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113年 - 2024 藥學專業題庫(選擇題)101-141#119331

科目：藥學專業 | 年份：113年 | 選擇題數：41 | 申論題數：0

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所屬科目：藥學專業

選擇題 (41)

101. 目前糖尿病治療藥物中之針劑，除胰島素外，也有 GLP-1 receptor agonist 針劑藥物，與 DPP-4 inhibitors 均為 Incretin 類藥物。以下有關 Incretin 之敘述，何者為錯誤？ (A)GLP-1 可刺激胰島素分泌，抑制昇糖激素 (Glucagon)分泌 (B)使用 GLP-1 receptor agonist 治療糖尿病患者時，也有明顯減輕體重之效果 (C)第一型糖尿病患者也適用 GLP-1 receptor agonist (D)使用 GLP-1 receptor agonist 可降低糖尿病患之食慾及延緩未排空時間
102. 下列何者骨質疏鬆治療藥物的給藥頻率為每月一次? (A)Alendronate sodium tab (B)Zoledronic acid bot (Aclasta) (C)Ibandronate tab (D)Denosumab syringe
103. 下列何者最不可能是 amiodarone 造成之副作用？ (A)Hypothyroidism (B)Pulmonary fibrosis (C)Abnormal liver function (D)Hypokalemia
104. 有關合併症與高血壓治療首選之配對，下列何者正確？ (A)糖尿病(Diabetes Mellitus)－felodipine (B)上心室心搏過速（paroxysmal supraventricular tachycardia, PSVT）－losartan (C)冠狀動脈心臟疾病(coronary artery disease, CAD)－metoprolol (D)慢性腎臟疾病(chronic kidney disease, CKD)－diltiazem
105. A 45-year-old male stomach cancer patient underwent tumor removal surgery. After surgery, he developed megaloblastic anemia. His anemia is caused by a deficiency of X and can be treated with Y. (A)X = intrinsic factor； Y = folic acid. (B)X = intrinsic factor； Y = vitamin B12 (C)X = extrinsic factor； Y = parenteral iron (D)X = extrinsic factor； Y = sargramostim
106. Which of the following drugs has a high affinity for 5-HT2 receptors in the brain, does not cause extrapyramidal dysfunction or hematotoxicity, but is reported to increase the risk of significant QT prolongation? (A)Clozapine (B)Haloperidol (C)Valproic acid (D)Ziprasidone
107. A 40-year-old woman has sporadic attacks of intense anxiety with marked physical symptoms, including hyperventilation, tachycardia, and sweating. If she is diagnosed as suffering from a panic disorder, the most appropriate drug to use is (A)Alprazolam (B)Eszopiclone (C)Flurazepam (D)Ramelteon
108. A 62-year-old man with advanced prostate cancer is admitted to the emergency department with mental obtundation. An electrolyte panel shows a serum calcium of 16.5 (normal 8.5-10.5 mg/dL). Which of the following therapies would be most useful in the management of severe hypercalcemia? (A)Acetazolamide plus saline infusion (B)Furosemide plus saline infusion (C)Hydrochlorothiazide plus saline infusion (D)Mannitol plus saline infusion
109. Trimethoprim-sulfamethoxazole is established to be effective against which of the following opportunistic infections in the AIDS patient? (A)Cryptococcal meningitis (B)Herpes simplex (C)Toxoplasmosis (D)Tuberculosis
110. 38 歲男性，175 公分，108 公斤，無過去病史。因左下肢紅、腫、熱、痛而住院，診斷為深層靜脈血栓 (deep vein thrombosis, DVT)，入院後醫師立即以 heparin 治療，使用 heparin5 天後，醫師欲改為口服藥，下列何者最適當？ (A) aspirin 100 mg QD (B) cilostazol 100 mg BID (C) warfarin，international normalized ratio (INR)目標值 2.5～3.5 (D) edoxaban 60 mg QD
111. 有關合併症與高血壓治療首選之配對，下列何者正確？ (A) 糖尿病 (DM)－Amlodipine (B) 上心室心搏過速 (PSVT)－Irbesartan (C) 冠狀動脈心臟疾病 (CAD)－Bisoprolol (D) 慢性腎臟疾病 (CKD)－Verapamil
