体重过重，并无中央性肥胖，应先予以饮食指导及运动咨询"}}
{"meta_info": "taiwanese_test_Q", "question": "下列有关多发性骨髓瘤（Multiple myeloma），何者正确？", "answer_idx": "B", "answer": "常引起蚀骨性病灶", "options": {"A": "常好发于 45 岁以下的成年人", "B": "常引起蚀骨性病灶", "C": "发生率占原发性骨骼惡性肿瘤的第三位", "D": "好发部位包括脊椎、腓骨、手指骨及颅骨"}}