108 Francesca Laylah Jamilah 2015.11.27 1 2 2 2 3 3 3.1 A............................................... 3 3.2 B............................................... 13 3.3 C............................................... 20 3.4 D............................................... 23 3.5 E............................................... 30 3.6 F............................................... 37 3.7 G............................................... 40 3.8 H............................................... 46 3.9 I............................................... 49 4 57 4.1 A............................................... 57 4.2 B............................................... 61 4.3 C............................................... 63 4.4 D............................................... 64 4.5 E............................................... 66 4.6 F............................................... 68 4.7 G............................................... 69 4.8 H............................................... 71 4.9 I............................................... 72 1
1 Francesca Laylah Jamilah webmaster@jamilah.jp 108 http://www.mhlw.go.jp/seisakunitsuite/bunya/kenkou iryou/iryou/topics/tp140512-01.html 2016 3 Francesca Laylah Jamilah http://jamilah.jp/ 2 fibre 2
3 3.1 A 1. (a., b. ) (a., b., c. ) 1) 2. Kaposi ( ) ( ) 2) Steavens-Johnson 3. 3) (a., b. ) (a., b. ) 4. 4) ( ) 5) (a. B, b. T ) 30-45 % 6) (a., b. ) (a., b. ) 5. ( ) 7) 0 0-I 0-III 0-I 0-III 0-I ( ) ( ) (a., b., c. ) 0-III ( ) 0-II 0-II 0-IIa 0-IIc 0-IIa 0-I ( ) 0-IIc 0-III ( ) 0-IIb 0-II 8) 6. Candida albicans Candida (a., b., c. ),, 1) (a., b., c. ) 9) ( ) 9) 3
( ) ( ) 1) 9) ( 108 ) 7. ( ) ( ) Cushing ( ) 7) Cushing ( ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) ( ) Na +, Cl 7) ( ) 10) 8. (a., b., c. ) ( ) (a., b., c. ) 20 11) ( ) ( ) 9. ( ) ( ) ( ) (a., b., c. ) 10. ( ) ( ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) 11. ( ) ( ) ( ) ( ) ( ) 12. (a., b. ) 3 (a., b. ) Stanford ( ) A ( ) B De Bakey I (a., b. ) (a., b. ) II ( ) III ( ) 8) 4
13. (a., b. ) T2 ( ) ( ) ( ) ( ) 9) ( ) ( ) ( ) ( ) (a., b. ) ( 108 ) 14. ( ) (a., b., c. ) 13) ( ) (a., b. ) 15. (a., b., c. ) (a., b., c. ) 16. ( ) ( ) ( ) 5) (a., b., c. ) (a., b. ) (a., b. ) 5) (a., b. ) (a., b. ) 6) 17. ( ) ( ) 5) (a., b., c. ), (a., b., c. ), (a., b., c., d. ), (a., b., c. ) (a., b. ) 30 (a., b. ) 14) ( ) (a., b. ) 7) ( ) (a., b. ) 7) ( ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) (a., b. 5
