18. Which test has the highest sensitivity of screening renovascular hypertension ?
(A) Duplex ultrasonography
(B) Computed tomography angiography
(C) Captopril renogram
(D) Magnetic resonance angiography (MRA)
(E) Captopril plus diuretics renogram

14. A 48 y/o male was found to develop acute renal failure after 7 days of drug therapy. His clinical presentation were: fever, rash, peripheral eosinophilia, and oliguric renal failure, but without proteinuria. Which statement is correct? 1.A possible etiology of acute interstitial nephritis (AIN) 2.His manifestation is compatible with nonsteroidal anti-inflammatory drug (NSAID)-induced AIN 3.Peripheral blood eosinophilia is common in most of AIN patients 4.Urinary eosinophils are sensitive and specific for diagnosis of AIN, therefore, this testing is highly recommended 5.Renal biopsy is generally not required for diagnosis of AIN (A) 1+3+4+5 (B) 1+5 (C) 1+3+4 (D) 1+2 (E) 1+2+3+4+5

15. Which statement regarding Lithium-associated nephropathy is not correct ? (A) Most of the patients presented as oliguric acute renal failure (B) Prolonged (>10-20 years) lithium use, or those experienced repeated episodes of toxic lithium levels, may develop chronic tubulointerstitial nephritis (C) The most prudent approach is to monitor lithium levels frequently and adjust dosing to avoid toxic levels (D) In patients with significant proteinuria, ACEI or ARB treatment should be helpful (E) typical findings on renal biopsy are interstitial fibrosis and tubular atrophy

16. Which statement regarding mineral metabolism in CKD is correct? 1.increased production of parathyroid hormone 2.reduced production of fibroblast growth factor-23 (FGF-23) 3.increased renal excretion of phosphate 4.reduced produce of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] 5.reduction in serum calcium (A) 1+3+4+5 (B) 1+2+4 (C) 1+2+3+4 (D) 1+2+4+5 (E) 1+4+5

17. Primary glomerular diseases with reduced complement levels is: (A) Cryoglobulinemia (B) Minimal-change disease (C) IgA nephropathy (D) focal segmental glomerular sclerosis (E) Wegener's granulomatosis

19. For diagnosis of acute renal failure, which urinary indices indicating prerenal azotemia rather than acute tubular necrosis or obstruction ? (A) Urine Na > 40 mEq/L (B) Urine osmolarity < 400 (C) Urine/plasma creatinine ratio < 20 (D) Renal failure index < 1 (E) FENa > 2%

20. A 52-year-old man with a 20-year history of cigarette smoking is admitted to the hospital because of cough and weakness. On admission, his serum electrolyte levels are: serum [Na] 112 mEq/L; [K] 4.5 mEq/L; [Cl] 80 mEq/L; and HCO3-, 26 mEq/L. The BUN was 8 mg/dL , serum creatinine 0.8 mg/dL and serum uric acid 3.0 mg/dL. These data are most consistent with which of the following? (A) SIADH (syndrome of inappropriate antidiuretic hormone secretion) (B) Congestive heart failure (C) Cirrhosis and ascites (D) Severe salt and water depletion (E) Adrenal insufficiency

21. A 28 y/o young male visited your outpatient clinic with an elevated blood pressure of 148/100 mmHg. He denies taking any medications, but has a family history of hypertension. His laboratory values were: [Na] 140 mEq/L, [K] 3.1 mEq/L, [Cl] 98 mEq/L, BUN 25 mg/dL, Creatinine 0.9 mg/dL, Glucose: 85 mg/dL. The arterial blood gas (ABG) test reveals: Arterial pH: 7.48, PCO2: 46 mm Hg, HCO3-: 34 mEq/L. What is the most appropriate characterization of his acid-base disorder? (A) Metabolic alkalosis (B) Metabolic alkalosis and respiratory acidosis (C) Respiratory alkalosis and metabolic acidosis (D) Metabolic alkalosis and respiratory alkalosis (E) Respiratory alkalosis

22. 相較於血液透析(HD, hemodialysis)，有關腹膜透析(PD, peritoneal dialysis)的敘述與長期合併症，何者不正確? (A) PD病人使用高糖透析液是為了要達到透析清除尿毒素(uremic toxin)的效果 (B) PD病人容易出現hypertriglyceridemia，是因為使用高糖透析液 (C) 相較於血液透析(HD)，腹膜透析(PD)病人較容易發生腹膜炎(peritonitis) (D) 相較於血液透析(HD)，腹膜透析(PD)病人每日蛋白質流失量較高 (E) 相較於腹膜透析(PD)，血液透析(HD)病人較出現透析中低血壓

1. Who was the first chemist to realize clearly that the bitter taste of seawater was due to the presence of MgSO4 and MgCl2? (A) Antoine Lavoisier, (B) Michael Pilson, (C) John Riley, (D) Wallace Broecker, (E) John

2.Which gases have the highest average concentration in the ocean? (A) He (B) O, (C) N, (D) CO2, (E) Ar