112. Mr. Wu is a 71 year-old male who has worked as a painter for 50 years. He presented to his primary care doctor with complaints of hematuria and urinary urgency. He was referred to a urologist for cystoscopy. Office cystoscopy found a lesion in the bladder and he underwent a subsequent TURBT (transurethral resection of the bladder tumor) that revealed Tis (in situ), nonmuscle invasive urothelial carcinoma (UC). What is the best treatment option for Mr. Wu? (A) Intravesical Bacillus Calmette-Guerin (BCG) (B) Intravesical Valrubicin (C) Intravesical Mitomycin (D) No therapy is needed at this time
113. LB is a 25 year-old female with AML day 24 s/p 7+3 induction (anthracycline plus cytarabine). Her course has been complicated by culture negative febrile neutropenia with chest x-ray findings (day 20) suggestive of pneumonia. She has received cefepime since day 20. She has been afebrile for 72 hours and has now recovered her neutrophil count. Your leukemia team would like to know when it would be appropriate to discontinue antibacterials. Which of the following is most appropriate response? (A) LB should stop cefepime since neutropenia has resolved and has been afebrile for at least 2 days (B) LB has received an adequate course for pneumonia therefore cefepime can be discontinued (C) LB has received an adequate course for pneumonia and cefepime can be switched to levofloxacin prophylaxis (D) LB has not received an adequate course for pneumonia but can be de-escalated to oral stepdown therapy to complete her treatment
114. 下列敘述何者正確？ (A)steady-state vancomycin trough concentration 建議維持在＜10 μg/mL，避免毒性發生 (B)vancomycin 屬於 concentration-dependent 抗生素 (C)建議在給與第二次 vancomycin 劑量前進行 steady-state trough concentration 監測 (D)vancomycin 使用時，須定期監測病人的 WBC、體溫及 serum creatinine
115. 有關 phenytoin 之敘述，下列何者錯誤？ (A)眼球震顫及步態不穩為其副作用 (B)齒齦增生及多毛症為其副作用 (C)長期使用不會影響骨質 (D)其代謝為非線性藥動學
116. 下列何者不屬於 inodilators？ (A) Milrinone (B) Norepinephrine (C) Dobutamine (D) Levosimendan
117. 40 歲肝腎功能正常男性，感染 Staphylococcus aureus 骨髓炎，下列治療何者最不適當？ (A) methicillin-susceptible，使用 oxacillin 2 g Q4H IV (B) methicillin-resistant，使用 vancomycin 1 g Q12H IV (C) methicillin-resistant，使用 rifampin 600 mg QD PO (D) methicillin-resistant，使用 linezolid 600 mg Q12H PO
118. 15 歲學生，有輕度氣喘 5 年，近 1 年內平均每 3～4 個月需要使用一次 inhaled albuterol。 規劃參加韻律舞課，每週 2 次、每次 1 小時。運動前 15 分鐘單獨使用下列何種吸入劑最適當？ (A) salmeterol (B) salbutamol (C) budesonide (D) tiotropium
119. 利尿劑用於心衰竭病人的主要目的為何？ (A) 增加心跳以提高心輸出量 (B) 降低 afterload 以減少心臟負擔 (C) 降低 preload 以減少心臟負擔 (D) 增強心收縮力以提高心輸出量
複選題
120. 有關靜脈注射鐵劑之敘述，下列何者正確？ (A) 須與 fluoroquinolone、MgO 間隔 2 小時給藥 (B) 可能導致輸注反應，如低血壓 (C) 可能導致糞便顏色變黑 (D) 空腹給藥時吸收較佳
121. 70 歲男性，因高血壓及慢性腎臟病（CKD）長期使用 furosemide、valsartan 與 amlodipine，腎功能穩定。今發現血中 K+ 5.6 mmol/L（參考值 3.5～5.0），但無任何不適，心電圖正常。下列何者與其血鉀異常的關連性最低？① furosemide ② valsartan ③ amlodipine ④ CKD ⑤ 病人表示最近攝取較多水果與果汁 (A) ①, ③ (B) ④, ⑤ (C) ①, ⑤ (D) ②, ④