) 5) (a., b. ) 18. (Graft-versus-host disease; GVHD) ( ) GVHD GVHD GVHD (a., b., c. ) GVHD ( ) ( ), ( ), ( ) GVHD ( ) (a., b. ) GVHD (a., b., c. ) ( ) 2) 19. ( ) ( ) (a., b., c. ) ( ) ( ) ( ) 1-3 % ( ) 10 % ( ) -O- ( ) ( ) 10) 20. ( ) (a., b. ) (a., b. ) ( ) Na + (a., b. ) (a., b. ) 14) Sheehan ( ) ( ) ( ) (a., b. ) 21. ( ) (a., b., c. ) 1 (a., b., c. ) ( ) (a., b. ) ( ) (a., b. ) (a., b. ) (a., b., c. ) (a., b. ) 6
(a., b. ) ( ) 15) 22. ( ) ( ) ( ) ( ) ( ) (a., b., c. ) ( ) ( ) ( ) 16) 23. ( ) ( ) ( ), ( ) ( 108 MR ) 24. ( ) I ( ) (a., b. ) 11) ( 108 ) 25. ( ) ( ) ( ) (a., b. ) ( ) ( ) ( ) ( ) 12) D-dimer (a., b. ) 26. (a., b. ) (a., b., c. ) ( ) ( ) ( ) ( 108 ) 27. 28. 29. FISH (a., b. 7
) ( 108 BCR/ABL 1 ) 30. α ( ) ( ), ( ) ( ) ( ) (a., b. ) (a., b. ) 31. ( ) ( ) Wilson (a., b. ) (a., b. ) Leigh ( ) ( ) (a., b. ) ( ) Gaucher ( ) (a., b. ) (a., b. ) Machado-Joseph (a., b., c., d. ) MJD CAG ( ) 7) Duchenne Becker ( ) ( ) (a. Duchenne, b. Becker) (a. Duchenne, b. Becker) 32. ( ) ( 108 ) 33. 34. CT MRI (a., b. ) ( ) ( ) ( ), ( ) ( 108 ) 35., ( ), ( ) ( ) (a., b., c. ) (a., b., c. ) (a., b. ) (a., b. ) 17) (a., b. ) 8
36. 37. PCR PCR (a., b., c. ) (a., b. ), (a., b. ) ( ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) (a., b., c. ) PET/CT (a., b., c. ) (a., b. ) 38. ( ) 16) ( ) (a., b., c., d. ) (a., b. ) (a. CT, b. MRI, c. SPECT, d. PET/CT) 18) ( ) (a., b. ) (a., b., c. ) ( ) ( ) 19) 39. 40. 41. ( ) (a., b., c., d. β, e. ) ( ) (a., b., c., d., e. ) (a., b., c., d., e. ) ( ) (a. β, b. β, c. α, d. α ) ( ) ( ) 5) 42. 43. 44. ( ) (a., b. ) ( ) 20) ( ) 45. 9
46. 47. (a., b. ) ( ) (a., b. ) CT MRI (a., b. ) (a., b., c. ) 15) (a., b. ) ( ) ( ) 48. 49. 50. (a., b. ) ( ) (a., b. ) (a., b., c. ) Jo-1 ( ) ( ) % DNA (a., b. Sjögren, c., d. SLE, e. ) ( ) ( ) (a., b., c. ) (a., b. ) (a., b. Sjögren, c., d. SLE, e. ) I ( ) ( ) 51. ( ) Staphylococcus Streptococcus (a., b. ) β (a., b., c. ) ( ) ( ) 52. ( ) ( ), ( ),, ( ) ( ) ( ) ( ) ( ) (a., b. ) (a., b. ) 10
53. 54. ( ) (a., b. ) ( ) (a., b. ) (a., b. ) ( ) ( ) TGF-β ( ) ( ) (a., b., c. ) (a., b. ) ( ) 8) ( ) (a., b., c. ) ( ) ( ) 55. (a., b. ) B B ( ) ( ) ( ) ( ) ( ) ( ) 1 2 ( ) ( ) ( ) 50-66 (a., b. ) 45 (a., b. ) ( ) (a., b. ) ( ) ( ) 21) (a., b. ) ( ) LDH ( ) ( ) (a., b. ) 56. ( ) (a., b. ) ( ) 57. ( ) ( ) (a., b. ) ( ) 11
58. HTLV-1 ( ) HTLV-1 (a. B, b. T ) (a. CD4, b. CD8, c. CD20) (a., b. ) HTLV-1 (a., b. ) HTLV-1 RANK (a. K, b. K, c. Ca, d. Ca ) ( ) 22) 59. ( ) 60. 12
3.2 B 1. 2014 ( ) ( ) 2. ( ) (a., b. ) (a., b., c. ) 3. 4. 5. 6. (a., b. ) (a. 0.005 %, b. 0.05 %, c. 0.5 %, d. 1 %) (a., b. ) 7. 8. 9. 10. (a., b., c. ) (a., b., c. ) (a., b. ) ( ) Hz (a. α, b. β, c. γ, d. δ, e. λ, f. θ) (a., b. ) (a., b. ) (a., b. ) REM ( ) (a., b. ) (a., b. ) 11. ( ) (a., b., c. ) 10 ( ) 7) 12. 13
