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• PGY‧面試襲來

  PGY，你準備好了嗎？

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• 國考筆記
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  2021年檔案請參考連結 免疫、藥物與皮膚

  (1) 蕁麻疹(urticarial)與血管水腫(angioedema)

  蕁麻疹
  暫時性的皮疹(膨疹wheal)，為papillary dermis的水腫→很癢
  血管水腫：更深層組織的水腫，邊界不清，以『腫』為主要表現

  急性蕁麻疹

  急性發作、單一病灶24小時內消失 (>24小時要小心血管炎) 可能經IgE、補體、自體免疫、物理因素(壓力/光/冷/皮膚劃紋)誘發 要記得詢問藥物史、飲食紀錄、接觸史等，但很常找不到原因 若合併血管水腫，小心喉頭/氣管水腫→記得確認生命徵象 避免碰觸過敏原，給抗組織胺；若有anaphylaxis，給IM的腎上腺素 考試愛問使用aspirin可能會惡化蕁麻疹，要記！

  慢性蕁麻疹

  超過6周以上的時間，反覆出現蕁麻疹，大部分找不到原因 可能因物理因素/NSAIDs/壓力等誘發；大部分是自限性 治療：抗組織胺(第一線)、白三烯受體拮抗劑、口服類固醇、Omalizumab

  (2) 結節性紅斑(Erythema nodosum)

  疼痛的紅色皮下結節(主要在前脛) 為皮下脂肪的發炎(脂膜炎的一種；septal panniculitis without vasculitis) 誘發因子：鏈球菌感染/不明原因/TB/Sarcoidosis/炎性大腸疾病/Behcet

  (3) 多形性紅斑(Erythema multiforme)

  特徵為target lesion (紅-白-紅 三圈；中間可能出
  現水泡)；可能合併黏膜侵犯 主要因為病毒感染誘發(以HSV最常見，其次為
  mycoplasma)

  (4) Neutrophilic dermatosis

  Sweet syndrome

  典型為亮紅色的丘疹、按壓疼痛；部分病灶因真皮水腫而有水泡感(pseudo-vesicle) 患者常會合併系統性症狀(如發燒/全身無力) 可能因為血液科癌症、藥物(G-CSF)、感染等誘發

  Pyoderma gangrenosum

  典型以疼痛的潰瘍表現，紫色且undermined border為重要特徵 常合併系統性疾病，包括關節炎/發炎性腸道疾病/血液科癌症/藥物(G-CSF)有關 診斷需要先排除其他可能性(如感染，血管炎、腫瘤等) 治療為系統性類固醇或dapsone，避免過度清創或補皮(會因Pathergy而擴大)

  (5) 皮膚狼瘡(lupus)

  皮膚狼瘡可以分成急性/亞急性/慢性三個大類 急性
  malar rash/光敏感/和SLE關聯最大
  (malar rash：兩頰紅斑且nasolabial fold sparing) (要會認圖片) 亞急性
  環形(annular)和鱗狀丘疹(papulosquamous) 慢性
  多樣，包括圓盤型(discoid lupus，特徵為圓盤狀的脫屑斑塊，中央可能出現萎縮/scarring等變化)、脂膜炎(panniculitis)、凍瘡型(天冷/肢端)、肥厚型等；和SLE關聯性較急性皮膚狼瘡低 新生兒
  和母體anti-Ro(SSA)關係高，造成環形紅疹和房室阻斷

  (6) 硬皮症(systemic sclerosis)

  早期有雷諾氏現象→晚期手指硬化/指尖潰
  瘍、皮膚硬化 (要會認照片) LcSSc：CREST (皮下鈣化/雷諾氏/食道異常/硬
  指/微血管擴張)

  (7) 皮肌炎(dermatomyositis)

  重要的皮膚表現包括了Heliotrope sign(上眼瞼淡紫色變化)、Shawl sign(頸前V字皮疹)、Gottron sign(紫色平頂丘疹，分布於手指關節背面)等 補充：Anti-MDA5 DM較易出現inverse gottron sign(手指關節掌面丘疹)和皮膚潰瘍

