28. 胃腸道淋巴瘤的最好發部位是？
(A) 食道
(B) 胃
(C) 小腸
(D) 大腸
(E) 肛門

29. 下列何者是胃癌的危險因子？(1) Fundic gland polyp (2) Epstein–Barr virus (EBV) infection (3) Helicobacter pylori infection (4) Gastric atrophy (5) Non-steroid anti-inflammatory drug-related gastritis (A) (1)＋(2) (B) (3)＋(4) (C) (1)＋(3)＋(5) (D) (2)＋(4)＋(5) (E) (2)＋(3)＋(4)

30. 下列有關轉移性胃癌治療之治療的藥物選擇何者為是？ (1) HER2 陽性胃癌適合以Platinum + fluoropyridine + Trastuzumab 治療 (2) HER2 陰性胃癌適合以Platinum + fluoropyridine ± Nivolumab 治療 (3) MSI-high 胃癌適合以Pembrolizumab 治療 (4) CLDN18.2 胃癌適合以Zolbetuximab 治療 (A) (1)＋(2) (B) (2)＋(3)＋(4) (C) (1)＋(3) (D) (1)＋(2)＋(3) (E) (1)＋(2)＋(3)＋(4)

31. 關於diarrhea 以下何者敘述錯誤？ (A) 依據pathogenesis 可區分為osmotic 及secretory 兩個主要type (B) Ingestion of poorly absorbed cations and anions or poorly absorbed sugars or sugar alcohols (e.g., mannitol, sorbitol) accounts for most osmotic  diarrhea (C) The most common cause of secretory diarrhea is infection (D) Slow intestinal transit may lead to a secretory diarrhea by promoting SIBO (E) Peptides produced by endocrine tumors (e.g., vasoactive intestinal peptide) cause osmotic diarrhea

32. 下列關於便祕的描述，何者正確？ (1) Risk factors for constipation 包括advanced age、male gender、high level of education 等。 (2) Secondary Causes of Constipation 包括mechanical obstruction、 medication、metabolic disorders、neurological disorders. (3) Constipation may be aggravated by stress or may be a manifestation of emotional disturbance. (4) Dietary fiber appears to be effective in relieving mild to moderate but not severe constipation. (5) Mineral oils alter the stool by undergoing emulsification into the stool mass and providing lubrication for stool passage. (A) (1)＋(2)＋(3) (B) (2)＋(3)＋(5) (C) (1)＋(3)＋(4) (D) (2)＋(3)＋(4)＋(5) (E) (1)＋(2)＋(3)＋(4)＋(5)

33. 下列關於Intestinal ischemia 的敘述，何者為是？ (1) CT has largely replaced plain film study of the abdomen for diagnosis of acute mesenteric ischemia and is used to identify arterial and venous thromboses as well as to evaluate bowel injury. (2) Among the types of Intestinal Ischemia, acute mesenteric ischemia is more frequent than colon ischemia. (3) CT angiogram is highly accurate in the detection of occlusive disease of the SMA but is not as reliable for nonocclusive mesenteric ischemia. (4) Most patients with acute mesenteric ischemia have acute abdominal pain. (5) Unexplained abdominal distention or GI bleeding may be the only indications of acute mesenteric ischemia when pain is absent, especially when acute mesenteric ischemia is caused by nonocclusive mesenteric ischemia. (A) (1)＋(2)＋(3) (B) (1)＋(3)＋(5) (C) (1)＋(3)＋(4)＋(5) (D) (2)＋(3)＋(4)＋(5) (E) (1)＋(2)＋(3)＋(4)＋(5)

34. 下列何者不是inflammatory bowel disease（IBD）治療用藥？ (A) Aminosalicylates (B) Glucocorticoid (C) Interferon (D) Immunomodulators (E) Anti-IL12/23

35. 有關大腸憩室疾病，以下敘述何者正確？ (1) Prevalence clearly increases with age, ranging from less than 10% in those younger than 40 years of age to an estimated 66% in patients 80 years of age and older. (2) NSAIDs including aspirin, have been associated with an increased risk of diverticular bleeding. (3) CT scanning of the abdomen and pelvis has become the radiologic test of choice in patients with suspected diverticulitis. (4) Diverticular bleeding is the most common cause of significant LGIB in adults. (5) Approximately 15% of patients with acute diverticulitis will develop pericolic or intra-mesenteric abscess. (A) (1)＋(2)＋(3) (B) (2)＋(3)＋(4) (C) (1)＋(3)＋(4)＋(5) (D) (2)＋(3)＋(4)＋(5) (E) (1)＋(2)＋(3)＋(4)＋(5)

36. 下列何者不是大腸激躁症（Irritable bowel syndrome）風險因素？ (A) Infectious gastroenteritis (B) Gastric cancer (C) Preexisting psychologic issues, such as anxiety, depression (D) Food intolerance (E) Previous antibiotic use

37. 關於Amebic Colitis 以下何者正確？ (1) Usual duration of symptoms ＞7 days. (2) Colonoscopic findings in a patient with amebic colitis. Multiple punctate ulcers are visible. (3) Noninvasive methods to accurately differentiate E. histolytica from E. dispar include stool culture with isoenzyme analysis, serum amebic-antibody titers, PCR, and an enzyme-linked immunosorbent assay (ELISA). (4) The tissue amebicides include metronidazole, tinidazole, nitazoxanide, erythromycin, and chloroquine. (A) (1)＋(2) (B) (2)＋(3) (C) (1)＋(3)＋(4) (D) (2)＋(3)＋(4) (E) (1)＋(2)＋(3)＋(4)

38. 關於PNEUMATOSIS COLI（PNEUMATOSIS CYSTOIDES INTESTINALIS） 何者正確？ (A) This uncommon disorder is characterized by multiple gas-filled cysts, which are located in the mucosa and serosa of the intestine. (B) The frequency of pneumatosis coli is highest in the fourth decades with equal frequency among men and women.  (C) The most common symptoms are diarrhea (68%), mucus discharge (68%), rectal bleeding (60%), and constipation (48%).  (D) A plain abdominal film may identify radiopaque clusters with or without pneumoperitoneum. (E) 以上皆是

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