(a., b. ) (a., b. ) (a., b. ) 13. AIDS AIDS ( ) ( ) ( ) ( ) ( ) ( ) ( ) AIDS 5) ( ) AIDS 14. 15. 16. 17. PIVKA-II ( ) ( ) ( ) ( ) ( ) (a., b., c., d. ) (a., b., c., d. ) (a. A, b. B, c. C, d. D, e. E., f. K) ( ) PIVKA-II (a., b. ) ( ) PIVKA-II (a., b. ) 18. 19. 20. 21. ( ) ( ) 4) 22. ( ) ( ) ( ) 1 (a., b., c., d., e., f. ) ( ) ( ) 2 (a., b., c., d., e., f. ) ( ) ( ) 3 (a., b., c., d., e., f. ) ( ) ( ) 9) ( ) 4) (a. 1, b. 2, c. 3, d. ) 14
23. ( ) HE (a., b. ) (a., b. ) (a., b. ) ( ) (a., b., c., d. ) 24. 25. (a., b., c., d. ) (a., b., c., d., e. ) ( ) ( ), ( ) 26. (a., b. ) (a., b., c. ) ( ) ( ) (a., b., c. ) (a., b., c., d. ) (a., b., c. ) ( ) ( ) (a., b. ) ( ) (a., b. ) ( ) (a., b. ) 2) 27. 28. 29. 30. 31. 32. 33. 15
34. 35. (a., b., c. ) (a., b., c., d. ) (a., b. ) (a., ) (a., b. ) 6) (a., b. ) (a., b., c., d. ) ( ) 23) 36. (a., b. ) 20) (a., b. ) (a., b. ) (a., b., c. ) Na + -K + ATPase (a., b., c. ) Na + (a., b. ) (a., b. ) ( ) Na + (a., b., c. ) (a., b. ) (a., b. ) 37. 38. ( ) (a., b. ) (a., b. ) (a., b. ) ( ) ( ) (a., b. ) ( ) (a., b. ) ( ) ( ) ( ) ( ) 24) 39. 40. 41. ( ) ( ) ( ) ( ) ( ) 42. ( ) ( ) body mass index (BMI) 16
BMI ( ) ( ) BMI (a., b., c., d. ) BMI BMI ( ) 7) Nelson Textbook of Pediatrics 25) 3 BMI ( ) (97 ) (a. 2, b. 6, c. 10) BMI 20) 43. 44. (a., b., c. ) (a., b. ) (a., b., c. ) ( 108 ) 45. postpartum depression (a., b. ) (a., b. ) (a., b. ) ( 108 ) 46. 47. 48. (a., b., c. ) (Systemic Lupus Erythemathosus; SLE) 70 % ( ) ( ) ( ) 2) (a. I, b. II, c. III, d. IV ) SLE SLE (a., b. ) ( 108 SLE ( ) SLE ) 49. ( ) (a. 1.006, b. 1.009, c. 1.012) (a. 1.010, b. 1.020, c. 1.030) 26) (a., b., c. 17
), ( ) ( ) (a., b. ) ( ) ( ) ( ) 50-52. ( ) (a., b., c. ) ( ) 53-55. ( ), ( ),, ( ) ( ) ( ) 26) HMG-CoA ( ) 10) ( 108 B-54 ) 56-58. 59. ( ) ( ) (a., b. ) (a., b. ) B 1 ( ) ( ) 8) B 1 ( ) ( ) B ( ), ( ), ( ) ( ) 7) ( ) 7) ( ) ( ) ( ) (a., b. ) 60. (Motor nerve Conduction Velocity; MCV) ( ) (Compound Muscle Action Potential; CMAP) (a. E, b. F, c. N, d. M) ( ) latency ( ) ( ) ( ) ( ) ( ) ( ) CMAP ms ( ) (a., b., c., d. ) CMAP (a., b., c. ) (a., b., c. ) (a., b. ) 18
(a., b. ) F ( ) 27) ( 108 ) 61. Guillain Barré ( ) (a., b., c. ) 17) ( ) ( ) ( ) 62. 19
3.3 C 1. 2. ( ) 6 (a., b., c. ) (a., b., c. ) 3. 4. ( ) ( ), ( ), ( ) 3 8) 5. (a., b., c. ) (a., b., c. ) ( ) 14) 6. 7. (a., b. ) (a., b., c. ) (a., b., c. ) ( ) (a., b., c. ) 23) 8. ROC 28) (a., b., c. ROC ) ( 108 ) 9. ( ) ( ) (a., b., c. ) 10. ( ) ( ) ( ) 26) ( 108 ) 11. ( ) ( ), ( ) 20
( ) ( ) 17) (a., b., c. ) (a., b. ) 12. 13. 14. ( 108 ) 15. 16. 17. 18. ( 108 ) 19. 20. 21. ( 108 ) 22. 23. 24. 25. 26-27. 21