  (8) 藥物不良反應

  Steven Johnson syndrome (SJS)和Toxic epidermal necrosis(TEN)

  嚴重不良反應，廣泛的上皮壞死(SJS<10%，TEN>30%)，黏膜常侵犯，Nikolsky (+) 小心Allopurinol(HLA-B 5801)、Carbamazepine(HLA-B 1502)、phenytoin、磺胺類

  DRESS (Drug reaction with eosinophilia and systemic symptoms)

  廣泛皮疹+ eosinophil高、臉水腫、遲發性(用藥2-6周後)、發燒 系統性侵犯(atypical lymphocytes, 肝功能) (少數出現myocarditis) 相關藥物包括抗癲癇藥物/allopurinol/磺胺類(如dapsone、Baktar)/NSAIDs 治療為系統性類固醇

  EGFR inhibitors
  acneiform eruption、paronychia、睫毛捲長(trichomegaly)等

  Hand foot syndrome
  手腳掌廣泛紅腫痛脫皮，傳統化療較常見(如cytarabine)

  Hand foot skin reaction
  multi-kinase inhibitor較常見，受壓處出現疼痛水泡/callus

  其他

  (1) 紅皮症erythroderma

  定義：全身皮膚變紅，侵犯超過90%以上的皮膚 成因：乾癬>濕疹(含atopic)>藥物>T細胞淋巴癌(題幹線索：全身淋巴結腫大) 併發症
  水分/電解質不平衡、體溫散失、蛋白質消耗
  心輸出量增加(導致高心輸出量心臟衰竭)、感染

  (2) 下肢潰瘍(leg ulcer)

  動脈性：好發於遠端/外踝，理學檢查脈搏不明顯/冰冷/抬腳時疼痛惡化(Buerger sign) 靜脈性：長期鬱積造成，好發於內踝，常合併鬱積性皮膚炎/靜脈屈張等 神經性：常在受壓處或腳底；理學檢查發現感覺下降

  (3) 光敏感(photosensitivity)

  皮膚中的藥物/化學物質和UV (esp. UVA)產生交互作用，可以分成光毒性和光過敏 皮膚病灶出現在暴露陽光的部位為重要線索 多種藥物可造成光敏感，內專考試中最常出現的藥物為fenofibrate
• 搶救OSCE大作戰
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  The innovative Pokemon fan behind a new flood of workmanship changing Pokemon into humanoid renditions of the animals has gone to the Water/Rock-type Corsola for their latest task. Fans who have been put resources into this craftsman's work will likely be satisfied by how their unique plan for the selective Apparition type Galarian Corsola ended up.

  This specific craftsman is by all accounts unbelievably devoted to their humanoid Pokemon fan workmanship project. Like clockwork, another piece is posted online until the end of the Pokemon people group to see and appreciate. Their latest works highlighted Swinub, Piloswine, Slugma, and Magcargo as people, all of which showed similar measure of detail and care in them as their past tasks. Presently, the craftsman's center has gone to Corsola and how the Pokemon's remarkable looks could be converted into intriguing humanistic elements.
  On Reddit, client endifi posted pictures of their Pokemon humanoid plan ideas of both the standard and Galarian Corsola. Endifi decided to depict the coral Pokemon in female structures, dressing both in tube-top ball outfits with various shades mirroring the pocket animals' notable variety plans. Water/Rock-type Corsola has energetic pink hair and its coral spikes were addressed in the plan's fascinating crown. The Galarian Corsola seems like the identical representation of its customary partner, save for the more pale tones and the spooky look that both the pocket animal and character's plan show.

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  Individual fans responded with similar energy and inspiration as they have with the craftsman's other Pokemon humanoid fan workmanship, it are astonishing and tremendous to guarantee that their pieces. One specific analyst appeared to connect with the contradicting energies of endifi's pieces, sharing that the person plans helped them to remember themselves. Considering that the ordinary Corsola is brimming with life and variety while the Galarian Corsola appears to be miserable and is monochromatic, it's not difficult to perceive how Pokemon fans can connect with the two kinds of feelings radiating from the fan craftsmanship.

