【評論主題】28.Haemophilus influenzae之生物型(Biotypes)是以何種測試來區分? (A)Serological test(B)Ornithine decarboxylase、indo

【評論內容】Haemophilus influenzae的Biotype是依照Ornithine decarboxylase、indole production、urease分型的,給大家表格加深印象。 圖片來源:  August 1990,Journal of Clinical Pathology 43(7):581-3https://www.researchgate.net/publication/20955596_Evaluation_of_two_rapid_methods_for_identifying_and_biotyping_Haemophilus_influenza...

【評論主題】20.下列何種試驗最適合用於鑑別A群鏈球菌與G群鏈球菌? (A)pyrrolidonyl arylamidase(PYR)test (B)bacitracin susceptibility test

【評論內容】leucine aminopeptidase(LAP)test 可以用來鑑定 catalase-negative Gram-positive cocci bacteria.具有Leucine aminopeptidase 的菌可以水解disk中的leucine-p-naphthylamide components而呈現紅色。陽性的菌有: Streptococcus spp., Enterococcus spp., Lactococcus spp., and Pediococcus spp.  因此無法用來區分GAS 跟 GGS。參考資料: https://microbenotes.com/leucine-amino-peptidase-lap-test/。 GAS跟 G群鏈球菌皆為bacitracin susceptibility test(S)、beta溶血...

【評論主題】6.有關細菌和適合操作該細菌的實驗室生物安全等級(Biosafety level, BSL)的配對,一般而言下列何者最 不適當? (A)Bacillus subtilis \\/ BSL-I (B)

【評論內容】細菌到目前為止,只有到BSL-III的層級,BSL-IV只有病毒需要,如伊波拉

【評論主題】1.下列何種主要組織相容性複合體(MHC)表現在胎兒衍生的胎盤細胞(fetus-derived placental cells), 可以抑制NK細胞對胎盤細胞的毒殺? (A)HLA-A (B)HLA

【評論內容】HLA-G 是一種非典型的MHC-I,於懷孕時扮演重要的角色,包含spiral artery remodeling, immune tolerance, and fetal growth。 懷孕時,胎兒需要養分及氧氣的交換,Extravillous trophoblasts (EVTs)絨毛外滋養層細胞會進入胎盤,而取代原本的內皮細胞,重塑整個微環境,都是為了讓胎兒更好生存。 EVTs 上面會表達HLA-G,而HLA-G可以去結合NK cell上的KIR2DL4(又稱 CD158d),啟動signal pathway(參考附圖),除了抑制NK cell的毒殺能力(ADCC)以外(避免亂殺,immune tolerance),也能使NK cell衰老而釋放物質,讓血管通透性增加(更多養分跟氧氣)。 參考資料: Front. Immunol., 22 October 2020 Sec. Molecular Innate Immunity Volume 11 ...

【評論主題】6.關於LIM broth的敘述,下列何者最適當?(A)通常用tryptic soy broth當基底培養基 (B)常用於增殖咽喉檢體中之A群鏈球菌 (C)是一種選擇及滋養性培養基 (D)需添加pen

【評論內容】A Todd Hewitt broth base, made up of beef heart infusion, peptone and yeast extract.選擇及滋養性培養基 for GBS

【評論主題】5.有關葉酸之敘述,下列何者錯誤?(A)飲食攝取減少為造成葉酸缺乏之主因 (B)酗酒可能造成葉酸缺乏 (C)量測血清以及紅血球葉酸可評估葉酸缺乏與否 (D)量測半胱胺酸(cysteine)可評估葉酸缺

【評論內容】量測半胱胺酸(homocysteine)可評估葉酸缺乏與否。葉酸人體無法合成,最常是由飲食攝取中缺乏葉酸,或加上葉酸利用增加或吸收不良等狀況的結果。《血液學精要》 課本第64、69頁。