28-29. 30-31. 22
3.4 D 1. 2. ( ) (a., b. ) (a. 800, b. 80, c. 8) (a., b. ) (a., b. ) ( ) ( ) 13) 3. 4. ( ) (a. 10-15, b. 15-20, c. 20-25) mmhg 7) 5. ( ) ( ) ( ) (a. S1, b. S4) (a., b. ) S1 S4 (a. S1, b. S4) 4) 6. seizure generalised seizure ( ) focal seizure ( ) ( ) primary generalised seizure ( ) secondary generalised seizure ( ) ( ) (a., b., c. ) (a., b., c., d., e. ) (a., b. ) (a., b., c. L, d. T ) ( ) ( ) Na + ( ) (a., b. ) Na + T (a., b. GABA, c. ) (a., b. ) ( ) ( ) ( ) 10) 7. Wiskott-Aldrich (a., b. X, c. Y ) WAS deletion (a., b., c. ) ( ), ( ) WAS ( ) 25) ( 108 ) 8. Creutzfeldt-Jakob (CJD) ( ) ( ) ( ) 134 C 1 23
(SDS) 1) SDS (a. Polymerase Chain Reaction (PCR), b., c. ) 29) ( ) 9. 10. 11. 12. 14 14 ( ) (a., b., c. ) 14 18 ( ) ( ) ( ) (a., b. ) 5) 13. 14. 15. syndrome ( ) sequence ( ) ( ) Potter sequence ( ) (a., b. ) ( ) 5, 25) Potter sequence (a., b. ) ( ) 16. ( ) ( ) 22) (a., b., c. ) ( ), ( ), ( ) (International Prognostic Scoring System; IPSS) 22) IPSS (a., b., c. ) ( 108 ) 17. (a., b. ) (a., b. ACTH, c. ) ( ) 24
(a., b. ) ( ) 11-α ( ) 18. 19. 20. 21. Paragonimus westermanii,,, (a., b., c. ) (a., b. ) 30) ( 108 ) 22. (Computed Tomography; CT) (a., b. ) ( 108 ) 23. ( 108 ) 24. ( 108 ) 25. ( ) ( 108 ) 26. 27. Blumberg ( ) ( ) ( ) 7) 25
(a., b. ) (a., b. ) (a., b. ) 15) (a., b. ) ( 108 ) 28. ( ) (a., b., c., d. ) (a., b. ) (a., b. ) ( ) 8) 29. (a., b., c. ) (a., b., c. ) ( ) (a., b. ) ( ) 9) ( ) 7) ( 108 ) 30. Huntington 4p16.3 ( ) CAG (a., b., c. ) ( ) ( ) ( ) CAG (a., b., c. ) ( ) (a., b. ) (a., b. ) Charcot-Marie-Tooth (a., b., c. X, d. ) ( ) ( ) (a., b. ) (a., b. 40-60, c. ) Duchenne Becker (a., b., c. ) Genomics ( ) ( ) (a. 1, b. 15, c. 30, d. 45) (a. Duchenne, b. Becker ) 16 ( ) 17) 31. (a., b., c., d. ) ( ) ( ) (a. 5-10, b. 30-50, c. 70-80) % ( ) (a., b. ) ( ) (a., b. ) 31) 32. 33. 26
34. ( ) ( ) ( ) ( ),, ( ) ( ) ( ) ( ) 2) 35. 36. ( ) ( ) ( 108 ) 37. (Toxic Epidermal Necrolysis; TEN) ( ) ( ) ( ) TEN ( ) (a., b., c., d. ) ( ) (a., b., c. ) (a., b., b. T ) 2) ( ) ( ) (a., b., c. ) 15) 2) ( 108 (Staphylococcal Scalded Skin Syndrome; SSSS) a. b. ) 38. ( ) ( ) 13) 39. 40. 41. 42. 43. ( 108 ) 27
44. (a., b., c., d. ) ( ) 4) ( 108 ) 45. ( ) ( ) ( ) (a., b., c. ) 17) ( 108 CRP MRI ) 46. 47. ( 108 ) 48. 49. ( 108 ) 50. ( 108 ) 51. 52. ( 108 ) 53. 54. 55. 56. 57. ( 108 ) 28
58. KL-6 ( ) (a., b., c. ) (a., b. ) (a., b. ) ( ) ( ) ( ) ( ) KL-6 1 26) ( 108 ) ( ) ( ) CCP 32) 59. ( 108 ) 60. 29