  Fans ought to hope to see more humanoid Pokemon character plans from endifi before long. Considering that they appear to be strictly following the numbering on the Pokemon establishment's widespread Pokedex, the craftsman is probably going to highlight the Water-type Stream Pokemon Remoraid and its last development structure Octillery next. Ideally endifi keeps on imparting their parts of the Pokemon people group individuals, as many are presumably partaking in each piece that they emerge with.

• 遺傳代謝之不思議

  由台北榮總遺傳代謝科朱子宏醫師主筆

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  作者：朱子宏醫師

  長期以來，食品工業利用量產的精製糖，透過大眾廣告征服大家的味蕾。幾乎所有的包裝食品都有額外添加的糖的存在，例如，市售一般含糖碳酸飲料，大約每100cc有10g的糖，亦即42kcal/100ml的熱量。半世紀以來，世人對於脂肪和心血管等代謝疾病的連結幾乎根深蒂固，推行低脂飲食的結果卻是增加更多糖的攝取，一直到近年才被推翻。

  近二、三十年來，食品製造業開始使用糖的替代品，又稱代糖，以減少精製糖的份量。包括天然糖取代物(natural sugar substitutes)，如山梨糖醇(sorbitol)、木糖醇(xylitol)；或是人工甘味劑(artificial sweetener)，包括1879年起使用的糖精(saccharin，約是蔗糖300~400倍甜度)、1931年提煉的甜菊糖(stevia, 200~300倍蔗糖甜度)、 1965年合成的阿斯巴甜(aspartame, 200倍甜度)、醋磺內酯鉀(ACE-K, 1967年發明，亦為200倍甜度)、蔗糖素(sucralose, 蔗糖320~1000倍甜度)等。其中，人工甘味劑又被稱為nonnutritive sweetener，和前者天然糖取代物比，幾乎沒有熱量(山梨糖醇sorbitol每克仍有2.6kcal、xylitol約為2.43kca/g，這兩者因為不會被口腔細菌分解，所以常用來當作口香糖的原料)。

  目前的研究，除了糖精一度在1970年代的老鼠實驗中會致膀胱癌，一度被列為人類可能的致癌原(2000年又因證據不足被移除)；2014年的Nature有人把食用糖精的受試者，其糞便拿去餵小鼠，有產生胰島素拮抗外，其他的代糖並未有危害人體健康的證據。阿斯巴甜因在腸道會降解成苯丙胺酸，對於苯酮尿症(phenylketonuria/PKU)的病人會造成暫時血液苯丙胺酸過量，雖然同時間也會產生甲醇，但你要喝到12公升的無糖可樂才能在體內測得到(Nutr Rev. 2016 Nov;74(11):670-689)。縱然阿斯巴甜每克有4.0kcal的熱量(和一般的糖差不多)，但由於其甜度為蔗糖200倍，實際上每人每天的平均攝取量才4.9 mg/kg/day(美國FDA是規定上限於50mg/kg/d)。每一種代糖都是不一樣的化合物，因此都需分別看待。而不同的代糖，也可以相互混合，創造不同的口感，例如一罐330cc零卡可樂除了180mg的阿斯巴甜(=0.72kcal/罐)外，每罐也摻有約61mg的醋磺內酯鉀(=0kcal)。坊間謠言食用阿斯巴甜因為苯丙胺酸造成腦部過度興奮的學說，都純屬虛構。(試想一天喝5罐零卡可樂，食用的1g的阿斯巴甜，產生了0.5g的苯丙胺酸。你知道你一天吃50克的蛋白質，就吃下2.5克的苯丙胺酸嗎)