【評論主題】7.有關iron refractory iron deficiency anemia(IRIDA)的敘述,下列何者錯誤?(A)大多是autosomal recessive的遺傳疾病 (B)口服與靜脈注

【評論內容】Iron refractory iron deficiency anemia is a hereditary recessive anemia due to a defect in the TMPRSS6 gene encoding Matriptase-2. This protein is a transmembrane serine protease that plays an essential role in down-regulating hepcidin, the key regulator of iron homeostasis. Hallmarks of this disease are microcytic hypochromic anemia, low transferrin saturation and normal/high serum hepcidin values.參考資料: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669438/課本p.46,靜脈注射鐵劑可能有血液學反應,但口服鐵劑無效...

【評論主題】74.實體腫瘤(solid tumor)中,檢驗腫瘤突變負荷(tumor mutation burden)主要是為了評估癌症的那一種治療效果? (A)化學治療 (B)放射線治療 (C)標靶藥物治療 (

【評論內容】標靶藥物治療是針對出問題的東西進行治療,例如tyrosine kinase跟tyrosine kinase inhibitor。免疫治療 可以用一些單株抗體,以激活病人本身免疫力或是阻止腫瘤細胞繼續生長,來達到治療,例如anti-PD1,去結合T細胞上的PD1,以激活T細胞免疫。之前考過針對黑色素瘤的藥物,anti-PDL1,則是target腫瘤細胞。

【評論主題】45.白血病融合基因(fusion gene)分子檢測,最適合的檢體為何?(A)DNA (B)RNA (C)protein (D)cfDNA

【評論內容】RNA Sequencing (RNA-Seq) is much better, because it allows us to define the fusion gene directly, as well as the consequence of the chromosomal translocation. Targeting genes that are more relevant in this process enables us to identify the partners in the translocation, which is a major advantage. With RNA-Seq, we can also measure gene expression in the amount of RNA.Fusion genes are the consequence of chromosomal translocation or internal deletions.Translocations are the most common molecular rearrangement events that we see in leukemia.因為fusion gene 最常發生在轉譯的時候,所以偵測RNA為佳。參考資料: https://www.illumina.com/science/customer-stories/icommunity-customer-interviews-case-studies/cazzaniga-milan-interview-targeted-gene-panel.html

【評論主題】42.下列何者會導致一個或多個鹼基對的刪除或插入(deletion and insertion)?(A)活性自由基(reactive radicals)如O -、H O 、OH• 2 2 2 (B)D

【評論內容】活性自由基(reactive radicals)-氧化壓力造成DNA破壞。DNA嵌入劑(intecalating agents)-造成鹼基插入&刪除https://www.quora.com/What-is-an-intercalating-agent誘變劑(mutagens)-只改變序列,而不影響DNA結構圖源: https://www.biologyonline.com/dictionary/mutagen誘變鹼基類似物(base analogs)-與DNA結合 阻止DNA複製圖源: https://slideplayer.com/slide/13322480/

【評論主題】【題組】8.承上題,此尿液檢體檢驗結果與何種疾病最相關?(A)慢性腎衰竭 (B)泌尿道感染 (C)糖尿病 (D)黃疸

【評論內容】黃疸 會出現膽紅素結晶,且整個畫面會是偏...

【評論主題】圖中顯示為尿沉渣檢體,pH值為5.5,【題組】7.箭頭所指為何種有形成分(formed elements)?(A)hyaline cast & triple phosphate crystal (B)

【評論內容】

pH值為5.5,酸性尿,因此可以刪去A B選項,因為 triple phosphate crystal 是鹼性尿的結晶,且為信封狀。waxy cast 的特徵是它的邊邊會有皺褶、裂痕,cellular cast 則是裡面會有細胞,這題我覺得出的算佛w如果前面pH值的觀念有,就還蠻好選的,如果是waxy cast 跟 hyaline cast 二選一,就真的會猶豫XDhyaline cast會必較光滑透明不明顯(光線調低比較好觀察)

【評論主題】6.下列何種情況可能會導致腎絲球過濾率增加?(A)腎病症候群 (B)脫水 (C)腎水腫 (D)輸尿管阻塞

【評論內容】

腎病症候群 (nephrotic ☆☆☆☆☆☆☆☆,...