3.5 E 1. 2. ( ) 24 ( ) (a., b., c. ) 7) 3. (a., b., c., d. ) (a., b., c. ) (a., b. ) 7) 4. 5. 6. (a., b., c., d. ) (a., b., c., d. ) ( ) (a., b., c. 17-, d. ) ( ) 20) 7. 8. 9. HE (Bowman ) (Descemet ) 33) 34) (a., b., c., d. ) (a., b., c., d. ) (a., b. I, c. II ) (a., b. ) (a. I, b. II, c. III, d. IV ) ( ) (a., b. I, c. II ) ( ) (a., b. ) (a., b., c. ) 33) (a., b., c., d. ) (a., b. ) 34) 13) 33) ( 108 30
) 10. 11. (a., b. ) (a., b., c. ) (a., b., c. ) 25) (a., b., c., d. ) (a. 1-2 %, b. 6-10 %, c. 10-20 %) 20) 12. 13. ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 2) ( 108 - ) 14. (a., b. ) (a., b. 3-8, c. 9 ) (a., b. 3-8, c. 9 ) (a. 8-15, b. 16-25, c. 26 ) (International Commission on Radiological Protection; ICRP) 100 msv 35) (a., b. 1 msv, c. 10 msv, d. 50 msv ) 15. (a., b., c. ) 36) 16. 17. ( 108 ) 18. 19. 31
20. ( ) 2001 ( ), ( ), ( ) 3 36) 21. 22. (a., b. ) (a., b. ) (a., b. ) 15) Rome III 3 1) (a., b. ); 2) (a., b. ); 3) (a., b. ) 8) 23. 24. Virchow (a., b. ) ( ) ( ) May R Thurner J 22 % 37) - 7) ( 108 ) 25. 26. 27. ( 108 ) 28. 29. (a., b. ) (a., b. ) Retinitis Pigmentosa Retinopathia Pigmentosa (a., b. ) ( ) (a., b. ) (a., b. ) 13) ( ) ( ) ( ) 38) (Electroretinogram; ERG) ( ) ( ) ( ) ( ) 13) 32
30. 31. 32. 33. ( ) ( ) ( ) (a. damp, b. dtmp, c. dgmp, dcmp) ( ) (a., b., c. ) RNA (a., c., b. ) MCV ( ) ( ) 22) (a., b., c. ) ( ) 34. 35. WHO (a., b. ) (a. 3, b., c., d. ) ( ) (a., b., c. ) ( ) WHO ( ) 36. ( 108 c ) 37. (a., b., c. ) ( ) ( ) (a,, b. ) (a., b. ) ( ) (a., b. ) (a., b., c. ) (a., b., c. ) (a., b. ) (a., b., c., d. ) 14) 33
38. 39. ( ) 40. (a., b., c. ) 4 ( ) 41. ( ) (a., b. ) 42. (a., b. ) (a., b. ) (a., b. ) (a., b., c., d. ) 10-25 µg/dl ( ) 25-60 µg/dl δ- (a., b., c. ) 39) ( ) G6PD G6PD 40) (a., b., c. ) 39) ( 108 ) 43. ( ) ( ) ( ) (a., b. ) (a., b. 4500 g, c. ) ( ) ( ) ( ) ( ) ( ) ( ) (a. 5, b. 15, c. 30, d. 45) (a. 5, b. 15, c. 30, d. 45) ( ) (a., b., c. ) ( ) 9) 44. ( 108 ) 45. TNM 34
(a., b. TNM ) IV ( ) III ( ) 41) 46. ( 108 ) 47. ( 108 ) 48. 49. ( 108 ) 50. 51. 52. ( 108 ) 53. 54. ( ) ( ) ( ) ( ) (a., b., c. ) 55. ( ) (AChE) ( ) (a., b., c. ) VX AChE P=O AChE ( ) AChE P=O ( ) (a., b., c. ) (a., b. ) (a., b. ) AChE ( ) ( ) AChE ( ) (a., b., c. ) ( ) ( ) AChE 39) 35
56. ( ) ( ) (a., b. ) 9) 57. 58. 59. ( 108 CT ) 60-62. 63-65. I ( ) II ( ) ( ) III II (a. I, b. II, c. III ) 9 (a., b., c. ) I (Burn Index; BI) II ( ) III 42) 66. 67. 68. ( 108 ) 69. 36
3.6 F 1. 2. 3. 4. ( 108 ) 5. ( 108 ) 6. 7. (a., b. ) (a., b. ) ( ) ( ) ( ) ( ) (a., b. ) 2) 8. 9. (a., b. ) (a., b. ) (a., b. ) (a., b. ) ( ) ( 108 ) 10. ( 108 ) 11. 12. 37