  美國的糖尿病協會，於今年發佈的指引上，認定精製糖與第二型糖尿病的發生有關，並提醒病友與高風險族群應避免含糖飲料和果汁(現在兒科醫學會也建議未滿1歲的幼兒不要喝包裝果汁了)，促進血糖的調控、體重控制與降低心血管因子、脂肪肝(People with diabetes and those at risk are advised to avoid sugar-sweetened beverages (including fruit juices) in order to control glycemia and weight and reduce their risk for cardiovascular disease
  and fatty liver，證據等級B)；而對於代糖的使用，則是認為 “nonnutritive sweeteners may be an acceptable substitute for nutritive sweeteners…when consumed in moderation”，食用低至無熱量的甜味劑，無顯示會造成血糖的變化，也可以減少整體熱量與糖的攝取 “use of nonnutritive sweeteners does not appear to have a significant effect on glycemic control. They can reduce overall calories and carbohydrate intake”，也列舉了兩篇研究可以促進減重。如果是習慣喝含糖飲料的人，可以嘗試作為短期替代使用(for those who consume sugar-sweetened beverages regularly, a low-calories or nonnutritive-sweentened beverage may serve as a short-term replacement strategy)，不過大家還是要盡量喝水啦(but overall, people are encouraged to decrease both sweetened and nonnutritive-sweetened beverages and use other alternative, with an emphasis on water intake)證據等級B.

• 基礎學科筆記

  組織學、有機化學、生物化學、免疫學、臨床溝通

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  plasma membrane (PM)

  (1) 流體鑲嵌模型 Fluid mosaic model

  (2) PM的成分

  主要的成份是phospholipid，有親水性頭部與兩條疏水性尾部；頭部有許多不同的結構(PC PS PI PE)，有不同的功能

  PM中有許多cholesterol，像墊板般插入膜中，能增加膜的穩固性

  膜蛋白
  可以分成integral(穿膜蛋白)，peripheral(以非共價鍵附著在膜上)
  功能：channel，載體，訊號傳遞，還有很多很多

  (3) 物質通過細胞膜的機制

  小分子
  擴散，facilitated diffusion，active transport(詳見生理) 大分子
  進行endocytosis與exocytosis

  (4) endocytosis

  分成pinocytosis，phagocytosis，receptor-mediated endocytosis pinocytosis：胞飲，膜凹陷，將液體分子包入細胞中 phagocytosis：胞噬：最常見的例子是macrophage伸出偽足吞細菌 RME
  膜上受器接收分子後，會促進coated pit的形成(clathrin，adaptin)
  接著會往細胞內凹陷形成coated vesicle，最後clathrin等蛋白質脫離，形成uncoated vesicele

  (5) exocytosis

  需要一些特殊蛋白質的協助(v-SNARE，t-SNARE) 依照其分泌是否受調控分為constitutive，regulated兩種

  (6) hypercholesterolemia高膽固醇血症

  LDL分子乃利用RME機制進入細胞中 然而，要是膜上缺乏receptor，LDL無法進入cell，因此堆積在血液 cytoplasm

  (1) cytoplasm

  Cytpplasm = cytosol + organelles +inclusions cytosol：細胞內的jelly like溶液

  (2) ER內質網

  依照是否附著ribosome分為RER，SER RER：蛋白質的運輸、glycosilation、protein quality control等等 SER：儲存鈣離子、合成性激素、解毒(肝細胞)

  (3) Golgi apparatus

  蛋白質修飾，送到各自的目標 是個由許多disk shape構成的膜狀結構 Cis Golgi network→cis cisternae→medial cisternnae→trans cisternae→TGN

  (4) Lysosome：溶酶體

  裝有許多水解酵素，能夠與其他的膜狀結構fuse，進行分解 小分子能夠直接進入lysosome；較大的物質如mit，則先由ER的膜包住形成autophagosome vacuole，最後與lysosome fuse而分解；易有部份的物質，是藉由chaperone的協助送入lysosome中 lysosome的酵素缺失會造成很嚴重的疾病，ppt上提到Tay-Sachs disease就是缺少了β-hexosaminidase，因此造成ganglioside在神經系統中的堆積，造成嚴重的傷害。