122. 有關口服 P2Y12 inhibitors 之敘述，下列何者正確？ (A) clopidogrel 的 onset of action 最快 (B) ticagrelor 的作用 duration 最長 (C) 有中風病史的病人最好選用 clopidogrel (D) prasugrel 最可能受到 CYP2C19 抑制劑影響而降低效果
123. 下列何者敘述為正確 ? (A) 院內 Potassium chloride extended-release 750mg/tab，每一錠含有鉀 20mEq。 (B) Potassium gluconate 595mg/tab 不能用於管灌病人。 (C) 當含鉀注射劑中鉀離子濃度為 400 mEq /L，建議周邊靜脈施打即可。 (D) Pot. citrate H2O 3.3g+Citric acid H2O 1g 之健保適應症為鹼化劑
124. What is the indication for the anti-VEGF drugs : Brolucizumab ? (A) Dry Age-related Macular Degeneration (B) Wet Age-related Macular Degeneration (C) Metastatic colorectal cancer (D) Cataract
125. What is the wrong statement about lithium? (A) Nephrogenic diabetes insipidus is one of kidney toxicity in patients on chronic lithium treatment. (B) Lithium freely crosses the placenta labeled as pregnancy class D and has been implicated in the increased risk of congenital cardiac defects, particularly the Ebstein anomaly. (C) Lithium administration interfere in thyroid hormone synthesis and subsequent release, resulting in hyperthyroidism. (D) The kidneys treat lithium and sodium similarly which is the reason sodium depletion can significantly elevate lithium reabsorption.
126. What is the right statement about "Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU"? (A) Sedative agent should be treated before pain control in critical ill. (B) Analgesia-based sedation is usually a NSAID. (C) The recent guidelines suggest that propofol or dexmedetomidine are preferable to either midazolam or lorazepam in critically ill as light sedative agent. (D) Morphine is the preffred pain control than fentanyl for those acute renal failure in ICU.
127. What is the worng statement for the hypoglycemic agent use ? (A) Patient undergoing elective surgery, metformin should be withheld on the date of surgery. (B) Patient undergoing elective surgery, empagliflozin must bePatient undergoing elective surgery, empagliflozin must be stopped 3-4 days after surgery. (C) Liraglutide is the choice for with diabetes with atherosclerotic cardiovascular disease . (D) Canagliflozin is the choice for the patient wirh chronic kidney disease.
128. What is the correct symptom about the medication related adverse effect or overdose?
A. Morphine- miosis, B. Bupivacaine-seizure, C. Methimazole-agranulocytosis, D. Cefoperazone/Sulbactam-ischemic event, (E) Amphotericin B-hyperkalemia, F. Amphetamine-miosis, G. Trimethoprim/sulfamethoxazole-hyperkalemia. (A) ABCG (B) BDEF (C) BCDG (D) AEFG
129. 有關 Ceftazidime-avibactam (Zavicefta® )的描述何者為是? (A) Ceftazidime-avibactam 仿單中的適應症包含社區性肺炎、菌血症、單純性尿道炎。 (B)當患者的腎功能: CrCl ＞30 mL/minute 方須調整 Ceftazidime-avibactam 之劑量。 (C)肝功能不全病人無須調整劑量。 (D)可用來治療多重抗藥性 AB 菌(Acinetobacter sp.) 以及 MBL-producing carbapenemresistant Klebsiella pneumoniae。
130. 糖尿病降血糖藥物眾多，下列降血糖藥物中，實證研究顯示那些藥物，有明確可降低 Major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarctiomn,non-fatal stroke) 之結果?