13. 14. ( ) ( ) ( ) ( ) ( ) 16) : a., b., c., d., e. 15. 16. 17. 18. ( 108 ) 19. 20. Glasgow Coma Scale (GCS) E ( ) V ( ) M ( ) = 15 3 E ( ) V ( ) M ( ) 12) 21. ( 108 ) 22. ( ) (a., b., c. c. ) 13) ( 108 FAST ) 23. 30 (a. 10, b. 20, c. 30, d. 40) mm ( ) ( ) (a. α, b. β, c. α, d. β ) ( ) (a., b., c. ) NSAID ( ) 9) 24. 25. 38
( 108 ) 26-27. ( 108 F-27 c ) 28-29. ( 108 Buerger ) 30-31. ( 108 ) 39
3.7 G 1. 2. 3. 17 ( 17( )202) (a., b. ) (a., b. ) 43) 4. 5. ( 108 ) 6. 7. (a., b., c., d. ) ( ) (a., b., c. ) ( ) (a., b. ) (a., b., c. ) ( ) (a., b. ) (a., b., c. ) (a., b. ) ( ) ( ) 2) 8. (a. tight junction, b. adherence junction, c. desmosome, d. hemidesmosome) ( ) ( ) ( ) 2) ( 108 ) 9. (a., b. ) Na + -Ca 2+ Na + ( ) Ca 2+ 1 (a., b. ) Na + (a., b. ) 44) (a., b. ) 14) 40
10. K (a., b. ) K (a., b. ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) ( ) (a., b. ) ( 108 ) 11. primitive reflexes 4 ( ) ( ) ( ) ( ) ( ) 25) 12. (a., b. ) 13. 14. 15. ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 1 ( ) ( ) ( ) (a., b. ) 3) 16. 17. 18. ( ) 10) ( ) ( ) ( ) κ δ 12) 19. 20. 41
21. 22. 23. 24. ( ) ( ) 16) 25. ( ) (a., b. ) (a., b. ) (a., b. ) (a., b., c., d. ) (a., b., c., d. ) 14) 26. 27. (a., b. ) (a., b. ) ( ) (a., b. ) TNM ( ) (a. I, b. II, c. III, d. IV) (a., b., c. ) TNM N > 0 (a., b. ) ( 108 ) 28. 29. 30. ( ) (a., b., c. ) ( ) ( ) ( ) (a., b., c., d. ) ( ) 45) 31. 42
32. 33. 34. 35. Clostridium difficile ( ) 1, 46) ( ) ( ) ( 108 ) 36. (a., b. ) ( 108 ) 37. Courvoisier ( ) 7) 38. ( 108 a b ) 39. 40. ( ) ( ) 2) 41. (a. 1, b. 5, c. 10, d. 15) ( ) (a., b. X, c. ) ( ) 7) ( 108 ) 42. ( 108 e. ) 43. 43
44. ( ) ( ) (a., b. ) ( ) (a. 5, b. 15, c. 25) mg/dl 24 ( ) ( ) (a. 2, b. 2, c. 2 ) ( ) Erythroblastosis Fetalis ( ) ( ) ( ) ( ) 25) ( 108 ) 45. ( ) 7) ( ) ( ) 7-8 17) ( 108 ) 46. ( ) ( ) (a., b., c. ) 5) 47. 48. CT ( ) PET ( ) 49. 50. 51. 52. 53. (a., b., c. MRI, d. X, e. ) ( ) 44
(Amniotic Fluid Index; AFI) (a. 3, b. 5, c. 7, d. 9) cm (a, 14, b. 16, c. 18, d. 20) cm (a., b. ) ( ) 1 2 (a. 1-2, b. 5-25, c. 20-50) bpm ( ) 32 (a. 5, b. 15, c. 25) bpm (a. 30, b. 15 2, c. 1 ) (a., c. ) (a, b., c. ) (a. 5, b., 15, c. 25) bpm (a. 5, b. 15, c. 25) bpm 15 (a. 30, b. 1, c. 2 ) (a., b., c. ) (a., b., c. ) ( ) ( ) 9) 54. (a. 0.3, b. 0.8, c. 3, d. 8) % 9) 55. 56. 57. ( 108 c. ) 58. 59. 60. 61-63. 64-66. 67-69. 45
3.8 H 1. ( ) 45) ( ) 2. 3. 4. 5. 6. 7. 8. (a., b., c., d. ) (a., b. ) 19) 9. 10. 11. 12. 13. asterixis ( ) wing beating ( ) 17) 14. ( 108 b ) 15. 16. 46
17. 18. 19. 20. 21. 22. 23. 24. 25. 26. ( 108 ) 27. ( 108 ) 28. ( 108 b ) 29. 30. 31-32. (a., b. ) (a., b. ) ( 108 31 a 32 ) 33-34. 47
( 108 33 d ) 35-36. ( 108 36 e ) 37-38. ( 108 Libman-Sacks (Systemic Lupus Erythematosus; SLE) 48
