110年 - 110 國立臺灣大學_碩士班招生考試_臨床藥學研究所:臨床藥學及治療學#102126

選擇題 (15)

1. Pregnant w women often use a antidepressants, despite Iimited available information regarding individual antidepressants and specific birth defect risks. Which one had the greatest proportion of elevated birth defect risks? (A) Venlafaxine (B) Escitalopram (C) Fluoxetine (D) Paroxetine

2. After kidney transplant, which of the following imm nunosuppressive therapies should be avoided during pregnancy and discontinued at least 6 weeks before pregnancy? (A) Azathioprine (B) Mycophenolate mofetil (C) Cyclosporine (D) Sirolimus

3. You are a member of the healthcare team seeing a 74-year-old woman with a number of medical conditions and a medication list including 14 drugs. She complains of dizziness. Which of the following drugs is considered to have strong anticholinergic effects? (A) Oxybutynin (B)citalopram (C) loratadine (D) loperamide

4. You are a member of the health care team for a 57-year-old womnan in whom hormone replacement therapy (HRT) is being considered for postmenopausal symptoms. Which one of the following statements is correct? (A) Long-term systemic HRT use is linked to increased breast cancer risks. These risks could be eliminated completely afier HRT discontinuation. (B) Risk varied among HRT types, with higher risks for combination estrogen-progestogen treatments and longer duration of usc. (C) Adjustment for personal characteristics, smoking, alcohol intake, comorbidities, family history, and other prescribed drugs abolished the observed associations. (D) Increased risk for combined progestogens was highest for dydrogesterone and lowest for norethisterone

5. You are a member of the healthcare team sccing a 70-ycar-old man with newly-diagnosed AF. The patient is worried about his risk of bleeding with an nticoagulation, and he asks for a dose of the new oral anticoagulants(NOACs) less than the recommended dose. Which of the following g outcomes was associated with underdosing of NOACs vs standard dosing? (A) Higher risk for stroke or systemic embolism (B) Higher risk for mortality (C) No difference in the risk of major bleeding (D) Lower risk for CV events

6. Which treatment strategy does the "2020 American College of Rheumatology Guideline for the Management of Gout" recommend for patients taking urate-lowering therapy (ULT) for their gout? (A) Treat-to-target with a target of serum uric acid (UA) level < 8 mg/dL (B) Treat-to-target with a target of serum UA level < 6 mg/dL (C) Treat with a fixed standard-dose ULT strategy for up to 12 months (D) Treat with a fixed standard-dose ULT strategy for up to 6 months

7. Tom is a 53-year-old man who recently prese ented with painful subcutancous tophi on his left first metatarsophalangeal joint and his right wrist. The patient had previously been diagnosed with acute gouty arthritis appr proximately 2 years ago but had not experienced an acute attack since his original diagnosis. He reports that he had experienced similar symptoms with his last flare, which lasted 4 to 5 days, and was treated in urgent care. He is currently taking prednisone to treat his gout tlare. Tom was also diagnosed with stage 3 chronic kidney discase 2 ycars ago. According to the 2020 American College of Rheumatology Guideline for gout management, which of the following treatments is best for Tom? (A) Start low-dose allopurinol (B) Start probenecid (C) Start high-dose allopurinol (D) Start pegloticase

8. Which of the following best describes the response rate for monotherapy with programmed cell death protein 1 /programmed death-ligand 1 inhibitors? (A) It varies by tumor type, but is never more than 10% (B) It varies by tumor type, but is usually around 10% to 25% (C) It varies by tumor type, but is usually around 40% to 50% (D) It is typically around 50% to 60%

9. You are a member of the healthcare team seeing a 60-year-old man with a I-hour history of lett chest pain radiating to his jaw. He developed a "bad cold" 3 days ago. Which of the following pathogens was associated with a higher risk for acute myocardial infarct ction (AMT)? (A) Only influenza A was associated with a higher risk for AMI (B) Only influenza A and B were associated with a higher risk for AMI (C) Only respiratory syncytial virus was associated with a higher risk for AMI (D) Infection with any respiratory virus was associated with a higher risk for AMI

複選題
10. The patient is diagnosed with an AMI as well as coronavirus disease 2019 (COVID-19). What is the potential relationship between COVID-19 and myocardial injury?(A) Nearly 20% of patients admitted with COVID-19 had elevated serum troponin levels.(B) Most patients with evidence of myocardial injury had normal trans nsthoracic echocardiography (TTE) findings. (C) Any myocardial injury was associated with a higher risk for mortality. (D) Only myocardial injury with abnormal findings on TTE was associated with a higher risk for mortality.

11. Published guidelines exist for management of care following an AM! to promote secondary prevention and to minimize the risk of developing HF. Which of the following is incorrect? (A) Nearly 22% percentage of patients who experienced an AMI went on to develop heart failure (HF). (B) The pattern of BNP dynam mic change ge within the first w week of the MI event is monophasic and increases linearly. (C) Drigs that help to minimize the risk of Hr include beta-blockers (BBs), angiotensin con nverting-enzyr yme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and mineralocorticoid receptor antagonists (MRAs). The utilization of BBs, ARBS, and A CE-inhibitors post-MI is good, while the use of MRAs is marginal. (D) Evidence from the Europ ociety of Cardiology (ESC) Heart Failure Long Term Registry showed that reaching target doses has been better achieved in ACE inhibitors and MRAs.

12. Catherine is a 72-year-old female has a 20-mninute episode of difficulty expressing herselt, right arm and band weakness. You have the following information:
(1) Past medical history: HTN, CAD, dyslipidemia.
(2) Medications: clopidogrel 75 mg qd, amlodipine 5 mg qd, irbesartan 150 mg/HCTZ 12.5 mg qd.
(3) B P: 132/82 mmHg, LDL 103 mg/dL
(4) MRI: small diffusion-weighted imaging lesion in the left frontal cortex, 3 small microbleeds in the basal ganglia, mild periventricular hyperintensities
(5) MRA: 30% left internal carotid artery origin stenosis
if you are considering adjusting medications, which of the following is incorrect? (A) Check for heart rhythm to ensure that there is no concomitant or paroxysmal AF. (B) If no AF, patient should be treated with DAPT immediately. Clopidogrel plus aspirin is indicated. (C) Clopidogrel has less eficacy in CYP3A4 loss-of-function carriers than non-carriers. (D) In this patient with a 30% left internal carotid artery origin stenosis, ticagrelor-aspirin is also a good choice.

13. Several meta-analyses have evaluated the impact of rapid diagnostic modalities for bloodstream infections. Investigators found a decrease in mortality when rapid diagnostic testing was used in concert with which of the following? (A) Longer duration of antibiotic therapy (B) Increased antibiotic dose (C) Antibiotic stewardship intervention (D) Confirmed phenotypic susceptibility results

複選題
14. You are a member of the healthcare team seeing a 64-ycar-old man who experienced his first MI 3 months ago. He complains of increasing pain from lett hip osteoarthritis, and his current regimen of acetaminophen plus physical therapy is insufficient. You consider prescribing him an NSAID. What should you bear in mind regarding the CV and GI side effects? (A) Naproxen was associated with a lower risk for CV events compared with celecoxib (B) Naproxen was associated with a lower risk for CV events compared with ibuprofen (C) Celecoxib was associated with a lower risk for GI events compared with naproxen and ibuprofen (D) Naproxen was associated with a lower risk for GI events compared with ibuprofen

15. Following the previous question, you decide to prescribe an NSAID to help this patient's pain. Which NSAID is least likely to promote CV and bleeding events? (A)Meloxicam (B) Ibuprofen (C) Naproxen (D) Diclofenac