【評論主題】3.自動尿液化學分析儀的原理屬於何者?(A)細胞影像分析法(cell image) (B)流式細胞分析法(flow cytometry) (C)反射比光度測定法(reflectance photome

【評論內容】

反射光度計(reflectance photometer)採用球面積分儀接受雙波長反射光的方式,測定試帶上的顏色變化進行半定量測定。我的理解是,一般尿試紙呈色由人工判讀,現在改為機器判讀,機器藉由光線打在試紙條上面所的到的反射光,來判斷呈色,得出陽性/陰性的結果。參考資料:  http://cht.a-hospital.com/w/%E5%B0%BF%E6%B6%B2%E5%88%86%E6%9E%90%E4%BB%AA另外,下圖是 103-2 生化考題

【評論主題】6.關於LIM broth的敘述,下列何者最適當?(A)通常用tryptic soy broth當基底培養基 (B)常用於增殖咽喉檢體中之A群鏈球菌 (C)是一種選擇及滋養性培養基 (D)需添加pen

【評論內容】A Todd Hewitt broth base, made up of beef heart infusion, peptone and yeast extract.選擇及滋養性培養基 for GBS

【評論主題】7.有關iron refractory iron deficiency anemia(IRIDA)的敘述,下列何者錯誤?(A)大多是autosomal recessive的遺傳疾病 (B)口服與靜脈注

【評論內容】Iron refractory iron deficiency anemia is a hereditary recessive anemia due to a defect in the TMPRSS6 gene encoding Matriptase-2. This protein is a transmembrane serine protease that plays an essential role in down-regulating hepcidin, the key regulator of iron homeostasis. Hallmarks of this disease are microcytic hypochromic anemia, low transferrin saturation and normal/high serum hepcidin values.參考資料: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669438/課本p.46,靜脈注射鐵劑可能有血液學反應,但口服鐵劑無效...

【評論主題】5.有關葉酸之敘述,下列何者錯誤?(A)飲食攝取減少為造成葉酸缺乏之主因 (B)酗酒可能造成葉酸缺乏 (C)量測血清以及紅血球葉酸可評估葉酸缺乏與否 (D)量測半胱胺酸(cysteine)可評估葉酸缺

【評論內容】量測半胱胺酸(homocysteine)可評估葉酸缺乏與否。葉酸人體無法合成,最常是由飲食攝取中缺乏葉酸,或加上葉酸利用增加或吸收不良等狀況的結果。《血液學精要》 課本第64、69頁。

【評論主題】15.有關單個hemoglobin A分子的組成單元,排序為α chain/β chain/protoporphyrin/Fe2+,其對應的數目下列何者正確? (A)2/2/4/4 (B)2/2/2/

【評論內容】圖源: https://www.getbodysmart.com/respiratory-gases-and-their-transport/hemoglobin-structure/

【評論主題】74.實體腫瘤(solid tumor)中,檢驗腫瘤突變負荷(tumor mutation burden)主要是為了評估癌症的那一種治療效果? (A)化學治療 (B)放射線治療 (C)標靶藥物治療 (

【評論內容】標靶藥物治療是針對出問題的東西進行治療,例如tyrosine kinase跟tyrosine kinase inhibitor。免疫治療 可以用一些單株抗體,以激活病人本身免疫力或是阻止腫瘤細胞繼續生長,來達到治療,例如anti-PD1,去結合T細胞上的PD1,以激活T細胞免疫。之前考過針對黑色素瘤的藥物,anti-PDL1,則是target腫瘤細胞。

