98. 16 歲女孩被父母帶來急診，症狀為這兩週開始漸進性頭暈、目眩、合併病態 不穩，最近一個月經常性原因不明嘔吐，體重減輕兩公斤。病患檢查爲意識清 楚，無發燒，有營養不良與言語不清，複視(diplopia)、旋轉性眼球震顫 (rotatory nystagmus) 、及四肢輕癱 (quadriparesis)。病患非素食主義者也無酗 酒。住院治療期間因心因性休克而過世，病理解剖之腦部如下圖：

 

以下何者爲最可能的診斷?
(A)Mitochondrial Encephalomyopathy
(B)Wernicke encephalopathy
(C)Multiple sclerosis
(D)Cobalamin deficiency related neurological disea

51. In WHO2016 classification, the urothelial proliferation of uncertain malignant potential refers to the lesion formerly called(A) Papillary urothelial neoplasm of low malignant potential (B)Reactive atypia(C)Dysplasia (D)Papillary and flat urothelial hyperplasia

52. The most compatible immunoprofile of so-called invasive urothelial carcinoma of “luminal type” is(A) CK5/6+ GATA3+ (B)CK5/6- GATA3+(C)CK5/6+ GATA3-(D)CK5/6- GATA3-

53 The triple immunostain cocktail recommended for diagnosing limited prostatic adenocarcinoma (2016 WHO, p.147) comprises (A) AMACR/NKX3.1/high-molecular weight cytokeratin (B)AMACR/p63/ high-molecular weight cytokeratin (C)AE1/AE3/AMACR(D)ERG/PSMA/NKX3.1

54. According to 2016 WHO classification, a dermoid cyst in the testis found in a 20- year-old man is classified as (A)Teratoma, prepubertal-type (B)Teratoma, postpubertal-type (C)Germ cell tumor, type III (D)Non-germ cell tumor

55. Which of the following statements about IgA nephropathy (IgAN) is INCORRECT?(A) Dominant or codominant IgA mesangial staining is essential for diagnosis. (B)Antigenic galactose-deficient IgA1 plays a central role in the pathogenesis of IgAN. IgG or IgA autoantibodies form immune complexes with aberrantly galactosylated IgA1 leading to glomerular deposition.(C)The parameters in Oxford classification of IgAN include mesangial hypercellularity (M), endocapillary hypercellularity( E ), segmental sclerosis (S), interstitial fibrosis/tubular atrophy (T) and crescents ( C ). (D)Henoch-Schönlein purpura also has glomerular mesangial IgA deposition, and can be distinguished from IgAN by renal biopsy.

56. Which of the following statements about membranous nephropathy (MN) is INCORRECT?(A)Primary MN (previously called idiopathic MN) is now considered a kidneyspecific, autoimmune glomerular disease due to autoantibodies against certain native podocyte antigens.(B)The phospholipase A2 receptor (PLA2R) is the antigen in about 70% of patients with primary MN. (C)The presence of endothelial tubuloreticular inclusions by electron microscopy would suggest a diagnosis of primary MN. (D)Thrombospondin type 1 domain-containing 7A (THSD7A), another target antigen of primary MN, may be overexpressed by certain malignancies leading to MN.

57. 下列何者正確? (A) The most frequent cause of dysfunctional uterine bleeding is generalized metabolic disturbances.(B)Activation of the PTEN is a common genetic alteration in both endometrial hyperplasia and endometrioid endometrial carcinoma.(C)High-grade endometrial stromal sarcoma usually has a translocation of JAZF1 gene, fused to a second gene, such as SUZ12. (D)Most vulvar cancers are not related to HPV and develop in a background of lichen sclerosus or squamous cell hyperplasia.

58. 根據 staging of cervical carcinoma to the FIGO 2018 staging system, 下列何者正確? (A) The involvement of vascular/lymphatic spaces and presence of isolated tumor cells do change the stage. (B)Stage III excludes lymph node metastases (identified by image or pathology). (C)Assessment of stage IA disease on the basis of depth of stromal invasion only. (D)Subdivision of stage IB into two size categories.

59. 根據 WHO classification (5th edition) of tumors of the uterine cervix, 下列何者錯 誤?(A) Serous carcinoma of the cervix has been removed because there is no evidence that it occurs as a primary tumor. (B)Adenofibroma has been omitted because it is a rare and controversial entity. (C)The p16 immunostaining or HPV testing is required to distinguish HPV-associated and HPV-independent squamous cell carcinomas. (D)Silva pattern of invasion is applicable to all invasive cervical carcinomas.

60. 以下關於子宮內膜癌的描述，何者為非？ (A) Low-grade endometrial endometrioid carcinoma shows diffuse strong immunoreactivity for estrogen receptor/progesterone receptor and patchy positive for p16. (B)High-copy number alterations and TP53 mutations endometrial carcinomas are associated with intermediate prognosis. (C)POLE mutations are associated with good prognosis. (D)The morphology of most metastases (~90%) from carcinosarcoma contains the carcinomatous component.

110年 - 110年度解剖病理專科醫師甄試筆試1-50#108994

110年 - 110年度解剖病理專科醫師甄試筆試51-124#108993