3.9 I 1. 2. 3. 4. ( 108 ) 5. 6. (a., b., c., d. ) (a., b. ) (a., b. ) 7) 7. ( 108 ) 8. 9. 10. (a., b., c., d. ) (a., b. ) (a., b., c. ) (a., b. ) (a., b., c., d. ) (a., b., c. ) (a., b. ) (a., b. ) ( 108 a. ) 11. Selective Estrogen Receptor Modulator (SERM) ( ) ( ) ( ) 10) 12. ( 108 ) 49
13. 100 (a. 0.015, b. 0.15, c. 1.5, d. 15) 15) 14. 15. Waterhouse-Friderichsen syndrome ( ) ( ) ( ) 5) 16. botulinum toxin ( ) ( ) (a., b. ) (a., b. ) (a., b. ) tetanospasmin ( ) (a., b. ) (a., b. ) (a., b. ) (a., b. ) 1) 17. ( ) ( ) ( ) ( ) 47) ( 108 ) 11) 18. recruitment ( ) ( ) ( ) 19. 20. ( 108 PQ I I II II ) 21. 22. ( 108 ) 23. ( ) ( ) 50
( ) ( ) ( ) ( ) Blumberg (a., b. ) (a., b., c. ) 48) 24. (Anti-Neutrophil Cytoplasmic Antibody; ANCA) (a. p-anca, b. c-anca, c. q-anca) (a. p-anca, b. c-anca, c. q-anca) (a. PR3, b. MPO) (a. PR3, b. MPO) MPO ( ) (a., b., c. ) MPO MPO ( ) 26) ANCA IgG (a., b. ) 6) ( ) (a., b. ) (a., b. ) 5) ( 108 ) 25. ( 108 ) 26. 27. 28. ( 108 e. ) 29. 30. (a. SSRI, b. SNRI, c., d. ) ( ) ( ) (a., b., c., d. ) ( ) ( ) ( ) 10) 31. 51
32. ( ) (a., b., c. ) ( ) ( ) ( ) (a., b. ) (a., b., c., d. ) (a. TNF-α, b. TGB-β, c. IL-6, d. IFN-α) 22) (a., b., c., d. ) ( 5, p.145) ) 33. ( 108 ) 34. ( ) 9) ( 108 ) 35. 36. ( 108 ) 37. 38. ( 108 ) 39. 40. (a. BCG, b., c. ), (a., b., c. ), (a., b., c. ), (a., b., c. ) 1) 41. ( 108 ) 42. 43. ( ) 1) ph (a., b. ) (a., b. ) 19 20 (a., b., c. ) (a., b., c. ) 7) 44. 52
( 108 IgE ) 45. 46. ( 108 ) 47. 48. 49. ( 108 ) 50. ( 108 ) 51. 52. ( ) ( ) (a., b. ) (a., b., c. ) (a., b., c., d., e. ) 80 % (a. 9, b. 18, c. 9, d. 18 ) 7) 53. 54. 6 60 38 C ( ) ( ) (a., b. ) (a. 50 %, b. 30 %, c. ) ( ) 25) 55. ( 108 ) 56. 53
57. ( ) ( ) (a., b., c. ) CT (a., b., c. ) ( ) ( ) CT ( ) (a., b. ) 49) ( ) ( ) ( ) ( ) (a., b. ) (a., b. ) 26) ( 108 ) 58. ( 108 ) 59. ( 108 ) 60. 61. (a., b., c. ) ( ) (a., b., c. ) (a., b. ) ( 108 ) 62. ( 108 ) 63. 64. ( 108 ) 65. 54
66. 67. ( 108 ) 68. prostatic hyperplasia hypertrophy hyperplasia 9 Harrison s Principles of Internal Medicine 19th Ed. (a., b. ) ( ) ( ) (a., b. ) PSA (a., b. ) (a., b. ) 15) ( ) ( ) ( ) ( ) 69. 70. 71. 72. ( ) ( ) (a., b., c. ) 7) ( ) ( ) NSAID (a., b. ) ( ) ( ) ( ) 31) 73. ( ) ( ) ( ) 10) ( 108 ) 74. 75. 76. 55
77. 78. ( 108 ) 79. 80. ( ) ( ) 51) AFP hcg ( ) ( ) AFP ( ) hcg ( ) 23) 5 80 % 50) AFP ( ) BEP ( ) ( ) ( ) ( ) 56
4 4.1 A 1., 2., 3., 4., T,, 5.,,,,,, 6.,,,, 7.,, ACTH Cushing,,,,,, α, 8.,,,, 11) 9.,,, 10.,,,,, 11.,,,, 12.,,,,,,, 13.,,,,,,,,, 14.,,, 15., 57
16.,,,,,,, 17.,,,,,,,,,,,,,,,,,, 18.,,,,,,,,, 19.,,,,,,,, MAO, 108 L- L- 20.,,,,,,,,, 21.,,,,,,,,,,, 22.,,,,,,,, 23.,,, 24.,, 25. P AO2, P ao2, A a D O2,, Sp O2,,,, 26.,,,, 29. 58