  (5) Mitochondria

  ATP的製造場所，細胞的發電廠 同時會製造出自由基(ROS)，需要有一系列的酵素處理 在細胞自殺(apoptosis)中扮演重要角色

  (6) Peroxisome

  解毒，消除自由基(肝臟細胞多) 分解長鏈的脂肪(較短的則在mit進行β oxidation)

  (7) Cytoskeleton

  actin filament：微絲 由actin蛋白所組成，組成微絲 具有(+)(-)兩端(polarity)，與細胞的形狀與運動有關 intermediate filament：中間絲 其基本架構為四條protein組成的tetramer，不具polarity 能夠固定胞器的位置，在細胞junction也扮演重要角色 microtubule：微管 由α，β兩種tubulin組成的，形成一個管狀結構，具有polarity MAP(microtubule associated protein)能夠穩固microtubule得結構 motor protein：kinesin(往正端移動)，dynein(往負端移動)，消耗能量產生運動！ microtubule有個dynamic instability，意指microtubule的plus end可以組裝或分解tubulin，讓microtubule的長度發生改變(消耗GTP) microtubule構成cilia，flagella，mitotic spindle等構造 Microtubule organizing center (MTOCs)，為特化的結構，為microtubule聚合的起始點，常見的例子為centrosome

  (8) cytoplasmic inclusions

  為一些暫存的構造，並不出現在每個cell ex. glycosome能夠儲存glycogen(肝醣)，lipid droplet Nucleus、DNA、cell cycle

  (1) nucleus細胞核

  是否具有核膜(nuclear envelope)為區分真核原核的基準 由核膜(上有核孔，對小分子不具選擇性通透)，核仁(nucleolus，合成rRNA的subunit)，核質(染色質的位置)等結構所組成 chromatin(染色質)，依照其摺疊的緊密程度分為condensed與extended，較緊密者，則該段基因較不易表現，藉由改變緊密程度能夠控制特定protein的表現量。有些regulatory protein即能影響(zinc finger結構)，或是對histone protein做共價修飾(ex.甲基化、acetylation)

  (2) DNA

  細胞核中的DNA若延展開來，約有1.8m長！因此需要很多層次的摺疊 最基本的就是由histone protein的『nucleosome』核小體，組成所謂『beads on a string』得結構 接著還有所謂的30nm fiber，supercoiled等等結構，讓超長的DNA能夠容納於細胞核 histone的共價性修飾能夠改變gene的表現情況，若甲基化則抑制，acetylation則會活化基因

  (3) 細胞生命週期(life cycle)

  細胞的周期可以先分成mitotic phase與interphase interphase又可分成G1期，S期(DNA複製)，G2期 M期又可分成prophase，metaphase，anaphase，telophase Prophase：染色質濃縮成染色體，中心體移到兩側，spindle形成 metaphase：DNA排列在赤道板 anaphase：DNA從赤道板往兩側移動 telophase：完成DNA的移動，染色體拆開，核膜逐漸形成 cytolinesis：細胞質分裂，細胞分裂成兩個子細胞！！

  (4) 腫瘤

  tumor為一群cell cycle不受控制的細胞，可能是兩種類型的gene壞掉 protooncogene：為一群促進細胞分裂的gene，如果壞掉、或是過度表現，可能會加速細胞分裂 tumor suppressor gene：為一群抑制細胞分裂的gene，如果壞掉了，會讓細胞分裂不受抑制 通常癌症都是要有許多的gene壞掉，才會產生

  (5) Apoptosis細胞自殺

  programmed cell death (ex.手指間的蹼狀物消失，蝌蚪的尾巴)

