| (C) |   1. | 
下列何者不是國際上評估diffuse large B cell lymphoma病人預後的指標IPI (International Prognostic Index)?
 | 
| A. | Performance status | 
| B. | Age | 
| C. | Hb | 
| D. | Stage | 
| E. | LDH | 
|   | 
| (B) |   2. | 
目前Azacytidine以治療骨髓化生不良症候群(MDS)高危險之病患,已有健保給付。此藥作用的機轉為何?
 | 
| A. | Tyrosine kinase inhibitor | 
| B. | DNA methylation inhibitor | 
| C. | Proteosome inhibitor | 
| D. | Immunomodulator | 
| E. | Vascular endothelial growth factor inhibitor | 
|   | 
| (E) |   3. | 
一位37歲女性病患過去無特殊病史,最近因為疲倦、黃疸及深色尿應診,血液檢查顯示Hb 8.7 g/dL,reticulocyte 4.8%,白血球3560/uL,血小板145000/uL,血液抹片如圖所示;bilirubin全量3.7 mg/dL,直接型0.6 mg/dL,AST 75 U/L,ALT 31 U/L,LDH 2350 U/L,Coombs' test陰性;小便如圖所示,潛血反應呈陽性,沈澱物中RBC 0-2/HPF,WBC 1-3/HPF。下列何種檢查對診斷最有幫助?
 | 
| A. | Urine myoglobin | 
| B. | Hb electrophoresis | 
| C. | Bone marrow examination | 
| D. | Hepatitis markers | 
| E. | Flow cytometry for CD55 and CD59 expression | 
|   | 
| (C) |   4. | 
下列何種狀況造成iron deficiency anemia的機會最小?
 | 
| A. | Gastrectomy | 
| B. | Paroxysmal nocturnal hemoglobinuria | 
| C. | Thalassemia | 
| D. | Pregnancy | 
| E. | Colon Cancer | 
|   | 
| (D) |   5. | 
下列化學治療或標靶治療藥物中,何者造成神經學毒性的可能性最小?
 | 
| A. | Vincristine | 
| B. | Cisplatin | 
| C. | Thalidomide | 
| D. | Etoposide | 
| E. | Bortezomib | 
|   | 
| (A) |   6. | 
下列檢查為多發性骨髓瘤診斷或分期所必需,何者為例外?
 | 
| A. | Bone scan | 
| B. | β2-microglobulin | 
| C. | Albumin | 
| D. | Daily urine light chain quantification | 
| E. | Blood M-protein level | 
|   | 
| (B) |   7. | 
一位25歲急性白血病人周邊血中血紅素7.5 g/dL,白血球165000/uL,血小板13000/uL;尿酸10.5 mg/dL,Cr 1.7 mg/dL;為及早降低白血球的數目,化學治療必須儘快開始。在化學治療前,為快速達到預防及治療tumor lysis syndrome的目的,下列何種藥物最適當?
 | 
| A. | Allopurinol | 
| B. | Rasburicase | 
| C. | Benzbromarone | 
| D. | Furosemide | 
| E. | Magnexium oxide | 
|   | 
| (A) |   8. | 
一位31歲女性身體檢查顯示有輕微黃疸,皮膚少許淤青,無其他出血現象。血紅素9.2 g/dL,網狀紅血球(reticulocyte) 4.1%,白血球4750/uL,血小板23000/uL;PT及PTT正常,血液抹片如圖所示,此病人最可能的診斷為何?
 | 
| A. | Thrombotic thrombocytopenic purpura | 
| B. | Disseminated intravascular coagulation | 
| C. | G-6PD deficiency | 
| D. | Evan syndrome | 
| E. | Hypersplenism | 
|   | 
| (C) |   9. | 
一位35歲病患,被診斷得了費城染色體(Ph)陽性之acute lymphoblastic leukemia。除了化學治療外,下列何種治療可進一步改善病人的預後?(1)all-trans retinoic acid (2)dasatinib (3)allogeneic hematopoietic stem cell transplantation(必須選出所有正確答案)
 | 
| A. | (1) | 
| B. | (3) | 
| C. | (2)+(3) | 
| D. | (1)+(3) | 
| E. | (1)+(2)+(3) | 
|   | 
| (E) |  10. | 
一位72歲男性,有長期肺病病史,最近抽血檢驗發現Hb 18.6 g/dL,Hct 55%,被轉診到血液科門診。身體檢查發現其面色潮紅,嘴唇稍有發鉗現象,並有杵狀指。下列何種檢查對區分此病人是polycythemia vera或secondary erythrocytosis有幫助?(必須選出所有正確答案)
(1)arterial blood gas (2)JAK2 mutation (3)erythropoietin level
 | 
| A. | (1) | 
| B. | (2) | 
| C. | (1)+(2) | 
| D. | (2)+(3) | 
| E. | (1)+(2)+(3) | 
|   |