( A ) Alpha-glucosidase inhibitors
( B ) Glucagon-like peptide 1 receptor agonists
( C ) Sulfonylurea
( D ) Dipepetidyl peptidase inhibitor
( E ) Sodium-glucose co-transporter-2 inhibitors(A) A+ C(B) B + D(C) A+ D(D) C+ E(E) B + E
131. 李先生，64 歲，糖尿病病史為 8 年，一年前因冠狀動脈疾病(three vessles disease )進行心導管，並置放 支架，目前使用之血糖控藥物為胰島素 insulin degludec (70%)/aspart (30%)。高血壓藥物為每日 Valsatan 160mg 及 Amlodipine 5mg ，膽固醇藥物為 Atorvastatin 每日 40mg。目前之空腹血糖為 132 mg/dL，HbA1c 為 7.0 %，LDL cholesterol 為 55 mg/dL，HDL cholesterol 48 mg/dL，Triglyceride 為 628 mg/dL，尿液顯 示有巨量白蛋白尿 (macroalbuminuria)，且有非增殖型視網膜病變 (Non-proliferative retinopathy)，目前應該增加使用下列哪一項藥物 ? (A) Ezetimibe (B) Cholestyramine (C) PCSK9 (Proprotein convertase subtilisin/kexin type9) inhibitor (D) Fenofibrate (5) Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors
132. 一位 65 歲女性因胸悶至門診，十二導程心電圖發現有心房顫動。為了評估之後缺血性中風風險，可以使用 CHA2DS2-VASc score。下列何者不是 CHA2DS2-VASc score 之計分項目？ (A) 心衰竭 (B) 冠狀動脈心臟病 (C) 年紀大於等於 65 歲 (D) 深部靜脈血栓
133. Amphotericin B 可能引起的藥品不良反應中，下列何者為"非"？ (A) nephrotoxicity (B) rigors (C) aplastic anemia (D) hypokalemia
134. 下列何者為過度活躍譫妄(hyperactive delirium) 之首選治療藥物？ (A) lorazepam (B) haloperidol (C) midazolam (D) propofol
135. A 6-year-old child (BW=17kg, body surface area= 0.9 m2 ) is given a diagnosis of central diabetes insipidus. Which is the most appropriatte initial treatment? (A) Desmopressin (B) Hydrocortisone (C) fludrocortisone (D) water restriction of no more than 900ml/day
136. A 6-year-old girl presents in shock. She has a past medical history significant for a dilated viral cardiomyopathy with a baseline ejection fraction of 45%. Her current ejection fraction is 35%. Her current blood pressure is 130/80 mmHg. Which is the most appropriate agent to use in this child for cardiac support? (A) Norepinephrine (B) Milrinone (C) Dopamine (D) Phenylephrine
137. 對於糖尿病腎病變之病人,當醫師欲開始使用 dapagliflozin 控制血糖與蛋白尿時，在病人 eGFR 下降到多少時，不應該使用該藥品? (A) eGFR 45-60 ml/min/1.73m2 (B) eGFR 30-45 ml/min/1.73m2 (C) eGFR 25-30 ml/min/1.73m2 (D) eGFR ＜25 ml/min/1.73m2
138. 林小帥為一糖尿病腎病病人，目前血壓 155/95 mmHg、eGFR 45 ml/min/1.73m2、 HbA1c8.5，正在使用 valsartan 160 mg QD 與 metformin 1000 mg BID 治療，醫師欲增加降血糖藥 品的使用，下列何者藥品目前證實具有心臟與腎臟保護效果，為您優先建議的藥品 (A) Acarbose (B) Pioglitazone (C) Dapagliflozin (D) Saxagliptin
139. 下列常見的輸注溶液的配對中何者有誤? (A) Amiodarone~D5W (B) Ertapenem ~D5W (C) Amphotericin B~D5W (D) Norepinephrine~D5W
140. 請問下列何種藥物不適用於治療 invasive pulmonary aspergillosis ? (A) Liposomal Amphotericin B (B) Voriconazole (C) Sulfamethoxazole/Trimethoprim (D) Micafungin
141. 下列有關抗生素治療的敘述何者為非? (A) Ceftazidime/Avibactam 無法抑制 metallo-beta-lactamases (MβLs), 但對於 carbapenemresistant Enterobacterales 及 carbapenem-resistant Pseudomonas aeruginosa 有效 (B) Ceftaroline 可治療 MDR-Acinetobacter baumannii 及 carbapenem-resistant Pseudomonas aeruginosa (C) Meropenem 用於治療 carbapenem-resistant Enterobacterales 及 carbapenem-resistant Acinetobacter baumannii 時, 建議給予 2 g IV q8h, 並 infusion 超過 3 小時 (D) Colistin 需給予 loading dose 300mg CBA, 之後 12-24 小時給予 maintenance dose

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