  相對的概念是necrosis，細胞因為外力或其他因素死亡，會破裂釋放出細胞的物質，導致發炎反應的產生

  apoptosis的發生可能來自於兩種途徑，intrinsic與extrinsic兩種

  intrinsic的機制來自於細胞的壓力(stress，例如自由基、DNA損壞)，會促此mit中的cytocrome C釋放，與細胞中的procaspase組成apoptosome，進行切割，促使apoptosis的進行

  extrinsic的機制則來自於胞外的訊號(ex. T cell)，訊號會與膜上的ligand結合，促進下游蛋白質的活化，最後導致apoptosis的產生

• 實證醫學讀書會
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  @wayne030 不好意思，回去確認內容後發現有誤植，已經重新更正，非常感謝您的幫忙

• 醫學整合課程

  感謝陳和謙醫師提供醫學整合課程系列文章

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  Diabetes Freedom Reviews – Hello, are you searching for Diabetes Freedom Real customer review? Then you are in the right place. Read this review about Diabetes Freedom shake recipe review before order.

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  A self-paced online course called Diabetes Freedom educates individuals about the complexities of type 2 diabetes. Authors George and James say they have created a three-step process to Maximize the improvement of blood sugar. Overall, the goal of this program is to highlight the potential of certain fruits, vegetables, and herbs to slow disease progression. Both suggest that our fat cells, specifically the way they move through the circulation, are to blame.
  As a result, the pancreas and liver become blocked, preventing the secretion of the hormone insulin. The latter is considered important for glucose absorption. When this doesn’t happen, the body’s blood sugar levels naturally rise, and the longer they stay at abnormally high levels, the more likely diabetes symptoms are to appear. Let’s focus on the overall structure of the program to understand its overall meaning.
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  The Diabetes Freedom Main Manual
  The basics of the designers’ diabetes diet are explained in the Freedom Diabetes master guide. Modifications George has made to prevent diabetic coma and amputations – which medical experts have warned him against – as well as his personal experience with stopping prescription drugs are covered in more depth by George. James has also contributed to this effort, focusing on counseling, diet and lifestyle modifications, and exercise for long-term pain relief.
  The Diabetes Freedom Quick Start Accelerator the Freedom
  Diabetes Quick Start Accelerator covers the same area as the classic guide, but it’s a condensed, more practical version that quickly summarizes the most important ideas. That’s basically all it takes to start the three-step process. People can check out the master guide to learn more about the difference between insulin resistance and insulin sensitivity, the many organs that support proper blood sugar, and any other educational elements of the program.
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  The second-best choice for visual learners is the Freedom Diabetes video course. Each topic has been broken down so people can spend time researching everything from meal timing tips to weight loss techniques to pancreatic resetting dietary recommendations. These movies can be used in place of text if something you’re reading doesn’t make sense right away.
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  What is the price for Diabetes Freedom?
  Currently, the complete Diabetes Freedom package costs only $37, which is a significant discount from its usual cost of $99.95. A 60-day money-back guarantee is also offered with every transaction. Individuals should contact customer service for a full refund if they feel that George and James’ method is not appropriate for their situation. To do this, send an email to support@diabetesfreedom.org.
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  The Fat Burning Blueprint is an example of a diet that promotes the elimination of white blood cells, which are believed to affect organ function. It is believed that the pancreas should begin performing normal functions at this time to help regulate blood sugar and possibly reduce symptoms of diabetes. A list of foods that help turn fat cells into energy is also provided. George and James will also be launching a 5-part video series on the fight against diabetes with treats for breakfast, lunch and dinner as a bonus (for this offer).
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  In the Stay Young program, users will learn a series of 2-minute exercises that help increase metabolism and reduce fat accumulation, helping to maintain an overall youthful body. Three drink recipes are also included in this program to lower blood sugar and blood pressure while on vacation, going out to dinner, or celebrating important occasions.
  Bonus #3. 33 Power Foods for Diabetics
  A video guide to 33 diabetic foods is our ultimate pick. People will learn about the variety of carbohydrates and sweets they can eat in this resource, as well as the planning requirements for maintaining steady blood sugar. Everyone will receive an in-depth strategy to help them understand the importance of time as well as the concept of a 60 second breakfast that has been shown to significantly reduce sugar cravings, increase energy, burn fat and suppress hunger.
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  Diabetes Freedom Reviews – The Conclusion
  The course called Diabetes freedom is only for those who are curious about diabetes and its accompanying symptoms, or who have been diagnosed with diabetes and want to get rid of it naturally. Going natural means not using drugs or supplements, through whole foods, exercising, and avoiding these. In an age where ignorance and rigidity seem to be the norm, it is imperative that individuals access a simple course that provides clarity, answers and the assurance that they will not deny their favorite people of all time. The fact that this course is offered in a variety of formats (such as textbooks, worksheets, and videos) shows that the writers have considered multiple individual learning styles, which is commendable.
  The course is quite comprehensive and has a number of extras available to complete the course. Overall, neither George nor James is in favor of stopping prescription drugs. If they are already regulated, they must be obeyed. It is important to note that George was only allowed to stop taking the medication once he started using this program, which was approved by his doctor. Instead of challenging the proven, Diabetes freedom is a hands-on course with actionable tips that will keep patients on track.
  Click to Get Diabetes Freedom for an Exclusive Discounted Price