30.,,,,,, 31., Y,,,,,,,,,,,,, X, Duchenne, Becker 32. 34.,,,, 35.,,,,,,, 108 37.,,,,,,,,,, 38.,,,, SPECT,,,, SPECT, 108 41.,, β,,,, β,, TGF-β 44.,,, 47.,,,,,,, PET 50.,,,, /, 100, SLE,,,,, SLE, Scl-70, 51.,,, Rickettsia, 59
52.,,,,,,, ST,, 54.,,,,, ACE, β,,,,, β,, ACE, β 55., CD19, CD20,,,,,, 1, 10,,, BCR-ABL,,,,,,,, 56.,, 57.,,, 58. T /, T, CD4,,, Ca, 59. 60
4.2 B 1. 100, 125 2.,, 6., 0.005 %, 10.,,, 8-13, α,,,, Rapid Eye Movement,, 11. IgA,, 12.,, 13.,,,, LMP, EB,, 17. Protein Induced by Vitamin K Absence II, K,, K, II,,, K,,,, 21., 4 22.,,,,,,,,,,,, 23.,,,,, 25.,,,, 26.,,,,,,,,,,,,, 35.,,,,,,, 36.,,,,,,, Na + -Ca 2+, 61
,, 38.,,,,,,,,,,,, 41.,,, 6, 14 42.,, 24, 30,,, 18, 6 44.,, 45.,, 48.,,,, III, 49. 1.006, 1.030,, 3-4,,, MRI,, 50-52.,, 53-55.,,,,, 59.,,,, Wernicke, B 1,,,,,,,,,,, 60., M,, CMAP,,,,,,,,,,,, α 61.,,,, 62
4.3 C 2.,, 4.,,, 5.,, 7.,,,, 8. 9.,, 10.,, 11.,,,,,, 63
4.4 D 2. RB,, 80,,,, 4., 15-20 5.,,, S1,, S4 6.,,,,,,,, T,,,,, GABA,, GABA,, GABA 7. X,,,, X 8.,,,, 12. IgH,, IgH, BCL2,, 15.,,,,,,, 16.,,,,,, 17., ACTH,,,, 11-, 21., 22. 25. 27., rebound tenderness,,,,, 64
28.,,,, 29.,,,,, 30. (HTT),,,,,, X,,,,,,,,, Duchenne Becker in frame,, 15, Duchenne, 31.,,, 5-10,,,, 34. A16, 71,,,,,, 36.,, 37., Stevens-Johnson, 10 %, 30 %,,,, T,,,, 38., VEGF 44., 45.,,, 58. II,,,,,, A, D,,, 65
4.5 E 2., 30, 3.,, 6.,, 21, 17-, 9.,, I,, I,,,,,,, 11.,,,, 6-10 % 13.,,, 24-48, Behçet,,,, 14.,, 3-8, 8-15, 15. 20. WHO,,, 22.,,,,, 24.,, 29.,,,,,,,,,,,, 33., B 12,, dtmp, dump,,, (RDW),,, 35.,,,,, 37.,,,,,,,,,, 66
40., 41., 42.,,,,,,, 43., 37, 42,,, 4000 g,,,,,, 30, 15,,, 1 45. TNM, M > 0, M = 0 N > 0 54.,,,, 55.,,, P=S,,,,,, 2-PAM (pralidoxime),,,, 56., FSH, 63-66.,,, II,, 0.5 67
4.6 F 7.,,,, D,, 9.,,,, 14.,,,, 20. 4, 5, 6, 3, 3, 4 22., 23. 30,,, β,,, 68
4.7 G 3., 7., 5,, 3-4,,,,,,, 5, 3 8. desmosome,,, 9., 3,,, 10.,,,,,,,,,, 11., 7-8, 2-3, 5-6, 6-7 12. 15. 8, 4, 8, 12, 32, 8, 4, 8, 20,,,,, 18. µ,,, 24. depersonalisation, 25.,,,,, 27.,,,, M > 0, IV,, 30.,,,, 18,, 35.,, 36. 37. 40. Koplik, 41. 5,, X, 44.,,, 24, 15,,, 2,, 69
,,, RDW 45.,, 10 46.,, 48., CT 53.,, 5, 18,,, 5-25,, 15, 15 2,,, 15, 15, 2,,,, 54. 3 70
4.8 H 1., 8., 13., Wilson 31-32., 71
4.9 I 6.,, 10.,,,,,,, 11.,, 13. 1.5 15.,, 16.,,,,,,,,, 17. 1,,, 18., 23.,,,,,,, 24. c-anca, p-anca, PR3, MPO,,, Fc,,,, 30., SSRI,,,,, 32.,, JAK2,, dry tap,,, TGF-β,, -II 34. 40. BCG,,, 43.,,,, 52. JC,,,,, 9 54.,,, 30 %, 72
57.,,,,,,,, KL-6, SP-A, SP-D, II,, 61.,,, 68., PSA,,,,, α 1, 5α-,, 72.,,, Sjögren,,,, TNF-α, IL-6 73. Toll-like receptor,, 80.,,,,,,,,, 73
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