【評論主題】45.白血病融合基因(fusion gene)分子檢測,最適合的檢體為何?(A)DNA (B)RNA (C)protein (D)cfDNA

【評論內容】RNA Sequencing (RNA-Seq) is much better, because it allows us to define the fusion gene directly, as well as the consequence of the chromosomal translocation. Targeting genes that are more relevant in this process enables us to identify the partners in the translocation, which is a major advantage. With RNA-Seq, we can also measure gene expression in the amount of RNA.Fusion genes are the consequence of chromosomal translocation or internal deletions.Translocations are the most common molecular rearrangement events that we see in leukemia.因為fusion gene 最常發生在轉譯的時候,所以偵測RNA為佳。參考資料: https://www.illumina.com/science/customer-stories/icommunity-customer-interviews-case-studies/cazzaniga-milan-interview-targeted-gene-panel.html

【評論主題】42.下列何者會導致一個或多個鹼基對的刪除或插入(deletion and insertion)?(A)活性自由基(reactive radicals)如O -、H O 、OH• 2 2 2 (B)D

【評論內容】活性自由基(reactive radicals)-氧化壓力造成DNA破壞。DNA嵌入劑(intecalating agents)-造成鹼基插入&刪除https://www.quora.com/What-is-an-intercalating-agent誘變劑(mutagens)-只改變序列,而不影響DNA結構圖源: https://www.biologyonline.com/dictionary/mutagen誘變鹼基類似物(base analogs)-與DNA結合 阻止DNA複製圖源: https://slideplayer.com/slide/13322480/

【評論主題】【題組】8.承上題,此尿液檢體檢驗結果與何種疾病最相關?(A)慢性腎衰竭 (B)泌尿道感染 (C)糖尿病 (D)黃疸

【評論內容】黃疸 會出現膽紅素結晶,且整個畫面會是偏...

【評論主題】圖中顯示為尿沉渣檢體,pH值為5.5,【題組】7.箭頭所指為何種有形成分(formed elements)?(A)hyaline cast & triple phosphate crystal (B)

【評論內容】

pH值為5.5,酸性尿,因此可以刪去A B選項,因為 triple phosphate crystal 是鹼性尿的結晶,且為信封狀。waxy cast 的特徵是它的邊邊會有皺褶、裂痕,cellular cast 則是裡面會有細胞,這題我覺得出的算佛w如果前面pH值的觀念有,就還蠻好選的,如果是waxy cast 跟 hyaline cast 二選一,就真的會猶豫XDhyaline cast會必較光滑透明不明顯(光線調低比較好觀察)

【評論主題】6.下列何種情況可能會導致腎絲球過濾率增加?(A)腎病症候群 (B)脫水 (C)腎水腫 (D)輸尿管阻塞

【評論內容】

腎病症候群 (nephrotic ☆☆☆☆☆☆☆☆,...

【評論主題】3.自動尿液化學分析儀的原理屬於何者?(A)細胞影像分析法(cell image) (B)流式細胞分析法(flow cytometry) (C)反射比光度測定法(reflectance photome

【評論內容】

反射光度計(reflectance photometer)採用球面積分儀接受雙波長反射光的方式,測定試帶上的顏色變化進行半定量測定。我的理解是,一般尿試紙呈色由人工判讀,現在改為機器判讀,機器藉由光線打在試紙條上面所的到的反射光,來判斷呈色,得出陽性/陰性的結果。參考資料:  http://cht.a-hospital.com/w/%E5%B0%BF%E6%B6%B2%E5%88%86%E6%9E%90%E4%BB%AA另外,下圖是 103-2 生化考題

【評論主題】24.在含界面活性劑 SDS 的電泳中,下列何種血漿蛋白最接近正極?(A)白蛋白(albumin) (B)微球蛋白(BMG) (C)運鐵蛋白(TRF) (D)C-反應蛋白(CRP)

【評論內容】蛋白質經過SDS處理後,表面皆帶負電,因此不是依據帶電量分離,而是以大小分離,BMG的分子量最小(11.8kDa),跑的最快,因此最接近正極