• 基礎學習架構
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  作者：陽明醫學系 蕭伯任 泌尿科的診斷工具 尿液分析(urine analysis) 尿路動力學檢查 膀胱鏡 影像學檢查 泌尿科的重要臨床表現 血尿(hematuria) 下泌尿道症狀 (LUTS) 陰囊疼痛 血精Hematospermia 泌尿道外傷 腎臟、膀胱創傷 生殖器創傷 腎臟

  (1)腎臟囊腫(renal cyst)

  (2)腎臟感染

  急性腎盂腎炎(acute pyelonephritis, APN) 產氣性腎盂腎炎(emphysematous pyelonephritis) 腎膿瘍(renal abscess) 黃色肉芽腫性腎盂腎炎(xanthogranulomatous pyelonephritis, XGP)

  (3)腎臟良性腫瘤

  如嗜酸細胞瘤(oncocytoma)、血管肌肉脂肪瘤(amgiomyolipoma, AML)等

  (4) 腎臟惡性腫瘤

  腎細胞瘤(renal cell carcinoma, RCC) 腎母細胞瘤=Wilms瘤(nephroblastoma=Wilms tumor) 上泌尿道泌尿上皮癌(upper tract urothelial carcinoma, UTUC)

  (5)腎臟移植

  膀胱

  (1)構造與功能異常

  膀胱輸尿管逆流(vesicourethral reflux, VUR) 間質性膀胱炎(interstitial cystitis) K他命膀胱炎(Ketamine Cystitis)

  (2)感染症

  膀胱炎(cystitis)

  (3)泌尿細胞癌

  膀胱癌(bladder tumor) 外生殖器

  (1)構造異常

  尿道後瓣膜(posterior urethral valve) 尿道下裂(hypospadias) 隱睪症(cryptorchidism) 包莖(phimosis)與箝頓性包莖(paraphimosis) 尿道狹窄(urethral stricture) 睪丸扭轉(testicular torsion) 精索靜脈曲張(varicocele)

  (2)感染

  睪丸炎(orchitis)/副睪炎(epididymitis) 龜頭炎(balanitis) 尖形濕疣(Condyloma acuminate=Warts)

  (3)腫瘤

  睪丸癌(testicular cancer) 陰莖癌(penile cancer) 攝護腺

  攝護腺炎(bacterial prostatitis)

  良性攝護腺增生(benign prostate hyperplasia, BPH)

  攝護腺癌(prostate cancer)

  泌尿道結石 泌尿道結石 尿路動力學與下泌尿道功能異常 尿路動力學簡介 尿液滯留 尿失禁(incontinence) 神經異常膀胱(neuropathic bladder disorder, NGB) 男性學

  (1)男性性功能障礙

  陰莖持續勃起症(priapism) 勃起功能障礙(erectile dysfunction, ED=impotence)

  (2)男性不孕症(male infertility)

  腎上腺疾病

  (1)嗜鉻細胞瘤(pheochromocytoma)

• COVID-19專區
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